[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 1754 Reported in Senate (RS)]
Calendar No. 424
105th CONGRESS
2d Session
S. 1754
[Report No. 105-220]
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to consolidate and reauthorize
health professions and minority and disadvantaged health education
programs, and for other purposes.
_______________________________________________________________________
June 23, 1998
Reported with an amendment
Calendar No. 424
105th CONGRESS
2d Session
S. 1754
[Report No. 105-220]
To amend the Public Health Service Act to consolidate and reauthorize
health professions and minority and disadvantaged health education
programs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 12, 1998
Mr. Frist (for himself, Mr. Kennedy, Mr. Jeffords, Mr. Bingaman, Mr.
Cochran, Mr. Inouye, Ms. Mikulski, Ms. Collins, Mr. Faircloth, Mr.
Sarbanes, and Mr. Enzi) introduced the following bill; which was read
twice and referred to the Committee on Human Resources
June 23, 1998
Reported by Mr. Jeffords, 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 consolidate and reauthorize
health professions and minority and disadvantaged health education
programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This Act may be cited as the ``Health
Professions Education Partnerships Act of 1998''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents of this Act
is as follows:</DELETED>
<DELETED>Sec. 1. Short title; table of contents.
<DELETED>TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE
PROGRAMS
<DELETED>Subtitle A--Health Professions Education Programs
<DELETED>Sec. 101. Under-represented minority health professions grant
program.
<DELETED>Sec. 102. Training in primary care medicine and dentistry.
<DELETED>Sec. 103. Interdisciplinary, community-based linkages.
<DELETED>Sec. 104. Health professions workforce information and
analysis.
<DELETED>Sec. 105. Public health workforce development.
<DELETED>Sec. 106. General provisions.
<DELETED>Sec. 107. Preference in certain programs.
<DELETED>Sec. 108. Definitions.
<DELETED>Sec. 109. Technical amendment on National Health Service
Corps.
<DELETED>Sec. 110. Savings provision.
<DELETED>Subtitle B--Nursing Workforce Development
<DELETED>Sec. 121. Short title.
<DELETED>Sec. 122. Purpose.
<DELETED>Sec. 123. Amendments to Public Health Service Act.
<DELETED>Sec. 124. Savings provision.
<DELETED>Subtitle C--Financial Assistance
<DELETED>Chapter 1--School-Based Revolving Loan Funds
<DELETED>Sec. 131. Primary care loan program.
<DELETED>Sec. 132. Loans for disadvantaged students.
<DELETED>Sec. 133. Student loans regarding schools of nursing.
<DELETED>Sec. 134. General provisions.
<DELETED>Chapter 2--Insured Health Education Assistance Loans to
Graduate Students
<DELETED>Sec. 141. Health Education Assistance Loan Program.
<DELETED>Sec. 142. Heal lender and holder performance standards.
<DELETED>Sec. 143. Reauthorization.
<DELETED>Sec. 144. HEAL bankruptcy.
<DELETED>Sec. 145. HEAL refinancing.
<DELETED>TITLE II--OFFICE OF MINORITY HEALTH
<DELETED>Sec. 201. Revision and extension of programs of Office of
Minority Health.
<DELETED>TITLE III--SELECTED INITIATIVES
<DELETED>Sec. 301. State offices of rural health.
<DELETED>Sec. 302. Demonstration projects regarding Alzheimer's
Disease.
<DELETED>Sec. 303. Project grants for immunization services.
<DELETED>TITLE IV--MISCELLANEOUS PROVISIONS
<DELETED>Sec. 401. Technical corrections regarding Public Law 103-183.
<DELETED>Sec. 402. Miscellaneous amendments regarding PHS commissioned
officers.
<DELETED>Sec. 403. Clinical traineeships.
<DELETED>Sec. 404. Project grants for screenings, referrals, and
education regarding lead poisoning.
<DELETED>Sec. 405. Project grants for preventive health services
regarding tuberculosis.
<DELETED>Sec. 406. Certain authorities of Centers for Disease Control
and Prevention.
<DELETED>Sec. 407. Community programs on domestic violence.
<DELETED>Sec. 408. State loan repayment program.
<DELETED>Sec. 409. Construction of regional centers for research on
primates.
<DELETED>Sec. 410. Peer review.
<DELETED>Sec. 411. Funding for trauma care.
<DELETED>Sec. 412. Health information and health promotion.
<DELETED>Sec. 413. Emergency medical services for children.
<DELETED>Sec. 414. Administration of certain requirements.
<DELETED>Sec. 415. Aids drug assistance program.
<DELETED>TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE
PROGRAMS</DELETED>
<DELETED>Subtitle A--Health Professions Education Programs</DELETED>
<DELETED>SEC. 101. UNDER-REPRESENTED MINORITY HEALTH PROFESSIONS GRANT
PROGRAM.</DELETED>
<DELETED> (a) In General.--Part B of title VII of the Public Health
Service Act (42 U.S.C. 293 et seq.) is amended to read as
follows:</DELETED>
<DELETED>``PART B--HEALTH PROFESSIONS TRAINING FOR DIVERSITY</DELETED>
<DELETED>``SEC. 736. CENTERS OF EXCELLENCE.</DELETED>
<DELETED> ``(a) In General.--The Secretary shall make grants to
designated health professions schools described in subsection (c) for
the purpose of assisting the schools in supporting programs of
excellence in health professions education for under-represented
minority individuals.</DELETED>
<DELETED> ``(b) Required Use of Funds.--The Secretary may not make a
grant under subsection (a) unless the designated health professions
school involved agrees, subject to subsection (c)(1)(C), to expend the
grant--</DELETED>
<DELETED> ``(1) to develop a large competitive applicant
pool through linkages with institutions of higher education,
local school districts, and other community-based entities and
establish an education pipeline for health professions
careers;</DELETED>
<DELETED> ``(2) to establish, strengthen, or expand programs
to enhance the academic performance of under-represented
minority students attending the school;</DELETED>
<DELETED> ``(3) to improve the capacity of such school to
train, recruit, and retain under-represented minority faculty
including the payment of such stipends and fellowships as the
Secretary may determine appropriate;</DELETED>
<DELETED> ``(4) to carry out activities to improve the
information resources, clinical education, curricula and
cultural competence of the graduates of the school, as it
relates to minority health issues;</DELETED>
<DELETED> ``(5) to facilitate faculty and student research
on health issues particularly affecting under-represented
minority groups, including research on issues relating to the
delivery of health care; and</DELETED>
<DELETED> ``(6) to carry out a program to train students of
the school in providing health services to a significant number
of under-represented minority individuals through training
provided to such students at community-based health facilities
that--</DELETED>
<DELETED> ``(A) provide such health services;
and</DELETED>
<DELETED> ``(B) are located at a site remote from
the main site of the teaching facilities of the
school.</DELETED>
<DELETED> ``(c) Centers of Excellence.--</DELETED>
<DELETED> ``(1) Designated schools.--</DELETED>
<DELETED> ``(A) In general.--The designated health
professions schools referred to in subsection (a) are
such schools that meet each of the conditions specified
in subparagraphs (B) and (C), and that--</DELETED>
<DELETED> ``(i) meet each of the conditions
specified in paragraph (2)(A);</DELETED>
<DELETED> ``(ii) meet each of the conditions
specified in paragraph (3);</DELETED>
<DELETED> ``(iii) meet each of the
conditions specified in paragraph (4);
or</DELETED>
<DELETED> ``(iv) meet each of the conditions
specified in paragraph (5).</DELETED>
<DELETED> ``(B) General conditions.--The conditions
specified in this subparagraph are that a designated
health professions school--</DELETED>
<DELETED> ``(i) has a significant number of
under-represented minority individuals enrolled
in the school, including individuals accepted
for enrollment in the school;</DELETED>
<DELETED> ``(ii) has been effective in
assisting under-represented minority students
of the school to complete the program of
education and receive the degree
involved;</DELETED>
<DELETED> ``(iii) has been effective in
recruiting under-represented minority
individuals to enroll in and graduate from the
school, including providing scholarships and
other financial assistance to such individuals
and encouraging under-represented minority
students from all levels of the educational
pipeline to pursue health professions careers;
and</DELETED>
<DELETED> ``(iv) has made significant
recruitment efforts to increase the number of
under-represented minority individuals serving
in faculty or administrative positions at the
school.</DELETED>
<DELETED> ``(C) Consortium.--The condition specified
in this subparagraph is that, in accordance with
subsection (e)(1), the designated health profession
school involved has with other health profession
schools (designated or otherwise) formed a consortium
to carry out the purposes described in subsection (b)
at the schools of the consortium.</DELETED>
<DELETED> ``(D) Application of criteria to other
programs.--In the case of any criteria established by
the Secretary for purposes of determining whether
schools meet the conditions described in subparagraph
(B), this section may not, with respect to racial and
ethnic minorities, be construed to authorize, require,
or prohibit the use of such criteria in any program
other than the program established in this
section.</DELETED>
<DELETED> ``(2) Centers of excellence at certain
historically black colleges and universities.--</DELETED>
<DELETED> ``(A) Conditions.--The conditions
specified in this subparagraph are that a designated
health professions school--</DELETED>
<DELETED> ``(i) is a school described in
section 799B(1); and</DELETED>
<DELETED> ``(ii) received a contract under
section 788B for fiscal year 1987, as such
section was in effect for such fiscal
year.</DELETED>
<DELETED> ``(B) Use of grant.--In addition to the
purposes described in subsection (b), a grant under
subsection (a) to a designated health professions
school meeting the conditions described in subparagraph
(A) may be expended--</DELETED>
<DELETED> ``(i) to develop a plan to achieve
institutional improvements, including financial
independence, to enable the school to support
programs of excellence in health professions
education for under-represented minority
individuals; and</DELETED>
<DELETED> ``(ii) to provide improved access
to the library and informational resources of
the school.</DELETED>
<DELETED> ``(C) Exception.--The requirements of
paragraph (1)(C) shall not apply to a historically
black college or university that receives funding under
paragraphs (2) or (5).</DELETED>
<DELETED> ``(3) Hispanic centers of excellence.--The
conditions specified in this paragraph are that--</DELETED>
<DELETED> ``(A) with respect to Hispanic
individuals, each of clauses (i) through (iv) of
paragraph (1)(B) applies to the designated health
professions school involved;</DELETED>
<DELETED> ``(B) the school agrees, as a condition of
receiving a grant under subsection (a), that the school
will, in carrying out the duties described in
subsection (b), give priority to carrying out the
duties with respect to Hispanic individuals;
and</DELETED>
<DELETED> ``(C) the school agrees, as a condition of
receiving a grant under subsection (a), that--
</DELETED>
<DELETED> ``(i) the school will establish an
arrangement with 1 or more public or nonprofit
community based Hispanic serving organizations,
or public or nonprofit private institutions of
higher education, including schools of nursing,
whose enrollment of students has traditionally
included a significant number of Hispanic
individuals, the purposes of which will be to
carry out a program--</DELETED>
<DELETED> ``(I) to identify Hispanic
students who are interested in a career
in the health profession involved;
and</DELETED>
<DELETED> ``(II) to facilitate the
educational preparation of such
students to enter the health
professions school; and</DELETED>
<DELETED> ``(ii) the school will make
efforts to recruit Hispanic students, including
students who have participated in the
undergraduate or other matriculation program
carried out under arrangements established by
the school pursuant to clause (i)(II) and will
assist Hispanic students regarding the
completion of the educational requirements for
a degree from the school.</DELETED>
<DELETED> ``(4) Native american centers of excellence.--
Subject to subsection (e), the conditions specified in this
paragraph are that--</DELETED>
<DELETED> ``(A) with respect to Native Americans,
each of clauses (i) through (iv) of paragraph (1)(B)
applies to the designated health professions school
involved;</DELETED>
<DELETED> ``(B) the school agrees, as a condition of
receiving a grant under subsection (a), that the school
will, in carrying out the duties described in
subsection (b), give priority to carrying out the
duties with respect to Native Americans; and</DELETED>
<DELETED> ``(C) the school agrees, as a condition of
receiving a grant under subsection (a), that--
</DELETED>
<DELETED> ``(i) the school will establish an
arrangement with 1 or more public or nonprofit
private institutions of higher education,
including schools of nursing, whose enrollment
of students has traditionally included a
significant number of Native Americans, the
purpose of which arrangement will be to carry
out a program--</DELETED>
<DELETED> ``(I) to identify Native
American students, from the
institutions of higher education
referred to in clause (i), who are
interested in health professions
careers; and</DELETED>
<DELETED> ``(II) to facilitate the
educational preparation of such
students to enter the designated health
professions school; and</DELETED>
<DELETED> ``(ii) the designated health
professions school will make efforts to recruit
Native American students, including students
who have participated in the undergraduate
program carried out under arrangements
established by the school pursuant to clause
(i) and will assist Native American students
regarding the completion of the educational
requirements for a degree from the designated
health professions school.</DELETED>
<DELETED> ``(5) Other centers of excellence.--The conditions
specified in this paragraph are--</DELETED>
<DELETED> ``(A) with respect to other centers of
excellence, the conditions described in clauses (i)
through (iv) of paragraph (1)(B); and</DELETED>
<DELETED> ``(B) that the health professions school
involved has an enrollment of under-represented
minorities above the national average for such
enrollments of health professions schools.</DELETED>
<DELETED> ``(d) Designation as Center of Excellence.--</DELETED>
<DELETED> ``(1) In general.--Any designated health
professions school receiving a grant under subsection (a) and
meeting the conditions described in paragraph (2) or (5) of
subsection (c) shall, for purposes of this section, be
designated by the Secretary as a Center of Excellence in Under-
Represented Minority Health Professions Education.</DELETED>
<DELETED> ``(2) Hispanic centers of excellence.--Any
designated health professions school receiving a grant under
subsection (a) and meeting the conditions described in
subsection (c)(3) shall, for purposes of this section, be
designated by the Secretary as a Hispanic Center of Excellence in
Health Professions Education.</DELETED>
<DELETED> ``(3) Native american centers of excellence.--Any
designated health professions school receiving a grant under
subsection (a) and meeting the conditions described in
subsection (c)(4) shall, for purposes of this section, be
designated by the Secretary as a Native American Center of
Excellence in Health Professions Education. Any consortium
receiving such a grant pursuant to subsection (e) shall, for
purposes of this section, be so designated.</DELETED>
<DELETED> ``(e) Authority Regarding Native American Centers of
Excellence.--With respect to meeting the conditions specified in
subsection (c)(4), the Secretary may make a grant under subsection (a)
to a designated health professions school that does not meet such
conditions if--</DELETED>
<DELETED> ``(1) the school has formed a consortium in
accordance with subsection (d)(1); and</DELETED>
<DELETED> ``(2) the schools of the consortium collectively
meet such conditions, without regard to whether the schools
individually meet such conditions.</DELETED>
<DELETED> ``(f) Duration of Grant.--The period during which payments
are made under a grant under subsection (a) may not exceed 5 years.
Such payments shall be subject to annual approval by the Secretary and
to the availability of appropriations for the fiscal year involved to
make the payments.</DELETED>
<DELETED> ``(g) Definitions.--In this section:</DELETED>
<DELETED> ``(1) Designated health professions school.--
</DELETED>
<DELETED> ``(A) In general.--The term `health
professions school' means, except as provided in
subparagraph (B), a school of medicine, a school of
osteopathic medicine, a school of dentistry, a school
of pharmacy, or a graduate program in behavioral or
mental health.</DELETED>
<DELETED> ``(B) Exception.--The definition
established in subparagraph (A) shall not apply to the
use of the term `designated health professions school'
for purposes of subsection (c)(2).</DELETED>
<DELETED> ``(2) Program of excellence.--The term `program of
excellence' means any program carried out by a designated
health professions school with a grant made under subsection
(a), if the program is for purposes for which the school
involved is authorized in subsection (b) or (c) to expend the
grant.</DELETED>
<DELETED> ``(3) Native americans.--The term `Native
Americans' means American Indians, Alaskan Natives, Aleuts, and
Native Hawaiians.</DELETED>
<DELETED> ``(h) Funding.--</DELETED>
<DELETED> ``(1) Authorization of appropriations.--For the
purpose of making grants under subsection (a), there authorized
to be appropriated $26,000,000 for fiscal year 1998, and such
sums as may be necessary for each of the fiscal years 1999
through 2002.</DELETED>
<DELETED> ``(2) Allocations.--Based on the amount
appropriated under paragraph (1) for a fiscal year, one of the
following subparagraphs shall apply:</DELETED>
<DELETED> ``(A) In general.--If the amounts
appropriated under paragraph (1) for a fiscal year are
less than $24,000,000--</DELETED>
<DELETED> ``(i) the Secretary shall make
available $12,000,000 for grants under
subsection (a) to health professions schools that meet the conditions
described in subsection (c)(2)(A); and</DELETED>
<DELETED> ``(ii) and available after grants
are made with funds under clause (i), the
Secretary shall make available--</DELETED>
<DELETED> ``(I) 60 percent of such
amount for grants under subsection (a)
to health professions schools that meet
the conditions described in paragraph
(3) or (4) of subsection (c) (including
meeting the conditions under subsection
(e)); and</DELETED>
<DELETED> ``(II) 40 percent of such
amount for grants under subsection (a)
to health professions schools that meet
the conditions described in subsection
(c)(5).</DELETED>
<DELETED> ``(B) Funding in excess of $24,000,000.--
If amounts appropriated under paragraph (1) for a
fiscal year exceed $24,000,000 but are less than
$30,000,000--</DELETED>
<DELETED> ``(i) 80 percent of such excess
amounts shall be made available for grants
under subsection (a) to health professions
schools that meet the requirements described in
paragraph (3) or (4) of subsection (c)
(including meeting conditions pursuant to
subsection (e)); and</DELETED>
<DELETED> ``(ii) 20 percent of such excess
amount shall be made available for grants under
subsection (a) to health professions schools
that meet the conditions described in
subsection (c)(5).</DELETED>
<DELETED> ``(C) Funding in excess of $30,000,000.--
If amounts appropriated under paragraph (1) for a
fiscal year exceed $30,000,000, the Secretary shall
make available--</DELETED>
<DELETED> ``(i) not less than $12,000,000
for grants under subsection (a) to health
professions schools that meet the conditions
described in subsection (c)(2)(A);</DELETED>
<DELETED> ``(ii) not less than $12,000,000
for grants under subsection (a) to health
professions schools that meet the conditions
described in paragraph (3) or (4) of subsection
(c) (including meeting conditions pursuant to
subsection (e));</DELETED>
<DELETED> ``(iii) not less than $6,000,000
for grants under subsection (a) to health
professions schools that meet the conditions
described in subsection (c)(5); and</DELETED>
<DELETED> ``(iv) after grants are made with
funds under clauses (i) through (iii), any
remaining funds for grants under subsection (a)
to health professions schools that meet the
conditions described in paragraph (2)(A), (3),
(4), or (5) of subsection (c).</DELETED>
<DELETED> ``(3) No limitation.--Nothing in this subsection
shall be construed as limiting the centers of excellence
referred to in this section to the designated amount, or to
preclude such entities from competing for other grants under
this section.</DELETED>
<DELETED> ``(4) Maintenance of effort.--</DELETED>
<DELETED> ``(A) In general.--With respect to
activities for which a grant made under this part are
authorized to be expended, the Secretary may not make
such a grant to a center of excellence for any fiscal
year unless the center agrees to maintain expenditures
of non-Federal amounts for such activities at a level
that is not less than the level of such expenditures
maintained by the center for the fiscal year preceding
the fiscal year for which the school receives such a
grant.</DELETED>
<DELETED> ``(B) Use of federal funds.--With respect
to any Federal amounts received by a center of
excellence and available for carrying out activities
for which a grant under this part is authorized to be
expended, the Secretary may not make such a grant to
the center for any fiscal year unless the center agrees
that the center will, before expending the grant,
expend the Federal amounts obtained from sources other
than the grant.</DELETED>
<DELETED>``SEC. 737. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may make a grant to an
eligible entity (as defined in subsection (d)(1)) under this section
for the awarding of scholarships by schools to any full-time student
who is an eligible individual as defined in subsection (d). Such
scholarships may be expended only for tuition expenses, other
reasonable educational expenses, and reasonable living expenses
incurred in the attendance of such school.</DELETED>
<DELETED> ``(b) Preference in Providing Scholarships.--The Secretary
may not make a grant to an entity under subsection (a) unless the
health professions and nursing schools involved agree that, in
providing scholarships pursuant to the grant, the schools will give
preference to students for whom the costs of attending the schools
would constitute a severe financial hardship and, notwithstanding other
provisions of this section, to former recipients of scholarships under
sections 736 and 740(d)(2)(B) (as such sections existed on the day
before the date of enactment of this section).</DELETED>
<DELETED> ``(c) Amount of Award.--In awarding grants to eligible
entities that are health professions and nursing schools, the Secretary
shall give priority to eligible entities based on the proportion of
graduating students going into primary care, the proportion of
underrepresented minority students, and the proportion of graduates
working in medically underserved communities.</DELETED>
<DELETED> ``(d) Definitions.--In this section:</DELETED>
<DELETED> ``(1) Eligible entities.--The term `eligible
entities' means an entity that--</DELETED>
<DELETED> ``(A) is a school of medicine, osteopathic
medicine, dentistry, nursing (as defined in section
801), pharmacy, podiatric medicine, optometry,
veterinary medicine, public health, or allied health, a
school offering a graduate program in behavioral and
mental health practice, or an entity providing programs
for the training of physician assistants; and</DELETED>
<DELETED> ``(B) is carrying out a program for
recruiting and retaining students from disadvantaged
backgrounds, including students who are members of
racial and ethnic minority groups.</DELETED>
<DELETED> ``(2) Eligible individual.--The term `eligible
individual' means an individual who--</DELETED>
<DELETED> ``(A) is from a disadvantaged
background;</DELETED>
<DELETED> ``(B) has a financial need for a
scholarship; and</DELETED>
<DELETED> ``(C) is enrolled (or accepted for
enrollment) at an eligible health professions or
nursing school as a full-time student in a program
leading to a degree in a health profession or
nursing.</DELETED>
<DELETED>``SEC. 738. LOAN REPAYMENTS AND FELLOWSHIPS REGARDING FACULTY
POSITIONS.</DELETED>
<DELETED> ``(a) Loan Repayments.--</DELETED>
<DELETED> ``(1) Establishment of program.--The Secretary
shall establish a program of entering into contracts with
individuals described in paragraph (2) under which the
individuals agree to serve as members of the faculties of
schools described in paragraph (3) in consideration of the
Federal Government agreeing to pay, for each year of such
service, not more than $20,000 of the principal and interest of
the educational loans of such individuals.</DELETED>
<DELETED> ``(2) Eligible individuals.--The individuals
referred to in paragraph (1) are individuals from disadvantaged
backgrounds who--</DELETED>
<DELETED> ``(A) have a degree in medicine,
osteopathic medicine, dentistry, nursing, or another
health profession;</DELETED>
<DELETED> ``(B) are enrolled in an approved graduate
training program in medicine, osteopathic medicine,
dentistry, nursing, or other health profession;
or</DELETED>
<DELETED> ``(C) are enrolled as full-time students--
</DELETED>
<DELETED> ``(i) in an accredited (as
determined by the Secretary) school described
in paragraph (3); and</DELETED>
<DELETED> ``(ii) in the final year of a
course of a study or program, offered by such
institution and approved by the Secretary,
leading to a degree from such a
school.</DELETED>
<DELETED> ``(3) Eligible health professions schools.--The
schools described in this paragraph are schools of medicine,
nursing (as schools of nursing are defined in section 801),
osteopathic medicine, dentistry, pharmacy, allied health,
podiatric medicine, optometry, veterinary medicine, or public
health, or schools offering graduate programs in behavioral and
mental health.</DELETED>
<DELETED> ``(4) Requirements regarding faculty positions.--
The Secretary may not enter into a contract under paragraph (1)
unless--</DELETED>
<DELETED> ``(A) the individual involved has entered
into a contract with a school described in paragraph
(3) to serve as a member of the faculty of the school
for not less than 2 years; and</DELETED>
<DELETED> ``(B) the contract referred to in
subparagraph (A) provides that--</DELETED>
<DELETED> ``(i) the school will, for each
year for which the individual will serve as a
member of the faculty under the contract with
the school, make payments of the principal and
interest due on the educational loans of the
individual for such year in an amount equal to
the amount of such payments made by the
Secretary for the year;</DELETED>
<DELETED> ``(ii) the payments made by the
school pursuant to clause (i) on behalf of the
individual will be in addition to the pay that
the individual would otherwise receive for
serving as a member of such faculty;
and</DELETED>
<DELETED> ``(iii) the school, in making a
determination of the amount of compensation to
be provided by the school to the individual for
serving as a member of the faculty, will make
the determination without regard to the amount
of payments made (or to be made) to the
individual by the Federal Government under
paragraph (1).</DELETED>
<DELETED> ``(5) Applicability of certain provisions.--The
provisions of sections 338C, 338G, and 338I shall apply to the
program established in paragraph (1) to the same extent and in
the same manner as such provisions apply to the National Health
Service Corps Loan Repayment Program established in subpart III
of part D of title III, including the applicability of
provisions regarding reimbursements for increased tax liability
and regarding bankruptcy.</DELETED>
<DELETED> ``(6) Waiver regarding school contributions.--The
Secretary may waive the requirement established in paragraph
(4)(B) if the Secretary determines that the requirement will
impose an undue financial hardship on the school
involved.</DELETED>
<DELETED> ``(b) Fellowships.--</DELETED>
<DELETED> ``(1) In general.--The Secretary may make grants
to and enter into contracts with eligible entities to assist
such entities in increasing the number of underrepresented
minority individuals who are members of the faculty of such
schools.</DELETED>
<DELETED> ``(2) Applications.--To be eligible to receive a
grant or contract under this subsection, an entity shall
provide an assurance, in the application submitted by the
entity, that--</DELETED>
<DELETED> ``(A) amounts received under such a grant
or contract will be used to award a fellowship to an
individual only if the individual meets the
requirements of paragraphs (3) and (4); and</DELETED>
<DELETED> ``(B) each fellowship awarded pursuant to
the grant or contract will include--</DELETED>
<DELETED> ``(i) a stipend in an amount not
exceeding 50 percent of the regular salary of a
similar faculty member for not to exceed 3
years of training; and</DELETED>
<DELETED> ``(ii) an allowance for other
expenses, such as travel to professional
meetings and costs related to specialized
training.</DELETED>
<DELETED> ``(3) Eligibility.--To be eligible to receive a
grant or contract under paragraph (1), an applicant shall
demonstrate to the Secretary that such applicant has or will
have the ability to--</DELETED>
<DELETED> ``(A) identify, recruit and select
underrepresented minority individuals who have the
potential for teaching, administration, or conducting
research at a health professions institution;</DELETED>
<DELETED> ``(B) provide such individuals with the
skills necessary to enable them to secure a tenured
faculty position at such institution, which may include
training with respect to pedagogical skills, program
administration, the design and conduct of research,
grants writing, and the preparation of articles
suitable for publication in peer reviewed
journals;</DELETED>
<DELETED> ``(C) provide services designed to assist
such individuals in their preparation for an academic
career, including the provision of counselors;
and</DELETED>
<DELETED> ``(D) provide health services to rural or
medically underserved populations.</DELETED>
<DELETED> ``(4) Requirements.--To be eligible to receive a
grant or contract under paragraph (1) an applicant shall--
</DELETED>
<DELETED> ``(A) provide an assurance that such
applicant will make available (directly through cash
donations) $1 for every $1 of Federal funds received
under this section for the fellowship;</DELETED>
<DELETED> ``(B) provide an assurance that
institutional support will be provided for the
individual for the second and third years at a level
that is equal to the total amount of institutional
funds provided in the year in which the grant or
contract was awarded;</DELETED>
<DELETED> ``(C) provide an assurance that the
individual that will receive the fellowship will be a
member of the faculty of the applicant school;
and</DELETED>
<DELETED> ``(D) provide an assurance that the
individual that will receive the fellowship will have,
at a minimum, appropriate advanced preparation (such as
a master's or doctoral degree) and special skills
necessary to enable such individual to teach and
practice.</DELETED>
<DELETED> ``(5) Definition.--For purposes of this
subsection, the term `underrepresented minority individuals'
means individuals who are members of racial or ethnic minority
groups that are underrepresented in the health professions
including nursing.</DELETED>
<DELETED>``SEC. 739. EDUCATIONAL ASSISTANCE IN THE HEALTH PROFESSIONS
REGARDING INDIVIDUALS FROM DISADVANTAGED
BACKGROUNDS.</DELETED>
<DELETED> ``(a) In General.--</DELETED>
<DELETED> ``(1) Authority for grants.--For the purpose of
assisting individuals from disadvantaged backgrounds, as
determined in accordance with criteria prescribed by the
Secretary, to undertake education to enter a health profession,
the Secretary may make grants to and enter into contracts with
schools of medicine, osteopathic medicine, public health,
dentistry, veterinary medicine, optometry, pharmacy, allied
health, chiropractic, and podiatric medicine, public and
nonprofit private schools that offer graduate programs in
behavioral and mental health, programs for the training of
physician assistants, and other public or private nonprofit
health or educational entities to assist in meeting the costs
described in paragraph (2).</DELETED>
<DELETED> ``(2) Authorized expenditures.--A grant or
contract under paragraph (1) may be used by the entity to meet
the cost of--</DELETED>
<DELETED> ``(A) identifying, recruiting, and
selecting individuals from disadvantaged backgrounds,
as so determined, for education and training in a
health profession;</DELETED>
<DELETED> ``(B) facilitating the entry of such
individuals into such a school;</DELETED>
<DELETED> ``(C) providing counseling, mentoring, or
other services designed to assist such individuals to
complete successfully their education at such a
school;</DELETED>
<DELETED> ``(D) providing, for a period prior to the
entry of such individuals into the regular course of
education of such a school, preliminary education and
health research training designed to assist them to
complete successfully such regular course of education
at such a school, or referring such individuals to
institutions providing such preliminary
education;</DELETED>
<DELETED> ``(E) publicizing existing sources of
financial aid available to students in the education
program of such a school or who are undertaking
training necessary to qualify them to enroll in such a
program;</DELETED>
<DELETED> ``(F) paying such scholarships as the
Secretary may determine for such individuals for any
period of health professions education at a health
professions school;</DELETED>
<DELETED> ``(G) paying such stipends as the
Secretary may approve for such individuals for any
period of education in student-enhancement programs
(other than regular courses) at any health professions
school, except that such a stipend may not be provided
to an individual for more than 12 months, and such a
stipend shall be in an amount determined appropriate by
the Secretary (notwithstanding any other provision of
law regarding the amount of stipends);</DELETED>
<DELETED> ``(H) carrying out programs under which
such individuals gain experience regarding a career in
a field of primary health care through working at
facilities of public or private nonprofit community-
based providers of primary health services;
and</DELETED>
<DELETED> ``(I) conducting activities to develop a
larger and more competitive applicant pool through
partnerships with institutions of higher education,
school districts, and other community-based
entities.</DELETED>
<DELETED> ``(3) Definition.--In this section, the term
`regular course of education of such a school' as used in
subparagraph (D) includes a graduate program in behavioral or
mental health.</DELETED>
<DELETED> ``(b) Requirements for Awards.--In making awards to
eligible entities under subsection (a)(1), the Secretary shall give
preference to approved applications for programs that involve a
comprehensive approach by several public or nonprofit private health or
educational entities to establish, enhance and expand educational
programs that will result in the development of a competitive applicant
pool of individuals from disadvantaged backgrounds who desire to pursue
health professions careers. In considering awards for such a
comprehensive partnership approach, the following shall apply with
respect to the entity involved:</DELETED>
<DELETED> ``(1) The entity shall have a demonstrated
commitment to such approach through formal agreements that have
common objectives with institutions of higher education, school
districts, and other community-based entities.</DELETED>
<DELETED> ``(2) Such formal agreements shall reflect the
coordination of educational activities and support services,
increased linkages, and the consolidation of resources within a
specific geographic area.</DELETED>
<DELETED> ``(3) The design of the educational activities
involved shall provide for the establishment of a competitive
health professions applicant pool of individuals from
disadvantaged backgrounds by enhancing the total preparation
(academic and social) of such individuals to pursue a health
professions career.</DELETED>
<DELETED> ``(4) The programs or activities under the award
shall focus on developing a culturally competent health care
workforce that will serve the unserved and underserved
populations within the geographic area.</DELETED>
<DELETED> ``(c) Equitable Allocation of Financial Assistance.--The
Secretary, to the extent practicable, shall ensure that services and
activities under subsection (a) are adequately allocated among the
various racial and ethnic populations who are from disadvantaged
backgrounds.</DELETED>
<DELETED> ``(d) Matching Requirements.--The Secretary may require
that an entity that applies for a grant or contract under subsection
(a), provide non-Federal matching funds, as appropriate, to ensure the
institutional commitment of the entity to the projects funded under the
grant or contract. As determined by the Secretary, such non-Federal
matching funds may be provided directly or through donations from
public or private entities and may be in cash or in-kind, fairly
evaluated, including plant, equipment, or services.</DELETED>
<DELETED>``SEC. 740. AUTHORIZATION OF APPROPRIATION.</DELETED>
<DELETED> ``(a) Scholarships.--There are authorized to be
appropriated to carry out section 737, $37,000,000 for fiscal year
1998, and such sums as may be necessary for each of the fiscal years
1999 through 2002. Of the amount appropriated in any fiscal year, the
Secretary shall ensure that not less than 16 percent shall be
distributed to schools of nursing.</DELETED>
<DELETED> ``(b) Loan Repayments and Fellowships.--For the purpose of
carrying out section 738, there is authorized to be appropriated
$1,100,000 for fiscal year 1998, and such sums as may be necessary for
each of the fiscal years 1999 through 2002.</DELETED>
<DELETED> ``(c) Undergraduate Assistance.--For the purpose of grants
and contracts under section 739(a)(1), there is authorized to be
appropriated $29,400,000 for fiscal year 1998, and such sums as may be
necessary for each of the fiscal years 1999 through 2002. The Secretary
may use not to exceed 20 percent of the amount appropriated for a
fiscal year under this subsection to provide scholarships under section
739(a)(2)(F).</DELETED>
<DELETED> ``(d) Report.--Not later than 6 months after the date of
enactment of this part, the Secretary shall prepare and submit to the
appropriate committees of Congress a report concerning the efforts of
the Secretary to address the need for a representative mix of
individuals from historically minority health professions schools, or
from institutions or other entities that historically or by geographic
location have a demonstrated record of training or educating
underrepresented minorities, within various health professions
disciplines, on peer review councils.''.</DELETED>
<DELETED> (b) Repeal.--</DELETED>
<DELETED> (1) In general.--Section 795 of the Public Health
Service Act (42 U.S.C. 295n) is repealed.</DELETED>
<DELETED> (2) Nontermination of authority.--The amendments
made by this section shall not be construed to terminate
agreements that, on the day before the date of enactment of
this Act, are in effect pursuant to section 795 of the Public
Health Service Act (42 U.S.C. 795) as such section existed on
such date. Such agreements shall continue in effect in
accordance with the terms of the agreements. With respect to
compliance with such agreements, any period of practice as a
provider of primary health services shall be counted towards
the satisfaction of the requirement of practice pursuant to
such section 795.</DELETED>
<DELETED> (c) Conforming Amendments.--Section 481A(c)(3)(D)(i) of
the Public Health Service Act (42 U.S.C. 287a-2(c)(3)(D)(i)) is amended
by striking ``section 739'' and inserting ``part B of title
VII''.</DELETED>
<DELETED>SEC. 102. TRAINING IN PRIMARY CARE MEDICINE AND
DENTISTRY.</DELETED>
<DELETED> Part C of title VII of the Public Health Service Act (42
U.S.C. 293 et seq.) is amended--</DELETED>
<DELETED> (1) in the part heading by striking ``PRIMARY
HEALTH CARE'' and inserting ``FAMILY MEDICINE, GENERAL INTERNAL
MEDICINE, GENERAL PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL
DENTISTRY, AND PEDIATRIC DENTISTRY'';</DELETED>
<DELETED> (2) by repealing section 746 (42 U.S.C.
