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90 STAT. 2287

liable to the United States for the amount which has been paid to him, OT^bn his behalf, under the contract. ^ "(c) If an individual breaches his written contract by failing (for any reason) either to begin such individual's service obligation in accordance with section 752 or 753 or to complete such service obligation, the United States shall be entitled to recover from the individual an amount determined in accordance with the formula

-3*(^0 in which 'A' is the amount the United States is entitled to recover. '0' is the sum of the amount paid under this subpart to or on behali of the individual and the interest on such amount which would be payable if at the time it was paid it was a loan bearing interest at the maximum legal prevuiling rate, as determined by the Treasurer of the United States; 't' is the total number of months in the individual's period of obligated service; and 's' is the number of months of such period served by him in accordance with section 752 or a written agreement under section 753. Any amount of damages which the United States is entitled to recover under this subsection shall, within the one year period beginning on the date of the breach of the written contract, be paid to the United States. "(d)(1) Any obligation of an individual under the Scholarship Program (or a contract thereunder) for service or payment of damages shall be canceled upon the death of the individual. "(2) The Secretary shall by regulation provide for the waiver or suspension of any obligation of service or payment by an individual under the Scholarship P r o - a m (or a contract thereunder) whenever compliance by the individual is impossible or would involve extreme hardship to the individual and if enforcement of such obligation with respect to any individual would be unconscionable. "(3) Any obligation of an individual under the Scholarship Program (or a contract thereunder) for payment of damages may be released by a discharge in bankruptcy under title 11 of the United States Code only if such discharge is granted after the expiration of 11 USC 1 et seq. the five-year period beginning on the first date that payment of such damages is required. "SPECIAL GRANTS FOR FORMER CORPS MEMBERS TO ENTER PRIVATE PRACTICE

"SEC. 755. (a) The Secretary may make one grant to an individual 42 USC 294x. (other than an individual who has entered into an agreement under section 763)— "(1) who has completed his period of obligated service in the Corps, and "(2) who has agreed in writing— Agreement. "(A) to engage in the private full-time clinical practice of his profession in a health manpower shortage area (designated under section 332 and described in paragraphs (1) Ante, p. 2270. and (2) of section 753(a)) for a period (beginning not later than one year after the date he completed his period of obligated service in the Corps) of not less than one year; " (B) to conduct such practice in accordance with the provisions of section 753(b)(1); and ' "(C) to such additional conditions as the Secretary may require to carry out the purposes of this section;

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 90 STAT. 2288

Breach of agreement, notification.

PUBLIC LAW 94-484—OCT. 12. 1976 to assist such individual in meeting the costs of beginning the practice of such individual's profession in accordance with such agreement, including the costs of acquiring equipment and renovating facilities for use in providing health services, and of h i r i n g nurses and other personnel to assist in providing health services. Such g r a n t may not be used for the purchase or construction of any building. " (b) The amount of the g r a n t under subsection (a) to an individual shall be— " (1) $12,500, if the individual agrees to practice his profession in accordance with the agreement for a period of at least one year, but less than two year s; or " (2) $25,000 if the individual agrees to practice his profession in accordance with the agreement for a period of a t least two years. " (c) The Secretary may not make a g r a n t under this section unless an application therefor has been submitted to, and approved by, the Secretary. " (d) I f the Secretary determines that an individual has breached a written agreement entered into under subsection (a), he shall, as soon j^g practicable after making such determination, notify the individual of such determination. I f within 120 days after the date of giving such notice, such individual is not practicing his profession in accordance with the agreement under such subsection and has not provided assurances satisfactory to the Secretary that he will not knowingly violate such agreement again, the United States shall be entitled to recover from such individual an amount determined under section 754(c), except that in applying the formula contained in such section, '0' snail be the sum of the amount of the g r a n t made under subsection (a) to such individual and the interest on such amount which would be payable if at the time it was paid it was a loan bearing interest a t the maximum legal prevailing rate, 't' shall be the number of months that such individual agreed to practice his profession under such agreement, and 's' shall be the number of months that such individual practices his profession in accordance with such agreement.

((AUTHORIZATION 42 USC 294y.

42 USC 294t °°*®'

Bte, p. 415.

OF APPROPRIATIONS

" SEC. 756. (a) There are authorized to be appropriated for scholarships under this subpart $75,000,000 for the fiscal year ending September 30, 1978, $140,000,000 for the fiscal year ending September 30, 1979, and $200,000,000 for the fiscal year ending September 30, 1980. For the fiscal year ending September 30, 1981, and for each of the two succeeding fiscal years, there are authorized to be appropriated such sums as may be necessary to continue to make scholarship awards to students who have entered into written contracts under the Scholarship Program before October 1, 1980. " (b) Of the sums appropriated under this section (1) 90 percent shall be obligated for sdiolarships for medical, osteopathic, and dental students, and (2) 10 percent of such 90 percent shall be obligated for scholarships for dental students,". (2)(A) Except as provided in subparagraph (B), the amendment made by paragraph (1) of this subsection shall applj^ w i t h respect to scholarships awarded under the National Health Service Corps Scholarship Program from appropriations for such Program for fiscal years beginning after September 30, 1977. (B) The provisions of section 2 2 5 (f)(1) of the P u b l i c Health Service Act (as in effect on September 30, 1977) prescribing the

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90 STAT. 2289

financial obligation of a participant in the Public Health and National Health Service Corps Scholarship Program who fails to complete an active duty service obligation incurred under that Program shall apply to any individual who received a scholarship under such Program for any school year ending before September 30, 1977, irrespective of whether such individual received such a scholarship after that date. (C) Periods of internship or residency served before September 30, 1976, in a facility of the National Health Service Corps or other facility of the Public Health Service in accordance with an agreement entered into under section 225(b) of the Public Health Service Act 42 USC 234. (as in effect before that date) shall be creditable in satisfying a service obligation incurred under the Public Health and National Health Service Corps Scholarship Program as revised by this subsection. (c) Effective October 1, 1977, part C of title VII (as amended by 42 USC 294z subsections (a) and (b)) is amended by adding after subpart IV the note. following new subpart: "Subpart V—Other Scholarships " S C H O L A R S H I P S FOR FIRST-TEAR

S T U D E N T S o r EXCEPTIONAL FINANCIAIj

NEED

"SEC. 758. (a) The Secretary shall make grants to a public or nonprofit school of medicine, osteopathy, dentistry, optometry, pharmacy, podiatry, or veterinary medicine which is accredited as provided in section 721(b)(1)(B), for scholarships to be awarded by the school to full-time students thereof who are of exceptional financial need and who are in their first year of study at such school in the school year ending in the fiscal year in which such grant is made. "(b)(1) Scholarships may be awarded by a school from a grant under subsection (a) only to individuals who have been accepted by it for enrollment as full-time students in their first year of study at such school. "(2) A scholarship awarded to a student for a school year under a grant made under subsection (a) shall be the scholarship described in section 751(g). "(3) For purposes of this section, the term 'first year of study* means, with respect to a student of a school other than a school ol pharmacy, the student's first year of postbaccalaureate study at such school. "(c) The Secretary shall distribute grants under this section among all schools of the health professions, but shall give priority in distributing such grants to schools of medicine, osteopathy, and dentistry. "(d) For the purpose of making grants under this section, there is authorized to be appropriated $16,000,000 for the fiscal year ending September 30, 1978, $17,000,000 for the fiscal year ending September 30, 1979, and $18,000,000 for the fiscal year ending September 30, 1980.

