Health Equity and Justice Act of 2006 - Amends the Public Health Service Act to provide for: (1) establishment of the Robert T. Matsui Center for Cultural and Linguistic Competence in Healthcare; (2) programs to improve language access to health care for individuals with limited English proficiency; and (3) programs to improve health care for patient populations that have low functional health literacy.
Provides for the establishment of: (1) a national working group on workforce diversity; (2) a technical clearinghouse on health workforce diversity; (3) a health and healthcare disparities education program; and (4) an Advisory Committee on Health Professions Training for Diversity.
Requires federal health-related programs to: (1) require the collection of data on the race, ethnicity, and primary language of each applicant for and recipient of health-related assistance; and (2) analyze such data to detect racial and ethnic disparities in health and health care.
Renames the Office of Minority Health as the Office of Minority Health Disparity Elimination.
Requires the Indian Health Service (IHS) to be administered by an Assistant Secretary of Indian Health (in place of the Director of IHS), who shall report directly to the Secretary of Health and Human Services.
Requires four specified federal agencies to each establish an Office of Minority Health and Racial, Ethnic, and Primary Language Health Disparities Elimination. Directs the Secretary to establish: (1) an Office of Minority Health within the Centers for Medicare and Medicaid Services; and (2) an Office of Minority Affairs within the Office of the Commissioner of Food and Drugs.
Establishes the Interagency Working Group on Environmental Justice and the Federal Environmental Justice Advisory Committee.
Provides for grants to establish health empowerment zone programs in communities that disproportionately experience disparities in health status and health care.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6275 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 6275
To improve the health of minority individuals.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 29, 2006
Mrs. Christensen (for herself, Mr. Davis of Alabama, and Ms. Norton)
introduced the following bill; which was referred to the Committee on
Energy and Commerce, and in addition to the Committees on Education and
the Workforce, the Judiciary, Ways and Means, and Resources, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To improve the health of minority individuals.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Equity and Justice Act of
2006''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE
Sec. 101. Amendment to the Public Health Service Act.
Sec. 102. Standards for language access services.
Sec. 103. Federal reimbursement for culturally and linguistically
appropriate services under the Medicare,
Medicaid and State Children's Health
Insurance Program.
Sec. 104. Increasing understanding of health literacy.
Sec. 105. Report on Federal efforts to provide culturally and
linguistically appropriate healthcare
services.
Sec. 106. General Accounting Office report on impact of language access
services.
Sec. 107. Definitions.
Sec. 108. Treatment of the Medicare part B program under title VI of
the Civil Rights Act of 1964.
TITLE II--HEALTH WORKFORCE DIVERSITY
Sec. 201. Amendment to the Public Health Service Act.
Sec. 202. Health Careers Opportunity Program.
Sec. 203. Program of Excellence in Health Professions Education for
Underrepresented Minorities.
Sec. 204. Hispanic-serving health professions schools.
Sec. 205. Health Professions Student Loan fund; authorizations of
appropriations regarding students from
disadvantaged backgrounds.
Sec. 206. National Health Service Corps; recruitment and fellowships
for individuals from disadvantaged
backgrounds.
Sec. 207. Loan Repayment Program of the Centers for Disease Control and
Prevention.
Sec. 208. Cooperative agreements for online degree programs at schools
of public health and schools of allied
health.
Sec. 209. Mid-career health professions scholarship program.
Sec. 210. Strengthening and expanding rural health provider networks.
Sec. 211. National report on the preparedness of health professionals
to care for diverse populations.
Sec. 212. Scholarship and fellowship programs.
Sec. 213. Advisory Committee on Health Professions Training for
Diversity.
Sec. 214. McNair Postbaccalaureate Achievement program.
TITLE III--DATA COLLECTION AND REPORTING
Sec. 301. Amendment to the Public Health Service Act.
Sec. 302. Collection of race and ethnicity data by the Social Security
Administration.
Sec. 303. Revision of HIPAA claims standards.
Sec. 304. National Center for Health Statistics.
Sec. 305. Geo-access study.
Sec. 306. Racial, ethnic, and linguistic data collected by the Federal
Government.
TITLE IV--ACCOUNTABILITY AND EVALUATION
Subtitle A--General Provisions
Sec. 401. Report on workforce diversity.
Sec. 402. Federal agency plan to eliminate disparities and improve the
health of minority populations.
Sec. 403. Accountability within the Department of Health and Human
Services.
Sec. 404. Office of Minority Health Disparity Elimination.
Sec. 405. Establishment of the Indian Health Service as an agency of
the Public Health Service.
Sec. 406. Establishment of individual offices of minority health within
agencies of the Public Health Service.
Sec. 407. Office of Minority Health at the Centers for Medicare and
Medicaid Services.
Sec. 408. Office of Minority Affairs at the Food and Drug
Administration.
Sec. 409. Safety and effectiveness of drugs with respect to racial and
ethnic background.
Sec. 410. United States Commission on Civil Rights.
Sec. 411. Sense of Congress concerning full funding of activities to
eliminate racial and ethnic health
disparities.
Sec. 412. Guidelines for disease screening for minority patients.
Subtitle B--Improving Environmental Justice
Sec. 421. Definitions.
Sec. 422. Environmental justice responsibilities of Federal agencies.
Sec. 423. Interagency environmental justice working group.
Sec. 424. Federal agency strategies.
Sec. 425. Federal Environmental Justice Advisory Committee.
Sec. 426. Human health and environmental research, data collection and
analysis.
TITLE V--HEALTH EMPOWERMENT ZONES
Sec. 501. Health empowerment zones.
TITLE I--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE
SEC. 101. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by
adding at the end the following:
``TITLE XXIX--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTHCARE
``SEC. 2900. DEFINITIONS.
``In this title:
``(1) Appropriate healthcare services.--The term
`appropriate healthcare services' includes services or
treatments to address physical, mental, and behavioral
disorders or syndromes.
``(2) Indian tribe.--The term `Indian tribe' means any
Indian tribe, band, nation, or other organized group or
community, including any Alaska Native village or group or
regional or village corporation as defined in or established
pursuant to the Alaska Native Claims Settlement Act (85 Stat.
688) (43 U.S.C. 1601 et seq.), which is recognized as eligible
for the special programs and services provided by the United
States to Indians because of their status as Indians.
``(3) Limited english proficient.--The term `limited
English proficient' with respect to an individual means an
individual who cannot speak, read, write, or understand the
English language at a level that permits them to interact
effectively with clinical or nonclinical staff at a healthcare
organization.
``(4) Minority.--
``(A) In general.--The terms `minority' and
`minorities' refer to individuals from a minority
group.
``(B) Populations.--The term `minority', with
respect to populations, refers to racial and ethnic
minority groups.
``(5) Minority group.--The term `minority group' has the
meaning given the term `racial and ethnic minority group'.
``(6) Racial and ethnic minority group.--The term `racial
and ethnic minority group' means American Indians and Alaska
Natives, African Americans (including Caribbean Blacks and
Africans), Asian Americans, Hispanics (including Latinos), and
Native Hawaiians and other Pacific Islanders.
``(7) State.--The term `State' means each of the several
states, the District of Columbia, the Commonwealth of Puerto
Rico, the Indian tribes, the Virgin Islands, Guam, American
Samoa, and the Commonwealth of the Northern Mariana Islands.
``SEC. 2901. IMPROVING ACCESS TO SERVICES FOR INDIVIDUALS WITH LIMITED
ENGLISH PROFICIENCY.
``(a) Purpose.--As provided in Executive Order 13166, it is the
purpose of this section--
``(1) to improve access to federally conducted and
federally assisted programs and activities for individuals who
are limited in their English proficiency;
``(2) to require each Federal agency to examine the
services it provides and develop and implement a system by
which limited English proficient individuals can enjoy
meaningful access to those services consistent with, and
without substantially burdening, the fundamental mission of the
agency;
``(3) to require each Federal agency to ensure that
recipients of Federal financial assistance provide meaningful
access to their limited English proficient applicants and
beneficiaries;
``(4) to ensure that recipients of Federal financial
assistance take reasonable steps, consistent with the
guidelines set forth in the Limited English Proficient Guidance
of the Department of Justice (as issued on June 12, 2002), to
ensure meaningful access to their programs and activities by
limited English proficient individuals; and
``(5) to ensure compliance with title VI of the Civil
Rights Act of 1964 and that healthcare providers and
organizations do not discriminate in the provision of services.
``(b) Federally Conducted Programs and Activities.--
``(1) In general.--Not later than 120 days after the date
of enactment of this Act, each Federal agency that carries out
health care-related activities shall prepare a plan to improve
access to the federally conducted health care-related programs
and activities of the agency by limited English proficient
individuals.
``(2) Plan requirement.--Each plan under paragraph (1)
shall be consistent with the standards set forth in section 102
of the Healthcare Equality and Accountability Act, and shall
include the steps the agency will take to ensure that limited
English proficient individuals have access to the agency's
health care-related programs and activities. Each agency shall
send a copy of such plan to the Department of Justice, which
shall serve as the central repository of the agencies' plans.
``(c) Federally Assisted Programs and Activities.--
``(1) In general.--Not later than 120 days after the date
of enactment of this Act, each Federal agency providing health
care-related Federal financial assistance shall ensure that the
guidance for recipients of Federal financial assistance
developed by the agency to ensure compliance with title VI of
the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.) is
specifically tailored to the recipients of such assistance and
is consistent with the standards described in section 102 of
the Healthcare Equality and Accountability Act. Each agency
shall send a copy of such guidance to the Department of Justice
which shall serve as the central repository of the agencies'
plans. After approval by the Department of Justice, each agency
shall publish its guidance document in the Federal Register for
public comment.
``(2) Requirements.--The agency-specific guidance developed
under paragraph (1) shall--
``(A) detail how the general standards established
under section 102 of the Healthcare Equality and
Accountability Act will be applied to the agency's
recipients; and
``(B) take into account the types of health care
services provided by the recipients, the individuals
served by the recipients, and other factors set out in
such standards.
``(3) Existing guidances.--A Federal agency that has
developed a guidance for purposes of title VI of the Civil
Rights Act of 1964 that the Department of Justice determines is
consistent with the standards described in section 102 of the
Healthcare Equality and Accountability Act shall examine such
existing guidance, as well as the programs and activities to
which such guidance applies, to determine if modification of
such guidance is necessary to comply with this subsection.
``(4) Consultation.--Each Federal agency shall consult with
the Department of Justice in establishing the guidances under
this subsection.
``(d) Consultations.--
``(1) In general.--In carrying out this section, each
Federal agency that carriers out health care-related activities
shall ensure that stakeholders, such as limited English
proficient individuals and their representative organizations,
recipients of Federal assistance, and other appropriate
individuals or entities, have an adequate and comparable
opportunity to provide input with respect to the actions of the
agency.
``(2) Evaluation.--Each Federal agency described in
paragraph (1) shall evaluate the--
``(A) particular needs of the limited English
proficient individuals served by the agency, and by a
recipient of assistance provided by the agency;
``(B) burdens of compliance with the agency
guidance and its recipients of the requirements of this
section; and
``(C) outcomes or effectiveness of services.
``SEC. 2902. NATIONAL STANDARDS FOR CULTURALLY AND LINGUISTICALLY
APPROPRIATE SERVICES IN HEALTHCARE.
``Recipients of Federal financial assistance from the Secretary
shall, to the extent reasonable and practicable after applying the 4-
factor analysis described in title V of the Guidance to Federal
Financial Assistance Recipients Regarding Title VI Prohibition Against
National Origin Discrimination Affecting Limited-English Proficient
Persons (June 12, 2002)--
``(1) implement strategies to recruit, retain, and promote
individuals at all levels of the organization to maintain a
diverse staff and leadership that can provide culturally and
linguistically appropriate healthcare to patient populations of
the service area of the organization;
``(2) ensure that staff at all levels and across all
disciplines of the organization receive ongoing education and
training in culturally and linguistically appropriate service
delivery;
``(3) offer and provide language assistance services,
including bilingual staff and interpreter services, at no cost
to each patient with limited English proficiency at all points
of contact, in a timely manner during all hours of operation;
``(4) notify patients of their right to receive language
assistance services in their primary language;
``(5) ensure the competence of language assistance provided
to limited English proficient patients by interpreters and
bilingual staff, and ensure that family, particularly minor
children, and friends are not used to provide interpretation
services--
``(A) except in case of emergency; or
``(B) except on request of the patient, who has
been informed in his or her preferred language of the
availability of free interpretation services;
``(6) make available easily understood patient-related
materials, if such materials exist for non-limited English
proficient patients, including information or notices about
termination of benefits and post signage in the languages of
the commonly encountered groups or groups represented in the
service area of the organization;
``(7) develop and implement clear goals, policies,
operational plans, and management accountability and oversight
mechanisms to provide culturally and linguistically appropriate
services;
``(8) conduct initial and ongoing organizational
assessments of culturally and linguistically appropriate
services-related activities and integrate valid linguistic
competence-related measures into the internal audits,
performance improvement programs, patient satisfaction
assessments, and outcomes-based evaluations of the
organization;
``(9) ensure that, consistent with the privacy protections
provided for under the regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability
Act of 1996 (42 U.S.C. 1320d-2 note)--
``(A) data on the individual patient's race,
ethnicity, and primary language are collected in health
records, integrated into the organization's management
information systems, and periodically updated; and
``(B) if the patient is a minor or is
incapacitated, the primary language of the parent or
legal guardian is collected;
``(10) maintain a current demographic, cultural, and
epidemiological profile of the community as well as a needs
assessment to accurately plan for and implement services that
respond to the cultural and linguistic characteristics of the
service area of the organization;
``(11) develop participatory, collaborative partnerships
with communities and utilize a variety of formal and informal
mechanisms to facilitate community and patient involvement in
designing and implementing culturally and linguistically
appropriate services-related activities;
``(12) ensure that conflict and grievance resolution
processes are culturally and linguistically sensitive and
capable of identifying, preventing, and resolving cross-
cultural conflicts or complaints by patients;
``(13) regularly make available to the public information
about their progress and successful innovations in implementing
the standards under this section and provide public notice in
their communities about the availability of this information;
and
``(14) if requested, regularly make available to the head
of each Federal entity from which Federal funds are received,
information about their progress and successful innovations in
implementing the standards under this section as required by
the head of such entity.
``SEC. 2903. ROBERT T. MATSUI CENTER FOR CULTURAL AND LINGUISTIC
COMPETENCE IN HEALTHCARE.
``(a) Establishment.--The Secretary, acting through the Director of
the Office of Minority Health Disparity Elimination, shall establish
and support a center to be known as the `Robert T. Matsui Center for
Cultural and Linguistic Competence in Healthcare' (referred to in this
section as the `Center') to carry out the following activities:
``(1) Remote medical interpreting.--The Center shall
provide remote medical interpreting, directly or through
contracts, to healthcare providers who otherwise would be
unable to provide language interpreting services, at reasonable
or no cost as determined appropriate by the Director of the
Center. Methods of interpretation may include remote,
simultaneous or consecutive interpreting through telephonic
systems, video conferencing, and other methods determined
appropriate by the Secretary for patients with limited English
proficiency. The quality of such interpreting shall be
monitored and reported publicly. Nothing in this paragraph
shall be construed to limit the ability of healthcare providers
or organizations to provide medical interpreting services
directly and obtain reimbursement for such services as provided
for under the medicare, medicaid or SCHIP programs under titles
XVIII, XIX, or XXI of the Social Security Act.
``(2) Model language assistance programs.--The Center shall
provide for the collection and dissemination of information on
current model language assistance programs and strategies to
improve language access to healthcare for individuals with
limited English proficiency, including case studies using de-
identified patient information, program summaries, and program
evaluations.
``(3) Medical interpreting guidelines.--
``(A) In general.--The Center shall convene a
national working group to develop medical interpreting
and translation guidelines and standards for--
``(i) the provision of services;
``(ii) the actual practice of interpreting;
``(iii) the training of medical
interpreters and translators, developed by
interpreters and translators.
``(B) Publication.--Not later than 18 months after
the date of enactment of this Act, the Center shall
publish guidelines and standards developed under this
paragraph in the Federal Register.
``(4) Internet health clearinghouse.--The Center shall
develop and maintain an Internet clearinghouse to reduce
medical errors and improve medical outcomes and reduce
healthcare costs caused by communication with individuals with
limited English proficiency or low functional health literacy
and reduce or eliminate the duplication of effort to translate
materials by--
``(A) developing and making available templates for
standard documents that are necessary for patients and
consumers to access and make educated decisions about
their healthcare, including--
``(i) administrative and legal documents
such as informed consent, advanced directives,
and waivers of rights;
``(ii) clinical information such as how to
take medications, how to prevent transmission
of a contagious disease, and other prevention
and treatment instructions;
``(iii) patient education and outreach
materials such as immunization notices, health
warnings, or screening notices; and
``(iv) additional health or healthcare-
related materials as determined appropriate by
the Director of the Center;
``(B) ensuring that the documents the posted in
English and non-English languages and are culturally
appropriate;
``(C) allowing public review of the documents
before dissemination in order to ensure that the
documents are understandable and culturally appropriate
for the target populations;
``(D) allowing healthcare providers to customize
the documents for their use;
``(E) facilitating access to these documents;
``(F) providing technical assistance with respect
to the access and use of such information; and
``(G) carrying out any other activities the
Secretary determines to be useful to fulfill the
purposes of the Clearinghouse.
``(5) Provision of information.--The Center shall provide
information relating to culturally and linguistically competent
healthcare for minority populations residing in the United
States to all healthcare providers and healthcare organizations
at no cost. Such information shall include--
``(A) tenets of culturally and linguistically
competent care;
``(B) cultural and linguistic competence self-
assessment tools;
``(C) cultural and linguistic competence training
tools;
``(D) strategic plans to increase cultural and
linguistic competence in different types of healthcare
organizations; and
``(E) resources for cultural competence information
for educators, practitioners and researchers.
``(b) Director.--The Center shall be headed by a Director who shall
be appointed by, and who shall report to, the Deputy Assistant
Secretary for Minority Health Disparity Elimination.
