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funds paid under this part to the tribal organization, including any funds paid by the tribal organization to a recipient of a grant or contract. "(b) For the purpose of any application submitted under this part, the tribal organization may develop its own population statistics, with certification from the Bureau of Indian Affairs, in order to establish eligibility. "(c) The Commission shall approve any application which complies with the provisions of subsection (a). "(d) Whenever the Commissioner determines not to approve an application submitted under subsection (a) the Commission shall— "(1) state objections in writing to the tribal organization within 60 days after such decision; "(2) provide to the extent practicable technical assistance to the tribal organization to overcome such stated objections; and "(3) provide the tribal organization with a hearing, under such rules and regulations as the Commissioner may prescribe. "(e) Whenever the Commissioner approves an application of a tribal organization under this part, funds shall be awarded for not less than 12 months.

.

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"SURPLUS EDUCATIONAL FACILITIES

"SEC. 615. (a) Notwithstanding any other provision of law, the 42 USC 3057f. Secretary of the Interior through the Bureau of Indian Affairs shall make available surplus Indian educational facilities to tribal organizations, and nonprofit organizations with tribal approval, for use as multipurpose senior centers. Such centers may be altered so as to provide extended care facilities, community center facilities, nutrition services, child care services, and other supportive services. "(b) Each eligible tribal organization desiring to take advantage of such surplus facilities shall submit an application to the Secretary of the Interior at such time and in such manner, and containing or accompanied by such information, as the Secretary of the Interior determines to be necessary to carry out the provisions of this section. "PART B—NATIVE HAWAIIAN PROGRAM

FINDINGS

"SEC. 621. The Congress finds the older Native Hawaiians— 42 USC 3057g. "(1) have a life expectancy 10 years less than any other ethnic group in the State of Hawaii; "(2) rank lowest on 9 of 11 standard health indicies for all ethnic groups in Hawaii; "(3) are often unaware of social services and do not know how to go about seeking such assistance; and "(4) live in poverty at a rate of 34 percent. ELIGIBILITY

"SEC. 622. A public or nonprofit private organization having the 42 USC 3057h. capacity to provide services under this part for Native Hawaiians is eligible for assistance under this part only if— "(1) the organization will serve at least 50 individuals who have attained 60 years of age or older; and "(2) the organization demonstrates the ability to deliver supportive services, including nutrition services.

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42 USC 30571.

PUBLIC LAW 100-175—NOV. 29, 1987 «

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GRANTS AUTHORIZED

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"SEC. 623. The Commissioner may make grants to public and nonprofit private organizations to pay all of the costs for the delivery of supportive services and nutrition services to older Native Hawaiians.;K,,;>^.jfiv .-...j. "APPLICATION

42 USC 3057J.

Reports.

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, ' '

"SEC. 624. (a) No grant may be made under this part unless the public or nonprofit private organization submits an application to the Commissioner which meets such criteria as the Commissioner may by regulation prescribe. Each such application shall— "(1) provide that the organization will evaluate the need for supportive and nutrition services among older Native Hawaiians to be represented by the organization; "(2) provide for the use of such methods of administration as are necessary for the proper and efficient administration of the program to be assisted; "(3) provide assurances that the organization will coordinate its activities with the State agency on aging; "(4) provide that the organization will make such reports in such form and containing such information as the Commissioner may reasonably require, and comply with such requirements as the Commissioner may impose to ensure the correctness of such reports; "(5) provide for periodic evaluation of activities and projects carried out under the application; "(6) establish objectives, consistent with the purpose of this title, toward which activities described in the application will be directed, identify obstacles to the attainment of such objectives, and indicate the manner in which the organization proposes to overcome such obstacles; "(7) provide for establishing and maintaining information and "' referral services to assure that older Native Hawaiians to be served by the assistance made available under this part will have reasonably convenient access to such services; "(8) provide a preference for Native Hawaiians 60 years of age and older for full or part-time staff positions wherever feasible; "(9) provide that any legal or ombudsman services made ., available to older Native Hawaiians represented by the nonprofit private organization will be substantially in compliance ^-. with the provisions of title III relating to the furnishing and similar services; and ,tff; "(10) provide satisfactory assurances that the fiscal control and fund accounting procedures will be adopted as may be necessary to assure proper disbursement of, and accounting for. Federal funds paid under this part to the nonprofit private organization, including any funds paid by the organization to a recipient of a grant or contract. "Oo) The Commissioner shall approve any application which complies with the provisions of subsection (a). "(c) Whenever the Commissioner determines not to approve an application submitted under subsection (a) the Commissioner shall— "(1) state objections in writing to the nonprofit private organization within 60 days after such decision;

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"(2) provide to the extent practicable technical assistance to the nonprofit private organization to overcome such stated objections; and "(3) provide the organization with a hearing under such rules and regulations as the Commissioner may prescribe. "(d) Whenever the Commissioner approves an application of a nonprofit private or public organization under this part funds shall be awarded for not less than 12 months. DEFINITION

"SEC. 625. For the purpose of this part, the term 'Native Hawai- 42 USC 3057k. ian' means any individual any of whose ancestors were natives of the area which consists of the Hawaiian Islands prior to 1778. 'PART C—GENERAL PROVISIONS ADMINISTRATION

"SEC. 631. In establishing regulations for the purpose of part A the 42 USC 3057/. Commissioner shall consult with the Secretary of the Interior. PAYMENTS

"SEC. 632. Payments may be made under this title (after necessary 42 USC 3057m. adjustments, in the case of grants, on account of previously made overpayments or underpayments) in advance or by way of reimbursement in such installments and on such conditions, as the Commissioner may determine. AUTHORIZATION OF APPROPRIATIONS

"SEC. 633. (a) Subject to subsection (b), there are authorized to be 42 USC 3057n. appropriated to carry out this title (other than section 615)— "(1) $13,400,000 for fiscal year 1988, of which $12,100,000 shall be available to carry out part A and $1,300,000 shall be available to carry out part B; "(2) $16,265,000 for fiscal year 1989, of which $14,900,000 shall be available to carry out part A and $1,365,000 shall be availC able to carry out part B; "(3) $19,133,000 for fiscal year 1990, of which $17,700,000 shall be available to carry out part A and $1,433,000 shall be availf able to carry out part B; and "(4) $22,105,000 for fiscal year 1991, of which $20,600,000 shall be available to carry out part A and $1,505,000 shall be available to carry out part B.". "(b)(l) If the amount appropriated under subsection (a) for a fiscal year does not exceed the amount appropriated to carry out this title (as in effect before the effective date of the Older Americans Act Amendments of 1987) in fiscal year 1987, then the amount appropriated under subsection (a) for such fiscal year shall be available only to carry out part A. "(2) If the amount appropriated under subsection (a) for a fiscal year exceeds the amount appropriated to carry out this title (as in effect before the effective date of the Older Americans Act Amendments of 1987) in fiscal year 1987, then— "(A) $250,000 of such excess shall be made available to carry out part B; and

91-194 O - 90 - 32: QL.3 Part 1

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"(B) one-half of the remaining amount of such excess shall be made available to carry out part B; except that the aggregate amount made available to carry out part B may not exceed the amount required (without regard to this paragraph) by subsection (a) to be made available to carry out part B.". PART F—MISCELLANEOUS AND TECHNICAL AMENDMENTS SEC. 181. REPEAL OF OLDER AMERICANS PERSONAL HEALTH EDUCATION AND TRAINING PROGRAM.

'

--''^

Title VII of the Older Americans Act of 1965 (42 U.S.C. 30583058d) is repealed. SEC. 182. TECHNICAL AMENDMENTS.

(a) Section 102(1) of the Older Americans Act of 1965 (42 U.S.C. 3002(1)) is amended by striking "other than for purposes of title V" and inserting "except that for purposes of title V such term means the Secretary of Labor".
 * u c;.' i;

(i,)(i) Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended— (A) in paragraph (3)— (i) by striking "includes" and inserting "means any of the ,.,..,,, ^ several States,", and .5, (ii) by striking "Puerto Rico" and inserting "the Commonwealth of Puerto Rico", and (B) by adding at the end the following: "(8) The term 'Trust Territory of the Pacific Islands' includes the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.". (2) Section 302 of the Older Americans Act of 1965 (42 U.S.C. 3022), (trc.: ' -; i • as amended by sections 136(a) and 144(a), is amended— (A) by striking paragraph (6), and i'i (B) by redesignating paragraphs (7) through (20) as paragraphs (6) through (19), respectively. (3) Section 506(a)(4)(A) of the Older Americans Act of 1965 (42 U.S.C. 3056d(a)(4)(A)) is amended by striking "Puerto Rico" and inserting "the Commonwealth of Puerto Rico". (4) Section 507 of the Older Americans Act of 1965 (42 U.S.C. 3056e), as amended by section 164(b), is amended— (A) by striking paragraph (1), and (B) by redesignating paragraphs (2), (3), (4), and (5) as paragraphs (1), (2), (3), and (4), respectively. (c) Section 201(a) of the Older Americans Act of 1965 (42 U.S.C. 3011(a)) is amended by striking "his functions" and inserting "the functions of the Commissioner". (d) Section 204(d)(3) of the Older Americans Act of 1965 (42 U.S.C. 3015(d)(3)) is amended by inserting "to" after "Secretary,". (e)(l) Section 302 of the Older Americans Act of 1965 (42 U.S.C. 3022), as amended by subsection (b)(2) and sections 136(a) and 144(a), is amended by adding at the end the following: "(20) The term 'greatest economic need' means the need " resulting from an income level at or below the poverty levels ^ " established by the Office of Management and Budget. "(21) The term 'greatest social need' means the need caused '^' by noneconomic factors which include physical and mental disabilities, language barriers, and cultural, social, or geo-

