[House Prints 111-B]
[From the U.S. Government Printing Office]




   111th Congress                                     Committee
     2nd Session            COMMITTEE PRINT          Print 111-B
_______________________________________________________________________



                  COMPILATION OF SELECTED ACTS WITHIN
                   THE JURISDICTION OF THE COMMITTEE
                         ON ENERGY AND COMMERCE

                               ----------                              

                               HEALTH LAW

                       Public Health Service Act
                   As Amended Through January 2, 2011

                               ----------                              

                      prepared for the use of the

                    COMMITTEE ON ENERGY AND COMMERCE

                     U.S. HOUSE OF REPRESENTATIVES








111th Congress                                                Committee
 2nd Session                COMMITTEE PRINT                 Print 111-B
_______________________________________________________________________

 
                  COMPILATION OF SELECTED ACTS WITHIN
                   THE JURISDICTION OF THE COMMITTEE
                         ON ENERGY AND COMMERCE

                               __________

                               HEALTH LAW

                       Public Health Service Act

                   As Amended Through January 2, 2011

                               __________

                      prepared for the use of the

                    COMMITTEE ON ENERGY AND COMMERCE

                     U.S. HOUSE OF REPRESENTATIVES









                  U.S. GOVERNMENT PRINTING OFFICE
  63-169                  WASHINGTON : 2011
-----------------------------------------------------------------------
For sale by the Superintendent of Documents, U.S. Government Printing 
Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; DC 
area (202) 512-1800 Fax: (202) 512-2104  Mail: Stop IDCC, Washington, DC 
20402-0001







                    COMMITTEE ON ENERGY AND COMMERCE

                 HENRY A. WAXMAN, California, Chairman

JOHN D. DINGELL, Michigan            JOE BARTON, Texas
  Chairman Emeritus                    Ranking Member
EDWARD J. MARKEY, Massachusetts      RALPH M. HALL, Texas
RICK BOUCHER, Virginia               FRED UPTON, Michigan
FRANK PALLONE, Jr., New Jersey       CLIFF STEARNS, Florida
BART GORDON, Tennessee               ED WHITFIELD, Kentucky
BOBBY L. RUSH, Illinois              JOHN SHIMKUS, Illinois
ANNA G. ESHOO, California            JOHN B. SHADEGG, Arizona
BART STUPAK, Michigan                ROY BLUNT, Missouri
ELIOT L. ENGEL, New York               Deputy Ranking Member
GENE GREEN, Texas                    STEVE BUYER, Indiana
DIANA DeGETTE, Colorado              GEORGE RADANOVICH, California
  Vice Chairman                      JOSEPH R. PITTS, Pennsylvania
LOIS CAPPS, California               MARY BONO MACK, California
MIKE DOYLE, Pennsylvania             LEE TERRY, Nebraska
JANE HARMAN, California              MIKE ROGERS, Michigan
JAN SCHAKOWSKY, Illinois             SUE WILKINS MYRICK, North Carolina
CHARLES A. GONZALEZ, Texas           JOHN SULLIVAN, Oklahoma
JAY INSLEE, Washington               TIM MURPHY, Pennsylvania
TAMMY BALDWIN, Wisconsin             MICHAEL C. BURGESS, Texas
MIKE ROSS, Arkansas                  MARSHA BLACKBURN, Tennessee
ANTHONY D. WEINER, New York          PHIL GINGREY, Georgia
JIM MATHESON, Utah                   STEVE SCALISE, Louisiana
G.K. BUTTERFIELD, North Carolina     PARKER GRIFFITH, Alabama
CHARLIE MELANCON, Louisiana          ROBERT E. LATTA, Ohio
JOHN BARROW, Georgia
BARON P. HILL, Indiana
DORIS O. MATSUI, California
DONNA M. CHRISTENSEN, Virgin 
Islands
KATHY CASTOR, Florida
JOHN SARBANES, Maryland
CHRISTOPHER S. MURPHY, Connecticut
ZACHARY T. SPACE, Ohio
JERRY McNERNEY, California
BETTY SUTTON, Ohio
BRUCE BRALEY, Iowa
PETER WELCH, Vermont

                   Philip S. Barnett, Staff Director

                   Kristin L. Amerling, Chief Counsel

               David L. Cavicke, Minority Chief of Staff

                                  (ii)

  


    For changes after the closing date of this publication 
(January 2, 2011) to provisions of law in this publication, see 
the United States Code Classification Tables published by the 
Office of the Law Revision Counsel of the House of 
Representatives at 
http://uscode.house.gov/classification/tables.shtml.

                                 (iii)
               COMPILATION OF SELECTED ACTS -- HEALTH LAW
======================================================================


                       PUBLIC HEALTH SERVICE ACT

======================================================================


    NOTE.--Reorganization Plan No. 3 of 1966 transferred all 
statutory powers and functions of the Surgeon General and other 
officers of the Public Health Service and of all agencies of or 
in the Service to the Secretary of Health, Education, and 
Welfare. The Department of Education Organization Act 
designated the Secretary of Health, Education, and Welfare as 
the Secretary of Health and Human Services. References in the 
Act to the Surgeon General, other officers of the Service, the 
Secretary of Health, Education, and Welfare, and the Department 
of Health, Education, and Welfare, should be read in the light 
of the transfer of statutory functions and the redesignation.
START OF STATUTE deg.STATUTE NAME= deg.PUBLIC HEALTH 
                              SERVICE ACT

   [As Amended Through P.L. ___ (H.R. 847), Enacted January 2, 2011]

   (References in brackets [  ] are to title 42, United States Code)

                  TITLE I--SHORT TITLE AND DEFINITIONS

                              short title

    Section 1. [201 note] This Act may be cited as the ``Public 
Health Service Act''.

                              definitions

    Sec. 2. [201] When used in this Act--
    (a) The term ``Service'' means the Public Health Service;
    (b) The term ``Surgeon General'' means the Surgeon General 
of the Public Health Service;
    (c) Unless the context otherwise requires, the term 
``Secretary'' means the Secretary of Health and Human Services;
    (d) The term ``regulations'', except when otherwise 
specified, means rules and regulations made by the Surgeon 
General with the approval of the Secretary;
    (e) The term ``executive department'' means any executive 
department, agency, or independent establishment of the United 
States or any corporation wholly owned by the United States;
    (f) Except as provided in sections 314(g)(4)(B), 318(c)(1), 
331(h)(3), 335(5), 361(d), 701(9), 1002(c), 1401(13), 1531(1), 
and 1633(1), the term ``State'' includes, in addition to the 
several States, only the District of Columbia, Guam, the 
Commonwealth of Puerto Rico, the Northern Mariana Islands, the 
Virgin Islands, American Samoa, and the Trust Territory of the 
Pacific Islands.
    (g) The term ``possession'' includes, among other 
possessions, Puerto Rico and the Virgin Islands;
    (h) [Repealed.]
    (i) The term ``vessel'' includes every description of 
watercraft or other artificial contrivance used, or capable of 
being used, as a means of transportation on water, exclusive of 
aircraft and amphibious contrivances;
    (j) The term ``habit-forming narcotic drug'' or 
``narcotic'' means opium and coca leaves and the several 
alkaloids derived therefrom, the best known of these alkaloids 
being morphia, heroin, and codeine, obtained from opium, and 
cocaine derived from the coca plant; all compounds, salts, 
preparations, or other derivatives obtained either from the raw 
material or from the various alkaloids; Indian hemp and its 
various derivatives, compounds, and preparations, and peyote in 
its various forms; isonipecaine and its derivatives, compounds, 
salts and preparations; opiates (as defined in section 3228(f) 
of the Internal Revenue Code);
    (k) The term ``addict'' means any person who habitually 
uses any habit-forming narcotic drugs so as to endanger the 
public morals, health, safety, or welfare, or who is or has 
been so far addicted to the use of such habit-forming narcotic 
drugs as to have lost the power of self-control with reference 
to his addiction;
    (l) The term ``psychiatric disorders'' includes diseases of 
the nervous system which affect mental health;
    (m) The term ``State mental health authority'' means the 
State health authority, except that, in the case of any State 
in which there is a single State agency, other than the State 
health authority, charged with responsibility for administering 
the mental health program of the State, it means such other 
State agency;
    (n) The term ``heart diseases'' means diseases of the heart 
and circulation;
    (o) The term ``dental diseases and conditions'' means 
diseases and conditions affecting teeth and their supporting 
structures, and other related diseases of the mouth;
    (p) The term ``uniformed service'' means the Army, Navy, 
Air Force, Marine Corps, Coast Guard, Public Health Service, or 
Coast and Geodetic Survey; and
    (q) The term ``drug dependent person'' means a person who 
is using a controlled substance (as defined in section 102 of 
the Controlled Substances Act) and who is in a state of psychic 
or physical dependence, or both, arising from the use of that 
substance on a continuous basis. Drug dependence is 
characterized by behavioral and other responses which include a 
strong compulsion to take the substance on a continuous basis 
in order to experience its psychic effects or to avoid the 
discomfort caused by its absence.
         TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS

                         Part A--Administration

                         public health service

    Sec. 201. [202] The Public Health Service in the Department 
of Health and Human Services shall be administered by the 
Assistant Secretary for Health under the supervision and 
direction of the Secretary.

                              organization

    Sec. 202. \1\ [203] The Service shall consist of (1) the 
Office of the Surgeon General, (2) the National Institutes of 
Health, (3) the Bureau of Medical Services, and (4) the Bureau 
of State Services, and the Agency for Health Care Policy and 
Research. \2\ The Secretary is authorized and directed to 
assign to the Office of the Secretary, to the National 
Institutes of Health, to the Bureau of Medical Services, and to 
the Bureau of State Services, respectively, the several 
functions of the Service, and to establish within them such 
divisions, sections and other units as he may find necessary; 
and from time to time, abolish, transfer, and consolidate 
divisions, sections, and other units and assign their functions 
and personnel in such manner as he may find necessary for 
efficient operation of the Service. No division shall be 
established, abolished, or transferred, and no divisions shall 
be consolidated, except with the approval of the Secretary. The 
National Institutes of Health shall be administered as a part 
of the field service. The Secretary may delegate to any officer 
or employee of the Service such of his powers and duties under 
this Act, except the making of regulations, as he may deem 
necessary or expedient.
---------------------------------------------------------------------------
    \1\ The organizational units specified in this section, other than 
the Agency for Health Care Policy and Research, were all abolished as 
statutory entities by Reorganization Plan No. 3 of 1966. Although the 
Reorganization Plan abolished the National Institutes of Health as an 
agency, it did not abolish the individual research institutes.
        In 1985, Public Law 99-158 added title IV of this Act, which 
provides that the National Institutes of Health is an agency of the 
Public Health Service. See section 401(a).
        Other laws have established additional agencies within the 
Service. Section 501(a) of this Act provides that the Substance Abuse 
and Mental Health Services Administration is an agency of the Service. 
Section 901(a) establishes the Agency for Healthcare Research and 
Quality within the Service (formerly designated as the Agency for 
Health Care Policy and Research).
        Although not established in this Act, the Centers for Disease 
Control and Prevention, the Health Resources and Services 
Administration, and the Agency for Toxic Substances and Disease 
Registry are agencies of the Service.
        The Food and Drug Administration is also an agency of the 
Service.
    \2\  So in law. See section 2008(g)(2) of Public Law 103-43 (107 
Stat. 212). The term ``the Agency'' probably should be preceded by 
``(5)'', and the ``and'' before ``(4)'' probably should be struck. 
Further, Public Law 106-129 redesignated the Agency for Health Care 
Policy and Research as the Agency for Healthcare Research and Quality 
(see 113 Stat. 1653).
---------------------------------------------------------------------------

SEC. 203. [204] COMMISSIONED CORPS AND READY RESERVE CORPS.

    (a) Establishment.--
            (1) In general.--There shall be in the Service a 
        commissioned Regular Corps and a Ready Reserve Corps 
        for service in time of national emergency.
            (2) Requirement.--All commissioned officers shall 
        be citizens of the United States and shall be appointed 
        without regard to the civil-service laws and 
        compensated without regard to the Classification Act of 
        1923, \1\ as amended.
---------------------------------------------------------------------------
    \1\ Civil service and classification laws are now codified to title 
5, United States Code.
---------------------------------------------------------------------------
            (3) Appointment.--Commissioned officers of the 
        Ready Reserve Corps shall be appointed by the President 
        and commissioned officers of the Regular Corps shall be 
        appointed by the President with the advice and consent 
        of the Senate.
            (4) Active duty.--Commissioned officers of the 
        Ready Reserve Corps shall at all times be subject to 
        call to active duty by the Surgeon General, including 
        active duty for the purpose of training.
            (5) Warrant officers.--Warrant officers may be 
        appointed to the Service for the purpose of providing 
        support to the health and delivery systems maintained 
        by the Service and any warrant officer appointed to the 
        Service shall be considered for purposes of this Act 
        and title 37, United States Code, to be a commissioned 
        officer within the Commissioned Corps of the Service.
    (b) Assimilating Reserve Corp Officers Into the Regular 
Corps.--Effective on the date of enactment of the Patient 
Protection and Affordable Care Act, all individuals classified 
as officers in the Reserve Corps under this section (as such 
section existed on the day before the date of enactment of such 
Act) and serving on active duty shall be deemed to be 
commissioned officers of the Regular Corps.
    (c) Purpose and Use of Ready Research.--
            (1) Purpose.--The purpose of the Ready Reserve 
        Corps is to fulfill the need to have additional 
        Commissioned Corps personnel available on short notice 
        (similar to the uniformed service's reserve program) to 
        assist regular Commissioned Corps personnel to meet 
        both routine public health and emergency response 
        missions.
            (2) Uses.--The Ready Reserve Corps shall--
                    (A) participate in routine training to meet 
                the general and specific needs of the 
                Commissioned Corps;
                    (B) be available and ready for involuntary 
                calls to active duty during national 
                emergencies and public health crises, similar 
                to the uniformed service reserve personnel;
                    (C) be available for backfilling critical 
                positions left vacant during deployment of 
                active duty Commissioned Corps members, as well 
                as for deployment to respond to public health 
                emergencies, both foreign and domestic; and
                    (D) be available for service assignment in 
                isolated, hardship, and medically underserved 
                communities (as defined in section 799B) to 
                improve access to health services.
    (d) Funding.--For the purpose of carrying out the duties 
and responsibilities of the Commissioned Corps under this 
section, there are authorized to be appropriated $5,000,000 for 
each of fiscal years 2010 through 2014 for recruitment and 
training and $12,500,000 for each of fiscal years 2010 through 
2014 for the Ready Reserve Corps.

SEC. 203A. [204A] DEPLOYMENT READINESS.

    (a) Readiness Requirements for Commissioned Corps 
Officers.--
            (1) In general.--The Secretary, with respect to 
        members of the following Corps components, shall 
        establish requirements, including training and medical 
        examinations, to ensure the readiness of such 
        components to respond to urgent or emergency public 
        health care needs that cannot otherwise be met at the 
        Federal, State, and local levels:
                    (A) Active duty Regular Corps.
                    (B) Active Reserves.
            (2) Annual assessment of members.--The Secretary 
        shall annually determine whether each member of the 
        Corps meets the applicable readiness requirements 
        established under paragraph (1).
            (3) Failure to meet requirements.--A member of the 
        Corps who fails to meet or maintain the readiness 
        requirements established under paragraph (1) or who 
        fails to comply with orders to respond to an urgent or 
        emergency public health care need shall, except as 
        provided in paragraph (4), in accordance with 
        procedures established by the Secretary, be subject to 
        disciplinary action as prescribed by the Secretary.
            (4) Waiver of requirements.--
                    (A) In general.--The Secretary may waive 
                one or more of the requirements established 
                under paragraph (1) for an individual who is 
                not able to meet such requirements because of--
                            (i) a disability;
                            (ii) a temporary medical condition; 
                        or
                            (iii) any other extraordinary 
                        limitation as determined by the 
                        Secretary.
                    (B) Regulations.--The Secretary shall 
                promulgate regulations under which a waiver 
                described in subparagraph (A) may be granted.
            (5) Urgent or emergency public health care need.--
        For purposes of this section and section 214, the term 
        ``urgent or emergency public health care need'' means a 
        health care need, as determined by the Secretary, 
        arising as the result of--
                    (A) a national emergency declared by the 
                President under the National Emergencies Act 
                (50 U.S.C. 1601 et seq.);
                    (B) an emergency or major disaster declared 
                by the President under the Robert T. Stafford 
                Disaster Relief and Emergency Assistance Act 
                (42 U.S.C. 5121 et seq.);
                    (C) a public health emergency declared by 
                the Secretary under section 319 of this Act; or
                    (D) any emergency that, in the judgment of 
                the Secretary, is appropriate for the 
                deployment of members of the Corps.
    (b) Corps Management for Deployment.--The Secretary shall--
            (1) organize members of the Corps into units for 
        rapid deployment by the Secretary to respond to urgent 
        or emergency public health care needs;
            (2) establish appropriate procedures for the 
        command and control of units or individual members of 
        the Corps that are deployed at the direction of the 
        President or the Secretary in response to an urgent or 
        emergency public health care need of national, State or 
        local significance;
            (3) ensure that members of the Corps are trained, 
        equipped and otherwise prepared to fulfill their public 
        health and emergency response roles; and
            (4) ensure that deployment planning takes into 
        account--
                    (A) any deployment exemptions that may be 
                granted by the Secretary based on the unique 
                requirements of an agency and an individual's 
                functional role in such agency; and
                    (B) the nature of the urgent or emergency 
                public health care need.
    (c) Deployment of Detailed or Assigned Officers.--For 
purposes of pay, allowances, and benefits of a Commissioned 
Corps officer who is detailed or assigned to a Federal entity, 
the deployment of such officer by the Secretary in response to 
an urgent or emergency public health care need shall be deemed 
to be an authorized activity of the Federal entity to which the 
officer is detailed or assigned.

                            surgeon general

    Sec. 204. [205] The Surgeon General shall be appointed from 
the Regular Corps for a four-year term by the President by and 
with the advice and consent of the Senate. The Surgeon General 
shall be appointed from individuals who (1) are members of the 
Regular Corps, and (2) have specialized training or significant 
experience in public health programs. Upon the expiration of 
such term, the Surgeon General, unless reappointed, shall 
revert to the grade and number in the Regular or Reserve Corps 
that he would have occupied had he not served as Surgeon 
General.

         deputy surgeon general and assistant surgeons general

    Sec. 205. [206] (a) The Surgeon General shall assign one 
commissioned officer from the Regular Corps to administer the 
Office of the Surgeon General, to act as Surgeon General during 
the absence or disability of the Surgeon General or in the 
event of a vacancy in that office, and to perform such other 
duties as the Surgeon General may prescribe, and while so 
assigned he shall have the title of Deputy Surgeon General.
    (b) The Surgeon General shall assign eight commissioned 
officers from the Regular Corps to be, respectively, the 
Director of the National Institutes of Health, the Chief of the 
Bureau of State Services, the Chief of the Bureau of Medical 
Services, the Chief Medical Officer of the United States Coast 
Guard, the Chief Dental Officer of the Service, the Chief Nurse 
Officer of the Service, the Chief Pharmacist Officer of the 
Service, and the Chief Sanitary Engineering Officer of the 
Service, and while so serving they shall each have the title of 
Assistant Surgeon General.
    (c)(1) The Surgeon General, with the approval of the 
Secretary, is authorized to create special temporary positions 
in the grade of Assistant Surgeons General when necessary for 
the proper staffing of the Service. The Surgeon General may 
assign officers of either the Regular Corps or the Reserve 
Corps to any such temporary position, and while so serving they 
shall each have the title of Assistant Surgeon General.
    (2) Except as provided in this paragraph, the number of 
special temporary positions created by the Surgeon General 
under paragraph (1) shall not on any day exceed 1 per centum of 
the highest number, during the ninety days preceding such day, 
of officers of the Regular Corps on active duty and officers of 
the Reserve Corps on active duty for more than thirty days. If 
on any day the number of such special temporary positions 
exceeds such 1 per centum limitations, for a period of not more 
than one year after such day, the number of such special 
temporary positions shall be reduced for purposes of complying 
with such 1 per centum limitation only by the resignation, 
retirement, death, or transfer to a position of a lower grade, 
of any officer holding any such temporary position.
    (d) The Surgeon General shall designate the Assistant 
Surgeon General who shall serve as Surgeon General in case of 
absence or disability, or vacancy in the offices, of both the 
Surgeon General and the Deputy Surgeon General.

          grades, ranks, and titles of the commissioned corps

    Sec. 206. [207] (a) The Surgeon General during the period 
of his appointment as such, shall be of the same grade as the 
Surgeon General of the army; the Deputy Surgeon General and the 
Chief Medical Officer of the United States Coast Guard, while 
assigned as such, shall have the grade corresponding with the 
grade of major general; and the Chief Dental Officer, while 
assigned as such, shall have the grade as is prescribed by law 
for the officer of the Dental Corps selected and appointed as 
Assistant Surgeon General of the Army. During the period of 
appointment to the position of Assistant Secretary for Health, 
a commissioned officer of the Public Health Service shall have 
the grade corresponding to the grade of General of the Army. 
Assistant Surgeons General, while assigned as such, shall have 
the grade corresponding with either the grade of brigadier 
general or the grade of major general, as may be determined by 
the Secretary after considering the importance of the duties to 
be performed: Provided, That the number of Assistant Surgeons 
General having a grade higher than that corresponding to the 
grade of brigadier general shall at no time exceed one-half of 
the number of positions created by subsection (b) of section 
205 or pursuant to subsection (c) of such section. The grades 
of commissioned officers of the Service shall correspond with 
grades of officers of the Army as follows:
            (1) Officers of the director grade--colonel;
            (2) Officers of the senior grade--lieutenant 
        colonel;
            (3) Officers of the full grade--major;
            (4) Officers of the senior assistant grade--
        captain;
            (5) Officers of the assistant grade--first 
        lieutenant;
            (6) Officers of the junior assistant grade--second 
        lieutenant;
            (7) Chief warrant officers of (W-4) grade--chief 
        warrant officer (W-4);
            (8) Chief warrant officers of (W-3) grade--chief 
        warrant officer (W-3);
            (9) Chief warrant officers of (W-2) grade--chief 
        warrant officer (W-2); and
            (10) Warrant officers of (W-1) grade--warrant 
        officer (W-1).
    (b) The titles of medical officers of the foregoing grades 
shall be respectively (1) medical director, (2) senior surgeon, 
(3) surgeon, (4) senior assistant surgeon, (5) assistant 
surgeon and (6) junior assistant surgeon.
    (c) The President is authorized to prescribe titles, 
appropriate to the several grades, for commissioned officers of 
the Service other than medical officers. All titles of the 
officers of the Reserve Corps shall have the suffix 
``Reserve''.
    (d) Within the total number of officers of the Regular 
Corps authorized by the appropriation Act or Acts for each 
fiscal year to be on active duty, the Secretary shall by 
regulation prescribe the maximum number of officers authorized 
to be in each of the grades from the warrant officer (W-1) 
grade to the director grade, inclusive. Such numbers shall be 
determined after considering the anticipated needs of the 
Service during the fiscal year, the funds available, the number 
of officers in each grade at the beginning of the fiscal year, 
and the anticipated appointments, the anticipated promotions 
based on years of service, and the anticipated retirements 
during the fiscal year. The number so determined for any grade 
for a fiscal year may not exceed the number limitation (if any) 
contained in the appropriation Act or Acts for such year. Such 
regulations for each fiscal year shall be prescribed as 
promptly as possible after the appropriation Act fixing the 
authorized strength of the corps for that year, and shall be 
subject to amendment only if such authorized strength or such 
number limitation is thereafter changed. The maxima established 
by such regulations shall not require (apart from action 
pursuant to other provisions of this Act) any officer to be 
separated from the Service or reduced in grade.
      (e) In computing the maximum number of commissioned 
officers of the Public Health Service authorized by law to hold 
a grade which corresponds to the grade of brigadier general or 
major general, there may be excluded from such computation not 
more than three officers who hold such a grade so long as such 
officers are assigned to duty and are serving in a policymaking 
position in the Department of Defense.
    (f) In computing the maximum number of commissioned 
officers of the Public Health Service authorized by law or 
administrative determination to serve on active duty, there may 
be excluded from such computation officers who are assigned to 
duty in the Department of Defense.
                        appointment of personnel
    Sec. 207. [209] (a)(1) Except as provided in subsections 
(b) and (e) of this section, original appointments to the 
Regular Corps may be made only in the warrant officer (W-1), 
chief warrant officer (W-2), chief warrant officer (W-3), chief 
warrant officer (W-4), junior assistant, assistant, and senior 
assistant grades and original appointments to a grade above 
junior assistant shall be made only after passage of an 
examination, given in accordance with regulations of the 
President, in one or more of the several branches of medicine, 
dentistry, hygiene, sanitary engineering, pharmacy, psychology, 
nursing, or related scientific specialties in the field of 
public health.
    (2) Original appointments to the Reserve Corps may be made 
to any grade up to and including the director grade but only 
after passage of an examination given in accordance with 
regulations of the President. Reserve commissions shall be for 
an indefinite period and may be terminated at any time, as the 
President may direct.
    (3) No individual who has attained the age of forty-four 
shall be appointed to the Regular Corps, or called to active 
duty in the Reserve Corps for a period in excess of one year, 
unless (A) he has had a number of years of active service (as 
defined in section 211(d)) equal to the number of years by 
which his age exceeds forty-four, or (B) the Surgeon General 
determines that he possesses exceptional qualifications, not 
readily available elsewhere in the Commissioned Corps of the 
Public Health Service, for the performance of special duties 
with the Service, or (C) in the case of an officer of the 
Reserve Corps, the Commissioned Corps of the Service has been 
declared by the President to be a military service.
    (b)(1) Not more than 10 per centum of the original 
appointments to the Regular Corps authorized to be made during 
any fiscal year may be made to grades above that of senior 
assistant, but no such appointment (other than an appointment 
under section 204) may be made to a grade above that of 
director. For the purpose of this subsection the number of 
original appointments authorized to be made during a fiscal 
year shall be (1) the excess of the number of officers of the 
Regular Corps authorized by the appropriation Act or Acts for 
such year over the number of officers on active duty in the 
Regular Corps on the first day of such year, plus (2) the 
number of such officers of the Regular Corps who, during such 
fiscal year, have been or will be retired upon attainment of 
age sixty-four or have for any other reason ceased to be on 
active duty. In determining the number of appointments 
authorized by this subsection an appointment shall be deemed to 
be made in the fiscal year in which the nomination is 
transmitted by the President to the Senate.
    (2) In addition to the number of original appointments to 
the Regular Corps authorized by paragraph (1) to be made to 
grades above that of senior assistant, original appointments 
authorized to be made to the Regular Corps in any year may be 
made to grades above that of senior assistant, but not above 
that of director, in the case of any individual who--
            (A)(i) was on active duty in the Regular Corps on 
        July 1, 1960, (ii) was on such active duty continuously 
        for not less than one year immediately prior to such 
        date, and (iii) applies for appointment to the Regular 
        Corps prior to July 1, 1962; or
            (B) does not come within clause (A)(i) and (ii) but 
        was on active duty in the Reserve Corps continuously 
        for not less than one year immediately prior to his 
        appointment to the Regular Corps and has not served on 
        active duty continuously for a period, occurring after 
        June 30, 1960, of more than three and one-half years 
        prior to applying for such appointment.
    (3) No person shall be appointed pursuant to this 
subsection unless he meets standards established in accordance 
with regulations of the President.
    (c) Commissions evidencing the appointment by the President 
of officers of the Regular or Reserve Corps shall be issued by 
the Secretary under the seal of the Department of Health, 
Education, and Welfare.
    (d)(1) For purposes of basic pay and for purposes of 
promotion, any person appointed under subsection (a) to the 
grade of senior assistant in the Regular Corps and any person 
appointed under subsection (b), shall, except as provided in 
paragraphs (2) and (3) of this subsection, be considered as 
having had on the date of appointment the following length of 
service: Three years if appointed to the senior assistant 
grade, ten years if appointed to the full grade, seventeen 
years if appointed to the senior grade, and eighteen years if 
appointed to the director grade.
    (2) For purposes of basic pay, any person appointed under 
subsection (a) to the grade of senior assistant in the Regular 
Corps, and any person appointed under subsection (b), shall, in 
lieu of the credit provided in paragraph (1), be credited with 
the service for which he is entitled to credit under any other 
provision of law if such service exceeds that to which he would 
be entitled under such paragraph.
    (3) For purposes of promotion, any person originally 
appointed in the Regular Corps to the senior assistant grade or 
above who has had active service in the Reserve Corps shall be 
considered as having had on the date of appointment the length 
of service provided for in paragraph (1), plus whichever of the 
following is greater: (A) The excess of his total active 
service in the Reserve Corps (above the grade of junior 
assistant) over the length of service provided in such 
paragraph, to the extent that such excess is on account of 
service in the Reserve Corps in or above the grade to which he 
is appointed in the Regular Corps or (B) his active service in 
the same or any higher grade in the Reserve Corps after the 
first day on which, under regulations in effect on the date of 
his appointment to the Regular Corps, he would have had the 
training and experience necessary for such appointment.
    (4) For purposes of promotion, any person whose original 
appointment is to the assistant grade in the Regular Corps 
shall be considered as having had on the date of appointment 
service equal to his total active service in the Reserve Corps 
in and above the assistant grade.
    (e)(1) A former officer of the Regular Corps may, if 
application for appointment is made within two years after the 
date of the termination of his prior commission in the Regular 
Corps, be reappointed to the Regular Corps without examination, 
except as the Surgeon General may otherwise prescribe, and 
without regard to the numerical limitations of subsection (b).
    (2) Reappointments pursuant to this subsection may be made 
to the permanent grade held by the former officer at the time 
of the termination of his prior commission, or to the next 
higher grade if such officer meets the eligibility requirements 
prescribed by regulation for original appointment to such 
higher grade. For purposes of pay, promotion, and seniority in 
grade, such reappointed officer shall receive the credits for 
service to which he would be entitled if such appointment were 
an original appointment, but in no event less than the credits 
he held at the time his prior commission was terminated, except 
that if such officer is reappointed to the next higher grade he 
shall receive no credit for seniority in grade.
    (3) No former officer shall be reappointed pursuant to this 
subsection unless he shall meet such standards as the Secretary 
may prescribe.
    (f) In accordance with regulations, special consultants may 
be employed to assist and advise in the operations of the 
Service. Such consultants may be appointed without regard to 
the civil-service laws and their compensation may be fixed 
without regard to the Classification Act of 1923, as amended. 
\1\
---------------------------------------------------------------------------
    \1\ See footnote for the second sentence of section 203.
---------------------------------------------------------------------------
    (g) In accordance with regulations, individual scientists, 
other than commissioned officers of the Service, may be 
designated by the Surgeon General to receive fellowships, 
appointed for duty with the Service without regard to the 
civil-service laws and compensated without regard to the 
Classification Act of 1923, as amended, \1\ may hold their 
fellowships under conditions prescribed therein, and may be 
assigned for studies or investigations either in this country 
or abroad during the terms of their fellowships.
    (h) Persons who are not citizens may be employed as 
consultants pursuant to subsection (e) and may be appointed to 
fellowships pursuant to subsection (f). Unless otherwise 
specifically provided, any prohibition in any other Act against 
the employment of aliens, or against the payment of 
compensation to them, shall not be applicable in the case of 
persons employed or appointed pursuant to such subsections.
    (i) The appointment of any officer or employee of the 
Service made in accordance with the civil-service laws shall be 
made by the Secretary, and may be made effective as of the date 
on which such officer or employee enters upon duty.
                           pay and allowances
    Sec. 208. [210] (a)(1) Commissioned officers of the Regular 
and Reserve Corps shall be entitled to receive such pay and 
allowances as are now or may hereafter be authorized by law.
    (2) For provisions relating to the receipt of special pay 
by commissioned officers of the Regular and Reserve Corps while 
on active duty, see section 303a(b) of title 37, United States 
Code.
    (b) Commissioned officers on active duty, and retired 
officers entitled to retired pay pursuant to section 210(g)(3), 
section 211 or section 221(a), shall be permitted to purchase 
supplies from the Army, Navy, Air Force, and Marine Corps at 
the same price as is charged officers thereof.
    (c) Members of the National Advisory Health Council and 
members of other national advisory or review councils or 
committees established under this Act, including members of the 
Technical Electronic Product Radiation Safety Standards 
Committee and the Board of Regents of the National Library of 
Medicine, but excluding ex officio members, while attending 
conferences or meetings of their respective councils or 
committees or while otherwise serving at the request of the 
Secretary shall be entitled to receive compensation at rates to 
be fixed by the Secretary, but at rates not exceeding the daily 
equivalent of the rate specified at the time of such service 
for grade GS-18 of the General Schedule, including traveltime; 
and while away from their homes or regular places of business 
they may be allowed travel expenses, including per diem in lieu 
of subsistence, as authorized by section 5703 of title 5 of the 
United States Code for persons in the Government service 
employed intermittently.
    (d) Field employees of the Service, except those employed 
on a per diem or fee basis, who render part-time duty and are 
also subject to call at any time for services not contemplated 
in their regular part-time employment, may be paid annual 
compensation for such part-time duty and, in addition, such 
fees for such other services as the Surgeon General may 
determine; but in no case shall the total paid to any such 
employee for any fiscal year exceed the amount of the minimum 
annual salary rate of the classification grade of the employee.
    (e) Any civilian employee of the Service who is employed at 
the Gillis W. Long Hansen's Disease Center on the date of the 
enactment of the Consolidated Omnibus Budget Reconciliation Act 
of 1985 shall be entitled to receive, in addition to any 
compensation to which the employee may otherwise be entitled 
and for so long as the employee remains employed at the Center, 
an amount equal to one-fourth of such compensation.
    (f) Individuals appointed under subsection (g) shall have 
included in their fellowships such stipends or allowances, 
including travel and subsistence expenses, as the Surgeon 
General may deem necessary to procure qualified fellows.
    (g) The Secretary is authorized to establish and fix the 
compensation for, within the Public Health Service, not more 
than one hundred and seventy-nine positions, of which not less 
than one hundred and fifteen shall be for the National 
Institutes of Health, not less than five shall be for the 
National Institute on Alcohol Abuse and Alcoholism for 
individuals engaged in research on alcohol and alcoholism, not 
less than ten shall be for the National Center for Health 
Services Research, not less than twelve shall be for the 
National Center for Health Statistics, and not less than seven 
shall be for the National Center for Health Care Technology, in 
the professional, scientific, and executive service, each such 
position being established to effectuate those research and 
development activities of the Public Health Service which 
require the services of specially qualified scientific, 
professional, and administrative personnel: Provided, That the 
rates of compensation for positions established pursuant to the 
provisions of this subsection shall not be less than the 
minimum rate of grade 16 of the General Schedule of the 
Classification Act of 1949, as amended, \1\ nor more than (1) 
the highest rate of grade 18 of the General Schedule of such 
Act, or (2) in the case of two such positions, the rate 
specified, at the time the service in the position is 
performed, for level II of the Executive Schedule (5 U.S.C. 
5313); and such rates of compensation for all positions 
included in this proviso shall be subject to the approval of 
the Civil Service Commission. Positions created pursuant to 
this subsection shall be included in the classified civil 
service of the United States, but appointments to such 
positions shall be made without competitive examination upon 
approval of the proposed appointee's qualifications by the 
Civil Service Commission or such officers or agents as it may 
designate for this purpose.
---------------------------------------------------------------------------
    \1\ See footnote for the second sentence of section 203.
---------------------------------------------------------------------------
                        professional categories
    Sec. 209. [210b] (a) For the purpose of establishing 
eligibility of officers of the Regular Corps for promotions, 
the Surgeon General shall by regulation divide the corps into 
professional categories. Each category shall, as far as 
practicable, be based upon one of the subjects of examination 
set forth in section 207(a)(1) or upon a subdivision of such 
subject, and the categories shall be designed to group officers 
by fields of training in such manner that officers in any one 
grade in any one category will be available for similar duty in 
the discharge of the several functions of the Service.
    (b) Each officer of the Regular Corps on active duty shall, 
on the basis of his training and experience, be assigned by the 
Surgeon General to one of the categories established by 
regulations under subsection (a). Except upon amendment of such 
regulations, no assignment so made shall be changed unless the 
Surgeon General finds (1) that the original assignment was 
erroneous, or (2) that the officer is equally well qualified to 
serve in another category to which he has requested to be 
transferred, and that such transfer is in the interests of the 
Service.
    (c) Within the limits fixed by the Secretary in regulations 
under section 206(d) for any fiscal year, the Surgeon General 
shall determine for each category in the Regular Corps the 
maximum number of officers authorized to be in each of the 
grades from the warrant officer (W-1) grade to the director 
grade, inclusive.
    (d) The excess of the number so fixed for any grade in any 
category over the number of officers of the Regular Corps on 
active duty in such grade in such category (including, in the 
case of the director grade, officers holding such grade in 
accordance with section 206(c)) shall for the purpose of 
promotions constitute vacancies in such grade in such category. 
For purposes of this subsection, an officer who has been 
temporarily promoted or who is temporarily holding the grade of 
director in accordance with section 206(c) shall be deemed to 
hold the grade to which so promoted or which he is temporarily 
holding; but while he holds such promotion or grade, and while 
any officer is temporarily assigned to a position pursuant to 
section 205(c), the number fixed under subsection (c) of this 
section for the grade of his permanent rank shall be reduced by 
one.
    (e) The absence of a vacancy in a grade in a category shall 
not prevent an appointment to such grade pursuant to section 
207, a permanent length of service promotion, or the recall of 
a retired officer to active duty; but the making of such an 
appointment, promotion, or recall shall be deemed to fill a 
vacancy if one exists.
    (f) Whenever a vacancy exists in any grade in a category 
the Surgeon General may increase by one the number fixed by him 
under subsection (c) for the next lower grade in the same 
category, without regard to the numbers fixed in regulations 
under section 206(d); and in that event the vacancy in the 
higher grade shall not be filled except by a permanent 
promotion, and upon the making of such promotion the number for 
the next lower grade shall be reduced by one.
promotions and separation of commissioned officers in the regular corps
    Sec. 210. [211] (a) Promotions of officers of the Regular 
Corps to any grade up to and including the director grade shall 
be either permanent promotions based on length of service, 
other permanent promotions to fill vacancies, or temporary 
promotions. Permanent promotions shall be made by the 
President, by and with the advice and consent of the Senate, 
and temporary promotions shall be made by the President. Each 
permanent promotion shall be to the next higher grade, and 
shall be made only after examination given in accordance with 
regulations of the President.
    (b) The President may by regulation provide that in a 
specified professional category permanent promotions to the 
senior grade, or to both the full grade and the senior grade, 
shall be made only if there are vacancies in such grade. A 
grade in any category with respect to which such regulations 
have been issued is referred to in this section as a 
``restricted grade''.
    (c) Examinations to determine qualification for permanent 
promotions may be either noncompetitive or competitive, as the 
Surgeon General shall in each case determine; except that 
examinations for promotions to the assistant or senior 
assistant grade shall in all cases be noncompetitive. The 
officers to be examined shall be selected by the Surgeon 
General from the professional category, and in the order of 
seniority in the grade, from which promotion is to be 
recommended. In the case of a competitive examination the 
Surgeon General shall determine in advance of the examination 
the number (which may be one or more) of officers who, after 
passing the examination, will be recommended to the President 
for promotion; but if the examination is one for promotions 
based on length of service, or is one for promotions to fill 
vacancies other than vacancies in the director grade or in a 
restricted grade, such number shall not be less than 80 per 
centum of the number of officers to be examined.
    (d) Officers of the Regular Corps, found pursuant to 
subsection (c) to be qualified, shall be given permanent 
promotions based on length of service, as follows:
    (1) Officers in the warrant officer (W-1) grade, chief 
warrant officer (W-2) grade, chief warrant officer (W-3) grade, 
chief warrant officer (W-4) grade, and junior assistant grade 
shall be promoted at such times as may be prescribed in 
regulations of the President.
    (2) Officers with permanent rank in the assistant grade, 
the senior assistant grade, and the full grade shall (except as 
provided in regulations under subsection (b)) be promoted after 
completion of three, ten, and seventeen years, respectively, of 
service in grades above the junior assistant grade; and such 
promotions, when made, shall be effective, for purposes of pay 
and seniority in grade, as of the day following the completion 
of such years of service. An officer with permanent rank in the 
assistant, senior assistant, or full grade who has not 
completed such years of service shall be promoted at the same 
time, and his promotion shall be effective as of the same day, 
as any officer junior to him in the same grade in the same 
professional category who is promoted under this paragraph.
    (e) Officers in a professional category of the Regular 
Corps, found pursuant to subsection (c) to be qualified may be 
given permanent promotions to fill any or all vacancies in such 
category in the senior assistant grade, the full grade, the 
senior grade, or the director grade; but no officer who has not 
had one year of service with permanent or temporary rank in the 
next lower grade shall be promoted to any restricted grade or 
to the director grade.
    (f) If an officer who has completed the years of service 
required for promotion to a grade under paragraph (2) of 
subsection (d) fails to receive such promotion, he shall 
(unless he has already been twice examined for promotion to 
such grade) be once reexamined for promotion to such grade. If 
he is thereupon promoted (otherwise than under subsection (e)), 
the effective date of such promotion shall be one year later 
than it would have been but for such failure. Upon the 
effective date of any permanent promotion of such officer to 
such grade, he shall be considered as having had only the 
length of service required for such promotion which he 
previously failed to receive.
    (g) If, for reasons other than physical disability, an 
officer of the Regular Corps in the warrant officer (W-1) grade 
or junior assistant grade is found pursuant to subsection (c) 
not to be qualified for promotion he shall be separated from 
the Service. If, for reasons other than physical disability, an 
officer of the Regular Corps in the chief warrant officer (W-
2), chief warrant officer (W-3), assistant, senior assistant, 
or full grade, after having been twice examined for promotion 
(other than promotion to a restricted grade), fails to be 
promoted--
            (1) if in the chief warrant officer (W-2) or 
        assistant grade he shall be separated from the Service 
        and paid six months' basic pay and allowances;
            (2) if in the chief warrant officer (W-3) or senior 
        assistant grade he shall be separated from the Service 
        and paid one year's basic pay and allowances;
            (3) if in the full grade he shall be considered as 
        not in line for promotion and shall, at such time 
        thereafter as the Surgeon General may determine, be 
        retired from the Service with retired pay (unless he is 
        entitled to a greater amount by reason of another 
        provision of law)--
                    (A) in the case of an officer who first 
                became a member of a uniformed service before 
                September 8, 1980, at the rate of 2\1/2\ 
                percent of the retired pay base determined 
                under section 1406(h) of title 10, United 
                States Code, for each year, not in excess of 
                30, of his active commissioned service in the 
                Service; or
                    (B) in the case of an officer who first 
                became a member of a uniformed service on or 
                after September 8, 1980, at the rate determined 
                by multiplying--
                            (i) the retired pay base determined 
                        under section 1407 of title 10, United 
                        States Code; by
                            (ii) the retired pay multiplier 
                        determined under section 1409 of such 
                        title for the number of years of his 
                        active commissioned service in the 
                        Service.
    (h) If an officer of the Regular Corps, eligible to take an 
examination for promotion, refuses to take such examination, he 
may be separated from the Service in accordance with 
regulations of the President.
    (i) At the end of his first three years of service, the 
record of each officer of the Regular Corps, originally 
appointed to the senior assistant grade or above, shall be 
reviewed in accordance with regulations of the President and, 
if found not qualified for further service, he shall be 
separated from the Service and paid six months' pay and 
allowances.
    (j)(1) The order of seniority of officers in a grade in the 
Regular Corps shall be determined, subject to the provisions of 
paragraph (2), by the relative length of time spent in active 
service after the effective date of each such officer's 
original appointment or permanent promotion in that grade. When 
permanent promotions of two or more officers to the same grade 
are effective on the same day, their relative seniority shall 
be the same as it was in the grade from which promoted. In all 
other cases of original appointments or permanent promotions 
(or both) to the same grade effective on the same day, relative 
seniority shall be determined in accordance with regulations of 
the President.
    (2) In the case of an officer originally appointed in the 
Regular Corps to the grade of assistant or above, his seniority 
in the grade to which appointed shall be determined after 
inclusion, as service in such grade, of any active service in 
such grade or in any higher grade in the Reserve Corps, but (if 
the appointment is to the grade of senior assistant or above) 
only to the extent of whichever of the following is greater: 
(A) His active service in such grade or any higher grade in the 
Reserve Corps after the first day on which, under regulations 
in effect on the date of his appointment to the Regular Corps, 
he had the training and experience necessary for such 
appointment, or (B) the excess of his total active service in 
the Reserve Corps (above the grade of junior assistant) over 
three years if his appointment in the Regular Corps is to the 
senior assistant grade, over ten years if the appointment is to 
the full grade, or over seventeen years if the appointment is 
to the senior grade.
    (k) Any commissioned officer of the Regular Corps in any 
grade in any professional category may be recommended to the 
President for temporary promotion to fill a vacancy in any 
higher grade in such category, up to and including the director 
grade. In time of war, or of national emergency proclaimed by 
the President, any commissioned officer of the Regular Corps in 
any grade in any professional category may be recommended to 
the President for promotion to any higher grade in such 
category, up to and including the director grade, whether or 
not a vacancy exists in such grade. The selection of officers 
to be recommended for temporary promotions shall be made in 
accordance with regulations of the President. Promotion of an 
officer recommended pursuant to this subsection may be made 
without regard to length of service, without examination, and 
without vacating his permanent appointment, and shall carry 
with it the pay and allowances of the grade to which promoted. 
Such promotions may be terminated at any time, as may be 
directed by the President.
    (l) Whenever the number of officers of the Regular Corps on 
active duty, plus the number of officers of the Reserve Corps 
who have been on active duty for thirty days or more, exceeds 
the authorized strength of the Regular Corps, the Secretary 
shall determine the requirements of the Service in each grade 
in each category, based upon the total number of officers so 
serving on active duty and the tasks being performed by the 
Service; and the Surgeon General shall thereupon assign each 
officer of the Reserve Corps on active duty to a professional 
category. If the Secretary finds that the number of officers 
fixed under section 209(c) for any grade and category (or the 
number of officers, including officers of the Reserve Corps, on 
active duty in such grade in such category, if such number is 
greater than the number fixed under section 209(c)) is 
insufficient to meet such requirements of the Service, officers 
of either the Regular Corps or the Reserve Corps may be 
recommended for temporary promotion to such grade in such 
category. Any such promotion may be terminated at any time, as 
may be directed by the President.
    (m) Any officer of the Regular Corps, or any officer of the 
Reserve Corps on active duty, who is promoted to a higher grade 
shall, unless he expressly declines such promotion, be deemed 
for all purposes to have accepted such promotion; and shall not 
be required to renew his oath of office, or to execute a new 
affidavit as required by the Act of December 11, 1926, as 
amended (5 U.S.C. 21a). \1\
---------------------------------------------------------------------------
    \1\ That Act has been codified to section 3332 of title 5, United 
States Code.
---------------------------------------------------------------------------
                  retirement of commissioned officers
    Sec. 211. [212] (a)(1) A commissioned officer of the 
Service shall, if he applies for retirement, be retired on or 
after the first day of the month following the month in which 
he attains the age of sixty-four years. This paragraph does not 
permit or require the involuntary retirement of any individual 
because of the age of the individual.
    (2) A commissioned officer of the Service may be retired by 
the Secretary, and shall be retired if he applies for 
retirement, on the first day of any month after completion of 
thirty years of active service.
    (3) Any commissioned officer of the Service who has had 
less than thirty years of active service may be retired by the 
Secretary, with or without application by the officer, on the 
first day of any month after completion of twenty or more years 
of active service of which not less than ten are years of 
active commissioned service in any of the uniformed services.
    (4) Except as provided in paragraph (6), a commissioned 
officer retired pursuant to paragraph (1), (2), or (3) who was 
(in the case of an officer in the Reserve Corps) on active duty 
with the Service on the day preceding such retirement shall be 
entitled to receive retired pay at the rate of 2\1/2\ per 
centum of the basic pay of the highest grade held by him as 
such officer and in which, in the case of a temporary promotion 
to such grade, he has performed active duty for not less than 
six months, (A) for each year of active service, or (B) if it 
results in higher retired pay, for each of the following years:
            (i) his years of active service (determined without 
        regard to subsection (d)) as a member of a uniformed 
        service; plus
            (ii) in the case of a medical or dental officer, 
        four years and, in the case of a medical officer, who 
        has completed one year of medical internship or the 
        equivalent thereof, one additional year, the four years 
        and the one year to be reduced by the period of active 
        service performed during such officer's attendance at 
        medical school or dental school or during his medical 
        internship; plus
            (iii) the number of years of service with which he 
        was entitled to be credited for purposes of basic pay 
        on May 31, 1958, or (if higher) on any date prior 
        thereto, reduced by any such year included under clause 
        (i) and further reduced by any such year with which he 
        was entitled to be credited under paragraphs (7) and 
        (8) of section 205(a) of title 37, United States Code, 
        on any date before June 1, 1958;
except that (C) in the case of any officer whose retired pay, 
so computed, is less than 50 per centum of such basic pay, who 
retires pursuant to paragraph (1) of this subsection, who has 
not less than twelve whole years of active service (computed 
without the application of subsection (e)), and who does not 
use, for purposes of a retirement annuity under the Civil 
Service Retirement Act, \1\ any service which is also 
creditable in computing his retired pay from the Service, it 
shall, instead, be 50 per centum of such pay, and (D) the 
retired pay of an officer shall in no case be more than 75 per 
centum of such basic pay.
---------------------------------------------------------------------------
    \1\ The Civil Service Retirement Act has been codified to chapter 
83 of title 5, United States Code.
---------------------------------------------------------------------------
    (5) With the approval of the President, a commissioned 
officer whose service as Surgeon General, Deputy Surgeon 
General, or Assistant Surgeon General has totaled four years or 
more and who has had not less than twenty-five years of active 
service in the Service may retire voluntarily at any time; and 
except as provided in paragraph (6), his retired pay shall be 
at the rate of 75 per centum of the basic pay of the highest 
grade held by him as such officer.
    (6) The retired pay of a commissioned officer retired under 
this subsection who first became a member of a uniformed 
service after September 7, 1980, is determined by multiplying--
            (A) the retired pay base determined under section 
        1407 of title 10, United States Code; by
            (B) the retired pay multiplier determined under 
        section 1409 of such title for the number of years of 
        service credited to the officer under paragraph (4).
    (7) Retired pay computed under section 210(g)(3) or under 
paragraph (4) or (5) of this subsection, if not a multiple of 
$1, shall be rounded to the next lower multiple of $1.
    (b) For purposes of subsection (a), the basic pay of the 
highest grade to which a commissioned officer has received a 
temporary promotion means the basic pay to which he would be 
entitled if serving on active duty in such grade on the date of 
his retirement.
    (c) A commissioned officer, retired for reasons other than 
for failure of promotion to the senior grade, may (1) if an 
officer of the Regular Corps or an officer of the Reserve Corps 
entitled to retired pay under subsection (a), be involuntarily 
recalled to active duty during such times as the Commissioned 
Corps constitutes a branch of the land or naval forces of the 
United States, and (2) if an officer of either the Regular or 
Reserve Corps, be recalled to active duty at any time with his 
consent.
    (d) The term ``active service'', as used in subsection (a), 
includes:
            (1) all active service in any of the uniformed 
        services;
            (2) active service with the Public Health Service, 
        other than as a commissioned officer, which the Surgeon 
        General determines is comparable to service performed 
        by commissioned officers of the Service, except that, 
        if there are more than five years of such service only 
        the last five years thereof may be included;
            (3) all active service (other than service included 
        under the preceding provisions of this subsection) 
        which is creditable for retirement purposes under laws 
        governing the retirement of members of any of the 
        uniformed services; and
            (4) service performed as a member of the Senior 
        Biomedical Research Service established by section 228, 
        except that, if there are more than 5 years of such 
        service, only the last 5 years thereof may be included.
    (e) For the purpose of determining the number of years by 
which a percentage of the basic pay of an officer is to be 
multiplied in computing the amount of his retired pay pursuant 
to section 210(g)(3) or paragraph (4) of subsection (a) of this 
section, each full month of service that is in addition to the 
number of full years of service credited to an officer is 
counted as one-twelfth of a year and any remaining fractional 
part of a month is disregarded.
    (f) For purposes of retirement or separation for physical 
disability under chapter 61 of title 10, United States Code, a 
commissioned officer of the Service shall be credited, in 
addition to the service described in section 1208(a)(2) of that 
title, with active service with the Public Health Service, 
other than as a commissioned officer, which the Surgeon General 
determines is comparable to service performed by commissioned 
officers of the Service, except that, if there are more than 
five years of such service, only the last five years thereof 
may be so credited. For such purposes, such section 1208(a)(2) 
shall be applicable to officers of the Regular or Reserve Corps 
of the Service.

                           military benefits

    Sec. 212. [213] (a) Except as provided in subsection (b), 
commissioned officers of the Service and their surviving 
beneficiaries shall, with respect to active service performed 
by such officers--
            (1) in time of war;
            (2) on detail for duty with the Army, Navy, Air 
        Force, Marine Corps, or Coast Guard; or
            (3) while the Service is part of the military 
        forces of the United States pursuant to Executive order 
        of the President;
be entitled to all rights, privileges, immunities, and benefits 
now or hereafter provided under any law of the United States in 
the case of commissioned officers of the Army or their 
surviving beneficiaries on account of active military service, 
except retired pay and uniform allowances.
    (b) The President may prescribe the conditions under which 
commissioned officers of the Service may be awarded military 
ribbons, medals, and decorations.
    (c) The authority vested by law in the Department of the 
Army, the Secretary of the Army, or other officers of the 
Department of the Army with respect to rights, privileges, 
immunities, and benefits referred to in subsection (a) shall be 
exercised, with respect to commissioned officers of the 
Service, by the Surgeon General.
    (d) 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 the purposes of all laws 
administered by the Secretary of Veterans Affairs (except the 
Servicemen's Indemnity Act of 1951) and section 217 of the 
Social Security Act.
    (e) 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 the purposes of all rights, 
privileges, immunities, and benefits now or hereafter provided 
under the Servicemembers Civil Relief Act (50 App. U.S.C. 501 
et seq.).
    (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.
           presentation of united states flag upon retirement
    Sec. 213. [214] (a) Presentation of Flag.--Upon the release 
of an officer of the commissioned corps of the Service from 
active commissioned service for retirement, the Secretary of 
Health and Human Services shall present a United States flag to 
the officer.
    (b) Multiple Presentations Not Authorized.--An officer is 
not eligible for presentation of a flag under subsection (a) if 
the officer has previously been presented a flag under this 
section or any other provision of law providing for the 
presentation of a United States flag incident to release from 
active service for retirement.
    (c) No Cost to Recipient.--The presentation of a flag under 
this section shall be at no cost to the recipient.
                          detail of personnel
    Sec. 214. \1\ [215] (a) The Secretary is authorized, upon 
the request of the head of an executive department, to detail 
officers or employees of the Service to such department for 
duty as agreed upon by the Secretary and the head of such 
department in order to cooperate in, or conduct work related 
to, the functions of such department or of the Service. When 
officers or employees are so detailed their salaries and 
allowances may be paid from working funds established as 
provided by law or may be paid by the Service from applicable 
appropriation and reimbursement may be made as agreed upon by 
the Secretary and the head of the executive department 
concerned. Officers detailed for duty with the Army, Navy, or 
Coast Guard shall be subject to the laws for the government of 
the service to which detailed.
---------------------------------------------------------------------------
    \1\ Former section 213 was repealed by section 14 of Public Law 87-
649 (76 Stat. 499). Section 415(c) of title 37, United States Code, now 
applies to the matter with which former section 213 was concerned.
---------------------------------------------------------------------------
    (b) Upon the request of any State health authority or, in 
the case of work relating to mental health, any State mental 
health authority, personnel of the Service may be detailed by 
the Surgeon General for the purpose of assisting such State or 
political subdivision thereof in work related to the functions 
of the Service.
    (c) The Surgeon General may detail personnel of the Service 
to any appropriate committee of the Congress or to nonprofit 
educational research or other institutions engaged in health 
activities for special studies of scientific problems and for 
the dissemination of information relating to public health.
    (d) Personnel detailed under subsections (b) and (c) shall 
be paid from applicable appropriations of the Service except 
that, in accordance with regulations such personnel may be 
placed on leave without pay and paid by the State, subdivision, 
or institution to which they are detailed. In the case of 
detail of personnel under subsections (b) or (c) to be paid 
from applicable Service appropriations, the Secretary may 
condition such detail on an agreement by the State, 
subdivision, or institution concerned that such State, 
subdivision, or institution concerned shall reimburse the 
United States for the amount of such payments made by the 
Service. The services of personnel while detailed pursuant to 
this section shall be considered as having been performed in 
the Service for purposes of the computation of basic pay, 
promotion, retirement, compensation for injury or death, and 
the benefits provided by section 212.
    (e) Except with respect to the United States Coast Guard 
and the Department of Defense, and except as provided in 
agreements negotiated with officials at agencies where officers 
of the Commissioned Corps may be assigned, the Secretary shall 
have the sole authority to deploy any Commissioned Corps 
officer assigned under this section to an entity outside of the 
Department of Health and Human Services for service under the 
Secretary's direction in response to an urgent or emergency 
public health care need (as defined in section 203A(a)(5)).

                              regulations

    Sec. 215. [216] (a) The President shall from time to time 
prescribe regulations with respect to the appointment, 
promotion, retirement, termination of commission, title, pay, 
uniforms, allowances (including increased allowances for 
foreign service), and discipline of the commissioned corps of 
the Service.
    (b) The Surgeon General, with the approval of the 
Secretary, unless specifically otherwise provided, shall 
promulgate all other regulations necessary to the 
administration of the Service, including regulations with 
respect to uniforms for employees, and regulations with respect 
to the custody, use, and preservation of the records, papers, 
and property of the Service.
    (c) No regulations relating to qualifications for 
appointment of medical officers or employees shall give 
preference to any school of medicine.

               use of service in time of war or emergency

    Sec. 216. [217] In time of war, or of emergency proclaimed 
by the President, he may utilize the Service to such extent and 
in such manner as shall in his judgment promote the public 
interest. In time of war, or of emergency involving the 
national defense proclaimed by the President, he may by 
Executive order declare the commissioned corps of the Service 
to be a military service. Upon such declaration, and during the 
period of such war or such emergency or such part thereof as 
the President shall prescribe, the commissioned corps (a) shall 
constitute a branch of the land and naval forces of the United 
States, (b) shall, to the extent prescribed by regulations of 
the President, be subject to the Uniform Code of Military 
Justice, and (c) shall continue to operate as part of the 
Service except to the extent that the President may direct as 
Commander in Chief.

                       national advisory councils

    Sec. 217. [218] (a) Within 120 days of the date of the 
enactment of this subsection, the Secretary shall appoint and 
organize a National Advisory Council on Migrant Health 
(hereinafter in this subsection referred to as the Council) 
which shall advise, consult with, and make recommendations to, 
the Secretary on matters concerning the organization, 
operation, selection, and funding of migrant health centers and 
other entities under grants and contracts under section 329. 
\1\
---------------------------------------------------------------------------
    \1\ As a result of the amendments made by Public Law 104-299 (110 
Stat. 3626), the Public Health Service Act no longer contained a 
section 329, 340, or 340A, and section 330 of such Act was 
substantially revised. Section 330 now includes provisions that relate 
to medically underserved populations, to migratory and seasonal 
agricultural workers, to homeless individuals, and to residents of 
public housing. Section 402 of Public Law 107-251 (116 Stat. 1655) 
added a new section 340 that relates to a healthy communities access 
program.
---------------------------------------------------------------------------
    (b) The Council shall consist of fifteen members, at least 
twelve of whom shall be members of the governing boards of 
migrant health centers or other entities assisted under section 
329. \1\ Of such twelve members who are members of such 
governing boards, at least nine shall be chosen from among 
those members of such governing boards who are being served by 
such centers or grantees and who are familiar with the delivery 
of health care to migratory agricultural workers and seasonal 
agricultural workers. The remaining three Council members shall 
be individuals qualified by training and experience in the 
medical sciences or in the administration of health programs.
    (c) Each member of the Council shall hold office for a term 
of four years, except that (1) any member appointed to fill a 
vacancy occurring prior to the expiration of the term for which 
his predecessor was appointed shall be appointed for the 
remainder of such term; and (2) the terms of the members first 
taking office after the date of enactment of this subsection 
shall expire as follows: four shall expire four years after 
such date, four shall expire three years after such date, four 
shall expire two years after such date, and three shall expire 
one year after such date, as designated by the Secretary at the 
time of appointment.
    (d) Section 14(a) of the Federal Advisory Committee Act 
shall not apply to the Council.

                          training of officers

    Sec. 218. [218a] (a) Appropriations available for the pay 
and allowances of commissioned officers of the Service shall 
also be available for the pay and allowances of any such 
officer on active duty while attending any Federal or non-
Federal educational institution or training program and, 
subject to regulations of the President and to the limitation 
prescribed in such appropriations, for payment of his tuition, 
fees, and other necessary expenses incident to such attendance.
    (b) Any officer whose tuition, fees, and other necessary 
expenses are paid pursuant to subsection (a) while attending an 
educational institution or training program for a period in 
excess of thirty days shall be obligated to pay to the Service 
an amount equal to two times the total amount of such tuition, 
fees, and other necessary expenses received by such officer 
during such period, and two times the total amount of any 
compensation received by, and any allowance paid to, such 
officer during such period, if after return to active service 
such officer voluntarily leaves the Service within (1) six 
months, or (2) twice the period of such attendance, whichever 
is greater. Such subsequent period of service shall commence 
upon the cessation of such attendance and of any further 
continuous period of training duty for which no tuition and 
fees are paid by the Service and which is part of the officer's 
prescribed formal training program, whether such further 
training is at Service facility or otherwise. The Surgeon 
General may waive, in whole or in part, any payment which may 
be required by this subsection upon a determination that such 
payment would be inequitable or would not be in public 
interest.
    (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.

                         annual and sick leave

    Sec. 219. [210-1] (a) In accordance with regulations of the 
President, commissioned officers of the Regular Corps and 
officers of the Reserve Corps on active duty may be granted 
annual leave and sick leave without any deductions from their 
pay and allowances: Provided, That such regulations shall not 
authorize annual leave to be accumulated in excess of sixty 
days.
    (d) \1\ For purposes of this section the term ``accumulated 
annual leave'' means unused accrued annual leave carried 
forward from one leave year into a succeeding leave year, and 
the term ``accrued annual leave'' means the annual leave 
accruing to an officer during one leave year.
---------------------------------------------------------------------------
    \1\ Former subsection (b) was repealed by section 14 of Public Law 
87-649 (76 Stat. 499). Section 503(b) of title 37, United States Code, 
now applies to the matter with which former subsection (b) was 
concerned. Former subsection (c) was repealed by section 311 of Public 
Law 96-76 (93 Stat. 586).
---------------------------------------------------------------------------

                   promotion credit--assistant grade

    Sec. 220. [211c] Any medical officer of the Regular Corps 
of the Public Health Service who--
            (1)(A) was appointed to the assistant grade in the 
        Regular Corps and whose service in such Corps has been 
        continuous from the date of appointment or (B) may 
        hereafter be appointed to the assistant grade in the 
        Regular Corps, and
            (2) had or will have completed a medical internship 
        on the date of such appointment,
shall be credited with one year for purposes of promotion and 
seniority in grade, except that no such credit shall be 
authorized if the officer has received or will receive similar 
credit for his internship under other provisions of law. In the 
case of an officer on active duty on the effective date of this 
section who is entitled to the credit authorized herein, the 
one year shall be added to the promotion and seniority-in-grade 
credits with which he is credited on such date.

    rights, privileges, etc. of officers and surviving beneficiaries

    Sec. 221. [213a] (a) Commissioned officers of the Service 
or their surviving beneficiaries are entitled to all the 
rights, benefits, privileges, and immunities now or hereafter 
provided for commissioned officers of the Army or their 
surviving beneficiaries under the following provisions of title 
10, United States Code:
            (1) Section 1036, Escorts for dependents of 
        members: transportation and travel allowances.
            (2) Chapter 61, Retirement or Separation for 
        Physical Disability, except that sections 1201, 1202, 
        and 1203 do not apply to commissioned officers of the 
        Public Health Service who have been ordered to active 
        duty for training for a period of more than 30 days.
            (3) Chapter 69, Retired Grade, except sections 
        1370, 1374, 1375, and 1376(a).
            (4) Chapter 71, Computation of Retired Pay, except 
        formula No. 3 of section 1401.
            (5) Chapter 73, Retired Serviceman's Family 
        Protection Plan, Survivor Benefit Plan.
            (6) Chapter 75, Death Benefits.
            (7) Section 2771, Final settlement of accounts: 
        deceased members.
            (8) Chapter 163, Military Claims, but only when 
        commissioned officers of the Service are entitled to 
        military benefits under section 212 of this Act.
            (9) Section 2603, Acceptance of fellowships, 
        scholarships, or grants.
            (10) Section 2634 Motor vehicles: for members on 
        permanent change of station.
            (11) Section 1035, Deposit of savings.
            (12) Section 1552, Correction of military records: 
        claims incident thereto.
            (13) Section 1553, Review of discharge or 
        dismissal.
            (14) Section 1554, Review of retirement or 
        separation without pay for physical disability.
            (15) Section 1124, Cash awards for suggestions, 
        inventions, or scientific achievements.
            (16) Section 1052, Reimbursement for adoption 
        expenses.
            (17) Section 1059, Transitional compensation and 
        commissary and exchange benefits for dependents of 
        members separated for dependent abuse.
    (b) The authority vested by title 10, United States Code, 
in the ``military departments'', ``the Secretary concerned'', 
or ``the Secretary of Defense'' with respect to the rights, 
privileges, immunities, and benefits referred to in subsection 
(a) shall be exercised, with respect to commissioned officers 
of the Service, by the Secretary of Health, Education, and 
Welfare or his designee.

                    advisory councils or committees

    Sec. 222. [217a] (a) The Secretary 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, from time to time, appoint such advisory councils or 
committees (in addition to those authorized to be established 
under other provisions of law), for such periods of time, as he 
deems desirable with such period commencing on a date specified 
by the Secretary for the purpose of advising him in connection 
with any of his functions.
    (b) Members of any advisory council or committee appointed 
under this section who are not regular full-time employees of 
the United States shall, while attending meetings or 
conferences of such council or committee or otherwise engaged 
on business of such council or committee receive compensation 
and allowances as provided in section 208(c) for members of 
national advisory councils established under this Act.
    (c) Upon appointment of any such council or committee, the 
Secretary may delegate to such council or committee such 
advisory functions relating to grants-in-aid for research or 
training projects or programs, in the areas or fields with 
which such council or committee is concerned, as the Secretary 
determines to be appropriate.

                           volunteer services

    Sec. 223. [217b] Subject to regulations, volunteer and 
uncompensated services may be accepted by the Secretary, or by 
any other officer or employee of the Department of Health and 
Human Services designated by him, for use in the operation of 
any health care facility or in the provision of health care.

          defense of certain malpractice and negligence suits

    Sec. 224. [233] (a) The remedy against the United States 
provided by sections 1346(b) and 2672 of title 28, or by 
alternative benefits provided by the United States where the 
availability of such benefits precludes a remedy under section 
1346(b) of title 28, for damage for personal injury, including 
death, resulting from the performance of medical, surgical, 
dental, or related functions, including the conduct of clinical 
studies or investigation, by any commissioned officer or 
employee of the Public Health Service while acting within the 
scope of his office or employment, shall be exclusive of any 
other civil action or proceeding by reason of the same subject-
matter against the officer or employee (or his estate) whose 
act or omission gave rise to the claim.
    (b) The Attorney General shall defend any civil action or 
proceeding brought in any court against any person referred to 
in subsection (a) of this section (or his estate) for any such 
damage or injury. Any such person against whom such civil 
action or proceeding is brought shall deliver within such time 
after date of service or knowledge of service as determined by 
the Attorney General, all process served upon him or an 
attested true copy thereof to his immediate superior or to 
whomever was designated by the Secretary to receive such papers 
and such persons shall promptly furnish copies of the pleading 
and process therein to the United States attorney for the 
district embracing the place wherein the proceeding is brought, 
to the Attorney General, and to the Secretary.
    (c) Upon a certification by the Attorney General that the 
defendant was acting in the scope of his employment at the time 
of the incident out of which the suit arose, any such civil 
action or proceeding commenced in a State court shall be 
removed without bond at any time before trial by the Attorney 
General to the district court of the United States of the 
district and division embracing the place wherein it is pending 
and the proceeding deemed a tort action brought against the 
United States under the provisions of title 28 and all 
references thereto. Should a United States district court 
determine on a hearing on a motion to remand held before a 
trial on the merit that the case so removed is one in which a 
remedy by suit within the meaning of subsection (a) of this 
section is not available against the United States, the case 
shall be remanded to the State Court: Provided, That where such 
a remedy is precluded because of the availability of a remedy 
through proceedings for compensation or other benefits from the 
United States as provided by any other law, the case shall be 
dismissed, but in the event the running of any limitation of 
time for commencing, or filing an application or claim in, such 
proceedings for compensation or other benefits shall be deemed 
to have been suspended during the pendency of the civil action 
or proceeding under this section.
    (d) The Attorney General may compromise or settle any claim 
asserted in such civil action or proceeding in the manner 
provided in section 2677 of title 28 and with the same effect.
    (e) For purposes of this section, the provisions of section 
2680(h) of title 28 shall not apply to assault or battery 
arising out of negligence in the performance of medical, 
surgical, dental, or related functions, including the conduct 
of clinical studies or investigations.
    (f) The Secretary or his designee may, to the extent that 
he deems appropriate, hold harmless or provide liability 
insurance for any officer or employee of the Public Health 
Service for damage for personal injury, including death, 
negligently caused by such officer or employee while acting 
within the scope of his office or employment and as a result of 
the performance of medical, surgical, dental, or related 
functions, including the conduct of clinical studies or 
investigations, if such employee is assigned to a foreign 
country or detailed to a State or political subdivision thereof 
or to a non-profit institution, and if the circumstances are 
such as are likely to preclude the remedies of third persons 
against the United States described in section 2679(b) of title 
28, for such damage or injury.
    (g)(1)(A) For purposes of this section and subject to the 
approval by the Secretary of an application under subparagraph 
(D), an entity described in paragraph (4), and any officer, 
governing board member, or employee of such an entity, and any 
contractor of such an entity who is a physician or other 
licensed or certified health care practitioner (subject to 
paragraph (5)), shall be deemed to be an employee of the Public 
Health Service for a calendar year that begins during a fiscal 
year for which a transfer was made under subsection (k)(3) 
(subject to paragraph (3)). The remedy against the United 
States for an entity described in paragraph (4) and any 
officer, governing board member, employee, or contractor 
(subject to paragraph (5)) of such an entity who is deemed to 
be an employee of the Public Health Service pursuant to this 
paragraph shall be exclusive of any other civil action or 
proceeding to the same extent as the remedy against the United 
States is exclusive pursuant to subsection (a).
    (B) The deeming of any entity or officer, governing board 
member, employee, or contractor of the entity to be an employee 
of the Public Health Service for purposes of this section shall 
apply with respect to services provided--
            (i) to all patients of the entity, and
            (ii) subject to subparagraph (C), to individuals 
        who are not patients of the entity.
    (C) Subparagraph (B)(ii) applies to services provided to 
individuals who are not patients of an entity if the Secretary 
determines, after reviewing an application submitted under 
subparagraph (D), that the provision of the services to such 
individuals--
            (i) benefits patients of the entity and general 
        populations that could be served by the entity through 
        community-wide intervention efforts within the 
        communities served by such entity;
            (ii) facilitates the provision of services to 
        patients of the entity; or
            (iii) are otherwise required under an employment 
        contract (or similar arrangement) between the entity 
        and an officer, governing board member, employee, or 
        contractor of the entity.
    (D) The Secretary may not under subparagraph (A) deem an 
entity or an officer, governing board member, employee, or 
contractor of the entity to be an employee of the Public Health 
Service for purposes of this section, and may not apply such 
deeming to services described in subparagraph (B)(ii), unless 
the entity has submitted an application for such deeming to the 
Secretary in such form and such manner as the Secretary shall 
prescribe. The application shall contain detailed information, 
along with supporting documentation, to verify that the entity, 
and the officer, governing board member, employee, or 
contractor of the entity, as the case may be, meets the 
requirements of subparagraphs (B) and (C) of this paragraph and 
that the entity meets the requirements of paragraphs (1) 
through (4) of subsection (h).
    (E) The Secretary shall make a determination of whether an 
entity or an officer, governing board member, employee, or 
contractor of the entity is deemed to be an employee of the 
Public Health Service for purposes of this section within 30 
days after the receipt of an application under subparagraph 
(D). The determination of the Secretary that an entity or an 
officer, governing board member, employee, or contractor of the 
entity is deemed to be an employee of the Public Health Service 
for purposes of this section shall apply for the period 
specified by the Secretary under subparagraph (A).
    (F) Once the Secretary makes a determination that an entity 
or an officer, governing board member, employee, or contractor 
of an entity is deemed to be an employee of the Public Health 
Service for purposes of this section, the determination shall 
be final and binding upon the Secretary and the Attorney 
General and other parties to any civil action or proceeding. 
Except as provided in subsection (i), the Secretary and the 
Attorney General may not determine that the provision of 
services which are the subject of such a determination are not 
covered under this section.
    (G) In the case of an entity described in paragraph (4) 
that has not submitted an application under subparagraph (D):
            (i) The Secretary may not consider the entity in 
        making estimates under subsection (k)(1).
            (ii) This section does not affect any authority of 
        the entity to purchase medical malpractice liability 
        insurance coverage with Federal funds provided to the 
        entity under section 329, 330, or 340A.
    (H) In the case of an entity described in paragraph (4) for 
which an application under subparagraph (D) is in effect, the 
entity may, through notifying the Secretary in writing, elect 
to terminate the applicability of this subsection to the 
entity. With respect to such election by the entity:
            (i) The election is effective upon the expiration 
        of the 30-day period beginning on the date on which the 
        entity submits such notification.
            (ii) Upon taking effect, the election terminates 
        the applicability of this subsection to the entity and 
        each officer, governing board member, employee, and 
        contractor of the entity.
            (iii) Upon the effective date for the election, 
        clauses (i) and (ii) of subparagraph (G) apply to the 
        entity to the same extent and in the same manner as 
        such clauses apply to an entity that has not submitted 
        an application under subparagraph (D).
            (iv) If after making the election the entity 
        submits an application under subparagraph (D), the 
        election does not preclude the Secretary from approving 
        the application (and \1\ thereby restoring the 
        applicability of this subsection to the entity and each 
        officer, governing board member, employee, and 
        contractor of the entity, subject to the provisions of 
        this subsection and the subsequent provisions of this 
        section.
---------------------------------------------------------------------------
    \1\ So in law. See section 5(a) of Public Law 104-73 (109 Stat. 
779). There is no closing parenthesis.
---------------------------------------------------------------------------
    (2) If, with respect to an entity or person deemed to be an 
employee for purposes of paragraph (1), a cause of action is 
instituted against the United States pursuant to this section, 
any claim of the entity or person for benefits under an 
insurance policy with respect to medical malpractice relating 
to such cause of action shall be subrogated to the United 
States.
    (3) This subsection shall apply with respect to a cause of 
action arising from an act or omission which occurs on or after 
January 1, 1993.
    (4) An entity described in this paragraph is a public or 
non-profit private entity receiving Federal funds under section 
330.
    (5) For purposes of paragraph (1), an individual may be 
considered a contractor of an entity described in paragraph (4) 
only if--
            (A) the individual normally performs on average at 
        least 32\1/2\ hours of service per week for the entity 
        for the period of the contract; or
            (B) in the case of an individual who normally 
        performs an average of less than 32\1/2\ hours of 
        services per week for the entity for the period of the 
        contract, the individual is a licensed or certified 
        provider of services in the fields of family practice, 
        general internal medicine, general pediatrics, or 
        obstetrics and gynecology.
    (h) The Secretary may not approve an application under 
subsection (g)(1)(D) unless the Secretary determines that the 
entity--
            (1) has implemented appropriate policies and 
        procedures to reduce the risk of malpractice and the 
        risk of lawsuits arising out of any health or health-
        related functions performed by the entity;
            (2) has reviewed and verified the professional 
        credentials, references, claims history, fitness, 
        professional review organization findings, and license 
        status of its physicians and other licensed or 
        certified health care practitioners, and, where 
        necessary, has obtained the permission from these 
        individuals to gain access to this information;
            (3) has no history of claims having been filed 
        against the United States as a result of the 
        application of this section to the entity or its 
        officers, employees, or contractors as provided for 
        under this section, or, if such a history exists, has 
        fully cooperated with the Attorney General in defending 
        against any such claims and either has taken, or will 
        take, any necessary corrective steps to assure against 
        such claims in the future; and
            (4) will fully cooperate with the Attorney General 
        in providing information relating to an estimate 
        described under subsection (k).
    (i)(1) Notwithstanding subsection (g)(1), the Attorney 
General, in consultation with the Secretary, may on the record 
determine, after notice and opportunity for a full and fair 
hearing, that an individual physician or other licensed or 
certified health care practitioner who is an officer, employee, 
or contractor of an entity described in subsection (g)(4) shall 
not be deemed to be an employee of the Public Health Service 
for purposes of this section, if treating such individual as 
such an employee would expose the Government to an unreasonably 
high degree of risk of loss because such individual--
            (A) does not comply with the policies and 
        procedures that the entity has implemented pursuant to 
        subsection (h)(1);
            (B) has a history of claims filed against him or 
        her as provided for under this section that is outside 
        the norm for licensed or certified health care 
        practitioners within the same specialty;
            (C) refused to reasonably cooperate with the 
        Attorney General in defending against any such claim;
            (D) provided false information relevant to the 
        individual's performance of his or her duties to the 
        Secretary, the Attorney General, or an applicant for or 
        recipient of funds under this Act; or
            (E) was the subject of disciplinary action taken by 
        a State medical licensing authority or a State or 
        national professional society.
    (2) A final determination by the Attorney General under 
this subsection that an individual physician or other licensed 
or certified health care professional shall not be deemed to be 
an employee of the Public Health Service shall be effective 
upon receipt by the entity employing such individual of notice 
of such determination, and shall apply only to acts or 
omissions occurring after the date such notice is received.
    (j) In the case of a health care provider who is an 
officer, employee, or contractor of an entity described in 
subsection (g)(4), section 335(e) shall apply with respect to 
the provider to the same extent and in the same manner as such 
section applies to any member of the National Health Service 
Corps.
    (k)(1)(A) For each fiscal year, the Attorney General, in 
consultation with the Secretary, shall estimate by the 
beginning of the year the amount of all claims which are 
expected to arise under this section (together with related 
fees and expenses of witnesses) for which payment is expected 
to be made in accordance with section 1346 and chapter 171 of 
title 28, United States Code, from the acts or omissions, 
during the calendar year that begins during that fiscal year, 
of entities described in subsection (g)(4) and of officers, 
employees, or contractors (subject to subsection (g)(5)) of 
such entities.
    (B) The estimate under subparagraph (A) shall take into 
account--
            (i) the value and frequency of all claims for 
        damage for personal injury, including death, resulting 
        from the performance of medical, surgical, dental, or 
        related functions by entities described in subsection 
        (g)(4) or by officers, employees, or contractors 
        (subject to subsection (g)(5)) of such entities who are 
        deemed to be employees of the Public Health Service 
        under subsection (g)(1) that, during the preceding 5-
        year period, are filed under this section or, with 
        respect to years occurring before this subsection takes 
        effect, are filed against persons other than the United 
        States,
            (ii) the amounts paid during that 5-year period on 
        all claims described in clause (i), regardless of when 
        such claims were filed, adjusted to reflect payments 
        which would not be permitted under section 1346 and 
        chapter 171 of title 28, United States Code, and
            (iii) amounts in the fund established under 
        paragraph (2) but unspent from prior fiscal years.
    (2) Subject to appropriations, for each fiscal year, the 
Secretary shall establish a fund of an amount equal to the 
amount estimated under paragraph (1) that is attributable to 
entities receiving funds under each of the grant programs 
described in paragraph (4) of subsection (g), but not to exceed 
a total of $10,000,000 for each such fiscal year. 
Appropriations for purposes of this paragraph shall be made 
separate from appropriations made for purposes of sections 329, 
330 and 340A.
    (3) In order for payments to be made for judgments against 
the United States (together with related fees and expenses of 
witnesses) pursuant to this section arising from the acts or 
omissions of entities described in subsection (g)(4) and of 
officers, \1\ employees, or contractors (subject to subsection 
(g)(5)) of such entities, the total amount contained within the 
fund established by the Secretary under paragraph (2) for a 
fiscal year shall be transferred not later than the December 31 
that occurs during the fiscal year to the appropriate accounts 
in the Treasury.
---------------------------------------------------------------------------
    \1\ Section 3(2) of Public Law 104-73 (109 Stat. 778) provides that 
subsection (k)(3) is amended by inserting ``governing board member,'' 
after ``officer,''. The amendment cannot be executed because the latter 
term does not appear. (Compare ``officer,'' and ``officers,''.)
---------------------------------------------------------------------------
    (l)(1) If a civil action or proceeding is filed in a State 
court against any entity described in subsection (g)(4) or any 
officer, governing board member, employee, or any contractor of 
such an entity for damages described in subsection (a), the 
Attorney General, within 15 days after being notified of such 
filing, shall make an appearance in such court and advise such 
court as to whether the Secretary has determined under 
subsections (g) and (h), that such entity, officer, governing 
board member, employee, or contractor of the entity is deemed 
to be an employee of the Public Health Service for purposes of 
this section with respect to the actions or omissions that are 
the subject of such civil action or proceeding. Such advice 
shall be deemed to satisfy the provisions of subsection (c) 
that the Attorney General certify that an entity, officer, 
governing board member, employee, or contractor of the entity 
was acting within the scope of their employment or 
responsibility.
    (2) If the Attorney General fails to appear in State court 
within the time period prescribed under paragraph (1), upon 
petition of any entity or officer, governing board member, 
employee, or contractor of the entity named, the civil action 
or proceeding shall be removed to the appropriate United States 
district court. The civil action or proceeding shall be stayed 
in such court until such court conducts a hearing, and makes a 
determination, as to the appropriate forum or procedure for the 
assertion of the claim for damages described in subsection (a) 
and issues an order consistent with such determination.
    (m)(1) An entity or officer, governing board member, 
employee, or contractor of an entity described in subsection 
(g)(1) shall, for purposes of this section, be deemed to be an 
employee of the Public Health Service with respect to services 
provided to individuals who are enrollees of a managed care 
plan if the entity contracts with such managed care plan for 
the provision of services.
    (2) Each managed care plan which enters into a contract 
with an entity described in subsection (g)(4) shall deem the 
entity and any officer, governing board member, employee, or 
contractor of the entity as meeting whatever malpractice 
coverage requirements such plan may require of contracting 
providers for a calendar year if such entity or officer, 
governing board member, employee, or contractor of the entity 
has been deemed to be an employee of the Public Health Service 
for purposes of this section for such calendar year. Any plan 
which is found by the Secretary on the record, after notice and 
an opportunity for a full and fair hearing, to have violated 
this subsection shall upon such finding cease, for a period to 
be determined by the Secretary, to receive and to be eligible 
to receive any Federal funds under titles XVIII or XIX of the 
Social Security Act.
    (3) For purposes of this subsection, the term ``managed 
care plan'' shall mean health maintenance organizations and 
similar entities that contract at-risk with payors for the 
provision of health services or plan enrollees and which 
contract with providers (such as entities described in 
subsection (g)(4)) for the delivery of such services to plan 
enrollees.
    (n)(1) Not later than one year after the date of the 
enactment of the Federally Supported Health Centers Assistance 
Act of 1995, the Comptroller General of the United States shall 
submit to the Congress a report on the following:
            (A) The medical malpractice liability claims 
        experience of entities that have been deemed to be 
        employees for purposes of this section.
            (B) The risk exposure of such entities.
            (C) The value of private sector risk-management 
        services, and the value of risk-management services and 
        procedures required as a condition of receiving a grant 
        under section 329, 330, or 340A.
            (D) A comparison of the costs and the benefits to 
        taxpayers of maintaining medical malpractice liability 
        coverage for such entities pursuant to this section, 
        taking into account--
                    (i) a comparison of the costs of premiums 
                paid by such entities for private medical 
                malpractice liability insurance with the cost 
                of coverage pursuant to this section; and
                    (ii) an analysis of whether the cost of 
                premiums for private medical malpractice 
                liability insurance coverage is consistent with 
                the liability claims experience of such 
                entities.
    (2) The report under paragraph (1) shall include the 
following:
            (A) A comparison of--
                    (i) an estimate of the aggregate amounts 
                that such entities (together with the officers, 
                governing board members, employees, and 
                contractors of such entities who have been 
                deemed to be employees for purposes of this 
                section) would have directly or indirectly paid 
                in premiums to obtain medical malpractice 
                liability insurance coverage if this section 
                were not in effect; with
                    (ii) the aggregate amounts by which the 
                grants received by such entities under this Act 
                were reduced pursuant to subsection (k)(2).
            (B) A comparison of--
                    (i) an estimate of the amount of privately 
                offered such insurance that such entities 
                (together with the officers, governing board 
                members, employees, and contractors of such 
                entities who have been deemed to be employees 
                for purposes of this section) purchased during 
                the three-year period beginning on January 1, 
                1993; with
                    (ii) an estimate of the amount of such 
                insurance that such entities (together with the 
                officers, governing board members, employees, 
                and contractors of such entities who have been 
                deemed to be employees for purposes of this 
                section) will purchase after the date of the 
                enactment of the Federally Supported Health 
                Centers Assistance Act of 1995.
            (C) An estimate of the medical malpractice 
        liability loss history of such entities for the 10-year 
        period preceding October 1, 1996, including but not 
        limited to the following:
                    (i) Claims that have been paid and that are 
                estimated to be paid, and legal expenses to 
                handle such claims that have been paid and that 
                are estimated to be paid, by the Federal 
                Government pursuant to deeming entities as 
                employees for purposes of this section.
                    (ii) Claims that have been paid and that 
                are estimated to be paid, and legal expenses to 
                handle such claims that have been paid and that 
                are estimated to be paid, by private medical 
                malpractice liability insurance.
          (D) An analysis of whether the cost of premiums for 
        private medical malpractice liability insurance 
        coverage is consistent with the liability claims 
        experience of entities that have been deemed as 
        employees for purposes of this section.
    (3) In preparing the report under paragraph (1), the 
Comptroller General of the United States shall consult with 
public and private entities with expertise on the matters with 
which the report is concerned.
    (o)(1) For purposes of this section, a free clinic health 
professional shall in providing a qualifying health service to 
an individual, or an officer, governing board member, employee, 
or contractor of a free clinic shall in providing services for 
the free clinic, be deemed to be an employee of the Public 
Health Service for a calendar year that begins during a fiscal 
year for which a transfer was made under paragraph (6)(D). The 
preceding sentence is subject to the provisions of this 
subsection.
    (2) In providing a health service to an individual, a 
health care practitioner shall for purposes of this subsection 
be considered to be a free clinic health professional if the 
following conditions are met:
            (A) The service is provided to the individual at a 
        free clinic, or through offsite programs or events 
        carried out by the free clinic.
            (B) The free clinic is sponsoring the health care 
        practitioner pursuant to paragraph (5)(C).
            (C) The service is a qualifying health service (as 
        defined in paragraph (4)).
            (D) Neither the health care practitioner nor the 
        free clinic receives any compensation for the service 
        from the individual or from any third-party payor 
        (including reimbursement under any insurance policy or 
        health plan, or under any Federal or State health 
        benefits program). With respect to compliance with such 
        condition:
                    (i) The health care practitioner may 
                receive repayment from the free clinic for 
                reasonable expenses incurred by the health care 
                practitioner in the provision of the service to 
                the individual.
                    (ii) The free clinic may accept voluntary 
                donations for the provision of the service by 
                the health care practitioner to the individual.
            (E) Before the service is provided, the health care 
        practitioner or the free clinic provides written notice 
        to the individual of the extent to which the legal 
        liability of the health care practitioner is limited 
        pursuant to this subsection (or in the case of an 
        emergency, the written notice is provided to the 
        individual as soon after the emergency as is 
        practicable). If the individual is a minor or is 
        otherwise legally incompetent, the condition under this 
        subparagraph is that the written notice be provided to 
        a legal guardian or other person with legal 
        responsibility for the care of the individual.
            (F) At the time the service is provided, the health 
        care practitioner is licensed or certified in 
        accordance with applicable law regarding the provision 
        of the service.
    (3)(A) For purposes of this subsection, the term ``free 
clinic'' means a health care facility operated by a nonprofit 
private entity meeting the following requirements:
            (i) The entity does not, in providing health 
        services through the facility, accept reimbursement 
        from any third-party payor (including reimbursement 
        under any insurance policy or health plan, or under any 
        Federal or State health benefits program).
            (ii) The entity, in providing health services 
        through the facility, either does not impose charges on 
        the individuals to whom the services are provided, or 
        imposes a charge according to the ability of the 
        individual involved to pay the charge.
            (iii) The entity is licensed or certified in 
        accordance with applicable law regarding the provision 
        of health services.
    (B) With respect to compliance with the conditions under 
subparagraph (A), the entity involved may accept voluntary 
donations for the provision of services.
    (4) For purposes of this subsection, the term ``qualifying 
health service'' means any medical assistance required or 
authorized to be provided in the program under title XIX of the 
Social Security Act, without regard to whether the medical 
assistance is included in the plan submitted under such program 
by the State in which the health care practitioner involved 
provides the medical assistance. References in the preceding 
sentence to such program shall as applicable be considered to 
be references to any successor to such program.
    (5) Subsection (g) (other than paragraphs (3) through (5)) 
and subsections (h), (i), and (l) apply to a health care 
practitioner for purposes of this subsection to the same extent 
and in the same manner as such subsections apply to an officer, 
governing board member, employee, or contractor of an entity 
described in subsection (g)(4), subject to paragraph (6) and 
subject to the following:
            (A) The first sentence of paragraph (1) applies in 
        lieu of the first sentence of subsection (g)(1)(A).
            (B) This subsection may not be construed as deeming 
        any free clinic to be an employee of the Public Health 
        Service for purposes of this section.
            (C) With respect to a free clinic, a health care 
        practitioner is not a free clinic health professional 
        unless the free clinic sponsors the health care 
        practitioner. For purposes of this subsection, the free 
        clinic shall be considered to be sponsoring the health 
        care practitioner if--
                    (i) with respect to the health care 
                practitioner, the free clinic submits to the 
                Secretary an application meeting the 
                requirements of subsection (g)(1)(D); and
                    (ii) the Secretary, pursuant to subsection 
                (g)(1)(E), determines that the health care 
                practitioner is deemed to be an employee of the 
                Public Health Service.
            (D) In the case of a health care practitioner who 
        is determined by the Secretary pursuant to subsection 
        (g)(1)(E) to be a free clinic health professional, this 
        subsection applies to the health care practitioner 
        (with respect to the free clinic sponsoring the health 
        care practitioner pursuant to subparagraph (C)) for any 
        cause of action arising from an act or omission of the 
        health care practitioner occurring on or after the date 
        on which the Secretary makes such determination.
            (E) Subsection (g)(1)(F) applies to a health care 
        practitioner for purposes of this subsection only to 
        the extent that, in providing health services to an 
        individual, each of the conditions specified in 
        paragraph (2) is met.
    (6)(A) For purposes of making payments for judgments 
against the United States (together with related fees and 
expenses of witnesses) pursuant to this section arising from 
the acts or omissions of free clinic health professionals, 
there is authorized to be appropriated $10,000,000 for each 
fiscal year.
    (B) The Secretary shall establish a fund for purposes of 
this subsection. Each fiscal year amounts appropriated under 
subparagraph (A) shall be deposited in such fund.
    (C) Not later than May 1 of each fiscal year, the Attorney 
General, in consultation with the Secretary, shall submit to 
the Congress a report providing an estimate of the amount of 
claims (together with related fees and expenses of witnesses) 
that, by reason of the acts or omissions of free clinic health 
professionals, will be paid pursuant to this section during the 
calendar year that begins in the following fiscal year. 
Subsection (k)(1)(B) applies to the estimate under the 
preceding sentence regarding free clinic health professionals 
to the same extent and in the same manner as such subsection 
applies to the estimate under such subsection regarding 
officers, governing board members, employees, and contractors 
of entities described in subsection (g)(4).
    (D) Not later than December 31 of each fiscal year, the 
Secretary shall transfer from the fund under subparagraph (B) 
to the appropriate accounts in the Treasury an amount equal to 
the estimate made under subparagraph (C) for the calendar year 
beginning in such fiscal year, subject to the extent of amounts 
in the fund.
    (7)(A) This subsection takes effect on the date of the 
enactment of the first appropriations Act that makes an 
appropriation under paragraph (6)(A), except as provided in 
subparagraph (B)(i).
    (B)(i) Effective on the date of the enactment of the Health 
Insurance Portability and Accountability Act of 1996--
            (I) the Secretary may issue regulations for 
        carrying out this subsection, and the Secretary may 
        accept and consider applications submitted pursuant to 
        paragraph (5)(C); and
            (II) reports under paragraph (6)(C) may be 
        submitted to the Congress.
    (ii) For the first fiscal year for which an appropriation 
is made under subparagraph (A) of paragraph (6), if an estimate 
under subparagraph (C) of such paragraph has not been made for 
the calendar year beginning in such fiscal year, the transfer 
under subparagraph (D) of such paragraph shall be made 
notwithstanding the lack of the estimate, and the transfer 
shall be made in an amount equal to the amount of such 
appropriation.
    (p) Administration of Smallpox Countermeasures by Health 
Professionals.--
            (1) In general.--For purposes of this section, and 
        subject to other provisions of this subsection, a 
        covered person shall be deemed to be an employee of the 
        Public Health Service with respect to liability arising 
        out of administration of a covered countermeasure 
        against smallpox to an individual during the effective 
        period of a declaration by the Secretary under 
        paragraph (2)(A).
            (2) Declaration by secretary concerning 
        countermeasure against smallpox.--
                    (A) Authority to issue declaration.--
                            (i) In general.--The Secretary may 
                        issue a declaration, pursuant to this 
                        paragraph, concluding that an actual or 
                        potential bioterrorist incident or 
                        other actual or potential public health 
                        emergency makes advisable the 
                        administration of a covered 
                        countermeasure to a category or 
                        categories of individuals.
                            (ii) Covered countermeasure.--The 
                        Secretary shall specify in such 
                        declaration the substance or substances 
                        that shall be considered covered 
                        countermeasures (as defined in 
                        paragraph (7)(A)) for purposes of 
                        administration to individuals during 
                        the effective period of the 
                        declaration.
                            (iii) Effective period.--The 
                        Secretary shall specify in such 
                        declaration the beginning and ending 
                        dates of the effective period of the 
                        declaration, and may subsequently amend 
                        such declaration to shorten or extend 
                        such effective period, provided that 
                        the new closing date is after the date 
                        when the declaration is amended.
                            (iv) Publication.--The Secretary 
                        shall promptly publish each such 
                        declaration and amendment in the 
                        Federal Register.
                    (B) Liability of united states only for 
                administrations within scope of declaration.--
                Except as provided in paragraph (5)(B)(ii), the 
                United States shall be liable under this 
                subsection with respect to a claim arising out 
                of the administration of a covered 
                countermeasure to an individual only if--
                            (i) the countermeasure was 
                        administered by a qualified person, for 
                        a purpose stated in paragraph 
                        (7)(A)(i), and during the effective 
                        period of a declaration by the 
                        Secretary under subparagraph (A) with 
                        respect to such countermeasure; and
                            (ii)(I) the individual was within a 
                        category of individuals covered by the 
                        declaration; or
                            (II) the qualified person 
                        administering the countermeasure had 
                        reasonable grounds to believe that such 
                        individual was within such category.
                    (C) Presumption of administration within 
                scope of declaration in case of accidental 
                vaccinia inoculation.--
                            (i) In general.--If vaccinia 
                        vaccine is a covered countermeasure 
                        specified in a declaration under 
                        subparagraph (A), and an individual to 
                        whom the vaccinia vaccine is not 
                        administered contracts vaccinia, then, 
                        under the circumstances specified in 
                        clause (ii), the individual--
                                    (I) shall be rebuttably 
                                presumed to have contracted 
                                vaccinia from an individual to 
                                whom such vaccine was 
                                administered as provided by 
                                clauses (i) and (ii) of 
                                subparagraph (B); and
                                    (II) shall (unless such 
                                presumption is rebutted) be 
                                deemed for purposes of this 
                                subsection to be an individual 
                                to whom a covered 
                                countermeasure was administered 
                                by a qualified person in 
                                accordance with the terms of 
                                such declaration and as 
                                described by subparagraph (B).
                            (ii) Circumstances in which 
                        presumption applies.--The presumption 
                        and deeming stated in clause (i) shall 
                        apply if--
                                    (I) the individual 
                                contracts vaccinia during the 
                                effective period of a 
                                declaration under subparagraph 
                                (A) or by the date 30 days 
                                after the close of such period; 
                                or
                                    (II) the individual has 
                                resided with, or has had 
                                contact with, an individual to 
                                whom such vaccine was 
                                administered as provided by 
                                clauses (i) and (ii) of 
                                subparagraph (B) and contracts 
                                vaccinia after such date.
                    (D) Acts and omissions deemed to be within 
                scope of employment.--
                            (i) In general.--In the case of a 
                        claim arising out of alleged 
                        transmission of vaccinia from an 
                        individual described in clause (ii), 
                        acts or omissions by such individual 
                        shall be deemed to have been taken 
                        within the scope of such individual's 
                        office or employment for purposes of--
                                    (I) subsection (a); and
                                    (II) section 1346(b) and 
                                chapter 171 of title 28, United 
                                States Code.
                            (ii) Individuals to whom deeming 
                        applies.--An individual is described by 
                        this clause if--
                                    (I) vaccinia vaccine was 
                                administered to such individual 
                                as provided by subparagraph 
                                (B); and
                                    (II) such individual was 
                                within a category of 
                                individuals covered by a 
                                declaration under subparagraph 
                                (A)(i).
            (3) Exhaustion; exclusivity; offset.--
                    (A) Exhaustion.--
                            (i) In general.--A person may not 
                        bring a claim under this subsection 
                        unless such person has exhausted such 
                        remedies as are available under part C 
                        of this title, except that if the 
                        Secretary fails to make a final 
                        determination on a request for benefits 
                        or compensation filed in accordance 
                        with the requirements of such part 
                        within 240 days after such request was 
                        filed, the individual may seek any 
                        remedy that may be available under this 
                        section.
                            (ii) Tolling of statute of 
                        limitations.--The time limit for filing 
                        a claim under this subsection, or for 
                        filing an action based on such claim, 
                        shall be tolled during the pendency of 
                        a request for benefits or compensation 
                        under part C of this title.
                            (iii) Construction.--This 
                        subsection shall not be construed as 
                        superseding or otherwise affecting the 
                        application of a requirement, under 
                        chapter 171 of title 28, United States 
                        Code, to exhaust administrative 
                        remedies.
                    (B) Exclusivity.--The remedy provided by 
                subsection (a) shall be exclusive of any other 
                civil action or proceeding for any claim or 
                suit this subsection encompasses, except for a 
                proceeding under part C of this title.
                    (C) Offset.--The value of all compensation 
                and benefits provided under part C of this 
                title for an incident or series of incidents 
                shall be offset against the amount of an award, 
                compromise, or settlement of money damages in a 
                claim or suit under this subsection based on 
                the same incident or series of incidents.
            (4) Certification of action by attorney general.--
        Subsection (c) applies to actions under this 
        subsection, subject to the following provisions:
                    (A) Nature of certification.--The 
                certification by the Attorney General that is 
                the basis for deeming an action or proceeding 
                to be against the United States, and for 
                removing an action or proceeding from a State 
                court, is a certification that the action or 
                proceeding is against a covered person and is 
                based upon a claim alleging personal injury or 
                death arising out of the administration of a 
                covered countermeasure.
                    (B) Certification of attorney general 
                conclusive.--The certification of the Attorney 
                General of the facts specified in subparagraph 
                (A) shall conclusively establish such facts for 
                purposes of jurisdiction pursuant to this 
                subsection.
            (5) Covered person to cooperate with united 
        states.--
                    (A) In general.--A covered person shall 
                cooperate with the United States in the 
                processing and defense of a claim or action 
                under this subsection based upon alleged acts 
                or omissions of such person.
                    (B) Consequences of failure to cooperate.--
                Upon the motion of the United States or any 
                other party and upon finding that such person 
                has failed to so cooperate--
                            (i) the court shall substitute such 
                        person as the party defendant in place 
                        of the United States and, upon motion, 
                        shall remand any such suit to the court 
                        in which it was instituted if it 
                        appears that the court lacks subject 
                        matter jurisdiction;
                            (ii) the United States shall not be 
                        liable based on the acts or omissions 
                        of such person; and
                            (iii) the Attorney General shall 
                        not be obligated to defend such action.
            (6) Recourse against covered person in case of 
        gross misconduct or contract violation.--
                    (A) In general.--Should payment be made by 
                the United States to any claimant bringing a 
                claim under this subsection, either by way of 
                administrative determination, settlement, or 
                court judgment, the United States shall have, 
                notwithstanding any provision of State law, the 
                right to recover for that portion of the 
                damages so awarded or paid, as well as interest 
                and any costs of litigation, resulting from the 
                failure of any covered person to carry out any 
                obligation or responsibility assumed by such 
                person under a contract with the United States 
                or from any grossly negligent, reckless, or 
                illegal conduct or willful misconduct on the 
                part of such person.
                    (B) Venue.--The United States may maintain 
                an action under this paragraph against such 
                person in the district court of the United 
                States in which such person resides or has its 
                principal place of business.
            (7) Definitions.--As used in this subsection, terms 
        have the following meanings:
                    (A) Covered countermeasure.--The term 
                ``covered countermeasure'' or ``covered 
                countermeasure against smallpox'', means a 
                substance that is--
                            (i)(I) used to prevent or treat 
                        smallpox (including the vaccinia or 
                        another vaccine); or
                                    (II) \1\ used to control or 
                                treat the adverse effects of 
                                vaccinia inoculation or of 
                                administration of another 
                                covered countermeasure; and
---------------------------------------------------------------------------
    \1\ Indentation is so in law. See section 3(e) of Public Law 108-20 
(117 Stat. 647).
---------------------------------------------------------------------------
                            (ii) specified in a declaration 
                        under paragraph (2).
                    (B) Covered person.--The term ``covered 
                person'', when used with respect to the 
                administration of a covered countermeasure, 
                means a person who is--
                            (i) a manufacturer or distributor 
                        of such countermeasure;
                            (ii) a health care entity under 
                        whose auspices \2\--
---------------------------------------------------------------------------
    \2\ Clause (ii) is shown according to the probable intent of the 
Congress. In amending the clause to create a subclause (I), section 
3(f)(2)(B) of Public Law 108-20 (117 Stat. 647) provided that the 
clause is amended by redesignating certain words ``as clause (I) and 
indenting accordingly''. The reference in the amendatory instructions 
to ``clause (I)'' probably should be to ``subclause (I)'', and the use 
in the instructions of the word ``accordingly'' requires the exercise 
of editorial judgment.
---------------------------------------------------------------------------
                                    (I) such countermeasure was 
                                administered;
                                    (II) a determination was 
                                made as to whether, or under 
                                what circumstances, an 
                                individual should receive a 
                                covered countermeasure;
                                    (III) the immediate site of 
                                administration on the body of a 
                                covered countermeasure was 
                                monitored, managed, or cared 
                                for; or
                                    (IV) an evaluation was made 
                                of whether the administration 
                                of a countermeasure was 
                                effective;
                            (iii) a qualified person who 
                        administered such countermeasure;
                            (iv) a State, a political 
                        subdivision of a State, or an agency or 
                        official of a State or of such a 
                        political subdivision, if such State, 
                        subdivision, agency, or official has 
                        established requirements, provided 
                        policy guidance, supplied technical or 
                        scientific advice or assistance, or 
                        otherwise supervised or administered a 
                        program with respect to administration 
                        of such countermeasures;
                            (v) in the case of a claim arising 
                        out of alleged transmission of vaccinia 
                        from an individual--
                                    (I) the individual who 
                                allegedly transmitted the 
                                vaccinia, if vaccinia vaccine 
                                was administered to such 
                                individual as provided by 
                                paragraph (2)(B) and such 
                                individual was within a 
                                category of individuals covered 
                                by a declaration under 
                                paragraph (2)(A)(i); or
                                    (II) an entity that employs 
                                an individual described by 
                                clause (I) or where such 
                                individual has privileges or is 
                                otherwise authorized to provide 
                                health care;
                            (vi) an official, agent, or 
                        employee of a person described in 
                        clause (i), (ii), (iii), or (iv);
                            (vii) a contractor of, or a 
                        volunteer working for, a person 
                        described in clause (i), (ii), or (iv), 
                        if the contractor or volunteer performs 
                        a function for which a person described 
                        in clause (i), (ii), or (iv) is a 
                        covered person; or
                            (viii) an individual who has 
                        privileges or is otherwise authorized 
                        to provide health care under the 
                        auspices of an entity described in 
                        clause (ii) or (v)(II).
                    (C) Qualified person.--The term ``qualified 
                person'', when used with respect to the 
                administration of a covered countermeasure, 
                means a licensed health professional or other 
                individual who \1\--
---------------------------------------------------------------------------
    \1\ Subparagraph (C) is shown according to the probable intent of 
the Congress. In amending the subparagraph to create a clause (i), 
section 3(g) of Public Law 108-20 (117 Stat. 648) provided that the 
subparagraph is amended by redesignating certain words ``as clause (i) 
and indenting accordingly''. The use in the amendatory instructions of 
the word ``accordingly'' requires the exercise of editorial judgment.
---------------------------------------------------------------------------
                            (i) is authorized to administer 
                        such countermeasure under the law of 
                        the State in which the countermeasure 
                        was administered; or
                            (ii) is otherwise authorized by the 
                        Secretary to administer such 
                        countermeasure.
                    (D) Arising out of administration of a 
                covered countermeasure.--The term ``arising out 
                of administration of a covered 
                countermeasure'', when used with respect to a 
                claim or liability, includes a claim or 
                liability arising out of--
                            (i) determining whether, or under 
                        what conditions, an individual should 
                        receive a covered countermeasure;
                            (ii) obtaining informed consent of 
                        an individual to the administration of 
                        a covered countermeasure;
                            (iii) monitoring, management, or 
                        care of an immediate site of 
                        administration on the body of a covered 
                        countermeasure, or evaluation of 
                        whether the administration of the 
                        countermeasure has been effective; or
                            (iv) transmission of vaccinia virus 
                        by an individual to whom vaccinia 
                        vaccine was administered as provided by 
                        paragraph (2)(B).

