Minority Health Improvement and Health Disparity Elimination Act - Amends the Public Health Service Act to require the Secretary of Health and Human Services to: (1) provide for the development of an Internet Clearinghouse within the Office of Minority Health and Health Disparity Elimination; (2) provide for programs of excellence in health professions education for underrepresented minorities in health professions; and (3) support demonstration projects designed to improve the health and health care of racial and ethnic minority and other health disparity populations through improved access to health care, patient navigators, and health literacy education and services.
Provides for grants to: (1) design, implement, and evaluate culturally and linguistically appropriate, science-based and community-driven sustainable strategies to eliminate racial and ethnic health and health care disparities; and (2) implement systems of primary care practices to eliminate disparities in the delivery of health care and improve the health care provided to all patients.
Requires the Secretary to establish the Community Health Initiative demonstration program to support comprehensive state, tribal, or local initiatives to improve the health of racial and ethnic minority and other health disparity populations.
Provides for grants or contracts for research to improve the health of racial and ethnic minorities and other health disparity populations.
Requires the Secretary to ensure the collection of data from federally conducted or supported health programs by race, ethnicity, geographic location, socioeconomic position, primary language, and, when practicable, health literacy.
Establishes an Office of Minority Health and Health Disparity Elimination and transfers to it functions of the Office of Minority Health. Requires the Secretary to establish the Advisory Committee on Minority Health and Health Disparities.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 4024 Introduced in Senate (IS)]
109th CONGRESS
2d Session
S. 4024
To amend the Public Health Service Act to improve the health and
healthcare of racial and ethnic minority and other health disparity
populations.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 29, 2006
Mr. Frist (for himself, Mr. Kennedy, Mr. Obama, and Mr. Bingaman)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve the health and
healthcare of racial and ethnic minority and other health disparity
populations.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Minority Health
Improvement and Health Disparity Elimination Act''.
(b) Table of Contents.--
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
TITLE I--EDUCATION AND TRAINING
Sec. 101. Cultural competency and communication for providers.
Sec. 102. Healthcare workforce, education, and training.
Sec. 103. Workforce training to achieve diversity.
Sec. 104. Mid-career health professions scholarship program.
Sec. 105. Cultural competency training.
Sec. 106. Authorization of appropriations; reauthorizations.
TITLE II--CARE AND ACCESS
Sec. 201. Care and access.
Sec. 202. Authorization of appropriations.
TITLE III--RESEARCH
Sec. 301. Agency for healthcare research and quality.
Sec. 302. Genetic variation and health.
Sec. 303. Evaluations by the Institute of Medicine.
Sec. 304. National Center for Minority Health and Health Disparities
reauthorization.
Sec. 305. Authorization of appropriations.
TITLE IV--DATA COLLECTION, ANALYSIS, AND QUALITY
Sec. 401. Data collection, analysis, and quality.
TITLE V--LEADERSHIP, COLLABORATION, AND NATIONAL ACTION PLAN
Sec. 501. Office of Minority Health and Health Disparity Elimination.
SEC. 2. DEFINITIONS.
In this Act and the amendments made by this Act:
(1) Cultural competency.--The term ``culturally
competent''--
(A) when used to describe health-related services,
means providing healthcare tailored to meet the social,
cultural, and linguistic needs of patients from diverse
backgrounds; and
(B) when used to describe education or training,
means education or training designed to prepare those
receiving the education or training to provide health-
related services tailored to meet the social, cultural,
and linguistic needs of patients from diverse
backgrounds.
(2) Health disparity population.--The term ``health
disparity population'' has the meaning given such term in
section 903(d)(1) of the Public Health Service Act (42 U.S.C.
299a-1(d)(1)).
(3) Health literacy.--The term ``health literacy'' means
the degree to which an individual has the capacity to obtain,
communicate, process, and understand health information
(including the language in which the information is provided)
and services in order to make appropriate health decisions.
(4) Minority group.--The term ``minority group'' has the
meaning given the term ``racial and ethnic minority group'' in
section 1707 of the Public Health Service Act (42 U.S.C. 300u-
6) (as amended by section 501).
(5) Practice-based research networks.--The term ``practice-
based research network'' means a group of ambulatory practices
devoted principally to the primary care of patients, and
affiliated in their mission to investigate questions related to
community-based practice and to improve the quality of primary
care.
(6) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
TITLE I--EDUCATION AND TRAINING
SEC. 101. CULTURAL COMPETENCY AND COMMUNICATION FOR PROVIDERS.
Title II of the Public Health Service Act (42 U.S.C. 202 et seq.)
is amended by adding at the end the following:
``SEC. 270. INTERNET CLEARINGHOUSE TO IMPROVE CULTURAL COMPETENCY AND
COMMUNICATION BY HEALTHCARE PROVIDERS.
``(a) Establishment.--Not later than 1 year after the date of
enactment of the Minority Health Improvement and Health Disparity
Elimination Act, the Secretary, acting through the Deputy Assistant
Secretary for Minority Health and Health Disparity Elimination, shall
assist providers to improve the health and healthcare of racial and
ethnic minority and other health disparity populations by developing
and maintaining an Internet Clearinghouse within the Office of Minority
Health and Health Disparity Elimination that--
``(1) increases cultural competency;
``(2) improves communication between healthcare providers,
staff, and their patients, including those patients with low
functional health literacy;
``(3) improves healthcare quality and patient satisfaction;
``(4) reduces medical errors and healthcare costs; and
``(5) reduces duplication of effort regarding translation
of materials.
``(b) Internet Clearinghouse.--Not later than 12 months after the
date of enactment of this section the Secretary, acting through the
Deputy Assistant Secretary for Minority Health and Health Disparity
Elimination, and in consultation with the Director of the Office for
Civil Rights, shall carry out subsection (a) by--
``(1) developing and maintaining, through the Office of
Minority Health and Health Disparity Elimination, an accessible
library and database on the Internet with easily searchable,
clinically-relevant information regarding culturally competent
healthcare for racial and ethnic minority and other health
disparity populations, including Internet links to additional
resources that fulfill the purpose of this section;
``(2) developing and making templates for visual aids and
standard documents with clear explanations that can help
patients and consumers access and make informed decisions about
healthcare, including--
``(A) administrative and legal documents, including
informed consent and advanced directives;
``(B) clinical information, including information
pertaining to treatment adherence, self-management
training for chronic conditions, preventing
transmission of disease, and discharge instructions;
``(C) patient education and outreach materials,
including immunization or screening notices and health
warnings; and
``(D) Federal health forms and notices;
``(3) ensuring that documents described in paragraph (2)
are posted in English and non-English languages and are
culturally appropriate;
``(4) encouraging healthcare providers to customize such
documents for their use;
``(5) facilitating access to such documents, including
distribution in both paper and electronic formats;
``(6) providing technical assistance to healthcare
providers with respect to the access and use of information
described in paragraph (1) including information to help
healthcare providers--
``(A) understand the concept of cultural
competence;
``(B) implement culturally competent practices;
``(C) care for patients with low functional health
literacy, including helping such patients understand
and participate in healthcare decisions;
``(D) understand and apply Federal guidance and
directives regarding healthcare for racial and ethnic
minority and other health disparity populations;
``(E) obtain reimbursement for provision of
culturally competent services;
``(F) understand and implement bioinformatics and
health information technology in order to improve
healthcare for racial and ethnic minority and other
health disparity populations; and
``(G) conduct other activities determined
appropriate by the Secretary;
``(7) providing educational materials to patients,
representatives of community-based organizations, and the
public with respect to the access and use of information
described in paragraph (1), including--
``(A) information to help such individuals--
``(i) understand the concept of cultural
competence, and the role of cultural competence
in the delivery of healthcare;
``(ii) work with healthcare providers to
implement culturally competent practices; and
``(iii) understand the concept of low
functional health literacy, and the barriers it
presents to care; and
``(B) other material determined appropriate by the
Secretary; and
``(8) supporting initiatives that the Secretary determines
to be useful to fulfill the purposes of the Internet
Clearinghouse.
``(c) Definitions.--The definitions contained in section 2 of the
Minority Health Improvement and Health Disparity Elimination Act shall
apply for purposes of this section.''.
SEC. 102. HEALTHCARE WORKFORCE, EDUCATION, AND TRAINING.
(a) In General.--Part F of title VII of the Public Health Service
Act (42 U.S.C. 295j et seq.) is amended by inserting after section 792
the following:
``SEC. 793. HEALTHCARE WORKFORCE, EDUCATION, AND TRAINING.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration and the Deputy
Assistant Secretary for Minority Health and Health Disparity
Elimination, shall establish an aggregated and disaggregated database
on health professional students, including applicants, matriculates,
and graduates.
``(b) Requirement To Collect Data.--
``(1) In general.--Each health professions school described
in paragraph (2) that receives Federal funds, shall collect
race and ethnicity data, primary language data, and other
health disparity data, as feasible and pursuant to subsection
(d), concerning the students described in subsection (a), as
well as intended geographical site of practice and intended
discipline of practice for graduates. In collecting such data,
a school shall--
``(A) at a minimum, use the categories for race and
ethnicity established by the Director of the Office of
Management and Budget in effect on the date of
enactment of the Minority Health Improvement and Health
Disparity Elimination Act; and
``(B) if practicable, collect data on additional
population groups if such data can be aggregated into
the minimum race and ethnicity data categories.
``(2) Health professions school.--A health professions
school described under this paragraph is a school of medicine
or osteopathic medicine, public health, nursing, dentistry,
optometry, pharmacy, allied health, podiatric medicine, or
veterinary medicine, or a graduate program in mental health
practice.
``(c) Reporting.--Each school or program described under subsection
(b), shall, on an annual basis, report to the Secretary data on race
and ethnicity and primary language collected under this section for
inclusion in the database established under subsection (a). The
Secretary shall ensure that such disparity data is reported to Congress
and made available to the public.
``(d) Health Disparity Measures.--The Secretary shall develop,
report, and disseminate measures of the other health data referenced in
section 793(b)(1), to ensure uniform and consistent collection and
reporting of these measures by health professions schools. In
developing such measures, the Secretary shall take into consideration
health disparity indicators developed pursuant to section 2901(c).
``(e) Use of Data.--Data reported pursuant to subsection (c) shall
be used by the Secretary to conduct ongoing short- and long-term
analyses of diversity within health professions schools and the health
professions. The Secretary shall ensure that such analyses are reported
to Congress and made available to the public.
``(f) Cultural Competency Training.--The Secretary shall collect
and report data from health professions schools regarding the extent to
which cultural competency training is provided to health professions
students, and conduct periodic assessments regarding the preparedness
of such students to care for patients from racial and ethnic minority
and other health disparity populations.
``(g) 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.
``(h) Partnership.--The Secretary may contract with external
entities to fulfill the requirements under this section if such
entities have demonstrated expertise and experience collecting,
analyzing, and reporting data required under this section for health
professional students.''.
(b) National Health Service Corps Program.--
(1) Assignment of corps personnel.--Section 333(a)(3) of
the Public Health Service Corps (42 U.S.C. 254f(a)(3)) is
amended to read as follows:
``(3)(A) In approving applications for assignment of
members of the Corps the Secretary shall not discriminate
against application from entities which are not receiving
Federal financial assistance under this Act.
``(B) In approving such applications, the Secretary shall--
``(i) give preference to applications in which a
nonprofit entity or public entity shall provide a site
to which Corps members may be assigned; and
``(ii) give highest preference to applications--
``(I) from entities described in clause (i)
that are federally qualified health centers as
defined in section 1905(l)(2)(B) of the Social
Security Act; and
``(II) from entities described in clause
(i) that primarily serve racial and ethnic
minority and other health disparity populations
with annual incomes at or below twice those set
forth in the most recent poverty guidelines
issued by the Secretary pursuant to section
673(2) of the Community Services Block Grant
Act (42 U.S.C. 9902(2)).''.
(2) Priorities in assignment of corps personnel.--Section
333A of the Public Health Service Act (42 U.S.C. 254f-1) is
amended--
(A) in subsection (a)--
(i) by redesignating paragraphs (1), (2),
and (3) as paragraphs (2), (3), and (4),
respectively; and
(ii) by striking ``shall--'' and inserting
``shall--
``(1) give preference to applications as set forth in
subsection (a)(3) of section 333;''; and
(B) by striking ``subsection (a)(1)'' each place it
appears and inserting ``subsection (a)(2)''.
(3) Conforming amendment.--Section 338I(c)(3)(B)(ii) of the
Public Health Service Act (42 U.S.C. 254q-1(c)(3)(B)(ii)) is
amended by striking ``section 333A(a)(1)'' and inserting
``section 333A(a)(2)''.
SEC. 103. WORKFORCE TRAINING TO ACHIEVE DIVERSITY.