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graphical isolation including that caused by racial or ethnic status which restricts an individual's ability to perform normal daily tasks or which threatens such individual's capacity to live independently.". (2) Section 305(d) of the Older Americans Act of 1965 (42 U.S.C. 3025(d)) is amended— (A) by striking "(d)(1)" and inserting "(d)", and (B) by striking paragraph (2). (3) Section 306(a) of the Older Americans Act of 1965 (42 U.S.C. 3026(a)) is amended by striking the last sentence. (f) Section 304(d)(1) of the Older Americans Act of 1965 (42 U.S.C. 3024(d)(1)) is amended in the matter preceding subparagraph (A) by inserting a comma after "section 308(b)". (g) Section 305(a)(1)(E) of the Older Americans Act of 1965 (42 U.S.C. 3025(a)(1)(E)) is amended by striking "legal services" and inserting "legal assistance", (h) Section 305(a)(2)(C) of the Older Americans Act of 1965 (42 U.S.C. 3025(a)(2)(C)) is amended by inserting "in accordance with subsection (d)" before the semicolon at the end. (i) Section 306(a)(6)(G) of the Act (42 U.S.C. 3026(a)(6)(G)), as amended by section 137(b), is amended by striking "and" at the end. 0) Section 306(a)(2)(B) of the Older Americans Act of 1965 (42 U.S.C. 3026(a)(2)(B)) is amended by striking "other neurological and organic brain disorders of the Alzheimer's type" and inserting "related disorders with neurological and organic brain dysfunction'. (k) Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 3027(a)) is amended— (1) by striking "Each such plan shall—" and inserting "Each such plan shall comply with all of the following requirements:", (2) in paragraph (1)— -«* (A) by inserting "The plan shall" after "(1)", and (B) by striking the semicolon at the end and inserting a period, (3) in paragraph (2)— a la.., (A) by inserting "The plan shall" after "(2)", and (B) by striking the semicolon at the end and inserting a period, (4) in paragraph (3)— » c (A) in subparagraph (A) by inserting "The plan shall" after "(3)(A)", and (B) in subparagraph (B)— (i) by inserting "The plan shall" after "(B)", and i. I.'* •. (ii) by striking the semicolon at the end and inserting a period, (5) in paragraph (4)— (A) by inserting "The plan shall" after "(4)", and K 1^ (B) by striking the semicolon at the end and inserting a period, (6) in paragraph (5)— (A) by inserting "The plan shall" after "(5)", and (B) by striking the semicolon at the end and inserting a period, (7) in paragraph (6)— (A) by inserting "The plan shall" after "(6)", and (B) by striking the semicolon at the end and inserting a period, (8) in paragraph (7)—

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PUBLIC LAW 100-175—NOV. 29, 1987 (A) by inserting "The plan shall" after "(7)", and (B) by striking the semicolon at the end and inserting a period, ^-=-.:'••J:-' (9) in paragraph (8)— (A) by inserting "The plan shall" after "(8)", and (B) by striking the semicolon at the end and inserting a period, (10) in paragraph (9)— (A) by inserting "The plan shall" after "(9)", and (B) by striking the semicolon at the end and inserting a period, ' •' (11) in paragraph (10)— (A) by inserting "The plan shall" after "(10)", and ' (B) by striking the semicolon at the end and inserting a rith period, (12) in paragraph (11)— (A) by inserting "The plan shall" after "(11)", and '(B) by striking the semicolon at the end and inserting a period, ^ (13) in paragraph (13)— ,. (A) by inserting "The plan shall" after "(13)", and (B) in subparagraph (I) by striking the semicolon at the end and inserting a period, (14) in paragraph (14)— (A) by inserting "The plan shall" after "(14)", and (B) in subparagraph (E) by striking the semicolon at the end and inserting a period, (15) in paragraph (15)— (A) by inserting "The plan shall" after "(15)", and (B) in subparagraph (D) by striking the semicolon and inserting a period, (16) in paragraph (16)— (A) by inserting "The plan shall" after "(16)", and (B) in subparagraph (C) by striking the semicolon at the end and inserting a period, (17) in paragraph (17)— (A) by inserting "The plan shall" after "(17)", and IA, (B) by striking the semicolon at the end and inserting a period, (18) in paragraph (18)— b (A) by inserting "The plan shall" after "(18)", and (B) by striking the semicolon at the end and inserting a period, (19) in paragraph (19)— (A) by inserting "The plan shall" after "(19)", and (B) by striking the semicolon at the end and inserting a period, and (20) in paragraph (20)— (A) by inserting "The plan shall" after "(20)", and EJ (B) in subparagraph (B)(ii) by striking "; and" at the end and inserting a period. (1) Section 308(b) of the Older Americans Act of 1965 (42 U.S.C. 3028(b)) is amended— (1) by striking "(b)(1)(A)" and inserting "ObXD", (2) in paragraph (1)— (A) by striking "(i)" and inserting "(A)", and
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(B) by striking "(ii)" the second place it appears and inserting "(B)", (3) in paragraph (2)— (A) by striking "(2)(A)" and inserting "(2)", (B) by striking "(i)" and inserting "(A)", and (C) by striking "(ii)" the second place it appears and inserting "(B)", (4) in paragraph (3)(C) by striking "he" and inserting "the Commissioner", (5) in subparagraphs (A) and (B) of paragraph (5) by striking ' "appropriated" each place it appears and inserting "allotted", and (6) in paragraph (5)(B) beginning with the dash strike out all through the period and insert: "not more than 30 percent of the funds allotted for any fiscal year.". (m) Section 321(a)(10) of the Older Americans Act of 1965 (42 U.S.C. 3030d(a)(10)) is amended by inserting "for" after "advocate". (n) Section 337 of the Older Americans Act of 1965 (42 U.S.C. 3030g) is amended by striking "Association of Area Agencies on Aging" and inserting "National Association of Area Agencies on Aging". (o) Section 422(b)(1) of the Older Americans Act of 1965 (42 U.S.C. 3035a(b)(l)) is amended by striking "Alzheimers' disease and other organic and neurological brain disorders of the Alzheimers' type" and inserting "Alzheimer's disease and related disorders with neurological and organic brain dysfunction", (p) Section 507(1) of the Older Americans Act of 1965 (42 U.S.C. 3056e(2)), as amended by subsection (b)(4), is amended by striking "the Bureau of Labor Statistics" and inserting "the Office of Management and Budget". PART G—CONSUMER PRICE INDEX FOR OLDER AMERICANS SEC. 191. INDEX AUTHORIZED.

29 USC 2 note.

The Secretary of Labor shall, through the Bureau of Labor Statistics, develop, from existing data sources, a reweighted index of consumer prices which reflects the expenditures for consumption by Americans 62 years of age and older. The Secretary shall furnish to the Congress the index within 180 days after the date of enactment of this Act. The Secretary shall include with the index furnished a report which explains the characteristics of the reweighted index, the research necessary to develop and measure accurately the rate of inflation affecting such Americans, and provides estimates of time and cost required for additional activities necessary to carry out the objectives of this section.

TITLE 11—1991 WHITE HOUSE CONFERENCE ON AGING SEC. 201. WHITE HOUSE CONFERENCE AUTHORIZED.

(a) FINDINGS.—The Congress finds that— (1) the number of individuals 55 years of age or older was approximately 51,400,000 in 1986, and will, by the year 2040, be approximately 101,700,000,

42 USC 3001

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(2) more than 1 of every 6 persons 55 years of age or older will be hospitalized during the next year, (3) persons 55 years of age or older have a higher average outof-pocket medical cost burden than younger persons; approximately 17 percent of individuals age 55 to 64 experience out-ofb pocket costs in excess of 20 percent of their family income and the average per capita out-of-pocket cost of persons 65 years of y age or older is expected to equal 18.5 percent of income by 1991, (4) there is a great need to ensure access and the quality of •jj affordable health care to all older individuals, (5) the need for a comprehensive and responsive long-term care delivery system is great, 11 (6) the availability and cost of suitable housing, together with ft, suitable services needed for independent or semi-independent living, still cause concern to older individuals, gi (7) the ability to lead an independent or semi-independent life is contingent, in many cases, upon the availability of a comprehensive and effective social service system for older 4 individuals, n (8) the availability and access to opportunities for continued productivity and employment is of great importance to middleaged and older individuals who want or need to work, T. (9) the fulfillment, dignity, and satisfaction of retirees still depend on the continuing development of a consistent national retirement policy, (10) there is a continuing need to maintain and preserve the national policy with respect to increasing, coordinating, and expediting biomedical and other appropriate research directed "ti. at determining the causes and effects of the aging process, (11) false stereotypes about aging and the process of aging continue to be prevalent throughout the United States and policies should be nurtured to overcome such stereotypes, and (12) the talents and experience of older individuals represent ?io - 5 -a j >i a valuable community resource which should be developed and more widely shared within the local community. j (b) POLICY.—It is the policy of the Congress that— (1) the Federal Government should work jointly with the J* States and their citizens to develop recommendations and plans for action to meet the challenges and needs of older individuals, r consistent with the objectives of this section, and (2) in developing programs for the aging pursuant to this Ij section emphasis should be directed toward individual, private, \^- and public initiatives and resources intended to enhance the economic security and self-sufficiency of elder Americans. 42 USC 3001

SEC. 202. AUTHORIZATION OF THE CONFERENCE.

"° ^'

(a) AUTHORITY TO CALL CONFERENCE.—The President may call a White House Conference on Aging in 1991 in order to develop recommendations for additional research and action in the field of aging which will further the policy set forth in subsection (b). (b) PLANNING AND DIRECTION.—The Conference shall be planned and conducted under the direction of the Secretary in cooperation with the Commissioner on Aging and the Director of the National Institute on Aging, and the heads of such other Federal departments and agencies as are appropriate. Such assistance may include the assignment of personnel.

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(c) PURPOSE OF THE CONFERENCE.—The purpose of the Conference shall be— (1) to increase the public awareness of the essential contributions of older individuals to society, (2) to identify the problems of the older individuals, (3) to develop recommendations for the coordination of Federal policy with State and local needs and the implementation of such recommendations, (4) to examine the well-being of older individuals, (5) to develop such specific and comprehensive recommendations for executive and legislative action as may be appropriate for maintaining and improving the well-being of older individuals, and (6) to review the status of recommendations adopted at previous White House Conferences on Aging. (d) CONFERENCE PARTICIPANTS AND DELEGATES.—

(1) PARTICIPANTS.—In order to carry out the purposes of this section, the Conference shall bring together— (A) representatives of Federal, State, and local r,.j.,,,.^. governments, (B) professional and lay people who are working in the field of aging, and (C) representatives of the general public, particularly older individuals. (2) SELECTION OF DELEGATES.—The delegates shall be selected without regard to political affiliation or past partisan activity and shall, to the best of the appointing authority's ability, be representative of the spectrum of thought in the field of aging. SEC. 203. CONFERENCE ADMINISTRATION.