``(c) Availability of Language Access.--The Director shall
collaborate with the Administrator of the Centers for Medicare and
Medicaid Services and the Administrator of the Health Resources and
Services Administration, to notify healthcare providers and healthcare
organizations about the availability of language access services by the
Center.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2006 through 2011.
``SEC. 2904. INNOVATIONS IN LANGUAGE ACCESS GRANTS.
``(a) In General.--The Secretary, acting through the Administrator
of the Centers for Medicare and Medicaid Services, the Administrator of
the Health Resources and Services Administration, the Secretary of
Education, and the Deputy Assistant Secretary for Minority Health
Disparity Elimination, shall award grants to eligible entities to
enable such entities to design, implement, and evaluate innovative,
cost-effective programs to improve language access to healthcare for
individuals with limited English proficiency.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a) an entity shall--
``(1) be a city, county, Indian tribe, State, territory,
community-based and other nonprofit organization, health center
or community clinic, university, college, or other entity
designated by the Secretary; and
``(2) prepare and submit to the Secretary an application,
at such time, in such manner, and accompanied by such
additional information as the Secretary may require.
``(c) Use of Funds.--An entity shall use funds received under a
grant under this section to--
``(1) develop, implement, and evaluate models of providing
real-time interpretation services through in-person
interpretation, communications, and computer technology,
including the Internet, teleconferencing, or video
conferencing;
``(2) develop short-term medical interpretation training
courses and incentives for bilingual healthcare staff who are
asked to interpret in the workplace;
``(3) develop formal training programs for individuals
interested in becoming dedicated healthcare interpreters;
``(4) provide staff language training instruction which
shall include information on the practical limitations of such
instruction for non-native speakers;
``(5) provide basic healthcare-related English language
instruction for limited English proficient individuals; and
``(6) develop other language assistance services as
determined appropriate by the Secretary.
``(d) Priority.--In awarding grants under this section, the
Secretary shall give priority to entities that have developed
partnerships with organizations or agencies with experience in language
access services.
``(e) Evaluation.--An entity that receives a grant under this
section shall submit to the Secretary an evaluation that describes the
activities carried out with funds received under the grant, and how
such activities improved access to healthcare services and the quality
of healthcare for individuals with limited English proficiency. Such
evaluation shall be collected and disseminated through the Center for
Linguistic and Cultural Competence in Healthcare established under
section 2903.
``(f) Grantee Convention.--The Secretary, acting through the
Director of the Center for Linguistic and Cultural Competence in
Healthcare, shall at the end of the grant cycle convene grantees under
this section to share findings and develop and disseminate model
programs and practices.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2006 through 2011.
``SEC. 2905. RESEARCH ON LANGUAGE ACCESS.
``(a) In General.--The Director of the Agency for Healthcare
Research and Quality, in collaboration with the Deputy Assistant
Secretary for Minority Health Disparity Elimination, shall expand
research concerning--
``(1) the barriers to healthcare services including mental
and behavioral services that are faced by limited English
proficient individuals;
``(2) the impact of language barriers on the quality of
healthcare and the health status of limited English proficient
individuals and populations;
``(3) healthcare provider attitudes, knowledge, and
awareness of the barriers described in paragraphs (1) and (2);
``(4) the means by which language access services are
provided to limited English proficient individuals and how such
services are effective in improving the quality of care;
``(5) the cost-effectiveness of providing language access;
and
``(6) optimal approaches for delivering language access.
``(b) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2006 through 2011.
``SEC. 2906. INFORMATION ABOUT FEDERAL HEALTH PROGRAMS FOR LIMITED
ENGLISH PROFICIENT POPULATIONS.
``The Secretary shall provide for a means by which limited English
proficient individuals who are seeking information about, or assistance
with, Federal healthcare programs may obtain such information or
assistance.''.
SEC. 102. STANDARDS FOR LANGUAGE ACCESS SERVICES.
Not later than 120 days after the date of enactment of this Act,
the head of each Federal agency that carries out health care-related
activities shall develop and adopt a guidance on language services for
those with limited English proficiency who attempt to have access to or
participate in such activities that provides at the minimum the factors
and principles set forth in the Department of Justice guidance
published on June 12, 2002.
SEC. 103. FEDERAL REIMBURSEMENT FOR CULTURALLY AND LINGUISTICALLY
APPROPRIATE SERVICES UNDER THE MEDICARE, MEDICAID AND
STATE CHILDREN'S HEALTH INSURANCE PROGRAM.
(a) Demonstration Project Promoting Access for Medicare
Beneficiaries With Limited English Proficiency.--
(1) In general.--The Secretary shall conduct a
demonstration project (in this section referred to as the
``project'') to demonstrate the impact on costs and health
outcomes of providing reimbursement for interpreter services to
certain medicare beneficiaries who are limited English
proficient in urban and rural areas.
(2) Scope.--The Secretary shall carry out the project in
not less than 30 States through contracts with--
(A) health plans (under part C of title XVIII of
the Social Security Act);
(B) small providers;
(C) hospitals; and
(D) community-based clinics.
(3) Duration.--Each contract entered into under the project
shall extend over a period of not longer than 2 years.
(4) Report.--Upon completion of the project, the Secretary
shall submit a report to Congress on the project which shall
include recommendations regarding the extension of such project
to the entire medicare program.
(5) Evaluation.--The Director of the Agency for Healthcare
Research and Quality shall award grants to public and private
nonprofit entities for the evaluation of the project. Such
evaluations shall focus on access, utilization, efficiency,
cost-effectiveness, patient satisfaction, and select health
outcomes.
(b) Medicaid.--Section 1903(a)(3) of the Social Security Act (42
U.S.C. 1396b(a)(3)) is amended--
(1) in subparagraph (E), by striking ``plus'' at the end
and inserting ``and''; and
(2) by adding at the end the following:
``(F) 90 percent of the sums expended with respect
to costs incurred during such quarter as are
attributable to the provision of culturally and
linguistically appropriate services, including oral
interpretation, translations of written materials, and
other cultural and linguistic services for individuals
with limited English proficiency and disabilities who
apply for, or receive, medical assistance under the
State plan (including any waiver granted to the State
plan); plus''.
(c) SCHIP.--Section 2105(a)(1) of the Social Security Act (42
U.S.C. 1397ee(a)) is amended--
(1) in the matter preceding subparagraph (A), by inserting
``or, in the case of expenditures described in subparagraph
(D)(iv), 90 percent'' after ``enhanced FMAP''; and
(2) in subparagraph (D)--
(A) in clause (iii), by striking ``and'' at the
end;
(B) by redesignating clause (iv) as clause (v); and
(C) by inserting after clause (iii) the following:
``(iv) for expenditures attributable to the
provision of culturally and linguistically
appropriate services, including oral
interpretation, translations of written
materials, and other language services for
individuals with limited English proficiency
and disabilities who apply for, or receive,
child health assistance under the plan; and''.
(d) Effective Date.--The amendments made by this section take
effect on October 1, 2006.
SEC. 104. INCREASING UNDERSTANDING OF HEALTH LITERACY.
(a) In General.--The Secretary, acting through the Director of the
Agency for Healthcare Research and Quality and the Administrator of the
Health Resources and Services Administration, shall award grants to
eligible entities to improve healthcare for patient populations that
have low functional health literacy.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) be a hospital, health center or clinic, health plan, or
other health entity; and
(2) prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require.
(c) Use of Funds.--
(1) Agency for healthcare research and quality.--Grants
awarded under subsection (a) through the Agency for Healthcare
Research and Quality shall be used--
(A) to define and increase the understanding of
health literacy;
(B) to investigate the correlation between low
health literacy and health and healthcare;
(C) to clarify which aspects of health literacy
have an effect on health outcomes; and
(D) for any other activity determined appropriate
by the Director of the Agency.
(2) Health resources and services administration.--Grants
awarded under subsection (a) through the Health Resources and
Services Administration shall be used to conduct demonstration
projects for interventions for patients with low health
literacy that may include--
(A) the development of new disease management
programs for patients with low health literacy;
(B) the tailoring of existing disease management
programs addressing mental and physical health
conditions for patients with low health literacy;
(C) the translation of written health materials for
patients with low health literacy;
(D) the identification, implementation, and testing
of low health literacy screening tools;
(E) the conduct of educational campaigns for
patients and providers about low health literacy; and
(F) other activities determined appropriate by the
Administrator of the Health Resources and Services
Administration.
(d) Definitions.--In this section, the term ``low health literacy''
means the inability of an individual to obtain, process, and understand
basic health information and services needed to make appropriate health
decisions.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2006 through 2011.
SEC. 105. REPORT ON FEDERAL EFFORTS TO PROVIDE CULTURALLY AND
LINGUISTICALLY APPROPRIATE HEALTHCARE SERVICES.
Not later than 1 year after the date of enactment of this Act and
annually thereafter, the Secretary of Health and Human Services shall
enter into a contract with the Institute of Medicine for the
preparation and publication of a report that describes Federal efforts
to ensure that all individuals have meaningful access to culturally and
linguistically appropriate healthcare services. Such report shall
include--
(1) a description and evaluation of the activities carried
out under this Act; and
(2) a description of best practices, model programs,
guidelines, and other effective strategies for providing access
to culturally and linguistically appropriate healthcare
services.
SEC. 106. GENERAL ACCOUNTING OFFICE REPORT ON IMPACT OF LANGUAGE ACCESS
SERVICES.
Not later than 3 years after the date of enactment of this Act, the
Comptroller General of the United States shall examine, and prepare and
publish a report on, the impact of language access services on the
health and healthcare of limited English proficient populations. Such
report shall include--
(1) recommendations on the development and implementation
of policies and practices by healthcare organizations and
providers for limited English proficient patient populations;
(2) a description of the effect of providing language
access services on quality of healthcare and access to care and
reduced medical error; and
(3) a description of the costs associated with or savings
related to provision of language access services.
SEC. 107. DEFINITIONS.
In this title:
(1) Incorporated definitions.--The definitions contained in
section 2900 of the Public Health Service Act, as added by
section 101, shall apply.
(2) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 108. TREATMENT OF THE MEDICARE PART B PROGRAM UNDER TITLE VI OF
THE CIVIL RIGHTS ACT OF 1964.
A payment provider of services or physician or other supplier under
part B of title XVIII of the Social Security Act shall be deemed a
grant, and not a contract of insurance or guaranty, for the purposes of
title VI of the Civil Rights Act of 1964.
TITLE II--HEALTH WORKFORCE DIVERSITY
SEC. 201. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
Title XXIX of the Public Health Service Act, as added by section
101, is amended by adding at the end the following:
``Subtitle A--Diversifying the Healthcare Workplace
``SEC. 2911. REPORT ON WORKFORCE DIVERSITY.
``(a) In General.--Not later than July 1, 2006, and biannually
thereafter, the Secretary, acting through the director of each entity
within the Department of Health and Human Services, shall prepare and
submit to the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of the House of
Representatives a report on health workforce diversity.
``(b) Requirement.--The report under subsection (a) shall contain
the following information:
``(1) A description of any grant support that is provided
by each entity for workforce diversity initiatives with the
following information--
``(A) the number of grants made;
``(B) the purpose of the grants;
``(C) the populations served through the grants;
``(D) the organizations and institutions receiving
the grants; and
``(E) the tracking efforts that were used to follow
the progress of participants.
``(2) A description of the entity's plan to achieve
workforce diversity goals that includes, to the extent relevant
to such entity--
``(A) the number of underrepresented minority
health professionals that will be needed in various
disciplines over the next 10 years to achieve
population parity;
``(B) the level of funding needed to fully expand
and adequately support health professions pipeline
programs;
``(C) the impact such programs have had on the
admissions practices and policies of health professions
schools;
``(D) the management strategy necessary to
effectively administer and institutionalize health
profession pipeline programs; and
``(E) the impact that the Government Performance
and Results Act (GPRA) has had on evaluating the
performance of grantees and whether the GPRA is the
best assessment tool for programs under titles VII and
VIII.
``(3) A description of measurable objectives of each entity
relating to workforce diversity initiatives.
``(c) Public Availability.--The report under subsection (a) shall
be made available for public review and comment.
``SEC. 2912. NATIONAL WORKING GROUP ON WORKFORCE DIVERSITY.
``(a) In General.--The Secretary, acting through the Bureau of
Health Professions within the Health Resources and Services
Administration, shall award a grant to an entity determined appropriate
by the Secretary for the establishment of a national working group on
workforce diversity.
``(b) Representation.--In establishing the national working group
under subsection (a), the grantee shall ensure that the group has
representation from the following entities:
``(1) The Health Resources and Services Administration.
``(2) The Department of Health and Human Services Data
Council.
``(3) The Office of Minority Health Disparity Elimination.
``(4) The Bureau of Labor Statistics of the Department of
Labor.
``(5) The Public Health Practice Program Office--Office of
Workforce Policy and Planning.
``(6) The National Center on Minority Health and Health
Disparities.
``(7) The Agency for Healthcare Research and Quality.
``(8) The Institute of Medicine Study Committee for the
2004 workforce diversity report.
``(9) The Indian Health Service.
``(10) Academic institutions.
``(11) Consumer organizations.
``(12) Health professional associations, including those
that represent underrepresented minority populations.
``(13) Researchers in the area of health workforce.
``(14) Health workforce accreditation entities.
``(15) Private foundations that have sponsored workforce
diversity initiatives.
``(16) Not less than 5 health professions students
representing various health profession fields and levels of
training.
``(c) Activities.--The working group established under subsection
(a) shall convene at least twice each year to complete the following
activities:
``(1) Review current public and private health workforce
diversity initiatives.
``(2) Identify successful health workforce diversity
programs and practices.
``(3) Examine challenges relating to the development and
implementation of health workforce diversity initiatives.
``(4) Draft a national strategic work plan for health
workforce diversity, including recommendations for public and
private sector initiatives.
``(5) Develop a framework and methods for the evaluation of
current and future health workforce diversity initiatives.
``(6) Develop recommended standards for workforce diversity
that could be applicable to all health professions programs and
programs funded under this Act.
``(7) Develop curriculum guidelines for diversity training.
``(8) Develop a strategy for the inclusion of community
members on admissions committees for health profession schools.
``(9) Other activities determined appropriate by the
Secretary.
``(d) Annual Report.--Not later than 1 year after the establishment
of the working group under subsection (a), and annually thereafter, the
working group shall prepare and make available to the general public
for comment, an annual report on the activities of the working group.
Such report shall include the recommendations of the working group for
improving health workforce diversity.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2913. TECHNICAL CLEARINGHOUSE FOR HEALTH WORKFORCE DIVERSITY.
``(a) In General.--The Secretary, acting through the Office of
Minority Health Disparity Elimination, and in collaboration with the
Bureau of Health Professions within the Health Resources and Services
Administration, shall establish a technical clearinghouse on health
workforce diversity within the Office of Minority Health Disparity
Elimination and coordinate current and future clearinghouses.
``(b) Information and Services.--The clearinghouse established
under subsection (a) shall offer the following information and
services:
``(1) Information on the importance of health workforce
diversity.
``(2) Statistical information relating to underrepresented
minority representation in health and allied health professions
and occupations.
``(3) Model health workforce diversity practices and
programs.
``(4) Admissions policies that promote health workforce
diversity and are in compliance with Federal and State laws.
``(5) Lists of scholarship, loan repayment, and loan
cancellation grants as well as fellowship information for
underserved populations for health professions schools.
``(6) Foundation and other large organizational initiatives
relating to health workforce diversity.
``(c) Consultation.--In carrying out this section, the Secretary
shall consult with non-Federal entities which may include minority
health professional associations to ensure the adequacy and accuracy of
information.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2914. EVALUATION OF WORKFORCE DIVERSITY INITIATIVES.
``(a) In General.--The Secretary, acting through the Bureau of
Health Professions within the Health Resources and Services
Administration, shall award grants to eligible entities for the conduct
of an evaluation of current health workforce diversity initiatives
funded by the Department of Health and Human Services.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a) an entity shall--
``(1) be a city, county, Indian tribe, State, territory,
community-based nonprofit organization, health center,
university, college, or other entity determined appropriate by
the Secretary;
``(2) with respect to an entity that is not an academic
medical center, university, or private research institution,
carry out activities under the grant in partnership with an
academic medical center, university, or private research
institution; and
``(3) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts awarded under a grant under subsection
(a) shall be used to support the following evaluation activities:
``(1) Determinations of measures of health workforce
diversity success.
``(2) The short- and long-term tracking of participants in
health workforce diversity pipeline programs funded by the
Department of Health and Human Services.
``(3) Assessments of partnerships formed through activities
to increase health workforce diversity.
``(4) Assessments of barriers to health workforce
diversity.
``(5) Assessments of policy changes at the Federal, State,
and local levels.
``(6) Assessments of coordination within and between
Federal agencies and other institutions.
``(7) Other activities determined appropriate by the
Secretary and the Working Group established under section 2912.
``(d) Report.--Not later than 1 year after the date of enactment of
this title, the Bureau of Health Professions within the Health
Resources and Services Administration shall prepare and make available
for public comment a report that summarizes the findings made by
entities under grants under this section.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2915. DATA COLLECTION AND REPORTING BY HEALTH PROFESSIONAL
SCHOOLS.
``(a) In General.--The Secretary, acting through the Bureau of
Health Professions of the Health Resources and Services Administration
and the Office of Minority Health Disparity Elimination, shall
establish an aggregated database on health professional students.
``(b) Requirement to Collect Data.--Each health professional school
(including medical, dental, and nursing schools) and allied health
profession school and program that receives Federal funds shall collect
race, ethnicity, and language proficiency data concerning those
students enrolled at such schools or in such programs. In collecting
such data, a school or program shall--
``(1) at a minimum, use the categories for race and
ethnicity described in the 1997 Office of Management and Budget
Standards for Maintaining, Collecting, and Presenting Federal
Data on Race and Ethnicity and available language standards;
and
``(2) if practicable, collect data on additional population
groups if such data can be aggregated into the minimum race and
ethnicity data categories.
``(c) Use of Data.--Data on race, ethnicity, and primary language
collected under this section shall be reported to the database
established under subsection (a) on an annual basis. Such data shall be
available for public use.