(a) Centers of Excellence.--Section 736 of the Public Health
Service Act (42 U.S.C. 293) is amended--
(1) by striking subsection (a) and inserting the following:
``(a) In General.--The Secretary shall make grants to, and enter
into contracts with, public and nonprofit private health or educational
entities, including designated health professions schools described in
subsection (c), for the purpose of assisting the entities in supporting
programs of excellence in health professions education for
underrepresented minorities in health professions.'';
(2) by striking subsection (b) and inserting the following:
``(b) Required Use of Funds.--The Secretary may not make a grant
under subsection (a) unless the designated health professions school
involved agrees, subject to subsection (c)(1)(C), to use the funds
awarded under the grant to--
``(1) develop a large competitive applicant pool through
linkages with institutions of higher education, local school
districts, and other community-based entities and establish an
education pipeline for health professions careers;
``(2) establish, strengthen, or expand programs to enhance
the academic performance of underrepresented minority in health
professions students attending the school;
``(3) improve the capacity of such school to train,
recruit, and retain underrepresented minority faculty members
including the payment of such stipends and fellowships as the
Secretary may determine appropriate;
``(4) carry out activities to improve the information
resources, clinical education, curricula, and cultural and
linguistic competence of the graduates of the school, as it
relates to minority health and other health disparity issues;
``(5) facilitate faculty and student research on health
issues particularly affecting racial and ethnic minority and
other health disparity populations, including research on
issues relating to the delivery of culturally competent
healthcare (as defined in section 270);
``(6) carry out a program to train students of the school
in providing health services to racial and ethnic minority and
other health disparity populations (as defined in section
903(d)(1)) through training provided to such students at
community-based health facilities that--
``(A) provide such health services; and
``(B) are located at a site remote from the main
site of the teaching facilities of the school;
``(7) provide stipends as the Secretary determines
appropriate, in amounts as the Secretary determines
appropriate; and
``(8) conduct accountability and other reporting
activities, as required by the Secretary in subsection (i).'';
(3) in subsection (c)--
(A) by amending paragraph (1) to read as follows:
``(1) Designated schools.--
``(A) In general.--The designated health
professions schools referred to in subsection (a) are
such schools that meet each of the conditions specified
in subparagraphs (B) and (C), and that--
``(i) meet each of the conditions specified
in paragraph (2)(A);
``(ii) meet each of the conditions
specified in paragraph (3);
``(iii) meet each of the conditions
specified in paragraph (4); or
``(iv) meet each of the conditions
specified in paragraph (5).
``(B) General conditions.--The conditions specified
in this subparagraph are that a designated health
professions school--
``(i) has a significant number of
underrepresented minority in health professions
students enrolled in the school, including
individuals accepted for enrollment in the
school;
``(ii) has been effective in assisting such
students of the school to complete the program
of education and receive the degree involved;
``(iii) has been effective in recruiting
such students to enroll in and graduate from
the school, including providing scholarships
and other financial assistance to such students
and encouraging such students from all levels
of the educational pipeline to pursue health
professions careers; and
``(iv) has made significant recruitment
efforts to increase the number of
underrepresented minority in health professions
individuals serving in faculty or
administrative positions at the school.
``(C) Consortium.--The condition specified in this
subparagraph is that, in accordance with subsection
(e)(1), the designated health profession school
involved has with other health profession schools
(designated or otherwise) formed a consortium to carry
out the purposes described in subsection (b) at the
schools of the consortium.
``(D) Application of criteria to other programs.--
In the case of any criteria established by the
Secretary for purposes of determining whether schools
meet the conditions described in subparagraph (B), this
section may not, with respect to racial and ethnic
minorities, be construed to authorize, require, or
prohibit the use of such criteria in any program other
than the program established in this section.'';
(B) by amending paragraph (2) to read as follows:
``(2) Centers of excellence at certain historically black
colleges and universities.--
``(A) Conditions.--The conditions specified in this
subparagraph are that a designated health professions
school is a school described in section 799B(1).
``(B) Use of grant.--In addition to the purposes
described in subsection (b), a grant under subsection
(a) to a designated health professions school meeting
the conditions described in subparagraph (A) may be
expended--
``(i) to develop a plan to achieve
institutional improvements, including financial
independence, to enable the school to support
programs of excellence in health professions
education for underrepresented minority
individuals; and
``(ii) to provide improved access to the
library and informational resources of the
school.
``(C) Exception.--The requirements of paragraph
(1)(C) shall not apply to a historically black college
or university that receives funding under this
paragraph or paragraph (5).''; and
(C) by amending paragraphs (3) through (5) to read
as follows:
``(3) Hispanic centers of excellence.--The conditions
specified in this paragraph are that--
``(A) with respect to Hispanic individuals, each of
clauses (i) through (iv) of paragraph (1)(B) applies to
the designated health professions school involved;
``(B) the school agrees, as a condition of
receiving a grant under subsection (a) of this section,
that the school will, in carrying out the duties
described in subsection (b) of this section, give
priority to carrying out the duties with respect to
Hispanic individuals; and
``(C) the school agrees, as a condition of
receiving a grant under subsection (a) of this section,
that--
``(i) the school will establish an
arrangement with 1 or more public or nonprofit
community-based Hispanic serving organizations,
or public or nonprofit private institutions of
higher education, including schools of nursing,
whose enrollment of students has traditionally
included a significant number of Hispanic
individuals, the purposes of which will be to
cary out a program--
``(I) to identify Hispanic students
who are interested in a career in the
health profession involved; and
``(II) to facilitate the
educational preparation of such
students to enter the health
professions school; and
``(ii) the school will make efforts to
recruit Hispanic students, including students
who have participated in the undergraduate or
other matriculation program carried out under
arrangements established by the school pursuant
to clause (i)(II) and will assist Hispanic
students regarding the completion of the
educational requirements for a degree from the
school.
``(4) Native american centers of excellence.--Subject to
subsection (e), the conditions specified in this paragraph are
that--
``(A) with respect to Native Americans, each of
clauses (i) through (iv) of paragraph (1)(B) applies to
the designated health professions school involved;
``(B) the school agrees, as a condition of
receiving a grant under subsection (a) of this section,
that the school will, in carrying out the duties
described in subsection (b) of this section, give
priority to carrying out the duties with respect to
Native Americans; and
``(C) the school agrees, as a condition of
receiving a grant under subsection (a) of this section,
that--
``(i) the school will establish an
arrangement with 1 or more public or nonprofit
private institutions of higher education,
including schools of nursing, whose enrollment
of students has traditionally included a
significant number of Native Americans, the
purpose of which arrangement will be to carry
out a program--
``(I) to identify Native American
students, from the institutions of
higher education referred to in clause
(i), who are interested in health
professions careers; and
``(II) to facilitate the
educational preparation of such
students to enter the designated health
professions school; and
``(ii) the designated health professions
school will make efforts to recruit Native
American students, including students who have
participated in the undergraduate program
carried out under arrangements established by
the school pursuant to clause (i) and will
assist Native American students regarding the
completion of the educational requirements for
a degree from the designated health professions
school.
``(5) Other centers of excellence.--The conditions
specified in this paragraph are--
``(A) with respect to other centers of excellence,
the conditions described in clauses (i) through (iv) of
paragraph (1)(B); and
``(B) that the health professions school involved
has an enrollment of underrepresented minorities in
health professions significantly above the national
average for such enrollments of health professions
schools.''; and
(4) by striking subsection (h) and inserting the following:
``(h) Formula for Allocations.--
``(1) Allocations.--Based on the amount appropriated under
section 106(a) of the Minority Health Improvement and Health
Disparity Elimination Act for a fiscal year, the following
subparagraphs shall apply as appropriate:
``(A) In general.--If the amounts appropriated
under section 106(a) of the Minority Health Improvement
and Health Disparity Elimination Act for a fiscal year
are $24,000,000 or less--
``(i) the Secretary shall make available
$12,000,000 for grants under subsection (a) to
health professions schools that meet the
conditions described in subsection (c)(2)(A);
and
``(ii) and available after grants are made
with funds under clause (i), the Secretary
shall make available--
``(I) 60 percent of such amount for
grants under subsection (a) to health
professions schools that meet the
conditions described in paragraph (3)
or (4) of subsection (c) (including
meeting the conditions under subsection
(e)); and
``(II) 40 percent of such amount
for grants under subsection (a) to
health professions schools that meet
the conditions described in subsection
(c)(5).
``(B) Funding in excess of $24,000,000.--If amounts
appropriated under section 106(a) of the Minority
Health Improvement and Health Disparity Elimination Act
for a fiscal year exceed $24,000,000 but are less than
$30,000,000--
``(i) 80 percent of such excess amounts
shall be made available for grants under
subsection (a) to health professions schools
that meet the requirements described in
paragraph (3) or (4) of subsection (c)
(including meeting conditions pursuant to
subsection (e)); and
``(ii) 20 percent of such excess amount
shall be made available for grants under
subsection (a) to health professions schools
that meet the conditions described in
subsection (c)(5).
``(C) Funding in excess of $30,000,000.--If amounts
appropriated under section 106(a) of the Minority
Health Improvement and Health Disparity Elimination Act
for a fiscal year exceed $30,000,000 but are less than
$40,000,000, the Secretary shall make available--
``(i) not less than $12,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
subsection (c)(2)(A);
``(ii) not less than $12,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
paragraph (3) or (4) of subsection (c)
(including meeting conditions pursuant to
subsection (e));
``(iii) not less than $6,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
subsection (c)(5); and
``(iv) after grants are made with funds
under clauses (i) through (iii), any remaining
excess amount for grants under subsection (a)
to health professions schools that meet the
conditions described in paragraph (2)(A), (3),
(4), or (5) of subsection (c).
``(D) Funding in excess of $40,000,000.--If amounts
appropriated under section 106(a) of the Minority
Health Improvement and Health Disparity Elimination Act
for a fiscal year are $40,000,000 or more, the
Secretary shall make available--
``(i) not less than $16,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
subsection (c)(2)(A);
``(ii) not less than $16,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
paragraph (3) or (4) of subsection (c)
(including meeting conditions pursuant to
subsection (e));
``(iii) not less than $8,000,000 for grants
under subsection (a) to health professions
schools that meet the conditions described in
subsection (c)(5); and
``(iv) after grants are made with funds
under clauses (i) through (iii), any remaining
funds for grants under subsection (a) to health
professions schools that meet the conditions
described in paragraph (2)(A), (3), (4), or (5)
of subsection (c).
``(2) No limitation.--Nothing in this subsection shall be
construed as limiting the centers of excellence referred to in
this section to the designated amount, or to preclude such
entities from competing for grants under this section.
``(3) Maintenance of effort.--
``(A) In general.--With respect to activities for
which a grant made under this part are authorized to be
expended, the Secretary may not make such a grant to a
center of excellence for any fiscal year unless the
center agrees to maintain expenditures of non-Federal
amounts for such activities at a level that is not less
than the level of such expenditures maintained by the
center for the fiscal year preceding the fiscal year
for which the school receives such a grant.
``(B) Use of federal funds.--With respect to any
Federal amounts received by a center of excellence and
available for carrying out activities for which a grant
under this part is authorized to be expended, the
center shall, before expending the grant, expend the
Federal amounts obtained from sources other than the
grant, unless given prior approval from the Secretary.
``(i) Evaluations.--
``(1) Advisory committee.--
``(A) In general.--Not later than 90 days after the
date of enactment of the Minority Health Improvement
and Health Disparity Elimination Act, the Secretary
shall establish and appoint the members of an advisory
committee composed of representatives of government
agencies, including the Health Resources and Services
Administration, the Office of Minority Health and
Health Disparity Elimination, and the Indian Health
Service, community stakeholders and experts in
identifying and addressing the health concerns of
racial and ethnic minority and other health disparity
populations, and designees from health professions
schools described in subsection (b).
``(B) Duties.--The advisory committee shall develop
and recommend performance measures with which to
assess, based on data to be compiled by recipients of
grants or contracts under this section or section 736,
737, 738, or 739, the extent to which the program
described in this section and sections 736, 737, 738,
and 739 has met the purpose of this part. The advisory
committee shall submit such recommendations to the
Administrator of the Health Resources and Services
Administration not later than 6 months after the
appointment of the advisory committee.
``(C) Notification.--Not later than 30 days after
the submission of the recommendations, the
Administrator of the Health Resources and Services
Administration shall review the recommendations and
establish performance measures described in
subparagraph (B), and the Administrator shall notify
recipients of grants or contracts under this section or
section 736, 737, 738, or 739 of the new performance
measures and make requirements related to the
performance measures publicly available both on the
website of the Administration and as part of any
notifications of awards released to entities receiving
the grants or contracts.
``(2) Data collection and annual evaluations.--
``(A) In general.--The Administrator of the Health
Resources and Services Administration shall collect
annual data from recipients of grants or contracts
under this section or section 736, 737, 738, or 739 on
the performance measures established under paragraph
(1).
``(B) Biannual meeting.--The Administrator of the
Health Resources and Services Administration shall
convene a meeting of the advisory committee established
under paragraph (1) not less than twice per year. At
the meeting, the advisory committee shall recommend any
necessary changes to such performance measures to
improve data collection and short-term evaluation with
respect to the programs carried out under this section
or section 736, 737, 738, or 739, and provide technical
assistance as necessary.
``(3) Updates.--The Administrator of the Health Resources
and Services Administration shall determine whether to
incorporate the recommended changes as described in paragraph
(2)(B) and provide technical assistance as necessary. The
Administrator shall not penalize a current recipient of a grant
or contract under this section or section 736, 737, 738, or 739
for failing to comply with the revised data collection or
performance measure requirements if the recipient demonstrates
an inability to provide additional data mandated under the
requirements.
