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PUBLIC LAW 93-348-JULY 12, 1974

351

ADMINISTRATIVE PROVISIONS

SEC. 204. (a) The Commission may for the purpose of carrying out ^J^te,"^^ 289^i its duties under sections 202 and 203 hold such hearings, sit and act at such times and places, take such testimony, and receive such evidence as the Commission deems advisable. (b) The Commission may secure directly from any department or agency of the United States information necessary to enable it to carry out its duties. Upon the request of the chairman of the Commission, the head of such department or agency shall furnish such information to the Commission. (c) The Commission shall not disclose any information reported information disto or otherwise obtained by it in carrying out its duties which (1) uon."*^^' '"^^ identifies any individual who has been the subject of an activity studied and investigated by the Commission, or (2) which concerns any information which contains or relates to a trade secret or other matter referred to in section 1905 of title 18 of the United States Code. (d) Except as provided in subsection (b) of section 202, the Commission shall complete its duties under sections 202 and 203 not later than the expiration of the 24-month period beginning on the first day of the first month that follows the date on which all the members of the Commission have taken office. The Commission shall make periodic p^gg?j°J^^j *^^^_ reports to the President, the Congress, and the Secretary respecting gr'^s^^ ^nd'HEwr its activities under sections 202 and 203 and shall, not later than ninety days after the expiration of such 24-month period, make a final report to the President, the Congress, and the Secretary respecting such activities and including its recommendations for administrative action and legislation. (e) The Commission shall cease to exist thirty days following the ^^7^'''"^"^*^°" date. submission of its final report pursuant to subsection (d). DUTIES OF THE SECRETARY

SEC. 205. Within 60 days of the receipt of any recommendation made " ^ use 289Z.i ^ by the Commission under section 202, the Secretary shall publish it in the Federal Register and provide opportunity for interested per- Publication in sons to submit written data, views, and arguments with respect to ^ ^'^^ agister such recommendation. The Secretary shall consider the Commission's recommendation and relevant matter submitted with respect to it and, within 180 days of the date of its publication in the Federal Register, the Secretary shall (1) determine whether the administrative action proposed by such recommendation is appropriate to assure the protection of human subjects of biomedical and behavioral research conducted or supported under programs administered by him, and (2) if he determines that such action is not so appropriate, publish in the Federal Register such determination together with an adequate statement of the reasons for his determination. If the Secretary determines that administrative action recommended by the Commission should be undertaken by him, he shall undertake such action as expeditiously as is feasible. P A R T B—MiscELiiANEOtis NATIONAL ADVISORY COUNCIL FOR THE PROTECTION OF SUBJECTS OF BIOMEDICAL A N D BEHAVIORAL RESEARCH

S E C 211. (a) Section 217 of the Public Health Service Act is amended by adding at the end the following new subsection: " (f)(1) There shall be established a National Advisory Council for the Protection of Subjects of Biomedical and Behavioral Research

42 USC 21 s. Establishment.

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 352 Membership.

5 USC 101 et seq.

Ante, p. 348. Term.

5 USC app. I. Effective date. 42 USC 218 note.

PUBLIC LAW 93-348-JULY 12, 1974

[88

STAT.

(hereinafter in this subsection referred to as the 'Council') which shall consist of the Secretary who shall be Chairman and not less than seven nor more than fifteen other members who shall be appointed by the Secretary without regard to the provisions of title 5, United States Code, governing appointments in the competitive service. The Secretary shall select members of the Council from individuals distinguished in the fields of medicine, law, ethics, theology, the biological, physical, behavioral and social sciences, philosophy, humanities, health administration, government, and public affairs; but three (and not more than three) of the members of the Council shall be individuals who are or who have been engaged in biomedical or behavioral research involving human subjects. No individual who was appointed to be a member of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (established under title II of the National Research Act) may be appointed to be a member of the Council. The appointed members of the Council shall have terms of office of four years, except that for the purpose of staggering the expiration of the terms of office of the Council members, the Secretary shall, at the time of appointment, designate a term of office of less than four years for members first appointed to the Council. "(2) The Council shall— " (A) advise, consult with, and make recommendations to, the Secretary concerning all matters pertaining to the protection of human subjects of biomedical and behavioral research; " (B) review policies, regulations, and other requirements of the Secretary governing such research to determine the extent to which such policies, regulations, and requirements require and are effective in requiring observance in such research of the basic ethical principles which should underlie the conduct of such research and, to the extent such policies, regulations, or requirements do not require or are not effective in requiring observance of such principles, make recommendations to the Secretary respecting appropriate revision of such policies, regulations, or requirements; and " (C) review periodically changes in the scope, purpose, and types of biomedical and behavioral research being conducted and the impact such changes have on the policies, regulations, and other requirements of the Secretary for the protection of human subjects of such research. "(3) The Council may disseminate to the public such information, recommendations, and other matters relating to its functions as it deems appropriate. "(4) Section 14 of the Federal Advisory Committee Act shall not apply with respect to the Council." (b) The amendment made by subsection (a) shall take effect July 1, 1976. INSTITUTIONAL REVIEW BOARDS; ETHICS GUIDANCE PROGRAM

SEC. 212. (a) Part I of title IV of the Public Health Service Act, as amended by section 103 of this Act, is amended by adding at the end the following new section: INSTITUTIONAL REVIEW BOARDS; ETHICS GUIDANCE PROGRAM 42 USC 289Z-3.

"SEC. 474. (a) The Secretary shall by regulation require that each entity which applies for a grant or contract under this Act for any project or program which involves the conduct of biomedical or behavioral research involving human subjects submit in or with its

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license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


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Page:The Eurypterida of New York Volume 1.pdf/76

 Another more recent brief account is given by H. W. Fowler which reads in effect as follows:

The king crabs prefer such conditions as are afforded in Delaware Bay, where there are muddy or sandy bottoms, and it is seldom that they are found along the ocean beach. They also prefer more or less tranquil water where there is little or no surf and burrow in these places just under the sand or mud where they find an abundance of food in the many small animals; they are said to feed principally on worms. Although without any means of offense to such animals as fishes, they are amply protected from most enemies by their hard covering. The strong tail spine is used to right themselves when overturned. They progress through the sand by crawling, and when burying themselves are assisted by means of the hinged back, and also the spine. They are good swimmers, though they may frequently be seen crawling about over the bottom. When in shoal water they may easily be discovered by the two rows of small bubbles constantly appearing at the surface of the water.

From these notes on the habits of the American king crab it may be inferred that though a good swimmer, it mostly frequents the bottom and is a crawler, but feeds by digging in the mud and sand. In an aquarium such as that in Castle Garden, New York, it can be seen to swim easily by napping the powerful sternites which thus function as breathing and swimming organs. It crawls by the use of the four pairs of endognathites, and digs by the combined use of the shovelshaped head shield, the pushing spine, the activity of the legs, especially of the last pair, which are adapted to this function and probably even by the aid of the flapping sternites.

The features of Limulus which appear to be of importance in ascertaining the habits of the eurypterids, being also observed in one or the other of their genera, are: the broad carapace, its beveled edge, the triangular concave shield in the middle of the doublure of the underside, the subapical position of the lateral eyes, the large, platelike sternites,


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STAT.]

PUBLIC LAW 93-348-JULY 12, 1974

353

application for such grant or contract assurances satisfactory to the Secretary that it has established (in accordance with regulations which the Secretary shall prescribe) a board (to be known as an 'Institutional Review Board') to review biomedical and behavioral research involving human subjects conducted at or sponsored by such entity in order to protect the rights of the human subjects of such research. "(b) The Secretary shall establish a program within the Department under which requests for clarification and guidance with respect to ethical issues raised in connection with biomedical or behavioral research involving human subjects are responded to promptly and appropriately.'' (b) The Secretary of Health, Education, and Welfare shall within Ja^^us^ S - a 240 days of the date of the enactment of this Act promulgate such note. regulations as may be required to carry out section 474(a) of the Public Health Service Act. Such regulations shall apply with respect ^"'®' P- ^52. to applications for grants and contracts under such Act submitted after promulgation of such regulations. LIMITATION ON RESEARCH

SEC. 213. Lentil the Commission has made its recommendations to the Secretary pursuant to section 202(b), the Secretary may not conduct or support research in the United States or abroad on a living human fetus, before or after the induced abortion of such fetus, unless such research is done for the purpose of assuring the survival of such fetus.

42 USC 289/-1

INDIVIDUAL RIGHTS

SEC. 214. (a) Subsection (c) of section 401 of the Health Programs Extension Act of 1973 is amended (1) by inserting " (1) " after " (c) ", (2) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and (3) by adding at the end the following new paragraph: "(2) No entity which receives after the date of enactment of this paragraph a grant or contract for biomedical or behavioral research under any pix)gram administered by the Secretary of Health, Education, and WelfariB may— " (A) discriminate in the employment, promotion, or termination of employment of any physician or other health care personnel, or " (B) discriminate in the extension of staff or other privileges to any physician or other health care personnel, because he performed or assisted in the performance of any lawful health service or research activity, because he refused to perform or assist in the performance of any such service or activity on the groiinds that his performance or assistance in the performance of such service or activity would be contrary to his religious beliefs or moral convictions, or because of his religious beliefs or moral convictions respecting any such service or activity." (b) Section 401 of such Act is amended by adding at the end the following new subsection: " (d) No individual shall be required to perform or assist in the performance of any part of a health service program or research activity funded in whole or in part under a program administered by the Secretary of Health, Education, and Welfare if his performance or assistance in the performance of such part of such program or activity would be contrary to his religious beliefs or moral convictions."