        administration of grants in certain multigrant projects

    Sec. 226. \2\ [235] For the purpose of facilitating the 
administration of, and expediting the carrying out of the 
purposes of, the programs established by titles VII, VIII, and 
IX, and sections 304, 314(a), 314(b), 314(c), 314(d), and 
314(e) of this Act in situations in which grants are sought or 
made under two or more of such programs with respect to a 
single project, the Secretary is authorized to promulgate 
regulations--
---------------------------------------------------------------------------
    \2\ Former section 225 was repealed by section 408(b)(1) of Public 
Law 94-484 (90 Stat. 2281). Subpart III of part D of title III now 
applies to the matter with which former section 225 was concerned.
---------------------------------------------------------------------------
            (1) under which the administrative functions under 
        such programs with respect to such project will be 
        performed by a single administrative unit which is the 
        administrative unit charged with the administration of 
        any of such programs or is the administrative unit 
        charged with the supervision of two or more of such 
        programs;
            (2) designed to reduce the number of applications, 
        reports, and other materials required under such 
        programs to be submitted with respect to such project, 
        and otherwise to simplify, consolidate, and make 
        uniform (to the extent feasible), the data and 
        information required to be contained in such 
        applications, reports, and other materials; and
            (3) under which inconsistent or duplicative 
        requirements imposed by such programs will be revised 
        and made uniform with respect to such project;
except that nothing in this section shall be construed to 
authorize the Secretary to waive or suspend, with respect to 
any such project, any requirement with respect to any of such 
programs if such requirement is imposed by law or by any 
regulation required by law.

                         orphan products board

    Sec. 227. [236] (a) There is established in the Department 
of Health and Human Services a board for the development of 
drugs (including biologics) and devices (including diagnostic 
products) for rare diseases or conditions to be known as the 
Orphan Products Board. The Board shall be comprised of the 
Assistant Secretary for Health of the Department of Health and 
Human Services and representatives, selected by the Secretary, 
of the Food and Drug Administration, the National Institutes of 
Health, the Centers for Disease Control and Prevention, and any 
other Federal department or agency which the Secretary 
determines has activities relating to drugs and devices for 
rare diseases or conditions. The Assistant Secretary for Health 
shall chair the Board.
    (b) The function of the Board shall be to promote the 
development of drugs and devices for rare diseases or 
conditions and the coordination among Federal, other public, 
and private agencies in carrying out their respective functions 
relating to the development of such articles, such diseases or 
conditions.
    (c) In the case of drugs for rare diseases or conditions 
the Board shall--
            (1) evaluate--
                    (A) the effect of subchapter B of the 
                Federal Food, Drug, and Cosmetic Act on the 
                development of such drugs, and
                    (B) the implementation of such subchapter; 
                \1\
---------------------------------------------------------------------------
    \1\ So in law. The semicolon probably should be a comma.
---------------------------------------------------------------------------
            (2) evaluate the activities of the National 
        Institutes of Health for the development of drugs for 
        such diseases or conditions,
            (3) assure appropriate coordination among the Food 
        and Drug Administration, the National Institutes of 
        Health and the Centers for Disease Control and 
        Prevention in the carrying out of their respective 
        functions relating to the development of drugs for such 
        diseases or conditions to assure that the activities of 
        each agency are complementary.
            (4) assure appropriate coordination among all 
        interested Federal agencies, manufacturers, and 
        organizations representing patients, in their 
        activities relating to such drugs,
            (5) with the consent of the sponsor of a drug for a 
        rare disease or condition exempt under section 505(i) 
        of the Federal Food, Drug, and Cosmetic Act or 
        regulations issued under such section, inform 
        physicians and the public respecting the availability 
        of such drug for such disease or condition and inform 
        physicians and the public respecting the availability 
        of drugs approved under section 505(c) of such Act or 
        licensed under section 351 of this Act for rare 
        diseases or conditions,
            (6) seek business entities and others to undertake 
        the sponsorship of drugs for rare diseases or 
        conditions, seek investigators to facilitate the 
        development of such drugs, and seek business entities 
        to participate in the distribution of such drugs, and
            (7) recognize the efforts of public and private 
        entities and individuals in seeking the development of 
        drugs for rare diseases or conditions and in developing 
        such drugs.
    (d) The Board shall consult with interested persons 
respecting the activities of the Board under this section and 
as part of such consultation shall provide the opportunity for 
the submission of oral views.
    (e) The Board shall submit to the Committee on Labor and 
Human Resources of the Senate and the Committee on Energy and 
Commerce of the House of Representatives an annual report--
            (1) identifying the drugs which have been 
        designated under section 526 of the Federal Food, Drug, 
        and Cosmetic Act for a rare disease or condition,
            (2) describing the activities of the Board, and
            (3) containing the results of the evaluations 
        carried out by the Board.
The Director of the National Institutes of Health shall submit 
to the Board for inclusion in the annual report a report on the 
rare disease and condition research activities of the 
Institutes of the National Institutes of Health; the Secretary 
of the Treasury shall submit to the Board for inclusion in the 
annual report a report on the use of the credit against tax 
provided by section 44H of the Internal Revenue Code of 1954; 
and the Secretary of Health and Human Services shall submit to 
the Board for inclusion in the annual report a report on the 
program of assistance under section 5 of the Orphan Drug Act 
for the development of drugs for rare diseases and conditions. 
Each annual report shall be submitted by June 1 of each year 
for the preceding calendar year.
           silvio o. conte senior biomedical research service
    Sec. 228. [237] (a)(1) There shall be in the Public Health 
Service a Silvio O. Conte Senior Biomedical Research Service, 
not to exceed 500 members.
    (2) The authority established in paragraph (1) regarding 
the number of members in the Silvio O. Conte Senior Biomedical 
Research Service is in addition to any authority established 
regarding the number of members in the commissioned Regular 
Corps, in the Reserve Corps, and in the Senior Executive 
Service. Such paragraph may not be construed to require that 
the number of members in the commissioned Regular Corps, in the 
Reserve Corps, or in the Senior Executive Service be reduced to 
offset the number of members serving in the Silvio O. Conte 
Senior Biomedical Research Service (in this section referred to 
as the ``Service'').
    (b) The Service shall be appointed by the Secretary without 
regard to the provisions of title 5, United States Code, 
regarding appointment, and shall consist of individuals 
outstanding in the field of biomedical research or clinical 
research evaluation. No individual may be appointed to the 
Service unless such individual (1) has earned a doctoral level 
degree in biomedicine or a related field, and (2) meets the 
qualification standards prescribed by the Office of Personnel 
Management for appointment to a position at GS-15 of the 
General Schedule. Notwithstanding any previous applicability to 
an individual who is a member of the Service, the provisions of 
subchapter I of chapter 35 (relating to retention preference), 
chapter 43 (relating to performance appraisal and performance 
actions), chapter 51 (relating to classification), subchapter 
III of chapter 53 (relating to General Schedule pay rates), and 
chapter 75 (relating to adverse actions) of title 5, United 
States Code, shall not apply to any member of the Service.
    (c) The Secretary shall develop a performance appraisal 
system designed to--
            (1) provide for the systematic appraisal of the 
        performance of members, and
            (2) encourage excellence in performance by members.
    (d)(1) The Secretary shall determine, subject to the 
provisions of this subsection, the pay of members of the 
Service.
    (2) The pay of a member of the Service shall not be less 
than the minimum rate payable for GS-15 of the General Schedule 
and shall not exceed the rate payable for level I of the 
Executive Schedule unless approved by the President under 
section 5377(d)(2) of title 5, United States Code.
    (e) The Secretary may, upon the request of a member who--
            (1) performed service in the employ of an 
        institution of higher education immediately prior to 
        his appointment as a member of the Service, and
            (2) retains the right to continue to make 
        contributions to the retirement system of such 
        institution,
contribute an amount not to exceed 10 percent per annum of the 
member's basic pay to such institution's retirement system on 
behalf of such member. A member who requests that such 
contribution be made shall not be covered by, or earn service 
credit under, any retirement system established for employees 
of the United States under title 5, United States Code, but 
such service shall be creditable for determining years of 
service under section 6303(a) of such title.
    (f) Subject to the following sentence, the Secretary may, 
notwithstanding the provisions of title 5, United States Code, 
regarding appointment, appoint an individual who is separated 
from the Service involuntarily and without cause to a position 
in the competitive civil service at GS-15 of the General 
Schedule, and such appointment shall be a career appointment. 
In the case of such an individual who immediately prior to his 
appointment to the Service was not a career appointee in the 
civil service or the Senior Executive Service, such appointment 
shall be in the excepted civil service and may not exceed a 
period of 2 years.
    (g) The Secretary shall promulgate such rules and 
regulations, not inconsistent with this section, as may be 
necessary for the efficient administration of the Service.

SEC. 229. \1\ [237A] HEALTH AND HUMAN SERVICES OFFICE ON WOMEN'S 
                    HEALTH.
---------------------------------------------------------------------------

    \1\ Section 3509 of the Patient Protection and Affordable Care Act 
(Public Law 111-148, enacted March 23, 2010) established offices of 
womens health in the Office of the Secretary of HHS (this section), the 
Centers for Disease Control and Prevention (section 310A of this Act), 
the Agency for Healthcare Research and Quality (section 925 of this 
Act), the Health Resources and Services Administration (section 713 of 
the Social Security Act), and the Food and Drug Administration (section 
1011 of the Federal Food, Drug, and Cosmetic Act).
---------------------------------------------------------------------------
    (a) Establishment of Office.--There is established within 
the Office of the Secretary, an Office on Women's Health 
(referred to in this section as the ``Office''). The Office 
shall be headed by a Deputy Assistant Secretary for Women's 
Health who may report to the Secretary.
    (b) Duties.--The Secretary, acting through the Office, with 
respect to the health concerns of women, shall--
            (1) establish short-range and long-range goals and 
        objectives within the Department of Health and Human 
        Services and, as relevant and appropriate, coordinate 
        with other appropriate offices on activities within the 
        Department that relate to disease prevention, health 
        promotion, service delivery, research, and public and 
        health care professional education, for issues of 
        particular concern to women throughout their lifespan;
            (2) provide expert advice and consultation to the 
        Secretary concerning scientific, legal, ethical, and 
        policy issues relating to women's health;
            (3) monitor the Department of Health and Human 
        Services' offices, agencies, and regional activities 
        regarding women's health and identify needs regarding 
        the coordination of activities, including intramural 
        and extramural multidisciplinary activities;
            (4) establish a Department of Health and Human 
        Services Coordinating Committee on Women's Health, 
        which shall be chaired by the Deputy Assistant 
        Secretary for Women's Health and composed of senior 
        level representatives from each of the agencies and 
        offices of the Department of Health and Human Services;
            (5) establish a National Women's Health Information 
        Center to--
                    (A) facilitate the exchange of information 
                regarding matters relating to health 
                information, health promotion, preventive 
                health services, research advances, 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 the matters described in 
                this paragraph; and
                    (D) provide technical assistance with 
                respect to the exchange of information 
                (including facilitating the development of 
                materials for such technical assistance);
            (6) coordinate efforts to promote women's health 
        programs and policies with the private sector; and
            (7) through publications and any other means 
        appropriate, provide for the exchange of information 
        between the Office and recipients of grants, contracts, 
        and agreements under subsection (c), and between the 
        Office and health professionals and the general public.
    (c) Grants and Contracts Regarding Duties.--
            (1) Authority.--In carrying out subsection (b), the 
        Secretary may make grants to, and enter into 
        cooperative agreements, contracts, and interagency 
        agreements with, public and private entities, agencies, 
        and organizations.
            (2) Evaluation and dissemination.--The Secretary 
        shall directly or through contracts with public and 
        private entities, agencies, and organizations, provide 
        for evaluations of projects carried out with financial 
        assistance provided under paragraph (1) and for the 
        dissemination of information developed as a result of 
        such projects.
    (d) Reports.--Not later than 1 year after the date of 
enactment of this section, and every second year thereafter, 
the Secretary shall prepare and submit to the appropriate 
committees of Congress a report describing the activities 
carried out under this section during the period for which the 
report is being prepared.
    (e) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2010 through 2014.

                    Part B--Miscellaneous Provisions

                                 gifts
    Sec. 231. [238] (a) The Secretary is authorized to accept 
on behalf of the United States gifts made unconditionally by 
will or otherwise for the benefit of the Service or for the 
carrying out of any of its functions. Conditional gifts may be 
so accepted if recommended by the Surgeon General, and the 
principal of and income from any such conditional gift shall be 
held, invested, reinvested, and used in accordance with its 
conditions, but no gift shall be accepted which is conditioned 
upon any expenditure not to be met therefrom or from the income 
thereof unless such expenditure has been approved by Act of 
Congress.
    (b) Any unconditional gift of money accepted, pursuant to 
the authority granted in subsection (a) of this section, the 
net proceeds from the liquidation (pursuant to subsection (c) 
or subsection (d) of this section) of any other property so 
accepted, and the proceeds of insurance on any such gift 
property not used for its restoration, shall be deposited in 
the Treasury of the United States and are hereby appropriated 
and shall be held in trust by the Secretary of the Treasury for 
the benefit of the Service, and he may invest and reinvest such 
funds in interest-bearing obligations of the United States or 
in obligations guaranteed as to both principal and interest by 
the United States. Such gifts and the income from such 
investments shall be available for expenditure in the operation 
of the Service and the performance of its functions, subject to 
the same examination and audit as is provided for 
appropriations made for the Service by Congress.
    (c) The evidences of any unconditional gift of intangible 
personal property, other than money, accepted pursuant to the 
authority granted in subsection (a) of this section shall be 
deposited with the Secretary of the Treasury and he, in his 
discretion, may hold them, or liquidate them except that they 
shall be liquidated upon the request of the Secretary, whenever 
necessary to meet payments required in the operation of the 
Service or the performance of its functions. The proceeds and 
income from any such property held by the Secretary of the 
Treasury shall be available for expenditure as is provided in 
subsection (b) of this section.
    (d) The Secretary shall hold any real property or any 
tangible personal property accepted unconditionally pursuant to 
the authority granted in subsection (a) of this section and he 
shall permit such property to be used for the operation of the 
Service and the performance of its functions or he may lease or 
hire such property, and may insure such property, and deposit 
the income thereof with the Secretary of the Treasury to be 
available for expenditure as provided in subsection (b) of this 
section: Provided, That the income from any such real property 
or tangible personal property shall be available for 
expenditure in the discretion of the Secretary for the 
maintenance, preservation, or repair and insurance of such 
property and that any proceeds from insurance may be used to 
restore the property insured. Any such property when not 
required for the operation of the Service or the performance of 
its functions may be liquidated by the Secretary, and the 
proceeds thereof deposited with the Secretary of the Treasury, 
whenever in his judgment the purposes of the gifts will be 
served thereby.

                  use of immigration station hospitals

    Sec. 232. [238a] The Immigration and Naturalization Service 
may, by agreement of the heads of the departments concerned, 
permit the Public Health Service to use hospitals at 
immigration stations for the care of Public Health Service 
patients. The Surgeon General shall reimburse the Immigration 
and Naturalization Service for the actual cost of furnishing 
fuel, light, water, telephone, and similar supplies and 
services, which reimbursement shall be covered into the proper 
Immigration and Naturalization Service appropriation, or such 
costs may be paid from working funds established as provided by 
law, but no charge shall be made for the expense of physical 
upkeep of the hospitals. The Immigration and Naturalization 
Service shall reimburse the Surgeon General for the care and 
treatment of persons detained in hospitals of the Public Health 
Service at the request of the Immigration and Naturalization 
Service unless such persons are entitled to care and treatment 
under section 322(a). \1\
---------------------------------------------------------------------------
    \1\ Subsection (a) of section 322 was repealed by section 986 of 
Public Law 97-35, and the Public Law redesignated former subsection (c) 
as subsection (a). Section 232 (above) was enacted before this repeal 
and redesignation. Current section 322(a) authorizes the treatment and 
care of certain persons. (Section 232 was originally enacted as section 
502, and was subsequently redesignated by Public Laws 98-24, 99-660, 
100-690, and 103-43.)
---------------------------------------------------------------------------

                  money collected for care of patients

    Sec. 233. [238b] Money collected as provided by law for 
expenses incurred in the care and treatment of foreign seamen, 
and money received for the care and treatment of pay patients, 
including any amounts received from any executive department on 
account of care and treatment of pay patients, shall be covered 
into the appropriation from which the expenses of such care and 
treatment were paid.

                 transportation of remains of officers

    Sec. 234. [238c] Appropriations available for traveling 
expenses of the Service shall be available for meeting the cost 
of preparation for burial and of transportation to the place of 
burial of remains of commissioned officers, and of personnel 
specified in regulations, who die in line of duty. 
Appropriations available for carrying out the provisions of 
this Act shall also be available for the payment of such 
expenses relating to the recovery, care, and disposition of the 
remains of personnel or their dependents as may be authorized 
under other provisions of law.

                     grants to federal institutions

    Sec. 235. [238d] Appropriations to the Public Health 
Service available under this Act for research, training, or 
demonstration project grants or for grants to expand existing 
treatment and research programs and facilities for alcoholism, 
narcotic addiction, drug abuse, and drug dependence and 
appropriations under title VI of the Mental Health Systems Act 
shall also be available, on the same terms and conditions as 
apply to non-Federal institutions, for grants for the same 
purpose to Federal institutions, except that grants to such 
Federal institutions may be funded at 100 per centum of the 
costs.

                           transfer of funds

    Sec. 236. [238e] For the purpose of any reorganization 
under section 202, the Secretary, with the approval of the 
Director of the Bureau of the Budget, \1\ is authorized to make 
such transfers of funds between appropriations as may be 
necessary for the continuance of transferred functions.
---------------------------------------------------------------------------
    \1\ Now the Office of Management and Budget.
---------------------------------------------------------------------------

                     availability of appropriations

    Sec. 237. [238f] Appropriations for carrying out the 
purposes of this Act shall be available for expenditure for 
personal services and rent at the seat of Government; books of 
reference, periodicals, and exhibits; printing and binding; 
transporting in Government-owned automotive equipment, to and 
from school, children of personnel who have quarters for 
themselves and their families at stations determined by the 
Surgeon General to be isolated stations; expenses incurred in 
pursuing, identifying, and returning prisoners who escape from 
any hospital, institution, or station of the Service or from 
the custody of any officer or employee of the Service, 
including rewards for the capture of such prisoners; 
furnishing, repairing, and cleaning such wearing apparel as may 
be prescribed by the Surgeon General for use by employees in 
the performance of their official duties; reimbursing officers 
and employees, subject to regulations of the Secretary, for the 
cost of repairing or replacing their personal belongings 
damaged or destroyed by patients while such officers or 
employees are engaged in the performance of their official 
duties; and maintenance of buildings of the National Institutes 
of Health.

                    unauthorized wearing of uniforms

    Sec. 238. [238g] Except as may be authorized by regulations 
of the President, the insignia and uniform of commissioned 
officers of the Service, or any distinctive part of such 
insignia or uniform, or any insignia or uniform any part of 
which is similar to a distinctive part thereof, shall not be 
worn, after the promulgation of such regulations, by any person 
other than a commissioned officer of the Service.
                            biannual report
    Sec. 239. [238h] The Surgeon General shall transmit to the 
Secretary, for submission to the Congress, on January 1, 1995, 
and on January 1, every 2 years thereafter, a full report of 
the administration of the functions of the Service under this 
Act, including a detailed statement of receipts and 
disbursements.

                  memorials and other acknowledgments

    Sec. 240. [238i] The Secretary may provide for suitably 
acknowledging, within the Department (whether by memorials, 
designations, or other suitable acknowledgments), (1) efforts 
of persons who have contributed substantially to the health of 
the Nation and (2) gifts for use in activities of the 
Department related to health.
                         evaluation of programs
    Sec. 241. [238j] (a) In General.--Such portion as the 
Secretary shall determine, but not less than 0.2 percent nor 
more than 1 percent, of any amounts appropriated for programs 
authorized under this Act shall be made available for the 
evaluation (directly, or by grants of contracts) of the 
implementation and effectiveness of such programs.
    (b) Report on Evaluations.--Not later than February 1 of 
each year, the Secretary shall prepare and submit to the 
Committee on Labor and Human Resources of the Senate and the 
Committee on Energy and Commerce of the House of 
Representatives a report summarizing the findings of the 
evaluations conducted under subsection (a).

                           contract authority

    Sec. 242. [238k] The authority of the Secretary to enter 
into contracts under this Act shall be effective for any fiscal 
year only to such extent or in such amounts as are provided in 
advance by appropriation Acts.

                                recovery

      Sec. 243. [238l] (a) If any facility with respect to 
which funds have been paid under the Community Mental Health 
Centers Act (as such Act was in effect prior to October 1, 
1981) is, at any time within twenty years after the completion 
of remodeling, construction, or expansion or after the date of 
its acquisition--
            (1) sold or transferred to any entity (A) which 
        would not have been qualified to file an application 
        under section 222 of such Act (as such section was in 
        effect prior to October 1, 1981) or (B) which is 
        disapproved as a transferee by the State mental health 
        agency or by another entity designated by the chief 
        executive officer of the State, or
            (2) ceases to be used by a community mental health 
        center in the provision of comprehensive mental health 
        services,
the United States shall be entitled to recover from the 
transferor, transferee, or owner of the facility, the base 
amount prescribed by subsection (c)(1) plus the interest (if 
any) prescribed by subsection (c)(2).
      (b) The transferor and transferee of a facility that is 
sold or transferred as described in subsection (a)(1), or the 
owner of a facility the use of which changes as described in 
subsection (a)(2), shall provide the Secretary written notice 
of such sale, transfer, or change within 10 days after the date 
on which such sale, transfer, or cessation of use occurs or 
within 30 days after the date of enactment of this subsection, 
whichever is later.
      (c)(1) The base amount that the United States is entitled 
to recover under subsection (a) is the amount bearing the same 
ratio to the then value (as determined by the agreement of the 
parties or in an action brought in the district court of the 
United States for the district in which the facility is 
situated) of so much of the facility as constituted an approved 
project or projects as the amount of the Federal participation 
bore to the cost of the remodeling, construction, expansion, or 
acquisition of the project or projects.
      (2)(A) The interest that the United States is entitled to 
recover under subsection (a) is the interest for the period (if 
any) described in subparagraph (B) at a rate (determined by the 
Secretary) based on the average of the bond equivalent rates of 
ninety-one-day Treasury bills auctioned during that period.
      (B) The period referred to in subparagraph (A) is the 
period beginning--
            (i) if notice is provided as prescribed by 
        subsection (b), 191 days after the date on which such 
        sale, transfer, or cessation of use occurs, or
            (ii) if notice is not provided as prescribed by 
        subsection (b), 11 days after such sale, transfer, or 
        cessation of use occurs,
and ending on the date the amount the United States is entitled 
to recover is collected.
      (d) The Secretary may waive the recovery rights of the 
United States under subsection (a) with respect to a facility 
(under such conditions as the Secretary may establish by 
regulation) if the Secretary determines that there is good 
cause for waiving such rights.
      (e) The right of recovery of the United States under 
subsection (a) shall not, prior to judgment, constitute a lien 
on any facility.
                          use of fiscal agents
    Sec. 244. [238m] (a) The Secretary may enter into contracts 
with fiscal agents--
            (1)(A) to determine the amounts payable to persons 
        who, on behalf of the Indian Health Service, furnish 
        health services to eligible Indians,
            (B) to determine the amounts payable to persons 
        who, on behalf of the Public Health Service, furnish 
        health services to individuals pursuant to section 319 
        or 322,
            (2) to receive, disburse, and account for funds in 
        making payments described in paragraph (1),
            (3) to make such audits of records as may be 
        necessary to assure that these payments are proper, and
            (4) to perform such additional functions as may be 
        necessary to carry out the functions described in 
        paragraphs (1) through (3).
    (b)(1) Contracts under subsection (a) may be entered into 
without regard to section 3709 of the Revised Statutes (41 
U.S.C. 5) or any other provision of law requiring competition.
    (2) No such contract shall be entered into with an entity 
unless the Secretary finds that the entity will perform its 
obligations under the contract efficiently and effectively and 
will meet such requirements as to financial responsibility, 
legal authority, and other matters as he finds pertinent.
    (c) A contract under subsection (a) may provide for 
advances of funds to enable entities to make payments under the 
contract.
    (d) Subsections (d) and (e) of section 1842 of the Social 
Security Act shall apply to contracts with entities under 
subsection (a) in the same manner as they apply to contracts 
with carriers under that section.
    (e) In this section, the term ``fiscal agent'' means a 
carrier described in section 1842(f)(1) of the Social Security 
Act and includes, with respect to contracts under subsection 
(a)(1)(A), an Indian tribe or tribal organization acting under 
contract with the Secretary under the Indian Self-Determination 
Act (Public Law 93-638).
 abortion-related discrimination in governmental activities regarding 
                  training and licensing of physicians
      Sec. 245. [238n] (a) In General.--The Federal Government, 
and any State or local government that receives Federal 
financial assistance, may not subject any health care entity to 
discrimination on the basis that--
            (1) the entity refuses to undergo training in the 
        performance of induced abortions, to require or provide 
        such training, to perform such abortions, or to provide 
        referrals for such training or such abortions;
            (2) the entity refuses to make arrangements for any 
        of the activities specified in paragraph (1); or
            (3) the entity attends (or attended) a post-
        graduate physician training program, or any other 
        program of training in the health professions, that 
        does not (or did not) perform induced abortions or 
        require, provide or refer for training in the 
        performance of induced abortions, or make arrangements 
        for the provision of such training.
      (b) Accreditation of Postgraduate Physician Training 
Programs.--
            (1) In general.--In determining whether to grant a 
        legal status to a health care entity (including a 
        license or certificate), or to provide such entity with 
        financial assistance, services or other benefits, the 
        Federal Government, or any State or local government 
        that receives Federal financial assistance, shall deem 
        accredited any postgraduate physician training program 
        that would be accredited but for the accrediting 
        agency's reliance upon an accreditation standard that 
        requires an entity to perform an induced abortion or 
        require, provide, or refer for training in the 
        performance of induced abortions, or make arrangements 
        for such training, regardless of whether such standard 
        provides exceptions or exemptions. The government 
        involved shall formulate such regulations or other 
        mechanisms, or enter into such agreements with 
        accrediting agencies, as are necessary to comply with 
        this subsection.
            (2) Rules of construction.--
                    (A) In general.--With respect to subclauses 
                (I) and (II) of section 705(a)(2)(B)(i) 
                (relating to a program of insured loans for 
                training in the health professions), the 
                requirements in such subclauses regarding 
                accredited internship or residency programs are 
                subject to paragraph (1) of this subsection.
                    (B) Exceptions.--This section shall not--
                            (i) prevent any health care entity 
                        from voluntarily electing to be 
                        trained, to train, or to arrange for 
                        training in the performance of, to 
                        perform, or to make referrals for 
                        induced abortions; or
                            (ii) prevent an accrediting agency 
                        or a Federal, State or local government 
                        from establishing standards of medical 
                        competency applicable only to those 
                        individuals who have voluntarily 
                        elected to perform abortions.
      (c) Definitions.--For purposes of this section:
            (1) The term ``financial assistance'', with respect 
        to a government program, includes governmental payments 
        provided as reimbursement for carrying out health-
        related activities.
            (2) The term ``health care entity'' includes an 
        individual physician, a postgraduate physician training 
        program, and a participant in a program of training in 
        the health professions.
            (3) The term ``postgraduate physician training 
        program'' includes a residency training program.

SEC. 246. [238O] RESTRICTION ON USE OF FUNDS FOR ASSISTED SUICIDE, 
                    EUTHANASIA, AND MERCY KILLING.

    Appropriations for carrying out the purposes of this Act 
shall not be used in a manner inconsistent with the Assisted 
Suicide Funding Restriction Act of 1997. \1\
---------------------------------------------------------------------------
    \1\ Public Law 105-12 (111 Stat. 23).
---------------------------------------------------------------------------
      recommendations and guidelines regarding automated external 
                  defibrillators for federal buildings
    Sec. 247. [238p] (a) Guidelines on Placement.--The 
Secretary shall establish guidelines with respect to placing 
automated external defibrillator devices in Federal buildings. 
Such guidelines shall take into account the extent to which 
such devices may be used by lay persons, the typical number of 
employees and visitors in the buildings, the extent of the need 
for security measures regarding the buildings, buildings or 
portions of buildings in which there are special circumstances 
such as high electrical voltage or extreme heat or cold, and 
such other factors as the Secretary determines to be 
appropriate.
    (b) Related Recommendations.--The Secretary shall publish 
in the Federal Register the recommendations of the Secretary on 
the appropriate implementation of the placement of automated 
external defibrillator devices under subsection (a), including 
procedures for the following:
            (1) Implementing appropriate training courses in 
        the use of such devices, including the role of 
        cardiopulmonary resuscitation.
            (2) Proper maintenance and testing of the devices.
            (3) Ensuring coordination with appropriate licensed 
        professionals in the oversight of training of the 
        devices.
            (4) Ensuring coordination with local emergency 
        medical systems regarding the placement and incidents 
        of use of the devices.
    (c) Consultations; Consideration of Certain 
Recommendations.--In carrying out this section, the Secretary 
shall--
            (1) consult with appropriate public and private 
        entities;
            (2) consider the recommendations of national and 
        local public-health organizations for improving the 
        survival rates of individuals who experience cardiac 
        arrest in nonhospital settings by minimizing the time 
        elapsing between the onset of cardiac arrest and the 
        initial medical response, including defibrillation as 
        necessary; and
            (3) consult with and counsel other Federal agencies 
        where such devices are to be used.
    (d) Date Certain for Establishing Guidelines and 
Recommendations.--The Secretary shall comply with this section 
not later than 180 days after the date of the enactment of the 
Cardiac Arrest Survival Act of 2000.
    (e) Definitions.--For purposes of this section:
            (1) The term ``automated external defibrillator 
        device'' has the meaning given such term in section 
        248.
            (2) The term ``Federal building'' includes a 
        building or portion of a building leased or rented by a 
        Federal agency, and includes buildings on military 
        installations of the United States.
 liability regarding emergency use of automated external defibrillators
    Sec. 248. [238q] (a) Good Samaritan Protections Regarding 
AEDs.--Except as provided in subsection (b), any person who 
uses or attempts to use an automated external defibrillator 
device on a victim of a perceived medical emergency is immune 
from civil liability for any harm resulting from the use or 
attempted use of such device; and in addition, any person who 
acquired the device is immune from such liability, if the harm 
was not due to the failure of such acquirer of the device--
            (1) to notify local emergency response personnel or 
        other appropriate entities of the most recent placement 
        of the device within a reasonable period of time after 
        the device was placed;
            (2) to properly maintain and test the device; or
            (3) to provide appropriate training in the use of 
        the device to an employee or agent of the acquirer when 
        the employee or agent was the person who used the 
        device on the victim, except that such requirement of 
        training does not apply if--
                    (A) the employee or agent was not an 
                employee or agent who would have been 
                reasonably expected to use the device; or
                    (B) the period of time elapsing between the 
                engagement of the person as an employee or 
                agent and the occurrence of the harm (or 
                between the acquisition of the device and the 
                occurrence of the harm, in any case in which 
                the device was acquired after such engagement 
                of the person) was not a reasonably sufficient 
                period in which to provide the training.
    (b) Inapplicability of Immunity.--Immunity under subsection 
(a) does not apply to a person if--
            (1) the harm involved was caused by willful or 
        criminal misconduct, gross negligence, reckless 
        misconduct, or a conscious, flagrant indifference to 
        the rights or safety of the victim who was harmed;
            (2) the person is a licensed or certified health 
        professional who used the automated external 
        defibrillator device while acting within the scope of 
        the license or certification of the professional and 
        within the scope of the employment or agency of the 
        professional;
            (3) the person is a hospital, clinic, or other 
        entity whose purpose is providing health care directly 
        to patients, and the harm was caused by an employee or 
        agent of the entity who used the device while acting 
        within the scope of the employment or agency of the 
        employee or agent; or
            (4) the person is an acquirer of the device who 
        leased the device to a health care entity (or who 
        otherwise provided the device to such entity for 
        compensation without selling the device to the entity), 
        and the harm was caused by an employee or agent of the 
        entity who used the device while acting within the 
        scope of the employment or agency of the employee or 
        agent.
    (c) Rules of Construction.--
            (1) In general.--The following applies with respect 
        to this section:
                    (A) This section does not establish any 
                cause of action, or require that an automated 
                external defibrillator device be placed at any 
                building or other location.
                    (B) With respect to a class of persons for 
                which this section provides immunity from civil 
                liability, this section supersedes the law of a 
                State only to the extent that the State has no 
                statute or regulations that provide persons in 
                such class with immunity for civil liability 
                arising from the use by such persons of 
                automated external defibrillator devices in 
                emergency situations (within the meaning of the 
                State law or regulation involved).
                    (C) This section does not waive any 
                protection from liability for Federal officers 
                or employees under--
                            (i) section 224; or
                            (ii) sections 1346(b), 2672, and 
                        2679 of title 28, United States Code, 
                        or under alternative benefits provided 
                        by the United States where the 
                        availability of such benefits precludes 
                        a remedy under section 1346(b) of title 
                        28.
            (2) Civil actions under federal law.--
                    (A) In general.--The applicability of 
                subsections (a) and (b) includes applicability 
                to any action for civil liability described in 
                subsection (a) that arises under Federal law.
                    (B) Federal areas adopting state law.--If a 
                geographic area is under Federal jurisdiction 
                and is located within a State but out of the 
                jurisdiction of the State, and if, pursuant to 
                Federal law, the law of the State applies in 
                such area regarding matters for which there is 
                no applicable Federal law, then an action for 
                civil liability described in subsection (a) 
                that in such area arises under the law of the 
                State is subject to subsections (a) through (c) 
                in lieu of any related State law that would 
                apply in such area in the absence of this 
                subparagraph.
    (d) Federal Jurisdiction.--In any civil action arising 
under State law, the courts of the State involved have 
jurisdiction to apply the provisions of this section exclusive 
of the jurisdiction of the courts of the United States.
    (e) Definitions.--
            (1) Perceived medical emergency.--For purposes of 
        this section, the term ``perceived medical emergency'' 
        means circumstances in which the behavior of an 
        individual leads a reasonable person to believe that 
        the individual is experiencing a life-threatening 
        medical condition that requires an immediate medical 
        response regarding the heart or other cardiopulmonary 
        functioning of the individual.
            (2) Other definitions.--For purposes of this 
        section:
                    (A) The term ``automated external 
                defibrillator device'' means a defibrillator 
                device that--
                            (i) is commercially distributed in 
                        accordance with the Federal Food, Drug, 
                        and Cosmetic Act;
                            (ii) is capable of recognizing the 
                        presence or absence of ventricular 
                        fibrillation, and is capable of 
                        determining without intervention by the 
                        user of the device whether 
                        defibrillation should be performed;
                            (iii) upon determining that 
                        defibrillation should be performed, is 
                        able to deliver an electrical shock to 
                        an individual; and
                            (iv) in the case of a defibrillator 
                        device that may be operated in either 
                        an automated or a manual mode, is set 
                        to operate in the automated mode.
                    (B)(i) The term ``harm'' includes physical, 
                nonphysical, economic, and noneconomic losses.
                    (ii) The term ``economic loss'' means any 
                pecuniary loss resulting from harm (including 
                the loss of earnings or other benefits related 
                to employment, medical expense loss, 
                replacement services loss, loss due to death, 
                burial costs, and loss of business or 
                employment opportunities) to the extent 
                recovery for such loss is allowed under 
                applicable State law.
                    (iii) The term ``noneconomic losses'' means 
                losses for physical and emotional pain, 
                suffering, inconvenience, physical impairment, 
                mental anguish, disfigurement, loss of 
                enjoyment of life, loss of society and 
                companionship, loss of consortium (other than 
                loss of domestic service), hedonic damages, 
                injury to reputation and all other nonpecuniary 
                losses of any kind or nature.

            Part C--Smallpox Emergency Personnel Protection

SEC. 261. [239] GENERAL PROVISIONS.

    (a) Definitions.--For purposes of this part:
            (1) Covered countermeasure.--The term ``covered 
        countermeasure'' means a covered countermeasure as 
        specified in a Declaration made pursuant to section 
        224(p).
            (2) Covered individual.--The term ``covered 
        individual'' means an individual--
                    (A) who is a health care worker, law 
                enforcement officer, firefighter, security 
                personnel, emergency medical personnel, other 
                public safety personnel, or support personnel 
                for such occupational specialities;
                    (B) who is or will be functioning in a role 
                identified in a State, local, or Department of 
                Health and Human Services smallpox emergency 
                response plan (as defined in paragraph (7)) 
                approved by the Secretary;
                    (C) who has volunteered and been selected 
                to be a member of a smallpox emergency response 
                plan described in subparagraph (B) prior to the 
                time at which the Secretary publicly announces 
                that an active case of smallpox has been 
                identified either within or outside of the 
                United States; and
                    (D) to whom a smallpox vaccine is 
                administered pursuant to such approved plan 
                during the effective period of the Declaration 
                (including the portion of such period before 
                the enactment of this part).
            (3) Covered injury.--The term ``covered injury'' 
        means an injury, disability, illness, condition, or 
        death (other than a minor injury such as minor scarring 
        or minor local reaction) determined, pursuant to the 
        procedures established under section 262, to have been 
        sustained by an individual as the direct result of--
                    (A) administration to the individual of a 
                covered countermeasure during the effective 
                period of the Declaration; or
                    (B) accidental vaccinia inoculation of the 
                individual in circumstances in which--
                            (i) the vaccinia is contracted 
                        during the effective period of the 
                        Declaration or within 30 days after the 
                        end of such period;
                            (ii) smallpox vaccine has not been 
                        administered to the individual; and
                            (iii) the individual has been in 
                        contact with an individual who is (or 
                        who was accidentally inoculated by) a 
                        covered individual.
            (4) Declaration.--The term ``Declaration'' means 
        the Declaration Regarding Administration of Smallpox 
        Countermeasures issued by the Secretary on January 24, 
        2003, and published in the Federal Register on January 
        28, 2003.
            (5) Effective period of the declaration.--The term 
        ``effective period of the Declaration'' means the 
        effective period specified in the Declaration, unless 
        extended by the Secretary.
            (6) Eligible individual.--The term ``eligible 
        individual'' means an individual who is (as determined 
        in accordance with section 262)--
                    (A) a covered individual who sustains a 
                covered injury in the manner described in 
                paragraph (3)(A); or
                    (B) an individual who sustains a covered 
                injury in the manner described in paragraph 
                (3)(B).
            (7) Smallpox emergency response plan.--The term 
        ``smallpox emergency response plan'' or ``plan'' means 
        a response plan detailing actions to be taken in 
        preparation for a possible smallpox-related emergency 
        during the period prior to the identification of an 
        active case of smallpox either within or outside the 
        United States.
    (b) Voluntary Program.--The Secretary shall ensure that a 
State, local, or Department of Health and Human Services plan 
to vaccinate individuals that is approved by the Secretary 
establishes procedures to ensure, consistent with the 
Declaration and any applicable guidelines of the Centers for 
Disease Control and Prevention, that--
            (1) potential participants are educated with 
        respect to contraindications, the voluntary nature of 
        the program, and the availability of potential benefits 
        and compensation under this part;
            (2) there is voluntary screening provided to 
        potential participants that can identify health 
        conditions relevant to contraindications; and
            (3) there is appropriate post-inoculation medical 
        surveillance that includes an evaluation of adverse 
        health effects that may reasonably appear to be due to 
        such vaccine and prompt referral of, or the provision 
        of appropriate information to, any individual requiring 
        health care as a result of such adverse health event.

SEC. 262. [239A] DETERMINATION OF ELIGIBILITY AND BENEFITS.

    (a) In General.--The Secretary shall establish procedures 
for determining, as applicable with respect to an individual--
            (1) whether the individual is an eligible 
        individual;
            (2) whether an eligible individual has sustained a 
        covered injury or injuries for which medical benefits 
        or compensation may be available under sections 264 and 
        265, and the amount of such benefits or compensation; 
        and
            (3) whether the covered injury or injuries of an 
        eligible individual caused the individual's death for 
        purposes of benefits under section 266.
    (b) Covered Individuals.--The Secretary may accept a 
certification, by a Federal, State, or local government entity 
or private health care entity participating in the 
administration of covered countermeasures under the 
Declaration, that an individual is a covered individual.
    (c) Criteria for Reimbursement.--
            (1) Injuries specified in injury table.--In any 
        case where an injury or other adverse effect specified 
        in the injury table established under section 263 as a 
        known effect of a vaccine manifests in an individual 
        within the time period specified in such table, such 
        injury or other effect shall be presumed to have 
        resulted from administration of such vaccine.
            (2) Other determinations.--In making determinations 
        other than those described in paragraph (1) as to the 
        causation or severity of an injury, the Secretary shall 
        employ a preponderance of the evidence standard and 
        take into consideration all relevant medical and 
        scientific evidence presented for consideration, and 
        may obtain and consider the views of qualified medical 
        experts.
    (d) Deadline for Filing Request.--The Secretary shall not 
consider any request for a benefit under this part with respect 
to an individual, unless--
            (1) in the case of a request based on the 
        administration of the vaccine to the individual, the 
        individual files with the Secretary an initial request 
        for benefits or compensation under this part not later 
        than one year after the date of administration of the 
        vaccine; or
            (2) in the case of a request based on accidental 
        vaccinia inoculation, the individual files with the 
        Secretary an initial request for benefits or 
        compensation under this part not later than two years 
        after the date of the first symptom or manifestation of 
        onset of the adverse effect.
    (e) Structured Settlements at Secretary's Option.--In any 
case in which there is a reasonable likelihood that 
compensation or payment under section 264, 265, or 266(b) will 
be required for a period in excess of one year from the date an 
individual is determined eligible for such compensation or 
payment, the Secretary shall have the discretion to make a 
lump-sum payment, purchase an annuity or medical insurance 
policy, or execute an appropriate structured settlement 
agreement, provided that such payment, annuity, policy, or 
agreement is actuarially determined to have a value equal to 
the present value of the projected total amount of benefits or 
compensation that the individual is eligible to receive under 
such section or sections.
    (f) Review of Determination.--
            (1) Secretary's review authority.--The Secretary 
        may review a determination under this section at any 
        time on the Secretary's own motion or on application, 
        and may affirm, vacate, or modify such determination in 
        any manner the Secretary deems appropriate. The 
        Secretary shall develop a process by which an 
        individual may file a request for reconsideration of 
        any determination made by the Secretary under this 
        section.
            (2) Judicial and administrative review.--No court 
        of the United States, or of any State, District, 
        territory or possession thereof, shall have subject 
        matter jurisdiction to review, whether by mandamus or 
        otherwise, any action by the Secretary under this 
        section. No officer or employee of the United States 
        shall review any action by the Secretary under this 
        section (unless the President specifically directs 
        otherwise).

SEC. 263. [239B] SMALLPOX VACCINE INJURY TABLE.

    (a) \1\ Smallpox Vaccine Injury Table.--
---------------------------------------------------------------------------
    \1\ Subsection (a) designation so in law. Section 263 does not 
contain a subsection (b). See the amendment made by section 2 of Public 
Law 108-20 (117 Stat. 638, 641), which added a new part C to title II.
---------------------------------------------------------------------------
            (1) Establishment required.--The Secretary shall 
        establish by interim final regulation a table 
        identifying adverse effects (including injuries, 
        disabilities, illnesses, conditions, and deaths) that 
        shall be presumed to result from the administration of 
        (or exposure to) a smallpox vaccine, and the time 
        period in which the first symptom or manifestation of 
        onset of each such adverse effect must manifest in 
        order for such presumption to apply.
            (2) Amendments.--The Secretary may by regulation 
        amend the table established under paragraph (1). An 
        amendment to the table takes effect on the date of the 
        promulgation of the final rule that makes the 
        amendment, and applies to all requests for benefits or 
        compensation under this part that are filed on or after 
        such date or are pending as of such date. In addition, 
        the amendment applies retroactively to an individual 
        who was not with respect to the injury involved an 
        eligible individual under the table as in effect before 
        the amendment but who with respect to such injury is an 
        eligible individual under the table as amended. With 
        respect to a request for benefits or compensation under 
        this part by an individual who becomes an eligible 
        individual as described in the preceding sentence, the 
        Secretary may not provide such benefits or compensation 
        unless the request (or amendment to a request, as 
        applicable) is filed before the expiration of one year 
        after the effective date of the amendment to the table 
        in the case of an individual to whom the vaccine was 
        administered and before the expiration of two years 
        after such effective date in the case of a request 
        based on accidental vaccinia inoculation.

SEC. 264. [239C] MEDICAL BENEFITS.

    (a) In General.--Subject to the succeeding provisions of 
this section, the Secretary shall make payment or reimbursement 
for medical items and services as reasonable and necessary to 
treat a covered injury of an eligible individual, including the 
services, appliances, and supplies prescribed or recommended by 
a qualified physician, which the Secretary considers likely to 
cure, give relief, reduce the degree or the period of 
disability, or aid in lessening the amount of monthly 
compensation.
    (b) Benefits Secondary to Other Coverage.--Payment or 
reimbursement for services or benefits under subsection (a) 
shall be secondary to any obligation of the United States or 
any third party (including any State or local governmental 
entity, private insurance carrier, or employer) under any other 
provision of law or contractual agreement, to pay for or 
provide such services or benefits.

SEC. 265. [239D] COMPENSATION FOR LOST EMPLOYMENT INCOME.

    (a) In General.--Subject to the succeeding provisions of 
this section, the Secretary shall provide compensation to an 
eligible individual for loss of employment income (based on 
such income at the time of injury) incurred as a result of a 
covered injury, at the rate specified in subsection (b).
    (b) Amount of Compensation.--
            (1) In general.--Compensation under subsection (a) 
        shall be at the rate of 66\2/3\ percent of the relevant 
        pay period (weekly, monthly, or otherwise), except as 
        provided in paragraph (2).
            (2) Augmented compensation for dependents.--If an 
        eligible individual has one or more dependents, the 
        basic compensation for loss of employment income as 
        described in paragraph (1) shall be augmented at the 
        rate of 8\1/3\ percent.
            (3) Consideration of other programs.--
                    (A) In general.--The Secretary may consider 
                the provisions of sections 8114, 8115, and 
                8146a of title 5, United States Code, and any 
                implementing regulations, in determining the 
                amount of payment under subsection (a) and the 
                circumstances under which such payments are 
                reasonable and necessary.
                    (B) Minors.--With respect to an eligible 
                individual who is a minor, the Secretary may 
                consider the provisions of section 8113 of 
                title 5, United States Code, and any 
                implementing regulations, in determining the 
                amount of payment under subsection (a) and the 
                circumstances under which such payments are 
                reasonable and necessary.
            (4) Treatment of self-employment income.--For 
        purposes of this section, the term ``employment 
        income'' includes income from self-employment.
    (c) Limitations.--
            (1) Benefits secondary to other coverage.--
                    (A) In general.--Any compensation under 
                subsection (a) shall be secondary to the 
                obligation of the United States or any third 
                party (including any State or local 
                governmental entity, private insurance carrier, 
                or employer), under any other law or 
                contractual agreement, to pay compensation for 
                loss of employment income or to provide 
                disability or retirement benefits.
                    (B) Relation to other obligations.--
                Compensation under subsection (a) shall not be 
                made to an eligible individual to the extent 
                that the total of amounts paid to the 
                individual under such subsection and under the 
                other obligations referred to in subparagraph 
                (A) is an amount that exceeds the rate 
                specified in subsection (b)(1). If under any 
                such other obligation a lump-sum payment is 
                made, such payment shall, for purposes of this 
                paragraph, be deemed to be received over 
                multiple years rather than received in a single 
                year. The Secretary may, in the discretion of 
                the Secretary, determine how to apportion such 
                payment over multiple years.
            (2) No benefits in case of death.--No payment shall 
        be made under subsection (a) in compensation for loss 
        of employment income subsequent to the receipt, by the 
        survivor or survivors of an eligible individual, of 
        benefits under section 266 for death.
            (3) Limit on total benefits.--
                    (A) In general.--Except as provided in 
                subparagraph (B)--
                            (i) total compensation paid to an 
                        individual under subsection (a) shall 
                        not exceed $50,000 for any year; and
                            (ii) the lifetime total of such 
                        compensation for the individual may not 
                        exceed an amount equal to the amount 
                        authorized to be paid under section 
                        266.
                    (B) Permanent and total disability.--The 
                limitation under subparagraph (A)(ii) does not 
                apply in the case of an eligible individual who 
                is determined to have a covered injury or 
                injuries meeting the definition of disability 
                in section 216(i) of the Social Security Act 
                (42 U.S.C. 416(i)).
            (4) Waiting period.--
                    (A) In general.--Except as provided in 
                subparagraph (B), an eligible individual shall 
                not be provided compensation under this section 
                for the first 5 work days of loss of employment 
                income.
                    (B) Exception.--Subparagraph (A) does not 
                apply if the period of loss of employment 
                income of an eligible individual is 10 or more 
                work days.
            (5) Termination of benefits.--No payment shall be 
        made under subsection (a) in compensation for loss of 
        employment income once the eligible individual involves 
        reaches the age of 65.
    (d) Benefit in Addition to Medical Benefits.--A benefit 
under subsection (a) shall be in addition to any amounts 
received by an eligible individual under section 264.

SEC. 266. [239E] PAYMENT FOR DEATH.

    (a) Death Benefit.--
            (1) In general.--The Secretary shall pay, in the 
        case of an eligible individual whose death is 
        determined to have resulted from a covered injury or 
        injuries, a death benefit in the amount determined 
        under paragraph (2) to the survivor or survivors in the 
        same manner as death benefits are paid pursuant to the 
        Public Safety Officers' Benefits Program under subpart 
        1 of part L of title I of the Omnibus Crime Control and 
        Safe Streets Act of 1968 (42 U.S.C. 3796 et seq.) with 
        respect to an eligible deceased (except that in the 
        case of an eligible individual who is a minor with no 
        living parent, the legal guardian shall be considered 
        the survivor in the place of the parent).
            (2) Benefit amount.--
                    (A) In general.--The amount of the death 
                benefit under paragraph (1) in a fiscal year 
                shall equal the amount of the comparable 
                benefit calculated under the Public Safety 
                Officers' Benefits Program under subpart 1 of 
                part L of title I of the Omnibus Crime Control 
                and Safe Streets Act of 1968 (42 U.S.C. 3796 et 
                seq.) in such fiscal year, without regard to 
                any reduction attributable to a limitation on 
                appropriations, but subject to subparagraph 
                (B).
                    (B) Reduction for payments for lost 
                employment income.--The amount of the benefit 
                as determined under subparagraph (A) shall be 
                reduced by the total amount of any benefits 
                paid under section 265 with respect to lost 
                employment income.
            (3) Limitations.--
                    (A) In general.--No benefit is payable 
                under paragraph (1) with respect to the death 
                of an eligible individual if--
                            (i) a disability benefit is paid 
                        with respect to such individual under 
                        the Public Safety Officers' Benefits 
                        Program under subpart 1 of part L of 
                        title I of the Omnibus Crime Control 
                        and Safe Streets Act of 1968 (42 U.S.C. 
                        3796 et seq.); or
                            (ii) a death benefit is paid or 
                        payable with respect to such individual 
                        under the Public Safety Officers' 
                        Benefits Program under subpart 1 of 
                        part L of title I of the Omnibus Crime 
                        Control and Safe Streets Act of 1968 
                        (42 U.S.C. 3796 et seq.).
                    (B) Exception in the case of a limitation 
                on appropriations for disability benefits under 
                psob.--In the event that disability benefits 
                available to an eligible individual under the 
                Public Safety Officers' Benefits Program under 
                subpart 1 of part L of title I of the Omnibus 
                Crime Control and Safe Streets Act of 1968 (42 
                U.S.C. 3796 et seq.) are reduced because of a 
                limitation on appropriations, and such 
                reduction would affect the amount that would be 
                payable under subparagraph (A) without regard 
                to this subparagraph, benefits shall be 
                available under paragraph (1) to the extent 
                necessary to ensure that the survivor or 
                survivors of such individual receives a total 
                amount equal to the amount described in 
                paragraph (2).
    (b) Election in Case of Dependents.--
            (1) In general.--In the case of an eligible 
        individual whose death is determined to have resulted 
        from a covered injury or injuries, if the individual 
        had one or more dependents under the age of 18, the 
        legal guardian of the dependents may, in lieu of the 
        death benefit under subsection (a), elect to receive on 
        behalf of the aggregate of such dependents payments in 
        accordance with this subsection. An election under the 
        preceding sentence is effective in lieu of a request 
        under subsection (a) by an individual who is not the 
        legal guardian of such dependents.
            (2) Amount of payments.--Payments under paragraph 
        (1) with respect to an eligible individual described in 
        such paragraph shall be made as if such individual were 
        an eligible individual to whom compensation would be 
        paid under subsection (a) of section 265, with the rate 
        augmented in accordance with subsection (b)(2) of such 
        section and with such individual considered to be an 
        eligible individual described in subsection (c)(3)(B) 
        of such section.
            (3) Limitations.--
                    (A) Age of dependents.--No payments may be 
                made under paragraph (1) once the youngest of 
                the dependents involved reaches the age of 18.
                    (B) Benefits secondary to other coverage.--
                            (i) In general.--Any payment under 
                        paragraph (1) shall be secondary to the 
                        obligation of the United States or any 
                        third party (including any State or 
                        local governmental entity, private 
                        insurance carrier, or employer), under 
                        any other law or contractual agreement, 
                        to pay compensation for loss of 
                        employment income or to provide 
                        disability benefits, retirement 
                        benefits, life insurance benefits on 
                        behalf of dependents under the age of 
                        18, or death benefits.
                            (ii) Relation to other 
                        obligations.--Payments under paragraph 
                        (1) shall not be made to with respect 
                        to an eligible individual to the extent 
                        that the total of amounts paid with 
                        respect to the individual under such 
                        paragraph and under the other 
                        obligations referred to in clause (i) 
                        is an amount that exceeds the rate of 
                        payment that applies under paragraph 
                        (2). If under any such other obligation 
                        a lump-sum payment is made, such 
                        payment shall, for purposes of this 
                        subparagraph, be deemed to be received 
                        over multiple years rather than 
                        received in a single year. The 
                        Secretary may, in the discretion of the 
                        Secretary, determine how to apportion 
                        such payment over multiple years.
    (c) Benefit in Addition to Medical Benefits.--A benefit 
under subsection (a) or (b) shall be in addition to any amounts 
received by an eligible individual under section 264.

SEC. 267. [239F] ADMINISTRATION.

    (a) Administration by Agreement With Other Agency or 
Agencies.--The Secretary may administer any or all of the 
provisions of this part through Memorandum of Agreement with 
the head of any appropriate Federal agency.
    (b) Regulations.--The head of the agency administering this 
part or provisions thereof (including any agency head 
administering such Act or provisions through a Memorandum of 
Agreement under subsection (a)) may promulgate such 
implementing regulations as may be found necessary and 
appropriate. Initial implementing regulations may be interim 
final regulations.

SEC. 268. [239G] AUTHORIZATION OF APPROPRIATIONS.

    For the purpose of carrying out this part, there are 
authorized to be appropriated such sums as may be necessary for 
each of the fiscal years 2003 through 2007, to remain available 
until expended, including administrative costs and costs of 
provision and payment of benefits. The Secretary's payment of 
any benefit under section 264, 265, or 266 shall be subject to 
the availability of appropriations under this section.

SEC. 269. [239H] RELATIONSHIP TO OTHER LAWS.

    Except as explicitly provided herein, nothing in this part 
shall be construed to override or limit any rights an 
individual may have to seek compensation, benefits, or redress 
under any other provision of Federal or State law.

           PART D--UNITED STATES PUBLIC HEALTH SCIENCES TRACK

SEC. 271. [239L] ESTABLISHMENT.

    (a) United States Public Health Services Track.--
            (1) In general.--There is hereby authorized to be 
        established a United States Public Health Sciences 
        Track (referred to in this part as the ``Track''), at 
        sites to be selected by the Secretary, with authority 
        to grant appropriate advanced degrees in a manner that 
        uniquely emphasizes team-based service, public health, 
        epidemiology, and emergency preparedness and response. 
        It shall be so organized as to graduate not less than--
                    (A) 150 medical students annually, 10 of 
                whom shall be awarded studentships to the 
                Uniformed Services University of Health 
                Sciences;
                    (B) 100 dental students annually;
                    (C) 250 nursing students annually;
                    (D) 100 public health students annually;
                    (E) 100 behavioral and mental health 
                professional students annually;
                    (F) 100 physician assistant or nurse 
                practitioner students annually; and
                    (G) 50 pharmacy students annually.
            (2) Locations.--The Track shall be located at 
        existing and accredited, affiliated health professions 
        education training programs at academic health centers 
        located in regions of the United States determined 
        appropriate by the Surgeon General, in consultation 
        with the National Health Care Workforce Commission 
        established in section 5101 of the Patient Protection 
        and Affordable Care Act.
    (b) Number of Graduates.--Except as provided in subsection 
(a), the number of persons to be graduated from the Track shall 
be prescribed by the Secretary. In so prescribing the number of 
persons to be graduated from the Track, the Secretary shall 
institute actions necessary to ensure the maximum number of 
first-year enrollments in the Track consistent with the 
academic capacity of the affiliated sites and the needs of the 
United States for medical, dental, and nursing personnel.
    (c) Development.--The development of the Track may be by 
such phases as the Secretary may prescribe subject to the 
requirements of subsection (a).
    (d) Integrated Longitudinal Plan.--The Surgeon General 
shall develop an integrated longitudinal plan for health 
professions continuing education throughout the continuum of 
health-related education, training, and practice. Training 
under such plan shall emphasize patient-centered, 
interdisciplinary, and care coordination skills. Experience 
with deployment of emergency response teams shall be included 
during the clinical experiences.
    (e) Faculty Development.--The Surgeon General shall develop 
faculty development programs and curricula in decentralized 
venues of health care, to balance urban, tertiary, and 
inpatient venues.

SEC. 272. [239L-1] ADMINISTRATION.

    (a) In General.--The business of the Track shall be 
conducted by the Surgeon General with funds appropriated for 
and provided by the Department of Health and Human Services. 
The National Health Care Workforce Commission shall assist the 
Surgeon General in an advisory capacity.
    (b) Faculty.--
            (1) In general.--The Surgeon General, after 
        considering the recommendations of the National Health 
        Care Workforce Commission, shall obtain the services of 
        such professors, instructors, and administrative and 
        other employees as may be necessary to operate the 
        Track, but utilize when possible, existing affiliated 
        health professions training institutions. Members of 
        the faculty and staff shall be employed under salary 
        schedules and granted retirement and other related 
        benefits prescribed by the Secretary so as to place the 
        employees of the Track faculty on a comparable basis 
        with the employees of fully accredited schools of the 
        health professions within the United States.
            (2) Titles.--The Surgeon General may confer 
        academic titles, as appropriate, upon the members of 
        the faculty.
            (3) Nonapplication of provisions.--The limitations 
        in section 5373 of title 5, United States Code, shall 
        not apply to the authority of the Surgeon General under 
        paragraph (1) to prescribe salary schedules and other 
        related benefits.
    (c) Agreements.--The Surgeon General may negotiate 
agreements with agencies of the Federal Government to utilize 
on a reimbursable basis appropriate existing Federal medical 
resources located in the United States (or locations selected 
in accordance with section 271(a)(2)). Under such agreements 
the facilities concerned will retain their identities and basic 
missions. The Surgeon General may negotiate affiliation 
agreements with accredited universities and health professions 
training institutions in the United States. Such agreements may 
include provisions for payments for educational services 
provided students participating in Department of Health and 
Human Services educational programs.
    (d) Programs.--The Surgeon General may establish the 
following educational programs for Track students:
            (1) Postdoctoral, postgraduate, and technological 
        programs.
            (2) A cooperative program for medical, dental, 
        physician assistant, pharmacy, behavioral and mental 
        health, public health, and nursing students.
            (3) Other programs that the Surgeon General 
        determines necessary in order to operate the Track in a 
        cost-effective manner.
    (e) Continuing Medical Education.--The Surgeon General 
shall establish programs in continuing medical education for 
members of the health professions to the end that high 
standards of health care may be maintained within the United 
States.
    (f) Authority of the Surgeon General.--
            (1) In general.--The Surgeon General is 
        authorized--
                    (A) to enter into contracts with, accept 
                grants from, and make grants to any nonprofit 
                entity for the purpose of carrying out 
                cooperative enterprises in medical, dental, 
                physician assistant, pharmacy, behavioral and 
                mental health, public health, and nursing 
                research, consultation, and education;
                    (B) to enter into contracts with entities 
                under which the Surgeon General may furnish the 
                services of such professional, technical, or 
                clerical personnel as may be necessary to 
                fulfill cooperative enterprises undertaken by 
                the Track;
                    (C) to accept, hold, administer, invest, 
                and spend any gift, devise, or bequest of 
                personal property made to the Track, including 
                any gift, devise, or bequest for the support of 
                an academic chair, teaching, research, or 
                demonstration project;
                    (D) to enter into agreements with entities 
                that may be utilized by the Track for the 
                purpose of enhancing the activities of the 
                Track in education, research, and technological 
                applications of knowledge; and
                    (E) to accept the voluntary services of 
                guest scholars and other persons.
            (2) Limitation.--The Surgeon General may not enter 
        into any contract with an entity if the contract would 
        obligate the Track to make outlays in advance of the 
        enactment of budget authority for such outlays.
            (3) Scientists.--Scientists or other medical, 
        dental, or nursing personnel utilized by the Track 
        under an agreement described in paragraph (1) may be 
        appointed to any position within the Track and may be 
        permitted to perform such duties within the Track as 
        the Surgeon General may approve.
            (4) Volunteer services.--A person who provides 
        voluntary services under the authority of subparagraph 
        (E) of paragraph (1) shall be considered to be an 
        employee of the Federal Government for the purposes of 
        chapter 81 of title 5, relating to compensation for 
        work-related injuries, and to be an employee of the 
        Federal Government for the purposes of chapter 171 of 
        title 28, relating to tort claims. Such a person who is 
        not otherwise employed by the Federal Government shall 
        not be considered to be a Federal employee for any 
        other purpose by reason of the provision of such 
        services.

SEC. 273. [239L-2] STUDENTS; SELECTION; OBLIGATION.

    (a) Student Selection.--
            (1) In general.--Medical, dental, physician 
        assistant, pharmacy, behavioral and mental health, 
        public health, and nursing students at the Track shall 
        be selected under procedures prescribed by the Surgeon 
        General. In so prescribing, the Surgeon General shall 
        consider the recommendations of the National Health 
        Care Workforce Commission.
            (2) Priority.--In developing admissions procedures 
        under paragraph (1), the Surgeon General shall ensure 
        that such procedures give priority to applicant 
        medical, dental, physician assistant, pharmacy, 
        behavioral and mental health, public health, and 
        nursing students from rural communities and 
        underrepresented minorities.
    (b) Contract and Service Obligation.--
            (1) Contract.--Upon being admitted to the Track, a 
        medical, dental, physician assistant, pharmacy, 
        behavioral and mental health, public health, or nursing 
        student shall enter into a written contract with the 
        Surgeon General that shall contain--
                    (A) an agreement under which--
                            (i) subject to subparagraph (B), 
                        the Surgeon General agrees to provide 
                        the student with tuition (or tuition 
                        remission) and a student stipend 
                        (described in paragraph (2)) in each 
                        school year for a period of years (not 
                        to exceed 4 school years) determined by 
                        the student, during which period the 
                        student is enrolled in the Track at an 
                        affiliated or other participating 
                        health professions institution pursuant 
                        to an agreement between the Track and 
                        such institution; and
                            (ii) subject to subparagraph (B), 
                        the student agrees--
                                    (I) to accept the provision 
                                of such tuition and student 
                                stipend to the student;
                                    (II) to maintain enrollment 
                                at the Track until the student 
                                completes the course of study 
                                involved;
                                    (III) while enrolled in 
                                such course of study, to 
                                maintain an acceptable level of 
                                academic standing (as 
                                determined by the Surgeon 
                                General);
                                    (IV) if pursuing a degree 
                                from a school of medicine or 
                                osteopathic medicine, dental, 
                                public health, or nursing 
                                school or a physician 
                                assistant, pharmacy, or 
                                behavioral and mental health 
                                professional program, to 
                                complete a residency or 
                                internship in a specialty that 
                                the Surgeon General determines 
                                is appropriate; and
                                    (V) to serve for a period 
                                of time (referred to in this 
                                part as the ``period of 
                                obligated service'') within the 
                                Commissioned Corps of the 
                                Public Health Service equal to 
                                2 years for each school year 
                                during which such individual 
                                was enrolled at the College, 
                                reduced as provided for in 
                                paragraph (3);
                    (B) a provision that any financial 
                obligation of the United States arising out of 
                a contract entered into under this part and any 
                obligation of the student which is conditioned 
                thereon, is contingent upon funds being 
                appropriated to carry out this part;
                    (C) a statement of the damages to which the 
                United States is entitled for the student's 
                breach of the contract; and
                    (D) such other statements of the rights and 
                liabilities of the Secretary and of the 
                individual, not inconsistent with the 
                provisions of this part.
            (2) Tuition and student stipend.--
                    (A) Tuition remission rates.--The Surgeon 
                General, based on the recommendations of the 
                National Health Care Workforce Commission, 
                shall establish Federal tuition remission rates 
                to be used by the Track to provide 
                reimbursement to affiliated and other 
                participating health professions institutions 
                for the cost of educational services provided 
                by such institutions to Track students. The 
                agreement entered into by such participating 
                institutions under paragraph (1)(A)(i) shall 
                contain an agreement to accept as payment in 
                full the established remission rate under this 
                subparagraph.
                    (B) Stipend.--The Surgeon General, based on 
                the recommendations of the National Health Care 
                Workforce Commission, shall establish and 
                update Federal stipend rates for payment to 
                students under this part.
            (3) Reductions in the period of obligated 
        service.--The period of obligated service under 
        paragraph (1)(A)(ii)(V) shall be reduced--
                    (A) in the case of a student who elects to 
                participate in a high-needs speciality 
                residency (as determined by the National Health 
                Care Workforce Commission), by 3 months for 
                each year of such participation (not to exceed 
                a total of 12 months); and
                    (B) in the case of a student who, upon 
                completion of their residency, elects to 
                practice in a Federal medical facility (as 
                defined in section 781(e)) that is located in a 
                health professional shortage area (as defined 
                in section 332), by 3 months for year of full-
                time practice in such a facility (not to exceed 
                a total of 12 months).
    (c) Second 2 Years of Service.--During the third and fourth 
years in which a medical, dental, physician assistant, 
pharmacy, behavioral and mental health, public health, or 
nursing student is enrolled in the Track, training should be 
designed to prioritize clinical rotations in Federal medical 
facilities in health professional shortage areas, and emphasize 
a balance of hospital and community-based experiences, and 
training within interdisciplinary teams.
    (d) Dentist, Physician Assistant, Pharmacist, Behavioral 
and Mental Health Professional, Public Health Professional, and 
Nurse Training.--The Surgeon General shall establish provisions 
applicable with respect to dental, physician assistant, 
pharmacy, behavioral and mental health, public health, and 
nursing students that are comparable to those for medical 
students under this section, including service obligations, 
tuition support, and stipend support. The Surgeon General shall 
give priority to health professions training institutions that 
train medical, dental, physician assistant, pharmacy, 
behavioral and mental health, public health, and nursing 
students for some significant period of time together, but at a 
minimum have a discrete and shared core curriculum.
    (e) Elite Federal Disaster Teams.--The Surgeon General, in 
consultation with the Secretary, the Director of the Centers 
for Disease Control and Prevention, and other appropriate 
military and Federal government agencies, shall develop 
criteria for the appointment of highly qualified Track faculty, 
medical, dental, physician assistant, pharmacy, behavioral and 
mental health, public health, and nursing students, and 
graduates to elite Federal disaster preparedness teams to train 
and to respond to public health emergencies, natural disasters, 
bioterrorism events, and other emergencies.
    (f) Student Dropped From Track in Affiliate School.--A 
medical, dental, physician assistant, pharmacy, behavioral and 
mental health, public health, or nursing student who, under 
regulations prescribed by the Surgeon General, is dropped from 
the Track in an affiliated school for deficiency in conduct or 
studies, or for other reasons, shall be liable to the United 
States for all tuition and stipend support provided to the 
student.

SEC. 274. [239L-3] FUNDING.