``(4) Accountability.--The Administrator shall review and
take into consideration performance measurement data previously
collected from recipients of grants or contracts under this
section or section 736, 737, 738, or 739 when deciding to renew
the grants or contracts of such recipients.''.
(b) 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.) is amended by adding
at the end the following:
``SEC. 742. COOPERATIVE AGREEMENTS FOR ONLINE DEGREE PROGRAMS.
``(a) Cooperative Agreements.--The Secretary shall award
cooperative agreements to accredited schools of public health, schools
of allied health, and public health programs to design and implement a
degree program over the Internet (referred to in this section as an
`online degree program').
``(b) Application.--To be eligible to receive a cooperative
agreement under subsection (a), an accredited school of public health,
school of allied health, or public health program shall submit an
application at such time, in such manner, and containing such
information as the Secretary may require.
``(c) Priority.--In awarding cooperative agreements under this
section, the Secretary shall give priority to any accredited school of
public health, school of allied health, or public health program that
serves a disproportionate number of individuals from racial and ethnic
minority and other health disparity populations.
``(d) Requirements.--Awardees shall use an award under subsection
(a) to design and implement an online degree program that meets the
following conditions:
``(1) Limiting enrollment to individuals who have obtained
a secondary school diploma or a recognized equivalent.
``(2) Maintaining significant enrollment and graduation of
underrepresented minorities in health professions.''.
(c) Definition.--Part B of title VII of the Public Health Service
Act (42 U.S.C. 293 et seq.) is amended by inserting after the part
heading the following:
``SEC. 735A. APPLICATION OF DEFINITION.
``The definition contained in section 738(b)(5) shall apply for
purposes of this part, except that such definition shall also apply in
the case of references to `underrepresented minority students',
`underrepresented minority faculty members', `underrepresented minority
faculty administrators', and `underrepresented minorities in health
professions'.''.
SEC. 104. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.
Subpart 2 of part E of title VII of the Public Health Service Act
(42 U.S.C. 295 et seq.) is amended--
(1) in section 770, by inserting ``(other than section
771)'' after ``this subpart'';
(2) by redesignating section 770 as section 771; and
(3) by inserting after section 769 the following:
``SEC. 770. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.
``(a) In General.--The Secretary may make grants to eligible
schools to award 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) Application.--To receive a grant under this section, an
eligible school shall 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 as a scholarship under this
section may be expended only for tuition expenses, other reasonable
educational expenses, and reasonable living expenses incurred in the
attendance of the school involved.
``(d) Definitions.--In this section:
``(1) Eligible school.--The term `eligible school' means an
accredited school of medicine, osteopathic medicine, dentistry,
nursing, pharmacy, podiatric medicine, optometry, veterinary
medicine, public health, chiropractic, allied health, a school
offering a graduate program in behavioral and mental health
practice, or an entity providing programs for the training of
physician assistants.
``(2) Eligible individual.--The term `eligible individual'
means an individual who is an underrepresented minority
individual who has obtained a secondary school diploma or its
recognized equivalent.''.
SEC. 105. CULTURAL COMPETENCY TRAINING.
Part B of title VII of the Public Health Service Act (42 U.S.C. 293
et seq.), as amended by section 104, is amended by adding at the end
the following:
``SEC. 743. CULTURAL COMPETENCY TRAINING.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration and in
collaboration with the Office of Minority Health and Health Disparity
Elimination and Agency for Healthcare Research and Quality, shall
support the development, evaluation, and dissemination of model
curricula for cultural competency training for use in health
professions schools and continuing education programs, and other
purposes determined appropriate by the Secretary.
``(b) Curricula.--In carrying out subsection (a), the Secretary
shall collaborate with health professional societies, licensing and
accreditation entities, health professions schools, and experts in
minority health and cultural competency, and other organizations as
determined appropriate by the Secretary. Such curricula shall include a
focus on cultural competency measures and cultural competency self-
assessment methodology for health providers, systems and institutions.
``(c) Dissemination.--
``(1) In general.--Such model curricula should be
disseminated through the Internet Clearinghouse under section
270 and other means as determined appropriate by the Secretary.
``(2) Evaluation.--The Secretary shall evaluate adoption
and the implementation of cultural competency training
curricula, and facilitate inclusion of cultural competency
measures in quality measurement systems as appropriate.''.
SEC. 106. AUTHORIZATION OF APPROPRIATIONS; REAUTHORIZATIONS.
(a) Authorization of Appropriations.--There are authorized to be
appropriated--
(1) such sums as may be necessary for each of fiscal years
2007 through 2011, to carry out the amendments made by sections
101 and 102 of this title (adding sections 270 and 793 to the
Public Health Service Act);
(2) $45,000,000 for fiscal year 2007, and such sums as may
be necessary for each of fiscal years 2008 through 2011, to
carry out the amendments made by section 103(a) (relating to
centers of excellence in section 736 of the Public Health
Service Act);
(3) such sums as may be necessary for each of fiscal years
2007 through 2011, to carry out the amendments made by section
103(b) (adding section 742 to the Public Health Service Act);
(4) such sums as may be necessary for each of fiscal years
2007 through 2011, to carry out the amendments made by section
104(b) (adding section 770 to the Public Health Service Act);
and
(5) such sums as may be necessary for each of fiscal years
2007 through 2011, to carry out the amendment made by section
105 (adding section 743 to the Public Health Service Act).
(b) Reauthorizations.--The following programs are reauthorized as
follows:
(1) Educational assistance in the health professions
regarding individuals from disadvantaged background.--Section
740(c) of the Public Health Service Act (42 U.S.C. 293a(c)) is
amended by striking the first sentence and inserting the
following: ``For the purpose of grants and contracts under
section 739(a)(1), there is authorized to be appropriated
$60,000,000 for fiscal year 2007 and such sums as may be
necessary for each of fiscal years 2008 through 2011.''.
(2) Scholarships for disadvantaged students.--Section
740(a) of the Public Health Service Act (42 U.S.C. 293a(a)) is
amended by striking ``$37,000,000'' and all that follows
through ``through 2002'' and inserting ``$51,000,000 for fiscal
year 2007, and such sums as may be necessary for each of fiscal
years 2008 through 2011''.
(3) Loan repayments and fellowships.--Section 740(b) of the
Public Health Service Act (42 U.S.C. 293a(b)) is amended by
striking ``$1,100,000'' and all that follows through ``through
2002'' and inserting ``$1,700,000 for fiscal year 2007, and
such sums as may be necessary for each of fiscal years 2008
through 2011''.
(4) Grants for health professions education.--Section 741
of the Public Health Service Act (42 U.S.C. 293e) is amended in
subsection (b), by striking ``$3,500,000'' and all that follows
through the period and inserting ``such sums as may be
necessary for each of fiscal years 2007 through 2011.''.
TITLE II--CARE AND ACCESS
SEC. 201. CARE AND ACCESS.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by--
(1) redesignating the second section 339O (as added by
section 504 of the Violence Against Women and Department of
Justice Reauthorization Act of 2005) as section 399P; and
(2) adding at the end the following:
``SEC. 399Q. ACCESS, AWARENESS, AND OUTREACH ACTIVITIES.
``(a) Demonstration Projects.--The Secretary shall award multiyear
contracts or competitive grants to eligible entities to support
demonstration projects designed to improve the health and healthcare of
racial and ethnic minority and other health disparity populations
through improved access to healthcare, patient navigators, and health
literacy education and services.
``(b) Eligibility.--In this section:
``(1) Eligible entity.--The term `eligible entity' means an
organization or a community-based consortium.
``(2) Organization.--The term `organization' means--
``(A) a hospital, health plan, or clinic;
``(B) an academic institution;
``(C) a State health agency;
``(D) an Indian Health Service hospital or clinic,
Indian tribal health facility, or urban Indian
facility;
``(E) a nonprofit organization, including a faith-
based organization or consortium, to the extent that a
contract or grant awarded to such an entity is
consistent with the requirements of section 1955;
``(F) a primary care practice-based research
network; and
``(G) any other similar entity determined to be
appropriate by the Secretary.
``(3) Community-based consortium.--The term `community-
based consortium' means a partnership that--
``(A) includes--
``(i) individuals who are representatives
of organizations of racial and ethnic minority
and other health disparity populations;
``(ii) community leaders and leaders of
community-based organizations;
``(iii) healthcare providers, including
providers who treat racial and ethnic minority
and other health disparity populations; and
``(iv) experts in the area of social and
behavioral science, who have knowledge,
training, or practical experience in health
policy, advocacy, cultural or linguistic
competency, or other relevant areas as
determined by the Secretary; and
``(B) is located within a federally- or State-
designated medically underserved area, a federally
designated health provider shortage area, or an area
with a significant population of racial and ethnic
minorities.
``(c) Application.--An eligible entity seeking a contract or grant
under this section shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may require, including assurances that the eligible entity will--
``(1) target populations that are members of racial and
ethnic minority groups and health disparity populations through
specific outreach activities;
``(2) collaborate with appropriate community organizations
and include meaningful community participation in planning,
implementation, and evaluation of activities;
``(3) demonstrate capacity to promote culturally competent
and appropriate care for target populations with consideration
for health literacy;
``(4) develop a plan for long-term sustainability;
``(5) evaluate the effectiveness of activities under this
section, within an appropriate timeframe, which shall include a
focus on quality and outcomes performance measures to ensure
that the activities are meeting the intended goals, and that
the entity is able to disseminate findings from such
evaluations;
``(6) provide ongoing outreach and education to the health
disparity populations served;
``(7) demonstrate coordination between public and private
entities; and
``(8) assist individuals and groups in accessing public and
private programs that will help eliminate disparities in health
and healthcare.
``(d) Priorities.--In awarding contracts and grants under this
section, the Secretary shall give priority to applicants that are--
``(1) safety-net hospitals, defined as hospitals with a low
income utilization rate (as defined in Section 1923(b)(3) of
the Social Security Act (42 U.S.C 1396r-4(b)(3))) greater than
25 percent;
``(2) community health centers, as defined in section
1905(l)(2)(B) of the Social Security Act (42 U.S.C.
1396d(l)(2)(B)); and
``(3) other health systems that--
``(A) by legal mandate or explicitly adopted
mission, provide patients with access to services
regardless of their ability to pay;
``(B) provide care or treatment for a substantial
number of patients who are uninsured, are receiving
assistance under a State program under title XIX of the
Social Security Act, or are members of vulnerable
populations, as determined by the Secretary;
``(C) serve a disproportionate percentage of
patients from racial and ethnic minority and other
health disparity populations;
``(D) provide an assurance that amounts received
under the grant or contract will be used to implement
strategies that address patients' linguistic needs,
where necessary, and recruit and maintain diverse staff
and leadership; and
``(E) provide an assurance that amounts received
under the grant or contract will be used to support
quality improvement activities for patients from racial
and ethnic minority and other health disparity
populations.
``(e) Use of Funds.--An eligible entity shall use such amounts
received under this section for demonstration projects to--
``(1) address health disparities in the United States-
Mexico Border Area, as defined in section 8 of the United
States-Mexico Border Health Commission Act (22 U.S.C. 290n-6),
relating to health disparities in the areas of--
``(A) maternal and child health;
``(B) primary care and preventive health, including
health education and promotion;
``(C) public health and public infrastructure;
``(D) oral health;
``(E) behavioral and mental health and substance
abuse;
``(F) health conditions that have a
disproportionate impact on racial and ethnic minorities
and a high prevalence in the Border Area;
``(G) health services research;
``(H) the health impacts of exposure to
environmental hazards;
``(I) workforce training and development; or
``(J) other areas determined appropriate by the
Secretary;
``(2) implement the best practices in disease management,
including those that address co-occurring chronic conditions,
as defined by the public- private partnership established under
section 918(b), target patients with low functional health
literacy, and, as feasible, incorporate health information
technology;
``(3) evaluate methods for strengthening the health
coverage of, and continuity of coverage of, migratory
agricultural workers and seasonal agricultural workers, as such
terms are defined in section 330(g), and workers in other
industries with traditionally low rates of employer-sponsored
health insurance;
``(4) train community health workers to educate, guide, and
provide outreach in a community setting regarding problems
prevalent among medically underserved populations (as defined
in section 330(b)); or
``(5) identify, educate, and enroll eligible patients from
racial and ethnic minorities and other health disparity
populations into clinical trials.
``(f) Report.--Not later than 3 years after the date an entity
receives a contract or grant under this section and annually
thereafter, the entity shall provide to the Secretary a report
containing the results of any evaluation conducted pursuant to
subsection (c)(5).
``(g) Dissemination of Findings.--The Secretary shall, as
appropriate, disseminate to public and private entities, including
Congress, the findings made in evaluations described under subsection
(f).
``SEC. 399R. GRANTS FOR RACIAL AND ETHNIC APPROACHES TO COMMUNITY
HEALTH.
``(a) Purpose.--It is the purpose of this section to provide for
the awarding of grants to assist communities in mobilizing and
organizing resources in support of effective and sustainable programs
that will reduce or eliminate disparities in health and healthcare
experienced by racial and ethnic minority individuals.