42 USC 300a-7.

Nondiscrimination.

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PUBLIC LAW 93-349-JULY 12, 1974

[88 STAT.

SPECIAL PROJECT GRANTS AND CONTRACTS 42 USC 295f-2.

SEC. 215. Section 772(a)(7) of the Public Health Service Act is amended by inserting immediately before the semicolon at the end thereof the following: ", or (C) providing increased emphasis on the ethical, social, legal, and moral miplications of advances in biomedical research and technology with respect to the effects of such advances on individuals and socjety". Approved July 12, 1974. Public Law 93-349

July 12, 1974 [H. R. 29]

Civil Service Retirement Fund. Postal Service payments.

39 USC 101 et seq.

Unfunded liability increase, determination.

Repeal.

Supra. Effective date, exceptions. 39 USC 1005 note.

87 Stat. 513.

AN ACT To provide for payments by the Postal Service to the Civil Service Retirement Fund for increases in the unfunded liability of the Fund due to increases in benefits for Postal Service employees, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assemMed, That section 8348 of title 5, United States Code, is amended by adding at the end thereof the following new subsection: " (h)(1) Notwithstanding any other statute, the United States Postal Service shall be liable for that portion of any estimated increase in the unfunded liability of the Fund which is attributable to any benefits payable from the Fund to active and retired Postal Service officers and employees, and to their survivors, when the increase results from an employee-management agreement under title ^9, or any administrative action by the Postal Service taken pursuant to law, which authorizes increases in pay on which benefits are computed. "(2) The estimated increase in the unfunded liability, referred to in paragraph (1) of this subsection, shall be determined by the Civil Sarvice Commission. The United States Postal Service shall pay the amount so determined to the Commission in thirty equal annual installments with interest computed at the rate used in the most recent valuation of the Civil Service Retirement System, with the first payment thereof due at the end of the fiscal year in which an increase in pay becomes effective.". SEC. 2. (a) The last sentence of section 1005(d) of title 39, United States Code, is repealed. (b) Section 1005(d) of title 39, United States Code, is amended by adding at the end thereof the following new sentence: "The Postal Service shall pay into the Civil Service Retirement and Disability Fund the amounts determined by the Civil Service Commission under section 8348(h) of title 5.". SEC. 3. The effective date of this Act shall be July 1, 1971, except that the Postal Service shall not be required to make (1) the payments due June 30, 1972, June 30, 1973, and June 30, 1974, attributable to pay increases granted by the Postal Service prior to July 1, 1973, until such time as funds are appropriated to the Postal Service for that purpose, and (2) the transfer to the Civil Service Retirement and Disability Fund required by title II of the Treasury, Postal Service, and General Government Appropriation Act, 1974, Public Law 93-143. Approved July 12, 1974.

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 88 STAT. ]

PUBLIC LAW 93-350-JULY 12, 1974

355

Public Law 93-350 AN ACT To amend title 5, United States Code, with respect to the retirement of certain law enforcement and firefighter personnel, and for other purposes.

July 12, 1974 [H. R. 9281]

Be it enacted by the Senate and House of Representatives of the Certain United States of America in Congress assembled, That section 3307 of forcement law enand title 5, United States Code, is amended— firefighting per(1) by striking out in subsection (a) thereof "subsections (b) sonnel. Retirement beneand (c) " and inserting in lieu thereof "subsections (b), (c), and fits. (d)";and (2) by adding the following new subsection at the end thereof: " (d) The head of any agency may, with the concurrence of such agent as the President may designate, determine and fix the minimum and maximum limits of age within which an original appointment may be made to a position as a law enforcement officer or firefighter, as Intra. defined by section 8331 (20) and-(21), respectively, of this title." SEC. 2. (a) Section 8331(3) of title 5, United States Code, is amended— (1) by striking out the word "and" at the end of clause (B) ( i i); (2) by inserting the word "and" immediately after the semicolon at the end of subparagraph (C); (3) by adding immediately below subparagraph (C) the following new subparagraph: " (D) with respect to a law enforcement officer, premium 5 USC 5545. pay under section 5545(c)(2) of this title;"; and (4) by striking out "subparagraphs (B) and (C) of this paragraph" and inserting in lieu thereof "subparagraphs (B), (C), and (D) of this paragraph". (b) Section 8331 of title 5, United States Code, is amended— (1) by striking out "and" at the end of paragraph ( 1 8); (2J by striking out the period at the end of paragraph (19) and inserting in lieu thereof a semicolon and the word "and"; and (3) by adding at the end thereof the following: "(20) 'law enforcement officer' means an employee, the duties "Law enforceof whose position are primarily the investigation, apprehension, ment officer." or detention of individuals suspected or convicted of offenses against the criminal laws of the United States, including an employee engaged in this activity who is transferred to a supervisory or administrative position. For the purpose of this para- "Detention. graph, 'detention' includes the duties of— " (A) employees of the Bureau of Prisons and Federal Prison Industries, Incorporated; " (B) employees of the Public Health Service assigned to the field service of the Bureau of Prisons or of the Federal Prison Industries, Incorporated; " (C) employees in the field service at Army or Navy disciplinary barracks or at confinement and rehabilitation facilities operated by any of the armed forces; and " (D) employees of the Department of Corrections of the District of Columbia, its industries and utilities; whose duties in connection with individuals in detention suspected or convicted of offenses against the criminal laws of the United States or of the District of Columbia or offenses against the punitive articles of the Uniformed Code of Military Justice (chapter

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 356 10 USC 801.

"Firefighter.'

Deposits.

PUBLIC LAW 93-350-JULY 12, 1974

Exemption.

Early retirement.

Annuity computation.

Supra.

Effective dates. 5 USC 3307 note.

STAT.

47 of title 10) require frequent (as determined by the appropriate administrative authority with the concurrence of the Commission) direct contact with these individuals in their detention, direction, supervision, inspection, training, employment, care, transportation, or rehabilitation; and "(21) 'firefighter' means an employee, the duties of whose position are primarily to perform work directly connected with the control and extinguishment of fires or the maintenance and use of firefighting apparatus and equipment, including an employee engaged in this activity who is transferred to a supervisory or administrative position." SEC. 3. (a) The first sentence of section 8334(a)(1) of title 5, United States Code, is amended by inserting "a law enforcement officer, and a firefighter," following "Congressional employee,". (b) The first sentence of section 8334(c) of title 5, United States Code, is amended by adding at the end thereof the following new schedule: "Law enforcement officer for law enforcement service and firefighter for firefighter service.

Mandatory separation.

[88

2^/^ Sy^ 5 6 61^ 7 IVz

August 1, 1920, to June 30, 1926, July 1, 1926, to June 30, 1942. July 1, 1942, to June 30, 1948. July 1, 1948, to October 31, 1956. November 1, 1956, to December 31, 1969. January 1, 1970, to December 31, 1974. After December 31, 1974.".

SEC. 4. Section 8335 of title 5, United States Code, is amended by adding the following new subsection at the end thereof: " (g) A law enforcement officer or a firefighter who is otherwise eligible for immediate retirement under section 8336(c) of this title shall be separated from the service on the last day of the month in which he becomes 55 years of age or completes 20 years of service if then over that age. The head of the agency, when in his judgment the public interest so requires, may exempt such an employee from automatic separation under this subsection until that employee becomes 60 years of age. The employing office shall notify the employee in writing of the date of separation at least 60 days in advance thereof. Action to separate the employee is not effective, without the consent of the employee, until the last day of the month in which the 60-day notice expires." SEC. 5.. Section 8336(c) of title 5, United States Code, is amended to read as follows: "(c) An employee who is separated from the service after becoming 50 years of age and completing 20 years of service as a law enforcement officer or firefighter, or any combination of such service totaling at least 20 years, is entitled to an annuity." SEC. 6. Section 8339(d) of title 5, United States Code, is amended to read as follows: " (d) The annuity of an employee retiring under section 8335(g) or 8336 (c) of this title is— " (A) 21/^ percent of his average pay multiplied by so much of his total service as does not exceed 20 years; plus " (B) 2 percent of his average pay multiplied by so much of his total service as exceeds 20 years." SEC. 7. The amendments made by the first section, and sections 2(b), 5, and 6, of this Act shall become effective on the date of enactment of this Act. The amendments made by sections 2(a) and 3 of this Act shall become effective at the beginning of the first applicable pay period which begins after December 31, 1974. The amendment made by section 4 of this Act shall become effective on January 1, 1978. Approved July 12, 1974.

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PUBLIC LAW 93-351-JULY 12, 1974

357

Public Law 93-351 AN ACT

July 12, 1974

To amend title VII of the Older Americans Act relating to the nutrition pro- ———— gram for the elderly to provide authorization of appropriations, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the first sentence of section 708 of the Older Americans Act is amended by striking out the word "and" before "$150,000,000" and by inserting before the period a comma and the following: "$150,000,000 for the fiscal year ending June 30, 1975, $200,000,000 for the fiscal year ending June 30, 1976, and $250,000,000 for the fiscal year ending June 30, 1977". SEC. 2. (a) Section 201(a) of the Older Americans Act (42 U.S.C. 3011) is amended by striking out everything in such section that follows the word "Commissioner" the second time it appears in the fourth sentence of such section and inserting in lieu thereof a period. (b) Any delegation of the functions of the Commissioner on Aging in effect on the date of enactment of this Act, issued pursuant to section 201(a) of such Act, shall be modified by the Commissioner to comply with the provisions of the amendment made by this section. SEC. 3. Title III of the Older Americans Act of 1965 (42 U.S.C. 3021ff.) is amended by adding the following new section:

 * !i

o l d e r Ameri-

amendments/^^^' 42 USC 3 04 5g.

de?e°'^'tio^n ^ f ^ ^ o" " ' functions, modifi^12^'QC 3 on note. 42 USC 3021.