293j);</DELETED>
<DELETED> (3) in section 747 (42 U.S.C. 293k)--</DELETED>
<DELETED> (A) by striking the section heading and
inserting the following:</DELETED>
<DELETED>``SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDICINE,
GENERAL PEDIATRICS, GENERAL DENTISTRY, PEDIATRIC
DENTISTRY, AND PHYSICIAN ASSISTANTS.'';</DELETED>
<DELETED> (B) in subsection (a)--</DELETED>
<DELETED> (i) in paragraph (1)--</DELETED>
<DELETED> (I) by inserting ``,
internal medicine, or pediatrics''
after ``family medicine'';
and</DELETED>
<DELETED> (II) by inserting before
the semicolon the following: ``that
emphasizes training for the practice of
family medicine, general internal
medicine, or general pediatrics (as
defined by the Secretary)'';</DELETED>
<DELETED> (ii) in paragraph (2), by
inserting ``, general internal medicine, or
general pediatrics'' before the
semicolon;</DELETED>
<DELETED> (iii) in paragraphs (3) and (4),
by inserting ``, general internal medicine or
general pediatrics'' after ``family
medicine'';</DELETED>
<DELETED> (iv) in paragraphs (3) and (4), by
inserting ``(including geriatrics) after
``family medicine'';</DELETED>
<DELETED> (v) in paragraph (3), by striking
``and'' at the end thereof;</DELETED>
<DELETED> (vi) in paragraph (4), by striking
the period and inserting a semicolon;
and</DELETED>
<DELETED> (vii) by adding at the end thereof
the following new paragraphs:</DELETED>
<DELETED> ``(5) to meet the costs of projects to plan,
develop, and operate or maintain programs for the training of
physician assistants (as defined in section 799B), and for the
training of individuals who will teach in programs to provide
such training; and</DELETED>
<DELETED> ``(6) to meet the costs of planning, developing,
or operating programs, and to provide financial assistance to
residents in such programs, of general dentistry or pediatric
dentistry.</DELETED>
<DELETED>For purposes of paragraph (6), entities eligible for such
grants or contracts shall include entities that have programs in dental
schools, approved residency programs in the general or pediatric
practice of dentistry, approved advanced education programs in the
general or pediatric practice of dentistry, or approved residency
programs in pediatric dentistry.'';</DELETED>
<DELETED> (C) in subsection (b)--</DELETED>
<DELETED> (i) in paragraphs (1) and (2)(A),
by inserting ``, general internal medicine, or
general pediatrics'' after ``family
medicine'';</DELETED>
<DELETED> (ii) in paragraph (2)--</DELETED>
<DELETED> (I) in subparagraph (A),
by striking ``or'' at the end;
and</DELETED>
<DELETED> (II) in subparagraph (B),
by striking the period and inserting
``; or''; and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(3) Priority in making awards.--In making awards
of grants and contracts under paragraph (1), the Secretary
shall give priority to any qualified applicant for such an
award that proposes a collaborative project between departments
of primary care.'';</DELETED>
<DELETED> (D) by redesignating subsections (c) and
(d) as subsections (d) and (e), respectively;</DELETED>
<DELETED> (E) by inserting after subsection (b), the
following new subsection:</DELETED>
<DELETED> ``(c) Priority.--</DELETED>
<DELETED> ``(1) In general.--With respect to programs for
the training of interns or residents, the Secretary shall give
priority in awarding grants under this section to qualified
applicants that have a record of training the greatest
percentage of providers, or that have demonstrated significant
improvements in the percentage of providers, which enter and
remain in primary care practice or general or pediatric
dentistry.</DELETED>
<DELETED> ``(2) Disadvantaged individuals.--With respect to
programs for the training of interns, residents, or physician
assistants, the Secretary shall give priority in awarding
grants under this section to qualified applicants that have a
record of training individuals who are from disadvantaged
backgrounds (including racial and ethnic minorities
underrepresented among primary care practice or general or
pediatric dentistry).</DELETED>
<DELETED> ``(3) Special consideration.--In awarding grants
under this section the Secretary shall give special
consideration to projects which prepare practitioners to care
for underserved populations and other high risk groups such as
the elderly, individuals with HIV-AIDS, substance abusers,
homeless, and victims of domestic violence.''; and</DELETED>
<DELETED> (F) in subsection (e) (as so redesignated
by subparagraph (D))--</DELETED>
<DELETED> (i) in paragraph (1), by striking
``$54,000,000'' and all that follows and
inserting ``$78,300,000 for fiscal year 1998,
and such sums as may be necessary for each of
the fiscal years 1999 through 2002.'';
and</DELETED>
<DELETED> (ii) by striking paragraph (2) and
inserting the following:</DELETED>
<DELETED> ``(2) Allocation.--</DELETED>
<DELETED> ``(A) In general.--Of the amounts
appropriated under paragraph (1) for a fiscal year, the
Secretary shall make available--</DELETED>
<DELETED> ``(i) not less than $49,300,000
for awards of grants and contracts under
subsection (a) to programs of family medicine,
of which not less than $8,600,000 shall be made
available for awards of grants and contracts
under subsection (b) for family medicine
academic administrative units;</DELETED>
<DELETED> ``(ii) not less than $17,700,000
for awards of grants and contracts under
subsection (a) to programs of general internal
medicine and general pediatrics;</DELETED>
<DELETED> ``(iii) not less than $6,800,000
for awards of grants and contracts under
subsection (a) to programs relating to
physician assistants; and</DELETED>
<DELETED> ``(iv) not less than $4,500,000
for awards of grants and contracts under
subsection (a) to programs of general or
pediatric dentistry.</DELETED>
<DELETED> ``(B) Ratable reduction.--If amounts
appropriated under paragraph (1) for any fiscal year
are less than the amount required to comply with
subparagraph (A), the Secretary shall ratably reduce
the amount to be made available under each of clauses
(i) through (iv) of such subparagraph accordingly.'';
and</DELETED>
<DELETED> (4) by repealing sections 748 through 752 (42
U.S.C. 293l through 293p) and inserting the
following:</DELETED>
<DELETED>``SEC. 748. ADVISORY COMMITTEE ON TRAINING IN PRIMARY CARE
MEDICINE AND DENTISTRY.</DELETED>
<DELETED> ``(a) Establishment.--The Secretary shall establish an
advisory committee to be known as the Advisory Committee on Training in
Primary Care Medicine and Dentistry (in this section referred to as the
`Advisory Committee').</DELETED>
<DELETED> ``(b) Composition.--</DELETED>
<DELETED> ``(1) In general.--The Secretary shall determine
the appropriate number of individuals to serve on the Advisory
Committee. Such individuals shall not be officers or employees
of the Federal Government.</DELETED>
<DELETED> ``(2) Appointment.--Not later than 90 days after
the date of enactment of this Act, the Secretary shall appoint
the members of the Advisory Committee from among individuals
who are health professionals. In making such appointments, the
Secretary shall ensure a fair balance between the health
professions, that at least 75 percent of the members of the
Advisory Committee are health professionals, a broad geographic
representation of members and a balance between urban and rural
members. Members shall be appointed based on their competence,
interest, and knowledge of the mission of the profession
involved.</DELETED>
<DELETED> ``(3) Minority representation.--In appointing the
members of the Advisory Committee under paragraph (2), the
Secretary shall ensure the adequate representation of women and
minorities.</DELETED>
<DELETED> ``(c) Terms.--</DELETED>
<DELETED> ``(1) In general.--A member of the Advisory
Committee shall be appointed for a term of 3 years, except that
of the members first appointed--</DELETED>
<DELETED> ``(A) </DELETED>\<DELETED>1/3</DELETED>\
<DELETED>of such members shall serve for a term of 1
year;</DELETED>
<DELETED> ``(B) </DELETED>\<DELETED>1/3</DELETED>\
<DELETED>of such members shall serve for a term of 2
years; and</DELETED>
<DELETED> ``(C) </DELETED>\<DELETED>1/3</DELETED>\
<DELETED>of such members shall serve for a term of 3
years.</DELETED>
<DELETED> ``(2) Vacancies.--</DELETED>
<DELETED> ``(A) In general.--A vacancy on the
Advisory Committee shall be filled in the manner in
which the original appointment was made and shall be
subject to any conditions which applied with respect to
the original appointment.</DELETED>
<DELETED> ``(B) Filling unexpired term.--An
individual chosen to fill a vacancy shall be appointed
for the unexpired term of the member
replaced.</DELETED>
<DELETED> ``(d) Duties.--The Advisory Committee shall--</DELETED>
<DELETED> ``(1) provide advice and recommendations to the
Secretary concerning policy and program development and other
matters of significance concerning the activities under section
747; and</DELETED>
<DELETED> ``(2) not later than 3 years after the date of
enactment of this section, and annually thereafter, prepare and
submit to the Secretary, and the Committee on Labor and Human
Resources of the Senate, and the Committee on Commerce of the
House of Representatives, a report describing the activities of
the Committee, including findings and recommendations made by
the Committee concerning the activities under section
747.</DELETED>
<DELETED> ``(e) Meetings and Documents.--</DELETED>
<DELETED> ``(1) Meetings.--The Advisory Committee shall meet
not less than 2 times each year. Such meetings shall be held
jointly with other related entities established under this
title where appropriate.</DELETED>
<DELETED> ``(2) Documents.--Not later than 14 days prior to
the convening of a meeting under paragraph (1), the Advisory
Committee shall prepare and make available an agenda of the
matters to be considered by the Advisory Committee at such
meeting. At any such meeting, the Advisory Council shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Committee shall prepare and make
available a summary of the meeting and any actions taken by the
Committee based upon the meeting.</DELETED>
<DELETED> ``(f) Compensation and Expenses.--</DELETED>
<DELETED> ``(1) Compensation.--Each member of the Advisory
Committee shall be compensated at a rate equal to the daily
equivalent of the annual rate of basic pay prescribed for level
IV of the Executive Schedule under section 5315 of title 5,
United States Code, for each day (including travel time) during
which such member is engaged in the performance of the duties
of the Committee.</DELETED>
<DELETED> ``(2) Expenses.--The members of the Advisory
Committee shall be allowed travel expenses, including per diem
in lieu of subsistence, at rates authorized for employees of
agencies under subchapter I of chapter 57 of title 5, United
States Code, while away from their homes or regular places of
business in the performance of services for the
Committee.</DELETED>
<DELETED> ``(g) FACA.--The Federal Advisory Committee Act shall
apply to the Advisory Committee under this section only to the extent
that the provisions of such Act do not conflict with the requirements
of this section.''.</DELETED>
<DELETED>SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED
LINKAGES.</DELETED>
<DELETED> Part D of title VII of the Public Health Service Act (42
U.S.C. 294 et seq.) is amended to read as follows:</DELETED>
<DELETED>``PART D--INTERDISCIPLINARY, COMMUNITY-BASED
LINKAGES</DELETED>
<DELETED>``SEC. 750. GENERAL PROVISIONS.</DELETED>
<DELETED> ``(a) Collaboration.--To be eligible to receive assistance
under this part, an academic institution shall use such assistance in
collaboration with 2 or more disciplines.</DELETED>
<DELETED> ``(b) Activities.--An entity shall use assistance under
this part to carry out innovative demonstration projects for strategic
workforce supplementation activities as needed to meet national goals
for interdisciplinary, community-based linkages. Such assistance may be
used consistent with this part--</DELETED>
<DELETED> ``(1) to develop and support training
programs;</DELETED>
<DELETED> ``(2) for faculty development;</DELETED>
<DELETED> ``(3) for model demonstration programs;</DELETED>
<DELETED> ``(4) for the provision of stipends for fellowship
trainees;</DELETED>
<DELETED> ``(5) to provide technical assistance;
and</DELETED>
<DELETED> ``(6) for other activities that will produce
outcomes consistent with the purposes of this part.</DELETED>
<DELETED>``SEC. 751. AREA HEALTH EDUCATION CENTERS.</DELETED>
<DELETED> ``(a) Authority for Provision of Financial Assistance.--
</DELETED>
<DELETED> ``(1) Assistance for planning, development, and
operation of programs.--</DELETED>
<DELETED> ``(A) In general.--The Secretary shall
award grants to and enter into contracts with schools
of medicine and osteopathic medicine, and incorporated
consortia made up of such schools, or the parent
institutions of such schools, for projects for the
planning, development and operation of area health
education center programs that--</DELETED>
<DELETED> ``(i) improve the recruitment,
distribution, supply, quality and efficiency of
personnel providing health services in
underserved rural and urban areas and personnel
providing health services to populations having
demonstrated serious unmet health care
needs;</DELETED>
<DELETED> ``(ii) increase the number of
primary care physicians and other primary care
providers who provide services in underserved
areas through the offering of an educational
continuum of health career recruitment through
clinical education concerning underserved areas
in a comprehensive health workforce
strategy;</DELETED>
<DELETED> ``(iii) carry out recruitment and
health career awareness programs to recruit
individuals from underserved areas and under-
represented populations, including minority and
other elementary or secondary students, into
the health professions;</DELETED>
<DELETED> ``(iv) prepare individuals to more
effectively provide health services to
underserved areas or underserved populations
through field placements, preceptorships, the
conduct of or support of community-based
primary care residency programs, and agreements
with community-based organizations such as
community health centers, migrant health
centers, Indian health centers, public health
departments and others;</DELETED>
<DELETED> ``(v) conduct health professions
education and training activities for students
of health professions schools and medical
residents;</DELETED>
<DELETED> ``(vi) conduct at least 10 percent
of medical student required clinical education
at sites remote to the primary teaching
facility of the contracting institution;
and</DELETED>
<DELETED> ``(vii) provide information
dissemination and educational support to reduce
professional isolation, increase retention,
enhance the practice environment, and improve
health care through the timely dissemination of
research findings using relevant
resources.</DELETED>
<DELETED> ``(B) Other eligible entities.--With
respect to a State in which no area health education
center program is in operation, the Secretary may award
a grant or contract under subparagraph (A) to a school
of nursing.</DELETED>
<DELETED> ``(C) Project terms.--</DELETED>
<DELETED> ``(i) In general.--Except as
provided in clause (ii), the period during
which payments may be made under an award under
subparagraph (A) may not exceed--</DELETED>
<DELETED> ``(I) in the case of a
project, 12 years or</DELETED>
<DELETED> ``(II) in the case of a
center within a project, 6
years.</DELETED>
<DELETED> ``(ii) Exception.--The periods
described in clause (i) shall not apply to
projects that have completed the initial period
of Federal funding under this section and that
desire to compete for model awards under
paragraph (2)(A).</DELETED>
<DELETED> ``(2) Assistance for operation of model
programs.--</DELETED>
<DELETED> ``(A) In general.--In the case of any
entity described in paragraph (1)(A) that--</DELETED>
<DELETED> ``(i) has previously received
funds under this section;</DELETED>
<DELETED> ``(ii) is operating an area health
education center program; and</DELETED>
<DELETED> ``(iii) is no longer receiving
financial assistance under paragraph
(1);</DELETED>
<DELETED>the Secretary may provide financial assistance
to such entity to pay the costs of operating and
carrying out the requirements of the program as
described in paragraph (1).</DELETED>
<DELETED> ``(B) Matching requirement.--With respect
to the costs of operating a model program under
subparagraph (A), an entity, to be eligible for
financial assistance under subparagraph (A), shall make
available (directly or through contributions from
State, county or municipal governments, or the private
sector) recurring non-Federal contributions in cash
toward such costs in an amount that is equal to not
less than 50 percent of such costs.</DELETED>
<DELETED> ``(C) Limitation.--The aggregate amount of
awards provided under subparagraph (A) to entities in a
State for a fiscal year may not exceed the lesser of--
</DELETED>
<DELETED> ``(i) $2,000,000; or</DELETED>
<DELETED> ``(ii) an amount equal to the
product of $250,000 and the aggregate number of
area health education centers operated in the
State by such entities.</DELETED>
<DELETED> ``(b) Requirements for Centers.--</DELETED>
<DELETED> ``(1) General requirement.--Each area health
education center that receives funds under this section shall
encourage the regionalization of health professions schools
through the establishment of partnerships with community-based
organizations.</DELETED>
<DELETED> ``(2) Service area.--Each area health education
center that receives funds under this section shall
specifically designate a geographic area or medically
underserved population to be served by the center. Such area or
population shall be in a location removed from the main
location of the teaching facilities of the schools
participating in the program with such center.</DELETED>
<DELETED> ``(3) Other requirements.--Each area health
education center that receives funds under this section shall--
</DELETED>
<DELETED> ``(A) assess the health personnel needs of
the area to be served by the center and assist in the
planning and development of training programs to meet
such needs;</DELETED>
<DELETED> ``(B) arrange and support rotations for
students and residents in family medicine, general
internal medicine or general pediatrics, with at least
one center in each program being affiliated with or
conducting a rotating osteopathic internship or medical
residency training program in family medicine
(including geriatrics), general internal medicine
(including geriatrics), or general pediatrics in which
no fewer than 4 individuals are enrolled in first-year
positions;</DELETED>
<DELETED> ``(C) conduct and participate in
interdisciplinary training that involves physicians and
other health personnel including, where practicable,
public health professionals, physician assistants,
nurse practitioners, nurse midwives, and behavioral and
mental health providers; and</DELETED>
<DELETED> ``(D) have an advisory board, at least 75
percent of the members of which shall be individuals,
including both health service providers and consumers,
from the area served by the center.</DELETED>
<DELETED> ``(c) Certain Provisions Regarding Funding.--</DELETED>
<DELETED> ``(1) Allocation to center.--Not less than 75
percent of the total amount of Federal funds provided to an
entity under this section shall be allocated by an area health
education center program to the area health education center.
Such entity shall enter into an agreement with each center for
purposes of specifying the allocation of such 75 percent of
funds.</DELETED>
<DELETED> ``(2) Operating costs.--With respect to the
operating costs of the area health education center program of
an entity receiving funds under this section, the entity shall
make available (directly or through contributions from State,
county or municipal governments, or the private sector) non-
Federal contributions in cash toward such costs in an amount
that is equal to not less than 50 percent of such costs, except
that the Secretary may grant a waiver for up to 75 percent of the
amount of the required non-Federal match in the first 3 years in which
an entity receives funds under this section.</DELETED>
<DELETED>``SEC. 752. HEALTH EDUCATION AND TRAINING CENTERS.</DELETED>
<DELETED> ``(a) In General.--To be eligible for funds under this
section, an health education training center shall be an entity
otherwise eligible for funds under section 751 that--</DELETED>
<DELETED> ``(1) addresses the persistent and severe unmet
health care needs in States along the border between the United
States and Mexico and in the State of Florida, and in other
urban and rural areas with populations with serious unmet
health care needs;</DELETED>
<DELETED> ``(2) establishes an advisory board comprised of
health service providers, educators and consumers from the
service area;</DELETED>
<DELETED> ``(3) conducts training and education programs for
health professions students in these areas;</DELETED>
<DELETED> ``(4) conducts training in health education
services, including training to prepare community health
workers; and</DELETED>
<DELETED> ``(5) supports health professionals (including
nursing) practicing in the area through educational and other
services.</DELETED>
<DELETED> ``(b) Allocation of Funds.--The Secretary shall make
available 50 percent of the amounts appropriated for each fiscal year
under section 752 for the establishment or operation of health
education training centers through projects in States along the border
between the United States and Mexico and in the State of
Florida.</DELETED>
<DELETED>``SEC. 753. EDUCATION AND TRAINING RELATING TO
GERIATRICS.</DELETED>
<DELETED> ``(a) Geriatric Education Centers.--</DELETED>
<DELETED> ``(1) In general.--The Secretary shall award
grants or contracts under this section to entities described in
paragraphs (1), (3), or (4) of section 799B, and section
853(2), for the establishment or operation of geriatric
education centers.</DELETED>
<DELETED> ``(2) Requirements.--A geriatric education center
is a program that--</DELETED>
<DELETED> ``(A) improves the training of health
professionals in geriatrics, including geriatric
residencies, traineeships, or fellowships;</DELETED>
<DELETED> ``(B) develops and disseminates curricula
relating to the treatment of the health problems of
elderly individuals;</DELETED>
<DELETED> ``(C) supports the training and retraining
of faculty to provide instruction in
geriatrics;</DELETED>
<DELETED> ``(D) supports continuing education of
health professionals who provide geriatric care;
and</DELETED>
<DELETED> ``(E) provides students with clinical
training in geriatrics in nursing homes, chronic and
acute disease hospitals, ambulatory care centers, and
senior centers.</DELETED>
<DELETED> ``(b) Geriatric Training Regarding Physicians and
Dentists.--</DELETED>
<DELETED> ``(1) In general.--The Secretary may make grants
to, and enter into contracts with, schools of medicine, schools
of osteopathic medicine, teaching hospitals, and graduate
medical education programs, for the purpose of providing
support (including residencies, traineeships, and fellowships)
for geriatric training projects to train physicians, dentists
and behavioral and mental health professionals who plan to
teach geriatric medicine, geriatric behavioral or mental
health, or geriatric dentistry.</DELETED>
<DELETED> ``(2) Requirements.--Each project for which a
grant or contract is made under this subsection shall--
</DELETED>
<DELETED> ``(A) be staffed by full-time teaching
physicians who have experience or training in geriatric
medicine or geriatric behavioral or mental
health;</DELETED>
<DELETED> ``(B) be staffed, or enter into an
agreement with an institution staffed by full-time or
part-time teaching dentists who have experience or
training in geriatric dentistry;</DELETED>
<DELETED> ``(C) be staffed, or enter into an
agreement with an institution staffed by full-time or
part-time teaching behavioral mental health
professionals who have experience or training in
geriatric behavioral or mental health;</DELETED>
<DELETED> ``(D) be based in a graduate medical
education program in internal medicine or family
medicine or in a department of geriatrics or behavioral
or mental health;</DELETED>
<DELETED> ``(E) provide training in geriatrics and
exposure to the physical and mental disabilities of
elderly individuals through a variety of service
rotations, such as geriatric consultation services,
acute care services, dental services, geriatric
behavioral or mental health units, day and home care
programs, rehabilitation services, extended care
facilities, geriatric ambulatory care and comprehensive
evaluation units, and community care programs for
elderly mentally retarded individuals; and</DELETED>
<DELETED> ``(F) provide training in geriatrics
through one or both of the training options described
in subparagraphs (A) and (B) of paragraph
(3).</DELETED>
<DELETED> ``(3) Training options.--The training options
referred to in subparagraph (F) of paragraph (2) shall be as
follows:</DELETED>
<DELETED> ``(A) A 1-year retraining program in
geriatrics for--</DELETED>
<DELETED> ``(i) physicians who are faculty
members in departments of internal medicine,
family medicine, gynecology, geriatrics, and
behavioral or mental health at schools of
medicine and osteopathic medicine;</DELETED>
<DELETED> ``(ii) dentists who are faculty
members at schools of dentistry or at hospital
departments of dentistry; and</DELETED>
<DELETED> ``(iii) behavioral or mental
health professionals who are faculty members in
departments of behavioral or mental health;
and</DELETED>
<DELETED> ``(B) A 2-year internal medicine or family
medicine fellowship program providing emphasis in
geriatrics, which shall be designed to provide training
in clinical geriatrics and geriatrics research for--
</DELETED>
<DELETED> ``(i) physicians who have
completed graduate medical education programs
in internal medicine, family medicine,
behavioral or mental health, neurology,
gynecology, or rehabilitation
medicine;</DELETED>
<DELETED> ``(ii) dentists who have
demonstrated a commitment to an academic career
and who have completed postdoctoral dental
training, including postdoctoral dental
education programs or who have relevant
advanced training or experience; and</DELETED>
<DELETED> ``(iii) behavioral or mental
health professionals who have completed
graduate medical education programs in
behavioral or mental health.</DELETED>
<DELETED> ``(4) Definitions.--For purposes of this
subsection:</DELETED>
<DELETED> ``(A) The term `graduate medical education
program' means a program sponsored by a school of
medicine, a school of osteopathic medicine, a hospital,
or a public or private institution that--</DELETED>
<DELETED> ``(i) offers postgraduate medical
training in the specialties and subspecialties
of medicine; and</DELETED>
<DELETED> ``(ii) has been accredited by the
Accreditation Council for Graduate Medical
Education or the American Osteopathic
Association through its Committee on
Postdoctoral Training.</DELETED>
<DELETED> ``(B) The term `post-doctoral dental
education program' means a program sponsored by a
school of dentistry, a hospital, or a public or private
institution that--</DELETED>
<DELETED> ``(i) offers post-doctoral
training in the specialties of dentistry,
advanced education in general dentistry, or a
dental general practice residency;
and</DELETED>
<DELETED> ``(ii) has been accredited by the
Commission on Dental Accreditation.</DELETED>
<DELETED> ``(c) Geriatric Faculty Fellowships.--</DELETED>
<DELETED> ``(1) Establishment of program.--The Secretary
shall establish a program to provide Geriatric Academic Career
Awards to eligible individuals to promote the career
development of such individuals as academic
geriatricians.</DELETED>
<DELETED> ``(2) Eligible individuals.--To be eligible to
receive an Award under paragraph (1), an individual shall--
</DELETED>
<DELETED> ``(A) have a degree in internal medicine,
family practice, or behavioral or mental health
science;</DELETED>
<DELETED> ``(B) have completed an approved
fellowship program in geriatrics; and</DELETED>
<DELETED> ``(C) have a junior faculty appointment at
an accredited (as determined by the Secretary) school
of medicine or osteopathic medicine.</DELETED>
<DELETED> ``(3) Limitations.--No Award under paragraph (1)
may be made to an eligible individual unless the individual--
</DELETED>
<DELETED> ``(A) has submitted to the Secretary an
application, at such time, in such manner, and
containing such information as the Secretary may
require, and the Secretary has approved such
application; and</DELETED>
<DELETED> ``(B) provides, in such form and manner as
the Secretary may require, assurances that the
individual will meet the service requirement described
in subsection (e).</DELETED>
<DELETED> ``(4) Amount and term.--</DELETED>
<DELETED> ``(A) Amount.--The amount of an Award
under this section shall equal $50,000 for fiscal year
1998, adjusted for subsequent fiscal years to reflect
the increase in the Consumer Price Index.</DELETED>
<DELETED> ``(B) Term.--The term of any Award made
under this subsection shall not exceed 5
years.</DELETED>
<DELETED> ``(5) Service requirement.--An individual who
receives an Award under this subsection shall provide training
in clinical geriatrics, including the training of
interdisciplinary teams of health care professionals. The
provision of such training shall constitute at least 75 percent
of the obligations of such individual under the
Award.</DELETED>
<DELETED>``SEC. 754. RURAL INTERDISCIPLINARY TRAINING GRANTS.</DELETED>
<DELETED> ``(a) Grants.--The Secretary may make grants or contracts
under this section to help entities fund authorized activities under an
application approved under subsection (c).</DELETED>
<DELETED> ``(b) Use of Amounts.--</DELETED>
<DELETED> ``(1) In general.--Amounts provided under
subsection (a) shall be used by the recipients to fund
interdisciplinary training projects designed to--</DELETED>
<DELETED> ``(A) use new and innovative methods to
train health care practitioners to provide services in
rural areas;</DELETED>
<DELETED> ``(B) demonstrate and evaluate innovative
interdisciplinary methods and models designed to
provide access to cost-effective comprehensive health
care;</DELETED>
<DELETED> ``(C) deliver health care services to
individuals residing in rural areas;</DELETED>
<DELETED> ``(D) enhance the amount of relevant
research conducted concerning health care issues in
rural areas; and</DELETED>
<DELETED> ``(E) increase the recruitment and
retention of health care practitioners from rural areas
and make rural practice a more attractive career choice
for health care practitioners.</DELETED>
<DELETED> ``(2) Methods.--A recipient of funds under
subsection (a) may use various methods in carrying out the
projects described in paragraph (1), including--</DELETED>
<DELETED> ``(A) the distribution of stipends to
students of eligible applicants;</DELETED>
<DELETED> ``(B) the establishment of a post-doctoral
fellowship program;</DELETED>
<DELETED> ``(C) the training of faculty in the
economic and logistical problems confronting rural
health care delivery systems; or</DELETED>
<DELETED> ``(D) the purchase or rental of
transportation and telecommunication equipment where
the need for such equipment due to unique
characteristics of the rural area is demonstrated by
the recipient.</DELETED>
<DELETED> ``(3) Administration.--</DELETED>
<DELETED> ``(A) In general.--An applicant shall not
use more than 10 percent of the funds made available to
such applicant under subsection (a) for administrative
expenses.</DELETED>
<DELETED> ``(B) Training.--Not more than 10 percent
of the individuals receiving training with funds made
available to an applicant under subsection (a) shall be
trained as doctors of medicine or doctors of
osteopathy.</DELETED>
<DELETED> ``(C) Limitation.--An institution that
receives a grant under this section shall use amounts
received under such grant to supplement, not supplant,
amounts made available by such institution for
activities of the type described in subsection (b)(1)
in the fiscal year preceding the year for which the
grant is received.</DELETED>
<DELETED> ``(c) Applications.--Applications submitted for assistance
under this section shall--</DELETED>
<DELETED> ``(1) be jointly submitted by at least two
eligible applicants with the express purpose of assisting
individuals in academic institutions in establishing long-term
collaborative relationships with health care providers in rural
areas; and</DELETED>
<DELETED> ``(2) designate a rural health care agency or
agencies for clinical treatment or training, including
hospitals, community health centers, migrant health centers,
rural health clinics, community behavioral and mental health
centers, long-term care facilities, Native Hawaiian health
centers, or facilities operated by the Indian Health Service or
an Indian tribe or tribal organization or Indian organization
under a contract with the Indian Health Service under the
Indian Self-Determination Act.</DELETED>
<DELETED> ``(d) Definitions.--For the purposes of this section, the
term `rural' means geographic areas that are located outside of
standard metropolitan statistical areas.</DELETED>
<DELETED>``SEC. 755. ALLIED HEALTH AND OTHER DISCIPLINES.</DELETED>
<DELETED> ``(a) In General.--The Secretary may make grants or
contracts under this section to help entities fund activities of the
type described in subsection (b).</DELETED>
<DELETED> ``(b) Activities.--Activities of the type described in
this subsection include the following:</DELETED>
<DELETED> ``(1) Assisting entities in meeting the costs
associated with expanding or establishing programs that will
increase the number of individuals trained in allied health
professions. Programs and activities funded under this
paragraph may include--</DELETED>
<DELETED> ``(A) those that expand enrollments in
allied health professions with the greatest shortages
or whose services are most needed by the
elderly;</DELETED>
<DELETED> ``(B) those that provide rapid transition
training programs in allied health fields to
individuals who have baccalaureate degrees in health-
related sciences;</DELETED>
<DELETED> ``(C) those that establish community-based
allied health training programs that link academic
centers to rural clinical settings;</DELETED>
<DELETED> ``(D) those that provide career
advancement training for practicing allied health
professionals;</DELETED>
<DELETED> ``(E) those that expand or establish
clinical training sites for allied health professionals
in medically underserved or rural communities in order
to increase the number of individuals
trained;</DELETED>
<DELETED> ``(F) those that develop curriculum that
will emphasize knowledge and practice in the areas of
prevention and health promotion, geriatrics, long-term
care, home health and hospice care, and
ethics;</DELETED>
<DELETED> ``(G) those that expand or establish
interdisciplinary training programs that promote the
effectiveness of allied health practitioners in
geriatric assessment and the rehabilitation of the
elderly;</DELETED>
<DELETED> ``(H) those that expand or establish
demonstration centers to emphasize innovative models to
link allied health clinical practice, education, and
research;</DELETED>
<DELETED> ``(I) those that provide financial
assistance (in the form of traineeships) to students
who are participants in any such program; and</DELETED>
<DELETED> ``(i) who plan to pursue a career
in an allied health field that has a
demonstrated personnel shortage; and</DELETED>
<DELETED> ``(ii) who agree upon completion
of the training program to practice in a
medically underserved community;</DELETED>
<DELETED>that shall be utilized to assist in the
payment of all or part of the costs associated with
tuition, fees and such other stipends as the Secretary
may consider necessary; and</DELETED>
<DELETED> ``(J) those to meet the costs of projects
to plan, develop, and operate or maintain graduate
programs in behavioral and mental health
practice.</DELETED>
<DELETED> ``(2) Planning and implementing projects in
preventive and primary care training for podiatric physicians
in approved or provisionally approved residency programs that
shall provide financial assistance in the form of traineeships
to residents who participate in such projects and who plan to
specialize in primary care.</DELETED>
<DELETED> ``(3) Carrying out demonstration projects in which
chiropractors and physicians collaborate to identify and
provide effective treatment for spinal and lower-back
conditions.</DELETED>
<DELETED>``SEC. 756. ADVISORY COMMITTEE ON INTERDISCIPLINARY,
COMMUNITY-BASED LINKAGES.</DELETED>
<DELETED> ``(a) Establishment.--The Secretary shall establish an
advisory committee to be known as the Advisory Committee on
Interdisciplinary, Community-Based Linkages (in this section referred
to as the `Advisory Committee').</DELETED>
<DELETED> ``(b) Composition.--</DELETED>
<DELETED> ``(1) In general.--The Secretary shall determine
the appropriate number of individuals to serve on the Advisory
Committee. Such individuals shall not be officers or employees
of the Federal Government.</DELETED>
<DELETED> ``(2) Appointment.--Not later than 90 days after
the date of enactment of this Act, the Secretary shall appoint
the members of the Advisory Committee from among individuals
who are health professionals from schools of the types
described in sections 751(a)(1)(A), 751(a)(1)(B), 753(b),
754(3)(A), and 755(b). In making such appointments, the
Secretary shall ensure a fair balance between the health
professions, that at least 75 percent of the members of the
Advisory Committee are health professionals, a broad geographic
representation of members and a balance between urban and rural
members. Members shall be appointed based on their competence,
interest, and knowledge of the mission of the profession
involved.</DELETED>
<DELETED> ``(3) Minority representation.--In appointing the
members of the Advisory Committee under paragraph (2), the
Secretary shall ensure the adequate representation of women and
minorities.</DELETED>
<DELETED> ``(c) Terms.--</DELETED>
<DELETED> ``(1) In general.--A member of the Advisory
Committee shall be appointed for a term of 3 years, except that
of the members first appointed--</DELETED>
<DELETED> ``(A) </DELETED>\<DELETED>1/3</DELETED>\
<DELETED>of the members shall serve for a term of 1
year;</DELETED>
<DELETED> ``(B) </DELETED>\<DELETED>1/3</DELETED>\
<DELETED>of the members shall serve for a term of 2
years; and</DELETED>
<DELETED> ``(C) </DELETED>\<DELETED>1/3</DELETED>\
<DELETED>of the members shall serve for a term of 3
years.</DELETED>
<DELETED> ``(2) Vacancies.--</DELETED>
<DELETED> ``(A) In general.--A vacancy on the
Advisory Committee shall be filled in the manner in
which the original appointment was made and shall be
subject to any conditions which applied with respect to
the original appointment.</DELETED>
<DELETED> ``(B) Filling unexpired term.--An
individual chosen to fill a vacancy shall be appointed
for the unexpired term of the member
replaced.</DELETED>
<DELETED> ``(d) Duties.--The Advisory Committee shall--</DELETED>
<DELETED> ``(1) provide advice and recommendations to the
Secretary concerning policy and program development and other
matters of significance concerning the activities under this
part; and</DELETED>
<DELETED> ``(2) not later than 3 years after the date of
enactment of this section, and annually thereafter, prepare and
submit to the Secretary, and the Committee on Labor and Human
Resources of the Senate, and the Committee on Commerce of the
House of Representatives, a report describing the activities of
the Committee, including findings and recommendations made by
the Committee concerning the activities under this
part.</DELETED>
<DELETED> ``(e) Meetings and Documents.--</DELETED>
<DELETED> ``(1) Meetings.--The Advisory Committee shall meet
not less than 3 times each year. Such meetings shall be held
jointly with other related entities established under this
title where appropriate.</DELETED>
<DELETED> ``(2) Documents.--Not later than 14 days prior to
the convening of a meeting under paragraph (1), the Advisory
Committee shall prepare and make available an agenda of the
matters to be considered by the Advisory Committee at such
meeting. At any such meeting, the Advisory Council shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Committee shall prepare and make
available a summary of the meeting and any actions taken by the
Committee based upon the meeting.</DELETED>
<DELETED> ``(f) Compensation and Expenses.--</DELETED>
<DELETED> ``(1) Compensation.--Each member of the Advisory
Committee shall be compensated at a rate equal to the daily
equivalent of the annual rate of basic pay prescribed for level
IV of the Executive Schedule under section 5315 of title 5,
United States Code, for each day (including travel time) during
which such member is engaged in the performance of the duties
of the Committee.</DELETED>
<DELETED> ``(2) Expenses.--The members of the Advisory
Committee shall be allowed travel expenses, including per diem
in lieu of subsistence, at rates authorized for employees of
agencies under subchapter I of chapter 57 of title 5, United
States Code, while away from their homes or regular places of
business in the performance of services for the
Committee.</DELETED>
<DELETED> ``(g) FACA.--The Federal Advisory Committee Act shall
apply to the Advisory Committee under this section only to the extent
that the provisions of such Act do not conflict with the requirements
of this section.</DELETED>
<DELETED>``SEC. 757. AUTHORIZATION OF APPROPRIATIONS.</DELETED>
<DELETED> ``(a) In General.--There are authorized to be appropriated
to carry out this part, $55,600,000 for fiscal year 1998, and such sums
as may be necessary for each of the fiscal years 1999 through
2002.</DELETED>
<DELETED> ``(b) Allocation.--</DELETED>
<DELETED> ``(1) In general.--Of the amounts appropriated
under subsection (a) for a fiscal year, the Secretary shall
make available--</DELETED>
<DELETED> ``(A) not less than $28,587,000 for awards
of grants and contracts under section 751;</DELETED>
<DELETED> ``(B) not less than $3,765,000 for awards
of grants and contracts under section 752, of which not
less than 50 percent of such amount shall be made
available for centers described in subsection (a)(1) of
such section; and</DELETED>
<DELETED> ``(C) not less than $22,631,000 for awards
of grants and contracts under sections 753, 754, and
755.</DELETED>
<DELETED> ``(2) Ratable reduction.--If amounts appropriated
under subsection (a) for any fiscal year are less than the
amount required to comply with paragraph (1), the Secretary shall
ratably reduce the amount to be made available under each of
subparagraphs (A) through (C) of such paragraph accordingly.</DELETED>
<DELETED> ``(c) Obligation of Certain Amounts.--</DELETED>
<DELETED> ``(1) Area health education center programs.--Of
the amounts made available under subsection (b)(1)(A) for each
fiscal year, the Secretary may obligate for awards under
section 751(a)(2)--</DELETED>
<DELETED> ``(A) not less than 23 percent of such
amounts in fiscal year 1998;</DELETED>
<DELETED> ``(B) not less than 30 percent of such
amounts in fiscal year 1999;</DELETED>
<DELETED> ``(C) not less than 35 percent of such
amounts in fiscal year 2000;</DELETED>
<DELETED> ``(D) not less than 40 percent of such
amounts in fiscal year 2001; and</DELETED>
<DELETED> ``(E) not less than 45 percent of such
amounts in fiscal year 2002.</DELETED>
<DELETED> ``(2) Sense of congress.--It is the sense of the
Congress that--</DELETED>
<DELETED> ``(A) every State have an area health
education center program in effect under this section;
and</DELETED>
<DELETED> ``(B) the ratio of Federal funding for the
model program under section 751(a)(2) should increase
over time and that Federal funding for other awards
under this section shall decrease so that the national
program will become entirely comprised of programs that
are funded at least 50 percent by State and local
partners.''.</DELETED>
<DELETED>SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMATION AND
ANALYSIS.</DELETED>
<DELETED> (a) In General.--Part E of title VII of the Public Health
Service Act (42 U.S.C. 294n et seq.) is amended to read as
follows:</DELETED>
<DELETED>``PART E--HEALTH PROFESSIONS AND PUBLIC HEALTH
WORKFORCE</DELETED>
<DELETED>``Subpart 1--Health Professions Workforce Information and
Analysis</DELETED>
<DELETED>``SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMATION AND
ANALYSIS.</DELETED>
<DELETED> ``(a) Purpose.--It is the purpose of this section to--
</DELETED>
<DELETED> ``(1) provide for the development of information
describing the health professions workforce and the analysis of
workforce related issues; and</DELETED>
<DELETED> ``(2) provide necessary information for decision-
making regarding future directions in health professions and
nursing programs in response to societal and professional
needs.</DELETED>
<DELETED> ``(b) Grants or Contracts.--The Secretary may award grants
or contracts to State or local governments, health professions schools,
schools of nursing, academic health centers, community-based health
facilities, and other appropriate public or private nonprofit entities
to provide for--</DELETED>
<DELETED> ``(1) targeted information collection and analysis
activities related to the purposes described in subsection
(a);</DELETED>
<DELETED> ``(2) research on high priority workforce
questions;</DELETED>
<DELETED> ``(3) the development of a non-Federal analytic
and research infrastructure related to the purposes described
in subsection (a); and</DELETED>
<DELETED> ``(4) the conduct of program evaluation and
assessment.</DELETED>
<DELETED> ``(c) Authorization of Appropriations.--</DELETED>
<DELETED> ``(1) In general.--There are authorized to be
appropriated to carry out this section, $750,000 for fiscal
year 1998, and such sums as may be necessary for each of the
fiscal years 1999 through 2002.</DELETED>
<DELETED> ``(2) Reservation.--Of the amounts appropriated
under subsection (a) for a fiscal year, the Secretary shall
reserve not less than $600,000 for conducting health
professions research and for carrying out data collection and
analysis in accordance with section 792.</DELETED>
<DELETED> ``(3) Availability of additional funds.--Amounts
otherwise appropriated for programs or activities under this
title may be used for activities under subsection (b) with
respect to the programs or activities from which such amounts
were made available.''.</DELETED>
<DELETED> (b) Council on Graduate Medical Education.--Section 301 of
the Health Professions Education Extension Amendments of 1992 (Public
Law 102-408) is amended--</DELETED>
<DELETED> (1) in subsection (j), by striking ``1995'' and
inserting ``2002'';</DELETED>
<DELETED> (2) in subsection (k), by striking ``1995'' and
inserting ``2002'';</DELETED>
<DELETED> (3) by adding at the end thereof the following new
subsection:</DELETED>
<DELETED> ``(l) Funding.--Amounts otherwise appropriated under this
title may be utilized by the Secretary to support the activities of the
Council.'';</DELETED>
<DELETED> (4) by transferring such section to part E of
title VII of the Public Health Service Act (as amended by
subsection (a));</DELETED>
<DELETED> (5) by redesignating such section as section 763;
and</DELETED>
<DELETED> (6) by inserting such section after section
762.</DELETED>
<DELETED>SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.</DELETED>
<DELETED> Part E of title VII of the Public Health Service Act (as
amended by section 104) is further amended by adding at the end the
following:</DELETED>
<DELETED>``Subpart 2--Public Health Workforce</DELETED>
<DELETED>``SEC. 765. GENERAL PROVISIONS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may award grants or
contracts to eligible entities to increase the number of individuals in
the public health workforce, to enhance the quality of such workforce,
and to enhance the ability of the workforce to meet national, State,
and local health care needs.</DELETED>
<DELETED> ``(b) Eligibility.--To be eligible to receive a grant or
contract under subsection (a) an entity shall--</DELETED>
<DELETED> ``(1) be--</DELETED>
<DELETED> ``(A) a health professions school,
including an accredited school or program of public
health, health administration, preventive medicine, or
dental public health or a school providing health
management programs;</DELETED>
<DELETED> ``(B) an academic health center;</DELETED>
<DELETED> ``(C) a State or local government;
or</DELETED>
<DELETED> ``(D) any other appropriate public or
private nonprofit entity; and</DELETED>
<DELETED> ``(2) prepare and submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require.</DELETED>
<DELETED> ``(c) Preference.--In awarding grants or contracts under
this section the Secretary may grant a preference to entities--
</DELETED>
<DELETED> ``(1) serving individuals who are from
disadvantaged backgrounds (including underrepresented racial
and ethnic minorities); and</DELETED>
<DELETED> ``(2) graduating large proportions of individuals
who serve in underserved communities.</DELETED>
<DELETED> ``(d) Activities.--Amounts provided under a grant or
contract awarded under this section may be used for--</DELETED>
<DELETED> ``(1) the costs of planning, developing, or
operating demonstration training programs;</DELETED>
<DELETED> ``(2) faculty development;</DELETED>
<DELETED> ``(3) trainee support;</DELETED>
<DELETED> ``(4) technical assistance;</DELETED>
<DELETED> ``(5) to meet the costs of projects--</DELETED>
<DELETED> ``(A) to plan and develop new residency
training programs and to maintain or improve existing
residency training programs in preventive medicine and
dental public health, that have available full-time
faculty members with training and experience in the
fields of preventive medicine and dental public health;
and</DELETED>
<DELETED> ``(B) to provide financial assistance to
residency trainees enrolled in such programs;</DELETED>
<DELETED> ``(6) the retraining of existing public health
workers as well as for increasing the supply of new
practitioners to address priority public health, preventive
medicine, public health dentistry, and health administration
needs;</DELETED>
<DELETED> ``(7) preparing public health professionals for
employment at the State and community levels; or</DELETED>
<DELETED> ``(8) other activities that may produce outcomes
that are consistent with the purposes of this section</DELETED>
<DELETED> ``(e) Traineeships.--</DELETED>
<DELETED> ``(1) In general.--With respect to amounts used
under this section for the training of health professionals,
such training programs shall be designed to--</DELETED>
<DELETED> ``(A) make public health education more
accessible to the public and private health
workforce;</DELETED>
<DELETED> ``(B) increase the relevance of public
health academic preparation to public health practice
in the future;</DELETED>
<DELETED> ``(C) provide education or training for
students from traditional on-campus programs in
practice-based sites; or</DELETED>
<DELETED> ``(D) develop educational methods and
distance-based approaches or technology that address
adult learning requirements and increase knowledge and
skills related to community-based cultural diversity in
public health education.</DELETED>
<DELETED> ``(2) Severe shortage disciplines.--Amounts
provided under grants or contracts under this section may be
used for the operation of programs designed to award
traineeships to students in accredited schools of public health
who enter educational programs in fields where there is a
severe shortage of public health professionals, including
epidemiology, biostatistics, environmental health, toxicology,
public health nursing, nutrition, preventive medicine, maternal
and child health, and behavioral and mental health
professions.</DELETED>
<DELETED>``SEC. 766. PUBLIC HEALTH TRAINING CENTERS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may make grants or
contracts for the operation of public health training
centers.</DELETED>
<DELETED> ``(b) Eligible Entities.--</DELETED>
<DELETED> ``(1) In general.--A public health training center
shall be an accredited school of public health, or another
public or nonprofit private institution accredited for the
provision of graduate or specialized training in public health,
that plans, develops, operates, and evaluates projects that are
in furtherance of the goals established by the Secretary for
the year 2000 in the areas of preventive medicine, health
promotion and disease prevention, or improving access to and
quality of health services in medically underserved
communities.</DELETED>
<DELETED> ``(2) Preference.--In awarding grants or contracts
under this section the Secretary shall give preference to
accredited schools of public health.</DELETED>
<DELETED> ``(c) Certain Requirements.--With respect to a public
health training center, an award may not be made under subsection (a)
unless the program agrees that it--</DELETED>
<DELETED> ``(1) will establish or strengthen field
placements for students in public or nonprofit private health
agencies or organizations;</DELETED>
<DELETED> ``(2) will involve faculty members and students in
collaborative projects to enhance public health services to
medically underserved communities;</DELETED>
<DELETED> ``(3) will specifically designate a geographic
area or medically underserved population to be served by the
center that shall be in a location removed from the main
location of the teaching facility of the school that is
participating in the program with such center; and</DELETED>
<DELETED> ``(4) will assess the health personnel needs of
the area to be served by the center and assist in the planning
and development of training programs to meet such
needs.</DELETED>
<DELETED>``SEC. 767. PUBLIC HEALTH TRAINEESHIPS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may make grants to
accredited schools of public health, and to other public or nonprofit
private institutions accredited for the provision of graduate or
specialized training in public health, for the purpose of assisting
such schools and institutions in providing traineeships to individuals
described in subsection (b)(3).</DELETED>
<DELETED> ``(b) Certain Requirements.--</DELETED>
<DELETED> ``(1) Amount.--The amount of any grant under this
section shall be determined by the Secretary.</DELETED>
<DELETED> ``(2) Use of grant.--Traineeships awarded under
grants made under subsection (a) shall provide for tuition and
fees and such stipends and allowances (including travel and
subsistence expenses and dependency allowances) for the
trainees as the Secretary may deem necessary.</DELETED>
<DELETED> ``(3) Eligible individuals.--The individuals
referred to in subsection (a) are individuals who are pursuing
a course of study in a health professions field in which there
is a severe shortage of health professionals (which fields
include the fields of epidemiology, environmental health,
biostatistics, toxicology, nutrition, and maternal and child
health).</DELETED>
<DELETED>``SEC. 768. PREVENTIVE MEDICINE; DENTAL PUBLIC
HEALTH.</DELETED>
<DELETED> ``(a) In General.--The Secretary may make grants to and
enter into contracts with schools of medicine, osteopathic medicine,
public health, and dentistry to meet the costs of projects--</DELETED>
<DELETED> ``(1) to plan and develop new residency training
programs and to maintain or improve existing residency training
programs in preventive medicine and dental public health;
and</DELETED>
<DELETED> ``(2) to provide financial assistance to residency
trainees enrolled in such programs.</DELETED>
<DELETED> ``(b) Administration.--</DELETED>
<DELETED> ``(1) Amount.--The amount of any grant under
subsection (a) shall be determined by the Secretary.</DELETED>
<DELETED> ``(2) Eligibility.--To be eligible for a grant
under subsection (a), the applicant must demonstrate to the
Secretary that it has or will have available full-time faculty
members with training and experience in the fields of
preventive medicine or dental public health and support from
other faculty members trained in public health and other
relevant specialties and disciplines.</DELETED>
<DELETED> ``(3) Other funds.--Schools of medicine,
osteopathic medicine, dentistry, and public health may use
funds committed by State, local, or county public health
officers as matching amounts for Federal grant funds for
residency training programs in preventive medicine.</DELETED>
<DELETED>``SEC. 769. HEALTH ADMINISTRATION TRAINEESHIPS AND SPECIAL
PROJECTS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may make grants to State
or local governments (that have in effect preventive medical and dental
public health residency programs) or public or nonprofit private
educational entities (including graduate schools of social work and
business schools that have health management programs) that offer a
program described in subsection (b)--</DELETED>
<DELETED> ``(1) to provide traineeships for students
enrolled in such a program; and</DELETED>
<DELETED> ``(2) to assist accredited programs health
administration in the development or improvement of programs to
prepare students for employment with public or nonprofit
private entities.</DELETED>
<DELETED> ``(b) Relevant Programs.--The program referred to in
subsection (a) is an accredited program in health administration,
hospital administration, or health policy analysis and planning, which
program is accredited by a body or bodies approved for such purpose by
the Secretary of Education and which meets such other quality standards
as the Secretary of Health and Human Services by regulation may
prescribe.</DELETED>
<DELETED> ``(c) Preference in Making Grants.--In making grants under
subsection (a), the Secretary shall give preference to qualified
applicants that meet the following conditions:</DELETED>
<DELETED> ``(1) Not less than 25 percent of the graduates of
the applicant are engaged in full-time practice settings in
medically underserved communities.</DELETED>
<DELETED> ``(2) The applicant recruits and admits students
from medically underserved communities.</DELETED>
<DELETED> ``(3) For the purpose of training students, the
applicant has established relationships with public and
nonprofit providers of health care in the community
involved.</DELETED>
<DELETED> ``(4) In training students, the applicant
emphasizes employment with public or nonprofit private
entities.</DELETED>
<DELETED> ``(d) Certain Provisions Regarding Traineeships.--
</DELETED>
<DELETED> ``(1) Use of grant.--Traineeships awarded under
grants made under subsection (a) shall provide for tuition and
fees and such stipends and allowances (including travel and
subsistence expenses and dependency allowances) for the
trainees as the Secretary may deem necessary.</DELETED>
<DELETED> ``(2) Preference for certain students.--Each
entity applying for a grant under subsection (a) for
traineeships shall assure to the satisfaction of the Secretary
that the entity will give priority to awarding the traineeships
to students who demonstrate a commitment to employment with
public or nonprofit private entities in the fields with respect
to which the traineeships are awarded.</DELETED>
<DELETED>``SEC. 770. AUTHORIZATION OF APPROPRIATIONS.</DELETED>
<DELETED> ``(a) In General.--For the purpose of carrying out this
subpart, there is authorized to be appropriated $9,100,000 for fiscal
year 1998, and such sums as may be necessary for each of the fiscal
years 1999 through 2002.</DELETED>
<DELETED> ``(b) Limitation Regarding Certain Program.--In obligating
amounts appropriated under subsection (a), the Secretary may not
obligate more than 30 percent for carrying out section
767.''.</DELETED>
<DELETED>SEC. 106. GENERAL PROVISIONS.</DELETED>
<DELETED> (a) In General.--</DELETED>
<DELETED> (1) Part F of title VII of the Public Health
Service Act (42 U.S.C. 295 et seq.) is repealed.</DELETED>
<DELETED> (2) Part G of title VII of the Public Health
Service Act (42 U.S.C. 295j et seq.) is amended--</DELETED>
<DELETED> (A) by redesignating such part as part
F;</DELETED>
<DELETED> (B) in section 791 (42 U.S.C. 295j)--
</DELETED>
<DELETED> (i) by striking subsection (b);
and</DELETED>
<DELETED> (ii) redesignating subsection (c)
as subsection (b);</DELETED>
<DELETED> (C) by repealing section 793 (42 U.S.C.