(a) ADMINISTRATION.—In administering this section, the Secretary shall— (1) request the cooperation and assistance of the heads of such other Federal departments and agencies as may be appropriate in the carrying out of this section, (2) furnish all reasonable assistance, including financial assistance, to State agencies on the aging and to area agencies on the aging, and to other appropriate organizations, to enable them to organize and conduct conferences in conjunction with the Conference, (3) prepare and make available for public comment a proposed agenda for the Conference which will reflect to the greatest extent possible the major issues facing older individuals consistent with the provisions of subsection (a), (4) prepare and make available background materials for the use of delegates to the Conference which the Secretary deems necessary, and (5) engage such additional personnel as may be necessary to carry out the provisions of this section without regard to provisions of title 5, United States Code, governing appointments in the competitive service, and without regard to chapter 51 and subchapter III of chapter 53 of such title relating to classification and General Schedule pay rates. (b) DUTIES.—The Secretary shall, in carrying out the Secretary's responsibilities and functions under this section, assure that— (1) the conferences under subsection (a)(2) will—

42 USC 3001

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Federal Register, publication. Federal Register, publication.

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Grants. Contracts.

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42 USC 3001 note.

(A) include a conference on older Indians to identify conditions that adversely affect older Indians, to propose < solutions to ameliorate such conditions, and to provide for the exchange of information relating to the delivery of services to older Indians, and (B) be so conducted as to assure broad participation of older individuals, (2) the proposed agenda for the Conference under subsection (a)(3) is published in the Federal Register not less than 180 days before the beginning of the Conference and the proposed agenda is open for public comment for a period of not less than 60 days, (3) the final agenda for the Conference under subsection (a)(3), taking into consideration the comments received under paragraph (2), is published in the Federal Register and transmitted to the chief executive officers of the States not later than 30 days after the close of the public comment period provided for under paragraph (2), (4) the personnel engaged under subsection (a)(5) shall be fairly balanced in terms of points of views represented and shall be appointed without regard to political affiliation or previous partisan activities, (5) the recommendations of the Conference are not inappropriately influenced by any appointing authority or by any special interest, but will instead be the result of the independent judgment of the Conference, and (6) current and adequate statistical data, including decennial census data, and other information on the well-being of older individuals in the United States are readily available, in advance of the Conference, to the delegates of the Conference, together with such information as may be necessary to evaluate Federal programs and policies relating to aging. In carrying out this subparagraph, the Secretary is authorized to make grants to, and enter into cooperative agreements with, public agencies and nonprofit private organizations.

SEC. 204. CONFERENCE COMMITTEES. (a) ADVISORY COMMITTEE.—The Secretary shall establish an ad-

visory committee to the Conference which shall include representation from the Federal Council on Aging and other public agencies and private nonprofit organizations as appropriate. (b) OTHER COMMITTEES.—The Secretary may establish such other committees, including technical committees, as may be necessary to assist in the planning, conducting, and reviewing of the Conference. (c) COMPOSITION OF COMMITTEES.—Each such committee shall be composed of professionals and public members, and shall include individuals from low-income families and from minority groups. A majority of the public members of each such committee shall be 55 years of age or older. (d) COMPENSATION.—Appointed members of any such committee (other than any officers or employees of the Federal Government), while attending conferences or meetings of the committee or otherwise serving at the request of the Secretary, shall be entitled to receive compensation at a rate to be fixed by the Secretary, but not to exceed the daily prescribed rate for GS-18 under section 5332 of title 5, United States Code (including travel time). While away from their homes or regular places of business, such members may be allowed travel expenses, including per diem in lieu of subsistence, as

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authorized under section 5703 of such title for persons employed intermittently in Federal Government service. SEC. 205. REPORT OF THE CONFERENCE.

State and local

(a) PROPOSED REPORT.—A proposed report of the Conference, 42 USC 3001 which shall include a statement of comprehensive coherent national note, policy on aging together with recommendations for the implementation of the policy, shall be published and submitted to the chief executive officers of the States not later than 60 days following the date on which the Conference is adjourned. The findings and recommendations included in the published proposed report shall be immediately available to the public. (h) RESPONSE TO PROPOSED REPORT.—The chief executive officers of the States, after reviewing and soliciting recommendations and comments on the report of the Conference, shall submit to the Secretary, not later than 180 days after receiving the report, their views and findings on the recommendations of the Conference. (c) FINAL REPORT.—The Secretary shall, after reviewing the views " 'and recommendations of the chief executive officers of the States, ' prepare a final report of the Conference, which shall include a compilation of the actions of the chief executive officers of the States and take into consideration the views and findings of such officers. (d) RECOMMENDATIONS OF SECRETARY.—The Secretary shall, within 90 days after submission of the views of the chief executive officers of the States, publish and transmit to the President and to the Congress recommendations for the administrative action and the legislation necessary to implement the recommendations contained within the report. SEC. 206. DEFINITIONS.

42 USC 3001

For the purposes of this title— (1) the term "area agency on aging" means the agency designated under section 305(a)(2)(A) of the Act, (2) the term "State agency on aging" means the State agency designated under section 305(a)(1) of the Act, (3) the term "Secretary" means the Secretary of Health and Human Services, (4) the term "Conference" means the White House Conference on Aging authorized in subsection (b), and (5) the term "State" means any of the several States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, American Samoa, the Virgin Islands, the Trust Territory of the Pacific Islands, or the Commonwealth of the Northern Mariana Islands. SEC. 207. AUTHORIZATION OF APPROPRIATIONS.

(a) AUTHORIZATION.—There are authorized to be appropriated such sums as may be necessary, for each of the fiscal years 1989, 1990, and 1991, to carry out this title. Sums appropriated under this paragraph shall remain available until the expiration of the 1-year period beginning on the date the Conference is adjourned. New spending authority or authority to enter into contracts as provided in this section shall be effective only to the extent and in such amounts as are provided in advance in appropriations Acts. (b) RETURN OF UNEXPENDED FUNDS.—Any funds remaining upon the expiration of such 1-year period shall be returned to the Treasury of the United States and credited as miscellaneous receipts.

42 USC 3001

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TITLE III—ALZHEIMER'S DISEASE RESEARCH 42 USC 285e-2

SEC. 301. REQUIREMENT FOR CLINICAL TRIALS.

(a) IN GENERAL.—The Director of the National Institute on Aging shall provide for the conduct of clinical trials on the efficacy of the use of such promising therapeutic agents as have been or may be discovered and recommended for further scientific analysis by the National Institute on Aging and the Food and Drug Administration to treat individuals with Alzheimer's disease, to retard the progression of symptoms of Alzheimer's disease, or to improve the functioning of individuals with such disease. (b) RULE OF CONSTRUCTION.—Nothing in this title shall be construed to affect adversely any research being conducted as of the date of the enactment of this Act. 42 USC 285e-2

SEC. 302. AUTHORIZATION OF APPROPRIATIONS.

^°^'

For the purpose of carrying out section 301, there is authorized to be appropriated $2,000,000 for fiscal year 1988.

, TITLE IV—NATIONAL SCHOOL LUNCH ACT AMENDMENT SEC. 401. PARTICIPATION OF OLDER PERSONS AND CHRONICALLY IMPAIRED DISABLED PERSONS IN CHILD CARE FOOD PROGRAM.

i^

i '? 'i ^'

Section 17 of the National School Lunch Act (42 U.S.C. 1766) is amended by adding at the end the following: "(p)(1) For purposes of this section, adult day care centers shall be considered eligible institutions for reimbursement for meals or supplements served to persons 60 years of age or older or to chronically impaired disabled persons, including victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunction. Reimbursement provided to such institutions for such purposes shall improve the quality of meals or level of services provided or increase participation in the program. "(2) For purposes of this subsection— "(A) the term 'adult day care center'means any public agency .( or private nonprofit organization, or any proprietary title XIX 5 or title XX center, which— "(i) is licensed or approved by Federal, State, or local authorities to provide adult day care services to chronically impaired disabled adults or persons 60 years of age or older in a group setting outside their homes on a less than 24(„ hour basis; and .'' "(ii) provides for such care and services directly or under arrangements made by the agency or organization whereby i:'the agency or organization maintains professional management responsibility for all such services; and i "(B) the term 'proprietary title XIX or title XX center' means f any private, for-profit center providing adult day care services for which it receives compensation from amounts granted to the f States under title XIX or XX of the Social Security Act and which title XIX or title XX beneficiaries were not less than 25 percent of enrolled eligible participants in a calendar month

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preceding initial application or annual reapplication for program participation. "(3)(A) The Secretary of Agriculture, in consultation with the Commissioner on Aging, may establish separate guidelines for reimbursement of institutions described in this subsection. "(B) The guidelines shall contain provisions designed to assure that reimbursement under this subsection shall not duplicate reimbursement under part C of title III of the Older Americans Act of 1965, for the same meal served.".

TITLE V—NATIVE AMERICAN PROGRAMS SEC. 501. SHORT TITLE.

This title may be cited as the "Native American Programs Act Amendments of 1987".

Native American Programs Act Amendments of 1987. 42 USC 2991 note.

SEC. 502. REVIEW OF APPLICATIONS FOR ASSISTANCE.