``(b) Authority To Award Grants.--The Secretary, acting through the
Centers for Disease Control and Prevention and the Office of Minority
Health and Health Disparity Elimination, shall award planning,
implementation, and evaluation grants to eligible entities to assist in
designing, implementing, and evaluating culturally and linguistically
appropriate, science-based and community-driven sustainable strategies
to eliminate racial and ethnic health and healthcare disparities.
``(c) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall--
``(1) represent a coalition--
``(A) whose principal purpose is to develop and
implement interventions to reduce or eliminate a health
or healthcare disparity in a targeted racial or ethnic
minority group in the community served by the
coalition; and
``(B) that includes--
``(i) at least 3 members selected from
among--
``(I) public health departments;
``(II) community-based
organizations;
``(III) university and research
organizations;
``(IV) American Indian tribal
organizations, national American Indian
organizations, Indian Health Service,
or organizations serving Alaska
Natives;
``(V) organizations serving Native
Hawaiians;
``(VI) organizations serving
Pacific Islanders; and
``(VII) interested public or
private healthcare providers or
organizations as deemed appropriate by
the Secretary; and
``(ii) at least 1 member from a community-
based organization that represents the targeted
racial or ethnic minority group; and
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require, which shall include--
``(A) a description of the targeted racial or
ethnic population in the community to be served under
the grant;
``(B) a description of at least 1 health disparity
that exists in the racial or ethnic targeted
population, including infant mortality, breast and
cervical cancer screening and management,
cardiovascular disease, diabetes, child and adult
immunization levels, or HIV/AIDS; and
``(C) a demonstration of a proven record of
accomplishment of the coalition members in serving and
working with the targeted community.
``(d) Planning Grants.--
``(1) In general.--The Secretary shall award one-time
grants to eligible entities described in subsection (c) to
support the planning and development of culturally and
linguistically appropriate programs that utilize science-based
and community-driven strategies to reduce or eliminate a health
or healthcare disparity in the targeted population. Such grants
may be used to--
``(A) expand the coalition that is represented by
the eligible entity through the identification of
additional partners, particularly among the targeted
community, and establish linkages with national, State,
tribal, or local public and private partners which may
include community health workers, advocacy, and policy
organizations;
``(B) establish community working groups;
``(C) conduct a needs assessment of the community
and targeted population to determine a health disparity
and the factors contributing to that disparity, using
input from the targeted community;
``(D) participate in workshops sponsored by the
Office of Minority Health and Health Disparity
Elimination or the Centers for Disease Control and
Prevention for technical assistance, planning,
evaluation, and other programmatic issues;
``(E) identify promising intervention strategies;
and
``(F) develop a plan with the input of the targeted
community that includes strategies for--
``(i) implementing intervention strategies
that have the greatest potential for reducing
the health disparity in the target population;
``(ii) identifying other sources of revenue
and integrating current and proposed funding
sources to ensure long-term sustainability of
the program; and
``(iii) evaluating the program, including
collecting data and measuring progress toward
reducing or eliminating the health disparity in
the targeted population that takes into account
the evaluation model developed by the Centers
for Disease Control and Prevention in
collaboration with the Office of Minority
Health and Health Disparity Elimination.
``(2) Duration.--The period during which payments may be
made under a grant under paragraph (1) shall not exceed 1 year,
except where the Secretary determines that extraordinary
circumstances exist as described in section 340(c)(3).
``(e) Implementation Grants.--
``(1) In general.--The Secretary shall award grants to
eligible entities that have received a planning grant under
subsection (d) to enable such entity to--
``(A) implement a plan to address the selected
health disparity for the target population, in an
effective and timely manner;
``(B) collect data appropriate for monitoring and
evaluating the program carried out under the grant;
``(C) analyze and interpret data, or collaborate
with academic or other appropriate institutions, for
such analysis and collection;
``(D) participate in conferences and workshops for
the purpose of informing and educating others regarding
the experiences and lessons learned from the project;
``(E) collaborate with appropriate partners to
publish the results of the project for the benefit of
the public health community;
``(F) establish mechanisms with other public or
private groups to maintain financial support for the
program after the grant terminates; and
``(G) maintain relationships with local partners
and continue to develop new relationships with national
and State partners.
``(2) Duration.--The period during which payments may be
made under a grant under paragraph (1) shall not exceed 4
years. Such payments shall be subject to annual approval by the
Secretary and to the availability of appropriations for the
fiscal year involved.
``(f) Evaluation Grants.--
``(1) In general.--The Secretary may award grants to
eligible entities that have received an implementation grant
under subsection (e) that require additional assistance for the
purpose of rigorous data analysis, program evaluation
(including process and outcome measures), or dissemination of
findings.
``(2) Priority.--In awarding grants under this subsection,
the Secretary shall give priority to--
``(A) entities that in previous funding cycles--
``(i) have received a planning grant under
subsection (d); or
``(ii) implemented activities of the type
described in subsection (e)(1); and
``(B) entities that incorporate best practices or
build on successful models in their action plan,
including the use of community health workers.
``(g) Sustainability.--The Secretary shall give priority to an
eligible entity under this section if the entity agrees that, with
respect to the costs to be incurred by the entity in carrying out the
activities for which the grant was awarded, the entity (and each of the
participating partners in the coalition represented by the entity) will
maintain its expenditures of non-Federal funds for such activities at a
level that is not less than the level of such expenditures during the
fiscal year immediately preceding the first fiscal year for which the
grant is awarded.
``(h) Nonduplication.--Funds provided through this grant program
should supplement, not supplant, existing Federal funding, and the
funds should not be used to duplicate the activities of the other
health disparity grant programs in this Act.
``(i) Technical Assistance.--The Secretary may, either directly or
by grant or contract, provide any entity that receives a grant under
this section with technical and other nonfinancial assistance necessary
to meet the requirements of this section.
``(j) Dissemination.--The Secretary shall enable grantees to share
best practices, evaluation results, and reports using the Internet,
conferences, and other pertinent information regarding the projects
funded by this section, including the outreach efforts of the Office of
Minority Health and Health Disparity Elimination.
``(k) Administrative Burdens.--The Secretary shall make every
effort to minimize duplicative or unnecessary administrative burdens on
grantees.
``SEC. 399S. GRANTS FOR HEALTH DISPARITY COLLABORATIVES.
``(a) Purpose.--The Secretary, acting through the Administrator of
the Health Resources and Services Administration, shall award grants to
eligible entities to assist in implementing systems of primary care
practices through which to eliminate disparities in the delivery of
healthcare and improve the healthcare provided to all patients.
``(b) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall--
``(1) be a federally qualified health center as defined in
section 1905(l)(2)(B) of the Social Security Act with the
ability to establish and lead a collaborative partnership; and
``(2) submit to the Secretary an application, at such time,
in such manner, and containing such information as the
Secretary may require, which shall include plans to implement
collaboratives in one or more of the following areas:
``(A) Diabetes.
``(B) Asthma.
``(C) Depression.
``(D) Cardiovascular disease.
``(E) Cancer.
``(F) Preventive health, including screenings.
``(G) Perinatal health.
``(H) Patient safety.
``(I) Other areas as designated by the Secretary.
``(c) Nonduplication.--Funds provided through this grant program
should supplement, not supplant, existing Federal funding, and the
funds should not be used to duplicate the activities of the other
health disparity grant programs in this Act.
``(d) Technical Assistance.--The Secretary may, either directly or
by grant or contract, provide any entity that receives a grant under
this section with technical and other nonfinancial assistance necessary
to meet the requirements of this section.
``(e) Administrative Burdens.--The Secretary shall make every
effort to minimize duplicative or unnecessary administrative burdens on
grantees.
``SEC. 399T. COMMUNITY HEALTH INITIATIVES.
``(a) Purpose.--The Secretary shall establish the Community Health
Initiative demonstration program to support comprehensive State,
tribal, or local initiatives to improve the health of racial and ethnic
minority and other health disparity populations.
``(b) Community Health Initiative Program.--
``(1) In general.--The Secretary shall award Community
Health Initiative Program grants to State and local public
health agencies of eligible communities. Each grant shall be
funded for 5 years.
``(2) Eligible communities.--
``(A) Identification.--The Secretary shall develop,
after opportunity for public review and comment, and
implement a metric for identifying and notifying
eligible communities pursuant to subparagraph (B), and
report such findings to Congress and the public.
``(B) Eligibility.--Eligible communities shall be
communities that are most at risk, or at greatest
disproportionate risk, for adverse health outcomes, as
measured by--
``(i) overall burden of disease and health
conditions;
``(ii) accessibility to and availability of
health and economic resources;
``(iii) proportion of individuals from
racial and ethnic minority and other health
disparity populations; and
``(iv) other factors as determined
appropriate by the Secretary.
``(3) Agency collaboration.--The Secretary, in
collaboration with the Deputy Assistant Secretary for Minority
Health and Health Disparity Elimination, the Director of the
Centers for Disease Control and Prevention, the Administrator
of the Health Resources and Services Administration, the
Director of the Indian Health Service, and heads of other
Federal agencies as appropriate, shall determine, with respect
to the Community Health Initiative Program--
``(A) core goals, objectives and reasonable
timelines for implementing, evaluating and sustaining
comprehensive and effective health and healthcare
improvement activities in eligible communities;
``(B) current programmatic and research initiatives
in which eligible communities may participate;
``(C) existing agency resources that can be
targeted to eligible communities; and
``(D) mechanisms to facilitate joint application,
or establish a common application, to multiple grant
programs, as appropriate.
``(4) Applications.--
``(A) In general.--The State and local public
health agencies of eligible communities shall jointly
submit an application to the Secretary at such time, in
such manner, and accompanied by such information as the
Secretary may require, including a strategic plan that
shall--
``(i) describe the proposed activities
pursuant to paragraph (5);
``(ii) report the extent to which local
institutions and organizations and community
residents have participated in the strategic
plan development;
``(iii) identify established public-private
partnerships, and State, local, and private
resources that will be available;
``(iv) identify Federal funding needed to
support the proposed activities; and
``(v) report the baselines, methods, and
benchmarks for measuring the success of
activities proposed in the strategic plan.
``(B) Community advisory board.--
``(i) In general.--In order to receive a
Community Health Initiative Program grant under
this section, an eligible community shall have
a community advisory board.
``(ii) Members.--
``(I) Community.--The majority of
the members of a community advisory
board under clause (i) shall be
individuals that will benefit from the
activities or services provided by the
grants under this section.
``(II) Representatives.--A
community advisory board shall include
representatives from the State health
department and county or local health
department, community-based
organizations, environmental and public
health experts, healthcare
professionals and providers, nonprofit
leaders, community organizers, elected
officials, private payers, employers,
and consumers.
``(iii) Duties.--A community advisory board
shall--
``(I) oversee the functions and
operations of Community Health
Initiative Program grant activities;
``(II) assist in the evaluation of
such activities; and
``(III) prepare an annual report
that describes the progress made
towards achieving stated goals and
recommends future courses of action.
``(5) Use of funds.--An eligible community that receives a
grant under this section shall use the funding to support
activities to achieve stated core goals and objectives,
pursuant to paragraph (3), which may include initiatives that--
``(A) promote disease prevention and health
promotion, particularly for racial and ethnic minority
and other health disparity populations;
``(B) facilitate partnerships between healthcare
providers, public and health agencies, academic
institutions, community based or advocacy
organizations, elected officials, professional
societies, and other stakeholder groups;
``(C) enhance the local capacity for aggregated and
disaggregated health data collection and reporting;
``(D) coordinate and integrate community-based
activities including education, city planning,
transportation initiatives, environmental changes, and
other related activities at the local level that help
improve public health and address health concerns;
``(E) mobilize financial and other resources from
the public and private sector to increase local
capacity to address health issues;
``(F) support the training of staff in
communication and outreach to the general public,
particularly those at disproportionate risk for health
and healthcare disparities;
``(G) assist eligible communities in meeting
Healthy People 2010 objectives; and
``(H) aid eligible communities in providing
employment, and cultural and recreational resources
that enable healthy lifestyles.
``(6) Evaluation.--The Secretary, directly or through
contract, shall conduct and report an evaluation of the
Community Health Initiative Program that shall be available to
the public.
``(7) Supplement not supplant.--Grant funds received under
this section shall be used to supplement, and not supplant,
funding that would otherwise be used for activities described
under this section.
``SEC. 399U. OUTREACH.
``(a) In General.--The Secretary, in collaboration with the Office
for Minority Health and Health Disparity Elimination, the Centers for
Medicare and Medicaid Services, and the Health Resources and Services
Administration, shall establish a grant program to improve outreach,
participation, and enrollment by eligible entities with respect to
available healthcare programs.
``(b) Eligibility.--In this section, the term `eligible entity'
means any of the following:
``(1) A State or local government.
``(2) A Federal health safety net organization.
``(3) A national, local, or community-based public or
nonprofit private organization.
``(4) A faith-based organization or consortia, to the
extent that a grant awarded to such an entity is consistent
with the requirements of section 1955 relating to a grant award
to nongovernmental entities.
``(5) An elementary or secondary school.
``(c) Definition.--In this section:
``(1) Federal health safety net organization.--The term
`Federal health safety net organization' means--
``(A) an Indian tribe, tribal organization, or an
urban Indian organization receiving funds under title V
of the Indian Health Care Improvement Act (25 U.S.C.