295l);</DELETED>
<DELETED> (D) by repealing section 798;</DELETED>
<DELETED> (E) by redesignating section 799 as
section 799B; and</DELETED>
<DELETED> (F) by inserting after section 794, the
following new sections:</DELETED>
<DELETED>``SEC. 796. APPLICATION.</DELETED>
<DELETED> ``(a) In General.--To be eligible to receive a grant or
contract under this title, an eligible entity shall prepare and submit
to the Secretary an application that meets the requirements of this
section, at such time, in such manner, and containing such information
as the Secretary may require.</DELETED>
<DELETED> ``(b) Plan.--An application submitted under this section
shall contain the plan of the applicant for carrying out a project with
amounts received under this title. Such plan shall be consistent with
relevant Federal, State, or regional health professions program
plans.</DELETED>
<DELETED> ``(c) Performance Outcome Standards.--An application
submitted under this section shall contain a specification by the
applicant entity of performance outcome standards that the project to
be funded under the grant or contract will be measured against. Such
standards shall address relevant health workforce needs that the
project will meet. The recipient of a grant or contract under this
section shall meet the standards set forth in the grant or contract
application.</DELETED>
<DELETED> ``(d) Linkages.--An application submitted under this
section shall contain a description of the linkages with relevant
educational and health care entities, including training programs for
other health professionals as appropriate, that the project to be
funded under the grant or contract will establish. To the extent
practicable, grantees under this section shall establish linkages with
health care providers who provide care for underserved communities and
populations.</DELETED>
<DELETED>``SEC. 797. USE OF FUNDS.</DELETED>
<DELETED> ``(a) In General.--Amounts provided under a grant or
contract awarded under this title may be used for training program
development and support, faculty development, model demonstrations,
trainee support including tuition, books, program fees and reasonable
living expenses during the period of training, technical assistance,
workforce analysis, dissemination of information, and exploring new
policy directions, as appropriate to meet recognized health workforce
objectives, in accordance with this title.</DELETED>
<DELETED> ``(b) Maintenance of Effort.--With respect to activities
for which a grant awarded under this title is to be expended, the
entity shall agree to maintain expenditures of non-Federal amounts for
such activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant.</DELETED>
<DELETED>``SEC. 798. MATCHING REQUIREMENT.</DELETED>
<DELETED> ``The Secretary may require that an entity that applies
for a grant or contract under this title provide non-Federal matching
funds, as appropriate, to ensure the institutional commitment of the
entity to the projects funded under the grant. As determined by the
Secretary, such non-Federal matching funds may be provided directly or
through donations from public or private entities and may be in cash or
in-kind, fairly evaluated, including plant, equipment, or
services.</DELETED>
<DELETED>``SEC. 799. GENERALLY APPLICABLE PROVISIONS.</DELETED>
<DELETED> ``(a) Awarding of Grants and Contracts.--The Secretary
shall ensure that grants and contracts under this title are awarded on
a competitive basis, as appropriate, to carry out innovative
demonstration projects or provide for strategic workforce
supplementation activities as needed to meet health workforce goals and
in accordance with this title. Contracts may be entered into under this
title with public or private entities as may be necessary.</DELETED>
<DELETED> ``(b) Eligible Entities.--Unless specifically required
otherwise in this title, the Secretary shall accept applications for
grants or contracts under this title from health professions schools,
academic health centers, State or local governments, or other
appropriate public or private nonprofit entities for funding and
participation in health professions and nursing training activities.
The Secretary may accept applications from for-profit private entities
if determined appropriate by the Secretary.</DELETED>
<DELETED> ``(c) Information Requirements.--</DELETED>
<DELETED> ``(1) In general.--Recipients of grants and
contracts under this title shall meet information requirements
as specified by the Secretary.</DELETED>
<DELETED> ``(2) Data collection.--The Secretary shall
establish procedures to ensure that, with respect to any data
collection required under this title, such data is collected in
a manner that takes into account age, gender, race, and
ethnicity.</DELETED>
<DELETED> ``(3) Use of funds.--The Secretary shall establish
procedures to permit the use of amounts appropriated under this
title to be used for data collection purposes.</DELETED>
<DELETED> ``(4) Evaluations.--The Secretary shall establish
procedures to ensure the annual evaluation of programs and
projects operated by recipients of grants or contracts under
this title. Such procedures shall ensure that continued funding
for such programs and projects will be conditioned upon a
demonstration that satisfactory progress has been made by the
program or project in meeting the objectives of the program or
project.</DELETED>
<DELETED> ``(d) Training Programs.--Training programs conducted with
amounts received under this title shall meet applicable accreditation
and quality standards.</DELETED>
<DELETED> ``(e) Duration of Assistance.--</DELETED>
<DELETED> ``(1) In general.--Subject to paragraph (2), in
the case of an award to an entity of a grant, cooperative
agreement, or contract under this title, the period during
which payments are made to the entity under the award may not
exceed 5 years. The provision of payments under the award shall
be subject to annual approval by the Secretary of the payments
and subject to the availability of appropriations for the
fiscal year involved to make the payments. This paragraph may
not be construed as limiting the number of awards under the
program involved that may be made to the entity.</DELETED>
<DELETED> ``(2) Limitation.--In the case of an award to an
entity of a grant, cooperative agreement, or contract under
this title, paragraph (1) shall apply only to the extent not
inconsistent with any other provision of this title that
relates to the period during which payments may be made under
the award.</DELETED>
<DELETED> ``(f) Peer Review Regarding Certain Programs.--</DELETED>
<DELETED> ``(1) In general.--Each application for a grant
under this title, except any scholarship or loan program,
including those under sections 701, 721, or 723, shall be
submitted to a peer review group for an evaluation of the
merits of the proposals made in the application. The Secretary
may not approve such an application unless a peer review group
has recommended the application for approval.</DELETED>
<DELETED> ``(2) Composition.--Each peer review group under
this subsection shall be composed principally of individuals
who are not officers or employees of the Federal Government. In
providing for the establishment of peer review groups and
procedures, the Secretary shall ensure gender, racial, ethnic,
and geographic balance among the membership of such
groups.</DELETED>
<DELETED> ``(3) Administration.--This subsection shall be
carried out by the Secretary acting through the Administrator
of the Health Resources and Services Administration.</DELETED>
<DELETED> ``(g) Preference or Priority Considerations.--In
considering a preference or priority for funding which is based on
outcome measures for an eligible entity under this title, the Secretary
may also consider the future ability of the eligible entity to meet the
outcome preference or priority through improvements in the eligible
entity's program design.</DELETED>
<DELETED> ``(h) Analytic Activities.--The Secretary shall ensure
that--</DELETED>
<DELETED> ``(1) cross-cutting workforce analytical
activities are carried out as part of the workforce information
and analysis activities under section 761; and</DELETED>
<DELETED> ``(2) discipline-specific workforce information
and analytical activities are carried out as part of--
</DELETED>
<DELETED> ``(A) the community-based linkage program
under part D; and</DELETED>
<DELETED> ``(B) the health workforce development
program under subpart 2 of part E.</DELETED>
<DELETED> ``(i) Osteopathic Schools.--For purposes of this title,
any reference to--</DELETED>
<DELETED> ``(1) medical schools shall include osteopathic
medical schools; and</DELETED>
<DELETED> ``(2) medical students shall include osteopathic
medical students.</DELETED>
<DELETED>``SEC. 799A. TECHNICAL ASSISTANCE.</DELETED>
<DELETED> ``Funds appropriated under this title may be used by the
Secretary to provide technical assistance in relation to any of the
authorities under this title.''.</DELETED>
<DELETED> (b) Profession Counselors as Mental Health
Professionals.--Section 792(a) of the Public Health Service Act (42
U.S.C. 295k(a)) is amended by inserting ``professional counselors,''
after ``clinical psychologists,''.</DELETED>
<DELETED>SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.</DELETED>
<DELETED> (a) In General.--Section 791 of the Public Health Service
Act (42 U.S.C. 295j), as amended by section 105(a)(2)(B), is further
amended by adding at the end thereof the following
subsection:</DELETED>
<DELETED> ``(c) Exceptions for New Programs.--</DELETED>
<DELETED> ``(1) In general.--To permit new programs to
compete equitably for funding under this section, those new
programs that meet at least 4 of the criteria described in
paragraph (3) shall qualify for a funding preference under this
section.</DELETED>
<DELETED> ``(2) Definition.--As used in this subsection, the
term `new program' means any program that has graduated less
than three classes. Upon graduating at least three classes, a
program shall have the capability to provide the information
necessary to qualify the program for the general funding
preferences described in subsection (a).</DELETED>
<DELETED> ``(3) Criteria.--The criteria referred to in
paragraph (1) are the following:</DELETED>
<DELETED> ``(A) The mission statement of the program
identifies a specific purpose of the program as being
the preparation of health professionals to serve
underserved populations.</DELETED>
<DELETED> ``(B) The curriculum of the program
includes content which will help to prepare
practitioners to serve underserved
populations.</DELETED>
<DELETED> ``(C) Substantial clinical training
experience is required under the program in medically
underserved communities.</DELETED>
<DELETED> ``(D) A minimum of 20 percent of the
clinical faculty of the program spend at least 50
percent of their time providing or supervising care in
medically underserved communities.</DELETED>
<DELETED> ``(E) The entire program or a substantial
portion of the program is physically located in a
medically underserved community.</DELETED>
<DELETED> ``(F) Student assistance, which is linked
to service in medically underserved communities
following graduation, is available to the students in
the program.</DELETED>
<DELETED> ``(G) The program provides a placement
mechanism for deploying graduates to medically
underserved communities.''.</DELETED>
<DELETED> (b) Conforming Amendments.--Section 791(a) of the Public
Health Service Act (42 U.S.C. 295j(a)) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``sections 747''
and all that follows through ``767'' and inserting ``sections
747 and 750''; and</DELETED>
<DELETED> (2) in paragraph (2), by striking ``under section
798(a)''.</DELETED>
<DELETED>SEC. 108. DEFINITIONS.</DELETED>
<DELETED> (a) Graduate Program in Behavioral and Mental Health
Practice.--Section 799B(1)(D) of the Public Health Service Act (42
U.S.C. 295p(1)(D)) (as so redesignated by section 106(a)(2)(E)) is
amended--</DELETED>
<DELETED> (1) by inserting ``behavioral health and'' before
``mental''; and</DELETED>
<DELETED> (2) by inserting ``behavioral health and mental
health practice,'' before ``clinical''.</DELETED>
<DELETED> (b) Professional Counseling as a Behavioral and Mental
Health Practice.--Section 799B of the Public Health Service Act (42
U.S.C. 295p) (as so redesignated by section 106(a)(2)(E)) is amended--
</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) in subparagraph (C)--</DELETED>
<DELETED> (i) by inserting ``and `graduate
program in professional counseling''' after
``graduate program in marriage and family
therapy'''; and</DELETED>
<DELETED> (ii) by inserting before the
period the following: ``and a concentration
leading to a graduate degree in
counseling'';</DELETED>
<DELETED> (B) in subparagraph (D), by inserting
``professional counseling,'' after ``social work,'';
and</DELETED>
<DELETED> (C) in subparagraph (E), by inserting
``professional counseling,'' after ``social work,'';
and</DELETED>
<DELETED> (2) in paragraph (5)(C), by inserting before the
period the following: ``or a degree in counseling or an
equivalent degree''.</DELETED>
<DELETED> (c) Medically Underserved Community.--Section 799B(6) of
the Public Health Service Act (42 U.S.C. 295p(6)) (as so redesignated
by section 105(a)(2)(E)) is amended--</DELETED>
<DELETED> (1) in subparagraph (B), by striking ``or'' at the
end thereof;</DELETED>
<DELETED> (2) in subparagraph (C), by striking the period
and inserting ``; or''; and</DELETED>
<DELETED> (3) by adding at the end the following:</DELETED>
<DELETED> ``(D) is designated by a State Governor
(in consultation with the medical community) as a
shortage area or medically underserved
community.''.</DELETED>
<DELETED> (d) Programs for the Training of Physician Assistants.--
Paragraph (3) of section 799B of the Public Health Service Act (42
U.S.C. 295p) (as so redesignated by section 105(a)(2)(E)) is amended to
read as follows:</DELETED>
<DELETED> ``(3) The term `program for the training of
physician assistants' means an educational program that--
</DELETED>
<DELETED> ``(A) has as its objective the education
of individuals who will, upon completion of their
studies in the program, be qualified to provide primary
care under the supervision of a physician;</DELETED>
<DELETED> ``(B) extends for at least one academic
year and consists of--</DELETED>
<DELETED> ``(i) supervised clinical
practice; and</DELETED>
<DELETED> ``(ii) at least four months (in
the aggregate) of classroom instruction,
directed toward preparing students to deliver
health care;</DELETED>
<DELETED> ``(C) has an enrollment of not less than
eight students; and</DELETED>
<DELETED> ``(D) trains students in primary care,
disease prevention, health promotion, geriatric
medicine, and home health care.''.</DELETED>
<DELETED>SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH SERVICE
CORPS.</DELETED>
<DELETED> Section 338B(b)(1)(B) of the Public Health Service Act (42
U.S.C. 254l-1(b)(1)(B)) is amended by striking ``or other health
profession'' and inserting ``behavioral and mental health, or other
health profession''.</DELETED>
<DELETED>SEC. 110. SAVINGS PROVISION.</DELETED>
<DELETED> In the case of any authority for making awards of grants
or contracts that is terminated by the amendments made by this
subtitle, the Secretary of Health and Human Services may,
notwithstanding the termination of the authority, continue in effect
any grant or contract made under the authority that is in effect on the
day before the date of the enactment of this Act, subject to the
duration of any such grant or contract not exceeding the period
determined by the Secretary in first approving such financial
assistance, or in approving the most recent request made (before the
date of such enactment) for continuation of such assistance, as the
case may be.</DELETED>
<DELETED>Subtitle B--Nursing Workforce Development</DELETED>
<DELETED>SEC. 121. SHORT TITLE.</DELETED>
<DELETED> This title may be cited as the ``Nursing Education and
Practice Improvement Act of 1998''.</DELETED>
<DELETED>SEC. 122. PURPOSE.</DELETED>
<DELETED> It is the purpose of this title to restructure the nurse
education authorities of title VIII of the Public Health Service Act to
permit a comprehensive, flexible, and effective approach to Federal
support for nursing workforce development.</DELETED>
<DELETED>SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.</DELETED>
<DELETED> Title VIII of the Public Health Service Act (42 U.S.C.
296k et seq.) is amended--</DELETED>
<DELETED> (1) by striking the title heading and all that
follows except for subpart II of part B and sections 846 and
855; and inserting the following:</DELETED>
<DELETED>``TITLE VIII--NURSING WORKFORCE DEVELOPMENT'';</DELETED>
<DELETED> (2) in subpart II of part B, by striking the
subpart heading and inserting the following:</DELETED>
<DELETED>``PART E--STUDENT LOANS'';</DELETED>
<DELETED> (3) by striking section 837;</DELETED>
<DELETED> (4) by inserting after the title heading the
following new parts:</DELETED>
<DELETED>``PART A--GENERAL PROVISIONS</DELETED>
<DELETED>``SEC. 801. DEFINITIONS.</DELETED>
<DELETED> ``As used in this title:</DELETED>
<DELETED> ``(1) Eligible entities.--The term `eligible
entities' means schools of nursing, nursing centers, academic
health centers, State or local governments, and other public or
private nonprofit entities determined appropriate by the
Secretary that submit to the Secretary an application in
accordance with section 802.</DELETED>
<DELETED> ``(2) School of nursing.--The term `school of
nursing' means a collegiate, associate degree, or diploma
school of nursing in a State.</DELETED>
<DELETED> ``(3) Collegiate school of nursing.--The term
`collegiate school of nursing' means a department, division, or
other administrative unit in a college or university which
provides primarily or exclusively a program of education in
professional nursing and related subjects leading to the degree
of bachelor of arts, bachelor of science, bachelor of nursing,
or to an equivalent degree, or to a graduate degree in nursing,
or to an equivalent degree, and including advanced training
related to such program of education provided by such school,
but only if such program, or such unit, college or university
is accredited.</DELETED>
<DELETED> ``(4) Associate degree school of nursing.--The
term `associate degree school of nursing' means a department,
division, or other administrative unit in a junior college,
community college, college, or university which provides
primarily or exclusively a two-year program of education in
professional nursing and allied subjects leading to an
associate degree in nursing or to an equivalent degree, but
only if such program, or such unit, college, or university is
accredited.</DELETED>
<DELETED> ``(5) Diploma school of nursing.--The term
`diploma school of nursing' means a school affiliated with a
hospital or university, or an independent school, which
provides primarily or exclusively a program of education in
professional nursing and allied subjects leading to a diploma
or to equivalent indicia that such program has been
satisfactorily completed, but only if such program, or such
affiliated school or such hospital or university or such
independent school is accredited.</DELETED>
<DELETED> ``(6) Accredited.--</DELETED>
<DELETED> ``(A) In general.--Except as provided in
subparagraph (B), the term `accredited' when applied to
any program of nurse education means a program
accredited by a recognized body or bodies, or by a
State agency, approved for such purpose by the
Secretary of Education and when applied to a hospital,
school, college, or university (or a unit thereof)
means a hospital, school, college, or university (or a
unit thereof) which is accredited by a recognized body
or bodies, or by a State agency, approved for such
purpose by the Secretary of Education. For the purpose
of this paragraph, the Secretary of Education shall
publish a list of recognized accrediting bodies, and of
State agencies, which the Secretary of Education
determines to be reliable authority as to the quality
of education offered.</DELETED>
<DELETED> ``(B) New programs.--A new program of
nursing that, by reason of an insufficient period of
operation, is not, at the time of the submission of an application for
a grant or contract under this title, eligible for accreditation by
such a recognized body or bodies or State agency, shall be deemed
accredited for purposes of this title if the Secretary of Education
finds, after consultation with the appropriate accreditation body or
bodies, that there is reasonable assurance that the program will meet
the accreditation standards of such body or bodies prior to the
beginning of the academic year following the normal graduation date of
students of the first entering class in such a program.</DELETED>
<DELETED> ``(7) Nonprofit.--The term `nonprofit' as applied
to any school, agency, organization, or institution means one
which is a corporation or association, or is owned and operated
by one or more corporations or associations, no part of the net
earnings of which inures, or may lawfully inure, to the benefit
of any private shareholder or individual.</DELETED>
<DELETED> ``(8) State.--The term `State' means a State, the
Commonwealth of Puerto Rico, the District of Columbia, the
Commonwealth of the Northern Mariana Islands, Guam, American
Samoa, the Virgin Islands, or the Trust Territory of the
Pacific Islands.</DELETED>
<DELETED>``SEC. 802. APPLICATION.</DELETED>
<DELETED> ``(a) In General.--To be eligible to receive a grant or
contract under this title, an eligible entity shall prepare and submit
to the Secretary an application that meets the requirements of this
section, at such time, in such manner, and containing such information
as the Secretary may require.</DELETED>
<DELETED> ``(b) Plan.--An application submitted under this section
shall contain the plan of the applicant for carrying out a project with
amounts received under this title. Such plan shall be consistent with
relevant Federal, State, or regional program plans.</DELETED>
<DELETED> ``(c) Performance Outcome Standards.--An application
submitted under this section shall contain a specification by the
applicant entity of performance outcome standards that the project to
be funded under the grant or contract will be measured against. Such
standards shall address relevant national nursing needs that the
project will meet. The recipient of a grant or contract under this
section shall meet the standards set forth in the grant or contract
application.</DELETED>
<DELETED> ``(d) Linkages.--An application submitted under this
section shall contain a description of the linkages with relevant
educational and health care entities, including training programs for
other health professionals as appropriate, that the project to be
funded under the grant or contract will establish.</DELETED>
<DELETED>``SEC. 803. USE OF FUNDS.</DELETED>
<DELETED> ``(a) In General.--Amounts provided under a grant or
contract awarded under this title may be used for training program
development and support, faculty development, model demonstrations,
trainee support including tuition, books, program fees and reasonable
living expenses during the period of training, technical assistance,
workforce analysis, and dissemination of information, as appropriate to
meet recognized nursing objectives, in accordance with this
title.</DELETED>
<DELETED> ``(b) Maintenance of Effort.--With respect to activities
for which a grant awarded under this title is to be expended, the
entity shall agree to maintain expenditures of non-Federal amounts for
such activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant.</DELETED>
<DELETED>``SEC. 804. MATCHING REQUIREMENT.</DELETED>
<DELETED> ``The Secretary may require that an entity that applies
for a grant or contract under this title provide non-Federal matching
funds, as appropriate, to ensure the institutional commitment of the
entity to the projects funded under the grant. Such non-Federal
matching funds may be provided directly or through donations from
public or private entities and may be in cash or in-kind, fairly
evaluated, including plant, equipment, or services.</DELETED>
<DELETED>``SEC. 805. PREFERENCE.</DELETED>
<DELETED> ``In awarding grants or contracts under this title, the
Secretary shall give preference to applicants with projects that will
substantially benefit rural or underserved populations, or help meet
public health nursing needs in State or local health
departments.</DELETED>
<DELETED>``SEC. 806. GENERALLY APPLICABLE PROVISIONS.</DELETED>
<DELETED> ``(a) Awarding of Grants and Contracts.--The Secretary
shall ensure that grants and contracts under this title are awarded on
a competitive basis, as appropriate, to carry out innovative
demonstration projects or provide for strategic workforce
supplementation activities as needed to meet national nursing service
goals and in accordance with this title. Contracts may be entered into
under this title with public or private entities as determined
necessary by the Secretary.</DELETED>
<DELETED> ``(b) Information Requirements.--</DELETED>
<DELETED> ``(1) In general.--Recipients of grants and
contracts under this title shall meet information requirements
as specified by the Secretary.</DELETED>
<DELETED> ``(2) Evaluations.--The Secretary shall establish
procedures to ensure the annual evaluation of programs and
projects operated by recipients of grants under this title. Such
procedures shall ensure that continued funding for such programs and
projects will be conditioned upon a demonstration that satisfactory
progress has been made by the program or project in meeting the
objectives of the program or project.</DELETED>
<DELETED> ``(c) Training Programs.--Training programs conducted with
amounts received under this title shall meet applicable accreditation
and quality standards.</DELETED>
<DELETED> ``(d) Duration of Assistance.--</DELETED>
<DELETED> ``(1) In general.--Subject to paragraph (2), in
the case of an award to an entity of a grant, cooperative
agreement, or contract under this title, the period during
which payments are made to the entity under the award may not
exceed 5 years. The provision of payments under the award shall
be subject to annual approval by the Secretary of the payments
and subject to the availability of appropriations for the
fiscal year involved to make the payments. This paragraph may
not be construed as limiting the number of awards under the
program involved that may be made to the entity.</DELETED>
<DELETED> ``(2) Limitation.--In the case of an award to an
entity of a grant, cooperative agreement, or contract under
this title, paragraph (1) shall apply only to the extent not
inconsistent with any other provision of this title that
relates to the period during which payments may be made under
the award.</DELETED>
<DELETED> ``(e) Peer Review Regarding Certain Programs.--</DELETED>
<DELETED> ``(1) In general.--Each application for a grant
under this title, except advanced nurse traineeship grants
under section 811(a)(2), shall be submitted to a peer review
group for an evaluation of the merits of the proposals made in
the application. The Secretary may not approve such an
application unless a peer review group has recommended the
application for approval.</DELETED>
<DELETED> ``(2) Composition.--Each peer review group under
this subsection shall be composed principally of individuals
who are not officers or employees of the Federal Government. In
providing for the establishment of peer review groups and
procedures, the Secretary shall, except as otherwise provided,
ensure gender, racial, ethnic, and geographic balance among the
membership of such groups.</DELETED>
<DELETED> ``(3) Administration.--This subsection shall be
carried out by the Secretary acting through the Administrator
of the Health Resources and Services Administration.</DELETED>
<DELETED> ``(f) Analytic Activities.--The Secretary shall ensure
that--</DELETED>
<DELETED> ``(1) cross-cutting workforce analytical
activities are carried out as part of the workforce information
and analysis activities under this title; and</DELETED>
<DELETED> ``(2) discipline-specific workforce information is
developed and analytical activities are carried out as part
of--</DELETED>
<DELETED> ``(A) the advanced practice nursing
activities under part B;</DELETED>
<DELETED> ``(B) the workforce diversity activities
under part C; and</DELETED>
<DELETED> ``(C) basic nursing education and practice
activities under part D.</DELETED>
<DELETED> ``(g) State and Regional Priorities.--Activities under
grants or contracts under this title shall, to extent practicable, be
consistent with related Federal, State, or regional nursing professions
program plans and priorities.</DELETED>
<DELETED> ``(h) Filing of Applications.--</DELETED>
<DELETED> ``(1) In general.--Applications for grants or
contracts under this title may be submitted by health
professions schools, schools of nursing, academic health
centers, State or local governments, or other appropriate
public or private nonprofit entities as determined appropriate
by the Secretary in accordance with this title.</DELETED>
<DELETED> ``(2) For profit entities.--Notwithstanding
paragraph (1), a for-profit entity may be eligible for a grant
or contract under this title as determined appropriated by the
Secretary.</DELETED>
<DELETED>``SEC. 807. TECHNICAL ASSISTANCE.</DELETED>
<DELETED> ``Funds appropriated under this title may be used by the
Secretary to provide technical assistance in relation to any of the
authorities under this title.</DELETED>
<DELETED>``PART B--NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE
ANESTHETISTS, AND OTHER ADVANCED PRACTICE NURSES</DELETED>
<DELETED>``SEC. 811. ADVANCED PRACTICE NURSING GRANTS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may award grants to and
enter into contracts with eligible entities to meet the costs of--
</DELETED>
<DELETED> ``(1) projects that support the enhancement of
advanced practice nursing education and practice; and</DELETED>
<DELETED> ``(2) traineeships for individuals in advanced
practice nursing programs.</DELETED>
<DELETED> ``(b) Definition of Advanced Practice Nurses.--For
purposes of this section, the term `advanced practice nurses' means
individuals trained in advanced degree programs including individuals
in combined R.N./Master's degree programs, post-nursing master's
certificate programs, or, in the case of nurse midwives, in certificate
programs in existence on the date that is one day prior to the date of
enactment of this section, to serve as nurse practitioners, clinical
nurse specialists, nurse midwives, nurse anesthetists, nurse educators,
nurse administrators, or public health nurses, or in other nurse
specialties determined by the Secretary to require advanced
education.</DELETED>
<DELETED> ``(c) Authorized Nurse Practitioner and Nurse-Midwifery
Programs.--Nurse practitioner and nurse midwifery programs eligible for
support under this section are educational programs for registered
nurses (irrespective of the type of school of nursing in which the
nurses received their training) that--</DELETED>
<DELETED> ``(1) meet guidelines prescribed by the Secretary;
and</DELETED>
<DELETED> ``(2) have as their objective the education of
nurses who will upon completion of their studies in such
programs, be qualified to effectively provide primary health
care, including primary health care in homes and in ambulatory
care facilities, long-term care facilities, acute care, and
other health care settings.</DELETED>
<DELETED> ``(d) Authorized Nurse Anesthesia Programs.--Nurse
anesthesia programs eligible for support under this section are
education programs that--</DELETED>
<DELETED> ``(1) provide registered nurses with full-time
anesthetist education; and</DELETED>
<DELETED> ``(2) are accredited by the Council on
Accreditation of Nurse Anesthesia Educational
Programs.</DELETED>
<DELETED> ``(e) Other Authorized Educational Programs.--The
Secretary shall prescribe guidelines as appropriate for other advanced
practice nurse education programs eligible for support under this
section.</DELETED>
<DELETED> ``(f) Traineeships.--</DELETED>
<DELETED> ``(1) In general.--The Secretary may not award a
grant to an applicant under subsection (a) unless the applicant
involved agrees that traineeships provided with the grant will
only pay all or part of the costs of--</DELETED>
<DELETED> ``(A) the tuition, books, and fees of the
program of advanced nursing practice with respect to
which the traineeship is provided; and</DELETED>
<DELETED> ``(B) the reasonable living expenses of
the individual during the period for which the
traineeship is provided.</DELETED>
<DELETED> ``(2) Doctoral programs.--The Secretary may not
obligate more than 10 percent of the traineeships under
subsection (a) for individuals in doctorate degree
programs.</DELETED>
<DELETED> ``(3) Special consideration.--In making awards of
grants and contracts under subsection (a)(2), the Secretary
shall give special consideration to an eligible entity that
agrees to expend the award to train advanced practice nurses
who will practice in health professional shortage areas
designated under section 332.</DELETED>
<DELETED>``PART C--INCREASING NURSING WORKFORCE DIVERSITY</DELETED>
<DELETED>``SEC. 821. WORKFORCE DIVERSITY GRANTS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may award grants to and
enter into contracts with eligible entities to meet the costs of
special projects to increase nursing education opportunities for
individuals who are from disadvantaged backgrounds (including racial
and ethnic minorities underrepresented among registered nurses) by
providing student scholarships or stipends, pre-entry preparation, and
retention activities.</DELETED>
<DELETED> ``(b) Guidance.--In carrying out subsection (a), the
Secretary shall take into consideration the recommendations of the
First, Second and Third Invitational Congresses for Minority Nurse
Leaders on `Caring for the Emerging Majority,' in 1992, 1993 and 1997,
and consult with nursing associations including the American Nurses
Association, the National League for Nursing, the American Association
of Colleges of Nursing, the National Black Nurses Association, the
National Association of Hispanic Nurses, the Association of Asian
American and Pacific Islander Nurses, the Native American Indian and
Alaskan Nurses Association, and the National Council of State Boards of
Nursing.</DELETED>
<DELETED> ``(c) Required Information and Conditions for Award
Recipients.--</DELETED>
<DELETED> ``(1) In general.--Recipients of awards under this
section may be required, where requested, to report to the
Secretary concerning the annual admission, retention, and
graduation rates for individuals from disadvantaged backgrounds
and ethnic and racial minorities in the school or schools
involved in the projects.</DELETED>
<DELETED> ``(2) Falling rates.--If any of the rates reported
under paragraph (1) fall below the average of the two previous
years, the grant or contract recipient shall provide the
Secretary with plans for immediately improving such
rates.</DELETED>
<DELETED> ``(3) Ineligibility.--A recipient described in
paragraph (2) shall be ineligible for continued funding under
this section if the plan of the recipient fails to improve the
rates within the 1-year period beginning on the date such plan
is implemented.</DELETED>
<DELETED>``PART D--STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND
PRACTICE</DELETED>
<DELETED>``SEC. 831. BASIC NURSE EDUCATION AND PRACTICE
GRANTS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may award grants to and
enter into contracts with eligible entities for projects to strengthen
capacity for basic nurse education and practice.</DELETED>
<DELETED> ``(b) Priority Areas.--In awarding grants or contracts
under this section the Secretary shall give priority to entities that
will use amounts provided under such a grant or contract to enhance the
educational mix and utilization of the basic nursing workforce by
strengthening programs that provide basic nurse education, such as
through--</DELETED>
<DELETED> ``(1) establishing or expanding nursing practice
arrangements in noninstitutional settings to demonstrate
methods to improve access to primary health care in medically
underserved communities;</DELETED>
<DELETED> ``(2) providing care for underserved populations
and other high-risk groups such as the elderly, individuals
with HIV-AIDS, substance abusers, the homeless, and victims of
domestic violence;</DELETED>
<DELETED> ``(3) providing managed care, quality improvement,
and other skills needed to practice in existing and emerging
organized health care systems;</DELETED>
<DELETED> ``(4) developing cultural competencies among
nurses;</DELETED>
<DELETED> ``(5) expanding the enrollment in baccalaureate