The Native American Programs Act of 1974 (42 U.S.C. 29912992d) is amended— (1) in the first sentence of section 803(a) by inserting ", on a 42 USC 2991b. single year or multiyear basis," after "financial assistance", (2) by redesignating sections 813 and 814 as sections 815 and 42 USC 2992c, 2992d. 816, respectively, (3) by redesignating sections 806 through 812, as sections 807 42 USC 2991e-2992b. through 813, respectively, and (4) by inserting after section 805 the following: PANEL REVIEW OF APPLICATIONS FOR ASSISTANCE

"SEC. 806. (a)(1) The Secretary shall establish a formal panel 42 USC 299ld-l. review process for purposes of— "(A) evaluating applications for financial assistance under sections 803 and 805; and V "(B) determining the relative merits of the projects for which such assistance is requested. "(2) To implement the process established under paragraph (1), the Secretary shall appoint members of review panels from among individuals who are not officers or employees of the Administration for Native Americans. In making appointments to such panels, the Secretary shall give preference to American Indians, Native Hawaiians, and Alaskan Natives. "(b) Each review panel appointed under subsection (a)(2) that reviews any application for financial assistance shall— "(1) determine the merit of each project described in such application; "(2) rank such application with respect to all other applications it reviews for the fiscal year involved, according to the relative merit of all of the projects that are described in such application and for which financial assistance is requested; and > "(3) submit to the Secretary a list that identifies all applications reviewed by such panel and arranges such applications according to rank determined under paragraph (2). "(c) Upon the request of the chairman of the Select Committee on Indian Affairs of the Senate or of the chairman of the Committee on Education and Labor of the House of Representatives made with respect to any application for financial assistance under section 803

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 101 STAT. 974

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PUBLIC LAW 100-175—NOV. 29, 1987

or 805, the Secretary shall transmit to the chairman written notice— "(1) identifying such application; "(2) containing a copy of the list submitted to the Secretary under subsection G))(3) in which such application is ranked; "(3) specifying which other applications ranked in such list have been approved by the Secretary under sections 803 and 805; and "(4) if the Secretary has not approved each application superior in merit, as indicated on such list, to the application with respect to which such notice is transmitted, containing a statement of the reasons relied upon by the Secretary for— "(A) approving the application with respect to which such notice is transmitted; and u "(B) failing to approve each pending application that is superior in merit, as indicated on such list, to the application described in subparagraph (A).". SEC. 503. PROCEDURAL REQUIREMENTS.

}

(a) RULEMAKING.—The Native American Programs Act of 1974 (42 U.S.C. 2991-2992d) is amended by inserting after section 813, as so redesignated by section 502, the following: "ADDITIONAL REQUIREMENTS APPLICABLE TO RULEMAKING

Loans. Grants. 42 USC^*2992b-i

"SEC. 814. (a) Notwithstanding subsection (a) of section 553 of title 5, United States Code, and except as otherwise provided in this section, such section 553 shall apply with respect to the establishment and general operation of any program that provides loans, grants, benefits, or contracts authorized by this title. "03)(1) Subparagraph (A) of the last sentence of section 553(b) of title 5, United States Code, shall not apply with respect to any interpretative rule or general statement of policy— "(A) proposed under this title; or ' " "(B) applicable exclusively to any program, project, or activity authorized by, or carried out under, this title. "(2) Subparagraph (B) of the last sentence of section 553(b) of title 5, United States Code, shall not apply with respect to any rule (other than an interpretative rule or a general statement of policy)— "(A) proposed under this title; or "(B) applicable exclusively to any program, project, or activity authorized by, or carried out under, this title. "(3) The first 2 sentences of section 5530)) of title 5, United States Code, shall apply with respect to any rule (other than an interpretative rule, a general statement of policy, or a rule of agency organization, procedure, or practice) that is— "(A) proposed under this title; or "(B) applicable exclusively to any program, project, or activity authorized by, or carried out under, this title; unless the Secretary for good cause finds (and incorporates the finding and a brief statement of the reasons therefor in such rule) that notice and public procedure thereon are contrary to the public interest or would impair the effective administration of any program, project, or activity with respect to which such rule is issued. "(c) Notwithstanding section 553(d) of title 5, United States Code, no rule (including an interpretative rule) or general statement of policy that—

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"(1) is issued to carry out this title; or "(2) applies exclusively to any program, project, or activity authorized by, or carried out under, this title; may take effect until 30 days after the publication required under the first 2 sentences of section 5530?) of title 5, United States Code. "(d) Each rule (including an interpretative rule) and each general statement of policy to which this section applies shall contain after each of its sections, paragraphs, or similar textual units a citation to the particular provision of statutory or other law that is the legal authority for such section, paragraph, or unit. "(e) Except as provided in subsection (c), if as a result of the enactment of any law affecting the administration of this title it is necessary or appropriate for the Secretary to issue any rule (including any interpretative rule) or a general statement of policy, the Secretary shall issue such rule or such general statement of policy not later than 180 days after the date of the enactment of such law. "(f) Whenever an agency publishes in the Federal Register a rule (including an interpretative rule) or a general statement of policy to which subsection (c) applies, such agency shall transmit a copy of such rule or such general statement of policy to the Speaker of the House of Representatives and the President pro tempore of the Senate.". (b) DEFINITION OF RULE.—Section 815 of the Native American Programs Act of 1974 (42 U.S.C. 2992c), as so redesignated by section 502, is amended— (1) in paragraph (3) by striking "and" at the end thereof, (2) by redesignating paragraph (4) as paragraph (5), and (3) by inserting after paragraph (3) the following: "(4) the term 'rule' has the meaning given it in section 551(4) of title 5, United States Code, as amended from time to time; and".

-

SEC. 504. INCLUSION OF OTHER NATIVE AMERICAN PACIFIC ISLANDERS.

(a) FINANCIAL ASSISTANCE.—Section 803(a) of the Native American Programs Act of 1974 (42 U.S.C. 2991b(a)) is amended by inserting after the first sentence the following: "The Secretary is authorized, subject to the availability of funds appropriated under the authority of section 816(c), to provide financial assistance to public and nonprofit private agencies serving other Native American Pacific Islanders (including American Samoan Natives) for projects pertaining to the purposes of this Act.". (b) CONFORMING AMENDMENTS.—(1) Section 802 of the Native

American Programs Act of 1974 (42 U.S.C. 2991a) is amended by inserting ", other Native American Pacific Islanders (including American Samoan Natives)," after "Hawaiian Natives". (2) Section 806(a)(2) of the Native American Programs Act, as 42 USC 299ld-l. added by section 502(4) of this Act, is amended by inserting "other Native American Pacific Islanders (including American Samoan Natives)," after "Hawaiian Natives,". (3) Section 808 of the Native American Programs Act of 1974 (42 U.S.C. 29910, as so redesignated by section 502, is amended by inserting "or Territory" after "State' each place it appears. SEC. 505. AUTHORIZATION OF APPROPRIATIONS.

Section 816 of the Native American Programs Act of 1974 (42 U.S.C. 2992d), as so redesignated by section 502 of this Act, is amended—

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PUBLIC LAW 100-175—NOV. 29, 1987

(1) in subsection (a) by striking "1979 through 1986" and " "" inserting "1988, 1989, 1990, and 1991", and (2) by adding at the end the following: "(c)(1) Except as provided in paragraph (2), there are authorized to be appropriated $500,000 for each of the fiscal years 1988, 1989, 1990, and 1991 for the purpose of providing financial assistance to other Native American Pacific Islanders (including American Samoan Natives) under section 803(a). "(2) No funds may be appropriated under paragraph (1) for a fiscal year unless the amount appropriated under subsection (a) for such fiscal year exceeds 105 percent of the amount appropriated under subsection (a) for the preceding fiscal year.". SEC. 506. REVOLVING LOAN FUND FOR NATIVE HAWAIIANS. (a) ESTABLISHMENT OF FUND AND AUTHORITY FOR GRANTS.—The

Native American Programs Act of 1974 (42 U.S.C. 2991 et seq.) is amended by inserting after section 803 the following: "LOAN FUND; DEMONSTRATION PROJECT

42 USC 299ib-L

" •< ,

"SEC. 803A. (a)(1) In order to provide funding that is not available from private sources, the Secretary shall award grants to one agency of the State of Hawaii, or to one community-based Native Hawaiian organization whose purpose is the economic and social self-sufficiency of Native Hawaiians, which shall use such grants to establish and carry out, in the State of Hawaii, a 5-year demonstration project involving the establishment of a revolving loan fund— "(A) from which such agency or Native Hawaiian organization shall make loans to Native Hawaiian organizations and to individual Native Hawaiians for the purpose of promoting economic development in the State of Hawaii; and . > "(B) into which all payments, interest, charges, and other v amounts collected from loans made under subparagraph (A) shall be deposited notwithstanding any other provision of law. "(2) The agreement under which a grant is awarded under paragraph (1) shall contain provisions which set forth the administrative costs of the grantee that are to be paid out of the funds provided under the grant. "(h)(1) The agency or organization to which a grant is awarded under subsection (a)(1) may make loans to a borrower under subsection (a)(1)(A) only if the agency or organization determines that— "(A) the borrower is unable to obtain financing from other sources on reasonable terms and conditions; and "(B) there is a reasonable prospect that the borrower will repay the loan. O;:. ii "(2) Loans made under subsection (a)(1)(A) shall be— "(A) for a term that does not exceed 5 years; and "(B) at a rate of interest that is 2 percentage points below the average market yield on the most recent public offering of United States Treasury bills occurring before the date on which the loan is made. "(3) The agency or organization to which a grant is awarded under subsection (a)(1) may require any borrower of a loan made under subsection (a)(1)(A) to provide such collateral as the agency or organization determines to be necessary to secure the loan. "(4) Prior to making loans under subsection (a)(1)(A), the agency or organization to which a grant is awarded under subsection (a)(1)

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shall establish written procedures and definitions pertaining to defaults and collections of payments under the loans which shall be subject to the review and approval of the Secretary. Such agency or organization shall provide to each applicant for a loan under subsection (a)(1)(A), at the time application for the loan is made, a written copy of such procedures and definitions. "(5) The agency or organization to which a grant is awarded under subsection (a)(1) may not lend to itself any of the funds awarded under the grant. "(6) No loan may be made from the revolving fund that is required to be established under subsection (a) after the close of the 5-year period beginning on the date of enactment of the Native American Programs Act Amendments of 1987. "(c)(1) The agency or organization to which a grant is awarded under subsection (a)(1) shall provide the Secretary at regular intervals written notice of each loan made under subsection (a)(1)(A) that is in default and the status of such loan. "(2)(A) After making reasonable efforts to collect all amounts payable under a loan made under subsection (a)(1)(A) that is in default, the agency or organization to which a grant is awarded under subsection (a)(1) shall notify the Secretary that such loan is uncoUectable or collectable only at an unreasonable cost. Such notice shall include recommendations for future action to be taken by the agency or organization. ^n.: "(B) Upon receiving such notice, the Secretary shall instruct the agency or organization— "(i) to continue with its collection activities; "(ii) to cancel, adjust, compromise, or reduce the amount of such loan; or "(iii) to modify any term or condition of such loan, including te any term or condition relating to the rate of interest or the time of payment of any installment of principal or interest, or portion thereof, that is payable under such loan. "(C) The agency or organization shall carry out all instructions received under subparagraph (B) from the Secretary. "(d)(1) The agency or organization to which a grant is awarded under subsection (a)(1) shall, out of funds available in the revolving loan fund established under such subsection— "(A) pay expenses incurred by the agency or organization in administering the revolving loan fund; and "(B) provide competent management and technical assistance to borrowers of loans made under subsection (a)(1)(A) to assist the borrowers to achieve the purposes of such loans. "(2) The Secretary shall provide to the agency or organization to which a grant is made under subsection (a)(1) such management and technical assistance as the agency or organization may request in order to carry out the provisions of this section. "(e) Not later than 120 days after the date of enactment of the Regulations. Native American Programs Act Amendments of 1987, the Secretary, in consultation with appropriate agencies of the State of Hawaii and community-based Native Hawaiian organizations, shall prescribe regulations which set forth the procedures and criteria to be used— "(1) in making loans under subsection (a)(1)(A); and "(2) in canceling, adjusting, compromising, and reducing under subsection (c) the outstanding amounts of such loans.