``(d) Privacy.--The Secretary shall ensure that all data collected
under this section is protected from inappropriate internal and
external use by any entity that collects, stores, or receives the data
and that such data is collected without personally identifiable
information.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2916. SUPPORT FOR INSTITUTIONS COMMITTED TO WORKFORCE DIVERSITY.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, shall award grants
to eligible entities that demonstrate a commitment to health workforce
diversity.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
``(1) be an educational institution or entity that
historically produces or trains meaningful numbers of
underrepresented minority health professionals, including--
``(A) Historically Black Colleges and Universities;
``(B) Hispanic-Serving Health Professions Schools;
``(C) Hispanic-Serving Institutions;
``(D) Tribal Colleges and Universities;
``(E) Asian American and Pacific Islander-serving
institutions;
``(F) institutions that have programs to recruit
and retain underrepresented minority health
professionals, in which a significant number of the
enrolled participants are underrepresented minorities;
``(G) health professional associations, which may
include underrepresented minority health professional
associations; and
``(H) institutions--
``(i) located in communities with
predominantly underrepresented minority
populations;
``(ii) with whom partnerships have been
formed for the purpose of increasing workforce
diversity; and
``(iii) in which at least 20 percent of the
enrolled participants are underrepresented
minorities; and
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts received under a grant under
subsection (a) shall be used to expand existing workforce diversity
programs, implement new workforce diversity programs, or evaluate
existing or new workforce diversity programs, including with respect to
mental health care professions. Such programs shall enhance diversity
by considering minority status as part of an individualized
consideration of qualifications. Possible activities may include--
``(1) educational outreach programs relating to
opportunities in the health professions;
``(2) scholarship, fellowship, grant, loan repayment, and
loan cancellation programs;
``(3) post-baccalaureate programs;
``(4) academic enrichment programs, particularly targeting
those who would not be competitive for health professions
schools;
``(5) kindergarten through 12th grade and other health
pipeline programs;
``(6) mentoring programs;
``(7) internship or rotation programs involving hospitals,
health systems, health plans and other health entities;
``(8) community partnership development for purposes
relating to workforce diversity; or
``(9) leadership training.
``(d) Reports.--Not later than 1 year after receiving a grant under
this section, and annually for the term of the grant, a grantee shall
submit to the Secretary a report that summarizes and evaluates all
activities conducted under the grant.
``(e) Definition.--In this section, the term `Asian American and
Pacific Islander-serving institutions' means institutions--
``(1) that are eligible institutions under section 312(b)
of the Higher Education Act of 1965; and
``(2) that, at the time of their application, have an
enrollment of undergraduate students that is made up of at
least 10 percent Asian American and Pacific Islander students.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2917. CAREER DEVELOPMENT FOR SCIENTISTS AND RESEARCHERS.
``(a) In General.--The Secretary, acting through the Director of
the National Institutes of Health, the Director of the Centers for
Disease Control and Prevention, the Commissioner of Food and Drugs, and
the Director of the Agency for Healthcare Research and Quality, shall
award grants that expand existing opportunities for scientists and
researchers and promote the inclusion of underrepresented minorities in
the health professions.
``(b) Research Funding.--The head of each entity within the
Department of Health and Human Services shall establish or expand
existing programs to provide research funding to scientists and
researchers in-training. Under such programs, the head of each such
entity shall give priority in allocating research funding to support
health research in traditionally underserved communities, including
underrepresented minority communities, and research classified as
community or participatory.
``(c) Data Collection.--The head of each entity within the
Department of Health and Human Services shall collect data on the
number (expressed as an absolute number and a percentage) of
underrepresented minority and nonminority applicants who receive and
are denied agency funding at every stage of review. Such data shall be
reported annually to the Secretary and the appropriate committees of
Congress.
``(d) Student Loan Reimbursement.--The Secretary shall establish a
student loan reimbursement program to provide student loan
reimbursement assistance to researchers who focus on racial and ethnic
disparities in health. The Secretary shall promulgate regulations to
define the scope and procedures for the program under this subsection.
``(e) Student Loan Cancellation.--The Secretary shall establish a
student loan cancellation program to provide student loan cancellation
assistance to researchers who focus on racial and ethnic disparities in
health. Students participating in the program shall make a minimum 5-
year commitment to work at an accredited health profession school. The
Secretary shall promulgate additional regulations to define the scope
and procedures for the program under this subsection.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2918. CAREER SUPPORT FOR NON-RESEARCH HEALTH PROFESSIONALS.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, the Administrator of
the Substance Abuse and Mental Health Services Administration, the
Administrator of the Health Resources and Services Administration, and
the Administrator of the Centers for Medicare and Medicaid Services
shall establish a program to award grants to eligible individuals for
career support in non-research-related healthcare.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a) an individual shall--
``(1) be a student in a health professions school, a
graduate of such a school who is working in a health
profession, or a faculty member of such a school; and
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--An individual shall use amounts received under
a grant under this section to--
``(1) support the individual's health activities or
projects that involve underserved communities, including racial
and ethnic minority communities;
``(2) support health-related career advancement activities;
and
``(3) to pay, or as reimbursement for payments of, student
loans for individuals who are health professionals and are
focused on health issues affecting underserved communities,
including racial and ethnic minority communities.
``(d) Definition.--In this section, the term `career in non-
research-related healthcare' means employment or intended employment in
the field of public health, health policy, health management, health
administration, medicine, nursing, pharmacy, allied health, community
health, or other fields determined appropriate by the Secretary, other
than in a position that involves research.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2919. RESEARCH ON THE EFFECT OF WORKFORCE DIVERSITY ON QUALITY.
``(a) In General.--The Director of the Agency for Healthcare
Research and Quality, in collaboration with the Deputy Assistant
Secretary for Minority Health Disparity Elimination and the Director of
the National Center on Minority Health and Health Disparities, shall
award grants to eligible entities to expand research on the link
between health workforce diversity and quality healthcare.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a) an entity shall--
``(1) be a clinical, public health, or health services
research entity or other entity determined appropriate by the
Director; and
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts received under a grant awarded under
subsection (a) shall be used to support research that investigates the
effect of health workforce diversity on--
``(1) language access;
``(2) cultural competence;
``(3) patient satisfaction;
``(4) timeliness of care;
``(5) safety of care;
``(6) effectiveness of care;
``(7) efficiency of care;
``(8) patient outcomes;
``(9) community engagement;
``(10) resource allocation;
``(11) organizational structure; or
``(12) other topics determined appropriate by the Director.
``(d) Priority.--In awarding grants under subsection (a), the
Director shall give individualized consideration to all relevant
aspects of the applicant's background. Consideration of prior research
experience involving the health of underserved communities shall be
such a factor.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2920. HEALTH DISPARITIES EDUCATION PROGRAM.
``(a) Establishment.--The Secretary, acting through the National
Center on Minority Health and Health Disparities and in collaboration
with the Office of Minority Health Disparity Elimination, the Office
for Civil Rights, the Centers for Disease Control and Prevention, the
Centers for Medicare and Medicaid Services, the Health Resources and
Services Administration, and other appropriate public and private
entities, shall establish and coordinate a health and healthcare
disparities education program to support, develop, and implement
educational initiatives and outreach strategies that inform healthcare
professionals and the public about the existence of and methods to
reduce racial and ethnic disparities in health and healthcare.
``(b) Activities.--The Secretary, through the education program
established under subsection (a) shall, through the use of public
awareness and outreach campaigns targeting the general public and the
medical community at large--
``(1) disseminate scientific evidence for the existence and
extent of racial and ethnic disparities in healthcare,
including disparities that are not otherwise attributable to
known factors such as access to care, patient preferences, or
appropriateness of intervention, as described in the 2002
Institute of Medicine Report, Unequal Treatment;
``(2) disseminate new research findings to healthcare
providers and patients to assist them in understanding,
reducing, and eliminating health and healthcare disparities;
``(3) disseminate information about the impact of
linguistic and cultural barriers on healthcare quality and the
obligation of health providers who receive Federal financial
assistance to ensure that people with limited English
proficiency have access to language access services;
``(4) disseminate information about the importance and
legality of racial, ethnic, and primary language data
collection, analysis, and reporting;
``(5) design and implement specific educational initiatives
to health care providers relating to health and health care
disparities;
``(6) assess the impact of the programs established under
this section in raising awareness of health and healthcare
disparities and providing information on available resources.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2920A. CULTURAL COMPETENCE TRAINING FOR HEALTHCARE
PROFESSIONALS.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, the Deputy
Assistant Secretary for Minority Health Disparity Elimination, and the
Director of the National Center for Minority Health and Health
Disparities, shall award grants to eligible entities to test,
implement, and evaluate models of cultural competence training,
including continuing education, for healthcare providers in
coordination with the initiative under section 2920(a).
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
``(1) be an academic medical center, a health center or
clinic, a hospital, a health plan, a health system, or a health
care professional guild (including a mental health care
professional guild);
``(2) partner with a minority serving institution, minority
professional association, or community-based organization
representing minority populations, in addition to a research
institution to carry out activities under this grant; and
``(3) prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.''.
SEC. 202. HEALTH CAREERS OPPORTUNITY PROGRAM.
(a) Purpose.--It is the purpose of this section to diversify the
healthcare workforce by increasing the number of individuals from
disadvantaged backgrounds in the health and allied health professions
by enhancing the academic skills of students from disadvantaged
backgrounds and supporting them in successfully competing, entering,
and graduating from health professions training programs.
(b) Authorization of Appropriations.--Section 740(c) of the Public
Health Service Act (42 U.S.C. 293d(c)) is amended by striking
``$29,400,000'' and all that follows through ``2002'' and inserting
``$50,000,000 for fiscal year 2007, and such sums as may be necessary
for each of fiscal years 2008 through 2012''.
SEC. 203. PROGRAM OF EXCELLENCE IN HEALTH PROFESSIONS EDUCATION FOR
UNDERREPRESENTED MINORITIES.
(a) Purpose.--It is the purpose of this section to diversify the
healthcare workforce by supporting programs of excellence in designated
health professions schools that demonstrate a commitment to
underrepresented minority populations with a focus on minority health
issues, cultural and linguistic competence, and eliminating health
disparities.
(b) Authorization of Appropriation.--Section 737(h)(1) of the
Public Health Service Act (42 U.S.C. 293(h)(1)) is amended to read as
follows:
``(1) Authorization of appropriations.--For the purpose of
making grants under subsection (a), there are authorized to be
appropriated $50,000,000 for fiscal year 2007, and such sums as
may be necessary for each of the fiscal years 2008 through
2012.''.
SEC. 204. HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.
Part B of title VII of the Public Health Service Act (42 U.S.C. 293
et seq.) is amended by adding at the end the following:
``SEC. 742. HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, shall award grants
to Hispanic-serving health professions schools for the purpose of
carrying out programs to recruit Hispanic individuals to enroll in and
graduate from such schools, which may include providing scholarships
and other financial assistance as appropriate.
``(b) Eligibility.--In subsection (a), the term `Hispanic-serving
health professions school' means an entity that--
``(1) is a school or program under section 799B;
``(2) has an enrollment of full-time equivalent students
that is made up of at least 9 percent Hispanic students;
``(3) has been effective in carrying out programs to
recruit Hispanic individuals to enroll in and graduate from the
school;
``(4) has been effective in recruiting and retaining
Hispanic faculty members; and
``(5) has a significant number of graduates who are
providing health services to medically underserved populations
or to individuals in health professional shortage areas.''.
SEC. 205. HEALTH PROFESSIONS STUDENT LOAN FUND; AUTHORIZATIONS OF
APPROPRIATIONS REGARDING STUDENTS FROM DISADVANTAGED
BACKGROUNDS.
Section 724(f)(1) of the Public Health Service Act (42 U.S.C.
292t(f)(1)) is amended by striking ``$8,000,000'' and all that follows
and inserting ``$35,000,000 for fiscal year 2007, and such sums as may
be necessary for each of the fiscal years 2008 through 2012.''.
SEC. 206. NATIONAL HEALTH SERVICE CORPS; RECRUITMENT AND FELLOWSHIPS
FOR INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.
(a) In General.--Section 331(b) of the Public Health Service Act
(42 U.S.C. 254d(b)) is amended by adding at the end the following:
``(3) The Secretary shall ensure that the individuals with respect
to whom activities under paragraphs (1) and (2) are carried out include
individuals from disadvantaged backgrounds, including activities
carried out to provide health professions students with information on
the Scholarship and Repayment Programs.''.
(b) Assignment of Corps Personnel.--Section 333(a) of the Public
Health Service Act (42 U.S.C. 254f(a)) is amended by adding at the end
the following:
``(4) In assigning Corps personnel under this section, the
Secretary shall give preference to applicants who request assignment to
a federally qualified health center (as defined in section
1905(l)(2)(B) of the Social Security Act) or to a provider organization
that has a majority of patients who are minorities or individuals from
low-income families (families with a family income that is less than
200 percent of the Official Poverty Line).''.
SEC. 207. LOAN REPAYMENT PROGRAM OF THE CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Section 317F(c) of the Public Health Service Act (42 U.S.C. 247b-
7(c)) is amended--
(1) by striking ``and'' after ``1994,''; and
(2) by inserting before the period the following:
``$750,000 for fiscal year 2007, and such sums as may be
necessary for each of the fiscal years 2008 through 2012.''.
SEC. 208. COOPERATIVE AGREEMENTS FOR ONLINE DEGREE PROGRAMS AT SCHOOLS
OF PUBLIC HEALTH AND SCHOOLS OF ALLIED HEALTH.
Part B of title VII of the Public Health Service Act (42 U.S.C. 293
et seq.), as amended by section 204, is further amended by adding at
the end the following:
``SEC. 743. COOPERATIVE AGREEMENTS FOR ONLINE DEGREE PROGRAMS.
``(a) Cooperative Agreements.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration, in
consultation with the Director of the Centers for Disease Control and
Prevention, the Director of the Agency for Healthcare Research and
Quality, and the Deputy Assistant Secretary for Minority Health
Disparity Elimination, shall award cooperative agreements to schools of
public health and schools of allied health to design and implement
online degree programs.
``(b) Priority.--In awarding cooperative agreements under this
section, the Secretary shall give priority to any school of public
health or school of allied health that has an established track record
of serving medically underserved communities.
``(c) Requirements.--Awardees must design and implement an online
degree program, that meet the following restrictions:
``(1) Enrollment of individuals who have obtained a
secondary school diploma or its recognized equivalent.
``(2) Maintaining a significant enrollment of
underrepresented minority or disadvantaged students.
``(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.''.
SEC. 209. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.
Part B of title VII of the Public Health Service Act (as amended by
section 208) is further amended by adding at the end the following:
``SEC. 744. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.
``(a) In General.--The Secretary may make grants to eligible
schools for awarding scholarships to eligible individuals to attend the
school involved, for the purpose of enabling the individuals to make a
career change from a non-health profession to a health profession.
``(b) Expenses.--Amounts awarded as a scholarship under this
section--
``(1) subject to paragraph (2), may be expended only for
tuition expenses, other reasonable educational expenses, and
reasonable living expenses incurred in the attendance of the
school involved; and
``(2) may be expended for stipends to eligible individuals
for the enrolled period at eligible schools, except that such a
stipend may not be provided to an individual for more than 4
years, and such a stipend may not exceed $35,000 per year
(notwithstanding any other provision of law regarding the
amount of stipends).
``(c) Definitions.--In this section:
``(1) Eligible school.--The term `eligible school' means a
school of medicine, osteopathic medicine, dentistry, nursing
(as defined in section 801), pharmacy, podiatric medicine,
optometry, veterinary medicine, public health, chiropractic, or
allied health, a school offering a graduate program in mental
and behavioral health practice, or an entity providing programs
for the training of physician assistants.
``(2) Eligible individual.--The term `eligible individual'
means an individual who has obtained a secondary school diploma
or its recognized equivalent.
``(d) Priority.--In providing scholarships to eligible individuals,
eligible schools shall give to individuals from disadvantaged
backgrounds.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.''.
SEC. 210. STRENGTHENING AND EXPANDING RURAL HEALTH PROVIDER NETWORKS.
Section 330A of the Public Health Service Act (42 U.S.C. 254c) is
amended--
(1) in subsection (h), by adding at the end the following:
``(4) Rural minority, border, and indian populations.--In
making grants under this section, the Director of the Office of
Rural Health Policy of the Health Resources and Services
Administration, in coordination with the Director of the Indian
Health Service and the Deputy Assistant Secretary for Minority
Health Disparity Elimination, shall make grants to entities
that serve rural minority, border, and Indian populations.
``(5) Diversity health training programs.--The Director of
the Office of Rural Health Policy of the Health Resources and
Services Administration, in coordination with the Director of
the Indian Health Service and the Deputy Assistant Secretary
for Minority Health Disparity Elimination, shall coordinate the
awarding of grants under this section with the awarding of
grants and contracts under section 765 to connect and integrate
diversity health training programs.''; and
(2) in subsection (k), as redesignated by this section, by
striking ``and such sums as may be necessary for each of fiscal
years 2003 through 2006'' and inserting ``, such sums as may be
necessary for each of fiscal years 2003 through 2005, and
$60,000,000 for each of fiscal years 2006 through 2010''.
SEC. 211. NATIONAL REPORT ON THE PREPAREDNESS OF HEALTH PROFESSIONALS
TO CARE FOR DIVERSE POPULATIONS.
The Secretary of Health and Human Services shall include in the
report prepared under section 1707(c) of the Public Health Service Act
(as added by section 404 of this Act), information relating to the
preparedness of health professionals to care for racially and
ethnically diverse populations. Such information, which shall be
collected by the Bureau of Health Professions, shall include--
(1) with respect to health professions education, the
number and percentage of hours of classroom discussion relating
to minority health issues, including cultural competence;
(2) a description of the coursework involved in such
education;
(3) a description of the results of an evaluation of the
preparedness of students in such education;
(4) a description of the types of exposure that students
have during their education to minority patient populations;
and
(5) a description of model programs and practices.