    Beginning with fiscal year 2010, the Secretary shall 
transfer from the Public Health and Social Services Emergency 
Fund such sums as may be necessary to carry out this 
part.3/1/01 9:05:59 AM - F:\V7\030101\030101.005 
Created by: PMG deg.ATTORNEY: PMG/FD (May 26, 
1999) deg.
     TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

                   Part A--Research and Investigation

                               in general

    Sec. 301. [241] (a) The Secretary shall conduct in the 
Service, and encourage, cooperate with, and render assistance 
to other appropriate public authorities, scientific 
institutions, and scientists in the conduct of, and promote the 
coordination of, research, investigations, experiments, 
demonstrations, and studies relating to the causes, diagnosis, 
treatment, control, and prevention of physical and mental 
diseases and impairments of man, including water purification, 
sewage treatment, and pollution of lakes and streams. In 
carrying out the foregoing the Secretary is authorized to--
            (1) collect and make available through publications 
        and other appropriate means, information as to, and the 
        practical application of, such research and other 
        activities;
            (2) make available research facilities of the 
        Service to appropriate public authorities, and to 
        health officials and scientists engaged in special 
        study;
            (3) make grants-in-aid to universities, hospitals, 
        laboratories, and other public or private institutions, 
        and to individuals for such research projects as are 
        recommended by the advisory council to the entity of 
        the Department supporting such projects and make, upon 
        recommendation of the advisory council to the 
        appropriate entity of the Department, grants-in-aid to 
        public or nonprofit universities, hospitals, 
        laboratories, and other institutions for the general 
        support of their research;
            (4) secure from time to time and for such periods 
        as he deems advisable, the assistance and advice of 
        experts, scholars, and consultants from the United 
        States or abroad;
            (5) for purposes of study, admit and treat at 
        institutions, hospitals, and stations of the Service, 
        persons not otherwise eligible for such treatment;
            (6) make available, to health officials, 
        scientists, and appropriate public and other nonprofit 
        institutions and organizations, technical advice and 
        assistance on the application of statistical methods to 
        experiments, studies, and surveys in health and medical 
        fields;
            (7) enter into contracts, including contracts for 
        research in accordance with and subject to the 
        provisions of law applicable to contracts entered into 
        by the military departments under title 10, United 
        States Code, sections 2353 and 2354, except that 
        determination, approval, and certification required 
        thereby shall be by the Secretary of Health, Education, 
        and Welfare; and
            (8) adopt, upon recommendations of the advisory 
        councils to the appropriate entities of the Department 
        or, with respect to mental health, the National 
        Advisory Mental Health Council, such additional means 
        as the Secretary considers necessary or appropriate to 
        carry out the purposes of this section.
The Secretary may make available to individuals and entities, 
for biomedical and behavioral research, substances and living 
organisms. Such substances and organisms shall be made 
available under such terms and conditions (including payment 
for them) as the Secretary determines appropriate.
    (b)(1) The Secretary shall conduct and may support through 
grants and contracts studies and testing of substances for 
carcinogenicity, teratogenicity, mutagenicity, and other 
harmful biological effects. In carrying out this paragraph, the 
Secretary shall consult with entities of the Federal 
Government, outside of the Department of Health, Education, and 
Welfare, engaged in comparable activities. The Secretary, upon 
request of such an entity and under appropriate arrangements 
for the payment of expenses, may conduct for such entity 
studies and testing of substances for carcinogenicity, 
teratogenicity, mutagenicity, and other harmful biological 
effects.
    (2)(A) The Secretary shall establish a comprehensive 
program of research into the biological effects of low-level 
ionizing radiation under which program the Secretary shall 
conduct such research and may support such research by others 
through grants and contracts.
    (B) The Secretary shall conduct a comprehensive review of 
Federal programs of research on the biological effects of 
ionizing radiation.
    (3) The Secretary shall conduct and may support through 
grants and contracts research and studies on human nutrition, 
with particular emphasis on the role of nutrition in the 
prevention and treatment of disease and on the maintenance and 
promotion of health, and programs for the dissemination of 
information respecting human nutrition to health professionals 
and the public. In carrying out activities under this 
paragraph, the Secretary shall provide for the coordination of 
such of these activities as are performed by the different 
divisions within the Department of Health, Education, and 
Welfare and shall consult with entities of the Federal 
Government, outside of the Department of Health, Education, and 
Welfare, engaged in comparable activities. The Secretary, upon 
request of such an entity and under appropriate arrangements 
for the payment of expenses, may conduct and support such 
activities for such entity.
    (4) The Secretary shall publish a biennial report which 
contains--
            (A) a list of all substances (i) which either are 
        known to be carcinogens or may reasonably be 
        anticipated to be carcinogens and (ii) to which a 
        significant number of persons residing in the United 
        States are exposed;
            (B) information concerning the nature of such 
        exposure and the estimated number of persons exposed to 
        such substances;
            (C) a statement identifying (i) each substance 
        contained in the list under subparagraph (A) for which 
        no effluent, ambient, or exposure standard has been 
        established by a Federal agency, and (ii) for each 
        effluent, ambient, or exposure standard established by 
        a Federal agency with respect to a substance contained 
        in the list under subparagraph (A), the extent to 
        which, on the basis of available medical, scientific, 
        or other data, such standard, and the implementation of 
        such standard by the agency, decreases the risk to 
        public health from exposure to the substance; and
            (D) a description of (i) each request received 
        during the year involved--
                    (I) from a Federal agency outside the 
                Department of Health, Education, and Welfare 
                for the Secretary, or
                    (II) from an entity within the Department 
                of Health, Education, and Welfare to any other 
                entity within the Department,
        to conduct research into, or testing for, the 
        carcinogenicity of substances or to provide information 
        described in clause (ii) of subparagraph (C), and (ii) 
        how the Secretary and each such other entity, 
        respectively, have responded to each such request.
    (5) The authority of the Secretary to enter into any 
contract for the conduct of any study, testing, program, 
research, or review, or assessment under this subsection shall 
be effective for any fiscal year only to such extent or in such 
amounts as are provided in advance in Appropriation Acts.
      (c) The Secretary may conduct biomedical research, 
directly or through grants or contracts, for the 
identification, control, treatment, and prevention of diseases 
(including tropical diseases) which do not occur to a 
significant extent in the United States.
    (d) The Secretary may authorize persons engaged in 
biomedical, behavioral, clinical, or other research (including 
research on mental health, including research on the use and 
effect of alcohol and other psychoactive drugs) to protect the 
privacy of individuals who are the subject of such research by 
withholding from all persons not connected with the conduct of 
such research the names or other identifying characteristics of 
such individuals. Persons so authorized to protect the privacy 
of such individuals may not be compelled in any Federal, State, 
or local civil, criminal, administrative, legislative, or other 
proceedings to identify such individuals.
    (e) The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall expand, 
intensify, and coordinate the activities of the Centers for 
Disease Control and Prevention with respect to preterm labor 
and delivery and infant mortality.

                               narcotics

    Sec. 302. [242] (a) In carrying out the purposes of section 
301 with respect to drugs the use or misuse of which might 
result in drug abuse or dependency, the studies and 
investigations authorized therein shall include the use and 
misuse of narcotic drugs and other drugs. Such studies and 
investigations shall further include the quantities of crude 
opium, coca leaves, and their salts, derivatives, and 
preparations, and other drugs subject to control under the 
Controlled Substances Act and Controlled Substances Import and 
Export Act, together with reserves thereof, necessary to supply 
the normal and emergency medicinal and scientific requirements 
of the United States. The results of studies and investigations 
of the quantities of narcotic drugs or other drugs subject to 
control under such Acts, together with reserves of such drugs, 
that are necessary to supply the normal and emergency medicinal 
and scientific requirements of the United States, shall be 
reported not later than the first day of April of each year to 
the Attorney General, to be used at his discretion in 
determining manufacturing quotas or importation requirements 
under such Acts.
    (b) The Surgeon General shall cooperate with States for the 
purpose of aiding them to solve their narcotic drug problems 
and shall give authorized representatives of the States the 
benefit of his experience in the care, treatment, and 
rehabilitation of narcotic addicts to the end that each State 
may be encouraged to provide adequate facilities and methods 
for the care and treatment of its narcotic addicts.

general authority respecting research, evaluations, and demonstrations 
   in health statistics, health services, and health care technology 
                               assessment

    Sec. 304. \1\ [242b] (a) The Secretary may, through the 
Agency for Health Care Policy and Research or the National 
Center for Health Statistics or using National Research Service 
Awards or other appropriate authorities, undertake and support 
training programs to provide for an expanded and continuing 
supply of individuals qualified to perform the research, 
evaluation, and demonstration projects set forth in section 306 
and in title IX.
---------------------------------------------------------------------------
    \1\ Former section 303 was repealed by section 3201(b)(1) of Public 
Law 106-310 (114 Stat. 1190).
---------------------------------------------------------------------------
    (b) To implement subsection (a) and section 306, the 
Secretary may, in addition to any other authority which under 
other provisions of this Act or any other law may be used by 
him to implement such subsection, do the following:
            (1) Utilize personnel and equipment, facilities, 
        and other physical resources of the Department of 
        Health and Human Services, permit appropriate (as 
        determined by the Secretary) entities and individuals 
        to utilize the physical resources of such Department, 
        provide technical assistance and advice, make grants to 
        public and nonprofit private entities and individuals, 
        and, when appropriate, enter into contracts with public 
        and private entities and individuals.
            (2) Admit and treat at hospitals and other 
        facilities of the Service persons not otherwise 
        eligible for admission and treatment at such 
        facilities.
            (3) Secure, from time to time and for such periods 
        as the Secretary deems advisable but in accordance with 
        section 3109 of title 5, United States Code, the 
        assistance and advice of consultants from the United 
        States or abroad. The Secretary may for the purpose of 
        carrying out the functions set forth in sections 305, 
        \2\ 306, and 309, obtain (in accordance with section 
        3109 of title 5 of the United States Code, but without 
        regard to the limitation in such section on the number 
        of days or the period of service) for each of the 
        centers the services of not more than fifteen experts 
        who have appropriate scientific or professional 
        qualifications.
---------------------------------------------------------------------------
    \2\ See footnote for section 306.
---------------------------------------------------------------------------
            (4) Acquire, construct, improve, repair, operate, 
        and maintain laboratory, research, and other necessary 
        facilities and equipment, and such other real or 
        personal property (including patents) as the Secretary 
        deems necessary; and acquire, without regard to the Act 
        of March 3, 1877 (40 U.S.C. 34), by lease or otherwise, 
        through the Administrator of General Services, 
        buildings or parts of buildings in the District of 
        Columbia or communities located adjacent to the 
        District of Columbia.
    (c)(1) The Secretary shall coordinate all health services 
research, evaluations, and demonstrations, all health 
statistical and epidemiological activities, and all research, 
evaluations, and demonstrations respecting the assessment of 
health care technology undertaken and supported through units 
of the Department of Health and Human Services. To the maximum 
extent feasible such coordination shall be carried out through 
the Agency for Health Care Policy and Research and the National 
Center for Health Statistics.
    (2) The Secretary shall coordinate the health services 
research, evaluations, and demonstrations, the health 
statistical and (where appropriate) epidemiological activities, 
and the research, evaluations, and demonstrations respecting 
the assessment of health care technology authorized by this Act 
through the Agency for Health Care Policy and Research and the 
National Center for Health Statistics.
                 national center for health statistics
    Sec. 306. \1\ [242k] (a) There is established in the 
Department of Health and Human Services the National Center for 
Health Statistics (hereinafter in this section referred to as 
the ``Center'') which shall be under the direction of a 
Director who shall be appointed by the Secretary. The 
Secretary, acting through the Center, shall conduct and support 
statistical and epidemiological activities for the purpose of 
improving the effectiveness, efficiency, and quality of health 
services in the United States.
---------------------------------------------------------------------------
    \1\ Former section 305 was repealed by section 6103(d)(1)(A) of 
Public Law 101-239 (103 Stat. 2205). Title IX now applies to the matter 
with which former section 305 was concerned.
---------------------------------------------------------------------------
    (b) In carrying out subsection (a), the Secretary, acting 
through the Center--
            (1) shall collect statistics on--
                    (A) the extent and nature of illness and 
                disability of the population of the United 
                States (or of any groupings of the people 
                included in the population), including life 
                expectancy, the incidence of various acute and 
                chronic illnesses, and infant and maternal 
                morbidity and mortality,
                    (B) the impact of illness and disability of 
                the population on the economy of the United 
                States and on other aspects of the well-being 
                of its population (or of such groupings),
                    (C) environmental, social, and other health 
                hazards,
                    (D) determinants of health,
                    (E) health resources, including physicians, 
                dentists, nurses, and other health 
                professionals by specialty and type of practice 
                and the supply of services by hospitals, 
                extended care facilities, home health agencies, 
                and other health institutions,
                    (F) utilization of health care, including 
                utilization of (i) ambulatory health services 
                by specialties and types of practice of the 
                health professionals providing such services, 
                and (ii) services of hospitals, extended care 
                facilities, home health agencies, and other 
                institutions,
                    (G) health care costs and financing, 
                including the trends in health care prices and 
                cost, the sources of payments for health care 
                services, and Federal, State, and local 
                governmental expenditures for health care 
                services, and
                    (H) family formation, growth, and 
                dissolution;
            (2) shall undertake and support (by grant or 
        contract) research, demonstrations, and evaluations 
        respecting new or improved methods for obtaining 
        current data on the matters referred to in paragraph 
        (1);
            (3) may undertake and support (by grant or 
        contract) epidemiological research, demonstrations, and 
        evaluations on the matters referred to in paragraph 
        (1); and
            (4) may collect, furnish, tabulate, and analyze 
        statistics, and prepare studies, on matters referred to 
        in paragraph (1) upon request of public and nonprofit 
        private entities under arrangements under which the 
        entities will pay the cost of the service provided.
Amounts appropriated to the Secretary from payments made under 
arrangements made under paragraph (4) shall be available to the 
Secretary for obligation until expended.
    (c) The Center shall furnish such special statistical and 
epidemiological compilations and surveys as the Committee on 
Labor and Human Resources and the Committee on Appropriations 
of the Senate and the Committee on Energy and Commerce and the 
Committee on Appropriations of the House of Representatives may 
request. Such statistical and epidemiological compilations and 
surveys shall not be made subject to the payment of the actual 
or estimated cost of the preparation of such compilations and 
surveys.
    (d) To insure comparability and reliability of health 
statistics, the Secretary shall, through the Center, provide 
adequate technical assistance to assist State and local 
jurisdictions in the development of model laws dealing with 
issues of confidentiality and comparability of data.
    (e) For the purpose of producing comparable and uniform 
health information and statistics, there is established the 
Cooperative Health Statistics System. The Secretary, acting 
through the Center, shall--
            (1) coordinate the activities of Federal agencies 
        involved in the design and implementation of the 
        System;
            (2) undertake and support (by grant or contract) 
        research, development, demonstrations, and evaluations 
        respecting the System;
            (3) make grants to and enter into contracts with 
        State and local health agencies to assist them in 
        meeting the costs of data collection and other 
        activities carried out under the System; and
            (4) review the statistical activities of the 
        Department of Health and Human Services to assure that 
        they are consistent with the System.
States participating in the System shall designate a State 
agency to administer or be responsible for the administration 
of the statistical activities within the State under the 
System. The Secretary, acting through the Center, shall 
prescribe guidelines to assure that statistical activities 
within States participating in the system \1\ produce uniform 
and timely data and assure appropriate access to such data.
---------------------------------------------------------------------------
    \1\ So in law. Probably should be capitalized.
---------------------------------------------------------------------------
    (f) To assist in carrying out this section, the Secretary, 
acting through the Center, shall cooperate and consult with the 
Departments of Commerce and Labor and any other interested 
Federal departments or agencies and with State and local health 
departments and agencies. For such purpose he shall utilize 
insofar as possible the services or facilities of any agency of 
the Federal Government and, without regard to section 3709 of 
the Revised Statutes (41 U.S.C. 5), of any appropriate State or 
other public agency, and may, without regard to such section, 
utilize the services or facilities of any private agency, 
organization, group, or individual, in accordance with written 
agreements between the head of such agency, organization, or 
group and the Secretary or between such individual and the 
Secretary. Payment, if any, for such services or facilities 
shall be made in such amounts as may be provided in such 
agreement.
    (g) To secure uniformity in the registration and collection 
of mortality, morbidity, and other health data, the Secretary 
shall prepare and distribute suitable and necessary forms for 
the collection and compilation of such data.
    (h)(1) There shall be an annual collection of data from the 
records of births, deaths, marriages, and divorces in 
registration areas. The data shall be obtained only from and 
restricted to such records of the States and municipalities 
which the Secretary, in his discretion, determines possess 
records affording satisfactory data in necessary detail and 
form. The Secretary shall encourage States and registration 
areas to obtain detailed data on ethnic and racial populations, 
including subpopulations of Hispanics, Asian Americans, and 
Pacific Islanders with significant representation in the State 
or registration area. Each State or registration area shall be 
paid by the Secretary the Federal share of its reasonable costs 
(as determined by the Secretary) for collecting and 
transcribing (at the request of the Secretary and by whatever 
method authorized by him) its records for such data.
    (2) There shall be an annual collection of data from a 
statistically valid sample concerning the general health, 
illness, and disability status of the civilian 
noninstitutionalized population. Specific topics to be 
addressed under this paragraph, on an annual or periodic basis, 
shall include the incidence of illness and accidental injuries, 
prevalence of chronic diseases and impairments, disability, 
physician visits, hospitalizations, and the relationship 
between demographic and socioeconomic characteristics and 
health characteristics.
    (i) The Center may provide to public and nonprofit private 
entities technical assistance in the effective use in such 
activities of statistics collected or compiled by the Center.
    (j) In carrying out the requirements of section 304(c) and 
paragraph (1) of subsection (e) of this section, the Secretary 
shall coordinate health statistical and epidemiological 
activities of the Department of Health and Human Services by--
            (1) establishing standardized means for the 
        collection of health information and statistics under 
        laws administered by the Secretary;
            (2) developing, in consultation with the National 
        Committee on Vital and Health Statistics, and 
        maintaining the minimum sets of data needed on a 
        continuing basis to fulfill the collection requirements 
        of subsection (b)(1);
            (3) after consultation with the National Committee 
        on Vital and Health Statistics, establishing standards 
        to assure the quality of health statistical and 
        epidemiological data collection, processing, and 
        analysis;
            (4) in the case of proposed health data collections 
        of the Department which are required to be reviewed by 
        the Director of the Office of Management and Budget 
        under section 3509 of title 44, United States Code, 
        reviewing such proposed collections to determine 
        whether they conform with the minimum sets of data and 
        the standards promulgated pursuant to paragraphs (2) 
        and (3), and if any such proposed collection is found 
        not to be in conformance, by taking such action as may 
        be necessary to assure that it will conform to such 
        sets of data and standards, and
            (5) periodically reviewing ongoing health data 
        collections of the Department, subject to review under 
        such section 3509, to determine if the collections are 
        being conducted in accordance with the minimum sets of 
        data and the standards promulgated pursuant to 
        paragraphs (2) and (3) and, if any such collection is 
        found not to be in conformance, by taking such action 
        as may be necessary to assure that the collection will 
        conform to such sets of data and standards not later 
        than the nineteenth day after the date of the 
        completion of the review of the collection.
    (k)(1) There is established in the Office of the Secretary 
a committee to be known as the National Committee on Vital and 
Health Statistics (hereinafter in this subsection, referred to 
as the ``Committee'') which shall consist of 18 members.
    (2) The members of the Committee shall be appointed from 
among persons who have distinguished themselves in the fields 
of health statistics, electronic interchange of health care 
information, privacy and security of electronic information, 
population-based public health, purchasing or financing health 
care services, integrated computerized health information 
systems, health services research, consumer interests in health 
information, health data standards, epidemiology, and the 
provision of health services. Members of the Committee shall be 
appointed for terms of 4 years.
    (3) Of the members of the Committee--
            (A) 1 shall be appointed, not later than 60 days 
        after the date of the enactment of the Health Insurance 
        Portability and Accountability Act of 1996, by the 
        Speaker of the House of Representatives after 
        consultation with the Minority Leader of the House of 
        Representatives;
            (B) 1 shall be appointed, not later than 60 days 
        after the date of the enactment of the Health Insurance 
        Portability and Accountability Act of 1996, by the 
        President pro tempore of the Senate after consultation 
        with the Minority Leader of the Senate; and
            (C) 16 shall be appointed by the Secretary.
    (4) Members of the Committee shall be compensated in 
accordance with section 208(c).
    (5) The Committee--
            (A) shall assist and advise the Secretary--
                    (i) to delineate statistical problems 
                bearing on health and health services which are 
                of national or international interest;
                    (ii) to stimulate studies of such problems 
                by other organizations and agencies whenever 
                possible or to make investigations of such 
                problems through subcommittees;
                    (iii) to determine, approve, and revise the 
                terms, definitions, classifications, and 
                guidelines for assessing health status and 
                health services, their distribution and costs, 
                for use (I) within the Department of Health and 
                Human Services, (II) by all programs 
                administered or funded by the Secretary, 
                including the Federal-State-local cooperative 
                health statistics system referred to in 
                subsection (e), and (III) to the extent 
                possible as determined by the head of the 
                agency involved, by the Department of Veterans 
                Affairs, the Department of Defense, and other 
                Federal agencies concerned with health and 
                health services;
                    (iv) with respect to the design of and 
                approval of health statistical and health 
                information systems concerned with the 
                collection, processing, and tabulation of 
                health statistics within the Department of 
                Health and Human Services, with respect to the 
                Cooperative Health Statistics System 
                established under subsection (e), and with 
                respect to the standardized means for the 
                collection of health information and statistics 
                to be established by the Secretary under 
                subsection (j)(1);
                    (v) to review and comment on findings and 
                proposals developed by other organizations and 
                agencies and to make recommendations for their 
                adoption or implementation by local, State, 
                national, or international agencies;
                    (vi) to cooperate with national committees 
                of other countries and with the World Health 
                Organization and other national agencies in the 
                studies of problems of mutual interest;
                    (vii) to issue an annual report on the 
                state of the Nation's health, its health 
                services, their costs and distributions, and to 
                make proposals for improvement of the Nation's 
                health statistics and health information 
                systems; and
                    (viii) in complying with the requirements 
                imposed on the Secretary under part C of title 
                XI of the Social Security Act;
            (B) shall study the issues related to the adoption 
        of uniform data standards for patient medical record 
        information and the electronic exchange of such 
        information;
            (C) shall report to the Secretary not later than 4 
        years after the date of the enactment of the Health 
        Insurance Portability and Accountability Act of 1996 
        recommendations and legislative proposals for such 
        standards and electronic exchange; and
            (D) shall be responsible generally for advising the 
        Secretary and the Congress on the status of the 
        implementation of part C of title XI of the Social 
        Security Act.
    (6) In carrying out health statistical activities under 
this part, the Secretary shall consult with, and seek the 
advice of, the Committee and other appropriate professional 
advisory groups.
    (7) Not later than 1 year after the date of the enactment 
of the Health Insurance Portability and Accountability Act of 
1996, and annually thereafter, the Committee shall submit to 
the Congress, and make public, a report regarding the 
implementation of part C of title XI of the Social Security 
Act. Such report shall address the following subjects, to the 
extent that the Committee determines appropriate:
            (A) The extent to which persons required to comply 
        with part C of title XI of the Social Security Act are 
        cooperating in implementing the standards adopted under 
        such part.
            (B) The extent to which such entities are meeting 
        the security standards adopted under such part and the 
        types of penalties assessed for noncompliance with such 
        standards.
            (C) Whether the Federal and State Governments are 
        receiving information of sufficient quality to meet 
        their responsibilities under such part.
            (D) Any problems that exist with respect to 
        implementation of such part.
            (E) The extent to which timetables under such part 
        are being met.
    (l) In carrying out this section, the Secretary, acting 
through the Center, shall collect and analyze adequate health 
data that is specific to particular ethnic and racial 
populations, including data collected under national health 
surveys. Activities carried out under this subsection shall be 
in addition to any activities carried out under subsection (m).
    (m)(1) The Secretary, acting through the Center, may make 
grants to public and nonprofit private entities for--
            (A) the conduct of special surveys or studies on 
        the health of ethnic and racial populations or 
        subpopulations;
            (B) analysis of data on ethnic and racial 
        populations and subpopulations; and
            (C) research on improving methods for developing 
        statistics on ethnic and racial populations and 
        subpopulations.
    (2) The Secretary, acting through the Center, may provide 
technical assistance, standards, and methodologies to grantees 
supported by this subsection in order to maximize the data 
quality and comparability with other studies.
    (3) Provisions of section 308(d) do not apply to surveys or 
studies conducted by grantees under this subsection unless the 
Secretary, in accordance with regulations the Secretary may 
issue, determines that such provisions are necessary for the 
conduct of the survey or study and receives adequate assurance 
that the grantee will enforce such provisions.
    (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.
    (n)(1) For health statistical and epidemiological 
activities undertaken or supported under subsections (a) 
through (l), there are authorized to be appropriated such sums 
as may be necessary for each of the fiscal years 1991 through 
2003.
    (2) For activities authorized in paragraphs (1) through (3) 
of subsection (m), there are authorized to be appropriated such 
sums as may be necessary for each of the fiscal years 1999 
through 2003. Of such amounts, the Secretary shall use not more 
than 10 percent for administration and for activities described 
in subsection (m)(2).
    (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.
                       international cooperation
    Sec. 307. [242l] (a) The Secretary may participate with 
other countries in cooperative endeavors in--
            (1) biomedical research, health care technology, 
        and the health services research and statistical 
        analysis authorized under section 306 and title IX; and
            (2) biomedical research, health care services, 
        health care research, or other related activities in 
        furtherance of the activities, objectives or goals 
        authorized under the Tom Lantos and Henry J. Hyde 
        United States Global Leadership Against HIV/AIDS, 
        Tuberculosis, and Malaria Reauthorization Act of 2008.
    (b) In connection with the cooperative endeavors authorized 
by subsection (a), the Secretary may--
            (1) make such use of resources offered by 
        participating foreign countries as he may find 
        necessary and appropriate;
            (2) establish and maintain fellowships in the 
        United States and in participating foreign countries;
            (3) make grants to public institutions or agencies 
        and to nonprofit private institutions or agencies in 
        the United States and in participating foreign 
        countries for the purpose of establishing and 
        maintaining the fellowships authorized by paragraph 
        (2);
            (4) make grants or loans of equipment and 
        materials, for use by public or nonprofit private 
        institutions or agencies, or by individuals, in 
        participating foreign countries;
            (5) participate and otherwise cooperate in any 
        international meetings, conferences, or other 
        activities concerned with biomedical research, health 
        services research, health statistics, or health care 
        technology;
            (6) facilitate the interchange between the United 
        States and participating foreign countries, and among 
        participating foreign countries, of research scientists 
        and experts who are engaged in experiments or programs 
        of biomedical research, health services research, 
        health statistical activities, or health care 
        technology activities, and in carrying out such purpose 
        may pay per diem compensation, subsistence, and travel 
        for such scientists and experts when away from their 
        places of residence at rates not to exceed those 
        provided in section 5703(b) of title 5, United States 
        Code, for persons in the Government service employed 
        intermittently;
            (7) procure, in accordance with section 3109 of 
        title 5, United States Code, the temporary or 
        intermittent services of experts or consultants;
            (8) enter into contracts with individuals for the 
        provision of services (as defined in section 104 of 
        part 37 of title 48, Code of Federal Regulations (48 
        CFR 37.104)) in participating foreign countries, which 
        individuals may not be deemed employees of the United 
        States for the purpose of any law administered by the 
        Office of Personnel Management;
            (9) provide such funds by advance or reimbursement 
        to the Secretary of State, as may be necessary, to pay 
        the costs of acquisition, lease, construction, 
        alteration, equipping, furnishing or management of 
        facilities outside of the United States; and
            (10) in consultation with the Secretary of State, 
        through grant or cooperative agreement, make funds 
        available to public or nonprofit private institutions 
        or agencies in foreign countries in which the Secretary 
        is participating in activities described under 
        subsection (a) to acquire, lease, construct, alter, or 
        renovate facilities in those countries.
    (c) The Secretary may provide to personnel appointed or 
assigned by the Secretary to serve abroad, allowances and 
benefits similar to those provided under chapter 9 of title I 
of the Foreign Service Act of 1980 (22 U.S.C. 4081 et seq.). 
Leaves of absence for personnel under this subsection shall be 
on the same basis as that provided under subchapter I of 
chapter 63 of title 5, United States Code or section 903 of the 
Foreign Service Act of 1980 (22 U.S.C. 4083), to individuals 
serving in the Foreign Service.
    (d) In carrying out immunization programs and other 
programs in developing countries for the prevention, treatment, 
and control of infectious diseases, including HIV/AIDS, 
tuberculosis, and malaria, the Director of the Centers for 
Disease Control and Prevention, in coordination with the 
Coordinator of United States Government Activities to Combat 
HIV/AIDS Globally, the National Institutes of Health, national 
and local government, and other organizations, such as the 
World Health Organization and the United Nations Children's 
Fund, shall develop and implement effective strategies to 
improve injection safety, including eliminating unnecessary 
injections, promoting sterile injection practices and 
technologies, strengthening the procedures for proper needle 
and syringe disposal, and improving the education and 
information provided to the public and to health professionals.

general provisions respecting effectiveness, efficiency, and quality of 
                            health services

    Sec. 308. [242m] (a)(1) Not later than March 15 of each 
year, the Secretary shall submit to the President and Congress 
the following reports:
            (A) A report on health care costs and financing. 
        Such report shall include a description and analysis of 
        the statistics collected under section 306(b)(1)(G).
            (B) A report on health resources. Such report shall 
        include a description and analysis, by geographical 
        area, of the statistics collected under section 
        306(b)(1)(E).
            (C) A report on the utilization of health 
        resources. Such report shall include a description and 
        analysis, by age, sex, income, and geographic area, of 
        the statistics collected under section 306(b)(1)(F).
            (D) A report on the health of the Nation's people. 
        Such report shall include a description and analysis, 
        by age, sex, income, and geographic area, of the 
        statistics collected under section 306(b)(1)(A).
    (2) The reports required in paragraph (1) shall be prepared 
through the National Center for Health Statistics.
    (3) The Office of Management and Budget may review any 
report required by paragraph (1) of this subsection before its 
submission to Congress, but the Office may not revise any such 
report or delay its submission beyond the date prescribed for 
its submission, and may submit to Congress its comments 
respecting any such report.
    (b)(1) No grant or contract may be made under section 304, 
306, or 307 unless an application therefor has been submitted 
to the Secretary in such form and manner, and containing such 
information, as the Secretary may by regulation prescribe and 
unless a peer review group referred to in paragraph (2) has 
recommended the application for approval.
    (2)(A) Each application submitted for a grant or contract 
under section 306 in an amount exceeding $50,000 of direct 
costs and for a health services research, evaluation, or 
demonstration project, or for a grant under section 306(m), 
shall be submitted to a peer review group for an evaluation of 
the technical and scientific merits of the proposals made in 
each such application. The Director of the National Center for 
Health Statistics shall establish such peer review groups as 
may be necessary to provide for such an evaluation of each such 
application.
    (B) A peer review group to which an application is 
submitted pursuant to subparagraph (A) shall report its finding 
and recommendations respecting the application to the 
Secretary, acting through the Director of the National Center 
for Health Statistics, in such form and manner as the Secretary 
shall by regulation prescribe. The Secretary may not approve an 
application described in such subparagraph unless a peer review 
group has recommended the application for approval.
    (C) The Secretary, acting through the Director of the 
National Center for Health Statistics, shall make appointments 
to the peer review groups required in subparagraph (A) from 
among persons who are not officers or employees of the United 
States and who possess appropriate technical and scientific 
qualifications, except that peer review groups regarding grants 
under section 306(m) may include appropriately qualified such 
officers and employees.
    (c) The Secretary shall take such action as may be 
necessary to assure that statistics developed under sections 
304 and 306 are of high quality, timely, comprehensive as well 
as specific, standardized, and adequately analyzed and indexed, 
and shall publish, make available, and disseminate such 
statistics on as wide a basis as is practicable.
    (d) No information, if an establishment or person supplying 
the information or described in it is identifiable, obtained in 
the course of activities undertaken or supported under section 
304, 306, or 307 may be used for any purpose other than the 
purpose for which it was supplied unless such establishment or 
person has consented (as determined under regulations of the 
Secretary) to its use for such other purpose and in the case of 
information obtained in the course of health statistical or 
epidemiological activities under section 304 or 306, such 
information may not be published or released in other form if 
the particular establishment or person supplying the 
information or described in it is identifiable unless such 
establishment or person has consented (as determined under 
regulations of the Secretary) to its publication or release in 
other form.
    (e)(1) Payments of any grant or under any contract under 
section 304, 306, or 307 may be made in advance or by way of 
reimbursement, and in such installments and on such conditions, 
as the Secretary deems necessary to carry out the purposes of 
such section.
    (2) The amounts otherwise payable to any person under a 
grant or contract made under section 304, 306, or 307 shall be 
reduced by--
            (A) amounts equal to the fair market value of any 
        equipment or supplies furnished to such person by the 
        Secretary for the purpose of carrying out the project 
        with respect to which such grant or contract is made, 
        and
            (B) amounts equal to the pay, allowances, traveling 
        expenses, and related personnel expenses attributable 
        to the performance of services by an officer or 
        employee of the Government in connection with such 
        project, if such officer or employee was assigned or 
        detailed by the Secretary to perform such services,
but only if such person requested the Secretary to furnish such 
equipment or supplies, or such services, as the case may be.
    (f) Contracts may be entered into under section 304 or 306 
without regard to section 3324 of title 31, United States Code, 
and section 3709 of the Revised Statutes (41 U.S.C. 5).
          health conferences and health education information
    Sec. 310. \1\ [242o] (a) A conference of the health 
authorities in and among the several States shall be called 
annually by the Secretary. Whenever in his opinion the 
interests of the public health would be promoted by a 
conference, the Secretary may invite as many of such health 
authorities and officials of other State or local public or 
private agencies, institutions, or organizations to confer as 
he deems necessary or proper. Upon the application of health 
authorities of five or more States it shall be the duty of the 
Secretary to call a conference of all State health authorities 
joining in the request. Each State represented at any 
conference shall be entitled to a single vote. Whenever at any 
such conference matters relating to mental health are to be 
discussed, the mental health authorities of the respective 
States shall be invited to attend.
---------------------------------------------------------------------------
    \1\ Former section 309 was repealed by section 6103(d)(1)(B) of 
Public Law 101-239 (103 Stat. 2205).
---------------------------------------------------------------------------
    (b) From time to time the Secretary shall issue information 
related to public health, in the form of publications or 
otherwise, for the use of the public, and shall publish weekly 
reports of health conditions in the United States and other 
countries and other pertinent health information for the use of 
persons and institutions concerned with health services.

SEC. 310A. [242S] CENTERS FOR DISEASE CONTROL AND PREVENTION OFFICE OF 
                    WOMEN'S HEALTH.

    (a) Establishment.--There is established within the Office 
of the Director of the Centers for Disease Control and 
Prevention, an office to be known as the Office of Women's 
Health (referred to in this section as the ``Office''). The 
Office shall be headed by a director who shall be appointed by 
the Director of such Centers.
    (b) Purpose.--The Director of the Office shall--
            (1) report to the Director of the Centers for 
        Disease Control and Prevention on the current level of 
        the Centers' activity regarding women's health 
        conditions across, where appropriate, age, biological, 
        and sociocultural contexts, in all aspects of the 
        Centers' work, including prevention programs, public 
        and professional education, services, and treatment;
            (2) establish short-range and long-range goals and 
        objectives within the Centers for women's health and, 
        as relevant and appropriate, coordinate with other 
        appropriate offices on activities within the Centers 
        that relate to prevention, research, education and 
        training, service delivery, and policy development, for 
        issues of particular concern to women;
            (3) identify projects in women's health that should 
        be conducted or supported by the Centers;
            (4) consult with health professionals, 
        nongovernmental organizations, consumer organizations, 
        women's health professionals, and other individuals and 
        groups, as appropriate, on the policy of the Centers 
        with regard to women; and
            (5) serve as a member of the Department of Health 
        and Human Services Coordinating Committee on Women's 
        Health (established under section 229(b)(4)).
    (c) Definition.--As used in this section, the term 
``women's health conditions'', with respect to women of all 
age, ethnic, and racial groups, means diseases, disorders, and 
conditions--
            (1) unique to, significantly more serious for, or 
        significantly more prevalent in women; and
            (2) for which the factors of medical risk or type 
        of medical intervention are different for women, or for 
        which there is reasonable evidence that indicates that 
        such factors or types may be different for women.
    (d) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2010 through 2014.

                   Part B--Federal-State Cooperation

                               in general

    Sec. 311. [243] (a) The Secretary is authorized to accept 
from State and local authorities any assistance in the 
enforcement of quarantine regulations made pursuant to this Act 
which such authorities may be able and willing to provide. The 
Secretary shall also assist States and their political 
subdivisions in the prevention and suppression of communicable 
diseases and with respect to other public health matters, shall 
cooperate with and aid State and local authorities in the 
enforcement of their quarantine and other health regulations, 
and shall advise the several States on matters relating to the 
preservation and improvement of the public health.
    (b) The Secretary shall encourage cooperative activities 
between the States with respect to comprehensive and continuing 
planning as to their current and future health needs, the 
establishment and maintenance of adequate public health 
services, and otherwise carrying out the public health 
activities. The Secretary is also authorized to train personnel 
for State and local health work. The Secretary may charge only 
private entities reasonable fees for the training of their 
personnel under the preceding sentence.
    (c)(1) The Secretary is authorized to develop (and may take 
such action as may be necessary to implement) a plan under 
which personnel, equipment, medical supplies, and other 
resources of the Service and other agencies under the 
jurisdiction of the Secretary may be effectively used to 
control epidemics of any disease or condition and to meet other 
health emergencies or problems. The Secretary may enter into 
agreements providing for the cooperative planning between the 
Service and public and private community health programs and 
agencies to cope with health problems (including epidemics and 
health emergencies).
    (2) The Secretary may, at the request of the appropriate 
State or local authority, extend temporary (not in excess of 
six months) assistance to States or localities in meeting 
health emergencies of such a nature as to warrant Federal 
assistance. The Secretary may require such reimbursement of the 
United States for assistance provided under this paragraph as 
he may determine to be reasonable under the circumstances. Any 
reimbursement so paid shall be credited to the applicable 
appropriation for the Service for the year in which such 
reimbursement is received.

SEC. 312. [244] PUBLIC ACCESS DEFIBRILLATION PROGRAMS.

    (a) In General.--The Secretary shall award grants to 
States, political subdivisions of States, Indian tribes, and 
tribal organizations to develop and implement public access 
defibrillation programs--
            (1) by training and equipping local emergency 
        medical services personnel, including firefighters, 
        police officers, paramedics, emergency medical 
        technicians, and other first responders, to administer 
        immediate care, including cardiopulmonary resuscitation 
        and automated external defibrillation, to cardiac 
        arrest victims;
            (2) by purchasing automated external 
        defibrillators, placing the defibrillators in public 
        places where cardiac arrests are likely to occur, and 
        training personnel in such places to administer 
        cardiopulmonary resuscitation and automated external 
        defibrillation to cardiac arrest victims;
            (3) by setting procedures for proper maintenance 
        and testing of such devices, according to the 
        guidelines of the manufacturers of the devices;
            (4) by providing training to members of the public 
        in cardiopulmonary resuscitation and automated external 
        defibrillation;
            (5) by integrating the emergency medical services 
        system with the public access defibrillation programs 
        so that emergency medical services personnel, including 
        dispatchers, are informed about the location of 
        automated external defibrillators in their community; 
        and
            (6) by encouraging private companies, including 
        small businesses, to purchase automated external 
        defibrillators and provide training for their employees 
        to administer cardiopulmonary resuscitation and 
        external automated defibrillation to cardiac arrest 
        victims in their community.
    (b) Preference.--In awarding grants under subsection (a), 
the Secretary shall give a preference to a State, political 
subdivision of a State, Indian tribe, or tribal organization 
that--
            (1) has a particularly low local survival rate for 
        cardiac arrests, or a particularly low local response 
        rate for cardiac arrest victims; or
            (2) demonstrates in its application the greatest 
        commitment to establishing and maintaining a public 
        access defibrillation program.
    (c) Use of Funds.--A State, political subdivision of a 
State, Indian tribe, or tribal organization that receives a 
grant under subsection (a) may use funds received through such 
grant to--
            (1) purchase automated external defibrillators that 
        have been approved, or cleared for marketing, by the 
        Food and Drug Administration;
            (2) provide automated external defibrillation and 
        basic life support training in automated external 
        defibrillator usage through nationally recognized 
        courses;
            (3) provide information to community members about 
        the public access defibrillation program to be funded 
        with the grant;
            (4) provide information to the local emergency 
        medical services system regarding the placement of 
        automated external defibrillators in public places;
            (5) produce materials to encourage private 
        companies, including small businesses, to purchase 
        automated external defibrillators;
            (6) establish an information clearinghouse, that 
        shall be administered by an organization that has 
        substantial expertise in pediatric education, pediatric 
        medicine, and electrophysiology and sudden death, that 
        provides information to increase public access to 
        defibrillation in schools; and
            (7) further develop strategies to improve access to 
        automated external defibrillators in public places.
    (d) Application.--
            (1) In general.--To be eligible to receive a grant 
        under subsection (a), a State, political subdivision of 
        a State, Indian tribe, or tribal organization shall 
        prepare and submit an application to the Secretary at 
        such time, in such manner, and containing such 
        information as the Secretary may reasonably require.
            (2) Contents.--An application submitted under 
        paragraph (1) shall--
                    (A) describe the comprehensive public 
                access defibrillation program to be funded with 
                the grant and demonstrate how such program 
                would make automated external defibrillation 
                accessible and available to cardiac arrest 
                victims in the community;
                    (B) contain procedures for implementing 
                appropriate nationally recognized training 
                courses in performing cardiopulmonary 
                resuscitation and the use of automated external 
                defibrillators;
                    (C) contain procedures for ensuring direct 
                involvement of a licensed medical professional 
                and coordination with the local emergency 
                medical services system in the oversight of 
                training and notification of incidents of the 
                use of the automated external defibrillators;
                    (D) contain procedures for proper 
                maintenance and testing of the automated 
                external defibrillators, according to the 
                labeling of the manufacturer;
                    (E) contain procedures for ensuring 
                notification of local emergency medical 
                services system personnel, including 
                dispatchers, of the location and type of 
                devices used in the public access 
                defibrillation program; and
                    (F) provide for the collection of data 
                regarding the effectiveness of the public 
                access defibrillation program to be funded with 
                the grant in affecting the out-of-hospital 
                cardiac arrest survival rate.
    (e) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated $25,000,000 for for \1\ each of fiscal years 2003 
through 2014. Not more than 10 percent of amounts received 
under a grant awarded under this section may be used for 
administrative expenses.
---------------------------------------------------------------------------
    \1\ The words ``for for'' so in law.
---------------------------------------------------------------------------

SEC. 313. [245] PUBLIC ACCESS DEFIBRILLATION DEMONSTRATION PROJECTS.

    (a) In General.--The Secretary shall award grants to 
political subdivisions of States, Indian tribes, and tribal 
organizations to develop and implement innovative, 
comprehensive, community-based public access defibrillation 
demonstration projects that--
            (1) provide cardiopulmonary resuscitation and 
        automated external defibrillation to cardiac arrest 
        victims in unique settings;
            (2) provide training to community members in 
        cardiopulmonary resuscitation and automated external 
        defibrillation; and
            (3) maximize community access to automated external 
        defibrillators.
    (b) Use of Funds.--A recipient of a grant under subsection 
(a) shall use the funds provided through the grant to--
            (1) purchase automated external defibrillators that 
        have been approved, or cleared for marketing, by the 
        Food and Drug Administration;
            (2) provide basic life training in automated 
        external defibrillator usage through nationally 
        recognized courses;
            (3) provide information to community members about 
        the public access defibrillation demonstration project 
        to be funded with the grant;
            (4) provide information to the local emergency 
        medical services system regarding the placement of 
        automated external defibrillators in the unique 
        settings; and
            (5) further develop strategies to improve access to 
        automated external defibrillators in public places.
    (c) Application.--
            (1) In general.--To be eligible to receive a grant 
        under subsection (a), a political subdivision of a 
        State, Indian tribe, or tribal organization shall 
        prepare and submit an application to the Secretary at 
        such time, in such manner, and containing such 
        information as the Secretary may reasonably require.
            (2) Contents.--An application submitted under 
        paragraph (1) may--
                    (A) describe the innovative, comprehensive, 
                community-based public access defibrillation 
                demonstration project to be funded with the 
                grant;
                    (B) explain how such public access 
                defibrillation demonstration project represents 
                innovation in providing public access to 
                automated external defibrillation; and
                    (C) provide for the collection of data 
                regarding the effectiveness of the 
                demonstration project to be funded with the 
                grant in--
                            (i) providing emergency 
                        cardiopulmonary resuscitation and 
                        automated external defibrillation to 
                        cardiac arrest victims in the setting 
                        served by the demonstration project; 
                        and
                            (ii) affecting the cardiac arrest 
                        survival rate in the setting served by 
                        the demonstration project.
    (d) Authorization of Appropriations.--There is authorized 
to be appropriated to carry out this section $5,000,000 for 
each of fiscal years 2002 through 2006. Not more than 10 
percent of amounts received under a grant awarded under this 
section may be used for administrative expenses.
  grants for comprehensive health planning and public health services

        Grants to States for Comprehensive State Health Planning

    Sec. 314. [246] (a)(1) Authorization.--In order to assist 
the States in comprehensive and continuing planning for their 
current and future health needs, the Secretary is authorized 
during the period beginning July 1, 1966, and ending June 30, 
1973, to make grants to States which have submitted, and had 
approved by the Secretary, State plans for comprehensive State 
health planning. For the purposes of carrying out this 
subsection, there are hereby authorized to be appropriated 
$2,500,000 for the fiscal year ending June 30, 1967, $7,000,000 
for the fiscal year ending June 30, 1968, $10,000,000 for the 
fiscal year ending June 30, 1969, $15,000,000 for the fiscal 
year ending June 30, 1970, $15,000,000 for the fiscal year 
ending June 30, 1971, $17,000,000 for the fiscal year ending 
June 30, 1972, $20,000,000 for the fiscal year ending June 30, 
1973, and $10,000,000 for the fiscal year ending June 30, 1974.
    (2) State Plans for Comprehensive State Health Planning.--
In order to be approved for purposes of this subsection, a 
State plan for comprehensive State health planning must--
            (A) designate, or provide for the establishment of, 
        a single State agency, which may be an 
        interdepartmental agency, as the sole agency for 
        administering or supervising the administration of the 
        State's health planning functions under the plan;
            (B) provide for the establishment of a State health 
        planning council, which shall include representatives 
        of Federal, State, and local agencies (including as an 
        ex officio member, if there is located in such State 
        one or more hospitals or other health care facilities 
        of the Department of Veterans Affairs, the individual 
        whom the Secretary of Veterans Affairs shall have 
        designated to serve on such council as the 
        representative of the hospitals or other health care 
        facilities of such Department which are located in such 
        State) and nongovernmental organizations and groups 
        concerned with health (including representation of the 
        regional medical program or programs included in whole 
        or in part within the State) and of consumers of health 
        services, to advise such State agency in carrying out 
        its functions under the plan, and a majority of the 
        membership of such council shall consist of 
        representatives of consumers of health services;
            (C) set forth policies and procedures for the 
        expenditure of funds under the plan, which, in the 
        judgment of the Secretary, are designed to provide for 
        comprehensive State planning for health services (both 
        public and private and including home health care), 
        including the facilities and persons required for the 
        provision of such services, to meet the health needs of 
        the people of the State and including environmental 
        considerations as they relate to public health;
            (D) provide for encouraging cooperative efforts 
        among governmental or nongovernmental agencies, 
        organizations and groups concerned with health 
        services, facilities, or manpower, and for cooperative 
        efforts between such agencies, organizations, and 
        groups and similar agencies, organizations, and groups 
        in the fields of education, welfare, and 
        rehabilitation;
            (E) contain or be supported by assurances 
        satisfactory to the Secretary that the funds paid under 
        this subsection will be used to supplement and, to the 
        extent practicable, to increase the level of funds that 
        would otherwise be made available by the State for the 
        purpose of comprehensive health planning and not to 
        supplant such non-Federal funds;
            (F) \1\ provide such methods of administration 
        (including methods relating to the establishment and 
        maintenance of personnel standards on a merit basis, 
        except that the Secretary shall exercise no authority 
        with respect to the selection, tenure of office, and 
        compensation of any individual employed in accordance 
        with such methods) as are found by the Secretary to be 
        necessary for the proper and efficient operation of the 
        plan;
---------------------------------------------------------------------------
    \1\ Section 208(a)(3) of Public Law 91-648 (42 U.S.C. 4728) 
transferred to the United States Civil Service Commission all 
functions, powers, and duties of the Secretary under any law applicable 
to a grant program which requires the establishment and maintenance of 
personnel standards on a merit basis with respect to the program. 
Reorganization Plan No. 2 of 1978 (42 U.S.C. 1101 note) transferred to 
the Office of Personnel Management all functions of the United States 
Civil Service Commission.
---------------------------------------------------------------------------
            (G) provide that the State agency will make such 
        reports, in such form and containing such information, 
        as the Secretary may from time to time reasonably 
        require, and will keep such records and afford such 
        access thereto as the Secretary finds necessary to 
        assure the correctness and verification of such 
        reports;
            (H) provide that the State agency will from time to 
        time, but not less often than annually, review its 
        State plan approved under this subsection and submit to 
        the Secretary appropriate modifications thereof;
            (I) effective July 1, 1968, (i) provide for 
        assisting each health care facility in the State to 
        develop a program for capital expenditures for 
        replacement, modernization, and expansion which is 
        consistent with an overall State plan developed in 
        accordance with criteria established by the Secretary 
        after consultation with the State which will meet the 
        needs of the State for health care facilities, 
        equipment, and services without duplication and 
        otherwise in the most efficient and economical manner, 
        and (ii) provide that the State agency furnishing such 
        assistance will periodically review the program 
        (developed pursuant to clause (i)) of each health care 
        facility in the State and recommended appropriate 
        modification thereof;
            (J) provide for such fiscal control and fund 
        accounting procedures as may be necessary to assure 
        proper disbursement of and accounting for funds paid to 
        the State under this subsection; and
            (K) contain such additional information and 
        assurances as the Secretary may find necessary to carry 
        out the purposes of this subsection.
    (3)(A) State Allotments.--From the sums appropriated for 
such purpose for each fiscal year, the several States shall be 
entitled to allotments determined, in accordance with 
regulations, on the basis of the population and the per capita 
income of the respective States; except that no such allotment 
to any State for any fiscal year shall be less than 1 per 
centum of the sum appropriated for such fiscal year pursuant to 
paragraph (1). Any such allotment to a State for a fiscal year 
shall remain available for obligation by the State, in 
accordance with the provisions of this subsection and the 
State's plan approved thereunder, until the close of the 
succeeding fiscal year.
    (B) The amount of any allotment to a State under 
subparagraph (A) for any fiscal year which the Secretary 
determines will not be required by the State, during the period 
for which it is available, for the purposes for which allotted 
shall be available for reallotment by the Secretary from time 
to time, on such date or dates as he may fix, to other States 
with respect to which such a determination has not been made, 
in proportion to the original allotments to such States under 
subparagraph (A) for such fiscal year, but with such 
proportionate amount for any of such other States being reduced 
to the extent it exceeds the sum the Secretary estimates such 
State needs and will be able to use during such period; and the 
total of such reductions shall be similarly reallotted among 
the States whose proportionate amounts were not so reduced. Any 
amount so reallotted to a State from funds appropriated 
pursuant to this subsection for a fiscal year shall be deemed 
part of its allotment under subparagraph (A) for such fiscal 
year.
    (4) Payments to States.--From each State's allotment for a 
fiscal year under this subsection, the State shall from time to 
time be paid the Federal share of the expenditures incurred 
during that year or the succeeding year pursuant to its State 
plan approved under this subsection. Such payments shall be 
made on the basis of estimates by the Secretary of the sums the 
State will need in order to perform the planning under its 
approved State plan under this subsection, but with such 
adjustments as may be necessary to take account of previously 
made underpayments or overpayments. The ``Federal share'' for 
any State for purposes of this subsection shall be all, or such 
part as the Secretary may determine, of the cost of such 
planning, except that in the case of the allotments for the 
fiscal year ending June 30, 1970, it shall not exceed 75 per 
centum, of such cost.

              Project Grants for Areawide Health Planning

    (b)(1)(A) The Secretary is authorized, during the period 
beginning July 1, 1966, and ending June 30, 1974, to make, with 
the approval of the State agency administering or supervising 
the administration of the State plan approved under subsection 
(a), project grants to any other public or nonprofit private 
agency or organization (but with appropriate representation of 
the interests of local government where the recipient of the 
grant is not a local government or combination thereof or an 
agency of such government or combination) to cover not to 
exceed 75 per centum of the costs of projects for developing 
(and from time to time revising) comprehensive regional, 
metropolitan area, or other local area plans for coordination 
of existing and planned health services, including the 
facilities and persons required for provision of such services; 
and including the provision of such services through home 
health care; except that in the case of project grants made in 
any State prior to July 1, 1968, approval of such State agency 
shall be required only if such State has such a State plan in 
effect at the time of such grants. No grant may be made under 
this subsection after June 30, 1970, to any agency or 
organization to develop or revise health plans for an area 
unless the Secretary determines that such agency or 
organization provides means for appropriate representation of 
the interests of the hospitals, other health care facilities, 
and practicing physicians serving such area, and the general 
public. For the purposes of carrying out this subsection, there 
are hereby authorized to be appropriated $5,000,000 for the 
fiscal year ending June 30, 1967, $7,500,000 for the fiscal 
year ending June 30, 1968, $10,000,000 for the fiscal year 
ending June 30, 1969, $15,000,000 for the fiscal year ending 
June 30, 1970, $20,000,000 for the fiscal year ending June 30, 
1971, $30,000,000 for the fiscal year ending June 30, 1972, 
$40,000,000 for the fiscal year ending June 30, 1973, and 
$25,100,000 for the fiscal year ending June 30, 1974.
    (B) Project grants may be made by the Secretary under 
subparagraph (A) to the State agency administering or 
supervising the administration of the State plan approved under 
subsection (a) with respect to a particular region or area, but 
only if (i) no application for such a grant with respect to 
such region or area has been filed by any other agency or 
organization qualified to receive such a grant, and (ii) such 
State agency certifies, and the Secretary finds, that ample 
opportunity has been afforded to qualified agencies and 
organizations to file application for such a grant with respect 
to such region or area and that it is improbable that, in the 
foresee-able future, any agency or organization which is 
qualified for such a grant will file application therefor.
    (2)(A) In order to be approved under this subsection, an 
application for a grant under this subsection must contain or 
be supported by reasonable assurances that there has been or 
will be established, in or for the area with respect to which 
such grant is sought, an areawide health planning council. The 
membership of such council shall include representatives of 
public, voluntary, and non-profit private agencies, 
institutions, and organizations concerned with health 
(including representatives of the interests of local government 
of the regional medical program for such area, and of consumers 
of health services). A majority of the members of such council 
shall consist of representatives of consumers of health 
services.
    (B) In addition, an application for a grant under this 
subsection must contain or be supported by reasonable 
assurances that the areawide health planning agency has made 
provision for assisting health care facilities in its area to 
develop a program for capital expenditures for replacement, 
modernization, and expansion, which is consistent with an 
overall State plan which will meet the needs of the State and 
the area for health care facilities, equipment, and services 
without duplication and otherwise in the most efficient and 
economical manner.

        Project Grants for Training, Studies, and Demonstrations

    (c) The Secretary is also authorized, during the period 
beginning July 1, 1966, and ending June 30, 1974, to make 
grants to any public or nonprofit private agency, institution, 
or other organization to cover all or any part of the cost of 
projects for training, studies, or demonstrations looking 
toward the development of improved or more effective 
comprehensive health planning throughout the Nation. For the 
purposes of carrying out this subsection, there are hereby 
authorized to be appropriated $1,500,000 for the fiscal year 
ending June 30, 1967, $2,500,000 for the fiscal year ending 
June 30, 1968, $5,000,000 for the fiscal year ending June 30, 
1969, $7,500,000 for the fiscal year ending June 30, 1970, 
$8,000,000 for the fiscal year ending June 30, 1971, 
$10,000,000 for the fiscal year ending June 30, 1972, 
$12,000,000 for the fiscal year ending June 30, 1973, and 
$4,700,000 for the fiscal year ending June 30, 1974.

         family support groups for alzheimer's disease patients

      Sec. 316. \1\ [247a] (a) Subject to available 
appropriations, the Secretary, acting through the National 
Institute of Mental Health, the National Institutes of Health, 
and the Administration on Aging, shall promote the 
establishment of family support groups to provide, without 
charge, educational, emotional, and practical support to assist 
individuals with Alzheimer's disease or a related memory 
disorder and members of the families of such individuals. In 
promoting the establishment of such groups, the Secretary shall 
give priority to--
---------------------------------------------------------------------------
    \1\ With respect to section 315, subsection (d) of such section 
provided as follows: ``This section shall cease to exist on March 31, 
1989.''. See section 1 of Public Law 100-471 (102 Stat. 2284).
---------------------------------------------------------------------------
            (1) university medical centers and other 
        appropriate health care facilities which receive 
        Federal funds from the Secretary and which conduct 
        research on Alzheimer's disease or provide services to 
        individuals with such disease; and
            (2) community-based programs which receive funds 
        from the Secretary, acting through the Administration 
        on Aging.
      (b) The Secretary shall promote the establishment of a 
national network to coordinate the family support groups 
described in subsection (a).

             project grants for preventive health services

    Sec. 317. [247b] (a) The Secretary may make grants to 
States, and in consultation with State health authorities, to 
political subdivisions of States and to other public entities 
to assist them in meeting the costs of establishing and 
maintaining preventive health service programs.
    (b) No grant may be made under subsection (a) unless an 
application therefor has been submitted to, and approved by, 
the Secretary. Such an application shall be in such form and be 
submitted in such manner as the Secretary shall by regulation 
prescribe and shall provide--
            (1) a complete description of the type and extent 
        of the program for which the applicant is seeking a 
        grant under subsection (a);
            (2) with respect to each such program (A) the 
        amount of Federal, State, and other funds obligated by 
        the applicant in its latest annual accounting period 
        for the provision of such program, (B) a description of 
        the services provided by the applicant in such program 
        in such period, (C) the amount of Federal funds needed 
        by the applicant to continue providing such services in 
        such program, and (D) if the applicant proposes changes 
        in the provision of the services in such program, the 
        priorities of such proposed changes, reasons for such 
        changes, and the amount of Federal funds needed by the 
        applicant to make such changes;
            (3) assurances satisfactory to the Secretary that 
        the program which will be provided with funds under a 
        grant under subsection (a) will be provided in a manner 
        consistent with the State health plan in effect under 
        section 1524(c) and in those cases where the applicant 
        is a State, that such program will be provided, where 
        appropriate, in a manner consistent with any plans in 
        effect under an application approved under section 315;
            (4) assurances satisfactory to the Secretary that 
        the applicant will provide for such fiscal control and 
        fund accounting procedures as the Secretary by 
        regulation prescribes to assure the proper disbursement 
        of and accounting for funds received under grants under 
        subsection (a);
            (5) assurances satisfactory to the Secretary that 
        the applicant will provide for periodic evaluation of 
        its program or programs;
            (6) assurances satisfactory to the Secretary that 
        the applicant will make such reports (in such form and 
        containing such information as the Secretary may by 
        regulation prescribe) as the Secretary may reasonably 
        require and keep such records and afford such access 
        thereto as the Secretary may find necessary to assure 
        the correctness of, and to verify, such reports;
            (7) assurances satisfactory to the Secretary that 
        the applicant will comply with any other conditions 
        imposed by this section with respect to grants; and
            (8) such other information as the Secretary may by 
        regulation prescribe.
    (c)(1) The Secretary shall not approve an application 
submitted under subsection (b) for a grant for a program for 
which a grant was previously made under subsection (a) unless 
the Secretary determines--
            (A) the program for which the application was 
        submitted is operating effectively to achieve its 
        stated purpose,
            (B) the applicant complied with the assurances 
        provided the Secretary when applying for such previous 
        grant, and
            (C) the applicant will comply with the assurances 
        provided with the application.
    (2) The Secretary shall review annually the activities 
undertaken by each recipient of a grant under subsection (a) to 
determine if the program assisted by such grant is operating 
effectively to achieve its stated purposes and if the recipient 
is in compliance with the assurances provided the Secretary 
when applying for such grant.
    (d) The amount of a grant under subsection (a) shall be 
determined by the Secretary. Payments under such grants may be 
made in advance on the basis of estimates or by the way of 
reimbursement, with necessary adjustments on account of 
underpayments or overpayments, and in such installments and on 
such terms and conditions as the Secretary finds necessary to 
carry out the purposes of such grants.
    (e) The Secretary, at the request of a recipient of a grant 
under subsection (a), may reduce the amount of such grant by--
            (1) the fair market value of any supplies 
        (including vaccines and other preventive agents) or 
        equipment furnished the grant recipient, and
            (2) the amount of the pay, allowances, and travel 
        expenses of any officer or employee of the Government 
        when detailed to the grant recipient and the amount of 
        any other costs incurred in connection with the detail 
        of such officer or employee.
When the furnishing of such supplies or equipment or the detail 
of such an officer or employee is for the convenience of and at 
the request of such grant recipient and for the purpose of 
carrying out a program with respect to which the grant under 
subsection (a) is made. The amount by which any such grant is 
so reduced shall be available for payment by the Secretary of 
the costs incurred in furnishing the supplies or equipment, or 
in detailing the personnel, on which the reduction of such 
grant is based, and such amount shall be deemed as part of the 
grant and shall be deemed to have been paid to the grant 
recipient.
    (f)(1) Each recipient of a grant under subsection (a) shall 
keep such records as the Secretary shall by regulation 
prescribe, including records which fully disclose the amount 
and disposition by such recipient of the proceeds of such 
grant, the total cost of the undertaking in connection with 
which such grant was made, and the amount of that portion of 
the cost of the undertaking supplied by other sources, and such 
other records as will facilitate an effective audit.
    (2) The Secretary and the Comptroller General of the United 
States, or any of their duly authorized representatives, shall 
have access for the purpose of audit and examination to any 
books, documents, papers, and records of the recipient of 
grants under subsection (a) that are pertinent to such grants.
    (g)(1) Nothing in this section shall limit or otherwise 
restrict the use of funds which are granted to a State or to an 
agency or a political subdivision of a State under provisions 
of Federal law (other than this section) and which are 
available for the conduct of preventive health service programs 
from being used on connection with programs assisted through 
grants under subsection (a).
    (2) Nothing in this section shall be construed to require 
any State or any agency or political subdivision of a State to 
have a preventive health service program which would require 
any person, who objects to any treatment provided under such a 
program, to be treated or to have any child or ward treated 
under such program.
    (h) The Secretary shall include, as part of the report 
required by section 1705, a report on the extent of the 
problems presented by the diseases and conditions referred to 
in subsection (j) on the amount of funds obligated under grants 
under subsection (a) in the preceding fiscal year for each of 
the programs listed in subsection (j); and on the effectiveness 
of the activities assisted under grants under subsection (a) in 
controlling such diseases and conditions.
    (i) The Secretary may provide technical assistance to 
States, State health authorities, and other public entities in 
connection with the operation of their preventive health 
service programs.
    (j)(1) Except for grants for immunization programs the 
authorization of appropriations for which are established in 
paragraph (2), for grants under subsections (a) and (k)(1) for 
preventive health service programs to immunize without charge 
children, adolescents, and adults against vaccine-preventable 
diseases, there are authorized to be appropriated such sums as 
may be necessary. Not more than 10 percent ot the total amount 
appropriated under the preceding sentence for any fiscal year 
shall be available for grants under subsection (k)(1) for such 
fiscal year.
    (2) For grants under subsection (a) for preventive health 
service programs for the provision without charge of 
immunizations with vaccines approved for use, and recommended 
for routine use, there are authorized to be appropriated such 
sums as may be necessary.
    (k)(1) The Secretary may make grants to States, political 
subdivisions of States, and other public and nonprofit private 
entities for--
            (A) research into the prevention and control of 
        diseases that may be prevented through vaccination;
            (B) demonstration projects for the prevention and 
        control of such diseases;
            (C) public information and education programs for 
        the prevention and control of such diseases; and
            (D) education, training, and clinical skills 
        improvement activities in the prevention and control of 
        such diseases for health professionals (including 
        allied health personnel).
    (2) The Secretary may make grants to States, political 
subdivisions of States, and other public and nonprofit private 
entities for--
            (A) research into the prevention and control of 
        diseases and conditions;
            (B) demonstration projects for the prevention and 
        control of such diseases and conditions;
            (C) public information and education programs for 
        the prevention and control of such diseases and 
        conditions; and
            (D) education, training, and clinical skills 
        improvement activities in the prevention and control of 
        such diseases and conditions for health professionals 
        (including allied health personnel).
    (3) No grant may be made under this subsection unless an 
application therefor is submitted to the Secretary in such 
form, at such time, and containing such information as the 
Secretary may by regulation prescribe.
    (4) Subsections (d), (e), and (f) shall apply to grants 
under this subsection in the same manner as such subsections 
apply to grants under subsection (a).
    (l) Authority to Purchase Recommended Vaccines for 
Adults.--
            (1) In general.--The Secretary may negotiate and 
        enter into contracts with manufacturers of vaccines for 
        the purchase and delivery of vaccines for adults as 
        provided for under subsection (e).
            (2) State purchase.--A State may obtain additional 
        quantities of such adult vaccines (subject to amounts 
        specified to the Secretary by the State in advance of 
        negotiations) through the purchase of vaccines from 
        manufacturers at the applicable price negotiated by the 
        Secretary under this subsection.
    (m) Demonstration Program To Improve Immunization 
Coverage.--
            (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, shall establish a demonstration program to 
        award grants to States to improve the provision of 
        recommended immunizations for children, adolescents, 
        and adults through the use of evidence-based, 
        population-based interventions for high-risk 
        populations.
            (2) State plan.--To be eligible for a grant under 
        paragraph (1), a State shall submit to the Secretary an 
        application at such time, in such manner, and 
        containing such information as the Secretary may 
        require, including a State plan that describes the 
        interventions to be implemented under the grant and how 
        such interventions match with local needs and 
        capabilities, as determined through consultation with 
        local authorities.
            (3) Use of funds.--Funds received under a grant 
        under this subsection shall be used to implement 
        interventions that are recommended by the Task Force on 
        Community Preventive Services (as established by the 
        Secretary, acting through the Director of the Centers 
        for Disease Control and Prevention) or other evidence-
        based interventions, including--
                    (A) providing immunization reminders or 
                recalls for target populations of clients, 
                patients, and consumers;
                    (B) educating targeted populations and 
                health care providers concerning immunizations 
                in combination with one or more other 
                interventions;
                    (C) reducing out-of-pocket costs for 
                families for vaccines and their administration;
                    (D) carrying out immunization-promoting 
                strategies for participants or clients of 
                public programs, including assessments of 
                immunization status, referrals to health care 
                providers, education, provision of on-site 
                immunizations, or incentives for immunization;
                    (E) providing for home visits that promote 
                immunization through education, assessments of 
                need, referrals, provision of immunizations, or 
                other services;
                    (F) providing reminders or recalls for 
                immunization providers;
                    (G) conducting assessments of, and 
                providing feedback to, immunization providers;
                    (H) any combination of one or more 
                interventions described in this paragraph; or
                    (I) immunization information systems to 
                allow all States to have electronic databases 
                for immunization records.
            (4) Consideration.--In awarding grants under this 
        subsection, the Secretary shall consider any reviews or 
        recommendations of the Task Force on Community 
        Preventive Services.
            (5) Evaluation.--Not later than 3 years after the 
        date on which a State receives a grant under this 
        subsection, the State shall submit to the Secretary an 
        evaluation of progress made toward improving 
        immunization coverage rates among high-risk populations 
        within the State.
            (6) Report to congress.--Not later than 4 years 
        after the date of enactment of the Affordable Health 
        Choices Act, the Secretary shall submit to Congress a 
        report concerning the effectiveness of the 
        demonstration program established under this subsection 
        together with recommendations on whether to continue 
        and expand such program.
            (7) Authorization of appropriations.--There is 
        authorized to be appropriated to carry out this 
        subsection, such sums as may be necessary for each of 
        fiscal years 2010 through 2014.
     screenings, referrals, and education regarding lead poisoning
    Sec. 317A. [247b-1] (a) Authority for Grants.--
            (1) In general.--Subject to paragraph (2), the 
        Secretary, acting through the Director of the Centers 
        for Disease Control and Prevention, may make grants to 
        States and political subdivisions of States for the 
        initiation and expansion of community programs 
        designed--
                    (A) to provide, for infants and children--
                            (i) screening for elevated blood 
                        lead levels;
                            (ii) referral for treatment of such 
                        levels; and
                            (iii) referral for environmental 
                        intervention associated with such 
                        levels; and
                    (B) to provide education about childhood 
                lead poisoning.
            (2) Authority regarding certain entities.--With 
        respect to a geographic area with a need for activities 
        authorized in paragraph (1), in any case in which 
        neither the State nor the political subdivision in 
        which such area is located has applied for a grant 
        under paragraph (1), the Secretary may make a grant 
        under such paragraph to any grantee under section 329, 
        330, or 340A for carrying out such activities in the 
        area.
            (3) Provision of all services and activities 
        through each grantee.--In making grants under paragraph 
        (1), the Secretary shall ensure that each of the 
        activities described in such paragraph is provided 
        through each grantee under such paragraph. The 
        Secretary may authorize such a grantee to provide the 
        services and activities directly, or through 
        arrangements with other providers.
    (b) Status as Medicaid Provider.--
            (1) In general.--Subject to paragraph (2), the 
        Secretary may not make a grant under subsection (a) 
        unless, in the case of any service described in such 
        subsection that is made available pursuant to the State 
        plan approved under title XIX of the Social Security 
        Act for the State involved--
                    (A) the applicant for the grant will 
                provide the service directly, and the applicant 
                has entered into a participation agreement 
                under the State plan and is qualified to 
                receive payments under such plan; or
                    (B) the applicant will enter into an 
                agreement with a provider under which the 
                provider will provide the service, and the 
                provider has entered into such a participation 
                agreement and is qualified to receive such 
                payments.
            (2) Waiver regarding certain secondary 
        agreements.--
                    (A) In the case of a provider making an 
                agreement pursuant to paragraph (1)(B) 
                regarding the provision of services, the 
                requirement established in such paragraph 
                regarding a participation agreement shall be 
                waived by the Secretary if the provider does 
                not, in providing health care services, impose 
                a charge or accept reimbursement available from 
                any third-party payor, including reimbursement 
                under any insurance policy or under any Federal 
                or State health benefits plan.
                    (B) A determination by the Secretary of 
                whether a provider referred to in subparagraph 
                (A) meets the criteria for a waiver under such 
                subparagraph shall be made without regard to 
                whether the provider accepts voluntary 
                donations regarding the provision of services 
                to the public.
    (c) Priority in Making Grants.--In making grants under 
subsection (a), the Secretary shall give priority to 
applications for programs that will serve areas with a high 
incidence of elevated blood lead levels in infants and 
children.
    (d) Grant Application.--No grant may be made under 
subsection (a), unless an application therefor has been 
submitted to, and approved by, the Secretary. Such an 
application shall be in such form and shall be submitted in 
such manner as the Secretary shall prescribe and shall include 
each of the following:
            (1) A complete description of the program which is 
        to be provided by or through the applicant.
            (2) Assurances satisfactory to the Secretary that 
        the program to be provided under the grant applied for 
        will include educational programs designed to--
                    (A) communicate to parents, educators, and 
                local health officials the significance and 
                prevalence of lead poisoning in infants and 
                children (including the sources of lead 
                exposure, the importance of screening young 
                children for lead, and the preventive steps 
                that parents can take in reducing the risk of 
                lead poisoning) which the program is designed 
                to detect and prevent; and
                    (B) communicate to health professionals and 
                paraprofessionals updated knowledge concerning 
                lead poisoning and research (including the 
                health consequences, if any, of low-level lead 
                burden; the prevalence of lead poisoning among 
                all socioeconomic groupings; the benefits of 
                expanded lead screening; and the therapeutic 
                and other interventions available to prevent 
                and combat lead poisoning in affected children 
                and families).
            (3) Assurances satisfactory to the Secretary that 
        the applicant will report on a quarterly basis the 
        number of infants and children screened for elevated 
        blood lead levels, the number of infants and children 
        who were found to have elevated blood lead levels, the 
        number and type of medical referrals made for such 
        infants and children, the outcome of such referrals, 
        and other information to measure program effectiveness.
            (4) Assurances satisfactory to the Secretary that 
        the applicant will make such reports respecting the 
        program involved as the Secretary may require.
            (5) Assurances satisfactory to the Secretary that 
        the applicant will coordinate the activities carried 
        out pursuant to subsection (a) with related activities 
        and services carried out in the State by grantees under 
        title V or XIX of the Social Security Act.
            (6) Assurances satisfactory to the Secretary that 
        Federal funds made available under such a grant for any 
        period will be so used as to supplement and, to the 
        extent practical, increase the level of State, local, 
        and other non-Federal funds that would, in the absence 
        of such Federal funds, be made available for the 
        program for which the grant is to be made and will in 
        no event supplant such State, local, and other non-
        Federal funds.
            (7) Assurances satisfactory to the Secretary that 
        the applicant will ensure complete and consistent 
        reporting of all blood lead test results from 
        laboratories and health care providers to State and 
        local health departments in accordance with guidelines 
        of the Centers for Disease Control and Prevention for 
        standardized reporting as described in subsection (m).
            (8) Such other information as the Secretary may 
        prescribe.
    (e) Relationship to Services and Activities Under Other 
Programs.--
            (1) In general.--A recipient of a grant under 
        subsection (a) may not make payments from the grant for 
        any service or activity to the extent that payment has 
        been made, or can reasonably be expected to be made, 
        with respect to such service or activity--
                    (A) under any State compensation program, 
                under an insurance policy, or under any Federal 
                or State health benefits program; or
                    (B) by an entity that provides health 
                services on a prepaid basis.
            (2) Applicability to certain secondary agreements 
        for provision of services.--Paragraph (1) shall not 
        apply in the case of a provider through which a grantee 
        under subsection (a) provides services under such 
        subsection if the Secretary has provided a waiver under 
        subsection (b)(2) regarding the provider.
    (f) Method and Amount of Payment.--The Secretary shall 
determine the amount of a grant made under subsection (a). 
Payments under such grants may be made in advance on the basis 
of estimates or by way of reimbursement, with necessary 
adjustments on account of underpayments or overpayments, and in 
such installments and on such terms and conditions as the 
Secretary finds necessary to carry out the purposes of such 
grants. Not more than 10 percent of any grant may be obligated 
for administrative costs.
    (g) Supplies, Equipment, and Employee Detail.--The 
Secretary, at the request of a recipient of a grant under 
subsection (a), may reduce the amount of such grant by--
            (1) the fair market value of any supplies or 
        equipment furnished the grant recipient; and
            (2) the amount of the pay, allowances, and travel 
        expenses of any officer or employee of the Government 
        when detailed to the grant recipient and the amount of 
        any other costs incurred in connection with the detail 
        of such officer or employee;
when the furnishing of such supplies or equipment or the detail 
of such an officer or employee is for the convenience of and at 
the request of such grant recipient and for the purpose of 
carrying out a program with respect to which the grant under 
subsection (a) is made. The amount by which any such grant is 
so reduced shall be available for payment by the Secretary of 
the costs incurred in furnishing the supplies or equipment, or 
in detailing the personnel, on which the reduction of such 
grant is based, and such amount shall be deemed as part of the 
grant and shall be deemed to have been paid to the grant 
recipient.
    (h) Records.--Each recipient of a grant under subsection 
(a) shall keep such records as the Secretary shall prescribe, 
including records which fully disclose the amount and 
disposition by such recipient of the proceeds of such grant, 
the total cost of the undertaking in connection with which such 
grant was made, and the amount of that portion of the cost of 
the undertaking supplied by other sources, and such other 
records as will facilitate an effective audit.
    (i) Audit and Examination of Records.--The Secretary and 
the Comptroller General of the United States, or any of their 
duly authorized representatives, shall have access for the 
purpose of audit and examination to any books, documents, 
papers, and records of the recipient of a grant under 
subsection (a), that are pertinent to such grant.
    (j) Annual Report.--
            (1) In general.--Not later than May 1 of each year, 
        the Secretary shall submit to the Congress a report on 
        the effectiveness during the preceding fiscal year of 
        programs carried out with grants under subsection (a) 
        and of any programs that are carried out by the 
        Secretary pursuant to subsection (l)(2).
            (2) Certain requirements.--Each report under 
        paragraph (1) shall include, in addition to any other 
        information that the Secretary may require, the 
        following information:
                    (A) The number of infants and children 
                screened.
                    (B) Demographic information on the 
                population of infants and children screened, 
                including the age and racial or ethnic status 
                of such population.
                    (C) The number of screening sites.
                    (D) A description of the severity of the 
                extent of the blood lead levels of the infants 
                and children screened, expressed in categories 
                of severity.
                    (E) The sources of payment for the 
                screenings.
                    (F) The number of grantees that have 
                established systems to ensure mandatory 
                reporting of all blood lead tests from 
                laboratories and health care providers to State 
                and local health departments.
                    (G) A comparison of the data provided 
                pursuant to subparagraphs (A) through (F) with 
                the equivalent data, if any, provided in the 
                report under paragraph (1) preceding the report 
                involved.
    (k) Indian Tribes.--For purposes of this section, the term 
``political subdivision'' includes Indian tribes.
    (l) Funding.--
            (1) Authorization of appropriations.--For the 
        purpose of carrying out this section, there are 
        authorized to be appropriated $40,000,000 for fiscal 
        year 1993, and such sums as may be necessary for each 
        of the fiscal years 1994 through 2005.
            (2) Allocation for other programs.--Of the amounts 
        appropriated under paragraph (1) for any fiscal year, 
        the Secretary may reserve not more than 20 percent for 
        carrying out programs regarding the activities 
        described in subsection (a) in addition to the program 
        of grants established in such subsection.
    (m) Guidelines for Standardized Reporting.--The Secretary, 
acting through the Director of the Centers for Disease Control 
and Prevention, shall develop national guidelines for the 
uniform reporting of all blood lead test results to State and 
local health departments.
   education, technology assessment, and epidemiology regarding lead 
                               poisoning
    Sec. 317B. [247b-3] (a) Prevention.--
            (1) Public education.--The Secretary, acting 
        through the Director of the Centers for Disease Control 
        and Prevention, shall carry out a program to educate 
        health professionals and paraprofessionals and the 
        general public on the prevention of lead poisoning in 
        infants and children. In carrying out the program, the 
        Secretary shall make available information concerning 
        the health effects of low-level lead toxicity, the 
        causes of lead poisoning, and the primary and secondary 
        preventive measures that may be taken to prevent such 
        poisoning.
            (2) Interagency task force.--
                    (A) Not later than 6 months after the date 
                of the enactment of the Preventive Health 
                Amendments of 1992 \1\, the Secretary shall 
                establish a council to be known as the 
                Interagency Task Force on the Prevention of 
                Lead Poisoning (in this paragraph referred to 
                as the ``Task Force''). The Task Force shall 
                coordinate the efforts of Federal agencies to 
                prevent lead poisoning.
---------------------------------------------------------------------------
    \1\ Enacted October 27, 1992.
---------------------------------------------------------------------------
                    (B) The Task Force shall be composed of--
                            (i) the Secretary, who shall serve 
                        as the chair of the Task Force;
                            (ii) the Secretary of Housing and 
                        Urban Development;
                            (iii) the Administrator of the 
                        Environmental Protection Agency; and
                            (iv) senior staff of each of the 
                        officials specified in clauses (i) 
                        through (iii), as selected by the 
                        officials respectively.
                    (C) The Task Force shall--
                            (i) review, evaluate, and 
                        coordinate current strategies and plans 
                        formulated by the officials serving as 
                        members of the Task Force, including--
                                    (I) the plan of the 
                                Secretary of Health and Human 
                                Services entitled ``Strategic 
                                Plan for the Elimination of 
                                Lead Poisoning'', dated 
                                February 21, 1991;
                                    (II) the plan of the 
                                Secretary of Housing and Urban 
                                Development entitled 
                                ``Comprehensive and Workable 
                                Plan for the Abatement of Lead-
                                Based Paint in Privately Owned 
                                Housing'', dated December 7, 
                                1990; and
                                    (III) the strategy of the 
                                Administrator of the 
                                Environmental Protection Agency 
                                entitled ``Strategy for 
                                Reducing Lead Exposures'', 
                                dated February 21, 1991;
                            (ii) develop a unified 
                        implementation plan for programs that 
                        receive Federal financial assistance 
                        for activities related to the 
                        prevention of lead poisoning;
                            (iii) establish a mechanism for 
                        sharing and disseminating information 
                        among the agencies represented on the 
                        Task Force;
                            (iv) identify the most promising 
                        areas of research and education 
                        concerning lead poisoning;
                            (v) identify the practical and 
                        technological constraints to expanding 
                        lead poisoning prevention;
                            (vi) annually carry out a 
                        comprehensive review of Federal 
                        programs providing assistance to 
                        prevent lead poisoning, and not later 
                        than May 1 of each year, submit to the 
                        Committee on Labor and Human Resources 
                        of the Senate and the Committee on the 
                        Environment and Public Works of the 
                        Senate, and to the Committee on Energy 
                        and Commerce of the House of 
                        Representatives, a report that 
                        summarizes the findings made as a 
                        result of such review and that contains 
                        the recommendations of the Task Force 
                        on the programs and policies with 
                        respect to which the Task Force is 
                        established, including related 
                        budgetary recommendations; and
                            (vii) annually review and 
                        coordinate departmental and agency 
                        budgetary requests with respect to all 
                        lead poisoning prevention activities of 
                        the Federal   Government.
    (b) Technology Assessment and Epidemiology.--The Secretary, 
acting through the Director of the Centers for Disease Control 
and Prevention, shall, directly or through grants or 
contracts--
            (1) provide for the development of improved, more 
        cost-effective testing measures for detecting lead 
        toxicity in children;
            (2) provide for the development of improved methods 
        of assessing the prevalence of lead poisoning, 
        including such methods as may be necessary to conduct 
        individual assessments for each State;
            (3) provide for the collection of data on the 
        incidence and prevalence of lead poisoning of infants 
        and children, on the demographic characteristics of 
        infants and children with such poisoning (including 
        racial and ethnic status), and on the source of payment 
        for treatment for such poisoning (including the extent 
        to which insurance has paid for such treatment); and
            (4) provide for any applied research necessary to 
        improve the effectiveness of programs for the 
        prevention of lead poisoning in infants and children.
    national center on birth defects and developmental disabilities
    Sec. 317C. [247b-4] (a) In General.--
            (1) National center.--There is established within 
        the Centers for Disease Control and Prevention a center 
        to be known as the National Center on Birth Defects and 
        Developmental Disabilities (referred to in this section 
        as the ``Center''), which shall be headed by a director 
        appointed by the Director of the Centers for Disease 
        Control and Prevention.
            (2) General duties.--The Secretary shall carry out 
        programs--
                    (A) to collect, analyze, and make available 
                data on birth defects, developmental 
                disabilities, and disabilities and health (in a 
                manner that facilitates compliance with 
                subsection (c)(2)), including data on the 
                causes of such defects and disabilities and on 
                the incidence and prevalence of such defects 
                and disabilities;
                    (B) to operate regional centers for the 
                conduct of applied epidemiological research on 
                the prevention of such defects and 
                disabilities;
                    (C) to provide information and education to 
                the public on the prevention of such defects 
                and disabilities;
                    (D) to conduct research on and to promote 
                the prevention of such defects and 
                disabilities, and secondary health conditions 
                among individuals with disabilities; and
                    (E) to support a National Spina Bifida 
                Program to prevent and reduce suffering from 
                the Nation's most common permanently disabling 
                birth defect.
            (3) Folic acid.--The Secretary shall carry out 
        section 317J through the Center.
            (4) Certain programs.--
                    (A) Transfers.--All programs and functions 
                described in subparagraph (B) are transferred 
                to the Center, effective upon the expiration of 
                the 180-day period beginning on the date of the 
                enactment of the Children's Health Act of 2000 
                \1\.
---------------------------------------------------------------------------
    \1\ Public Law 106-310, enacted October 17, 2000.
---------------------------------------------------------------------------
                    (B) Relevant programs.--The programs and 
                functions described in this subparagraph are 
                all programs and functions that--
                            (i) relate to birth defects; folic 
                        acid; cerebral palsy; mental 
                        retardation; child development; newborn 
                        screening; autism; fragile X syndrome; 
                        fetal alcohol syndrome; pediatric 
                        genetic disorders; disability 
                        prevention; or other relevant diseases, 
                        disorders, or conditions as determined 
                        the Secretary; and
                            (ii) were carried out through the 
                        National Center for Environmental 
                        Health as of the day before the date of 
                        the enactment of the Act referred to in 
                        subparagraph (A).
                    (C) Related transfers.--Personnel employed 
                in connection with the programs and functions 
                specified in subparagraph (B), and amounts 
                available for carrying out the programs and 
                functions, are transferred to the Center, 
                effective upon the expiration of the 180-day 
                period beginning on the date of the enactment 
                of the Act referred to in subparagraph (A). 
                Such transfer of amounts does not affect the 
                period of availability of the amounts, or the 
                availability of the amounts with respect to the 
                purposes for which the amounts may be expended.
    (b) Grants and Contracts.--
            (1) In general.--In carrying out subsection (a), 
        the Secretary may make grants to and enter into 
        contracts with public and nonprofit private entities.
            (2) Supplies and services in lieu of award funds.--
                    (A) Upon the request of a recipient of an 
                award of a grant or contract under paragraph 
                (1), the Secretary may, subject to subparagraph 
                (B), provide supplies, equipment, and services 
                for the purpose of aiding the recipient in 
                carrying out the purposes for which the award 
                is made and, for such purposes, may detail to 
                the recipient any officer or employee of the 
                Department of Health and Human Services.
                    (B) With respect to a request described in 
                subparagraph (A), the Secretary shall reduce 
                the amount of payments under the award involved 
                by an amount equal to the costs of detailing 
                personnel and the fair market value of any 
                supplies, equipment, or services provided by 
                the Secretary. The Secretary shall, for the 
                payment of expenses incurred in complying with 
                such request, expend the amounts withheld.
            (3) Application for award.--The Secretary may make 
        an award of a grant or contract under paragraph (1) 
        only if an application for the award is submitted to 
        the Secretary and the application is in such form, is 
        made in such manner, and contains such agreements, 
        assurances, and information as the Secretary determines 
        to be necessary to carry out the purposes for which the 
        award is to be made.
    (c) Biennial Report.--Not later than February 1 of fiscal 
year 1999 and of every second such year thereafter, the 
Secretary shall submit to the Committee on Commerce of the 
House of Representatives, and the Committee on Labor and Human 
Resources of the Senate, a report that, with respect to the 
preceding 2 fiscal years--
            (1) contains information regarding the incidence 
        and prevalence of birth defects, developmental 
        disabilities, and the health status of individuals with 
        disabilities and the extent to which these conditions 
        have contributed to the incidence and prevalence of 
        infant mortality and affected quality of life;
            (2) contains information under paragraph (1) that 
        is specific to various racial and ethnic groups 
        (including Hispanics, non-Hispanic whites, Blacks, 
        Native Americans, and Asian Americans);
            (3) contains an assessment of the extent to which 
        various approaches of preventing birth defects, 
        developmental disabilities, and secondary health 
        conditions among individuals with disabilities have 
        been effective;
            (4) describes the activities carried out under this 
        section;
            (5) contains information on the incidence and 
        prevalence of individuals living with birth defects and 
        disabilities or developmental disabilities, information 
        on the health status of individuals with disabilities, 
        information on any health disparities experienced by 
        such individuals, and recommendations for improving the 
        health and wellness and quality of life of such 
        individuals;
            (6) contains a summary of recommendations from all 
        birth defects research conferences sponsored by the 
        Centers for Disease Control and Prevention, including 
        conferences related to spina bifida; and
            (7) contains any recommendations of the Secretary 
        regarding this section.
    (d) Applicability of Privacy Laws.--The provisions of this 
section shall be subject to the requirements of section 552a of 
title 5, United States Code. All Federal laws relating to the 
privacy of information shall apply to the data and information 
that is collected under this section.
    (e) Advisory Committee.--Notwithstanding any other 
provision of law, the members of the advisory committee 
appointed by the Director of the National Center for 
Environmental Health that have expertise in birth defects, 
developmental disabilities, and disabilities and health shall 
be transferred to and shall advise the National Center on Birth 
Defects and Developmental Disabilities effective on the date of 
enactment of the Birth Defects and Developmental Disabilities 
Prevention Act of 2003.
    (f) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of fiscal 
years 2003 through 2007.
       preventive health measures with respect to prostate cancer
    Sec. 317D. [247b-5] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, may make grants to States and local health 
departments for the purpose of enabling such States and 
departments to carry out programs that may include the 
following:
            (1) To identify factors that influence the 
        attitudes or levels of awareness of men and health care 
        practitioners regarding screening for prostate cancer.
            (2) To evaluate, in consultation with the Agency 
        for Health Care Policy and Research and the National 
        Institutes of Health, the effectiveness of screening 
        strategies for prostate cancer.
            (3) To identify, in consultation with the Agency 
        for Health Care Policy and Research, issues related to 
        the quality of life for men after prostrate cancer 
        screening and followup.
            (4) To develop and disseminate public information 
        and education programs for prostate cancer, including 
        appropriate messages about the risks and benefits of 
        prostate cancer screening for the general public, 
        health care providers, policy makers and other 
        appropriate individuals.
            (5) To improve surveillance for prostate cancer.
            (6) To address the needs of underserved and 
        minority populations regarding prostate cancer.
            (7) Upon a determination by the Secretary, who 
        shall take into consideration recommendations by the 
        United States Preventive Services Task Force and shall 
        seek input, where appropriate, from professional 
        societies and other private and public entities, that 
        there is sufficient consensus on the effectiveness of 
        prostate cancer screening--
                    (A) to screen men for prostate cancer as a 
                preventive health measure;
                    (B) to provide appropriate referrals for 
                the medical treatment of men who have been 
                screened under subparagraph (A) and to ensure, 
                to the extent practicable, the provision of 
                appropriate followup services and support 
                services such as case management;
                    (C) to establish mechanisms through which 
                State and local health departments can monitor 
                the quality of screening procedures for 
                prostate cancer, including the interpretation 
                of such procedures; and
                    (D) to improve, in consultation with the 
                Health Resources and Services Administration, 
                the education, training, and skills of health 
                practitioners (including appropriate allied 
                health professionals) in the detection and 
                control of prostate cancer.
            (8) To evaluate activities conducted under 
        paragraphs (1) through (7) through appropriate 
        surveillance or program monitoring activities.
    (b) Requirement of Matching Funds.--
            (1) In general.--The Secretary may not make a grant 
        under subsection (a) unless the applicant involved 
        agrees, with respect to the costs to be incurred by the 
        applicant in carrying out the purpose described in such 
        section, to make available non-Federal contributions 
        (in cash or in kind under paragraph (2)) toward such 
        costs in an amount equal to not less than $1 for each 
        $3 of Federal funds provided in the grant. Such 
        contributions may be made directly or through donations 
        from public or private entities.
            (2) Determination of amount of non-federal 
        contribution.--
                    (A) Non-Federal contributions required in 
                paragraph (1) may be in cash or in kind, fairly 
                evaluated, including equipment or services (and 
                excluding indirect or overhead costs). Amounts 
                provided by the Federal Government, or services 
                assisted or subsidized to any significant 
                extent by the Federal Government, may not be 
                included in determining the amount of such non-
                Federal contributions.
                    (B) In making a determination of the amount 
                of non-Federal contributions for purposes of 
                paragraph (1), the Secretary may include only 
                non-Federal contributions in excess of the 
                average amount of non-Federal contributions 
                made by the applicant involved toward the 
                purpose described in subsection (a) for the 2-
                year period preceding the fiscal year for which 
                the applicant involved is applying to receive a 
                grant under such subsection.
                    (C) In making a determination of the amount 
                of non-Federal contributions for purposes of 
                paragraph (1), the Secretary shall, subject to 
                subparagraphs (A) and (B) of this paragraph, 
                include any non-Federal amounts expended 
                pursuant to title XIX of the Social Security 
                Act by the applicant involved toward the 
                purpose described in paragraphs (1) and (2) of 
                subsection (a).
    (c) Education on Significance of Early Detection.--The 
Secretary may not make a grant under subsection (a) unless the 
applicant involved agrees that, in carrying out subsection 
(a)(3), the applicant will carry out education programs to 
communicate to men, and to local health officials, the 
significance of the early detection of prostate cancer.
    (d) Requirement of Provision of All Services by Date 
Certain.--The Secretary may not make a grant under subsection 
(a) unless the applicant involved agrees--
            (1) to ensure that, initially and throughout the 
        period during which amounts are received pursuant to 
        the grant, not less than 60 percent of the grant is 
        expended to provide each of the services or activities 
        described in paragraphs (1) and (2) of such subsection;
            (2) to ensure that, by the end of any second fiscal 
        year of payments pursuant to the grant, each of the 
        services or activities described in such subsection is 
        provided; and
            (3) to ensure that not more than 40 percent of the 
        grant is expended to provide the services or activities 
        described in paragraphs (3) through (6) of such section 
        \1\.
---------------------------------------------------------------------------
    \1\ So in law. Probably should be ``subsection''.
---------------------------------------------------------------------------
    (e) Additional Required Agreements.--
            (1) Priority for low-income men.--The Secretary may 
        not make a grant under subsection (a) unless the 
        applicant involved agrees that low-income men, and men 
        at risk of prostate cancer, will be given priority in 
        the provision of services and activities pursuant to 
        paragraphs (1) and (2) of such subsection.
            (2) Limitation on imposition of fees for 
        services.--The Secretary may not make a grant under 
        subsection (a) unless the applicant involved agrees 
        that, if a charge is imposed for the provision of 
        services or activities under the grant, such charge--
                    (A) will be made according to a schedule of 
                charges that is made available to the public;
                    (B) will be adjusted to reflect the income 
                of the man involved; and
                    (C) will not be imposed on any man with an 
                income of less than 100 percent of the official 
                poverty line, as established by the Director of 
                the Office of Management and Budget and revised 
                by the Secretary in accordance with section 
                673(2) of the Omnibus Budget Reconciliation Act 
                of 1981.
            (3) Relationship to items and services under other 
        programs.--The Secretary may not make a grant under 
        subsection (a) unless the applicant involved agrees 
        that the grant will not be expended to make payment for 
        any item or service to the extent that payment has been 
        made, or can reasonably be expected to be made, with 
        respect to such item or service--
                    (A) under any State compensation program, 
                under an insurance policy, or under any Federal 
                or State health benefits program; or
                    (B) by an entity that provides health 
                services on a prepaid basis.
            (4) Coordination with other prostate cancer 
        programs.--The Secretary may not make a grant under 
        subsection (a) unless the applicant involved agrees 
        that the services and activities funded through the 
        grant will be coordinated with other Federal, State, 
        and local prostate cancer programs.
            (5) Limitation on administrative expenses.--The 
        Secretary may not make a grant under subsection (a) 
        unless the applicant involved agrees that not more than 
        10 percent of the grant will be expended for 
        administrative expenses with respect to the grant.
            (6) Restrictions on use of grant.--The Secretary 
        may not make a grant under subsection (a) unless the 
        applicant involved agrees that the grant will not be 
        expended to provide inpatient hospital services for any 
        individual.
            (7) Records and audits.--The Secretary may not make 
        a grant under subsection (a) unless the applicant 
        involved agrees that--
                    (A) the applicant will establish such 
                fiscal control and fund accounting procedures 
                as may be necessary to ensure the proper 
                disbursal of, and accounting for, amounts 
                received by the applicant under such section; 
                and
                    (B) upon request, the applicant will 
                provide records maintained pursuant to 
                paragraph (1) to the Secretary or the 
                Comptroller of the United States for purposes 
                of auditing the expenditures by the applicant 
                of the grant.
    (f) Reports to Secretary.--The Secretary may not make a 
grant under subsection (a) unless the applicant involved agrees 
to submit to the Secretary such reports as the Secretary may 
require with respect to the grant.
    (g) Description of Intended Uses of Grant.--The Secretary 
may not make a grant under subsection (a) unless--
            (1) the applicant involved submits to the Secretary 
        a description of the purposes for which the applicant 
        intends to expend the grant;
            (2) the description identifies the populations, 
        areas, and localities in the applicant \1\ with a need 
        for the services or activities described in subsection 
        (a);
---------------------------------------------------------------------------
    \1\ So in law.
---------------------------------------------------------------------------
            (3) the description provides information relating 
        to the services and activities to be provided, 
        including a description of the manner in which the 
        services and activities will be coordinated with any 
        similar services or activities of public or nonprivate 
        entities; and
            (4) the description provides assurances that the 
        grant funds will be used in the most cost-effective 
        manner.
    (h) Requirement of Submission of Application.--The 
Secretary may not make a grant under subsection (a) unless an 
application for the grant is submitted to the Secretary, the 
application contains the description of intended uses required 
in subsection (g), and the application is in such form, is made 
in such manner, and contains such agreements, assurances, and 
information as the Secretary determines to be necessary to 
carry out this section.
    (i) Method and Amount of Payment.--The Secretary shall 
determine the amount of a grant made under subsection (a). 
Payments under such grants may be made in advance on the basis 
of estimates or by way of reimbursement, with necessary 
adjustments on account of the underpayments or overpayments, 
and in such installments and on such terms and conditions as 
the Secretary finds necessary to carry out the purposes of such 
grants.
    (j) Technical Assistance and Provision of Supplies and 
Services in Lieu of Grant Funds.--
            (1) Technical assistance.--The Secretary may 
        provide training and technical assistance with respect 
        to the planning, development, and operation of any 
        program or service carried out pursuant to subsection 
        (a). The Secretary may provide such technical 
        assistance directly or through grants to, or contracts 
        with, public and private entities.
            (2) Provision of supplies and services in lieu of 
        grant funds.--
                    (A) Upon the request of an applicant 
                receiving a grant under subsection (a), the 
                Secretary may, subject to subparagraph (B), 
                provide supplies, equipment, and services for 
                the purpose of aiding the applicant in carrying 
                out such section and, for such purpose, may 
                detail to the applicant any officer or employee 
                of the Department of Health and Human Services.
                    (B) With respect to a request described in 
                subparagraph (A), the Secretary shall reduce 
                the amount of payments under the grant under 
                subsection (a) to the applicant involved by an 
                amount equal to the costs of detailing 
                personnel (including pay, allowances, and 
                travel expenses) and the fair market value of 
                any supplies, equipment, or services provided 
                by the Secretary. The Secretary shall, for the 
                payment of expenses incurred in complying with 
                such request, expend the amounts withheld.
    (k) Definition.--For purposes of this section, the term 
``units of local government'' includes Indian tribes.
    (l) Authorization of Appropriations.--
            (1) In general.--For the purpose of carrying out 
        this section, there are authorized to be appropriated 
        $20,000,000 for fiscal year 1993, and such sums as may 
        be necessary for each of the fiscal years 1994 through 
        2004.
            (2) Allocation for technical assistance.--Of the 
        amounts appropriated under paragraph (1) for a fiscal 
        year, the Secretary shall reserve not more than 20 
        percent for carrying out subsection (j)(1).
      national strategy for combating and eliminating tuberculosis
    Sec. 317E. [247b-6] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, may make grants to States, political subdivisions, 
and other public entities for preventive health service 
programs for the prevention, control, and elimination of 
tuberculosis.
    (b) Research and Development; Demonstration Projects; 
Education and Training.--With respect to the prevention, 
treatment, control, and elimination of tuberculosis, the 
Secretary may, directly or through grants to public or 
nonprofit private entities, carry out the following:
            (1) Research, with priority given to research and 
        development concerning latent tuberculosis infection, 
        strains of tuberculosis resistant to drugs, and 
        research concerning cases of tuberculosis that affect 
        certain populations at risk for tuberculosis.
            (2) Research and development and related activities 
        to develop new tools for the elimination of 
        tuberculosis, including drugs, diagnostics, vaccines, 
        and public health interventions, such as directly 
        observed therapy and non-pharmaceutical intervention, 
        and methods to enhance detection and response to 
        outbreaks of tuberculosis, including multidrug 
        resistant tuberculosis. The Secretary is encouraged to 
        give priority to programmatically relevant research so 
        that new tools can be utilized in public health 
        practice.
            (3) Demonstration projects for--
                    (A) the development of regional 
                capabilities to prevent, control, and eliminate 
                tuberculosis and prevent multidrug resistant 
                and extensively drug resistant strains of 
                tuberculosis;
                    (B) the intensification of efforts to 
                reduce health disparities in the incidence of 
                tuberculosis;
                    (C) the intensification of efforts to 
                control tuberculosis along the United States-
                Mexico border and among United States-Mexico 
                binational populations, including through 
                expansion of the scope and number of programs 
                that--
                            (i) detect and treat binational 
                        cases of tuberculosis; and
                            (ii) treat high-risk cases of 
                        tuberculosis referred from Mexican 
                        health departments;
                    (D) the intensification of efforts to 
                prevent, detect, and treat tuberculosis among 
                foreign-born persons who are in the United 
                States;
                    (E) the intensification of efforts to 
                prevent, detect, and treat tuberculosis among 
                populations and settings documented as having a 
                high risk for tuberculosis; and
                    (F) tuberculosis detection, control, and 
                prevention.
            (4) Public information and education activities.
            (5) Education, training, clinical skills 
        improvement activities, and workplace exposure 
        prevention for health professionals, including allied 
        health personnel and emergency response employees.
            (6) Support of Centers to carry out activities 
        under paragraphs (1) through (4).
            (7) Collaboration with international organizations 
        and foreign countries in carrying out such activities.
            (8) Develop, enhance, and expand information 
        technologies that support tuberculosis control 
        including surveillance and database management systems 
        with cross-jurisdictional capabilities, which shall 
        conform to the standards and implementation 
        specifications for such information technologies as 
        recommended by the Secretary.
    (c) Cooperation With Providers of Primary Health 
Services.--The Secretary may make a grant under subsection (a) 
or (b) only if the applicant for the grant agrees that, in 
carrying out activities under the grant, the applicant will 
cooperate with public and nonprofit private providers of 
primary health services or substance abuse services, including 
entities receiving assistance under section 329, 330, or 340A 
or under title V or XIX.
    (d) Application for Grant.--
            (1) In general.--The Secretary may make a grant 
        under subsection (a) or (b) only if an application for 
        the grant is submitted to the Secretary and the 
        application, subject to paragraph (2), is in such form, 
        is made in such manner, and contains such agreements, 
        assurances, and information as the Secretary determines 
        to be necessary to carry out the subsection involved.
            (2) Plan for prevention, control, and 
        elimination.--The Secretary may make a grant under 
        subsection (a) only if the application under paragraph 
        (1) contains a plan regarding the prevention, control, 
        and elimination of tuberculosis in the geographic area 
        with respect to which the grant is sought.
            (3) Determination of amount of nonfederal 
        contributions.--
                    (A) Priority.--In awarding grants under 
                subsection (a) or (b), the Secretary shall give 
                highest priority to an applicant that provides 
                assurances that the applicant will contribute 
                non-Federal funds to carry out activities under 
                this section, which may be provided directly or 
                through donations from public or private 
                entities and may be in cash or in kind, 
                including equipment or services.
                    (B) Federal amounts not to be included as 
                contributions.--Amounts provided by the Federal 
                Government, or services assisted or subsidized 
                to any significant extent by the Federal 
                Government, may not be included in determining 
                the amount of non-Federal contributions as 
                described in subparagraph (A).
    (e) Supplies and Services in Lieu of Grant Funds.--
            (1) In general.--Upon the request of a grantee 
        under subsection (a) or (b), the Secretary may, subject 
        to paragraph (2), provide supplies, equipment, and 
        services for the purpose of aiding the grantee in 
        carrying out the subsection involved and, for such 
        purpose, may detail to the State any officer or 
        employee of the Department of Health and Human 
        Services.
            (2) Corresponding reduction in payments.--With 
        respect to a request described in paragraph (1), the 
        Secretary shall reduce the amount of payments under the 
        grant involved by an amount equal to the costs of 
        detailing personnel and the fair market value of any 
        supplies, equipment, or services provided by the 
        Secretary. The Secretary shall, for the payment of 
        expenses incurred in complying with such request, 
        expend the amounts withheld.
    (f) Advisory Council.--
            (1) In general.--The Secretary shall establish an 
        advisory council to be known as the Advisory Council 
        for the Elimination of Tuberculosis (in this subsection 
        referred to as the ``Council'').
            (2) Duties.--The Council shall provide advice and 
        recommendations regarding the elimination of 
        tuberculosis to the Secretary. In addition, the Council 
        shall, with respect to eliminating such disease, 
        provide to the Secretary and other appropriate Federal 
        officials advice on--
                    (A) coordinating the activities of the 
                Department of Health and Human Services and 
                other Federal agencies that relate to the 
                disease, including activities under subsection 
                (b);
                    (B) responding rapidly and effectively to 
                emerging issues in tuberculosis; and
                    (C) efficiently utilizing the Federal 
                resources involved.
            (3) Comprehensive plan.--
                    (A) In general.--In carrying out paragraph 
                (2), the Council shall make or update 
                recommendations on the development, revision, 
                and implementation of a comprehensive plan to 
                eliminate tuberculosis in the United States.
                    (B) Consultation.--In carrying out 
                subparagraph (A), the Council may consult with 
                appropriate public and private entities, which 
                may, subject to the direction or discretion of 
                the Secretary, include--
                            (i) individuals who are scientists, 
                        physicians, laboratorians, and other 
                        health professionals, who are not 
                        officers or employees of the Federal 
                        Government and who represent the 
                        disciplines relevant to tuberculosis 
                        elimination;
                            (ii) members of public-private 
                        partnerships or private entities 
                        established to address the elimination 
                        of tuberculosis;
                            (iii) members of national and 
                        international nongovernmental 
                        organizations whose purpose is to 
                        eliminate tuberculosis;
                            (iv) members from the general 
                        public who are knowledgeable with 
                        respect to tuberculosis elimination 
                        including individuals who have or have 
                        had tuberculosis; and
                            (v) scientists, physicians, 
                        laboratorians, and other health 
                        professionals who reside in a foreign 
                        country with a substantial incidence or 
                        prevalence of tuberculosis, and who 
                        represent the specialties and 
                        disciplines relevant to the research 
                        under consideration.
                    (C) Certain components of plan.--In 
                carrying out subparagraph (A), the Council 
                shall, subject to the direction or discretion 
                of the Secretary--
                            (i) consider recommendations for 
                        the involvement of the United States in 
                        continuing global and cross-border 
                        tuberculosis control activities in 
                        countries where a high incidence of 
                        tuberculosis directly affects the 
                        United States; and
                            (ii) review the extent to which 
                        progress has been made toward 
                        eliminating tuberculosis.
            (4) Biennial report.--
                    (A) In general.--The Council shall submit a 
                biennial report to the Secretary, as determined 
                necessary by the Secretary, on the activities 
                carried under this section. Each such report 
                shall include the opinion of the Council on the 
                extent to which its recommendations regarding 
                the elimination of tuberculosis have been 
                implemented, including with respect to--
                            (i) activities under subsection 
                        (b); and
                            (ii) the national plan referred to 
                        in paragraph (3).
                    (B) Public.--The Secretary shall make a 
                report submitted under subparagraph (A) public.
            (5) Composition.--The Council shall be composed 
        of--
                    (A) ex officio representatives from the 
                Centers for Disease Control and Prevention, the 
                National Institutes of Health, the United 
                States Agency for International Development, 
                the Agency for Healthcare Research and Quality, 
                the Health Resources and Services 
                Administration, the United States-Mexico Border 
                Health Commission, and other Federal 
                departments and agencies that carry out 
                significant activities related to tuberculosis;
                    (B) State and local tuberculosis control 
                and public health officials;
                    (C) individuals who are scientists, 
                physicians, laboratorians, and other health 
                professionals who represent disciplines 
                relevant to tuberculosis elimination; and
                    (D) members of national and international 
                nongovernmental organizations established to 
                address the elimination of tuberculosis.
            (6) Staff, information, and other assistance.--The 
        Secretary shall provide to the Council such staff, 
        information, and other assistance as may be necessary 
        to carry out the duties of the Council.
    (g) Federal Tuberculosis Task Force.--
            (1) Duties.--The Federal Tuberculosis Task Force 
        (in this subsection referred to as the ``Task Force'') 
        shall provide to the Secretary and other appropriate 
        Federal officials advice on research into new tools 
        under subsection (b)(2), including advice regarding the 
        efficient utilization of the Federal resources 
        involved.
            (2) Comprehensive plan for new tools development.--
        In carrying out paragraph (1), the Task Force shall 
        make recommendations on the development of a 
        comprehensive plan for the creation of new tools for 
        the elimination of tuberculosis, including drugs, 
        diagnostics, and vaccines.
            (3) Consultation.--In developing the comprehensive 
        plan under paragraph (1), the Task Force shall consult 
        with external parties including representatives from 
        groups such as--
                    (A) scientists, physicians, laboratorians, 
                and other health professionals who represent 
                the specialties and disciplines relevant to the 
                research under consideration;
                    (B) members from public-private 
                partnerships, private entities, or foundations 
                (or both) engaged in activities relevant to 
                research under consideration;
                    (C) members of national and international 
                nongovernmental organizations established to 
                address tuberculosis elimination;
                    (D) members from the general public who are 
                knowledgeable with respect to tuberculosis 
                including individuals who have or have had 
                tuberculosis; and
                    (E) scientists, physicians, laboratorians, 
                and other health professionals who reside in a 
                foreign country with a substantial incidence or 
                prevalence of tuberculosis, and who represent 
                the specialties and disciplines relevant to the 
                research under consideration.
    (h) Authorization of Appropriations.--
            (1) General program.--
                    (A) In general.--For the purpose of 
                carrying out this section, there are authorized 
                to be appropriated $200,000,000 for fiscal year 
                2009, $210,000,000 for fiscal year 2010, 
                $220,500,000 for fiscal year 2011, $231,525,000 
                for fiscal year 2012, and $243,101,250 for 
                fiscal year 2013.
                    (B) Reservation for emergency grants.--Of 
                the amounts appropriated under subparagraph (A) 
                for a fiscal year, the Secretary may reserve 
                not more than 25 percent for emergency grants 
                under subsection (a) for any geographic area, 
                State, political subdivision of a State, or 
                other public entity in which there is, relative 
                to other areas, a substantial number of cases 
                of tuberculosis, multidrug resistant 
                tuberculosis, or extensively drug resistant 
                tuberculosis or a substantial rate of increase 
                in such cases.
                    (C) Priority.--In allocating amounts 
                appropriated under subparagraph (A), the 
                Secretary shall give priority to allocating 
                such amounts for grants under subsection (a).
                    (D) Allocation of funds.--
                            (i) Requirement of formula.--Of the 
                        amounts appropriated under subparagraph 
                        (A), not reserved under subparagraph 
                        (B), and allocated by the Secretary for 
                        grants under subsection (a), the 
                        Secretary shall distribute a portion of 
                        such amounts to grantees under 
                        subsection (a) on the basis of a 
                        formula.
                            (ii) Relevant factors.--The formula 
                        developed by the Secretary under clause 
                        (i) shall take into account the level 
                        of tuberculosis morbidity and case 
                        complexity in the respective geographic 
                        area and may consider other factors 
                        relevant to tuberculosis in such area.
                            (iii) No change to formula 
                        required.--This subparagraph does not 
                        require the Secretary to modify the 
                        formula that was used by the Secretary 
                        to distribute funds to grantees under 
                        subsection (a) for fiscal year 2009.
            (2) Limitation.--The authorization of 
        appropriations established in paragraph (1) for a 
        fiscal year is effective only if the amount 
        appropriated under such paragraph for such year equals 
        or exceeds the amount appropriated to carry out this 
        section for fiscal year 2009.
                         loan repayment program
    Sec. 317F. [247b-7] (a) In General.--
            (1) Authority.--Subject to paragraph (2), the 
        Secretary may carry out a program of entering into 
        contracts with appropriately qualified health 
        professionals under which such health professionals 
        agree to conduct prevention activities, as employees of 
        the Centers for Disease Control and Prevention and the 
        Agency for Toxic Substances and Disease Registry, in 
        consideration of the Federal Government agreeing to 
        repay, for each year of such service, not more than 
        $35,000 of the principal and interest of the 
        educational loans of such health professionals.
            (2) Limitation.--The Secretary may not enter into 
        an agreement with a health professional pursuant to 
        paragraph (1) unless such professional--
                    (A) has a substantial amount of educational 
                loans relative to income; and
                    (B) agrees to serve as an employee of the 
                Centers for Disease Control and Prevention or 
                the Agency for Toxic Substances and Disease 
                Registry for purposes of paragraph (1) for a 
                period of not less than 3 years.
    (b) Applicability of Certain Provisions.--With respect to 
the National Health Service Corps Loan Repayment Program 
established in subpart III of part D of title III of this Act, 
the provisions of such subpart shall, except as inconsistent 
with subsection (a), apply to the program established in this 
section in the same manner and to the same extent as such 
provisions apply to the National Health Service Corps Loan 
Repayment Program.
    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated $500,000 for fiscal year 1994, and such sums as 
may be necessary for each of the fiscal years 1995 through 
2002.
    (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. 317G. [247B-8] FELLOWSHIP AND TRAINING PROGRAMS.