1651 et seq.), or an Indian Health Service provider;
``(B) a Federally-qualified health center (as
defined in section 330);
``(C) a hospital defined as a disproportionate
share hospital;
``(D) a covered entity described in section
340B(a)(4); and
``(E) any other entity or a consortium that serves
children under a federally funded program, including
the special supplemental nutrition program for women,
infants, and children (WIC) established under section
17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786),
the head start and early head start programs under the
Head Start Act (42 U.S.C. 9831 et seq.), the school
lunch program established under the Richard B. Russell
National School Lunch Act (42 U.S.C. 1751 et seq.), and
an elementary or secondary school.
``(2) Indians; indian tribe; tribal organization; urban
indian organization.--The terms `Indian', `Indian tribe',
`tribal organization', and `urban Indian organization' have the
meanings given such terms in section 4 of the Indian Health
Care Improvement Act (25 U.S.C. 1603).
``(d) Priority for Award of Grants.--
``(1) In general.--In making grants under subsection (a),
the Secretary shall give priority to--
``(A) eligible entities that propose to target
geographic areas with high rates of--
``(i) eligible but unenrolled children,
including such children who reside in rural
areas; or
``(ii) racial and ethnic minorities and
health disparity populations, including those
proposals that address cultural and linguistic
barriers to enrollment; and
``(B) eligible entities that plan to engage in
outreach efforts with respect to individuals described
in subparagraph (A) and that are--
``(i) Federal health safety net
organizations; or
``(ii) faith-based organizations or
consortia.
``(2) Ten percent set aside for outreach to indian
children.--An amount equal to 10 percent of the funds
appropriated under section 202(3) of the Minority Health
Improvement and Health Disparity Elimination Act to carry out
this section for a fiscal year shall be used by the Secretary
to award grants to Indian Health Service providers and urban
Indian organizations receiving funds under title V of the
Indian Health Care Improvement Act (25 U.S.C. 1651 et seq.) for
outreach to, and enrollment of, children who are Indians.''.
SEC. 202. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated--
(1) such sums as may be necessary for each of fiscal years
2007 through 2011, to carry out section 399Q of the Public
Health Service Act (as added by section 201);
(2) $52,000,000 for fiscal year 2007, and such sums as may
be necessary for each of fiscal years 2008 through 2011, to
carry out section 399R of the Public Health Service Act (as
added by section 201); and
(3) such sums as necessary for each of fiscal years 2007
through 2011, to carry out sections 399S, 399T, and 399U of the
Public Health Service Act (as added by section 201).
TITLE III--RESEARCH
SEC. 301. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY.
Part B of title IX of the Public Health Service Act (42 U.S.C. 299b
et seq.) is amended by adding at the end the following:
``SEC. 918. ENHANCED RESEARCH WITH RESPECT TO HEALTHCARE DISPARITIES.
``(a) Accelerating the Elimination of Disparities.--
``(1) Strategic plan.--The Secretary, acting through the
Director, and in collaboration with the Deputy Assistant
Secretary for Minority Health and Health Disparity Elimination,
shall develop a strategic plan regarding research supported by
the agency to improve healthcare and eliminate healthcare
disparities among racial and ethnic minority and other health
disparity populations. In developing such plan, the Secretary
shall--
``(A) determine which areas of research focus would
have the greatest impact on healthcare improvement and
elimination of disparities, taking into consideration
the overall health status of various populations,
disproportionate burden of diseases or health
conditions, and types of interventions for which data
on effectiveness is limited;
``(B) establish measurable goals and objectives
which will allow assessment of progress;
``(C) solicit public review and comment from
experts in healthcare, minority health and health
disparities, health services research, and other areas
as determined appropriate by the Secretary;
``(D) incorporate recommendations from the
Institute of Medicine, pursuant to section 303 of the
Minority Health Improvement and Health Disparity
Elimination Act, as appropriate;
``(E) complete such plan within 12 months of
enactment of the Minority Health Improvement and Health
Disparity Elimination Act, and update such plan and
report on progress meeting established goals and
objectives not less than every 2 years;
``(F) include progress meeting plan goals and
objectives in annual performance budget submissions;
``(G) ensure coordination and integration with the
National Plan to Improve Minority Health and Eliminate
Health Disparities, as described in section 1707(c) and
other Department-wide initiatives, as feasible; and
``(H) report the plan to the Congress and make
available to the public in print and electronic format.
``(2) Establishment of grants.--The Secretary, acting
through the Director, and in collaboration with the Deputy
Assistant Secretary for Minority Health and Health Disparity
Elimination, may award grants or contracts to eligible entities
for research to improve the health of racial and ethnic
minority and other health disparity populations (as defined in
section 903(d)).
``(3) Application; eligible entities.--
``(A) Application.--To receive a grant or contract
under this section, an eligible entity shall submit to
the Secretary an application at such time, in such
manner, and containing such information as the
Secretary may require.
``(B) Eligible entities.--To be eligible to receive
a grant or contract under this section, an entity shall
be a health center, hospital, health plan, health
system, community clinic, or other health entity
determined appropriate by the Secretary, that--
``(i) by legal mandate or explicitly
adopted mission, provides patients with access
to services regardless of their ability to pay;
``(ii) provides care or treatment for a
substantial number of patients who are
uninsured, are receiving assistance under a
State program under title XIX of the Social
Security Act, or are members of vulnerable
populations, as determined by the Secretary;
``(iii) serves a disproportionate
percentage of patients from racial and ethnic
minority and other health disparity
populations;
``(iv) provides an assurance that amounts
received under the grant or contract will be
used to implement strategies that address
patients' linguistic needs, where necessary,
and recruit and maintain diverse staff and
leadership; and
``(v) provides an assurance that amounts
received under the grant or contract will be
used to support quality improvement activities
for patients from racial and ethnic minority
and other health disparity populations.
``(C) Preference.--Consortia of 3 or more eligible
entities shall be given a preference for grant or
contract funding.
``(4) Research.--The research funded under paragraph (2),
with respect to racial and ethnic minority and other health
disparity populations, shall--
``(A) prioritize the translation of existing
research into practical interventions for improving
health and healthcare and reducing disparities;
``(B) target areas of need as identified in the
strategic plan pursuant to subsection (a)(1), the
National Healthcare Disparities Report published by the
Agency for Healthcare Research and Quality, relevant
reports by the Institute of Medicine, and other reports
issued by Federal health agencies;
``(C) include a focus on community-based solutions
and partnerships as appropriate;
``(D) expand practice-based research networks
(primary care and larger delivery systems) to include
networks of delivery sites serving large numbers of
minority and health disparity populations including--
``(i) public hospitals and private non-
profit hospitals;
``(ii) health centers;
``(iii) health plans; and
``(iv) other sites as determined
appropriate by the Director.
``(5) Dissemination of research findings.--To ensure that
findings from the research described in paragraph (4) are
disseminated and applied promptly, the Director shall--
``(A) develop outreach and training programs for
healthcare providers with respect to the practical and
effective interventions that result from research
programs carried out with grants or contracts awarded
under this section; and
``(B) provide technical assistance for the
implementation of evidence-based practices that will
improve health and healthcare and reduce disparities.
``(b) Realizing the Potential of Disease Management.--
``(1) Public-private sector partnership to assess
effectiveness of existing disease management strategies.--
``(A) In general.--The Secretary shall establish a
public-private partnership to identify, evaluate, and
disseminate effective disease management strategies,
tailored to improve healthcare and health outcomes for
patients from racial and ethnic minority and other
health disparity populations. Such strategies shall
reflect established healthcare quality standards and
benchmarks and other evidence-based recommendations.
``(B) Partnership composition.--The partnership's
members shall include the following:
``(i) Representatives from the following:
``(I) The Office of Minority Health
and Health Disparity Elimination.
``(II) The Centers for Disease
Control and Prevention.
``(III) The Agency for Healthcare
Research and Quality.
``(IV) The Centers for Medicare and
Medicaid Services.
``(V) The Health Resources and
Services Administration.
``(VI) The Indian Health Service.
``(VII) Other agencies as
designated by the Secretary.
``(ii) Representatives of health plans,
employers, or other private entities that have
implemented disease management programs.
``(iii) Representatives of hospitals,
community health centers, large, small, or solo
provider groups, or other organizations that
provide healthcare and have implemented disease
management programs.
``(iv) Community-based representatives who
have been involved with establishing,
implementing, or evaluating disease management
programs.
``(v) Other individuals as designated by
the Secretary.
``(C) Partnership duties.--
``(i) In general.--Not later than 18 months
after the date of enactment of the Minority
Health Improvement and Health Disparity
Elimination Act, the partnership shall release
a best practices report, with a particular
focus on the following:
``(I) Self-management training.
``(II) Increasing patient
participation in and satisfaction with
healthcare encounters.
``(III) Helping patients use
quality performance and cost
information to choose appropriate
healthcare providers for their care.
``(IV) Interventions outside of a
traditional healthcare environment,
including the workplace, school,
community, or home.
``(V) Interventions utilizing
community health workers and case
managers.
``(VI) Interventions that implement
integrated disease management and
treatment strategies to address
multiple chronic co-occurring
conditions.
``(VII) Other interventions as
identified by the Secretary.
``(2) Report.--
``(A) In general.--Not later than September 30,
2010, the partnership shall submit to the Secretary and
the relevant committees of Congress a report that
describes the extent to which the activities and
research funded under this section have been successful
in reducing and eliminating disparities in health and
healthcare in targeted populations.
``(B) Availability.--The Secretary shall ensure
that the report is made available on the Internet
websites of the Office of Minority Health and Health
Disparity Elimination, the Agency for Healthcare
Research and Quality, and other agencies as
appropriate.''.
SEC. 302. GENETIC VARIATION AND HEALTH.
(a) In General.--The Secretary shall ensure that any current,
proposed, or future research and programmatic activities regarding
genomics include focus on genetic variation within and between
populations, with a focus on racial and ethnic minority populations,
that may affect risk of disease or response to drug therapy and other
treatments, in order to ensure that all populations are able to derive
full benefit from genomic tests and treatments that may improve their
health and healthcare. The Secretary shall encourage, with respect to
racial and ethnic minority populations, efforts to--
(1) increase access, availability, and utilization of
genomic tests and treatments;
(2) determine and monitor appropriateness of use of genomic
tests and treatments;
(3) increase awareness of the importance of knowing one's
family history and the relationships between genes, the social
and physical environment, and health; and
(4) expand genomics research that would help to--
(A) improve tests to facilitate earlier and more
accurate diagnoses;
(B) enhance the safety of drugs, particularly for
drugs that pose an elevated risk for adverse drug
events in such populations;
(C) increase the effectiveness of drugs,
particularly for diseases and conditions that
disproportionately affect such populations; and
(D) augment the current understanding of the
interactions between genomic, social and physical
environmental factors and their influence on the
causality, prevention, and treatment of diseases common
in such populations.
(b) Genetic Variation, Environment, and Health Summit.--
(1) Summit.--Not later than 1 year after the date of
enactment of this Act, the Director of the National Human
Genome Research Institute, in collaboration with the Director
of the Office of Genomics and Disease Prevention at the Centers
for Disease Control and Prevention, the Director of the Office
of Behavioral and Social Science Research at the National
Institutes of Health, and the Deputy Assistant Secretary of the
Office of Minority Health and Health Disparity Elimination,
shall convene a Summit for the purpose of providing leadership
and guidance to Secretary, Congress, and other public and
private entities on current and future areas of focus for
genomics research, including translation of findings from such
research, relating to improving the health of racial and ethnic
minority populations and reducing health disparities.
(2) Participation.--The Summit shall include--
(A) representatives from the Federal health
agencies, including the National Institutes of Health,
the Centers for Disease Control and Prevention, the
Food and Drug Administration, the Health Resources and
Services Administration, and additional agencies and
departments as determined appropriate by the Secretary;
(B) independent experts and stakeholders from
relevant industry and academic institutions,
particularly those that have demonstrated expertise in
both genomics and minority health and serve a
disproportionate number of racial and ethnic minority
patients; and
(C) leaders of community organizations that work to
reduce and eliminate health disparities.
(3) Report.--Not later than 90 days after the conclusion of
the Summit, the Director of the National Human Genome Research
Institute shall submit to Congress and make available to the
public a report detailing recommendations on--
(A) an appropriate description of human diversity,
incorporating available information on genetics, for
use in genomic research and programs operated or
supported by the Federal Government;
(B) guiding ethics, principles, and protocols for
the inclusion and designation of racial and ethnic
minority populations in genomics research, particularly
clinical trials programs operated or supported by the
Federal Government;
(C) ways to increase access to and utilization of
effective pharmacogenomic and other genetic screening
and services for racial and ethnic minority
populations;
(D) research opportunities and funding support in
the area of genomic variation that may improve the
health and healthcare of minority populations;
(E) ways to enhance integration of Federal
Government-wide efforts and activities pertaining to
race, genomics, and health; and
(F) need for additional privacy protections in
preventing stigmatization and inappropriate use of
genetic information.