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101 STAT. 978

Appropriation authorizations.

Reports.

The Secretary may prescribe such other regulations as may be necessary to carry out the purposes of this section, including regulations involving reporting and auditing. "(f)(1) There is authorized to be appropriated for fiscal years 1988, 1989, and 1990 the aggregate amount $3,000,000 for all such fiscal years for the purpose of carrying out the provisions of this section. Any amount appropriated under this paragraph shall remain available for expenditure without fiscal year limitation. "(2) The revolving loan fund that is required to be established under subsection (a)(1) shall be maintained as a separate account. Any portion of the revolving loan fund that is not required for expenditure shall be invested in obligations of the United States or in obligations guaranteed or insured by the United States. "(3)(A) All monies that are in the revolving loan fund at the close of the 5-year period beginning on the date of enactment of the Native American Programs Act Amendments of 1987 and that are not otherwise needed (as determined by the Secretary) to carry out the provisions of this section shall be deposited in the Treasury of the United States as miscellaneous receipts. "(B) All monies deposited in the revolving loan fund after the close of such period pursuant to subsection (a)(1)(B) shall be deposited into the Treasury of the United States as miscellaneous receipts. "(g)(1) The Secretary, in consultation with the agency or organization to which a grant is awarded under subsection (a)(1), shall submit to the Congress— "(A) an interim report not later than 2 years after the date of enactment of the Native American Programs Act Amendments of 1987; and "(B) a final report not later than 4 years after the date of enactment of the Native American Programs Act Amendments of 1987; regarding the administration of this section. "(2) Each such report shall include the views and recommendations of the Secretary regarding— "(A) the effectiveness of the demonstration project; "(B) whether the demonstration project should be expanded to other groups eligible for assistance under this title; and "(C) whether the duration of the demonstration project should be extended. O> CONFORMING AMENDMENTS.—Subsections (a) and (b) of section t)

42 USC 2991a. 42 USC 2991b.

816 of the Native American Programs Act of 1974 (42 U.S.C. 2992d), as so redesignated by section 502, are each amended by inserting "(other than section 803A)" after "title". (c) TECHNICAL AMENDMENTS.—The Native American Programs Act of 1974 (42 U.S.C. 2991 et seq.) is amended— (1) in section 802 by striking "Hawaiian Natives" and inserting "Native Hawaiians", and (2) in the first sentence of section 803 by striking "Hawaiian Natives" and inserting "Native Hawaiians".

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TITLE VI—HEALTH CARE SERVICES IN THE HOME SEC. 601. SHORT TITLE.

This title may be cited as the "Health Care Services in the Home Act of 1987".

Health Care Services in the Home Act of 1987. State and local governments. 42 USC 201 note.

SEC. 602. E^TABLISHMENT OF GRANT PROGRAMS FOR DEMONSTRATION PROJECTS.

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following: "PART K—HEALTH CARE SERVICES IN THE HOME

"Subpart I—Grants for Demonstration Projects "SEC. 395. ESTABLISHMENT OF PROGRAM.

42 USC 280c.

"(a) IN GENERAL.—The Secretary, acting through the Adminis- Disadvantaged trator of the Health Resources and Services Administration, shall persons. make not less than 3, and not more than 5, grants to States for the purpose of assisting grantees in carrying out demonstration projects— "(1) to identify low-income individuals who can avoid institutionalization or prolonged hospitalization if skilled medical services or related health services (or both) are provided in the homes of the individuals; "(2) to pay the costs of the provision of such services in the homes of such individuals; and "(3) to coordinate the provision by public and private entities of such services, and other long-term care services, in the homes of such individuals. "(b) REQUIREMENT WITH RESPECT TO AGE OF RECIPIENTS OF SERV-

ICES.—The Secretary may not make a grant under subsection (a) to a State unless the State agrees to ensure that not less than 25 percent of individuals receiving services pursuant to subsection (a) are individuals who are not less than 65 years of age. "(c) RELATIONSHIP TO ITEMS AND SERVICES UNDER OTHER PRO-

GRAMS.—A State may not make payments from a grant under subsection (a) for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service— "(1) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or "(2) by an entity that provides health services on a prepaid basis. "SEC. 396. LIMITATION ON DURATION OF GRANT AND REQUIREMENT OF MATCHING FUNDS.

"(a) LIMITATION ON DURATION OF GRANT.—The period during which payments are made to a State from a grant under section 395(a) may not exceed 3 years. Such payments shall be subject to annual evaluation by the Secretary. "(b) REQUIREMENT OF MATCHING FUNDS.—

42 USC 280C-1.

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 101 S T A T. 980 . •3. '

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P U B L I C L A W 1 0 0 - 1 7 5 — N O V. 29, 1987 "(1)(A) For the first year of payments to a State from a g r a n t under section 395(a), the Secretary may not m a k e such payments in a n a m o u n t exceeding 75 percent of the costs of services to be provided by the State pursuant to such section. "(B) For the second year of such payments to a State, the Secretary may not m a k e such payments in a n a m o u n t exceeding 65 percent of the costs of such services. "(C) For the third year of such payments to a State, the Secretary may not m a k e such payments in a n a m o u n t exceeding 55 percent of the costs of such services. "(2) The Secretary may not m a k e a g r a n t under section 395(a) to a State unless the State agrees to m a k e available, directly or through donations from public or private entities, non-Federal contributions toward the costs of services to be provided pursuant to such section in a n a m o u n t equal to— "(A) for the first year of payments to the State from the grant, not less than $25 (in cash or in kind under subsection (c)) for each $75 of Federal funds provided in the grant; "(B) for the second year of such payments to the State, not less than $35 (in cash or in kind under subsection (c)) for each $65 of such Federal funds; and "(C) for the third year of such payments to the State, not less than $45 (in cash or in kind under subsection (c)) for each $55 of such Federal funds. "(c) DETERMINATION OF A M O U N TO P N O N - FEDERAL CONTRIBU-

TION.—Non-Federal contributions required in subsection (b) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not b e included in determining the a m o u n t of such non-Federal contributions. 42 USC 280C-2.

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"SEC. 397. GENERAL PROVISIONS. "(a) LIMITATION ON ADMINISTRATIVE EXPENSES.—The Secretary

may not make a grant under section 395(a) to a State unless the State agrees that not more than 10 percent of the grant will be expended for administrative expenses with respect to the grant. "(b) DESCRIPTION OF INTENDED USE OF GRANT.—The Secretary may not make a grant under section 395(a) to a State unless— "(1) the State submits to the Secretary a description of the purposes for which the State intends to expend the grant; and "(2) such description provides information relating to the programs and activities to be supported and services to be provided, including— "(A) the number of individuals who will receive services pursuant to section 395(a) and the average costs of providi ^:• "(B) a description of the manner in which such programs and activities will be coordinated with any similar programs and activities of public and private entities. "(c) REQUIREMENT OF APPLICATION.—The Secretary may not make a grant under section 395(a) to a State unless the State has submitted to the Secretary an application for the grant. The application shall— "(1) contain the description of intended expenditures required in subsection (b);
 * ing such services to each such individual; and

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101 STAT. 981

"(2) with respect to carrying out the purpose for which the grant is to be made, provide assurances of compliance satisfactory to the Secretary; and "(3) otherwise be in such form, be made in such manner, and contain such information and agreements as the Secretary determines to be necessary to carry out this subpart. "(d) EVALUATIONS AND REPORT BY SECRETARY.—The Secretary

shall— "(1) provide for an evaluation of each demonstration project for which a grant is made under section 395(a); and "(2) not later than 6 months after the completion of such evaluations, submit to the Congress a report describing the findings made as a result of the evaluations. "(e) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of

carrying out this subpart, there is authorized to be appropriated $5,000,000 for each of the fiscal years 1988 through 1990. "Subpart II—Grants for Demonstrations Projects With Respect to Alzheimer's Disease "SEC. 398. ESTABLISHMENT OF PROGRAM.

42 USC 280c-3.

"(a) IN GENERAL.—The Secretary shall make not less than 3, and not more than 5, grants to States for the purpose of assisting grantees in carrying out demonstration projects for planning, establishing, and operating programs— -i "(1) to coordinate the development and operation by public and private organizations of diagnostic, treatment, care management, respite care, legal counseling, and education services provided within the State to individuals with Alzheimer's disease or related disorders and to the families and care providers of such individuals; ^^ "(2) to provide home health care, personal care, day care, companion services, short-term care in health facilities, and other respite care to individuals with Alzheimer's disease or related disorders; and "(3) to provide to health care providers, to individuals with Public Alzheimer's disease or related disorders, to the families of such information. individuals, to organizations established for such individuals and such families, and to the general public, information with respect to— "(A) diagnostic services, treatment services, and related services available to such individuals and to the families of such individuals; "(B) sources of assistance in obtaining such services, including assistance under entitlement programs; and ^ "(C) the legal rights of such individuals and such families. "(b) REQUIREMENT WITH RESPECT TO CERTAIN EXPENDITURES.—The

Secretary may not make a grant under subsection (a) to a State unless the State agrees to expend not less than 50 percent of the grant for the provision of services described in subsection (a)(2). "(c) RELATIONSHIP TO ITEMS AND SERVICES UNDER OTHER PRO-

GRAMS.—A State may not make payments from a grant under subsection (a) for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service—

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PUBLIC LAW 100-175—NOV. 29, 1987 "(1) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or "(2) by an entity that provides health services on a prepaid basis.