    The Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall establish fellowship 
and training programs to be conducted by such Centers to train 
individuals to develop skills in epidemiology, surveillance, 
laboratory analysis, and other disease detection and prevention 
methods. Such programs shall be designed to enable health 
professionals and health personnel trained under such programs 
to work, after receiving such training, in local, State, 
national, and international efforts toward the prevention and 
control of diseases, injuries, and disabilities. Such 
fellowships and training may be administered through the use of 
either appointment or nonappointment procedures.
                     diabetes in children and youth
    Sec. 317H. [247b-9] (a) Surveillance on Juvenile 
Diabetes.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall develop a 
sentinel system to collect data on juvenile diabetes, including 
with respect to incidence and prevalence, and shall establish a 
national database for such data.
    (b) Type 2 Diabetes in Youth.--The Secretary shall 
implement a national public health effort to address type 2 
diabetes in youth, including--
            (1) enhancing surveillance systems and expanding 
        research to better assess the prevalence and incidence 
        of type 2 diabetes in youth and determine the extent to 
        which type 2 diabetes is incorrectly diagnosed as type 
        1 diabetes among children; and
            (2) developing and improving laboratory methods to 
        assist in diagnosis, treatment, and prevention of 
        diabetes including, but not limited to, developing 
        noninvasive ways to monitor blood glucose to prevent 
        hypoglycemia and improving existing glucometers that 
        measure blood glucose.
    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
                     compilation of data on asthma
    Sec. 317I. [247b-10] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, shall--
            (1) conduct local asthma surveillance activities to 
        collect data on the prevalence and severity of asthma 
        and the quality of asthma management;
            (2) compile and annually publish data on the 
        prevalence of children suffering from asthma in each 
        State; and
            (3) to the extent practicable, compile and publish 
        data on the childhood mortality rate associated with 
        asthma nationally.
    (b) Surveillance Activities.--The Director of the Centers 
for Disease Control and Prevention, acting through the 
representative of the Director on the National Asthma Education 
Prevention Program Coordinating Committee, shall, in carrying 
out subsection (a), provide an update on surveillance 
activities at each Committee meeting.
    (c) Collaborative Efforts.--The activities described in 
subsection (a)(1) may be conducted in collaboration with 
eligible entities awarded a grant under section 399L.
    (d) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
          effects of folic acid in prevention of birth defects
    Sec. 317J. [247b-11] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, shall expand and intensify programs (directly or 
through grants or contracts) for the following purposes:
            (1) To provide education and training for health 
        professionals and the general public for purposes of 
        explaining the effects of folic acid in preventing 
        birth defects and for purposes of encouraging each 
        woman of reproductive capacity (whether or not planning 
        a pregnancy) to consume on a daily basis a dietary 
        supplement that provides an appropriate level of folic 
        acid.
            (2) To conduct research with respect to such 
        education and training, including identifying effective 
        strategies for increasing the rate of consumption of 
        folic acid by women of reproductive capacity.
            (3) To conduct research to increase the 
        understanding of the effects of folic acid in 
        preventing birth defects, including understanding with 
        respect to cleft lip, cleft palate, and heart defects.
            (4) To provide for appropriate epidemiological 
        activities regarding folic acid and birth defects, 
        including epidemiological activities regarding neural 
        tube defects.
    (b) Consultations With States and Private Entities.--In 
carrying out subsection (a), the Secretary shall consult with 
the States and with other appropriate public or private 
entities, including national nonprofit private organizations, 
health professionals, and providers of health insurance and 
health plans.
    (c) Technical Assistance.--The Secretary may (directly or 
through grants or contracts) provide technical assistance to 
public and nonprofit private entities in carrying out the 
activities described in subsection (a).
    (d) Evaluations.--The Secretary shall (directly or through 
grants or contracts) provide for the evaluation of activities 
under subsection (a) in order to determine the extent to which 
such activities have been effective in carrying out the 
purposes of the program under such subsection, including the 
effects on various demographic populations. Methods of 
evaluation under the preceding sentence may include surveys of 
knowledge and attitudes on the consumption of folic acid and on 
blood folate levels. Such methods may include complete and 
timely monitoring of infants who are born with neural tube 
defects.
    (e) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
                            safe motherhood
    Sec. 317K. [247b-12] (a) Surveillance.--
            (1) Purpose.--The purpose of this subsection is to 
        develop surveillance systems at the local, State, and 
        national level to better understand the burden of 
        maternal complications and mortality and to decrease 
        the disparities among population at risk of death and 
        complications from pregnancy.
            (2) Activities.--For the purpose described in 
        paragraph (1), the Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, may carry out the following activities:
                    (A) The Secretary may establish and 
                implement a national surveillance program to 
                identify and promote the investigation of 
                deaths and severe complications that occur 
                during pregnancy.
                    (B) The Secretary may expand the Pregnancy 
                Risk Assessment Monitoring System to provide 
                surveillance and collect data in each State.
                    (C) The Secretary may expand the Maternal 
                and Child Health Epidemiology Program to 
                provide technical support, financial 
                assistance, or the time-limited assignment of 
                senior epidemiologists to maternal and child 
                health programs in each State.
    (b) Prevention Research.--
            (1) Purpose.--The purpose of this subsection is to 
        provide the Secretary with the authority to further 
        expand research concerning risk factors, prevention 
        strategies, and the roles of the family, health care 
        providers and the community in safe motherhood.
            (2) Research.--The Secretary may carry out 
        activities to expand research relating to--
                    (A) encouraging preconception counseling, 
                especially for at risk populations such as 
                diabetics;
                    (B) the identification of critical 
                components of prenatal delivery and postpartum 
                care;
                    (C) the identification of outreach and 
                support services, such as folic acid education, 
                that are available for pregnant women;
                    (D) the identification of women who are at 
                high risk for complications;
                    (E) preventing preterm delivery;
                    (F) preventing urinary tract infections;
                    (G) preventing unnecessary caesarean 
                sections;
                    (H) an examination of the higher rates of 
                maternal mortality among African American 
                women;
                    (I) an examination of the relationship 
                between domestic violence and maternal 
                complications and mortality;
                    (J) preventing and reducing adverse health 
                consequences that may result from smoking, 
                alcohol and illegal drug use before, during and 
                after pregnancy;
                    (K) preventing infections that cause 
                maternal and infant complications; and
                    (L) other areas determined appropriate by 
                the Secretary.
    (c) Prevention Programs.--
            (1) \1\ In general.--The Secretary may carry out 
        activities to promote safe motherhood, including--
---------------------------------------------------------------------------
    \1\So in law. Subsection (c) does not contain a paragraph (2). See 
section 901 of Public Law 106-310 (114 Stat. 1126).
---------------------------------------------------------------------------
                    (A) public education campaigns on healthy 
                pregnancies and the building of partnerships 
                with outside organizations concerned about safe 
                motherhood;
                    (B) education programs for physicians, 
                nurses and other health care providers; and
                    (C) activities to promote community support 
                services for pregnant women.
    (d) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
                     prenatal and postnatal health
    Sec. 317L. [247b-13] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, shall carry out programs--
            (1) to collect, analyze, and make available data on 
        prenatal smoking, alcohol and illegal drug use, 
        including data on the implications of such activities 
        and on the incidence and prevalence of such activities 
        and their implications;
            (2) to conduct applied epidemiological research on 
        the prevention of prenatal and postnatal smoking, 
        alcohol and illegal drug use;
            (3) to support, conduct, and evaluate the 
        effectiveness of educational and cessation programs; 
        and
            (4) to provide information and education to the 
        public on the prevention and implications of prenatal 
        and postnatal smoking, alcohol and illegal drug use.
    (b) Grants.--In carrying out subsection (a), the Secretary 
may award grants to and enter into contracts with States, local 
governments, scientific and academic institutions, federally 
qualified health centers, and other public and nonprofit 
entities, and may provide technical and consultative assistance 
to such entities.
    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
              oral health promotion and disease prevention
    Sec. 317M. [247b-14] (a) Grants to Increase Resources for 
Community Water Fluoridation.--
            (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, may make grants to States and Indian tribes 
        for the purpose of increasing the resources available 
        for community water fluoridation.
            (2) Use of funds.--A State shall use amounts 
        provided under a grant under paragraph (1)--
                    (A) to purchase fluoridation equipment;
                    (B) to train fluoridation engineers;
                    (C) to develop educational materials on the 
                benefits of fluoridation; or
                    (D) to support the infrastructure necessary 
                to monitor and maintain the quality of water 
                fluoridation.
    (b) Community Water Fluoridation.--
            (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention and in collaboration with the Director of 
        the Indian Health Service, shall establish a 
        demonstration project that is designed to assist rural 
        water systems in successfully implementing the water 
        fluoridation guidelines of the Centers for Disease 
        Control and Prevention that are entitled ``Engineering 
        and Administrative Recommendations for Water 
        Fluoridation, 1995'' (referred to in this subsection as 
        the ``EARWF'').
            (2) Requirements.--
                    (A) Collaboration.--In collaborating under 
                paragraph (1), the Directors referred to in 
                such paragraph shall ensure that technical 
                assistance and training are provided to tribal 
                programs located in each of the 12 areas of the 
                Indian Health Service. The Director of the 
                Indian Health Service shall provide 
                coordination and administrative support to 
                tribes under this section.
                    (B) General use of funds.--Amounts made 
                available under paragraph (1) shall be used to 
                assist small water systems in improving the 
                effectiveness of water fluoridation and to meet 
                the recommendations of the EARWF.
                    (C) Fluoridation specialists.--
                            (i) In general.--In carrying out 
                        this subsection, the Secretary shall 
                        provide for the establishment of 
                        fluoridation specialist engineering 
                        positions in each of the Dental 
                        Clinical and Preventive Support Centers 
                        through which technical assistance and 
                        training will be provided to tribal 
                        water operators, tribal utility 
                        operators and other Indian Health 
                        Service personnel working directly with 
                        fluoridation projects.
                            (ii) Liaison.--A fluoridation 
                        specialist shall serve as the principal 
                        technical liaison between the Indian 
                        Health Service and the Centers for 
                        Disease Control and Prevention with 
                        respect to engineering and fluoridation 
                        issues.
                            (iii) CDC.--The Director of the 
                        Centers for Disease Control and 
                        Prevention shall appoint individuals to 
                        serve as the fluoridation specialists.
                    (D) Implementation.--The project 
                established under this subsection shall be 
                planned, implemented and evaluated over the 5-
                year period beginning on the date on which 
                funds are appropriated under this section and 
                shall be designed to serve as a model for 
                improving the effectiveness of water 
                fluoridation systems of small rural 
                communities.
            (3) Evaluation.--In conducting the ongoing 
        evaluation as provided for in paragraph (2)(D), the 
        Secretary shall ensure that such evaluation includes--
                    (A) the measurement of changes in water 
                fluoridation compliance levels resulting from 
                assistance provided under this section;
                    (B) the identification of the 
                administrative, technical and operational 
                challenges that are unique to the fluoridation 
                of small water systems;
                    (C) the development of a practical model 
                that may be easily utilized by other tribal, 
                State, county or local governments in improving 
                the quality of water fluoridation with emphasis 
                on small water systems; and
                    (D) the measurement of any increased 
                percentage of Native Americans or Alaskan 
                Natives who receive the benefits of optimally 
                fluoridated water.
    (c) School-Based Dental Sealant Program.--
            (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention and in collaboration with the Administrator 
        of the Health Resources and Services Administration, 
        shall award a grant to each of the 50 States and 
        territories and to Indians, Indian tribes, tribal 
        organizations and urban Indian organizations (as such 
        terms are defined in section 4 of the Indian Health 
        Care Improvement Act) to provide for the development of 
        school-based dental sealant programs to improve the 
        access of children to sealants.
            (2) Use of funds.--A State shall use amounts 
        received under a grant under paragraph (1) to provide 
        funds to eligible school-based entities or to public 
        elementary or secondary schools to enable such entities 
        or schools to provide children with access to dental 
        care and dental sealant services. Such services shall 
        be provided by licensed dental health professionals in 
        accordance with State practice licensing laws.
            (3) Eligibility.--To be eligible to receive funds 
        under paragraph (1), an entity shall--
                    (A) prepare and submit to the State an 
                application at such time, in such manner and 
                containing such information as the State may 
                require; and
                    (B) be a public elementary or secondary 
                school--
                            (i) that is located in an urban 
                        area in which and more than 50 percent 
                        of the student population is 
                        participating in Federal or State free 
                        or reduced meal programs; or
                            (ii) that is located in a rural 
                        area and, with respect to the school 
                        district in which the school is 
                        located, the district involved has a 
                        median income that is at or below 235 
                        percent of the poverty line, as defined 
                        in section 673(2) of the Community 
                        Services Block Grant Act (42 U.S.C. 
                        9902(2)).
    (d) Oral Health Infrastructure.--
            (1) Cooperative agreements.--The Secretary, acting 
        through the Director of the Centers for Disease Control 
        and Prevention, shall enter into cooperative agreements 
        with State, territorial, and Indian tribes or tribal 
        organizations (as those terms are defined in section 4 
        of the Indian Health Care Improvement Act) to establish 
        oral health leadership and program guidance, oral 
        health data collection and interpretation, (including 
        determinants of poor oral health among vulnerable 
        populations), a multi-dimensional delivery system for 
        oral health, and to implement science-based programs 
        (including dental sealants and community water 
        fluoridation) to improve oral health.
            (2) Authorization of appropriations.--There is 
        authorized to be appropriated such sums as necessary to 
        carry out this subsection for fiscal years 2010 through 
        2014.
    (e) Definitions.--For purposes of this section, the term 
``Indian tribe'' means an Indian tribe or tribal organization 
as defined in section 4(b) and section 4(c) of the Indian Self-
Determination and Education Assistance Act.
    (f) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
         surveillance and education regarding hepatitis c virus
    Sec. 317N. [247b-15] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, may (directly and through grants to public and 
nonprofit private entities) provide for programs to carry out 
the following:
            (1) To cooperate with the States in implementing a 
        national system to determine the incidence of hepatitis 
        C virus infection (in this section referred to as ``HCV 
        infection'') and to assist the States in determining 
        the prevalence of such infection, including the 
        reporting of chronic HCV cases.
            (2) To identify, counsel, and offer testing to 
        individuals who are at risk of HCV infection as a 
        result of receiving blood transfusions prior to July 
        1992, or as a result of other risk factors.
            (3) To provide appropriate referrals for 
        counseling, testing, and medical treatment of 
        individuals identified under paragraph (2) and to 
        ensure, to the extent practicable, the provision of 
        appropriate follow-up services.
            (4) To develop and disseminate public information 
        and education programs for the detection and control of 
        HCV infection, with priority given to high risk 
        populations as determined by the Secretary.
            (5) To improve the education, training, and skills 
        of health professionals in the detection and control of 
        HCV infection, with priority given to pediatricians and 
        other primary care physicians, and obstetricians and 
        gynecologists.
    (b) Laboratory Procedures.--The Secretary may (directly and 
through grants to public and nonprofit private entities) carry 
out programs to provide for improvements in the quality of 
clinical-laboratory procedures regarding hepatitis C, including 
reducing variability in laboratory results on hepatitis C 
antibody and PCR testing.
    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.
              grants for lead poisoning related activities
    Sec. 317O. [247b-16] (a) Authority To Make Grants.--
            (1) In general.--The Secretary shall make grants to 
        States to support public health activities in States 
        and localities where data suggests that at least 5 
        percent of preschool-age children have an elevated 
        blood lead level through--
                    (A) effective, ongoing outreach and 
                community education targeted to families most 
                likely to be at risk for lead poisoning;
                    (B) individual family education activities 
                that are designed to reduce ongoing exposures 
                to lead for children with elevated blood lead 
                levels, including through home visits and 
                coordination with other programs designed to 
                identify and treat children at risk for lead 
                poisoning; and
                    (C) the development, coordination and 
                implementation of community-based approaches 
                for comprehensive lead poisoning prevention 
                from surveillance to lead hazard control.
            (2) State match.--A State is not eligible for a 
        grant under this section unless the State agrees to 
        expend (through State or local funds) $1 for every $2 
        provided under the grant to carry out the activities 
        described in paragraph (1).
            (3) Application.--To be eligible to receive a grant 
        under this section, a State shall submit an application 
        to the Secretary in such form and manner and containing 
        such information as the Secretary may require.
    (b) Coordination With Other Children's Programs.--A State 
shall identify in the application for a grant under this 
section how the State will coordinate operations and activities 
under the grant with--
            (1) other programs operated in the State that serve 
        children with elevated blood lead levels, including any 
        such programs operated under title V, XIX, or XXI of 
        the Social Security Act; and
            (2) one or more of the following--
                    (A) the child welfare and foster care and 
                adoption assistance programs under parts B and 
                E of title IV of such Act;
                    (B) the head start program established 
                under the Head Start Act (42 U.S.C. 9831 et 
                seq.);
                    (C) the program of assistance under the 
                special supplemental nutrition program for 
                women, infants and children (WIC) under section 
                17 of the Child Nutrition Act of 1966 (42 
                U.S.C. 1786);
                    (D) local public and private elementary or 
                secondary schools; or
                    (E) public housing agencies, as defined in 
                section 3 of the United States Housing Act of 
                1937 (42 U.S.C. 1437a).
    (c) Performance Measures.--The Secretary shall establish 
needs indicators and performance measures to evaluate the 
activities carried out under grants awarded under this section. 
Such indicators shall be commensurate with national measures of 
maternal and child health programs and shall be developed in 
consultation with the Director of the Centers for Disease 
Control and Prevention.
    (d) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section such sums as may 
be necessary for each of the fiscal years 2001 through 2005.

                HUMAN PAPILLOMAVIRUS (JOHANNA'S LAW) \1\
---------------------------------------------------------------------------

    \1\ The typeface of the parenthetical matter in the section heading 
probably should appear in light face and all small caps.
---------------------------------------------------------------------------
    Sec. 317P. [247b-17] (a) Surveillance .--
            (1) In general.--The Secretary, acting through the 
        Centers for Disease Control and Prevention, shall--
                    (A) enter into cooperative agreements with 
                States and other entities to conduct sentinel 
                surveillance or other special studies that 
                would determine the prevalence in various age 
                groups and populations of specific types of 
                human papillomavirus (referred to in this 
                section as ``HPV'') in different sites in 
                various regions of the United States, through 
                collection of special specimens for HPV using a 
                variety of laboratory-based testing and 
                diagnostic tools; and
                    (B) develop and analyze data from the HPV 
                sentinel surveillance system described in 
                subparagraph (A).
            (2) Report.--The Secretary shall make a progress 
        report to the Congress with respect to paragraph (1) no 
        later than 1 year after the effective date of this 
        section.
    (b) Prevention Activities; Education Program.--
            (1) In general.--The Secretary, acting through the 
        Centers for Disease Control and Prevention, shall 
        conduct prevention research on HPV, including--
                    (A) behavioral and other research on the 
                impact of HPV-related diagnosis on individuals;
                    (B) formative research to assist with the 
                development of educational messages and 
                information for the public, for patients, and 
                for their partners about HPV;
                    (C) surveys of physician and public 
                knowledge, attitudes, and practices about 
                genital HPV infection; and
                    (D) upon the completion of and based on the 
                findings under subparagraphs (A) through (C), 
                develop and disseminate educational materials 
                for the public and health care providers 
                regarding HPV and its impact and prevention.
            (2) Report; final proposal.--The Secretary shall 
        make a progress report to the Congress with respect to 
        paragraph (1) not later than 1 year after the effective 
        date of this section, and shall develop a final report 
        not later than 3 years after such effective date, 
        including a detailed summary of the significant 
        findings and problems and the best strategies to 
        prevent future infections, based on available science.
    (c) HPV Education and Prevention.--
            (1) In general.--The Secretary shall prepare and 
        distribute educational materials for health care 
        providers and the public that include information on 
        HPV. Such materials shall address--
                    (A) modes of transmission;
                    (B) consequences of infection, including 
                the link between HPV and cervical cancer;
                    (C) the available scientific evidence on 
                the effectiveness or lack of effectiveness of 
                condoms in preventing infection with HPV; and
                    (D) the importance of regular Pap smears, 
                and other diagnostics for early intervention 
                and prevention of cervical cancer purposes in 
                preventing cervical cancer.
            (2) Medically accurate information.--Educational 
        material under paragraph (1), and all other relevant 
        educational and prevention materials prepared and 
        printed from this date forward for the public and 
        health care providers by the Secretary (including 
        materials prepared through the Food and Drug 
        Administration, the Centers for Disease Control and 
        Prevention, and the Health Resources and Services 
        Administration), or by contractors, grantees, or 
        subgrantees thereof, that are specifically designed to 
        address STDs including HPV shall contain medically 
        accurate information regarding the effectiveness or 
        lack of effectiveness of condoms in preventing the STD 
        the materials are designed to address. Such requirement 
        only applies to materials mass produced for the public 
        and health care providers, and not to routine 
        communications.
    (d) Johanna's Law.--
            (1) National public awareness campaign.--
                    (A) In general.--The Secretary shall carry 
                out a national campaign to increase the 
                awareness and knowledge of health care 
                providers and women with respect to gynecologic 
                cancers.
                    (B) Written materials.--Activities under 
                the national campaign under subparagraph (A) 
                shall include--
                            (i) maintaining a supply of written 
                        materials that provide information to 
                        the public on gynecologic cancers; and
                            (ii) distributing the materials to 
                        members of the public upon request.
                    (C) Public service announcements.--
                Activities under the national campaign under 
                subparagraph (A) shall, in accordance with 
                applicable law and regulations, include 
                developing and placing, in telecommunications 
                media, public service announcements intended to 
                encourage women to discuss with their 
                physicians their risks of gynecologic cancers. 
                Such announcements shall inform the public on 
                the manner in which the written materials 
                referred to in subparagraph (B) can be obtained 
                upon request, and shall call attention to early 
                warning signs and risk factors based on the 
                best available medical information.
            (2) Report and strategy.--
                    (A) Report.--Not later than 6 months after 
                the date of the enactment of this subsection, 
                the Secretary shall submit to the Congress a 
                report including the following:
                            (i) A description of the past and 
                        present activities of the Department of 
                        Health and Human Services to increase 
                        awareness and knowledge of the public 
                        with respect to different types of 
                        cancer, including gynecologic cancers.
                            (ii) A description of the past and 
                        present activities of the Department of 
                        Health and Human Services to increase 
                        awareness and knowledge of health care 
                        providers with respect to different 
                        types of cancer, including gynecologic 
                        cancers.
                            (iii) For each activity described 
                        pursuant to clause (i) or (ii), a 
                        description of the following:
                                    (I) The funding for such 
                                activity for fiscal year 2006 
                                and the cumulative funding for 
                                such activity for previous 
                                fiscal years.
                                    (II) The background and 
                                history of such activity, 
                                including--
                                            (aa) the goals of 
                                        such activity;
                                            (bb) the 
                                        communications 
                                        objectives of such 
                                        activity;
                                            (cc) the identity 
                                        of each agency within 
                                        the Department of 
                                        Health and Human 
                                        Services responsible 
                                        for any aspect of the 
                                        activity; and
                                            (dd) how such 
                                        activity is or was 
                                        expected to result in 
                                        change.
                                    (III) How long the activity 
                                lasted or is expected to last.
                                    (IV) The outcomes observed 
                                and the evaluation methods, if 
                                any, that have been, are being, 
                                or will be used with respect to 
                                such activity.
                                    (V) For each such outcome 
                                or evaluation method, a 
                                description of the associated 
                                results, analyses, and 
                                conclusions.
                    (B) Strategy.--
                            (i) Development; submission to 
                        congress.--Not later than 3 months 
                        after submitting the report required by 
                        subparagraph (A), the Secretary shall 
                        develop and submit to the Congress a 
                        strategy for improving efforts to 
                        increase awareness and knowledge of the 
                        public and health care providers with 
                        respect to different types of cancer, 
                        including gynecological cancers.
                            (ii) Consultation.--In developing 
                        the strategy under clause (i), the 
                        Secretary should consult with qualified 
                        private sector groups, including 
                        nonprofit organizations.
            (3) Full compliance.--
                    (A) In general.--Not later than March 1, 
                2008, the Secretary shall ensure that all 
                provisions of this section, including 
                activities directed to be carried out by the 
                Centers for Disease Control and Prevention and 
                the Food and Drug Administration, are fully 
                implemented and being complied with. Not later 
                than April 30, 2008, the Secretary shall submit 
                to Congress a report that certifies compliance 
                with the preceding sentence and that contains a 
                description of all activities undertaken to 
                achieve such compliance.
                    (B) If the Secretary fails to submit the 
                certification as provided for under 
                subparagraph (A), the Secretary shall, not 
                later than 3 months after the date on which the 
                report is to be submitted under subparagraph 
                (A), and every 3 months thereafter, submit to 
                Congress an explanation as to why the Secretary 
                has not yet complied with the first sentence of 
                subparagraph (A), a detailed description of all 
                actions undertaken within the month for which 
                the report is being submitted to bring the 
                Secretary into compliance with such sentence, 
                and the anticipated date the Secretary expects 
                to be in full compliance with such sentence.
            (4) Consultation with nonprofit gynecologic cancer 
        organizations.--In carrying out the national campaign 
        under this subsection, the Secretary shall consult with 
        nonprofit gynecologic cancer organizations, with a 
        mission both to conquer ovarian or other gynecologic 
        cancer and to provide outreach to State and local 
        governments and communities, for the purpose of 
        determining the best practices for providing 
        gynecologic cancer information and outreach services to 
        varied populations.
            (6) Authorization of appropriations.--For the 
        purpose of carrying out this subsection, there is 
        authorized to be appropriated $16,500,000 for the 
        period of fiscal years 2007 through 2009 and 
        $18,000,000 for the period of fiscal years 2012 through 
        2014.

SEC. 317Q. [247B-18] SURVEILLANCE AND RESEARCH REGARDING MUSCULAR 
                    DYSTROPHY.

    (a) In General.--The Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, may award 
grants and cooperative agreements to public or nonprofit 
private entities (including health departments of States and 
political subdivisions of States, and including universities 
and other educational entities) for the collection, analysis, 
and reporting of data on Duchenne and other forms of muscular 
dystrophy. In making such awards, the Secretary may provide 
direct technical assistance in lieu of cash.
    (b) National Muscular Dystrophy Epidemiology Program.--The 
Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, may award grants to public or 
nonprofit private entities (including health departments of 
States and political subdivisions of States, and including 
universities and other educational entities) for the purpose of 
carrying out epidemiological activities regarding Duchenne and 
other forms of muscular dystrophies, including collecting and 
analyzing information on the number, incidence, correlates, and 
symptoms of cases. In carrying out the preceding sentence, the 
Secretary shall provide for a national surveillance program. In 
making awards under this subsection, the Secretary may provide 
direct technical assistance in lieu of cash.
    (c) Coordination With Centers of Excellence.--The Secretary 
shall ensure that epidemiological information under subsections 
(a) and (b) is made available to centers of excellence 
supported under section 404E(b) by the Director of the National 
Institutes of Health.
    (d) Data.--In carrying out this section, the Secretary may 
ensure that any data on patients that is collected as part of 
the Muscular Dystrophy STARnet (under a grant under this 
section) is regularly updated to reflect changes in patient 
condition over time.
    (e) Reports and Study.--
            (1) Annual report.--Not later than 18 months after 
        the date of the enactment of the Paul D. Wellstone 
        Muscular Dystrophy Community Assistance, Research, and 
        Education Amendments of 2008, and annually thereafter, 
        the Director of the Centers for Disease Control and 
        Prevention shall submit to the appropriate committees 
        of the Congress a report--
                    (A) concerning the activities carried out 
                by MD STARnet site \1\ funded under this 
                section during the year for which the report is 
                prepared;
---------------------------------------------------------------------------
    \1\ So in law. The term ``site'' probably should be ``sites''.
---------------------------------------------------------------------------
                    (B) containing the data collected and 
                findings derived from the MD STARnet sites each 
                fiscal year (as funded under a grant under this 
                section during fiscal years 2008 through 2012); 
                and
                    (C) that every 2 years outlines prospective 
                data collection objectives and strategies.
            (2) Tracking health outcomes.--The Secretary may 
        provide health outcome data on the health and survival 
        of people with muscular dystrophy.
    (f) Authorization of Appropriations.--There are authorized 
to be appropriated such sums as may be necessary to carry out 
this section.

SEC. 317R. [247B-20] FOOD SAFETY GRANTS.

    (a) In General.--The Secretary may award grants to States 
and Indian tribes (as defined in section 4(e) of the Indian 
Self-Determination and Education Assistance Act (25 U.S.C. 
450b(e))) to expand participation in networks to enhance 
Federal, State, and local food safety efforts, including 
meeting the costs of establishing and maintaining the food 
safety surveillance, technical, and laboratory capacity needed 
for such participation.
    (b) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated $19,500,000 for fiscal year 2002, and such sums as 
may be necessary for each of the fiscal years 2003 through 
2006.

SEC. 317S. [247B-21] MOSQUITO-BORNE DISEASES; COORDINATION GRANTS TO 
                    STATES; ASSESSMENT AND CONTROL GRANTS TO POLITICAL 
                    SUBDIVISIONS.

    (a) Coordination Grants to States; Assessment Grants to 
Political Subdivisions.--
            (1) In general.--With respect to mosquito control 
        programs to prevent and control mosquito-borne diseases 
        (referred to in this section as ``control programs''), 
        the Secretary, acting through the Director of the 
        Centers for Disease Control and Prevention, may make 
        grants to States for the purpose of--
                    (A) coordinating control programs in the 
                State involved; and
                    (B) assisting such State in making grants 
                to political subdivisions of the State to 
                conduct assessments to determine the immediate 
                needs in such subdivisions for control 
                programs, and to develop, on the basis of such 
                assessments, plans for carrying out control 
                programs in the subdivisions.
            (2) Preference in making grants.--In making grants 
        under paragraph (1), the Secretary shall give 
        preference to States that have one or more political 
        subdivisions with an incidence, prevalence, or high 
        risk of mosquito-borne disease, or a population of 
        infected mosquitoes, that is substantial relative to 
        political subdivisions in other States.
            (3) Certain requirements.--A grant may be made 
        under paragraph (1) only if--
                    (A) the State involved has developed, or 
                agrees to develop, a plan for coordinating 
                control programs in the State, and the plan 
                takes into account any assessments or plans 
                described in subsection (b)(3) that have been 
                conducted or developed, respectively, by 
                political subdivisions in the State;
                    (B) in developing such plan, the State 
                consulted or will consult (as the case may be 
                under subparagraph (A)) with political 
                subdivisions in the State that are carrying out 
                or planning to carry out control programs;
                    (C) the State agrees to monitor control 
                programs in the State in order to ensure that 
                the programs are carried out in accordance with 
                such plan, with priority given to coordination 
                of control programs in political subdivisions 
                described in paragraph (2) that are contiguous;
                    (D) the State agrees that the State will 
                make grants to political subdivisions as 
                described in paragraph (1)(B), and that such a 
                grant will not exceed $10,000; and
                    (E) the State agrees that the grant will be 
                used to supplement, and not supplant, State and 
                local funds available for the purpose described 
                in paragraph (1).
            (4) Reports to secretary.--A grant may be made 
        under paragraph (1) only if the State involved agrees 
        that, promptly after the end of the fiscal year for 
        which the grant is made, the State will submit to the 
        Secretary a report that--
                    (A) describes the activities of the State 
                under the grant; and
                    (B) contains an evaluation of whether the 
                control programs of political subdivisions in 
                the State were effectively coordinated with 
                each other, which evaluation takes into account 
                any reports that the State received under 
                subsection (b)(5) from such subdivisions.
            (5) Number of grants.--A State may not receive more 
        than one grant under paragraph (1).
    (b) Prevention and Control Grants to Political 
Subdivisions.--
            (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, may make grants to political subdivisions 
        of States or consortia of political subdivisions of 
        States, for the operation of control programs.
            (2) Preference in making grants.--In making grants 
        under paragraph (1), the Secretary shall give 
        preference to a political subdivision or consortium of 
        political subdivisions that--
                    (A) has--
                            (i) a history of elevated incidence 
                        or prevalence of mosquito-borne 
                        disease;
                            (ii) a population of infected 
                        mosquitoes; or
                            (iii) met criteria determined by 
                        the Secretary to suggest an increased 
                        risk of elevated incidence or 
                        prevalence of mosquito-borne disease in 
                        the pending fiscal year;
                    (B) demonstrates to the Secretary that such 
                political subdivision or consortium of 
                political subdivisions will, if appropriate to 
                the mosquito circumstances involved, 
                effectively coordinate the activities of the 
                control programs with contiguous political 
                subdivisions;
                    (C) demonstrates to the Secretary (directly 
                or through State officials) that the State in 
                which such a political subdivision or 
                consortium of political subdivisions is located 
                has identified or will identify geographic 
                areas in such State that have a significant 
                need for control programs and will effectively 
                coordinate such programs in such areas; and
                    (D) is located in a State that has received 
                a grant under subsection (a).
            (3) Requirement of assessment and plan.--A grant 
        may be made under paragraph (1) only if the political 
        subdivision or consortium of political subdivisions 
        involved--
                    (A) has conducted an assessment to 
                determine the immediate needs in such 
                subdivision or consortium for a control 
                program, including an entomological survey of 
                potential mosquito breeding areas; and
                    (B) has, on the basis of such assessment, 
                developed a plan for carrying out such a 
                program.
            (4) Requirement of matching funds.--
                    (A) In general.--With respect to the costs 
                of a control program to be carried out under 
                paragraph (1) by a political subdivision or 
                consortium of political subdivisions, a grant 
                under such paragraph may be made only if the 
                subdivision or consortium agrees to make 
                available (directly or through donations from 
                public or private entities) non-Federal 
                contributions toward such costs in an amount 
                that is not less than \1/3\ of such costs ($1 
                for each $2 of Federal funds provided in the 
                grant).
                    (B) Determination of amount contributed.--
                Non-Federal contributions required in 
                subparagraph (A) may be in cash or in kind, 
                fairly evaluated, including plant, equipment, 
                or services. Amounts provided by the Federal 
                Government, or services assisted or subsidized 
                to any significant extent by the Federal 
                Government, may not be included in determining 
                the amount of such non-Federal contributions.
                    (C) Waiver.--The Secretary may waive the 
                requirement established in subparagraph (A) if 
                the Secretary determines that extraordinary 
                economic conditions in the political 
                subdivision or consortium of political 
                subdivisions involved justify the waiver.
            (5) Reports to secretary.--A grant may be made 
        under paragraph (1) only if the political subdivision 
        or consortium of political subdivisions involved agrees 
        that, promptly after the end of the fiscal year for 
        which the grant is made, the subdivision or consortium 
        will submit to the Secretary, and to the State within 
        which the subdivision or consortium is located, a 
        report that describes the control program and contains 
        an evaluation of whether the program was effective.
            (6) Amount of grant; number of grants.--
                    (A) Amount of grant.--
                            (i) Single political subdivision.--
                        A grant under paragraph (1) awarded to 
                        a political subdivision for a fiscal 
                        year may not exceed $100,000.
                            (ii) Consortium.--A grant under 
                        paragraph (1) awarded to a consortium 
                        of 2 or more political subdivisions may 
                        not exceed $110,000 for each political 
                        subdivision. A consortium is not 
                        required to provide matching funds 
                        under paragraph (4) for any amounts 
                        received by such consortium in excess 
                        of amounts each political subdivision 
                        would have received separately.
                            (iii) Waiver of requirement.--A 
                        grant may exceed the maximum amount in 
                        clause (i) or (ii) if the Secretary 
                        determines that the geographical area 
                        covered by a political subdivision or 
                        consortium awarded a grant under 
                        paragraph (1) has an extreme need due 
                        to the size or density of--
                                    (I) the human population in 
                                such geographical area; or
                                    (II) the mosquito 
                                population in such geographical 
                                area.
                    (B) Number of grants.--A political 
                subdivision or a consortium of political 
                subdivisions may not receive more than one 
                grant under paragraph (1).
    (c) Applications for Grants.--A grant may be made under 
subsection (a) or (b) only if an application for the grant is 
submitted to the Secretary and the application is in such form, 
is made in such manner, and contains such agreements, 
assurances, and information as the Secretary determines to be 
necessary to carry out this section.
    (d) Technical Assistance.--Amounts appropriated under 
subsection (f) may be used by the Secretary to provide training 
and technical assistance with respect to the planning, 
development, and operation of assessments and plans under 
subsection (a) and control programs under subsection (b). The 
Secretary may provide such technical assistance directly or 
through awards of grants or contracts to public and private 
entities.
    (e) Definition of Political Subdivision.--In this section, 
the term ``political subdivision'' means the local political 
jurisdiction immediately below the level of State government, 
including counties, parishes, and boroughs. If State law 
recognizes an entity of general government that functions in 
lieu of, and is not within, a county, parish, or borough, the 
Secretary may recognize an area under the jurisdiction of such 
other entities of general government as a political subdivision 
for purposes of this section.
    (f) Authorization of Appropriations.--
            (1) In general.--For the purpose of carrying out 
        this section, there are authorized to be appropriated 
        $100,000,000 for fiscal year 2003, and such sums as may 
        be necessary for each of fiscal years 2004 through 
        2007.
            (2) Public health emergencies.--In the case of 
        control programs carried out in response to a mosquito-
        borne disease that constitutes a public health 
        emergency, the authorization of appropriations under 
        paragraph (1) is in addition to applicable 
        authorizations of appropriations under the Public 
        Health Security and Bioterrorism Preparedness and 
        Response Act of 2002.
            (3) Fiscal year 2004 appropriations.--For fiscal 
        year 2004, 50 percent or more of the funds appropriated 
        under paragraph (1) shall be used to award grants to 
        political subdivisions or consortia of political 
        subdivisions under subsection (b).

SEC. 317T. [247B-22] MICROBICIDE RESEARCH.

    (a) In General.--The Director of the Centers for Disease 
Control and Prevention is strongly encouraged to fully 
implement the Centers' microbicide agenda to support research 
and development of microbicides for use to prevent the 
transmission of the human immunodeficiency virus.
    (b) Authorization of Appropriations.--There are authorized 
to be appropriated such sums as may be necessary for each of 
fiscal years 2009 through 2013 to carry out this section.

   projects and programs for the prevention and control of sexually 
                        transmitted diseases \1\
---------------------------------------------------------------------------

    \1\ Title II of Public Law 103-333, an appropriations Act, provides 
(under the heading relating to the Centers for Disease Control and 
Prevention; see 108 Stat. 2550) in part as follows: ``That funds 
appropriated under this heading for fiscal year 1995 and subsequent 
fiscal years shall be available for payment of the costs of medical 
care, related expenses, and burial expenses hereafter incurred by or on 
behalf of any person who had participated in the study of untreated 
syphilis initiated in Tuskegee, Alabama, in 1932, in such amounts and 
subject to such terms and conditions as prescribed by the Secretary of 
Health and Human Services and for payment, in such amounts and subject 
to such terms and conditions, of such costs and expenses hereafter 
incurred by or on behalf of such person's wife or offspring determined 
by the Secretary to have suffered injury or disease from syphilis 
contracted from such person''.
---------------------------------------------------------------------------
    Sec. 318. [247c] (a) The Secretary may provide technical 
assistance to appropriate public and non-profit private 
entities and to scientific institutions for their research in, 
and training and public health programs for the prevention and 
control of sexually transmitted diseases.
    (b) The Secretary may make grants to States, political 
subdivisions of States, and any other public and nonprofit 
private entity for--
            (1) research into the prevention and control of 
        sexually transmitted diseases;
            (2) demonstration projects for the prevention and 
        control of sexually transmitted diseases;
            (3) public information and education programs for 
        the prevention and control of such diseases; and
            (4) education, training, and clinical skills 
        improvement activities in the prevention and control of 
        such diseases for health professionals (including 
        allied health personnel).
    (c) The Secretary is also authorized to make project grants 
to States and, in consultation with the State health authority, 
to political subdivisions of States, for--
            (1) sexually transmitted diseases surveillance 
        activities, including the reporting, screening, and 
        followup of diagnostic tests for, and diagnosed cases 
        of, sexually transmitted diseases;
            (2) casefinding and case followup activities 
        respecting sexually transmitted diseases, including 
        contact tracing of infectious cases of sexually 
        transmitted diseases and routine testing, including 
        laboratory tests and followup systems;
            (3) interstate epidemiologic referral and followup 
        activities respecting sexually transmitted diseases; 
        and
            (4) such special studies or demonstrations to 
        evaluate or test sexually transmitted diseases 
        prevention and control strategies and activities as may 
        be prescribed by the Secretary.
    (d) The Secretary may make grants to States and political 
subdivisions of States for the development, implementation, and 
evaluation of innovative, interdisciplinary approaches to the 
prevention and control of sexually transmitted diseases.
    (e)(1) For the purpose of making grants under subsections 
(b) through (d), there are authorized to be appropriated 
$85,000,000 for fiscal year 1994, and such sums as may be 
necessary for each of the fiscal years 1995 through 1998.
    (2) Each recipient of a grant under this section shall keep 
such records as the Secretary shall prescribe including records 
which fully disclose the amount and disposition by such 
recipient of the proceeds of such grant, the total cost of the 
project or undertaking in connection with which such grant was 
given or used and the amount of that portion of the cost of the 
project or undertaking supplied by other sources, and such 
other records as will facilitate an effective audit.
    (3) The Secretary and the Comptroller General of the United 
States, or any of their duly authorized representatives, shall 
have access for the purpose of audit and examination to any 
books, documents, papers, and records of the recipients of 
grants under this section that are pertinent to such grants.
    (4) The Secretary, at the request of a recipient of a grant 
under this section, may reduce such grant by the fair market 
value of any supplies or equipment furnished to such recipient 
and by the amount of pay, allowances, travel expenses, and any 
other costs in connection with the detail of an officer or 
employee of the United States to the recipient when the 
furnishing of such supplies or equipment or the detail of such 
an officer or employee is for the convenience of and at the 
request of such recipient and for the purpose of carrying out 
the program with respect to which the grant under this section 
is made. The amount by which any such grant is so reduced shall 
be available for payment by the Secretary of the costs incurred 
in furnishing the supplies, equipment, or personal services on 
which the reduction of such grant is based.
    (5) All information obtained in connection with the 
examination, care, or treatment of any individual under any 
program which is being carried out with a grant made under this 
section shall not, without such individual's consent, be 
disclosed except as may be necessary to provide service to him 
or as may be required by a law of a State or political 
subdivision of a State. Information derived from any such 
program may be disclosed--
            (A) in summary, statistical, or other form; or
            (B) for clinical or research purposes;
but only if the identity of the individuals diagnosed or 
provided care or treatment under such program is not disclosed.
    (f) Nothing in this section shall be construed to require 
any State or any political subdivision of a State to have a 
sexually transmitted diseases program which would require any 
person, who objects to any treatment provided under such a 
program, to be treated under such a program.

             INFERTILITY AND SEXUALLY TRANSMITTED DISEASES

    Sec. 318A. [247c-1] (a) In General.--The Secretary, acting 
through the Director of the Centers for Disease Control and 
Prevention, may make grants to States, political subdivisions 
of States, and other public or nonprofit private entities for 
the purpose of carrying out the activities described in 
subsection (c) regarding any treatable sexually transmitted 
disease that can cause infertility in women if treatment is not 
received for the disease.
    (b) Authority Regarding Individual Diseases.--With respect 
to diseases described in subsection (a), the Secretary shall, 
in making a grant under such subsection, specify the particular 
disease or diseases with respect to which the grant is to be 
made. The Secretary may not make the grant unless the applicant 
involved agrees to carry out this section only with respect to 
the disease or diseases so specified.
    (c) Authorized Activities.--With respect to any sexually 
transmitted disease described in subsection (a), the activities 
referred to in such subsection are--
            (1) screening women for the disease and for 
        secondary conditions resulting from the disease, 
        subject to compliance with criteria issued under 
        subsection (f);
            (2) providing treatment to women for the disease;
            (3) providing counseling to women on the prevention 
        and control of the disease (including, in the case of a 
        woman with the disease, counseling on the benefits of 
        locating and providing such counseling to any 
        individual from whom the woman may have contracted the 
        disease and any individual whom the woman may have 
        exposed to the disease);
            (4) providing follow-up services;
            (5) referrals for necessary medical services for 
        women screened pursuant to paragraph (1), including 
        referrals for evaluation and treatment with respect to 
        acquired immune deficiency syndrome and other sexually 
        transmitted diseases;
            (6) in the case of any woman receiving services 
        pursuant to any of paragraphs (1) through (5), 
        providing to the partner of the woman the services 
        described in such paragraphs, as appropriate;
            (7) providing outreach services to inform women of 
        the availability of the services described in 
        paragraphs (1) through (6);
            (8) providing to the public information and 
        education on the prevention and control of the disease, 
        including disseminating such information; and
            (9) providing training to health care providers in 
        carrying out the screenings and counseling described in 
        paragraphs (1) and (3).
    (d) Requirement of Availability of All Services Through 
Each Grantee.--The Secretary may make a grant under subsection 
(a) only if the applicant involved agrees that each activity 
authorized in subsection (c) will be available through the 
applicant. With respect to compliance with such agreement, the 
applicant may expend the grant to carry out any of the 
activities directly, and may expend the grant to enter into 
agreements with other public or nonprofit private entities 
under which the entities carry out the activities.
    (e) Required Providers Regarding Certain Services.--The 
Secretary may make a grant under subsection (a) only if the 
applicant involved agrees that, in expending the grant to carry 
out activities authorized in subsection (c), the services 
described in paragraphs (1) through (7) of such subsection will 
be provided only through entities that are State or local 
health departments, grantees under section 329, 330, 340A, or 
1001, or are other public or nonprofit private entities that 
provide health services to a significant number of low-income 
women.
    (f) Quality Assurance Regarding Screening for Diseases.--
For purposes of this section, the Secretary shall establish 
criteria for ensuring the quality of screening procedures for 
diseases described in subsection (a).
    (g) Confidentiality.--The Secretary may make a grant under 
subsection (a) only if the applicant involved agrees, subject 
to applicable law, to maintain the confidentiality of 
information on individuals with respect to activities carried 
out under subsection (c).
    (h) Limitation on Imposition of Fees for Services.--The 
Secretary may make a grant under subsection (a) only if the 
applicant involved agrees that, if a charge is imposed for the 
provision of services or activities under the grant, such 
charge--
            (1) will be made according to a schedule of charges 
        that is made available to the public;
            (2) will be adjusted to reflect the income of the 
        individual involved; and
            (3) will not be imposed on any individual with an 
        income of less than 150 percent of the official poverty 
        line, as established by the Director of the Office of 
        Management and Budget and revised by the Secretary in 
        accordance with section 673(2) of the Omnibus Budget 
        Reconciliation Act of 1981.
    (i) Limitations on Certain Expenditures.--The Secretary may 
make a grant under subsection (a) only if the applicant 
involved agrees that not less than 80 percent of the grant will 
be expended for the purpose of carrying out paragraphs (1) 
through (7) of subsection (c).
    (j) Reports to Secretary.--
            (1) Collection of data.--The Secretary may make a 
        grant under subsection (a) only if the applicant 
        involved agrees, with respect to any disease selected 
        under subsection (b) for the applicant, to submit to 
        the Secretary, for each fiscal year for which the 
        applicant receives such a grant, a report providing--
                    (A) the incidence of the disease among the 
                population of individuals served by the 
                applicant;
                    (B) the number and demographic 
                characteristics of individuals in such 
                population;
                    (C) the types of interventions and 
                treatments provided by the applicant, and the 
                health conditions with respect to which 
                referrals have been made pursuant to subsection 
                (c)(5);
                    (D) an assessment of the extent to which 
                the activities carried pursuant to subsection 
                (a) have reduced the incidence of infertility 
                in the geographic area involved; and
                    (E) such other information as the Secretary 
                may require with respect to the project carried 
                out with the grant.
            (2) Utility and comparability of data.--The 
        Secretary shall carry out activities for the purpose of 
        ensuring the utility and comparability of data 
        collected pursuant to paragraph (1).
    (k) Maintenance of Effort.--With respect to activities for 
which a grant under subsection (a) is authorized to be 
expended, the Secretary may make such a grant only if the 
applicant involved agrees to maintain expenditures of non-
Federal amounts for such activities at a level that is not less 
than the average level of such expenditures maintained by the 
applicant for the 2-year period preceding the fiscal year for 
which the applicant is applying to receive such a grant.
    (l) Requirement of Application.--
            (1) In general.--The Secretary may make a grant 
        under subsection (a) only if an application for the 
        grant is submitted to the Secretary, the application 
        contains the plan required in paragraph (2), and the 
        application is in such form, is made in such manner, 
        and contains such agreements, assurances, and 
        information as the Secretary determines to be necessary 
        to carry out this section.
            (2) Submission of plan for program of grantee.--
                    (A) In general.--The Secretary may make a 
                grant under subsection (a) only if the 
                applicant involved submits to the Secretary a 
                plan describing the manner in which the 
                applicant will comply with the agreements 
                required as a condition of receiving such a 
                grant, including a specification of the 
                entities through which activities authorized in 
                subsection (c) will be provided.
                    (B) Participation of certain entities.--The 
                Secretary may make a grant under subsection (a) 
                only if the applicant provides assurances 
                satisfactory to the Secretary that the plan 
                submitted under subparagraph (A) has been 
                prepared in consultation with an appropriate 
                number and variety of--
                            (i) representatives of entities in 
                        the geographic area involved that 
                        provide services for the prevention and 
                        control of sexually transmitted 
                        diseases, including programs to provide 
                        to the public information and education 
                        regarding such diseases; and
                            (ii) representatives of entities in 
                        such area that provide family planning 
                        services.
    (m) Duration of Grant.--The period during which payments 
are made to an entity from a grant under subsection (a) may not 
exceed 3 years. The provision of such payments 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 in such year. The preceding 
sentence may not be construed to establish a limitation on the 
number of grants under such subsection that may be made to an 
entity.
    (n) Technical Assistance, and Supplies and Services in Lieu 
of Grant Funds.--
            (1) Technical assistance.--The Secretary may 
        provide training and technical assistance to grantees 
        under subsection (a) with respect to the planning, 
        development, and operation of any program or service 
        carried out under such subsection. The Secretary may 
        provide such technical assistance directly or through 
        grants or contracts.
            (2) Supplies, equipment, and employee detail.--The 
        Secretary, at the request of a recipient of a grant 
        under subsection (a), may reduce the amount of such 
        grant by--
                    (A) the fair market value of any supplies 
                or equipment furnished the grant recipient; and
                    (B) the amount of the pay, allowances, and 
                travel expenses of any officer or employee of 
                the Government when detailed to the grant 
                recipient and the amount of any other costs 
                incurred in connection with the detail of such 
                officer or employee;
        when the furnishing of such supplies or equipment or 
        the detail of such an officer or employee is for the 
        convenience of and at the request of such grant 
        recipient and for the purpose of carrying out a program 
        with respect to which the grant under subsection (a) is 
        made. The amount by which any such grant is so reduced 
        shall be available for payment by the Secretary of the 
        costs incurred in furnishing the supplies or equipment, 
        or in detailing the personnel, on which the reduction 
        of such grant is based, and such amount shall be deemed 
        as part of the grant and shall be deemed to have been 
        paid to the grant recipient.
    (o) Evaluations and Reports by Secretary.--
            (1) Evaluations.--The Secretary shall, directly or 
        through contracts with public or private entities, 
        provide for annual evaluations of programs carried out 
        pursuant to subsection (a) in order to determine the 
        quality and effectiveness of the programs.
            (2) Report to congress.--Not later than 1 year 
        after the date on which amounts are first appropriated 
        pursuant to subsection (q), and biennially 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--
                    (A) summarizing the information provided to 
                the Secretary in reports made pursuant to 
                subsection (j)(1), including information on the 
                incidence of sexually transmitted diseases 
                described in subsection (a); and
                    (B) summarizing evaluations carried out 
                pursuant to paragraph (1) during the preceding 
                fiscal year.
    (p) Coordination of Federal Programs.--The Secretary shall 
coordinate the program carried out under this section with any 
similar programs administered by the Secretary (including 
coordination between the Director of the Centers for Disease 
Control and Prevention and the Director of the National 
Institutes of Health).
    (q) Authorization of Appropriations.--For the purpose of 
carrying out this section, other than subsections (o) and (r), 
there are authorized to be appropriated $25,000,000 for fiscal 
year 1993, and such sums as may be necessary for each of the 
fiscal years 1994 through 1998.
    (r) Separate  Grants  for  Research  on  Delivery  of 
Services.--
            (1) In general.--The Secretary may make grants for 
        the purpose of conducting research on the manner in 
        which the delivery of services under subsection (a) may 
        be improved. The Secretary may make such grants only to 
        grantees under such subsection and to public and 
        nonprofit private entities that are carrying out 
        programs substantially similar to programs carried out 
        under such subsection.
            (2) Authorization of appropriations.--For the 
        purpose of carrying out paragraph (1), there are 
        authorized to be appropriated such sums as may be 
        necessary for each of the fiscal years 1993 through 
        1998.
          data collection regarding programs under title xxvi
    Sec. 318B. [247c-2] For the purpose of collecting and 
providing data for program planning and evaluation activities 
under title XXVI, there are authorized to be appropriated to 
the Secretary (acting through the Director of the Centers for 
Disease Control and Prevention) such sums as may be necessary 
for each of the fiscal years 2001 through 2005. Such 
authorization of appropriations is in addition to other 
authorizations of appropriations that are available for such 
purpose.

SEC. 319. [247D] PUBLIC HEALTH EMERGENCIES.

    (a) Emergencies.--If the Secretary determines, after 
consultation with such public health officials as may be 
necessary, that--
            (1) a disease or disorder presents a public health 
        emergency; or
            (2) a public health emergency, including 
        significant outbreaks of infectious diseases or 
        bioterrorist attacks, otherwise exists,
the Secretary may take such action as may be appropriate to 
respond to the public health emergency, including making 
grants, providing awards for expenses, and entering into 
contracts and conducting and supporting investigations into the 
cause, treatment, or prevention of a disease or disorder as 
described in paragraphs (1) and (2). Any such determination of 
a public health emergency terminates upon the Secretary 
declaring that the emergency no longer exists, or upon the 
expiration of the 90-day period beginning on the date on which 
the determination is made by the Secretary, whichever occurs 
first. Determinations that terminate under the preceding 
sentence may be renewed by the Secretary (on the basis of the 
same or additional facts), and the preceding sentence applies 
to each such renewal. Not later than 48 hours after making a 
determination under this subsection of a public health 
emergency (including a renewal), the Secretary shall submit to 
the Congress written notification of the determination.
    (b) Public Health Emergency Fund.--
            (1) In general.--There is established in the 
        Treasury a fund to be designated as the ``Public Health 
        Emergency Fund'' to be made available to the Secretary 
        without fiscal year limitation to carry out subsection 
        (a) only if a public health emergency has been declared 
        by the Secretary under such subsection. There is 
        authorized to be appropriated to the Fund such sums as 
        may be necessary.
            (2) Report.--Not later than 90 days after the end 
        of each fiscal year, the Secretary shall prepare and 
        submit to the Committee on Health, Education, Labor, 
        and Pensions and the Committee on Appropriations of the 
        Senate and the Committee on Commerce and the Committee 
        on Appropriations of the House of Representatives a 
        report describing--
                    (A) the expenditures made from the Public 
                Health Emergency Fund in such fiscal year; and
                    (B) each public health emergency for which 
                the expenditures were made and the activities 
                undertaken with respect to each emergency which 
                was conducted or supported by expenditures from 
                the Fund.
    (c) Supplement Not Supplant.--Funds appropriated under this 
section shall be used to supplement and not supplant other 
Federal, State, and local public funds provided for activities 
under this section.
    (d) Data Submittal and Reporting Deadlines.--In any case in 
which the Secretary determines that, wholly or partially as a 
result of a public health emergency that has been determined 
pursuant to subsection (a), individuals or public or private 
entities are unable to comply with deadlines for the submission 
to the Secretary of data or reports required under any law 
administered by the Secretary, the Secretary may, 
notwithstanding any other provision of law, grant such 
extensions of such deadlines as the circumstances reasonably 
require, and may waive, wholly or partially, any sanctions 
otherwise applicable to such failure to comply. Before or 
promptly after granting such an extension or waiver, the 
Secretary shall notify the Congress of such action and publish 
in the Federal Register a notice of the extension or waiver.

SEC. 319A. [247D-1] VACCINE TRACKING AND DISTRIBUTION.

    (a) Tracking.--The Secretary, together with relevant 
manufacturers, wholesalers, and distributors as may agree to 
cooperate, may track the initial distribution of federally 
purchased influenza vaccine in an influenza pandemic. Such 
tracking information shall be used to inform Federal, State, 
local, and tribal decision makers during an influenza pandemic.
    (b) Distribution.--The Secretary shall promote 
communication between State, local, and tribal public health 
officials and such manufacturers, wholesalers, and distributors 
as agree to participate, regarding the effective distribution 
of seasonal influenza vaccine. Such communication shall include 
estimates of high priority populations, as determined by the 
Secretary, in State, local, and tribal jurisdictions in order 
to inform Federal, State, local, and tribal decision makers 
during vaccine shortages and supply disruptions.
    (c) Confidentiality.--The information submitted to the 
Secretary or its contractors, if any, under this section or 
under any other section of this Act related to vaccine 
distribution information shall remain confidential in 
accordance with the exception from the public disclosure of 
trade secrets, commercial or financial information, and 
information obtained from an individual that is privileged and 
confidential, as provided for in section 552(b)(4) of title 5, 
United States Code, and subject to the penalties and exceptions 
under sections 1832 and 1833 of title 18, United States Code, 
relating to the protection and theft of trade secrets, and 
subject to privacy protections that are consistent with the 
regulations promulgated under section 264(c) of the Health 
Insurance Portability and Accountability Act of 1996. None of 
such information provided by a manufacturer, wholesaler, or 
distributor shall be disclosed without its consent to another 
manufacturer, wholesaler, or distributor, or shall be used in 
any manner to give a manufacturer, wholesaler, or distributor a 
proprietary advantage.
    (d) Guidelines.--The Secretary, in order to maintain the 
confidentiality of relevant information and ensure that none of 
the information contained in the systems involved may be used 
to provide proprietary advantage within the vaccine market, 
while allowing State, local, and tribal health officials access 
to such information to maximize the delivery and availability 
of vaccines to high priority populations, during times of 
influenza pandemics, vaccine shortages, and supply disruptions, 
in consultation with manufacturers, distributors, wholesalers 
and State, local, and tribal health departments, shall develop 
guidelines for subsections (a) and (b).
    (e) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section, such sums for 
each of fiscal years 2007 through 2011.
    (f) Report to Congress.--As part of the National Health 
Security Strategy described in section 2802, the Secretary 
shall provide an update on the implementation of subsections 
(a) through (d).