SEC. 212. SCHOLARSHIP AND FELLOWSHIP PROGRAMS.
Subtitle A of title XXIX of the Public Health Service Act, as
amended by section 201, is further amended by adding at the end the
following:
``SEC. 2920B. DAVID SATCHER PUBLIC HEALTH AND HEALTH SERVICES CORPS.
``(a) In General.--The Administrator of the Health Resources and
Services Administration and Director of the Centers for Disease Control
and Prevention, in collaboration with the Deputy Assistant Secretary
for Minority Health Disparity Elimination, shall award grants to
eligible entities to increase awareness among post-primary and post-
secondary students of career opportunities in the health professions.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a) an entity shall--
``(1) be a clinical, public health or health services
organization, community-based or non-profit entity, or other
entity determined appropriate by the Director of the Centers
for Disease Control and Prevention;
``(2) serve a health professional shortage area, as
determined by the Secretary;
``(3) work with students, including those from racial and
ethnic minority backgrounds, that have expressed an interest in
the health professions; and
``(4) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Grant awards under subsection (a) shall be
used to support internships that will increase awareness among students
of non-research based and career opportunities in the following health
professions:
``(1) Medicine.
``(2) Nursing.
``(3) Public Health.
``(4) Pharmacy.
``(5) Health Administration and Management.
``(6) Health Policy.
``(7) Psychology.
``(8) Dentistry.
``(9) International Health.
``(10) Social Work.
``(11) Allied Health.
``(12) Hospice.
``(13) Other professions deemed appropriate by the Director
of the Centers for Disease Control and Prevention.
``(d) Priority.--In awarding grants under subsection (a), the
Director of the Centers for Disease Control and Prevention shall give
priority to those entities that--
``(1) serve a high proportion of individuals from
disadvantaged backgrounds;
``(2) have experience in health disparity elimination
programs;
``(3) facilitate the entry of disadvantaged individuals
into institutions of higher education; and
``(4) provide counseling or other services designed to
assist disadvantaged individuals in successfully completing
their education at the post-secondary level.
``(e) Stipends.--The Secretary may approve stipends under this
section for individuals for any period of education in student-
enhancement programs (other than regular courses) at health professions
schools, programs, or entities, except that such a stipend may not be
provided to an individual for more than 6 months, and such a stipend
may not exceed $20 per day (notwithstanding any other provision of law
regarding the amount of stipends).
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2920C. LOUIS STOKES PUBLIC HEALTH SCHOLARS PROGRAM.
``(a) In General.--The Director of the Centers for Disease Control
and Prevention, in collaboration with the Deputy Assistant Secretary
for Minority Health Disparity Elimination, shall award scholarships to
postsecondary students who seek a career in public health.
``(b) Eligibility.--To be eligible to receive a scholarship under
subsection (a) an individual shall--
``(1) have experience in public health research or public
health practice, or other health professions as determined
appropriate by the Director of the Centers for Disease Control
and Prevention;
``(2) reside in a health professional shortage area as
determined by the Secretary;
``(3) have expressed an interest in public health;
``(4) demonstrate promise for becoming a leader in public
health;
``(5) secure admission to a 4-year institution of higher
education;
``(6) comply with subsection (f); and
``(7) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts received under an award under
subsection (a) shall be used to support opportunities for students to
become public health professionals.
``(d) Priority.--In awarding grants under subsection (a), the
Director shall give priority to those students that--
``(1) are from disadvantaged backgrounds;
``(2) have secured admissions to a minority serving
institution; and
``(3) have identified a health professional as a mentor at
their school or institution and an academic advisor to assist
in the completion of their baccalaureate degree.
``(e) Scholarships.--The Secretary may approve payment of
scholarships under this section for such individuals for any period of
education in student undergraduate tenure, except that such a
scholarship may not be provided to an individual for more than 4 years,
and such scholarships may not exceed $10,000 per academic year
(notwithstanding any other provision of law regarding the amount of
scholarship).
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2920D. PATSY MINK HEALTH AND GENDER RESEARCH FELLOWSHIP PROGRAM.
``(a) In General.--The Director of the Centers for Disease Control
and Prevention, in collaboration with the Deputy Assistant Secretary
for Minority Health Disparity Elimination, the Administrator of the
Substance Abuse and Mental Health Services Administration, and the
Director of the Indian Health Services, shall award research
fellowships to post-baccalaureate students to conduct research that
will examine gender and health disparities and to pursue a career in
the health professions.
``(b) Eligibility.--To be eligible to receive a fellowship under
subsection (a) an individual shall--
``(1) have experience in health research or public health
practice;
``(2) reside in a health professional shortage area as
determined by the Secretary;
``(3) have expressed an interest in the health professions;
``(4) demonstrate promise for becoming a leader in the
field of women's health;
``(5) secure admission to a health professions school or
graduate program with an emphasis in gender studies;
``(6) comply with subsection (f); and
``(7) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts received under an award under
subsection (a) shall be used to support opportunities for students to
become researchers and advance the research base on the intersection
between gender and health.
``(d) Priority.--In awarding grants under subsection (a), the
Director of the Centers for Disease Control and Prevention shall give
priority to those applicants that--
``(1) are from disadvantaged backgrounds; and
``(2) have identified a mentor and academic advisor who
will assist in the completion of their graduate or professional
degree and have secured a research assistant position with a
researcher working in the area of gender and health.
``(e) Fellowships.--The Director of the Centers for Disease Control
and Prevention may approve fellowships for individuals under this
section for any period of education in the student's graduate or health
profession tenure, except that such a fellowship may not be provided to
an individual for more than 3 years, and such a fellowship may not
exceed $18,000 per academic year (notwithstanding any other provision
of law regarding the amount of fellowship).
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2920E. PAUL DAVID WELLSTONE INTERNATIONAL HEALTH FELLOWSHIP
PROGRAM.
``(a) In General.--The Director of the Agency for Healthcare
Research and Quality, in collaboration with the Deputy Assistant
Secretary for Minority Health Disparity Elimination, shall award
research fellowships to college students or recent graduates to advance
their understanding of international health.
``(b) Eligibility.--To be eligible to receive a fellowship under
subsection (a) an individual shall--
``(1) have educational experience in the field of
international health;
``(2) reside in a health professional shortage area as
determined by the Secretary;
``(3) demonstrate promise for becoming a leader in the
field of international health;
``(4) be a college senior or recent graduate of a four year
higher education institution;
``(5) comply with subsection (f); and
``(6) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts received under an award under
subsection (a) shall be used to support opportunities for students to
become health professionals and to advance their knowledge about
international issues relating to healthcare access and quality.
``(d) Priority.--In awarding grants under subsection (a), the
Director shall give priority to those applicants that--
``(1) are from a disadvantaged background; and
``(2) have identified a mentor at a health professions
school or institution, an academic advisor to assist in the
completion of their graduate or professional degree, and an
advisor from an international health Non-Governmental
Organization, Private Volunteer Organization, or other
international institution or program that focuses on increasing
healthcare access and quality for residents in developing
countries.
``(e) Fellowships.--The Secretary shall approve fellowships for
college seniors or recent graduates, except that such a fellowship may
not be provided to an individual for more than 6 months, may not be
awarded to a graduate that has not been enrolled in school for more
than 1 year, and may not exceed $4,000 per academic year
(notwithstanding any other provision of law regarding the amount of
fellowship).
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2920F. EDWARD R. ROYBAL HEALTHCARE SCHOLAR PROGRAM.
``(a) In General.--The Director of the Agency for Healthcare
Research and Quality, the Director of the Centers for Medicaid and
Medicare, and the Administrator for Health Resources and Services
Administration, in collaboration with the Deputy Assistant Secretary
for Minority Health Disparity Elimination, shall award grants to
eligible entities to expose entering graduate students to the health
professions.
``(b) Eligibility.--To be eligible to receive a grant under
subsection (a) an entity shall--
``(1) be a clinical, public health or health services
organization, community-based or non-profit entity, or other
entity determined appropriate by the Director of the Agency for
Healthcare Research and Quality;
``(2) serve in a health professional shortage area as
determined by the Secretary;
``(3) work with students obtaining a degree in the health
professions; and
``(4) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Use of Funds.--Amounts received under a grant awarded under
subsection (a) shall be used to support opportunities that expose
students to non-research based health professions, including--
``(1) public health policy;
``(2) healthcare and pharmaceutical policy;
``(3) healthcare administration and management;
``(4) health economics; and
``(5) other professions determined appropriate by the
Director of the Agency for Healthcare Research and Quality.
``(d) Priority.--In awarding grants under subsection (a), the
Director of the Agency for Healthcare Research and Quality shall give
priority to those entities that--
``(1) have experience with health disparity elimination
programs;
``(2) facilitate training in the fields described in
subsection (c); and
``(3) provide counseling or other services designed to
assist such individuals in successfully completing their
education at the post-secondary level.
``(e) Stipends.--The Secretary may approve the payment of stipends
for individuals under this section for any period of education in
student-enhancement programs (other than regular courses) at health
professions schools or entities, except that such a stipend may not be
provided to an individual for more than 2 months, and such a stipend
may not exceed $100 per day (notwithstanding any other provision of law
regarding the amount of stipends).
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2007 through 2012.''.
SEC. 213. ADVISORY COMMITTEE ON HEALTH PROFESSIONS TRAINING FOR
DIVERSITY.
(a) Establishment.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall establish an
advisory committee to be known as the Advisory Committee on Health
Professions Training for Diversity (in this section referred to as the
``Advisory Committee'').
(b) Composition.--
(1) In general.--The Secretary shall determine the
appropriate number of individuals to serve on the Advisory
Committee. Such individuals shall not be officers or employees
of the Federal Government.
(2) Appointment.--Not later than 60 days after the date of
enactment of this section, the Secretary shall appoint the
members of the Advisory Committee from among individuals who
are health professionals. In making such appointments, the
Secretary shall ensure a fair balance between the health
professions, that at least 75 percent of the members of the
Advisory Committee are health professionals, a broad geographic
representation of members and a balance between urban and rural
members. Members shall be appointed based on their competence,
interest, and knowledge of the mission of the profession
involved.
(3) Minority representation.--In appointing the members of
the Advisory Committee under paragraph (2), the Secretary shall
ensure the adequate representation of women and minorities.
(c) Terms.--
(1) In general.--A member of the Advisory Committee shall
be appointed for a term of 3 years, except that of the members
first appointed--
(A) \1/3\ of such members shall serve for a term of
1 year;
(B) \1/3\ of such members shall serve for a term of
2 years; and
(C) \1/3\ of such members shall serve for a term of
3 years.
(2) Vacancies.--
(A) In general.--A vacancy on the Advisory
Committee shall be filled in the manner in which the
original appointment was made and shall be subject to
any conditions which applied with respect to the
original appointment.
(B) Filling unexpired term.--An individual chosen
to fill a vacancy shall be appointed for the unexpired
term of the member replaced.
(d) Duties.--
(1) In general.--The Advisory Committee shall--
(A) provide advice and recommendations to the
Secretary concerning policy and program development and
other matters of significance concerning activities
under this part; and
(B) not later than 2 years after the date of
enactment of this section, and annually thereafter,
prepare and submit to the Secretary, and the Committee
on Health, Education, Labor and Pensions of the Senate,
and the Committee on Energy and Commerce of the House
of Representatives, a report describing the activities
of the Committee.
(2) Consultation with students.--In carrying out duties
under paragraph (1), the Advisory Committee shall consult with
individuals who are attending health professions schools with
which this part is concerned.
(e) Meetings and Documents.--
(1) Meetings.--The Advisory Committee shall meet not less
than 2 times each year. Such meetings shall be held jointly
with other related entities established under this title where
appropriate.
(2) Documents.--Not later than 14 days prior to the
convening of a meeting under paragraph (1), the Advisory
Committee shall prepare and make available an agenda of the
matters to be considered by the Advisory Committee at such
meeting. At any such meeting, the Advisory Committee shall
distribute materials with respect to the issues to be addressed
at the meeting. Not later than 30 days after the adjourning of
such a meeting, the Advisory Committee shall prepare and make
available a summary of the meeting and any actions taken by the
Committee based upon the meeting.
(f) Compensation and Expenses.--
(1) Compensation.--Each member of the Advisory Committee
shall be compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such
member is engaged in the performance of the duties of the
Committee.
(2) Expenses.--The members of the Advisory Committee shall
be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Committee.
(g) FACA.--The Federal Advisory Committee Act shall apply to the
Advisory Committee under this section only to the extent that the
provisions of such Act do not conflict with the requirements of this
section.
SEC. 214. MCNAIR POSTBACCALAUREATE ACHIEVEMENT PROGRAM.
Section 402E of the Higher Education Act of 1965 (20 U.S.C. 1070a-
15) is amended by striking subsection (f) and inserting the following:
``(f) Collaboration in Health Profession Diversity Training
Programs.--The Secretary of Education shall coordinate with the
Secretary of Health and Human Services to ensure that there is
collaboration between the goals of the program under this section and
programs of the Health Resources and Services Administration that
promote health workforce diversity. The Secretary of Education shall
take such measures as may be necessary to encourage participants in
programs under this section to consider health profession careers.
``(g) Funding.--From amounts appropriated pursuant to the authority
of section 402A(f), the Secretary shall, to the extent practicable,
allocate funds for projects authorized by this section in an amount
which is not less than $31,000,000 for each of the fiscal years 2006
through 2012.''.
TITLE III--DATA COLLECTION AND REPORTING
SEC. 301. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
(a) Purpose.--It is the purpose of this section to promote data
collection, analysis, and reporting by race, ethnicity, and primary
language among federally supported health programs.
(b) Amendment.--Title XXIX of the Public Health Service Act, as
amended by title II of this Act, is further amended by adding at the
end the following:
``Subtitle B--Strengthening Data Collection, Improving Data Analysis,
and Expanding Data Reporting
``SEC. 2931. DATA ON RACE, ETHNICITY, AND PRIMARY LANGUAGE.
``(a) Requirements.--
``(1) In general.--Each health-related program operated by
or that receives funding or reimbursement, in whole or in part,
either directly or indirectly from the Department of Health and
Human Services shall--
``(A) require the collection, by the agency or
program involved, of data on the race, ethnicity, and
primary language of each applicant for and recipient of
health-related assistance under such program--
``(i) using, at a minimum, the categories
for race and ethnicity described in the 1997
Office of Management and Budget Standards for
Maintaining, Collecting, and Presenting Federal
Data on Race and Ethnicity;
``(ii) using the standards developed under
subsection (e) for the collection of language
data;
``(iii) where practicable, collecting data
for additional population groups if such groups
can be aggregated into the minimum race and
ethnicity categories; and
``(iv) where practicable, through self-
report;
``(B) with respect to the collection of the data
described in subparagraph (A) for applicants and
recipients who are minors or otherwise legally
incapacitated, require that--
``(i) such data be collected from the
parent or legal guardian of such an applicant
or recipient; and
``(ii) the preferred language of the parent
or legal guardian of such an applicant or
recipient be collected;
``(C) systematically analyze such data using the
smallest appropriate units of analysis feasible to
detect racial and ethnic disparities in health and
healthcare and when appropriate, for men and women
separately, and report the results of such analysis to
the Secretary, the Director of the Office for Civil
Rights, the Committee on Health, Education, Labor, and
Pensions and the Committee on Finance of the Senate,
and the Committee on Energy and Commerce and the
Committee on Ways and Means of the House of
Representatives;
``(D) provide such data to the Secretary on at
least an annual basis; and
``(E) ensure that the provision of assistance to an
applicant or recipient of assistance is not denied or
otherwise adversely affected because of the failure of
the applicant or recipient to provide race, ethnicity,
and primary language data.
``(2) Rules of construction.--Nothing in this subsection
shall be construed to--
``(A) permit the use of information collected under
this subsection in a manner that would adversely affect
any individual providing any such information; and
``(B) require health care providers to collect
data.
``(b) Protection of Data.--The Secretary shall ensure (through the
promulgation of regulations or otherwise) that all data collected
pursuant to subsection (a) is protected--
``(1) under the same privacy protections as the Secretary
applies to other health data under the regulations promulgated
under section 264(c) of the Health Insurance Portability and
Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033)
relating to the privacy of individually identifiable health
information and other protections; and
``(2) from all inappropriate internal use by any entity
that collects, stores, or receives the data, including use of
such data in determinations of eligibility (or continued
eligibility) in health plans, and from other inappropriate
uses, as defined by the Secretary.
``(c) National Plan of the Data Council.--The Secretary shall
develop and implement a national plan to improve the collection,
analysis, and reporting of racial, ethnic, and primary language data at
the Federal, State, territorial, Tribal, and local levels, including
data to be collected under subsection (a). The Data Council of the
Department of Health and Human Services, in consultation with the
National Committee on Vital Health Statistics, the Office of Minority
Health Disparity Elimination, and other appropriate public and private
entities, shall make recommendations to the Secretary concerning the
development, implementation, and revision of the national plan. Such
plan shall include recommendations on how to--
``(1) implement subsection (a) while minimizing the cost
and administrative burdens of data collection and reporting;
``(2) expand awareness among Federal agencies, States,
territories, Indian tribes, health providers, health plans,
health insurance issuers, and the general public that data
collection, analysis, and reporting by race, ethnicity, and
primary language is legal and necessary to assure equity and
non-discrimination in the quality of healthcare services;
``(3) ensure that future patient record systems have data
code sets for racial, ethnic, and primary language identifiers
and that such identifiers can be retrieved from clinical
records, including records transmitted electronically;
``(4) improve health and healthcare data collection and
analysis for more population groups if such groups can be
aggregated into the minimum race and ethnicity categories,
including exploring the feasibility of enhancing collection
efforts in States for racial and ethnic groups that comprise a
significant proportion of the population of the State;
``(5) provide researchers with greater access to racial,
ethnic, and primary language data, subject to privacy and
confidentiality regulations; and
``(6) safeguard and prevent the misuse of data collected
under subsection (a).
``(d) Compliance With Standards.--Data collected under subsection
(a) shall be obtained, maintained, and presented (including for
reporting purposes) in accordance with the 1997 Office of Management
and Budget Standards for Maintaining, Collecting, and Presenting
Federal Data on Race and Ethnicity (at a minimum).