Grants. 42 USC 294z.

"First year of study."

Appropriation authorization.

"LISTER HILL SCHOLARSHIP PROGRAM

"SEC. 759. (a) The Secretary annually shall make grants to at least 10 individuals (to be known as Lister Hill scholars) for scholarships of up to $8,000 per year for up to four years of medical school if such individuals agree to enter into the family practice of medicine in a health manpower shortage area in accordance with this section. Grants made under this section shall be made only from funds appropriated under subsection (b).

Grants. 42 USC 294aa.

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 90 STAT. 2290 Appropriation authorization.

PUBLIC LAW 94-4«4—OCT. 12, 1976 "(b) There are authorized to be appropriated to carry out the purposes of this section $80,000 for the fiscal year ending September 30, 1977, $160,000 for the fiscal year ending September 30, 1978, $240,000 for the fiscal year ending September 30, 1979, and $320,000 for the fiscal year ending September 30, 1980. For the fiscal year ending September 30, 1981 and for each succeeding fiscal year, there are authorized to be appropriated such sums as may be necessary to continue to make such grants to students who (prior to October 1, 1980) have received such a grant under this section during such succeeding fiscal year.". SCHOLARSHIPS

Repeal. 42 USC 295g, 295g-l, 295g-ll, 295g-21295g-23. Grants. 42 USC 295g note. 42 USC 295g.

42 USC 295g-21.

SEC. 409. (a) Effective October 1, 1976, subparts I, II, and III of part F of title VII are repealed. (b) The Secretary of Health, Education, and Welfare during the period beginning October 1, 1976, and ending September 30, 1979, may (1) make grants under section 780 of the Public Health Service Act (as in effect before October 1, 1976) to public and nonprofit private schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, and pharmacy to enable such schools to continue making payments under scholarship awards to individuals enrolled and in good standing as full-time students who initially received such awards out of grants made to the schools under such section 780 for fiscal years ending before October 1, 1976, and (2) make scholarship grants under section 784 of such Act (as in effect before October 1, 1976) to individuals enrolled and in good standing as medical students who initially received such grants before October 1, 1976. TITLE V—GKANTS FOR H E A L T H PROFESSIONS SCHOOLS GRANT A M O U N T S; AUTHORIZATIONS

42 USC 295f.

SEC. 501. (a) Section 770(a) is amended to read as follows: " (a) GRANT COMPUTATION.—The Secretary shall make annual grants to schools of medicine, osteopathy, dentistry, public health, veterinary medicine, optometry, pharmacy, and podiatry for the support of the education programs of such schools. The amount of the annual grant to each such school with an approved application shall be computed for each fiscal year as follows: "(1) Each school of medicine, osteopathy, and dentistry shall receive— "(A) for the fiscal year ending September 30, 1978, $2,000 for each full-time student enrolled in such school in the school year beginning in such fiscal year, "(B) for the fiscal year ending September 30, 1979, $2,050 for each full-time student enrolled in such school in the school year beginning in such fiscal year, and "(C) for the fiscal year ending September 30, 1980, $2,100 for each full-time student enrolled in such school in the school year beginning in such fiscal year. " (2)(A) Each school of public health shall receive for the fiscal year ending September 30, 1978, and for each of the next two fiscal years an amount equal to the product of— "(i) $1,400, and "(ii) the sum of (I) the number of full-time students enrolled in such school in the school year beginning in such

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90 STAT. 2291

fiscal year, and ( II) the number of full-time equivalents of part-time students, determined pursuant to subparagraph (B), for such school for such school year. "(B) For purposes of subparagraph (A) the number of fulltime equivalents of part-time students for a school of public health for any school year is a number equal to— " (i) the total number of credit hours of instruction in such year lor which part-time students of such school, who are pursuing a course of study leading to a graduate degree in public health or an equivalent degree, have enrolled, divided by "(ii) the greater of (I) the number of credit hours of instruction which a full-time student of such school was required to take in such year, or ( II) 9, rounded to the next highest whole number. "(3) For the fiscal year ending September 30, 1978, and for each of the next two fiscal years, each school of veterinary medicine shall receive $1,450 for each full-time student enrolled in such school in the school year beginning in such fiscal year. "(4) For the fiscal year ending September 30, 1978, and for each of the next two fiscal years, each school of optometry shall receive $765 for each full-time student enrolled in such school in the school year beginning in such fiscal year. "(5) For the fiscal year ending September 30, 1978, and for each of the next two fiscal years, each school of pharmacy (other than a school of pharmacy with a course of study of more than four years) shall receive $695 for each full-time student enrolled in such school in the school year beginning in such fiscal year. Each school of pharmacy with a course of study of more than four years shall receive $695 for each full-time student enrolled in the last four years of such school. For purposes of section 771, a Post, p. 2293. student enrolled in the first year of the last four years of such school shall be considered a first-year student. "(6) For the fiscal year ending September 30, 1978, and for each of the next two fiscal years, each school of podiatry shall receive $965 for each full-time student enrolled in such school in the school year beginning in such fiscal year.", (b) Subsection (b) of section 770 is amended to read as follows: '*2 USC 295f. "(b) APPORTIONMENT OF APPROPRIATIONS.—Notwithstanding subsec-

tion (a), if the aggregate of the amounts of the grants to be made in accordance with such subsection for any fiscal year to schools of either medicine, osteopathy, dentistry, public health, veterinary medicine, optometry, pharmacy, or podiatry with approved applications exceeds the total of the amounts appropriated for such category of schools under the appropriate paragraph of subsection (e) for such grants, the amount of a school's grant with respect to which such excess exists shall for such fiscal year be an amount which bears the same ratio to the amount determined for the school under subsection (a) as the total of the amounts appropriated for that year under the appropriate paragraph of subsection (e) for grants to schools of the same category as such school bears to the amount required to make grants in accordance with subsection (a) to each of the schools of that category with approved applications.". (c)(1) Subsections (c), (d), (e), (f), and (g) of section 770 are Repeal, repealed. (2) Subsection (h) of section 770 is (A) redesignated as subsection (c), and (B) is amended to read as follows:

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 90 STAT. 2292

PUBLIC LAW 94-484—OCT. 12, 1976 "(c)

"Full time students."