nursing programs;</DELETED>
<DELETED> ``(6) promoting career mobility for nursing
personnel in a variety of training settings and cross training
or specialty training among diverse population
groups;</DELETED>
<DELETED> ``(7) providing education in informatics,
including distance learning methodologies; or</DELETED>
<DELETED> ``(8) other priority areas as determined by the
Secretary.'';</DELETED>
<DELETED> (5) by adding at the end the following:</DELETED>
<DELETED>``PART F--AUTHORIZATION OF APPROPRIATIONS</DELETED>
<DELETED>``SEC. 841. AUTHORIZATION OF APPROPRIATIONS.</DELETED>
<DELETED> ``There are authorized to be appropriated to carry out
sections 811, 821, and 831, $65,000,000 for fiscal year 1998, and such
sums as may be necessary in each of the fiscal years 1999 through
2002.</DELETED>
<DELETED>``PART G--NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND
PRACTICE</DELETED>
<DELETED>``SEC. 845. NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND
PRACTICE.</DELETED>
<DELETED> ``(a) Establishment.--The Secretary shall establish an
advisory council to be known as the National Advisory Council on Nurse
Education and Practice (in this section referred to as the `Advisory
Council').</DELETED>
<DELETED> ``(b) Composition.--</DELETED>
<DELETED> ``(1) In general.--The Advisory Council shall be
composed of</DELETED>
<DELETED> ``(A) not less than 21, nor more than 23
individuals, who are not officers or employees of the
Federal Government, appointed by the Secretary without
regard to the Federal civil service laws, of which--
</DELETED>
<DELETED> ``(i) 2 shall be selected from
full-time students enrolled in schools of
nursing;</DELETED>
<DELETED> ``(ii) 2 shall be selected from
the general public;</DELETED>
<DELETED> ``(iii) 2 shall be selected from
practicing professional nurses; and</DELETED>
<DELETED> ``(iv) 9 shall be selected from
among the leading authorities in the various
fields of nursing, higher, and secondary
education, and from representatives of advanced
practice nursing groups (such as nurse
practitioners, nurse midwives, and nurse
anesthetists), hospitals, and other
institutions and organizations which provide
nursing services; and</DELETED>
<DELETED> ``(B) the Secretary (or the delegate of
the Secretary (who shall be an ex officio member and
shall serve as the Chairperson)).</DELETED>
<DELETED> ``(2) Appointment.--Not later than 90 days after
the date of enactment of this Act, the Secretary shall appoint
the members of the Advisory Council and each such member shall
serve a 4 year term. In making such appointments, the Secretary
shall ensure a fair balance between the nursing professions, a
broad geographic representation of members and a balance
between urban and rural members. Members shall be appointed
based on their competence, interest, and knowledge of the
mission of the profession involved. A majority of the members
shall be nurses.</DELETED>
<DELETED> ``(3) Minority representation.--In appointing the
members of the Advisory Council under paragraph (1), the
Secretary shall ensure the adequate representation of
minorities.</DELETED>
<DELETED> ``(c) Vacancies.--</DELETED>
<DELETED> ``(1) In general.--A vacancy on the Advisory
Council shall be filled in the manner in which the original
appointment was made and shall be subject to any conditions
which applied with respect to the original
appointment.</DELETED>
<DELETED> ``(2) Filling unexpired term.--An individual
chosen to fill a vacancy shall be appointed for the unexpired
term of the member replaced.</DELETED>
<DELETED> ``(d) Duties.--The Advisory Council shall--</DELETED>
<DELETED> ``(1) provide advice and recommendations to the
Secretary and Congress concerning policy matters arising in the
administration of this title, including the range of issues
relating to the nurse workforce, education, and practice
improvement;</DELETED>
<DELETED> ``(2) provide advice to the Secretary and Congress
in the preparation of general regulations and with respect to
policy matters arising in the administration of this title,
including the range of issues relating to nurse supply,
education and practice improvement; and</DELETED>
<DELETED> ``(3) not later than 3 years after the date of
enactment of this section, and annually thereafter, prepare and
submit to the Secretary, the Committee on Labor and Human
Resources of the Senate, and the Committee on Commerce of the
House of Representatives, a report describing the activities of
the Council, including findings and recommendations made by the
Council concerning the activities under this title.</DELETED>
<DELETED> ``(e) Meetings and Documents.--</DELETED>
<DELETED> ``(1) Meetings.--The Advisory Council shall meet
not less than 2 times each year. Such meetings shall be held
jointly with other related entities established under this
title where appropriate.</DELETED>
<DELETED> ``(2) Documents.--Not later than 14 days prior to
the convening of a meeting under paragraph (1), the Advisory
Council shall prepare and make available an agenda of the
matters to be considered by the Advisory Council at such
meeting. At any such meeting, the Advisory Council shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Council shall prepare and make
available a summary of the meeting and any actions taken by the
Council based upon the meeting.</DELETED>
<DELETED> ``(f) Compensation and Expenses.--</DELETED>
<DELETED> ``(1) Compensation.--Each member of the Advisory
Council shall be compensated at a rate equal to the daily
equivalent of the annual rate of basic pay prescribed for level
IV of the Executive Schedule under section 5315 of title 5,
United States Code, for each day (including travel time) during
which such member is engaged in the performance of the duties
of the Council. All members of the Council who are officers or
employees of the United States shall serve without compensation
in addition to that received for their services as officers or
employees of the United States.</DELETED>
<DELETED> ``(2) Expenses.--The members of the Advisory
Council shall be allowed travel expenses, including per diem in
lieu of subsistence, at rates authorized for employees of
agencies under subchapter I of chapter 57 of title 5, United
States Code, while away from their homes or regular places of
business in the performance of services for the
Council.</DELETED>
<DELETED> ``(g) Funding.--Amounts appropriated under this title may
be utilized by the Secretary to support the nurse education and
practice activities of the Council.</DELETED>
<DELETED> ``(h) FACA.--The Federal Advisory Committee Act shall
apply to the Advisory Committee under this section only to the extent
that the provisions of such Act do not conflict with the requirements
of this section.''; and</DELETED>
<DELETED> (6) by redesignating section 855 as section 810,
and transferring such section so as to appear after section 809
(as added by the amendment made by paragraph (5)).</DELETED>
<DELETED>SEC. 124. SAVINGS PROVISION.</DELETED>
<DELETED> In the case of any authority for making awards of grants
or contracts that is terminated by the amendment made by section 123,
the Secretary of Health and Human Services may, notwithstanding the
termination of the authority, continue in effect any grant or contract
made under the authority that is in effect on the day before the date
of the enactment of this Act, subject to the duration of any such grant
or contract not exceeding the period determined by the Secretary in
first approving such financial assistance, or in approving the most
recent request made (before the date of such enactment) for
continuation of such assistance, as the case may be.</DELETED>
<DELETED>Subtitle C--Financial Assistance</DELETED>
<DELETED>CHAPTER 1--SCHOOL-BASED REVOLVING LOAN FUNDS</DELETED>
<DELETED>SEC. 131. PRIMARY CARE LOAN PROGRAM.</DELETED>
<DELETED> (a) Requirement for Schools.--Section 723(b)(1) of the
Public Health Service Act (42 U.S.C. 292s(b)(1)), as amended by section
2014(c)(2)(A)(ii) of Public Law 103-43 (107 Stat. 216), is amended by
striking ``3 years before'' and inserting ``4 years before''.</DELETED>
<DELETED> (b) Noncompliance.--Section 723(a)(3) of the Public Health
Service Act (42 U.S.C. 292s(a)(3)) is amended to read as
follows:</DELETED>
<DELETED> ``(3) Noncompliance by student.--Each agreement
entered into with a student pursuant to paragraph (1) shall
provide that, if the student fails to comply with such
agreement, the loan involved will begin to accrue interest at a
rate of 18 percent per year beginning on the date of such
noncompliance.''.</DELETED>
<DELETED> (c) Report Requirement.--Section 723 of the Public Health
Service Act (42 U.S.C. 292s) is amended--</DELETED>
<DELETED> (1) by striking subsection (c); and</DELETED>
<DELETED> (2) by redesignating subsection (d) as subsection
(c).</DELETED>
<DELETED>SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.</DELETED>
<DELETED> (a) Authorization of Appropriations.--Section 724(f)(1) of
the Public Health Service Act (42 U.S.C. 292t(f)(1)) is amended by
striking ``$15,000,000 for fiscal year 1993'' and inserting
``$8,000,000 for each of the fiscal years 1998 through
2002''.</DELETED>
<DELETED> (b) Repeal.--Effective October 1, 2002, paragraph (1) of
section 724(f) of the Public Health Service Act (42 U.S.C. 292t(f)(1))
is repealed.</DELETED>
<DELETED>SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF
NURSING.</DELETED>
<DELETED> (a) In General.--Section 836(b) of the Public Health
Service Act (42 U.S.C. 297b(b)) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking the period at
the end and inserting a semicolon;</DELETED>
<DELETED> (2) in paragraph (2)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking
``and'' at the end; and</DELETED>
<DELETED> (B) by inserting before the semicolon at
the end the following: ``, and (C) such additional
periods under the terms of paragraph (8) of this
subsection'';</DELETED>
<DELETED> (3) in paragraph (7), by striking the period at
the end and inserting ``; and''; and</DELETED>
<DELETED> (4) by adding at the end the following
paragraph:</DELETED>
<DELETED> ``(8) pursuant to uniform criteria established by
the Secretary, the repayment period established under paragraph
(2) for any student borrower who during the repayment period
failed to make consecutive payments and who, during the last 12
months of the repayment period, has made at least 12
consecutive payments may be extended for a period not to exceed
10 years.''.</DELETED>
<DELETED> (b) Minimum Monthly Payments.--Section 836(g) of the
Public Health Service Act (42 U.S.C. 297b(g)) is amended by striking
``$15'' and inserting ``$40''.</DELETED>
<DELETED> (c) Elimination of Statute of Limitation for Loan
Collections.--</DELETED>
<DELETED> (1) In general.--Section 836 of the Public Health
Service Act (42 U.S.C. 297b) is amended by adding at the end
the following new subsection:</DELETED>
<DELETED> ``(l) Elimination of Statute of Limitation for Loan
Collections.--</DELETED>
<DELETED> ``(1) Purpose.--It is the purpose of this
subsection to ensure that obligations to repay loans under this
section are enforced without regard to any Federal or State
statutory, regulatory, or administrative limitation on the
period within which debts may be enforced.</DELETED>
<DELETED> ``(2) Prohibition.--Notwithstanding any other
provision of Federal or State law, no limitation shall
terminate the period within which suit may be filed, a judgment
may be enforced, or an offset, garnishment, or other action may
be initiated or taken by a school of nursing that has an
agreement with the Secretary pursuant to section 835 that is
seeking the repayment of the amount due from a borrower on a
loan made under this subpart after the default of the borrower
on such loan.''.</DELETED>
<DELETED> (2) Effective date.--The amendment made by
paragraph (1) shall be effective with respect to actions
pending on or after the date of enactment of this
Act.</DELETED>
<DELETED> (d) Breach of Agreements.--Section 338D of the Public
Health Service Act is amended by adding at the end thereof the
following new subsection:</DELETED>
<DELETED> ``(g) Breach of Agreement.--</DELETED>
<DELETED> ``(1) In general.--In the case of any program
under this section under which an individual makes an agreement
to provide health services for a period of time in accordance
with such program in consideration of receiving an award of
Federal funds regarding education as a nurse (including an
award for the repayment of loans), the following applies if the
agreement provides that this subsection is
applicable:</DELETED>
<DELETED> ``(A) In the case of a program under this
section that makes an award of Federal funds for
attending an accredited program of nursing (in this
section referred to as a `nursing program'), the
individual is liable to the Federal Government for the amount of such
award (including amounts provided for expenses related to such
attendance), and for interest on such amount at the maximum legal
prevailing rate, if the individual--</DELETED>
<DELETED> ``(i) fails to maintain an
acceptable level of academic standing in the
nursing program (as indicated by the program in
accordance with requirements established by the
Secretary);</DELETED>
<DELETED> ``(ii) is dismissed from the
nursing program for disciplinary reasons;
or</DELETED>
<DELETED> ``(iii) voluntarily terminates the
nursing program.</DELETED>
<DELETED> ``(B) The individual is liable to the
Federal Government for the amount of such award
(including amounts provided for expenses related to
such attendance), and for interest on such amount at
the maximum legal prevailing rate, if the individual
fails to provide health services in accordance with the
program under this section for the period of time
applicable under the program.</DELETED>
<DELETED> ``(2) Waiver or suspension of liability.--In the
case of an individual or health facility making an agreement
for purposes of paragraph (1), the Secretary shall provide for
the waiver or suspension of liability under such subsection if
compliance by the individual or the health facility, as the
case may be, with the agreements involved is impossible, or
would involve extreme hardship to the individual or facility,
and if enforcement of the agreements with respect to the
individual or facility would be unconscionable.</DELETED>
<DELETED> ``(3) Date certain for recovery.--Subject to
paragraph (2), any amount that the Federal Government is
entitled to recover under paragraph (1) shall be paid to the
United States not later than the expiration of the 3-year
period beginning on the date the United States becomes so
entitled.</DELETED>
<DELETED> ``(4) Availability.--Amounts recovered under
paragraph (1) with respect to a program under this section
shall be available for the purposes of such program, and shall
remain available for such purposes until expended.''.</DELETED>
<DELETED> (e) Technical Amendments.--Section 839 of the Public
Health Service Act (42 U.S.C. 297e) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by striking the matter preceding
paragraph (1) and inserting the following:</DELETED>
<DELETED> ``(a) If a school terminates a loan fund established under
an agreement pursuant to section 835(b), or if the Secretary for good
cause terminates the agreement with the school, there shall be a
capital distribution as follows:''; and</DELETED>
<DELETED> (B) in paragraph (1), by striking ``at the
close of September 30, 1999,'' and inserting ``on the
date of termination of the fund''; and</DELETED>
<DELETED> (2) in subsection (b), to read as
follows:</DELETED>
<DELETED> ``(b) If a capital distribution is made under subsection
(a), the school involved shall, after such capital distribution, pay to
the Secretary, not less often than quarterly, the same proportionate
share of amounts received by the school in payment of principal or
interest on loans made from the loan fund established under section
835(b) as determined by the Secretary under subsection
(a).''.</DELETED>
<DELETED>SEC. 134. GENERAL PROVISIONS.</DELETED>
<DELETED> (a) Maximum Student Loan Provisions and Minimum
Payments.--</DELETED>
<DELETED> (1) In general.--Section 722(a)(1) of the Public
Health Service Act (42 U.S.C. 292r(a)(1)), as amended by
section 2014(b)(1) of Public Law 103-43, is amended by striking
``the sum of'' and all that follows through the end thereof and
inserting ``the cost of attendance (including tuition, other
reasonable educational expenses, and reasonable living costs)
for that year at the educational institution attended by the
student (as determined by such educational
institution).''.</DELETED>
<DELETED> (2) Third and fourth years.--Section 722(a)(2) of
the Public Health Service Act (42 U.S.C. 292r(a)(2)), as
amended by section 2014(b)(1) of Public Law 103-43, is amended
by striking ``the amount $2,500'' and all that follows through
``including such $2,500'' and inserting ``the amount of the
loan may, in the case of the third or fourth year of a student
at a school of medicine or osteopathic medicine, be increased
to the extent necessary''.</DELETED>
<DELETED> (3) Repayment period.--Section 722(c) of the
Public Health Service Act (42 U.S.C. 292r(c)), as amended by
section 2014(b)(1) of Public Law 103-43, is amended--</DELETED>
<DELETED> (A) in the subsection heading by striking
``Ten-Year'' and inserting ``Repayment'';</DELETED>
<DELETED> (B) by striking ``ten-year period which
begins'' and inserting ``period of not less than
10 years nor more than 25 years, at the discretion of the institution,
which begins''; and</DELETED>
<DELETED> (C) by striking ``such ten-year period''
and inserting ``such period''.</DELETED>
<DELETED> (4) Minimum payments.--Section 722(j) of the
Public Health Service Act (42 U.S.C. 292r(j)), as amended by
section 2014(b)(1) of Public Law 103-43, is amended by striking
``$15'' and inserting $40''.</DELETED>
<DELETED> (b) Elimination of Statute of Limitation for Loan
Collections.--</DELETED>
<DELETED> (1) In general.--Section 722 of the Public Health
Service Act (42 U.S.C. 292r), as amended by section 2014(b)(1)
of Public Law 103-43, is amended by adding at the end the
following new subsection:</DELETED>
<DELETED> ``(m) Elimination of Statute of Limitation for Loan
Collections.--</DELETED>
<DELETED> ``(1) Purpose.--It is the purpose of this
subsection to ensure that obligations to repay loans under this
section are enforced without regard to any Federal or State
statutory, regulatory, or administrative limitation on the
period within which debts may be enforced.</DELETED>
<DELETED> ``(2) Prohibition.--Notwithstanding any other
provision of Federal or State law, no limitation shall
terminate the period within which suit may be filed, a judgment
may be enforced, or an offset, garnishment, or other action may
be initiated or taken by a school that has an agreement with
the Secretary pursuant to section 721 that is seeking the
repayment of the amount due from a borrower on a loan made
under this subpart after the default of the borrower on such
loan.''.</DELETED>
<DELETED> (2) Effective date.--The amendment made by
paragraph (1) shall be effective with respect to actions
pending on or after the date of enactment of this
Act.</DELETED>
<DELETED> (c) Date Certain for Contributions.--Paragraph (2) of
section 735(e) of the Public Health Service Act (42 U.S.C. 292y(e)(2))
is amended to read as follows:</DELETED>
<DELETED> ``(2) Date certain for contributions.--Amounts
described in paragraph (1) that are returned to the Secretary
shall be obligated before the end of the succeeding fiscal
year.''.</DELETED>
<DELETED>CHAPTER 2--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO
GRADUATE STUDENTS</DELETED>
<DELETED>SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PROGRAM.</DELETED>
<DELETED> (a) Health Education Assistance Loan Deferment for
Borrowers Providing Health Services to Indians.--</DELETED>
<DELETED> (1) In general.--Section 705(a)(2)(C) of the
Public Health Service Act (42 U.S.C. 292d(a)(2)(C)) is amended
by striking ``and (x)'' and inserting ``(x) not in excess of
three years, during which the borrower is providing health care
services to Indians through an Indian health program (as
defined in section 108(a)(2)(A) of the Indian Health Care
Improvement Act (25 U.S.C. 1616a(a)(2)(A)); and
(xi)''.</DELETED>
<DELETED> (2) Conforming amendments.--Section 705(a)(2)(C)
of the Public Health Service Act (42 U.S.C. 292d(a)(2)(C)) is
further amended--</DELETED>
<DELETED> (A) in clause (xi) (as so redesignated) by
striking ``(ix)'' and inserting ``(x)''; and</DELETED>
<DELETED> (B) in the matter following such clause
(xi), by striking ``(x)'' and inserting
``(xi)''.</DELETED>
<DELETED> (3) Effective date.--The amendments made by this
subsection shall apply with respect to services provided on or
after the first day of the third month that begins after the
date of the enactment of this Act.</DELETED>
<DELETED> (b) Report Requirement.--Section 709(b) of the Public
Health Service Act (42 U.S.C. 292h(b)) is amended--</DELETED>
<DELETED> (1) in paragraph (4)(B), by adding ``and'' after
the semicolon;</DELETED>
<DELETED> (2) in paragraph (5), by striking ``; and'' and
inserting a period; and</DELETED>
<DELETED> (3) by striking paragraph (6).</DELETED>
<DELETED> (c) Collection From Estates.--Section 714 of the Public
Health Service Act (42 U.S.C. 292m) is amended by adding at the end the
following new sentence: ``Notwithstanding the first sentence, the
Secretary may, in the case of a borrower who dies, collect any
remaining unpaid balance owed to the lender, the holder of the loan, or
the Federal Government from the borrower's estate.''.</DELETED>
<DELETED> (d) Program Eligibility.--</DELETED>
<DELETED> (1) Limitations on loans.--Section 703(a) of the
Public Health Service Act (42 U.S.C. 292b(a)) is amended by
striking ``or clinical psychology'' and inserting ``or
behavioral and mental health practice, including clinical
psychology''.</DELETED>
<DELETED> (2) Definition of eligible institution.--Section
719(1) of the Public Health Service Act (42 U.S.C. 292o(1)) is
amended by striking ``or clinical psychology'' and inserting ``or
behavioral and mental health practice, including clinical
psychology''.</DELETED>
<DELETED>SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE
STANDARDS.</DELETED>
<DELETED> (a) General Amendments.--Section 707(a) of the Public
Health Service Act (42 U.S.C. 292f) is amended--</DELETED>
<DELETED> (1) by striking the last sentence;</DELETED>
<DELETED> (2) by striking ``determined.'' and inserting
``determined, except that, if the insurance beneficiary
including any servicer of the loan is not designated for
`exceptional performance', as set forth in paragraph (2), the
Secretary shall pay to the beneficiary a sum equal to 98
percent of the amount of the loss sustained by the insured upon
that loan.'';</DELETED>
<DELETED> (3) by striking ``Upon'' and inserting:</DELETED>
<DELETED> ``(1) In general.--Upon''; and</DELETED>
<DELETED> (4) by adding at the end the following new
paragraph:</DELETED>
<DELETED> ``(2) Exceptional performance.--</DELETED>
<DELETED> ``(A) Authority.--Where the Secretary
determines that an eligible lender, holder, or servicer
has a compliance performance rating that equals or
exceeds 97 percent, the Secretary shall designate that
eligible lender, holder, or servicer, as the case may
be, for exceptional performance.</DELETED>
<DELETED> ``(B) Compliance performance rating.--For
purposes of subparagraph (A), a compliance performance
rating is determined with respect to compliance with
due diligence in the disbursement, servicing, and
collection of loans under this subpart for each year
for which the determination is made. Such rating shall
be equal to the percentage of all due diligence
requirements applicable to each loan, on average, as
established by the Secretary, with respect to loans
serviced during the period by the eligible lender,
holder, or servicer.</DELETED>
<DELETED> ``(C) Annual audits for lenders, holders,
and servicers.--Each eligible lender, holder, or
servicer desiring a designation under subparagraph (A)
shall have an annual financial and compliance audit
conducted with respect to the loan portfolio of such
eligible lender, holder, or servicer, by a qualified
independent organization from a list of qualified
organizations identified by the Secretary and in
accordance with standards established by the Secretary.
The standards shall measure the lender's, holder's, or
servicer's compliance with due diligence standards and
shall include a defined statistical sampling technique
designed to measure the performance rating of the
eligible lender, holder, or servicer for the purpose of
this section. Each eligible lender, holder, or servicer
shall submit the audit required by this section to the
Secretary.</DELETED>
<DELETED> ``(D) Secretary's determinations.--The
Secretary shall make the determination under
subparagraph (A) based upon the audits submitted under
this paragraph and any information in the possession of
the Secretary or submitted by any other agency or
office of the Federal Government.</DELETED>
<DELETED> ``(E) Quarterly compliance audit.--To
maintain its status as an exceptional performer, the
lender, holder, or servicer shall undergo a quarterly
compliance audit at the end of each quarter (other than
the quarter in which status as an exceptional performer
is established through a financial and compliance
audit, as described in subparagraph (C)), and submit
the results of such audit to the Secretary. The
compliance audit shall review compliance with due
diligence requirements for the period beginning on the
day after the ending date of the previous audit, in
accordance with standards determined by the
Secretary.</DELETED>
<DELETED> ``(F) Revocation authority.--The Secretary
shall revoke the designation of a lender, holder, or
servicer under subparagraph (A) if any quarterly audit
required under subparagraph (E) is not received by the
Secretary by the date established by the Secretary or
if the audit indicates the lender, holder, or servicer
has failed to meet the standards for designation as an
exceptional performer under subparagraph (A). A lender,
holder, or servicer receiving a compliance audit not
meeting the standard for designation as an exceptional
performer may reapply for designation under
subparagraph (A) at any time.</DELETED>
<DELETED> ``(G) Documentation.--Nothing in this
section shall restrict or limit the authority of the
Secretary to require the submission of claims
documentation evidencing servicing performed on loans,
except that the Secretary may not require exceptional
performers to submit greater documentation than that
required for lenders, holders, and servicers not
designated under subparagraph (A).</DELETED>
<DELETED> ``(H) Cost of audits.--Each eligible
lender, holder, or servicer shall pay for all the costs
associated with the audits required under this
section.</DELETED>
<DELETED> ``(I) Additional revocation authority.--
Notwithstanding any other provision of this section, a
designation under subparagraph (A) may be revoked at
any time by the Secretary if the Secretary determines
that the eligible lender, holder, or servicer has
failed to maintain an overall level of compliance
consistent with the audit submitted by the eligible
lender, holder, or servicer under this paragraph or if
the Secretary asserts that the lender, holder, or
servicer may have engaged in fraud in securing
designation under subparagraph (A) or is failing to
service loans in accordance with program
requirements.</DELETED>
<DELETED> ``(J) Noncompliance.--A lender, holder, or
servicer designated under subparagraph (A) that fails
to service loans or otherwise comply with applicable
program regulations shall be considered in violation of
the Federal False Claims Act.''.</DELETED>
<DELETED> (b) Definition.--Section 707(e) of the Public Health
Service Act (42 U.S.C. 292f(e)) is amended by adding at the end the
following new paragraph:</DELETED>
<DELETED> ``(4) The term `servicer' means any agency acting
on behalf of the insurance beneficiary.''.</DELETED>
<DELETED> (c) Effective Date.--The amendments made by subsections
(a) and (b) shall apply with respect to loans submitted to the
Secretary for payment on or after the first day of the sixth month that
begins after the date of enactment of this Act.</DELETED>
<DELETED>SEC. 143. REAUTHORIZATION.</DELETED>
<DELETED> (a) Loan Program.--Section 702(a) of the Public Health
Service Act (42 U.S.C. 292a(a)) is amended--</DELETED>
<DELETED> (1) by striking ``$350,000,000'' and all that
follows through ``1995'' and inserting ``$350,000,000 for
fiscal year 1998, $375,000,000 for fiscal year 1999, and
$425,000,000 for each of the fiscal years 2000 through
2002'';</DELETED>
<DELETED> (2) by striking ``obtained prior loans insured
under this subpart'' and inserting ``obtained loans insured
under this subpart in fiscal year 2002 or in prior fiscal
years'';</DELETED>
<DELETED> (3) by adding at the end thereof the following new
sentence: ``The Secretary may establish guidelines and
procedures that lenders must follow in distributing funds under
this subpart.''; and</DELETED>
<DELETED> (4) by striking ``September 30, 1998'' and
inserting ``September 30, 2005''.</DELETED>
<DELETED> (b) Insurance Program.--Section 710(a)(2)(B) of the Public
Health Service Act (42 U.S.C. 292i(a)(2)(B)) is amended by striking
``any of the fiscal years 1993 through 1996'' and inserting ``fiscal
year 1993 and subsequent fiscal years''.</DELETED>
<DELETED>SEC. 144. HEAL BANKRUPTCY.</DELETED>
<DELETED> (a) In General.--Section 707(g) of the Public Health
Service Act (42 U.S.C. 292f(g)) is amended in the first sentence by
striking ``A debt which is a loan insured'' and inserting
``Notwithstanding any other provision of Federal or State law, a debt
that is a loan insured''.</DELETED>
<DELETED> (b) Application.--The amendment made by subsection (a)
shall apply to any loan insured under the authority of subpart I of
part A of title VII of the Public Health Service Act (42 U.S.C. 292 et
seq.) that is listed or scheduled by the debtor in a case under title
XI, United States Code, filed--</DELETED>
<DELETED> (1) on or after the date of enactment of this Act;
or</DELETED>
<DELETED> (2) prior to such date of enactment in which a
discharge has not been granted.</DELETED>
<DELETED>SEC. 145. HEAL REFINANCING.</DELETED>
<DELETED> Section 706 of the Public Health Service Act (42 U.S.C.
292e) is amended--</DELETED>
<DELETED> (1) in subsection (d)--</DELETED>
<DELETED> (A) in the subsection heading, by striking
``Consolidation'' and inserting ``Refinancing or
Consolidation''; and</DELETED>
<DELETED> (B) in the first sentence, by striking
``indebtedness'' and inserting ``indebtedness or the
refinancing of a single loan''; and</DELETED>
<DELETED> (2) in subsection (e)--</DELETED>
<DELETED> (A) in the subsection heading, by striking
``Debts'' and inserting ``Debts and
Refinancing'';</DELETED>
<DELETED> (B) in the first sentence, by striking
``all of the borrower's debts into a single
instrument'' and inserting ``all of the borrower's
loans insured under this subpart into a single
instrument (or, if the borrower obtained only 1 loan
insured under this subpart, refinancing the loan 1
time)''; and</DELETED>
<DELETED> (C) in the second sentence, by striking
``consolidation'' and inserting ``consolidation or
refinancing''.</DELETED>
<DELETED>TITLE II--OFFICE OF MINORITY HEALTH</DELETED>
<DELETED>SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF
MINORITY HEALTH.</DELETED>
<DELETED> (a) Duties and Requirements.--Section 1707 of the Public
Health Service Act (42 U.S.C. 300u-6) is amended by striking subsection
(b) and all that follows and inserting the following:</DELETED>
<DELETED> ``(b) Duties.--With respect to improving the health of
racial and ethnic minority groups, the Secretary, acting through the
Deputy Assistant Secretary for Minority Health (in this section
referred to as the `Deputy Assistant Secretary'), shall carry out the
following:</DELETED>
<DELETED> ``(1) Establish short-range and long-range goals
and objectives and coordinate all other activities within the
Public Health Service that relate to disease prevention, health
promotion, service delivery, and research concerning such
individuals. The heads of each of the agencies of the Service
shall consult with the Deputy Assistant Secretary to ensure the
coordination of such activities.</DELETED>
<DELETED> ``(2) Enter into interagency agreements with other
agencies of the Public Health Service.</DELETED>
<DELETED> ``(3) Support research, demonstrations and
evaluations to test new and innovative models.</DELETED>
<DELETED> ``(4) Increase knowledge and understanding of
health risk factors.</DELETED>
<DELETED> ``(5) Develop mechanisms that support better
information dissemination, education, prevention, and service
delivery to individuals from disadvantaged backgrounds,
including individuals who are members of racial or ethnic
minority groups.</DELETED>
<DELETED> ``(6) Ensure that the National Center for Health
Statistics collects data on the health status of each minority
group.</DELETED>
<DELETED> ``(7) With respect to individuals who lack
proficiency in speaking the English language, enter into
contracts with public and nonprofit private providers of
primary health services for the purpose of increasing the
access of the individuals to such services by developing and
carrying out programs to provide bilingual or interpretive
services.</DELETED>
<DELETED> ``(8) Support a national minority health resource
center to carry out the following:</DELETED>
<DELETED> ``(A) Facilitate the exchange of
information regarding matters relating to health
information and health promotion, preventive health
services, and education in the appropriate use of
health care.</DELETED>
<DELETED> ``(B) Facilitate access to such
information.</DELETED>
<DELETED> ``(C) Assist in the analysis of issues and
problems relating to such matters.</DELETED>
<DELETED> ``(D) Provide technical assistance with
respect to the exchange of such information (including
facilitating the development of materials for such
technical assistance).</DELETED>
<DELETED> ``(9) Carry out programs to improve access to
health care services for individuals with limited proficiency
in speaking the English language. Activities under the
preceding sentence shall include developing and evaluating
model projects.</DELETED>
<DELETED> ``(c) Advisory Committee.--</DELETED>
<DELETED> ``(1) In general.--The Secretary shall establish
an advisory committee to be known as the Advisory Committee on
Minority Health (in this subsection referred to as the
`Committee').</DELETED>
<DELETED> ``(2) Duties.--The Committee shall provide advice
to the Deputy Assistant Secretary carrying out this section,
including advice on the development of goals and specific
program activities under paragraphs (1) through (9) of
subsection (b) for each racial and ethnic minority
group.</DELETED>
<DELETED> ``(3) Chair.--The chairperson of the Committee
shall be selected by the Secretary from among the members of
the voting members of the Committee. The term of office of the
chairperson shall be 2 years.</DELETED>
<DELETED> ``(4) Composition.--</DELETED>
<DELETED> ``(A) The Committee shall be composed of
12 voting members appointed in accordance with
subparagraph (B), and nonvoting, ex officio members
designated in subparagraph (C).</DELETED>
<DELETED> ``(B) The voting members of the Committee
shall be appointed by the Secretary from among
individuals who are not officers or employees of the
Federal Government and who have expertise regarding
issues of minority health. The racial and ethnic
minority groups shall be equally represented among such
members.</DELETED>
<DELETED> ``(C) The nonvoting, ex officio members of
the Committee shall be such officials of the Department
of Health and Human Services as the Secretary
determines to be appropriate.</DELETED>
<DELETED> ``(5) Terms.--Each member of the Committee shall
serve for a term of 4 years, except that the Secretary shall
initially appoint a portion of the members to terms of 1 year,
2 years, and 3 years.</DELETED>
<DELETED> ``(6) Vacancies.--If a vacancy occurs on the
Committee, a new member shall be appointed by the Secretary
within 90 days from the date that the vacancy occurs, and serve
for the remainder of the term for which the predecessor of such
member was appointed. The vacancy shall not affect the power of
the remaining members to execute the duties of the
Committee.</DELETED>
<DELETED> ``(7) Compensation.--Members of the Committee who
are officers or employees of the United States shall serve
without compensation. Members of the Committee who are not
officers or employees of the United States shall receive
compensation, for each day (including travel time) they are
engaged in the performance of the functions of the Committee.