``(e) Language Collection Standards.--Not later than 1 year after
the date of enactment of this title, the Deputy Assistant Secretary for
Minority Health Disparity Elimination, in consultation with the Office
for Civil Rights of the Department of Health and Human Services, shall
develop and disseminate Standards for the Classification of Federal
Data on Preferred Written and Spoken Language.
``(f) Technical Assistance for the Collection and Reporting of
Data.--
``(1) In general.--The Secretary may, either directly or
through grant or contract, provide technical assistance to
enable a healthcare program or an entity operating under such
program to comply with the requirements of this section.
``(2) Types of assistance.--Assistance provided under this
subsection may include assistance to--
``(A) enhance or upgrade computer technology that
will facilitate racial, ethnic, and primary language
data collection and analysis;
``(B) improve methods for health data collection
and analysis including additional population groups
beyond the Office of Management and Budget categories
if such groups can be aggregated into the minimum race
and ethnicity categories;
``(C) develop mechanisms for submitting collected
data subject to existing privacy and confidentiality
regulations; and
``(D) develop educational programs to inform health
insurance issuers, health plans, health providers,
health-related agencies, and the general public that
data collection and reporting by race, ethnicity, and
preferred language are legal and essential for
eliminating health and healthcare disparities.
``(g) Analysis of Racial and Ethnic Data.--The Secretary, acting
through the Director of the Agency for Healthcare Research and Quality
and in coordination with the Administrator of the Centers for Medicare
and Medicaid Services, shall provide technical assistance to agencies
of the Department of Health and Human Services in meeting Federal
standards for race, ethnicity, and primary language data collection and
analysis of racial and ethnic disparities in health and healthcare in
public programs by--
``(1) identifying appropriate quality assurance mechanisms
to monitor for health disparities;
``(2) specifying the clinical, diagnostic, or therapeutic
measures which should be monitored;
``(3) developing new quality measures relating to racial
and ethnic disparities in health and healthcare;
``(4) identifying the level at which data analysis should
be conducted; and
``(5) sharing data with external organizations for research
and quality improvement purposes.
``(h) National Conference.--
``(1) In general.--The Secretary shall sponsor a biennial
national conference on racial, ethnic, and primary language
data collection to enhance coordination, build partnerships,
and share best practices in racial, ethnic, and primary
language data collection, analysis, and reporting.
``(2) Reports.--Not later than 6 months after the date on
which a national conference has convened under paragraph (1),
the Secretary shall publish in the Federal Register and submit
to the Committee on Health, Education, Labor, and Pensions and
the Committee on Finance of the Senate and the Committee on
Energy and Commerce and the Committee on Ways and Means of the
House of Representatives a report concerning the proceedings
and findings of the conference.
``(i) Report.--Not later than 2 years after the date of enactment
of this title, and biennially thereafter, the Secretary shall submit to
the appropriate committees of Congress a report on the effectiveness of
data collection, analysis, and reporting on race, ethnicity, and
primary language under the programs and activities of the Department of
Health and Human Services and under other Federal data collection
systems with which the Department interacts to collect relevant data on
race and ethnicity. The report shall evaluate the progress made in the
Department with respect to the national plan under subsection (c) or
subsequent revisions thereto.
``(j) Definition.--In this section, the term `health-related
program' mean a program--
``(1) under the Social Security Act (42 U.S.C. 301 et seq.)
that pay for healthcare and services; and
``(2) under this Act that provide Federal financial
assistance for healthcare, biomedical research, health services
research, and programs designed to improve the public's health.
``(k) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2932. PROVISIONS RELATING TO NATIVE AMERICANS.
``(a) Epidemiology Centers.--
``(1) Establishment.--
``(A) In general.--In addition to those centers
operating 1 day prior to the date of enactment of this
title, (including those centers for which funding is
currently being provided through funding agreements
under the Indian Self-Determination and Education
Assistance Act), the Secretary shall, not later than
180 days after such date of enactment, establish and
fund an epidemiology center in each service area which
does not have such a center to carry out the functions
described in subparagraph (B). Any centers established
under the preceding sentence may be operated by Indian
tribes or tribal organizations pursuant to funding
agreements under the Indian Self-Determination and
Education Assistance Act, but funding under such
agreements may not be divisible.
``(B) Functions.--In consultation with and upon the
request of Indian tribes, tribal organizations and
urban Indian organizations, each area epidemiology
center established under this subsection shall, with
respect to such area shall--
``(i) collect data related to the health
status objective described in section 3(b) of
the Indian Health Care Improvement Act, and
monitor the progress that the Service, Indian
tribes, tribal organizations, and urban Indian
organizations have made in meeting such health
status objective;
``(ii) evaluate existing delivery systems,
data systems, and other systems that impact the
improvement of Indian health;
``(iii) assist Indian tribes, tribal
organizations, and urban Indian organizations
in identifying their highest priority health
status objectives and the services needed to
achieve such objectives, based on
epidemiological data;
``(iv) make recommendations for the
targeting of services needed by tribal, urban,
and other Indian communities;
``(v) make recommendations to improve
healthcare delivery systems for Indians and
urban Indians;
``(vi) provide requested technical
assistance to Indian tribes and urban Indian
organizations in the development of local
health service priorities and incidence and
prevalence rates of disease and other illness
in the community; and
``(vii) provide disease surveillance and
assist Indian tribes, tribal organizations, and
urban Indian organizations to promote public
health.
``(C) Technical assistance.--The director of the
Centers for Disease Control and Prevention shall
provide technical assistance to the centers in carrying
out the requirements of this subsection.
``(2) Funding.--The Secretary may make funding available to
Indian tribes, tribal organizations, and eligible intertribal
consortia or urban Indian organizations to conduct
epidemiological studies of Indian communities.
``(b) Definitions.--For purposes of this section, the definitions
contained in section 4 of the Indian Health Care Improvement Act shall
apply.''.
SEC. 302. COLLECTION OF RACE AND ETHNICITY DATA BY THE SOCIAL SECURITY
ADMINISTRATION.
Part A of title XI of the Social Security Act (42 U.S.C. 1301 et
seq.) is amended by adding at the end the following:
``SEC. 1150A. COLLECTION OF RACE AND ETHNICITY DATA BY THE SOCIAL
SECURITY ADMINISTRATION.
``(a) Requirement.--The Commissioner of the Social Security
Administration in consultation with the Administrator of the Centers
for Medicare and Medicaid Services shall--
``(1) require the collection of data on the race,
ethnicity, and primary language of all applicants for social
security numbers, social security income, social security
disability, and medicare--
``(A) using, at a minimum, the categories for race
and ethnicity described in the 1997 Office of
Management and Budget Standards for Maintaining,
Collecting, and Presenting Federal Data on Race and
Ethnicity and available language standards; and
``(B) where practicable, collecting data for
additional population groups if such groups can be
aggregated into the minimum race and ethnicity
categories;
``(2) with respect to the collection of the data described
in paragraph (1) for applicants who are under 18 years of age
or otherwise legally incapacitated, require that--
``(A) such data be collected from the parent or
legal guardian of such an applicant; and
``(B) the primary language of the parent or legal
guardian of such an applicant or recipient be used;
``(3) require that such data be uniformly analyzed and
reported at least annually to the Commissioner of Social
Security;
``(4) be responsible for storing the data reported under
paragraph (3);
``(5) ensure transmission to the Centers for Medicare and
Medicaid Services and other Federal health agencies;
``(6) provide such data to the Secretary on at least an
annual basis; and
``(7) ensure that the provision of assistance to an
applicant is not denied or otherwise adversely affected because
of the failure of the applicant to provide race, ethnicity, and
primary language data.
``(b) Protection of Data.--The Commissioner of Social Security
shall ensure (through the promulgation of regulations or otherwise)
that all data collected pursuant subsection (a) is protected--
``(1) under the same privacy protections as the Secretary
applies to other health data under the regulations promulgated
under section 264(c) of the Health Insurance Portability and
Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033)
relating to the privacy of individually identifiable health
information and other protections; and
``(2) from all inappropriate internal use by any entity
that collects, stores, or receives the data, including use of
such data in determinations of eligibility (or continued
eligibility) in health plans, and from other inappropriate
uses, as defined by the Secretary.
``(c) National Education Program.--Not later than 18 months after
the date of enactment of this section, the Secretary, acting through
the Deputy Assistant Secretary for Minority Health Disparity
Elimination and in collaboration with the Commissioner of the Social
Security Administration, shall develop and implement a program to
educate all populations about the purpose and uses of racial, ethnic,
and primary language health data collection.
``(d) Rule of Construction.--Nothing in this section shall be
construed to permit the use of information collected under this section
in a manner that would adversely affect any individual providing any
such information.
``(e) Technical Assistance.--The Secretary may, either directly or
by grant or contract, provide technical assistance to enable any health
entity to comply with the requirements of this section.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.''.
SEC. 303. REVISION OF HIPAA CLAIMS STANDARDS.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Secretary of Health and Human Services shall revise
the regulations promulgated under part C of title XI of the Social
Security Act (42 U.S.C. 1320d et seq.), as added by the Health
Insurance Portability and Accountability Act of 1996 (Public Law 104-
191), relating to the collection of data on race, ethnicity, and
primary language in a health-related transaction to require--
(1) the use, at a minimum, of the categories for race and
ethnicity described in the 1997 Office of Management and Budget
Standards for Maintaining, Collecting, and Presenting Federal
Data on Race and Ethnicity;
(2) the establishment of a new data code set for primary
language; and
(3) the designation of the racial, ethnic, and primary
language code sets as ``required'' for claims and enrollment
data.
(b) Dissemination.--The Secretary of Health and Human Services
shall disseminate the new standards developed under subsection (a) to
all health entities that are subject to the regulations described in
such subsection and provide technical assistance with respect to the
collection of the data involved.
(c) Compliance.--The Secretary of Health and Human Services shall
require that health entities comply with the new standards developed
under subsection (a) not later than 2 years after the final
promulgation of such standards.
SEC. 304. NATIONAL CENTER FOR HEALTH STATISTICS.
Section 306(n) of the Public Health Service Act (42 U.S.C. 242k(n))
is amended--
(1) in paragraph (1), by striking ``2005'' and inserting
``2012'';
(2) in paragraph (2), in the first sentence, by striking
``2005'' and inserting ``2012''; and
(3) in paragraph (3), by striking ``2002'' and inserting
``2012''.
SEC. 305. GEO-ACCESS STUDY.
The Administrator of the Substance Abuse and Mental Health Services
Administration shall--
(1) conduct a study to--
(A) determine which geographic areas of the United
States have shortages of specialty mental health
providers; and
(B) assess the preparedness of speciality mental
health providers to deliver culturally and
linguistically appropriate services; and
(2) submit a report to the Congress on the results of such
study.
SEC. 306. RACIAL, ETHNIC, AND LINGUISTIC DATA COLLECTED BY THE FEDERAL
GOVERNMENT.
(a) Collection; Submission.--Not later than 90 days after the date
of the enactment of this Act, and January 31st of each year thereafter,
each department, agency, and office of the Federal Government that has
collected racial, ethnic, or linguistic data during the preceding
calendar year shall submit such data to the Secretary of Health and
Human Services.
(b) Analysis; Public Availability; Reporting.--Not later than April
30, 2007, and each April 30th thereafter, the Secretary of Health and
Human Services, acting through the Director of the National Center on
Minority Health and Health Disparities and the Deputy Assistant
Secretary for Minority Health Disparity Elimination, shall--
(1) collect and analyze the racial, ethnic, and linguistic
data submitted under subsection (a) for the preceding calendar
year;
(2) make publicly available such data and the results of
such analysis; and
(3) submit a report to the Congress on such data and
analysis.
TITLE IV--ACCOUNTABILITY AND EVALUATION
Subtitle A--General Provisions
SEC. 401. REPORT ON WORKFORCE DIVERSITY.
(a) In General.--Not later than July 1, 2007, and annually
thereafter, the Secretary, acting through the director of each entity
within the Department of Health and Human Services, shall prepare and
submit to the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of the House of
Representatives a report on healthcare workforce diversity.
(b) Requirement.--The report under subsection (a) shall contain the
following information:
(1) The response of the entity involved to the 2004
Institute of Medicine report entitled ``In the Nation's
Compelling Interest: Ensuring Diversity in the Health Care
Workforce'', the 2002 Institute of Medicine report entitled
``The Future of the Public Health in the 21st Century'', and
the Healthy People 2010 initiative.
(2) A description of the personnel in each such entity who
are responsible for overseeing workforce diversity initiatives.
(3) The level of workforce diversity achieved within each
such entity, including absolute numbers and percentages of
minority employees as well as the rank of such employees.
(4) A description of any grant support that is provided by
each entity for workforce diversity initiatives, including the
amount of the grants and the percentage of grant funds as
compared to overall entity funding.
(c) Public Availability.--The report under subsection (a) shall be
made available for public review and comment.
SEC. 402. FEDERAL AGENCY PLAN TO ELIMINATE DISPARITIES AND IMPROVE THE
HEALTH OF MINORITY POPULATIONS.
(a) In General.--Not later than September 1, 2007, each Federal
health agency shall develop and implement a national strategic action
plan to eliminate disparities on the basis of race, ethnicity, and
primary language and improve the health and healthcare of minority
populations, through programs relevant to the mission of the agency.
(b) Publication.--Each action plan described in paragraph (1)
shall--
(1) be publicly reported in draft form for public review
and comment;
(2) include a response to the review and comment described
in paragraph (1) in the final plan;
(3) include the agency response to the 2002 Institute of
Medicine report, Unequal Treatment--Confronting Racial and
Ethnic Disparities in Healthcare;
(4) demonstrate progress in meeting the Healthy People 2010
objectives; and
(5) be updated, including progress reports, for inclusion
in an annual report to Congress.
SEC. 403. ACCOUNTABILITY WITHIN THE DEPARTMENT OF HEALTH AND HUMAN
SERVICES.
Title XXIX of the Public Health Service Act, as amended by titles
II and III of this Act, is further amended by adding at the end the
following:
``Subtitle C--Strengthening Accountability
``SEC. 2941. ELEVATION OF THE OFFICE OF CIVIL RIGHTS.
``(a) In General.--The Secretary shall establish within the Office
for Civil Rights an Office of Health Disparities, which shall be headed
by a director to be appointed by the Secretary.
``(b) Purpose.--The Office of Health Disparities shall ensure that
the health programs, activities, and operations of health entities
which receive Federal financial assistance are in compliance with title
VI of the Civil Rights Act, which prohibits discrimination on the basis
of race, color, or national origin. The activities of the Office shall
include the following:
``(1) The development and implementation of an action plan
to address racial and ethnic healthcare disparities, which
shall address concerns relating to the Office for Civil Rights
as released by the United States Commission on Civil Rights in
the report entitled `Health Care Challenge: Acknowledging
Disparity, Confronting Discrimination, and Ensuring Equity'
(September, 1999). This plan shall be publicly disclosed for
review and comment and the final plan shall address any
comments or concerns that are received by the Office.
``(2) Investigative and enforcement actions against
intentional discrimination and policies and practices that have
a disparate impact on minorities.
``(3) The review of racial, ethnic, and primary language
health data collected by Federal health agencies to assess
healthcare disparities related to intentional discrimination
and policies and practices that have a disparate impact on
minorities.
``(4) Outreach and education activities relating to
compliance with title VI of the Civil Rights Act.
``(5) The provision of technical assistance for health
entities to facilitate compliance with title VI of the Civil
Rights Act.
``(6) Coordination and oversight of activities of the civil
rights compliance offices established under section 2942.
``(7) Ensuring compliance with the 1997 Office of
Management and Budget Standards for Maintaining, Collecting,
and Presenting Federal Data on Race, Ethnicity and the
available language standards.
``(c) Funding and Staff.--The Secretary shall ensure the
effectiveness of the Office of Health Disparities by ensuring that the
Office is provided with--
``(1) adequate funding to enable the Office to carry out
its duties under this section; and
``(2) staff with expertise in--
``(A) epidemiology;
``(B) statistics;
``(C) health quality assurance;
``(D) minority health and health disparities; and
``(E) civil rights.
``(d) Report.--Not later than December 31, 2007, and annually
thereafter, the Secretary, in collaboration with the Director of the
Office for Civil Rights, shall 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 that includes--
``(1) the number of cases filed, broken down by category;
``(2) the number of cases investigated and closed by the
office;
``(3) the outcomes of cases investigated; and
``(4) the staffing levels of the office including staff
credentials.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
``SEC. 2942. ESTABLISHMENT OF HEALTH PROGRAM OFFICES FOR CIVIL RIGHTS
WITHIN FEDERAL HEALTH AND HUMAN SERVICES AGENCIES.
``(a) In General.--The Secretary shall establish civil rights
compliance offices in each agency within the Department of Health and
Human Services that administers health programs.
``(b) Purpose of Offices.--Each office established under subsection
(a) shall ensure that recipients of Federal financial assistance under
Federal health programs administer their programs, services, and
activities in a manner that--
``(1) does not discriminate, either intentionally or in
effect, on the basis of race, national origin, language,
ethnicity, sex, age, or disability; and
``(2) promotes the reduction and elimination of disparities
in health and healthcare based on race, national origin,
language, ethnicity, sex, age, and disability.
``(c) Powers and Duties.--The offices established in subsection (a)
shall have the following powers and duties:
``(1) The establishment of compliance and program
participation standards for recipients of Federal financial
assistance under each program administered by an agency within
the Department of Health and Human Services including the
establishment of disparity reduction standards to encompass
disparities in health and healthcare related to race, national
origin, language, ethnicity, sex, age, and disability.
``(2) The development and implementation of program-
specific guidelines that interpret and apply Department of
Health and Human Services guidance under title VI of the Civil
Rights Act of 1964 to each Federal health program administered
by the agency.
``(3) The development of a disparity-reduction impact
analysis methodology that shall be applied to every rule issued
by the agency and published as part of the formal rulemaking
process under sections 555, 556, and 557 of title 5, United
States Code.