42 USC 295f.

ENROLLMENT DETERMINATIONS.—

" (1) For purposes of this section, regulations of the Secretary shall include provisions relating to the determination of the number of students enrolled in a school or in a particular year-class in a school on the basis of estimates, on the basis of the number of students who in an earlier year were enrolled in a school or in a particular year-class, or on such other basis as he deems appropriate for making such determination, and shall include methods of making such determination when a school or a year-class was not in existence in an earlier year at a school. "(2) For purposes of this section, the term 'full-time students' (whether such term is used by itself or in connection with a particular year-class) means students pursuing a full-time course of study leading to a degree of doctor of medicine, doctor of dentistry or an equivalent degree, doctor of osteopathy, bachelor or master of science in pharmacy or an equivalent degree, doctor of optometry or an equivalent degree, doctor of veterinary medicine or an equivalent degree, or doctor of podiatry or an equivalent degree or to a graduate degree in public health or equivalent degree. In the case of a training program of a school designed to permit the students enrolled in such program to complete, within six years after completing secondary school, the requirements for degree of doctor of medicine, doctor of dentistry or an equivalent degree, or doctor of osteopathy, the term 'full-time students' shall only include students enrolled on a full-time basis in the last four years of such program and for purposes of section 771, students enrolled in the first of the last four years of such program shall be considered as first-year students.". (3) Subsection (i) of section 770 is amended (A) by inserting ", public health" after "dentistry", (B) by striking out "and (b)", and (C) by redesignating it as subsection (d). (4) Subsection (j) of section 770 is redesignated as subsection (e) and is amended to read as follows: "(e) AUTHORIZATIONS or APPROPRIATIONS.—

"(1) There are authorized to be appropriated $124,182,000 for the fiscal year ending September 30, 1978, $131,683,800 for the fiscal year ending September 30, 1979, and $139,400,100 for the fiscal year ending September 30, 1980, for payments under grants under this section to schools of medicine. "(2) There are authorized to be appropriated $8,680,000 for the fiscal year ending September 30, 1978, $9,337,750 for the fiscal year ending September 30, 1979, and $10,159,800 for the fiscal year ending September 30, 1980, for payments under grants under this section for schools of osteopathy. "(3) There are authorized to be appropriated $43,798,000 for the fiscal year ending September 30, 1978, $45,409,550 for the fiscal year ending September 30, 1979, and $46,909,800 for the fiscal year ending September 30, 1980, for payments under grants under this section for schools of dentistry. "(4) There are authorized to be appropriated $9,739,800 for the fiscal year ending September 30, 1978, $10,462,200 for the fiscal year ending September 30, 1979, and $11,060,000 for the fiscal year ending September 30, 1980, for payments under grants under this section to schools of public health. "(5) There are authorized to be appropriated $10,219,000 for the fiscal year ending September 30, 1978, $10,548,750 for t ho fiscal year ending September 30, 1979, and $10,705,350 for the fiscal

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90 STAT. 2293

year ending September 30, 1980, for payments under grants under this section to schools of veterinary medicine. "(6) There are authorized to he appropriated $3,204,585 for the fiscal year ending September 30, 1978, $3,272,670 for the fiscal year ending September 30, 1979, and $3,366,000 for the fiscal year ending September 30, 1980, for payments under grants under this section to schools of optometry. "(7) There are authorized to be appropriated $16,989,970 for the fiscal year ending September 30, 1978, $17,110,205 for the fiscal year ending September 30, 1979, and $17,368,050 for the fiscal year ending September 30, 1980, for payments under grants under this section to schools of pharmacy. "(8) There are authorized to be appropriated $2,267,750 for the fiscal year ending September 30, 1978, $2,270,645 for the fiscal year ending September 30, 1979, and $2,285,120 for the fiscal year ending September 30, 1980, for payments under grants under this section to schools of podiatry.". (d) For the fiscal year ending September 30, 1978, and for each of 42 USC 295f the next two fiscal years, there are authorized to be appropriated "o*®such sums as may be necessary to continue to make annual grants to schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, and podiatry under section 770(a) of the Public Health Service Act (as in effect on September 30, 1977) based on the 42 USC 295f. number of enrollment bonus students (determined in accordance with subsections (d) and (e) of section 770 of such Act (as so in effect)) enrolled in such schools who were first-year students in such schools for school years ending before September 30, 1977, except that the amount of any grant made to such a school from sums appropriated under this subsection may not exceed the amount of the grant the school received in the fiscal year ending September 30, 1977, based on the number of such students enrolled in it. (e) Effective October 1, 1977, the heading for part E of title VII is amended to read as follows: "PART E—GRANTS To IMPROVE THE QUALITY or SCHOOLS OF MEDICINE, OSTEOPATHY, DENTISTRY, PUBLIC HEALTH, VETERINARY MEDICINE, OPTOMETRY, PHARMACY, AND PODIATRY".

(f) The amendments made by subsections (a), (b), and (c) shall Effective date, apply with respect to appropriations under section 770 of the Public 42 USC 295f Health Service Act, and grants under that section, for fiscal years note, beginning after September 30, 1977. GRANT REQUIREMENTS

SEC. 502. Effective with respect to fiscal years beginning after September 30, 1977, part E of title VII is amended (1) by striking out sections 771, 772, 773, and 774, and (2) by adding after section 770 42 USC the following new section: 295f-l295f-4. 'ELIGIBILITY FOR CAPITATION GRANTS

"SEC. 771. (a) IN GENERAL.—The Secretary shall not make a grant 42 USC 295f-l. under section 770 to any school in a fiscal year beginning after September 30, 1977, unless the application for the grant contains, or is supported by, assurances satisfactory to the Secretary that— "(1)_ the first-year enrollment of full-time students in the school in the school year beginning in the fiscal year in which the

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 90 STAT. 2294

Ante, p. 2290.

PUBLIC LAW 94-484—OCT. 12, 1976 grant applied for is to be made will not be less than the first-year enrollment of such students in the school in the preceding scnool year or in the school year beginning in the fiscal year ending September 30, 1976, whichever is greater; and "(2) the applicant will expend in carrying out its functions as a school of medicine, osteopathy, dentistry, public health, veterinary medicine, optometry, pharmacy, or podiatry, as the case may be, during the fiscal year for which such grant is sought, an amount of funds (other than funds for construction as determined by the Secretary) from non-Federal sources which is at least as great as the amount of funds expended by such applicant for such purpose (excluding expenditures of a nonrecurring nature) in the fiscal year preceding the fiscal year for which such grant is sought. "(b)(1) Mia)iCAL SCHOOLS.—To be eligible for a grant under section 770 each school of medicine shall, in addition to the requirements of subsection (a), meet the applicable requirements of paragraphs (2) and (3). " (2)(A)(i) Unless, as determined under subparagraph (B), the number of filled first year positions on July 15, 1977, in direct or affliated medical residency training programs in primary care is at least 35 percent of the number of filled first year positions on that date in all direct or affiliated medical residency training programs, to be eligible for a grant under section 770 for the fiscal year ending September 30, 1978, a school of medicine shall have on July 15, 1978, at least 35 percent of its filled first year positions, as determined under subparagraphs (C) and (D), in its direct or affiliated medical residency training programs in nrst year positions in such programs in primary care. "(ii) Unless, as determined under subparagraph (B), the number of filled first year positions on July 15, 1978, in direct or affiliated medical residency training programs in primary care is at least 40 percent of the number of filled first year positions on that date in all direct or affiliated medical residency training programs, to be eligible for a grant under section 770 for the fiscal year ending September 30, 1979, a school of medicine shall have on July 15, 1979, at least 40 percent of its filled first year positions, as determined under subparagraphs (C) and (D), in its direct or affiliated medical residency training programs in nrst year positions in such programs in primary care, "(iii) Unless, as determined under subparagraph (B), the number of filled first year positions on July 15 of any year (beginning with 1979) in direct or affiliated medical residency training programs in primary care is at least 50 percent of the number of filled first year positions on that date in all direct or affiliated medical residency training programs, to be eligible for a grant under section 770 for the fiscal year ending on September 30 of the following year, a school of medicine shall have on July 15 of such following year at least 50 percent of its filled first year positions, as determined under subparagraphs (C) and (D), in its direct or affiliated medical residency training programs in first year positions in such programs in primary care. "(B) The Secretary shall determine what percent of all the positions filled, as of July 15, 1977, and July 15 of each subsequent year, in all direct or affiliated medical residency training programs are filled positions in such programs in primary care. In determining the number of such positions in primary care on July 15, 1977, or on July 15 of a subsequent year, the Secretary shall deduct from such number a number equal to the number of individuals who were in a first year