Such compensation may not be in an amount in excess of the
daily equivalent of the annual maximum rate of basic pay
payable under the General Schedule (under title 5, United
States Code) for positions above GS-15.</DELETED>
<DELETED> ``(d) Certain Requirements Regarding Duties.--</DELETED>
<DELETED> ``(1) Recommendations regarding language as
impediment to health care.--The Deputy Assistant Secretary for
Minority Health shall consult with the Director of the Office
of Refugee Health, the Director of the Office of Civil Rights,
and the Directors of other appropriate Departmental entities
regarding recommendations for carrying out activities under
subsection (b)(9).</DELETED>
<DELETED> ``(2) Equitable allocation regarding activities.--
</DELETED>
<DELETED> ``(A) In general.--In making awards of
grants, cooperative agreements, or contracts under this
section or section 338A, 338C, 340A, 404, or 724, or
part B of title VII, the Secretary, acting as
appropriate through the Deputy Assistant Secretary or
the Administrator of the Health Resources and Services
Administration, shall ensure that such awards are
equitably allocated with respect to the various racial
and minority populations.</DELETED>
<DELETED> ``(B) Requirements.--With respect to
grants, cooperative agreements, and contracts that are
available under the sections specified in subparagraph
(A), the Secretary shall--</DELETED>
<DELETED> ``(i) carry out activities to
inform entities, as appropriate, that the
entities may be eligible for awards of such
assistance;</DELETED>
<DELETED> ``(ii) provide technical
assistance to such entities in the process of
preparing and submitting applications for the
awards in accordance with the policies of the
Secretary regarding such application;
and</DELETED>
<DELETED> ``(iii) inform populations, as
appropriate, that members of the populations
may be eligible to receive services or
otherwise participate in the activities carried
out with such awards.</DELETED>
<DELETED> ``(3) Cultural competency of services.--The
Secretary shall ensure that information and services provided
pursuant to subsection (b) are provided in the language,
educational, and cultural context that is most appropriate for
the individuals for whom the information and services are
intended.</DELETED>
<DELETED> ``(e) Grants and Contracts Regarding Duties.--</DELETED>
<DELETED> ``(1) In general.--In carrying out subsection (b),
the Secretary acting through the Deputy Assistant Secretary may
make awards of grants, cooperative agreements, and contracts to
public and nonprofit private entities.</DELETED>
<DELETED> ``(2) Process for making awards.--The Deputy
Assistant Secretary shall ensure that awards under paragraph
(1) are made only on a competitive basis, and that a grant is
awarded for a proposal only if the proposal has been
recommended for such an award through a process of peer
review.</DELETED>
<DELETED> ``(3) Evaluation and dissemination.--The Deputy
Assistant Secretary, directly or through contracts with public
and private entities, shall provide for evaluations of projects
carried out with awards made under paragraph (1) during the
preceding 2 fiscal years. The report shall be included in the
report required under subsection (f) for the fiscal year
involved.</DELETED>
<DELETED> ``(f) Reports.--</DELETED>
<DELETED> ``(1) In general.--Not later than February 1 of
fiscal year 1999 and of each second year thereafter, the
Secretary shall submit to the Committee on Energy and Commerce
of the House of Representatives, and to the Committee on Labor
and Human Resources of the Senate, a report describing the
activities carried out under this section during the preceding
2 fiscal years and evaluating the extent to which such activities have
been effective in improving the health of racial and ethnic minority
groups. Each such report shall include the biennial reports submitted
under sections 201(e)(3) and 201(f)(2) for such years by the heads of
the Public Health Service agencies.</DELETED>
<DELETED> ``(2) Agency reports.--Not later than February 1,
1999, and biennially thereafter, the heads of the Public Health
Service agencies shall submit to the Deputy Assistant Secretary
a report summarizing the minority health activities of each of
the respective agencies.</DELETED>
<DELETED> ``(g) Definition.--For purposes of this section:</DELETED>
<DELETED> ``(1) The term `racial and ethnic minority group'
means American Indians (including Alaska Natives, Eskimos, and
Aleuts); Asian Americans and Pacific Islanders; Blacks; and
Hispanics.</DELETED>
<DELETED> ``(2) The term `Hispanic' means individuals whose
origin is Mexican, Puerto Rican, Cuban, Central or South
American, or any other Spanish-speaking country.</DELETED>
<DELETED> ``(h) Funding.--</DELETED>
<DELETED> ``(1) Authorization of appropriations.--For the
purpose of carrying out this section, there are authorized to
be appropriated $30,000,000 for fiscal year 1998, such sums as
may be necessary for each of the fiscal years 1999 through
2002.</DELETED>
<DELETED> ``(2) National center for health statistics.--For
the purpose of enabling the National Center for Health
Statistics to collect data on Hispanics and major Hispanic
subpopulation groups, American Indians, and to develop special
area population studies on major Asian American and Pacific
Islander populations, there are authorized to be appropriated
$1,000,000 for fiscal year 1998, such sums as may be necessary
for each of the fiscal years 1999 through 2002.''.</DELETED>
<DELETED> (b) Miscellaneous Amendments.--Section 1707 of the Public
Health Service Act (42 U.S.C. 300u-6) is amended--</DELETED>
<DELETED> (1) in the heading for the section by striking
``establishment of''; and</DELETED>
<DELETED> (2) in subsection (a), by striking ``Office of the
Assistant Secretary for Health'' and inserting ``Office of
Public Health and Science''.</DELETED>
<DELETED>TITLE III--SELECTED INITIATIVES</DELETED>
<DELETED>SEC. 301. STATE OFFICES OF RURAL HEALTH.</DELETED>
<DELETED> (a) In General.--Section 338J of the Public Health Service
Act (42 U.S.C. 254r) is amended--</DELETED>
<DELETED> (1) in subsection (b)(1), in the matter preceding
subparagraph (A), by striking ``in cash''; and</DELETED>
<DELETED> (2) in subsection (j)(1)--</DELETED>
<DELETED> (A) by striking ``and'' after ``1992,'';
and</DELETED>
<DELETED> (B) by inserting before the period the
following: ``, and such sums as may be necessary for
each of the fiscal years 1998 through 2002'';
and</DELETED>
<DELETED> (3) in subsection (k), by striking ``$10,000,000''
and inserting ``$20,000,000''.</DELETED>
<DELETED> (b) Repeal.--Effective on October 1, 2002, section 338J of
the Public Health Service Act is repealed.</DELETED>
<DELETED>SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZHEIMER'S
DISEASE.</DELETED>
<DELETED> (a) In General.--Section 398(a) of the Public Health
Service Act (42 U.S.C. 280c-3(a)) is amended--</DELETED>
<DELETED> (1) in the matter preceding paragraph (1), by
striking ``not less than 5, and not more than 15,'';</DELETED>
<DELETED> (2) in paragraph (2)--</DELETED>
<DELETED> (A) by inserting after ``disorders'' the
following: ``who are living in single family homes or
in congregate settings''; and</DELETED>
<DELETED> (B) by striking ``and'' at the
end;</DELETED>
<DELETED> (3) by redesignating paragraph (3) as paragraph
(4); and</DELETED>
<DELETED> (4) by inserting after paragraph (2) the
following:</DELETED>
<DELETED> ``(3) to improve the access of such individuals to
home-based or community-based long-term care services (subject
to the services being provided by entities that were providing
such services in the State involved as of October 1, 1995),
particularly such individuals who are members of racial or
ethnic minority groups, who have limited proficiency in
speaking the English language, or who live in rural areas;
and''.</DELETED>
<DELETED> (b) Duration.--Section 398A of the Public Health Service
Act (42 U.S.C. 280c-4) is amended--</DELETED>
<DELETED> (1) in the heading for the section, by striking
``LIMITATION'' and all that follows and inserting ``REQUIREMENT
OF MATCHING FUNDS'';</DELETED>
<DELETED> (2) by striking subsection (a);</DELETED>
<DELETED> (3) by redesignating subsections (b) and (c) as
subsections (a) and (b), respectively;</DELETED>
<DELETED> (4) in subsection (a) (as so redesignated), in
each of paragraphs (1)(C) and (2)(C), by striking ``third
year'' and inserting ``third or subsequent year''.</DELETED>
<DELETED> (c) Authorization of Appropriations.--Section 398B(e) of
the Public Health Service Act (42 U.S.C. 280c-5(e)) is amended--
</DELETED>
<DELETED> (1) by striking ``and such sums'' and inserting
``such sums''; and</DELETED>
<DELETED> (2) by inserting before the period the following:
``, $8,000,000 for fiscal year 1998, and such sums as may be
necessary for each of the fiscal years 1999 through
2002''.</DELETED>
<DELETED>SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.</DELETED>
<DELETED> Section 317(j) of the Public Health Service Act (42 U.S.C.
247b(j)) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``individuals
against vaccine-preventable diseases'' and all that follows
through the first period and inserting the following:
``children, adolescents, and adults against vaccine-preventable
diseases, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 1998 through
2002.''; and</DELETED>
<DELETED> (2) in paragraph (2), by striking ``1990'' and
inserting ``1997''.</DELETED>
<DELETED>TITLE IV--MISCELLANEOUS PROVISIONS</DELETED>
<DELETED>SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC LAW 103-
183.</DELETED>
<DELETED> (a) Amendatory Instructions.--Public Law 103-183 is
amended--</DELETED>
<DELETED> (1) in section 601--</DELETED>
<DELETED> (A) in subsection (b), in the matter
preceding paragraph (1), by striking ``Section 1201 of
the Public Health Service Act (42 U.S.C. 300d)'' and
inserting ``Title XII of the Public Health Service Act
(42 U.S.C. 300d et seq.)''; and</DELETED>
<DELETED> (B) in subsection (f)(1), by striking ``in
section 1204(c)'' and inserting ``in section 1203(c)
(as redesignated by subsection (b)(2) of this
section)'';</DELETED>
<DELETED> (2) in section 602, by striking ``for the
purpose'' and inserting ``For the purpose''; and</DELETED>
<DELETED> (3) in section 705(b), by striking ``317D((l)(1)''
and inserting ``317D(l)(1)''.</DELETED>
<DELETED> (b) Public Health Service Act.--The Public Health Service
Act, as amended by Public Law 103-183 and by subsection (a) of this
section, is amended--</DELETED>
<DELETED> (1) in section 317E(g)(2), by striking ``making
grants under subsection (b)'' and inserting ``carrying out
subsection (b)'';</DELETED>
<DELETED> (2) in section 318, in subsection (e) as in effect
on the day before the date of the enactment of Public Law 103-
183, by redesignating the subsection as subsection
(f);</DELETED>
<DELETED> (3) in subpart 6 of part C of title IV--</DELETED>
<DELETED> (A) by transferring the first section 447
(added by section 302 of Public Law 103-183) from the
current placement of the section;</DELETED>
<DELETED> (B) by redesignating the section as
section 447A; and</DELETED>
<DELETED> (C) by inserting the section after section
447;</DELETED>
<DELETED> (4) in section 1213(a)(8), by striking ``provides
for for'' and inserting ``provides for'';</DELETED>
<DELETED> (5) in section 1501, by redesignating the second
subsection (c) (added by section 101(f) of Public Law 103-183)
as subsection (d); and</DELETED>
<DELETED> (6) in section 1505(3), by striking ``nonprivate''
and inserting ``private''.</DELETED>
<DELETED> (c) Miscellaneous Correction.--Section 401(c)(3) of Public
Law 103-183 is amended in the matter preceding subparagraph (A) by
striking ``(d)(5)'' and inserting ``(e)(5)''.</DELETED>
<DELETED> (d) Effective Date.--This section is deemed to have taken
effect immediately after the enactment of Public Law 103-183.</DELETED>
<DELETED>SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS COMMISSIONED
OFFICERS.</DELETED>
<DELETED> (a) Anti-Discrimination Laws.--Amend section 212 of the
Public Health Service Act (42 U.S.C. 213) by adding the following new
subsection at the end thereof:</DELETED>
<DELETED> ``(f) Active service of commissioned officers of the
Service shall be deemed to be active military service in the Armed
Forces of the United States for purposes of all laws related to
discrimination on the basis of race, color, gender, ethnicity, age,
religion, and disability.''</DELETED>
<DELETED> (b) Training in Leave Without Pay Status.--Section 218 of
the Public Health Service Act (42 U.S.C. 218a) is amended by adding at
the end the following:</DELETED>
<DELETED> ``(c) A commissioned officer may be placed in leave
without pay status while attending an educational institution or
training program whenever the Secretary determines that such status is
in the best interest of the Service. For purposes of computation of
basic pay, promotion, retirement, compensation for injury or death, and
the benefits provided by sections 212 and 224, an officer in such
status pursuant to the preceding sentence shall be considered as
performing service in the Service and shall have an active service
obligation as set forth in subsection (b) of this section.''.</DELETED>
<DELETED> (c) Utilization of Alcohol and Drug Abuse Records That
Apply to the Armed Forces.--Section 543(e) of the Public Health Service
Act (42 U.S.C. 290dd-2(e)) is amended by striking ``Armed Forces'' each
place that such term appears and inserting ``Uniformed
Services''.</DELETED>
<DELETED>SEC. 403. CLINICAL TRAINEESHIPS.</DELETED>
<DELETED> Section 303(d)(1) of the Public Health Service Act (42
U.S.C. 242a(d)(1)) is amended by inserting ``counseling,'' after
``family therapy,''.</DELETED>
<DELETED>SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS, AND
EDUCATION REGARDING LEAD POISONING.</DELETED>
<DELETED> Section 317A(l)(1) of the Public Health Service Act (42
U.S.C. 247b-1(l)(1)) is amended by striking ``1998'' and inserting
``2004''.</DELETED>
<DELETED>SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH SERVICES
REGARDING TUBERCULOSIS.</DELETED>
<DELETED> Section 317E(g)(1) of the Public Health Service Act (42
U.S.C. 247b-6(g)(1)) is amended--</DELETED>
<DELETED> (1) in subparagraph (A), by striking ``1998'' and
inserting ``2004''; and</DELETED>
<DELETED> (2) in subparagraph (B), by striking
``$50,000,000'' and inserting ``25 percent''.</DELETED>
<DELETED>SEC. 406. CERTAIN AUTHORITIES OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.</DELETED>
<DELETED> (a) In General.--Part B of title III of the Public Health
Service Act is amended by inserting after section 317H the following
section:</DELETED>
<DELETED>``miscellaneous authorities regarding centers for disease
control and prevention</DELETED>
<DELETED> ``Sec. 317I. The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, may, without regard to
the provisions of title 5, United States Code, governing appointments
in the competitive service, and without regard to the provisions of
chapter 51 and subchapter III of chapter 53 of such title relating to
classification and General Schedule pay rates, establish such technical
and scientific peer review groups and scientific program advisory
committees as are needed to carry out the functions of such Centers and
appoint and pay the members of such groups, except that officers and
employees of the United States shall not receive additional
compensation for service as members of such groups. The Federal
Advisory Committee Act shall not apply to the duration of such peer
review groups. Not more than one-fourth of the members of any such
group shall be officers or employees of the United States.''.</DELETED>
<DELETED> (b) Effective Date.--This section is deemed to have taken
effect July 1, 1995.</DELETED>
<DELETED>SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIOLENCE.</DELETED>
<DELETED> (a) In General.--Section 318(h)(2) of the Family Violence
Prevention and Services Act (42 U.S.C. 10418(h)(2)) is amended by
striking ``fiscal year 1997'' and inserting ``for each of the fiscal
years 1997 through 2002''.</DELETED>
<DELETED> (b) Study.--The Secretary of Health and Human Services
shall request that the Institute of Medicine conduct a study concerning
the training needs of health professionals with respect to the
detection and referral of victims of family or acquaintance violence.
Not later than 2 years after the date of enactment of this Act, the
Institute of Medicine shall prepare and submit to Congress a report
concerning the study conducted under this subsection.</DELETED>
<DELETED>SEC. 408. STATE LOAN REPAYMENT PROGRAM.</DELETED>
<DELETED> Section 338I(i)(1) of the Public Health Service Act (42
U.S.C. 254q-1(i)(1)) is amended by inserting before the period ``, and
such sums as may be necessary for each of the fiscal years 1998 through
2002''.</DELETED>
<DELETED>SEC. 409. CONSTRUCTION OF REGIONAL CENTERS FOR RESEARCH ON
PRIMATES.</DELETED>
<DELETED> Section 481B(a) of the Public Health Service Act (42
U.S.C. 287a-3(a)) is amended--</DELETED>
<DELETED> (1) by striking ``shall'' and inserting ``may'';
and</DELETED>
<DELETED> (2) by striking ``$5,000,000'' and inserting ``up
to $2,500,000''.</DELETED>
<DELETED>SEC. 410. PEER REVIEW.</DELETED>
<DELETED> Section 504(d)(2) of the Public Health Service Act (42
U.S.C. 290aa-3(d)(2)) is amended by striking ``cooperative agreement,
or contract'' each place that such appears and inserting ``or
cooperative agreement''.</DELETED>
<DELETED>SEC. 411. FUNDING FOR TRAUMA CARE.</DELETED>
<DELETED> Section 1232(a) of the Public Health Service Act (42
U.S.C. 300d-32) is amended by striking ``and 1996'' and inserting
``through 2002''.</DELETED>
<DELETED>SEC. 412. HEALTH INFORMATION AND HEALTH PROMOTION.</DELETED>
<DELETED> Section 1701(b) of the Public Health Service Act (42
U.S.C. 300u(b)) is amended by striking ``through 1996'' and inserting
``through 2002''.</DELETED>
<DELETED>SEC. 413. EMERGENCY MEDICAL SERVICES FOR CHILDREN.</DELETED>
<DELETED> Section 1910 of the Public Health Service Act (42 U.S.C.
300w-9) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by striking ``two-year period'' and
inserting ``3-year period (with an optional 4th year
based on performance)''; and</DELETED>
<DELETED> (B) by striking ``one grant'' and
inserting ``3 grants''; and</DELETED>
<DELETED> (2) in subsection (d), by striking ``1997'' and
inserting ``2005''.</DELETED>
<DELETED>SEC. 414. ADMINISTRATION OF CERTAIN REQUIREMENTS.</DELETED>
<DELETED> (a) In General.--Section 2004 of Public Law 103-43 (107
Stat. 209) is amended by striking subsection (a).</DELETED>
<DELETED> (b) Conforming Amendments.--Section 2004 of Public Law
103-43, as amended by subsection (a) of this section, is amended--
</DELETED>
<DELETED> (1) by striking ``(b) Sense'' and all that follows
through ``In the case'' and inserting the following:</DELETED>
<DELETED> ``(a) Sense of Congress Regarding Purchase of American-
Made Equipment and Products.--In the case'';</DELETED>
<DELETED> (2) by striking ``(2) Notice to recipients of
assistance'' and inserting the following:</DELETED>
<DELETED> ``(b) Notice to Recipients of Assistance''; and</DELETED>
<DELETED> (3) in subsection (b), as redesignated by
paragraph (2) of this subsection, by striking ``paragraph (1)''
and inserting ``subsection (a)''.</DELETED>
<DELETED> (c) Effective Date.--This section is deemed to have taken
effect immediately after the enactment of Public Law 103-43.</DELETED>
<DELETED>SEC. 415. AIDS DRUG ASSISTANCE PROGRAM.</DELETED>
<DELETED> Section 2618(b)(3) of the Public Health Service Act (42
U.S.C. 300ff-28(b)(3)) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``and the
Commonwealth of Puerto Rico'' and inserting ``, the
Commonwealth of Puerto Rico, the Virgin Islands, and Guam'';
and</DELETED>
<DELETED> (2) in paragraph (2), by striking ``the Virgin
Islands, Guam''.</DELETED>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Health Professions
Education Partnerships Act of 1998''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS
Subtitle A--Health Professions Education Programs
Sec. 101. Under-represented minority health professions grant program.
Sec. 102. Training in primary care medicine and dentistry.
Sec. 103. Interdisciplinary, community-based linkages.
Sec. 104. Health professions workforce information and analysis.
Sec. 105. Public health workforce development.
Sec. 106. General provisions.
Sec. 107. Preference in certain programs.
Sec. 108. Definitions.
Sec. 109. Technical amendment on National Health Service Corps.
Sec. 110. Savings provision.
Subtitle B--Nursing Workforce Development
Sec. 121. Short title.
Sec. 122. Purpose.
Sec. 123. Amendments to Public Health Service Act.
Sec. 124. Savings provision.
Subtitle C--Financial Assistance
CHAPTER 1--SCHOOL-BASED REVOLVING LOAN FUNDS
Sec. 131. Primary care loan program.
Sec. 132. Loans for disadvantaged students.
Sec. 133. Student loans regarding schools of nursing.
Sec. 134. General provisions.
CHAPTER 2--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE
STUDENTS
Sec. 141. Health Education Assistance Loan Program.
Sec. 142. HEAL lender and holder performance standards.
Sec. 143. Reauthorization.
Sec. 144. HEAL bankruptcy.
Sec. 145. HEAL refinancing.
TITLE II--OFFICE OF MINORITY HEALTH
Sec. 201. Revision and extension of programs of Office of Minority
Health.
TITLE III--SELECTED INITIATIVES
Sec. 301. State offices of rural health.
Sec. 302. Demonstration projects regarding Alzheimer's Disease.
Sec. 303. Project grants for immunization services.
TITLE IV--MISCELLANEOUS PROVISIONS
Sec. 401. Technical corrections regarding Public Law 103-183.
Sec. 402. Miscellaneous amendments regarding PHS commissioned officers.
Sec. 403. Clinical traineeships.
Sec. 404. Project grants for screenings, referrals, and education
regarding lead poisoning.
Sec. 405. Project grants for preventive health services regarding
tuberculosis.
Sec. 406. CDC loan repayment program.
Sec. 407. Community programs on domestic violence.
Sec. 408. State loan repayment program.
Sec. 409. Authority of the director of NIH.
Sec. 410. Raise in maximum level of loan repayments.
Sec. 411. Construction of regional centers for research on primates.
Sec. 412. Peer review.
Sec. 413. Funding for trauma care.
Sec. 414. Health information and health promotion.
Sec. 415. Emergency medical services for children.
Sec. 416. Administration of certain requirements.
Sec. 417. Aids drug assistance program.
Sec. 418. National Foundation for Biomedical Research.
TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS
Subtitle A--Health Professions Education Programs
SEC. 101. UNDER-REPRESENTED MINORITY HEALTH PROFESSIONS GRANT PROGRAM.
(a) In General.--Part B of title VII of the Public Health Service
Act (42 U.S.C. 293 et seq.) is amended to read as follows:
``PART B--HEALTH PROFESSIONS TRAINING FOR DIVERSITY
``SEC. 736. CENTERS OF EXCELLENCE.
``(a) In General.--The Secretary shall make grants to, and enter
into contracts with, designated health professions schools described in
subsection (c), and other public and nonprofit health or educational
entities, for the purpose of assisting the schools in supporting
programs of excellence in health professions education for under-
represented minority individuals.
``(b) Required Use of Funds.--The Secretary may not make a grant
under subsection (a) unless the designated health professions school
involved agrees, subject to subsection (c)(1)(C), to expend the grant--
``(1) to develop a large competitive applicant pool through
linkages with institutions of higher education, local school
districts, and other community-based entities and establish an
education pipeline for health professions careers;
``(2) to establish, strengthen, or expand programs to
enhance the academic performance of under-represented minority
students attending the school;
``(3) to improve the capacity of such school to train,
recruit, and retain under-represented minority faculty
including the payment of such stipends and fellowships as the
Secretary may determine appropriate;
``(4) to carry out activities to improve the information
resources, clinical education, curricula and cultural
competence of the graduates of the school, as it relates to
minority health issues;
``(5) to facilitate faculty and student research on health
issues particularly affecting under-represented minority
groups, including research on issues relating to the delivery
of health care;
``(6) to carry out a program to train students of the
school in providing health services to a significant number of
under-represented minority individuals through training
provided to such students at community-based health facilities
that--
``(A) provide such health services; and
``(B) are located at a site remote from the main
site of the teaching facilities of the school; and
``(7) to provide stipends as the Secretary determines
appropriate, in amounts as the Secretary determines
appropriate.
``(c) Centers of Excellence.--
``(1) Designated schools.--
``(A) In general.--The designated health
professions schools referred to in subsection (a) are
such schools that meet each of the conditions specified
in subparagraphs (B) and (C), and that--
``(i) meet each of the conditions specified
in paragraph (2)(A);
``(ii) meet each of the conditions
specified in paragraph (3);
``(iii) meet each of the conditions
specified in paragraph (4); or
``(iv) meet each of the conditions
specified in paragraph (5).
``(B) General conditions.--The conditions specified
in this subparagraph are that a designated health
professions school--
``(i) has a significant number of under-
represented minority individuals enrolled in
the school, including individuals accepted for
enrollment in the school;
``(ii) has been effective in assisting
under-represented minority students of the
school to complete the program of education and
receive the degree involved;
``(iii) has been effective in recruiting
under-represented minority individuals to
enroll in and graduate from the school,
including providing scholarships and other
financial assistance to such individuals and
encouraging under-represented minority students
from all levels of the educational pipeline to
pursue health professions careers; and
``(iv) has made significant recruitment
efforts to increase the number of under-
represented minority individuals serving in
faculty or administrative positions at the
school.
``(C) Consortium.--The condition specified in this
subparagraph is that, in accordance with subsection
(e)(1), the designated health profession school
involved has with other health profession schools
(designated or otherwise) formed a consortium to carry
out the purposes described in subsection (b) at the
schools of the consortium.
``(D) Application of criteria to other programs.--
In the case of any criteria established by the
Secretary for purposes of determining whether schools
meet the conditions described in subparagraph (B), this
section may not, with respect to racial and ethnic
minorities, be construed to authorize, require, or
prohibit the use of such criteria in any program other
than the program established in this section.
``(2) Centers of excellence at certain historically black
colleges and universities.--
``(A) Conditions.--The conditions specified in this
subparagraph are that a designated health professions
school--
``(i) is a school described in section
799B(1); and
``(ii) received a contract under section
788B for fiscal year 1987, as such section was
in effect for such fiscal year.
``(B) Use of grant.--In addition to the purposes
described in subsection (b), a grant under subsection
(a) to a designated health professions school meeting
the conditions described in subparagraph (A) may be
expended--
``(i) to develop a plan to achieve
institutional improvements, including financial
independence, to enable the school to support
programs of excellence in health professions
education for under-represented minority
individuals; and
``(ii) to provide improved access to the
library and informational resources of the
school.
``(C) Exception.--The requirements of paragraph
(1)(C) shall not apply to a historically black college
or university that receives funding under paragraphs
(2) or (5).
``(3) Hispanic centers of excellence.--The conditions
specified in this paragraph are that--
``(A) with respect to Hispanic individuals, each of
clauses (i) through (iv) of paragraph (1)(B) applies to
the designated health professions school involved;
``(B) the school agrees, as a condition of
receiving a grant under subsection (a), that the school
will, in carrying out the duties described in
subsection (b), give priority to carrying out the
duties with respect to Hispanic individuals; and
``(C) the school agrees, as a condition of
receiving a grant under subsection (a), that--
``(i) the school will establish an
arrangement with 1 or more public or nonprofit
community based Hispanic serving organizations,
or public or nonprofit private institutions of
higher education, including schools of nursing,
whose enrollment of students has traditionally
included a significant number of Hispanic
individuals, the purposes of which will be to
carry out a program--
``(I) to identify Hispanic students
who are interested in a career in the
health profession involved; and
``(II) to facilitate the
educational preparation of such
students to enter the health
professions school; and
``(ii) the school will make efforts to
recruit Hispanic students, including students
who have participated in the undergraduate or
other matriculation program carried out under
arrangements established by the school pursuant
to clause (i)(II) and will assist Hispanic
students regarding the completion of the
educational requirements for a degree from the
school.
``(4) Native american centers of excellence.--Subject to
subsection (e), the conditions specified in this paragraph are
that--
``(A) with respect to Native Americans, each of
clauses (i) through (iv) of paragraph (1)(B) applies to
the designated health professions school involved;
``(B) the school agrees, as a condition of
receiving a grant under subsection (a), that the school
will, in carrying out the duties described in
subsection (b), give priority to carrying out the
duties with respect to Native Americans; and
``(C) the school agrees, as a condition of
receiving a grant under subsection (a), that--
``(i) the school will establish an
arrangement with 1 or more public or nonprofit
private institutions of higher education,
including schools of nursing, whose enrollment
of students has traditionally included a
significant number of Native Americans, the
purpose of which arrangement will be to carry
out a program--
``(I) to identify Native American
students, from the institutions of
higher education referred to in clause
(i), who are interested in health
professions careers; and
``(II) to facilitate the
educational preparation of such
students to enter the designated health
professions school; and
``(ii) the designated health professions
school will make efforts to recruit Native
American students, including students who have
participated in the undergraduate program
carried out under arrangements established by
the school pursuant to clause (i) and will
assist Native American students regarding the
completion of the educational requirements for
a degree from the designated health professions
school.
``(5) Other centers of excellence.--The conditions
specified in this paragraph are--
``(A) with respect to other centers of excellence,
the conditions described in clauses (i) through (iv) of
paragraph (1)(B); and
``(B) that the health professions school involved
has an enrollment of under-represented minorities above
the national average for such enrollments of health
professions schools.
``(d) Designation as Center of Excellence.--
``(1) In general.--Any designated health professions school
receiving a grant under subsection (a) and meeting the
conditions described in paragraph (2) or (5) of subsection (c)
shall, for purposes of this section, be designated by the
Secretary as a Center of Excellence in Under-Represented
Minority Health Professions Education.
``(2) Hispanic centers of excellence.--Any designated
health professions school receiving a grant under subsection
(a) and meeting the conditions described in subsection (c)(3)
shall, for purposes of this section, be designated by the
Secretary as a Hispanic Center of Excellence in Health
Professions Education.
``(3) Native american centers of excellence.--Any
designated health professions school receiving a grant under
subsection (a) and meeting the conditions described in
subsection (c)(4) shall, for purposes of this section, be
designated by the Secretary as a Native American Center of
Excellence in Health Professions Education. Any consortium
receiving such a grant pursuant to subsection (e) shall, for
purposes of this section, be so designated.
``(e) Authority Regarding Native American Centers of Excellence.--
With respect to meeting the conditions specified in subsection (c)(4),
the Secretary may make a grant under subsection (a) to a designated
health professions school that does not meet such conditions if--
``(1) the school has formed a consortium in accordance with
subsection (d)(1); and
``(2) the schools of the consortium collectively meet such
conditions, without regard to whether the schools individually
meet such conditions.
``(f) Duration of Grant.--The period during which payments are made
under a grant under subsection (a) may not exceed 5 years. Such
payments shall be subject to annual approval by the Secretary and to
the availability of appropriations for the fiscal year involved to make
the payments.
``(g) Definitions.--In this section:
``(1) Designated health professions school.--
``(A) In general.--The term `health professions
school' means, except as provided in subparagraph (B),
a school of medicine, a school of osteopathic medicine,
a school of dentistry, a school of pharmacy, or a
graduate program in behavioral or mental health.
``(B) Exception.--The definition established in
subparagraph (A) shall not apply to the use of the term
`designated health professions school' for purposes of
subsection (c)(2).
``(2) Program of excellence.--The term `program of
excellence' means any program carried out by a designated
health professions school with a grant made under subsection
(a), if the program is for purposes for which the school
involved is authorized in subsection (b) or (c) to expend the
grant.
``(3) Native americans.--The term `Native Americans' means
American Indians, Alaskan Natives, Aleuts, and Native
Hawaiians.
``(h) Funding.--
``(1) Authorization of appropriations.--For the purpose of
making grants under subsection (a), there authorized to be
appropriated $26,000,000 for fiscal year 1998, and such sums as
may be necessary for each of the fiscal years 1999 through
2002.
``(2) Allocations.--Based on the amount appropriated under
paragraph (1) for a fiscal year, one of the following
subparagraphs shall apply:
``(A) In general.--If the amounts appropriated
under paragraph (1) for a fiscal year are $24,000,000
or less--
``(i) the Secretary shall make available
$12,000,000 for grants under subsection (a) to
health professions schools that meet the
conditions described in subsection (c)(2)(A);
and
``(ii) and available after grants are made
with funds under clause (i), the Secretary
shall make available--
``(I) 60 percent of such amount for
grants under subsection (a) to health
professions schools that meet the
conditions described in paragraph (3)
or (4) of subsection (c) (including
meeting the conditions under subsection
(e)); and
``(II) 40 percent of such amount
for grants under subsection (a) to
health professions schools that meet
the conditions described in subsection
(c)(5).
``(B) Funding in excess of $24,000,000.--If amounts
appropriated under paragraph (1) for a fiscal year
exceed $24,000,000 but are less than $30,000,000--
``(i) 80 percent of such excess amounts
shall be made available for grants under
subsection (a) to health professions schools
that meet the requirements described in
paragraph (3) or (4) of subsection (c)
(including meeting conditions pursuant to
subsection (e)); and
``(ii) 20 percent of such excess amount
shall be made available for grants under
subsection (a) to health professions schools
that meet the conditions described in
subsection (c)(5).
``(C) Funding in excess of $30,000,000.--If amounts
appropriated under paragraph (1) for a fiscal year are
$30,000,000 or more, the Secretary shall make
available--
``(i) not less than $12,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
subsection (c)(2)(A);
``(ii) not less than $12,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
paragraph (3) or (4) of subsection (c)
(including meeting conditions pursuant to
subsection (e));
``(iii) not less than $6,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
subsection (c)(5); and
``(iv) after grants are made with funds
under clauses (i) through (iii), any remaining
funds for grants under subsection (a) to health
professions schools that meet the conditions
described in paragraph (2)(A), (3), (4), or (5)
of subsection (c).
``(3) No limitation.--Nothing in this subsection shall be
construed as limiting the centers of excellence referred to in
this section to the designated amount, or to preclude such
entities from competing for other grants under this section.
``(4) Maintenance of effort.--
``(A) In general.--With respect to activities for
which a grant made under this part are authorized to be
expended, the Secretary may not make such a grant to a
center of excellence for any fiscal year unless the
center agrees to maintain expenditures of non-Federal
amounts for such activities at a level that is not less
than the level of such expenditures maintained by the
center for the fiscal year preceding the fiscal year
for which the school receives such a grant.
``(B) Use of federal funds.--With respect to any
Federal amounts received by a center of excellence and
available for carrying out activities for which a grant
under this part is authorized to be expended, the
Secretary may not make such a grant to the center for
any fiscal year unless the center agrees that the
center will, before expending the grant, expend the
Federal amounts obtained from sources other than the
grant.
``SEC. 737. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.
``(a) In General.--The Secretary may make a grant to an eligible
entity (as defined in subsection (d)(1)) under this section for the
awarding of scholarships by schools to any full-time student who is an
eligible individual as defined in subsection (d). Such scholarships may
be expended only for tuition expenses, other reasonable educational
expenses, and reasonable living expenses incurred in the attendance of
such school.
``(b) Preference in Providing Scholarships.--The Secretary may not
make a grant to an entity under subsection (a) unless the health
professions and nursing schools involved agree that, in providing
scholarships pursuant to the grant, the schools will give preference to
students for whom the costs of attending the schools would constitute a
severe financial hardship and, notwithstanding other provisions of this
section, to former recipients of scholarships under sections 736 and
740(d)(2)(B) (as such sections existed on the day before the date of
enactment of this section).
``(c) Amount of Award.--In awarding grants to eligible entities
that are health professions and nursing schools, the Secretary shall
give priority to eligible entities based on the proportion of
graduating students going into primary care, the proportion of
underrepresented minority students, and the proportion of graduates
working in medically underserved communities.
``(d) Definitions.--In this section:
``(1) Eligible entities.--The term `eligible entities'
means an entity that--
``(A) is a school of medicine, osteopathic
medicine, dentistry, nursing (as defined in section
801), pharmacy, podiatric medicine, optometry,
veterinary medicine, public health, chiropractic, or
allied health, a school offering a graduate program in
behavioral and mental health practice, or an entity
providing programs for the training of physician
assistants; and
``(B) is carrying out a program for recruiting and
retaining students from disadvantaged backgrounds,
including students who are members of racial and ethnic
minority groups.
``(2) Eligible individual.--The term `eligible individual'
means an individual who--
``(A) is from a disadvantaged background;
``(B) has a financial need for a scholarship; and
``(C) is enrolled (or accepted for enrollment) at
an eligible health professions or nursing school as a
full-time student in a program leading to a degree in a
health profession or nursing.
``SEC. 738. LOAN REPAYMENTS AND FELLOWSHIPS REGARDING FACULTY
POSITIONS.
``(a) Loan Repayments.--
``(1) Establishment of program.--The Secretary shall
establish a program of entering into contracts with individuals
described in paragraph (2) under which the individuals agree to
serve as members of the faculties of schools described in
paragraph (3) in consideration of the Federal Government
agreeing to pay, for each year of such service, not more than
$20,000 of the principal and interest of the educational loans
of such individuals.
``(2) Eligible individuals.--The individuals referred to in
paragraph (1) are individuals from disadvantaged backgrounds
who--
``(A) have a degree in medicine, osteopathic
medicine, dentistry, nursing, or another health
profession;
``(B) are enrolled in an approved graduate training
program in medicine, osteopathic medicine, dentistry,
nursing, or other health profession; or
``(C) are enrolled as full-time students--
``(i) in an accredited (as determined by
the Secretary) school described in paragraph
(3); and
``(ii) in the final year of a course of a
study or program, offered by such institution
and approved by the Secretary, leading to a
degree from such a school.
``(3) Eligible health professions schools.--The schools
described in this paragraph are schools of medicine, nursing
(as schools of nursing are defined in section 801), osteopathic
medicine, dentistry, pharmacy, allied health, podiatric
medicine, optometry, veterinary medicine, or public health, or
schools offering graduate programs in behavioral and mental
health.
``(4) Requirements regarding faculty positions.--The
Secretary may not enter into a contract under paragraph (1)
unless--
``(A) the individual involved has entered into a
contract with a school described in paragraph (3) to
serve as a member of the faculty of the school for not
less than 2 years; and
``(B) the contract referred to in subparagraph (A)
provides that--
``(i) the school will, for each year for
which the individual will serve as a member of
the faculty under the contract with the school,
make payments of the principal and interest due
on the educational loans of the individual for
such year in an amount equal to the amount of
such payments made by the Secretary for the
year;
``(ii) the payments made by the school
pursuant to clause (i) on behalf of the
individual will be in addition to the pay that
the individual would otherwise receive for
serving as a member of such faculty; and
``(iii) the school, in making a
determination of the amount of compensation to
be provided by the school to the individual for
serving as a member of the faculty, will make
the determination without regard to the amount
of payments made (or to be made) to the
individual by the Federal Government under
paragraph (1).
``(5) Applicability of certain provisions.--The provisions
of sections 338C, 338G, and 338I shall apply to the program
established in paragraph (1) to the same extent and in the same
manner as such provisions apply to the National Health Service
Corps Loan Repayment Program established in subpart III of part
D of title III, including the applicability of provisions
regarding reimbursements for increased tax liability and
regarding bankruptcy.
``(6) Waiver regarding school contributions.--The Secretary
may waive the requirement established in paragraph (4)(B) if
the Secretary determines that the requirement will impose an
undue financial hardship on the school involved.
``(b) Fellowships.--
``(1) In general.--The Secretary may make grants to and
enter into contracts with eligible entities to assist such
entities in increasing the number of underrepresented minority
individuals who are members of the faculty of such schools.
``(2) Applications.--To be eligible to receive a grant or
contract under this subsection, an entity shall provide an
assurance, in the application submitted by the entity, that--
``(A) amounts received under such a grant or
contract will be used to award a fellowship to an
individual only if the individual meets the
requirements of paragraphs (3) and (4); and
``(B) each fellowship awarded pursuant to the grant
or contract will include--
``(i) a stipend in an amount not exceeding
50 percent of the regular salary of a similar
faculty member for not to exceed 3 years of
training; and
``(ii) an allowance for other expenses,
such as travel to professional meetings and
costs related to specialized training.
``(3) Eligibility.--To be eligible to receive a grant or
contract under paragraph (1), an applicant shall demonstrate to
the Secretary that such applicant has or will have the ability
to--
``(A) identify, recruit and select underrepresented
minority individuals who have the potential for
teaching, administration, or conducting research at a
health professions institution;
``(B) provide such individuals with the skills
necessary to enable them to secure a tenured faculty
position at such institution, which may include
training with respect to pedagogical skills, program
administration, the design and conduct of research,
grants writing, and the preparation of articles
suitable for publication in peer reviewed journals;
``(C) provide services designed to assist such
individuals in their preparation for an academic
career, including the provision of counselors; and
``(D) provide health services to rural or medically
underserved populations.
``(4) Requirements.--To be eligible to receive a grant or
contract under paragraph (1) an applicant shall--
``(A) provide an assurance that such applicant will
make available (directly through cash donations) $1 for
every $1 of Federal funds received under this section
for the fellowship;
``(B) provide an assurance that institutional
support will be provided for the individual for the
second and third years at a level that is equal to the
total amount of institutional funds provided in the
year in which the grant or contract was awarded;
``(C) provide an assurance that the individual that
will receive the fellowship will be a member of the
faculty of the applicant school; and
``(D) provide an assurance that the individual that
will receive the fellowship will have, at a minimum,
appropriate advanced preparation (such as a master's or
doctoral degree) and special skills necessary to enable
such individual to teach and practice.
``(5) Definition.--For purposes of this subsection, the
term `underrepresented minority individuals' means individuals
who are members of racial or ethnic minority groups that are
underrepresented in the health professions including nursing.
``SEC. 739. EDUCATIONAL ASSISTANCE IN THE HEALTH PROFESSIONS REGARDING
INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.
``(a) In General.--
``(1) Authority for grants.--For the purpose of assisting
individuals from disadvantaged backgrounds, as determined in
accordance with criteria prescribed by the Secretary, to
undertake education to enter a health profession, the Secretary
may make grants to and enter into contracts with schools of
medicine, osteopathic medicine, public health, dentistry,
veterinary medicine, optometry, pharmacy, allied health,
chiropractic, and podiatric medicine, public and nonprofit
private schools that offer graduate programs in behavioral and
mental health, programs for the training of physician
assistants, and other public or private nonprofit health or
educational entities to assist in meeting the costs described
in paragraph (2).
``(2) Authorized expenditures.--A grant or contract under
paragraph (1) may be used by the entity to meet the cost of--
``(A) identifying, recruiting, and selecting
individuals from disadvantaged backgrounds, as so
determined, for education and training in a health
profession;
``(B) facilitating the entry of such individuals
into such a school;
``(C) providing counseling, mentoring, or other
services designed to assist such individuals to
complete successfully their education at such a school;
``(D) providing, for a period prior to the entry of
such individuals into the regular course of education
of such a school, preliminary education and health
research training designed to assist them to complete
successfully such regular course of education at such a
school, or referring such individuals to institutions
providing such preliminary education;
``(E) publicizing existing sources of financial aid
available to students in the education program of such
a school or who are undertaking training necessary to
qualify them to enroll in such a program;
``(F) paying such scholarships as the Secretary may
determine for such individuals for any period of health
professions education at a health professions school;
``(G) paying such stipends as the Secretary may
approve for such individuals for any period of
education in student-enhancement programs (other than
regular courses), except that such a stipend may not be
provided to an individual for more than 12 months, and
such a stipend shall be in an amount determined
appropriate by the Secretary (notwithstanding any other
provision of law regarding the amount of stipends);
``(H) carrying out programs under which such
individuals gain experience regarding a career in a
field of primary health care through working at
facilities of public or private nonprofit community-
based providers of primary health services; and
``(I) conducting activities to develop a larger and
more competitive applicant pool through partnerships
with institutions of higher education, school
districts, and other community-based entities.