"TRANSPORTATION PROJECTS

"SEC. 309. (a) There are authorized to be appropriated $35,000,000 ^j'^usc's^'S'' for the fiscal year ending June 30, 1975, to carry out the purposes of this section. From sums appropriated under this section, the Commissioner is authorized to make grants to each State having a State plan approved under section 305 for the purpose of paying up to 75 per *2 USC 3025. centum of the costs of meeting the transportation needs of older persons, with special emphasis on providing supportive transportation in connection with nutrition projects operated pursuant to title VTI of this Act. Sums appropriated under this section shall be allotted l^ySw'*^' 1

c^

•

I

'

l

i

n

n

1

.

•

State allotments.

to the tbtates m accordance with the allotment formula contamed m section 303. ^ _ _ Tiiotm^ent?^ "(b) The allotment to a State under this section shall remain avail- avaiiabTu"y!' able until December 31, 1975, for grants and contracts to area agencies on aging, organized under section 305(b), or to other public or nonprofit private agencies that the State agency determines have the capacity to meet the transportation needs of older persons and to provide supportive transportation services in connection with nutrition projects operated under title VII. I n making grants and contracts under this section, State agencies shall give priority to applicants pro- Applicants ,

'

.

I. ' 1 ii

•

l_T

J.

•Lt i*

•

granted priority.

posing to serve areas m which there is no public transportation or in which existing public transportation is inadequate to meet the special needs of older persons. "(c) Within ninety days following the enactment of legislation tion"^^'^^^"^^" appropriating funds as authorized by this section, the Commissioner shall issue final regulations for implementation of the program herein authorized. " (d) The Commissioner is authorized and directed to request the siltan"^'^^'^^ technical assistance and cooperation of the Secretary of Transportation and such other departments and agencies of the Federal Government as may be appropriate for the proper and effective administration SEC. 4. Section 201 of Public Law 93-113 (87 Stat. 401, October 1, 42 USC 5001. 1973) is amended by inserting the following new subsection (b) after

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Local contrib u t i o n s, required proportion.

42 USC 3045f. L e v e l of assistance.

Food s t a m p s, regulations.

PUBLIC LAW 93-352-JULY 23, 1974

[88 STAT.

subsection (a) and redesignating the present subsection (b) as subsection (c): " (b) I n no event shall the required proportion of the local contribution (including in-kind contributions) for a grant or contract made under this section be more than 10 per centum in the first year of assistance under this section, 20 per centum in the second such year, 30 per centum in the third such year, 40 per centum in the fourth such year, and 50 per centum in any subsequent such years: Provided, lioweiieT^ That the Director may make exceptions in cases of demonstrated need, determined (in accordance with regulations which the Director shall prescribe) on the basis of the financial capability of a particular recipient of assistance under this section, to permit a lesser local contribution proportion than any required contribution proportion established by the Director in generally applicable regulations.". SEC. 5. Section 707 of the Older Americans Act of 1965 is amended by adding at the end thereof the following new subsections: " (d) I n donating commodities pursuant to this section, the Secretary of Agriculture shall maintain an annually programed level of assistance of not less than 10 cents per meal: Provided, That this amount shall be adjusted on an annual basis each fiscal year after June 30, 1975, to reflect changes in the series for food away from home of the Consumer Price Index published by the Bureau of Labor Statistics of the Department of Labor. Such adjustment shall be computed to the nearest one-fourth cent. Among the commodities delivered under this section, the Secretary shall give special emphasis to high protein foods, meat, and meat alternates. The Secretary of Agriculture, in consultation with the Commissioner, is authorized to prescribe the terms and conditions respecting the donating of commodities pursuant to this section, and, within ninety days after the date of enactment of this subsection (d), the Secretary of Agriculture shall issue regulations governing the donation of such commodities. "(e) The Secretary of Agriculture in consultation with the Commissioner shall, within ninety days after the date of enactment of this subsection, issue regulations clarifying the use of food stamps under this title.". Approved July 12, 1974. Public Law 93-352

July 23, 1974 [S. 2893]

National c a n cer program, improvement. National C a n c e r Act Amendments of 1974. 42 USC 282 note. 42 USC 282.

AN ACT

To amend the Public Health Service Act to improve the national cancer program and to authorize appropriations for such program for the next three fiscal years. Be it enacted by the Senate and House of Representatives United States of America in Congress assembled, TITLE I—EXTENSION OF (\\NCER

of the

PROGRAM

SEC. 101. This title may be cited as the "National Cancer Act Amendments of 1974". SEC. 102. Section 402(b) of the Public Health Service Act is amended— (1) by striking out "in amounts not to exceed $35,000" in paragraph (1) and inserting in lieu thereof "if the direct costs of such research and training do not exceed $35,000, but only"; and (2) by striking out "in amounts exceeding $35,000" in para-

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STAT.]

PUBLIC LAW 93-352-JULY 23, 1974

graph (2) and inserting in lieu thereof ''if the direct costs of such research and training exceed $35,000, but only". SEC. 103. Section 407(b)(4) of the Public Health Service Act is amended by striking out "all data" and inserting in lieu thereof "information (including information respecting nutrition programs for cancer patients and the relationship betM'een nutrition and cancer)". SEC. 104. Section 407(b)(7) of the Public Health Service Act is amended by striking out "where appropriate". SEC. 105. Section 407(b)(9)(A) of the Public Health Service Act is amended by inserting "(including an estimate of the number and type of personnel needed for the National Cancer Program) " after "budget estimate". SEC. 106. Section 408(a) of the Public Health Service Act is amended by striking out "fifteen". SEC. 107. (a) Subsection (a) of section 409 of the Public Health Service Act is amended by inserting before the period at the end thereof a comma and the following: "including programs to provide appropriate trials of programs of routine exfoliative cytology tests conducted for the diagnosis of uterine cancer". (b) Subsection (b) of such section is amended by striking out "and" before "$40,000,000" and by inserting before the period at the end thereof a comma and the following: "$53,500,000 for the fiscal year ending June 30, 1975, $68,500,000 for the fiscal year ending June 30, 1976, and $88,500,000 for the fiscal year ending June 30, 1977". SEC. 108. Section 410 of the Public Health Service Act is amended— (1) by striking out "fifty" in paragraph (1) and inserting in lieu thereof "one hundred"; (2) by striking out "and" at the end of paragraph (7); (3) by striking out the period at the end of paragraph (8) and inserting in lieu thereof "; and"; (4) by adding after paragraph (8) the following new paragraph: " (9) to award grants for new construction as well as alterations and renovations for improvement of basic research laboratory facilities, including those related to biohazard control, as deemed necessary for the National Cancer Program."; and (5) by inserting " (a) " after "410." and by adding after paragraph (9) the following new subsection: " (b)(1) The Director of the National Cancer Institute shall provide and contract for a program to disseminate and interpret, on a current basis, for practitioners and other health professionals, scientists, and the general public scientific and other information respecting the cause, prevention, diagnosis, and treatment of cancer. "(2) The Director of the National Cancer Institute shall include in the annual report required by section 410A(b) a report on the progress, activities, and accomplishments of, and expenditures for, the information services of the National Cancer Program." SEC. 109. Section 410C of the Public Health Service Act is amended by striking out "and" before "$600,000,000" and by inserting before the period at the end thereof a semicolon and the following: "$750,000,000 for the fiscal year ending June 30, 1975; $830,000,000 for the fiscal year ending June 30, 1976; and $985,000,000 for the fiscal year ending June 30, 1977".

359

42 USC 286a.

42 USC 286b.

42 USC 286c.

^^ use 286d

Information dissemination program.

Report. 42 USC 286e.

42 USC 286g.

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 360 Anto, p. 135, 342.

PUBLIC LAW 93-352-JULY 23, 1974

[88

STAT.

SEC. 110. The part H of the Public Health Service Act relating to the appointment of the Directors of the National Institutes of Health and the National Cancer Institute is redesignated as part I, section 461 of such part is redesignated as section 471, and such part is amended by adding at the end the following new section: " P E E R REVIEW OF GRANT APPLICATIONS AND CONTRACT PROJECTS

42 USC 289M.

42 USC 241,

Effective date. 42 USC 289Z

42 USC 201 note.

"SEC. 472. (a) The Secretary, after consultation with the Director of the National Institutes of Health, and, where appropriate, the Directors of the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse, shall by regulation require appropriate scientific peer review of— "(1) applications made after the effective date of such regulations for grants under this Act for biomedical and behavioral research; and "(2) biomedical and behavioral research and development contract projects to be administered after such effective date through an institute established under this title, the National Institute on Alcohol Abuse and Alcoholism, or the National Institute on Drug Abuse. " (b) Regulations promulgated under subsection (a) shall, to the extent practical, require that the review of grant applications required by the regulations be conducted— "(1) in a manner consistent with the system for scientific peer review applicable on the date of the enactment of this section to applications for grants under this Act for biomedical and behavioral research, and " (2) by peer review groups performing such review on or before such date. "(c) The members of any peer review group established under such regulations shall be individuals who by virtue of their training or experience are eminently qualified to perform the review functions of the group and not more than one-fourth of the members of any peer review group established under such regulations shall be officers or employees of the United States." SEC. 111. Section 301(h) of the Public Health Service Act is amended by striking out "during the fiscal year ending June 30, 1966, and each of the eight succeeding fiscal years". SEC. 112. (a) The first sentence of section 471 of the Public Health Service Act (as so redesignated by section 110) is amended to read as follows: "The Director of the National Institutes of Health shall be appointed by the President by and with the advice and consent of the Senate; and the Director of the National Cancer Institute shall be appointed by the President." (b) The amendment made by subsection (a) shall apply with respect to appointments to the office of Director of the National Institutes of Health made after the date of the enactment of this Act. SEC. 113. Section 601 of the Medical Facilities Construction and Modernization Amendments of 1970 is amended by striking out "ending prior to July 1, 1974,".