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90 STAT. 2295

position in any direct or affiliated medical residency training program m primary care as of July 15 of the previous year and who on the date for which the determination is to be made were not in any direct or affiliated medical residency training program in primary care. Each Publication in determination under this subparagraph shall, not later than 45 days Federal Register; after the date for which the determination is made, be published in the report to medical schools and Federal Register and reported in writing to each school of medicine in congressional the States and to the Committee on Interstate and Foreign Commerce committees. of the House of Representatives and to the Committee on Labor and Public Welfare of the Senate. "(C) In determining if a school of medicine meets an applicable requirement of clause (i), (ii), or (iii) of subparagraph (A) for a fiscal year, the number of filled first year positions in direct or affiliated medical residency training programs of such school in primary care on July 15 in such fiscal year shall be reduced by the number of individuals who were in a first year position in a direct or affiliated medical residency training program of such school in primary care on July 15 in the previous fiscal year and who on July 15 in the fiscal year to which the requirement applies were not in a direct or affiliated medical residency training program of such school in primary care. Each determination, with respect to a school, under this subparagraph Determination; shall, not later than 45 days after the date on which the determination report to medical is made, be reported in writing to siich school and to the Committee school and on Interstate and Foreign Commerce bf the House of Representatives congressional committees. and to the Committee on Labor and Public Welfare of the Senate. "(D) The requirement under subparagraph (A) that a school of medicine have a particular percent of its filled first-year positions in its direct or affiliated medical residency training programs in primary care on a date in order to be eligible for a grant under section 770 shall •^'»'«» P- 2290. be waived by the Secretary if he determines that (i) such school has made a good faith effort to comply with such requirement, and (ii) such school has at least 98 percent of such percent of such positions in primary care on such date. " (E) The Secretary shall not make any grant under section 770 Notice and to a school of medicine for any fiscal year if the Secretary, after pro- hearing. viding notice and opportunity for a hearing, determines that in the fiscal year such school— "(i) terminated or failed to renew an affiliation with a medical resiaency training program for the purpose of meeting the requirements of this paragraph, and "(ii) after such a termination or failure to renew, provided support for such medical residency training program (including any interchange of medical residents, students, or faculty between the school and such program, the offering of amr faculty position at such school to any individual on the staff of such entity who has any responsibility for such program, or the provision or receipt by such school of any funds for such program). " (F) For purposes of this paragraph: Definitions. "(i^ The term 'direct or affiliated medical residency training program means a medical residency training program with which a school of medicine is affiliated or has a similar arrangement (including any arrangement which provides for any interchange of medical residents, students, or faculty between the school and such program, the offering of any faculty position at such school to any individual on the staff of such entity who has any responsibility for such program, or the provision or receipt by such school of any funds for such program), as determined under regulations of the Secretary, or which is primarily conducted in facilities owned by a school ot medicine.

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 90 STAT. 2296

Ante, p. 2290.

Ante, p. 2243.

Waiver.

PUBLIC LAW 94-484—OCT. 12, 1976 "(ii) The term 'primary care' means general internal medicine, family medicine, or general pediatrics. "(iii) The term 'medical residency training program' means a program which trains graduates of schools of medicine and schools of osteopathy in a medical specialty and which provides the graduate education required by the appropriate specialty board for certification in such specialty. Such term does not include a residency training program in an osteopathic hospital. "(3)(A) To be eligible for a grant under section 770 a school of medicine shall, in its application for such grant, give assurances satisfactory to the Secretary that, except as provided in subparagraphs (C) and (D), the school will reserve positions, in the school year beginning immediately before the fiscal year for which such grant is applied for, for students described in subparagraph (B). "(B) No later than August 15, 1977, and August 15 of each of the next two years, the Secretary shall identify the citizens of the United States who, before the date of enactment of the Health Professions Educational Assistance Act of 1976, were students in a school of medicine not in a State and who by the date of the identification made under this subparagraph— "(i) successfully completed at least two years in such school of medicine, and "(ii) successfully completed part I of the National Board of Medical Examiners' examination (or any successor to such examination). The Secretary shall equitably apportion a number of positions adequate to fill the needs of students described in subparagraph (B) among the schools of medicine in the States. "(C) A school of medicine shall not be required to enroll a student described in subparagraph (B) if— "(i) the individual does not meet, as determined under guidelines established by the Secretary by regulation, the entrance requirements of the school (other than requirements related to academic qualifications or to place of residence), or "(ii) enrollment of such individual will, as determined by the Secretary after consultation with the appropriate accreditation body, result in the school's not meeting the accreditation standards of such body. "(D) The Secretary may waive the requirements of this paragraph upon a finding that, because of the inadequate size of the population served by the hospital or clinical facility in which such school conducts its clinical training, compliance by such school with such assurances will prevent such school from providing high quality clinical training for the students added by the application of this paragraph to such school. "(c) SCHOOLS OF OSTEOPATHY.—(1) To be eligible for a grant under section 770 for a fiscal year beginning after September 30, 1977, a school of osteopathy shall, in addition to the requirements of subsection (a), submit to the Secretary and have approved by him before the grant applied for is made, a plan to train full-time students in ambulatory care settings, in the school year beginning in the fiscal year for which the grant is made and in each school year thereafter beginning in a fiscal year for which such a grant is made, either in areas geographically remote from the main site of the teaching facilities of the applicant (or any other school of osteopathy which has joined with the applicant in the submission of the plan) or in areas in which medically underserved populations reside.