42 USC 280C-4.

"SEC. 399. LIMITATION ON DURATION OF GRANT AND REQUIREMENT OF MATCHING FUNDS.

"(a) LIMITATION ON DURATION OF GRANT.—The period during which payments are made to a State from a grant under section 398(a) may not exceed 3 years. Such payments shall be subject to annual evaluation by the Secretary. "(b) REQUIREMENT OF MATCHING FUNDS.—

'

"(1)(A) For the first year of payments to a State from a grant under section 398(a), the Secretary may not make such payments in an amount exceeding 75 percent of the costs of services to be provided by the State pursuant to such section. "(B) For the second year of such payments to a State, the " Secretary may not make such payments in an amount exceeding 65 percent of the costs of such services. '(C) For the third year of such payments to a State, the Secretary may not make such payments in an amount exceeding 55 percent of the costs of such services. "(2) The Secretary may not make a grant under section 398(a) to a State unless the State agrees to make available, directly or through donations from public or private entities, non-Federal contributions toward the costs of services to be provided pursuant to such section in an amount equal to— "(A) for the first year of payments to the State from the grant, not less than $25 (in cash or in kind under subsection (c)) for each $75 of Federal funds provided in the grant; "(B) for the second year of such payments to the State, not less than $35 (in cash or in kind under subsection (c)) for each $65 of such Federal funds; and "(C) for the third year of such pa5mients to the State, not less than $45 (in cash or in kind under subsection (c)) for each $55 of such Federal funds. "(c) DETERMINATION OF AMOUNT OF NON-FEDERAL CONTRIBU-

TION.—Non-Federal contributions required in subsection (b) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. 42 USC 280C-5.

"SEC. 399A. GENERAL PROVISIONS.

"(a) LIMITATION ON ADMINISTRATIVE EXPENSES.—The Secretary

may not make a grant under section 398(a) to a State unless the State agrees that not more than 10 percent of the grant will be expended for administrative expenses with respect to the grant. "(b) DESCRIPTION OF INTENDED USE OF GRANT.—The Secretary may

not make a grant under section 398(a) to a State unless— "(1) the State submits to the Secretary a description of the purposes for which the State intends to expend the grant; and "(2) such description provides information relating to the programs and activities to be supported and services to be provided, including—
 * r

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101 STAT. 983

"(A) the number of individuals who will receive services pursuant to section 398(a) and the average costs of providing such services to each such individual; and "(B) a description of the manner in which such programs and activities will be coordinated with any similar programs and activities of public and private entities. "(c) REQUIREMENT OF APPLICATION.—The Secretary may not make a grant under section 398(a) to a State unless the State has submitted to the Secretary an application for the grant. The application shall— "(1) contain the description of intended expenditures required in subsection (b); "(2) with respect to carrying out the purpose for which the grant is to be made, provide assurances of compliance satisfactory to the Secretary; and "(3) otherwise be in such form, be made in such manner, and contain such information and agreements as the Secretary determines to be necessary to carry out this subpart. "(d) EVALUATIONS AND REPORT BY SECRETARY.—The Secretary

shall— "(1) provide for an evaluation of each demonstration project for which a grant is made under section 398(a); and "(2) not later than 6 months after the completion of such evaluations, submit to the Congress a report describing the findings made as a result of the evaluations. "(e) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of

carrying out this subpart, there is authorized to be appropriated $5,000,000 for each of the fiscal years 1988 through 1990.".

TITLE VII—GENERAL PROVISIONS SEC. 701. EFFECTIVE DATES; APPLICATION OF AMENDMENTS.

(a) GENERAL EFFECTIVE DATE.—Except as provided in subsections (b) and (c), this Act and the amendments made by this Act shall take effect on October 1, 1987. (b) APPLICATION OF AMENDMENTS.—The amendments made by title I of this Act shall not apply with respect to— (1) any area plan submitted under section 306(a) of the Older Americans Act of 1965, or

42 USC 3001

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 with that muck." He stopped to light his pipe, looked in vain for a match, felt in his pockets, and pulled out a piece of paper—the letter.

"I tell you what I'd do. I'd——" He slowly and medita tively tore the letter in two, dropped one piece, on the floor, thrust the other into a convenient gas jet, and applied it to the tobacco.

"I'd get 'em 'gether in a heap and I'd—— Damn this pipe." He picked up the other half of the letter, and relighted the pipe.

"After you, mate," said a man sitting near, who was just biting the end from a cigar.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1014

 101 STAT. 984

PUBLIC LAW 100-175—NOV. 29, 1987

(2) any State plan submitted under section 307(a) of such Act, and approved for any fiscal year beginning before the date of the enactment of this Act. (c) EFFECTIVE DATE OF SECTION 506.—The amendments made by section 506 of this Act shall take effect upon the expiration of the 90day period beginning on the date of the enactment of this Act. Approved November 29, 1987.

LEGISLATIVE HISTORY—H.R. 1451 (S. 887): HOUSE REPORTS: No. 100-97 (Comm. on Education and Labor) and No. 100-427 (Comm. of Conference). SENATE REPORTS: No. 100-136 (Comm. on Labor and Human Resources) and No. 100-140 (Select Comm. on Indian Affairs), both accompanying S. 887. CONGRESSIONAL RECORD, Vol. 133 (1987): May 27, 28, considered and passed House: Aug. 6, considered and passed Senate, amended, in lieu of S. 887. Nov. 5, 12, Senate agreed to conference report. Nov. 17, House agreed to conference report. WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 23 (1987): Nov. 30, Presidential statement.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1015

 PUBLIC LAW 100-176—NOV. 30, 1987

101 STAT. 985

Public Law 100-176 100th Congress Joint Resolution To designate the week of November 29, 1987, through December 5, 1987, as "National Home Health Care Week".

Whereas organized home health care services to the elderly and disabled have existed in this country since the last quarter of the eighteenth century; Whereas home health care, including skilled nursing services, physical therapy, speech therapy, social services, occupational therapy, health counseling and education, and homemaker-home health aide services, is recognized as an effective and economical alter' native to unnecessary institutionalization; Whereas caring for the ill and disabled in their homes places emphasis on the dignity and independence of the individual receiving such services; Whereas the Federal Government has supported home health services since the enactment of the medicare program, with the number of home health agencies providing services increasing from less than five hundred to more than five thousand; and Whereas many private, public, and charitable organizations provide these and similar services to millions of patients each year preventing, postponing, and limiting the need for institutionalization and enabling such patients to remain independent: Now, therefore, be it Resolved by the Senate and House of Representatives of the United States of America in Congress assembled, That the week of November 29, 1987 through December 5, 1987, is designated as "National Home Health Care Week", and the President is authorized and requested to issue a proclamation calling upon the people of the United States to observe the week with appropriate programs, ceremonies, and activities. Approved November 30, 1987.

LEGISLATIVE HISTORY—S. J. Res. 98: CONGRESSIONAL RECORD, Vol. 133 (1987): Oct. 30, considered and passed Senate. Nov. 17, considered and passed House.

Nov. 30, 1987 [S.J. Res. 98]

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1016

 101 STAT. 986

PUBLIC LAW 100-177—DEC. 1, 1987

Public Law 100-177 100th Congress

An Act Dec. 1, 1987 [S. 1158]

Public Health Service Amendments of 1987. 42 USC 201 note.

To amend the Public Health Service Act to establish a National Health Service Corps Loan Repayment Program and to otherwise revise and extend the program for the National Health Service Corps.

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 "Public Health Service Amendments of 1987". (b) TABLE OF CONTENTS.—The table of contents is as follows: Sec. 1. Short title; table of contents. Sec. 2. References to the Public Health Service Act.

Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec.

Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec. Sec.

TITLE I - H E A L T H RESEARCH, TECHNOLOGY, STATISTICS, AND PREVENTIVE HEALTH PROGRAMS 101. Establishment of certain rural programs of National Center for Health Services Research and Health Care Technology Assessment. 102. Duties and composition of National Advisory Council on Health Care Technology Assessment. 103. Prohibition against altering certain administrative relationships. 104. National Center for Health Statistics. 105. National Committee on Vital and Health Statistics. , i, 106. Health care reports and profiles. 107. Requirement of peer review groups for evaluations of grant proposals. 108. Authorization of appropriations. 109. Requirement with respect to amount of non-Federal contributions in grant program for Council on Health Care Technology. 110. Project grants for preventive health projects for immunizations. 111. Project grants for preventive health projects for tuberculosis; additional grants. TITLE II—NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM 201. Establishment of loan repayment program. 202. Technical and conforming amendments. 203. Report and authorization of appropriations for scholarship and loan repayment programs; State programs. 204. Special repayment provisions. 205. Regulations. TITLE III—NATIONAL HEALTH SERVICE CORPS 301. Requirement of consideration of needs of Indian Health Service, certain Indian tribes, and the homeless. 302. Designation of health manpower shortage areas. 303. Placement of physicians. 304. Assignment of family physicians. 305. Authorizations of appropriations for general operations of National Health Service Corps. 306. Obligated service. 307. Private practice. 308. Discharge of obligations in bankruptcy. 309. Special loans for Corps members to enter private practice.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1017

 PUBLIC LAW 100-177—DEC. 1, 1987

101 STAT. 987

TITLE IV-MISCELLANEOUS Sec. 401. Geriatric medicine training projects. Sec. 402. Professional review activities.