``(3) Definition.--In this section, the term `regular
course of education of such a school' as used in subparagraph
(D) includes a graduate program in behavioral or mental health.
``(b) Requirements for Awards.--In making awards to eligible
entities under subsection (a)(1), the Secretary shall give preference
to approved applications for programs that involve a comprehensive
approach by several public or nonprofit private health or educational
entities to establish, enhance and expand educational programs that
will result in the development of a competitive applicant pool of
individuals from disadvantaged backgrounds who desire to pursue health
professions careers. In considering awards for such a comprehensive
partnership approach, the following shall apply with respect to the
entity involved:
``(1) The entity shall have a demonstrated commitment to
such approach through formal agreements that have common
objectives with institutions of higher education, school
districts, and other community-based entities.
``(2) Such formal agreements shall reflect the coordination
of educational activities and support services, increased
linkages, and the consolidation of resources within a specific
geographic area.
``(3) The design of the educational activities involved
shall provide for the establishment of a competitive health
professions applicant pool of individuals from disadvantaged
backgrounds by enhancing the total preparation (academic and
social) of such individuals to pursue a health professions
career.
``(4) The programs or activities under the award shall
focus on developing a culturally competent health care
workforce that will serve the unserved and underserved
populations within the geographic area.
``(c) Equitable Allocation of Financial Assistance.--The Secretary,
to the extent practicable, shall ensure that services and activities
under subsection (a) are adequately allocated among the various racial
and ethnic populations who are from disadvantaged backgrounds.
``(d) Matching Requirements.--The Secretary may require that an
entity that applies for a grant or contract under subsection (a),
provide non-Federal matching funds, as appropriate, to ensure the
institutional commitment of the entity to the projects funded under the
grant or contract. As determined by the Secretary, such non-Federal
matching funds may be provided directly or through donations from
public or private entities and may be in cash or in-kind, fairly
evaluated, including plant, equipment, or services.
``SEC. 740. AUTHORIZATION OF APPROPRIATION.
``(a) Scholarships.--There are authorized to be appropriated to
carry out section 737, $37,000,000 for fiscal year 1998, and such sums
as may be necessary for each of the fiscal years 1999 through 2002. Of
the amount appropriated in any fiscal year, the Secretary shall ensure
that not less than 16 percent shall be distributed to schools of
nursing.
``(b) Loan Repayments and Fellowships.--For the purpose of carrying
out section 738, there is authorized to be appropriated $1,100,000 for
fiscal year 1998, and such sums as may be necessary for each of the
fiscal years 1999 through 2002.
``(c) Educational Assistance in Health Professions Regarding
Individuals for Disadvantaged Backgrounds.--For the purpose of grants
and contracts under section 739(a)(1), there is authorized to be
appropriated $29,400,000 for fiscal year 1998, and such sums as may be
necessary for each of the fiscal years 1999 through 2002. The Secretary
may use not to exceed 20 percent of the amount appropriated for a
fiscal year under this subsection to provide scholarships under section
739(a)(2)(F).
``(d) Report.--Not later than 6 months after the date of enactment
of this part, the Secretary shall prepare and submit to the appropriate
committees of Congress a report concerning the efforts of the Secretary
to address the need for a representative mix of individuals from
historically minority health professions schools, or from institutions
or other entities that historically or by geographic location have a
demonstrated record of training or educating underrepresented
minorities, within various health professions disciplines, on peer
review councils.''.
(b) Repeal.--
(1) In general.--Section 795 of the Public Health Service
Act (42 U.S.C. 295n) is repealed.
(2) Nontermination of authority.--The amendments made by
this section shall not be construed to terminate agreements
that, on the day before the date of enactment of this Act, are
in effect pursuant to section 795 of the Public Health Service
Act (42 U.S.C. 795) as such section existed on such date. Such
agreements shall continue in effect in accordance with the
terms of the agreements. With respect to compliance with such
agreements, any period of practice as a provider of primary
health services shall be counted towards the satisfaction of
the requirement of practice pursuant to such section 795.
(c) Conforming Amendments.--Section 481A(c)(3)(D)(i) of the Public
Health Service Act (42 U.S.C. 287a-2(c)(3)(D)(i)) is amended by
striking ``section 739'' and inserting ``part B of title VII''.
SEC. 102. TRAINING IN PRIMARY CARE MEDICINE AND DENTISTRY.
Part C of title VII of the Public Health Service Act (42 U.S.C. 293
et seq.) is amended--
(1) in the part heading by striking ``PRIMARY HEALTH CARE''
and inserting ``FAMILY MEDICINE, GENERAL INTERNAL MEDICINE,
GENERAL PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL DENTISTRY,
AND PEDIATRIC DENTISTRY'';
(2) by repealing section 746 (42 U.S.C. 293j);
(3) in section 747 (42 U.S.C. 293k)--
(A) by striking the section heading and inserting
the following:
``SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL
PEDIATRICS, GENERAL DENTISTRY, PEDIATRIC DENTISTRY, AND
PHYSICIAN ASSISTANTS.'';
(B) in subsection (a)--
(i) in paragraph (1)--
(I) by inserting ``, internal
medicine, or pediatrics'' after
``family medicine''; and
(II) by inserting before the
semicolon the following: ``that
emphasizes training for the practice of
family medicine, general internal
medicine, or general pediatrics (as
defined by the Secretary)'';
(ii) in paragraph (2), by inserting ``,
general internal medicine, or general
pediatrics'' before the semicolon;
(iii) in paragraphs (3) and (4), by
inserting ``(including geriatrics), general
internal medicine or general pediatrics'' after
``family medicine'';
(iv) in paragraph (3), by striking ``and''
at the end thereof;
(v) in paragraph (4), by striking the
period and inserting a semicolon; and
(vii) by adding at the end thereof the
following new paragraphs:
``(5) to meet the costs of projects to plan, develop, and
operate or maintain programs for the training of physician
assistants (as defined in section 799B), and for the training
of individuals who will teach in programs to provide such
training; and
``(6) to meet the costs of planning, developing, or
operating programs, and to provide financial assistance to
residents in such programs, of general dentistry or pediatric
dentistry.
For purposes of paragraph (6), entities eligible for such grants or
contracts shall include entities that have programs in dental schools,
approved residency programs in the general or pediatric practice of
dentistry, approved advanced education programs in the general or
pediatric practice of dentistry, or approved residency programs in
pediatric dentistry.'';
(C) in subsection (b)--
(i) in paragraphs (1) and (2)(A), by
inserting ``, general internal medicine, or
general pediatrics'' after ``family medicine'';
(ii) in paragraph (2)--
(I) in subparagraph (A), by
striking ``or'' at the end; and
(II) in subparagraph (B), by
striking the period and inserting ``;
or''; and
(iii) by adding at the end the following:
``(3) Priority in making awards.--In making awards of
grants and contracts under paragraph (1), the Secretary shall
give priority to any qualified applicant for such an award that
proposes a collaborative project between departments of primary
care.'';
(D) by redesignating subsections (c) and (d) as
subsections (d) and (e), respectively;
(E) by inserting after subsection (b), the
following new subsection:
``(c) Priority.--
``(1) In general.--With respect to programs for the
training of interns or residents, the Secretary shall give
priority in awarding grants under this section to qualified
applicants that have a record of training the greatest
percentage of providers, or that have demonstrated significant
improvements in the percentage of providers, which enter and
remain in primary care practice or general or pediatric
dentistry.
``(2) Disadvantaged individuals.--With respect to programs
for the training of interns, residents, or physician
assistants, the Secretary shall give priority in awarding
grants under this section to qualified applicants that have a
record of training individuals who are from disadvantaged
backgrounds (including racial and ethnic minorities
underrepresented among primary care practice or general or
pediatric dentistry).
``(3) Special consideration.--In awarding grants under this
section the Secretary shall give special consideration to
projects which prepare practitioners to care for underserved
populations and other high risk groups such as the elderly,
individuals with HIV-AIDS, substance abusers, homeless, and
victims of domestic violence.''; and
(F) in subsection (e) (as so redesignated by
subparagraph (D))--
(i) in paragraph (1), by striking
``$54,000,000'' and all that follows and
inserting ``$78,300,000 for fiscal year 1998,
and such sums as may be necessary for each of
the fiscal years 1999 through 2002.''; and
(ii) by striking paragraph (2) and
inserting the following:
``(2) Allocation.--
``(A) In general.--Of the amounts appropriated
under paragraph (1) for a fiscal year, the Secretary
shall make available--
``(i) not less than $49,300,000 for awards
of grants and contracts under subsection (a) to
programs of family medicine, of which not less
than $8,600,000 shall be made available for
awards of grants and contracts under subsection
(b) for family medicine academic administrative
units;
``(ii) not less than $17,700,000 for awards
of grants and contracts under subsection (a) to
programs of general internal medicine and
general pediatrics;
``(iii) not less than $6,800,000 for awards
of grants and contracts under subsection (a) to
programs relating to physician assistants; and
``(iv) not less than $4,500,000 for awards
of grants and contracts under subsection (a) to
programs of general or pediatric dentistry.
``(B) Ratable reduction.--If amounts appropriated
under paragraph (1) for any fiscal year are less than
the amount required to comply with subparagraph (A),
the Secretary shall ratably reduce the amount to be
made available under each of clauses (i) through (iv)
of such subparagraph accordingly.''; and
(4) by repealing sections 748 through 752 (42 U.S.C. 293l
through 293p) and inserting the following:
``SEC. 748. ADVISORY COMMITTEE ON TRAINING IN PRIMARY CARE MEDICINE AND
DENTISTRY.
``(a) Establishment.--The Secretary shall establish an advisory
committee to be known as the Advisory Committee on Training in Primary
Care Medicine and Dentistry (in this section referred to as the
`Advisory Committee').
``(b) Composition.--
``(1) In general.--The Secretary shall determine the
appropriate number of individuals to serve on the Advisory
Committee. Such individuals shall not be officers or employees
of the Federal Government.
``(2) Appointment.--Not later than 90 days after the date
of enactment of this Act, the Secretary shall appoint the
members of the Advisory Committee from among individuals who
are health professionals. In making such appointments, the
Secretary shall ensure a fair balance between the health
professions, that at least 75 percent of the members of the
Advisory Committee are health professionals, a broad geographic
representation of members and a balance between urban and rural
members. Members shall be appointed based on their competence,
interest, and knowledge of the mission of the profession
involved.
``(3) Minority representation.--In appointing the members
of the Advisory Committee under paragraph (2), the Secretary
shall ensure the adequate representation of women and
minorities.
``(c) Terms.--
``(1) In general.--A member of the Advisory Committee shall
be appointed for a term of 3 years, except that of the members
first appointed--
``(A) \1/3\ of such members shall serve for a term
of 1 year;
``(B) \1/3\ of such members shall serve for a term
of 2 years; and
``(C) \1/3\ of such members shall serve for a term
of 3 years.
``(2) Vacancies.--
``(A) In general.--A vacancy on the Advisory
Committee shall be filled in the manner in which the
original appointment was made and shall be subject to
any conditions which applied with respect to the
original appointment.
``(B) Filling unexpired term.--An individual chosen
to fill a vacancy shall be appointed for the unexpired
term of the member replaced.
``(d) Duties.--The Advisory Committee shall--
``(1) provide advice and recommendations to the Secretary
concerning policy and program development and other matters of
significance concerning the activities under section 747; and
``(2) not later than 3 years after the date of enactment of
this section, and annually thereafter, prepare and submit to
the Secretary, and the Committee on Labor and Human Resources
of the Senate, and the Committee on Commerce of the House of
Representatives, a report describing the activities of the
Committee, including findings and recommendations made by the
Committee concerning the activities under section 747.
``(e) Meetings and Documents.--
``(1) Meetings.--The Advisory Committee shall meet not less
than 2 times each year. Such meetings shall be held jointly
with other related entities established under this title where
appropriate.
``(2) Documents.--Not later than 14 days prior to the
convening of a meeting under paragraph (1), the Advisory
Committee shall prepare and make available an agenda of the
matters to be considered by the Advisory Committee at such
meeting. At any such meeting, the Advisory Council shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Committee shall prepare and make
available a summary of the meeting and any actions taken by the
Committee based upon the meeting.
``(f) Compensation and Expenses.--
``(1) Compensation.--Each member of the Advisory Committee
shall be compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such
member is engaged in the performance of the duties of the
Committee.
``(2) Expenses.--The members of the Advisory Committee
shall be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Committee.
``(g) FACA.--The Federal Advisory Committee Act shall apply to the
Advisory Committee under this section only to the extent that the
provisions of such Act do not conflict with the requirements of this
section.''.
SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES.
Part D of title VII of the Public Health Service Act (42 U.S.C. 294
et seq.) is amended to read as follows:
``PART D--INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES
``SEC. 750. GENERAL PROVISIONS.
``(a) Collaboration.--To be eligible to receive assistance under
this part, an academic institution shall use such assistance in
collaboration with 2 or more disciplines.
``(b) Activities.--An entity shall use assistance under this part
to carry out innovative demonstration projects for strategic workforce
supplementation activities as needed to meet national goals for
interdisciplinary, community-based linkages. Such assistance may be
used consistent with this part--
``(1) to develop and support training programs;
``(2) for faculty development;
``(3) for model demonstration programs;
``(4) for the provision of stipends for fellowship
trainees;
``(5) to provide technical assistance; and
``(6) for other activities that will produce outcomes
consistent with the purposes of this part.
``SEC. 751. AREA HEALTH EDUCATION CENTERS.
``(a) Authority for Provision of Financial Assistance.--
``(1) Assistance for planning, development, and operation
of programs.--
``(A) In general.--The Secretary shall award grants
to and enter into contracts with schools of medicine
and osteopathic medicine, and incorporated consortia
made up of such schools, or the parent institutions of
such schools, for projects for the planning,
development and operation of area health education
center programs that--
``(i) improve the recruitment,
distribution, supply, quality and efficiency of
personnel providing health services in
underserved rural and urban areas and personnel
providing health services to populations having
demonstrated serious unmet health care needs;
``(ii) increase the number of primary care
physicians and other primary care providers who
provide services in underserved areas through
the offering of an educational continuum of
health career recruitment through clinical
education concerning underserved areas in a
comprehensive health workforce strategy;
``(iii) carry out recruitment and health
career awareness programs to recruit
individuals from underserved areas and under-
represented populations, including minority and
other elementary or secondary students, into
the health professions;
``(iv) prepare individuals to more
effectively provide health services to
underserved areas or underserved populations
through field placements, preceptorships, the
conduct of or support of community-based
primary care residency programs, and agreements
with community-based organizations such as
community health centers, migrant health
centers, Indian health centers, public health
departments and others;
``(v) conduct health professions education
and training activities for students of health
professions schools and medical residents;
``(vi) conduct at least 10 percent of
medical student required clinical education at
sites remote to the primary teaching facility
of the contracting institution; and
``(vii) provide information dissemination
and educational support to reduce professional
isolation, increase retention, enhance the
practice environment, and improve health care
through the timely dissemination of research
findings using relevant resources.
``(B) Other eligible entities.--With respect to a
State in which no area health education center program
is in operation, the Secretary may award a grant or
contract under subparagraph (A) to a school of nursing.
``(C) Project terms.--
``(i) In general.--Except as provided in
clause (ii), the period during which payments
may be made under an award under subparagraph
(A) may not exceed--
``(I) in the case of a project, 12
years or
``(II) in the case of a center
within a project, 6 years.
``(ii) Exception.--The periods described in
clause (i) shall not apply to projects that
have completed the initial period of Federal
funding under this section and that desire to
compete for model awards under paragraph
(2)(A).
``(2) Assistance for operation of model programs.--
``(A) In general.--In the case of any entity
described in paragraph (1)(A) that--
``(i) has previously received funds under
this section;
``(ii) is operating an area health
education center program; and
``(iii) is no longer receiving financial
assistance under paragraph (1);
the Secretary may provide financial assistance to such
entity to pay the costs of operating and carrying out
the requirements of the program as described in
paragraph (1).
``(B) Matching requirement.--With respect to the
costs of operating a model program under subparagraph
(A), an entity, to be eligible for financial assistance
under subparagraph (A), shall make available (directly
or through contributions from State, county or
municipal governments, or the private sector) recurring
non-Federal contributions in cash toward such costs in
an amount that is equal to not less than 50 percent of
such costs.
``(C) Limitation.--The aggregate amount of awards
provided under subparagraph (A) to entities in a State
for a fiscal year may not exceed the lesser of--
``(i) $2,000,000; or
``(ii) an amount equal to the product of
$250,000 and the aggregate number of area
health education centers operated in the State
by such entities.
``(b) Requirements for Centers.--
``(1) General requirement.--Each area health education
center that receives funds under this section shall encourage
the regionalization of health professions schools through the
establishment of partnerships with community-based
organizations.
``(2) Service area.--Each area health education center that
receives funds under this section shall specifically designate
a geographic area or medically underserved population to be
served by the center. Such area or population shall be in a
location removed from the main location of the teaching
facilities of the schools participating in the program with
such center.
``(3) Other requirements.--Each area health education
center that receives funds under this section shall--
``(A) assess the health personnel needs of the area
to be served by the center and assist in the planning
and development of training programs to meet such
needs;
``(B) arrange and support rotations for students
and residents in family medicine, general internal
medicine or general pediatrics, with at least one
center in each program being affiliated with or
conducting a rotating osteopathic internship or medical
residency training program in family medicine
(including geriatrics), general internal medicine
(including geriatrics), or general pediatrics in which
no fewer than 4 individuals are enrolled in first-year
positions;
``(C) conduct and participate in interdisciplinary
training that involves physicians and other health
personnel including, where practicable, public health
professionals, physician assistants, nurse
practitioners, nurse midwives, and behavioral and
mental health providers; and
``(D) have an advisory board, at least 75 percent
of the members of which shall be individuals, including
both health service providers and consumers, from the
area served by the center.
``(c) Certain Provisions Regarding Funding.--
``(1) Allocation to center.--Not less than 75 percent of
the total amount of Federal funds provided to an entity under
this section shall be allocated by an area health education
center program to the area health education center. Such entity
shall enter into an agreement with each center for purposes of
specifying the allocation of such 75 percent of funds.
``(2) Operating costs.--With respect to the operating costs
of the area health education center program of an entity
receiving funds under this section, the entity shall make
available (directly or through contributions from State, county
or municipal governments, or the private sector) non-Federal
contributions in cash toward such costs in an amount that is
equal to not less than 50 percent of such costs, except that
the Secretary may grant a waiver for up to 75 percent of the
amount of the required non-Federal match in the first 3 years
in which an entity receives funds under this section.
``SEC. 752. HEALTH EDUCATION AND TRAINING CENTERS.
``(a) In General.--To be eligible for funds under this section, a
health education training center shall be an entity otherwise eligible
for funds under section 751 that--
``(1) addresses the persistent and severe unmet health care
needs in States along the border between the United States and
Mexico and in the State of Florida, and in other urban and
rural areas with populations with serious unmet health care
needs;
``(2) establishes an advisory board comprised of health
service providers, educators and consumers from the service
area;
``(3) conducts training and education programs for health
professions students in these areas;
``(4) conducts training in health education services,
including training to prepare community health workers; and
``(5) supports health professionals (including nursing)
practicing in the area through educational and other services.
``(b) Allocation of Funds.--The Secretary shall make available 50
percent of the amounts appropriated for each fiscal year under section
752 for the establishment or operation of health education training
centers through projects in States along the border between the United
States and Mexico and in the State of Florida.
``SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.
``(a) Geriatric Education Centers.--
``(1) In general.--The Secretary shall award grants or
contracts under this section to entities described in
paragraphs (1), (3), or (4) of section 799B, and section
853(2), for the establishment or operation of geriatric
education centers.
``(2) Requirements.--A geriatric education center is a
program that--
``(A) improves the training of health professionals
in geriatrics, including geriatric residencies,
traineeships, or fellowships;
``(B) develops and disseminates curricula relating
to the treatment of the health problems of elderly
individuals;
``(C) supports the training and retraining of
faculty to provide instruction in geriatrics;
``(D) supports continuing education of health
professionals who provide geriatric care; and
``(E) provides students with clinical training in
geriatrics in nursing homes, chronic and acute disease
hospitals, ambulatory care centers, and senior centers.
``(b) Geriatric Training Regarding Physicians and Dentists.--
``(1) In general.--The Secretary may make grants to, and
enter into contracts with, schools of medicine, schools of
osteopathic medicine, teaching hospitals, and graduate medical
education programs, for the purpose of providing support
(including residencies, traineeships, and fellowships) for
geriatric training projects to train physicians, dentists and
behavioral and mental health professionals who plan to teach
geriatric medicine, geriatric behavioral or mental health, or
geriatric dentistry.
``(2) Requirements.--Each project for which a grant or
contract is made under this subsection shall--
``(A) be staffed by full-time teaching physicians
who have experience or training in geriatric medicine
or geriatric behavioral or mental health;
``(B) be staffed, or enter into an agreement with
an institution staffed by full-time or part-time
teaching dentists who have experience or training in
geriatric dentistry;
``(C) be staffed, or enter into an agreement with
an institution staffed by full-time or part-time
teaching behavioral mental health professionals who
have experience or training in geriatric behavioral or
mental health;
``(D) be based in a graduate medical education
program in internal medicine or family medicine or in a
department of geriatrics or behavioral or mental
health;
``(E) provide training in geriatrics and exposure
to the physical and mental disabilities of elderly
individuals through a variety of service rotations,
such as geriatric consultation services, acute care
services, dental services, geriatric behavioral or
mental health units, day and home care programs,
rehabilitation services, extended care facilities,
geriatric ambulatory care and comprehensive evaluation
units, and community care programs for elderly mentally
retarded individuals; and
``(F) provide training in geriatrics through one or
both of the training options described in subparagraphs
(A) and (B) of paragraph (3).
``(3) Training options.--The training options referred to
in subparagraph (F) of paragraph (2) shall be as follows:
``(A) A 1-year retraining program in geriatrics
for--
``(i) physicians who are faculty members in
departments of internal medicine, family
medicine, gynecology, geriatrics, and
behavioral or mental health at schools of
medicine and osteopathic medicine;
``(ii) dentists who are faculty members at
schools of dentistry or at hospital departments
of dentistry; and
``(iii) behavioral or mental health
professionals who are faculty members in
departments of behavioral or mental health; and
``(B) A 2-year internal medicine or family medicine
fellowship program providing emphasis in geriatrics,
which shall be designed to provide training in clinical
geriatrics and geriatrics research for--
``(i) physicians who have completed
graduate medical education programs in internal
medicine, family medicine, behavioral or mental
health, neurology, gynecology, or
rehabilitation medicine;
``(ii) dentists who have demonstrated a
commitment to an academic career and who have
completed postdoctoral dental training,
including postdoctoral dental education
programs or who have relevant advanced training
or experience; and
``(iii) behavioral or mental health
professionals who have completed graduate
medical education programs in behavioral or
mental health.
``(4) Definitions.--For purposes of this subsection:
``(A) The term `graduate medical education program'
means a program sponsored by a school of medicine, a
school of osteopathic medicine, a hospital, or a public
or private institution that--
``(i) offers postgraduate medical training
in the specialties and subspecialties of
medicine; and
``(ii) has been accredited by the
Accreditation Council for Graduate Medical
Education or the American Osteopathic
Association through its Committee on
Postdoctoral Training.
``(B) The term `post-doctoral dental education
program' means a program sponsored by a school of
dentistry, a hospital, or a public or private
institution that--
``(i) offers post-doctoral training in the
specialties of dentistry, advanced education in
general dentistry, or a dental general practice
residency; and
``(ii) has been accredited by the
Commission on Dental Accreditation.
``(c) Geriatric Faculty Fellowships.--
``(1) Establishment of program.--The Secretary shall
establish a program to provide Geriatric Academic Career Awards
to eligible individuals to promote the career development of
such individuals as academic geriatricians.
``(2) Eligible individuals.--To be eligible to receive an
Award under paragraph (1), an individual shall--
``(A) be board certified or board eligible in
internal medicine, family practice, or psychiatry;
``(B) have completed an approved fellowship program
in geriatrics; and
``(C) have a junior faculty appointment at an
accredited (as determined by the Secretary) school of
medicine or osteopathic medicine.
``(3) Limitations.--No Award under paragraph (1) may be
made to an eligible individual unless the individual--
``(A) has submitted to the Secretary an
application, at such time, in such manner, and
containing such information as the Secretary may
require, and the Secretary has approved such
application; and
``(B) provides, in such form and manner as the
Secretary may require, assurances that the individual
will meet the service requirement described in
subsection (e).
``(4) Amount and term.--
``(A) Amount.--The amount of an Award under this
section shall equal $50,000 for fiscal year 1998,
adjusted for subsequent fiscal years to reflect the
increase in the Consumer Price Index.
``(B) Term.--The term of any Award made under this
subsection shall not exceed 5 years.
``(5) Service requirement.--An individual who receives an
Award under this subsection shall provide training in clinical
geriatrics, including the training of interdisciplinary teams
of health care professionals. The provision of such training
shall constitute at least 75 percent of the obligations of such
individual under the Award.
``SEC. 754. RURAL INTERDISCIPLINARY TRAINING GRANTS.
``(a) Grants.--The Secretary may make grants or contracts under
this section to help entities fund authorized activities under an
application approved under subsection (c).
``(b) Use of Amounts.--
``(1) In general.--Amounts provided under subsection (a)
shall be used by the recipients to fund interdisciplinary
training projects designed to--
``(A) use new and innovative methods to train
health care practitioners to provide services in rural
areas;
``(B) demonstrate and evaluate innovative
interdisciplinary methods and models designed to
provide access to cost-effective comprehensive health
care;
``(C) deliver health care services to individuals
residing in rural areas;
``(D) enhance the amount of relevant research
conducted concerning health care issues in rural areas;
and
``(E) increase the recruitment and retention of
health care practitioners from rural areas and make
rural practice a more attractive career choice for
health care practitioners.
``(2) Methods.--A recipient of funds under subsection (a)
may use various methods in carrying out the projects described
in paragraph (1), including--
``(A) the distribution of stipends to students of
eligible applicants;
``(B) the establishment of a post-doctoral
fellowship program;
``(C) the training of faculty in the economic and
logistical problems confronting rural health care
delivery systems; or
``(D) the purchase or rental of transportation and
telecommunication equipment where the need for such
equipment due to unique characteristics of the rural
area is demonstrated by the recipient.
``(3) Administration.--
``(A) In general.--An applicant shall not use more
than 10 percent of the funds made available to such
applicant under subsection (a) for administrative
expenses.
``(B) Training.--Not more than 10 percent of the
individuals receiving training with funds made
available to an applicant under subsection (a) shall be
trained as doctors of medicine or doctors of
osteopathy.
``(C) Limitation.--An institution that receives a
grant under this section shall use amounts received
under such grant to supplement, not supplant, amounts
made available by such institution for activities of
the type described in subsection (b)(1) in the fiscal
year preceding the year for which the grant is
received.
``(c) Applications.--Applications submitted for assistance under
this section shall--
``(1) be jointly submitted by at least two eligible
applicants with the express purpose of assisting individuals in
academic institutions in establishing long-term collaborative
relationships with health care providers in rural areas; and
``(2) designate a rural health care agency or agencies for
clinical treatment or training, including hospitals, community
health centers, migrant health centers, rural health clinics,
community behavioral and mental health centers, long-term care
facilities, Native Hawaiian health centers, or facilities
operated by the Indian Health Service or an Indian tribe or
tribal organization or Indian organization under a contract
with the Indian Health Service under the Indian Self-
Determination Act.
``(d) Definitions.--For the purposes of this section, the term
`rural' means geographic areas that are located outside of standard
metropolitan statistical areas.
``SEC. 755. ALLIED HEALTH AND OTHER DISCIPLINES.
``(a) In General.--The Secretary may make grants or contracts under
this section to help entities fund activities of the type described in
subsection (b).
``(b) Activities.--Activities of the type described in this
subsection include the following:
``(1) Assisting entities in meeting the costs associated
with expanding or establishing programs that will increase the
number of individuals trained in allied health professions.
Programs and activities funded under this paragraph may
include--
``(A) those that expand enrollments in allied
health professions with the greatest shortages or whose
services are most needed by the elderly;
``(B) those that provide rapid transition training
programs in allied health fields to individuals who
have baccalaureate degrees in health-related sciences;
``(C) those that establish community-based allied
health training programs that link academic centers to
rural clinical settings;
``(D) those that provide career advancement
training for practicing allied health professionals;
``(E) those that expand or establish clinical
training sites for allied health professionals in
medically underserved or rural communities in order to
increase the number of individuals trained;
``(F) those that develop curriculum that will
emphasize knowledge and practice in the areas of
prevention and health promotion, geriatrics, long-term
care, home health and hospice care, and ethics;
``(G) those that expand or establish
interdisciplinary training programs that promote the
effectiveness of allied health practitioners in
geriatric assessment and the rehabilitation of the
elderly;
``(H) those that expand or establish demonstration
centers to emphasize innovative models to link allied
health clinical practice, education, and research;
``(I) those that provide financial assistance (in
the form of traineeships) to students who are
participants in any such program; and
``(i) who plan to pursue a career in an
allied health field that has a demonstrated
personnel shortage; and
``(ii) who agree upon completion of the
training program to practice in a medically
underserved community;
that shall be utilized to assist in the payment of all
or part of the costs associated with tuition, fees and
such other stipends as the Secretary may consider
necessary; and
``(J) those to meet the costs of projects to plan,
develop, and operate or maintain graduate programs in
behavioral and mental health practice.
``(2) Planning and implementing projects in preventive and
primary care training for podiatric physicians in approved or
provisionally approved residency programs that shall provide
financial assistance in the form of traineeships to residents
who participate in such projects and who plan to specialize in
primary care.
``(3) Carrying out demonstration projects in which
chiropractors and physicians collaborate to identify and
provide effective treatment for spinal and lower-back
conditions.
``SEC. 756. ADVISORY COMMITTEE ON INTERDISCIPLINARY, COMMUNITY-BASED
LINKAGES.
``(a) Establishment.--The Secretary shall establish an advisory
committee to be known as the Advisory Committee on Interdisciplinary,
Community-Based Linkages (in this section referred to as the `Advisory
Committee').
``(b) Composition.--
``(1) In general.--The Secretary shall determine the
appropriate number of individuals to serve on the Advisory
Committee. Such individuals shall not be officers or employees
of the Federal Government.
``(2) Appointment.--Not later than 90 days after the date
of enactment of this Act, the Secretary shall appoint the
members of the Advisory Committee from among individuals who
are health professionals from schools of the types described in
sections 751(a)(1)(A), 751(a)(1)(B), 753(b), 754(3)(A), and
755(b). In making such appointments, the Secretary shall ensure
a fair balance between the health professions, that at least 75
percent of the members of the Advisory Committee are health
professionals, a broad geographic representation of members and
a balance between urban and rural members. Members shall be
appointed based on their competence, interest, and knowledge of
the mission of the profession involved.
``(3) Minority representation.--In appointing the members
of the Advisory Committee under paragraph (2), the Secretary
shall ensure the adequate representation of women and
minorities.
``(c) Terms.--
``(1) In general.--A member of the Advisory Committee shall
be appointed for a term of 3 years, except that of the members
first appointed--
``(A) \1/3\ of the members shall serve for a term
of 1 year;
``(B) \1/3\ of the members shall serve for a term
of 2 years; and
``(C) \1/3\ of the members shall serve for a term
of 3 years.
``(2) Vacancies.--
``(A) In general.--A vacancy on the Advisory
Committee shall be filled in the manner in which the
original appointment was made and shall be subject to
any conditions which applied with respect to the
original appointment.
``(B) Filling unexpired term.--An individual chosen
to fill a vacancy shall be appointed for the unexpired
term of the member replaced.
``(d) Duties.--The Advisory Committee shall--
``(1) provide advice and recommendations to the Secretary
concerning policy and program development and other matters of
significance concerning the activities under this part; and
``(2) not later than 3 years after the date of enactment of
this section, and annually thereafter, prepare and submit to
the Secretary, and the Committee on Labor and Human Resources
of the Senate, and the Committee on Commerce of the House of
Representatives, a report describing the activities of the
Committee, including findings and recommendations made by the
Committee concerning the activities under this part.
``(e) Meetings and Documents.--
``(1) Meetings.--The Advisory Committee shall meet not less
than 3 times each year. Such meetings shall be held jointly
with other related entities established under this title where
appropriate.
``(2) Documents.--Not later than 14 days prior to the
convening of a meeting under paragraph (1), the Advisory
Committee shall prepare and make available an agenda of the
matters to be considered by the Advisory Committee at such
meeting. At any such meeting, the Advisory Council shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Committee shall prepare and make
available a summary of the meeting and any actions taken by the
Committee based upon the meeting.
``(f) Compensation and Expenses.--
``(1) Compensation.--Each member of the Advisory Committee
shall be compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such
member is engaged in the performance of the duties of the
Committee.
``(2) Expenses.--The members of the Advisory Committee
shall be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Committee.
``(g) FACA.--The Federal Advisory Committee Act shall apply to the
Advisory Committee under this section only to the extent that the
provisions of such Act do not conflict with the requirements of this
section.
``SEC. 757. AUTHORIZATION OF APPROPRIATIONS.
``(a) In General.--There are authorized to be appropriated to carry
out this part, $55,600,000 for fiscal year 1998, and such sums as may
be necessary for each of the fiscal years 1999 through 2002.
``(b) Allocation.--
``(1) In general.--Of the amounts appropriated under
subsection (a) for a fiscal year, the Secretary shall make
available--
``(A) not less than $28,587,000 for awards of
grants and contracts under section 751;
``(B) not less than $3,765,000 for awards of grants
and contracts under section 752, of which not less than
50 percent of such amount shall be made available for
centers described in subsection (a)(1) of such section;
and
``(C) not less than $22,631,000 for awards of
grants and contracts under sections 753, 754, and 755.
``(2) Ratable reduction.--If amounts appropriated under
subsection (a) for any fiscal year are less than the amount
required to comply with paragraph (1), the Secretary shall
ratably reduce the amount to be made available under each of
subparagraphs (A) through (C) of such paragraph accordingly.
``(3) Increase in amounts.--If amounts appropriated for a
fiscal year under subsection (a) exceed the amount authorized
under such subsection for such fiscal year, the Secretary may
increase the amount to be made available for programs and
activities under this part without regard to the amounts
specified in each of subparagraphs (A) through (C) of paragraph
(2).
``(c) Obligation of Certain Amounts.--
``(1) Area health education center programs.--Of the
amounts made available under subsection (b)(1)(A) for each
fiscal year, the Secretary may obligate for awards under
section 751(a)(2)--
``(A) not less than 23 percent of such amounts in
fiscal year 1998;
``(B) not less than 30 percent of such amounts in
fiscal year 1999;
``(C) not less than 35 percent of such amounts in
fiscal year 2000;
``(D) not less than 40 percent of such amounts in
fiscal year 2001; and
``(E) not less than 45 percent of such amounts in
fiscal year 2002.
``(2) Sense of congress.--It is the sense of the Congress
that--
``(A) every State have an area health education
center program in effect under this section; and
``(B) the ratio of Federal funding for the model
program under section 751(a)(2) should increase over
time and that Federal funding for other awards under
this section shall decrease so that the national
program will become entirely comprised of programs that
are funded at least 50 percent by State and local
partners.''.
SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.
(a) In General.--Part E of title VII of the Public Health Service
Act (42 U.S.C. 294n et seq.) is amended to read as follows:
``PART E--HEALTH PROFESSIONS AND PUBLIC HEALTH WORKFORCE
``Subpart 1--Health Professions Workforce Information and Analysis
``SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.
``(a) Purpose.--It is the purpose of this section to--
``(1) provide for the development of information describing
the health professions workforce and the analysis of workforce
related issues; and
``(2) provide necessary information for decision-making
regarding future directions in health professions and nursing
programs in response to societal and professional needs.
``(b) Grants or Contracts.--The Secretary may award grants or
contracts to State or local governments, health professions schools,
schools of nursing, academic health centers, community-based health
facilities, and other appropriate public or private nonprofit entities
to provide for--
``(1) targeted information collection and analysis
activities related to the purposes described in subsection (a);
``(2) research on high priority workforce questions;
``(3) the development of a non-Federal analytic and
research infrastructure related to the purposes described in
subsection (a); and
``(4) the conduct of program evaluation and assessment.
``(c) Authorization of Appropriations.--
``(1) In general.--There are authorized to be appropriated
to carry out this section, $750,000 for fiscal year 1998, and
such sums as may be necessary for each of the fiscal years 1999
through 2002.
``(2) Reservation.--Of the amounts appropriated under
subsection (a) for a fiscal year, the Secretary shall reserve
not less than $600,000 for conducting health professions
research and for carrying out data collection and analysis in
accordance with section 792.
``(3) Availability of additional funds.--Amounts otherwise
appropriated for programs or activities under this title may be
used for activities under subsection (b) with respect to the
programs or activities from which such amounts were made
available.''.
(b) Council on Graduate Medical Education.--Section 301 of the
Health Professions Education Extension Amendments of 1992 (Public Law
102-408) is amended--
(1) in subsection (j), by striking ``1995'' and inserting
``2002'';
(2) in subsection (k), by striking ``1995'' and inserting
``2002'';
(3) by adding at the end thereof the following new
subsection:
``(l) Funding.--Amounts otherwise appropriated under this title may
be utilized by the Secretary to support the activities of the
Council.'';
(4) by transferring such section to part E of title VII of
the Public Health Service Act (as amended by subsection (a));
(5) by redesignating such section as section 762; and
(6) by inserting such section after section 761.
SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.
Part E of title VII of the Public Health Service Act (as amended by
section 104) is further amended by adding at the end the following:
``Subpart 2--Public Health Workforce
``SEC. 765. GENERAL PROVISIONS.
``(a) In General.--The Secretary may award grants or contracts to
eligible entities to increase the number of individuals in the public
health workforce, to enhance the quality of such workforce, and to
enhance the ability of the workforce to meet national, State, and local
health care needs.
``(b) Eligibility.--To be eligible to receive a grant or contract
under subsection (a) an entity shall--
``(1) be--
``(A) a health professions school, including an
accredited school or program of public health, health
administration, preventive medicine, or dental public
health or a school providing health management
programs;
``(B) an academic health center;
``(C) a State or local government; or
``(D) any other appropriate public or private
nonprofit entity; and
``(2) prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require.
``(c) Preference.--In awarding grants or contracts under this
section the Secretary may grant a preference to entities--
``(1) serving individuals who are from disadvantaged
backgrounds (including underrepresented racial and ethnic
minorities); and
``(2) graduating large proportions of individuals who serve
in underserved communities.
``(d) Activities.--Amounts provided under a grant or contract
awarded under this section may be used for--
``(1) the costs of planning, developing, or operating
demonstration training programs;
``(2) faculty development;
``(3) trainee support;
``(4) technical assistance;
``(5) to meet the costs of projects--
``(A) to plan and develop new residency training
programs and to maintain or improve existing residency
training programs in preventive medicine and dental
public health, that have available full-time faculty
members with training and experience in the fields of
preventive medicine and dental public health; and
``(B) to provide financial assistance to residency
trainees enrolled in such programs;
``(6) the retraining of existing public health workers as
well as for increasing the supply of new practitioners to
address priority public health, preventive medicine, public
health dentistry, and health administration needs;
``(7) preparing public health professionals for employment
at the State and community levels; or
``(8) other activities that may produce outcomes that are
consistent with the purposes of this section
``(e) Traineeships.--
``(1) In general.--With respect to amounts used under this
section for the training of health professionals, such training
programs shall be designed to--
``(A) make public health education more accessible
to the public and private health workforce;
``(B) increase the relevance of public health
academic preparation to public health practice in the
future;
``(C) provide education or training for students
from traditional on-campus programs in practice-based
sites; or
``(D) develop educational methods and distance-
based approaches or technology that address adult
learning requirements and increase knowledge and skills
related to community-based cultural diversity in public
health education.