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 PUBLIC LAW 94-464—OCT. 12, 1976

90 STAT. 2297

"(2^ More than one applicant may join in the submission of a plan described in paragraph (1). No plan may be approved by the Secretary unless— "(A) the application for a grant under section 770 of each Ante, f. 2290. school which has joined in the submission of the plan contains or is supported by assurances satisfactory to the Secretary that all of the full-time students who will graduate from such school will upon graduation have received at least 6 weeks (at least 3 of which shall be consecutive) of clinical training in an area vvliich is geographically remote from the main site of the training facilities of such school or in which medically underserved popuhitions reside; "(B) the plan contains a list of the areas where the training under such plan is to be conducted, a detailed description of the type and amount of training to be given in such areas, and provision for periodic review by experts in osteopathic education of the desirability of providing training in such areas and of the quality of training rendered in such areas; "(C) the plan contains a specific program for the appointing, as members of the faculty of the school or schools submitting the plan, of practicing physicians to serve as instructors in the training program in such areas; and "(D) the plan contains a plan for frequent counseling and consultation between the faculty of the school or schools at the main site of their training facilities and the instructors in the training program in such areas, "(d) SCHOOLS or DENTISTRY.— (1) To be eligible for a grant under section 770 for a fiscal year beginning after September 30, 1977, a school of dentistry shall, in addition to the requirements of subjection (a), meet the requirements of paragraph (2) and of paragraph (3) or (4). "(2) In the school year beginning in the fiscal year ending September 30, 1978, and in each school year thereafter beginning m a fiscal year for which a grant under section 770 is applied for, at least 70 percent of a school of dentistry's filled positions in dental specialty programs which are in excess of the number of filled positions in its programs in the school year beginning in the fiscal year ending September 30, 1977, shall be positions in dental specialty programs m general dentistry or pedodontics. "(3) A school of dentistry shall maintain an enrollment of fulltime first-year students, for the school year beginning in the fiscal year ending September 30, 1978, and for each school year thereafter beginning in a fiscal year for which a grant under section 770 is applied for, which exceeds the number of full-time, first-year students enrolled in such school in the school year beginning in the fiscal year ending September 30, 1976— "(A) by 10 percent of such number if such number was not more than 100, or "(B) by 5 percent of such number, or 10 students, whichever is greater, if such number was more than 100. "(4)(A) A school of dentistry shall submit to the Secretary and have approved by him before the grant applied for is made, a plan to train full-time students in ambulatory care settings, in the school year beginning in the fiscal year for which the grant is made and in each school year thereafter beginning in a fiscal year for which such a grant is made, either in areas geographically remote from the main site of the teaching facilities of the applicant (or any other school of

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Page:United States Statutes at Large Volume 90 Part 2.djvu/830

 90 STAT. 2298

Ante, p. 2290.

PUBLIC LAW 94-4«4—OCT. 12, 1976 dentistry which has joined with the applicant in the submission of the plan) or in areas in which medically underserved populations reside. "(JB) More than one applicant may join in the submission of a plan described in subparagraph (A). No plan may be approved by the Secretary unless— "(i) the application for a grant under section 770 of each school which has joined in the submission of the plan contains or is supported by assurances satisfactory to the Secretary that all of the full-time students who will graduate from such school will upon graduation have received at least 6 weeks (in the aggregate) of clinical training in an area which is geographically remote from the main site of the training facilities of such school or in which medically underserved populations reside; "(ii) the plan contains a list of the areas where the training under such plan is to be conducted, a detailed description of the type and amount of training to be given in such areas, and provision for periodic review by experts in dental education of the desirability of providing training in such areas and of the quality of training rendered in such areas; "(iii) the plan contains a specific program for the appointing, as members of the faculty of the school or schools submitting the plan, of practicing dentists to serve as instructors in the training program in such areas; and "(iv) the plan contains a plan for frequent counseling and consultation between the faculty of the school or schools at the main site of their training facilities and the instructors in the training program in such areas. "(e) SCHOOLS OF PUBLIC HEALTH.—(1) To be eligible for a grant under section 770 for a fiscal year beginning after September 30, 1977, a school of public health shall, in addition to the requirements of subsection (a), maintain an enrollment of full-time, first-year students, for the school year beginning in the fiscal year ending September 30, 1978, and for each school year thereafter beginning in a fiscal year for which a grant under section 770 is applied for, which exceeds the number of full-time, first-year students enrolled in such school in the school year beginning in the fiscal year ending September 30, 1976— " (A) by 5 percent of such number if such number was not more than 100, or "(B) by 2.5 percent of such number, or 5 students, whichever is greater, if such number was more than 100. "(2) The Secretary may waive (in whole or in part) application to a school of public health of the rec[uirement of paragraph (1) if the Secretary determines, after receiving the written recommendation of the appropriate accreditation body or bodies (approved for such purpose by the Commissioner of Education) that compliance by such school with such requirement will prevent it from maintaining its accreditation. "(f)

SCHOOLS OF VETERINARY MEDICINE.—(1) To be eligible for

a

grant under section 770 for a fiscal year beginning after September 30, 1977, a school of veterinary medicine shall, in addition to the requirements of subsection (a), meet the requirements of paragraph (2) and paragraph (3) or (4). "(2) An application of a school of veterinary medicine for a grant under section 770 shall contain or be supported by assurances satisfactory to the Secretary that the clinical training of the school shall emphasize predominantly care to food-producing animals or to fibreproducing animals, or to both types of animals.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/831

 PUBLIC LAW 94-484—OCT. 12, 1976

90 STAT. 2299

"(3) A school of veterinary medicine shall maintain an enrollment of full-time, first-year students, for the school year beginning in the fiscal year ending September 30, 1978, and for each school year thereafter beginning in a fiscal year for which a grant under section 770 is Ante, p. 2290. applied for, which exceeds the number of full-time, first-year students enrolled in such school in the school year beginning in the fiscal year ending September 30, 1976— " (A) by 5 percent of such number if such number was not more than 100, or "(B) by 2.5 percent of such number, or 5 students, whichever is greater, if such number was more than 100. " (4) An application of a school of veterinary medicine shall contain or be supported by assurances satisfactory to the Secretary that for the school year beginning in the fiscal year for which a grant is made under section 770 at least 30 percent of the enrollment of fulltime, first-year students in such school will be comprised of students who are residents of States in which there are no accredited schools of veterinary medicine. "(g) SCHOOLS or OPTOMETRY,— (1) To be eligible for a grant under section 770 for a fiscal year beginning after September 30, 1977, a school of optometry shall, in addition to the requirements of subsection (a), meet the requirement of paragraph (2) or (3). "(2) A school of optometry shall maintain an enrollment of fulltime, first-year students, for the school year beginning in the fiscal year ending September 30, 1978, and for each school year thereafter beginning in a fiscal year for which a grant under section 770 is applied for, which exceeds the number of full-time, first-year students enrolled in such school in the school year beginning in the fiscal year ending September 30, 1976— " (A) by 5 percent of such number if such number was not more than 100, or "(B) by 2.5 percent of such number, or 5 students, whichever is greater, if such number was more than 100. "(3) An application of a school of optometry shall contain or be supported by assurances satisfactory to the Secretary that for the school year beginning in the fiscal year for which a grant is made under section 770 at least 25 percent (or 50 percent if the applicant is a nonprofit private school of optometry) of the first-year enrollment of full-time students in such school will be comprised of students who are residents of States in which there are no accredited schools of optometry. "(h) SCHOOLS or PODL4.TRT.—(1) To be eligible for a grant under section 770 for a fiscal year beginning after September 30, 1977, a school of podiatry shall, in addition to the requirements of subsection (a), meet the requirements of paragraph (2) or (3). "(2) A school of podiatry shall maintain an enrollment of full-time, first-year students, for the school year beginning in the fiscal year ending September 30, 1978, and for each school year thereafter beginning in a fiscal year for which a grant under section 770 is applied for, which exceeds the number of full-time, first-year students enrolled in such school in the school year beginning in the fiscal year ending September 30, 1976— " (A) by 5 percent of such number if such number was not more than 100, or "(B) by 2.5 percent of such number, or 5 students, whichever is greater, if such number was more than 100.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/832

 90 STAT. 2300

Ante, p. 2290.