SEC. 319C-1. [247D-3A] IMPROVING STATE AND LOCAL PUBLIC HEALTH 
                    SECURITY. \1\
---------------------------------------------------------------------------

    \1\ Former sections 319B and 319C were repealed by section 
204(b)(1) of Public Law 109-417 (120 Stat. 2951).
---------------------------------------------------------------------------
    (a) In General.--To enhance the security of the United 
States with respect to public health emergencies, the Secretary 
shall award cooperative agreements to eligible entities to 
enable such entities to conduct the activities described in 
subsection (d).
    (b) Eligible Entities.--To be eligible to receive an award 
under subsection (a), an entity shall--
            (1)(A) be a State;
            (B) be a political subdivision determined by the 
        Secretary to be eligible for an award under this 
        section (based on criteria described in subsection 
        (i)(4)); or
            (C) be a consortium of entities described in 
        subparagraph (A); and
            (2) prepare and submit to the Secretary an 
        application at such time, and in such manner, and 
        containing such information as the Secretary may 
        require, including--
                    (A) an All-Hazards Public Health Emergency 
                Preparedness and Response Plan which shall 
                include--
                            (i) a description of the activities 
                        such entity will carry out under the 
                        agreement to meet the goals identified 
                        under section 2802;
                            (ii) a pandemic influenza plan 
                        consistent with the requirements of 
                        paragraphs (2) and (5) of subsection 
                        (g);
                            (iii) preparedness and response 
                        strategies and capabilities that take 
                        into account the medical and public 
                        health needs of at-risk individuals in 
                        the event of a public health emergency;
                            (iv) a description of the mechanism 
                        the entity will implement to utilize 
                        the Emergency Management Assistance 
                        Compact or other mutual aid agreements 
                        for medical and public health mutual 
                        aid; and
                            (v) a description of how the entity 
                        will include the State Unit on Aging in 
                        public health emergency preparedness;
                    (B) an assurance that the entity will 
                report to the Secretary on an annual basis (or 
                more frequently as determined by the Secretary) 
                on the evidence-based benchmarks and objective 
                standards established by the Secretary to 
                evaluate the preparedness and response 
                capabilities of such entity under subsection 
                (g);
                    (C) an assurance that the entity will 
                conduct, on at least an annual basis, an 
                exercise or drill that meets any criteria 
                established by the Secretary to test the 
                preparedness and response capabilities of such 
                entity, and that the entity will report back to 
                the Secretary within the application of the 
                following year on the strengths and weaknesses 
                identified through such exercise or drill, and 
                corrective actions taken to address material 
                weaknesses;
                    (D) an assurance that the entity will 
                provide to the Secretary the data described 
                under section 319D(d)(3) as determined feasible 
                by the Secretary;
                    (E) an assurance that the entity will 
                conduct activities to inform and educate the 
                hospitals within the jurisdiction of such 
                entity on the role of such hospitals in the 
                plan required under subparagraph (A);
                    (F) an assurance that the entity, with 
                respect to the plan described under 
                subparagraph (A), has developed and will 
                implement an accountability system to ensure 
                that such entity make satisfactory annual 
                improvement and describe such system in the 
                plan under subparagraph (A);
                    (G) a description of the means by which to 
                obtain public comment and input on the plan 
                described in subparagraph (A) and on the 
                implementation of such plan, that shall include 
                an advisory committee or other similar 
                mechanism for obtaining comment from the public 
                and from other State, local, and tribal 
                stakeholders; and
                    (H) as relevant, a description of the 
                process used by the entity to consult with 
                local departments of public health to reach 
                consensus, approval, or concurrence on the 
                relative distribution of amounts received under 
                this section.
    (c) Limitation.--Beginning in fiscal year 2009, the 
Secretary may not award a cooperative agreement to a State 
unless such State is a participant in the Emergency System for 
Advance Registration of Volunteer Health Professionals 
described in section 319I.
    (d) Use of Funds.--
            (1) In general.--An award under subsection (a) 
        shall be expended for activities to achieve the 
        preparedness goals described under paragraphs (1), (2), 
        (4), (5), and (6) of section 2802(b).
            (2) Effect of section.--Nothing in this subsection 
        may be construed as establishing new regulatory 
        authority or as modifying any existing regulatory 
        authority.
    (e) Coordination With Local Response Capabilities.--An 
entity shall, to the extent practicable, ensure that activities 
carried out under an award under subsection (a) are coordinated 
with activities of relevant Metropolitan Medical Response 
Systems, local public health departments, the Cities Readiness 
Initiative, and local emergency plans.
    (f) Consultation With Homeland Security.--In making awards 
under subsection (a), the Secretary shall consult with the 
Secretary of Homeland Security to--
            (1) ensure maximum coordination of public health 
        and medical preparedness and response activities with 
        the Metropolitan Medical Response System, and other 
        relevant activities;
            (2) minimize duplicative funding of programs and 
        activities;
            (3) analyze activities, including exercises and 
        drills, conducted under this section to develop 
        recommendations and guidance on best practices for such 
        activities; and
            (4) disseminate such recommendations and guidance, 
        including through expanding existing lessons learned 
        information systems to create a single Internet-based 
        point of access for sharing and distributing medical 
        and public health best practices and lessons learned 
        from drills, exercises, disasters, and other 
        emergencies.
    (g) Achievement of Measurable Evidence-Based Benchmarks and 
Objective Standards.--
            (1) In general.--Not later than 180 days after the 
        date of enactment of the Pandemic and All-Hazards 
        Preparedness Act, the Secretary shall develop or where 
        appropriate adopt, and require the application of, 
        measurable evidence-based benchmarks and objective 
        standards that measure levels of preparedness with 
        respect to the activities described in this section and 
        with respect to activities described in section 319C-2. 
        In developing such benchmarks and standards, the 
        Secretary shall consult with and seek comments from 
        State, local, and tribal officials and private 
        entities, as appropriate. Where appropriate, the 
        Secretary shall incorporate existing objective 
        standards. Such benchmarks and standards shall--
                    (A) include outcome goals representing 
                operational achievement of the National 
                Preparedness Goals developed under section 
                2802(b); and
                    (B) at a minimum, require entities to--
                            (i) measure progress toward 
                        achieving the outcome goals; and
                            (ii) at least annually, test, 
                        exercise, and rigorously evaluate the 
                        public health and medical emergency 
                        preparedness and response capabilities 
                        of the entity, and report to the 
                        Secretary on such measured and tested 
                        capabilities and measured and tested 
                        progress toward achieving outcome 
                        goals, based on criteria established by 
                        the Secretary.
            (2) Criteria for pandemic influenza plans.--
                    (A) In general.--Not later than 180 days 
                after the date of enactment of the Pandemic and 
                All-Hazards Preparedness Act, the Secretary 
                shall develop and disseminate to the chief 
                executive officer of each State criteria for an 
                effective State plan for responding to pandemic 
                influenza.
                    (B) Rule of construction.--Nothing in this 
                section shall be construed to require the 
                duplication of Federal efforts with respect to 
                the development of criteria or standards, 
                without regard to whether such efforts were 
                carried out prior to or after the date of 
                enactment of this section.
            (3) Technical assistance.--The Secretary shall, as 
        determined appropriate by the Secretary, provide to a 
        State, upon request, technical assistance in meeting 
        the requirements of this section, including the 
        provision of advice by experts in the development of 
        high-quality assessments, the setting of State 
        objectives and assessment methods, the development of 
        measures of satisfactory annual improvement that are 
        valid and reliable, and other relevant areas.
            (4) Notification of failures.--The Secretary shall 
        develop and implement a process to notify entities that 
        are determined by the Secretary to have failed to meet 
        the requirements of paragraph (1) or (2). Such process 
        shall provide such entities with the opportunity to 
        correct such noncompliance. An entity that fails to 
        correct such noncompliance shall be subject to 
        paragraph (5).
            (5) Withholding of amounts from entities that fail 
        to achieve benchmarks or submit influenza plan.--
        Beginning with fiscal year 2009, and in each succeeding 
        fiscal year, the Secretary shall--
                    (A) withhold from each entity that has 
                failed substantially to meet the benchmarks and 
                performance measures described in paragraph (1) 
                for the immediately preceding fiscal year 
                (beginning with fiscal year 2008), pursuant to 
                the process developed under paragraph (4), the 
                amount described in paragraph (6); and
                    (B) withhold from each entity that has 
                failed to submit to the Secretary a plan for 
                responding to pandemic influenza that meets the 
                criteria developed under paragraph (2), the 
                amount described in paragraph (6).
            (6) Amounts described.--
                    (A) In general.--The amounts described in 
                this paragraph are the following amounts that 
                are payable to an entity for activities 
                described in section 319C-1 or 319C-2:
                            (i) For the fiscal year immediately 
                        following a fiscal year in which an 
                        entity experienced a failure described 
                        in subparagraph (A) or (B) of paragraph 
                        (5) by the entity, an amount equal to 
                        10 percent of the amount the entity was 
                        eligible to receive for such fiscal 
                        year.
                            (ii) For the fiscal year 
                        immediately following two consecutive 
                        fiscal years in which an entity 
                        experienced such a failure, an amount 
                        equal to 15 percent of the amount the 
                        entity was eligible to receive for such 
                        fiscal year, taking into account the 
                        withholding of funds for the 
                        immediately preceding fiscal year under 
                        clause (i).
                            (iii) For the fiscal year 
                        immediately following three consecutive 
                        fiscal years in which an entity 
                        experienced such a failure, an amount 
                        equal to 20 percent of the amount the 
                        entity was eligible to receive for such 
                        fiscal year, taking into account the 
                        withholding of funds for the 
                        immediately preceding fiscal years 
                        under clauses (i) and (ii).
                            (iv) For the fiscal year 
                        immediately following four consecutive 
                        fiscal years in which an entity 
                        experienced such a failure, an amount 
                        equal to 25 percent of the amount the 
                        entity was eligible to receive for such 
                        a fiscal year, taking into account the 
                        withholding of funds for the 
                        immediately preceding fiscal years 
                        under clauses (i), (ii), and (iii).
                    (B) Separate accounting.--Each failure 
                described in subparagraph (A) or (B) of 
                paragraph (5) shall be treated as a separate 
                failure for purposes of calculating amounts 
                withheld under subparagraph (A).
            (7) Reallocation of amounts withheld.--
                    (A) In general.--The Secretary shall make 
                amounts withheld under paragraph (6) available 
                for making awards under section 319C-2 to 
                entities described in subsection (b)(1) of such 
                section.
                    (B) Preference in reallocation.--In making 
                awards under section 319C-2 with amounts 
                described in subparagraph (A), the Secretary 
                shall give preference to eligible entities (as 
                described in section 319C-2(b)(1)) that are 
                located in whole or in part in States from 
                which amounts have been withheld under 
                paragraph (6).
            (8) Waive or reduce withholding.--The Secretary may 
        waive or reduce the withholding described in paragraph 
        (6), for a single entity or for all entities in a 
        fiscal year, if the Secretary determines that 
        mitigating conditions exist that justify the waiver or 
        reduction.
    (h) Grants for Real-Time Disease Detection Improvement.--
            (1) In general.--The Secretary may award grants to 
        eligible entities to carry out projects described under 
        paragraph (4).
            (2) Eligible entity.--For purposes of this section, 
        the term ``eligible entity'' means an entity that is--
                    (A)(i) a hospital, clinical laboratory, 
                university; or
                    (ii) a poison control center or 
                professional organization in the field of 
                poison control; and
                    (B) a participant in the network 
                established under subsection 319D(d).
            (3) Application.--Each eligible entity desiring a 
        grant under this subsection shall submit to the 
        Secretary an application at such time, in such manner, 
        and containing such information as the Secretary may 
        require.
            (4) Use of funds.--
                    (A) In general.--An eligible entity 
                described in paragraph (2)(A)(i) that receives 
                a grant under this subsection shall use the 
                funds awarded pursuant to such grant to carry 
                out a pilot demonstration project to purchase 
                and implement the use of advanced diagnostic 
                medical equipment to analyze real-time clinical 
                specimens for pathogens of public health or 
                bioterrorism significance and report any 
                results from such project to State, local, and 
                tribal public health entities and the network 
                established under section 319D(d).
                    (B) Other entities.--An eligible entity 
                described in paragraph (2)(A)(ii) that receives 
                a grant under this section shall use the funds 
                awarded pursuant to such grant to--
                            (i) improve the early detection, 
                        surveillance, and investigative 
                        capabilities of poison control centers 
                        for chemical, biological, radiological, 
                        and nuclear events by training poison 
                        information personnel to improve the 
                        accuracy of surveillance data, 
                        improving the definitions used by the 
                        poison control centers for 
                        surveillance, and enhancing timely and 
                        efficient investigation of data 
                        anomalies;
                            (ii) improve the capabilities of 
                        poison control centers to provide 
                        information to health care providers 
                        and the public with regard to chemical, 
                        biological, radiological, or nuclear 
                        threats or exposures, in consultation 
                        with the appropriate State, local, and 
                        tribal public health entities; or
                            (iii) provide surge capacity in the 
                        event of a chemical, biological, 
                        radiological, or nuclear event through 
                        the establishment of alternative poison 
                        control center worksites and the 
                        training of nontraditional personnel.
    (i) Funding.--
            (1) Authorization of appropriations.--
                    (A) In general.--For the purpose of 
                carrying out this section, there is authorized 
                to be appropriated $824,000,000 for fiscal year 
                2007, of which $35,000,000 shall be used to 
                carry out subsection (h), for awards pursuant 
                to paragraph (3) (subject to the authority of 
                the Secretary to make awards pursuant to 
                paragraphs (4) and (5)), and such sums as may 
                be necessary for each of fiscal years 2008 
                through 2011.
                    (B) Coordination.--There are authorized to 
                be appropriated, $10,000,000 for fiscal year 
                2007 to carry out subsection (f)(4) of this 
                section and section 2814.
                    (C) Requirement for state matching funds.--
                Beginning in fiscal year 2009, in the case of 
                any State or consortium of two or more States, 
                the Secretary may not award a cooperative 
                agreement under this section unless the State 
                or consortium of States agree that, with 
                respect to the amount of the cooperative 
                agreement awarded by the Secretary, the State 
                or consortium of States will make available 
                (directly or through donations from public or 
                private entities) non-Federal contributions in 
                an amount equal to--
                            (i) for the first fiscal year of 
                        the cooperative agreement, not less 
                        than 5 percent of such costs ($1 for 
                        each $20 of Federal funds provided in 
                        the cooperative agreement); and
                            (ii) for any second fiscal year of 
                        the cooperative agreement, and for any 
                        subsequent fiscal year of such 
                        cooperative agreement, not less than 10 
                        percent of such costs ($1 for each $10 
                        of Federal funds provided in the 
                        cooperative agreement).
                    (D) Determination of amount of non-federal 
                contributions.--As determined by the Secretary, 
                non-Federal contributions required in 
                subparagraph (C) 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. Amounts provided by the Federal 
                government, or services assisted or subsidized 
                to any significant extent by the Federal 
                government, may not be included in determining 
                the amount of such non-Federal contributions.
            (2) Maintaining state funding.--
                    (A) In general.--An entity that receives an 
                award under this section shall maintain 
                expenditures for public health security at a 
                level that is not less than the average level 
                of such expenditures maintained by the entity 
                for the preceding 2 year period.
                    (B) Rule of construction.--Nothing in this 
                section shall be construed to prohibit the use 
                of awards under this section to pay salary and 
                related expenses of public health and other 
                professionals employed by State, local, or 
                tribal public health agencies who are carrying 
                out activities supported by such awards 
                (regardless of whether the primary assignment 
                of such personnel is to carry out such 
                activities).
            (3) Determination of amount.--
                    (A) In general.--The Secretary shall award 
                cooperative agreements under subsection (a) to 
                each State or consortium of 2 or more States 
                that submits to the Secretary an application 
                that meets the criteria of the Secretary for 
                the receipt of such an award and that meets 
                other implementation conditions established by 
                the Secretary for such awards
                    (B) Base amount.--In determining the amount 
                of an award pursuant to subparagraph (A) for a 
                State, the Secretary shall first determine an 
                amount the Secretary considers appropriate for 
                the State (referred to in this paragraph as the 
                ``base amount''), except that such amount may 
                not be greater than the minimum amount 
                determined under subparagraph (D).
                    (C) Increase on basis of population.--After 
                determining the base amount for a State under 
                subparagraph (B), the Secretary shall increase 
                the base amount by an amount equal to the 
                product of--
                            (i) the amount appropriated under 
                        paragraph (1)(A)(i)(I) for the fiscal 
                        year, less an amount equal to the sum 
                        of all base amounts determined for the 
                        States under subparagraph (B), and less 
                        the amount, if any, reserved by the 
                        Secretary under paragraphs (4) and (5); 
                        and
                            (ii) subject to paragraph (4)(C), 
                        the percentage constituted by the ratio 
                        of an amount equal to the population of 
                        the State over an amount equal to the 
                        total population of the States (as 
                        indicated by the most recent data 
                        collected by the Bureau of the Census).
                    (D) Minimum amount.--Subject to the amount 
                appropriated under paragraph (1)(A)(i)(I), an 
                award pursuant to subparagraph (A) for a State 
                shall be the greater of the base amount as 
                increased under subparagraph (C), or the 
                minimum amount under this subparagraph. The 
                minimum amount under this subparagraph is--
                            (i) in the case of each of the 
                        several States, the District of 
                        Columbia, and the Commonwealth of 
                        Puerto Rico, an amount equal to the 
                        lesser of--
                                    (I) $5,000,000; or
                                    (II) if the amount 
                                appropriated under paragraph 
                                (1)(A)(i)(I) is less than 
                                $667,000,000, an amount equal 
                                to 0.75 percent of the amount 
                                appropriated under such 
                                paragraph, less the amount, if 
                                any, reserved by the Secretary 
                                under paragraphs (4) and (5); 
                                or
                            (ii) in the case of each of 
                        American Samoa, Guam, the Commonwealth 
                        of the Northern Mariana Islands, and 
                        the Virgin Islands, an amount 
                        determined by the Secretary to be 
                        appropriate, except that such amount 
                        may not exceed the amount determined 
                        under clause (i).
            (4) Certain political subdivisions.--
                    (A) In general.--For fiscal year 2007, the 
                Secretary may, before making awards pursuant to 
                paragraph (3) for such year, reserve from the 
                amount appropriated under paragraph (1) for the 
                year an amount determined necessary by the 
                Secretary to make awards under subsection (a) 
                to political subdivisions that have a 
                substantial number of residents, have a 
                substantial local infrastructure for responding 
                to public health emergencies, and face a high 
                degree of risk from bioterrorist attacks or 
                other public health emergencies. Not more than 
                three political subdivisions may receive awards 
                pursuant to this subparagraph.
                    (B) Coordination with statewide plans.--An 
                award pursuant to subparagraph (A) may not be 
                made unless the application of the political 
                subdivision involved is in coordination with, 
                and consistent with, applicable Statewide plans 
                described in subsection (c).
                    (C) Relationship to formula grants.--In the 
                case of a State that will receive an award 
                pursuant to paragraph (3), and in which there 
                is located a political subdivision that will 
                receive an award pursuant to subparagraph (A), 
                the Secretary shall, in determining the amount 
                under paragraph (3)(C) for the State, subtract 
                from the population of the State an amount 
                equal to the population of such political 
                subdivision.
                    (D) Continuity of funding.--In determining 
                whether to make an award pursuant to 
                subparagraph (A) to a political subdivision, 
                the Secretary may consider, as a factor 
                indicating that the award should be made, that 
                the political subdivision received public 
                health funding from the Secretary for fiscal 
                year 2006.
            (5) Significant unmet needs; degree of risk.--
                    (A) In general.--For fiscal year 2007, the 
                Secretary may, before making awards pursuant to 
                paragraph (3) for such year, reserve from the 
                amount appropriated under paragraph (1) for the 
                year an amount determined necessary by the 
                Secretary to make awards under subsection (a) 
                to eligible entities that--
                            (i) have a significant need for 
                        funds to build capacity to identify, 
                        detect, monitor, and respond to a 
                        bioterrorist or other threat to the 
                        public health, which need will not be 
                        met by awards pursuant to paragraph 
                        (3); and
                            (ii) face a particularly high 
                        degree of risk of such a threat.
                    (B) Recipients of grants.--Awards pursuant 
                to subparagraph (A) may be supplemental awards 
                to States that receive awards pursuant to 
                paragraph (3), or may be awards to eligible 
                entities described in subsection (b)(1)(B) 
                within such States.
                    (C) Finding with respect to district of 
                columbia.--The Secretary shall consider the 
                District of Columbia to have a significant 
                unmet need for purposes of subparagraph (A), 
                and to face a particularly high degree of risk 
                for such purposes, on the basis of the 
                concentration of entities of national 
                significance located within the District.
            (6) Funding of local entities.--The Secretary 
        shall, in making awards under this section, ensure that 
        with respect to the cooperative agreement awarded, the 
        entity make available appropriate portions of such 
        award to political subdivisions and local departments 
        of public health through a process involving the 
        consensus, approval or concurrence with such local 
        entities.
    (j) Administrative and Fiscal Responsibility.--
            (1) Annual reporting requirements.--Each entity 
        shall prepare and submit to the Secretary annual 
        reports on its activities under this section and 
        section 319C-2. Each such report shall be prepared by, 
        or in consultation with, the health department. In 
        order to properly evaluate and compare the performance 
        of different entities assisted under this section and 
        section 319C-2 and to assure the proper expenditure of 
        funds under this section and section 319C-2, such 
        reports shall be in such standardized form and contain 
        such information as the Secretary determines and 
        describes within 180 days of the date of enactment of 
        the Pandemic and All-Hazards Preparedness Act (after 
        consultation with the States) to be necessary to--
                    (A) secure an accurate description of those 
                activities;
                    (B) secure a complete record of the 
                purposes for which funds were spent, and of the 
                recipients of such funds;
                    (C) describe the extent to which the entity 
                has met the goals and objectives it set forth 
                under this section or section 319C-2;
                    (D) determine the extent to which funds 
                were expended consistent with the entity's 
                application transmitted under this section or 
                section 319C-2; and
                    (E) publish such information on a Federal 
                Internet website consistent with subsection 
                (k).
            (2) Audits; implementation.--
                    (A) In general.--Each entity receiving 
                funds under this section or section 319C-2 
                shall, not less often than once every 2 years, 
                audit its expenditures from amounts received 
                under this section or section 319C-2. Such 
                audits shall be conducted by an entity 
                independent of the agency administering a 
                program funded under this section or section 
                319C-2 in accordance with the Comptroller 
                General's standards for auditing governmental 
                organizations, programs, activities, and 
                functions and generally accepted auditing 
                standards. Within 30 days following the 
                completion of each audit report, the entity 
                shall submit a copy of that audit report to the 
                Secretary.
                    (B) Repayment.--Each entity shall repay to 
                the United States amounts found by the 
                Secretary, after notice and opportunity for a 
                hearing to the entity, not to have been 
                expended in accordance with this section or 
                section 319C-2 and, if such repayment is not 
                made, the Secretary may offset such amounts 
                against the amount of any allotment to which 
                the entity is or may become entitled under this 
                section or section 319C-2 or may otherwise 
                recover such amounts.
                    (C) Withholding of payment.--The Secretary 
                may, after notice and opportunity for a 
                hearing, withhold payment of funds to any 
                entity which is not using its allotment under 
                this section or section 319C-2 in accordance 
                with such section. The Secretary may withhold 
                such funds until the Secretary finds that the 
                reason for the withholding has been removed and 
                there is reasonable assurance that it will not 
                recur.
            (3) Maximum carryover amount.--
                    (A) In general.--For each fiscal year, the 
                Secretary, in consultation with the States and 
                political subdivisions, shall determine the 
                maximum percentage amount of an award under 
                this section that an entity may carryover to 
                the succeeding fiscal year.
                    (B) Amount exceeded.--For each fiscal year, 
                if the percentage amount of an award under this 
                section unexpended by an entity exceeds the 
                maximum percentage permitted by the Secretary 
                under subparagraph (A), the entity shall return 
                to the Secretary the portion of the unexpended 
                amount that exceeds the maximum amount 
                permitted to be carried over by the Secretary.
                    (C) Action by secretary.--The Secretary 
                shall make amounts returned to the Secretary 
                under subparagraph (B) available for awards 
                under section 319C-2(b)(1). In making awards 
                under section 319C-2(b)(1) with amounts 
                collected under this paragraph the Secretary 
                shall give preference to entities that are 
                located in whole or in part in States from 
                which amounts have been returned under 
                subparagraph (B).
                    (D) Waiver.--An entity may apply to the 
                Secretary for a waiver of the maximum 
                percentage amount under subparagraph (A). Such 
                an application for a waiver shall include an 
                explanation why such requirement should not 
                apply to the entity and the steps taken by such 
                entity to ensure that all funds under an award 
                under this section will be expended 
                appropriately.
                    (E) Waive or reduce withholding.--The 
                Secretary may waive the application of 
                subparagraph (B), or reduce the amount 
                determined under such subparagraph, for a 
                single entity pursuant to subparagraph (D) or 
                for all entities in a fiscal year, if the 
                Secretary determines that mitigating conditions 
                exist that justify the waiver or reduction.
    (k) Compilation and Availability of Data.--The Secretary 
shall compile the data submitted under this section and make 
such data available in a timely manner on an appropriate 
Internet website in a format that is useful to the public and 
to other entities and that provides information on what 
activities are best contributing to the achievement of the 
outcome goals described in subsection (g).

SEC. 319C-2. [247D-3B] PARTNERSHIPS FOR STATE AND REGIONAL HOSPITAL 
                    PREPAREDNESS TO IMPROVE SURGE CAPACITY.

    (a) In General.--The Secretary shall award competitive 
grants or cooperative agreements to eligible entities to enable 
such entities to improve surge capacity and enhance community 
and hospital preparedness for public health emergencies.
    (b) Eligibility.--To be eligible for an award under 
subsection (a), an entity shall--
            (1)(A) be a partnership consisting of--
                    (i) one or more hospitals, at least one of 
                which shall be a designated trauma center, 
                consistent with section 1213(c);
                    (ii) one or more other local health care 
                facilities, including clinics, health centers, 
                primary care facilities, mental health centers, 
                mobile medical assets, or nursing homes; and
                    (iii)(I) one or more political 
                subdivisions;
                    (II) one or more States; or
                    (III) one or more States and one or more 
                political subdivisions; and
            (B) prepare, in consultation with the Chief 
        Executive Officer and the lead health officials of the 
        State, District, or territory in which the hospital and 
        health care facilities described in subparagraph (A) 
        are located, and submit to the Secretary, an 
        application at such time, in such manner, and 
        containing such information as the Secretary may 
        require; or
            (2)(A) be an entity described in section 319C-
        1(b)(1); and
            (B) submit an application at such time, in such 
        manner, and containing such information as the 
        Secretary may require, including the information or 
        assurances required under section 319C-1(b)(2) and an 
        assurance that the State will adhere to any applicable 
        guidelines established by the Secretary.
    (c) Use of Funds.--An award under subsection (a) shall be 
expended for activities to achieve the preparedness goals 
described under paragraphs (1), (3), (4), (5), and (6) of 
section 2802(b).
    (d) Preferences.--
            (1) Regional coordination.--In making awards under 
        subsection (a), the Secretary shall give preference to 
        eligible entities that submit applications that, in the 
        determination of the Secretary--
                    (A) will enhance coordination--
                            (i) among the entities described in 
                        subsection (b)(1)(A)(i); and
                            (ii) between such entities and the 
                        entities described in subsection 
                        (b)(1)(A)(ii); and
                    (B) include, in the partnership described 
                in subsection (b)(1)(A), a significant 
                percentage of the hospitals and health care 
                facilities within the geographic area served by 
                such partnership.
            (2) Other preferences.--In making awards under 
        subsection (a), the Secretary shall give preference to 
        eligible entities that, in the determination of the 
        Secretary--
                    (A) include one or more hospitals that are 
                participants in the National Disaster Medical 
                System;
                    (B) are located in a geographic area that 
                faces a high degree of risk, as determined by 
                the Secretary in consultation with the 
                Secretary of Homeland Security; or
                    (C) have a significant need for funds to 
                achieve the medical preparedness goals 
                described in section 2802(b)(3).
    (e) Consistency of Planned Activities.--The Secretary may 
not award a cooperative agreement to an eligible entity 
described in subsection (b)(1) unless the application submitted 
by the entity is coordinated and consistent with an applicable 
State All-Hazards Public Health Emergency Preparedness and 
Response Plan and relevant local plans, as determined by the 
Secretary in consultation with relevant State health officials.
    (f) Limitation on Awards.--A political subdivision shall 
not participate in more than one partnership described in 
subsection (b)(1).
    (g) Coordination With Local Response Capabilities.--An 
eligible entity shall, to the extent practicable, ensure that 
activities carried out under an award under subsection (a) are 
coordinated with activities of relevant local Metropolitan 
Medical Response Systems, local Medical Reserve Corps, the 
Cities Readiness Initiative, and local emergency plans.
    (h) Maintenance of Funding.--
            (1) In general.--An entity that receives an award 
        under this section shall maintain expenditures for 
        health care preparedness at a level that is not less 
        than the average level of such expenditures maintained 
        by the entity for the preceding 2 year period.
            (2) Rule of construction.--Nothing in this section 
        shall be construed to prohibit the use of awards under 
        this section to pay salary and related expenses of 
        public health and other professionals employed by 
        State, local, or tribal agencies who are carrying out 
        activities supported by such awards (regardless of 
        whether the primary assignment of such personnel is to 
        carry out such activities).
    (i) Performance and Accountability.--The requirements of 
section 319C-1(g), (j), and (k) shall apply to entities 
receiving awards under this section (regardless of whether such 
entities are described under subsection (b)(1)(A) or (b)(2)(A)) 
in the same manner as such requirements apply to entities under 
section 319C-1. An entity described in subsection (b)(1)(A) 
shall make such reports available to the lead health official 
of the State in which such partnership is located.
    (j) Authorization of Appropriations.--
            (1) In general.--For the purpose of carrying out 
        this section, there is authorized to be appropriated 
        $474,000,000 for fiscal year 2007, and such sums as may 
        be necessary for each of fiscal years 2008 through 
        2011.
            (2) Reservation of amounts for partnerships.--Prior 
        to making awards described in paragraph (3), the 
        Secretary may reserve from the amount appropriated 
        under paragraph (1) for a fiscal year, an amount 
        determined appropriate by the Secretary for making 
        awards to entities described in subsection (b)(1)(A).
            (3) Awards to states and political subdivisions.--
                    (A) In general.--From amounts appropriated 
                for a fiscal year under paragraph (1) and not 
                reserved under paragraph (2), the Secretary 
                shall make awards to entities described in 
                subsection (b)(2)(A) that have completed an 
                application as described in subsection 
                (b)(2)(B).
                    (B) Amount.--The Secretary shall determine 
                the amount of an award to each entity described 
                in subparagraph (A) in the same manner as such 
                amounts are determined under section 319C-1(i).

SEC. 319D. [247D-4] REVITALIZING THE CENTERS FOR DISEASE CONTROL AND 
                    PREVENTION.

    (a) Facilities; Capacities.--
            (1) Findings.--Congress finds that the Centers for 
        Disease Control and Prevention has an essential role in 
        defending against and combatting public health threats 
        domestically and abroad and requires secure and modern 
        facilities, and expanded and improved capabilities 
        related to bioterrorism and other public health 
        emergencies, sufficient to enable such Centers to 
        conduct this important mission.
            (2) Facilities.--
                    (A) In general.--The Director of the 
                Centers for Disease Control and Prevention may 
                design, construct, and equip new facilities, 
                renovate existing facilities (including 
                laboratories, laboratory support buildings, 
                scientific communication facilities, 
                transshipment complexes, secured and isolated 
                parking structures, office buildings, and other 
                facilities and infrastructure), and upgrade 
                security of such facilities, in order to better 
                conduct the capacities described in section 
                319A, and for supporting public health 
                activities.
                    (B) Multiyear contracting authority.--For 
                any project of designing, constructing, 
                equipping, or renovating any facility under 
                subparagraph (A), the Director of the Centers 
                for Disease Control and Prevention may enter 
                into a single contract or related contracts 
                that collectively include the full scope of the 
                project, and the solicitation and contract 
                shall contain the clause ``availability of 
                funds'' found at section 52.232-18 of title 48, 
                Code of Federal Regulations.
            (3) Improving the capacities of the centers for 
        disease control and prevention.--The Secretary shall 
        expand, enhance, and improve the capabilities of the 
        Centers for Disease Control and Prevention relating to 
        preparedness for and responding effectively to 
        bioterrorism and other public health emergencies. 
        Activities that may be carried out under the preceding 
        sentence include--
                    (A) expanding or enhancing the training of 
                personnel;
                    (B) improving communications facilities and 
                networks, including delivery of necessary 
                information to rural areas;
                    (C) improving capabilities for public 
                health surveillance and reporting activities, 
                taking into account the integrated system or 
                systems of public health alert communications 
                and surveillance networks under subsection (b); 
                and
                    (D) improving laboratory facilities related 
                to bioterrorism and other public health 
                emergencies, including increasing the security 
                of such facilities.
    (b) National Communications and Surveillance Networks.--
            (1) In general.--The Secretary, directly or through 
        awards of grants, contracts, or cooperative agreements, 
        shall provide for the establishment of an integrated 
        system or systems of public health alert communications 
        and surveillance networks between and among--
                    (A) Federal, State, and local public health 
                officials;
                    (B) public and private health-related 
                laboratories, hospitals, and other health care 
                facilities; and
                    (C) any other entities determined 
                appropriate by the Secretary.
            (2) Requirements.--The Secretary shall ensure that 
        networks under paragraph (1) allow for the timely 
        sharing and discussion, in a secure manner, of 
        essential information concerning bioterrorism or 
        another public health emergency, or recommended methods 
        for responding to such an attack or emergency.
            (3) Standards.--Not later than one year after the 
        date of the enactment of the Public Health Security and 
        Bioterrorism Preparedness and Response Act of 2002, the 
        Secretary, in cooperation with health care providers 
        and State and local public health officials, shall 
        establish any additional technical and reporting 
        standards (including standards for interoperability) 
        for networks under paragraph (1).
    (c) Authorization of Appropriations.--
            (1) Facilities; capacities.--
                    (A) Facilities.--For the purpose of 
                carrying out subsection (a)(2), there are 
                authorized to be appropriated $300,000,000 for 
                each of the fiscal years 2002 and 2003, and 
                such sums as may be necessary for each of the 
                fiscal years 2004 through 2006.
                    (B) Mission; Improving capacities.--For the 
                purposes of achieving the mission of the 
                Centers for Disease Control and Prevention 
                described in subsection (a)(1), for carrying 
                out subsection (a)(3), for better conducting 
                the capacities described in section 319A, and 
                for supporting public health activities, there 
                are authorized to be appropriated such sums as 
                may be necessary for each of the fiscal years 
                2002 through 2006.
            (2) National communications and surveillance 
        networks.--For the purpose of carrying out subsection 
        (b), there are authorized to be appropriated such sums 
        as may be necessary for each of the fiscal years 2002 
        through 2006.
    (d) Public Health Situational Awareness.--
            (1) In general.--Not later than 2 years after the 
        date of enactment of the Pandemic and All-Hazards 
        Preparedness Act, the Secretary, in collaboration with 
        State, local, and tribal public health officials, shall 
        establish a near real-time electronic nationwide public 
        health situational awareness capability through an 
        interoperable network of systems to share data and 
        information to enhance early detection of rapid 
        response to, and management of, potentially 
        catastrophic infectious disease outbreaks and other 
        public health emergencies that originate domestically 
        or abroad. Such network shall be built on existing 
        State situational awareness systems or enhanced systems 
        that enable such connectivity.
            (2) Strategic plan.--Not later than 180 days after 
        the date of enactment the Pandemic and All-Hazards 
        Preparedness Act, the Secretary shall submit to the 
        appropriate committees of Congress, a strategic plan 
        that demonstrates the steps the Secretary will 
        undertake to develop, implement, and evaluate the 
        network described in paragraph (1), utilizing the 
        elements described in paragraph (3).
            (3) Elements.--The network described in paragraph 
        (1) shall include data and information transmitted in a 
        standardized format from--
                    (A) State, local, and tribal public health 
                entities, including public health laboratories;
                    (B) Federal health agencies;
                    (C) zoonotic disease monitoring systems;
                    (D) public and private sector health care 
                entities, hospitals, pharmacies, poison control 
                centers or professional organizations in the 
                field of poison control, and clinical 
                laboratories, to the extent practicable and 
                provided that such data are voluntarily 
                provided simultaneously to the Secretary and 
                appropriate State, local, and tribal public 
                health agencies; and
                    (E) such other sources as the Secretary may 
                deem appropriate.
            (4) Rule of construction.--Paragraph (3) shall not 
        be construed as requiring separate reporting of data 
        and information from each source listed.
            (5) Required activities.--In establishing and 
        operating the network described in paragraph (1), the 
        Secretary shall--
                    (A) utilize applicable interoperability 
                standards as determined by the Secretary 
                through a joint public and private sector 
                process;
                    (B) define minimal data elements for such 
                network;
                    (C) in collaboration with State, local, and 
                tribal public health officials, integrate and 
                build upon existing State, local, and tribal 
                capabilities, ensuring simultaneous sharing of 
                data, information, and analyses from the 
                network described in paragraph (1) with State, 
                local, and tribal public health agencies; and
                    (D) in collaboration with State, local, and 
                tribal public health officials, develop 
                procedures and standards for the collection, 
                analysis, and interpretation of data that 
                States, regions, or other entities collect and 
                report to the network described in paragraph 
                (1).
    (e) State and Regional Systems To Enhance Situational 
Awareness in Public Health Emergencies.--
            (1) In general.--To implement the network described 
        in subsection (d), the Secretary may award grants to 
        States or consortia of States to enhance the ability of 
        such States or consortia of States to establish or 
        operate a coordinated public health situational 
        awareness system for regional or Statewide early 
        detection of, rapid response to, and management of 
        potentially catastrophic infectious disease outbreaks 
        and public health emergencies, in collaboration with 
        appropriate public health agencies, sentinel hospitals, 
        clinical laboratories, pharmacies, poison control 
        centers, other health care organizations, and animal 
        health organizations within such States.
            (2) Eligibility.--To be eligible to receive a grant 
        under paragraph (1), the State or consortium of States 
        shall submit to the Secretary an application at such 
        time, in such manner, and containing such information 
        as the Secretary may require, including an assurance 
        that the State or consortium of States will submit to 
        the Secretary--
                    (A) reports of such data, information, and 
                metrics as the Secretary may require;
                    (B) a report on the effectiveness of the 
                systems funded under the grant; and
                    (C) a description of the manner in which 
                grant funds will be used to enhance the 
                timelines and comprehensiveness of efforts to 
                detect, respond to, and manage potentially 
                catastrophic infectious disease outbreaks and 
                public health emergencies.
            (3) Use of funds.--A State or consortium of States 
        that receives an award under this subsection--
                    (A) shall establish, enhance, or operate a 
                coordinated public health situational awareness 
                system for regional or Statewide early 
                detection of, rapid response to, and management 
                of potentially catastrophic infectious disease 
                outbreaks and public health emergencies;
                    (B) may award grants or contracts to 
                entities described in paragraph (1) within or 
                serving such State to assist such entities in 
                improving the operation of information 
                technology systems, facilitating the secure 
                exchange of data and information, and training 
                personnel to enhance the operation of the 
                system described in subparagraph (A); and
                    (C) may conduct a pilot program for the 
                development of multi-State telehealth network 
                test beds that build on, enhance, and securely 
                link existing State and local telehealth 
                programs to prepare for, monitor, respond to, 
                and manage the events of public health 
                emergencies, facilitate coordination and 
                communication among medical, public health, and 
                emergency response agencies, and provide 
                medical services through telehealth initiatives 
                within the States that are involved in such a 
                multi-State telehealth network test bed.
            (4) Limitation.--Information technology systems 
        acquired or implemented using grants awarded under this 
        section must be compliant with--
                    (A) interoperability and other 
                technological standards, as determined by the 
                Secretary; and
                    (B) data collection and reporting 
                requirements for the network described in 
                subsection (d).
            (5) Independent evaluation.--Not later than 4 years 
        after the date of enactment of the Pandemic and All-
        Hazards Preparedness Act, the Government Accountability 
        Office shall conduct an independent evaluation, and 
        submit to the Secretary and the appropriate committees 
        of Congress a report concerning the activities 
        conducted under this subsection and subsection (d).
    (f) Telehealth Enhancements for Emergency Response.--
            (1) Evaluation.--The Secretary, in consultation 
        with the Federal Communications Commission and other 
        relevant Federal agencies, shall--
                    (A) conduct an inventory of telehealth 
                initiatives in existence on the date of 
                enactment of the Pandemic and All-Hazards 
                Preparedness Act, including--
                            (i) the specific location of 
                        network components;
                            (ii) the medical, technological, 
                        and communications capabilities of such 
                        components;
                            (iii) the functionality of such 
                        components; and
                            (iv) the capacity and ability of 
                        such components to handle increased 
                        volume during the response to a public 
                        health emergency;
                    (B) identify methods to expand and 
                interconnect the regional health information 
                networks funded by the Secretary, the State and 
                regional broadband networks funded through the 
                rural health care support mechanism pilot 
                program funded by the Federal Communications 
                Commission, and other telehealth networks;
                    (C) evaluate ways to prepare for, monitor, 
                respond rapidly to, or manage the events of, a 
                public health emergency through the enhanced 
                use of telehealth technologies, including 
                mechanisms for payment or reimbursement for use 
                of such technologies and personnel during 
                public health emergencies;
                    (D) identify methods for reducing legal 
                barriers that deter health care professionals 
                from providing telemedicine services, such as 
                by utilizing State emergency health care 
                professional credentialing verification 
                systems, encouraging States to establish and 
                implement mechanisms to improve interstate 
                medical licensure cooperation, facilitating the 
                exchange of information among States regarding 
                investigations and adverse actions, and 
                encouraging States to waive the application of 
                licensing requirements during a public health 
                emergency;
                    (E) evaluate ways to integrate the practice 
                of telemedicine within the National Disaster 
                Medical System; and
                    (F) promote greater coordination among 
                existing Federal interagency telemedicine and 
                health information technology initiatives.
            (2) Report.--Not later than 12 months after the 
        date of enactment of the Pandemic and All-Hazards 
        Preparedness Act, the Secretary shall prepare and 
        submit a report to the Committee on Health, Education, 
        Labor, and Pensions of the Senate and the Committee on 
        Energy and Commerce of the House of Representatives 
        regarding the findings and recommendations pursuant to 
        subparagraphs (A) through (F) of paragraph (1).
    (g) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section, such sums as may 
be necessary in each of fiscal years 2007 through 2011.

SEC. 319E. [247D-5] COMBATING ANTIMICROBIAL RESISTANCE.

    (a) Task Force.--
            (1) In general.--The Secretary shall establish an 
        Antimicrobial Resistance Task Force to provide advice 
        and recommendations to the Secretary and coordinate 
        Federal programs relating to antimicrobial resistance. 
        The Secretary may appoint or select a committee, or 
        other organization in existence as of the date of the 
        enactment of this section, to serve as such a task 
        force, if such committee, or other organization meets 
        the requirements of this section.
            (2) Members of task force.--The task force 
        described in paragraph (1) shall be composed of 
        representatives from such Federal agencies, and shall 
        seek input from public health constituencies, 
        manufacturers, veterinary and medical professional 
        societies and others, as determined to be necessary by 
        the Secretary, to develop and implement a comprehensive 
        plan to address the public health threat of 
        antimicrobial resistance.
            (3) Agenda.--
                    (A) In general.--The task force described 
                in paragraph (1) shall consider factors the 
                Secretary considers appropriate, including--
                            (i) public health factors 
                        contributing to increasing 
                        antimicrobial resistance;
                            (ii) public health needs to detect 
                        and monitor antimicrobial resistance;
                            (iii) detection, prevention, and 
                        control strategies for resistant 
                        pathogens;
                            (iv) the need for improved 
                        information and data collection;
                            (v) the assessment of the risk 
                        imposed by pathogens presenting a 
                        threat to the public health; and
                            (vi) any other issues which the 
                        Secretary determines are relevant to 
                        antimicrobial resistance.
                    (B) Detection and control.--The Secretary, 
                in consultation with the task force described 
                in paragraph (1) and State and local public 
                health officials, shall--
                            (i) develop, improve, coordinate or 
                        enhance participation in a surveillance 
                        plan to detect and monitor emerging 
                        antimicrobial resistance; and
                            (ii) develop, improve, coordinate 
                        or enhance participation in an 
                        integrated information system to 
                        assimilate, analyze, and exchange 
                        antimicrobial resistance data between 
                        public health departments.
            (4) Meetings.--The task force described under 
        paragraph (1) shall convene not less than twice a year, 
        or more frequently as the Secretary determines to be 
        appropriate.
    (b) Research and Development of New Antimicrobial Drugs and 
Diagnostics.--The Secretary and the Director of Agricultural 
Research Services, consistent with the recommendations of the 
task force established under subsection (a), shall directly or 
through awards of grants or cooperative agreements to public or 
private entities provide for the conduct of research, 
investigations, experiments, demonstrations, and studies in the 
health sciences that are related to--
            (1) the development of new therapeutics, including 
        vaccines and antimicrobials, against resistant 
        pathogens;
            (2) the development or testing of medical 
        diagnostics to detect pathogens resistant to 
        antimicrobials;
            (3) the epidemiology, mechanisms, and pathogenesis 
        of antimicrobial resistance;
            (4) the sequencing of the genomes, or other DNA 
        analysis, or other comparative analysis, of priority 
        pathogens (as determined by the Director of the 
        National Institutes of Health in consultation with the 
        task force established under subsection (a)), in 
        collaboration and coordination with the activities of 
        the Department of Defense and the Joint Genome 
        Institute of the Department of Energy; and
            (5) other relevant research areas.
    (c) Education of Medical and Public Health Personnel.--The 
Secretary, after consultation with the Assistant Secretary for 
Health, the Surgeon General, the Director of the Centers for 
Disease Control and Prevention, the Administrator of the Health 
Resources and Services Administration, the Director of the 
Agency for Healthcare Research and Quality, members of the task 
force described in subsection (a), professional organizations 
and societies, and such other public health officials as may be 
necessary, shall--
            (1) develop and implement educational programs to 
        increase the awareness of the general public with 
        respect to the public health threat of antimicrobial 
        resistance and the appropriate use of antibiotics;
            (2) develop and implement educational programs to 
        instruct health care professionals in the prudent use 
        of antibiotics; and
            (3) develop and implement programs to train 
        laboratory personnel in the recognition or 
        identification of resistance in pathogens.
    (d) Grants.--
            (1) In general.--The Secretary shall award 
        competitive grants to eligible entities to enable such 
        entities to increase the capacity to detect, monitor, 
        and combat antimicrobial resistance.
            (2) Eligible entities.--Eligible entities for 
        grants under paragraph (1) shall be State or local 
        public health agencies, Indian tribes or tribal 
        organizations, or other public or private nonprofit 
        entities.
            (3) Use of funds.--An eligible entity receiving a 
        grant under paragraph (1) shall use funds from such 
        grant for activities that are consistent with the 
        factors identified by the task force under subsection 
        (a)(3), which may include activities that--
                    (A) provide training to enable such entity 
                to identify patterns of resistance rapidly and 
                accurately;
                    (B) develop, improve, coordinate or enhance 
                participation in information systems by which 
                data on resistant infections can be shared 
                rapidly among relevant national, State, and 
                local health agencies and health care 
                providers; and
                    (C) develop and implement policies to 
                control the spread of antimicrobial resistance.
    (e) Grants for Demonstration Programs.--
            (1) In general.--The Secretary shall award 
        competitive grants to eligible entities to establish 
        demonstration programs to promote judicious use of 
        antimicrobial drugs or control the spread of 
        antimicrobial-resistant pathogens.
            (2) Eligible entities.--Eligible entities for 
        grants under paragraph (1) may include hospitals, 
        clinics, institutions of long-term care, professional 
        medical societies, schools or programs that train 
        medical laboratory personnel, or other public or 
        private nonprofit entities.
            (3) Technical assistance.--The Secretary shall 
        provide appropriate technical assistance to eligible 
        entities that receive grants under paragraph (1).
    (f ) Supplement Not Supplant.--Funds appropriated under 
this section shall be used to supplement and not supplant other 
Federal, State, and local public funds provided for activities 
under this section.
    (g) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section, $40,000,000 for 
fiscal year 2001, $25,000,000 for each of the fiscal years 2002 
and 2003, and such sums as may be necessary for each of the 
fiscal years 2004 through 2006.

SEC. 319F. [247D-6] PUBLIC HEALTH COUNTERMEASURES TO A BIOTERRORIST 
                    ATTACK.

    (a) All-Hazards Public Health and Medical Response 
Curricula and Training.--
            (1) In general.--The Secretary, in collaboration 
        with the Secretary of Defense, and in consultation with 
        relevant public and private entities, shall develop 
        core health and medical response curricula and 
        trainings by adapting applicable existing curricula and 
        training programs to improve responses to public health 
        emergencies.
            (2) Curriculum.--The public health and medical 
        response training program may include course work 
        related to--
                    (A) medical management of casualties, 
                taking into account the needs of at-risk 
                individuals;
                    (B) public health aspects of public health 
                emergencies;
                    (C) mental health aspects of public health 
                emergencies;
                    (D) national incident management, including 
                coordination among Federal, State, local, 
                tribal, international agencies, and other 
                entities; and
                    (E) protecting health care workers and 
                health care first responders from workplace 
                exposures during a public health emergency.
            (3) Peer review.--On a periodic basis, products 
        prepared as part of the program shall be rigorously 
        tested and peer-reviewed by experts in the relevant 
        fields.
            (4) Credit.--The Secretary and the Secretary of 
        Defense shall--
                    (A) take into account continuing 
                professional education requirements of public 
                health and healthcare professions; and
                    (B) cooperate with State, local, and tribal 
                accrediting agencies and with professional 
                associations in arranging for students enrolled 
                in the program to obtain continuing 
                professional education credit for program 
                courses.
            (5) Dissemination and training.--
                    (A) In general.--The Secretary may provide 
                for the dissemination and teaching of the 
                materials described in paragraphs (1) and (2) 
                by appropriate means, as determined by the 
                Secretary.
                    (B) Certain entities.--The education and 
                training activities described in subparagraph 
                (A) may be carried out by Federal public health 
                or medical entities, appropriate educational 
                entities, professional organizations and 
                societies, private accrediting organizations, 
                and other nonprofit institutions or entities 
                meeting criteria established by the Secretary.
                    (C) Grants and contracts.--In carrying out 
                this subsection, the Secretary may carry out 
                activities directly or through the award of 
                grants and contracts, and may enter into 
                interagency agreements with other Federal 
                agencies.
    (b) Advice to the Federal Government.--
            (1) Required advisory committees.--In coordination 
        with the working group under subsection (a), the 
        Secretary shall establish advisory committees in 
        accordance with paragraphs (2) and (3) to provide 
        expert recommendations to assist such working groups in 
        carrying out their respective responsibilities under 
        subsections (a) and (b) \1\.
---------------------------------------------------------------------------
    \1\ Probably should be ``to assist such working group in carrying 
out its responsibilities under subsection (a)''. Formerly there were 
two working groups, one under subsection (a) and one under subsection 
(b). Now there is only the working group under subsection (a). See the 
amendments made by sections 104(a) and 108 of Public Law 107-188 (116 
Stat. 605, 609).
---------------------------------------------------------------------------
            (2) National advisory committee on children and 
        terrorism \2\.--
---------------------------------------------------------------------------
    \2\ The heading for subsection (b)(2) probably should read 
``National advisory committee on at-risk individuals and public health 
emergencies''. The amendment made by section 301(d)(1) of Public Law 
109-417 (120 Stat. 2854) to strike ``Children and terrorism'' and 
insert ``At-risk individuals and public health emergencies'' could not 
be executed due to incorrect capitalization of the word ``Children'' in 
the matter to be struck. Also the letter ``A'' in the word ``At-risk'' 
in the inserted text probably should be lowercase type.
---------------------------------------------------------------------------
                    (A) In general.--For purposes of paragraph 
                (1), the Secretary shall establish an advisory 
                committee to be known as the National Advisory 
                Committee on At-Risk Individuals and Public 
                Health Emergencies (referred to in this 
                paragraph as the ``Advisory Committee'').
                    (B) Duties.--The Advisory Committee shall 
                provide recommendations regarding--
                            (i) the preparedness of the health 
                        care (including mental health care) 
                        system to respond to public health 
                        emergencies as they relate to at-risk 
                        individuals;
                            (ii) needed changes to the health 
                        care and emergency medical service 
                        systems and emergency medical services 
                        protocols to meet the special needs of 
                        at-risk individuals; and
                            (iii) changes, if necessary, to the 
                        national stockpile under section 121 of 
                        the Public Health Security and 
                        Bioterrorism Preparedness and Response 
                        Act of 2002 to meet the emergency 
                        health security of at-risk individuals.
                    (C) Composition.--The Advisory Committee 
                shall be composed of such Federal officials as 
                may be appropriate to address the special needs 
                of the diverse population groups of at-risk 
                populations.
                    (D) Termination.--The Advisory Committee 
                terminates six years after the date of the 
                enactment of the Public Health Security and 
                Bioterrorism Preparedness and Response Act of 
                2002.
            (3) Emergency public information and communications 
        advisory committee.--
                    (A) In general.--For purposes of paragraph 
                (1), the Secretary shall establish an advisory 
                committee to be known as the Emergency Public 
                Information and Communications Advisory 
                Committee (referred to in this paragraph as the 
                ``EPIC Advisory Committee'').
                    (B) Duties.--The EPIC Advisory Committee 
                shall make recommendations to the Secretary and 
                report on appropriate ways to communicate 
                public health information regarding 
                bioterrorism and other public health 
                emergencies to the public.
                    (C) Composition.--The EPIC Advisory 
                Committee shall be composed of individuals 
                representing a diverse group of experts in 
                public health, medicine, communications, 
                behavioral psychology, and other areas 
                determined appropriate by the Secretary.
                    (D) Dissemination.--The Secretary shall 
                review the recommendations of the EPIC Advisory 
                Committee and ensure that appropriate 
                information is disseminated to the public.
                    (E) Termination.--The EPIC Advisory 
                Committee terminates one year after the date of 
                the enactment of Public Health Security and 
                Bioterrorism Preparedness and Response Act of 
                2002.
    (c) Expansion of Epidemic Intelligence Service Program.--
The Secretary may establish 20 officer positions in the 
Epidemic Intelligence Service Program, in addition to the 
number of the officer positions offered under such Program in 
2006, for individuals who agree to participate, for a period of 
not less than 2 years, in the Career Epidemiology Field Officer 
program in a State, local, or tribal health department that 
serves a health professional shortage area (as defined under 
section 332(a)), a medically underserved population (as defined 
under section 330(b)(3)), or a medically underserved area or 
area at high risk of a public health emergency as designated by 
the Secretary.
    (d) Centers for Public Health Preparedness; Core Curricula 
and Training.--
            (1) In general.--The Secretary may establish at 
        accredited schools of public health, Centers for Public 
        Health Preparedness (hereafter referred to in this 
        section as the ``Centers'').
            (2) Eligibility.--To be eligible to receive an 
        award under this subsection to establish a Center, an 
        accredited school of public health shall agree to 
        conduct activities consistent with the requirements of 
        this subsection.
            (3) Core curricula.--The Secretary, in 
        collaboration with the Centers and other public or 
        private entities shall establish core curricula based 
        on established competencies leading to a 4-year 
        bachelor's degree, a graduate degree, a combined 
        bachelor and master's degree, or a certificate program, 
        for use by each Center. The Secretary shall disseminate 
        such curricula to other accredited schools of public 
        health and other health professions schools determined 
        appropriate by the Secretary, for voluntary use by such 
        schools.
            (4) Core competency-based training program.--The 
        Secretary, in collaboration with the Centers and other 
        public or private entities shall facilitate the 
        development of a competency-based training program to 
        train public health practitioners. The Centers shall 
        use such training program to train public health 
        practitioners. The Secretary shall disseminate such 
        training program to other accredited schools of public 
        health, health professions schools, and other public or 
        private entities as determined by the Secretary, for 
        voluntary use by such entities.
            (5) Content of core curricula and training 
        program.--The Secretary shall ensure that the core 
        curricula and training program established pursuant to 
        this subsection respond to the needs of State, local, 
        and tribal public health authorities and integrate and 
        emphasize essential public health security capabilities 
        consistent with section 2802(b)(2).
            (6) Academic-workforce communication.--As a 
        condition of receiving funding from the Secretary under 
        this subsection, a Center shall collaborate with a 
        State, local, or tribal public health department to--
                    (A) define the public health preparedness 
                and response needs of the community involved;
                    (B) assess the extent to which such needs 
                are fulfilled by existing preparedness and 
                response activities of such school or health 
                department, and how such activities may be 
                improved;
                    (C) prior to developing new materials or 
                trainings, evaluate and utilize relevant 
                materials and trainings developed by others 
                Centers; and
                    (D) evaluate community impact and the 
                effectiveness of any newly developed materials 
                or trainings.
            (7) Public health systems research.--In 
        consultation with relevant public and private entities, 
        the Secretary shall define the existing knowledge base 
        for public health preparedness and response systems, 
        and establish a research agenda based on Federal, 
        State, local, and tribal public health preparedness 
        priorities. As a condition of receiving funding from 
        the Secretary under this subsection, a Center shall 
        conduct public health systems research that is 
        consistent with the agenda described under this 
        paragraph.
    (e) Accelerated Research and Development on Priority 
Pathogens and Countermeasures.--
            (1) In general.--With respect to pathogens of 
        potential use in a bioterrorist attack, and other 
        agents that may cause a public health emergency, the 
        Secretary, taking into consideration any 
        recommendations of the working group under subsection 
        (a), shall conduct, and award grants, contracts, or 
        cooperative agreements for, research, investigations, 
        experiments, demonstrations, and studies in the health 
        sciences relating to--
                    (A) the epidemiology and pathogenesis of 
                such pathogens;
                    (B) the sequencing of the genomes, or other 
                DNA analysis, or other comparative analysis, of 
                priority pathogens (as determined by the 
                Director of the National Institutes of Health 
                in consultation with the working group 
                established in subsection (a)), in 
                collaboration and coordination with the 
                activities of the Department of Defense and the 
                Joint Genome Institute of the Department of 
                Energy;
                    (C) the development of priority 
                countermeasures; and
                    (D) other relevant areas of research;
        with consideration given to the needs of children and 
        other vulnerable populations.
            (2) Priority.--The Secretary shall give priority 
        under this section to the funding of research and other 
        studies related to priority countermeasures.
            (3) Role of department of veterans affairs.--In 
        carrying out paragraph (1), the Secretary shall 
        consider using the biomedical research and development 
        capabilities of the Department of Veterans Affairs, in 
        conjunction with that Department's affiliations with 
        health-professions universities. When advantageous to 
        the Government in furtherance of the purposes of such 
        paragraph, the Secretary may enter into cooperative 
        agreements with the Secretary of Veterans Affairs to 
        achieve such purposes.
            (4) Priority countermeasures.--For purposes of this 
        section, the term ``priority countermeasure'' means a 
        drug, biological product, device, vaccine, vaccine 
        adjuvant, antiviral, or diagnostic test that the 
        Secretary determines to be--
                    (A) a priority to treat, identify, or 
                prevent infection by a biological agent or 
                toxin listed pursuant to section 351A(a)(1), or 
                harm from any other agent that may cause a 
                public health emergency; or
                    (B) a priority to treat, identify, or 
                prevent conditions that may result in adverse 
                health consequences or death and may be caused 
                by the administering of a drug, biological 
                product, device, vaccine, vaccine adjuvant, 
                antiviral, or diagnostic test that is a 
                priority under subparagraph (A).
    (f) Authorization of Appropriations.--
            (1) Fiscal year 2007.--There are authorized to be 
        appropriated to carry out this section for fiscal year 
        2007--
                    (A) to carry out subsection (a)--
                            (i) $5,000,000 to carry out 
                        paragraphs (1) through (4); and
                            (ii) $7,000,000 to carry out 
                        paragraph (5);
                    (B) to carry out subsection (c), 
                $3,000,000; and
                    (C) to carry out subsection (d), 
                $31,000,000, of which $5,000,000 shall be used 
                to carry out paragraphs (3) through (5) of such 
                subsection.
            (2) Subsequent fiscal years.--There are authorized 
        to be appropriated such sums as may be necessary to 
        carry out this section for fiscal year 2008 and each 
        subsequent fiscal year.

SEC. 319F-1. [247D-6A] AUTHORITY FOR USE OF CERTAIN PROCEDURES 
                    REGARDING QUALIFIED COUNTERMEASURE RESEARCH AND 
                    DEVELOPMENT ACTIVITIES. \2\

    (a) In General.--
            (1) Authority.--In conducting and supporting 
        research and development activities regarding 
        countermeasures under section 319F(h), the Secretary 
        may conduct and support such activities in accordance 
        with this section and, in consultation with the 
        Director of the National Institutes of Health, as part 
        of the program under section 446, if the activities 
        concern qualified countermeasures.
---------------------------------------------------------------------------
    \2\ Section 5 of Public Law 108-276 (118 Stat. 860) requires 
various reports regarding section 319F-1 and related provisions of law. 
Section 5 is included in the appendix to this compilation.
---------------------------------------------------------------------------
            (2) Definitions.--In this section:
                    (A) Qualified countermeasure.--The term 
                ``qualified countermeasure'' means a drug (as 
                that term is defined by section 201(g)(1) of 
                the Federal Food, Drug, and Cosmetic Act (21 
                U.S.C. 321(g)(1))), biological product (as that 
                term is defined by section 351(i) of this Act 
                (42 U.S.C. 262(i))), or device (as that term is 
                defined by section 201(h) of the Federal Food, 
                Drug, and Cosmetic Act (21 U.S.C. 321(h))), 
                that the Secretary determines to be a priority 
                (consistent with sections 302(2) and 304(a) of 
                the Homeland Security Act of 2002) to--
                            (i) diagnose, mitigate, prevent, or 
                        treat harm from any biological agent 
                        (including organisms that cause an 
                        infectious disease) or toxin, chemical, 
                        radiological, or nuclear agent that may 
                        cause a public health emergency 
                        affecting national security; or
                            (ii) diagnose, mitigate, prevent, 
                        or treat harm from a condition that may 
                        result in adverse health consequences 
                        or death and may be caused by 
                        administering a drug, biological 
                        product, or device that is used as 
                        described in this subparagraph.
                    (B) Infectious disease.--The term 
                ``infectious disease'' means a disease 
                potentially caused by a pathogenic organism 
                (including a bacteria, virus, fungus, or 
                parasite) that is acquired by a person and that 
                reproduces in that person.
            (3) Interagency cooperation.--
                    (A) In general.--In carrying out activities 
                under this section, the Secretary is 
                authorized, subject to subparagraph (B), to 
                enter into interagency agreements and other 
                collaborative undertakings with other agencies 
                of the United States Government.
                    (B) Limitation.--An agreement or 
                undertaking under this paragraph shall not 
                authorize another agency to exercise the 
                authorities provided by this section.
            (4) Availability of facilities to the secretary.--
        In any grant, contract, or cooperative agreement 
        entered into under the authority provided in this 
        section with respect to a biocontainment laboratory or 
        other related or ancillary specialized research 
        facility that the Secretary determines necessary for 
        the purpose of performing, administering, or supporting 
        qualified countermeasure research and development, the 
        Secretary may provide that the facility that is the 
        object of such grant, contract, or cooperative 
        agreement shall be available as needed to the Secretary 
        to respond to public health emergencies affecting 
        national security.
            (5) Transfers of qualified countermeasures.--Each 
        agreement for an award of a grant, contract, or 
        cooperative agreement under section 319F(h) for the 
        development of a qualified countermeasure shall provide 
        that the recipient of the award will comply with all 
        applicable export-related controls with respect to such 
        countermeasure.
    (b) Expedited Procurement Authority.--
            (1) Increased simplified acquisition threshold for 
        qualified countermeasure procurements.--
                    (A) In general.--For any procurement by the 
                Secretary of property or services for use (as 
                determined by the Secretary) in performing, 
                administering, or supporting qualified 
                countermeasure research or development 
                activities under this section that the 
                Secretary determines necessary to respond to 
                pressing research and development needs under 
                this section, the amount specified in section 
                4(11) of the Office of Federal Procurement 
                Policy Act (41 U.S.C. 403(11)), as applicable 
                pursuant to section 302A(a) of the Federal 
                Property and Administrative Services Act of 
                1949 (41 U.S.C. 252a(a)), shall be deemed to be 
                $25,000,000 in the administration, with respect 
                to such procurement, of--
                            (i) section 303(g)(1)(A) of the 
                        Federal Property and Administrative 
                        Services Act of 1949 (41 U.S.C. 
                        253(g)(1)(A)) and its implementing 
                        regulations; and
                            (ii) section 302A(b) of such Act 
                        (41 U.S.C. 252a(b)) and its 
                        implementing regulations.
                    (B) Application of certain provisions.--
                Notwithstanding subparagraph (A) and the 
                provision of law and regulations referred to in 
                such subparagraph, each of the following 
                provisions shall apply to procurements 
                described in this paragraph to the same extent 
                that such provisions would apply to such 
                procurements in the absence of subparagraph 
                (A):
                            (i) Chapter 37 of title 40, United 
                        States Code (relating to contract work 
                        hours and safety standards).
                            (ii) Subsections (a) and (b) of 
                        section 7 of the Anti-Kickback Act of 
                        1986 (41 U.S.C. 57(a) and (b)).
                            (iii) Section 304C of the Federal 
                        Property and Administrative Services 
                        Act of 1949 (41 U.S.C. 254d) (relating 
                        to the examination of contractor 
                        records).
                            (iv) Section 3131 of title 40, 
                        United States Code (relating to bonds 
                        of contractors of public buildings or 
                        works).
                            (v) Subsection (a) of section 304 
                        of the Federal Property and 
                        Administrative Services Act of 1949 (41 
                        U.S.C. 254(a)) (relating to contingent 
                        fees to middlemen).
                            (vi) Section 6002 of the Solid 
                        Waste Disposal Act (42 U.S.C. 6962).
                            (vii) Section 1354 of title 31, 
                        United States Code (relating to the 
                        limitation on the use of appropriated 
                        funds for contracts with entities not 
                        meeting veterans employment reporting 
                        requirements).
                    (C) Internal controls to be instituted.--
                The Secretary shall institute appropriate 
                internal controls for procurements that are 
                under this paragraph, including requirements 
                with regard to documenting the justification 
                for use of the authority in this paragraph with 
                respect to the procurement involved.
                    (D) Authority to limit competition.--In 
                conducting a procurement under this paragraph, 
                the Secretary may not use the authority 
                provided for under subparagraph (A) to conduct 
                a procurement on a basis other than full and 
                open competition unless the Secretary 
                determines that the mission of the BioShield 
                Program under the Project BioShield Act of 2004 
                would be seriously impaired without such a 
                limitation.
            (2) Procedures other than full and open 
        competition.--
                    (A) In general.--In using the authority 
                provided in section 303(c)(1) of title III of 
                the Federal Property and Administrative 
                Services Act of 1949 (41 U.S.C. 253(c)(1)) to 
                use procedures other than competitive 
                procedures in the case of a procurement 
                described in paragraph (1) of this subsection, 
                the phrase ``available from only one 
                responsible source'' in such section 303(c)(1) 
                shall be deemed to mean ``available from only 
                one responsible source or only from a limited 
                number of responsible sources''.
                    (B) Relation to other authorities.--The 
                authority under subparagraph (A) is in addition 
                to any other authority to use procedures other 
                than competitive procedures.
                    (C) Applicable government-wide 
                regulations.--The Secretary shall implement 
                this paragraph in accordance with government-
                wide regulations implementing such section 
                303(c)(1) (including requirements that offers 
                be solicited from as many potential sources as 
                is practicable under the circumstances, that 
                required notices be published, and that 
                submitted offers be considered), as such 
                regulations apply to procurements for which an 
                agency has authority to use procedures other 
                than competitive procedures when the property 
                or services needed by the agency are available 
                from only one responsible source or only from a 
                limited number of responsible sources and no 
                other type of property or services will satisfy 
                the needs of the agency.
            (3) Increased micropurchase threshold.--
                    (A) In general.--For a procurement 
                described by paragraph (1), the amount 
                specified in subsections (c), (d), and (f) of 
                section 32 of the Office of Federal Procurement 
                Policy Act (41 U.S.C. 428) shall be deemed to 
                be $15,000 in the administration of that 
                section with respect to such procurement.
                    (B) Internal controls to be instituted.--
                The Secretary shall institute appropriate 
                internal controls for purchases that are under 
                this paragraph and that are greater than 
                $2,500.
                    (C) Exception to preference for purchase 
                card mechanism.--No provision of law 
                establishing a preference for using a 
                Government purchase card method for purchases 
                shall apply to purchases that are under this 
                paragraph and that are greater than $2,500.
            (4) Review.--
                    (A) Review allowed.--Notwithstanding 
                subsection (f), section 1491 of title 28, 
                United States Code, and section 3556 of title 
                31 of such Code, review of a contracting agency 
                decision relating to a procurement described in 
                paragraph (1) may be had only by filing a 
                protest--
                            (i) with a contracting agency; or
                            (ii) with the Comptroller General 
                        under subchapter V of chapter 35 of 
                        title 31, United States Code.
                    (B) Override of stay of contract award or 
                performance committed to agency discretion.--
                Notwithstanding section 1491 of title 28, 
                United States Code, and section 3553 of title 
                31 of such Code, the following authorizations 
                by the head of a procuring activity are 
                committed to agency discretion:
                            (i) An authorization under section 
                        3553(c)(2) of title 31, United States 
                        Code, to award a contract for a 
                        procurement described in paragraph (1) 
                        of this subsection.
                            (ii) An authorization under section 
                        3553(d)(3)(C) of such title to perform 
                        a contract for a procurement described 
                        in paragraph (1) of this subsection.
    (c) Authority to Expedite Peer Review.--
            (1) In general.--The Secretary may, as the 
        Secretary determines necessary to respond to pressing 
        qualified countermeasure research and development needs 
        under this section, employ such expedited peer review 
        procedures (including consultation with appropriate 
        scientific experts) as the Secretary, in consultation 
        with the Director of NIH, deems appropriate to obtain 
        assessment of scientific and technical merit and likely 
        contribution to the field of qualified countermeasure 
        research, in place of the peer review and advisory 
        council review procedures that would be required under 
        sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 
        406(a)(3)(A), 492, and 494, as applicable to a grant, 
        contract, or cooperative agreement--
                    (A) that is for performing, administering, 
                or supporting qualified countermeasure research 
                and development activities; and
                    (B) the amount of which is not greater than 
                $1,500,000.
            (2) Subsequent phases of research.--The Secretary's 
        determination of whether to employ expedited peer 
        review with respect to any subsequent phases of a 
        research grant, contract, or cooperative agreement 
        under this section shall be determined without regard 
        to the peer review procedures used for any prior peer 
        review of that same grant, contract, or cooperative 
        agreement. Nothing in the preceding sentence may be 
        construed to impose any requirement with respect to 
        peer review not otherwise required under any other law 
        or regulation.
    (d) Authority for Personal Services Contracts.--
            (1) In general.--For the purpose of performing, 
        administering, or supporting qualified countermeasure 
        research and development activities, the Secretary may, 
        as the Secretary determines necessary to respond to 
        pressing qualified countermeasure research and 
        development needs under this section, obtain by 
        contract (in accordance with section 3109 of title 5, 
        United States Code, but without regard to the 
        limitations in such section on the period of service 
        and on pay) the personal services of experts or 
        consultants who have scientific or other professional 
        qualifications, except that in no case shall the 
        compensation provided to any such expert or consultant 
        exceed the daily equivalent of the annual rate of 
        compensation for the President.
            (2) Federal tort claims act coverage.--
                    (A) In general.--A person carrying out a 
                contract under paragraph (1), and an officer, 
                employee, or governing board member of such 
                person, shall, subject to a determination by 
                the Secretary, be deemed to be an employee of 
                the Department of Health and Human Services for 
                purposes of claims under sections 1346(b) and 
                2672 of title 28, United States Code, for money 
                damages for personal injury, including death, 
                resulting from performance of functions under 
                such contract.
                    (B) Exclusivity of remedy.--The remedy 
                provided by subparagraph (A) shall be exclusive 
                of any other civil action or proceeding by 
                reason of the same subject matter against the 
                entity involved (person, officer, employee, or 
                governing board member) for any act or omission 
                within the scope of the Federal Tort Claims 
                Act.
                    (C) Recourse in case of gross misconduct or 
                contract violation.--
                            (i) In general.--Should payment be 
                        made by the United States to any 
                        claimant bringing a claim under this 
                        paragraph, either by way of 
                        administrative determination, 
                        settlement, or court judgment, the 
                        United States shall have, 
                        notwithstanding any provision of State 
                        law, the right to recover against any 
                        entity identified in subparagraph (B) 
                        for that portion of the damages so 
                        awarded or paid, as well as interest 
                        and any costs of litigation, resulting 
                        from the failure of any such entity to 
                        carry out any obligation or 
                        responsibility assumed by such entity 
                        under a contract with the United States 
                        or from any grossly negligent or 
                        reckless conduct or intentional or 
                        willful misconduct on the part of such 
                        entity.
                            (ii) Venue.--The United States may 
                        maintain an action under this 
                        subparagraph against such entity in the 
                        district court of the United States in 
                        which such entity resides or has its 
                        principal place of business.
            (3) Internal controls to be instituted.--
                    (A) In general.--The Secretary shall 
                institute appropriate internal controls for 
                contracts under this subsection, including 
                procedures for the Secretary to make a 
                determination of whether a person, or an 
                officer, employee, or governing board member of 
                a person, is deemed to be an employee of the 
                Department of Health and Human Services 
                pursuant to paragraph (2).
                    (B) Determination of employee status to be 
                final.--A determination by the Secretary under 
                subparagraph (A) that a person, or an officer, 
                employee, or governing board member of a 
                person, is or is not deemed to be an employee 
                of the Department of Health and Human Services 
                shall be final and binding on the Secretary and 
                the Attorney General and other parties to any 
                civil action or proceeding.
            (4) Number of personal services contracts 
        limited.--The number of experts and consultants whose 
        personal services are obtained under paragraph (1) 
        shall not exceed 30 at any time.
    (e) Streamlined Personnel Authority.--
            (1) In general.--In addition to any other personnel 
        authorities, the Secretary may, as the Secretary 
        determines necessary to respond to pressing qualified 
        countermeasure research and development needs under 
        this section, without regard to those 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, appoint professional and technical 
        employees, not to exceed 30 such employees at any time, 
        to positions in the National Institutes of Health to 
        perform, administer, or support qualified 
        countermeasure research and development activities in 
        carrying out this section.
            (2) Limitations.--The authority provided for under 
        paragraph (1) shall be exercised in a manner that--
                    (A) recruits and appoints individuals based 
                solely on their abilities, knowledge, and 
                skills;
                    (B) does not discriminate for or against 
                any applicant for employment on any basis 
                described in section 2302(b)(1) of title 5, 
                United States Code;
                    (C) does not allow an official to appoint 
                an individual who is a relative (as defined in 
                section 3110(a)(3) of such title) of such 
                official;
                    (D) does not discriminate for or against an 
                individual because of the exercise of any 
                activity described in paragraph (9) or (10) of 
                section 2302(b) of such title; and
                    (E) accords a preference, among equally 
                qualified persons, to persons who are 
                preference eligibles (as defined in section 
                2108(3) of such title).
            (3) Internal controls to be instituted.--The 
        Secretary shall institute appropriate internal controls 
        for appointments under this subsection.
    (f) Actions Committed to Agency Discretion.--Actions by the 
Secretary under the authority of this section are committed to 
agency discretion.

SEC. 319F-2. [247D-6B] STRATEGIC NATIONAL STOCKPILE AND SECURITY 
                    COUNTERMEASURE PROCUREMENTS. \1\

    (a) Strategic National Stockpile.--
            (1) In general.--The Secretary, in collaboration 
        with the Director of the Centers for Disease Control 
        and Prevention, and in coordination with the Secretary 
        of Homeland Security (referred to in this section as 
        the ``Homeland Security Secretary''), shall maintain a 
        stockpile or stockpiles of drugs, vaccines and other 
        biological products, medical devices, and other 
        supplies in such numbers, types, and amounts as are 
        determined by the Secretary to be appropriate and 
        practicable, taking into account other available 
        sources, to provide for the emergency health security 
        of the United States, including the emergency health 
        security of children and other vulnerable populations, 
        in the event of a bioterrorist attack or other public 
        health emergency. The Secretary shall conduct an annual 
        review (taking into account at-risk individuals) of the 
        contents of the stockpile, including non-pharmaceutical 
        supplies, and make necessary additions or modifications 
        to the contents based on such review.
---------------------------------------------------------------------------
    \1\ Section 5 of Public Law 108-276 (118 Stat. 860) requires 
various reports regarding section 319F-2 and related provisions of law. 
Section 5 is included in the appendix to this compilation.
---------------------------------------------------------------------------
            (2) Procedures.--The Secretary, in managing the 
        stockpile under paragraph (1), shall--
                    (A) consult with the working group under 
                section 319F(a);
                    (B) ensure that adequate procedures are 
                followed with respect to such stockpile for 
                inventory management and accounting, and for 
                the physical security of the stockpile;
                    (C) in consultation with Federal, State, 
                and local officials, take into consideration 
                the timing and location of special events;
                    (D) review and revise, as appropriate, the 
                contents of the stockpile on a regular basis to 
                ensure that emerging threats, advanced 
                technologies, and new countermeasures are 
                adequately considered;
                    (E) devise plans for the effective and 
                timely supply-chain management of the 
                stockpile, in consultation with appropriate 
                Federal, State and local agencies, and the 
                public and private health care infrastructure;
                    (F) deploy the stockpile as required by the 
                Secretary of Homeland Security to respond to an 
                actual or potential emergency;
                    (G) deploy the stockpile at the discretion 
                of the Secretary to respond to an actual or 
                potential public health emergency or other 
                situation in which deployment is necessary to 
                protect the public health or safety; and
                    (H) ensure the adequate physical security 
                of the stockpile.
    (b) Smallpox Vaccine Development.--
            (1) In general.--The Secretary shall award 
        contracts, enter into cooperative agreements, or carry 
        out such other activities as may reasonably be required 
        in order to ensure that the stockpile under subsection 
        (a) includes an amount of vaccine against smallpox as 
        determined by such Secretary to be sufficient to meet 
        the health security needs of the United States.
            (2) Rule of construction.--Nothing in this section 
        shall be construed to limit the private distribution, 
        purchase, or sale of vaccines from sources other than 
        the stockpile described in subsection (a).
    (c) Additional Authority Regarding Procurement of Certain 
Countermeasures; Availability of Special Reserve Fund.--
            (1) In general.--
                    (A) Use of fund.--A security countermeasure 
                may, in accordance with this subsection, be 
                procured with amounts in the special reserve 
                fund under paragraph (10).
                    (B) Security countermeasure.--For purposes 
                of this subsection, the term ``security 
                countermeasure'' means a drug (as that term is 
                defined by section 201(g)(1) of the Federal 
                Food, Drug, and Cosmetic Act (21 U.S.C. 
                321(g)(1))), biological product (as that term 
                is defined by section 351(i) of this Act (42 
                U.S.C. 262(i))), or device (as that term is 
                defined by section 201(h) of the Federal Food, 
                Drug, and Cosmetic Act (21 U.S.C. 321(h))) 
                that--
                            (i)(I) the Secretary determines to 
                        be a priority (consistent with sections 
                        302(2) and 304(a) of the Homeland 
                        Security Act of 2002) to diagnose, 
                        mitigate, prevent, or treat harm from 
                        any biological, chemical, radiological, 
                        or nuclear agent identified as a 
                        material threat under paragraph 
                        (2)(A)(ii), or to diagnose, mitigate, 
                        prevent, or treat harm from a condition 
                        that may result in adverse health 
                        consequences or death and may be caused 
                        by administering a drug, biological 
                        product, or device against such an 
                        agent;
                            (II) the Secretary determines under 
                        paragraph (2)(B)(ii) to be a necessary 
                        countermeasure; and
                            (III)(aa) is approved or cleared 
                        under chapter V of the Federal Food, 
                        Drug, and Cosmetic Act or licensed 
                        under section 351 of this Act; or
                            (bb) is a countermeasure for which 
                        the Secretary determines that 
                        sufficient and satisfactory clinical 
                        experience or research data (including 
                        data, if available, from pre-clinical 
                        and clinical trials) support a 
                        reasonable conclusion that the 
                        countermeasure will qualify for 
                        approval or licensing within eight 
                        years after the date of a determination 
                        under paragraph (5); or
                            (ii) is authorized for emergency 
                        use under section 564 of the Federal 
                        Food, Drug, and Cosmetic Act.
            (2) Determination of material threats.--
                    (A) Material threat.--The Homeland Security 
                Secretary, in consultation with the Secretary 
                and the heads of other agencies as appropriate, 
                shall on an ongoing basis--
                            (i) assess current and emerging 
                        threats of chemical, biological, 
                        radiological, and nuclear agents; and
                            (ii) determine which of such agents 
                        present a material threat against the 
                        United States population sufficient to 
                        affect national security.
                    (B) Public health impact; necessary 
                countermeasures.--The Secretary shall on an 
                ongoing basis--
                            (i) assess the potential public 
                        health consequences for the United 
                        States population of exposure to agents 
                        identified under subparagraph (A)(ii); 
                        and
                            (ii) determine, on the basis of 
                        such assessment, the agents identified 
                        under subparagraph (A)(ii) for which 
                        countermeasures are necessary to 
                        protect the public health.
                    (C) Notice to congress.--The Secretary and 
                the Homeland Security Secretary shall promptly 
                notify the designated congressional committees 
                (as defined in paragraph (10)) that a 
                determination has been made pursuant to 
                subparagraph (A) or (B).
                    (D) Assuring access to threat 
                information.--In making the assessment and 
                determination required under subparagraph (A), 
                the Homeland Security Secretary shall use all 
                relevant information to which such Secretary is 
                entitled under section 202 of the Homeland 
                Security Act of 2002, including but not limited 
                to information, regardless of its level of 
                classification, relating to current and 
                emerging threats of chemical, biological, 
                radiological, and nuclear agents.
            (3) Assessment of availability and appropriateness 
        of countermeasures.--
                    (A) In general.--The Secretary, in 
                consultation with the Homeland Security 
                Secretary, shall assess on an ongoing basis the 
                availability and appropriateness of specific 
                countermeasures to address specific threats 
                identified under paragraph (2).
                    (B) Information.--The Secretary shall 
                institute a process for making publicly 
                available the results of assessments under 
                subparagraph (A) while withholding such 
                information as--
                            (i) would, in the judgment of the 
                        Secretary, tend to reveal public health 
                        vulnerabilities; or
                            (ii) would otherwise be exempt from 
                        disclosure under section 552 of title 
                        5, United States Code.
            (4) Call for development of countermeasures; 
        commitment for recommendation for procurement.--
                    (A) Proposal to the president.--If, 
                pursuant to an assessment under paragraph (3), 
                the Homeland Security Secretary and the 
                Secretary make a determination that a 
                countermeasure would be appropriate but is 
                either
                currently not developed or unavailable for 
                procurement as a security countermeasure or is 
                approved, licensed, or cleared only for 
                alternative uses, such Secretaries may jointly 
                submit to the President a proposal to--
                            (i) issue a call for the 
                        development of such countermeasure; and
                            (ii) make a commitment that, upon 
                        the first development of such 
                        countermeasure that meets the 
                        conditions for procurement under 
                        paragraph (5), the Secretaries will, 
                        based in part on information obtained 
                        pursuant to such call, make a 
                        recommendation under paragraph (6) that 
                        the special reserve fund under 
                        paragraph (10) be made available for 
                        the procurement of such countermeasure.
                    (B) Countermeasure specifications.--The 
                Homeland Security Secretary and the Secretary 
                shall, to the extent practicable, include in 
                the proposal under subparagraph (A)--
                            (i) estimated quantity of purchase 
                        (in the form of number of doses or 
                        number of effective courses of 
                        treatments regardless of dosage form);
                            (ii) necessary measures of minimum 
                        safety and effectiveness;
                            (iii) estimated price for each dose 
                        or effective course of treatment 
                        regardless of dosage form; and
                            (iv) other information that may be 
                        necessary to encourage and facilitate 
                        research, development, and manufacture 
                        of the countermeasure or to provide 
                        specifications for the countermeasure.
                    (C) Presidential approval.--If the 
                President approves a proposal under 
                subparagraph (A), the Homeland Security 
                Secretary and the Secretary shall make known to 
                persons who may respond to a call for the 
                countermeasure involved--
                            (i) the call for the 
                        countermeasure;
                            (ii) specifications for the 
                        countermeasure under subparagraph (B); 
                        and
                            (iii) the commitment described in 
                        subparagraph (A)(ii).
            (5) Secretary's determination of countermeasures 
        appropriate for funding from special reserve fund.--
                    (A) In general.--The Secretary, in 
                accordance with the provisions of this 
                paragraph, shall identify specific security 
                countermeasures that the Secretary determines, 
                in consultation with the Homeland Security 
                Secretary, to be appropriate for inclusion in 
                the stockpile under subsection (a) pursuant to 
                procurements made with amounts in the special 
                reserve fund under paragraph (10) (referred to 
                in this subsection individually as a 
                ``procurement under this subsection'').
                    (B) Requirements.--In making a 
                determination under subparagraph (A) with 
                respect to a security countermeasure, the 
                Secretary shall determine and consider the 
                following:
                            (i) The quantities of the product 
                        that will be needed to meet the 
                        stockpile needs.
                            (ii) The feasibility of production 
                        and delivery within eight years of 
                        sufficient quantities of the product.
                            (iii) Whether there is a lack of a 
                        significant commercial market for the 
                        product at the time of procurement, 
                        other than as a security 
                        countermeasure.
            (6) Recommendation for president's approval.--
                    (A) Recommendation for procurement.--In the 
                case of a security countermeasure that the 
                Secretary has, in accordance with paragraphs 
                (3) and (5), determined to be appropriate for 
                procurement under this subsection, the Homeland 
                Security Secretary and the Secretary shall 
                jointly submit to the President, in 
                coordination with the Director of the Office of 
                Management and Budget, a recommendation that 
                the special reserve fund under paragraph (10) 
                be made available for the procurement of such 
                countermeasure.
                    (B) Presidential approval.--The special 
                reserve fund under paragraph (10) is available 
                for a procurement of a security countermeasure 
                only if the President has approved a 
                recommendation under subparagraph (A) regarding 
                the countermeasure.
                    (C) Notice to designated congressional 
                committees.--The Secretary and the Homeland 
                Security Secretary shall notify the designated 
                congressional committees of each decision of 
                the President to approve a recommendation under 
                subparagraph (A). Such notice shall include an 
                explanation of the decision to make available 
                the special reserve fund under paragraph (10) 
                for procurement of such a countermeasure, 
                including, where available, the number of, 
                nature of, and other information concerning 
                potential suppliers of such countermeasure, and 
                whether other potential suppliers of the same 
                or similar countermeasures were considered and 
                rejected for procurement under this section and 
                the reasons therefor.
                    (D) Subsequent specific countermeasures.--
                Procurement under this subsection of a security 
                countermeasure for a particular purpose does 
                not preclude the subsequent procurement under 
                this subsection of any other security 
                countermeasure for such purpose if the 
                Secretary has determined under paragraph (5)(A) 
                that such countermeasure is appropriate for 
                inclusion in the stockpile and if, as 
                determined by the Secretary, such 
                countermeasure provides improved safety or 
                effectiveness, or for other reasons enhances 
                preparedness to respond to threats of use of a 
                biological, chemical, radiological, or nuclear 
                agent. Such a determination by the Secretary is 
                committed to agency discretion.
                    (E) Rule of construction.--Recommendations 
                and approvals under this paragraph apply solely 
                to determinations that the special reserve fund 
                under paragraph (10) will be made available for 
                a procurement of a security countermeasure, and 
                not to the substance of contracts for such 
                procurement or other matters relating to awards 
                of such contracts.
            (7) Procurement.--
                    (A) In general.--For purposes of a 
                procurement under this subsection that is 
                approved by the President under paragraph (6), 
                the Homeland Security Secretary and the 
                Secretary shall have responsibilities in 
                accordance with subparagraphs (B) and (C).
                    (B) Interagency agreement; cost.--The 
                Homeland Security Secretary shall enter into an 
                agreement with the Secretary for procurement of 
                a security countermeasure in accordance with 
                the provisions of this paragraph. The special 
                reserve fund under paragraph (10) shall be 
                available for payments made by the Secretary to 
                a vendor for such procurement.
                    (C) Procurement.--
                            (i) In general.--The Secretary 
                        shall be responsible for--
                                    (I) arranging for 
                                procurement of a security 
                                countermeasure, including 
                                negotiating terms (including 
                                quantity, production schedule, 
                                and price) of, and entering 
                                into, contracts and cooperative 
                                agreements, and for carrying 
                                out such other activities as 
                                may reasonably be required, in 
                                accordance with the provisions 
                                of this subparagraph; and
                                    (II) promulgating such 
                                regulations as the Secretary 
                                determines necessary to 
                                implement the provisions of 
                                this subsection.
                            (ii) Contract terms.--A contract 
                        for procurements under this subsection 
                        shall (or, as specified below, may) 
                        include the following terms:
                                    (I) Payment conditioned on 
                                delivery.--The contract shall 
                                provide that no payment may be 
                                made until delivery of a 
                                portion, acceptable to the 
                                Secretary, of the total number 
                                of units contracted for, except 
                                that, notwithstanding any other 
                                provision of law, the contract 
                                may provide that, if the 
                                Secretary determines (in the 
                                Secretary's discretion) that an 
                                advance payment, partial 
                                payment for significant 
                                milestones, or payment to 
                                increase manufacturing capacity 
                                is necessary to ensure success 
                                of a project, the Secretary 
                                shall pay an amount, not to 
                                exceed 10 percent of the 
                                contract amount, in advance of 
                                delivery. The Secretary shall, 
                                to the extent practicable, make 
                                the determination of advance 
                                payment at the same time as the 
                                issuance of a solicitation. The 
                                contract shall provide that 
                                such advance payment is 
                                required to be repaid if there 
                                is a failure to perform by the 
                                vendor under the contract. The 
                                contract may also provide for 
                                additional advance payments of 
                                5 percent each for meeting the 
                                milestones specified in such 
                                contract, except that such 
                                payments shall not exceed 50 
                                percent of the total contract 
                                amount. If the specified 
                                milestones are reached, the 
                                advanced payments of 5 percent 
                                shall not be required to be 
                                repaid. Nothing in this 
                                subclause shall be construed as 
                                affecting the rights of vendors 
                                under provisions of law or 
                                regulation (including the 
                                Federal Acquisition Regulation) 
                                relating to the termination of 
                                contracts for the convenience 
                                of the Government.
                                    (II) Discounted payment.--
                                The contract may provide for a 
                                discounted price per unit of a 
                                product that is not licensed, 
                                cleared, or approved as 
                                described in paragraph 
                                (1)(B)(i)(III)(aa) at the time 
                                of delivery, and may provide 
                                for payment of an additional 
                                amount per unit if the product 
                                becomes so licensed, cleared, 
                                or approved before the 
                                expiration date of the contract 
                                (including an additional amount 
                                per unit of product delivered 
                                before the effective date of 
                                such licensing, clearance, or 
                                approval).
                                    (III) Contract duration.--
                                The contract shall be for a 
                                period not to exceed five 
                                years, except that, in first 
                                awarding the contract, the 
                                Secretary may provide for a 
                                longer duration, not exceeding 
                                eight years, if the Secretary 
                                determines that complexities or 
                                other difficulties in 
                                performance under the contract 
                                justify such a period. The 
                                contract shall be renewable for 
                                additional periods, none of 
                                which shall exceed five years.
                                    (IV) Storage by vendor.--
                                The contract may provide that 
                                the vendor will provide storage 
                                for stocks of a product 
                                delivered to the ownership of 
                                the Federal Government under 
                                the contract, for such period 
                                and under such terms and 
                                conditions as the Secretary may 
                                specify, and in such case 
                                amounts from the special 
                                reserve fund under paragraph 
                                (10) shall be available for 
                                costs of shipping, handling, 
                                storage, and related costs for 
                                such product.
                                    (V) Product approval.--The 
                                contract shall provide that the 
                                vendor seek approval, 
                                clearance, or licensing of the 
                                product from the Secretary; for 
                                a timetable for the development 
                                of data and other information 
                                to support such approval, 
                                clearance, or licensing; and 
                                that the Secretary may waive 
                                part or all of this contract 
                                term on request of the vendor 
                                or on the initiative of the 
                                Secretary.
                                    (VI) Non-stockpile 
                                transfers of security 
                                countermeasures.--The contract 
                                shall provide that the vendor 
                                will comply with all applicable 
                                export-related controls with 
                                respect to such countermeasure.
                                    (VII) Sales exclusivity.--
                                The contract may provide that 
                                the vendor is the exclusive 
                                supplier of the product to the 
                                Federal Government for a 
                                specified period of time, not 
                                to exceed the term of the 
                                contract, on the condition that 
                                the vendor is able to satisfy 
                                the needs of the Government. 
                                During the agreed period of 
                                sales exclusivity, the vendor 
                                shall not assign its rights of 
                                sales exclusivity to another 
                                entity or entities without 
                                approval by the Secretary. Such 
                                a sales exclusivity provision 
                                in such a contract shall 
                                constitute a valid basis for a 
                                sole source procurement under 
                                section 303(c)(1) of the 
                                Federal Property and 
                                Administrative Services Act of 
                                1949 (41 U.S.C. 253(c)(1)).
                                    (VIII) Warm based surge 
                                capacity.--The contract may 
                                provide that the vendor 
                                establish domestic 
                                manufacturing capacity of the 
                                product to ensure that 
                                additional production of the 
                                product is available in the 
                                event that the Secretary 
                                determines that there is a need 
                                to quickly purchase additional 
                                quantities of the product. Such 
                                contract may provide a fee to 
                                the vendor for establishing and 
                                maintaining such capacity in 
                                excess of the initial 
                                requirement for the purchase of 
                                the product. Additionally, the 
                                cost of maintaining the 
                                domestic manufacturing capacity 
                                shall be an allowable and 
                                allocable direct cost of the 
                                contract.
                                    (IX) Contract terms.--The 
                                Secretary, in any contract for 
                                procurement under this section, 
                                may specify--
                                            (aa) the dosing and 
                                        administration 
                                        requirements for 
                                        countermeasures to be 
                                        developed and procured;
                                            (bb) the amount of 
                                        funding that will be 
                                        dedicated by the 
                                        Secretary for 
                                        development and 
                                        acquisition of the 
                                        countermeasure; and
                                            (cc) the 
                                        specifications the 
                                        countermeasure must 
                                        meet to qualify for 
                                        procurement under a 
                                        contract under this 
                                        section.
                            (iii) Availability of simplified 
                        acquisition procedures.--
                                    (I) In general.--If the 
                                Secretary determines that there 
                                is a pressing need for a 
                                procurement of a specific 
                                countermeasure, the amount of 
                                the procurement under this 
                                subsection shall be deemed to 
                                be below the threshold amount 
                                specified in section 4(11) of 
                                the Office of Federal 
                                Procurement Policy Act (41 
                                U.S.C. 403(11)), for purposes 
                                of application to such 
                                procurement, pursuant to 
                                section 302A(a) of the Federal 
                                Property and Administrative 
                                Services Act of 1949 (41 U.S.C. 
                                252a(a)), of--
                                            (aa) section 
                                        303(g)(1)(A) of the 
                                        Federal Property and 
                                        Administrative Services 
                                        Act of 1949 (41 U.S.C. 
                                        253(g)(1)(A)) and its 
                                        implementing 
                                        regulations; and
                                            (bb) section 
                                        302A(b) of such Act (41 
                                        U.S.C. 252a(b)) and its 
                                        implementing 
                                        regulations.
                                    (II) Application of certain 
                                provisions.--Notwithstanding 
                                subclause (I) and the provision 
                                of law and regulations referred 
                                to in such clause, each of the 
                                following provisions shall 
                                apply to procurements described 
                                in this clause to the same 
                                extent that such provisions 
                                would apply to such 
                                procurements in the absence of 
                                subclause (I):
                                            (aa) Chapter 37 of 
                                        title 40, United States 
                                        Code (relating to 
                                        contract work hours and 
                                        safety standards).
                                            (bb) Subsections 
                                        (a) and (b) of section 
                                        7 of the Anti-Kickback 
                                        Act of 1986 (41 U.S.C. 
                                        57(a) and (b)).
                                            (cc) Section 304C 
                                        of the Federal Property 
                                        and Administrative 
                                        Services Act of 1949 
                                        (41 U.S.C. 254d) 
                                        (relating to the 
                                        examination of 
                                        contractor records).
                                            (dd) Section 3131 
                                        of title 40, United 
                                        States Code (relating 
                                        to bonds of contractors 
                                        of public buildings or 
                                        works).
                                            (ee) Subsection (a) 
                                        of section 304 of the 
                                        Federal Property and 
                                        Administrative Services 
                                        Act of 1949 (41 U.S.C. 
                                        254(a)) (relating to 
                                        contingent fees to 
                                        middlemen).
                                            (ff) Section 6002 
                                        of the Solid Waste 
                                        Disposal Act (42 U.S.C. 
                                        6962).
                                            (gg) Section 1354 
                                        of title 31, United 
                                        States Code (relating 
                                        to the limitation on 
                                        the use of appropriated 
                                        funds for contracts 
                                        with entities not 
                                        meeting veterans 
                                        employment reporting 
                                        requirements).
                                    (III) Internal controls to 
                                be established.--The Secretary 
                                shall establish appropriate 
                                internal controls for 
                                procurements made under this 
                                clause, including requirements 
                                with respect to documentation 
                                of the justification for the 
                                use of the authority provided 
                                under this paragraph with 
                                respect to the procurement 
                                involved.
                                    (IV) Authority to limit 
                                competition.--In conducting a 
                                procurement under this 
                                subparagraph, the Secretary may 
                                not use the authority provided 
                                for under subclause (I) to 
                                conduct a procurement on a 
                                basis other than full and open 
                                competition unless the 
                                Secretary determines that the 
                                mission of the BioShield 
                                Program under the Project 
                                BioShield Act of 2004 would be 
                                seriously impaired without such 
                                a limitation.
                            (iv) Procedures other than full and 
                        open competition.--
                                    (I) In general.--In using 
                                the authority provided in 
                                section 303(c)(1) of title III 
                                of the Federal Property and 
                                Administrative Services Act of 
                                1949 (41 U.S.C. 253(c)(1)) to 
                                use procedures other than 
                                competitive procedures in the 
                                case of a procurement under 
                                this subsection, the phrase 
                                ``available from only one 
                                responsible source'' in such 
                                section 303(c)(1) shall be 
                                deemed to mean ``available from 
                                only one responsible source or 
                                only from a limited number of 
                                responsible sources''.
                                    (II) Relation to other 
                                authorities.--The authority 
                                under subclause (I) is in 
                                addition to any other authority 
                                to use procedures other than 
                                competitive procedures.
                                    (III) Applicable 
                                government-wide regulations.--
                                The Secretary shall implement 
                                this clause in accordance with 
                                government-wide regulations 
                                implementing such section 
                                303(c)(1) (including 
                                requirements that offers be 
                                solicited from as many 
                                potential sources as is 
                                practicable under the 
                                circumstances, that required 
                                notices be published, and that 
                                submitted offers be 
                                considered), as such 
                                regulations apply to 
                                procurements for which an 
                                agency has authority to use 
                                procedures other than 
                                competitive procedures when the 
                                property or services needed by 
                                the agency are available from 
                                only one responsible source or 
                                only from a limited number of 
                                responsible sources and no 
                                other type of property or 
                                services will satisfy the needs 
                                of the agency.
                            (v) Premium provision in multiple 
                        award contracts.--
                                    (I) In general.--If, under 
                                this subsection, the Secretary 
                                enters into contracts with more 
                                than one vendor to procure a 
                                security countermeasure, such 
                                Secretary may, notwithstanding 
                                any other provision of law, 
                                include in each of such 
                                contracts a provision that--
                                            (aa) identifies an 
                                        increment of the total 
                                        quantity of security 
                                        countermeasure 
                                        required, whether by 
                                        percentage or by 
                                        numbers of units; and
                                            (bb) promises to 
                                        pay one or more 
                                        specified premiums 
                                        based on the priority 
                                        of such vendors' 
                                        production and delivery 
                                        of the increment 
                                        identified under item 
                                        (aa), in accordance 
                                        with the terms and 
                                        conditions of the 
                                        contract.
                                    (II) Determination of 
                                government's requirement not 
                                reviewable.--If the Secretary 
                                includes in each of a set of 
                                contracts a provision as 
                                described in subclause (I), 
                                such Secretary's determination 
                                of the total quantity of 
                                security countermeasure 
                                required, and any amendment of 
                                such determination, is 
                                committed to agency discretion.
                            (vi) Extension of closing date for 
                        receipt of proposals not reviewable.--A 
                        decision by the Secretary to extend the 
                        closing date for receipt of proposals 
                        for a procurement under this subsection 
                        is committed to agency discretion.
                            (vii) Limiting competition to 
                        sources responding to request for 
                        information.--In conducting a 
                        procurement under this subsection, the 
                        Secretary may exclude a source that has 
                        not responded to a request for 
                        information under section 303A(a)(1)(B) 
                        of the Federal Property and 
                        Administrative Services Act of 1949 (41 
                        U.S.C. 253a(a)(1)(B)) if such request 
                        has given notice that the Secretary may 
                        so exclude such a source.
            (8) Interagency cooperation.--
                    (A) In general.--In carrying out activities 
                under this section, the Homeland Security 
                Secretary and the Secretary are authorized, 
                subject to subparagraph (B), to enter into 
                interagency agreements and other collaborative 
                undertakings with other agencies of the United 
                States Government. Such agreements may allow 
                other executive agencies to order qualified and 
                security countermeasures under procurement 
                contracts or other agreements established by 
                the Secretary. Such ordering process (including 
                transfers of appropriated funds between an 
                agency and the Department of Health and Human 
                Services as reimbursements for such orders for 
                countermeasures) may be conducted under the 
                authority of section 1535 of title 31, United 
                States Code, except that all such orders shall 
                be processed under the terms established under 
                this subsection for the procurement of 
                countermeasures.
                    (B) Limitation.--An agreement or 
                undertaking under this paragraph shall not 
                authorize another agency to exercise the 
                authorities provided by this section to the 
                Homeland Security Secretary or to the 
                Secretary.
            (9) Restrictions on use of funds.--Amounts in the 
        special reserve fund under paragraph (10) shall not be 
        used to pay--
                    (A) costs for the purchase of vaccines 
                under procurement contracts entered into before 
                the date of the enactment of the Project 
                BioShield Act of 2004; or
                    (B) costs other than payments made by the 
                Secretary to a vendor for a procurement of a 
                security countermeasure under paragraph (7).
            (10) Definitions.--
                    (A) Special reserve fund.--For purposes of 
                this subsection, the term ``special reserve 
                fund'' has the meaning given such term in 
                section 510 of the Homeland Security Act of 
                2002 \1\.
---------------------------------------------------------------------------
    \1\ Subsections (a) through (c) of such section provide as follows:
    (a) Authorization of Appropriations.--For the procurement of 
security countermeasures under section 319F-2(c) of the Public Health 
Service Act (referred to in this section as the ``security 
countermeasures program''), there is authorized to be appropriated up 
to $5,593,000,000 for the fiscal years 2004 through 2013. Of the 
amounts appropriated under the preceding sentence, not to exceed 
$3,418,000,000 may be obligated during the fiscal years 2004 through 
2008, of which not to exceed $890,000,000 may be obligated during 
fiscal year 2004.
    (b) Special Reserve Fund.--For purposes of the security 
countermeasures program, the term ``special reserve fund'' means the 
``Biodefense Countermeasures'' appropriations account or any other 
appropriation made under subsection (a).
    (c) Availability.--Amounts appropriated under subsection (a) become 
available for a procurement under the security countermeasures program 
only upon the approval by the President of such availability for the 
procurement in accordance with paragraph (6)(B) of such program.
---------------------------------------------------------------------------
                    (B) Designated congressional committees.--
                For purposes of this section, the term 
                ``designated congressional committees'' means 
                the following committees of the Congress:
                            (i) In the House of 
                        Representatives: the Committee on 
                        Energy and Commerce, the Committee on 
                        Appropriations, the Committee on 
                        Government Reform, and the Select 
                        Committee on Homeland Security (or any 
                        successor to the Select Committee).
                            (ii) In the Senate: the appropriate 
                        committees.
    (d) Disclosures.--No Federal agency shall disclose under 
section 552 of title 5, United States Code, any information 
identifying the location at which materials in the stockpile 
under subsection (a) are stored.
    (e) Definition.--For purposes of subsection (a), the term 
``stockpile'' includes--
            (1) a physical accumulation (at one or more 
        locations) of the supplies described in subsection (a); 
        or
            (2) a contractual agreement between the Secretary 
        and a vendor or vendors under which such vendor or 
        vendors agree to provide to such Secretary supplies 
        described in subsection (a).
    (f) Authorization of Appropriations.--
            (1) Strategic national stockpile.--For the purpose 
        of carrying out subsection (a), there are authorized to 
        be appropriated $640,000,000 for fiscal year 2002, and 
        such sums as may be necessary for each of fiscal years 
        2003 through 2006. Such authorization is in addition to 
        amounts in the special reserve fund referred to in 
        subsection (c)(10)(A).
            (2) Smallpox vaccine development.--For the purpose 
        of carrying out subsection (b), there are authorized to 
        be appropriated $509,000,000 for fiscal year 2002, and 
        such sums as may be necessary for each of fiscal years 
        2003 through 2006.