(c) Pharmacogenomics and Emerging Issues Advisory Committee.--
(1) In general.--The Secretary, under section 222 of the
Public Health Service Act (42 U.S.C. 217a), shall convene and
consult an advisory committee on issues relating to
pharmacogenomics (referred to in this subsection as the
``Advisory Committee'').
(2) Duties.--
(A) In general.--The Advisory Committee shall
advise and make recommendations to the Secretary,
through the Commissioner of Food and Drugs and in
consultation with the Director of the National
Institutes of Health, on the evolving science of
pharmacogenomics and interindividual variability in
drug response, as it relates to the health of racial
and ethnic minorities.
(B) Matters considered.--The recommendations under
subparagraph (A) shall include recommendations on--
(i) the ethics, design, and analysis of
clinical trials involving racial and ethnic
minorities conducted under section 351, 409I,
or 499 of the Public Health Service Act or
section 505(i), 505A, 505B, or 515(g) of the
Federal Food, Drug, and Cosmetic Act;
(ii) general policy and guidance with
respect to the development, approval or
clearance, and labeling of medical products for
racial and ethnic minorities;
(iii) the role of pharmacogenomics during
the development of drugs, biological products,
and diagnostics;
(iv) the understanding of interindividual
variability in drug response;
(v) diagnostics or treatments for diseases
or conditions common in racial and ethnic
minorities; and
(vi) the identification of other areas of
unmet medical need.
(3) Composition.--The Advisory Committee shall include--
(A) experts in the fields of--
(i) minority health and health disparities;
(ii) genomics;
(iii) pharmaceutical and diagnostic
research and development;
(iv) ethical, legal, and social issues
relating to clinical trials; and
(v) bioinformatics and information
technology;
(B) representatives from minority health
organizations and relevant patient organizations; and
(C) other experts as deemed appropriate by the
Secretary.
(4) Coordination with other advisory committees.--The
Advisory Committee may consult and coordinate with other
advisory committees of the Department of Health and Human
Services as determined appropriate by the Secretary.
(5) Recommendations.--The Advisory Committee shall submit
recommendations to the Secretary with respect to each of the
matters described under paragraph (2)(B) prior to the
development by the Secretary of the report described under
paragraph (6).
(6) Report.--Not later than 180 days after the date of
enactment of this Act, the Secretary--
(A) shall, acting through the Commissioner of Food
and Drugs and in consultation with the Director of the
National Institutes of Health, and taking into
consideration the recommendations of the Advisory
Committee submitted under paragraph (5), 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 the evolving
science of pharmacogenomics as it relates to racial and
ethnic minorities, including a review of the guidance
of the Food and Drug Administration on the
participation of racial and ethnic minorities in
clinical trials; and
(B) shall ensure that such report is made publicly
available.
SEC. 303. EVALUATIONS BY THE INSTITUTE OF MEDICINE.
(a) Health Disparities Summit.--
(1) In general.--Not later than 270 days after the date of
enactment of this Act, the Institute of Medicine shall convene
a summit on health disparities (referred to this section as the
``Summit'').
(2) Purpose.--The purposes of the Summit include--
(A) reviewing current activities of the Federal
Government in addressing health and healthcare
disparities as experienced by racial and ethnic
minority populations, and other health disparity
populations as practicable; and
(B) assessing progress made since the 2002
Institute of Medicine National Healthcare Disparities
Report.
(3) Areas of focus.--The Summit shall examine the
activities of the Federal Government to reduce and eliminate
health disparities, with a focus on--
(A) education and training, including health
professions programs that increase minority
representation in medicine and the health professions;
(B) data collection and analysis;
(C) coordination among agencies and departments in
addressing healthcare disparities;
(D) research into the causes of and strategies to
eliminate health disparities; and
(E) programs that increase access to care and
improve health outcomes for health disparity
populations.
(4) Participation.--Summit participants shall include--
(A) representatives of the Federal Government;
(B) experts with research experience in identifying
and addressing healthcare disparities among racial and
ethnic minority and other health disparity populations;
and
(C) representatives from community-based
organizations and nonprofit groups that address the
issues of racial and ethnic minority and other health
disparity populations.
(5) Summit proceedings.--Not later than 180 days after the
conclusion of the Summit, the Secretary shall offer to enter
into a contract with the Institute of Medicine to publish a
report summarizing the discussions of the Summit and review of
current Federal activities to address healthcare disparities
for racial and ethnic minority and other health disparity
populations.
(b) National Plan To Eliminate Disparities.--
(1) Plan.--Not later than 2 years after the date of
enactment of this Act, the Institute of Medicine shall develop
an evidence-based, strategic, national plan to eliminate
disparities which shall--
(A) include goals, interventions, and resources
needed to eliminate disparities;
(B) establish a reasonable timetable to reach
selected priorities;
(C) inform and complement the National Plan to
Improve Minority Health and Eliminate Health
Disparities, pursuant to section 1707(c)(2) of the
Public Health Service Act (as added by section 501 of
this Act); and
(D) inform the development of criteria for
evaluation of the effectiveness of programs authorized
under this Act (and the amendments made by this Act),
pursuant to subsection (c).
(2) Report.--The Secretary shall offer to enter into a
contract with the Institute of Medicine to publish the National
Plan to Eliminate Disparities.
(c) Institute of Medicine Evaluation.--
(1) In general.--Not later than 3 years after the date of
enactment of this Act, the Secretary shall offer to enter into
a contract with the Institute of Medicine to evaluate the
effectiveness of the programs authorized under this Act (and
the amendments made by this Act) in addressing and reducing
health disparities experienced by racial and ethnic minority
and other health disparity populations. In making such an
evaluation, the Institute of Medicine shall consult--
(A) representatives of the Federal Government;
(B) experts with research and policy experience in
identifying and addressing healthcare disparities among
racial and ethnic minority and other health disparity
populations; and
(C) representatives from community-based
organizations and nonprofit groups that address health
disparity issues.
(2) Report.--Not later than 2 years after the Secretary
enters into the contract under paragraph (1), the Institute of
Medicine shall submit to the Secretary and relevant committees
of Congress a report that contains the results of the
evaluation described under such subparagraph, and any
recommendations of such Institute.
(3) Response.--Not later than 180 days after the date the
Institute of Medicine submits the report under this subsection,
the Secretary shall publish a response to such recommendations,
which shall be provided to the relevant committees of Congress
and made publicly available through the Internet Clearinghouse
under section 270 of the Public Health Service Act (as added by
section 101).
(d) Health Information Technology.--
(1) In general.--Not later than 180 days after the date of
enactment of this Act, the Secretary, acting through the
Director of the National Library of Medicine, shall offer to
enter into a contract with the Institute of Medicine to study
and make recommendations regarding the use of health
information technology and bioinformatics to improve the health
and healthcare of racial and ethnic minority and other health
disparity populations.
(2) Study.--The study under paragraph (1), with respect to
increasing access and quality of healthcare for racial and
ethnic minority and other health disparity populations, shall
assess and make recommendations regarding--
(A) effective applications of health information
technology, including telemedicine and telepsychiatry;
(B) status of development of health information
technology standards that will permit healthcare
information of the type required to support patient
care;
(C) inclusion of organizations with expertise in
minority health and health disparities in the
development of health information technology standards
and applications;
(D) priority areas for research to improve the
dissemination, management, and use of biomedical
knowledge that address identified and unmet needs;
(E) educational and training needs and
opportunities to assist health professionals understand
and apply health information technology; and
(F) ways to increase recruitment and retention of
racial and ethnic minorities into the field of medical
informatics.
(3) Report.--Not later than 2 years after the Secretary
enters into the contract under paragraph (1), the Institute of
Medicine shall submit to the Secretary and relevant committees
of Congress a report that contains the findings and
recommendations of this study.
SEC. 304. NATIONAL CENTER FOR MINORITY HEALTH AND HEALTH DISPARITIES
REAUTHORIZATION.
Section 485E of the Public Health Service Act (42 U.S.C. 287c-31)
is amended--
(1) by striking subsection (e) and inserting the following:
``(e) Duties of the Director.--
``(1) Interagency coordination of minority health and
health disparities activities.--With respect to minority health
and health disparities, the Director of the Center shall plan,
coordinate, and evaluate research and other activities
conducted or supported by the agencies of the National
Institutes of Health. In carrying out the preceding sentence,
the Director of the Center shall evaluate the minority health
and health disparity activities of each of such agencies and
shall provide for the periodic reevaluation of such activities.
``(2) Consultations.--The Director of the Center shall
carry out this subpart (including developing and revising the
plan and budget required in subsection (f)) in consultation
with the Directors of the agencies (or a designee of the
Directors) of the National Institutes of Health, with the
advisory councils of the agencies, and with the advisory
council established under section (j).
``(3) Coordination of activities.--The Director of the
Center shall act as the primary Federal official with
responsibility for coordinating all minority health disparities
research and other health disparities research conducted or
supported by the National Institutes of Health and shall--
``(A) represent the health disparities research
program of the National Institutes of Health including
the minority health disparities research program at all
relevant executive branch task forces, committees, and
planning activities;
``(B) maintain communications with all relevant
Public Health Service agencies, including the Indian
Health Service and various other departments of the
Federal Government, to ensure the timely transmission
of information concerning advances in minority health
disparities research and other health disparities
research between these various agencies for
dissemination to affected communities and healthcare
providers; and
``(C) engage with community-based organizations and
health provider groups to--
``(i) increase education and awareness
about the Center's activities and areas of
research focus; and
``(ii) accelerate the translation of
research findings into programs including those
carried out by community-based
organizations.'';
(2) in subsection (f)--
(A) by striking the subsection heading and
inserting the following:
``(f) Comprehensive Plan for Research; Budget Estimate; Allocation
of Appropriations.--'';
(B) in paragraph (1)--
(i) by striking the matter preceding
subparagraph (A) and subparagraph (A) and
inserting the following:
``(1) In general.--Subject to the provisions of this
section and other applicable law, the Director of the Center,
in consultation with the Director of NIH, the Directors of the
other agencies of the National Institutes of Health, and the
advisory council established under subsection (j) shall--
``(A) annually review and revise a comprehensive
plan (referred to in this section as `the Plan') and
budget for the conduct and support of all minority
health and health disparities research and other health
disparities research activities of the agencies of the
National Institutes of Health;'';
(ii) in subparagraph (D), by striking ``,
with respect to amounts appropriated for
activities of the Center,'';
(iii) by striking subparagraph (F) and
inserting the following:
``(F) ensure that the Plan and budget are presented
to and considered by the Director during the
formulation of the overall annual budget for the
National Institutes of Health;'';
(iv) by redesignating subparagraphs (G) and
(H) as subparagraphs (I) and (J), respectively;
and
(v) by inserting after subparagraph (F),
the following:
``(G) annually submit to Congress a report on the
progress made with respect to the Plan;
``(H) creating and implementing a plan for the
systematic review of research activities supported by
the National Institutes of Health that are within the
mission of both the Center and other agencies of the
National Institutes of Health, by establishing
mechanisms for--
``(i) tracking minority health and health
disparity research conducted within the
agencies;
``(ii) the early identification of
applications and proposals for grants,
contracts, and cooperative agreements
supporting extramural training, research, and
development, that are submitted to the agencies
and that are within the mission of the Center;
``(iii) providing the Center with the
written descriptions and scientific peer review
results of such applications and proposals;
``(iv) enabling the agencies to consult
with the Director of the Center prior to final
approval of such applications and proposals;
and
``(v) reporting to the Director of the
Center all such applications and proposals that
are approved for funding by the agencies;'';
and
(C) in paragraph (2)--
(i) in subparagraph (D), by striking
``and'' at the end;
(ii) in subparagraph (E), by striking the
period and inserting ``; and''; and
(iii) by adding at the end the following:
``(F) the number and type of personnel needs of the
Center.'';
(3) in subsection (h)--
(A) in paragraph (1), by striking ``endowments at
centers of excellence under section 736.'' and
inserting the following: ``endowments at--
``(A) centers of excellence under section 736; and
``(B) centers of excellence under section 485F.'';
and
(B) in paragraph (2)(A), by striking ``average''
and inserting ``median'';
(4) by redesignating subsections (k) and (l) as subsections
(m) and (n), respectively;
(5) by inserting after subsection (j), the following:
``(k) Representation of Minorities Among Researchers.--The
Secretary, in collaboration with the Director of the Center, shall
determine the extent to which racial and ethnic minority and other
health disparity populations are represented among senior physicians
and scientists of the national research institutes and among physicians
and scientists conducting research with funds provided by such
institutes, and as appropriate, carry out activities to increase the
extent of such representation.
``(l) Cancer Research.--The Secretary, in collaboration with the
Director of the Center, shall designate and support a cancer
prevention, control, and population science center to address the
significantly elevated rate of morbidity and mortality from cancer in
racial and ethnic minority populations. Such designated center shall be
housed within an existing, stand-alone cancer center at a historically
black college and university that has a demonstrable commitment to and
expertise in cancer research in the basic, clinical, and population
sciences.'';
(6) in subsection (l)(1) (as so redesignated), by inserting
before the semicolon the following: ``, with a particular focus
on evaluation of progress made toward fulfillment of the goals
of the Plan''; and
(7) by striking subsection (m) (as so redesignated).