SEC. 2. REFERENCES TO THE PUBLIC HEALTH SERVICE ACT. Except as otherwise specifically provided, whenever in this Act an amendment or repeal is expressed in terms of an amendment to, or a repeal of, a section or other provision, the reference shall be considered to be made to a section or other provision of the Public Health Service Act (42 U.S.C. 201 et seq.).

TITLE I—HEALTH RESEARCH, TECHNOLOGY, STATISTICS, AND PREVENTIVE HEALTH PROGRAMS SEC. 101. ESTABLISHMENT OF CERTAIN RURAL PROGRAMS OF NATIONAL CENTER FOR HEALTH SERVICES RESEARCH AND HEALTH CARE TECHNOLOGY ASSESSMENT.

Section 305 (42 U.S.C. 242c) is amended— (1) by redesignating subsections (c) through (i) as subsections (d) through (j), respectively; and (2) by inserting after subsection (b) the following new subsection: "(c) In carrying out section 304(a), the Secretary, acting through the Center, shall undertake and support research, evaluation, and demonstration projects (that may include and shall be appropriately coordinated with experiments and demonstration activities authorized by the Social Security Act (42 U.S.C. 301 et seq.) and the Social Security Amendments of 1967 (Public Law 90-248; 81 Stat. 821)) respecting the delivery of health care services in rural areas (including frontier areas), which may include projects with respect to— "(1) the future of the rural hospital; "(2) long-term health care for the rural elderly; "(3) hospital care for the rural poor and uninsured; and "(4) alternative health care delivery systems and managed health care in rural areas.". SEC. 102. DUTIES AND COMPOSITION OF NATIONAL ADVISORY COUNCIL ON HEALTH CARE TECHNOLOGY ASSESSMENT.

Section 305(h) (as redesignated in section 101(1) of this Act) is amended— (1) in the last sentence of paragraph (1), by striking out "shall assist the Director in developing" and inserting in lieu thereof "shall make recommendations to the Director with respect to the development of; and (2) by striking out paragraph (3) and inserting in lieu thereof the following new paragraph: "(3)(A) The Secretary shall appoint to the Council— "(i) six individuals distinguished in the fields of medicine, engineering, and science (including social science); "(ii) four individuals distinguished in the fields of law, ethics, economics, and management; and "(iii) two individuals representing the interests of consumers of health care services.

Health care facilities. Aged persons. Disadvantaged persons.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1018

 101 STAT. 988

PUBLIC LAW 100-177—DEC. 1, 1987

"(B) The Secretary shall ensure that members of the Council, as a group, are representative of professions and entities concerned with, or affected by, health care technology.". 42 USC 242c note.

SEC. 103. PROHIBITION AGAINST ALTERING CERTAIN ADMINISTRATIVE RELATIONSHIPS.

With respect to carrying out section 305 of the Public Health Service Act (42 U.S.C. 242c), the Secretary may not alter the administrative relationship between the Assistant Secretary for Health and the Director of the National Center for Health Services Research and Health Care Technology Assessment, as in effect during fiscal year 1986. SEC. 104. NATIONAL CENTER FOR HEALTH STATISTICS.

J

Section 306(a) (42 U.S.C. 242k(a)) is amended by striking out "and supervised" and all that follows through the period and inserting in lieu thereof a period. SEC. 105. NATIONAL COMMITTEE ON VITAL AND HEALTH STATISTICS.

•J

42 USC 242k note.

(a) IN GENERAL.—Section 306(k) (42 U.S.C. 242k(k)) is amended— (1) in paragraph (1), by striking out "fifteen" and inserting in lieu thereof "16"; (2) in the second sentence of paragraph (2)(A), by striking out w "three" and inserting in lieu thereof "4"; and (3) in paragraph (2), by striking out subparagraph (B) and inserting in lieu thereof the following: "(B)(i) In the case of membership terms on the Committee under this subsection (as in effect prior to January 1, 1988) that expire in calendar year 1988, the appointments to three such terms in such calendar year shall be for a period of 4 years and the appointments to two such terms in such calendar year shall be for a period of 3 years, as designated by the Secretary. "(ii) In the case of membership terms on the Committee under this subsection (as in effect prior to January 1, 1988) that expire in calendar year 1989, one such term shall be extended for an additional consecutive 1-year period, as designated by the Secretary. "(iii) In the case of membership terms on the Committee under this subsection (as in effect prior to January 1, 1988) that expire in calendar year 1990, two of such terms shall each be extended for an additional consecutive 1-year period, as designated by the Secretary.". (b) EFFECTIVE DATE.—The amendments made by this section shall become effective on January 1, 1988. SEC. 106. HEALTH CARE REPORTS AND PROFILES.

(a) REPORTS.—Section 308 (42 U.S.C. 242m(a)) is amended— (1) by striking out paragraphs (1) and (2) and inserting in lieu thereof the following new paragraphs: "(1) Not later than March 15 of each year, the Secretary shall submit to the President and Congress the following reports: "(A) A report on— _, "(i) the administration of sections 304 through 307 and ,pnf/i section 309 during the preceding fiscal year; and "(ii) the current state and progress of health services dT:rtS!».- research, health statistics, and health care technology.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1019

 PUBLIC LAW 100-177—DEC. 1, 1987

101 STAT. 989

"(B) A report on health care costs and financing. Such report shall include a description and analysis of the statistics collected under section 30603)(1)(G). "(C) A report on health resources. Such report shall include a description and analysis, by geographical area, of the statistics collected under section 306(b)(1)(E). "(D) A report on the utilization of health resources. Such report shall include a description and analysis, by age, sex, income, and geographic area, of the statistics collected under section 306(b)(1)(F). "(E) A report on the health of the Nation's people. Such report shall include a description and analysis, by age, sex, income, and geographic area, of the statistics collected under section 306(b)(1)(A). "(2) The reports required by subparagraphs (B) through (E) of paragraph (2) shall be prepared through the National Center for Health Services Research and Health Care Technology Assessment and the National Center for Health Statistics."; and (2) in paragraph (3), by striking out "or (2)". (b) NATIONAL DISEASE PREVENTION DATA PROFILES.—The first sentence of section 404(a) of the Health Services and Centers Amendments of 1978 (42 U.S.C. 242p(a)) is amended by striking out "on December 1, 1980, and on December 1 of every third year thereafter" and inserting in lieu thereof "on March 15, 1990, and on March 15 of every third year thereafter". (c) EFFECTIVE DATE.—The amendments made by subsections (a) 42 USC 242m and (b) shall apply to reports and profiles required to be submitted note. after November 1, 1987. SEC. 107. REQUIREMENT OF PEER REVIEW GROUPS FOR EVALUATIONS OF GRANT PROPOSALS.

Section 308(b) (42 U.S.C. 242m(b)) is amended— (1) in paragraph (1), by inserting before the period at the end thereof the following: "and unless a peer review group referred to in paragraph (2) has recommended the application for approval"; and (2) by striking out paragraph (2) and inserting in lieu thereof the following new paragraph: "(2)(A) Each application submitted for a grant or contract under section 304 or 305, in an amount exceeding $50,000 of direct costs and for a health services research, evaluation, or demonstration project, shall be submitted to a peer review group for an evaluation of the technical and scientific merits of the proposals made in each such application. The Secretary, acting through the Director of the National Center for Health Services Research and Health Care Technology Assessment (or, as appropriate, through the Director of the National Center for Health Statistics), shall establish such peer review groups as may be necessary to provide for such an evaluation of each such application. "(B) A peer review group to which an application is submitted Reports. pursuant to subparagraph (A) shall report its finding and recommendations respecting the application to the Secretary, acting through the Director involved, in such form and manner as the Secretary shall by regulation prescribe. The Secretary may not approve an application described in such subparagraph unless a peer review group has recommended the application for approval.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1020

 101 STAT. 990

PUBLIC LAW 100-177—DEC. 1, 1987

"(C) The Secretary, acting through the Directors, shall make appointments to the peer review groups required in subparagraph (A) from among persons who are not officers or employees of the United States and who possess appropriate technical and scientific qualifications.". SEC. 108. AUTHORIZATION OF APPROPRIATIONS.

Subsection (i) of section 308 (42 U.S.C. 242m(i)) is amended to read as follows: "(i)(l)(A) For health service research, evaluation, and demonstration activities undertaken or supported under section 304 or 305, there are authorized to be appropriated $30,000,000 for fiscal year 1988 and such sums as may be necessary for each of the fiscal years 1989 and 1990. At least 20 percent of the amount appropriated under the preceding sentence for any fiscal year or $6,000,000, whichever is less, shall be available only for health services research, evaluation and demonstration activities directly undertaken through the National Center for Health Services Research and Health Care Technology Assessment, and at least 10 percent of such amount or $1,500,000 whichever is less, shall be available only for the user liaison program and the technical assistance program referred to in section 305(d)(2) and for dissemination activities directly undertaken through such Center. "(B) For health care technology assessment activities undertaken under subsections (b)(5), (g), and (h) of section 305, the Secretary shall obligate from funds appropriated under this paragraph not less than $4,500,000 for each of the fiscal years 1988 through 1990. "(C) For grants under section 309, the Secretary shall make available from funds appropriated under this paragraph not more than $750,000 for each of the fiscal years 1988 through 1990. Of such amounts made available, the Secretary shall, with respect to nonFederal contributions made available by grantees pursuant to section 309(a)(2)(B), obligate during each such fiscal year such amounts as may be necessary to pay the Federal share appropriate under such section as a result of such contributions. "(D) Of the amounts appropriated under this paragraph for any fiscal year, not more than $1,500,000 may be used for grants and contracts for all the costs of planning, establishing, and operating centers under section 305(e). "(2) For health statistical and epidemiological activities undertaken or supported under section 304 or 306, there are authorized to be appropriated $55,000,000 for fiscal year 1988 and such sums as may be necessary for each of the fiscal years 1989 and 1990.". SEC. 109. REQUIREMENT WITH RESPECT TO AMOUNT OF NON-FEDERAL CONTRIBUTIONS IN GRANT PROGRAM FOR COUNCIL ON HEALTH CARE TECHNOLOGY.