``(4) Oversight of data collection, analysis, and
publication requirements for all recipients of Federal
financial assistance under each Federal health program
administered by the agency, and compliance with the 1997 Office
of Management and Budget Standards for Maintaining, Collecting,
and Presenting Federal Data on Race and Ethnicity and the
available language standards.
``(5) The conduct of publicly available studies regarding
discrimination within Federal health programs administered by
the agency as well as disparity reduction initiatives by
recipients of Federal financial assistance under Federal health
programs.
``(6) Annual reports to the Committee on Health, Education,
Labor, and Pensions and the Committee on Finance of the Senate
and the Committee on Energy and Commerce and the Committee on
Ways and Means of the House of Representatives on the progress
in reducing disparities in health and healthcare through the
Federal programs administered by the agency.
``(d) Relationship to Office for Civil Rights in the Department of
Justice.--
``(1) Department of health and human services.--The Office
for Civil Rights in the Department of Health and Human Services
shall provide standard-setting and compliance review
investigation support services to the Civil Rights Compliance
Office for each agency.
``(2) Department of justice.--The Office for Civil Rights
in the Department of Justice shall continue to maintain the
power to institute formal proceedings when an agency Office for
Civil Rights determines that a recipient of Federal financial
assistance is not in compliance with the disparity reduction
standards of the agency.
``(e) Definition.--In this section, the term `Federal health
programs' mean programs--
``(1) under the Social Security Act (42 U.S.C. 301 et seq.)
that pay for healthcare and services; and
``(2) under this Act that provide Federal financial
assistance for healthcare, biomedical research, health services
research, and programs designed to improve the public's
health.''.
SEC. 404. OFFICE OF MINORITY HEALTH DISPARITY ELIMINATION.
Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is
amended--
(1) by striking the section heading and inserting the
following: ``office of minority health disparity elimination'';
(2) by striking ``Office of Minority Health'' each place
such term appears and inserting ``Office of Minority Health
Disparity Elimination'';
(3) by striking subsection (b) and inserting the following:
``(b) Duties.--With respect to improving the health of racial and
ethnic minority groups, the Secretary, acting through the Deputy
Assistant Secretary for Minority Health Disparity Elimination (in this
section referred to as the `Deputy Assistant Secretary'), shall carry
out the following:
``(1) Establish, implement, monitor, and evaluate short-
range and long-range goals and objectives and oversee all other
activities within the Public Health Service that relate to
disease prevention, health promotion, service delivery, and
research concerning minority groups. The heads of each of the
agencies of the Service shall consult with the Deputy Assistant
Secretary to ensure the coordination of such activities.
``(2) Oversee all activities within the Department of
Health and Human Services that relate to reducing or
eliminating disparities in health and healthcare in racial and
ethnic minority populations, including coordinating--
``(A) the design of programs, support for programs,
and the evaluation of programs;
``(B) the monitoring of trends in health and
healthcare;
``(C) research efforts;
``(D) the training of health providers; and
``(E) information and education programs and
campaigns.
``(3) Enter into interagency and intra-agency agreements
with other agencies of the Public Health Service.
``(4) Ensure that the Federal health agencies and the
National Center for Health Statistics collect data on the
health status and healthcare of each minority group, using at a
minimum the categories specified in the 1997 OMB Standards for
Maintaining, Collecting, and Presenting Federal Data on Race
and Ethnicity as required under subtitle B and available
language standards.
``(5) Provide technical assistance to States, local
agencies, territories, Indian tribes, and entities for
activities relating to the elimination of racial and ethnic
disparities in health and healthcare.
``(6) Support a national minority health resource center to
carry out the following:
``(A) Facilitate the exchange of information
regarding matters relating to health information,
health promotion and wellness, preventive health
services, and education in the appropriate use of
health services.
``(B) Facilitate timely access to culturally and
linguistically appropriate information.
``(C) Assist in the analysis of such information.
``(D) Provide technical assistance with respect to
the exchange of such information (including
facilitating the development of materials for such
technical assistance).
``(7) Carry out programs to improve access to healthcare
services for individuals with limited English proficiency,
including developing and carrying out programs to provide
bilingual or interpretive services through the development and
support of the Robert T. Matsui Center for Cultural and
Linguistic Competence in Healthcare as provided for in section
2903.
``(8) Carry out programs to improve access to healthcare
services and to improve the quality of healthcare services for
individuals with low functional health literacy. As used in the
preceding sentence, the term `functional health literacy' means
the ability to obtain, process, and understand basic health
information and services needed to make appropriate health
decisions.
``(9) Advise in matters related to the development,
implementation, and evaluation of health professions education
on decreasing disparities in healthcare outcomes, with focus on
cultural competency as a method of eliminating disparities in
health and healthcare in racial and ethnic minority
populations.
``(10) Assist healthcare professionals, community and
advocacy organizations, academic centers and public health
departments in the design and implementation of programs that
will improve the quality of health outcomes by strengthening
the provider-patient relationship.''.
(4) by redesignating subsections (c) through (f) and
subsections (g) and (h) as subsections (d) through (g) and
subsections (j) and (k), respectively;
(5) by inserting after subsection (b), the following:
``(c) National Plan to Eliminate Racial and Ethnic Health and
Healthcare Disparities.--
``(1) In general.--The Secretary, acting through the Deputy
Assistant Secretary, shall--
``(A) not later than 1 year after the date of
enactment of the Healthcare Equality and Accountability
Act, establish and implement a comprehensive plan to
achieve the goal of Healthy People 2010 to eliminate
health disparities in the United States;
``(B) establish the plan referred to in
subparagraph (A) in consultation with--
``(i) the Director of the Centers for
Disease Control and Prevention;
``(ii) the Director of the National
Institutes of Health;
``(iii) the Director of the National Center
on Minority Health and Health Disparities;
``(iv) the Director of the Agency for
Healthcare Research and Quality;
``(v) the Administrator of the Health
Resources and Services Administration;
``(vi) the Administrator of the Centers for
Medicare and Medicaid Services;
``(vii) the Director of the Office for
Civil Rights;
``(viii) the Administrator of the Substance
Abuse and Mental Health Services
Administration;
``(ix) the Commissioner of Food and Drugs;
and
``(x) the heads of other appropriate public
and private entities;
``(C) ensure that the plan includes measurable
objectives, describes the means for achieving such
objectives, and designates a date by which such
objectives are expected to be achieved;
``(D) ensure that all amounts appropriated for such
activities are expended in accordance with the plan;
``(E) review the plan on at least an annual basis
and revise the plan as appropriate;
``(F) ensure that the plan will serve as a binding
statement of policy with respect to the agencies'
activities related to disparities in health and
healthcare; and
``(G) not later than March 1 of each year, submit
the plan (or any revisions to the plan), to the
Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of
the House of Representatives.
``(2) Components of the plan.--The Deputy Assistant
Secretary shall ensure that the comprehensive plan established
under paragraph (1) addresses--
``(A) the recommendations of the 2002 Institute of
Medicine report (Unequal Treatment) with respect to
racial and ethnic disparities in healthcare;
``(B) health and disease prevention education for
racial, ethnic, and primary language health disparity
populations;
``(C) research to identify sources of health and
healthcare disparities in minority groups;
``(D) the implementation and assessment of
promising intervention strategies;
``(E) data collection and the monitoring of the
healthcare and health status of health disparity
populations;
``(F) care of individuals who lack proficiency with
the English language;
``(G) care of individuals with low functional
health literacy;
``(H) the training, recruitment, and retention of
minority health professionals;
``(I) programs to expand and facilitate access to
healthcare services, including the use of telemedicine,
National Health Service Scholars, community health
workers, and case managers;
``(J) public and health provider awareness of
racial and ethnic disparities in healthcare;
``(K) methods to evaluate and measure progress
toward the goal of eliminating disparities in health
and healthcare in racial and ethnic minority
populations;
``(L) the promotion of interagency and intra-agency
coordination and collaboration and public-private and
community partnerships; and
``(M) the preparedness of health professionals to
care for racially, ethnically, and linguistically
diverse populations and low functional health literacy
populations including evaluations.'';
(6) in subsection (d) (as so redesignated)--
(A) in paragraph (1), by inserting ``and Racial,
Ethnic, and Primary Language Health Disparities
Elimination'' after ``Minority Health''; and
(B) in paragraph (2)--
(i) by striking ``Deputy Assistant''; and
(ii) by striking ``(10) of subsection (b)''
and inserting ``(9) of subsection (c)'';
(7) in subsection (e)(1) (as so redesignated)--
(A) in subparagraph (A), by striking ``subsection
(b)(9)'' and inserting ``subsection (b)(7)''; and
(B) in subparagraph (B), by striking ``subsection
(b)(10)'' and inserting ``subsection (b)(8)'';
(8) in subsection (f)(3) (as so redesignated), by striking
``subsection (f)'' and inserting ``subsection (g)'';
(9) in subsection (g)(1) (as so redesignated)--
(A) by striking ``1999 and each second'' and
inserting ``2006 and each'';
(B) by striking ``Labor and Human Resources'' and
inserting ``Health, Education, Labor, and Pensions'';
(C) by striking ``2 fiscal years'' and inserting
``fiscal year''; and
(D) by inserting after ``improving the health of
racial and ethnic minority groups'' the following:
``reducing and eliminating disparities in health and
healthcare in racial and ethnic minority populations,
in accordance with the national plan specified under
subsection (c) and the goals of Healthy People 2010'';
(10) by inserting after subsection (g) (as so redesignated)
the following:
``(h) Federal Partnership With Accreditation Entities.--
``(1) In general.--Not later than 1 year after the date of
enactment of the Healthcare Equality and Accountability Act,
the Secretary, in collaboration with the Director of the Agency
for Healthcare Research and Quality, the Administrator of the
Centers for Medicare and Medicaid Services, the Director of the
Office for Minority Health, and the heads of appropriate State
agencies, shall convene a working group with members of
accreditation organizations and other quality standard setting
organizations to develop guidelines to evaluate and report on
the health and healthcare of minority populations served by
health centers, health plans, hospitals, and other federally
funded health entities.
``(2) Report.--Not later than 6 months after the convening
of the working group under paragraph (1), the working group
shall submit a report to the Secretary at such time, in such
manner, and containing such information as the Secretary may
require, including guidelines and recommendations on how each
accreditation body will work with constituent members to ensure
the adoption of such guidelines.
``(3) Demonstration projects.--The Secretary, acting
through the Administrator of the Centers for Medicare and
Medicaid Services, shall award grants for the establishment of
demonstration projects to assess the impact of providing
financial incentives for the reporting and analysis of the
quality of minority healthcare by hospitals, health plans,
health centers, and other healthcare entities.
``(4) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
such sums as may be necessary for each of fiscal years 2007
through 2012.
``(i) Preparation of Health Professionals To Provide Healthcare to
Minority Populations.--The Secretary, in collaboration with the
Director of the Bureau of Health Professions and the Deputy Assistant
Secretary for Minority Health Disparity Elimination, shall require that
health professional schools that receive Federal funds train future
health professionals to provide culturally and linguistically
appropriate healthcare to diverse populations.''; and
(11) by striking subsection (k) (as so redesignated) and
inserting the following:
``(k) Authorization of Appropriations.--For the purpose of carrying
out this section (other than subsection (h)), there is authorized to be
appropriated $100,000,000 for fiscal year 2006, and such sums as may be
necessary for each of fiscal years 2007 through 2012.''.
SEC. 405. ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN AGENCY OF
THE PUBLIC HEALTH SERVICE.
(a) Establishment.--
(1) In general.--In order to more effectively and
efficiently carry out the responsibilities, authorities, and
functions of the United States to provide healthcare services
to Indians and Indian tribes, as are or may be hereafter
provided by Federal statute or treaties, there is established
within the Public Health Service of the Department of Health
and Human Services the Indian Health Service.
(2) Assistant secretary of indian health.--The Service
shall be administered by an Assistant Secretary of Indian
Health, who shall be appointed by the President, by and with
the advice and consent of the Senate. The Assistant Secretary
shall report to the Secretary. Effective with respect to an
individual appointed by the President, by and with the advice
and consent of the Senate the term of service of the Assistant
Secretary shall be 4 years. An Assistant Secretary may serve
more than 1 term.
(b) Agency.--The Service shall be an agency within the Public
Health Service of the Department, and shall not be an office,
component, or unit of any other agency of the Department.
(c) Functions and Duties.--The Secretary shall carry out through
the Assistant Secretary of the Service--
(1) all functions which were, on the day before the date of
enactment of the Indian Health Care Amendments of 1988, carried
out by or under the direction of the individual serving as
Director of the Service on such day;
(2) all functions of the Secretary relating to the
maintenance and operation of hospital and health facilities for
Indians and the planning for, and provision and utilization of,
health services for Indians;
(3) all health programs under which healthcare is provided
to Indians based upon their status as Indians which are
administered by the Secretary, including programs under--
(A) the Indian Health Care Improvement Act;
(B) the Act of November 2, 1921 (25 U.S.C. 13);
(C) the Act of August 5, 1954 (42 U.S.C. 2001, et
seq.);
(D) the Act of August 16, 1957 (42 U.S.C. 2005 et
seq.);
(E) the Indian Self-Determination Act (25 U.S.C.
450f, et seq.); and
(F) title XXIX of the Public Health Service Act;
and
(4) all scholarship and loan functions carried out under
title I of the Indian Health Care Improvement Act.
(d) Authority.--
(1) In general.--The Secretary, acting through the
Assistant Secretary, shall have the authority--
(A) except to the extent provided for in paragraph
(2), to appoint and compensate employees for the
Service in accordance with title 5, United States Code;
(B) to enter into contracts for the procurement of
goods and services to carry out the functions of the
Service; and
(C) to manage, expend, and obligate all funds
appropriated for the Service.
(2) Personnel actions.--Notwithstanding any other provision
of law, the provisions of section 12 of the Act of June 18,
1934 (48 Stat. 986; 25 U.S.C. 472), shall apply to all
personnel actions taken with respect to new positions created
within the Service as a result of its establishment under
subsection (a).
(e) Rate of Pay.--
(1) Positions at level iv.--Section 5315 of title 5, United
States Code, is amended by striking the following: ``Assistant
Secretaries of Health and Human Services (6).'' and inserting
``Assistant Secretaries of Health and Human Services (7).''.
(2) Positions at level v.--Section 5316 of such title is
amended by striking the following: ``Director, Indian Health
Service, Department of Health and Human Services.''.
(f) Duties of Assistant Secretary for Indian Health.--Section 601
of the Indian Health Care Improvement Act (25 U.S.C. 1661) is amended
in subsection (a)--
(1) by inserting ``(1)'' after ``(a)'';
(2) in the second sentence of paragraph (1), as so
designated, by striking ``a Director,'' and inserting ``the
Assistant Secretary for Indian Health,'';
(3) by striking the third sentence of paragraph (1), as so
designated, and all that follows through the end of the
subsection (a) of such section and inserting the following:
``The Assistant Secretary for Indian Health shall carry out the
duties specified in paragraph (2).''; and
(4) by adding after paragraph (1) the following:
``(2) The Assistant Secretary for Indian Health shall--
``(A) report directly to the secretary concerning
all policy and budget-related matters affecting Indian
health;
``(B) collaborate with the Assistant Secretary for
Health concerning appropriate matters of Indian health
that affect the agencies of the Public Health Service;
``(C) advise each Assistant Secretary of the
Department of Health and Human Services concerning
matters of Indian health with respect to which that
Assistant Secretary has authority and responsibility;
``(D) advise the heads of other agencies and
programs of the Department of Health and Human Services
concerning matters of Indian health with respect to
which those heads have authority and responsibility;
and
``(E) coordinate the activities of the Department
of Health and Human Services concerning matters of
Indian health.''.
(g) Continued Service by Incumbent.--The individual serving in the
position of Director of the Indian Health Service on the date preceding
the date of enactment of this Act may serve as Assistant Secretary for
Indian Health, at the pleasure of the President after the date of
enactment of this Act.
(h) Conforming Amendments.--
(1) Amendments to indian health care improvement act.--The
Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is
amended--
(A) in section 601--
(i) in subsection (c), by striking
``Director of the Indian Health Service'' both
places it appears and inserting ``Assistant
Secretary for Indian Health''; and
(ii) in subsection (d), by striking
``Director of the Indian Health Service'' and
inserting ``Assistant Secretary for Indian
Health''; and
(B) in section 816(c)(1), by striking ``Director of
the Indian Health Service'' and inserting ``Assistant
Secretary for Indian Health''.
(2) Amendments to other provisions of law.--The following
provisions are each amended by striking ``Director of the
Indian Health Service'' each place it appears and inserting
``Assistant Secretary for Indian Health'':
(A) Section 203(a)(1) of the Rehabilitation Act of
1973 (29 U.S.C. 761b(a)(1)).
(B) Subsections (b) and (e) of section 518 of the
Federal Water Pollution Control Act (33 U.S.C. 1377 (b)
and (e)).
(C) Section 803B(d)(1) of the Native American
Programs Act of 1974 (42 U.S.C. 2991b-2(d)(1)).
(i) References.--Reference in any other Federal law, Executive
order, rule, regulation, or delegation of authority, or any document of
or relating to the Director of the Indian Health Service shall be
deemed to refer to the Assistant Secretary for Indian Health.
(j) Definitions.--For purposes of this section, the definitions
contained in section 4 of the Indian Health Care Improvement Act shall
apply.
SEC. 406. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN
AGENCIES OF THE PUBLIC HEALTH SERVICE.
Title XVII of the Public Health Service Act (42 U.S.C. 300u et
seq.) is amended by inserting after section 1707 the following section:
``individual offices of minority health within public health service
``Sec. 1707A. (a) In General.--The head of each agency specified
in subsection (b)(1) shall establish within the agency an office to be
known as the Office of Minority Health and Racial, Ethnic, and Primary
Language Health Disparities Elimination. Each such Office shall be
headed by a director, who shall be appointed by the head of the agency
within which the Office is established, and who shall report directly
to the head of the agency. The head of such agency shall carry out this
section (as this section relates to the agency) acting through such
Director.