SEC. 319F-3. [247D-6D] TARGETED LIABILITY PROTECTIONS FOR PANDEMIC AND 
                    EPIDEMIC PRODUCTS AND SECURITY COUNTERMEASURES.

    (a) Liability Protections.--
            (1) In general.--Subject to the other provisions of 
        this section, a covered person shall be immune from 
        suit and liability under Federal and State law with 
        respect to all claims for loss caused by, arising out 
        of, relating to, or resulting from the administration 
        to or the use by an individual of a covered 
        countermeasure if a declaration under subsection (b) 
        has been issued with respect to such countermeasure.
            (2) Scope of claims for loss.--
                    (A) Loss.--For purposes of this section, 
                the term ``loss'' means any type of loss, 
                including--
                            (i) death;
                            (ii) physical, mental, or emotional 
                        injury, illness, disability, or 
                        condition;
                            (iii) fear of physical, mental, or 
                        emotional injury, illness, disability, 
                        or condition, including any need for 
                        medical monitoring; and
                            (iv) loss of or damage to property, 
                        including business interruption loss.
                 Each of clauses (i) through (iv) applies 
                without regard to the date of the occurrence, 
                presentation, or discovery of the loss 
                described in the clause.
                    (B) Scope.--The immunity under paragraph 
                (1) applies to any claim for loss that has a 
                causal relationship with the administration to 
                or use by an individual of a covered 
                countermeasure, including a causal relationship 
                with the design, development, clinical testing 
                or investigation, manufacture, labeling, 
                distribution, formulation, packaging, 
                marketing, promotion, sale, purchase, donation, 
                dispensing, prescribing, administration, 
                licensing, or use of such countermeasure.
            (3) Certain conditions.--Subject to the other 
        provisions of this section, immunity under paragraph 
        (1) with respect to a covered countermeasure applies 
        only if--
                    (A) the countermeasure was administered or 
                used during the effective period of the 
                declaration that was issued under subsection 
                (b) with respect to the countermeasure;
                    (B) the countermeasure was administered or 
                used for the category or categories of 
                diseases, health conditions, or threats to 
                health specified in the declaration; and
                    (C) in addition, in the case of a covered 
                person who is a program planner or qualified 
                person with respect to the administration or 
                use of the countermeasure, the countermeasure 
                was administered to or used by an individual 
                who--
                            (i) was in a population specified 
                        by the declaration; and
                            (ii) was at the time of 
                        administration physically present in a 
                        geographic area specified by the 
                        declaration or had a connection to such 
                        area specified in the declaration.
            (4) Applicability of certain conditions.--With 
        respect to immunity under paragraph (1) and subject to 
        the other provisions of this section:
                    (A) In the case of a covered person who is 
                a manufacturer or distributor of the covered 
                countermeasure involved, the immunity applies 
                without regard to whether such countermeasure 
                was administered to or used by an individual in 
                accordance with the conditions described in 
                paragraph (3)(C).
                    (B) In the case of a covered person who is 
                a program planner or qualified person with 
                respect to the administration or use of the 
                covered countermeasure, the scope of immunity 
                includes circumstances in which the 
                countermeasure was administered to or used by 
                an individual in circumstances in which the 
                covered person reasonably could have believed 
                that the countermeasure was administered or 
                used in accordance with the conditions 
                described in paragraph (3)(C).
            (5) Effect of distribution method.--The provisions 
        of this section apply to a covered countermeasure 
        regardless of whether such countermeasure is obtained 
        by donation, commercial sale, or any other means of 
        distribution, except to the extent that, under 
        paragraph (2)(E) of subsection (b), the declaration 
        under such subsection provides that subsection (a) 
        applies only to covered countermeasures obtained 
        through a particular means of distribution.
            (6) Rebuttable presumption.--For purposes of 
        paragraph (1), there shall be a rebuttable presumption 
        that any administration or use, during the effective 
        period of the emergency declaration by the Secretary 
        under subsection (b), of a covered countermeasure shall 
        have been for the category or categories of diseases, 
        health conditions, or threats to health with respect to 
        which such declaration was issued.
    (b) Declaration by Secretary.--
            (1) Authority to issue declaration.--Subject to 
        paragraph (2), if the Secretary makes a determination 
        that a disease or other health condition or other 
        threat to health constitutes a public health emergency, 
        or that there is a credible risk that the disease, 
        condition, or threat may in the future constitute such 
        an emergency, the Secretary may make a declaration, 
        through publication in the Federal Register, 
        recommending, under conditions as the Secretary may 
        specify, the manufacture, testing, development, 
        distribution, administration, or use of one or more 
        covered countermeasures, and stating that subsection 
        (a) is in effect with respect to the activities so 
        recommended.
            (2) Contents.--In issuing a declaration under 
        paragraph (1), the Secretary shall identify, for each 
        covered countermeasure specified in the declaration--
                    (A) the category or categories of diseases, 
                health conditions, or threats to health for 
                which the Secretary recommends the 
                administration or use of the countermeasure;
                    (B) the period or periods during which, 
                including as modified by paragraph (3), 
                subsection (a) is in effect, which period or 
                periods may be designated by dates, or by 
                milestones or other description of events, 
                including factors specified in paragraph (6);
                    (C) the population or populations of 
                individuals for which subsection (a) is in 
                effect with respect to the administration or 
                use of the countermeasure (which may be a 
                specification that such subsection applies 
                without geographic limitation to all 
                individuals);
                    (D) the geographic area or areas for which 
                subsection (a) is in effect with respect to the 
                administration or use of the countermeasure 
                (which may be a specification that such 
                subsection applies without geographic 
                limitation), including, with respect to 
                individuals in the populations identified under 
                subparagraph (C), a specification, as 
                determined appropriate by the Secretary, of 
                whether the declaration applies only to 
                individuals physically present in such areas or 
                whether in addition the declaration applies to 
                individuals who have a connection to such 
                areas, which connection is described in the 
                declaration; and
                    (E) whether subsection (a) is effective 
                only to a particular means of distribution as 
                provided in subsection (a)(5) for obtaining the 
                countermeasure, and if so, the particular means 
                to which such subsection is effective.
            (3) Effective period of declaration.--
                    (A) Flexibility of period.--The Secretary 
                may, in describing periods under paragraph 
                (2)(B), have different periods for different 
                covered persons to address different 
                logistical, practical or other differences in 
                responsibilities.
                    (B) Additional time to be specified.--In 
                each declaration under paragraph (1), the 
                Secretary, after consulting, to the extent the 
                Secretary deems appropriate, with the 
                manufacturer of the covered countermeasure, 
                shall also specify a date that is after the 
                ending date specified under paragraph (2)(B) 
                and that allows what the Secretary determines 
                is--
                            (i) a reasonable period for the 
                        manufacturer to arrange for disposition 
                        of the covered countermeasure, 
                        including the return of such product to 
                        the manufacturer; and
                            (ii) a reasonable period for 
                        covered persons to take such other 
                        actions as may be appropriate to limit 
                        administration or use of the covered 
                        countermeasure.
                    (C) Additional period for certain strategic 
                national stockpile countermeasures.--With 
                respect to a covered countermeasure that is in 
                the stockpile under section 319F-2, if such 
                countermeasure was the subject of a declaration 
                under paragraph (1) at the time that it was 
                obtained for the stockpile, the effective 
                period of such declaration shall include a 
                period when the countermeasure is administered 
                or used pursuant to a distribution or release 
                from the stockpile.
            (4) Amendments to declaration.--The Secretary may 
        through publication in the Federal Register amend any 
        portion of a declaration under paragraph (1). Such an 
        amendment shall not retroactively limit the 
        applicability of subsection (a) with respect to the 
        administration or use of the covered countermeasure 
        involved.
            (5) Certain disclosures.--In publishing a 
        declaration under paragraph (1) in the Federal 
        Register, the Secretary is not required to disclose any 
        matter described in section 552(b) of title 5, United 
        States Code.
            (6) Factors to be considered.--In deciding whether 
        and under what circumstances or conditions to issue a 
        declaration under paragraph (1) with respect to a 
        covered countermeasure, the Secretary shall consider 
        the desirability of encouraging the design, 
        development, clinical testing or investigation, 
        manufacture, labeling, distribution, formulation, 
        packaging, marketing, promotion, sale, purchase, 
        donation, dispensing, prescribing, administration, 
        licensing, and use of such countermeasure.
            (7) Judicial review.--No court of the United 
        States, or of any State, shall have subject matter 
        jurisdiction to review, whether by mandamus or 
        otherwise, any action by the Secretary under this 
        subsection.
            (8) Preemption of state law.--During the effective 
        period of a declaration under subsection (b), or at any 
        time with respect to conduct undertaken in accordance 
        with such declaration, no State or political 
        subdivision of a State may establish, enforce, or 
        continue in effect with respect to a covered 
        countermeasure any provision of law or legal 
        requirement that--
                    (A) is different from, or is in conflict 
                with, any requirement applicable under this 
                section; and
                    (B) relates to the design, development, 
                clinical testing or investigation, formulation, 
                manufacture, distribution, sale, donation, 
                purchase, marketing, promotion, packaging, 
                labeling, licensing, use, any other aspect of 
                safety or efficacy, or the prescribing, 
                dispensing, or administration by qualified 
                persons of the covered countermeasure, or to 
                any matter included in a requirement applicable 
                to the covered countermeasure under this 
                section or any other provision of this Act, or 
                under the Federal Food, Drug, and Cosmetic Act.
            (9) Report to congress.--Within 30 days after 
        making a declaration under paragraph (1), the Secretary 
        shall submit to the appropriate committees of the 
        Congress a report that provides an explanation of the 
        reasons for issuing the declaration and the reasons 
        underlying the determinations of the Secretary with 
        respect to paragraph (2). Within 30 days after making 
        an amendment under paragraph (4), the Secretary shall 
        submit to such committees a report that provides the 
        reasons underlying the determination of the Secretary 
        to make the amendment.
    (c) Definition of Willful Misconduct.--
            (1) Definition.--
                    (A) In general.--Except as the meaning of 
                such term is further restricted pursuant to 
                paragraph (2), the term ``willful misconduct'' 
                shall, for purposes of subsection (d), denote 
                an act or omission that is taken--
                            (i) intentionally to achieve a 
                        wrongful purpose;
                            (ii) knowingly without legal or 
                        factual justification; and
                            (iii) in disregard of a known or 
                        obvious risk that is so great as to 
                        make it highly probable that the harm 
                        will outweigh the benefit.
                    (B) Rule of construction.--The criterion 
                stated in subparagraph (A) shall be construed 
                as establishing a standard for liability that 
                is more stringent than a standard of negligence 
                in any form or recklessness.
            (2) Authority to promulgate regulatory 
        definition.--
                    (A) In general.--The Secretary, in 
                consultation with the Attorney General, shall 
                promulgate regulations, which may be 
                promulgated through interim final rules, that 
                further restrict the scope of actions or 
                omissions by a covered person that may qualify 
                as ``willful misconduct'' for purposes of 
                subsection (d).
                    (B) Factors to be considered.--In 
                promulgating the regulations under this 
                paragraph, the Secretary, in consultation with 
                the Attorney General, shall consider the need 
                to define the scope of permissible civil 
                actions under subsection (d) in a way that will 
                not adversely affect the public health.
                    (C) Temporal scope of regulations.--The 
                regulations under this paragraph may specify 
                the temporal effect that they shall be given 
                for purposes of subsection (d).
                    (D) Initial rulemaking.--Within 180 days 
                after the enactment of the Public Readiness and 
                Emergency Preparedness Act, the Secretary, in 
                consultation with the Attorney General, shall 
                commence and complete an initial rulemaking 
                process under this paragraph.
            (3) Proof of willful misconduct.--In an action 
        under subsection (d), the plaintiff shall have the 
        burden of proving by clear and convincing evidence 
        willful misconduct by each covered person sued and that 
        such willful misconduct caused death or serious 
        physical injury.
            (4) Defense for acts or omissions taken pursuant to 
        secretary's declaration.--Notwithstanding any other 
        provision of law, a program planner or qualified person 
        shall not have engaged in ``willful misconduct'' as a 
        matter of law where such program planner or qualified 
        person acted consistent with applicable directions, 
        guidelines, or recommendations by the Secretary 
        regarding the administration or use of a covered 
        countermeasure that is specified in the declaration 
        under subsection (b), provided either the Secretary, or 
        a State or local health authority, was provided with 
        notice of information regarding serious physical injury 
        or death from the administration or use of a covered 
        countermeasure that is material to the plaintiff's 
        alleged loss within 7 days of the actual discovery of 
        such information by such program planner or qualified 
        person.
            (5) Exclusion for regulated activity of 
        manufacturer or distributor.--
                    (A) In general.--If an act or omission by a 
                manufacturer or distributor with respect to a 
                covered countermeasure, which act or omission 
                is alleged under subsection (e)(3)(A) to 
                constitute willful misconduct, is subject to 
                regulation by this Act or by the Federal Food, 
                Drug, and Cosmetic Act, such act or omission 
                shall not constitute ``willful misconduct'' for 
                purposes of subsection (d) if--
                            (i) neither the Secretary nor the 
                        Attorney General has initiated an 
                        enforcement action with respect to such 
                        act or omission; or
                            (ii) such an enforcement action has 
                        been initiated and the action has been 
                        terminated or finally resolved without 
                        a covered remedy.
                Any action or proceeding under subsection (d) 
                shall be stayed during the pendency of such an 
                enforcement action.
                    (B) Definitions.--For purposes of this 
                paragraph, the following terms have the 
                following meanings:
                            (i) Enforcement action.--The term 
                        ``enforcement action'' means a criminal 
                        prosecution, an action seeking an 
                        injunction, a seizure action, a civil 
                        monetary proceeding based on willful 
                        misconduct, a mandatory recall of a 
                        product because voluntary recall was 
                        refused, a proceeding to compel repair 
                        or replacement of a product, a 
                        termination of an exemption under 
                        section 505(i) or 520(g) of the Federal 
                        Food, Drug, and Cosmetic Act, a 
                        debarment proceeding, an investigator 
                        disqualification proceeding where an 
                        investigator is an employee or agent of 
                        the manufacturer, a revocation, based 
                        on willful misconduct, of an 
                        authorization under section 564 of such 
                        Act, or a suspension or withdrawal, 
                        based on willful misconduct, of an 
                        approval or clearance under chapter V 
                        of such Act or of a licensure under 
                        section 351 of this Act.
                            (ii) Covered remedy.--The term 
                        ``covered remedy'' means an outcome--
                                    (I) that is a criminal 
                                conviction, an injunction, or a 
                                condemnation, a civil monetary 
                                payment, a product recall, a 
                                repair or replacement of a 
                                product, a termination of an 
                                exemption under section 505(i) 
                                or 520(g) of the Federal Food, 
                                Drug, and Cosmetic Act, a 
                                debarment, an investigator 
                                disqualification, a revocation 
                                of an authorization under 
                                section 564 of such Act, or a 
                                suspension or withdrawal of an 
                                approval or clearance under 
                                chapter 5 of such Act or of a 
                                licensure under section 351 of 
                                this Act; and
                                    (II) that results from a 
                                final determination by a court 
                                or from a final agency action.
                            (iii) Final.--The terms ``final'' 
                        and ``finally''--
                                    (I) with respect to a court 
                                determination, or to a final 
                                resolution of an enforcement 
                                action that is a court 
                                determination, mean a judgment 
                                from which an appeal of right 
                                cannot be taken or a voluntary 
                                or stipulated dismissal; and
                                    (II) with respect to an 
                                agency action, or to a final 
                                resolution of an enforcement 
                                action that is an agency 
                                action, mean an order that is 
                                not subject to further review 
                                within the agency and that has 
                                not been reversed, vacated, 
                                enjoined, or otherwise 
                                nullified by a final court 
                                determination or a voluntary or 
                                stipulated dismissal.
                    (C) Rules of construction.--
                            (i) In general.--Nothing in this 
                        paragraph shall be construed--
                                    (I) to affect the 
                                interpretation of any provision 
                                of the Federal Food, Drug, and 
                                Cosmetic Act, of this Act, or 
                                of any other applicable statute 
                                or regulation; or
                                    (II) to impair, delay, 
                                alter, or affect the authority, 
                                including the enforcement 
                                discretion, of the United 
                                States, of the Secretary, of 
                                the Attorney General, or of any 
                                other official with respect to 
                                any administrative or court 
                                proceeding under this Act, 
                                under the Federal Food, Drug, 
                                and Cosmetic Act, under title 
                                18 of the United States Code, 
                                or under any other applicable 
                                statute or regulation.
                            (ii) Mandatory recalls.--A 
                        mandatory recall called for in the 
                        declaration is not a Food and Drug 
                        Administration enforcement action.
    (d) Exception to Immunity of Covered Persons.--
            (1) In general.--Subject to subsection (f), the 
        sole exception to the immunity from suit and liability 
        of covered persons set forth in subsection (a) shall be 
        for an exclusive Federal cause of action against a 
        covered person for death or serious physical injury 
        proximately caused by willful misconduct, as defined 
        pursuant to subsection (c), by such covered person. For 
        purposes of section 2679(b)(2)(B) of title 28, United 
        States Code, such a cause of action is not an action 
        brought for violation of a statute of the United States 
        under which an action against an individual is 
        otherwise authorized.
            (2) Persons who can sue.--An action under this 
        subsection may be brought for wrongful death or serious 
        physical injury by any person who suffers such injury 
        or by any representative of such a person.
    (e) Procedures for Suit.--
            (1) Exclusive federal jurisdiction.--Any action 
        under subsection (d) shall be filed and maintained only 
        in the United States District Court for the District of 
        Columbia.
            (2) Governing law.--The substantive law for 
        decision in an action under subsection (d) shall be 
        derived from the law, including choice of law 
        principles, of the State in which the alleged willful 
        misconduct occurred, unless such law is inconsistent 
        with or preempted by Federal law, including provisions 
        of this section.
            (3) Pleading with particularity.--In an action 
        under subsection (d), the complaint shall plead with 
        particularity each element of the plaintiff's claim, 
        including--
                    (A) each act or omission, by each covered 
                person sued, that is alleged to constitute 
                willful misconduct relating to the covered 
                countermeasure administered to or used by the 
                person on whose behalf the complaint was filed;
                    (B) facts supporting the allegation that 
                such alleged willful misconduct proximately 
                caused the injury claimed; and
                    (C) facts supporting the allegation that 
                the person on whose behalf the complaint was 
                filed suffered death or serious physical 
                injury.
            (4) Verification, certification, and medical 
        records.--
                    (A) In general.--In an action under 
                subsection (d), the plaintiff shall verify the 
                complaint in the manner stated in subparagraph 
                (B) and shall file with the complaint the 
                materials described in subparagraph (C). A 
                complaint that does not substantially comply 
                with subparagraphs (B) and (C) shall not be 
                accepted for filing and shall not stop the 
                running of the statute of limitations.
                    (B) Verification requirement.--
                            (i) In general.--The complaint 
                        shall include a verification, made by 
                        affidavit of the plaintiff under oath, 
                        stating that the pleading is true to 
                        the knowledge of the deponent, except 
                        as to matters specifically identified 
                        as being alleged on information and 
                        belief, and that as to those matters 
                        the plaintiff believes it to be true.
                            (ii) Identification of matters 
                        alleged upon information and belief.--
                        Any matter that is not specifically 
                        identified as being alleged upon the 
                        information and belief of the 
                        plaintiff, shall be regarded for all 
                        purposes, including a criminal 
                        prosecution, as having been made upon 
                        the knowledge of the plaintiff.
                    (C) Materials required.--In an action under 
                subsection (d), the plaintiff shall file with 
                the complaint--
                            (i) an affidavit, by a physician 
                        who did not treat the person on whose 
                        behalf the complaint was filed, 
                        certifying, and explaining the basis 
                        for such physician's belief, that such 
                        person suffered the serious physical 
                        injury or death alleged in the 
                        complaint and that such injury or death 
                        was proximately caused by the 
                        administration or use of a covered 
                        countermeasure; and
                            (ii) certified medical records 
                        documenting such injury or death and 
                        such proximate causal connection.
            (5) Three-judge court.--Any action under subsection 
        (d) shall be assigned initially to a panel of three 
        judges. Such panel shall have jurisdiction over such 
        action for purposes of considering motions to dismiss, 
        motions for summary judgment, and matters related 
        thereto. If such panel has denied such motions, or if 
        the time for filing such motions has expired, such 
        panel shall refer the action to the chief judge for 
        assignment for further proceedings, including any 
        trial. Section 1253 of title 28, United States Code, 
        and paragraph (3) of subsection (b) of section 2284 of 
        title 28, United States Code, shall not apply to 
        actions under subsection (d).
            (6) Civil discovery.--
                    (A) Timing.--In an action under subsection 
                (d), no discovery shall be allowed--
                            (i) before each covered person sued 
                        has had a reasonable opportunity to 
                        file a motion to dismiss;
                            (ii) in the event such a motion is 
                        filed, before the court has ruled on 
                        such motion; and
                            (iii) in the event a covered person 
                        files an interlocutory appeal from the 
                        denial of such a motion, before the 
                        court of appeals has ruled on such 
                        appeal.
                    (B) Standard.--Notwithstanding any other 
                provision of law, the court in an action under 
                subsection (d) shall permit discovery only with 
                respect to matters directly related to material 
                issues contested in such action, and the court 
                shall compel a response to a discovery request 
                (including a request for admission, an 
                interrogatory, a request for production of 
                documents, or any other form of discovery 
                request) under Rule 37, Federal Rules of Civil 
                Procedure, only if the court finds that the 
                requesting party needs the information sought 
                to prove or defend as to a material issue 
                contested in such action and that the likely 
                benefits of a response to such request equal or 
                exceed the burden or cost for the responding 
                party of providing such response.
            (7) Reduction in award of damages for collateral 
        source benefits.--
                    (A) In general.--In an action under 
                subsection (d), the amount of an award of 
                damages that would otherwise be made to a 
                plaintiff shall be reduced by the amount of 
                collateral source benefits to such plaintiff.
                    (B) Provider of collateral source benefits 
                not to have lien or subrogation.--No provider 
                of collateral source benefits shall recover any 
                amount against the plaintiff or receive any 
                lien or credit against the plaintiff's recovery 
                or be equitably or legally subrogated to the 
                right of the plaintiff in an action under 
                subsection (d).
                    (C) Collateral source benefit defined.--For 
                purposes of this paragraph, the term 
                ``collateral source benefit'' means any amount 
                paid or to be paid in the future to or on 
                behalf of the plaintiff, or any service, 
                product, or other benefit provided or to be 
                provided in the future to or on behalf of the 
                plaintiff, as a result of the injury or 
                wrongful death, pursuant to--
                            (i) any State or Federal health, 
                        sickness, income-disability, accident, 
                        or workers' compensation law;
                            (ii) any health, sickness, income-
                        disability, or accident insurance that 
                        provides health benefits or income-
                        disability coverage;
                            (iii) any contract or agreement of 
                        any group, organization, partnership, 
                        or corporation to provide, pay for, or 
                        reimburse the cost of medical, 
                        hospital, dental, or income disability 
                        benefits; or
                            (iv) any other publicly or 
                        privately funded program.
            (8) Noneconomic damages.--In an action under 
        subsection (d), any noneconomic damages may be awarded 
        only in an amount directly proportional to the 
        percentage of responsibility of a defendant for the 
        harm to the plaintiff. For purposes of this paragraph, 
        the term ``noneconomic damages'' means damages for 
        losses for physical and emotional pain, suffering, 
        inconvenience, physical impairment, mental anguish, 
        disfigurement, loss of enjoyment of life, loss of 
        society and companionship, loss of consortium, hedonic 
        damages, injury to reputation, and any other 
        nonpecuniary losses.
            (9) Rule 11 sanctions.--Whenever a district court 
        of the United States determines that there has been a 
        violation of Rule 11 of the Federal Rules of Civil 
        Procedure in an action under subsection (d), the court 
        shall impose upon the attorney, law firm, or parties 
        that have violated Rule 11 or are responsible for the 
        violation, an appropriate sanction, which may include 
        an order to pay the other party or parties for the 
        reasonable expenses incurred as a direct result of the 
        filing of the pleading, motion, or other paper that is 
        the subject of the violation, including a reasonable 
        attorney's fee. Such sanction shall be sufficient to 
        deter repetition of such conduct or comparable conduct 
        by others similarly situated, and to compensate the 
        party or parties injured by such conduct.
            (10) Interlocutory appeal.--The United States Court 
        of Appeals for the District of Columbia Circuit shall 
        have jurisdiction of an interlocutory appeal by a 
        covered person taken within 30 days of an order denying 
        a motion to dismiss or a motion for summary judgment 
        based on an assertion of the immunity from suit 
        conferred by subsection (a) or based on an assertion of 
        the exclusion under subsection (c)(5).
    (f) Actions by and Against the United States.--Nothing in 
this section shall be construed to abrogate or limit any right, 
remedy, or authority that the United States or any agency 
thereof may possess under any other provision of law or to 
waive sovereign immunity or to abrogate or limit any defense or 
protection available to the United States or its agencies, 
instrumentalities, officers, or employees under any other law, 
including any provision of chapter 171 of title 28, United 
States Code (relating to tort claims procedure).
    (g) Severability.--If any provision of this section, or the 
application of such provision to any person or circumstance, is 
held to be unconstitutional, the remainder of this section and 
the application of such remainder to any person or circumstance 
shall not be affected thereby.
    (h) Rule of Construction Concerning National Vaccine Injury 
Compensation Program.--Nothing in this section, or any 
amendment made by the Public Readiness and Emergency 
Preparedness Act, shall be construed to affect the National 
Vaccine Injury Compensation Program under title XXI of this 
Act.
    (i) Definitions.--In this section:
            (1) Covered countermeasure.--The term ``covered 
        countermeasure'' means--
                    (A) a qualified pandemic or epidemic 
                product (as defined in paragraph (7));
                    (B) a security countermeasure (as defined 
                in section 319F-2(c)(1)(B)); or
                    (C) a drug (as such term is defined in 
                section 201(g)(1) of the Federal Food, Drug, 
                and Cosmetic Act (21 U.S.C. 321(g)(1)), 
                biological product (as such term is defined by 
                section 351(i) of this Act), or device (as such 
                term is defined by section 201(h) of the 
                Federal Food, Drug and Cosmetic Act (21 U.S.C. 
                321(h)) that is authorized for emergency use in 
                accordance with section 564 of the Federal 
                Food, Drug, and Cosmetic Act.
            (2) Covered person.--The term ``covered person'', 
        when used with respect to the administration or use of 
        a covered countermeasure, means--
                    (A) the United States; or
                    (B) a person or entity that is--
                            (i) a manufacturer of such 
                        countermeasure;
                            (ii) a distributor of such 
                        countermeasure;
                            (iii) a program planner of such 
                        countermeasure;
                            (iv) a qualified person who 
                        prescribed, administered, or dispensed 
                        such countermeasure; or
                            (v) an official, agent, or employee 
                        of a person or entity described in 
                        clause (i), (ii), (iii), or (iv).
            (3) Distributor.--The term ``distributor'' means a 
        person or entity engaged in the distribution of drugs, 
        biologics, or devices, including but not limited to 
        manufacturers; repackers; common carriers; contract 
        carriers; air carriers; own-label distributors; 
        private-label distributors; jobbers; brokers; 
        warehouses, and wholesale drug warehouses; independent 
        wholesale drug traders; and retail pharmacies.
            (4) Manufacturer.--The term ``manufacturer'' 
        includes--
                    (A) a contractor or subcontractor of a 
                manufacturer;
                    (B) a supplier or licenser of any product, 
                intellectual property, service, research tool, 
                or component or other article used in the 
                design, development, clinical testing, 
                investigation, or manufacturing of a covered 
                countermeasure; and
                    (C) any or all of the parents, 
                subsidiaries, affiliates, successors, and 
                assigns of a manufacturer.
            (5) Person.--The term ``person'' includes an 
        individual, partnership, corporation, association, 
        entity, or public or private corporation, including a 
        Federal, State, or local government agency or 
        department.
            (6) Program planner.--The term ``program planner'' 
        means a State or local government, including an Indian 
        tribe, a person employed by the State or local 
        government, or other person who supervised or 
        administered a program with respect to the 
        administration, dispensing, distribution, provision, or 
        use of a security countermeasure or a qualified 
        pandemic or epidemic product, including a person who 
        has established requirements, provided policy guidance, 
        or supplied technical or scientific advice or 
        assistance or provides a facility to administer or use 
        a covered countermeasure in accordance with a 
        declaration under subsection (b).
            (7) Qualified pandemic or epidemic product.--The 
        term ``qualified pandemic or epidemic product'' means a 
        drug (as such term is defined in section 201(g)(1) of 
        the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
        321(g)(1)), biological product (as such term is defined 
        by section 351(i) of this Act), or device (as such term 
        is defined by section 201(h) of the Federal Food, Drug 
        and Cosmetic Act (21 U.S.C. 321(h)) that is--
                    (A)(i) a product manufactured, used, 
                designed, developed, modified, licensed, or 
                procured--
                            (I) to diagnose, mitigate, prevent, 
                        treat, or cure a pandemic or epidemic; 
                        or
                            (II) to limit the harm such 
                        pandemic or epidemic might otherwise 
                        cause; or
                    (ii) a product manufactured, used, 
                designed, developed, modified, licensed, or 
                procured to diagnose, mitigate, prevent, treat, 
                or cure a serious or life-threatening disease 
                or condition caused by a product described in 
                clause (i); and
                    (B)(i) approved or cleared under chapter V 
                of the Federal Food, Drug, and Cosmetic Act or 
                licensed under section 351 of this Act;
                    (ii) the object of research for possible 
                use as described by subparagraph (A) and is the 
                subject of an exemption under section 505(i) or 
                520(g) of the Federal Food, Drug, and Cosmetic 
                Act; or
                    (iii) authorized for emergency use in 
                accordance with section 564 of the Federal 
                Food, Drug, and Cosmetic Act.
            (8) Qualified person.--The term ``qualified 
        person'', when used with respect to the administration 
        or use of a covered countermeasure, means--
                    (A) a licensed health professional or other 
                individual who is authorized to prescribe, 
                administer, or dispense such countermeasures 
                under the law of the State in which the 
                countermeasure was prescribed, administered, or 
                dispensed; or
                    (B) a person within a category of persons 
                so identified in a declaration by the Secretary 
                under subsection (b).
            (9) Security countermeasure.--The term ``security 
        countermeasure'' has the meaning given such term in 
        section 319F-2(c)(1)(B).
            (10) Serious physical injury.--The term ``serious 
        physical injury'' means an injury that--
                    (A) is life threatening;
                    (B) results in permanent impairment of a 
                body function or permanent damage to a body 
                structure; or
                    (C) necessitates medical or surgical 
                intervention to preclude permanent impairment 
                of a body function or permanent damage to a 
                body structure.

SEC. 319F-4. [247D-6E] COVERED COUNTERMEASURE PROCESS.

    (a) Establishment of Fund.--Upon the issuance by the 
Secretary of a declaration under section 319F-3(b), there is 
hereby established in the Treasury an emergency fund designated 
as the ``Covered Countermeasure Process Fund'' for purposes of 
providing timely, uniform, and adequate compensation to 
eligible individuals for covered injuries directly caused by 
the administration or use of a covered countermeasure pursuant 
to such declaration, which Fund shall consist of such amounts 
designated as emergency appropriations under section 402 of H. 
Con. Res. 95 of the 109th Congress, this emergency designation 
shall remain in effect through October 1, 2006.
    (b) Payment of Compensation.--
            (1) In general.--If the Secretary issues a 
        declaration under 319F-3(b), the Secretary shall, after 
        amounts have by law been provided for the Fund under 
        subsection (a), provide compensation to an eligible 
        individual for a covered injury directly caused by the 
        administration or use of a covered countermeasure 
        pursuant to such declaration.
            (2) Elements of compensation.--The compensation 
        that shall be provided pursuant to paragraph (1) shall 
        have the same elements, and be in the same amount, as 
        is prescribed by sections 264, 265, and 266 in the case 
        of certain individuals injured as a result of 
        administration of certain countermeasures against 
        smallpox, except that section 266(a)(2)(B) shall not 
        apply.
            (3) Rule of construction.--Neither reasonable and 
        necessary medical benefits nor lifetime total benefits 
        for lost employment income due to permanent and total 
        disability shall be limited by section 266.
            (4) Determination of eligibility and 
        compensation.--Except as provided in this section, the 
        procedures for determining, and for reviewing a 
        determination of, whether an individual is an eligible 
        individual, whether such individual has sustained a 
        covered injury, whether compensation may be available 
        under this section, and the amount of such compensation 
        shall be those stated in section 262 (other than in 
        subsection (d)(2) of such section), in regulations 
        issued pursuant to that section, and in such additional 
        or alternate regulations as the Secretary may 
        promulgate for purposes of this section. In making 
        determinations under this section, other than those 
        described in paragraph (5)(A) as to the direct 
        causation of a covered injury, the Secretary may only 
        make such determination based on compelling, reliable, 
        valid, medical and scientific evidence.
            (5) Covered countermeasure injury table.--
                    (A) In general.--The Secretary shall by 
                regulation establish a table identifying 
                covered injuries that shall be presumed to be 
                directly caused by the administration or use of 
                a covered countermeasure and the time period in 
                which the first symptom or manifestation of 
                onset of each such adverse effect must manifest 
                in order for such presumption to apply. The 
                Secretary may only identify such covered 
                injuries, for purpose of inclusion on the 
                table, where the Secretary determines, based on 
                compelling, reliable, valid, medical and 
                scientific evidence that administration or use 
                of the covered countermeasure directly caused 
                such covered injury.
                    (B) Amendments.--The provisions of section 
                263 (other than a provision of subsection 
                (a)(2) of such section that relates to 
                accidental vaccinia inoculation) shall apply to 
                the table established under this section.
                    (C) Judicial review.--No court of the 
                United States, or of any State, shall have 
                subject matter jurisdiction to review, whether 
                by mandamus or otherwise, any action by the 
                Secretary under this paragraph.
            (6) Meanings of terms.--In applying sections 262, 
        263, 264, 265, and 266 for purposes of this section--
                    (A) the terms ``vaccine'' and ``smallpox 
                vaccine'' shall be deemed to mean a covered 
                countermeasure;
                    (B) the terms ``smallpox vaccine injury 
                table'' and ``table established under section 
                263'' shall be deemed to refer to the table 
                established under paragraph (4); and
                    (C) other terms used in those sections 
                shall have the meanings given to such terms by 
                this section.
    (c) Voluntary Program.--The Secretary shall ensure that a 
State, local, or Department of Health and Human Services plan 
to administer or use a covered countermeasure is consistent 
with any declaration under 319F-3 and any applicable guidelines 
of the Centers for Disease Control and Prevention and that 
potential participants are educated with respect to 
contraindications, the voluntary nature of the program, and the 
availability of potential benefits and compensation under this 
part.
    (d) Exhaustion; Exclusivity; Election.--
            (1) Exhaustion.--Subject to paragraph (5), a 
        covered individual may not bring a civil action under 
        section 319F-3(d) against a covered person (as such 
        term is defined in section 319F-3(i)(2)) unless such 
        individual has exhausted such remedies as are available 
        under subsection (a), except that if amounts have not 
        by law been provided for the Fund under subsection (a), 
        or if the Secretary fails to make a final determination 
        on a request for benefits or compensation filed in 
        accordance with the requirements of this section within 
        240 days after such request was filed, the individual 
        may seek any remedy that may be available under section 
        319F-3(d).
            (2) Tolling of statute of limitations.--The time 
        limit for filing a civil action under section 319F-3(d) 
        for an injury or death shall be tolled during the 
        pendency of a claim for compensation under subsection 
        (a).
            (3) Rule of construction.--This section shall not 
        be construed as superseding or otherwise affecting the 
        application of a requirement, under chapter 171 of 
        title 28, United States Code, to exhaust administrative 
        remedies.
            (4) Exclusivity.--The remedy provided by subsection 
        (a) shall be exclusive of any other civil action or 
        proceeding for any claim or suit this section 
        encompasses, except for a proceeding under section 
        319F-3.
            (5) Election.--If under subsection (a) the 
        Secretary determines that a covered individual 
        qualifies for compensation, the individual has an 
        election to accept the compensation or to bring an 
        action under section 319F-3(d). If such individual 
        elects to accept the compensation, the individual may 
        not bring such an action.
    (e) Definitions.--For purposes of this section, the 
following terms shall have the following meanings:
            (1) Covered countermeasure.--The term ``covered 
        countermeasure'' has the meaning given such term in 
        section 319F-3.
            (2) Covered individual.--The term ``covered 
        individual'', with respect to administration or use of 
        a covered countermeasure pursuant to a declaration, 
        means an individual--
                    (A) who is in a population specified in 
                such declaration, and with respect to whom the 
                administration or use of the covered 
                countermeasure satisfies the other 
                specifications of such declaration; or
                    (B) who uses the covered countermeasure, or 
                to whom the covered countermeasure is 
                administered, in a good faith belief that the 
                individual is in the category described by 
                subparagraph (A).
            (3) Covered injury.--The term ``covered injury'' 
        means serious physical injury or death.
            (4) Declaration.--The term ``declaration'' means a 
        declaration under section 319F-3(b).
            (5) Eligible individual.--The term ``eligible 
        individual'' means an individual who is determined, in 
        accordance with subsection (b), to be a covered 
        individual who sustains a covered injury.

SEC. 319G. [247D-7] DEMONSTRATION PROGRAM TO ENHANCE BIOTERRORISM 
                    TRAINING, COORDINATION, AND READINESS.

    (a) In General.--The Secretary shall make grants to not 
more than three eligible entities to carry out demonstration 
programs to improve the detection of pathogens likely to be 
used in a bioterrorist attack, the development of plans and 
measures to respond to bioterrorist attacks, and the training 
of personnel involved with the various responsibilities and 
capabilities needed to respond to acts of bioterrorism upon the 
civilian population. Such awards shall be made on a competitive 
basis and pursuant to scientific and technical review.
    (b) Eligible Entities.--Eligible entities for grants under 
subsection (a) are States, political subdivisions of States, 
and public or private non-profit organizations.
    (c) Specific Criteria.--In making grants under subsection 
(a), the Secretary shall take into account the following 
factors:
            (1) Whether the eligible entity involved is 
        proximate to, and collaborates with, a major research 
        university with expertise in scientific training, 
        identification of biological agents, medicine, and life 
        sciences.
            (2) Whether the entity is proximate to, and 
        collaborates with, a laboratory that has expertise in 
        the identification of biological agents.
            (3) Whether the entity demonstrates, in the 
        application for the program, support and participation 
        of State and local governments and research 
        institutions in the conduct of the program.
            (4) Whether the entity is proximate to, and 
        collaborates with, or is, an academic medical center 
        that has the capacity to serve an uninsured or 
        underserved population, and is equipped to educate 
        medical personnel.
            (5) Such other factors as the Secretary determines 
        to be appropriate.
    (d) Duration of Award.--The period during which payments 
are made under a grant under subsection (a) may not exceed 5 
years. The provision of such payments 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.
    (e) Supplement Not Supplant.--Grants under subsection (a) 
shall be used to supplement, and not supplant, other Federal, 
State, or local public funds provided for the activities 
described in such subsection.
    (f ) General Accounting Office Report \1\.--Not later than 
180 days after the conclusion of the demonstration programs 
carried out under subsection (a), the Comptroller General of 
the United States shall submit to the Committee on Health, 
Education, Labor, and Pensions and the Committee on 
Appropriations of the Senate, and the Committee on Commerce and 
the Committee on Appropriations of the House of 
Representatives, a report that describes the ability of 
grantees under such subsection to detect pathogens likely to be 
used in a bioterrorist attack, develop plans and measures for 
dealing with such threats, and train personnel involved with 
the various responsibilities and capabilities needed to deal 
with bioterrorist threats.
---------------------------------------------------------------------------
    \1\ Now the Government Accountability Office. See section 8 of 
Public Law 108-271 (118 Stat. 814).
---------------------------------------------------------------------------
    (g) Authorization of Appropriations.--There is authorized 
to be appropriated to carry out this section $6,000,000 for 
fiscal year 2001, and such sums as may be necessary through 
fiscal year 2006.

SEC. 319H. [247D-7A] GRANTS REGARDING TRAINING AND EDUCATION OF CERTAIN 
                    HEALTH PROFESSIONALS.

    (a) In General.--The Secretary may make awards of grants 
and cooperative agreements to appropriate public and nonprofit 
private health or educational entities, including health 
professions schools and programs as defined in section 799B, 
for the purpose of providing low-interest loans, partial 
scholarships, partial fellowships, revolving loan funds, or 
other cost-sharing forms of assistance for the education and 
training of individuals in any category of health professions 
for which there is a shortage that the Secretary determines 
should be alleviated in order to prepare for or respond 
effectively to bioterrorism and other public health 
emergencies.
    (b) Authority Regarding Non-Federal Contributions.--The 
Secretary may require as a condition of an award under 
subsection (a) that a grantee under such subsection provide 
non-Federal contributions toward the purpose described in such 
subsection.
    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2002 through 2006.

SEC. 319I. [247D-7B] EMERGENCY SYSTEM FOR ADVANCE REGISTRATION OF 
                    HEALTH PROFESSIONS VOLUNTEERS.

    (a) In General.--Not later than 12 months after the date of 
enactment of the Pandemic and All-Hazards Preparedness Act, the 
Secretary shall link existing State verification systems to 
maintain a single national interoperable network of systems, 
each system being maintained by a State or group of States, for 
the purpose of verifying the credentials and licenses of health 
care professionals who volunteer to provide health services 
during a public health emergency.
    (b) Requirements.--The interoperable network of systems 
established under subsection (a) (referred to in this section 
as the ``verification network'') shall include--
            (1) with respect to each volunteer health 
        professional included in the verification network--
                    (A) information necessary for the rapid 
                identification of, and communication with, such 
                professionals; and
                    (B) the credentials, certifications, 
                licenses, and relevant training of such 
                individuals; and
            (2) the name of each member of the Medical Reserve 
        Corps, the National Disaster Medical System, and any 
        other relevant federally-sponsored or administered 
        programs determined necessary by the Secretary.
    (c) Other Assistance.--The Secretary may make grants and 
provide technical assistance to States and other public or 
nonprofit private entities for activities relating to the 
verification network developed under subsection (a).
    (d) Accessibility.--The Secretary shall ensure that the 
verification network is electronically accessible by State, 
local, and tribal health departments and can be linked with the 
identification cards under section 2813.
    (e) Confidentiality.--The Secretary shall establish and 
require the application of and compliance with measures to 
ensure the effective security of, integrity of, and access to 
the data included in the verification network.
    (f) Coordination.--The Secretary shall coordinate with the 
Secretary of Veterans Affairs and the Secretary of Homeland 
Security to assess the feasibility of integrating the 
verification network under this section with the VetPro system 
of the Department of Veterans Affairs and the National 
Emergency Responder Credentialing System of the Department of 
Homeland Security. The Secretary shall, if feasible, integrate 
the verification network under this section with such VetPro 
system and the National Emergency Responder Credentialing 
System.
    (g) Updating of Information.--The States that are 
participants in the verification network shall, on at least a 
quarterly basis, work with the Director to provide for the 
updating of the information contained in the verification 
network.
    (h) Clarification.--Inclusion of a health professional in 
the verification network shall not constitute appointment of 
such individual as a Federal employee for any purpose, either 
under section 2812(c) or otherwise. Such appointment may only 
be made under section 2812 or 2813.
    (i) Health Care Provider Licenses.--The Secretary shall 
encourage States to establish and implement mechanisms to waive 
the application of licensing requirements applicable to health 
professionals, who are seeking to provide medical services 
(within their scope of practice), during a national, State, 
local, or tribal public health emergency upon verification that 
such health professionals are licensed and in good standing in 
another State and have not been disciplined by any State health 
licensing or disciplinary board.
    (j) Rule of Construction.--This section may not be 
construed as authorizing the Secretary to issue requirements 
regarding the provision by the States of credentials, licenses, 
accreditations, or hospital privileges.
    (k) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated $2,000,000 for fiscal year 2002, and such sums as 
may be necessary for each of the fiscal years 2003 through 
2011.

SEC. 319J. [247D-7C] SUPPLIES AND SERVICES IN LIEU OF AWARD FUNDS.

    (a) In General.--Upon the request of a recipient of an 
award under any of sections 319 through 319I or section 319K, 
the Secretary may, subject to subsection (b), provide supplies, 
equipment, and services for the purpose of aiding the recipient 
in carrying out the purposes for which the award is made and, 
for such purposes, may detail to the recipient any officer or 
employee of the Department of Health and Human Services.
    (b) Corresponding Reduction in Payments.--With respect to a 
request described in subsection (a), the Secretary shall reduce 
the amount of payments under the award involved by an amount 
equal to the costs of detailing personnel and the fair market 
value of any supplies, equipment, or services provided by the 
Secretary. The Secretary shall, for the payment of expenses 
incurred in complying with such request, expend the amounts 
withheld.

SEC. 319K. [247D-7D] SECURITY FOR COUNTERMEASURE DEVELOPMENT AND 
                    PRODUCTION.

    (a) In General.--The Secretary, in consultation with the 
Attorney General and the Secretary of Defense, may provide 
technical or other assistance to provide security to persons or 
facilities that conduct development, production, distribution, 
or storage of priority countermeasures (as defined in section 
319F(h)(4)).
    (b) Guidelines.--The Secretary may develop guidelines to 
enable entities eligible to receive assistance under subsection 
(a) to secure their facilities against potential terrorist 
attack.

SEC. 319L. [247D-7E] BIOMEDICAL ADVANCED RESEARCH AND DEVELOPMENT 
                    AUTHORITY.

    (a) Definitions.--In this section:
            (1) BARDA.--The term ``BARDA'' means the Biomedical 
        Advanced Research and Development Authority.
            (2) Fund.--The term ``Fund'' means the Biodefense 
        Medical Countermeasure Development Fund established 
        under subsection (d).
            (3) Other transactions.--The term ``other 
        transactions'' means transactions, other than 
        procurement contracts, grants, and cooperative 
        agreements, such as the Secretary of Defense may enter 
        into under section 2371 of title 10, United States 
        Code.
            (4) Qualified countermeasure.--The term ``qualified 
        countermeasure'' has the meaning given such term in 
        section 319F-1.
            (5) Qualified pandemic or epidemic product.--The 
        term ``qualified pandemic or epidemic product'' has the 
        meaning given the term in section 319F-3.
            (6) Advanced research and development.--
                    (A) In general.--The term ``advanced 
                research and development'' means, with respect 
                to a product that is or may become a qualified 
                countermeasure or a qualified pandemic or 
                epidemic product, activities that 
                predominantly--
                            (i) are conducted after basic 
                        research and preclinical development of 
                        the product; and
                            (ii) are related to manufacturing 
                        the product on a commercial scale and 
                        in a form that satisfies the regulatory 
                        requirements under the Federal Food, 
                        Drug, and Cosmetic Act or under section 
                        351 of this Act.
                    (B) Activities included.--The term under 
                subparagraph (A) includes--
                            (i) testing of the product to 
                        determine whether the product may be 
                        approved, cleared, or licensed under 
                        the Federal Food, Drug, and Cosmetic 
                        Act or under section 351 of this Act 
                        for a use that is or may be the basis 
                        for such product becoming a qualified 
                        countermeasure or qualified pandemic or 
                        epidemic product, or to help obtain 
                        such approval, clearance, or license;
                            (ii) design and development of 
                        tests or models, including animal 
                        models, for such testing;
                            (iii) activities to facilitate 
                        manufacture of the product on a 
                        commercial scale with consistently high 
                        quality, as well as to improve and make 
                        available new technologies to increase 
                        manufacturing surge capacity;
                            (iv) activities to improve the 
                        shelf-life of the product or 
                        technologies for administering the 
                        product; and
                            (v) such other activities as are 
                        part of the advanced stages of testing, 
                        refinement, improvement, or preparation 
                        of the product for such use and as are 
                        specified by the Secretary.
            (7) Security countermeasure.--The term ``security 
        countermeasure'' has the meaning given such term in 
        section 319F-2.
            (8) Research tool.--The term ``research tool'' 
        means a device, technology, biological material 
        (including a cell line or an antibody), reagent, animal 
        model, computer system, computer software, or 
        analytical technique that is developed to assist in the 
        discovery, development, or manufacture of qualified 
        countermeasures or qualified pandemic or epidemic 
        products.
            (9) Program manager.--The term ``program manager'' 
        means an individual appointed to carry out functions 
        under this section and authorized to provide project 
        oversight and management of strategic initiatives.
            (10) Person.--The term ``person'' includes an 
        individual, partnership, corporation, association, 
        entity, or public or private corporation, and a 
        Federal, State, or local government agency or 
        department.
    (b) Strategic Plan for Countermeasure Research, 
Development, and Procurement.--
            (1) In general.--Not later than 6 months after the 
        date of enactment of the Pandemic and All-Hazards 
        Preparedness Act, the Secretary shall develop and make 
        public a strategic plan to integrate biodefense and 
        emerging infectious disease requirements with the 
        advanced research and development, strategic 
        initiatives for innovation, and the procurement of 
        qualified countermeasures and qualified pandemic or 
        epidemic products. The Secretary shall carry out such 
        activities as may be practicable to disseminate the 
        information contained in such plan to persons who may 
        have the capacity to substantially contribute to the 
        activities described in such strategic plan. The 
        Secretary shall update and incorporate such plan as 
        part of the National Health Security Strategy described 
        in section 2802.
            (2) Content.--The strategic plan under paragraph 
        (1) shall guide--
                    (A) research and development, conducted or 
                supported by the Department of Health and Human 
                Services, of qualified countermeasures and 
                qualified pandemic or epidemic products against 
                possible biological, chemical, radiological, 
                and nuclear agents and to emerging infectious 
                diseases;
                    (B) innovation in technologies that may 
                assist advanced research and development of 
                qualified countermeasures and qualified 
                pandemic or epidemic products (such research 
                and development referred to in this section as 
                ``countermeasure and product advanced research 
                and development''); and
                    (C) procurement of such qualified 
                countermeasures and qualified pandemic or 
                epidemic products by such Department.
    (c) Biomedical Advanced Research and Development 
Authority.--
            (1) Establishment.--There is established within the 
        Department of Health and Human Services the Biomedical 
        Advanced Research and Development Authority.
            (2) In general.--Based upon the strategic plan 
        described in subsection (b), the Secretary shall 
        coordinate the acceleration of countermeasure and 
        product advanced research and development by--
                    (A) facilitating collaboration between the 
                Department of Health and Human Services and 
                other Federal agencies, relevant industries, 
                academia, and other persons, with respect to 
                such advanced research and development;
                    (B) promoting countermeasure and product 
                advanced research and development;
                    (C) facilitating contacts between 
                interested persons and the offices or employees 
                authorized by the Secretary to advise such 
                persons regarding requirements under the 
                Federal Food, Drug, and Cosmetic Act and under 
                section 351 of this Act; and
                    (D) promoting innovation to reduce the time 
                and cost of countermeasure and product advanced 
                research and development.
            (3) Director.--The BARDA shall be headed by a 
        Director (referred to in this section as the 
        ``Director'') who shall be appointed by the Secretary 
        and to whom the Secretary shall delegate such functions 
        and authorities as necessary to implement this section.
            (4) Duties.--
                    (A) Collaboration.--To carry out the 
                purpose described in paragraph (2)(A), the 
                Secretary shall--
                            (i) facilitate and increase the 
                        expeditious and direct communication 
                        between the Department of Health and 
                        Human Services and relevant persons 
                        with respect to countermeasure and 
                        product advanced research and 
                        development, including by--
                                    (I) facilitating such 
                                communication regarding the 
                                processes for procuring such 
                                advanced research and 
                                development with respect to 
                                qualified countermeasures and 
                                qualified pandemic or epidemic 
                                products of interest; and
                                    (II) soliciting information 
                                about and data from research on 
                                potential qualified 
                                countermeasures and qualified 
                                pandemic or epidemic products 
                                and related technologies;
                            (ii) at least annually--
                                    (I) convene meetings with 
                                representatives from relevant 
                                industries, academia, other 
                                Federal agencies, international 
                                agencies as appropriate, and 
                                other interested persons;
                                    (II) sponsor opportunities 
                                to demonstrate the operation 
                                and effectiveness of relevant 
                                biodefense countermeasure 
                                technologies; and
                                    (III) convene such working 
                                groups on countermeasure and 
                                product advanced research and 
                                development as the Secretary 
                                may determine are necessary to 
                                carry out this section; and
                            (iii) carry out the activities 
                        described in section 405 of the 
                        Pandemic and All-Hazards Preparedness 
                        Act.
                    (B) Support advanced research and 
                development.--To carry out the purpose 
                described in paragraph (2)(B), the Secretary 
                shall--
                            (i) conduct ongoing searches for, 
                        and support calls for, potential 
                        qualified countermeasures and qualified 
                        pandemic or epidemic products;
                            (ii) direct and coordinate the 
                        countermeasure and product advanced 
                        research and development activities of 
                        the Department of Health and Human 
                        Services;
                            (iii) establish strategic 
                        initiatives to accelerate 
                        countermeasure and product advanced 
                        research and development and innovation 
                        in such areas as the Secretary may 
                        identify as priority unmet need areas; 
                        and
                            (iv) award contracts, grants, 
                        cooperative agreements, and enter into 
                        other transactions, for countermeasure 
                        and product advanced research and 
                        development.
                    (C) Facilitating advice.--To carry out the 
                purpose described in paragraph (2)(C) the 
                Secretary shall--
                            (i) connect interested persons with 
                        the offices or employees authorized by 
                        the Secretary to advise such persons 
                        regarding the regulatory requirements 
                        under the Federal Food, Drug, and 
                        Cosmetic Act and under section 351 of 
                        this Act related to the approval, 
                        clearance, or licensure of qualified 
                        countermeasures or qualified pandemic 
                        or epidemic products; and
                            (ii) with respect to persons 
                        performing countermeasure and product 
                        advanced research and development 
                        funded under this section, enable such 
                        offices or employees to provide to the 
                        extent practicable such advice in a 
                        manner that is ongoing and that is 
                        otherwise designed to facilitate 
                        expeditious development of qualified 
                        countermeasures and qualified pandemic 
                        or epidemic products that may achieve 
                        such approval, clearance, or licensure.
                    (D) Supporting innovation.--To carry out 
                the purpose described in paragraph (2)(D), the 
                Secretary may award contracts, grants, and 
                cooperative agreements, or enter into other 
                transactions, such as prize payments, to 
                promote--
                            (i) innovation in technologies that 
                        may assist countermeasure and product 
                        advanced research and development;
                            (ii) research on and development of 
                        research tools and other devices and 
                        technologies; and
                            (iii) research to promote strategic 
                        initiatives, such as rapid diagnostics, 
                        broad spectrum antimicrobials, and 
                        vaccine manufacturing technologies.
            (5) Transaction authorities.--
                    (A) Other transactions.--
                            (i) In general.--The Secretary 
                        shall have the authority to enter into 
                        other transactions under this 
                        subsection in the same manner as the 
                        Secretary of Defense enters into such 
                        transactions under section 2371 of 
                        title 10, United States Code.
                            (ii) Limitations on authority.--
                                    (I) In general.--
                                Subsections (b), (c), and (h) 
                                of section 845 of the National 
                                Defense Authorization Act for 
                                Fiscal Year 1994 (10 U.S.C. 
                                2371 note) shall apply to other 
                                transactions under this 
                                subparagraph as if such 
                                transactions were for prototype 
                                projects described by 
                                subsection (a) of such section 
                                845.
                                    (II) Written determinations 
                                required.--The authority of 
                                this subparagraph may be 
                                exercised for a project that is 
                                expected to cost the Department 
                                of Health and Human Services in 
                                excess of $20,000,000 only upon 
                                a written determination by the 
                                senior procurement executive 
                                for the Department (as 
                                designated for purpose of 
                                section 16(c) of the Office of 
                                Federal Procurement Policy Act 
                                (41 U.S.C. 414(c))), that the 
                                use of such authority is 
                                essential to promoting the 
                                success of the project. The 
                                authority of the senior 
                                procurement executive under 
                                this subclause may not be 
                                delegated.
                            (iii) Guidelines.--The Secretary 
                        shall establish guidelines regarding 
                        the use of the authority under clause 
                        (i). Such guidelines shall include 
                        auditing requirements.
                    (B) Expedited authorities.--
                            (i) In general.--In awarding 
                        contracts, grants, and cooperative 
                        agreements, and in entering into other 
                        transactions under subparagraph (B) or 
                        (D) of paragraph (4), the Secretary 
                        shall have the expedited procurement 
                        authorities, the authority to expedite 
                        peer review, and the authority for 
                        personal services contracts, supplied 
                        by subsections (b), (c), and (d) of 
                        section 319F-1.
                            (ii) Application of provisions.--
                        Provisions in such section 319F-1 that 
                        apply to such authorities and that 
                        require institution of internal 
                        controls, limit review, provide for 
                        Federal Tort Claims Act coverage of 
                        personal services contractors, and 
                        commit decisions to the discretion of 
                        the Secretary shall apply to the 
                        authorities as exercised pursuant to 
                        this paragraph.
                            (iii) Authority to limit 
                        competition.--For purposes of applying 
                        section 319F-1(b)(1)(D) to this 
                        paragraph, the phrase ``BioShield 
                        Program under the Project BioShield Act 
                        of 2004'' shall be deemed to mean the 
                        countermeasure and product advanced 
                        research and development program under 
                        this section.
                            (iv) Availability of data.--The 
                        Secretary shall require that, as a 
                        condition of being awarded a contract, 
                        grant, cooperative agreement, or other 
                        transaction under subparagraph (B) or 
                        (D) of paragraph (4), a person make 
                        available to the Secretary on an 
                        ongoing basis, and submit upon request 
                        to the Secretary, all data related to 
                        or resulting from countermeasure and 
                        product advanced research and 
                        development carried out pursuant to 
                        this section.
                    (C) Advance payments; advertising.--The 
                Secretary may waive the requirements of section 
                3324(a) of title 31, United States Code, or 
                section 3709 of the Revised Statutes of the 
                United States (41 U.S.C. 5) upon the 
                determination by the Secretary that such waiver 
                is necessary to obtain countermeasures or 
                products under this section.
                    (D) Milestone-based payments allowed.--In 
                awarding contracts, grants, and cooperative 
                agreements, and in entering into other 
                transactions, under this section, the Secretary 
                may use milestone-based awards and payments.
                    (E) Foreign nationals eligible.--The 
                Secretary may under this section award 
                contracts, grants, and cooperative agreements 
                to, and may enter into other transactions with, 
                highly qualified foreign national persons 
                outside the United States, alone or in 
                collaboration with American participants, when 
                such transactions may inure to the benefit of 
                the American people.
                    (F) Establishment of research centers.--The 
                Secretary may assess the feasibility and 
                appropriateness of establishing, through 
                contract, grant, cooperative agreement, or 
                other transaction, an arrangement with an 
                existing research center in order to achieve 
                the goals of this section. If such an agreement 
                is not feasible and appropriate, the Secretary 
                may establish one or more federally-funded 
                research and development centers, or 
                university-affiliated research centers, in 
                accordance with section 303(c)(3) of the 
                Federal Property and Administrative Services 
                Act of 1949 (41 U.S.C. 253(c)(3)).
            (6) At-risk individuals.--In carrying out the 
        functions under this section, the Secretary may give 
        priority to the advanced research and development of 
        qualified countermeasures and qualified pandemic or 
        epidemic products that are likely to be safe and 
        effective with respect to children, pregnant women, 
        elderly, and other at-risk individuals.
            (7) Personnel authorities.--
                    (A) Specially qualified scientific and 
                professional personnel.--
                            (i) In general.--In addition to any 
                        other personnel authorities, the 
                        Secretary may--
                                    (I) without regard to those 
                                provisions of title 5, United 
                                States Code, governing 
                                appointments in the competitive 
                                service, appoint highly 
                                qualified individuals to 
                                scientific or professional 
                                positions in BARDA, such as 
                                program managers, to carry out 
                                this section; and
                                    (II) compensate them in the 
                                same manner and subject to the 
                                same terms and conditions in 
                                which individuals appointed 
                                under section 9903 of such 
                                title are compensated, 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.
                            (ii) Manner of exercise of 
                        authority.--The authority provided for 
                        in this subparagraph shall be exercised 
                        subject to the same limitations 
                        described in section 319F-1(e)(2).
                            (iii) Term of appointment.--The 
                        term limitations described in section 
                        9903(c) of title 5, United States Code, 
                        shall apply to appointments under this 
                        subparagraph, except that the 
                        references to the ``Secretary'' and to 
                        the ``Department of Defense's national 
                        security missions'' shall be deemed to 
                        be to the Secretary of Health and Human 
                        Services and to the mission of the 
                        Department of Health and Human Services 
                        under this section.
                    (B) Special consultants.--In carrying out 
                this section, the Secretary may appoint special 
                consultants pursuant to section 207(f).
                    (C) Limitation.--
                            (i) In general.--The Secretary may 
                        hire up to 100 highly qualified 
                        individuals, or up to 50 percent of the 
                        total number of employees, whichever is 
                        less, under the authorities provided 
                        for in subparagraphs (A) and (B).
                            (ii) Report.--The Secretary shall 
                        report to Congress on a biennial basis 
                        on the implementation of this 
                        subparagraph.
    (d) Fund.--
            (1) Establishment.--There is established the 
        Biodefense Medical Countermeasure Development Fund, 
        which shall be available to carry out this section in 
        addition to such amounts as are otherwise available for 
        this purpose.
            (2) Funding.--To carry out the purposes of this 
        section, there are authorized to be appropriated to the 
        Fund--
                    (A) $1,070,000,000 for fiscal years 2006 
                through 2008, the amounts to remain available 
                until expended; and
                    (B) such sums as may be necessary for 
                subsequent fiscal years, the amounts to remain 
                available until expended.
    (e) Inapplicability of Certain Provisions.--
            (1) Disclosure.--
                    (A) In general.--The Secretary shall 
                withhold from disclosure under section 552 of 
                title 5, United States Code, specific technical 
                data or scientific information that is created 
                or obtained during the countermeasure and 
                product advanced research and development 
                carried out under subsection (c) that reveals 
                significant and not otherwise publicly known 
                vulnerabilities of existing medical or public 
                health defenses against biological, chemical, 
                nuclear, or radiological threats. Such 
                information shall be deemed to be information 
                described in section 552(b)(3) of title 5, 
                United States Code.
                    (B) Review.--Information subject to 
                nondisclosure under subparagraph (A) shall be 
                reviewed by the Secretary every 5 years, or 
                more frequently as determined necessary by the 
                Secretary, to determine the relevance or 
                necessity of continued nondisclosure.
                    (C) Sunset.--This paragraph shall cease to 
                have force or effect on the date that is 7 
                years after the date of enactment of the 
                Pandemic and All-Hazards Preparedness Act.
            (2) Review.--Notwithstanding section 14 of the 
        Federal Advisory Committee Act, a working group of 
        BARDA under this section and the National Biodefense 
        Science Board under section 319M shall each terminate 
        on the date that is 5 years after the date on which 
        each such group or Board, as applicable, was 
        established. Such 5-year period may be extended by the 
        Secretary for one or more additional 5-year periods if 
        the Secretary determines that any such extension is 
        appropriate.

SEC. 319M. [247D-F] NATIONAL BIODEFENSE SCIENCE BOARD AND WORKING 
                    GROUPS.

    (a) In General.--
            (1) Establishment and function.--The Secretary 
        shall establish the National Biodefense Science Board 
        (referred to in this section as the ``Board'') to 
        provide expert advice and guidance to the Secretary on 
        scientific, technical and other matters of special 
        interest to the Department of Health and Human Services 
        regarding current and future chemical, biological, 
        nuclear, and radiological agents, whether naturally 
        occurring, accidental, or deliberate.
            (2) Membership.--The membership of the Board shall 
        be comprised of individuals who represent the Nation's 
        preeminent scientific, public health, and medical 
        experts, as follows--
                    (A) such Federal officials as the Secretary 
                may determine are necessary to support the 
                functions of the Board;
                    (B) four individuals representing the 
                pharmaceutical, biotechnology, and device 
                industries;
                    (C) four individuals representing academia; 
                and
                    (D) five other members as determined 
                appropriate by the Secretary, of whom--
                            (i) one such member shall be a 
                        practicing healthcare professional; and
                            (ii) one such member shall be an 
                        individual from an organization 
                        representing healthcare consumers.
            (3) Term of appointment.--A member of the Board 
        described in subparagraph (B), (C), or (D) of paragraph 
        (2) shall serve for a term of 3 years, except that the 
        Secretary may adjust the terms of the initial Board 
        appointees in order to provide for a staggered term of 
        appointment for all members.
            (4) Consecutive appointments; maximum terms.--A 
        member may be appointed to serve not more than 3 terms 
        on the Board and may serve not more than 2 consecutive 
        terms.
            (5) Duties.--The Board shall--
                    (A) advise the Secretary on current and 
                future trends, challenges, and opportunities 
                presented by advances in biological and life 
                sciences, biotechnology, and genetic 
                engineering with respect to threats posed by 
                naturally occurring infectious diseases and 
                chemical, biological, radiological, and nuclear 
                agents;
                    (B) at the request of the Secretary, review 
                and consider any information and findings 
                received from the working groups established 
                under subsection (b); and
                    (C) at the request of the Secretary, 
                provide recommendations and findings for 
                expanded, intensified, and coordinated 
                biodefense research and development activities.
            (6) Meetings.--
                    (A) Initial meeting.--Not later than one 
                year after the date of enactment of the 
                Pandemic and All-Hazards Preparedness Act, the 
                Secretary shall hold the first meeting of the 
                Board.
                    (B) Subsequent meetings.--The Board shall 
                meet at the call of the Secretary, but in no 
                case less than twice annually.
            (7) Vacancies.--Any vacancy in the Board shall not 
        affect its powers, but shall be filled in the same 
        manner as the original appointment.
            (8) Chairperson.--The Secretary shall appoint a 
        chairperson from among the members of the Board.
            (9) Powers.--
                    (A) Hearings.--The Board may hold such 
                hearings, sit and act at such times and places, 
                take such testimony, and receive such evidence 
                as the Board considers advisable to carry out 
                this subsection.
                    (B) Postal services.--The Board may use the 
                United States mails in the same manner and 
                under the same conditions as other departments 
                and agencies of the Federal Government.
            (10) Personnel.--
                    (A) Employees of the federal government.--A 
                member of the Board that is an employee of the 
                Federal Government may not receive additional 
                pay, allowances, or benefits by reason of the 
                member's service on the Board.
                    (B) Other members.--A member of the Board 
                that is not an employee of the Federal 
                Government may be compensated at a rate not to 
                exceed 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 the member is engaged 
                in the actual performance of duties as a member 
                of the Board.
                    (C) Travel expenses.--Each member of the 
                Board shall receive travel expenses, including 
                per diem in lieu of subsistence, in accordance 
                with applicable provisions under subchapter I 
                of chapter 57 of title 5, United States Code.
                    (D) Detail of government employees.--Any 
                Federal Government employee may be detailed to 
                the Board with the approval for the 
                contributing agency without reimbursement, and 
                such detail shall be without interruption or 
                loss of civil service status or privilege.
    (b) Other Working Groups.--The Secretary may establish a 
working group of experts, or may use an existing working group 
or advisory committee, to--
            (1) identify innovative research with the potential 
        to be developed as a qualified countermeasure or a 
        qualified pandemic or epidemic product;
            (2) identify accepted animal models for particular 
        diseases and conditions associated with any biological, 
        chemical, radiological, or nuclear agent, any toxin, or 
        any potential pandemic infectious disease, and identify 
        strategies to accelerate animal model and research tool 
        development and validation; and
            (3) obtain advice regarding supporting and 
        facilitating advanced research and development related 
        to qualified countermeasures and qualified pandemic or 
        epidemic products that are likely to be safe and 
        effective with respect to children, pregnant women, and 
        other vulnerable populations, and other issues 
        regarding activities under this section that affect 
        such populations.
    (c) Definitions.--Any term that is defined in section 319L 
and that is used in this section shall have the same meaning in 
this section as such term is given in section 319L.
    (d) Authorization of Appropriations.--There are authorized 
to be appropriated $1,000,000 to carry out this section for 
fiscal year 2007 and each fiscal year thereafter.

                        hansen's disease program

    Sec. 320. [247e] (a)(1) At or through the National Hansen's 
Disease Programs Center (located in the State of Louisiana), 
the Secretary shall without charge provide short-term care and 
treatment, including outpatient care, for Hansen's disease and 
related complications to any person determined by the Secretary 
to be in need of such care and treatment. The Secretary may not 
at or through such Center provide long-term care for any such 
disease or complication.
    (2) The Center referred to in paragraph (1) shall conduct 
training in the diagnosis and management of Hansen's disease 
and related complications, and shall conduct and promote the 
coordination of research (including clinical research), 
investigations, demonstrations, and studies relating to the 
causes, diagnosis, treatment, control, and prevention of 
Hansen's disease and other mycobacterial diseases and 
complications related to such diseases.
    (3) Paragraph (1) is subject to section 211 of the 
Department of Health and Human Services Appropriations Act, 
1998. \1\
---------------------------------------------------------------------------
    \1\ Title II of Public Law 105-78. See 111 Stat. 1477, 1489.
---------------------------------------------------------------------------
    (b) In addition to the Center referred to in subsection 
(a), the Secretary may establish sites regarding persons with 
Hansen's disease. Each such site shall provide for the 
outpatient care and treatment for Hansen's disease and related 
complications to any person determined by the Secretary to be 
in need of such care and treatment.
    (c) The Secretary shall carry out subsections (a) and (b) 
acting through an agency of the Service. For purposes of the 
preceding sentence, the agency designated by the Secretary 
shall carry out both activities relating to the provision of 
health services and activities relating to the conduct of 
research.
    (d) The Secretary shall make payments to the Board of 
Health of the State of Hawaii for the care and treatment 
(including outpatient care) in its facilities of persons 
suffering from Hansen's disease at a rate determined by the 
Secretary. The rate shall be approximately equal to the 
operating cost per patient of such facilities, except that the 
rate may not exceed the comparable costs per patient with 
Hansen's disease for care and treatment provided by the Center 
referred to in subsection (a). Payments under this subsection 
are subject to the availability of appropriations for such 
purpose.
          coordinated program to improve pediatric oral health
    Sec. 320A. \2\ [247d-8] (a) In General.--The Secretary, 
acting through the Administrator of the Health Resources and 
Services Administration, shall establish a program to fund 
innovative oral health activities that improve the oral health 
of children under 6 years of age who are eligible for services 
provided under a Federal health program, to increase the 
utilization of dental services by such children, and to 
decrease the incidence of early childhood and baby bottle tooth 
decay.
---------------------------------------------------------------------------
    \2\ The placement of this section in title III was carried out to 
reflect the probable intent of Congress. Section 1603 of Public Law 
106-310 (114 Stat. 1151) provided for an amendment to ``Part B of the 
Public Health Service Act'', without specifying which title of this Act 
was the subject of the amendment.
---------------------------------------------------------------------------
    (b) Grants.--The Secretary shall award grants to or enter 
into contracts with public or private nonprofit schools of 
dentistry or accredited dental training institutions or 
programs, community dental programs, and programs operated by 
the Indian Health Service (including federally recognized 
Indian tribes that receive medical services from the Indian 
Health Service, urban Indian health programs funded under title 
V of the Indian Health Care Improvement Act, and tribes that 
contract with the Indian Health Service pursuant to the Indian 
Self-Determination and Education Assistance Act) to enable such 
schools, institutions, and programs to develop programs of oral 
health promotion, to increase training of oral health services 
providers in accordance with State practice laws, or to 
increase the utilization of dental services by eligible 
children.
    (c) Distribution.--In awarding grants under this section, 
the Secretary shall, to the extent practicable, ensure an 
equitable national geographic distribution of the grants, 
including areas of the United States where the incidence of 
early childhood caries is highest.
    (d) Authorization of Appropriations.--There is authorized 
to be appropriated to carry out this section $10,000,000 for 
each the fiscal years 2001 through 2005.

       Part C--Hospitals, Medical Examinations, and Medical Care

                               hospitals

    Sec. 321. [248] The Surgeon General, pursuant to 
regulations, shall--
            (a) Control, manage, and operate all institutions, 
        hospitals, and stations of the Service, including minor 
        repairs and maintenance, and provide for the care, 
        treatment, and hospitalization of patients, including 
        the furnishing of prosthetic and orthopedic devices; 
        and from time to time with the approval of the 
        President, select suitable sites for and establish such 
        additional institutions, hospitals, and stations in the 
        States and possessions of the United States as in his 
        judgment are necessary to enable the Service to 
        discharge its functions and duties;
            (b) Provide for the transfer of Public Health 
        Service patients, in the care of attendants where 
        necessary, between hospitals and stations operated by 
        the Service or between such hospitals and stations and 
        other hospitals and stations in which Public Health 
        Service patients may be received, and the payment of 
        expenses of such transfer;
            (c) Provide for the disposal of articles produced 
        by patients in the course of their curative treatment, 
        either by allowing the patient to retain such articles 
        or by selling them and depositing the money received 
        therefor to the credit of the appropriation from which 
        the materials for making the articles were purchased;
            (d) Provide for the disposal of money and effects, 
        in the custody of the hospitals or stations, of 
        deceased patients; and
            (e) Provide, to the extent the Surgeon General 
        determines that other public or private funds are not 
        available therefor, for the payment of expenses of 
        preparing and transporting the remains of, or the 
        payment of reasonable burial expenses for, any patient 
        dying in a hospital or station.

   care and treatment of persons under quarantine and certain other 
                                persons

    Sec. 322. [249] (a) Any person when detained in accordance 
with quarantine laws, or, at the request of the Immigration and 
Naturalization Service, any person detained by that Service, 
may be treated and cared for by the Public Health Service.
    (b) Persons not entitled to treatment and care at 
institutions, hospitals, and stations of the Service may, in 
accordance with regulations of the Surgeon General, be admitted 
thereto for temporary treatment and care in case of emergency.
    (c) Persons whose care and treatment is authorized by 
subsection (a) may, in accordance with regulations, receive 
such care and treatment at the expense of the Service from 
public or private medical or hospital facilities other than 
those of the Service, when authorized by the officer in charge 
of the station at which the application is made.

              care and treatment of federal prisoners \1\

    Sec. 323. [250] The Service shall supervise and furnish 
medical treatment and other necessary medical, psychiatric, and 
related technical and scientific services, authorized by the 
Act of May 13, 1930, as amended (U.S.C., 1940 edition, title 
18, secs. 751, 752), \2\ in penal and correctional institutions 
of the United States.
---------------------------------------------------------------------------
    \1\ Title I of the Departments of Commerce, Justice, and State, the 
Judiciary, and Related Agencies Appropriations Act, 2005 (as contained 
in division B of Public Law 108-447) provided that of the amounts 
appropriated for salaries and expenses regarding the Federal Prison 
System ``the Attorney General may transfer to the Health Resources and 
Services Administration such amounts as may be necessary for direct 
expenditures by that Administration for medical relief for inmates of 
Federal penal and correctional institutions''. (See 118 Stat. 2860.) 
Similar provisions have appeared in the analogous appropriations Act of 
many prior years. See section 250a of title 42, United States Code, and 
the notes following such section.
    \2\ Now codified to section 4005 of title 18, United States Code.
---------------------------------------------------------------------------

             examination and treatment of federal employees

    Sec. 324. [251] (a) The Surgeon General is authorized to 
provide at institutions, hospitals, and stations of the Service 
medical, surgical, and hospital services and supplies for 
persons entitled to treatment under the United States 
Employees' Compensation Act \3\ and extensions thereof. The 
Surgeon General may also provide for making medical 
examinations of--
---------------------------------------------------------------------------
    \3\ Codified to chapter 81 of title 5, United States Code.
---------------------------------------------------------------------------
            (1) employees of the Federal Government for 
        retirement purposes;
            (2) employees in Federal classified service, and 
        applicants for appointment, as requested by the Civil 
        Service Commission for the purpose of promoting health 
        and efficiency;
            (3) seamen for purposes of qualifying for 
        certificates of service; and
            (4) employees eligible for benefits under the 
        Longshoremen's and Harbor Workers' Compensation Act, as 
        amended (U.S.C. 1940 edition, title 33, chapter 18), 
        \4\ as requested by any deputy commissioner thereunder.
---------------------------------------------------------------------------
    \4\ Codification remains chapter 18 of title 33, United States 
Code.
---------------------------------------------------------------------------
    (b) The Secretary is authorized to provide medical, 
surgical, and dental treatment and hospitalization and 
optometric care for Federal employees (as defined in section 
8901(1) of title 5 of the United States Code) and their 
dependents at remote medical facilities of the Public Health 
Service where such care and treatment are not otherwise 
available. Such employees and their dependents who are not 
entitled to this care and treatment under any other provision 
of law shall be charged for it at rates established by the 
Secretary to reflect the reasonable cost of providing the care 
and treatment. Any payments pursuant to the preceding sentence 
shall be credited to the applicable appropriation to the Public 
Health Service for the year in which such payments are 
received.