PUBLIC LAW 94-484—OCT. 12, 1976 "(3) An application of a school of podiatry shall contain or besupported by assurances satisfactory to the Secretary that, for the school year beginning in the fiscal year for which a grant is made under section 770, at least 40 percent of the enrollment of full-time, first-year students in such school will be comprised of students who are residents of States in which there are no accredited schools of podiatry. "(i) SCHOOLS or PHARMACY.—To be eligible for a grant under section 770 for a fiscal year beginning after September 30, 1977, a school of pharmacy's application for such a grant shall, in addition to the assurances required by subsection (a), contain or be supported by assurances that each student who is enrolled in the school will before graduation undergo a training program in clinical pharmacy, which shall include (1) an inpatient and outpatient clerkship experience in a hospital, extended care facility, or other clinical setting; (2) interaction with physicians and other health professionals; (3) training in the counseling of patients with regard to the appropriate use of and reactions to drugs; and (4) training in drug information retrieval and analysis in the context of actual patient problems.". TECHNICAL A N D CONFORMING AMENDMENTS

42 USC 295f-5, 295f-2.

Repeal. 42 USC 244-1, 245a.

S E C 503. (a) Section 775 is redesignated section 772 and is amended— (1) by striking out "section 770, 771, 772, or 773'^ each place it occurs and inserting in lieu thereof "section 770" in subsections (a) and (d) and "section 770 or subsection (a) or (b) of section 778" in subsection (b^, (2) by inserting ", public health" after "dentistry" in subsection (b), (3) by striking out "this part" in subsection (c) and inserting in lieu thereof "section 770", (4) by striking out "section 770, 771, or 773" in subsection (d) (1) and inserting in lieu thereof "section 771", and (5) by amending subsection (d)(3) to read as follows: "(3) provides for such fiscal control and accounting procedures and reports, including the use of such standard procedures for the recording and reporting of financial information, as the Secretary may prescribe, and access to the records of the applicant, as the Secretary may require to enable him to determine the costs to the applicant of its program for the education or training of students.". ^b) Sections 312 and 313 are repealed. (c) The amendments made by this section shall take effect October 1, 1977.

Effective date.

42^USC 295f-2

TITLE VI—FOREIGN MEDICAL GRADUATES LIMITATION ON IMMIGRATION OF FOREIGN MEDICAL GRADUATES

SEC. 601. (a) Section 212(a) of the Immigration and Nationality Act (8 U.S.C. 1182(a)) is amended by (1) striking out the period at the end thereof and inserting a semicolon in lieu thereof, and (2) by adding at the end thereof the following new paragraph: "(32) Aliens who are graduates of a medical school and are coming to the United States principally to perform services as members oi the medical profession, except such aliens who have passed parts I and

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Page:United States Statutes at Large Volume 90 Part 2.djvu/833

 PUBLIC LAW 94-484—OCT. 12, 1976

90 STAT. 2301

II of the National Board of Medical Examiners Examination (or an equivalent examination as determined by the Secretary of Health, Education, and Welfare) and who are competent in oral and written English. The exclusion of aliens under this paragraph shall apply to special immigrants defined in section 101(a) (27)(A) (other than 8 USC 1101. the parents, spouses, or children of United States citizens or of aliens lawfully admitted for permanent residence), to nonpreference immigrant aliens described in section 203(a)(8), and to preference 8 USC 1153. immigrant aliens described in section 203(a)(3) and (6).". (b) Section 101(a) (15) of the Immigration and Nationality Act (8 U.S.C. 1101(a) (15)) isamendedasfollows: (1) Subparagraph (H)(i) is amended by inserting before the semicolon ", and who, in the case of a graduate of a medical school coming to the United States to perform services as a member of the medical profession, is coming pursuant to an invitation from a public or nonprofit private educational or research institution or agency in the United States to teach or conduct research, or both, at or for such institution or agency". (2) Subparagraph (H) (ii) is amended by inserting before the semicolon ", but this clause shall not apply to graduates of medical schools coming to the United States to perform services as members of the medical profession". (3) Subparagraph (H) (iii) is amended by inserting before the semicolon ", other than to receive graduate medical education or training". (4) Subparagraph (J) is amended by inserting "and who, if he is coming to the United States to participate in a program under which he will receive graduate medical education or training, also meets the requirements of section 212(j)" before ", and the alien spouse". (c) Section 212(e) of such Act (8 U.S.C. 1182(e)) is amended— (1) by striking out "whose (i) " and inserting in lieu thereof "(i) whose"; (2) by striking out "or" immediately before " ( i i) "; (3) by inserting immediately before "shall be eligible" in the first sentence the following: "or (iii) who came to the United States or acquired such status in order to receive graduate medical education or training,"; and (4) by inserting ", except in the case of an alien described in clause (iii)." immediately after '"''Provided further, That". (d) Section 212 of such Act (8 U.S.C. 1182) is amended by inserting at the end thereof the following new subsection: "(j)(1) The additional requirements referred to in section 101(a) (15)(J) for an alien who is coming to the United States under a Supra. program under which he will receive graduate medical education or training are: "(A) A school of medicine or of one of the other health professions, which is accredited by a body or bodies approved for the purpose by the Commissioner of Education, has agreed in writing to provide the graduate medical education or training under the program for which the alien is coming to the United States or to assume responsibility for arranging for the provision thereof by an appropriate public or nonprofit private institution or agency, except that, in the case of such an agreement by a school of medicine, any one or more of its affiliated hospitals which are to participate in the provision of the graduate medical education or training must join in the agreement;

89-194 O—78—pt. 2

53

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Page:United States Statutes at Large Volume 90 Part 2.djvu/834

 90 STAT. 2302

"Graduates of medical school."