``(2) Severe shortage disciplines.--Amounts provided under
grants or contracts under this section may be used for the
operation of programs designed to award traineeships to
students in accredited schools of public health who enter
educational programs in fields where there is a severe shortage
of public health professionals, including epidemiology,
biostatistics, environmental health, toxicology, public health
nursing, nutrition, preventive medicine, maternal and child
health, and behavioral and mental health professions.
``SEC. 766. PUBLIC HEALTH TRAINING CENTERS.
``(a) In General.--The Secretary may make grants or contracts for
the operation of public health training centers.
``(b) Eligible Entities.--
``(1) In general.--A public health training center shall be
an accredited school of public health, or another public or
nonprofit private institution accredited for the provision of
graduate or specialized training in public health, that plans,
develops, operates, and evaluates projects that are in
furtherance of the goals established by the Secretary for the
year 2000 in the areas of preventive medicine, health promotion
and disease prevention, or improving access to and quality of
health services in medically underserved communities.
``(2) Preference.--In awarding grants or contracts under
this section the Secretary shall give preference to accredited
schools of public health.
``(c) Certain Requirements.--With respect to a public health
training center, an award may not be made under subsection (a) unless
the program agrees that it--
``(1) will establish or strengthen field placements for
students in public or nonprofit private health agencies or
organizations;
``(2) will involve faculty members and students in
collaborative projects to enhance public health services to
medically underserved communities;
``(3) will specifically designate a geographic area or
medically underserved population to be served by the center
that shall be in a location removed from the main location of
the teaching facility of the school that is participating in
the program with such center; and
``(4) will assess the health personnel needs of the area to
be served by the center and assist in the planning and
development of training programs to meet such needs.
``SEC. 767. PUBLIC HEALTH TRAINEESHIPS.
``(a) In General.--The Secretary may make grants to accredited
schools of public health, and to other public or nonprofit private
institutions accredited for the provision of graduate or specialized
training in public health, for the purpose of assisting such schools
and institutions in providing traineeships to individuals described in
subsection (b)(3).
``(b) Certain Requirements.--
``(1) Amount.--The amount of any grant under this section
shall be determined by the Secretary.
``(2) Use of grant.--Traineeships awarded under grants made
under subsection (a) shall provide for tuition and fees and
such stipends and allowances (including travel and subsistence
expenses and dependency allowances) for the trainees as the
Secretary may deem necessary.
``(3) Eligible individuals.--The individuals referred to in
subsection (a) are individuals who are pursuing a course of
study in a health professions field in which there is a severe
shortage of health professionals (which fields include the
fields of epidemiology, environmental health, biostatistics,
toxicology, nutrition, and maternal and child health).
``SEC. 768. PREVENTIVE MEDICINE; DENTAL PUBLIC HEALTH.
``(a) In General.--The Secretary may make grants to and enter into
contracts with schools of medicine, osteopathic medicine, public
health, and dentistry to meet the costs of projects--
``(1) to plan and develop new residency training programs
and to maintain or improve existing residency training programs
in preventive medicine and dental public health; and
``(2) to provide financial assistance to residency trainees
enrolled in such programs.
``(b) Administration.--
``(1) Amount.--The amount of any grant under subsection (a)
shall be determined by the Secretary.
``(2) Eligibility.--To be eligible for a grant under
subsection (a), the applicant must demonstrate to the Secretary
that it has or will have available full-time faculty members
with training and experience in the fields of preventive
medicine or dental public health and support from other faculty
members trained in public health and other relevant specialties
and disciplines.
``(3) Other funds.--Schools of medicine, osteopathic
medicine, dentistry, and public health may use funds committed
by State, local, or county public health officers as matching
amounts for Federal grant funds for residency training programs
in preventive medicine.
``SEC. 769. HEALTH ADMINISTRATION TRAINEESHIPS AND SPECIAL PROJECTS.
``(a) In General.--The Secretary may make grants to State or local
governments (that have in effect preventive medical and dental public
health residency programs) or public or nonprofit private educational
entities (including graduate schools of social work and business
schools that have health management programs) that offer a program
described in subsection (b)--
``(1) to provide traineeships for students enrolled in such
a program; and
``(2) to assist accredited programs health administration
in the development or improvement of programs to prepare
students for employment with public or nonprofit private
entities.
``(b) Relevant Programs.--The program referred to in subsection (a)
is an accredited program in health administration, hospital
administration, or health policy analysis and planning, which program
is accredited by a body or bodies approved for such purpose by the
Secretary of Education and which meets such other quality standards as
the Secretary of Health and Human Services by regulation may prescribe.
``(c) Preference in Making Grants.--In making grants under
subsection (a), the Secretary shall give preference to qualified
applicants that meet the following conditions:
``(1) Not less than 25 percent of the graduates of the
applicant are engaged in full-time practice settings in
medically underserved communities.
``(2) The applicant recruits and admits students from
medically underserved communities.
``(3) For the purpose of training students, the applicant
has established relationships with public and nonprofit
providers of health care in the community involved.
``(4) In training students, the applicant emphasizes
employment with public or nonprofit private entities.
``(d) Certain Provisions Regarding Traineeships.--
``(1) Use of grant.--Traineeships awarded under grants made
under subsection (a) shall provide for tuition and fees and
such stipends and allowances (including travel and subsistence
expenses and dependency allowances) for the trainees as the
Secretary may deem necessary.
``(2) Preference for certain students.--Each entity
applying for a grant under subsection (a) for traineeships
shall assure to the satisfaction of the Secretary that the
entity will give priority to awarding the traineeships to
students who demonstrate a commitment to employment with public
or nonprofit private entities in the fields with respect to
which the traineeships are awarded.
``SEC. 770. AUTHORIZATION OF APPROPRIATIONS.
``(a) In General.--For the purpose of carrying out this subpart,
there is authorized to be appropriated $9,100,000 for fiscal year 1998,
and such sums as may be necessary for each of the fiscal years 1999
through 2002.
``(b) Limitation Regarding Certain Program.--In obligating amounts
appropriated under subsection (a), the Secretary may not obligate more
than 30 percent for carrying out section 767.''.
SEC. 106. GENERAL PROVISIONS.
(a) In General.--
(1) Part F of title VII of the Public Health Service Act
(42 U.S.C. 295 et seq.) is repealed.
(2) Part G of title VII of the Public Health Service Act
(42 U.S.C. 295j et seq.) is amended--
(A) by redesignating such part as part F;
(B) in section 791 (42 U.S.C. 295j)--
(i) by striking subsection (b); and
(ii) redesignating subsection (c) as
subsection (b);
(C) by repealing section 793 (42 U.S.C. 295l);
(D) by repealing section 798;
(E) by redesignating section 799 as section 799B;
and
(F) by inserting after section 794, the following
new sections:
``SEC. 796. APPLICATION.
``(a) In General.--To be eligible to receive a grant or contract
under this title, an eligible entity shall prepare and submit to the
Secretary an application that meets the requirements of this section,
at such time, in such manner, and containing such information as the
Secretary may require.
``(b) Plan.--An application submitted under this section shall
contain the plan of the applicant for carrying out a project with
amounts received under this title. Such plan shall be consistent with
relevant Federal, State, or regional health professions program plans.
``(c) Performance Outcome Standards.--An application submitted
under this section shall contain a specification by the applicant
entity of performance outcome standards that the project to be funded
under the grant or contract will be measured against. Such standards
shall address relevant health workforce needs that the project will
meet. The recipient of a grant or contract under this section shall
meet the standards set forth in the grant or contract application.
``(d) Linkages.--An application submitted under this section shall
contain a description of the linkages with relevant educational and
health care entities, including training programs for other health
professionals as appropriate, that the project to be funded under the
grant or contract will establish. To the extent practicable, grantees
under this section shall establish linkages with health care providers
who provide care for underserved communities and populations.
``SEC. 797. USE OF FUNDS.
``(a) In General.--Amounts provided under a grant or contract
awarded under this title may be used for training program development
and support, faculty development, model demonstrations, trainee support
including tuition, books, program fees and reasonable living expenses
during the period of training, technical assistance, workforce
analysis, dissemination of information, and exploring new policy
directions, as appropriate to meet recognized health workforce
objectives, in accordance with this title.
``(b) Maintenance of Effort.--With respect to activities for which
a grant awarded under this title is to be expended, the entity shall
agree to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant.
``SEC. 798. MATCHING REQUIREMENT.
``The Secretary may require that an entity that applies for a grant
or contract under this title provide non-Federal matching funds, as
appropriate, to ensure the institutional commitment of the entity to
the projects funded under the grant. As determined by the Secretary,
such non-Federal matching funds may be provided directly or through
donations from public or private entities and may be in cash or in-
kind, fairly evaluated, including plant, equipment, or services.
``SEC. 799. GENERALLY APPLICABLE PROVISIONS.
``(a) Awarding of Grants and Contracts.--The Secretary shall ensure
that grants and contracts under this title are awarded on a competitive
basis, as appropriate, to carry out innovative demonstration projects
or provide for strategic workforce supplementation activities as needed
to meet health workforce goals and in accordance with this title.
Contracts may be entered into under this title with public or private
entities as may be necessary.
``(b) Eligible Entities.--Unless specifically required otherwise in
this title, the Secretary shall accept applications for grants or
contracts under this title from health professions schools, academic
health centers, State or local governments, or other appropriate public
or private nonprofit entities for funding and participation in health
professions and nursing training activities. The Secretary may accept
applications from for-profit private entities if determined appropriate
by the Secretary.
``(c) Information Requirements.--
``(1) In general.--Recipients of grants and contracts under
this title shall meet information requirements as specified by
the Secretary.
``(2) Data collection.--The Secretary shall establish
procedures to ensure that, with respect to any data collection
required under this title, such data is collected in a manner
that takes into account age, sex, race, and ethnicity.
``(3) Use of funds.--The Secretary shall establish
procedures to permit the use of amounts appropriated under this
title to be used for data collection purposes.
``(4) Evaluations.--The Secretary shall establish
procedures to ensure the annual evaluation of programs and
projects operated by recipients of grants or contracts under
this title. Such procedures shall ensure that continued funding
for such programs and projects will be conditioned upon a
demonstration that satisfactory progress has been made by the
program or project in meeting the objectives of the program or
project.
``(d) Training Programs.--Training programs conducted with amounts
received under this title shall meet applicable accreditation and
quality standards.
``(e) Duration of Assistance.--
``(1) In general.--Subject to paragraph (2), in the case of
an award to an entity of a grant, cooperative agreement, or
contract under this title, the period during which payments are
made to the entity under the award may not exceed 5 years. The
provision of payments under the award shall be subject to
annual approval by the Secretary of the payments and subject to
the availability of appropriations for the fiscal year involved
to make the payments. This paragraph may not be construed as
limiting the number of awards under the program involved that
may be made to the entity.
``(2) Limitation.--In the case of an award to an entity of
a grant, cooperative agreement, or contract under this title,
paragraph (1) shall apply only to the extent not inconsistent
with any other provision of this title that relates to the
period during which payments may be made under the award.
``(f) Peer Review Regarding Certain Programs.--
``(1) In general.--Each application for a grant under this
title, except any scholarship or loan program, including those
under sections 701, 721, or 723, shall be submitted to a peer
review group for an evaluation of the merits of the proposals
made in the application. The Secretary may not approve such an
application unless a peer review group has recommended the
application for approval.
``(2) Composition.--Each peer review group under this
subsection shall be composed principally of individuals who are
not officers or employees of the Federal Government. In
providing for the establishment of peer review groups and
procedures, the Secretary shall ensure sex, racial, ethnic, and
geographic balance among the membership of such groups.
``(3) Administration.--This subsection shall be carried out
by the Secretary acting through the Administrator of the Health
Resources and Services Administration.
``(g) Preference or Priority Considerations.--In considering a
preference or priority for funding which is based on outcome measures
for an eligible entity under this title, the Secretary may also
consider the future ability of the eligible entity to meet the outcome
preference or priority through improvements in the eligible entity's
program design.
``(h) Analytic Activities.--The Secretary shall ensure that--
``(1) cross-cutting workforce analytical activities are
carried out as part of the workforce information and analysis
activities under section 761; and
``(2) discipline-specific workforce information and
analytical activities are carried out as part of--
``(A) the community-based linkage program under
part D; and
``(B) the health workforce development program
under subpart 2 of part E.
``(i) Osteopathic Schools.--For purposes of this title, any
reference to--
``(1) medical schools shall include osteopathic medical
schools; and
``(2) medical students shall include osteopathic medical
students.
``SEC. 799A. TECHNICAL ASSISTANCE.
``Funds appropriated under this title may be used by the Secretary
to provide technical assistance in relation to any of the authorities
under this title.''.
(b) Professional Counselors as Mental Health Professionals.--
Section 792(a) of the Public Health Service Act (42 U.S.C. 295k(a)) is
amended by inserting ``professional counselors,'' after ``clinical
psychologists,''.
SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.
(a) In General.--Section 791 of the Public Health Service Act (42
U.S.C. 295j), as amended by section 105(a)(2)(B), is further amended by
adding at the end thereof the following subsection:
``(c) Exceptions for New Programs.--
``(1) In general.--To permit new programs to compete
equitably for funding under this section, those new programs
that meet at least 4 of the criteria described in paragraph (3)
shall qualify for a funding preference under this section.
``(2) Definition.--As used in this subsection, the term
`new program' means any program that has graduated less than
three classes. Upon graduating at least three classes, a
program shall have the capability to provide the information
necessary to qualify the program for the general funding
preferences described in subsection (a).
``(3) Criteria.--The criteria referred to in paragraph (1)
are the following:
``(A) The mission statement of the program
identifies a specific purpose of the program as being
the preparation of health professionals to serve
underserved populations.
``(B) The curriculum of the program includes
content which will help to prepare practitioners to
serve underserved populations.
``(C) Substantial clinical training experience is
required under the program in medically underserved
communities.
``(D) A minimum of 20 percent of the clinical
faculty of the program spend at least 50 percent of
their time providing or supervising care in medically
underserved communities.
``(E) The entire program or a substantial portion
of the program is physically located in a medically
underserved community.
``(F) Student assistance, which is linked to
service in medically underserved communities following
graduation, is available to the students in the
program.
``(G) The program provides a placement mechanism
for deploying graduates to medically underserved
communities.''.
(b) Conforming Amendments.--Section 791(a) of the Public Health
Service Act (42 U.S.C. 295j(a)) is amended--
(1) in paragraph (1), by striking ``sections 747'' and all
that follows through ``767'' and inserting ``sections 747 and
750''; and
(2) in paragraph (2), by striking ``under section 798(a)''.
SEC. 108. DEFINITIONS.
(a) Graduate Program in Behavioral and Mental Health Practice.--
Section 799B(1)(D) of the Public Health Service Act (42 U.S.C.
295p(1)(D)) (as so redesignated by section 106(a)(2)(E)) is amended--
(1) by inserting ``behavioral health and'' before
``mental''; and
(2) by inserting ``behavioral health and mental health
practice,'' before ``clinical''.
(b) Professional Counseling as a Behavioral and Mental Health
Practice.--Section 799B of the Public Health Service Act (42 U.S.C.
295p) (as so redesignated by section 106(a)(2)(E)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (C)--
(i) by inserting ``and `graduate program in
professional counseling''' after ``graduate
program in marriage and family therapy'''; and
(ii) by inserting before the period the
following: ``and a concentration leading to a
graduate degree in counseling'';
(B) in subparagraph (D), by inserting
``professional counseling,'' after ``social work,'';
and
(C) in subparagraph (E), by inserting
``professional counseling,'' after ``social work,'';
and
(2) in paragraph (5)(C), by inserting before the period the
following: ``or a degree in counseling or an equivalent
degree''.
(c) Medically Underserved Community.--Section 799B(6) of the Public
Health Service Act (42 U.S.C. 295p(6)) (as so redesignated by section
105(a)(2)(E)) is amended--
(1) in subparagraph (B), by striking ``or'' at the end
thereof;
(2) in subparagraph (C), by striking the period and
inserting ``; or''; and
(3) by adding at the end the following:
``(D) is designated by a State Governor (in
consultation with the medical community) as a shortage
area or medically underserved community.''.
(d) Programs for the Training of Physician Assistants.--Paragraph
(3) of section 799B of the Public Health Service Act (42 U.S.C. 295p)
(as so redesignated by section 105(a)(2)(E)) is amended to read as
follows:
``(3) The term `program for the training of physician
assistants' means an educational program that--
``(A) has as its objective the education of
individuals who will, upon completion of their studies
in the program, be qualified to provide primary care
under the supervision of a physician;
``(B) extends for at least one academic year and
consists of--
``(i) supervised clinical practice; and
``(ii) at least four months (in the
aggregate) of classroom instruction, directed
toward preparing students to deliver health
care;
``(C) has an enrollment of not less than eight
students; and
``(D) trains students in primary care, disease
prevention, health promotion, geriatric medicine, and
home health care.''.
(e) Psychologist.--Section 799B of the Public Health Service Act
(42 U.S.C. 295p) (as so redesignated by section 105(a)(2)(E)) is
amended by adding at the end the following:
``(11) The term `psychologist' means an individual who--
``(A) holds a doctoral degree in psychology; and
``(B) is licensed or certified on the basis of the
doctoral degree in psychology, by the State in which
the individual practices, at the independent practice
level of psychology to furnish diagnostic, assessment,
preventive, and therapeutic services directly to
individuals.''.
SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH SERVICE CORPS.
Section 338B(b)(1)(B) of the Public Health Service Act (42 U.S.C.
254l-1(b)(1)(B)) is amended by striking ``or other health profession''
and inserting ``behavioral and mental health, or other health
profession''.
SEC. 110. SAVINGS PROVISION.
In the case of any authority for making awards of grants or
contracts that is terminated by the amendments made by this subtitle,
the Secretary of Health and Human Services may, notwithstanding the
termination of the authority, continue in effect any grant or contract
made under the authority that is in effect on the day before the date
of the enactment of this Act, subject to the duration of any such grant
or contract not exceeding the period determined by the Secretary in
first approving such financial assistance, or in approving the most
recent request made (before the date of such enactment) for
continuation of such assistance, as the case may be.
Subtitle B--Nursing Workforce Development
SEC. 121. SHORT TITLE.
This title may be cited as the ``Nursing Education and Practice
Improvement Act of 1998''.
SEC. 122. PURPOSE.
It is the purpose of this title to restructure the nurse education
authorities of title VIII of the Public Health Service Act to permit a
comprehensive, flexible, and effective approach to Federal support for
nursing workforce development.
SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.
Title VIII of the Public Health Service Act (42 U.S.C. 296k et
seq.) is amended--
(1) by striking the title heading and all that follows
except for subpart II of part B and sections 846 and 855; and
inserting the following:
``TITLE VIII--NURSING WORKFORCE DEVELOPMENT'';
(2) in subpart II of part B, by striking the subpart
heading and inserting the following:
``PART E--STUDENT LOANS'';
(3) by striking section 837;
(4) by inserting after the title heading the following new
parts:
``PART A--GENERAL PROVISIONS
``SEC. 801. DEFINITIONS.
``As used in this title:
``(1) Eligible entities.--The term `eligible entities'
means schools of nursing, nursing centers, academic health
centers, State or local governments, and other public or
private nonprofit entities determined appropriate by the
Secretary that submit to the Secretary an application in
accordance with section 802.
``(2) School of nursing.--The term `school of nursing'
means a collegiate, associate degree, or diploma school of
nursing in a State.
``(3) Collegiate school of nursing.--The term `collegiate
school of nursing' means a department, division, or other
administrative unit in a college or university which provides
primarily or exclusively a program of education in professional
nursing and related subjects leading to the degree of bachelor
of arts, bachelor of science, bachelor of nursing, or to an
equivalent degree, or to a graduate degree in nursing, or to an
equivalent degree, and including advanced training related to
such program of education provided by such school, but only if
such program, or such unit, college or university is
accredited.
``(4) Associate degree school of nursing.--The term
`associate degree school of nursing' means a department,
division, or other administrative unit in a junior college,
community college, college, or university which provides
primarily or exclusively a two-year program of education in
professional nursing and allied subjects leading to an
associate degree in nursing or to an equivalent degree, but
only if such program, or such unit, college, or university is
accredited.
``(5) Diploma school of nursing.--The term `diploma school
of nursing' means a school affiliated with a hospital or
university, or an independent school, which provides primarily
or exclusively a program of education in professional nursing
and allied subjects leading to a diploma or to equivalent
indicia that such program has been satisfactorily completed,
but only if such program, or such affiliated school or such
hospital or university or such independent school is
accredited.
``(6) Accredited.--
``(A) In general.--Except as provided in
subparagraph (B), the term `accredited' when applied to
any program of nurse education means a program
accredited by a recognized body or bodies, or by a
State agency, approved for such purpose by the
Secretary of Education and when applied to a hospital,
school, college, or university (or a unit thereof)
means a hospital, school, college, or university (or a
unit thereof) which is accredited by a recognized body
or bodies, or by a State agency, approved for such
purpose by the Secretary of Education. For the purpose
of this paragraph, the Secretary of Education shall
publish a list of recognized accrediting bodies, and of
State agencies, which the Secretary of Education
determines to be reliable authority as to the quality
of education offered.
``(B) New programs.--A new program of nursing that,
by reason of an insufficient period of operation, is
not, at the time of the submission of an application
for a grant or contract under this title, eligible for
accreditation by such a recognized body or bodies or
State agency, shall be deemed accredited for purposes
of this title if the Secretary of Education finds,
after consultation with the appropriate accreditation
body or bodies, that there is reasonable assurance that
the program will meet the accreditation standards of
such body or bodies prior to the beginning of the
academic year following the normal graduation date of
students of the first entering class in such a program.
``(7) Nonprofit.--The term `nonprofit' as applied to any
school, agency, organization, or institution means one which is
a corporation or association, or is owned and operated by one
or more corporations or associations, no part of the net
earnings of which inures, or may lawfully inure, to the benefit
of any private shareholder or individual.
``(8) State.--The term `State' means a State, the
Commonwealth of Puerto Rico, the District of Columbia, the
Commonwealth of the Northern Mariana Islands, Guam, American
Samoa, the Virgin Islands, or the Trust Territory of the
Pacific Islands.
``SEC. 802. APPLICATION.
``(a) In General.--To be eligible to receive a grant or contract
under this title, an eligible entity shall prepare and submit to the
Secretary an application that meets the requirements of this section,
at such time, in such manner, and containing such information as the
Secretary may require.
``(b) Plan.--An application submitted under this section shall
contain the plan of the applicant for carrying out a project with
amounts received under this title. Such plan shall be consistent with
relevant Federal, State, or regional program plans.
``(c) Performance Outcome Standards.--An application submitted
under this section shall contain a specification by the applicant
entity of performance outcome standards that the project to be funded
under the grant or contract will be measured against. Such standards
shall address relevant national nursing needs that the project will
meet. The recipient of a grant or contract under this section shall
meet the standards set forth in the grant or contract application.
``(d) Linkages.--An application submitted under this section shall
contain a description of the linkages with relevant educational and
health care entities, including training programs for other health
professionals as appropriate, that the project to be funded under the
grant or contract will establish.
``SEC. 803. USE OF FUNDS.
``(a) In General.--Amounts provided under a grant or contract
awarded under this title may be used for training program development
and support, faculty development, model demonstrations, trainee support
including tuition, books, program fees and reasonable living expenses
during the period of training, technical assistance, workforce
analysis, and dissemination of information, as appropriate to meet
recognized nursing objectives, in accordance with this title.
``(b) Maintenance of Effort.--With respect to activities for which
a grant awarded under this title is to be expended, the entity shall
agree to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant.
``SEC. 804. MATCHING REQUIREMENT.
``The Secretary may require that an entity that applies for a grant
or contract under this title provide non-Federal matching funds, as
appropriate, to ensure the institutional commitment of the entity to
the projects funded under the grant. Such non-Federal matching funds
may be provided directly or through donations from public or private
entities and may be in cash or in-kind, fairly evaluated, including
plant, equipment, or services.
``SEC. 805. PREFERENCE.
``In awarding grants or contracts under this title, the Secretary
shall give preference to applicants with projects that will
substantially benefit rural or underserved populations, or help meet
public health nursing needs in State or local health departments.
``SEC. 806. GENERALLY APPLICABLE PROVISIONS.
``(a) Awarding of Grants and Contracts.--The Secretary shall ensure
that grants and contracts under this title are awarded on a competitive
basis, as appropriate, to carry out innovative demonstration projects
or provide for strategic workforce supplementation activities as needed
to meet national nursing service goals and in accordance with this
title. Contracts may be entered into under this title with public or
private entities as determined necessary by the Secretary.
``(b) Information Requirements.--
``(1) In general.--Recipients of grants and contracts under
this title shall meet information requirements as specified by
the Secretary.
``(2) Evaluations.--The Secretary shall establish
procedures to ensure the annual evaluation of programs and
projects operated by recipients of grants under this title.
Such procedures shall ensure that continued funding for such
programs and projects will be conditioned upon a demonstration
that satisfactory progress has been made by the program or
project in meeting the objectives of the program or project.
``(c) Training Programs.--Training programs conducted with amounts
received under this title shall meet applicable accreditation and
quality standards.
``(d) Duration of Assistance.--
``(1) In general.--Subject to paragraph (2), in the case of
an award to an entity of a grant, cooperative agreement, or
contract under this title, the period during which payments are
made to the entity under the award may not exceed 5 years. The
provision of payments under the award shall be subject to
annual approval by the Secretary of the payments and subject to
the availability of appropriations for the fiscal year involved
to make the payments. This paragraph may not be construed as
limiting the number of awards under the program involved that
may be made to the entity.
``(2) Limitation.--In the case of an award to an entity of
a grant, cooperative agreement, or contract under this title,
paragraph (1) shall apply only to the extent not inconsistent
with any other provision of this title that relates to the
period during which payments may be made under the award.
``(e) Peer Review Regarding Certain Programs.--
``(1) In general.--Each application for a grant under this
title, except advanced nurse traineeship grants under section
811(a)(2), shall be submitted to a peer review group for an
evaluation of the merits of the proposals made in the
application. The Secretary may not approve such an application
unless a peer review group has recommended the application for
approval.
``(2) Composition.--Each peer review group under this
subsection shall be composed principally of individuals who are
not officers or employees of the Federal Government. In
providing for the establishment of peer review groups and
procedures, the Secretary shall, except as otherwise provided,
ensure sex, racial, ethnic, and geographic representation among
the membership of such groups.
``(3) Administration.--This subsection shall be carried out
by the Secretary acting through the Administrator of the Health
Resources and Services Administration.
``(f) Analytic Activities.--The Secretary shall ensure that--
``(1) cross-cutting workforce analytical activities are
carried out as part of the workforce information and analysis
activities under this title; and
``(2) discipline-specific workforce information is
developed and analytical activities are carried out as part
of--
``(A) the advanced practice nursing activities
under part B;
``(B) the workforce diversity activities under part
C; and
``(C) basic nursing education and practice
activities under part D.
``(g) State and Regional Priorities.--Activities under grants or
contracts under this title shall, to the extent practicable, be
consistent with related Federal, State, or regional nursing professions
program plans and priorities.
``(h) Filing of Applications.--
``(1) In general.--Applications for grants or contracts
under this title may be submitted by health professions
schools, schools of nursing, academic health centers, State or
local governments, or other appropriate public or private
nonprofit entities as determined appropriate by the Secretary
in accordance with this title.
``(2) For profit entities.--Notwithstanding paragraph (1),
a for-profit entity may be eligible for a grant or contract
under this title as determined appropriated by the Secretary.
``SEC. 807. TECHNICAL ASSISTANCE.
``Funds appropriated under this title may be used by the Secretary
to provide technical assistance in relation to any of the authorities
under this title.
``PART B--NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE ANESTHETISTS, AND
OTHER ADVANCED PRACTICE NURSES
``SEC. 811. ADVANCED PRACTICE NURSING GRANTS.
``(a) In General.--The Secretary may award grants to and enter into
contracts with eligible entities to meet the costs of--
``(1) projects that support the enhancement of advanced
practice nursing education and practice; and
``(2) traineeships for individuals in advanced practice
nursing programs.
``(b) Definition of Advanced Practice Nurses.--For purposes of this
section, the term `advanced practice nurses' means individuals trained
in advanced degree programs including individuals in combined R.N./
Master's degree programs, post-nursing master's certificate programs,
or, in the case of nurse midwives, in certificate programs in existence
on the date that is one day prior to the date of enactment of this
section, to serve as nurse practitioners, clinical nurse specialists,
nurse midwives, nurse anesthetists, nurse educators, nurse
administrators, or public health nurses, or in other nurse specialties
determined by the Secretary to require advanced education.
``(c) Authorized Nurse Practitioner and Nurse-Midwifery Programs.--
Nurse practitioner and nurse midwifery programs eligible for support
under this section are educational programs for registered nurses
(irrespective of the type of school of nursing in which the nurses
received their training) that--
``(1) meet guidelines prescribed by the Secretary; and
``(2) have as their objective the education of nurses who
will upon completion of their studies in such programs, be
qualified to effectively provide primary health care, including
primary health care in homes and in ambulatory care facilities,
long-term care facilities, acute care, and other health care
settings.
``(d) Authorized Nurse Anesthesia Programs.--Nurse anesthesia
programs eligible for support under this section are education programs
that--
``(1) provide registered nurses with full-time anesthetist
education; and
``(2) are accredited by the Council on Accreditation of
Nurse Anesthesia Educational Programs.
``(e) Other Authorized Educational Programs.--The Secretary shall
prescribe guidelines as appropriate for other advanced practice nurse
education programs eligible for support under this section.
``(f) Traineeships.--
``(1) In general.--The Secretary may not award a grant to
an applicant under subsection (a) unless the applicant involved
agrees that traineeships provided with the grant will only pay
all or part of the costs of--
``(A) the tuition, books, and fees of the program
of advanced nursing practice with respect to which the
traineeship is provided; and
``(B) the reasonable living expenses of the
individual during the period for which the traineeship
is provided.
``(2) Doctoral programs.--The Secretary may not obligate
more than 10 percent of the traineeships under subsection (a)
for individuals in doctorate degree programs.
``(3) Special consideration.--In making awards of grants
and contracts under subsection (a)(2), the Secretary shall give
special consideration to an eligible entity that agrees to
expend the award to train advanced practice nurses who will
practice in health professional shortage areas designated under
section 332.
``PART C--INCREASING NURSING WORKFORCE DIVERSITY
``SEC. 821. WORKFORCE DIVERSITY GRANTS.
``(a) In General.--The Secretary may award grants to and enter into
contracts with eligible entities to meet the costs of special projects
to increase nursing education opportunities for individuals who are
from disadvantaged backgrounds (including racial and ethnic minorities
underrepresented among registered nurses) by providing student
scholarships or stipends, pre-entry preparation, and retention
activities.
``(b) Guidance.--In carrying out subsection (a), the Secretary
shall take into consideration the recommendations of the First, Second
and Third Invitational Congresses for Minority Nurse Leaders on `Caring
for the Emerging Majority,' in 1992, 1993 and 1997, and consult with
nursing associations including the American Nurses Association, the
National League for Nursing, the American Association of Colleges of
Nursing, the National Black Nurses Association, the National
Association of Hispanic Nurses, the Association of Asian American and
Pacific Islander Nurses, the Native American Indian and Alaskan Nurses
Association, and the National Council of State Boards of Nursing.
``(c) Required Information and Conditions for Award Recipients.--
``(1) In general.--Recipients of awards under this section
may be required, where requested, to report to the Secretary
concerning the annual admission, retention, and graduation
rates for individuals from disadvantaged backgrounds and ethnic
and racial minorities in the school or schools involved in the
projects.
``(2) Falling rates.--If any of the rates reported under
paragraph (1) fall below the average of the two previous years,
the grant or contract recipient shall provide the Secretary
with plans for immediately improving such rates.
``(3) Ineligibility.--A recipient described in paragraph
(2) shall be ineligible for continued funding under this
section if the plan of the recipient fails to improve the rates
within the 1-year period beginning on the date such plan is
implemented.
``PART D--STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND PRACTICE
``SEC. 831. BASIC NURSE EDUCATION AND PRACTICE GRANTS.
``(a) In General.--The Secretary may award grants to and enter into
contracts with eligible entities for projects to strengthen capacity
for basic nurse education and practice.
``(b) Priority Areas.--In awarding grants or contracts under this
section the Secretary shall give priority to entities that will use
amounts provided under such a grant or contract to enhance the
educational mix and utilization of the basic nursing workforce by
strengthening programs that provide basic nurse education, such as
through--
``(1) establishing or expanding nursing practice
arrangements in noninstitutional settings to demonstrate
methods to improve access to primary health care in medically
underserved communities;
``(2) providing care for underserved populations and other
high-risk groups such as the elderly, individuals with HIV-
AIDS, substance abusers, the homeless, and victims of domestic
violence;
``(3) providing managed care, quality improvement, and
other skills needed to practice in existing and emerging
organized health care systems;
``(4) developing cultural competencies among nurses;
``(5) expanding the enrollment in baccalaureate nursing
programs;
``(6) promoting career mobility for nursing personnel in a
variety of training settings and cross training or specialty
training among diverse population groups;
``(7) providing education in informatics, including
distance learning methodologies; or
``(8) other priority areas as determined by the
Secretary.'';
(5) by adding at the end the following:
``PART F--AUTHORIZATION OF APPROPRIATIONS
``SEC. 841. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out sections
811, 821, and 831, $65,000,000 for fiscal year 1998, and such sums as
may be necessary in each of the fiscal years 1999 through 2002.
``PART G--NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE
``SEC. 845. NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE.
``(a) Establishment.--The Secretary shall establish an advisory
council to be known as the National Advisory Council on Nurse Education
and Practice (in this section referred to as the `Advisory Council').
``(b) Composition.--
``(1) In general.--The Advisory Council shall be composed
of
``(A) not less than 21, nor more than 23
individuals, who are not officers or employees of the
Federal Government, appointed by the Secretary without
regard to the Federal civil service laws, of which--
``(i) 2 shall be selected from full-time
students enrolled in schools of nursing;
``(ii) 2 shall be selected from the general
public;
``(iii) 2 shall be selected from practicing
professional nurses; and
``(iv) 9 shall be selected from among the
leading authorities in the various fields of
nursing, higher, secondary education, and
associate degree schools of nursing, and from
representatives of advanced practice nursing
groups (such as nurse practitioners, nurse
midwives, and nurse anesthetists), hospitals,
and other institutions and organizations which
provide nursing services; and
``(B) the Secretary (or the delegate of the
Secretary (who shall be an ex officio member and shall
serve as the Chairperson)).
``(2) Appointment.--Not later than 90 days after the date
of enactment of this Act, the Secretary shall appoint the
members of the Advisory Council and each such member shall
serve a 4 year term. In making such appointments, the Secretary
shall ensure a fair balance between the nursing professions, a
broad geographic representation of members and a balance
between urban and rural members. Members shall be appointed
based on their competence, interest, and knowledge of the
mission of the profession involved. A majority of the members
shall be nurses.
``(3) Minority representation.--In appointing the members
of the Advisory Council under paragraph (1), the Secretary
shall ensure the adequate representation of minorities.
``(c) Vacancies.--
``(1) In general.--A vacancy on the Advisory Council shall
be filled in the manner in which the original appointment was
made and shall be subject to any conditions which applied with
respect to the original appointment.
``(2) Filling unexpired term.--An individual chosen to fill
a vacancy shall be appointed for the unexpired term of the
member replaced.
``(d) Duties.--The Advisory Council shall--
``(1) provide advice and recommendations to the Secretary
and Congress concerning policy matters arising in the
administration of this title, including the range of issues
relating to the nurse workforce, education, and practice
improvement;
``(2) provide advice to the Secretary and Congress in the
preparation of general regulations and with respect to policy
matters arising in the administration of this title, including
the range of issues relating to nurse supply, education and
practice improvement; and
``(3) not later than 3 years after the date of enactment of
this section, and annually thereafter, prepare and submit to
the Secretary, the Committee on Labor and Human Resources of
the Senate, and the Committee on Commerce of the House of
Representatives, a report describing the activities of the
Council, including findings and recommendations made by the
Council concerning the activities under this title.
``(e) Meetings and Documents.--
``(1) Meetings.--The Advisory Council shall meet not less
than 2 times each year. Such meetings shall be held jointly
with other related entities established under this title where
appropriate.
``(2) Documents.--Not later than 14 days prior to the
convening of a meeting under paragraph (1), the Advisory
Council shall prepare and make available an agenda of the
matters to be considered by the Advisory Council at such
meeting. At any such meeting, the Advisory Council shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Council shall prepare and make
available a summary of the meeting and any actions taken by the
Council based upon the meeting.
``(f) Compensation and Expenses.--
``(1) Compensation.--Each member of the Advisory Council
shall be compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such
member is engaged in the performance of the duties of the
Council. All members of the Council who are officers or
employees of the United States shall serve without compensation
in addition to that received for their services as officers or
employees of the United States.
``(2) Expenses.--The members of the Advisory Council shall
be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Council.
``(g) Funding.--Amounts appropriated under this title may be
utilized by the Secretary to support the nurse education and practice
activities of the Council.
``(h) FACA.--The Federal Advisory Committee Act shall apply to the
Advisory Committee under this section only to the extent that the
provisions of such Act do not conflict with the requirements of this
section.''; and
(6) by redesignating section 855 as section 810, and
transferring such section so as to appear after section 809 (as
added by the amendment made by paragraph (5)).
SEC. 124. SAVINGS PROVISION.
In the case of any authority for making awards of grants or
contracts that is terminated by the amendment made by section 123, the
Secretary of Health and Human Services may, notwithstanding the
termination of the authority, continue in effect any grant or contract
made under the authority that is in effect on the day before the date
of the enactment of this Act, subject to the duration of any such grant
or contract not exceeding the period determined by the Secretary in
first approving such financial assistance, or in approving the most
recent request made (before the date of such enactment) for
continuation of such assistance, as the case may be.
Subtitle C--Financial Assistance
CHAPTER 1--SCHOOL-BASED REVOLVING LOAN FUNDS
SEC. 131. PRIMARY CARE LOAN PROGRAM.
(a) Requirement for Schools.--Section 723(b)(1) of the Public
Health Service Act (42 U.S.C. 292s(b)(1)), as amended by section
2014(c)(2)(A)(ii) of Public Law 103-43 (107 Stat. 216), is amended by
striking ``3 years before'' and inserting ``4 years before''.
(b) Noncompliance.--Section 723(a)(3) of the Public Health Service
Act (42 U.S.C. 292s(a)(3)) is amended to read as follows:
``(3) Noncompliance by student.--Each agreement entered
into with a student pursuant to paragraph (1) shall provide
that, if the student fails to comply with such agreement, the
loan involved will begin to accrue interest at a rate of 18
percent per year beginning on the date of such
noncompliance.''.
(c) Report Requirement.--Section 723 of the Public Health Service
Act (42 U.S.C. 292s) is amended--
(1) by striking subsection (c); and
(2) by redesignating subsection (d) as subsection (c).
SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.
(a) Authorization of Appropriations.--Section 724(f)(1) of the
Public Health Service Act (42 U.S.C. 292t(f)(1)) is amended by striking
``$15,000,000 for fiscal year 1993'' and inserting ``$8,000,000 for
each of the fiscal years 1998 through 2002''.
(b) Repeal.--Effective October 1, 2002, paragraph (1) of section
724(f) of the Public Health Service Act (42 U.S.C. 292t(f)(1)) is
repealed.
SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF NURSING.