                         examination of aliens

    Sec. 325. [252] The Surgeon General shall provide for 
making, at places within the United States or in other 
countries, such physical and mental examinations of aliens as 
are required by the immigration laws, subject to administrative 
regulations prescribed by the Attorney General and medical 
regulations prescribed by the Surgeon General with the approval 
of the Secretary.

 services to coast guard, coast and geodetic survey, and public health 
                                service

    Sec. 326. [253] (a) Subject to regulations of the 
President--
            (1) commissioned officers, chief warrant officers, 
        warrant officers, cadets, and enlisted personnel of the 
        Regular Coast Guard on active duty, including those on 
        shore duty and those on detached duty; and Regular and 
        temporary members of the United States Coast Guard 
        Reserve when on active duty;
            (2) commissioned officers, ships' officers, and 
        members of the crews of vessels of the United States 
        Coast and Geodetic Survey on active duty including 
        those on shore duty and those on detached duty; and
            (3) commissioned officers of the Regular or Reserve 
        Corps of the Public Health Service on active duty;
shall be entitled to medical, surgical, and dental treatment 
and hospitalization by the Service. The Surgeon General may 
detail commissioned officers for duty aboard vessels of the 
Coast Guard or the Coast and Geodetic Survey.
      (b)(1) The Secretary may provide health care for an 
officer of the Regular or Reserve Corps involuntarily separated 
from the Service, and for any dependent of such officer, if--
            (A) the officer or dependent was receiving health 
        care at the expense of the Service at the time of the 
        separation; and
            (B) the Secretary finds that the officer or 
        dependent is unable to obtain appropriate insurance for 
        the conditions for which the officer or dependent was 
        receiving health care.
      (2) Health care may be provided under paragraph (1) for a 
period of not more than one year from the date of separation of 
the officer from the Service.
    (c) The Service shall provide all services referred to in 
subsection (a) required by the Coast Guard or Coast and 
Geodetic Survey and shall perform all duties prescribed by 
statute in connection with the examinations to determine 
physical or mental condition for purposes of appointment, 
enlistment, and reenlistment, promotion and retirement, and 
officers of the Service assigned to duty on Coast Guard or 
Coast and Geodetic Survey vessels may extend aid to the crews 
of American vessels engaged in deep-sea fishing.

                         interdepartmental work

    Sec. 327. [254] Nothing contained in this part shall affect 
the authority of the Service to furnish any materials, 
supplies, or equipment, or perform any work or services, 
requested in accordance with section 7 of the Act of May 21, 
1920, as amended (U.S.C., 1940 edition, title 31, sec. 686), or 
the authority of any other executive department to furnish any 
materials, supplies, or equipment, or perform any work or 
services, requested by the Department of Health, Education, and 
Welfare for the Service in accordance with that section.

            sharing of medical care facilities and resources

    Sec. 327A. [254a] (a) For purposes of this section--
            (1) the term ``specialized health resources'' means 
        health care resources (whether equipment, space, or 
        personnel) which, because of cost, limited 
        availability, or unusual nature, are either unique in 
        the health care community or are subject to maximum 
        utilization only through mutual use;
            (2) the term ``hospital'', unless otherwise 
        specified, includes (in addition to other hospitals) 
        any Federal hospital.
    (b) For the purpose of maintaining or improving the quality 
of care in Public Health Service facilities and to provide a 
professional environment therein which will help to attract and 
retain highly qualified and talented health personnel, to 
encourage mutually beneficial relationships between Public 
Health Service facilities and hospitals and other health 
facilities in the health care community, and to promote the 
full utilization of hospitals and other health facilities and 
resources, the Secretary may--
            (1) enter into agreements or arrangements with 
        schools of medicine, schools of osteopathic medicine, 
        and with other health professions schools, agencies, or 
        institutions, for such interchange or cooperative use 
        of facilities and services on a reciprocal or 
        reimbursable basis, as will be of benefit to the 
        training or research programs of the participating 
        agencies; and
            (2) enter into agreement or arrangements with 
        hospitals and other health care facilities for the 
        mutual use or the exchange of use of specialized health 
        resources, and providing for reciprocal reimbursement.
Any reimbursement pursuant to any such agreement or arrangement 
shall be based on charges covering the reasonable cost of such 
utilization, including normal depreciation and amortization 
costs of equipment. Any proceeds to the Government under this 
subsection shall be credited to the applicable appropriation of 
the Public Health Service for the year in which such proceeds 
are received.

                      Part D--Primary Health Care

                       Subpart I--Health Centers

SEC. 330. [254B] HEALTH CENTERS.

    (a) Definition of Health Center.--
            (1) In general.--For purposes of this section, the 
        term ``health center'' means an entity that serves a 
        population that is medically underserved, or a special 
        medically underserved population comprised of migratory 
        and seasonal agricultural workers, the homeless, and 
        residents of public housing, by providing, either 
        through the staff and supporting resources of the 
        center or through contracts or cooperative 
        arrangements--
                    (A) required primary health services (as 
                defined in subsection (b)(1)); and
                    (B) as may be appropriate for particular 
                centers, additional health services (as defined 
                in subsection (b)(2)) necessary for the 
                adequate support of the primary health services 
                required under subparagraph (A);
        for all residents of the area served by the center 
        (hereafter referred to in this section as the 
        ``catchment area'').
            (2) Limitation.--The requirement in paragraph (1) 
        to provide services for all residents within a 
        catchment area shall not apply in the case of a health 
        center receiving a grant only under subsection (g), 
        (h), or (i).
    (b) Definitions.--For purposes of this section:
            (1) Required primary health services.--
                    (A) In general.--The term ``required 
                primary health services'' means--
                            (i) basic health services which, 
                        for purposes of this section, shall 
                        consist of--
                                    (I) health services related 
                                to family medicine, internal 
                                medicine, pediatrics, 
                                obstetrics, or gynecology that 
                                are furnished by physicians and 
                                where appropriate, physician 
                                assistants, nurse 
                                practitioners, and nurse 
                                midwives;
                                    (II) diagnostic laboratory 
                                and radiologic services;
                                    (III) preventive health 
                                services, including--
                                            (aa) prenatal and 
                                        perinatal services;
                                            (bb) appropriate 
                                        cancer screening;
                                            (cc) well-child 
                                        services;
                                            (dd) immunizations 
                                        against vaccine-
                                        preventable diseases;
                                            (ee) screenings for 
                                        elevated blood lead 
                                        levels, communicable 
                                        diseases, and 
                                        cholesterol;
                                            (ff) pediatric eye, 
                                        ear, and dental 
                                        screenings to determine 
                                        the need for vision and 
                                        hearing correction and 
                                        dental care;
                                            (gg) voluntary 
                                        family planning 
                                        services; and
                                            (hh) preventive 
                                        dental services;
                                    (IV) emergency medical 
                                services; and
                                    (V) pharmaceutical services 
                                as may be appropriate for 
                                particular centers;
                            (ii) referrals to providers of 
                        medical services (including specialty 
                        referral when medically indicated) and 
                        other health-related services 
                        (including substance abuse and mental 
                        health services);
                            (iii) patient case management 
                        services (including counseling, 
                        referral, and follow-up services) and 
                        other services designed to assist 
                        health center patients in establishing 
                        eligibility for and gaining access to 
                        Federal, State, and local programs that 
                        provide or financially support the 
                        provision of medical, social, housing, 
                        educational, or other related services;
                            (iv) services that enable 
                        individuals to use the services of the 
                        health center (including outreach and 
                        transportation services and, if a 
                        substantial number of the individuals 
                        in the population served by a center 
                        are of limited English-speaking 
                        ability, the services of appropriate 
                        personnel fluent in the language spoken 
                        by a predominant number of such 
                        individuals); and
                            (v) education of patients and the 
                        general population served by the health 
                        center regarding the availability and 
                        proper use of health services.
                    (B) Exception.--With respect to a health 
                center that receives a grant only under 
                subsection (g), the Secretary, upon a showing 
                of good cause, shall--
                            (i) waive the requirement that the 
                        center provide all required primary 
                        health services under this paragraph; 
                        and
                            (ii) approve, as appropriate, the 
                        provision of certain required primary 
                        health services only during certain 
                        periods of the year.
            (2) Additional health services.--The term 
        ``additional health services'' means services that are 
        not included as required primary health services and 
        that are appropriate to meet the health needs of the 
        population served by the health center involved. Such 
        term may include--
                    (A) behavioral and mental health and 
                substance abuse services;
                    (B) recuperative care services;
                    (C) environmental health services, 
                including--
                            (i) the detection and alleviation 
                        of unhealthful conditions associated 
                        with--
                                    (I) water supply;
                                    (II) chemical and pesticide 
                                exposures;
                                    (III) air quality; or
                                    (IV) exposure to lead;
                            (ii) sewage treatment;
                            (iii) solid waste disposal;
                            (iv) rodent and parasitic 
                        infestation;
                            (v) field sanitation;
                            (vi) housing; and
                            (vii) other environmental factors 
                        related to health; and
                    (D) in the case of health centers receiving 
                grants under subsection (g), special 
                occupation-related health services for 
                migratory and seasonal agricultural workers, 
                including--
                            (i) screening for and control of 
                        infectious diseases, including 
                        parasitic diseases; and
                            (ii) injury prevention programs, 
                        including prevention of exposure to 
                        unsafe levels of agricultural chemicals 
                        including pesticides.
            (3) Medically underserved populations.--
                    (A) In general.--The term ``medically 
                underserved population'' means the population 
                of an urban or rural area designated by the 
                Secretary as an area with a shortage of 
                personal health services or a population group 
                designated by the Secretary as having a 
                shortage of such services.
                    (B) Criteria.--In carrying out subparagraph 
                (A), the Secretary shall prescribe criteria for 
                determining the specific shortages of personal 
                health services of an area or population group. 
                Such criteria shall--
                            (i) take into account comments 
                        received by the Secretary from the 
                        chief executive officer of a State and 
                        local officials in a State; and
                            (ii) include factors indicative of 
                        the health status of a population group 
                        or residents of an area, the ability of 
                        the residents of an area or of a 
                        population group to pay for health 
                        services and their accessibility to 
                        them, and the availability of health 
                        professionals to residents of an area 
                        or to a population group.
                    (C) Limitation.--The Secretary may not 
                designate a medically underserved population in 
                a State or terminate the designation of such a 
                population unless, prior to such designation or 
                termination, the Secretary provides reasonable 
                notice and opportunity for comment and consults 
                with--
                            (i) the chief executive officer of 
                        such State;
                            (ii) local officials in such State; 
                        and
                            (iii) the organization, if any, 
                        which represents a majority of health 
                        centers in such State.
                    (D) Permissible designation.--The Secretary 
                may designate a medically underserved 
                population that does not meet the criteria 
                established under subparagraph (B) if the chief 
                executive officer of the State in which such 
                population is located and local officials of 
                such State recommend the designation of such 
                population based on unusual local conditions 
                which are a barrier to access to or the 
                availability of personal health services.
    (c) Planning Grants.--
            (1) In general.--
                    (A) Centers.--The Secretary may make grants 
                to public and nonprofit private entities for 
                projects to plan and develop health centers 
                which will serve medically underserved 
                populations. A project for which a grant may be 
                made under this subsection may include the cost 
                of the acquisition and lease of buildings and 
                equipment (including the costs of amortizing 
                the principal of, and paying the interest on, 
                loans) and shall include--
                            (i) an assessment of the need that 
                        the population proposed to be served by 
                        the health center for which the project 
                        is undertaken has for required primary 
                        health services and additional health 
                        services;
                            (ii) the design of a health center 
                        program for such population based on 
                        such assessment;
                            (iii) efforts to secure, within the 
                        proposed catchment area of such center, 
                        financial and professional assistance 
                        and support for the project;
                            (iv) initiation and encouragement 
                        of continuing community involvement in 
                        the development and operation of the 
                        project; and
                            (v) proposed linkages between the 
                        center and other appropriate provider 
                        entities, such as health departments, 
                        local hospitals, and rural health 
                        clinics, to provide better coordinated, 
                        higher quality, and more cost-effective 
                        health care services.
                    (B) Managed care networks and plans.--The 
                Secretary may make grants to health centers 
                that receive assistance under this section to 
                enable the centers to plan and develop a 
                managed care network or plan. Such a grant may 
                only be made for such a center if--
                            (i) the center has received grants 
                        under subsection (e)(1)(A) for at least 
                        2 consecutive years preceding the year 
                        of the grant under this subparagraph or 
                        has otherwise demonstrated, as required 
                        by the Secretary, that such center has 
                        been providing primary care services 
                        for at least the 2 consecutive years 
                        immediately preceding such year; and
                            (ii) the center provides assurances 
                        satisfactory to the Secretary that the 
                        provision of such services on a prepaid 
                        basis, or under another managed care 
                        arrangement, will not result in the 
                        diminution of the level or quality of 
                        health services provided to the 
                        medically underserved population served 
                        prior to the grant under this 
                        subparagraph.
                    (C) Practice management networks.--The 
                Secretary may make grants to health centers 
                that receive assistance under this section to 
                enable the centers to plan and develop practice 
                management networks that will enable the 
                centers to--
                            (i) reduce costs associated with 
                        the provision of health care services;
                            (ii) improve access to, and 
                        availability of, health care services 
                        provided to individuals served by the 
                        centers;
                            (iii) enhance the quality and 
                        coordination of health care services; 
                        or
                            (iv) improve the health status of 
                        communities.
                    (D) Use of funds.--The activities for which 
                a grant may be made under subparagraph (B) or 
                (C) may include the purchase or lease of 
                equipment, which may include data and 
                information systems (including paying for the 
                costs of amortizing the principal of, and 
                paying the interest on, loans for equipment), 
                the provision of training and technical 
                assistance related to the provision of health 
                care services on a prepaid basis or under 
                another managed care arrangement, and other 
                activities that promote the development of 
                practice management or managed care networks 
                and plans.
            (2) Limitation.--Not more than two grants may be 
        made under this subsection for the same project, except 
        that upon a showing of good cause, the Secretary may 
        make additional grant awards.
            (3) Recognition of high poverty.--
                    (A) In general.--In making grants under 
                this subsection, the Secretary may recognize 
                the unique needs of high poverty areas.
                    (B) High poverty area defined.--For 
                purposes of subparagraph (A), the term ``high 
                poverty area'' means a catchment area which is 
                established in a manner that is consistent with 
                the factors in subsection (k)(3)(J), and the 
                poverty rate of which is greater than the 
                national average poverty rate as determined by 
                the Bureau of the Census.
    (d) Loan Guarantee Program.--
            (1) Establishment.--
                    (A) In general.--The Secretary shall 
                establish a program under which the Secretary 
                may, in accordance with this subsection and to 
                the extent that appropriations are provided in 
                advance for such program, guarantee up to 90 
                percent of the principal and interest on loans 
                made by non-Federal lenders to health centers, 
                funded under this section, for the costs of 
                developing and operating managed care networks 
                or plans described in subsection (c)(1)(B), or 
                practice management networks described in 
                subsection (c)(1)(C).
                    (B) Use of funds.--Loan funds guaranteed 
                under this subsection may be used--
                            (i) to establish reserves for the 
                        furnishing of services on a pre-paid 
                        basis;
                            (ii) for costs incurred by the 
                        center or centers, otherwise permitted 
                        under this section, as the Secretary 
                        determines are necessary to enable a 
                        center or centers to develop, operate, 
                        and own the network or plan; or
                            (iii) to refinance an existing loan 
                        (as of the date of refinancing) to the 
                        center or centers, if the Secretary 
                        determines--
                                    (I) that such refinancing 
                                will be beneficial to the 
                                health center and the Federal 
                                Government; or
                                    (II) that the center (or 
                                centers) can demonstrate an 
                                ability to repay the refinanced 
                                loan equal to or greater than 
                                the ability of the center (or 
                                centers) to repay the original 
                                loan on the date the original 
                                loan was made.
                    (C) Publication of guidance.--Prior to 
                considering an application submitted under this 
                subsection, the Secretary shall publish 
                guidelines to provide guidance on the 
                implementation of this section. The Secretary 
                shall make such guidelines available to the 
                universe of parties affected under this 
                subsection, distribute such guidelines to such 
                parties upon the request of such parties, and 
                provide a copy of such guidelines to the 
                appropriate committees of Congress.
                    (D) Provision directly to networks or 
                plans.--At the request of health centers 
                receiving assistance under this section, loan 
                guarantees provided under this paragraph may be 
                made directly to networks or plans that are at 
                least majority controlled and, as applicable, 
                at least majority owned by those health 
                centers.
                    (E) Federal credit reform.--The 
                requirements of the Federal Credit Reform Act 
                of 1990 (2 U.S.C. 661 et seq.) shall apply with 
                respect to loans refinanced under subparagraph 
                (B)(iii).
            (2) Protection of financial interests.--
                    (A) In general.--The Secretary may not 
                approve a loan guarantee for a project under 
                this subsection unless the Secretary determines 
                that--
                            (i) the terms, conditions, security 
                        (if any), and schedule and amount of 
                        repayments with respect to the loan are 
                        sufficient to protect the financial 
                        interests of the United States and are 
                        otherwise reasonable, including a 
                        determination that the rate of interest 
                        does not exceed such percent per annum 
                        on the principal obligation outstanding 
                        as the Secretary determines to be 
                        reasonable, taking into account the 
                        range of interest rates prevailing in 
                        the private market for similar loans 
                        and the risks assumed by the United 
                        States, except that the Secretary may 
                        not require as security any center 
                        asset that is, or may be, needed by the 
                        center or centers involved to provide 
                        health services;
                            (ii) the loan would not be 
                        available on reasonable terms and 
                        conditions without the guarantee under 
                        this subsection; and
                            (iii) amounts appropriated for the 
                        program under this subsection are 
                        sufficient to provide loan guarantees 
                        under this subsection.
                    (B) Recovery of payments.--
                            (i) In general.--The United States 
                        shall be entitled to recover from the 
                        applicant for a loan guarantee under 
                        this subsection the amount of any 
                        payment made pursuant to such 
                        guarantee, unless the Secretary for 
                        good cause waives such right of 
                        recovery (subject to appropriations 
                        remaining available to permit such a 
                        waiver) and, upon making any such 
                        payment, the United States shall be 
                        subrogated to all of the rights of the 
                        recipient of the payments with respect 
                        to which the guarantee was made. 
                        Amounts recovered under this clause 
                        shall be credited as reimbursements to 
                        the financing account of the program.
                            (ii) Modification of terms and 
                        conditions.--To the extent permitted by 
                        clause (iii) and subject to the 
                        requirements of section 504(e) of the 
                        Credit Reform Act of 1990 (2 U.S.C. 
                        661c(e)), any terms and conditions 
                        applicable to a loan guarantee under 
                        this subsection (including terms and 
                        conditions imposed under clause (iv)) 
                        may be modified or waived by the 
                        Secretary to the extent the Secretary 
                        determines it to be consistent with the 
                        financial interest of the United 
                        States.
                            (iii) Incontestability.--Any loan 
                        guarantee made by the Secretary under 
                        this subsection shall be 
                        incontestable--
                                    (I) in the hands of an 
                                applicant on whose behalf such 
                                guarantee is made unless the 
                                applicant engaged in fraud or 
                                misrepresentation in securing 
                                such guarantee; and
                                    (II) as to any person (or 
                                successor in interest) who 
                                makes or contracts to make a 
                                loan to such applicant in 
                                reliance thereon unless such 
                                person (or successor in 
                                interest) engaged in fraud or 
                                misrepresentation in making or 
                                contracting to make such loan.
                            (iv) Further terms and 
                        conditions.--Guarantees of loans under 
                        this subsection shall be subject to 
                        such further terms and conditions as 
                        the Secretary determines to be 
                        necessary to assure that the purposes 
                        of this section will be achieved.
            (3) Loan origination fees.--
                    (A) In general.--The Secretary shall 
                collect a loan origination fee with respect to 
                loans to be guaranteed under this subsection, 
                except as provided in subparagraph (C).
                    (B) Amount.--The amount of a loan 
                origination fee collected by the Secretary 
                under subparagraph (A) shall be equal to the 
                estimated long term cost of the loan guarantees 
                involved to the Federal Government (excluding 
                administrative costs), calculated on a net 
                present value basis, after taking into account 
                any appropriations that may be made for the 
                purpose of offsetting such costs, and in 
                accordance with the criteria used to award loan 
                guarantees under this subsection.
                    (C) Waiver.--The Secretary may waive the 
                loan origination fee for a health center 
                applicant who demonstrates to the Secretary 
                that the applicant will be unable to meet the 
                conditions of the loan if the applicant incurs 
                the additional cost of the fee.
            (4) Defaults.--
                    (A) In general.--Subject to the 
                requirements of the Credit Reform Act of 1990 
                (2 U.S.C. 661 et seq.), the Secretary may take 
                such action as may be necessary to prevent a 
                default on a loan guaranteed under this 
                subsection, including the waiver of regulatory 
                conditions, deferral of loan payments, 
                renegotiation of loans, and the expenditure of 
                funds for technical and consultative 
                assistance, for the temporary payment of the 
                interest and principal on such a loan, and for 
                other purposes. Any such expenditure made under 
                the preceding sentence on behalf of a health 
                center or centers shall be made under such 
                terms and conditions as the Secretary shall 
                prescribe, including the implementation of such 
                organizational, operational, and financial 
                reforms as the Secretary determines are 
                appropriate and the disclosure of such 
                financial or other information as the Secretary 
                may require to determine the extent of the 
                implementation of such reforms.
                    (B) Foreclosure.--The Secretary may take 
                such action, consistent with State law 
                respecting foreclosure procedures and, with 
                respect to reserves required for furnishing 
                services on a prepaid basis, subject to the 
                consent of the affected States, as the 
                Secretary determines appropriate to protect the 
                interest of the United States in the event of a 
                default on a loan guaranteed under this 
                subsection, except that the Secretary may only 
                foreclose on assets offered as security (if 
                any) in accordance with paragraph (2)(A)(i).
            (5) Limitation.--Not more than one loan guarantee 
        may be made under this subsection for the same network 
        or plan, except that upon a showing of good cause the 
        Secretary may make additional loan guarantees.
            (6) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this 
        subsection such sums as may be necessary.
    (e) Operating Grants.--
            (1) Authority.--
                    (A) In general.--The Secretary may make 
                grants for the costs of the operation of public 
                and nonprofit private health centers that 
                provide health services to medically 
                underserved populations.
                    (B) Entities that fail to meet certain 
                requirements.--The Secretary may make grants, 
                for a period of not to exceed 2 years, for the 
                costs of the operation of public and nonprofit 
                private entities which provide health services 
                to medically underserved populations but with 
                respect to which the Secretary is unable to 
                make each of the determinations required by 
                subsection (k)(3).
                    (C) Operation of networks and plans.--The 
                Secretary may make grants to health centers 
                that receive assistance under this section, or 
                at the request of the health centers, directly 
                to a network or plan (as described in 
                subparagraphs (B) and (C) of subsection (c)(1)) 
                that is at least majority controlled and, as 
                applicable, at least majority owned by such 
                health centers receiving assistance under this 
                section, for the costs associated with the 
                operation of such network or plan, including 
                the purchase or lease of equipment (including 
                the costs of amortizing the principal of, and 
                paying the interest on, loans for equipment).
            (2) Use of funds.--The costs for which a grant may 
        be made under subparagraph (A) or (B) of paragraph (1) 
        may include the costs of acquiring and leasing 
        buildings and equipment (including the costs of 
        amortizing the principal of, and paying interest on, 
        loans), and the costs of providing training related to 
        the provision of required primary health services and 
        additional health services and to the management of 
        health center programs.
            (3) Construction.--The Secretary may award grants 
        which may be used to pay the costs associated with 
        expanding and modernizing existing buildings or 
        constructing new buildings (including the costs of 
        amortizing the principal of, and paying the interest 
        on, loans) for projects approved prior to October 1, 
        1996.
            (4) Limitation.--Not more than two grants may be 
        made under subparagraph (B) of paragraph (1) for the 
        same entity.
            (5) Amount.--
                    (A) In general.--The amount of any grant 
                made in any fiscal year under subparagraphs (A) 
                and (B) of paragraph (1) to a health center 
                shall be determined by the Secretary, but may 
                not exceed the amount by which the costs of 
                operation of the center in such fiscal year 
                exceed the total of--
                            (i) State, local, and other 
                        operational funding provided to the 
                        center; and
                            (ii) the fees, premiums, and third-
                        party reimbursements, which the center 
                        may reasonably be expected to receive 
                        for its operations in such fiscal year.
                    (B) Networks and plans.--The total amount 
                of grant funds made available for any fiscal 
                year under paragraph (1)(C) and subparagraphs 
                (B) and (C) of subsection (c)(1) to a health 
                center or to a network or plan shall be 
                determined by the Secretary, but may not exceed 
                2 percent of the total amount appropriated 
                under this section for such fiscal year.
                    (C) Payments.--Payments under grants under 
                subparagraph (A) or (B) of paragraph (1) shall 
                be made in advance or by way of reimbursement 
                and in such installments as the Secretary finds 
                necessary and adjustments may be made for 
                overpayments or underpayments.
                    (D) Use of nongrant funds.--Nongrant funds 
                described in clauses (i) and (ii) of 
                subparagraph (A), including any such funds in 
                excess of those originally expected, shall be 
                used as permitted under this section, and may 
                be used for such other purposes as are not 
                specifically prohibited under this section if 
                such use furthers the objectives of the 
                project.
    (f) Infant Mortality Grants.--
            (1) In general.--The Secretary may make grants to 
        health centers for the purpose of assisting such 
        centers in--
                    (A) providing comprehensive health care and 
                support services for the reduction of--
                            (i) the incidence of infant 
                        mortality; and
                            (ii) morbidity among children who 
                        are less than 3 years of age; and
                    (B) developing and coordinating service and 
                referral arrangements between health centers 
                and other entities for the health management of 
                pregnant women and children described in 
                subparagraph (A).
            (2) Priority.--In making grants under this 
        subsection the Secretary shall give priority to health 
        centers providing services to any medically underserved 
        population among which there is a substantial incidence 
        of infant mortality or among which there is a 
        significant increase in the incidence of infant 
        mortality.
            (3) Requirements.--The Secretary may make a grant 
        under this subsection only if the health center 
        involved agrees that--
                    (A) the center will coordinate the 
                provision of services under the grant to each 
                of the recipients of the services;
                    (B) such services will be continuous for 
                each such recipient;
                    (C) the center will provide follow-up 
                services for individuals who are referred by 
                the center for services described in paragraph 
                (1);
                    (D) the grant will be expended to 
                supplement, and not supplant, the expenditures 
                of the center for primary health services 
                (including prenatal care) with respect to the 
                purpose described in this subsection; and
                    (E) the center will coordinate the 
                provision of services with other maternal and 
                child health providers operating in the 
                catchment area.
    (g) Migratory and Seasonal Agricultural Workers.--
            (1) In general.--The Secretary may award grants for 
        the purposes described in subsections (c), (e), and (f) 
        for the planning and delivery of services to a special 
        medically underserved population comprised of--
                    (A) migratory agricultural workers, 
                seasonal agricultural workers, and members of 
                the families of such migratory and seasonal 
                agricultural workers who are within a 
                designated catchment area; and
                    (B) individuals who have previously been 
                migratory agricultural workers but who no 
                longer meet the requirements of subparagraph 
                (A) of paragraph (3) because of age or 
                disability and members of the families of such 
                individuals who are within such catchment area.
            (2) Environmental concerns.--The Secretary may 
        enter into grants or contracts under this subsection 
        with public and private entities to--
                    (A) assist the States in the implementation 
                and enforcement of acceptable environmental 
                health standards, including enforcement of 
                standards for sanitation in migratory 
                agricultural worker and seasonal agricultural 
                worker labor camps, and applicable Federal and 
                State pesticide control standards; and
                    (B) conduct projects and studies to assist 
                the several States and entities which have 
                received grants or contracts under this section 
                in the assessment of problems related to camp 
                and field sanitation, exposure to unsafe levels 
                of agricultural chemicals including pesticides, 
                and other environmental health hazards to which 
                migratory agricultural workers and seasonal 
                agricultural workers, and members of their 
                families, are exposed.
            (3) Definitions.--For purposes of this subsection:
                    (A) Migratory agricultural worker.--The 
                term ``migratory agricultural worker'' means an 
                individual whose principal employment is in 
                agriculture, who has been so employed within 
                the last 24 months, and who establishes for the 
                purposes of such employment a temporary abode.
                    (B) Seasonal agricultural worker.--The term 
                ``seasonal agricultural worker'' means an 
                individual whose principal employment is in 
                agriculture on a seasonal basis and who is not 
                a migratory agricultural worker.
                    (C) Agriculture.--The term ``agriculture'' 
                means farming in all its branches, including--
                            (i) cultivation and tillage of the 
                        soil;
                            (ii) the production, cultivation, 
                        growing, and harvesting of any 
                        commodity grown on, in, or as an 
                        adjunct to or part of a commodity grown 
                        in or on, the land; and
                            (iii) any practice (including 
                        preparation and processing for market 
                        and delivery to storage or to market or 
                        to carriers for transportation to 
                        market) performed by a farmer or on a 
                        farm incident to or in conjunction with 
                        an activity described in clause (ii).
    (h) Homeless Population.--
            (1) In general.--The Secretary may award grants for 
        the purposes described in subsections (c), (e), and (f) 
        for the planning and delivery of services to a special 
        medically underserved population comprised of homeless 
        individuals, including grants for innovative programs 
        that provide outreach and comprehensive primary health 
        services to homeless children and youth and children 
        and youth at risk of homelessness.
            (2) Required services.--In addition to required 
        primary health services (as defined in subsection 
        (b)(1)), an entity that receives a grant under this 
        subsection shall be required to provide substance abuse 
        services as a condition of such grant.
            (3) Supplement not supplant requirement.--A grant 
        awarded under this subsection shall be expended to 
        supplement, and not supplant, the expenditures of the 
        health center and the value of in kind contributions 
        for the delivery of services to the population 
        described in paragraph (1).
            (4) Temporary continued provision of services to 
        certain former homeless individuals.--If any grantee 
        under this subsection has provided services described 
        in this section under the grant to a homeless 
        individual, such grantee may, notwithstanding that the 
        individual is no longer homeless as a result of 
        becoming a resident in permanent housing, expend the 
        grant to continue to provide such services to the 
        individual for not more than 12 months.
            (5) Definitions.--For purposes of this section:
                    (A) Homeless individual.--The term 
                ``homeless individual'' means an individual who 
                lacks housing (without regard to whether the 
                individual is a member of a family), including 
                an individual whose primary residence during 
                the night is a supervised public or private 
                facility that provides temporary living 
                accommodations and an individual who is a 
                resident in transitional housing.
                    (B) Substance abuse.--The term ``substance 
                abuse'' has the same meaning given such term in 
                section 534(4).
                    (C) Substance abuse services.--The term 
                ``substance abuse services'' includes 
                detoxification, risk reduction, outpatient 
                treatment, residential treatment, and 
                rehabilitation for substance abuse provided in 
                settings other than hospitals.
    (i) Residents of Public Housing.--
            (1) In general.--The Secretary may award grants for 
        the purposes described in subsections (c), (e), and (f) 
        for the planning and delivery of services to a special 
        medically underserved population comprised of residents 
        of public housing (such term, for purposes of this 
        subsection, shall have the same meaning given such term 
        in section 3(b)(1) of the United States Housing Act of 
        1937) and individuals living in areas immediately 
        accessible to such public housing.
            (2) Supplement not supplant.--A grant awarded under 
        this subsection shall be expended to supplement, and 
        not supplant, the expenditures of the health center and 
        the value of in kind contributions for the delivery of 
        services to the population described in paragraph (1).
            (3) Consultation with residents.--The Secretary may 
        not make a grant under paragraph (1) unless, with 
        respect to the residents of the public housing 
        involved, the applicant for the grant--
                    (A) has consulted with the residents in the 
                preparation of the application for the grant; 
                and
                    (B) agrees to provide for ongoing 
                consultation with the residents regarding the 
                planning and administration of the program 
                carried out with the grant.
    (j) Access Grants.--
            (1) In general.--The Secretary may award grants to 
        eligible health centers with a substantial number of 
        clients with limited English speaking proficiency to 
        provide translation, interpretation, and other such 
        services for such clients with limited English speaking 
        proficiency.
            (2) Eligible health center.--In this subsection, 
        the term ``eligible health center'' means an entity 
        that--
                    (A) is a health center as defined under 
                subsection (a);
                    (B) provides health care services for 
                clients for whom English is a second language; 
                and
                    (C) has exceptional needs with respect to 
                linguistic access or faces exceptional 
                challenges with respect to linguistic access.
            (3) Grant amount.--The amount of a grant awarded to 
        a center under this subsection shall be determined by 
        the Administrator. Such determination of such amount 
        shall be based on the number of clients for whom 
        English is a second language that is served by such 
        center, and larger grant amounts shall be awarded to 
        centers serving larger numbers of such clients.
            (4) Use of funds.--An eligible health center that 
        receives a grant under this subsection may use funds 
        received through such grant to--
                    (A) provide translation, interpretation, 
                and other such services for clients for whom 
                English is a second language, including hiring 
                professional translation and interpretation 
                services; and
                    (B) compensate bilingual or multilingual 
                staff for language assistance services provided 
                by the staff for such clients.
            (5) Application.--An eligible health center 
        desiring a grant under this subsection shall submit an 
        application to the Secretary at such time, in such 
        manner, and containing such information as the 
        Secretary may reasonably require, including--
                    (A) an estimate of the number of clients 
                that the center serves for whom English is a 
                second language;
                    (B) the ratio of the number of clients for 
                whom English is a second language to the total 
                number of clients served by the center;
                    (C) a description of any language 
                assistance services that the center proposes to 
                provide to aid clients for whom English is a 
                second language; and
                    (D) a description of the exceptional needs 
                of such center with respect to linguistic 
                access or a description of the exceptional 
                challenges faced by such center with respect to 
                linguistic access.
            (6) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this 
        subsection, in addition to any funds authorized to be 
        appropriated or appropriated for health centers under 
        any other subsection of this section, such sums as may 
        be necessary for each of fiscal years 2002 through 
        2006.
    (k) Applications.--
            (1) Submission.--No grant may be made under this 
        section unless an application therefore is submitted 
        to, and approved by, the Secretary. Such an application 
        shall be submitted in such form and manner and shall 
        contain such information as the Secretary shall 
        prescribe.
            (2) Description of need.--An application for a 
        grant under subparagraph (A) or (B) of subsection 
        (e)(1) for a health center shall include--
                    (A) a description of the need for health 
                services in the catchment area of the center;
                    (B) a demonstration by the applicant that 
                the area or the population group to be served 
                by the applicant has a shortage of personal 
                health services; and
                    (C) a demonstration that the center will be 
                located so that it will provide services to the 
                greatest number of individuals residing in the 
                catchment area or included in such population 
                group.
        Such a demonstration shall be made on the basis of the 
        criteria prescribed by the Secretary under subsection 
        (b)(3) or on any other criteria which the Secretary may 
        prescribe to determine if the area or population group 
        to be served by the applicant has a shortage of 
        personal health services. In considering an application 
        for a grant under subparagraph (A) or (B) of subsection 
        (e)(1), the Secretary may require as a condition to the 
        approval of such application an assurance that the 
        applicant will provide any health service defined under 
        paragraphs (1) and (2) of subsection (b) that the 
        Secretary finds is needed to meet specific health needs 
        of the area to be served by the applicant. Such a 
        finding shall be made in writing and a copy shall be 
        provided to the applicant.
            (3) Requirements.--Except as provided in subsection 
        (e)(1)(B), the Secretary may not approve an application 
        for a grant under subparagraph (A) or (B) of subsection 
        (e)(1) unless the Secretary determines that the entity 
        for which the application is submitted is a health 
        center (within the meaning of subsection (a)) and 
        that--
                    (A) the required primary health services of 
                the center will be available and accessible in 
                the catchment area of the center promptly, as 
                appropriate, and in a manner which assures 
                continuity;
                    (B) the center has made and will continue 
                to make every reasonable effort to establish 
                and maintain collaborative relationships with 
                other health care providers in the catchment 
                area of the center;
                    (C) the center will have an ongoing quality 
                improvement system that includes clinical 
                services and management, and that maintains the 
                confidentiality of patient records;
                    (D) the center will demonstrate its 
                financial responsibility by the use of such 
                accounting procedures and other requirements as 
                may be prescribed by the Secretary;
                    (E) the center--
                            (i)(I) has or will have a 
                        contractual or other arrangement with 
                        the agency of the State, in which it 
                        provides services, which administers or 
                        supervises the administration of a 
                        State plan approved under title XIX of 
                        the Social Security Act for the payment 
                        of all or a part of the center's costs 
                        in providing health services to persons 
                        who are eligible for medical assistance 
                        under such a State plan; and
                                    (II) \1\ has or will have a 
                                contractual or other 
                                arrangement with the State 
                                agency administering the 
                                program under title XXI of such 
                                Act (42 U.S.C. 1397aa et seq.) 
                                with respect to individuals who 
                                are State children's health 
                                insurance program 
                                beneficiaries; or
---------------------------------------------------------------------------
    \1\ Indentation is so in law. See section 101(7)(A)(i)(III) of 
Public Law 107-251 (116 Stat. 225).
---------------------------------------------------------------------------
                            (ii) has made or will make every 
                        reasonable effort to enter into 
                        arrangements described in subclauses 
                        (I) and (II) of clause (i);
                    (F) the center has made or will make and 
                will continue to make every reasonable effort 
                to collect appropriate reimbursement for its 
                costs in providing health services to persons 
                who are entitled to insurance benefits under 
                title XVIII of the Social Security Act, to 
                medical assistance under a State plan approved 
                under title XIX of such Act, or to assistance 
                for medical expenses under any other public 
                assistance program or private health insurance 
                program;
                    (G) the center--
                            (i) has prepared a schedule of fees 
                        or payments for the provision of its 
                        services consistent with locally 
                        prevailing rates or charges and 
                        designed to cover its reasonable costs 
                        of operation and has prepared a 
                        corresponding schedule of discounts to 
                        be applied to the payment of such fees 
                        or payments, which discounts are 
                        adjusted on the basis of the patient's 
                        ability to pay;
                            (ii) has made and will continue to 
                        make every reasonable effort--
                                    (I) to secure from patients 
                                payment for services in 
                                accordance with such schedules; 
                                and
                                    (II) to collect 
                                reimbursement for health 
                                services to persons described 
                                in subparagraph (F) on the 
                                basis of the full amount of 
                                fees and payments for such 
                                services without application of 
                                any discount;
                            (iii)(I) will assure that no 
                        patient will be denied health care 
                        services due to an individual's 
                        inability to pay for such services; and
                            (II) will assure that any fees or 
                        payments required by the center for 
                        such services will be reduced or waived 
                        to enable the center to fulfill the 
                        assurance described in subclause (I); 
                        and
                            (iv) has submitted to the Secretary 
                        such reports as the Secretary may 
                        require to determine compliance with 
                        this subparagraph;
                    (H) the center has established a governing 
                board which except in the case of an entity 
                operated by an Indian tribe or tribal or Indian 
                organization under the Indian Self-
                Determination Act or an urban Indian 
                organization under the Indian Health Care 
                Improvement Act (25 U.S.C. 1651 et seq.)--
                            (i) is composed of individuals, a 
                        majority of whom are being served by 
                        the center and who, as a group, 
                        represent the individuals being served 
                        by the center;
                            (ii) meets at least once a month, 
                        selects the services to be provided by 
                        the center, schedules the hours during 
                        which such services will be provided, 
                        approves the center's annual budget, 
                        approves the selection of a director 
                        for the center, and, except in the case 
                        of a governing board of a public center 
                        (as defined in the second sentence of 
                        this paragraph), establishes general 
                        policies for the center; and
                            (iii) in the case of an application 
                        for a second or subsequent grant for a 
                        public center, has approved the 
                        application or if the governing body 
                        has not approved the application, the 
                        failure of the governing body to 
                        approve the application was 
                        unreasonable;
                except that, upon a showing of good cause the 
                Secretary shall waive, for the length of the 
                project period, all or part of the requirements 
                of this subparagraph in the case of a health 
                center that receives a grant pursuant to 
                subsection (g), (h), (i), or (p);
                    (I) the center has developed--
                            (i) an overall plan and budget that 
                        meets the requirements of the 
                        Secretary; and
                            (ii) an effective procedure for 
                        compiling and reporting to the 
                        Secretary such statistics and other 
                        information as the Secretary may 
                        require relating to--
                                    (I) the costs of its 
                                operations;
                                    (II) the patterns of use of 
                                its services;
                                    (III) the availability, 
                                accessibility, and 
                                acceptability of its services; 
                                and
                                    (IV) such other matters 
                                relating to operations of the 
                                applicant as the Secretary may 
                                require;
                    (J) the center will review periodically its 
                catchment area to--
                            (i) ensure that the size of such 
                        area is such that the services to be 
                        provided through the center (including 
                        any satellite) are available and 
                        accessible to the residents of the area 
                        promptly and as appropriate;
                            (ii) ensure that the boundaries of 
                        such area conform, to the extent 
                        practicable, to relevant boundaries of 
                        political subdivisions, school 
                        districts, and Federal and State health 
                        and social service programs; and
                            (iii) ensure that the boundaries of 
                        such area eliminate, to the extent 
                        possible, barriers to access to the 
                        services of the center, including 
                        barriers resulting from the area's 
                        physical characteristics, its 
                        residential patterns, its economic and 
                        social grouping, and available 
                        transportation;
                    (K) in the case of a center which serves a 
                population including a substantial proportion 
                of individuals of limited English-speaking 
                ability, the center has--
                            (i) developed a plan and made 
                        arrangements responsive to the needs of 
                        such population for providing services 
                        to the extent practicable in the 
                        language and cultural context most 
                        appropriate to such individuals; and
                            (ii) identified an individual on 
                        its staff who is fluent in both that 
                        language and in English and whose 
                        responsibilities shall include 
                        providing guidance to such individuals 
                        and to appropriate staff members with 
                        respect to cultural sensitivities and 
                        bridging linguistic and cultural 
                        differences;
                    (L) the center, has developed an ongoing 
                referral relationship with one or more 
                hospitals; and
                    (M) the center encourages persons receiving 
                or seeking health services from the center to 
                participate in any public or private (including 
                employer-offered) health programs or plans for 
                which the persons are eligible, so long as the 
                center, in complying with this subparagraph, 
                does not violate the requirements of 
                subparagraph (G)(iii)(I).
        For purposes of subparagraph (H), the term ``public 
        center'' means a health center funded (or to be funded) 
        through a grant under this section to a public agency.
            (4) Approval of new or expanded service 
        applications.--The Secretary shall approve applications 
        for grants under subparagraph (A) or (B) of subsection 
        (e)(1) for health centers which--
                    (A) have not received a previous grant 
                under such subsection; or
                    (B) have applied for such a grant to expand 
                their services;
        in such a manner that the ratio of the medically 
        underserved populations in rural areas which may be 
        expected to use the services provided by such centers 
        to the medically underserved populations in urban areas 
        which may be expected to use the services provided by 
        such centers is not less than two to three or greater 
        than three to two.
    (l) Technical Assistance.--The Secretary shall establish a 
program through which the Secretary shall provide (either 
through the Department of Health and Human Services or by grant 
or contract) technical and other assistance to eligible 
entities to assist such entities to meet the requirements of 
subsection (k)(3). Services provided through the program may 
include necessary technical and nonfinancial assistance, 
including fiscal and program management assistance, training in 
fiscal and program management, operational and administrative 
support, and the provision of information to the entities of 
the variety of resources available under this title and how 
those resources can be best used to meet the health needs of 
the communities served by the entities.
    (m) Memorandum of Agreement.--In carrying out this section, 
the Secretary may enter into a memorandum of agreement with a 
State. Such memorandum may include, where appropriate, 
provisions permitting such State to--
            (1) analyze the need for primary health services 
        for medically underserved populations within such 
        State;
            (2) assist in the planning and development of new 
        health centers;
            (3) review and comment upon annual program plans 
        and budgets of health centers, including comments upon 
        allocations of health care resources in the State;
            (4) assist health centers in the development of 
        clinical practices and fiscal and administrative 
        systems through a technical assistance plan which is 
        responsive to the requests of health centers; and
            (5) share information and data relevant to the 
        operation of new and existing health centers.
    (n) Records.--
            (1) In general.--Each entity which receives a grant 
        under subsection (e) shall establish and maintain such 
        records as the Secretary shall require.
            (2) Availability.--Each entity which is required to 
        establish and maintain records under this subsection 
        shall make such books, documents, papers, and records 
        available to the Secretary or the Comptroller General 
        of the United States, or any of their duly authorized 
        representatives, for examination, copying or mechanical 
        reproduction on or off the premises of such entity upon 
        a reasonable request therefore. The Secretary and the 
        Comptroller General of the United States, or any of 
        their duly authorized representatives, shall have the 
        authority to conduct such examination, copying, and 
        reproduction.
    (o) Delegation of Authority.--The Secretary may delegate 
the authority to administer the programs authorized by this 
section to any office, except that the authority to enter into, 
modify, or issue approvals with respect to grants or contracts 
may be delegated only within the central office of the Health 
Resources and Services Administration.
    (p) Special Consideration.--In making grants under this 
section, the Secretary shall give special consideration to the 
unique needs of sparsely populated rural areas, including 
giving priority in the awarding of grants for new health 
centers under subsections (c) and (e), and the granting of 
waivers as appropriate and permitted under subsections 
(b)(1)(B)(i) and (k)(3)(G).
    (q) Audits.--
            (1) In general.--Each entity which receives a grant 
        under this section shall provide for an independent 
        annual financial audit of any books, accounts, 
        financial records, files, and other papers and property 
        which relate to the disposition or use of the funds 
        received under such grant and such other funds received 
        by or allocated to the project for which such grant was 
        made. For purposes of assuring accurate, current, and 
        complete disclosure of the disposition or use of the 
        funds received, each such audit shall be conducted in 
        accordance with generally accepted accounting 
        principles. Each audit shall evaluate--
                    (A) the entity's implementation of the 
                guidelines established by the Secretary 
                respecting cost accounting,
                    (B) the processes used by the entity to 
                meet the financial and program reporting 
                requirements of the Secretary, and
                    (C) the billing and collection procedures 
                of the entity and the relation of the 
                procedures to its fee schedule and schedule of 
                discounts and to the availability of health 
                insurance and public programs to pay for the 
                health services it provides.
        A report of each such audit shall be filed with the 
        Secretary at such time and in such manner as the 
        Secretary may require.
            (2) Records.--Each entity which receives a grant 
        under this section shall establish and maintain such 
        records as the Secretary shall by regulation require to 
        facilitate the audit required by paragraph (1). The 
        Secretary may specify by regulation the form and manner 
        in which such records shall be established and 
        maintained.
            (3) Availability of records.--Each entity which is 
        required to establish and maintain records or to 
        provide for and audit under this subsection shall make 
        such books, documents, papers, and records available to 
        the Secretary or the Comptroller General of the United 
        States, or any of their duly authorized 
        representatives, for examination, copying or mechanical 
        reproduction on or off the premises of such entity upon 
        a reasonable request therefore. The Secretary and the 
        Comptroller General of the United States, or any of 
        their duly authorized representatives, shall have the 
        authority to conduct such examination, copying, and 
        reproduction.
            (4) Waiver.--The Secretary may, under appropriate 
        circumstances, waive the application of all or part of 
        the requirements of this subsection with respect to an 
        entity.
    (r) Authorization of Appropriations.--
            (1) General amounts for grants.--For the purpose of 
        carrying out this section, in addition to the amounts 
        authorized to be appropriated under subsection (d), 
        there is authorized to be appropriated the following:
                    (A) For fiscal year 2010, $2,988,821,592.
                    (B) For fiscal year 2011, $3,862,107,440.
                    (C) For fiscal year 2012, $4,990,553,440.
                    (D) For fiscal year 2013, $6,448,713,307.
                    (E) For fiscal year 2014, $7,332,924,155.
                    (F) For fiscal year 2015, $8,332,924,155.
                    (G) For fiscal year 2016, and each 
                subsequent fiscal year, the amount appropriated 
                for the preceding fiscal year adjusted by the 
                product of--
                            (i) one plus the average percentage 
                        increase in costs incurred per patient 
                        served; and
                            (ii) one plus the average 
                        percentage increase in the total number 
                        of patients served.
            (2) Special provisions.--
                    (A) Public centers.--The Secretary may not 
                expend in any fiscal year, for grants under 
                this section to public centers (as defined in 
                the second sentence of subsection (k)(3)) the 
                governing boards of which (as described in 
                subsection (k)(3)(H)) do not establish general 
                policies for such centers, an amount which 
                exceeds 5 percent of the amounts appropriated 
                under this section for that fiscal year. For 
                purposes of applying the preceding sentence, 
                the term ``public centers'' shall not include 
                health centers that receive grants pursuant to 
                subsection (h) or (i).
                    (B) Distribution of grants.--For fiscal 
                year 2002 and each of the following fiscal 
                years, the Secretary, in awarding grants under 
                this section, shall ensure that the proportion 
                of the amount made available under each of 
                subsections (g), (h), and (i), relative to the 
                total amount appropriated to carry out this 
                section for that fiscal year, is equal to the 
                proportion of the amount made available under 
                that subsection for fiscal year 2001, relative 
                to the total amount appropriated to carry out 
                this section for fiscal year 2001.
            (3) Funding report.--The Secretary shall annually 
        prepare and submit to the appropriate committees of 
        Congress a report concerning the distribution of funds 
        under this section that are provided to meet the health 
        care needs of medically underserved populations, 
        including the homeless, residents of public housing, 
        and migratory and seasonal agricultural workers, and 
        the appropriateness of the delivery systems involved in 
        responding to the needs of the particular populations. 
        Such report shall include an assessment of the relative 
        health care access needs of the targeted populations 
        and the rationale for any substantial changes in the 
        distribution of funds.
            (4) Rule of construction with respect to rural 
        health clinics.--
                    (A) In general.--Nothing in this section 
                shall be construed to prevent a community 
                health center from contracting with a Federally 
                certified rural health clinic (as defined in 
                section 1861(aa)(2) of the Social Security 
                Act), a low-volume hospital (as defined for 
                purposes of section 1886 of such Act), a 
                critical access hospital, a sole community 
                hospital (as defined for purposes of section 
                1886(d)(5)(D)(iii) of such Act), or a medicare-
                dependent share hospital (as defined for 
                purposes of section 1886(d)(5)(G)(iv) of such 
                Act) for the delivery of primary health care 
                services that are available at the clinic or 
                hospital to individuals who would otherwise be 
                eligible for free or reduced cost care if that 
                individual were able to obtain that care at the 
                community health center. Such services may be 
                limited in scope to those primary health care 
                services available in that clinic or hospitals.
                    (B) Assurances.--In order for a clinic or 
                hospital to receive funds under this section 
                through a contract with a community health 
                center under subparagraph (A), such clinic or 
                hospital shall establish policies to ensure--
                            (i) nondiscrimination based on the 
                        ability of a patient to pay; and
                            (ii) the establishment of a sliding 
                        fee scale for low-income patients.
    (s) Demonstration Program for Individualized Wellness 
Plans.--
            (1) In general.--The Secretary shall establish a 
        pilot program to test the impact of providing at-risk 
        populations who utilize community health centers funded 
        under this section an individualized wellness plan that 
        is designed to reduce risk factors for preventable 
        conditions as identified by a comprehensive risk-factor 
        assessment.
            (2) Agreements.--The Secretary shall enter into 
        agreements with not more than 10 community health 
        centers funded under this section to conduct activities 
        under the pilot program under paragraph (1).
            (3) Wellness plans.--
                    (A) In general.--An individualized wellness 
                plan prepared under the pilot program under 
                this subsection may include one or more of the 
                following as appropriate to the individual's 
                identified risk factors:
                            (i) Nutritional counseling.
                            (ii) A physical activity plan.
                            (iii) Alcohol and smoking cessation 
                        counseling and services.
                            (iv) Stress management.
                            (v) Dietary supplements that have 
                        health claims approved by the 
                        Secretary.
                            (vi) Compliance assistance provided 
                        by a community health center employee.
                    (B) Risk factors.--Wellness plan risk 
                factors shall include--
                            (i) weight;
                            (ii) tobacco and alcohol use;
                            (iii) exercise rates;
                            (iv) nutritional status; and
                            (v) blood pressure.
                    (C) Comparisons.--Individualized wellness 
                plans shall make comparisons between the 
                individual involved and a control group of 
                individuals with respect to the risk factors 
                described in subparagraph (B).
            (4) Authorization of appropriations.--There is 
        authorized to be appropriated to carry out this 
        subsection, such sums as may be necessary.

SEC. 330A. [254C] RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH 
                    NETWORK DEVELOPMENT, AND SMALL HEALTH CARE PROVIDER 
                    QUALITY IMPROVEMENT GRANT PROGRAMS.

    (a) Purpose.--The purpose of this section is to provide 
grants for expanded delivery of health care services in rural 
areas, for the planning and implementation of integrated health 
care networks in rural areas, and for the planning and 
implementation of small health care provider quality 
improvement activities.
    (b) Definitions.--
            (1) Director.--The term ``Director'' means the 
        Director specified in subsection (d).
            (2) Federally qualified health center; rural health 
        clinic.--The terms ``Federally qualified health 
        center'' and ``rural health clinic'' have the meanings 
        given the terms in section 1861(aa) of the Social 
        Security Act (42 U.S.C. 1395x(aa)).
            (3) Health professional shortage area.--The term 
        ``health professional shortage area'' means a health 
        professional shortage area designated under section 
        332.
            (4) Medically underserved community.--The term 
        ``medically underserved community'' has the meaning 
        given the term in section 799B(6).
            (5) Medically underserved population.--The term 
        ``medically underserved population'' has the meaning 
        given the term in section 330(b)(3).
    (c) Program.--The Secretary shall establish, under section 
301, a small health care provider quality improvement grant 
program.
    (d) Administration.--
            (1) Programs.--The rural health care services 
        outreach, rural health network development, and small 
        health care provider quality improvement grant programs 
        established under section 301 shall be administered by 
        the Director of the Office of Rural Health Policy of 
        the Health Resources and Services Administration, in 
        consultation with State offices of rural health or 
        other appropriate State government entities.
            (2) Grants.--
                    (A) In general.--In carrying out the 
                programs described in paragraph (1), the 
                Director may award grants under subsections 
                (e), (f), and (g) to expand access to, 
                coordinate, and improve the quality of 
                essential health care services, and enhance the 
                delivery of health care, in rural areas.
                    (B) Types of grants.--The Director may 
                award the grants--
                            (i) to promote expanded delivery of 
                        health care services in rural areas 
                        under subsection (e);
                            (ii) to provide for the planning 
                        and implementation of integrated health 
                        care networks in rural areas under 
                        subsection (f); and
                            (iii) to provide for the planning 
                        and implementation of small health care 
                        provider quality improvement activities 
                        under subsection (g).
    (e) Rural Health Care Services Outreach Grants.--
            (1) Grants.--The Director may award grants to 
        eligible entities to promote rural health care services 
        outreach by expanding the delivery of health care 
        services to include new and enhanced services in rural 
        areas. The Director may award the grants for periods of 
        not more than 3 years.
            (2) Eligibility.--To be eligible to receive a grant 
        under this subsection for a project, an entity--
                    (A) shall be a rural public or rural 
                nonprofit private entity;
                    (B) shall represent a consortium composed 
                of members--
                            (i) that include 3 or more health 
                        care providers; and
                            (ii) that may be nonprofit or for-
                        profit entities; and
                    (C) shall not previously have received a 
                grant under this subsection for the same or a 
                similar project, unless the entity is proposing 
                to expand the scope of the project or the area 
                that will be served through the project.
            (3) Applications.--To be eligible to receive a 
        grant under this subsection, an eligible entity, in 
        consultation with the appropriate State office of rural 
        health or another appropriate State entity, shall 
        prepare and submit to the Secretary an application, at 
        such time, in such manner, and containing such 
        information as the Secretary may require, including--
                    (A) a description of the project that the 
                eligible entity will carry out using the funds 
                provided under the grant;
                    (B) a description of the manner in which 
                the project funded under the grant will meet 
                the health care needs of rural underserved 
                populations in the local community or region to 
                be served;
                    (C) a description of how the local 
                community or region to be served will be 
                involved in the development and ongoing 
                operations of the project;
                    (D) a plan for sustaining the project after 
                Federal support for the project has ended;
                    (E) a description of how the project will 
                be evaluated; and
                    (F) other such information as the Secretary 
                determines to be appropriate.
    (f) Rural Health Network Development Grants.--
            (1) Grants.--
                    (A) In general.--The Director may award 
                rural health network development grants to 
                eligible entities to promote, through planning 
                and implementation, the development of 
                integrated health care networks that have 
                combined the functions of the entities 
                participating in the networks in order to--
                            (i) achieve efficiencies;
                            (ii) expand access to, coordinate, 
                        and improve the quality of essential 
                        health care services; and
                            (iii) strengthen the rural health 
                        care system as a whole.
                    (B) Grant periods.--The Director may award 
                such a rural health network development grant 
                for implementation activities for a period of 3 
                years. The Director may also award such a rural 
                health network development grant for planning 
                activities for a period of 1 year, to assist in 
                the development of an integrated health care 
                network, if the proposed participants in the 
                network do not have a history of collaborative 
                efforts and a 3-year grant would be 
                inappropriate.
            (2) Eligibility.--To be eligible to receive a grant 
        under this subsection, an entity--
                    (A) shall be a rural public or rural 
                nonprofit private entity;
                    (B) shall represent a network composed of 
                participants--
                            (i) that include 3 or more health 
                        care providers; and
                            (ii) that may be nonprofit or for-
                        profit entities; and
                    (C) shall not previously have received a 
                grant under this subsection (other than a grant 
                for planning activities) for the same or a 
                similar project.
            (3) Applications.--To be eligible to receive a 
        grant under this subsection, an eligible entity, in 
        consultation with the appropriate State office of rural 
        health or another appropriate State entity, shall 
        prepare and submit to the Secretary an application, at 
        such time, in such manner, and containing such 
        information as the Secretary may require, including--
                    (A) a description of the project that the 
                eligible entity will carry out using the funds 
                provided under the grant;
                    (B) an explanation of the reasons why 
                Federal assistance is required to carry out the 
                project;
                    (C) a description of--
                            (i) the history of collaborative 
                        activities carried out by the 
                        participants in the network;
                            (ii) the degree to which the 
                        participants are ready to integrate 
                        their functions; and
                            (iii) how the local community or 
                        region to be served will benefit from 
                        and be involved in the activities 
                        carried out by the network;
                    (D) a description of how the local 
                community or region to be served will 
                experience increased access to quality health 
                care services across the continuum of care as a 
                result of the integration activities carried 
                out by the network;
                    (E) a plan for sustaining the project after 
                Federal support for the project has ended;
                    (F) a description of how the project will 
                be evaluated; and
                    (G) other such information as the Secretary 
                determines to be appropriate.
    (g) Small Health Care Provider Quality Improvement 
Grants.--
            (1) Grants.--The Director may award grants to 
        provide for the planning and implementation of small 
        health care provider quality improvement activities. 
        The Director may award the grants for periods of 1 to 3 
        years.
            (2) Eligibility.--To be eligible for a grant under 
        this subsection, an entity--
                    (A)(i) shall be a rural public or rural 
                nonprofit private health care provider or 
                provider of health care services, such as a 
                critical access hospital or a rural health 
                clinic; or
                    (ii) shall be another rural provider or 
                network of small rural providers identified by 
                the Secretary as a key source of local care; 
                and
                    (B) shall not previously have received a 
                grant under this subsection for the same or a 
                similar project.
            (3) Applications.--To be eligible to receive a 
        grant under this subsection, an eligible entity, in 
        consultation with the appropriate State office of rural 
        health or another appropriate State entity shall 
        prepare and submit to the Secretary an application, at 
        such time, in such manner, and containing such 
        information as the Secretary may require, including--
                    (A) a description of the project that the 
                eligible entity will carry out using the funds 
                provided under the grant;
                    (B) an explanation of the reasons why 
                Federal assistance is required to carry out the 
                project;
                    (C) a description of the manner in which 
                the project funded under the grant will assure 
                continuous quality improvement in the provision 
                of services by the entity;
                    (D) a description of how the local 
                community or region to be served will 
                experience increased access to quality health 
                care services across the continuum of care as a 
                result of the activities carried out by the 
                entity;
                    (E) a plan for sustaining the project after 
                Federal support for the project has ended;
                    (F) a description of how the project will 
                be evaluated; and
                    (G) other such information as the Secretary 
                determines to be appropriate.
            (4) Expenditures for small health care provider 
        quality improvement grants.--In awarding a grant under 
        this subsection, the Director shall ensure that the 
        funds made available through the grant will be used to 
        provide services to residents of rural areas. The 
        Director shall award not less than 50 percent of the 
        funds made available under this subsection to providers 
        located in and serving rural areas.
    (h) General Requirements.--
            (1) Prohibited uses of funds.--An entity that 
        receives a grant under this section may not use funds 
        provided through the grant--
                    (A) to build or acquire real property; or
                    (B) for construction.
            (2) Coordination with other agencies.--The 
        Secretary shall coordinate activities carried out under 
        grant programs described in this section, to the extent 
        practicable, with Federal and State agencies and 
        nonprofit organizations that are operating similar 
        grant programs, to maximize the effect of public 
        dollars in funding meritorious proposals.
            (3) Preference.--In awarding grants under this 
        section, the Secretary shall give preference to 
        entities that--
                    (A) are located in health professional 
                shortage areas or medically underserved 
                communities, or serve medically underserved 
                populations; or
                    (B) propose to develop projects with a 
                focus on primary care, and wellness and 
                prevention strategies.
    (i) Report.--Not later than September 30, 2005, the 
Secretary shall prepare and submit to the appropriate 
committees of Congress a report on the progress and 
accomplishments of the grant programs described in subsections 
(e), (f), and (g).
    (j) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section $45,000,000 for 
each of fiscal years 2008 through 2012.

SEC. 330A-1. [254C-1A] GRANTS TO NURSE-MANAGED HEALTH CLINICS.

    (a) Definitions.--
            (1) Comprehensive primary health care services.--In 
        this section, the term ``comprehensive primary health 
        care services'' means the primary health services 
        described in section 330(b)(1).
            (2) Nurse-managed health clinic.--The term ``nurse-
        managed health clinic'' means a nurse-practice 
        arrangement, managed by advanced practice nurses, that 
        provides primary care or wellness services to 
        underserved or vulnerable populations and that is 
        associated with a school, college, university or 
        department of nursing, federally qualified health 
        center, or independent nonprofit health or social 
        services agency.
    (b) Authority to Award Grants.--The Secretary shall award 
grants for the cost of the operation of nurse-managed health 
clinics that meet the requirements of this section.
    (c) Applications.--To be eligible to receive a grant under 
this section, an entity shall--
            (1) be an NMHC; and
            (2) submit to the Secretary an application at such 
        time, in such manner, and containing--
                    (A) assurances that nurses are the major 
                providers of services at the NMHC and that at 
                least 1 advanced practice nurse holds an 
                executive management position within the 
                organizational structure of the NMHC;
                    (B) an assurance that the NMHC will 
                continue providing comprehensive primary health 
                care services or wellness services without 
                regard to income or insurance status of the 
                patient for the duration of the grant period; 
                and
                    (C) an assurance that, not later than 90 
                days of receiving a grant under this section, 
                the NMHC will establish a community advisory 
                committee, for which a majority of the members 
                shall be individuals who are served by the 
                NMHC.
    (d) Grant Amount.--The amount of any grant made under this 
section for any fiscal year shall be determined by the 
Secretary, taking into account--
            (1) the financial need of the NMHC, considering 
        State, local, and other operational funding provided to 
        the NMHC; and
            (2) other factors, as the Secretary determines 
        appropriate.
    (e) Authorization of Appropriations.--For the purposes of 
carrying out this section, there are authorized to be 
appropriated $50,000,000 for the fiscal year 2010 and such sums 
as may be necessary for each of the fiscal years 2011 through 
2014.

SEC. 330B. [254C-2] SPECIAL DIABETES PROGRAMS FOR TYPE I DIABETES. \1\
---------------------------------------------------------------------------

    \1\ Section 4923 of Public Law 105-33 (111 Stat. 574, as amended by 
section 1(c) of Public Law 107-360 (116 Stat. 3019),) requires the 
Secretary of Health and Human Services to conduct evaluations regarding 
programs under sections 330B and 330C. An interim report is required to 
be submitted to the appropriate committees of Congress not later than 
January 1, 2000, and a final report is required to be submitted not 
later than January 1, 2007.
---------------------------------------------------------------------------
    (a) In General.--The Secretary, directly or through grants, 
shall provide for research into the prevention and cure of Type 
I diabetes.
    (b) Funding.--
            (1) Transferred funds.--Notwithstanding section 
        2104(a) of the Social Security Act, from the amounts 
        appropriated in such section for each of fiscal years 
        1998 through 2002, $30,000,000 is hereby transferred 
        and made available in such fiscal year for grants under 
        this section.
            (2) Appropriations.--For the purpose of making 
        grants under this section, there is appropriated, out 
        of any funds in the Treasury not otherwise 
        appropriated--
                    (A) $70,000,000 for each of fiscal years 
                2001 and 2002 (which shall be combined with 
                amounts transferred under paragraph (1) for 
                each such fiscal years);
                    (B) $100,000,000 for fiscal year 2003; and
                    (C) $150,000,000 for each of fiscal years 
                2004 through 2013.

SEC. 330C. [254C-3] SPECIAL DIABETES PROGRAMS FOR INDIANS. \1\

    (a) In General.--The Secretary shall make grants for 
providing services for the prevention and treatment of diabetes 
in accordance with subsection (b).
    (b) Services Through Indian Health Facilities.--For 
purposes of subsection (a), services under such subsection are 
provided in accordance with this subsection if the services are 
provided through any of the following entities:
            (1) The Indian Health Service.
            (2) An Indian health program operated by an Indian 
        tribe or tribal organization pursuant to a contract, 
        grant, cooperative agreement, or compact with the 
        Indian Health Service pursuant to the Indian Self-
        Determination Act.
            (3) An urban Indian health program operated by an 
        urban Indian organization pursuant to a grant or 
        contract with the Indian Health Service pursuant to 
        title V of the Indian Health Care Improvement Act.
    (c) Funding.--
            (1) Transferred funds.--Notwithstanding section 
        2104(a) of the Social Security Act, from the amounts 
        appropriated in such section for each of fiscal years 
        1998 through 2002, $30,000,000, to remain available 
        until expended, is hereby transferred and made 
        available in such fiscal year for grants under this 
        section.
            (2) Appropriations.--For the purpose of making 
        grants under this section, there is appropriated, out 
        of any money in the Treasury not otherwise 
        appropriated--
                    (A) $70,000,000 for each of fiscal years 
                2001 and 2002 (which shall be combined with 
                amounts transferred under paragraph (1) for 
                each such fiscal years);
                    (B) $100,000,000 for fiscal year 2003; and
                    (C) $150,000,000 for each of fiscal years 
                2004 through 2013.

SEC. 330D. [254C-4] CENTERS FOR STRATEGIES ON FACILITATING UTILIZATION 
                    OF PREVENTIVE HEALTH SERVICES AMONG VARIOUS 
                    POPULATIONS.

    (a) In General.--The Secretary, acting through the 
appropriate agencies of the Public Health Service, shall make 
grants to public or nonprofit private entities for the 
establishment and operation of regional centers whose purpose 
is to develop, evaluate, and disseminate effective strategies, 
which utilize quality management measures, to assist public and 
private health care programs and providers in the appropriate 
utilization of preventive health care services by specific 
populations.
    (b) Research and Training.--The activities carried out by a 
center under subsection (a) may include establishing programs 
of research and training with respect to the purpose described 
in such subsection, including the development of curricula for 
training individuals in implementing the strategies developed 
under such subsection.
    (c) Priority Regarding Infants and Children.--In carrying 
out the purpose described in subsection (a), the Secretary 
shall give priority to various populations of infants, young 
children, and their mothers.
    (d) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2000 through 2004.

SEC. 330E. [254C-5] EPILEPSY; SEIZURE DISORDER.

    (a) National Public Health Campaign.--
            (1) In general.--The Secretary shall develop and 
        implement public health surveillance, education, 
        research, and intervention strategies to improve the 
        lives of persons with epilepsy, with a particular 
        emphasis on children. Such projects may be carried out 
        by the Secretary directly and through awards of grants 
        or contracts to public or nonprofit private entities. 
        The Secretary may directly or through such awards 
        provide technical assistance with respect to the 
        planning, development, and operation of such projects.
            (2) Certain activities.--Activities under paragraph 
        (1) shall include--
                    (A) expanding current surveillance 
                activities through existing monitoring systems 
                and improving registries that maintain data on 
                individuals with epilepsy, including children;
                    (B) enhancing research activities on the 
                diagnosis, treatment, and management of 
                epilepsy;
                    (C) implementing public and professional 
                information and education programs regarding 
                epilepsy, including initiatives which promote 
                effective management of the disease through 
                children's programs which are targeted to 
                parents, schools, daycare providers, patients;
                    (D) undertaking educational efforts with 
                the media, providers of health care, schools 
                and others regarding stigmas and secondary 
                disabilities related to epilepsy and seizures, 
                and its effects on youth;
                    (E) utilizing and expanding partnerships 
                with organizations with experience addressing 
                the health and related needs of people with 
                disabilities; and
                    (F) other activities the Secretary deems 
                appropriate.
            (3) Coordination of activities.--The Secretary 
        shall ensure that activities under this subsection are 
        coordinated as appropriate with other agencies of the 
        Public Health Service that carry out activities 
        regarding epilepsy and seizure.
    (b) Seizure Disorder; Demonstration Projects in Medically 
Underserved Areas.--
            (1) In general.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, may make grants for the purpose of 
        carrying out demonstration projects to improve access 
        to health and other services regarding seizures to 
        encourage early detection and treatment in children and 
        others residing in medically underserved areas.
            (2) Application for grant.--A grant may not be 
        awarded under paragraph (1) unless an application 
        therefore is submitted to the Secretary and the 
        Secretary approves such application. Such application 
        shall be submitted in such form and manner and shall 
        contain such information as the Secretary may 
        prescribe.
    (c) Definitions.--For purposes of this section:
            (1) The term ``epilepsy'' refers to a chronic and 
        serious neurological condition characterized by 
        excessive electrical discharges in the brain causing 
        recurring seizures affecting all life activities. The 
        Secretary may revise the definition of such term to the 
        extent the Secretary determines necessary.
            (2) The term ``medically underserved'' has the 
        meaning applicable under section 799B(6).
    (d) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.

SEC. 330F. [254C-6] CERTAIN SERVICES FOR PREGNANT WOMEN.

    (a) Infant Adoption Awareness.--
            (1) In general.--The Secretary shall make grants to 
        national, regional, or local adoption organizations for 
        the purpose of developing and implementing programs to 
        train the designated staff of eligible health centers 
        in providing adoption information and referrals to 
        pregnant women on an equal basis with all other courses 
        of action included in nondirective counseling to 
        pregnant women.
            (2) Best-practices guidelines.--
                    (A) In general.--A condition for the 
                receipt of a grant under paragraph (1) is that 
                the adoption organization involved agree that, 
                in providing training under such paragraph, the 
                organization will follow the guidelines 
                developed under subparagraph (B).
                    (B) Process for development of 
                guidelines.--
                            (i) In general.--The Secretary 
                        shall establish and supervise a process 
                        described in clause (ii) in which the 
                        participants are--
                                    (I) an appropriate number 
                                and variety of adoption 
                                organizations that, as a group, 
                                have expertise in all models of 
                                adoption practice and that 
                                represent all members of the 
                                adoption triad (birth mother, 
                                infant, and adoptive parent); 
                                and
                                    (II) affected public health 
                                entities.
                            (ii) Description of process.--The 
                        process referred to in clause (i) is a 
                        process in which the participants 
                        described in such clause collaborate to 
                        develop best-practices guidelines on 
                        the provision of adoption information 
                        and referrals to pregnant women on an 
                        equal basis with all other courses of 
                        action included in nondirective 
                        counseling to pregnant women.
                            (iii) Date certain for 
                        development.--The Secretary shall 
                        ensure that the guidelines described in 
                        clause (ii) are developed not later 
                        than 180 days after the date of the 
                        enactment of the Children's Health Act 
                        of 2000 \1\.
---------------------------------------------------------------------------
    \1\ Public Law 106-310, enacted October 17, 2000.
---------------------------------------------------------------------------
                    (C) Relation to authority for grants.--The 
                Secretary may not make any grant under 
                paragraph (1) before the date on which the 
                guidelines under subparagraph (B) are 
                developed.
            (3) Use of grant.--
                    (A) In general.--With respect to a grant 
                under paragraph (1)--
                            (i) an adoption organization may 
                        expend the grant to carry out the 
                        programs directly or through grants to 
                        or contracts with other adoption 
                        organizations;
                            (ii) the purposes for which the 
                        adoption organization expends the grant 
                        may include the development of a 
                        training curriculum, consistent with 
                        the guidelines developed under 
                        paragraph (2)(B); and
                            (iii) a condition for the receipt 
                        of the grant is that the adoption 
                        organization agree that, in providing 
                        training for the designated staff of 
                        eligible health centers, such 
                        organization will make reasonable 
                        efforts to ensure that the individuals 
                        who provide the training are 
                        individuals who are knowledgeable in 
                        all elements of the adoption process 
                        and are experienced in providing 
                        adoption information and referrals in 
                        the geographic areas in which the 
                        eligible health centers are located, 
                        and that the designated staff receive 
                        the training in such areas.
                    (B) Rule of construction regarding training 
                of trainers.--With respect to individuals who 
                under a grant under paragraph (1) provide 
                training for the designated staff of eligible 
                health centers (referred to in this 
                subparagraph as ``trainers''), subparagraph 
                (A)(iii) may not be construed as establishing 
                any limitation regarding the geographic area in 
                which the trainers receive instruction in being 
                such trainers. A trainer may receive such 
                instruction in a different geographic area than 
                the area in which the trainer trains (or will 
                train) the designated staff of eligible health 
                centers.
            (4) Adoption organizations; eligible health 
        centers; other definitions.--For purposes of this 
        section:
                    (A) The term ``adoption organization'' 
                means a national, regional, or local 
                organization--
                            (i) among whose primary purposes 
                        are adoption;
                            (ii) that is knowledgeable in all 
                        elements of the adoption process and on 
                        providing adoption information and 
                        referrals to pregnant women; and
                            (iii) that is a nonprofit private 
                        entity.
                    (B) The term ``designated staff'', with 
                respect to an eligible health center, means 
                staff of the center who provide pregnancy or 
                adoption information and referrals (or will 
                provide such information and referrals after 
                receiving training under a grant under 
                paragraph (1)).
                    (C) The term ``eligible health centers'' 
                means public and nonprofit private entities 
                that provide health services to pregnant women.
            (5) Training for certain eligible health centers.--
        A condition for the receipt of a grant under paragraph 
        (1) is that the adoption organization involved agree to 
        make reasonable efforts to ensure that the eligible 
        health centers with respect to which training under the 
        grant is provided include--
                    (A) eligible health centers that receive 
                grants under section 1001 (relating to 
                voluntary family planning projects);
                    (B) eligible health centers that receive 
                grants under section 330 (relating to community 
                health centers, migrant health centers, and 
                centers regarding homeless individuals and 
                residents of public housing); and
                    (C) eligible health centers that receive 
                grants under this Act for the provision of 
                services in schools.
            (6) Participation of certain eligible health 
        clinics.--In the case of eligible health centers that 
        receive grants under section 330 or 1001:
                    (A) Within a reasonable period after the 
                Secretary begins making grants under paragraph 
                (1), the Secretary shall provide eligible 
                health centers with complete information about 
                the training available from organizations 
                receiving grants under such paragraph. The 
                Secretary shall make reasonable efforts to 
                encourage eligible health centers to arrange 
                for designated staff to participate in such 
                training. Such efforts shall affirm Federal 
                requirements, if any, that the eligible health 
                center provide nondirective counseling to 
                pregnant women.
                    (B) All costs of such centers in obtaining 
                the training shall be reimbursed by the 
                organization that provides the training, using 
                grants under paragraph (1).
                    (C) Not later than 1 year after the date of 
                the enactment of the Children's Health Act of 
                2000 \1\, the Secretary shall submit to the 
                appropriate committees of the Congress a report 
                evaluating the extent to which adoption 
                information and referral, upon request, are 
                provided by eligible health centers. Within a 
                reasonable time after training under this 
                section is initiated, the Secretary shall 
                submit to the appropriate committees of the 
                Congress a report evaluating the extent to 
                which adoption information and referral, upon 
                request, are provided by eligible health 
                centers in order to determine the effectiveness 
                of such training and the extent to which such 
                training complies with subsection (a)(1). In 
                preparing the reports required by this 
                subparagraph, the Secretary shall in no respect 
                interpret the provisions of this section to 
                allow any interference in the provider-patient 
                relationship, any breach of patient 
                confidentiality, or any monitoring or auditing 
                of the counseling process or patient records 
                which breaches patient confidentiality or 
                reveals patient identity. The reports required 
                by this subparagraph shall be conducted by the 
                Secretary acting through the Administrator of 
                the Health Resources and Services 
                Administration and in collaboration with the 
                Director of the Agency for Healthcare Research 
                and Quality.
---------------------------------------------------------------------------
    \1\ Public Law 106-310, enacted October 17, 2000.
---------------------------------------------------------------------------
    (b) Application for Grant.--The Secretary may make a grant 
under subsection (a) only if an application for the grant is 
submitted to the Secretary and the application is in such form, 
is made in such manner, and contains such agreements, 
assurances, and information as the Secretary determines to be 
necessary to carry out this section.
    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005.

SEC. 330G. [254C-7] SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS 
                    CAMPAIGN AND OTHER ACTIVITIES.

    (a) Special Needs Adoption Awareness Campaign.--
            (1) In general.--The Secretary shall, through 
        making grants to nonprofit private entities, provide 
        for the planning, development, and carrying out of a 
        national campaign to provide information to the public 
        regarding the adoption of children with special needs.
            (2) Input on planning and development.--In 
        providing for the planning and development of the 
        national campaign under paragraph (1), the Secretary 
        shall provide for input from a number and variety of 
        adoption organizations throughout the States in order 
        that the full national diversity of interests among 
        adoption organizations is represented in the planning 
        and development of the campaign.
            (3) Certain features.--With respect to the national 
        campaign under paragraph (1):
                    (A) The campaign shall be directed at 
                various populations, taking into account as 
                appropriate differences among geographic 
                regions, and shall be carried out in the 
                language and cultural context that is most 
                appropriate to the population involved.
                    (B) The means through which the campaign 
                may be carried out include--
                            (i) placing public service 
                        announcements on television, radio, and 
                        billboards; and
                            (ii) providing information through 
                        means that the Secretary determines 
                        will reach individuals who are most 
                        likely to adopt children with special 
                        needs.
                    (C) The campaign shall provide information 
                on the subsidies and supports that are 
                available to individuals regarding the adoption 
                of children with special needs.
                    (D) The Secretary may provide that the 
                placement of public service announcements, and 
                the dissemination of brochures and other 
                materials, is subject to review by the 
                Secretary.
            (4) Matching Requirement.--
                    (A) In general.--With respect to the costs 
                of the activities to be carried out by an 
                entity pursuant to paragraph (1), a condition 
                for the receipt of a grant under such paragraph 
                is that the entity agree to make available 
                (directly or through donations from public or 
                private entities) non-Federal contributions 
                toward such costs in an amount that is not less 
                than 25 percent of such costs.
                    (B) Determination of amount contributed.--
                Non-Federal contributions under subparagraph 
                (A) may be in cash or in kind, fairly 
                evaluated, including plant, equipment, or 
                services. Amounts provided by the Federal 
                Government, or services assisted or subsidized 
                to any significant extent by the Federal 
                Government, may not be included in determining 
                the amount of such contributions.
    (b) National Resources Program.--The Secretary shall 
(directly or through grant or contract) carry out a program 
that, through toll-free telecommunications, makes available to 
the public information regarding the adoption of children with 
special needs. Such information shall include the following:
            (1) A list of national, State, and regional 
        organizations that provide services regarding such 
        adoptions, including exchanges and other information on 
        communicating with the organizations. The list shall 
        represent the full national diversity of adoption 
        organizations.
            (2) Information beneficial to individuals who adopt 
        such children, including lists of support groups for 
        adoptive parents and other postadoptive services.
    (c) Other Programs.--With respect to the adoption of 
children with special needs, the Secretary shall make grants--
            (1) to provide assistance to support groups for 
        adoptive parents, adopted children, and siblings of 
        adopted children; and
            (2) to carry out studies to identify--
                    (A) the barriers to completion of the 
                adoption process; and
                    (B) those components that lead to favorable 
                long-term outcomes for families that adopt 
                children with special needs.
    (d) Application for Grant.--The Secretary may make an award 
of a grant or contract under this section only if an 
application for the award is submitted to the Secretary and the 
application is in such form, is made in such manner, and 
contains such agreements, assurances, and information as the 
Secretary determines to be necessary to carry out this section.
    (e) Funding.--For the purpose of carrying out this section, 
there are authorized to be appropriated such sums as may be 
necessary for each of the fiscal years 2001 through 2005.

SEC. 330H. [254C-8] HEALTHY START FOR INFANTS.

    (a) In General.--
            (1) Continuation and expansion of program.--The 
        Secretary, acting through the Administrator of the 
        Health Resources and Services Administration, Maternal 
        and Child Health Bureau, shall under authority of this 
        section continue in effect the Healthy Start Initiative 
        and may, during fiscal year 2001 and subsequent years, 
        carry out such program on a national basis.
            (2) Definition.--For purposes of paragraph (1), the 
        term ``Healthy Start Initiative'' is a reference to the 
        program that, as an initiative to reduce the rate of 
        infant mortality and improve perinatal outcomes, makes 
        grants for project areas with high annual rates of 
        infant mortality and that, prior to the effective date 
        of this section, was a demonstration program carried 
        out under section 301.
    (b) Considerations in Making Grants.--
            (1) Requirements.--In making grants under 
        subsection (a), the Secretary shall require that 
        applicants (in addition to meeting all eligibility 
        criteria established by the Secretary) establish, for 
        project areas under such subsection, community-based 
        consortia of individuals and organizations (including 
        agencies responsible for administering block grant 
        programs under title V of the Social Security Act, 
        consumers of project services, public health 
        departments, hospitals, health centers under section 
        330, and other significant sources of health care 
        services) that are appropriate for participation in 
        projects under subsection (a).
            (2) Other considerations.--In making grants under 
        subsection (a), the Secretary shall take into 
        consideration the following:
                    (A) Factors that contribute to infant 
                mortality, such as low birthweight.
                    (B) The extent to which applicants for such 
                grants facilitate--
                            (i) a community-based approach to 
                        the delivery of services; and
                            (ii) a comprehensive approach to 
                        women's health care to improve 
                        perinatal outcomes.
            (3) Special projects.--Nothing in paragraph (2) 
        shall be construed to prevent the Secretary from 
        awarding grants under subsection (a) for special 
        projects that are intended to address significant 
        disparities in perinatal health indicators in 
        communities along the United States-Mexico border or in 
        Alaska or Hawaii.
    (c) Coordination.--Recipients of grants under subsection 
(a) shall coordinate their services and activities with the 
State agency or agencies that administer block grant programs 
under title V of the Social Security Act in order to promote 
cooperation, integration, and dissemination of information with 
Statewide systems and with other community services funded 
under the Maternal and Child Health Block Grant.
    (d) Rule of Construction.--Except to the extent 
inconsistent with this section, this section may not be 
construed as affecting the authority of the Secretary to make 
modifications in the program carried out under subsection (a).
    (e) Funding.--
            (1) Authorization of appropriations.--For the 
        purpose of carrying out this section, there are 
        authorized to be appropriated--
                    (A) $120,000,000 for fiscal year 2008; and
                    (B) for each of fiscal years 2009 through 
                2013, the amount authorized for the preceding 
                fiscal year increased by the percentage 
                increase in the Consumer Price Index for all 
                urban consumers for such year.
            (2) Allocation.--
                    (A) Program administration.--Of the amounts 
                appropriated under paragraph (1) for a fiscal 
                year, the Secretary may reserve up to 5 percent 
                for coordination, dissemination, technical 
                assistance, and data activities that are 
                determined by the Secretary to be appropriate 
                for carrying out the program under this 
                section.
                    (B) Evaluation.--Of the amounts 
                appropriated under paragraph (1) for a fiscal 
                year, the Secretary may reserve up to 1 percent 
                for evaluations of projects carried out under 
                subsection (a). Each such evaluation shall 
                include a determination of whether such 
                projects have been effective in reducing the 
                disparity in health status between the general 
                population and individuals who are members of 
                racial or ethnic minority groups.

SEC. 330I. [254C-14] TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS 
                    GRANT PROGRAMS.