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361

PUBLIC LAW 93-352^JULY 23, 1974 TITLE II—BIOMEDICAL RESEARCH

SEC. 201. (a)(1) There is established the President's Biomedical Research Panel (hereinafter in this section referred to as the "Panel") which shall be composed of (A) the Chairman of the President's Cancer Panel (established under section 407(c) of the Public Health Service Act); and (B) six members appointed by the President who by virtue of their training, experience, and background are exceptionally qualified to carry out the duties of the Panel. At least five of the members of the Panel shall be distinguished scientists or physicians. The appointed members of the Panel shall be appointed for the life of the Panel. (2) The President shall designate one of the appointed members to serve as Chairman of the Panel. (3) Appointed members of the Panel shall each be entitled to receive the daily equivalent of the annual rate of basic pay in effect for grade GS-18 of the General Schedule for each day (including traveltime) during which they are engaged in the actual performance of duties vested in the Panel; and while away from their homes or regular places of business in the performance of services for the Panel, all members of the Panel shall be allowed travel expenses, including per diem in lieu of subsistence, in the same manner as persons employed intermittently in the Government service are allowed expenses under section 5703(b) of title 5 of the United States Code. (4) The Panel may appoint and fix the pay of such personnel as it deems necessary to carry out its duties. (b) The Panel shall— (1) review and assess, (2) identify and make recommendations with respect to policy issues concerning the subject and content of, and (3) identify and make recommendations with respect to policy issues concerning the organization and operation of, biomedical and behavioral research conducted and supported under programs of the National Institutes of Health and the National Institute of ]\rental Health. (c)(1) Not later than the expiration of the 15-month period beginning on the first day of the first month that follows the date on which all of the appointed members of the Panel have taken office, the Panel shall submit simultaneously to the President and to the Congress a comprehensive report of (A) its findings made on the basis of the review and assessment conducted under clause (1) of subsection (b). and (B) the policy issues identified under clauses (2) and (3) of such subsection and the Panel's recommendations with respect to such issues. (2) The Panel shall terminate upon the expiration of the 18-month period beginning on the first day of the first month that follows the date on which all of the appointed members of the Panel have taken office. Approved July 23, 1974.

President's Biomedical Research Panel. Establishment. 42 USC 2891-1 note. 42 USC 286a.

eompensati.on. 5 USC 5332 note.

Report to President and Congress.

Termination.

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PUBLIC LAW 93-353-JULY 23, 1974

[88 STAT.

Public Law 93-353 July 23, 1974 [H. R.11385]

Health Services Research, Health Statistics, and Medical Libraries Act of 1974. 42 USC 242b note. 42 USC 201 note. Health Services Research and Evaluation and Health Statistics Act of 1974. 42 USC 242b note. Repeals. 42 USC 242e, 244, 244a, 245, 247. 42 USC 242d. 42 USC 244-1.

42 USC 242g.

42 USC 245a.

42 USC 247d. 42 USC 235. 42 USC 242j. 42 USC 236.

42 USC 242b.

AN ACT To amend the Public Health Service Act to revise the programs of health services research and to extend the program of assistance for medical libraries.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. (a) This Act may be cited as the "Health Services Research, Health Statistics, and Medical Libraries Act of 1974". (b) Unless the context otherwise requires, whenever in this Act an amendment or repeal is expressed in terms of an amendment to, or 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. TITLE I — H E A L T H SERVICES R E S E A R C H AND E V A L U A TION; HEALTH STATISTICS SEC. 101. This title may be cited as the "Health Services Research and Evaluation and Health Statistics Act of 1974". SEC. 102. (a) Sections 307, 312, 312a, 313, and 315 are repealed. (b)(1) Section 306 is amended (A) by striking out "Surgeon General" each place it appears and inserting in lieu thereof "Secretary", (B) by striking out "309" each place it occurs in subsection (d) and inserting in lieu thereof "313", and (C) by striking out subsection (e) and redesignating subsection (f) as subsection (e). (2) Section 306 as amended by paragraph (1) is transferred to part B of title III, is redesignated section 312, and is inserted after section 311. (c) (1^ Section 309 is amended (A) by striking out "Surgeon General" each place it occurs and inserting in lieu thereof "Secretary", and (B) by striking out "306(d)" and inserting in lieu thereof "312(d)". (2) Section 309, as amended by paragraph (1), is transferred to part B of title III, is redesignated section 313, and is inserted immediately before section 314. (d) Section 310 is transferred to part B of title III, is redesignated section 319, and is inserted after section 318. (e) Section 310A is transferred to title II, is redesignated section 226, and is inserted after section 225. (f)(1) Section 310B is amended by striking out "304, 305,". ^2) Section 310B, as amended by'paragraph (1) is transferred to title II, is redesignated section 227, and is inserted after section 226 (inserted by subsection (e) of this section). SEC. 103. Section 304 is amended to read as follows: " GENERAL AUTHORITY R E S P E C T I N G HEAI/ril STATISTICS AND HEALTH SERVICES RESEARCH, EVALUATIONS, AND DEMONSTRATIONS

"SEC. 304. (a)(1) The Secretary shall— " (A) undertake through the National Center for Health Services Research, the National Center for Health Statistics, and such other units of the Department of Health, Education, and Welfare as he may select, and " (B) support, health statistical activities and health services research, evaluation, and demonstrations. "(2) In carrying out paragraph (1), the Secretary shall give appropriate emphasis to research and statistical activities respecting— " (A) the determinants of an individual's health,

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PUBLIC LAW 93-353-JULY 23, 1974

" (B) the impact of the environment on individual health and on health care, " (C) the accessibility, acceptability, planning, organization, technology, distribution, utilization, quality, and financing of systems for the delivery of health care, including systems for the delivery of preventive, personal, and mental health care, and " (D) individual and community knowledge of individual health and the systems for the delivery of health care. " (b) To implement subsection (a), the Secretary may, in addition to any other authority which under other provisions of this Act or any other law may be used by him to implement such subsection, do the following: "(1.) Utilize personnel and equipment, facilities, and other physical resources of the Department of Health, Education, and Welfare, permit appropriate (as determined by the Secretary) entities and individuals to utilize the physical resources of such Department, provide technical assistance and advice, make grants to public and nonprofit private entities and individuals, and enter into contracts with public and private entities and individuals, for (A) health services research, evaluation, and demonstrations, and (B) health services research and health statistics training, and (C) health statistical activities. ,» "(2) Admit and treat at hospitals and other facilities of the Service persons not otherwise eligible for admission and treatment at such facilities. "(3) Secure, from time to time and for such periods as the Secretary deems advisable, the assistance and advice of experts and consultants from the United States or abroad. "(4) Acquire, construct, improve, repair, operate, and maintain laboratory, research, and other necessary facilities and equipment, and such other real or personal property (including patents) as the Secretary deems necessary; and acquire, without regard to the Act of March 3, 1877 (40 U.S.C. 34), by lease or otherwise, through the Administrator of General Services, buildings or parts of buildings in the District of Columbia or communities located adjacent to the District of Columbia. " (c) The Secretary shall coordinate all health services research, evaluation, demonstration, and health statistical activities undertaken and supported through units of the Department of Health, Education, and Welfare. To the maximum extent feasible, such coordination shall be carried out through the National Center for Health Services Research and the National Center for Health Statistics." SEC. 104. Section 305 is amended to read as follows:

Additional authority.

Experts and consultants.

Health services and statistical activities, coordination.

42 USC 242c.

"NATIONAL CENTER FOR HEALTH SERVICES RESEARCH

"SEC. 305. (a) There is established in the Department of Health, Education, and Welfare the National Center for Health Services Research (hereinafter in this section referred to as the 'Center') which shall be under the direction of a Director who shall be appointed by the Secretary and supervised by the Assistant Secretary for Health (or such other officer of the Department as may be designated by the Secretary as the principal adviser to him for health programs). " (b) I n carrying out section 304(a), the Secretary, acting through the Center, may undertake and support research, evaluation, and demonstration projects (which may include and shall be appropriately coordinated with experiments and demonstration activities authorized by the Social Security Act and the Social Security Amendments of 1967) respecting—

Establishmenti

Ante, p. 362.

42 USC 1305. 42 USC 302 note.

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364

New centers, grants to nonprofit e n title s.

Post,

p. 368.

Health Care Technology Center. Health Care Management Center.

Requirements for aid.

[88 STAT.