``(b) Specified Agencies.--
``(1) In general.--The agencies referred to in subsection
(a) are the following:
``(A) The Centers for Disease Control and
Prevention.
``(B) The Health Resources and Services
Administration.
``(C) The Substance Abuse and Mental Health
Services Administration; and
``(D) The Administration on Aging.
``(c) Composition.--The head of each specified agency shall ensure
that the officers and employees of the minority health office of the
agency are, collectively, experienced in carrying out community-based
health programs for each of the various racial and ethnic minority
groups that are present in significant numbers in the United States.
``(d) Duties.--Each Director of a minority health office shall
establish and monitor the programs of the specified agency of such
office in order to carry out the following:
``(1) Determine the extent to which the purposes of the
programs are being carried out with respect to racial and
ethnic minority groups;
``(2) Determine the extent to which members of such groups
are represented among the Federal officers and employees who
administer the programs; and
``(3) Make recommendations to the head of such agency on
carrying out the programs with respect to such groups. In the
case of programs that provide services, such recommendations
shall include recommendations toward ensuring that--
``(A) the services are equitably delivered with
respect to racial and ethnic minority groups;
``(B) the programs provide the services in the
language and cultural context that is most appropriate
for the individuals for whom the services are intended;
and
``(C) the programs utilize racial and ethnic
minority community-based organizations to deliver
services.
``(e) Biennial Reports to Secretary.--The head of each specified
agency shall submit to the Secretary for inclusion in each biennial
report describing--
``(1) the extent to which the minority health office of the
agency employs individuals who are members of racial and ethnic
minority groups, including a specification by minority group of
the number of such individuals employed by such office.
``(f) Funding.--
``(1) Allocations.--Of the amounts appropriated for a
specified agency for a fiscal year, the Secretary must
designate an appropriate amount of funds for the purpose of
carrying out activities under this section through the minority
health office of the agency. In reserving an amount under the
preceding sentence for a minority health office for a fiscal
year, the Secretary shall reduce, by substantially the same
percentage, the amount that otherwise would be available for
each of the programs of the designated agency involved.
``(2) Availability of funds for staffing.--The purposes for
which amounts made available under paragraph may be expended by
a minority health office include the costs of employing staff
for such office.''.
SEC. 407. OFFICE OF MINORITY HEALTH AT THE CENTERS FOR MEDICARE AND
MEDICAID SERVICES.
(a) In General.--Not later than 60 days after the date of enactment
of this Act, the Secretary of Health and Human Services shall establish
within the Centers for Medicare and Medicaid Services an Office of
Minority Health (referred to in this section as the ``Office'').
(b) Duties.--The Office shall be responsible for the coordination
and facilitation of activities of the Centers for Medicare and Medicaid
Services to improve minority health and healthcare and to reduce racial
and ethnic disparities in health and healthcare, which shall include--
(1) creating a strategic plan, which shall be made
available for public review, to improve the health and
healthcare of Medicare, Medicaid, and SCHIP beneficiaries;
(2) promoting agency-wide policies relating to healthcare
delivery and financing that could have a beneficial impact on
the health and healthcare of minority populations;
(3) assisting health plans, hospitals, and other health
entities in providing culturally and linguistically appropriate
healthcare services;
(4) increasing awareness and outreach activities for
minority healthcare consumers and providers about the causes
and remedies for health and healthcare disparities;
(5) developing grant programs and demonstration projects to
identify, implement and evaluate innovative approaches to
improving the health and healthcare of minority beneficiaries
in the Medicare, Medicaid, and SCHIP programs;
(6) considering incentive programs relating to
reimbursement that would reward health entities for providing
quality healthcare for minority populations using established
benchmarks for quality of care;
(7) collaborating with the compliance office to ensure
compliance with the anti-discrimination provisions under title
VI of the Civil Rights Act of 1964;
(8) identifying barriers to enrollment in public programs
under the jurisdiction of the Centers for Medicare and Medicaid
Services;
(9) monitoring and evaluating on a regular basis the
success of minority health programs and initiatives;
(10) publishing an annual report about the activities of
the Centers for Medicare and Medicaid Services relating to
minority health improvement; and
(11) other activities determined appropriate by the
Secretary of Health and Human Services.
(c) Staff.--The staff at the Office shall include--
(1) one or more individuals with expertise in minority
health and racial and ethnic health disparities; and
(2) one or more individuals with expertise in healthcare
financing and delivery in underserved communities.
(d) Coordination.--In carrying out its duties under this section,
the Office shall coordinate with--
(1) the Office of Minority Health in the Office of the
Secretary of Health and Human Services;
(2) the National Centers for Minority Health and Health
Disparities in the National Institutes of Health; and
(3) the Office of Minority Health in the Centers for
Disease Control and Prevention.
(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $10,000,000
for fiscal year 2006, and such sums may be necessary for each of fiscal
years 2007 through 2012.
SEC. 408. OFFICE OF MINORITY AFFAIRS AT THE FOOD AND DRUG
ADMINISTRATION.
Chapter IX of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
391 et seq.) is amended by adding at the end the following:
``SEC. 908. OFFICE OF MINORITY AFFAIRS.
``(a) In General.--Not later than 60 days after the date of
enactment of this section, the Secretary shall establish within the
Office of the Commissioner of Food and Drugs an Office of Minority
Affairs (referred to in this section as the `Office').
``(b) Duties.--The Office shall be responsible for the coordination
and facilitation of activities of the Food and Drug Administration to
improve minority health and healthcare and to reduce racial and ethnic
disparities in health and healthcare, which shall include--
``(1) promoting policies in the development and review of
medical products that reduce racial and ethnic disparities in
health and healthcare;
``(2) encouraging appropriate data collection, analysis,
and dissemination of racial and ethnic differences using, at a
minimum, the categories described in the 1997 Office of
Management and Budget standards, in response to different
therapies in both adult and pediatric populations;
``(3) providing, in coordination with other appropriate
government agencies, education, training, and support to
increase participation of minority patients and physicians in
clinical trials;
``(4) collecting and analyzing data using, at a minimum,
the categories described in the 1997 Office of Management and
Budget standards, on the number of participants from minority
racial and ethnic backgrounds in clinical trials used to
support medical product approvals;
``(5) the identification of methods to reduce language and
literacy barriers; and
``(6) publishing an annual report about the activities of
the Food and Drug Administration pertaining to minority health.
``(c) Staff.--The staff of the Office shall include--
``(1) one or more individuals with expertise in the design
and conduct of clinical trials of drugs, biological products,
and medical devices; and
``(2) one or more individuals with expertise in therapeutic
classes or disease states for which medical evidence suggests a
difference based on race or ethnicity.
``(d) Coordination.--In carrying out its duties under this section,
the Office shall coordinate with--
``(1) the Office of Minority Health in the Office of the
Secretary of Health and Human Services;
``(2) the National Center for Minority Health and Health
Disparities in the National Institutes of Health; and
``(3) the Office of Minority Health in the Centers for
Disease Control and Prevention.
``(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 2007 through 2012.''.
SEC. 409. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND
ETHNIC BACKGROUND.
(a) In General.--Chapter V of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 351 et seq.) is amended by adding after section 505B the
following:
``SEC. 505C. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL
AND ETHNIC BACKGROUND.
``(a) Pre-Approval Studies.--If there is evidence that there may be
a disparity on the basis of racial or ethnic background as to the
safety or effectiveness of a drug, then--
``(1)(A) the investigations required under section
505(b)(1)(A) shall include adequate and well-controlled
investigations of the disparity; or
``(B) the evidence required under section 351(a) of the
Public Health Service Act for approval of a biologics license
application for the drug shall include adequate and well-
controlled investigations of the disparity; and
``(2) if the investigations confirm that there is a
disparity, the labeling of the drug shall include appropriate
information about the disparity.
``(b) Post-Market Studies.--
``(1) In general.--If there is evidence that there may be a
disparity on the basis of racial or ethnic background as to the
safety or effectiveness of a drug for which there is an
approved application under section 505 or a license under
section 351 of the Public Health Service Act, the Secretary may
by order require the holder of the approved application or
license to conduct, by a date specified by the Secretary, post-
marketing studies to investigate the disparity.
``(2) Labeling.--If the Secretary determines that the post-
market studies confirm that there is a disparity described in
paragraph (1), the labeling of the drug shall include
appropriate information about the disparity.
``(3) Study design.--The Secretary may specify all aspects
of study design, including the number of studies and study
participants, in the order requiring post-market studies of the
drug.
``(4) Modifications of study design.--The Secretary may by
order modify any aspect of the study design as necessary after
issuing an order under paragraph (1).
``(5) Study results.--The results from studies required
under paragraph (1) shall be submitted to the Secretary as
supplements to the drug application or biological license
application.
``(c) Disparity.--The term `evidence that there may be a disparity
on the basis of racial or ethnic background for adult and pediatric
populations as to the safety or effectiveness of a drug' includes--
``(1) evidence that there is a disparity on the basis of
racial or ethnic background as to safety or effectiveness of a
drug in the same chemical class as the drug;
``(2) evidence that there is a disparity on the basis of
racial or ethnic background in the way the drug is metabolized;
and
``(3) other evidence as the Secretary may determine.
``(d) Applications Under Section 505(b)(2) and 505(j).--
``(1) In general.--A drug for which an application has been
submitted or approved under section 505(j) shall not be
considered ineligible for approval under that section or
misbranded under section 502 on the basis that the labeling of
the drug omits information relating to a disparity on the basis
of racial or ethnic background as to the safety or
effectiveness of the drug, whether derived from investigations
or studies required under this section or derived from other
sources, when the omitted information is protected by patent or
by exclusivity under clause (iii) or (iv) of section
505(j)(5)(D).
``(2) Labeling.--Notwithstanding clauses (iii) and (iv) of
section 505(j)(5)(D), the Secretary may require that the
labeling of a drug approved under section 505(j) that omits
information relating to a disparity on the basis of racial or
ethnic background as to the safety or effectiveness of the drug
include a statement of any appropriate contraindications,
warnings, or precautions related to the disparity that the
Secretary considers necessary.''.
(b) Enforcement.--Section 502 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 352) is amended by adding at the end the
following:
``(w)(1) If it is a drug and the holder of the approved application
under section 505 or license under section 351 of the Public Health
Service Act for the drug has failed to complete the investigations or
studies, or comply with any other requirement, of section 505C.''.
(c) Drug Fees.--Section 736(a)(1)(A)(ii) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379h) is amended by adding after
``required'' the following: ``, including supplements required under
section 505C of the Act''.
SEC. 410. UNITED STATES COMMISSION ON CIVIL RIGHTS.
(a) Coordination Within Department of Justice of Activities
Regarding Health Disparities.--Section 3 of the Civil Rights Commission
Act of 1983 (42 U.S.C. 1975a) is amended--
(1) in paragraph (1)(B), by striking ``and'' at the end;
(2) in paragraph (2), in the matter after and below
subparagraph (D), by striking the period and inserting ``;
and''; and
(3) by adding at the end the following:
``(3) shall, with respect to activities carried out in
healthcare and correctional facilities toward the goal of
eliminating health disparities between the general population
and members of racial or ethnic minority groups, coordinate
such activities of--
``(A) the Office for Civil Rights within the
Department of Justice;
``(B) the Office of Justice Programs within the
Department of Justice;
``(C) the Office for Civil Rights within the
Department of Health and Human Services; and
``(D) the Office of Minority Health within the
Department of Health and Human Services (headed by the
Deputy Assistant Secretary for Minority Health
Disparity Elimination).''.
(b) Authorization of Appropriations.--Section 5 of the Civil Rights
Commission Act of 1983 (42 U.S.C. 1975c) is amended by striking the
first sentence and inserting the following: ``For the purpose of
carrying out this Act, there are authorized to be appropriated
$30,000,000 for fiscal year 2007, and such sums as may be necessary for
each of the fiscal years 2008 through 2012.''.
SEC. 411. SENSE OF CONGRESS CONCERNING FULL FUNDING OF ACTIVITIES TO
ELIMINATE RACIAL AND ETHNIC HEALTH DISPARITIES.
(a) Findings.--Congress makes the following findings:
(1) The health status of the American populace is declining
and the United States currently ranks below most industrialized
nations in health status measured by longevity, sickness, and
mortality.
(2) Racial and ethnic minority populations tend have the
poorest health status and face substantial cultural, social,
and economic barriers to obtaining quality healthcare.
(3) Efforts to improve minority health have been limited by
inadequate resources (funding, staffing, and stewardship) and
accountability.
(b) Sense of Congress.--It is the sense of Congress that--
(1) funding should be doubled by fiscal year 2007 for the
National Center for Minority Health Disparities, the Office of
Civil Rights in the Department of Health and Human Services,
the National Institute of Nursing Research, and the Office of
Minority Health;
(2) adequate funding by fiscal year 2007, and subsequent
funding increases, should be provided for health professions
training programs, the Racial and Ethnic Approaches to
Community Health (REACH) at the Center for Disease Control and
Prevention, the Minority HIV/AIDS Initiative, and the
Excellence Centers to Eliminate Ethnic/Racial Disparities
(EXCEED) Program at the Agency for Healthcare Research and
Quality;
(3) current and newly-created health disparity elimination
incentives, programs, agencies, and departments under this Act
(and the amendments made by this Act) should receive adequate
staffing and funding by fiscal year 2007; and
(4) stewardship and accountability should be provided by
Congress and the President for health disparity elimination.
SEC. 412. GUIDELINES FOR DISEASE SCREENING FOR MINORITY PATIENTS.
(a) In General.--The Secretary, acting through the Director of the
Agency for Healthcare Research and Quality, shall convene a series of
meetings to develop guidelines for disease screening for minority
patient populations which have a higher than average risk for many
chronic diseases and cancers.
(b) Participants.--In convening meetings under subsection (a), the
Secretary shall ensure that meeting participants include
representatives of--
(1) professional societies and associations;
(2) minority health organizations;
(3) healthcare researchers and providers, including those
with expertise in minority health;
(4) Federal health agencies, including the Office of
Minority Health and the National Institutes of Health; and
(5) other experts determined appropriate by the Secretary.
(c) Diseases.--Screening guidelines for minority populations shall
be developed under subsection (a) for--
(1) hypertension;
(2) hypercholesterolemia;
(3) diabetes;
(4) cardiovascular disease;
(5) prostate cancer;
(6) breast cancer;
(7) colon cancer;
(8) kidney disease;
(9) glaucoma; and
(10) other diseases determined appropriate by the
Secretary.
(d) Dissemination.--Not later than 24 months after the date of
enactment of this title, the Secretary shall publish and disseminate to
healthcare provider organizations the guidelines developed under
subsection (a).
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, sums as may be necessary for
each of fiscal years 2007 through 2012.
Subtitle B--Improving Environmental Justice
SEC. 421. DEFINITIONS.
For purposes of this subtitle:
(1) Environmental justice.--
(A) In general.--The term ``environmental justice''
means the fair treatment of people of all races,
cultures, and socioeconomic groups with respect to the
development, adoption, implementation, and enforcement
of laws, regulations, and policies affecting the
environment.
(B) Fair treatment.--The term ``fair treatment''
means policies and practices that will minimize the
likelihood that a minority, low-income, or Native
American community will bear a disproportionate share
of the adverse environmental consequences, or be denied
reasonable access to the environmental benefits,
resulting from implementation of a Federal program or
policy.
(2) Federal agency.--The term ``Federal agency'' means--
(A) each Federal entity represented on the Working
Group;
(B) any other entity that conducts any Federal
program or activity that substantially affects human
health or the environment; and
(C) each Federal agency that implements any
program, policy, or activity applicable to Native
Americans.
(3) Working group.--The term ``Working Group'' means the
interagency working group established by section 423.
(4) Advisory committee.--The term ``the Advisory
Committee'' means the advisory committee established by section
425.
SEC. 422. ENVIRONMENTAL JUSTICE RESPONSIBILITIES OF FEDERAL AGENCIES.
(a) Environmental Justice Mission.--To the greatest extent
practicable, the head of each Federal agency shall make achieving
environmental justice part of its mission by identifying and
addressing, as appropriate, disproportionately high and adverse human
health or environmental effects of its programs, policies, and
activities on minority and low-income populations in the United States
and its territories and possessions, including the District of
Columbia, the Commonwealth of Puerto Rico, Virgin Islands, Guam, and
the Commonwealth of the Mariana Islands.
(b) Nondiscrimination.--Each Federal agency shall conduct its
programs, policies, and activities in a manner that ensures that such
programs, policies, and activities do not have the effect of excluding
any person or group from participation in, denying any person or group
the benefits of, or subjecting any person or group to discrimination
under, such programs, policies, and activities, because of race, color,
national origin, or income.
SEC. 423. INTERAGENCY ENVIRONMENTAL JUSTICE WORKING GROUP.
(a) Creation and Composition.--There is hereby established the
Interagency Working Group on Environmental Justice, comprising the
heads of the following executive agencies and offices, or their
designees:
(1) The Department of Defense.
(2) The Department of Health and Human Services.
(3) The Department of Housing and Urban Development.
(4) The Department of Homeland Security.
(5) The Department of Labor.
(6) The Department of Agriculture.
(7) The Department of Transportation.
(8) The Department of Justice;
(9) The Department of the Interior.
(10) The Department of Commerce.
(11) The Department of Energy.
(12) The Environmental Protection Agency.
(13) The Office of Management and Budget.
(14) Any other official of the United States that the
President may designate.
(b) Functions.--The Working Group shall--
(1) provide guidance to Federal agencies on criteria for
identifying disproportionately high and adverse human health or
environmental effects on minority, low-income, and Native
American populations;
(2) coordinate with, provide guidance to, and serve as a
clearinghouse for, each Federal agency as it develops or
revises an environmental justice strategy as required by this
subtitle, in order to ensure that the administration,
interpretation and enforcement of programs, activities, and
policies are undertaken in a consistent manner;
(3) assist in coordinating research by, and stimulating
cooperation among, the Environmental Protection Agency, the
Department of Health and Human Services, the Department of
Housing and Urban Development, and other Federal agencies
conducting research or other activities in accordance with
section 424;
(4) assist in coordinating data collection, maintenance,
and analysis required by this subtitle;
(5) examine existing data and studies on environmental
justice;
(6) hold public meetings and otherwise solicit public
participation and consider complaints as required under
subsection (c);
(7) develop interagency model projects on environmental
justice that evidence cooperation among Federal agencies; and
(8) in coordination with the Department of the Interior and
after consultation with tribal leaders, coordinate steps to be
taken pursuant to this subtitle that affect or involve
federally-recognized Indian Tribes.