    (a) Definitions.--In this section:
            (1) Director; office.--The terms ``Director'' and 
        ``Office'' mean the Director and Office specified in 
        subsection (c).
            (2) Federally qualified health center and rural 
        health clinic.--The term ``Federally qualified health 
        center'' and ``rural health clinic'' have the meanings 
        given the terms in section 1861(aa) of the Social 
        Security Act (42 U.S.C. 1395x(aa)).
            (3) Frontier community.--The term ``frontier 
        community'' shall have the meaning given the term in 
        regulations issued under subsection (r).
            (4) Medically underserved area.--The term 
        ``medically underserved area'' has the meaning given 
        the term ``medically underserved community'' in section 
        799B(6).
            (5) Medically underserved population.--The term 
        ``medically underserved population'' has the meaning 
        given the term in section 330(b)(3).
            (6) Telehealth services.--The term ``telehealth 
        services'' means services provided through telehealth 
        technologies.
            (7) Telehealth technologies.--The term ``telehealth 
        technologies'' means technologies relating to the use 
        of electronic information, and telecommunications 
        technologies, to support and promote, at a distance, 
        health care, patient and professional health-related 
        education, health administration, and public health.
    (b) Programs.--The Secretary shall establish, under section 
301, telehealth network and telehealth resource centers grant 
programs.
    (c) Administration.--
            (1) Establishment.--There is established in the 
        Health Resources and Services Administration an Office 
        for the Advancement of Telehealth. The Office shall be 
        headed by a Director.
            (2) Duties.--The telehealth network and telehealth 
        resource centers grant programs established under 
        section 301 shall be administered by the Director, in 
        consultation with the State offices of rural health, 
        State offices concerning primary care, or other 
        appropriate State government entities.
    (d) Grants.--
            (1) Telehealth network grants.--The Director may, 
        in carrying out the telehealth network grant program 
        referred to in subsection (b), award grants to eligible 
        entities for projects to demonstrate how telehealth 
        technologies can be used through telehealth networks in 
        rural areas, frontier communities, and medically 
        underserved areas, and for medically underserved 
        populations, to--
                    (A) expand access to, coordinate, and 
                improve the quality of health care services;
                    (B) improve and expand the training of 
                health care providers; and
                    (C) expand and improve the quality of 
                health information available to health care 
                providers, and patients and their families, for 
                decisionmaking.
            (2) Telehealth resource centers grants.--The 
        Director may, in carrying out the telehealth resource 
        centers grant program referred to in subsection (b), 
        award grants to eligible entities for projects to 
        demonstrate how telehealth technologies can be used in 
        the areas and communities, and for the populations, 
        described in paragraph (1), to establish telehealth 
        resource centers.
    (e) Grant Periods.--The Director may award grants under 
this section for periods of not more than 4 years.
    (f) Eligible Entities.--
            (1) Telehealth network grants.--
                    (A) Grant recipient.--To be eligible to 
                receive a grant under subsection (d)(1), an 
                entity shall be a nonprofit entity.
                    (B) Telehealth networks.--
                            (i) In general.--To be eligible to 
                        receive a grant under subsection 
                        (d)(1), an entity shall demonstrate 
                        that the entity will provide services 
                        through a telehealth network.
                            (ii) Nature of entities.--Each 
                        entity participating in the telehealth 
                        network may be a nonprofit or for-
                        profit entity.
                            (iii) Composition of network.--The 
                        telehealth network shall include at 
                        least 2 of the following entities (at 
                        least 1 of which shall be a community-
                        based health care provider):
                                    (I) Community or migrant 
                                health centers or other 
                                Federally qualified health 
                                centers.
                                    (II) Health care providers, 
                                including pharmacists, in 
                                private practice.
                                    (III) Entities operating 
                                clinics, including rural health 
                                clinics.
                                    (IV) Local health 
                                departments.
                                    (V) Nonprofit hospitals, 
                                including community access 
                                hospitals.
                                    (VI) Other publicly funded 
                                health or social service 
                                agencies.
                                    (VII) Long-term care 
                                providers.
                                    (VIII) Providers of health 
                                care services in the home.
                                    (IX) Providers of 
                                outpatient mental health 
                                services and entities operating 
                                outpatient mental health 
                                facilities.
                                    (X) Local or regional 
                                emergency health care 
                                providers.
                                    (XI) Institutions of higher 
                                education.
                                    (XII) Entities operating 
                                dental clinics.
            (2) Telehealth resource centers grants.--To be 
        eligible to receive a grant under subsection (d)(2), an 
        entity shall be a nonprofit entity.
    (g) Applications.--To be eligible to receive a grant under 
subsection (d), an eligible entity, in consultation with the 
appropriate State office of rural health or another appropriate 
State entity, shall prepare and submit to the Secretary an 
application, at such time, in such manner, and containing such 
information as the Secretary may require, including--
            (1) a description of the project that the eligible 
        entity will carry out using the funds provided under 
        the grant;
            (2) a description of the manner in which the 
        project funded under the grant will meet the health 
        care needs of rural or other populations to be served 
        through the project, or improve the access to services 
        of, and the quality of the services received by, those 
        populations;
            (3) evidence of local support for the project, and 
        a description of how the areas, communities, or 
        populations to be served will be involved in the 
        development and ongoing operations of the project;
            (4) a plan for sustaining the project after Federal 
        support for the project has ended;
            (5) information on the source and amount of non-
        Federal funds that the entity will provide for the 
        project;
            (6) information demonstrating the long-term 
        viability of the project, and other evidence of 
        institutional commitment of the entity to the project;
            (7) in the case of an application for a project 
        involving a telehealth network, information 
        demonstrating how the project will promote the 
        integration of telehealth technologies into the 
        operations of health care providers, to avoid 
        redundancy, and improve access to and the quality of 
        care; and
            (8) other such information as the Secretary 
        determines to be appropriate.
    (h) Terms; Conditions; Maximum Amount of Assistance.--The 
Secretary shall establish the terms and conditions of each 
grant program described in subsection (b) and the maximum 
amount of a grant to be awarded to an individual recipient for 
each fiscal year under this section. The Secretary shall 
publish, in a publication of the Health Resources and Services 
Administration, notice of the application requirements for each 
grant program described in subsection (b) for each fiscal year.
    (i) Preferences.--
            (1) Telehealth networks.--In awarding grants under 
        subsection (d)(1) for projects involving telehealth 
        networks, the Secretary shall give preference to an 
        eligible entity that meets at least 1 of the following 
        requirements:
                    (A) Organization.--The eligible entity is a 
                rural community-based organization or another 
                community-based organization.
                    (B) Services.--The eligible entity proposes 
                to use Federal funds made available through 
                such a grant to develop plans for, or to 
                establish, telehealth networks that provide 
                mental health, public health, long-term care, 
                home care, preventive, or case management 
                services.
                    (C) Coordination.--The eligible entity 
                demonstrates how the project to be carried out 
                under the grant will be coordinated with other 
                relevant federally funded projects in the 
                areas, communities, and populations to be 
                served through the grant.
                    (D) Network.--The eligible entity 
                demonstrates that the project involves a 
                telehealth network that includes an entity 
                that--
                            (i) provides clinical health care 
                        services, or educational services for 
                        health care providers and for patients 
                        or their families; and
                            (ii) is--
                                    (I) a public library;
                                    (II) an institution of 
                                higher education; or
                                    (III) a local government 
                                entity.
                    (E) Connectivity.--The eligible entity 
                proposes a project that promotes local 
                connectivity within areas, communities, or 
                populations to be served through the project.
                    (F) Integration.--The eligible entity 
                demonstrates that health care information has 
                been integrated into the project.
            (2) Telehealth resource centers.--In awarding 
        grants under subsection (d)(2) for projects involving 
        telehealth resource centers, the Secretary shall give 
        preference to an eligible entity that meets at least 1 
        of the following requirements:
                    (A) Provision of services.--The eligible 
                entity has a record of success in the provision 
                of telehealth services to medically underserved 
                areas or medically underserved populations.
                    (B) Collaboration and sharing of 
                expertise.--The eligible entity has a 
                demonstrated record of collaborating and 
                sharing expertise with providers of telehealth 
                services at the national, regional, State, and 
                local levels.
                    (C) Broad range of telehealth services.--
                The eligible entity has a record of providing a 
                broad range of telehealth services, which may 
                include--
                            (i) a variety of clinical specialty 
                        services;
                            (ii) patient or family education;
                            (iii) health care professional 
                        education; and
                            (iv) rural residency support 
                        programs.
    (j) Distribution of Funds.--
            (1) In general.--In awarding grants under this 
        section, the Director shall ensure, to the greatest 
        extent possible, that such grants are equitably 
        distributed among the geographical regions of the 
        United States.
            (2) Telehealth networks.--In awarding grants under 
        subsection (d)(1) for a fiscal year, the Director shall 
        ensure that--
                    (A) not less than 50 percent of the funds 
                awarded shall be awarded for projects in rural 
                areas; and
                    (B) the total amount of funds awarded for 
                such projects for that fiscal year shall be not 
                less than the total amount of funds awarded for 
                such projects for fiscal year 2001 under 
                section 330A (as in effect on the day before 
                the date of enactment of the Health Care Safety 
                Net Amendments of 2002).
    (k) Use of Funds.--
            (1) Telehealth network program.--The recipient of a 
        grant under subsection (d)(1) may use funds received 
        through such grant for salaries, equipment, and 
        operating or other costs, including the cost of--
                    (A) developing and delivering clinical 
                telehealth services that enhance access to 
                community-based health care services in rural 
                areas, frontier communities, or medically 
                underserved areas, or for medically underserved 
                populations;
                    (B) developing and acquiring, through lease 
                or purchase, computer hardware and software, 
                audio and video equipment, computer network 
                equipment, interactive equipment, data terminal 
                equipment, and other equipment that furthers 
                the objectives of the telehealth network grant 
                program;
                    (C)(i) developing and providing distance 
                education, in a manner that enhances access to 
                care in rural areas, frontier communities, or 
                medically underserved areas, or for medically 
                underserved populations; or
                    (ii) mentoring, precepting, or supervising 
                health care providers and students seeking to 
                become health care providers, in a manner that 
                enhances access to care in the areas and 
                communities, or for the populations, described 
                in clause (i);
                    (D) developing and acquiring instructional 
                programming;
                    (E)(i) providing for transmission of 
                medical data, and maintenance of equipment; and
                    (ii) providing for compensation (including 
                travel expenses) of specialists, and referring 
                health care providers, who are providing 
                telehealth services through the telehealth 
                network, if no third party payment is available 
                for the telehealth services delivered through 
                the telehealth network;
                    (F) developing projects to use telehealth 
                technology to facilitate collaboration between 
                health care providers;
                    (G) collecting and analyzing usage 
                statistics and data to document the cost-
                effectiveness of the telehealth services; and
                    (H) carrying out such other activities as 
                are consistent with achieving the objectives of 
                this section, as determined by the Secretary.
            (2) Telehealth resource centers.--The recipient of 
        a grant under subsection (d)(2) may use funds received 
        through such grant for salaries, equipment, and 
        operating or other costs for--
                    (A) providing technical assistance, 
                training, and support, and providing for travel 
                expenses, for health care providers and a range 
                of health care entities that provide or will 
                provide telehealth services;
                    (B) disseminating information and research 
                findings related to telehealth services;
                    (C) promoting effective collaboration among 
                telehealth resource centers and the Office;
                    (D) conducting evaluations to determine the 
                best utilization of telehealth technologies to 
                meet health care needs;
                    (E) promoting the integration of the 
                technologies used in clinical information 
                systems with other telehealth technologies;
                    (F) fostering the use of telehealth 
                technologies to provide health care information 
                and education for health care providers and 
                consumers in a more effective manner; and
                    (G) implementing special projects or 
                studies under the direction of the Office.
    (l) Prohibited Uses of Funds.--An entity that receives a 
grant under this section may not use funds made available 
through the grant--
            (1) to acquire real property;
            (2) for expenditures to purchase or lease 
        equipment, to the extent that the expenditures would 
        exceed 40 percent of the total grant funds;
            (3) in the case of a project involving a telehealth 
        network, to purchase or install transmission equipment 
        (such as laying cable or telephone lines, or purchasing 
        or installing microwave towers, satellite dishes, 
        amplifiers, or digital switching equipment);
            (4) to pay for any equipment or transmission costs 
        not directly related to the purposes for which the 
        grant is awarded;
            (5) to purchase or install general purpose voice 
        telephone systems;
            (6) for construction; or
            (7) for expenditures for indirect costs (as 
        determined by the Secretary), to the extent that the 
        expenditures would exceed 15 percent of the total grant 
        funds.
    (m) Collaboration.--In providing services under this 
section, an eligible entity shall collaborate, if feasible, 
with entities that--
            (1)(A) are private or public organizations, that 
        receive Federal or State assistance; or
            (B) are public or private entities that operate 
        centers, or carry out programs, that receive Federal or 
        State assistance; and
            (2) provide telehealth services or related 
        activities.
    (n) Coordination With Other Agencies.--The Secretary shall 
coordinate activities carried out under grant programs 
described in subsection (b), to the extent practicable, with 
Federal and State agencies and nonprofit organizations that are 
operating similar programs, to maximize the effect of public 
dollars in funding meritorious proposals.
    (o) Outreach Activities.--The Secretary shall establish and 
implement procedures to carry out outreach activities to advise 
potential end users of telehealth services in rural areas, 
frontier communities, medically underserved areas, and 
medically underserved populations in each State about the grant 
programs described in subsection (b).
    (p) Telehealth.--It is the sense of Congress that, for 
purposes of this section, States should develop reciprocity 
agreements so that a provider of services under this section 
who is a licensed or otherwise authorized health care provider 
under the law of 1 or more States, and who, through telehealth 
technology, consults with a licensed or otherwise authorized 
health care provider in another State, is exempt, with respect 
to such consultation, from any State law of the other State 
that prohibits such consultation on the basis that the first 
health care provider is not a licensed or authorized health 
care provider under the law of that State.
    (q) Report.--Not later than September 30, 2005, the 
Secretary shall prepare and submit to the appropriate 
committees of Congress a report on the progress and 
accomplishments of the grant programs described in subsection 
(b).
    (r) Regulations.--The Secretary shall issue regulations 
specifying, for purposes of this section, a definition of the 
term ``frontier area''. The definition shall be based on 
factors that include population density, travel distance in 
miles to the nearest medical facility, travel time in minutes 
to the nearest medical facility, and such other factors as the 
Secretary determines to be appropriate. The Secretary shall 
develop the definition in consultation with the Director of the 
Bureau of the Census and the Administrator of the Economic 
Research Service of the Department of Agriculture.
    (s) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section--
            (1) for grants under subsection (d)(1), $40,000,000 
        for fiscal year 2002, and such sums as may be necessary 
        for each of fiscal years 2003 through 2006; and
            (2) for grants under subsection (d)(2), $20,000,000 
        for fiscal year 2002, and such sums as may be necessary 
        for each of fiscal years 2003 through 2006.

SEC. 330J. [254C-15] RURAL EMERGENCY MEDICAL SERVICE TRAINING AND 
                    EQUIPMENT ASSISTANCE PROGRAM.

    (a) Grants.--The Secretary, acting through the 
Administrator of the Health Resources and Services 
Administration (referred to in this section as the 
``Secretary'') shall award grants to eligible entities to 
enable such entities to provide for improved emergency medical 
services in rural areas.
    (b) Eligibility.--To be eligible to receive a grant under 
this section, an entity shall--
            (1) be--
                    (A) a State emergency medical services 
                office;
                    (B) a State emergency medical services 
                association;
                    (C) a State office of rural health;
                    (D) a local government entity;
                    (E) a State or local ambulance provider; or
                    (F) any other entity determined appropriate 
                by the Secretary; 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, that includes--
                    (A) a description of the activities to be 
                carried out under the grant; and
                    (B) an assurance that the eligible entity 
                will comply with the matching requirement of 
                subsection (e).
    (c) Use of Funds.--An entity shall use amounts received 
under a grant made under subsection (a), either directly or 
through grants to emergency medical service squads that are 
located in, or that serve residents of, a nonmetropolitan 
statistical area, an area designated as a rural area by any law 
or regulation of a State, or a rural census tract of a 
metropolitan statistical area (as determined under the most 
recent Goldsmith Modification, originally published in a notice 
of availability of funds in the Federal Register on February 
27, 1992, 57 Fed. Reg. 6725), to--
            (1) recruit emergency medical service personnel;
            (2) recruit volunteer emergency medical service 
        personnel;
            (3) train emergency medical service personnel in 
        emergency response, injury prevention, safety 
        awareness, and other topics relevant to the delivery of 
        emergency medical services;
            (4) fund specific training to meet Federal or State 
        certification requirements;
            (5) develop new ways to educate emergency health 
        care providers through the use of technology-enhanced 
        educational methods (such as distance learning);
            (6) acquire emergency medical services equipment, 
        including cardiac defibrillators;
            (7) acquire personal protective equipment for 
        emergency medical services personnel as required by the 
        Occupational Safety and Health Administration; and
            (8) educate the public concerning cardiopulmonary 
        resuscitation, first aid, injury prevention, safety 
        awareness, illness prevention, and other related 
        emergency preparedness topics.
    (d) Preference.--In awarding grants under this section the 
Secretary shall give preference to--
            (1) applications that reflect a collaborative 
        effort by 2 or more of the entities described in 
        subparagraphs (A) through (F) of subsection (b)(1); and
            (2) applications submitted by entities that intend 
        to use amounts provided under the grant to fund 
        activities described in any of paragraphs (1) through 
        (5) of subsection (c).
    (e) Matching Requirement.--The Secretary may not award a 
grant under this section to an entity unless the entity agrees 
that the entity will make available (directly or through 
contributions from other public or private entities) non-
Federal contributions toward the activities to be carried out 
under the grant in an amount equal to 25 percent of the amount 
received under the grant.
    (f) Emergency Medical Services.--In this section, the term 
``emergency medical services''--
            (1) means resources used by a qualified public or 
        private nonprofit entity, or by any other entity 
        recognized as qualified by the State involved, to 
        deliver medical care outside of a medical facility 
        under emergency conditions that occur--
                    (A) as a result of the condition of the 
                patient; or
                    (B) as a result of a natural disaster or 
                similar situation; and
            (2) includes services delivered by an emergency 
        medical services provider (either compensated or 
        volunteer) or other provider recognized by the State 
        involved that is licensed or certified by the State as 
        an emergency medical technician or its equivalent (as 
        determined by the State), a registered nurse, a 
        physician assistant, or a physician that provides 
        services similar to services provided by such an 
        emergency medical services provider.
    (g) Authorization of Appropriations.--
            (1) In general.--There are authorized to be 
        appropriated to carry out this section such sums as may 
        be necessary for each of fiscal years 2002 through 
        2006.
            (2) Administrative costs.--The Secretary may use 
        not more than 10 percent of the amount appropriated 
        under paragraph (1) for a fiscal year for the 
        administrative expenses of carrying out this section.

SEC. 330K. [254C-16] MENTAL HEALTH SERVICES DELIVERED VIA TELEHEALTH.

    (a) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' 
        means a public or nonprofit private telehealth provider 
        network that offers services that include mental health 
        services provided by qualified mental health providers.
            (2) Qualified mental health professionals.--The 
        term ``qualified mental health professionals'' refers 
        to providers of mental health services reimbursed under 
        the medicare program carried out under title XVIII of 
        the Social Security Act (42 U.S.C. 1395 et seq.) who 
        have additional training in the treatment of mental 
        illness in children and adolescents or who have 
        additional training in the treatment of mental illness 
        in the elderly.
            (3) Special populations.--The term ``special 
        populations'' refers to the following 2 distinct 
        groups:
                    (A) Children and adolescents in mental 
                health underserved rural areas or in mental 
                health underserved urban areas.
                    (B) Elderly individuals located in long-
                term care facilities in mental health 
                underserved rural or urban areas.
            (4) Telehealth.--The term ``telehealth'' means the 
        use of electronic information and telecommunications 
        technologies to support long distance clinical health 
        care, patient and professional health-related 
        education, public health, and health administration.
    (b) Program Authorized.--
            (1) In general.--The Secretary, acting through the 
        Director of the Office for the Advancement of 
        Telehealth of the Health Resources and Services 
        Administration, shall award grants to eligible entities 
        to establish demonstration projects for the provision 
        of mental health services to special populations as 
        delivered remotely by qualified mental health 
        professionals using telehealth and for the provision of 
        education regarding mental illness as delivered 
        remotely by qualified mental health professionals using 
        telehealth.
            (2) Populations served.--The Secretary shall award 
        the grants under paragraph (1) in a manner that 
        distributes the grants so as to serve equitably the 
        populations described in subparagraphs (A) and (B) of 
        subsection (a)(3).
    (c) Use of Funds.--
            (1) In general.--An eligible entity that receives a 
        grant under this section shall use the grant funds--
                    (A) for the populations described in 
                subsection (a)(3)(A)--
                            (i) to provide mental health 
                        services, including diagnosis and 
                        treatment of mental illness, as 
                        delivered remotely by qualified mental 
                        health professionals using telehealth; 
                        and
                            (ii) to collaborate with local 
                        public health entities to provide the 
                        mental health services; and
                    (B) for the populations described in 
                subsection (a)(3)(B)--
                            (i) to provide mental health 
                        services, including diagnosis and 
                        treatment of mental illness, in long-
                        term care facilities as delivered 
                        remotely by qualified mental health 
                        professionals using telehealth; and
                            (ii) to collaborate with local 
                        public health entities to provide the 
                        mental health services.
            (2) Other uses.--An eligible entity that receives a 
        grant under this section may also use the grant funds 
        to--
                    (A) pay telecommunications costs; and
                    (B) pay qualified mental health 
                professionals on a reasonable cost basis as 
                determined by the Secretary for services 
                rendered.
            (3) Prohibited uses.--An eligible entity that 
        receives a grant under this section shall not use the 
        grant funds to--
                    (A) purchase or install transmission 
                equipment (other than such equipment used by 
                qualified mental health professionals to 
                deliver mental health services using telehealth 
                under the project involved); or
                    (B) build upon or acquire real property.
    (d) Equitable Distribution.--In awarding grants under this 
section, the Secretary shall ensure, to the greatest extent 
possible, that such grants are equitably distributed among 
geographical regions of the United States.
    (e) Application.--An entity that desires a grant under this 
section shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the 
Secretary determines to be reasonable.
    (f) Report.--Not later than 4 years after the date of 
enactment of the Health Care Safety Net Amendments of 2002, the 
Secretary shall prepare and submit to the appropriate 
committees of Congress a report that shall evaluate activities 
funded with grants under this section.
    (g) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section, $20,000,000 for 
fiscal year 2002 and such sums as may be necessary for fiscal 
years 2003 through 2006.

SEC. 330L. [254C-18] TELEMEDICINE; INCENTIVE GRANTS REGARDING 
                    COORDINATION AMONG STATES.

    (a) In General.--The Secretary may make grants to State 
professional licensing boards to carry out programs under which 
such licensing boards of various States cooperate to develop 
and implement State policies that will reduce statutory and 
regulatory barriers to telemedicine.
    (b) Authorization of Appropriations.--For the purpose of 
carrying out subsection (a), there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2002 through 2006.

           Subpart II--National Health Service Corps Program

                     national health service corps

    Sec. 331. [254d] (a)(1) For the purpose of eliminating 
health manpower \1\ shortages in health professional shortage 
areas, there is established, within the Service, the National 
Health Service Corps, which shall consist of--
---------------------------------------------------------------------------
    \1\ So in law. Probably should be ``health professional 
shortages''. See section 401 of Public Law 101-597 (104 Stat. 3035).
---------------------------------------------------------------------------
            (A) such officers of the Regular and Reserve Corps 
        of the Service as the Secretary may designate,
            (B) such civilian employees of the United States as 
        the Secretary may appoint, and
            (C) such other individuals who are not employees of 
        the United States.
    (2) The Corps shall be utilized by the Secretary to provide 
primary health services in health professional shortage areas.
    (3) For purposes of this subpart and subpart III:
            (A) The term ``Corps'' means the National Health 
        Service Corps.
            (B) The term ``Corps member'' means each of the 
        officers, employees, and individuals of which the Corps 
        consists pursuant to paragraph (1).
            (C) The term ``health professional shortage area'' 
        has the meaning given such term in section 332(a).
            (D) The term ``primary health services'' means 
        health services regarding family medicine, internal 
        medicine, pediatrics, obstetrics and gynecology, 
        dentistry, or mental health, that are provided by 
        physicians or other health professionals.
            (E)(i) The term ``behavioral and mental health 
        professionals'' means health service psychologists, 
        licensed clinical social workers, licensed professional 
        counselors, marriage and family therapists, psychiatric 
        nurse specialists, and psychiatrists.
            (ii) The term `graduate program of behavioral and 
        mental health' means a program that trains behavioral 
        and mental health professionals.
    (b)(1) The Secretary may conduct at schools of medicine, 
osteopathic medicine, dentistry, and, as appropriate, nursing 
and other schools of the health professions, including schools 
at which graduate programs of behavioral and mental health are 
offered, and at entities which train allied health personnel, 
recruiting programs for the Corps, the Scholarship Program, and 
the Loan Repayment Program. Such recruiting programs shall 
include efforts to recruit individuals who will serve in the 
Corps other than pursuant to obligated service under the 
Scholarship or Loan Repayment Program.
    (2) In the case of physicians, dentists, behavioral and 
mental health professionals, certified nurse midwives, 
certified nurse practitioners, and physician assistants who 
have an interest and a commitment to providing primary health 
care, the Secretary may establish fellowship programs to enable 
such health professionals to gain exposure to and expertise in 
the delivery of primary health services in health professional 
shortage areas. To the maximum extent practicable, the 
Secretary shall ensure that any such programs are established 
in conjunction with accredited residency programs, and other 
training programs, regarding such health professions.
    (c)(1) The Secretary may reimburse an applicant for a 
position in the Corps (including an individual considering 
entering into a written agreement pursuant to section 338D) for 
the actual and reasonable expenses incurred in traveling to and 
from the applicant's place of residence to an eligible site to 
which the applicant may be assigned under section 333 for the 
purpose of evaluating such site with regard to being assigned 
at such site. The Secretary may establish a maximum total 
amount that may be paid to an individual as reimbursement for 
such expenses.
    (2) The Secretary may also reimburse the applicant for the 
actual and reasonable expenses incurred for the travel of 1 
family member to accompany the applicant to such site. The 
Secretary may establish a maximum total amount that may be paid 
to an individual as reimbursement for such expenses.
    (3) In the case of an individual who has entered into a 
contract for obligated service under the Scholarship Program or 
under the Loan Repayment Program, the Secretary may reimburse 
such individual for all or part of the actual and reasonable 
expenses incurred in transporting the individual, the 
individual's family, and the family's possessions to the site 
of the individual's assignment under section 333. The Secretary 
may establish a maximum total amount that may be paid to an 
individual as reimbursement for such expenses.
    (d)(1) The Secretary may, under regulations promulgated by 
the Secretary, adjust the monthly pay of each member of the 
Corps (other than a member described in subsection (a)(1)(C)) 
who is directly engaged in the delivery of health services in a 
health professional shortage area as follows:
            (A) During the first 36 months in which such a 
        member is so engaged in the delivery of health 
        services, his monthly pay may be increased by an amount 
        which when added to the member's monthly pay and 
        allowances will provide a monthly income competitive 
        with the average monthly income from a practice of an 
        individual who is a member of the profession of the 
        Corps member, who has equivalent training, and who has 
        been in practice for a period equivalent to the period 
        during which the Corps member has been in practice.
            (B) During the period beginning upon the expiration 
        of the 36 months referred to in subparagraph (A) and 
        ending with the month in which the member's monthly pay 
        and allowances are equal to or exceed the monthly 
        income he received for the last of such 36 months, the 
        member may receive in addition to his monthly pay and 
        allowances an amount which when added to such monthly 
        pay and allowances equals the monthly income he 
        received for such last month.
            (C) For each month in which a member is directly 
        engaged in the delivery of health services in a health 
        professional shortage area in accordance with an 
        agreement with the Secretary entered into under section 
        741(f)(1)(C), under which the Secretary is obligated to 
        make payments in accordance with section 741(f)(2), the 
        amount of any monthly increase under subparagraph (A) 
        or (B) with respect to such member shall be decreased 
        by an amount equal to one-twelfth of the amount which 
        the Secretary is obligated to pay upon the completion 
        of the year of practice in which such month occurs.
For purposes of subparagraphs (A) and (B), the term ``monthly 
pay'' includes special pay received under chapter 5 of title 37 
of the United States Code.
    (2) In the case of a member of the Corps who is directly 
engaged in the delivery of health services in a health 
professional shortage area in accordance with a service 
obligation incurred under the Scholarship Program or the Loan 
Repayment Program, the adjustment in pay authorized by 
paragraph (1) may be made for such a member only upon 
satisfactory completion of such service obligation, and the 
first 36 months of such member's being so engaged in the 
delivery of health services shall, for purposes of paragraph 
(1)(A), be deemed to begin upon such satisfactory completion.
    (3) A member of the Corps described in subparagraph (C) of 
subsection (a)(1) shall when assigned to an entity under 
section 333 be subject to the personnel system of such entity, 
except that such member shall receive during the period of 
assignment the income that the member would receive if the 
member was a member of the Corps described in subparagraph (B) 
of such subsection.
    (e) Corps members assigned under section 333 to provide 
health services in health professional shortage areas shall not 
be counted against any employment ceiling affecting the 
Department.
    (f) Sections 214 and 216 shall not apply to members of the 
National Health Service Corps during their period of obligated 
service under the Scholarship Program or the Loan Repayment 
Program, except when such members are Commissioned Corps 
officers who entered into a contract with Secretary under 
section 338A or 338B after December 31, 2006 and when the 
Secretary determines that exercising the authority provided 
under section 214 or 216 with respect to any such officer to 
would not cause unreasonable disruption to health care services 
provided in the community in which such officer is providing 
health care services.
    (g)(1) The Secretary shall, by rule, prescribe conversion 
provisions applicable to any individual who, within a year 
after completion of service as a member of the Corps described 
in subsection (a)(1)(C), becomes a commissioned officer in the 
Regular or Reserve Corps of the Service.
    (2) The rules prescribed under paragraph (1) shall provide 
that in applying the appropriate provisions of this Act which 
relate to retirement, any individual who becomes such an 
officer shall be entitled to have credit for any period of 
service as a member of the Corps described in subsection 
(a)(1)(C).
    (h) The Secretary shall ensure that adequate staff is 
provided to the Service with respect to effectively 
administering the program for the Corps.
    (i)(1) In carrying out subpart III, the Secretary may, in 
accordance with this subsection, issue waivers to individuals 
who have entered into a contract for obligated service under 
the Scholarship Program or the Loan Repayment Program under 
which the individuals are authorized to satisfy the requirement 
of obligated service through providing clinical practice that 
is half time.
    (2) A waiver described in paragraph (1) may be provided by 
the Secretary only if--
            (A) the entity for which the service is to be 
        performed--
                    (i) has been approved under section 333A 
                for assignment of a Corps member; and
                    (ii) has requested in writing assignment of 
                a health professional who would serve half 
                time;
            (B) the Secretary has determined that assignment of 
        a health professional who would serve half time would 
        be appropriate for the area where the entity is 
        located;
            (C) a Corps member who is required to perform 
        obligated service has agreed in writing to be assigned 
        for half-time service to an entity described in 
        subparagraph (A);
            (D) the entity and the Corps member agree in 
        writing that the Corps member will perform half-time 
        clinical practice;
            (E) the Corps member agrees in writing to fulfill 
        all of the service obligations under section 338C 
        through half-time clinical practice and either--
                    (i) double the period of obligated service 
                that would otherwise be required; or
                    (ii) in the case of contracts entered into 
                under section 338B, accept a minimum service 
                obligation of 2 years with an award amount 
                equal to 50 percent of the amount that would 
                otherwise be payable for full-time service; and
            (F) the Corps member agrees in writing that if the 
        Corps member begins providing half-time service but 
        fails to begin or complete the period of obligated 
        service, the method stated in 338E(c) for determining 
        the damages for breach of the individual's written 
        contract will be used after converting periods of 
        obligated service or of service performed into their 
        full-time equivalents.
    (3) In evaluating waivers issued under paragraph (1), the 
Secretary shall examine the effect of multidisciplinary teams.
    (j) For the purposes of this subpart and subpart III:
            (1) The term ``Department'' means the Department of 
        Health and Human Services.
            (2) The term ``Loan Repayment Program'' means the 
        National Health Service Corps Loan Repayment Program 
        established under section 338B.
            (3) The term ``Scholarship Program'' means the 
        National Health Service Corps Scholarship Program 
        established under section 338A.
            (4) The term ``State'' includes, in addition to the 
        several States, only the District of Columbia, the 
        Commonwealth of Puerto Rico, the Commonwealth of the 
        Northern Mariana Islands, the Virgin Islands, Guam, 
        American Samoa, and the Trust Territory of the Pacific 
        Islands.
            (5) The terms ``full time'' and ``full-time'' mean 
        a minimum of 40 hours per week in a clinical practice, 
        for a minimum of 45 weeks per year.
            (6) The terms ``half time'' and ``half-time'' mean 
        a minimum of 20 hours per week (not to exceed 39 hours 
        per week) in a clinical practice, for a minimum of 45 
        weeks per year.

           designation of health professional shortage areas

    Sec. 332. [254e] (a)(1) For purposes of this subpart the 
term ``health professional shortage area'' means (A) an area in 
an urban or rural area (which need not conform to the 
geographic boundaries of a political subdivision and which is a 
rational area for the delivery of health services) which the 
Secretary determines has a health manpower shortage, (B) a 
population group which the Secretary determines has such a 
shortage, or (C) a public or nonprofit private medical facility 
or other public facility which the Secretary determines has 
such a shortage. All Federally qualified health centers and 
rural health clinics, as defined in section 1861(aa) of the 
Social Security Act (42 U.S.C. 1395x(aa)), that meet the 
requirements of section 334 shall be automatically designated 
as having such a shortage. The Secretary shall not remove an 
area from the areas determined to be health professional 
shortage areas under subparagraph (A) of the preceding sentence 
until the Secretary has afforded interested persons and groups 
in such area an opportunity to provide data and information in 
support of the designation as a health professional shortage 
area or a population group described in subparagraph (B) of 
such sentence or a facility described in subparagraph (C) of 
such sentence, and has made a determination on the basis of the 
data and information submitted by such persons and groups and 
other data and information available to the Secretary.
    (2) For purposes of this subsection, the term ``medical 
facility'' means a facility for the delivery of health services 
and includes--
            (A) a hospital, State mental hospital, public 
        health center, outpatient medical facility, 
        rehabilitation facility, facility for long-term care, 
        community mental health center, migrant health center, 
        facility operated by a city or county health 
        department, and community health center and which is 
        not reasonably accessible to an adequately served area;
            (B) such a facility of a State correctional 
        institution or of the Indian Health Service, and a 
        health program or facility operated by a tribe or 
        tribal organization under the Indian Self-Determination 
        Act;
            (C) such a facility used in connection with the 
        delivery of health services under section 321 (relating 
        to hospitals), 322 (relating to care and treatment of 
        persons under quarantine and others), 323 (relating to 
        care and treatment of Federal prisoners), 324 (relating 
        to examination and treatment of certain Federal 
        employees), 325 (relating to examination of aliens), 
        326 (relating to services to certain Federal 
        employees), 320 (relating to services for persons with 
        Hansen's disease), or 330(h) (relating to the provision 
        of health services to homeless individuals); and
            (D) a Federal medical facility.
    (3) Homeless individuals (as defined in section 330(h)(5)), 
seasonal agricultural workers (as defined in section 330(g)(3)) 
and migratory agricultural workers (as so defined)), and 
residents of public housing (as defined in section 3(b)(1) of 
the United States Housing Act of 1937 (42 U.S.C. 1437a(b)(1))) 
may be population groups under paragraph (1).
    (b) The Secretary shall establish by regulation criteria 
for the designation of areas, population groups, medical 
facilities, and other public facilities, in the States, as 
health professional shortage areas. In establishing such 
criteria, the Secretary shall take into consideration the 
following:
            (1) The ratio of available health manpower to the 
        number of individuals in an area or population group, 
        or served by a medical facility or other public 
        facility under consideration for designation.
            (2) Indicators of a need, notwithstanding the 
        supply of health manpower, for health services for the 
        individuals in an area or population group or served by 
        a medical facility or other public facility under 
        consideration for designation.
            (3) The percentage of physicians serving an area, 
        population group, medical facility, or other public 
        facility under consideration for designation who are 
        employed by hospitals and who are graduates of foreign 
        medical schools.
    (c) In determining whether to make a designation, the 
Secretary shall take into consideration the following:
            (1) The recommendations of the Governor of each 
        State in which the area, population group, medical 
        facility, or other public facility under consideration 
        for designation is in whole or part located.
            (2) The extent to which individuals who are (A) 
        residents of the area, members of the population group, 
        or patients in the medical facility or other public 
        facility under consideration for designation, and (B) 
        entitled to have payment made for medical services 
        under title XVIII, XIX, or XXI of the Social Security 
        Act, cannot obtain such services because of suspension 
        of physicians from the programs under such titles.
    (d)(1) In accordance with the criteria established under 
subsection (b) and the considerations listed in subsection (c), 
the Secretary shall designate health professional shortage 
areas in the States, publish a descriptive list of the areas, 
population groups, medical facilities, and other public 
facilities so designated, and at least annually review and, as 
necessary, revise such designations.
    (2) For purposes of paragraph (1), a complete descriptive 
list shall be published in the Federal Register not later than 
July 1 of 1991 and each subsequent year.
    (e)(1) Prior to the designation of a public facility, 
including a Federal medical facility, as a health professional 
shortage area, the Secretary shall give written notice of such 
proposed designation to the chief administrative officer of 
such facility and request comments within 30 days with respect 
to such designation.
    (2) Prior to the designation of a health professional 
shortage area under this section, the Secretary shall, to the 
extent practicable, give written notice of the proposed 
designation of such area to appropriate public or private 
nonprofit entities which are located or have a demonstrated 
interest in such area and request comments from such entities 
with respect to the proposed designation of such area.
    (f) The Secretary shall give written notice of the 
designation of a health professional shortage area, not later 
than 60 days from the date of such designation, to--
            (1) the Governor of each State in which the area, 
        population group, medical facility, or other public 
        facility so designated is in whole or part located; and
            (2) appropriate public or nonprofit private 
        entities which are located or which have a demonstrated 
        interest in the area so designated.
    (g) Any person may recommend to the Secretary the 
designation of an area, population group, medical facility, or 
other public facility as a health professional shortage area.
    (h) The Secretary may conduct such information programs in 
areas, among population groups, and in medical facilities and 
other public facilities designated under this section as health 
professional shortage areas as may be necessary to inform 
public and nonprofit private entities which are located or have 
a demonstrated interest in such areas of the assistance 
available under this title by virtue of the designation of such 
areas.
    (i) Dissemination.--The Administrator of the Health 
Resources and Services Administration shall disseminate 
information concerning the designation criteria described in 
subsection (b) to--
            (1) the Governor of each State;
            (2) the representative of any area, population 
        group, or facility selected by any such Governor to 
        receive such information;
            (3) the representative of any area, population 
        group, or facility that requests such information; and
            (4) the representative of any area, population 
        group, or facility determined by the Administrator to 
        be likely to meet the criteria described in subsection 
        (b).
    (j)(1) The Secretary shall submit the report described in 
paragraph (2) if the Secretary, acting through the 
Administrator of the Health Resources and Services 
Administration, issues--
            (A) a regulation that revises the definition of a 
        health professional shortage area for purposes of this 
        section; or
            (B) a regulation that revises the standards 
        concerning priority of such an area under section 333A.
    (2) On issuing a regulation described in paragraph (1), the 
Secretary shall prepare and submit to the Committee on Energy 
and Commerce of the House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of the Senate a 
report that describes the regulation.
    (3) Each regulation described in paragraph (1) shall take 
effect 180 days after the committees described in paragraph (2) 
receive a report referred to in such paragraph describing the 
regulation.

                     assignment of corps personnel

    Sec. 333. [254f] (a)(1) The Secretary may assign members of 
the Corps to provide, under regulations promulgated by the 
Secretary, health services in or to a health professional 
shortage area during the assignment period only if--
            (A) a public or private entity, which is located or 
        has a demonstrated interest in such area, makes 
        application to the Secretary for such assignment;
            (B) such application has been approved by the 
        Secretary;
            (C) the entity agrees to comply with the 
        requirements of section 334; and
            (D) the Secretary has (i) conducted an evaluation 
        of the need and demand for health professional shortage 
        area, the intended use of Corps members to be assigned 
        to the area, community support for the assignment of 
        Corps members to the area, the area's efforts to secure 
        health professional shortage area, and the fiscal 
        management capability of the entity to which Corps 
        members would be assigned and (ii) on the basis of such 
        evaluation has determined that--
                    (I) there is a need and demand for health 
                manpower for the area;
                    (II) there has been appropriate and 
                efficient use of any Corps members previously 
                assigned to the entity for the area;
                    (III) there is general community support 
                for the assignment of Corps members to the 
                entity;
                    (IV) the area has made unsuccessful efforts 
                to secure health manpower for the area;
                    (V) there is a reasonable prospect of sound 
                fiscal management, including efficient 
                collection of fee-for-service, third-party, and 
                other appropriate funds, by the entity with 
                respect to Corps members assigned to such 
                entity; and
                                    (VI) \1\ the entity 
                                demonstrates willingness to 
                                support or facilitate 
                                mentorship, professional 
                                development, and training 
                                opportunities for Corps 
                                members.
---------------------------------------------------------------------------
    \1\ Margin so in law.
---------------------------------------------------------------------------
An application for assignment of a Corps member to a health 
professional shortage area shall include a demonstration by the 
applicant that the area or population group to be served by the 
applicant has a shortage of personal health services and that 
the Corps member will be located so that the member will 
provide services to the greatest number of persons residing in 
such area or included in such population group. Such a 
demonstration shall be made on the basis of the criteria 
prescribed by the Secretary under section 332(b) and on 
additional criteria which the Secretary shall prescribe to 
determine if the area or population group to be served by the 
applicant has a shortage of personal health services.
    (2) Corps members may be assigned to a Federal health care 
facility, but only upon the request of the head of the 
department or agency of which such facility is a part.
    (3) In approving applications for assignment of members of 
the Corps the Secretary shall not discriminate against 
applications from entities which are not receiving Federal 
financial assistance under this Act. In approving such 
applications, the Secretary shall give preference to 
applications in which a nonprofit entity or public entity shall 
provide a site to which Corps members may be assigned.
    (b)(1) The Secretary may not approve an application for the 
assignment of a member of the Corps described in subparagraph 
(C) of section 331(a)(1) to an entity unless the application of 
the entity contains assurances satisfactory to the Secretary 
that the entity (A) has sufficient financial resources to 
provide the member of the Corps with an income of not less than 
the income to which the member would be entitled if the member 
was a member described in subparagraph (B) of section 
331(a)(1), or (B) would have such financial resources if a 
grant was made to the entity under paragraph (2).
    (2)(A) If in approving an application of an entity for the 
assignment of a member of the Corps described in subparagraph 
(C) of section 331(a)(1) the Secretary determines that the 
entity does not have sufficient financial resources to provide 
the member of the Corps with an income of not less than the 
income to which the member would be entitled if the member was 
a member described in subparagraph (B) of section 331(a)(1), 
the Secretary may make a grant to the entity to assure that the 
member of the Corps assigned to it will receive during the 
period of assignment to the entity such an income.
    (B) The amount of any grant under subparagraph (A) shall be 
determined by the Secretary. Payments under such a grant may be 
made in advance or by way of reimbursement, and at such 
intervals and on such conditions, as the Secretary finds 
necessary. No grant may be made unless an application therefor 
is submitted to and approved by the Secretary. Such an 
application shall be in such form, submitted in such manner, 
and contain such information, as the Secretary shall by 
regulation prescribe.
    (c) The Secretary shall assign Corps members to entities in 
health professional shortage areas without regard to the 
ability of the individuals in such areas, population groups, 
medical facilities, or other public facilities to pay for such 
services.
    (d)(1) The Secretary may provide technical assistance to a 
public or private entity which is located in a health 
professional shortage area and which desires to make an 
application under this section for assignment of a Corps member 
to such area. Assistance provided under this paragraph may 
include assistance to an entity in (A) analyzing the potential 
use of health professions personnel in defined health services 
delivery areas by the residents of such areas, (B) determining 
the need for such personnel in such areas, (C) determining the 
extent to which such areas will have a financial base to 
support the practice of such personnel and the extent to which 
additional financial resources are needed to adequately support 
the practice, (D) determining the types of inpatient and other 
health services that should be provided by such personnel in 
such areas, and (E) developing long-term plans for addressing 
health professional shortages and improving access to health 
care. The Secretary shall encourage entities that receive 
technical assistance under this paragraph to communicate with 
other communities, State Offices of Rural Health, State Primary 
Care Associations and Offices, and other entities concerned 
with site development and community needs assessment.
    (2) The Secretary may provide, to public and private 
entities which are located in a health professional shortage 
area to which area a Corps member has been assigned, technical 
assistance to assist in the retention of such member in such 
area after the completion of such member's assignment to the 
area.
    (3) The Secretary may provide, to health professional 
shortage areas to which no Corps member has been assigned, (A) 
technical assistance to assist in the recruitment of health 
manpower for such areas, and (B) current information on public 
and private programs which provide assistance in the securing 
of health manpower.
    (4)(A) The Secretary shall undertake to demonstrate the 
improvements that can be made in the assignment of members of 
the Corps to health professional shortage areas and in the 
delivery of health care by Corps members in such areas through 
coordination with States, political subdivisions of States, 
agencies of States and political subdivisions, and other public 
and private entities which have expertise in the planning, 
development, and operation of centers for the delivery of 
primary health care. In carrying out this subparagraph, the 
Secretary shall enter into agreements with qualified entities 
which provide that if--
            (i) the entity places in effect a program for the 
        planning, development, and operation of centers for the 
        delivery of primary health care in health professional 
        shortage areas which reasonably addresses the need for 
        such care in such areas, and
            (ii) under the program the entity will perform the 
        functions described in subparagraph (B),
the Secretary will assign under this section members of the 
Corps in accordance with the program.
    (B) For purposes of subparagraph (A), the term ``qualified 
entity'' means a State, political subdivision of a State, an 
agency of a State or political subdivision, or other public or 
private entity operating solely within one State, which the 
Secretary determines is able--
            (i) to analyze the potential use of health 
        professions personnel in defined health services 
        delivery areas by the residents of such areas;
            (ii) to determine the need for such personnel in 
        such areas and to recruit, select, and retain health 
        professions personnel (including members of the 
        National Health Service Corps) to meet such need;
            (iii) to determine the extent to which such areas 
        will have a financial base to support the practice of 
        such personnel and the extent to which additional 
        financial resources are needed to adequately support 
        the practice;
            (iv) to determine the types of inpatient and other 
        health services that should be provided by such 
        personnel in such areas;
            (v) to assist such personnel in the development of 
        their clinical practice and fee schedules and in the 
        management of their practice;
            (vi) to assist in the planning and development of 
        facilities for the delivery of primary health care; and
            (vii) to assist in establishing the governing 
        bodies of centers for the delivery of such care and to 
        assist such bodies in defining and carrying out their 
        responsibilities.
    (e) Notwithstanding any other law, any member of the Corps 
licensed to practice medicine, osteopathic medicine, dentistry, 
or any other health profession in any State shall, while 
serving in the Corps, be allowed to practice such profession in 
any State.

SEC. 333A. [254F-1] PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL.

    (a) In General.--In approving applications made under 
section 333 for the assignment of Corps members, the Secretary 
shall--
            (1) give priority to any such application that--
                    (A) is made regarding the provision of 
                primary health services to a health 
                professional shortage area with the greatest 
                such shortage; and
                    (B) is made by an entity that--
                            (i) serves a health professional 
                        shortage area described in subparagraph 
                        (A);
                            (ii) coordinates the delivery of 
                        primary health services with related 
                        health and social services;
                            (iii) has a documented record of 
                        sound fiscal management; and
                            (iv) will experience a negative 
                        impact on its capacity to provide 
                        primary health services if a Corps 
                        member is not assigned to the entity;
            (2) with respect to the geographic area in which 
        the health professional shortage area is located, take 
        into consideration the willingness of individuals in 
        the geographic area, and of the appropriate 
        governmental agencies or health entities in the area, 
        to assist and cooperate with the Corps in providing 
        effective primary health services; and
            (3) take into consideration comments of medical, 
        osteopathic, dental, or other health professional 
        societies whose members deliver services to the health 
        professional shortage area, or if no such societies 
        exist, comments of physicians, dentists, or other 
        health professionals delivering services to the area.
    (b) Establishment of Criteria for Determining Priorities.--
            (1) In general.--The Secretary shall establish 
        criteria specifying the manner in which the Secretary 
        makes a determination under subsection (a)(1)(A) of the 
        health professional shortage areas with the greatest 
        such shortages.
            (2) Publication of criteria.--The criteria required 
        in paragraph (1) shall be published in the Federal 
        Register not later than July 1, 1991. Any revisions 
        made in the criteria by the Secretary shall be 
        effective upon publication in the Federal Register.
    (c) Notifications Regarding Priorities.--
            (1) Proposed list.--The Secretary shall prepare and 
        publish a proposed list of health professional shortage 
        areas and entities that would receive priority under 
        subsection (a)(1) in the assignment of Corps members. 
        The list shall contain the information described in 
        paragraph (2), and the relative scores and relative 
        priorities of the entities submitting applications 
        under section 333, in a proposed format. All such 
        entities shall have 30 days after the date of 
        publication of the list to provide additional data and 
        information in support of inclusion on the list or in 
        support of a higher priority determination and the 
        Secretary shall reasonably consider such data and 
        information in preparing the final list under paragraph 
        (2).
            (2) Preparation of list for applicable period.--For 
        the purpose of carrying out paragraph (3), the 
        Secretary shall prepare and, as appropriate, update a 
        list of health professional shortage areas and entities 
        that are receiving priority under subsection (a)(1) in 
        the assignment of Corps members. Such list--
                    (A) shall include a specification, for each 
                such health professional shortage area, of the 
                entities for which the Secretary has provided 
                an authorization to receive assignments of 
                Corps members in the event that Corps members 
                are available for the assignments; and
                    (B) shall, of the entities for which an 
                authorization described in subparagraph (A) has 
                been provided, specify--
                            (i) the entities provided such an 
                        authorization for the assignment of 
                        Corps members who are participating in 
                        the Scholarship Program;
                            (ii) the entities provided such an 
                        authorization for the assignment of 
                        Corps members who are participating in 
                        the Loan Repayment Program; and
                            (iii) the entities provided such an 
                        authorization for the assignment of 
                        Corps members who have become Corps 
                        members other than pursuant to 
                        contractual obligations under the 
                        Scholarship or Loan Repayment Programs.

                The Secretary may set forth such specifications 
                by medical specialty.
            (3) Notification of affected parties.--
                    (A) Entities.--Not later than 30 days after 
                the Secretary has added to a list under 
                paragraph (2) an entity specified as described 
                in subparagraph (A) of such paragraph, the 
                Secretary shall notify such entity that the 
                entity has been provided an authorization to 
                receive assignments of Corps members in the 
                event that Corps members are available for the 
                assignments.
                    (B) Individuals.--In the case of an 
                individual obligated to provide service under 
                the Scholarship Program, not later than 3 
                months before the date described in section 
                338C(b)(5), the Secretary shall provide to such 
                individual the names of each of the entities 
                specified as described in paragraph (2)(B)(i) 
                that is appropriate for the individual's 
                medical specialty and discipline.
            (4) Revisions.--If the Secretary proposes to make a 
        revision in the list under paragraph (2), and the 
        revision would adversely alter the status of an entity 
        with respect to the list, the Secretary shall notify 
        the entity of the revision. Any entity adversely 
        affected by such a revision shall be notified in 
        writing by the Secretary of the reasons for the 
        revision and shall have 30 days from such notification 
        to file a written appeal of the determination involved 
        which shall be reasonably considered by the Secretary 
        before the revision to the list becomes final. The 
        revision to the list shall be effective with respect to 
        assignment of Corps members beginning on the date that 
        the revision becomes final.
    (d) Limitation on Number of Entities Offered as Assignment 
Choices in Scholarship Program.--
            (1) Determination of available corps members.--By 
        April 1 of each calendar year, the Secretary shall 
        determine the number of participants in the Scholarship 
        Program who will be available for assignments under 
        section 333 during the program year beginning on July 1 
        of that calendar year.
            (2) Determination of number of entities.--At all 
        times during a program year, the number of entities 
        specified under subsection (c)(2)(B)(i) shall be--
                    (A) not less than the number of 
                participants determined with respect to that 
                program year under paragraph (1); and
                    (B) not greater than twice the number of 
                participants determined with respect to that 
                program year under paragraph (1).

SEC. 334. [254G] CHARGES FOR SERVICES BY ENTITIES USING CORPS MEMBERS.

    (a) Availability of Services Regardless of Ability To Pay 
or Payment Source.--An entity to which a Corps member is 
assigned shall not deny requested health care services, and 
shall not discriminate in the provision of services to an 
individual--
            (1) because the individual is unable to pay for the 
        services; or
            (2) because payment for the services would be made 
        under--
                    (A) the medicare program under title XVIII 
                of the Social Security Act (42 U.S.C. 1395 et 
                seq.);
                    (B) the medicaid program under title XIX of 
                such Act (42 U.S.C. 1396 et seq.); or
                    (C) the State children's health insurance 
                program under title XXI of such Act (42 U.S.C. 
                1397aa et seq.).
    (b) Charges for Services.--The following rules shall apply 
to charges for health care services provided by an entity to 
which a Corps member is assigned:
            (1) In general.--
                    (A) Schedule of fees or payments.--Except 
                as provided in paragraph (2), the entity shall 
                prepare a schedule of fees or payments for the 
                entity's services, consistent with locally 
                prevailing rates or charges and designed to 
                cover the entity's reasonable cost of 
                operation.
                    (B) Schedule of discounts.--Except as 
                provided in paragraph (2), the entity shall 
                prepare a corresponding schedule of discounts 
                (including, in appropriate cases, waivers) to 
                be applied to the payment of such fees or 
                payments. In preparing the schedule, the entity 
                shall adjust the discounts on the basis of a 
                patient's ability to pay.
                    (C) Use of schedules.--The entity shall 
                make every reasonable effort to secure from 
                patients fees and payments for services in 
                accordance with such schedules, and fees or 
                payments shall be sufficiently discounted in 
                accordance with the schedule described in 
                subparagraph (B).
            (2) Services to beneficiaries of federal and 
        federally assisted programs.--In the case of health 
        care services furnished to an individual who is a 
        beneficiary of a program listed in subsection (a)(2), 
        the entity--
                    (A) shall accept an assignment pursuant to 
                section 1842(b)(3)(B)(ii) of the Social 
                Security Act (42 U.S.C. 1395u(b)(3)(B)(ii)) 
                with respect to an individual who is a 
                beneficiary under the medicare program; and
                    (B) shall enter into an appropriate 
                agreement with--
                            (i) the State agency administering 
                        the program under title XIX of such Act 
                        with respect to an individual who is a 
                        beneficiary under the medicaid program; 
                        and
                            (ii) the State agency administering 
                        the program under title XXI of such Act 
                        with respect to an individual who is a 
                        beneficiary under the State children's 
                        health insurance program.
            (3) Collection of payments.--The entity shall take 
        reasonable and appropriate steps to collect all 
        payments due for health care services provided by the 
        entity, including payments from any third party 
        (including a Federal, State, or local government agency 
        and any other third party) that is responsible for part 
        or all of the charge for such services.
             provision of health services by corps members
    Sec. 335. [254h] (a) In providing health services in a 
health professional shortage area, Corps members shall utilize 
the techniques, facilities, and organizational forms most 
appropriate for the area, population group, medical facility, 
or other public facility, and shall, to the maximum extent 
feasible, provide such services (1) to all individuals in, or 
served by, such health professional shortage area regardless of 
their ability to pay for the services, and (2) in a manner 
which is cooperative with other health care providers serving 
such health professional shortage area.
    (b)(1) Notwithstanding any other provision of law, the 
Secretary may (A) to the maximum extent feasible make such 
arrangements as he determines necessary to enable Corps members 
to utilize the health facilities in or serving the health 
professional shortage area in providing health services; (B) 
make such arrangements as he determines are necessary for the 
use of equipment and supplies of the Service and for the lease 
or acquisition of other equipment and supplies; and (C) secure 
the permanent or temporary services of physicians, dentists, 
nurses, administrators, and other health personnel. If there 
are no health facilities in or serving such area, the Secretary 
may arrange to have Corps members provide health services in 
the nearest health facilities of the Service or may lease or 
otherwise provide facilities in or serving such area for the 
provision of health services.
    (2) If the individuals in or served by a health 
professional shortage area are being served (as determined 
under regulations of the Secretary) by a hospital or other 
health care delivery facility of the Service, the Secretary 
may, in addition to such other arrangements as he may make 
under paragraph (1), arrange for the utilization of such 
hospital or facility by Corps members in providing health 
services, but only to the extent that such utilization will not 
impair the delivery of health services and treatment through 
such hospital or facility to individuals who are entitled to 
health services and treatment through such hospital or 
facility.
    (c) The Secretary may make one loan to any entity with an 
approved application under section 333 to assist such entity in 
meeting the costs of (1) establishing medical, dental, or other 
health profession practices, including the development of 
medical practice management systems; (2) acquiring equipment 
for use in providing health services; and (3) renovating 
buildings to establish health facilities. No loan may be made 
under this subsection unless an application therefor is 
submitted to, and approved by, the Secretary. The amount of any 
such loan shall be determined by the Secretary, except that no 
such loan may exceed $50,000.
    (d) Upon the expiration of the assignment of all Corps 
members to a health professional shortage area, the Secretary 
may (notwithstanding any other provision of law) sell, to any 
appropriate local entity, equipment and other property of the 
United States utilized by such members in providing health 
services. Sales made under this subsection shall be made at the 
fair market value (as determined by the Secretary) of the 
equipment or such other property; except that the Secretary may 
make such sales for a lesser value to an appropriate local 
entity, if he determines that the entity is financially unable 
to pay the full market value.
    (e)(1)(A) It shall be unlawful for any hospital to deny an 
authorized Corps member admitting privileges when such Corps 
member otherwise meets the professional qualifications 
established by the hospital for granting such privileges and 
agrees to abide by the published bylaws of the hospital and the 
published bylaws, rules, and regulations of its medical staff.
    (B) Any hospital which is found by the Secretary, after 
notice and an opportunity for a hearing on the record, to have 
violated this subsection shall upon such finding cease, for a 
period to be determined by the Secretary, to receive and to be 
eligible to receive any Federal funds under this Act or under 
titles XVIII, XIX, or XXI of the Social Security Act.
    (2) For purposes of this subsection, the term ``hospital'' 
includes a State or local public hospital, a private profit 
hospital, a private nonprofit hospital, a general or special 
hospital, and any other type of hospital (excluding a hospital 
owned or operated by an agency of the Federal Government), and 
any related facilities.

SEC. 336. [254H-1] FACILITATION OF EFFECTIVE PROVISION OF CORPS 
                    SERVICES.

    (a) Consideration of Individual Characteristics of Members 
in Making Assignments.--In making an assignment of a Corps 
member to an entity that has had an application approved under 
section 333, the Secretary shall, subject to making the 
assignment in accordance with section 333A, seek to assign to 
the entity a Corps member who has (and whose spouse, if any, 
has) characteristics that increase the probability that the 
member will remain in the health professional shortage area 
involved after the completion of the period of service in the 
Corps.
    (b) Counseling on Service in Corps.--
            (1) In general.--The Secretary shall, subject to 
        paragraph (3), offer appropriate counseling on service 
        in the Corps to individuals during the period of 
        membership in the Corps, particularly during the 
        initial period of each assignment.
            (2) Career advisor regarding obligated service.--
                    (A) In the case of individuals who have 
                entered into contracts for obligated service 
                under the Scholarship or Loan Repayment 
                Program, counseling under paragraph (1) shall 
                include appropriate counseling on matters 
                particular to such obligated service. The 
                Secretary shall ensure that career advisors for 
                providing such counseling are available to such 
                individuals throughout the period of 
                participation in the Scholarship or Loan 
                Repayment Program.
                    (B) With respect to the Scholarship 
                Program, counseling under paragraph (1) shall 
                include counseling individuals during the 
                period in which the individuals are pursuing an 
                educational degree in the health profession 
                involved, including counseling to prepare the 
                individual for service in the Corps.
            (3) Extent of counseling services.--With respect to 
        individuals who have entered into contracts for 
        obligated service under the Scholarship or Loan 
        Repayment Program, this subsection shall be carried out 
        regarding such individuals throughout the period of 
        obligated service (and, additionally, throughout the 
        period specified in paragraph (2)(B), in the case of 
        the Scholarship Program). With respect to Corps members 
        generally, this subsection shall be carried out to the 
        extent practicable.
    (c) Grants Regarding Preparation of Students for 
Practice.--With respect to individuals who have entered into 
contracts for obligated service under the Scholarship or Loan 
Repayment Program, the Secretary may make grants to, and enter 
into contracts with, public and nonprofit private entities 
(including health professions schools) for the conduct of 
programs designed to prepare such individuals for the effective 
provision of primary health services in the health professional 
shortage areas to which the individuals are assigned.
    (d) Professional Development and Training.--
            (1) In general.--The Secretary shall assist Corps 
        members in establishing and maintaining professional 
        relationships and development opportunities, including 
        by--
                    (A) establishing appropriate professional 
                relationships between the Corps member involved 
                and the health professions community of the 
                geographic area with respect to which the 
                member is assigned;
                    (B) establishing professional development, 
                training, and mentorship linkages between the 
                Corps member involved and the larger health 
                professions community, including through 
                distance learning, direct mentorship, and 
                development and implementation of training 
                modules designed to meet the educational needs 
                of offsite Corps members;
                    (C) establishing professional networks 
                among Corps members; or
                    (D) engaging in other professional 
                development, mentorship, and training 
                activities for Corps members, at the discretion 
                of the Secretary.
            (2) Assistance in establishing professional 
        relationships.--In providing such assistance under 
        paragraph (1), the Secretary shall focus on 
        establishing relationships with hospitals, with 
        academic medical centers and health professions 
        schools, with area health education centers under 
        section 751, with health education and training centers 
        under section 752, and with border health education and 
        training centers under such section 752. Such 
        assistance shall include assistance in obtaining 
        faculty appointments at health professions schools.
            (3) Supplement not supplant.--Such efforts under 
        this subsection shall supplement, not supplant, non-
        government efforts by professional health provider 
        societies to establish and maintain professional 
        relationships and development opportunities.
    (e) Temporary Relief From Corps Duties.--
            (1) In general.--The Secretary shall, subject to 
        paragraph (4), provide assistance to Corps members in 
        establishing arrangements through which Corps members 
        may, as appropriate, be provided temporary relief from 
        duties in the Corps in order to pursue continuing 
        education in the health professions, to participate in 
        exchange programs with teaching centers, to attend 
        professional conferences, or to pursue other interests, 
        including vacations.
            (2) Assumption of duties of member.--
                    (A) Temporary relief under paragraph (1) 
                may be provided only if the duties of the Corps 
                member involved are assumed by another health 
                professional. With respect to such temporary 
                relief, the duties may be assumed by Corps 
                members or by health professionals who are not 
                Corps members, if the Secretary approves the 
                professionals for such purpose. Any health 
                professional so approved by the Secretary 
                shall, during the period of providing such 
                temporary relief, be deemed to be a Corps 
                member for purposes of section 224 (including 
                for purposes of the remedy described in such 
                section), section 333(f) \1\, and section 
                335(e).
---------------------------------------------------------------------------
    \1\ So in law. As a result of the amendments made by section 103(b) 
of Public Law 101-597 (104 Stat. 3015), there is no subsection (f) in 
section 333. (Subsection (e) of section 333, like sections 224 and 
335(e), establishes a right for Corps members.)
---------------------------------------------------------------------------
                    (B) In carrying out paragraph (1), the 
                Secretary shall provide for the formation and 
                continued existence of a group of health 
                professionals to provide temporary relief under 
                such paragraph.
            (3) Recruitment from general health professions 
        community.--In carrying out paragraph (1), the 
        Secretary shall--
                    (A) encourage health professionals who are 
                not Corps members to enter into arrangements 
                under which the health professionals 
                temporarily assume the duties of Corps members 
                for purposes of paragraph (1); and
                    (B) with respect to the entities to which 
                Corps members have been assigned under section 
                333, encourage the entities to facilitate the 
                development of arrangements described in 
                subparagraph (A).
            (4) Limitation.--In carrying out paragraph (1), the 
        Secretary may not, except as provided in paragraph (5), 
        obligate any amounts (other than for incidental 
        expenses) for the purpose of--
                    (A) compensating a health professional who 
                is not a Corps member for assuming the duties 
                of a Corps member; or
                    (B) paying the costs of a vacation, or 
                other interests that a Corps member may pursue 
                during the period of temporary relief under 
                such paragraph.
            (5) Sole providers of health services.--In the case 
        of any Corps member who is the sole provider of health 
        services in the geographic area involved, the Secretary 
        may, from amounts appropriated under section 338, 
        obligate on behalf of the member such sums as the 
        Secretary determines to be necessary for purposes of 
        providing temporary relief under paragraph (1).
    (f) Determinations Regarding Effective Service.--In 
carrying out subsection (a) and sections 338A(d) and 338B(d), 
the Secretary shall carry out activities to determine--
            (1) the characteristics of physicians, dentists, 
        and other health professionals who are more likely to 
        remain in practice in health professional shortage 
        areas after the completion of the period of service in 
        the Corps;
            (2) the characteristics of health manpower shortage 
        areas \1\, and of entities seeking assignments of Corps 
        members, that are more likely to retain Corps members 
        after the members have completed the period of service 
        in the Corps; and
---------------------------------------------------------------------------
    \1\ So in law. Probably should be ``health professional shortage 
areas''. See section 401 of Public Law 101-597 (104 Stat. 3035).
---------------------------------------------------------------------------
            (3) the appropriate conditions for the assignment 
        and utilization in health manpower shortage areas \1\ 
        of certified nurse practitioners, certified nurse 
        midwives, and physician assistants.
                             annual reports
    Sec. 336A. [254i] The Secretary shall submit an annual 
report to Congress, and shall include in such report with 
respect to the previous calendar year--
            (1) the number, identity, and priority of all 
        health professional shortage areas designated in such 
        year and the number of health professional shortage 
        areas which the Secretary estimates will be designated 
        in the subsequent year;
            (2) the number of applications filed under section 
        333 in such year for assignment of Corps members and 
        the action taken on each such application;
            (3) the number and types of Corps members assigned 
        in such year to health professional shortage areas, the 
        number and types of additional Corps members which the 
        Secretary estimates will be assigned to such areas in 
        the subsequent year, and the need for additional 
        members for the Corps;
            (4) the recruitment efforts engaged in for the 
        Corps in such year and the number of qualified 
        individuals who applied for service in the Corps in 
        such year;
            (5) the number of patients seen and the number of 
        patient visits recorded during such year with respect 
        to each health professional shortage area to which a 
        Corps member was assigned during such year;
            (6) the number of Corps members who elected, and 
        the number of Corps members who did not elect, to 
        continue to provide health services in health 
        professional shortage areas after termination of their 
        service in the Corps and the reasons (as reported to 
        the Secretary) of members who did not elect for not 
        making such election;
            (7) the results of evaluations and determinations 
        made under section 333(a)(1)(D) during such year; and
            (8) the amount charged during such year for health 
        services provided by Corps members, the amount which 
        was collected in such year by entities in accordance 
        with section 334, and the amount which was paid to the 
        Secretary in such year under such agreements \1\.
---------------------------------------------------------------------------
    \1\ There is no antecedent reference to ``agreements''. Formerly, 
paragraph (8) contained the clause ``, the amount which was collected 
in such year by entities in accordance with agreements under section 
334,''. Section 307(b) of Public Law 107-251 (116 Stat. 1649) struck 
``agreements under'' in that clause.
---------------------------------------------------------------------------
                       national advisory council
    Sec. 337. [254j] (a) There is established a council to be 
known as the National Advisory Council on the National Health 
Service Corps (hereinafter in this section referred to as the 
``Council''). The Council shall be composed of fifteen members 
appointed by the Secretary. The Council shall consult with, 
advise, and make recommendations to, the Secretary with respect 
to his responsibilities in carrying out this subpart (other 
than section 338G), and shall review and comment upon 
regulations promulgated by the Secretary under this subpart.
    (b)(1) Members of the Council shall be appointed for a term 
of three years, except that any member appointed to fill a 
vacancy occurring prior to the expiration of the term for which 
the member's predecessor was appointed shall be appointed for 
the remainder of such term. No member shall be removed, except 
for cause.
    (2) Members of the Council (other than members who are 
officers or employees of the United States), while attending 
meetings or conferences thereof or otherwise serving on the 
business of the Council, shall be entitled to receive for each 
day (including traveltime) in which they are so serving 
compensation at a rate fixed by the Secretary (but not to 
exceed the daily equivalent of the annual rate of basic pay in 
effect for grade GS-18 of the General Schedule); and while so 
serving away from their homes or regular places of business all 
members may be allowed travel expenses, including per diem in 
lieu of subsistence, as authorized by section 5703 of title 5 
of the United States Code for persons in the Government service 
employed intermittently.
    (c) Section 14 of the Federal Advisory Committee Act shall 
not apply with respect to the Council.
                     authorization of appropriation
    Sec. 338. [254k] (a) For the purpose of carrying out this 
subpart, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2008 through 
2012.
    (b) An appropriation under an authorization under 
subsection (a) for any fiscal year may be made at any time 
before that fiscal year and may be included in an Act making an 
appropriation under an authorization under subsection (a) for 
another fiscal year; but no funds may be made available from 
any appropriation under such authorization for obligation under 
sections 331 through 335, section 336A, and section 337 before 
the fiscal year for which such appropriation is authorized.

      Subpart III--Scholarship Program and Loan Repayment Program

           national health service corps scholarship program
    Sec. 338A. [254l] (a) The Secretary shall establish the 
National Health Service Corps Scholarship Program to assure, 
with respect to the provision of primary health services 
pursuant to section 331(a)(2)--
            (1) an adequate supply of physicians, dentists, 
        behavioral and mental health professionals, certified 
        nurse midwives, certified nurse practitioners, and 
        physician assistants; and
            (2) if needed by the Corps, an adequate supply of 
        other health professionals.
    (b) To be eligible to participate in the Scholarship 
Program, an individual must--
            (1) be accepted for enrollment, or be enrolled, as 
        a full-time student (A) in an accredited (as determined 
        by the Secretary) educational institution in a State 
        and (B) in a course of study or program, offered by 
        such institution and approved by the Secretary, leading 
        to a degree in medicine, osteopathic medicine, 
        dentistry, or other health profession, or an 
        appropriate degree from a graduate program of 
        behavioral and mental health;
            (2) be eligible for, or hold, an appointment as a 
        commissioned officer in the Regular or Reserve Corps of 
        the Service or be eligible for selection for civilian 
        service in the Corps;
            (3) submit an application to participate in the 
        Scholarship Program; and
            (4) sign and submit to the Secretary, at the time 
        of submittal of such application, a written contract 
        (described in subsection (f)) to accept payment of a 
        scholarship and to serve (in accordance with this 
        subpart) for the applicable period of obligated service 
        in a health professional shortage area.
    (c)(1) In disseminating application forms and contract 
forms to individuals desiring to participate in the Scholarship 
Program, the Secretary shall include with such forms--
            (A) a fair summary of the rights and liabilities of 
        an individual whose application is approved (and whose 
        contract is accepted) by the Secretary, including in 
        the summary a clear explanation of the damages to which 
        the United States is entitled under section 338E in the 
        case of the individual's breach of the contract; and
            (B) information respecting meeting a service 
        obligation through private practice under an agreement 
        under section 338D and such other information as may be 
        necessary for the individual to understand the 
        individual's prospective participation in the 
        Scholarship Program and service in the Corps, including 
        a statement of all factors considered in approving 
        applications for participation in the Program and in 
        making assignments for participants in the Program.
    (2) The application form, contract form, and all other 
information furnished by the Secretary under this subpart shall 
be written in a manner calculated to be understood by the 
average individual applying to participate in the Scholarship 
Program. The Secretary shall make such application forms, 
contract forms, and other information available to individuals 
desiring to participate in the Scholarship Program on a date 
sufficiently early to insure that such individuals have 
adequate time to carefully review and evaluate such forms and 
information.
    (3)(A) The Secretary shall distribute to health professions 
schools materials providing information on the Scholarship 
Program and shall encourage the schools to disseminate the 
materials to the students of the schools.
    (B)(i) In the case of any health professional whose period 
of obligated service under the Scholarship Program is nearing 
completion, the Secretary shall encourage the individual to 
remain in a health professional shortage area and to continue 
providing primary health services.
    (ii) During the period in which a health professional is 
planning and making the transition to private practice from 
obligated service under the Scholarship Program, the Secretary 
may provide assistance to the professional regarding such 
transition if the professional is remaining in a health 
professional shortage area and is continuing to provide primary 
health services.
    (C) In the case of entities to which participants in the 
Scholarship Program are assigned under section 333, the 
Secretary shall encourage the entities to provide options with 
respect to assisting the participants in remaining in the 
health professional shortage areas involved, and in continuing 
to provide primary health services, after the period of 
obligated service under the Scholarship Program is completed. 
The options with respect to which the Secretary provides such 
encouragement may include options regarding the sharing of a 
single employment position in the health professions by 2 or 
more health professionals, and options regarding the 
recruitment of couples where both of the individuals are health 
professionals.
    (d)(1) Subject to section 333A, in providing contracts 
under the Scholarship Program--
            (A) the Secretary shall consider the extent of the 
        demonstrated interest of the applicants for the 
        contracts in providing primary health services;
            (B) the Secretary, in considering applications from 
        individuals accepted for enrollment or enrolled in 
        dental school, shall consider applications from all 
        individuals accepted for enrollment or enrolled in any 
        accredited dental school in a State; and
            (C) may consider such other factors regarding the 
        applicants as the Secretary determines to be relevant 
        to selecting qualified individuals to participate in 
        such Program.
    (2) In providing contracts under the Scholarship Program, 
the Secretary shall give priority--
            (A) first, to any application for such a contract 
        submitted by an individual who has previously received 
        a scholarship under this section or under section 758;
            (B) second, to any application for such a contract 
        submitted by an individual who has characteristics that 
        increase the probability that the individual will 
        continue to serve in a health professional shortage 
        area after the period of obligated service pursuant to 
        subsection (f) is completed; and
            (C) third, subject to subparagraph (B), to any 
        application for such a contract submitted by an 
        individual who is from a disadvantaged background.
    (e)(1) An individual becomes a participant in the 
Scholarship Program only upon the Secretary's approval of the 
individual's application submitted under subsection (b)(3) and 
the Secretary's acceptance of the contract submitted by the 
individual under subsection (b)(4).
    (2) The Secretary shall provide written notice to an 
individual promptly upon the Secretary's approving, under 
paragraph (1), of the individual's participation in the 
Scholarship Program.
    (f) The written contract (referred to in this subpart) 
between the Secretary and an individual shall contain--
            (1) an agreement that--
                    (A) subject to paragraph (2), the Secretary 
                agrees (i) to provide the individual with a 
                scholarship (described in subsection (g)) in 
                each such school year or years for a period of 
                years (not to exceed four school years) 
                determined by the individual, during which 
                period the individual is pursuing a course of 
                study described in subsection (b)(1)(B), and 
                (ii) to accept (subject to the availability of 
                appropriated funds for carrying out sections 
                331 through 335 and section 337) the individual 
                into the Corps (or for equivalent service as 
                otherwise provided in this subpart); and
                    (B) subject to paragraph (2), the 
                individual agrees--
                            (i) to accept provision of such a 
                        scholarship to the individual;
                            (ii) to maintain enrollment in a 
                        course of study described in subsection 
                        (b)(1)(B) until the individual 
                        completes the course of study;
                            (iii) while enrolled in such course 
                        of study, to maintain an acceptable 
                        level of academic standing (as 
                        determined under regulations of the 
                        Secretary by the educational 
                        institution offering such course of 
                        study);
                            (iv) if pursuing a degree from a 
                        school of medicine or osteopathic 
                        medicine, to complete a residency in a 
                        specialty that the Secretary determines 
                        is consistent with the needs of the 
                        Corps; and
                            (v) to serve for a time period 
                        (hereinafter in the subpart referred to 
                        as the ``period of obligated service'') 
                        equal to--
                                    (I) one year for each 
                                school year for which the 
                                individual was provided a 
                                scholarship under the 
                                Scholarship Program, or
                                    (II) two years,
                        whichever is greater, as a provider of 
                        primary health services in a health 
                        professional shortage area (designated 
                        under section 332) to which he is 
                        assigned by the Secretary as a member 
                        of the Corps, or as otherwise provided 
                        in this subpart;
            (2) a provision that any financial obligation of 
        the United States arising out of a contract entered 
        into under this subpart and any obligation of the 
        individual which is conditioned thereon, is contingent 
        upon funds being appropriated for scholarships under 
        this subpart and to carry out the purposes of sections 
        331 through 335 and sections 337 and 338;
            (3) a statement of the damages to which the United 
        States is entitled, under section 338E for the 
        individual's breach of the contract; and
            (4) such other statements of the rights and 
        liabilities of the Secretary and of the individual, not 
        inconsistent with the provisions of this subpart.
    (g)(1) A scholarship provided to a student for a school 
year under a written contract under the Scholarship Program 
shall consist of--
            (A) payment to, or (in accordance with paragraph 
        (2)) on behalf of, the student of the amount (except as 
        provided in section 711) of--
                    (i) the tuition of the student in such 
                school year; and
                    (ii) all other reasonable educational 
                expenses, including fees, books, and laboratory 
                expenses, incurred by the student in such 
                school year; and
            (B) payment to the student of a stipend of $400 per 
        month (adjusted in accordance with paragraph (3)) for 
        each of the 12 consecutive months beginning with the 
        first month of such school year.
    (2) The Secretary may contract with an educational 
institution, in which a participant in the Scholarship Program 
is enrolled, for the payment to the educational institution of 
the amounts of tuition and other reasonable educational 
expenses described in paragraph (1)(A). Payment to such an 
educational institution may be made without regard to section 
3648 of the Revised Statutes (31 U.S.C. 529).
    (3) The amount of the monthly stipend, specified in 
paragraph (1)(B) and as previously adjusted (if at all) in 
accordance with this paragraph, shall be increased by the 
Secretary for each school year ending in a fiscal year 
beginning after September 30, 1978, by an amount (rounded to 
the next highest multiple of $1) equal to the amount of such 
stipend multiplied by the overall percentage (under section 
5303 of title 5, United States Code) of the adjustment (if such 
adjustment is an increase) in the rates of pay under the 
General Schedule made effective in the fiscal year in which 
such school year ends.
    (h) Notwithstanding any other provision of law, individuals 
who have entered into written contracts with the Secretary 
under this section, while undergoing academic training, shall 
not be counted against any employment ceiling affecting the 
Department.

SEC. 338B. [254L-1] NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT 
                    PROGRAM.

    (a) Establishment.--The Secretary shall establish a program 
to be known as the National Health Service Corps Loan Repayment 
Program to assure, with respect to the provision of primary 
health services pursuant to section 331(a)(2)--
            (1) an adequate supply of physicians, dentists, 
        behavioral and mental health professionals, certified 
        nurse midwives, certified nurse practitioners, and 
        physician assistants; and
            (2) if needed by the Corps, an adequate supply of 
        other health professionals.
    (b) Eligibility.--To be eligible to participate in the Loan 
Repayment Program, an individual must--
            (1)(A) have a degree in medicine, osteopathic 
        medicine, dentistry, or another health profession, or 
        an appropriate degree from a graduate program of 
        behavioral and mental health, or be certified as a 
        nurse midwife, nurse practitioner, or physician 
        assistant;
            (B) be enrolled in an approved graduate training 
        program in medicine, osteopathic medicine, dentistry, 
        behavioral and mental health, or other health 
        profession; or
            (C) be enrolled as a full-time student--
                    (i) in an accredited (as determined by the 
                Secretary) educational institution in a State; 
                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 in medicine, osteopathic medicine, 
                dentistry, or other health profession;
            (2) be eligible for, or hold, an appointment as a 
        commissioned officer in the Regular or Reserve Corps of 
        the Service or be eligible for selection for civilian 
        service in the Corps; and
            (3) submit to the Secretary an application for a 
        contract described in subsection (f) (relating to the 
        payment by the Secretary of the educational loans of 
        the individual in consideration of the individual 
        serving for a period of obligated service).
    (c) Application, Contract, and Information Requirements.--
            (1) Summary and information.--In disseminating 
        application forms and contract forms to individuals 
        desiring to participate in the Loan Repayment Program, 
        the Secretary shall include with such forms--
                    (A) a fair summary of the rights and 
                liabilities of an individual whose application 
                is approved (and whose contract is accepted) by 
                the Secretary, including in the summary a clear 
                explanation of the damages to which the United 
                States is entitled under section 338E in the 
                case of the individual's breach of the 
                contract; and
                    (B) information respecting meeting a 
                service obligation through private practice 
                under an agreement under section 338D and such 
                other information as may be necessary for the 
                individual to understand the individual's 
                prospective participation in the Loan Repayment 
                Program and service in the Corps.
            (2) Understandability.--The application form, 
        contract form, and all other information furnished by 
        the Secretary under this subpart shall be written in a 
        manner calculated to be understood by the average 
        individual applying to participate in the Loan 
        Repayment Program.
            (3) Availability.--The Secretary shall make such 
        application forms, contract forms, and other 
        information available to individuals desiring to 
        participate in the Loan Repayment Program on a date 
        sufficiently early to ensure that such individuals have 
        adequate time to carefully review and evaluate such 
        forms and information.
            (4) Recruitment and retention.--
                    (A) The Secretary shall distribute to 
                health professions schools materials providing 
                information on the Loan Repayment Program and 
                shall encourage the schools to disseminate the 
                materials to the students of the schools.
                    (B)(i) In the case of any health 
                professional whose period of obligated service 
                under the Loan Repayment Program is nearing 
                completion, the Secretary shall encourage the 
                individual to remain in a health professional 
                shortage area and to continue providing primary 
                health services.
                    (ii) During the period in which a health 
                professional is planning and making the 
                transition to private practice from obligated 
                service under the Loan Repayment Program, the 
                Secretary may provide assistance to the 
                professional regarding such transition if the 
                professional is remaining in a health 
                professional shortage area and is
                continuing to provide primary health services.
                    (C) In the case of entities to which 
                participants in the Loan Repayment Program are 
                assigned under section 333, the Secretary shall 
                encourage the entities to provide options with 
                respect to assisting the participants in 
                remaining in the health professional shortage 
                areas involved, and in continuing to provide 
                primary health services, after the period of 
                obligated service under the Loan Repayment 
                Program is completed. The options with respect 
                to which the Secretary provides such 
                encouragement may include options regarding the 
                sharing of a single employment position in the 
                health professions by 2 or more health 
                professionals, and options regarding the 
                recruitment of couples where both of the 
                individuals are health professionals.
    (d)(1) Subject to section 333A, in providing contracts 
under the Loan Repayment Program--
            (A) the Secretary shall consider the extent of the 
        demonstrated interest of the applicants for the 
        contracts in providing primary health services; and
            (B) may consider such other factors regarding the 
        applicants as the Secretary determines to be relevant 
        to selecting qualified individuals to participate in 
        such Program.
    (2) In providing contracts under the Loan Repayment 
Program, the Secretary shall give priority--
            (A) to any application for such a contract 
        submitted by an individual whose training is in a 
        health profession or specialty determined by the 
        Secretary to be needed by the Corps;
            (B) to any application for such a contract 
        submitted by an individual who has (and whose spouse, 
        if any, has) characteristics that increase the 
        probability that the individual will continue to serve 
        in a health professional shortage area after the period 
        of obligated service pursuant to subsection (f) is 
        completed; and
            (C) subject to subparagraph (B), to any application 
        for such a contract submitted by an individual who is 
        from a disadvantaged background.
    (e) Approval Required for Participation.--An individual 
becomes a participant in the Loan Repayment Program only upon 
the Secretary and the individual entering into a written 
contract described in subsection (f).
    (f) Contents of Contracts.--The written contract (referred 
to in this subpart) between the Secretary and an individual 
shall contain--
            (1) an agreement that--
                    (A) subject to paragraph (3), the Secretary 
                agrees--
                            (i) to pay on behalf of the 
                        individual loans in accordance with 
                        subsection (g); and
                            (ii) to accept (subject to the 
                        availability of appropriated funds for 
                        carrying out sections 331 through 335 
                        and section 337) the individual into 
                        the Corps (or for equivalent service as 
                        otherwise provided in this subpart); 
                        and
                    (B) subject to paragraph (3), the 
                individual agrees--
                            (i) to accept loan payments on 
                        behalf of the individual;
                            (ii) in the case of an individual 
                        described in subsection (b)(1)(C), to 
                        maintain enrollment in a course of 
                        study or training described in such 
                        subsection until the individual 
                        completes the course of study or 
                        training;
                            (iii) in the case of an individual 
                        described in subsection (b)(1)(C), 
                        while enrolled in such course of study 
                        or training, to maintain an acceptable 
                        level of academic standing (as 
                        determined under regulations of the 
                        Secretary by the educational 
                        institution offering such course of 
                        study or training); and
                            (iv) to serve for a time period 
                        (hereinafter in this subpart referred 
                        to as the ``period of obligated 
                        service'') equal to 2 years or such 
                        longer period as the individual may 
                        agree to, as a provider of primary 
                        health services in a health 
                        professional shortage area (designated 
                        under section 332) to which such 
                        individual is assigned by the Secretary 
                        as a member of the Corps or released 
                        under section 338D;
            (2) a provision permitting the Secretary to extend 
        for such longer additional periods, as the individual 
        may agree to, the period of obligated service agreed to 
        by the individual under paragraph (1)(B)(iv), including 
        extensions resulting in an aggregate period of 
        obligated service in excess of 4 years;
            (3) a provision that any financial obligation of 
        the United States arising out of a contract entered 
        into under this subpart and any obligation of the 
        individual that is conditioned thereon, is contingent 
        on funds being appropriated for loan repayments under 
        this subpart and to carry out the purposes of sections 
        331 through 335 and sections 337 and 338;
            (4) a statement of the damages to which the United 
        States is entitled, under section 338E for the 
        individual's breach of the contract; and
            (5) such other statements of the rights and 
        liabilities of the Secretary and of the individual, not 
        inconsistent with this subpart.
    (g) Payments.--
            (1) In general.--A loan repayment provided for an 
        individual under a written contract under the Loan 
        Repayment Program shall consist of payment, in 
        accordance with paragraph (2), on behalf of the 
        individual of the principal, interest, and related 
        expenses on government and commercial loans received by 
        the individual regarding the undergraduate or graduate 
        education of the individual (or both), which loans were 
        made for--
                    (A) tuition expenses;
                    (B) all other reasonable educational 
                expenses, including fees, books, and laboratory 
                expenses, incurred by the individual; or
                    (C) reasonable living expenses as 
                determined by the Secretary.
            (2) Payments for years served.--
                    (A) In general.--For each year of obligated 
                service that an individual contracts to serve 
                under subsection (f) the Secretary may pay up 
                to $50,000, plus, beginning with fiscal year 
                2012, an amount determined by the Secretary on 
                an annual basis to reflect inflation, on behalf 
                of the individual for loans described in 
                paragraph (1). In making a determination of the 
                amount to pay for a year of such service by an 
                individual, the Secretary shall consider the 
                extent to which each such determination--
                            (i) affects the ability of the 
                        Secretary to maximize the number of 
                        contracts that can be provided under 
                        the Loan Repayment Program from the 
                        amounts appropriated for such 
                        contracts;
                            (ii) provides an incentive to serve 
                        in health professional shortage areas 
                        with the greatest such shortages; and
                            (iii) provides an incentive with 
                        respect to the health professional 
                        involved remaining in a health 
                        professional shortage area, and 
                        continuing to provide primary health 
                        services, after the completion of the 
                        period of obligated service under the 
                        Loan Repayment Program.
                    (B) Repayment schedule.--Any arrangement 
                made by the Secretary for the making of loan 
                repayments in accordance with this subsection 
                shall provide that any repayments for a year of 
                obligated service shall be made no later than 
                the end of the fiscal year in which the 
                individual completes such year of service.
            (3) Tax liability.--For the purpose of providing 
        reimbursements for tax liability resulting from 
        payments under paragraph (2) on behalf of an 
        individual--
                    (A) the Secretary shall, in addition to 
                such payments, make payments to the individual 
                in an amount equal to 39 percent of the total 
                amount of loan repayments made for the taxable 
                year involved; and
                    (B) may make such additional payments as 
                the Secretary determines to be appropriate with 
                respect to such purpose.
            (4) Payment schedule.--The Secretary may enter into 
        an agreement with the holder of any loan for which 
        payments are made under the Loan Repayment Program to 
        establish a schedule for the making of such payments.
    (h) Employment Ceiling.--Notwithstanding any other 
provision of law, individuals who have entered into written 
contracts with the Secretary under this section, while 
undergoing academic or other training, shall not be counted 
against any employment ceiling affecting the Department.

                           obligated service

    Sec. 338C. [254m] (a) Service in Full-time Clinical 
Practice.--Except as provided in section 338D, each individual 
who has entered into a written contract with the Secretary 
under section 338A or 338B shall provide service in the full-
time clinical practice of such individual's profession as a 
member of the Corps for the period of obligated service 
provided in such contract. The Secretary may treat teaching as 
clinical practice for up to 20 percent of such period of 
obligated service. Notwithstanding the preceding sentence, with 
respect to a member of the Corps participating in the teaching 
health centers graduate medical education program under section 
340H, for the purpose of calculating time spent in full-time 
clinical practice under this section, up to 50 percent of time 
spent teaching by such member may be counted toward his or her 
service obligation.
    (b)(1) If an individual is required under subsection (a) to 
provide service as specified in section 338A(f)(1)(B)(v) or 
338B(f)(1)(B)(iv) (hereinafter in this subsection referred to 
as ``obligated service''), the Secretary shall, not later than 
ninety days before the date described in paragraph (5), 
determine if the individual shall provide such service--
            (A) as a member of the Corps who is a commissioned 
        officer in the Regular or Reserve Corps of the Service 
        or who is a civilian employee of the United States, or
            (B) as a member of the Corps who is not such an 
        officer or employee,
and shall notify such individual of such determination.
    (2) If the Secretary determines that an individual shall 
provide obligated service as a member of the Corps who is a 
commissioned officer in the Service or a civilian employee of 
the United States, the Secretary shall, not later than sixty 
days before the date described in paragraph (5), provide such 
individual with sufficient information regarding the advantages 
and disadvantages of service as such a commissioned officer or 
civilian employee to enable the individual to make a decision 
on an informed basis. To be eligible to provide obligated 
service as a commissioned officer in the Service, an individual 
shall notify the Secretary, not later than thirty days before 
the date described in paragraph (5), of the individual's desire 
to provide such service as such an officer. If an individual 
qualifies for an appointment as such an officer, the Secretary 
shall, as soon as possible after the date described in 
paragraph (5), appoint the individual as a commissioned officer 
of the Regular or Reserve Corps of the Service and shall 
designate the individual as a member of the Corps.
    (3) If an individual provided notice by the Secretary under 
paragraph (2) does not qualify for appointment as a 
commissioned officer in the Service, the Secretary shall, as 
soon as possible after the date described in paragraph (5), 
appoint