"(1) the accessibility, acceptability, planning, organization, distribution, technology, utilization, quality, and financing of health services and systems; "(2) the supply and distribution, education and training, quality, utilization, organization, and costs of health manpower; and "(3) the design, construction, utilization, organization, and cost of facilities and equipment. "(c) The Secretary shall afford appropriate consideration to requests of— "(1) State, regional, and local health planning and health agencies, "(2) public and private entities and individuals engaged in the delivery of health care, and " (3) other persons concerned with health services, to have the Center or other units of the Department of Health, Education, and Welfare undertake research, evaluations, and demonstrations respecting specific aspects of the matters referred to in subsection (b). " (d)(1) The Secretary shall, by grants or contracts, or both, assist public or private nonprofit entities in meeting the costs of planning and establishing new centers, and operating existing and new centers, for multidisciplinary health services, research, evaluations, and demonstrations respecting the matters referred to in subsection (b). To the extent practicable, the Secretary shall approve, in accordance with the requirements of this subsection and section 308, a number of applications for grants and contracts under this subsection which will result in at least six of such centers (including two national special emphasis centers, one of which (to be designated as the Health Care Technology Center) shall focus on all forms of technology, including computers and electronic devices, and its applications in health care delivery; and one of which (to be designated as the Health Care Management Center) shall focus on the improvement of management and organization in the health field, the training and retraining of administrators of health care enterprises, and the development of leaders, planners, and policy analysts in the health field) being operational in each fiscal year. " (2)(A) No grant or contract may be made under this subsection for planning and establishing a center unless the Secretary determines that when it is operational it will meet the requirements listed in subparagraph (B) and no payment shall be made under a grant or contract for operation of a center unless the center meets such requirements. " (B) The requirements referred to in subparagraph (A) are as follows: " (i) There shall be a full-time director of the center who possesses a demonsti''ated capacity for sustained productivity and leadership in health services research, demonstrations, and evaluations, and there shall be such additional full-time professional staff as may be appropriate. "(ii) The staff of the center shall represent all relevant disciplines. "(iii) The center shall (I) be located within an established academic or research institution with departments and resources appropriate to the programs of the center, and ( II) have working relationships with health service delivery systems where experiments in health services may be initiated and evaluated. "(iv) The center shall select problems in health services for research, demonstrations, and evaluations on the basis of (I) their regional or national importance, ( II) the unique potential

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PUBLIC LAW 93-353-JULY 23, 1974

for definitive research on the problem, and ( III) opportunities for local application of the research findings. " (v) Such additional requirements as the Secretary may by regulation prescribe. "(e) The authority of the Secretary under section 304(b) shall be available to him with respect to the undertaking and support of projects under subsections (b), (c),and (d) of this section." SEC. 105. The following new section is inserted in part A of title III after section 305:

365

Ante, p. 362.

Ante, p. 363.

'NATIONAL CENTER FOR HEALTH STATISTICS

"SEC. 306. (a) There is established in the Department of Health, Establishment. Education, and Welfare the National Center for Health Statistics 42 USC 242k. (hereinafter in this section referred to as the 'Center') which shall be under the direction of a Director who shall be appointed by the Secretary and supervised by the Assistant Secretary for Health (or such other officer of the Department as may be designated by the Secretary as the principal adviser to him for health programs). " (b) I n carrying out section 304(a), the Secretary, acting through Duties. the Center, may— "(1) collect statistics on— " (A) the extent and nature of illness and disability of the population of the United States (or of any groupings of the people included in the population), including life expectancy, the incidence of various acute and chronic illnesses, and infant and maternal morbidity and mortality, " (B) the impact of illness and disability of the population on the economy of the United States and on other aspects of the well-being of its population (or of such groupings), " (C) environmental, social, and other health hazards, " (D) determinants of health, " (E) health resources, including physicians, dentists, nurses, and other health professionals by specialty and type of practice and the supply of services by hospitals, extended care facilities, home health agencies, and other health institutions, " (F) utilization of health care, including utilization of (i) ambulatory health services by specialties and types of practice of the health professionals providing such services, and (ii) services of hospitals, extended care facilities, home health agencies, and other institutions, " (G) health care costs and financing, including the trends in health care prices and cost, the sources of payments for health care services, and Federal, State, and local governmental expenditures for health care services, and " (H) family formation, growth, and dissolution; and "(2) undertake and support (by grant or contract) research, demonstrations, and evaluations respecting new or improved methods for obtaining current data on the matters referred to in paragraph (1). "(c) The Center shall furnish such special statistical compilations Statistical and surveys as the Committee on Labor and Public Welfare and the compilations and urveys to conCommittee on Appropriations of the Senate and the Committee on gressionai com Interstate and Foreign Commerce and the Committee on Appropria- mittees. tions of the House of Representatives may request. Such statistical compilations and surveys shall not be made subject to the payment of the actual or estimated cost of the preparation of such compilations and surveys. " (d) To insure comparability and reliability of health statistics. Technical aid the Secretary shall, through the Center, provide adequate technical localities.^"'^ '° ^*^*^^

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Federal-state cooperation.

Data collection forms.

Registration area records.

United States National Committee on Vital and Health Statistics. Establishment; membership.

PUBLIC LAW 93-353-JULY 23, 1974

[88 STAT.

assistance to assist State and local jurisdictions in the development of model laws dealing with issues of confidentiality and comparability of data. "(e) The Secretary shall (1) assist State and local health agencies, and Federal agencies involved in matters relating to health, in the design and implementation of a cooperative system for producing comparable and uniform health information and statistics at the Federal, State, and local levels; (2) coordinate the activities of such Federal agencies respecting the design and implementation of such cooperative system; (3) undertake and support (by grant or contract) research, development, demonstrations, and evaluations respecting such cooperative system; (4) provide the Federal share of the data collection costs under such system; and (5) review statistical activities of the Department of Health, Education, and Welfare to assure that they are consistent with such cooperative system. " (f) To assist, in carrying out this section, the Secretary shall cooperate and consult with the Departments of Commerce and Labor and any other interested Federal departments or agencies and with State and local health departments and agencies. For such purpose he shall utilize insofar as possible the services or facilities of any agency of the Federal Government and, without regard to section 3709 of the Revised Statutes (41 U.S.C. 5), of any appropriate State or other public agency, and may, without regard to such section, utilize the services or facilities of any private agency, organization, group, or individual, in accordance with written agreements between the head of such agency, organization, or group and the Secretary or between such individual and the Secretary. Payment, if any, for such services or facilities shall be made in such amounts as may be provided in such agreement. " (g) To secure uniformity in the registration and collection of mortality, morbidity, and other health data, the Secretary shall prepare and distribute suitable and necessary forms for the collection and compilation of such data which shall be published as a part of the health reports published by the Secretary. " (h) There shall be an annual collection of data from the records of births, deaths, marriages, and divorces in registration areas. The data shall be obtained only from and restricted to such records of the States and municipalities which the Secretary, in his discretion, determines possess records affording satisfactory data in necessary detail and form. Each State or registration area shall be paid by the Secretary the Federal share of its reasonable costs (as determined by the Secretary) for collecting and transcribing (at the request of the Secretary and by whatever method authorized by him) its records for such data. "(i)(1) There is established in the Office of the Secretary a committee to be known as the United States National Committee on Vital and Health Statistics (hereinafter in this subsection referred to as the 'Committee') which shall consist of fifteen members. "(2)(A) The members of the Committee shall be appointed by the Secretary from among persons who have distinguished themselves in the fields of health statistics, epidemiology, and the provision of health services. Except as provided in subparagraph (B), members of the Committee shall be appointed for terms of three years. " (B) Of the members first appointed— " (i) five shall be appointed for terms of one year, " (ii) five shall be appointed for terijis of two years, and " (iii) five shall be appointed for terms of three years, as designated by the Secretary at the time of appointment. Any member appointed to fill a vacancy occurring prior to the expiration

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STAT.]

PUBLIC LAW 93-353-JULY 23, 1974

of the term for which his predecessor was appointed shall be appointed only for the remainder of such term. A member may serve after the expiration of his term until his successor has taken office. "(3) Members of the Committee shall be compensated in accordance with section 208(c). "(4) I t shall be the function of the Committee to assist and adv^e the Secretary— " (A) to delineate statistical problems bearing on health and health services which are of national or international interest; " (B) to stimulate studies of such problems by other organizations and agencies whenever possible or to make investigations of such problems through subcommittees; " (C) to determine, approve, and revise the terms, definitions, classifications, and guidelines for assessing health status and health services, their distribution and costs, for use (i) within the Department of Health, Education, and Welfare, (ii) by all programs administered or funded by the Secretary, including the Federal-State-local cooperative health statistics system referred to in subsection (e), and (iii) to the extent possible as determined by the head of the agency involved, by the Veterans' Administration, the Department oi Defense, and other Federal agencies concerned with health and, health services; " (D) with respect to the design of and approval of health statistical and health information systems concerned with the collection, processing, and tribulation of health statistics within the Department of Health, Education, and Welfare; " (E) to review and comment on findings and proposals developed by other organizations and agencies and to make recom^ mendations for their adoption or implementation by local, State, national, or international agencies; " (F) to cooperate with national committees of other countries and with the World Health Organization and other national agencies in the studies of problems of mutual interest; and " (G) to issue an annual report on the state of the Natioh's health, its health services, their costs and distributions, and to make proposals for improvement of the Nation's health Statistics and health information systems. " (5) I n carrying out health statistical activities under this part, the Secretary shall consult with, and seek the advice of, the Committee and other appropriate professional advisory groups." SEC. 106. Section 308 is redesignated as section 307 and is amended to read as follows:

367

Compensation. Post, p. 369. Functions.