"" '

Section 309(a)(2)(B) (42 U.S.C. 242n(a)(2)(B)) is amended by inserting before the period at the end thereof the following: ", except that for fiscal years 1988 and 1989, the Secretary may only require expenditures from non-Federal sources in an amount not less than the amount of the grant applied for". SEC. n o. PROJECT GRANTS FOR PREVENTIVE HEALTH PROJECTS FOR IMMUNIZATIONS.

(a) IN GENERAL.—Paragraph (1) of section 317(j) (42 U.S.C. 247b(j)(l)) is amended to read as follows:

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1021

 PUBLIC LAW 100-177—DEC. 1, 1987

101 STAT. 991

"(I)(A) Except for grants for immunization programs the authorization of appropriations for which are established in subparagraph (B), for grants under subsections (a) and (k)(l) for preventive health service programs to immunize without charge individuals against vaccine-preventable diseases, there are authorized to be appropriated $94,000,000 for fiscal year 1988, and such sums as may be necessary for each of the fiscal years 1989 and 1990. Not more than 10 percent of the total amount appropriated under the preceding sentence for any fiscal year shall be available for grants under subsection (k)(l) for such fiscal year. "(B) For grants under subsection (a) for preventive health service programs for the provision without charge of immunizations with vaccines approved for use, and recommended for routine use, after the date of the enactment of Public Health Service Amendments of 1987, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 1988, 1989, and 1990. "(C) On the implementation of subtitle 2 of title XXI, there are authorized to be appropriated for grants under subsection (a) for which appropriations are authorized in subparagraph (A) such sums as may be necessary for fiscal years 1988 through 1990 to make such grants.". (b) SUPPLY OF VACCINES.—

(1) IN GENERAL.—The Secretary of Health and Human Serv- 42 USC 300aa-2 ices, acting through the Director of the Centers for Disease note. Control, shall acquire and maintain a supply of vaccines sufficient to provide vaccinations throughout a 6-month period. (2) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to carry out paragraph (1) $5,000,000 for fiscal year 1988, and such sums as may be necessary for each of the fiscal years 1989 and 1990. SEC. 111. PROJECT GRANTS FOR PREVENTIVE HEALTH PROJECTS FOR TUBERCULOSIS; ADDITIONAL GRANTS. (a) PROJECT GRANTS.—Paragraph (2) of section 317(j) (42 U.S.C.

247b(j)(2)) is amended to read as follows: "(2) For grants under subsection (a) for preventive health service programs for tuberculosis, and for grants under subsection (k)(2), there are authorized to be appropriated $24,000,000 for fiscal year 1988, $31,000,000 for fiscal year 1989, and $36,000,000 for fiscal year 1990. Not more than 10 percent of the total amount appropriated under the preceding sentence for any fiscal year shall be available for grants under subsection (k)(2) for such fiscal year.". (b) ADDITIONAL GRANTS.—Section 317 is amended by adding at the end thereof the following new subsection: "(k)(1) The Secretary may make grants to States, political subdivisions of States, and other public and nonprofit private entities for— "(A) research into the prevention and control of diseases that may be prevented through vaccination; ' (B) demonstration projects for the prevention and control of such diseases; "(C) public information and education programs for the prevention and control of such diseases; and "(D) education, training, and clinical skills improvement activities in the prevention and control of such d^ases for health professionals (including allied health personnel). "(2) The Secretary may make grants to States, political subdivisions of States, and other public and nonprofit private entities for—

State and local governments. Health care professionals. Education.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1022

 101 STAT. 992

^"'- '

'^.••;

Health care professionals

' 42 USC 254Z-1.

PUBLIC LAW 100-177—DEC. 1, 1987

"(A) research into the prevention and control of tuberculosis, especially research concerning strains of tuberculosis resistant to drugs and research concerning cases of tuberculosis that affect certain populations; "(B) demonstration projects for the prevention and control of tuberculosis; "(C) public information and education programs for prevention and control of tuberculosis; and "(D) education, training, and clinical skills improvement activities in the prevention and control of tuberculosis for health professionals, including allied health personnel. "(3) The Secretary may make grants to States, political subdivisions of States, and other public and nonprofit private entities for— "(A) research into the prevention and control of diseases and conditions; "(B) demonstration projects for the prevention and control of such diseases and conditions; "(C) public information and education programs for the prevention and control of such diseases and conditions; and "(D) education, training, and clinical skills improvement activities in the prevention and control of such diseases and conditions for health professionals (including allied health personnel). "(4) No grant may be made under this subsection unless an application therefor is submitted to the Secretary in such form, at such time, and containing such information as the Secretary may by regulation prescribe. "(5) Subsections (d), (e), and (f) of section 317 shall apply to grants under this subsection in the same manner as such subsections apply to grants under subsection (a) of section 317.".

TITLE II—NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM SEC. 201. ESTABLISHMENT OF LOAN REPAYMENT PROGRAM. Subpart II of part D of title III (42 U.S.C. 254d et seq.) is amended— (1) by redesignating section 338G (42 U.S.C. 254r) as section 3381* (2) by redesignating sections 338B through 338F (42 U.S.C. and (3) by inserting after section 338A the following new section: "SEC. 338B. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM.
 * •* 254m through 254q) as sections 338C through 338G, respectively;

"(a) ESTABLISHMENT.—The Secretary shall establish a program to be known as the National Health Service Corps Loan Repayment Program (hereinafter in this subpart referred to as the 'Loan Repayment Program') in order to assure— "(1) an adequate supply of trained physicians, dentists, and nurses for the Corps; and "(2) if needed by the Corps, an adequate supply of podiatrists, 'h'& optometrists, pharmacists, clinical psychologists, graduates of ' schools of veterinary medicine, graduates of schools of public

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1023

 PUBLIC LAW 100-177—DEC. 1, 1987

101 STAT. 993

health, graduates of programs in health administration, graduates of programs for the training of physician assistants, expanded function dental auxiliaries, and nurse practitioners (as defined in section 822), and other health professionals. "(b) ELIGIBILITY.—To be eligible to participate in the Loan Repayment Program, an individual must— "(1)(A) be enrolled— "(i) as a full-time student— "(I) in an accredited (as determined by the Secretary) educational institution in a State; and "'' •' ' "(II) in the final year of a course of study or program, offered by such institution and approved by the Sec'/-'"'-' retary, leading to a degree in medicine, osteopathy, dentistry, or other health profession; or "(ii) in an approved graduate training program in medi*' cine, osteopathy, dentistry, or other health profession; or "(B) have— "(i) a degree in medicine, osteopathy, dentistry, or other •health profession; "(ii) completed an approved graduate training program in ^ medicine, osteopathy, dentistry, or other health profession in a State, except that the Secretary may waive the completion requirement of this clause for good cause; and "(iii) a license to practice medicine, osteopathy, dentistry, or other health profession in a State; '*' "(2) be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps of the Service or be eligible for selection for civilian service in the Corps; "(3) submit an application to participate in the Loan Repayment Program; and "(4) sign and submit to the Secretary, at the time of the submission of such application, a written contract (described in subsection (f)) to accept repayment of educational loans and to serve (in accordance with this subpart) for the applicable period ' of obligated service in a health manpower shortage area. "(c) APPLICATION, CONTRACT, AND INFORMATION REQUIREMENTS.— "(1) SUMMARY AND INFORMATION.—In disseminating applica-

tion forms and contract forms to individuals desiring to participate in the Loan Repayment Program, the Secretary shall include with such forms— "(A) a fair summary of the rights and liabilities of an individual whose application is approved (and whose contract is accepted) by the Secretary, including in the summary a clear explanation of the damages to which the United States is entitled under section 338E in the case of the individual's breach of the contract; and "(B) information respecting meeting a service obligation through private practice under an agreement under section 338D and such other information as may be necessary for the individual to understand the individual's prospective participation in the Loan Repayment Program and service in the Corps. "(2) UNDERSTANDABILITY.—The application form, contract form, and all other information furnished by the Secretary under this subpart shall be written in a manner calculated to be understood by the average individual applying to participate in the Loan Repayment Program.

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Page:United States Statutes at Large Volume 101 Part 1.djvu/1024

 101 STAT. 994

PUBLIC LAW 100-177—DEC. 1, 1987 •

"(3) AVAILABILITY.—The Secretary shall make such application forms, contract forms, and other information available to individuals desiring to participate in the Loan Repayment Program on a date sufficiently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information. "(d) PRIORITY.—In determining which applications under the Loan Repa3ment Program to approve (and which contracts to accept), the Secretary shall give priority to applications made by— "(1) individuals whose training is in a health profession or specialty determined by the Secretary to be needed by the Corps; and "(2) individuals who are committed to service in medically underserved areas. "(e) APPROVAL REQUIRED FOR PARTICIPATION.—

"(1) IN GENERAL.—An individual becomes a participant in the Loan Repayment Program only on the Secretary's approval of the individual's application submitted under subsection (b)(3) and the Secretary's acceptance of the contract submitted by the individual under subsection (b)(4). "(2) WRITTEN NOTICE.—The Secretary shall provide written notice to an individual promptly on— "(A) the Secretary's approving, under paragraph (1), of the individual's participation in the Loan Repa5ment Program; or "(B) the Secretary's disapproving an individual's participation in such Program. "(f) CONTENTS OP CONTRACTS.—The written contract (referred to in this subpart) between the Secretary and an individual shall contain— "(1) an agreement that— "(A) subject to paragraph (3), the Secretary agrees— "(i) to pay on behalf of the individual loans in accordance with subsection (g); and "(ii) to accept (subject to the availability of appropriated funds for carrying out sections 331 through 335 and section 337) the individual into the Corps (or for equivalent service as otherwise provided in this subf part); and "(B) subject to paragraph (3), the individual agrees— "(i) to accept loan payments on behalf of the individual; "(ii) in the case of an individual described in subsection (b)(l)(A), to maintain enrollment in a course of study or training described in such subsection until the individual completes the course of study or training; "(iii) in the case of an individual described in subsection (b)(l)(A), while enrolled in such course of study or training, to maintain an acceptable level of academic standing (as determined under regulations of the Secretary by the educational institution offering such course of study or training); and "(iv) to serve for a time period (hereinsifter in this subpart referred to as the 'period of obligated service') equal to 2 years or such longer period as the individual may agree to, in a health manpower shortage area (designated under section 332) to which such individual

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