PUBLIC LAW 94-484—OCT. 12, 1976

"(B) Before making such agreement, the accredited school has been satisfied that the alien has passed parts I and II of the National Board of Medical Examiners Examination (or an equivalent examination as determined by the Secretary of Health, Education, and Welfare), has competency in oral and written English, will be able to adapt to the educational and cultural environment in which he will be receiving his education or training, and has adequate prior education and training to participate satisfactorily in the program for which he is coming to the United States; "(C) The alien has made a commitment to return to the country of his nationality or last residence upon completion of the education or training for which he is coming to the United States (including any extension of the duration thereof under subparagraph (D)), and the government of the country of his nationality or last residence has provided a written assurance, satisfactory to the Secretary of Health, Education, and Welfare, that upon such completion and return, he will be appointed to a position in which he will fully utilize the skills acquired in such education or training in the government of that country or in an educational or other appropriate institution or agency in that country; and "(D) The duration of the alien's participation in the program for which he is coming to the United States is limited to not more than 2 years, except that such duration may be extended for one year at the request of the government of his nationality or last residence, if (i) such government provides a written assurance, satisfactory to the Secretary of Health, Education, and Welfare, that the alien will, at the end of such extension, be appointed to a position in which he will fully utilize the skills acquired in such education or training in the government of that country or in an educational or other appropriate institution or agency in that country, (ii) the accredited school providing or arranging for the provision of his education or training agrees in writing to such extension, and (iii) such extension is for the purpose of continuing the alien's education or training under the program for which he came to the United States. "(2)(A) Except as provided in subparagraph (B), the requirements of subparagraphs (A) through (D) of paragraph (1) shall not apply between the effective date of this subsection and December 31, 1980, to any alien who seeks to come to the United States to participate in an accredited program of graduate medical education or training if there would be a substantial disruption in the health services provided in such program because such alien was not permitted, because of his failure to meet such requirements, to enter the United States to participate in such program. "(B) In the administration of this subsection, the Attorney General shall take such action as may be necessary to ensure that the total number of aliens participating (at any time) in programs described in subparagraph (A) does not, because of the exemption provided by such subparagraph, exceed the total number of aliens participating in such programs on the effective date of this subsection.". (e) Section 101(a) of the Immigration and Nationality Act (8 U.S.C. 1101(a)) is amended by adding the following at the end thereof: " (41) The term 'graduates of medical school' means aliens who have graduated from a medical school or who have qualified to practice medicine in a foreign state.".

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Page:United States Statutes at Large Volume 90 Part 2.djvu/835

 PUBLIC LAW 94-484—OCT. 12, 1976

90 STAT. 2303

(f) The amendments made by this section shall take effect ninety Effective date, days after the date of enactment of this section. 8 USC 1182 note. TITLE VII—PUBLIC AND ALLIED H E A L T H PERSONNEL PUBLIC AND ALLIED HEALTH PERSONNEL

SEC. 701. (a) Effective October 1, 1977, part G of title VII is amended to read as follows: "PART G—PROGRAMS FOR PERSONNEL IN HEALTH ADMINISTRATION AND IN ALLIED H E A L T H

-J *

"SUBPART I—PUBLIC HEALTH PERSONNEL "GRANTS FOR GRADUATE PROGRAMS IN HEALTH ADMINISTRATION

"SEC. 791. (a) From funds appropriated under subsection (d), the 42 USC 295h. Secretary shall make annual grants to public or nonprofit private educational entities (including schools of social work and excluding accredited schools of public health) to support the graduate educational programs of such entities in health administration, hospital administration, and health planning. "(b) The amount of the grant for any fiscal year under subsection (a) to an educational entity with an application approved under subsection (c) shall be equal to the amount appropriated under subsection (d) for such fiscal year divided by the number of educational entities which have applications for grants for such fiscal year approved under subsection (c). "(c)(1) No grant may be made under subsection (a) unless an Application, application therefor has been submitted to the Secretary before such time as he shall by regulation prescribe and has been approved by the Secretary. Such application shall be in such form, and submitted in such manner, as the Secretary shall by regulation, prescribe. " (2) The Secretary may not approve an application submitted under paragraph (1) unless— "(A) such application— "(i) contains assurances satisfactory to the Secretary that in the school year (as defined in regulations of the Secretary) beginning in the fiscal year for which the applicant receives a grant under subsection (a) that— " (I) at least 25 individuals will complete the graduate educational programs of the entity for which such application is submitted; and " ( II) such entity shall expend or obligate at least $100,000 in funds from non-Federal sources to conduct such programs; "(ii) contains assurances satisfactory to the Secretary that such entity shall maintain a first-year enrollment of fulltime students in the programs, for the school year beginning in the fiscal year ending September 30, 1978, and for each school year thereafter beginning in a fiscal year for which a grant under this section is applied for, which exceeds the number of full-time, first-year students enrolled in such programs in the school year beginning in the fiscal year ending September 30, 1976— " (I) by 5 percent of such number if such number was not more than 100, or

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Page:United States Statutes at Large Volume 90 Part 2.djvu/836

 90 STAT. 2304

Waiver.

Appropriation authorization.

PUBLIC LAW 94-484—OCT. 12, 1976 " ( II) by 2.5 percent of such number, or 5 students, whichever is greater, if such number was more than 100; and "(iii) contains such other information as the Secretary may by regulation prescribe; and "(B) the program lor which such application was submitted has been accredited for the training of individuals for health administration, hospital administration, or health planning by a recognized body or bodies approved for such purpose by the Commissioner of Education and meets such other quality standards as the Secretary shall by regulation prescribe. "(3) The Secretary may waive (in whole or in part) the requirements of clause (ii) of paragraph (2)(A) with respect to any school upon written notification by the appropriate accreditation body or bodies that compliance with the assurances required by such paragraph will prevent such school from meeting the accreditation standards of such body or bodies. "(4) The Secretary may not approve or disapprove an application submitted under paragraph (1) except after consultation with the National Advisory Council on Health Professions Education. "(d) There are authorized to be appropriated for payments under grants under this section $8,250,000 for the fiscal year ending September 30, 1978, $3,500,000 for the fiscal year ending September 30, 1979, and $3,750,000 for the fiscal year ending September 30, 1980. SPECIAL PROJECTS FOR ACCREDITED SCHOOLS OE PUBLIC H E A L T H AND GRADUATE PROGRAMS I N H E A L T H ADMINISTRATION

Grants. 42 USC 295h-l.

Accredited program.

Appropriation authorization.

"SEC. 792. (a) The Secretary may make grants to assist accredited schools of public health in meeting the costs of special projects to develop new programs or to expand existing programs in— " (1) biostatistics or epidemiology, "(2) health administration, health planning, or health policy analysis and planning, " (3) environmental or occupational health, or "(4) dietetics and nutrition. "(b)(1) The Secretary may make grants to assist those public or non-profit educational entities (including graduate schools of social work) which have accredited programs described in paragraph (2) in meeting the costs of special projects to develop new programs or to expand existing programs in— " (A) biostatistics or epidemiology, "(B) health administration, health planning or health policy analysis and planning, "(C) environmental or occupational health, or "(D) dietetics and nutrition. "(2) For purposes of this subsection, an accredited program is a graduate program which is accredited for the training of individuals in health administration, health planning, or health policy analysis and planning by a recognized body or bodies approved by the Commissioner of Education and which meets such other quality standards as the Secretary may by regulation prescribe. "(c) There are authorized for the purpose of making payments under grants under this section $5,000,000 for the fiscal year ending September 30, 1978; $5,500,000 for the fiscal year ending September 30, 1979; and $6,000,000 for the fiscal year ending September 30, 1980.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/837