42 USC 242f,.

"INTERNATIONAL COOPERATION

"SEC. 307. (a) For the purpose of advancing the status of the health sciences in the United States (^nd thereby the health of the American people), the Secretary may participate with other countries in cooperative endeavors in biomedical research and the health services research and statistical activities authorized by sections 304, 305, and 306. "(b) I n connection with the cooperative endeavors authorized by subsection (a), the Secretary may— " (1) make such use of resources offered by participating foreign countries as he may find necessary and appropriate; "(2) establish and irtaintain fellowships m the United States and in participating foreign countrieis; "(3) make grants to public institutions or agencies and to nMiprofit private institutions or agencies in the United States and in participating foreign countries for the purpose of establishing and maintaining the fellowships authorized by paragraph (2);

42 USC 242/,,

Ante, pp. 362. 363, 365.

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368

Interchange of s c i e n t i s t s and experts.

Ante,

p. 367.

" (4) make grants or loans of equipment and materials, for use by public or nonprofit private institutions or agencies, or by individuals, in participating foreign countries; "(5) participate and otherwise cooperate in any international meetings, conferences, or other activities concerned with biomedical research, health services research, or health statistics; "(6) facilitate the interchange between the United States and participating foreign countries, and among participating foreign countries, of research scientists and experts who are engaged in experiments and programs of biomedical research, health services research, and health statistical activities, and in carrying out such purpose may pay per diem compensation, subsistence, and travel for such scientists and experts when away from their places of residence at rates not to exceed those provided in section 5703(b) of title 5, United States Code, for persons in the Government service employed intermittently; and "(7) procure, in accordance with section 3109 of title 5, United States Code, the temporary or intermittent services of experts or consultants. The Secretary may not, in the exercise of his authority under this section, provide financial assistance for the construction of any facility in any foreign country.". SEC. 107. (a) Part A of title III is amended by inserting after section 307 (as so redesignated) the following new sections: "GENERAL

42 USC 242m. Report to Congress. Ante, pp. 362, 363, 3 6 5, 3 6 7. Reports to P r e s i d e n t and Congress.

Ante,

p. 365..

OMB review.

Application submittal.

[88 STAT.

PROVISIONS

RESPECTING

SECTIONS

304,

305,

306,

AND

307

"SEC. 308. (a)(1) Not later than September 1 of each year, the Secretary shall make a report to Congress respecting (A) the administration of sections 304 through 307 during the preceding fiscal year, and (B) the current state and progress of health services research and health statistics. "(2) The Secretary, acting through the National Center for Health Services Research and the National Center for Health Statistics, shall assemble and submit to the President and the Congress not later than September 1 of each year the following reports: " (A) A report on health care costs and financing. Such report shall include a description and analysis of the statistics collected under section 306(b)(1)(G). " (B) A report on health resources. Such report shall include a description and analysis, by geographic area, of the statistics collected under section 306(b)(1)(E). " (C) A report on the utilization of health resources. Such report shall include a description and analysis, by age, sex, income, and geographic area, of the statistics collected under section 306(b)(1)(F). " (D) A report on the health of the Nation's people. Such report shall include a description and analysis, by age, sex, income, and geographic area, of the statistics collected under section 306(b) (1)(A). "(S) The Office of Management and Budget may review any report required by paragraph (1) or (2) of this subsection before its submission to Congress, but the Office may not revise any such report or delay its submission beyond the date prescribed for its submission, and may submit to Congress its comments respecting any such report. " (b)(1) No grant or contract may be made under section 304, 305, 306, or 307 unless an application therefor has been submitted to the Secretary in such form and manner, and containing such information, as the Secretary may by regulation prescribe.

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369

" (2) Each application submitted for a grant or contract under sec- revu^w'paneT tion 304 or 305, in an amount exceeding $35,000 of direct costs and for Ante, pp. 3*62, a health services research, evaluation, or demonstration project, shall ^^^• be submitted by the Secretary for review for scientific merit to a panel of experts appointed by him,from persons who are not officers or employees of the United States and who possess qualifications relevant to the project for which the application was made. A panel to which an application is submitted under this paragraph shall report its findings and recommendations respecting the application to the Secretary in such form and manner as the Secretary shall by regulation prescribe. Ante, p. 365,, "(3) If an application is submitted under section 304, 305, or 306 for a grant or contract for a project for which a grant or contract may be made or entered into under another provision of this Act, such application may not be approved under section 304, 305, or 306 and funds appropriated under this section may not be obligated for such grant or contract. The applicant who submitted such application shall be notified of the other provision (or provisions) of this Act under which such application may be submitted. " (c) The aggregate number of grants and contracts made or entered Limited grants. into under sections 304 and 305 for any fiscal year respecting a particular means of delivery of health services or another particular aspect of health services may not exceed twenty; and the aggregate amount of funds obligated under grants and contracts under such sections for any fiscal year respecting a particular means of delivery of health services or another particular aspect of health services may not exceed $5,000,000. j ^ ^ ^ ^ ^ ^.^^ " (d) No information obtained in the course of activities undertaken pubiica'tion"^^or supported under section 304, 305, 306, or 307 may be used for any strictions. purpose other than the purpose for which it was supplied unless '*"'^' P- 367. authorized under regulations of the Secretary; and (1) in the case of information obtained in the course of health statistical activities mider section 304 or 306, such information may not be published or released in other form if the particular establishment or person supplying the information or described in it is identifiable unless such establishment or person has consented (as determined under regulations of the Secretary) to its publication or release in other form, and (2) in the case of information obtained in the course of health services research, evaluations, or demonstrations under section 304 or 305, such information may not be published or released in other form if the person who supplied the information or who is described in it is identifiable unless such person has consented (as determined under regulations of the Secretary) to its publication or release in other form. " (e)(1) Payments of any grant or under any contract under section ^ Payment procedures. 304, 305, 306, or 307 may be made in advance or by way of reimburse- '' " ° ment, and in such installments and on such conditions, as the Secretary deems necessary to carry out the purposes of such section. " (2) The amounts otherwise payable to any person under a grant or contract made under section 304, 305, 306, or 307 shall be reduced by— " (A) amounts equal to the fair market value of any equipment or supplies furnished to such person by the Secretary for the purpose of carrying out the project with respect to which such grant or contract is made, and " (B) amounts equal to the pay, allowances, traveling expenses, and related personnel expenses attributable to the performance of services by an officer or employee of the Government in connection with such project, if such officer or employee was assigned or detailed by the Secretary to perform such services, but only if such person requested the Secretary to furnish such equipment or supplies, or such services, as the case may be.

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 370 Ante, pp. 362, 3 6 3, 365.

Research res u l t s, publication.

Indexing, abstracting, and other services.

Statistics, publication.

Laborers and mechanics, wage rate.

40 USC 276a note.

5 USC app. 11. Regulations. Appropriations.

PUBLIC LAW 93-353-JULY 23, 1974

[88 STAT.

" (f) Contracts may be entered into under section 304, 305, or 306 without regard to sections 3648 and 3709 of the Revised Statutes (31 U.S.C.529;41 U.S.C.5). " (g)(1) The Secretary shall— " (A) publish, make available and disseminate, promptly in understandable form and on as broad a basis as practicable, the results of health services research, demonstrations, and evaluations undertaken and supported under sections 304 and 305; " (B) make available to the public data developed in such research, demonstrations, and evaluations; and " (C) provide indexing, abstracting, translating, publishing, and other services leading to a more effective and timely dissemination of information on health services research, demonstrations, and evaluations in health care delivery to public and private entities and individuals engaged in the improvement of health care delivery and the general public; and undertake programs to develop new or improved methods for making such information available. Except as provided in subsection (d), the Secretary may not restrict the publication and dissemination of data from, and results of projects undertaken by, centers supported under section 305(d). "(2) The Secretary shall (A) take such action as may be necessary to assure that statistics developed under sections 304,305, and 306 are of high quality, timely, comprehensive as well as specific, standardized, and adequately analyzed and indexed, and (B) publish, make available, and disseminate such statistics on as wide a basis as is practicable. " (h)(1) Except where the Secretary determines that unusual circumstances make a larger percentage necessary in order to effectuate the purposes of section 304, 305, or 306, a grant or contract under section 304, 305, or 306 with respect to any project for construction of a facility or for acquisition of equipment may not provide for payment of more than 50 per centum of so much of the cost of the facility or equipment as the Secretary determines is reasonably attributable to research, evaluation, or demonstration purposes. "(2) Laborers and mechanics employed by contractors and subcontractors in the construction of such a facility shall be paid wages at rates not less than those prevailing on similar work in the locality, as determined by the Secretary of Labor in accordance with the Act of March 3, 1931 (40 U.S.C. 267a—267a-5, known as the Davis-Bacon Act); and the Secretary of Labor shall have with respect to any labor standards specified in this paragraph the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (5 U.S.C. Appendix) and section 2 of the Act of June 13, 1934 (40 U.S.C. 276c). "(3) Such grants and contracts shall be subject to such additional requirements as the Secretary may by regulation prescribe. " (i)(1) For health service research, evaluation, and demonstration activities undertaken or supported under section 304 or 305, there are authorized to be appropriated $65,200,000 for the fiscal year ending June 30, 1975, and $80,000,000 for the fiscal year ending June 30, 1976. Of the funds appropriated under this paragraph for any fiscal year, not less than 25 per centum of such funds shall be made available only for health services research, evaluation, and demonstration activities directly undertaken by the Secretary under such section. " (2) For health statistical activities undertaken or supported under section 304 or 306, there are authorized to be appropriated $30,000,000 for the fiscal year ending June 30, 1975, and $30,000,000 for the fiscal year ending June 30, 1976.