SEC. 305. AUTHORIZATION OF APPROPRIATIONS.
(a) Sections 301, 302, and 303.--There are authorized to be
appropriated such sums as may be necessary for each of fiscal years
2007 through 2011, to carry out sections 301, 302, and 303 (and the
amendments made by such sections).
(b) Section 304.--
(1) In general.--There are authorized to be appropriated
$240,000,000 for fiscal year 2007, such sums as may be
necessary for each of fiscal years 2008 through 2011, to carry
out section 304.
(2) Allocation of funds.--Subject to section 485E of the
Public Health Service Act (as amended by section 304) and other
applicable law, the Director of the Center under such section
485E shall direct all amounts appropriated for activities under
such section and in collaboration with the Director of National
Institutes of Health and the directors of other institutes and
centers of the National Institutes of Health.
(3) Management of allocations.--All amounts allocated or
expended for minority health and health disparities research
activities under this subsection shall be reported
programmatically to and approved by the Director of the Center
under such section 485E, in accordance with the Plan described
under such section 485E.
TITLE IV--DATA COLLECTION, ANALYSIS, AND QUALITY
SEC. 401. DATA COLLECTION, ANALYSIS, AND QUALITY.
The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by
adding at the end the following:
``TITLE XXIX--DATA COLLECTION, ANALYSIS, AND QUALITY
``SEC. 2901. DATA COLLECTION, ANALYSIS, AND QUALITY.
``(a) Data Collection and Reporting.--The Secretary shall ensure
that not later than 3 years after the date of enactment of the Minority
Health Improvement and Health Disparity Elimination Act any ongoing or
new federally conducted or supported health programs (including
surveys) result in the--
``(1) collection and reporting of data by race and
ethnicity using, at a minimum, Office of Budget and Management
standards in effect on the date of enactment of the Minority
Health Improvement and Health Disparity Elimination Act;
``(2) collection and reporting of data by geographic
location, socioeconomic position (such as employment, income,
and education), primary language, and, when determined
practicable by the Secretary, health literacy; and
``(3) if practicable, collection and reporting of data on
additional population groups if such data can be aggregated
into the minimum race and ethnicity data categories.
``(b) Data Analysis and Dissemination.--
``(1) Data analysis.--
``(A) In general.--The Secretary shall analyze data
collected under subsection (a) to detect and monitor
trends in disparities in health and healthcare for
racial and ethnic minority and other health disparity
populations, and examine the interaction between
various disparity indicators.
``(B) Quality analysis.--The Secretary shall ensure
that the analyses under subparagraph (A) incorporate
data reported according to quality measurement systems.
``(2) Quality measures.--When the Secretary, by statutory
or regulatory authority, adopts and implements any quality
measures or any quality measurement system, the Secretary shall
ensure the quality measures or quality measurement system
comply with the following:
``(A) Measures.--Measures selected shall, to the
extent practicable--
``(i) assess the effectiveness, timeliness,
patient self-management, patient centeredness,
equity, and efficiency of care received by
patients, including patients from racial and
ethnic minority and other health disparity
populations;
``(ii) are evidence based, reliable, and
valid; and
``(iii) include measures of clinical
processes and outcomes, patient experience and
efficiency.
``(B) Consultation.--In selecting quality measures
or a quality measurement system or systems for adoption
and implementation, the Secretary shall consult with--
``(i) individuals from racial and ethnic
minority and other health disparity
populations; and
``(ii) experts in the identification and
elimination of disparities in health and
healthcare among racial and ethnic minority and
other health disparity populations.
``(3) Dissemination.--
``(A) In general.--The Secretary shall make the
measures, data, and analyses described in paragraph (1)
and (2) available to--
``(i) the Office of Minority Health and
Health Disparity Elimination;
``(ii) the National Center on Minority
Health and Health Disparities;
``(iii) the Agency for Healthcare Research
and Quality for inclusion in the Agency's
reports;
``(iv) the Centers for Disease Control and
Prevention;
``(v) the Centers for Medicare and Medicaid
Services;
``(vi) the Indian Health Service;
``(vii) other agencies within the
Department of Health and Human Services; and
``(viii) other entities as determined
appropriate by the Secretary.
``(B) Additional research.--The Secretary may, as
the Secretary determines appropriate, make the
measures, data, and analysis described in paragraphs
(1) and (2) available for additional research,
analysis, and dissemination to nongovernmental entities
and the public.
``(c) Research.--
``(1) Disparity indicators.--
``(A) In general.--The Secretary shall award grants
or contracts for research to develop appropriate
methods, indicators, and measures that will enable the
detection and assessment of disparities in healthcare.
Such research shall prioritize research with respect to
the following:
``(i) Race and ethnicity.
``(ii) Geographic location (such as
geocoding).
``(iii) Socioeconomic position (such as
income or education level).
``(iv) Health literacy.
``(v) Cultural competency.
``(vi) Additional measures as determined
appropriate by the Secretary.
``(B) Applied research.--The Secretary shall use
the results of the research from grants awarded under
subparagraph (A) to improve the data collection
described under subsection (a).
``(2) Strategic partnerships to encourage and improve data
collection.--
``(A) In general.--The Secretary may award not more
than 20 grants to eligible entities for the purposes
of--
``(i) enhancing and improving methods for
the collection, reporting, analysis, and
dissemination of data, as required under the
Minority Health Improvement and Health
Disparity Elimination Act; and
``(ii) encouraging the collection,
reporting, analysis, and dissemination of data
to identify and address disparities in health
and healthcare.
``(B) Definition of eligible entity.--In this
paragraph, the term `eligible entity' means a health
plan, federally qualified health center, hospital,
rural health clinic, academic institution, policy
research organization, or other entity, including an
Indian Health Service hospital or clinic, Indian tribal
health facility, or urban Indian facility, that the
Secretary determines to be appropriate.
``(C) Application.--An eligible entity desiring a
grant under this paragraph shall submit an application
to the Secretary at such time, in such manner, and
containing such information as the Secretary may
require.
``(D) Priority in awarding grants.--In awarding
grants under this paragraph, the Secretary shall give
priority to eligible entities that represent
collaboratives with--
``(i) hospitals, health plans, or health
centers; and
``(ii) at least 1 community-based
organization or patient advocacy group.
``(E) Use of funds.--An eligible entity that
receives a grant under this paragraph shall use grant
funds to--
``(i) collect, analyze, or report data by
race, ethnicity, geographic location,
socioeconomic position, health literacy, or
other health disparity indicator;
``(ii) conduct and report analyses of
quality of healthcare and disparities in health
and healthcare for racial and ethnic minority
and other health disparity populations,
including disparities in diagnosis, management
and treatment, and health outcomes for acute
and chronic disease;
``(iii) improve health data collection,
analysis, and reporting for subpopulations and
categories;
``(iv) modify, implement, and evaluate use
of health information technology systems that
facilitate data collection, analysis and
reporting for racial and ethnic minority and
other health disparity populations, and support
healthcare interventions;
``(v) develop educational programs to
inform patients, providers, purchasers, and
other individuals served about the legality and
importance of the collection, analysis, and
reporting of data by race, ethnicity,
socioeconomic position, geographic location,
and health literacy, for eliminating
disparities in health; and
``(vi) evaluate the activities conducted
under this paragraph.
``(d) Technical Assistance.--The Secretary may provide technical
assistance to promote compliance with the data collection and reporting
requirements of the Minority Health Improvement and Health Disparity
Elimination Act.
``(e) Privacy and Security.--The Secretary shall ensure all
appropriate privacy and security protections for health data collected,
reported, analyzed, and disseminated pursuant to the Minority Health
Improvement and Health Disparity Elimination Act.
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of fiscal years 2007 through 2011.''.
TITLE V--LEADERSHIP, COLLABORATION, AND NATIONAL ACTION PLAN
SEC. 501. OFFICE OF MINORITY HEALTH AND HEALTH DISPARITY ELIMINATION.
(a) In General.--Section 1707 of the Public Health Service Act (42
U.S.C. 300u-6) is amended to read as follows:
``SEC. 1707. OFFICE OF MINORITY HEALTH AND HEALTH DISPARITY
ELIMINATION.
``(a) Establishment.--For the purpose of improving the health of
racial and ethnic minority populations and other health disparity
populations, as described in subsection (b), there is established an
Office of Minority Health and Health Disparity Elimination within the
Office of Public Health and Science. There shall be in the Department
of Health and Human Services a Deputy Assistant Secretary for Minority
Health and Health Disparity Elimination, who shall be the head of the
Office of Minority Health and Health Disparity Elimination. The
Secretary, acting through such Deputy Assistant Secretary, shall carry
out this section.
``(b) Populations To Be Served.--The Secretary shall ensure that
services provided under this section are prioritized to improve the
health of racial and ethnic minority groups. To the extent that
services are provided to other health disparity populations, such
populations, as compared to the general population, must experience a--
``(1) disproportionate burden of disease, particularly
chronic conditions such as hepatitis B, diabetes, heart
disease, stroke, high blood pressure, mental illness, asthma,
obesity, HIV/AIDS, and cancer;
``(2) significantly elevated risk for poor health outcomes,
including disability and premature mortality;
``(3) disproportionate lack of access to local health
resources, including hospitals, clinics, and health
professionals; and
``(4) lower socioeconomic position.
``(c) Duties.--With respect to racial and ethnic minority groups,
and other health disparity groups, the Secretary, acting through the
Deputy Assistant Secretary, shall carry out the following:
``(1) Coordinate and provide input on activities within the
Public Health Service that relate to disease prevention, health
promotion, health service delivery, health workforce, and
research concerning racial and ethnic minority populations, and
other health disparity populations. The Secretary shall ensure
that the heads of each of the agencies of the Service
collaborate with the Deputy Assistant Secretary on the
development and conduct of such activities.
``(2) Not later than 1 year after the date of enactment of
the Minority Health Improvement and Health Disparity
Elimination Act, develop and implement a comprehensive
Department-wide plan to improve minority health and eliminate
health disparities in the United States, to be known as the
National Plan to Improve Minority Health and Eliminate Health
Disparities, (referred to in this section as the `National
Plan'). With respect to development and implementation of the
National Plan, the Secretary shall carry out the following:
``(A) Consult with the following:
``(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 of
the National Institutes of Health.
``(iv) The Director of the Agency for
Healthcare Research and Quality.
``(v) The National Coordinator for Health
Information Technology.
``(vi) The Administrator of the Health
Resources and Services Administration.
``(vii) The Administrator of the Centers
for Medicare & Medicaid Services.
``(viii) The Director of the Office for
Civil Rights.
``(ix) The Secretary of Veterans Affairs.
``(x) The Administrator of the Substance
Abuse and Mental Health Services
Administration.
``(xi) The Secretary of Defense.
``(xii) The Commissioner of the Food and
Drug Administration.
``(xiii) The Director of the Indian Health
Service.
``(xiv) The Secretary of Education.
``(xv) The Secretary of Labor.
``(xvi) The heads of other public and
private entities, as determined appropriate by
the Secretary.
``(B) Review and integrate existing information and
recommendations as appropriate, such as Healthy People
2010, Institute of Medicine studies, and Surgeon
General Reports.
``(C) Ensure inclusion of measurable short-range
and long-range goals and objectives, a description of
the means for achieving such goals and objectives, and
a designated date by which such goals and objectives
are expected to be achieved.
``(D) Ensure that all amounts appropriated for such
activities are expended in accordance with the National
Plan.
``(E) Review the National Plan on at least an
annual basis, and report to the public and appropriate
committees of Congress on progress.
``(F) Revise such Plan as appropriate.
``(G) Ensure that the National Plan will serve as a
binding statement of policy with respect to the
agencies' activities related to improving health and
eliminating disparities in health and healthcare.
``(3) Work with Federal agencies and departments outside of
the Department of Health and Human Services as appropriate to
maximize resources available to increase understanding about
why disparities exist, and effective ways to improve health and
eliminate health disparities.
``(4) In cooperation with the appropriate agencies, support
research, demonstrations, and evaluations to test new and
innovative models for--
``(A) expanding healthcare access;
``(B) improving healthcare quality; and
``(C) increasing healthcare educational
opportunity.
``(5) Develop mechanisms that support better information
dissemination, education, prevention, and service delivery to
individuals from disadvantaged backgrounds, including
individuals who are members of racial or ethnic minority groups
or health disparity populations.
``(6) Increase awareness of disparities in healthcare, and
knowledge and understanding of health risk factors, among
healthcare providers, health plans, and the public.
``(7) Advise in matters related to the development,
implementation, and evaluation of health professions education
on improving healthcare outcomes and decreasing disparities in
healthcare outcomes, with focus on cultural competence.
``(8) Assist healthcare professionals, community and
advocacy organizations, academic medical centers and other
health entities and public health departments in the design and
implementation of programs that will improve health outcomes by
strengthening the patient-provider relationship.
``(9) Carry out programs to improve access to healthcare
services and to improve the quality of healthcare services for
individuals with low functional health literacy.
``(10) Facilitate the classification and collection of
healthcare data to allow for ongoing analysis to identify and
determine the causes of disparities and monitoring of progress
toward improving health and eliminating health disparities.