(a) In General.--Section 836(b) of the Public Health Service Act
(42 U.S.C. 297b(b)) is amended--
(1) in paragraph (1), by striking the period at the end and
inserting a semicolon;
(2) in paragraph (2)--
(A) in subparagraph (A), by striking ``and'' at the
end; and
(B) by inserting before the semicolon at the end
the following: ``, and (C) such additional periods
under the terms of paragraph (8) of this subsection'';
(3) in paragraph (7), by striking the period at the end and
inserting ``; and''; and
(4) by adding at the end the following paragraph:
``(8) pursuant to uniform criteria established by the
Secretary, the repayment period established under paragraph (2)
for any student borrower who during the repayment period failed
to make consecutive payments and who, during the last 12 months
of the repayment period, has made at least 12 consecutive
payments may be extended for a period not to exceed 10
years.''.
(b) Minimum Monthly Payments.--Section 836(g) of the Public Health
Service Act (42 U.S.C. 297b(g)) is amended by striking ``$15'' and
inserting ``$40''.
(c) Elimination of Statute of Limitation for Loan Collections.--
(1) In general.--Section 836 of the Public Health Service
Act (42 U.S.C. 297b) is amended by adding at the end the
following new subsection:
``(l) Elimination of Statute of Limitation for Loan Collections.--
``(1) Purpose.--It is the purpose of this subsection to
ensure that obligations to repay loans under this section are
enforced without regard to any Federal or State statutory,
regulatory, or administrative limitation on the period within
which debts may be enforced.
``(2) Prohibition.--Notwithstanding any other provision of
Federal or State law, no limitation shall terminate the period
within which suit may be filed, a judgment may be enforced, or
an offset, garnishment, or other action may be initiated or
taken by a school of nursing that has an agreement with the
Secretary pursuant to section 835 that is seeking the repayment
of the amount due from a borrower on a loan made under this
subpart after the default of the borrower on such loan.''.
(2) Effective date.--The amendment made by paragraph (1)
shall be effective with respect to actions pending on or after
the date of enactment of this Act.
(d) Breach of Agreements.--Section 846 of the Public Health Service
Act (42 U.S.C. 297n) is amended by adding at the end thereof the
following new subsection:
``(h) Breach of Agreement.--
``(1) In general.--In the case of any program under this
section under which an individual makes an agreement to provide
health services for a period of time in accordance with such
program in consideration of receiving an award of Federal funds
regarding education as a nurse (including an award for the
repayment of loans), the following applies if the agreement
provides that this subsection is applicable:
``(A) In the case of a program under this section
that makes an award of Federal funds for attending an
accredited program of nursing (in this section referred
to as a `nursing program'), the individual is liable to
the Federal Government for the amount of such award
(including amounts provided for expenses related to
such attendance), and for interest on such amount at
the maximum legal prevailing rate, if the individual--
``(i) fails to maintain an acceptable level
of academic standing in the nursing program (as
indicated by the program in accordance with
requirements established by the Secretary);
``(ii) is dismissed from the nursing
program for disciplinary reasons; or
``(iii) voluntarily terminates the nursing
program.
``(B) The individual is liable to the Federal
Government for the amount of such award (including
amounts provided for expenses related to such
attendance), and for interest on such amount at the
maximum legal prevailing rate, if the individual fails
to provide health services in accordance with the
program under this section for the period of time
applicable under the program.
``(2) Waiver or suspension of liability.--In the case of an
individual or health facility making an agreement for purposes
of paragraph (1), the Secretary shall provide for the waiver or
suspension of liability under such subsection if compliance by
the individual or the health facility, as the case may be, with
the agreements involved is impossible, or would involve extreme
hardship to the individual or facility, and if enforcement of
the agreements with respect to the individual or facility would
be unconscionable.
``(3) Date certain for recovery.--Subject to paragraph (2),
any amount that the Federal Government is entitled to recover
under paragraph (1) shall be paid to the United States not
later than the expiration of the 3-year period beginning on the
date the United States becomes so entitled.
``(4) Availability.--Amounts recovered under paragraph (1)
with respect to a program under this section shall be available
for the purposes of such program, and shall remain available
for such purposes until expended.''.
(e) Technical Amendments.--Section 839 of the Public Health Service
Act (42 U.S.C. 297e) is amended--
(1) in subsection (a)--
(A) by striking the matter preceding paragraph (1)
and inserting the following:
``(a) If a school terminates a loan fund established under an
agreement pursuant to section 835(b), or if the Secretary for good
cause terminates the agreement with the school, there shall be a
capital distribution as follows:''; and
(B) in paragraph (1), by striking ``at the close of
September 30, 1999,'' and inserting ``on the date of
termination of the fund''; and
(2) in subsection (b), to read as follows:
``(b) If a capital distribution is made under subsection (a), the
school involved shall, after such capital distribution, pay to the
Secretary, not less often than quarterly, the same proportionate share
of amounts received by the school in payment of principal or interest
on loans made from the loan fund established under section 835(b) as
determined by the Secretary under subsection (a).''.
SEC. 134. GENERAL PROVISIONS.
(a) Maximum Student Loan Provisions and Minimum Payments.--
(1) In general.--Section 722(a)(1) of the Public Health
Service Act (42 U.S.C. 292r(a)(1)), as amended by section
2014(b)(1) of Public Law 103-43, is amended by striking ``the
sum of'' and all that follows through the end thereof and
inserting ``the cost of attendance (including tuition, other
reasonable educational expenses, and reasonable living costs)
for that year at the educational institution attended by the
student (as determined by such educational institution).''.
(2) Third and fourth years.--Section 722(a)(2) of the
Public Health Service Act (42 U.S.C. 292r(a)(2)), as amended by
section 2014(b)(1) of Public Law 103-43, is amended by striking
``the amount $2,500'' and all that follows through ``including
such $2,500)'' and inserting ``the amount of the loan may, in
the case of the third or fourth year of a student at a school
of medicine or osteopathic medicine, be increased to the extent
necessary''.
(3) Repayment period.--Section 722(c) of the Public Health
Service Act (42 U.S.C. 292r(c)), as amended by section
2014(b)(1) of Public Law 103-43, is amended--
(A) in the subsection heading by striking ``Ten-
Year'' and inserting ``Repayment'';
(B) by striking ``ten-year period which begins''
and inserting ``period of not less than 10 years nor
more than 25 years, at the discretion of the
institution, which begins''; and
(C) by striking ``such ten-year period'' and
inserting ``such period''.
(4) Minimum payments.--Section 722(j) of the Public Health
Service Act (42 U.S.C. 292r(j)), as amended by section
2014(b)(1) of Public Law 103-43, is amended by striking ``$15''
and inserting $40''.
(b) Elimination of Statute of Limitation for Loan Collections.--
(1) In general.--Section 722 of the Public Health Service
Act (42 U.S.C. 292r), as amended by section 2014(b)(1) of
Public Law 103-43, is amended by adding at the end the
following new subsection:
``(m) Elimination of Statute of Limitation for Loan Collections.--
``(1) Purpose.--It is the purpose of this subsection to
ensure that obligations to repay loans under this section are
enforced without regard to any Federal or State statutory,
regulatory, or administrative limitation on the period within
which debts may be enforced.
``(2) Prohibition.--Notwithstanding any other provision of
Federal or State law, no limitation shall terminate the period
within which suit may be filed, a judgment may be enforced, or
an offset, garnishment, or other action may be initiated or
taken by a school that has an agreement with the Secretary
pursuant to section 721 that is seeking the repayment of the
amount due from a borrower on a loan made under this subpart
after the default of the borrower on such loan.''.
(2) Effective date.--The amendment made by paragraph (1)
shall be effective with respect to actions pending on or after
the date of enactment of this Act.
(c) Date Certain for Contributions.--Paragraph (2) of section
735(e) of the Public Health Service Act (42 U.S.C. 292y(e)(2)) is
amended to read as follows:
``(2) Date certain for contributions.--Amounts described in
paragraph (1) that are returned to the Secretary shall be
obligated before the end of the succeeding fiscal year.''.
CHAPTER 2--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE
STUDENTS
SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PROGRAM.
(a) Health Education Assistance Loan Deferment for Borrowers
Providing Health Services to Indians.--
(1) In general.--Section 705(a)(2)(C) of the Public Health
Service Act (42 U.S.C. 292d(a)(2)(C)) is amended by striking
``and (x)'' and inserting ``(x) not in excess of three years,
during which the borrower is providing health care services to
Indians through an Indian health program (as defined in section
108(a)(2)(A) of the Indian Health Care Improvement Act (25
U.S.C. 1616a(a)(2)(A)); and (xi)''.
(2) Conforming amendments.--Section 705(a)(2)(C) of the
Public Health Service Act (42 U.S.C. 292d(a)(2)(C)) is further
amended--
(A) in clause (xi) (as so redesignated) by striking
``(ix)'' and inserting ``(x)''; and
(B) in the matter following such clause (xi), by
striking ``(x)'' and inserting ``(xi)''.
(3) Effective date.--The amendments made by this subsection
shall apply with respect to services provided on or after the
first day of the third month that begins after the date of the
enactment of this Act.
(b) Report Requirement.--Section 709(b) of the Public Health
Service Act (42 U.S.C. 292h(b)) is amended--
(1) in paragraph (4)(B), by adding ``and'' after the
semicolon;
(2) in paragraph (5), by striking ``; and'' and inserting a
period; and
(3) by striking paragraph (6).
(c) Collection From Estates.--Section 714 of the Public Health
Service Act (42 U.S.C. 292m) is amended by adding at the end the
following new sentence: ``Notwithstanding the first sentence, the
Secretary may, in the case of a borrower who dies, collect any
remaining unpaid balance owed to the lender, the holder of the loan, or
the Federal Government from the borrower's estate.''.
(d) Program Eligibility.--
(1) Limitations on loans.--Section 703(a) of the Public
Health Service Act (42 U.S.C. 292b(a)) is amended by striking
``or clinical psychology'' and inserting ``or behavioral and
mental health practice, including clinical psychology''.
(2) Definition of eligible institution.--Section 719(1) of
the Public Health Service Act (42 U.S.C. 292o(1)) is amended by
striking ``or clinical psychology'' and inserting ``or
behavioral and mental health practice, including clinical
psychology''.
SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE STANDARDS.
(a) General Amendments.--Section 707(a) of the Public Health
Service Act (42 U.S.C. 292f) is amended--
(1) by striking the last sentence;
(2) by striking ``determined.'' and inserting ``determined,
except that, if the insurance beneficiary including any
servicer of the loan is not designated for `exceptional
performance', as set forth in paragraph (2), the Secretary
shall pay to the beneficiary a sum equal to 98 percent of the
amount of the loss sustained by the insured upon that loan.'';
(3) by striking ``Upon'' and inserting:
``(1) In general.--Upon''; and
(4) by adding at the end the following new paragraph:
``(2) Exceptional performance.--
``(A) Authority.--Where the Secretary determines
that an eligible lender, holder, or servicer has a
compliance performance rating that equals or exceeds 97
percent, the Secretary shall designate that eligible
lender, holder, or servicer, as the case may be, for
exceptional performance.
``(B) Compliance performance rating.--For purposes
of subparagraph (A), a compliance performance rating is
determined with respect to compliance with due
diligence in the disbursement, servicing, and
collection of loans under this subpart for each year
for which the determination is made. Such rating shall
be equal to the percentage of all due diligence
requirements applicable to each loan, on average, as
established by the Secretary, with respect to loans
serviced during the period by the eligible lender,
holder, or servicer.
``(C) Annual audits for lenders, holders, and
servicers.--Each eligible lender, holder, or servicer
desiring a designation under subparagraph (A) shall
have an annual financial and compliance audit conducted
with respect to the loan portfolio of such eligible
lender, holder, or servicer, by a qualified independent
organization from a list of qualified organizations
identified by the Secretary and in accordance with
standards established by the Secretary. The standards
shall measure the lender's, holder's, or servicer's
compliance with due diligence standards and shall
include a defined statistical sampling technique
designed to measure the performance rating of the
eligible lender, holder, or servicer for the purpose of
this section. Each eligible lender, holder, or servicer
shall submit the audit required by this section to the
Secretary.
``(D) Secretary's determinations.--The Secretary
shall make the determination under subparagraph (A)
based upon the audits submitted under this paragraph
and any information in the possession of the Secretary
or submitted by any other agency or office of the
Federal Government.
``(E) Quarterly compliance audit.--To maintain its
status as an exceptional performer, the lender, holder,
or servicer shall undergo a quarterly compliance audit
at the end of each quarter (other than the quarter in
which status as an exceptional performer is established
through a financial and compliance audit, as described
in subparagraph (C)), and submit the results of such
audit to the Secretary. The compliance audit shall
review compliance with due diligence requirements for
the period beginning on the day after the ending date
of the previous audit, in accordance with standards
determined by the Secretary.
``(F) Revocation authority.--The Secretary shall
revoke the designation of a lender, holder, or servicer
under subparagraph (A) if any quarterly audit required
under subparagraph (E) is not received by the Secretary
by the date established by the Secretary or if the
audit indicates the lender, holder, or servicer has
failed to meet the standards for designation as an
exceptional performer under subparagraph (A). A lender,
holder, or servicer receiving a compliance audit not
meeting the standard for designation as an exceptional
performer may reapply for designation under
subparagraph (A) at any time.
``(G) Documentation.--Nothing in this section shall
restrict or limit the authority of the Secretary to
require the submission of claims documentation
evidencing servicing performed on loans, except that
the Secretary may not require exceptional performers to
submit greater documentation than that required for
lenders, holders, and servicers not designated under
subparagraph (A).
``(H) Cost of audits.--Each eligible lender,
holder, or servicer shall pay for all the costs
associated with the audits required under this section.
``(I) Additional revocation authority.--
Notwithstanding any other provision of this section, a
designation under subparagraph (A) may be revoked at
any time by the Secretary if the Secretary determines
that the eligible lender, holder, or servicer has
failed to maintain an overall level of compliance
consistent with the audit submitted by the eligible
lender, holder, or servicer under this paragraph or if
the Secretary asserts that the lender, holder, or
servicer may have engaged in fraud in securing designation under
subparagraph (A) or is failing to service loans in accordance with
program requirements.
``(J) Noncompliance.--A lender, holder, or servicer
designated under subparagraph (A) that fails to service
loans or otherwise comply with applicable program
regulations shall be considered in violation of the
Federal False Claims Act.''.
(b) Definition.--Section 707(e) of the Public Health Service Act
(42 U.S.C. 292f(e)) is amended by adding at the end the following new
paragraph:
``(4) The term `servicer' means any agency acting on behalf
of the insurance beneficiary.''.
(c) Effective Date.--The amendments made by subsections (a) and (b)
shall apply with respect to loans submitted to the Secretary for
payment on or after the first day of the sixth month that begins after
the date of enactment of this Act.
SEC. 143. REAUTHORIZATION.
(a) Loan Program.--Section 702(a) of the Public Health Service Act
(42 U.S.C. 292a(a)) is amended--
(1) by striking ``$350,000,000'' and all that follows
through ``1995'' and inserting ``$350,000,000 for fiscal year
1998, $375,000,000 for fiscal year 1999, and $425,000,000 for
each of the fiscal years 2000 through 2002'';
(2) by striking ``obtained prior loans insured under this
subpart'' and inserting ``obtained loans insured under this
subpart in fiscal year 2002 or in prior fiscal years'';
(3) by adding at the end thereof the following new
sentence: ``The Secretary may establish guidelines and
procedures that lenders must follow in distributing funds under
this subpart.''; and
(4) by striking ``September 30, 1998'' and inserting
``September 30, 2005''.
(b) Insurance Program.--Section 710(a)(2)(B) of the Public Health
Service Act (42 U.S.C. 292i(a)(2)(B)) is amended by striking ``any of
the fiscal years 1993 through 1996'' and inserting ``fiscal year 1993
and subsequent fiscal years''.
SEC. 144. HEAL BANKRUPTCY.
(a) In General.--Section 707(g) of the Public Health Service Act
(42 U.S.C. 292f(g)) is amended in the first sentence by striking ``A
debt which is a loan insured'' and inserting ``Notwithstanding any
other provision of Federal or State law, a debt that is a loan
insured''.
(b) Application.--The amendment made by subsection (a) shall apply
to any loan insured under the authority of subpart I of part A of title
VII of the Public Health Service Act (42 U.S.C. 292 et seq.) that is
listed or scheduled by the debtor in a case under title XI, United
States Code, filed--
(1) on or after the date of enactment of this Act; or
(2) prior to such date of enactment in which a discharge
has not been granted.
SEC. 145. HEAL REFINANCING.
Section 706 of the Public Health Service Act (42 U.S.C. 292e) is
amended--
(1) in subsection (d)--
(A) in the subsection heading, by striking
``Consolidation'' and inserting ``Refinancing or
Consolidation''; and
(B) in the first sentence, by striking
``indebtedness'' and inserting ``indebtedness or the
refinancing of a single loan''; and
(2) in subsection (e)--
(A) in the subsection heading, by striking
``Debts'' and inserting ``Debts and Refinancing'';
(B) in the first sentence, by striking ``all of the
borrower's debts into a single instrument'' and
inserting ``all of the borrower's loans insured under
this subpart into a single instrument (or, if the
borrower obtained only 1 loan insured under this
subpart, refinancing the loan 1 time)''; and
(C) in the second sentence, by striking
``consolidation'' and inserting ``consolidation or
refinancing''.
TITLE II--OFFICE OF MINORITY HEALTH
SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF MINORITY
HEALTH.
(a) Duties and Requirements.--Section 1707 of the Public Health
Service Act (42 U.S.C. 300u-6) is amended by striking subsection (b)
and all that follows and inserting the following:
``(b) Duties.--With respect to improving the health of racial and
ethnic minority groups, the Secretary, acting through the Deputy
Assistant Secretary for Minority Health (in this section referred to as
the `Deputy Assistant Secretary'), shall carry out the following:
``(1) Establish short-range and long-range goals and
objectives and coordinate all other activities within the
Public Health Service that relate to disease prevention, health
promotion, service delivery, and research concerning such
individuals. The heads of each of the agencies of the Service
shall consult with the Deputy Assistant Secretary to ensure the
coordination of such activities.
``(2) Enter into interagency agreements with other agencies
of the Public Health Service.
``(3) Support research, demonstrations and evaluations to
test new and innovative models.
``(4) Increase knowledge and understanding of health risk
factors.
``(5) Develop mechanisms that support better information
dissemination, education, prevention, and service delivery to
individuals from disadvantaged backgrounds, including
individuals who are members of racial or ethnic minority
groups.
``(6) Ensure that the National Center for Health Statistics
collects data on the health status of each minority group.
``(7) With respect to individuals who lack proficiency in
speaking the English language, enter into contracts with public
and nonprofit private providers of primary health services for
the purpose of increasing the access of the individuals to such
services by developing and carrying out programs to provide
bilingual or interpretive services.
``(8) Support a national minority health resource center to
carry out the following:
``(A) Facilitate the exchange of information
regarding matters relating to health information and
health promotion, preventive health services, and
education in the appropriate use of health care.
``(B) Facilitate access to such information.
``(C) Assist in the analysis of issues and problems
relating to such matters.
``(D) Provide technical assistance with respect to
the exchange of such information (including
facilitating the development of materials for such
technical assistance).
``(9) Carry out programs to improve access to health care
services for individuals with limited proficiency in speaking
the English language. Activities under the preceding sentence
shall include developing and evaluating model projects.
``(c) Advisory Committee.--
``(1) In general.--The Secretary shall establish an
advisory committee to be known as the Advisory Committee on
Minority Health (in this subsection referred to as the
`Committee').
``(2) Duties.--The Committee shall provide advice to the
Deputy Assistant Secretary carrying out this section, including
advice on the development of goals and specific program
activities under paragraphs (1) through (9) of subsection (b)
for each racial and ethnic minority group.
``(3) Chair.--The chairperson of the Committee shall be
selected by the Secretary from among the members of the voting
members of the Committee. The term of office of the chairperson
shall be 2 years.
``(4) Composition.--
``(A) The Committee shall be composed of 12 voting
members appointed in accordance with subparagraph (B),
and nonvoting, ex officio members designated in
subparagraph (C).
``(B) The voting members of the Committee shall be
appointed by the Secretary from among individuals who
are not officers or employees of the Federal Government
and who have expertise regarding issues of minority
health. The racial and ethnic minority groups shall be
equally represented among such members.
``(C) The nonvoting, ex officio members of the
Committee shall be such officials of the Department of
Health and Human Services as the Secretary determines
to be appropriate.
``(5) Terms.--Each member of the Committee shall serve for
a term of 4 years, except that the Secretary shall initially
appoint a portion of the members to terms of 1 year, 2 years,
and 3 years.
``(6) Vacancies.--If a vacancy occurs on the Committee, a
new member shall be appointed by the Secretary within 90 days
from the date that the vacancy occurs, and serve for the
remainder of the term for which the predecessor of such member
was appointed. The vacancy shall not affect the power of the
remaining members to execute the duties of the Committee.
``(7) Compensation.--Members of the Committee who are
officers or employees of the United States shall serve without
compensation. Members of the Committee who are not officers or
employees of the United States shall receive compensation, for
each day (including travel time) they are engaged in the
performance of the functions of the Committee. Such
compensation may not be in an amount in excess of the daily
equivalent of the annual maximum rate of basic pay payable
under the General Schedule (under title 5, United States Code)
for positions above GS-15.
``(d) Certain Requirements Regarding Duties.--
``(1) Recommendations regarding language as impediment to
health care.--The Deputy Assistant Secretary for Minority
Health shall consult with the Director of the Office of
International and Refugee Health, the Director of the Office of
Civil Rights, and the Directors of other appropriate
Departmental entities regarding recommendations for carrying
out activities under subsection (b)(9).
``(2) Equitable allocation regarding activities.--In
carrying out subsection (b), the Secretary shall ensure that
services provided under such subsection are equitably allocated
among all groups served under this section by the Secretary.
``(3) Cultural competency of services.--The Secretary shall
ensure that information and services provided pursuant to
subsection (b) are provided in the language, educational, and
cultural context that is most appropriate for the individuals
for whom the information and services are intended.
``(e) Grants and Contracts Regarding Duties.--
``(1) In general.--In carrying out subsection (b), the
Secretary acting through the Deputy Assistant Secretary may
make awards of grants, cooperative agreements, and contracts to
public and nonprofit private entities.
``(2) Process for making awards.--The Deputy Assistant
Secretary shall ensure that awards under paragraph (1) are
made, to the extent practical, only on a competitive basis, and
that a grant is awarded for a proposal only if the proposal has
been recommended for such an award through a process of peer
review.
``(3) Evaluation and dissemination.--The Deputy Assistant
Secretary, directly or through contracts with public and
private entities, shall provide for evaluations of projects
carried out with awards made under paragraph (1) during the
preceding 2 fiscal years. The report shall be included in the
report required under subsection (f) for the fiscal year
involved.
``(f) Reports.--
``(1) In general.--Not later than February 1 of fiscal year
1999 and of each second year thereafter, the Secretary shall
submit to the Committee on Energy and Commerce of the House of
Representatives, and to the Committee on Labor and Human
Resources of the Senate, a report describing the activities
carried out under this section during the preceding 2 fiscal
years and evaluating the extent to which such activities have
been effective in improving the health of racial and ethnic
minority groups. Each such report shall include the biennial
reports submitted under sections 201(e)(3) and 201(f)(2) for
such years by the heads of the Public Health Service agencies.
``(2) Agency reports.--Not later than February 1, 1999, and
biennially thereafter, the heads of the Public Health Service
agencies shall submit to the Deputy Assistant Secretary a
report summarizing the minority health activities of each of
the respective agencies.
``(g) Definition.--For purposes of this section:
``(1) The term `racial and ethnic minority group' means
American Indians (including Alaska Natives, Eskimos, and
Aleuts); Asian Americans and Pacific Islanders; Blacks; and
Hispanics.
``(2) The term `Hispanic' means individuals whose origin is
Mexican, Puerto Rican, Cuban, Central or South American, or any
other Spanish-speaking country.
``(h) Funding.--
``(1) Authorization of appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $30,000,000 for fiscal year 1998, such sums as may
be necessary for each of the fiscal years 1999 through 2002.''.
(b) Authorization for National Center for Health Statistics.--
Section 306 of the Public Health Service Act (42 U.S.C. 242k) is
amended--
(1) in subsection (m), by adding at the end the following:
``(4)(A) Subject to subparagraph (B), the Secretary, acting through
the Center, shall collect data on Hispanics and major Hispanic
subpopulation groups and American Indians, and for developing special
area population studies on major Asian American and Pacific Islander
populations.
``(B) The provisions of subparagraph (A) shall be effective with
respect to a fiscal year only to the extent that funds are appropriated
pursuant to paragraph (3) of subsection (n), and only if the amounts
appropriated for such fiscal year pursuant to each of paragraphs (1)
and (2) of subsection (n) equal or exceed the amounts so appropriated
for fiscal year 1997.'';
(2) in subsection (n)(1), by striking ``through 1998'' and
inserting ``through 2003''; and
(3) in subsection (n)
(A) in the first sentence of paragraph (2)--
(i) by striking ``authorized in subsection
(m)'' and inserting ``authorized in paragraphs
(1) through (3) of subsection (m)''; and
(ii) by striking ``$5,000,000'' and all
that follows through the period and inserting
``such sums as may be necessary for each of the
fiscal years 1999 through 2003.''; and
(B) by adding at the end the following:
``(3) For activities authorized in subsection (m)(4), there are
authorized to be appropriated $1,000,000 for fiscal year 1998, and such
sums as may be necessary for each of the fiscal years 1999 through
2002.''.
(c) Miscellaneous Amendments.--Section 1707 of the Public Health
Service Act (42 U.S.C. 300u-6) is amended--
(1) in the heading for the section by striking
``establishment of''; and
(2) in subsection (a), by striking ``Office of the
Assistant Secretary for Health'' and inserting ``Office of
Public Health and Science''.
TITLE III--SELECTED INITIATIVES
SEC. 301. STATE OFFICES OF RURAL HEALTH.
Section 338J of the Public Health Service Act (42 U.S.C. 254r) is
amended--
(1) in subsection (b)(1), in the matter preceding
subparagraph (A), by striking ``in cash''; and
(2) in subsection (j)(1)--
(A) by striking ``and'' after ``1992,''; and
(B) by inserting before the period the following:
``, and such sums as may be necessary for each of the
fiscal years 1998 through 2002''; and
(3) in subsection (k), by striking ``$10,000,000'' and
inserting ``$36,000,000''.
SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZHEIMER'S DISEASE.
(a) In General.--Section 398(a) of the Public Health Service Act
(42 U.S.C. 280c-3(a)) is amended--
(1) in the matter preceding paragraph (1), by striking
``not less than 5, and not more than 15,'';
(2) in paragraph (2)--
(A) by inserting after ``disorders'' the following:
``who are living in single family homes or in
congregate settings''; and
(B) by striking ``and'' at the end;
(3) by redesignating paragraph (3) as paragraph (4); and
(4) by inserting after paragraph (2) the following:
``(3) to improve the access of such individuals to home-
based or community-based long-term care services (subject to
the services being provided by entities that were providing
such services in the State involved as of October 1, 1995),
particularly such individuals who are members of racial or
ethnic minority groups, who have limited proficiency in
speaking the English language, or who live in rural areas;
and''.
(b) Duration.--Section 398A of the Public Health Service Act (42
U.S.C. 280c-4) is amended--
(1) in the heading for the section, by striking
``LIMITATION'' and all that follows and inserting ``REQUIREMENT
OF MATCHING FUNDS'';
(2) by striking subsection (a);
(3) by redesignating subsections (b) and (c) as subsections
(a) and (b), respectively; and
(4) in subsection (a) (as so redesignated), in each of
paragraphs (1)(C) and (2)(C), by striking ``third year'' and
inserting ``third or subsequent year''.
(c) Authorization of Appropriations.--Section 398B(e) of the Public
Health Service Act (42 U.S.C. 280c-5(e)) is amended--
(1) by striking ``and such sums'' and inserting ``such
sums''; and
(2) by inserting before the period the following: ``,
$8,000,000 for fiscal year 1998, and such sums as may be
necessary for each of the fiscal years 1999 through 2002''.
SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.
Section 317(j) of the Public Health Service Act (42 U.S.C. 247b(j))
is amended--
(1) in paragraph (1), by striking ``individuals against
vaccine-preventable diseases'' and all that follows through the
first period and inserting the following: ``children,
adolescents, and adults against vaccine-preventable diseases,
there are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 1998 through 2002.'';
and
(2) in paragraph (2), by striking ``1990'' and inserting
``1997''.
TITLE IV--MISCELLANEOUS PROVISIONS
SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC LAW 103-183.
(a) Amendatory Instructions.--Public Law 103-183 is amended--
(1) in section 601--
(A) in subsection (b), in the matter preceding
paragraph (1), by striking ``Section 1201 of the Public
Health Service Act (42 U.S.C. 300d)'' and inserting
``Title XII of the Public Health Service Act (42 U.S.C.
300d et seq.)''; and
(B) in subsection (f)(1), by striking ``in section
1204(c)'' and inserting ``in section 1203(c) (as
redesignated by subsection (b)(2) of this section)'';
(2) in section 602, by striking ``for the purpose'' and
inserting ``For the purpose''; and
(3) in section 705(b), by striking ``317D((l)(1)'' and
inserting ``317D(l)(1)''.
(b) Public Health Service Act.--The Public Health Service Act, as
amended by Public Law 103-183 and by subsection (a) of this section, is
amended--
(1) in section 317E(g)(2), by striking ``making grants
under subsection (b)'' and inserting ``carrying out subsection
(b)'';
(2) in section 318, in subsection (e) as in effect on the
day before the date of the enactment of Public Law 103-183, by
redesignating the subsection as subsection (f);
(3) in subpart 6 of part C of title IV--
(A) by transferring the first section 447 (added by
section 302 of Public Law 103-183) from the current
placement of the section;
(B) by redesignating the section as section 447A;
and
(C) by inserting the section after section 447;
(4) in section 1213(a)(8), by striking ``provides for for''
and inserting ``provides for'';
(5) in section 1501, by redesignating the second subsection
(c) (added by section 101(f) of Public Law 103-183) as
subsection (d); and
(6) in section 1505(3), by striking ``nonprofit''.
(c) Miscellaneous Correction.--Section 401(c)(3) of Public Law 103-
183 is amended in the matter preceding subparagraph (A) by striking
``(d)(5)'' and inserting ``(e)(5)''.
(d) Conforming Amendment.--Section 308(b) of the Public Health
Service Act (42 U.S.C. 242m(b)) is amended--
(1) in paragraph (2)(A), by striking ``306(n)'' and
inserting ``306(m)''; and
(2) in paragraph (2)(C), by striking ``306(n)'' and
inserting ``306(m)''.
(e) Effective Date.--This section is deemed to have taken effect
immediately after the enactment of Public Law 103-183.
SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS COMMISSIONED OFFICERS.
(a) Anti-Discrimination Laws.--Amend section 212 of the Public
Health Service Act (42 U.S.C. 213) by adding the following new
subsection at the end thereof:
``(f) Active service of commissioned officers of the Service shall
be deemed to be active military service in the Armed Forces of the
United States for purposes of all laws related to discrimination on the
basis of race, color, sex, ethnicity, age, religion, and disability.''
(b) Training in Leave Without Pay Status.--Section 218 of the
Public Health Service Act (42 U.S.C. 218a) is amended by adding at the
end the following:
``(c) A commissioned officer may be placed in leave without pay
status while attending an educational institution or training program
whenever the Secretary determines that such status is in the best
interest of the Service. For purposes of computation of basic pay,
promotion, retirement, compensation for injury or death, and the
benefits provided by sections 212 and 224, an officer in such status
pursuant to the preceding sentence shall be considered as performing
service in the Service and shall have an active service obligation as
set forth in subsection (b) of this section.''.
(c) Utilization of Alcohol and Drug Abuse Records That Apply to the
Armed Forces.--Section 543(e) of the Public Health Service Act (42
U.S.C. 290dd-2(e)) is amended by striking ``Armed Forces'' each place
that such term appears and inserting ``Uniformed Services''.
SEC. 403. CLINICAL TRAINEESHIPS.
Section 303(d)(1) of the Public Health Service Act (42 U.S.C.
242a(d)(1)) is amended by inserting ``counseling,'' after ``family
therapy,''.
SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS, AND EDUCATION
REGARDING LEAD POISONING.
Section 317A(l)(1) of the Public Health Service Act (42 U.S.C.
247b-1(l)(1)) is amended by striking ``1998'' and inserting ``2002''.
SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH SERVICES REGARDING
TUBERCULOSIS.
Section 317E(g) of the Public Health Service Act (42 U.S.C. 247b-
6(g)(1)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by striking ``1998'' and
inserting ``2002''; and
(B) in subparagraph (B), by striking
``$50,000,000'' and inserting ``25 percent''; and
(2) in paragraph (2), by striking ``1998'' and inserting
``2002''.
SEC. 406. CDC LOAN REPAYMENT PROGRAM.
Section 317F of the Public Health Service Act (42 U.S.C. 247b-7) is
amended--
(1) in subsection (a)(1), by striking ``$20,000'' and
inserting ``$35,000'';
(2) in subsection (c), by striking ``1998'' and inserting
``2002''; and
(3) by adding at the end the following:
``(d) Availability of Appropriations.--Amounts appropriated for a
fiscal year for contracts under subsection (a) shall remain available
until the expiration of the second fiscal year beginning after the
fiscal year for which the amounts were appropriated.''.
SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIOLENCE.
(a) In General.--Section 318(h)(2) of the Family Violence
Prevention and Services Act (42 U.S.C. 10418(h)(2)) is amended by
striking ``fiscal year 1997'' and inserting ``for each of the fiscal
years 1997 through 2002''.
(b) Study.--The Secretary of Health and Human Services shall
request that the Institute of Medicine conduct a study concerning the
training needs of health professionals with respect to the detection
and referral of victims of family or acquaintance violence. Not later
than 2 years after the date of enactment of this Act, the Institute of
Medicine shall prepare and submit to Congress a report concerning the
study conducted under this subsection.
SEC. 408. STATE LOAN REPAYMENT PROGRAM.
Section 338I(i)(1) of the Public Health Service Act (42 U.S.C.
254q-1(i)(1)) is amended by inserting before the period ``, and such
sums as may be necessary for each of the fiscal years 1998 through
2002''.
SEC. 409. AUTHORITY OF THE DIRECTOR OF NIH.
Section 402(b) of the Public Health Service Act (42 U.S.C. 282(b))
is amended--
(1) in paragraph (11), by striking ``and'' at the end
thereof;
(2) in paragraph (12), by striking the period and inserting
a semicolon; and
(3) by adding after paragraph (12), the following new
paragraphs:
``(13) may conduct and support research training--
``(A) for which fellowship support is not provided
under section 487; and
``(B) which does not consist of residency training
of physicians or other health professionals; and
``(14) may appoint physicians, dentists, and other health
care professionals, subject to the provisions of title 5,
United States Code, relating to appointments and
classifications in the competitive service, and may compensate
such professionals subject to the provisions of chapter 74 of
title 38, United States Code.''.
SEC. 410. RAISE IN MAXIMUM LEVEL OF LOAN REPAYMENTS.
(a) Repayment Programs With Respect to AIDS.--Section 487A of the
Public Health Service Act (42 U.S.C. 288-1) is amended--
(1) in subsection (a), by striking ``$20,000'' and
inserting ``$35,000''; and
(2) in subsection (c), by striking ``1996'' and inserting
``2001''.
(b) Repayment Programs With Respect to Contraception and
Infertility.--Section 487B(a) of the Public Health Service Act (42
U.S.C. 288-2(a)) is amended by striking ``$20,000'' and inserting
``$35,000''.
(c) Repayment Programs With Respect to Research Generally.--Section
487C(a)(1) of the Public Health Service Act (42 U.S.C. 288-3(a)(1)) is
amended by striking ``$20,000'' and inserting ``$35,000''.
(d) Repayment Programs With Respect to Clinical Researchers From
Disadvantaged Backgrounds.--Section 487E(a) of the Public Health
Service Act (42 U.S.C. 288-5(a)) is amended--
(1) in paragraph (1), by striking ``$20,000'' and inserting
``$35,000''; and
(2) in paragraph (3), by striking ``338C'' and inserting
``338B, 338C''.
SEC. 411. CONSTRUCTION OF REGIONAL CENTERS FOR RESEARCH ON PRIMATES.
Section 481B(a) of the Public Health Service Act (42 U.S.C. 287a-
3(a)) is amended--
(1) by striking ``shall'' and inserting ``may''; and
(2) by striking ``$5,000,000'' and inserting ``up to
$2,500,000''.
SEC. 412. PEER REVIEW.
Section 504(d)(2) of the Public Health Service Act (42 U.S.C.
290aa-3(d)(2)) is amended by striking ``cooperative agreement, or
contract'' each place that such appears and inserting ``or cooperative
agreement''.
SEC. 413. FUNDING FOR TRAUMA CARE.
Section 1232(a) of the Public Health Service Act (42 U.S.C. 300d-
32) is amended by striking ``and 1996'' and inserting ``through 2002''.
SEC. 414. HEALTH INFORMATION AND HEALTH PROMOTION.
Section 1701(b) of the Public Health Service Act (42 U.S.C.
300u(b)) is amended by striking ``through 1996'' and inserting
``through 2002''.
SEC. 415. EMERGENCY MEDICAL SERVICES FOR CHILDREN.
Section 1910 of the Public Health Service Act (42 U.S.C. 300w-9) is
amended--
(1) in subsection (a)--
(A) by striking ``two-year period'' and inserting
``3-year period (with an optional 4th year based on
performance)''; and
(B) by striking ``one grant'' and inserting ``3
grants''; and
(2) in subsection (d), by striking ``1997'' and inserting
``2005''.
SEC. 416. ADMINISTRATION OF CERTAIN REQUIREMENTS.
(a) In General.--Section 2004 of Public Law 103-43 (107 Stat. 209)
is amended by striking subsection (a).
(b) Conforming Amendments.--Section 2004 of Public Law 103-43, as
amended by subsection (a) of this section, is amended--
(1) by striking ``(b) Sense'' and all that follows through
``In the case'' and inserting the following:
``(a) Sense of Congress Regarding Purchase of American-Made
Equipment and Products.--In the case'';
(2) by striking ``(2) Notice to recipients of assistance''
and inserting the following:
``(b) Notice to Recipients of Assistance''; and
(3) in subsection (b), as redesignated by paragraph (2) of
this subsection, by striking ``paragraph (1)'' and inserting
``subsection (a)''.
(c) Effective Date.--This section is deemed to have taken effect
immediately after the enactment of Public Law 103-43.
SEC. 417. AIDS DRUG ASSISTANCE PROGRAM.
Section 2618(b)(3) of the Public Health Service Act (42 U.S.C.
300ff-28(b)(3)) is amended--
(1) in subparagraph (A), by striking ``and the Commonwealth
of Puerto Rico'' and inserting ``, the Commonwealth of Puerto
Rico, the Virgin Islands, and Guam''; and
(2) in subparagraph (B), by striking ``the Virgin Islands,
Guam''.
SEC. 418. NATIONAL FOUNDATION FOR BIOMEDICAL RESEARCH.
Part I of title IV of the Public Health Service Act (42 U.S.C. 290b
et seq.) is amended--
(1) by striking the part heading and inserting the
following:
``PART I--FOUNDATION FOR THE NATIONAL INSTITUTES OF HEALTH'';
and
(2) in section 499--
(A) in subsection (a), by striking ``National
Foundation for Biomedical Research'' and inserting
``Foundation for the National Institutes of Health'';
(B) in subsection (k)(10)--
(i) by striking ``not''; and
(ii) by adding at the end the following:
``Any funds transferred under this paragraph
shall be subject to all Federal limitations
relating to Federally-funded research.''; and
(C) in subsection (m)(1), by striking ``$200,000''
and all that follows through ``1995'' and inserting
``$500,000 for each fiscal year''.