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"HEALTH CONFERENCES

"SEC. 309. A conference of the health authorities in and among the several States shall be called annually by the Secretary. Whenever in his opinion the interests of the public health would be promoted by a conference, the Secretary may invite as many of such health authorities and officials of other State or local public or private agencies, institutions, or organizations to confer as he deems necessary or roper. Upon the application of health authorities of five or more tates it shall be the duty of the Secretary to call a conference of all State health authorities joining in the request. Each State represented at any conference shall be entitled to a single vote. Whenever at any such conf erence matters relating to mental health are to be discussed, the mental health authorities of the respective States shall be invited to attend.

42 USC 242n.

g

ii HEALTH EDUCATION AND INFORMATION

"SEC. 310. From time to time the Secretary shall issue information related to public health, in the form of publications or otherwise, for the use of the public, and shall publish weekly reports of health conditions in the United States and other countries and other pertinent health information for the use of persons and institutions concerned with health services." (b) The authorizations of appropriations provided by section 308(i) of the Public Health Service Act is extended for the fiscal year ending June 30, 1977, in the amounts authorized for the preceding fiscal year unless before June 30, 1976, Congress has passed legislation repealing this subsection. SEC. 108. (a) Subject to regulations of the President, lightkeepers, assistant lightkeepers, and officers and crews of vessels of the former Lighthouse Service, including any such persons who subsequent to June 30, 1939, were involuntarily assigned to other civilian duty in the Coast Guard, who were entitled to medical relief at hospitals and other stations of the Public Health Service prior to July 1, 1944, and who retired under the provisions of section 6 of the Act of June 20, 1918 (40 U.S.C. 763), shall be entitled to medical, surgical, and dental treatment and hospitalization at hospitals and other stations of the Public Health Service. (b) Subsection (a) shall be effective from December 28, 1973. TITLE

4? u s e 2420.

Appropriation extension. 42 USC 242m note. Ante, p. 368.

Former Lighthouse Service employees, medical service eligibility. 42 USC 253b,.

33 USC 763.

Effective date.

II—REVISION AND E X T E N S I O N OF MEDICAL LIBRARY ASSISTANCE PROGRAMS

SEC. 201. (a) Effective July 1, 1974, section 390 is amended by adding after subsection (b) the following new subsection: "(c) For the purpose of grants and contracts under sections 393, 394, 395, 396, and 397, there are authorized to be appropriated $17^500,000 for the fiscal year ending June 30, 1975, and $20,000,000 for the fiscal year ending June 30, 1976." (b) The section heading for such section is amended to read as follows:

42 USC 280b. Appropriation. 42 USC 280b-3 to 280b-8.

" D E C L A R A T I O N O F POLICY, STATEMENT OF PURPOSE, AND AUTHORIZATION ^ OF APPROPRIATIONS".

(c) The authorization of appropriations provided by section 390(c) 42 USC'28'ob of the Public Health Service Act is extended for the fiscal year ending note. June 30, 1977, in the amount authorized for the preceding fiscal year S"P'-°-

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42 USC 280b.

42 USC 280b-l.

42 USC 280b-2.

Repeal. 42 USC 280b-3. 42 USC 280b-8.

Repeal. Repeals. 42 USC 280b-4.

Supra. 42 USC 280b-5.

Supra.

42 USC 280b-7.

42 USC 2 80b-8.

42 USC 280b-9.

PUBLIC LAW 93-353-JULY 23, 1974

[88 STAT.

unless before June 30, 1976, Congress has passed legislation repealing this subsection. SEC. 202. (a) Subsection (b) of section 390 is amended by striking out paragraph (1) and by redesignating paragraphs (2) through (7) as paragraphs (1) through (6), respectively. (b) Section 391 is amended— (1) by inserting "and" at the end of paragraph (2), (2) by striking out paragraph (3), and (3) by redesignating clause (4) as paragraph (3). (c) Section 392(b) is amended to read as follows: " (b) The Board shall advise and assist the Secretary in the preparation of general regulations and with respect to policy matters arising in the administration of this part." (d) Section 393 is repealed. (e) Section 397(b) is amended— (1) by inserting "and" at the end of paragraph (4), (2) by striking out "; and" at the end of paragraph (5) and inserting in lieu thereof a period, and (3) by striking out paragraph (6). (f) The first sentence ot section 397(d) is repealed. SEC. 203. (a) The first sentence of section 394(a) is repealed; and the second sentence of such section is amended by striking out "Sums made available under this section shall be utilized by the Secretary in making" and inserting in lieu thereof "To carry out the purposes of section 390(b)(1), the Secretary shall make". (b)(1) The first and second sentences of section 395(a) are repealed; and the third sentence of such section is amended by striking out "Sums made available under this subsection shall be utilized by the Secretary to" and inserting in lieu thereof "To carry out the purposes of section 390(b)(2), the Secretary shall". (2) The first and second sentences of section 395(b) are repealed; and the third sentence of such section is amended (A) by striking out "Sums made available under this subsection shall be utilized by the Secretary in making" and inserting in lieu thereof "To carry out the purposes of section 390(b)(3), the Secretary shall make", and (B) by striking out "entering into contracts" and inserting in lieu thereof "enter into contracts". (c)(1) The first sentence of section 396(b) is amended by striking out "Sums made available under this section shall be utilized by the Secretary for making" and inserting in lieu thereof "To carry out the purposes of section 390(b)(4), the Secretary shall make". (2) Clauses (A), (B), (C), and (D) of section 396(b) are redesignated as clauses (1), (2), (3), and (4),respectively. (3) Subsection (a) of section 396 is repealed and subsections (b) and (c) of such section are redesignated as subsections (a) and (b), respectively. (d)(1) The first sentence of section 397(a) is repealed; and the second sentence of such section is amended by striking out "Sums made available under this section shall be utilized by the Secretary, with the advice of the Board, to make" and inserting in lieu thereof "To carry out the purposes of section 390(b)(5), the Secretary, with the advice of the Board, shall make". (2) The section heading for section 397 is amended by inserting "AND CONTRACTS" after "GRANTS". (e) The first and second sentences of section 398(a) are repealed; and the third sentence of such section is amended by striking out "Sums made available under this section shall be utilized by the Secretary, with the advice of the Board, in making grants to, and enter-

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 the articulation between the carapace and abdomen and that between abdomen and telson, and the spiniform telson.

The other marine animals that have been repeatedly referred to as indicating the habits of the eurypterids by their similar swimming feet are the crabs of the family Portunidae, notably Matuta and Portunus (Huxley and Salter),  (Hall), and Portunus (Laurie). Our most common forms with swimming legs are the edible or blue crab and the lady crab. Here the question arises as to whether their last pair of limbs which so strongly resemble the swimming legs of many eurypterids, are better adapted to swimming or to digging. A full account of the habits of  has been given by Mary J. Rathbun, and a shorter account of the habits of the edible, lady and green  crabs by Paulmier. We learn from these descriptions that the edible crab usually wanders about crawling or hides under stones and logs and in seaweeds, but when pursued and finding speed ineffective, will rapidly bury itself in the sand to escape observation. As October draws to a close the crab moves into deep water and at this season may frequently be seen paddling near the surface as he works himself down stream with the tide. Paulmier states that "as may be supposed from the finlike posterior legs, it is a good swimmer and may often be found at the surface." On the other hand, he says of the lady crab, which has quite similar swimming legs: "Its usual habitat is the sandy beaches, even the most exposed, when at low water mark it buries itself all but the eyes and antennae and is on the watch for enemies and prey. If disturbed when feeding or if dug out, it disappears with great rapidity, burrowing backward into the sand."

We thus infer, and have verified this inference by actual observation, that they use their last legs with great ease for both digging and swimming, but are more given to a crawling and a burrowing than to a swimming habit.


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ing into appropriate contracts'' and inserting in lieu thereof "To c a r r j out the purposes of section 390(b)(6), the Secretary, with the 42 USC 280b. advice of the Board, shall make grants to, and enter into appropriate contracts". SEC. 204. Section 399b is repealed; and sections 394 through 399a Js^^'gc 280b-i2. are redesignated as sections 393 through 399, respectively. SEC. 205. The amendments made by sections 202, 203, and 204 shall J^l^^^'^ ^*°^ apply with respect to appropriations under part J of the Public 42 USC 280b. Health Service Act for fiscal years beginning after June 30, 1974. Approved July 23, 1974. Public Law 93-354 AN ACT

July 23, 1974 rs 28301

To amend the Public Health Service Act to provide for greater and more effective efforts in research and public education with regard to diabetes mellitus.

Be it enacted by the Senate and House of Representatives United States of America in Congress assembled, •'

i'

'.

of the

'

SHORT TITLE

. '^^*'°"1|.P'^" betes MelUtus Research and Education Act.