``(11) Ensure that the National Center for Health
Statistics collects data on the health status of each racial or
ethnic minority group or health disparity population pursuant
to section 2901.
``(12) Support a national minority health resource center
to carry out the following:
``(A) Facilitate the exchange of information
regarding matters relating to health information and
health promotion, preventive health services, and
education in the appropriate use of healthcare.
``(B) Facilitate access to such information.
``(C) Assist in the analysis of issues and problems
relating to such matters.
``(D) Provide technical assistance with respect to
the exchange of such information (including
facilitating the development of materials for such
technical assistance).
``(13) Support a center for linguistic and cultural
competence to carry out the following:
``(A) With respect to individuals who lack
proficiency in speaking the English language, enter
into contracts with public and nonprofit private
providers of primary health services for the purpose of
increasing the access of such individuals to such
services by developing and carrying out programs to
improve health literacy and cultural competency.
``(B) Carry out programs to improve access to
healthcare services for individuals with limited
proficiency in speaking the English language.
Activities under this subparagraph shall include
developing and evaluating model projects.
``(14) Enter into interagency agreements with other
agencies of the Public Health Service, as appropriate.
``(15) Collaborate with the Office for Civil Rights to--
``(A) assist healthcare providers with application
of guidance and directives regarding healthcare for
racial and ethnic minority and other health disparity
populations, including--
``(i) reviewing cases with the Office of
Inspector General and the Office for Civil
Rights which have been closed without a finding
of discrimination to determine if a pattern or
practice of activities that could lead to
discrimination exists, and if such a pattern or
practice is identified, provide technical
assistance or education, as applicable, to the
relevant provider or to a group of providers
located within a particular geographic area;
``(ii) biannually publishing information on
cases filed with the Office for Civil Rights
which have resulted in a finding of
discrimination, including the name and location
of the entity found to have discriminated, and
any findings and agreements entered into
between the Office for Civil Rights and the
entity; and
``(iii) monitoring and analysis of trends
in cases reported to the Office for Civil
Rights to ensure that the Office of Minority
Health and Health Disparity Elimination acts to
educate and assist healthcare providers as
necessary; and
``(B) provide technical assistance or education, as
applicable, to the relevant provider or to a group of
providers located within a particular geographic area.
``(16) Promote and expand efforts to increase racial and
ethnic minority enrollment in clinical trials.
``(17) Establish working groups--
``(A) to examine and report recommendations to the
Secretary regarding--
``(i) emergency preparedness and response
for underserved populations;
``(ii) development and implementation of
health information technology that can assist
providers to deliver culturally competent
healthcare;
``(iii) outreach and education of health
disparity groups about new Federal health
programs, as appropriate, including the
programs under part D of title XVIII of the
Social Security Act and chronic care management
programs under the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (and
the amendments made by such Act);
``(iv) leadership development in public
health; and
``(v) other emerging health issues at the
discretion of the Secretary; and
``(B) that include representation from the relevant
health agencies, centers and offices, as well as public
and private entities as appropriate.
``(d) Advisory Committee.--
``(1) In general.--The Secretary shall establish an
advisory committee to be known as the Advisory Committee on
Minority Health and Health Disparities (in this subsection
referred to as the `Committee').
``(2) Duties.--The Committee shall provide advice to the
Deputy Assistant Secretary carrying out this section, including
advice on the development of goals and specific program
activities under subsection (c) for racial and ethnic minority
groups and health disparity population.
``(3) Chair.--The chairperson of the Committee shall be
selected by the Secretary from among the members of the voting
members of the Committee. The term of office of the chairperson
shall be 2 years.
``(4) Composition.--
``(A) The Committee shall be composed of 12 voting
members appointed in accordance with subparagraph (B),
and nonvoting, ex-officio members designated in
subparagraph (C).
``(B) The voting members of the Committee shall be
appointed by the Secretary from among individuals who
are not officers or employees of the Federal Government
and who have expertise regarding issues of minority
health and health disparities. Racial and ethnic
minority groups and health disparity populations shall
be appropriately represented among such members.
``(C) The nonvoting, ex officio members of the
Committee shall be such officials of the Department of
Health and Human Services, including the Director of
the Office of Minority Health and Health Disparity
Elimination and the Office for Civil Rights, and other
officials as the Secretary determines to be
appropriate.
``(D) The Secretary shall provide an opportunity
for the Chairman and Ranking Member of the Committee on
Health, Education, Labor, and Pensions of the Senate to
submit to the Secretary names of potential Committee
members under this section for consideration.
``(5) Terms.--Each member of the Committee shall serve for
a term of 4 years, except that the Secretary shall initially
appoint a portion of the members to terms of 1 year, 2 years,
and 3 years.
``(6) Vacancies.--If a vacancy occurs on the Committee, a
new member shall be appointed by the Secretary within 90 days
from the date that the vacancy occurs, and serve for the
remainder of the term for which the predecessor of such member
was appointed. The vacancy shall not affect the power of the
remaining members to execute the duties of the Committee.
``(7) Compensation.--Members of the Committee who are
officers or employees of the United States shall serve without
additional compensation. Members of the Committee who are not
officers or employees of the United States shall receive
compensation, for each day (including travel time) they are
engaged in the performance of the functions of the Committee.
Such compensation may not be in an amount in excess of the
daily equivalent of the annual maximum rate of basic pay
payable under the General Schedule for positions above GS-15
under title 5, United States Code.
``(e) Certain Requirements Regarding Duties.--
``(1) Recommendations regarding language.--
``(A) Proficiency in speaking english.--The Deputy
Assistant Secretary shall consult with the Director of
the Office of International and Refugee Health, the
Director of the Office for Civil Rights, and the
Directors of other appropriate departmental entities
regarding recommendations for carrying out activities
under subsection (c)(9).
``(B) Health professions education regarding health
disparities.--The Deputy Assistant Secretary shall
carry out the duties under subsection (c)(7) in
collaboration with appropriate personnel of the
Department of Health and Human Services, other Federal
agencies, and other offices, centers, and institutions,
as appropriate, that have responsibilities under the
Minority Health and Health Disparities Research and
Education Act of 2000.
``(2) Resource allocation.--
``(A) Funding.--In carrying out subsection (c), the
Secretary shall ensure that such funding and other
resources directed to health disparity populations that
are not racial and ethnic minority populations are used
to supplement, not supplant, funding and other
resources currently or historically allocated for
services provided to such populations.
``(B) Activities.--When carrying out activities for
health disparity populations that are not racial and
ethnic minority populations, the Secretary shall ensure
that such activities carried out by the Office of
Minority Health and Health Disparity Elimination
supplement, not supplant, the activities of other
offices or agencies whose primary mission by
established mandate, or current or historical practice
is to serve such populations.
``(3) Cultural competency of services.--The Secretary shall
ensure that information and services provided pursuant to
subsection (c) consider the unique cultural or linguistic
issues facing such populations and are provided in the
language, educational, and cultural context that is most
appropriate for the individuals for whom the information and
services are intended.
``(4) Agency coordination.--In carrying out subsection (c),
the Secretary shall ensure that new or existing agency offices
of minority health, or other health disparity offices, report
current and proposed activities to the Deputy Assistant
Secretary, and provide, to the extent practicable, an
opportunity for input in the development of such activities by
the Deputy Assistant Secretary.
``(f) Grants and Contracts Regarding Duties.--
``(1) In general.--In carrying out subsection (c), the
Secretary acting through the Deputy Assistant Secretary, may
make awards of grants, cooperative agreements, and contracts to
public and nonprofit private entities.
``(2) Process for making awards.--The Deputy Assistant
Secretary shall ensure that awards under paragraph (1) are
made, to the extent practical, only on a competitive basis, and
that a grant is awarded for a proposal only if the proposal has
been recommended for such an award through a process of peer
review.
``(3) Evaluation and dissemination.--The Deputy Assistant
Secretary, directly or through contracts with public and
private entities, shall provide for evaluations of projects
carried out with awards made under paragraph (1) during the
preceding 2 fiscal years. The report shall be included in the
report required under subsection (g) for the fiscal year
involved.
``(g) State Offices of Minority Health.--The Deputy Assistant
Secretary shall assist the voluntary establishment and functions of
State offices of minority health in order to expand and coordinate
State efforts to improve the health of minority and other health
disparity populations.
``(1) Priorities.--The Deputy Assistant Secretary may
facilitate, with respect to minority and health disparity
populations--
``(A) integration and coordination of State and
national efforts, including those pertaining to the
National Plan pursuant to subsection (b);
``(B) strategic plan development within States to
assess and respond to local health concerns;
``(C) education and engagement of key stakeholders
within States, including representatives from public
health agencies, hospitals, clinics, provider groups,
elected officials, community-based organizations,
advocacy groups, media, and the private sector;
``(D) development and implementation of accepted
standards, core competencies, and minimum
infrastructure requirements for State offices;
``(E) access to State level health data for
minority and health disparity populations, which may
include State data collection and analysis;
``(F) development, implementation, and evaluation
of State programs and policies, as appropriate;
``(G) communication and networking among States to
share effective policies, programs and practices with
respect to increasing access and quality of care;
``(H) recognition and reporting of State successes
and challenges; and
``(I) identification of Federal grant programs and
other funding for which States could apply to carry out
health improvement activities.
``(2) Resources.--The Deputy Assistant Secretary may
provide grants and technical assistance for the voluntary
establishment or capacity development of State offices of
minority health.
``(3) Collaboration.--To the extent practicable, the Deputy
Assistant Secretary may encourage and facilitate collaboration
between State offices of minority health and State offices
addressing the needs of other health disparity or disadvantaged
populations, including offices of rural health.
``(4) Definition.--For the purpose of this subsection,
`State offices of minority health' include offices, councils,
commissions, or advisory panels designated by States or
territories to address the health of minority populations.
``(h) Reports.--
``(1) In general.--Not later than 1 year after the date of
enactment of the Minority Health Improvement and Health
Disparity Elimination Act, the Secretary shall submit to the
appropriate committees of Congress, a report on the National
Plan developed under subsection (c).
``(2) Report on activities.--Not later than February 1 of
fiscal year 2008 and of each second year thereafter, the
Secretary shall submit to the appropriate committees of
Congress, a report describing the activities carried out under
this section during the preceding 2 fiscal years and evaluating
the extent to which such activities have been effective in
improving the health of racial and ethnic minority groups and
health disparity populations. Each such report shall include
the biennial reports submitted under subsection (f)(3) for such
years by the heads of the Public Health Service agencies.
``(3) Agency reports.--Not later than February 1, 2007, and
on a biannual basis thereafter, the heads of the Public Health
Service shall submit to the Deputy Assistant Secretary a report
that summarizes the minority health and health disparity
activities of each of the respective agencies.
``(i) Definitions.--In this section:
``(1) The term `health disparity population' has the
meaning given the term in section 903(d)(1).
``(2) The term `racial and ethnic minority group' means
American Indians (including Alaska Natives, Eskimos, and
Aleuts), Asian Americans, Native Hawaiians and other Pacific
Islanders, Blacks, and Hispanics.
``(3) The term `Hispanic' means individuals whose origin is
Mexican, Puerto Rican, Cuban, Central or South American, or of
any other Spanish-speaking country.
``(j) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $110,000,000
for fiscal year 2007, such sums as may be necessary for each of fiscal
years 2008 through 2011.''.
(b) Transfer of Functions; References.--
(1) Transfer of functions.--
(A) Office of minority health and health disparity
elimination.--The functions of the Office of Minority
Health under section 1707 of the Public Health Service
Act (42 U.S.C. 300u-6) as in effect the day before the
date of enactment of this Act are transferred to the
Office of Minority Health and Health Disparity
Elimination under such section 1707 (as amended by
subsection (a)).
(B) Deputy assistant secretary for minority health
and health disparity elimination.--The functions of the
Deputy Assistant Secretary for Minority Health of the
Office of Minority Health under section 1707 of the
Public Health Service Act (42 U.S.C. 300u-6) as in
effect the day before the date of enactment of this Act
are transferred to the Deputy Assistant Secretary for
Minority Health and Health Disparity Elimination of the
Office of Minority Health and Health Disparity
Elimination under such section 1707 (as amended by
subsection (a)).
(2) References.--
(A) Office of minority health and health disparity
elimination.--Any reference in any Federal law,
Executive order, rule, regulation, or delegation of
authority, or any document of or pertaining to the
Office of Minority Health under section 1707 of the
Public Health Service Act (42 U.S.C. 300u-6) as in
effect the day before the enactment of this Act is
deemed to be a reference to the Office of Minority
Health and Health Disparity Elimination under such
section 1707 (as amended by subsection (a)).
(B) Deputy assistant secretary for minority health
and health disparity elimination.--Any reference in any
Federal law, Executive order, rule, regulation, or
delegation of authority, or any document of or
pertaining to the Deputy Assistant Secretary for
Minority Health of the Office of Minority Health under
section 1707 of the Public Health Service Act (42
U.S.C. 300u-6) as in effect the day before the
enactment of this Act is deemed to be a reference to
the Deputy Assistant Secretary for Minority Health and
Health Disparity Elimination of the Office of Minority
Health and Health Disparity Elimination under such
section 1707 (as amended by subsection (a)).
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S10696)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S10697-10710)
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