(c) Public Participation.--The Working Group shall--
(1) hold public meetings and otherwise solicit public
participation, as appropriate, for the purpose of fact-finding
with regard to implementation of this subtitle, and prepare for
public review a summary of the comments and recommendations
provided; and
(2) receive, consider, and in appropriate instances conduct
inquiries concerning complaints regarding environmental justice
and the implementation of this subtitle by Federal agencies.
(d) Annual Reports.--
(1) In general.--Each fiscal year following enactment of
this Act, the Working Group shall submit to the President,
through the Office of the Deputy Assistant to the President for
Environmental Policy and the Office of the Assistant to the
President for Domestic Policy, a report that describes the
implementation of this subtitle, including, but not limited to,
a report of the final environmental justice strategies
described in section 424 of this subtitle and annual progress
made in implementing those strategies.
(2) Copy of report.--The President shall transmit to the
Speaker of the House of Representatives and the President of
the Senate a copy of each report submitted to the President
pursuant to paragraph (1).
(e) Conforming Change.--The Interagency Working Group on
Environmental Justice established under Executive Order No. 12898,
dated February 11, 1994, is abolished.
SEC. 424. FEDERAL AGENCY STRATEGIES.
(a) Agency-Wide Strategies.--Each Federal agency shall develop an
agency-wide environmental justice strategy that identifies and
addresses disproportionally high and adverse human health or
environmental effects or disproportionally low benefits of its
programs, policies, and activities with respect to minority, low-
income, and Native American populations.
(b) Revisions.--Each strategy developed pursuant to subsection (a)
shall identify programs, policies, planning, and public participation
processes, rulemaking, and enforcement activities related to human
health or the environment that should be revised to--
(1) promote enforcement of all health and environmental
statutes in areas with minority, low-income, or Native American
populations;
(2) ensure greater public participation;
(3) improve research and data collection relating to the
health of and environment of minority, low-income, and Native
American populations; and
(4) identify differential patterns of use of natural
resources among minority, low-income, and Native American
populations.
(c) Timetables.--Each strategy developed pursuant to subsection (a)
shall include, where appropriate, a timetable for undertaking revisions
identified pursuant to subsection (b).
SEC. 425. FEDERAL ENVIRONMENTAL JUSTICE ADVISORY COMMITTEE.
(a) Establishment.--There is established a committee to be known as
the ``Federal Environmental Justice Advisory Committee''.
(b) Duties.--The Advisory Committee shall provide independent
advice and recommendations to the Environmental Protection Agency and
the Working Group on areas relating to environmental justice, which may
include any of the following:
(1) Advice on Federal agencies' framework development for
integrating socioeconomic programs into strategic planning,
annual planning, and management accountability for achieving
environmental justice results agency-wide.
(2) Advice on measuring and evaluating agencies' progress,
quality, and adequacy in planning, developing, and implementing
environmental justice strategies, projects, and programs.
(3) Advice on agencies' existing and future information
management systems, technologies, and data collection, and the
conduct of analyses that support and strengthen environmental
justice programs in administrative and scientific areas.
(4) Advice to help develop, facilitate, and conduct reviews
of the direction, criteria, scope, and adequacy of the Federal
agencies' scientific research and demonstration projects
relating to environmental justice.
(5) Advice for improving how the Environmental Protection
Agency and others participate, cooperate, and communicate
within that agency and between other Federal agencies, State or
local governments, federally recognized Tribes, environmental
justice leaders, interest groups, and the public.
(6) Advice regarding the Environmental Protection Agency's
administration of grant programs relating to environmental
justice assistance (not to include the review or
recommendations of individual grant proposals or awards).
(7) Advice regarding agencies' awareness, education,
training, and other outreach activities involving environmental
justice.
(c) Advisory Committee.--The Advisory Committee shall be considered
an advisory committee within the meaning of the Federal Advisory
Committee Act (5 U.S.C. App.).
(d) Membership.--
(1) In general.--The Advisory Committee shall be composed
of 21 members to be appointed in accordance with paragraph (2).
Members shall include representatives of--
(A) community-based groups;
(B) industry and business;
(C) academic and educational institutions;
(D) minority health organizations;
(E) State and local governments, federally
recognized tribes, and indigenous groups; and
(F) nongovernmental and environmental groups.
(2) Appointments.--Of the members of the Advisory
Committee--
(A) five members shall be appointed by the majority
leader of the Senate;
(B) five members shall be appointed by the minority
leader of the Senate;
(C) five members shall be appointed by the Speaker
of the House of Representatives;
(D) five members shall be appointed by the minority
leader of the House of Representatives; and
(E) one member to be appointed by the President.
(e) Meetings.--The Advisory Committee shall meet at least twice
annually. Meetings shall occur as needed and approved by the Director
of the Office of Environmental Justice of the Environmental Protection
Agency, who shall serve as the officer required to be appointed under
section 10(e) of the Federal Advisory Committee Act (5 U.S.C. App.)
with respect to the Committee (in this subsection referred to as the
``Designated Federal Officer''). The Administrator of the Environmental
Protection Agency may pay travel and per diem expenses of members of
the Advisory Committee when determined necessary and appropriate. The
Designated Federal Officer or a designee of such Officer shall be
present at all meetings, and each meeting will be conducted in
accordance with an agenda approved in advance by such Officer. The
Designated Federal Officer may adjourn any meeting when the Designated
Federal Officer determines it is in the public interest to do so. As
required by the Federal Advisory Committee Act, meetings of the
Advisory Committee shall be open to the public unless the President
determines that a meeting or a portion of a meeting may be closed to
the public in accordance with subsection (c) of section 552b of title
5, United States Code. Unless a meeting or portion thereof is closed to
the public, the Designated Federal Officer shall provide an opportunity
for interested persons to file comments before or after such meeting or
to make statements to the extent that time permits.
(f) Duration.--The Advisory Committee shall remain in existence
until otherwise provided by law.
SEC. 426. HUMAN HEALTH AND ENVIRONMENTAL RESEARCH, DATA COLLECTION AND
ANALYSIS.
(a) Disproportionate Impact.--To the extent permitted by other
applicable law, including section 552a of title 5, United States Code,
popularly known as the Privacy Act of 1974, the Administrator of the
Environmental Protection Agency, or the head of such other Federal
agency as the President may direct, shall collect, maintain, and
analyze information assessing and comparing environmental and human
health risks borne by populations identified by race, national origin,
or income. To the extent practical and appropriate, Federal agencies
shall use this information to determine whether their programs,
policies, and activities have disproportionally high and adverse human
health or environmental effects on, or disproportionally low benefits
for, minority, low-income, and Native American populations.
(b) Information Related to Non-Federal Facilities.--In connection
with the development and implementation of agency strategies in section
424, the Administrator of the Environmental Protection Agency, or the
head of such other Federal agency as the President may direct, shall
collect, maintain, and analyze information on the race, national
origin, and income level, and other readily accessible and appropriate
information, for areas surrounding facilities or sites expected to have
a substantial environmental, human health, or economic effect on the
surrounding populations, if such facilities or sites become the subject
of a substantial Federal environmental administrative or judicial
action.
(c) Impact From Federal Facilities.--The Administrator of the
Environmental Protection Agency, or the head of such other Federal
agency as the President may direct, shall collect, maintain, and
analyze information on the race, national origin, and income level, and
other readily accessible and appropriate information, for areas
surrounding Federal facilities that are--
(1) subject to the reporting requirements under the
Emergency Planning and Community Right-to-Know Act (42 U.S.C.
11001 et seq.) as mandated in Executive Order No. 12856; and
(2) expected to have a substantial environmental, human
health, or economic effect on surrounding populations.
(d) Information Sharing.--
(1) In general.--In carrying out the responsibilities in
this section, each Federal agency, to the extent practicable
and appropriate, shall share information and eliminate
unnecessary duplication of efforts through the use of existing
data systems and cooperative agreements among Federal agencies
and with State, local, and tribal governments.
(2) Public availability.--Except as prohibited by other
applicable law, information collected or maintained pursuant to
this section shall be made available to the public.
(e) Public Comment.--Federal agencies shall provide minority, low-
income, and Native American populations the opportunity to participate
in the development, design, and conduct of activities undertaken
pursuant to this section.
TITLE V--HEALTH EMPOWERMENT ZONES
SEC. 501. HEALTH EMPOWERMENT ZONES.
(a) Health Empowerment Zone Programs.--
(1) Grants.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration and the Deputy Assistant Secretary for Minority
Health Disparity Elimination, and in cooperation with the
Director of the Office of Community Services and the Director
of the National Center for Minority Health and Health
Disparities, shall make grants to partnerships of private and
public entities to establish health empowerment zone programs
in communities that disproportionately experience disparities
in health status and healthcare for the purpose described in
paragraph (2).
(2) Use of funds.--
(A) In general.--Subject to subparagraph (B), the
purpose of a health empowerment zone program under this
section shall be to assist individuals, businesses,
schools, minority health associations, non-profit
organizations, community-based organizations,
hospitals, healthcare clinics, foundations, and other
entities in communities that disproportionately
experience disparities in health status and healthcare
which are seeking--
(i) to improve the health or environment of
minority individuals in the community and to
reduce disparities in health status and
healthcare by assisting individuals in
accessing Federal programs; and
(ii) to coordinate the efforts of
governmental and private entities regarding the
elimination of racial and ethnic disparities in
health status and healthcare.
(B) Medicare and medicaid.--A health empowerment
zone program under this section shall not provide any
assistance (other than referral and follow-up services)
that is duplicative of programs under title XVIII or
XIX of the Social Security Act (42 U.S.C. 1395 and 1396
et seq.).
(3) Distribution.--The Secretary shall make at least 1
grant under this section to a partnership for a health
empowerment zone program in communities that disproportionately
experience disparities in health status and healthcare that is
located in a territory or possession of the United States.
(4) Application.--To obtain a grant under this section, a
partnership shall submit to the Secretary an application in
such form and in such manner as the Secretary may require. An
application under this paragraph shall--
(A) demonstrate that the communities to be served
by the health empowerment zone program are those that
disproportionately experience disparities in health
status and healthcare;
(B) set forth a strategic plan for accomplishing
the purpose described in paragraph (2), by--
(i) describing the coordinated health,
economic, human, community, and physical
development plan and related activities
proposed for the community;
(ii) describing the extent to which local
institutions and organizations have contributed
and will contribute to the planning process and
implementation;
(iii) identifying the projected amount of
Federal, State, local, and private resources
that will be available in the area and the
private and public partnerships to be used
(including any participation by or cooperation
with universities, colleges, foundations, non-
profit organizations, medical centers,
hospitals, health clinics, school districts, or
other private and public entities);
(iv) identifying the funding requested
under any Federal program in support of the
proposed activities;
(v) identifying benchmarks for measuring
the success of carrying out the strategic plan;
(vi) demonstrating the ability to reach and
service the targeted underserved minority
community populations in a culturally
appropriate and linguistically responsive
manner; and
(vii) demonstrating a capacity and
infrastructure to provide long-term community
response that is culturally appropriate and
linguistically responsive to communities that
disproportionately experience disparities in
health and healthcare; and
(C) include such other information as the Secretary
may require.
(5) Preference.--In awarding grants under this subsection,
the Secretary shall give preference to proposals from
indigenous community entities that have an expertise in
providing culturally appropriate and linguistically responsive
services to communities that disproportionately experience
disparities in health and health care.
(b) Federal Assistance for Health Empowerment Zone Grant
Programs.--The Secretary, the Administrator of the Small Business
Administration, the Secretary of Agriculture, the Secretary of
Education, the Secretary of Labor, and the Secretary of Housing and
Urban Development shall each--
(1) where appropriate, provide entity-specific technical
assistance and evidence-based strategies to communities that
disproportionately experience disparities in health status and
healthcare to further the purposes served by a health
empowerment zone program established with a grant under
subsection (a);
(2) identify all programs administered by the Department of
Health and Human Services, Small Business Administration,
Department of Agriculture, Department of Education, Department
of Labor, and the Department of Housing and Urban Development,
respectively, that may be used to further the purpose of a
health empowerment zone program established with a grant under
subsection (a); and
(3) in administering any program identified under paragraph
(2), consider the appropriateness of giving priority to any
individual or entity located in communities that
disproportionately experience disparities in health status and
healthcare served by a health empowerment zone program
established with a grant under subsection (a), if such priority
would further the purpose of the health empowerment zone
program.
(c) Health Empowerment Zone Coordinating Committee.--
(1) Establishment.--For each health empowerment zone
program established with a grant under subsection (a), the
Secretary acting through the Director of Office of Minority
Health and the Administrator of the Health Resources and
Services Administration shall establish a health empowerment
zone coordinating committee.
(2) Duties.--Each coordinating committee established, in
coordination with the Deputy Assistant Secretary for Minority
Health Disparity Elimination and the Administrator of the
Health Resources and Services Administration, shall provide
technical assistance and evidence-based strategies to the grant
recipient involved, including providing guidance on research,
strategies, health outcomes, program goals, management,
implementation, monitoring, assessment, and evaluation
processes.
(3) Membership.--
(A) Appointment.--The Deputy Assistant Secretary
for Minority Health Disparity Elimination and the
Administrator of the Health Resources and Services
Administration, in consultation with the respective
grant recipient shall appoint the members of each
coordinating committee.
(B) Composition.--The Deputy Assistant Secretary
for Minority Health Disparity Elimination, and the
Administrator of the Health Resources and Services
Administration shall ensure that each coordinating
committee established--
(i) has not more than 20 members;
(ii) includes individuals from communities
that disproportionately experience disparities
in health status and healthcare;
(iii) includes community leaders and
leaders of community-based organizations;
(iv) includes representatives of academia
and lay and professional organizations and
associations including those having expertise
in medicine, technical, social and behavioral
science, health policy, advocacy, cultural and
linguistic competency, research management, and
organization; and
(v) represents a reasonable cross-section
of knowledge, views, and application of
expertise on societal, ethical, behavioral,
educational, policy, legal, cultural,
linguistic, and workforce issues related to
eliminating disparities in health and
healthcare.
(C) Individual qualifications.--The Deputy
Assistant Secretary for Minority Health Disparity
Elimination and the Administrator of the Health
Resources and Services Administration may not appoint
an individual to serve on a coordinating committee
unless the individual meets the following
qualifications:
(i) The individual is not employed by the
Federal Government.
(ii) The individual has appropriate
experience, including experience in the areas
of community development, cultural and
linguistic competency, reducing and eliminating
racial and ethnic disparities in health and
health care, or minority health.
(D) Selection.--In selecting individuals to serve
on a coordinating committee, the Deputy Assistant
Secretary for Minority Health Disparity Elimination and
the Administrator Health Resources and Services
Administration shall give due consideration to the
recommendations of the Congress, industry leaders, the
scientific community (including the Institute of
Medicine), academia, community based non-profit
organizations, minority health and related
organizations, the education community, State and local
governments, and other appropriate organizations.
(E) Chairperson.--The Deputy Assistant Secretary
for Minority Health Disparity Elimination and the
Administrator of the Health Resources and Services
Administration, in consultation with the members of the
coordinating committee involved, shall designate a
chairperson of the coordinating committee, who shall
serve for a term of 3 years and who may be reappointed
at the expiration of each such term.
(F) Terms.--Each member of a coordinating committee
shall be appointed for a term of 1 to 3 years in
overlapping staggered terms, as determined by the
Deputy Assistant Secretary for Minority Health
Disparity Elimination and the Administrator of the
Health Resources and Services Administration at the
time of appointment, and may be reappointed at the
expiration of each such term.
(G) Vacancies.--A vacancy on a coordinating
committee shall be filled in the same manner in which
the original appointment was made.
(H) Compensation.--Each member of a coordinating
committee shall be compensated at a rate equal to the
daily equivalent of the annual rate of basic pay for
level IV of the Executive Schedule for each day
(including travel time) during which such member is
engaged in the performance of the duties of the
coordinating committee.
(I) Travel expenses.--Each member of a coordinating
committee 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.
(4) Meetings.--A coordinating committee shall meet 3 to 5
times each year, at the call of the coordinating committee's
chairperson and in consultation with the Deputy Assistant
Secretary for Minority Health Disparity Elimination and the
Administrator Health Resources and Services Administration.
(5) Report.--Each coordinating committee shall transmit to
the Congress an annual report that, with respect to the health
empowerment zone program involved, includes the following:
(A) A review of the program's effectiveness in
achieving stated goals and outcomes.
(B) A review of the program's management and the
coordination of the entities involved.
(C) A review of the activities in the program's
portfolio and components.
(D) An identification of policy issues raised by
the program.
(E) An assessment of the program's capacity,
infrastructure, and number of underserved minority
communities reached.
(F) Recommendations for new program goals, research
areas, enhanced approaches, partnerships, coordination
and management mechanisms, and projects to be
established to achieve the program's stated goals, to
improve outcomes, monitoring, and evaluation.
(G) A review of the degree of minority entity
participation in the program, and an identification of
a strategy to increase such participation.
(H) Any other reviews or recommendations determined
to be appropriate by the coordinating committee.
(d) Report.--The Deputy Assistant Secretary for Minority Health
Disparity Elimination and the Administrator of the Health Resources and
Services Administration shall submit a joint annual report to the
appropriate committees of Congress on the results of the implementation
of programs under this section.
(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2007 through 2012.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, the Judiciary, Ways and Means, and Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, the Judiciary, Ways and Means, and Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, the Judiciary, Ways and Means, and Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, the Judiciary, Ways and Means, and Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, the Judiciary, Ways and Means, and Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, the Judiciary, Ways and Means, and Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Executive Comment Requested from HHS.
Referred to the Subcommittee on Employer-Employee Relations.