1. This Act may be cited as the "National Diabetes Mellitus „o{e.^^^ 289c-2 Research and Education Act". SECTION

FINDINGS AND DECLARATION OF PURPOSE

SEC. 2. (a) The Congress makes the following findings: (1) Diabetes mellitus is a major health problem in the United States which directly affects perhaps as many as ten million Americans and indirectly affects perhaps as many as fifty million Americans who will pass the tendency to develop diabetes mellitus to their children or grandchildren or to both. (2) Diabetes mellitus is a family of diseases that has an impact on virtually all biological systems of the human body. (3) Diabetes mellitus is the fifth leading cause of death from disease, and it is the second leading cause of new cases of blindness. (4) The severity of diabetes mellitus in children and most adolescents is greater than in adults, which in most cases involves greater problems in the management of the disease. (5) The complications of diabetes mellitus, particularly cardiovascular degeneration, lead to many other serious health problems. (6) Uncontrolled diabetes mellitus significantly decreases life expectancy. (7) There is convincing evidence that the known prevalence of diabetes mellitus has increased dramatically in the past decade. (8) The citizens of the United States should have a full understanding of the nature of the impact of diabetes mellitus. (9) The attainment of better methods of diagnosis and treatment of diabetes mellitus deserves the highest priority. (10) The establishment of regional diabetes research and training centers throughout the country is essential for the development of scientific information and appropriate therapies to deal with diabetes mellitus. (11) I n order to provide for the most effective program against diabetes mellitus it is important to mobilize the resources of the National Institutes of Health as well as the public and private organizations capable of the necessary research and public education in the disease.

38-1S4 n - 76 - 27 Pt. 1

^'^ use 289c-2

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(b) I t is the purpose of this Act to— (1) expand the authority of the National Institutes of Health to advance the national attack on diabetes mellitus; and (2) as part of that attack, to establish a long-range plan to— (A) expand and coordinate the national research effort against diabetes mellitus; (B) advance activities of patient education, professional education, and public education which will alert the citizens of the United States to the early indications of diabetes mellitus; and (C) to emphasize the significance of early detection, proper control, and complications which may evolve from the disease. DIABETES P L A N

mi^sion^on m^-' S E C 3. (a) The Director of the National Institutes of Health shall, betes. within sixty days of the date of the enactment of this section, establish 42^ usc^2'89c"2" ^' ^^^ional Commission on Diabetes (hereinafter in this section referred note. to as the "Commission"). Membership. (b) The Commission shall be composed of seventeen members as follows: (1) The Directors of the seven Institutes referred to in subsection (e). (2) Six members appointed by the Secretary of Health, Education, and Welfare from scientists or physicians who are not in the employment of the Federal Government and who represent the various specialties and disciplines involving diabetes mellitus and related endocrine and metabolic diseases. (3) Four members appointed by the Secretary of Health, Education, and Welfare from the general public. A t least two of the members appointed pursuant to this paragraph sl;iall be diabetics or parents of diabetics. The members of the Commission shall select a chairman from among their own number. Director and (c) The Commission may appoint an executive director and such personnel. additional personnel as it determines are necessary for the performance of the Commission's functions. Compensation. ((j^ Mcmbcrs of the Commission who are officers or employees of the Federal Government shall serve as members of the Commission without compensation in addition to that received in their regular public employment. Members of the Commission who are not officers or employees of the Federal Government shall each receive the daily 5 USC 5332 equivalent of the rate in effect for grade GS-18 of the General Schedule note. for each day (including traveltime) they are engaged in the performTravei aucB of their duties as members of the Commission. All members of expenses. the Commission shall be entitled to reimbursement for travel, subsistence, and other necessary expenses incurred by them in the performance of their duties as members of the Commission. (e) The Commission shall formulate a long-range plan to combat diabetes mellitus with specific recommendations for the utilization and organization of national resources for that purpose. Such a plan shall be based on a comprehensive survey investigating the magnitude of diabetes mellitus, its epidemiology, and its economic and social consequences and on an evaluation of available scientific information and the national resources capable of dealing with the problem. The plan shall include a plan for a coordinated research program encompassing programs of the National Institute of Arthritis, Metabolism, and Digestive Diseases, the National Eye Institute, the National Institute of Neurological Diseases, the National Heart and Lung Institute, the

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National Institute of General Medical Sciences, the National Institute of Child Health and Human Development, and the National Institute of Dental Eesearch, and other Federal and non-Federal programs. The Investigation, coordinated research program shall provide for— s t u d i e s and (1) investigation in the epidemiology, etiology, prevention, r e s e a r c h proand control of diabetes mellitus, including investigation into the grams social, environmental, behavioral, nutritional, biological, and genetic determinants and influences involved in the epidemiology, etiology, prevention, and control of diabetes mellitus; (2) studies and research into the basic biological processes and mechanisms involved in the underlying normal and abnormal phenomena associated with diabetes mellitus, including abnormalities of the skin, cardiovascular system, kidneys, eyes, and nervous system, and evaluation of influences of other endocrine hormones on the etiology, treatment, and complications of diabetes mellitus; (3) research into the development, trial, and evaluation of techniques and drugs used in, and approaches to, the diagnosis, treatment, and prevention of diabetes mellitus; (4) establishment of programs that will focus and apply scientific and technological efforts involving biological, physical, and engineering science to all facets of diabetes mellitus; (5) establishment of programs for the conduct and direction of field studies, large-scale testing and evaluation, and demonstration of preventive diagnostic, therapeutic, rehabilitative, and control approaches to diabetes mellitus; (6) the education and training of scientists, clinicians, educators, and allied health personnel in the fields and specialties requisite to the conduct of programs respecting diabetes mellitus; (7) a system for the collection, analysis, and dissemination of all data useful in the prevention, diagnosis, and treatment of diabetes mellitus; (8^ appropriate distribution of resources between basic and applied research. The long-range plan formulated under this subsection shall also include within its scope related endocrine and metabolic diseases and basic biological processes and mechanisms, the better understanding of which is essential to the solution of the problem of diabetes mellitus. (f) In the development of the long-range plan under subsection (e), attention shall be given to means to assure continued development of knowledge, and dissemination of such knowledge to the public, which would form the basis of future advances in the understanding, treatment, and control of diabetes mellitus. (g) The Commission may hold such hearings, take such testimony, H e a r i n g s. and sit and act at such time and places as the Commission deems advisable to develop the long-range plan required by subsection (e). Budget (h)(1) The Commission shall prepare for each of the Institutes m a t e s. e s t i whose programs are to be encompassed by the plan for a coordinated diabetes research program described in subsection (e) budget estimates for each Institute's part of such program. The budget estimates shall be prepared for the fiscal year ending June 30, 1976, and for each of the next two fiscal years. Budget e t i (2) Within five days after the Budget for the fiscal year ending mates from sHEW, June 30, 1976, and the Budget for each of the next two fiscal years is t r a n s m i t t a l to con r transmitted by the President to the Congress the Secretary shall trans- c o mgm etstseieosn. a l i mit to the Committees on Appropriations of the House of Representatives and the Senate, the Committee on Labor and Public Welfare

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F i n a l report to Congress.

Termination.

Appropriation.

PUBLIC LAW 93-354^JULY 23, 1974

[88 STAT.

of the Senate, and the Committee on Interstate and Foreign Commerce of the House of Representatives an estimate of the amounts recjuested for each of the Institutes for diabetes research, and a comparison of such amounts with the budget estimates prepared by the Commission under paragraph (1). (i)(1) The Commission shall publish and transmit directly to the Congress (without prior administrative approval) a final report within nine months after the date funds are first appropriated for the implementation of this section. Such report shall contain the longrange plan required by subsection (e), the budget estimates required by subsection (h), and any recommendations of the Commission for legislation. (2) The Commission shall cease to exist on the thirtieth day following the date of the submission of its final report pursuant to paragraph (1) of this subsection. (j) There are authorized to be appropriated to carry out the purposes of this section $1,000,000. DIABETES MELLTTUS P R E V E N T I O N A N D CONTROL PROGRAMS

42 USC 247b.

SEC. 4. Section 317 of the Public Health Service Act is amended— (1) by striking out "communicable disease control" each place it occurs and inserting in lieu thereof "communicable and other disease control"; (2) by striking out "communicable diseases" in subsection (a) and inserting in lieu thereof "communicable or other diseases"; (3) by striking out "communicable disease program" in subsection (a) and inserting in lieu thereof "communicable or other disease control program"; (4) by striking out "communicable disease" in subsection (b) (2)(C)(i) and inserting in lieu thereof "communicable or other disease"; (5) by striking out "Rh disease," in subsection (h)(1) and by inserting "diabetes mellitus and Rh disease and" before "tuberculosis" in that subsection; and (6) by striking out "COMMUNICABLE" in the section hea^pig. RESEARCH A N D T R A I N I N G C E N T E R S; DIABETES COORDINATING A N D GENERAL AUTHORITY

COMMITTEE

S E C 5. (a) Part D of title IV of the Public Health Service Act is amended by adding at the end thereof the following new sections: " D I A B E T E S RESEARCH A N D T R A I N I N G 42 USC 289c-2.

CENTERS

"SEC. 435. (a) Consistent with applicable recommendations of the National Commission on Diabetes, the Secretary shall provide for the development, or substantial expansion, of centers for research and training in diabetes mellitus and related endocrine and metabolic disorders. Each center developed or expanded under this section shall (1) utilize the facilities of a single institution, or be formed from a consortium of cooperating institutions, meeting such research and training qualifications as may be prescribed by the Secretary; and (2) conduct (A) research in the diagnosis and treatment of diabetes mellitus and related endocrine and metabolic disorders and the complications resulting from such disease or disorders, (B) training programs for physicians and allied health personnel in current methods of diagnosis and treatment of such disease, disorders, and complications, and (C) information programs for physicians and allied health personnel who provide primary care for patients with such disease, disorders, or com-

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