 PUBLIC LAW 94-484—OCT. 12, 1976

90 STAT. 2305

'STATISTICS AND ANNUAL REPORT

"SEC. 793. (a) The Secretary shall, in coordination with the National 42 USC 295h-2. Center for Health Statistics (established under section 306), continuously develop, publish, and disseminate on a nationwide basis statistics and other information respecting public and community health personnel, including— "(1) detailed descriptions of the various types of activities in which public and community health personnel are engaged, "(2) the current and anticipated needs for the various types of public and community health personnel, and "(3) the number, employment, geographic locations, salaries, and surpluses and shortages of public and community health personnel, the educational and licensure requirements for the various types of such personnel, and the cost of training such personnel. "(b)(1) The Secretary and each program entity shall in securing Personal data. and maintaining any record of individually identifiable personal data (hereinafter in this subsection referred to as 'personal data') for purposes of this section— "(A) inform any individual who is asked to supply personal data whether he is legally required, or may refuse, to supply such data and inform him of any specific consequences, known to the Secretary or program entity as the case may be, of providing or not providing such data; " (B) upon request, inform any individual if he is the subject of personal data secured or maintained by the Secretary or program entity, as the case may be, and make the data available to him in a form comprehensible to him; "(C) assure that no use is made of personal data which is not within the purposes of this section unless an informed consent has been obtained from the individual who is the subject of such data; and "(D) upon request, inform any individual of the use being made of personal data respecting such individual and of the identity of the individuals and entities which will use the data and their relationship to the activities conducted under this section. "(2) Any entity which maintains a record of personal data and Consent for which receives a request from the Secretary or a program entity to transfer of data. use such data for purposes of this section shall not transfer any such data to the Secretary or to a program entity unless the individual whose personal data is to be so transferred gives an informed consent for such transfer. " (3)(A) Notwithstanding any other provision of law, personal Disclosure data collected by the Secretary or any program entity for purposes of this section may not be made available or disclosed by the Secretary or any program entity to any person other than the individual who is the subject of such data unless (i) such person requires such data for purposes of this section, or fii) in response to a demand for such data made by means of compulsory legal process. Any individual who is the subject of personal data made available or disclosed under clause (ii) shall be notified of the demand for such data. "(B) Subject to all applicable laws regarding confidentiality, only the data collected by the Secretary under this section which is not personal data shall be made available to bona fide researchers and policy analysts (including the Congress) for the purposes of assisting in the conduct of studies respecting health professions personnel "{4.\ For purposes of this subsection, the term 'program entity "Program ^(4) entity."

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Page:United States Statutes at Large Volume 90 Part 2.djvu/838

 9 0 STAT. 2306

PUBLIC LAW 9 4 - 4 8 4 ^ 0 C T. 12, 1976

means any public or private entity which collects, compiles, or analyzes health professions d a t a under an arrangement with the Secretary for purposes of this section. Report to " (c) The Secretary shall submit annually to the Committee on I n t e r congressional state and Foreign Commerce of the House of Representatives and to committees. the Committee on Labor and Public Welfare of the Senate a report on— " (1) the statistics and other information developed pursuant to subsection (a), and " (2) the activities conducted under this subpart, including an evaluation of such activities. Legislative Such report shall contain such recommendations for legislation as the recommendations. Secretary determines are needed to improve the programs authorized under this subpart. The Office of Management and Budget may review such report before its submission to such Committees, but the Office may not revise the report or delay its submission beyond the date prescribed for its submission and may submit to such Committees its comments respecting such report. The first report under this subsection shall be submitted not later than December 1, 1978. "Public and " (d) For purposes of this section, the term 'public and community community health personnel' means individuals who are engaged in— health " (1) the planning, development, monitoring, or management of personnel." health care or health care institutions, organizations, or systems, " (2) research on health care development and the collection and analysis of health statistics, data on the health of population groups, and any other health data, " (3) the development and improvement of individual and community knowledge of health (including environmental health and preventive medicine) and the health care system, or " (4) the planning and development of a healthful environment and control of environmental health hazards. "SUBPART II — A I J J E D H E A L T H PERSONNEL "DEFINITIONS

42 USC 295h-4.

" SEC. 795. For purposes of this subpart: " (1) The term 'allied health personnel' means individuals with t r a i n i n g and responsibilities for (A) supporting, complementing, or supplementing the professional functions of physicians, dentists, and other health professionals in the delivery of health care to patients, or (B) assisting environmental engineers and other personnel in environmental health control and preventive medicine activities. " (2) The term 'training center for allied health professions' means a junior college, college, or university— " (A) which provides, or can provide, programs of education leading to a baccalaureate or associate degree (or to the equivalent of either) or to a higher degree in medical technology, optometric technology, dental hygiene, or in any of such other of the allied health professions curricula as are specified by regulation, or which, if in a junior college, provides a program (i) leading to an associate or an equivalent degree, (ii) of education in optometric technology, dental hygiene, or such other curricula as are specified by regulation, and (iii) acceptable for full credit toward a baccalaureate or equivalent degree in the allied health professions or designed

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Page:United States Statutes at Large Volume 90 Part 2.djvu/839

 PUBLIC LAW 94-4S4—OCT. 12, 1976

90 STAT. 2307

to prepare the student to work as a technician in a health occupation specified by regulations of the Secretary, "(B) which provides training for not less than a total of twenty persons in such curricula, "(C) which, if in a college or university which does not include a teaching hospital or in a junior college, is affiliated (to the extent and in the manner determined in accordance with regulations) with such a hospital, and "(D) which is (or is in a college or university which is) accredited by a recognized body or bodies approved for such purpose by the Commissioner of Education, or which is in a junior college which is accredited by the regional accrediting agency for the region in which it is located or there is satisfactory assurance afforded by such accrediting agency to the Secretary that resasonable progress is being made toward accreditation by such junior college, except that an applicant for a grant under this subpart which does not at the time of application meet the requirement of subparagraph (B) shall be deemed to meet such requirement if the Secretary finds there is reasonable assurance that the unit will meet the requirement of subparagraph (B) prior to the beginning of the academic year following the normal graduation date of the first entering class in such unit. "(3) The term 'nonprofit' as applied to any training center for allied health professions means such a training center which is an entity, or is owned and operated by an entity, no part of the net earnings of which inures or may lawfully inure, to the benefit of any private shareholder or individual; and as applied to any entity means an entity no part of the net earnings of which inures or may lawfully inure to the benefit of any private shareholder or individual. a PROJECT GRANTS AND CONTRACTS

"SEC. 796. (a) The Secretary shall make grants to and enter into 42 USC 295h-5. contracts with eligible entities to assist them in meeting the costs of planning, developing, demonstrating, operating, and evaluating projects relating to: " (1) Establishment of regional or State systems for the coordination and management of education and training at various levels for allied health personnel and nurses within and among educational institutions and their clinical affiliates for the purpose of assuring that the needs of such region or State for allied ' >a;; health personnel and nurses are substantially met. "(2) Establishment of new roles and functions for allied health personnel and methods for increasing the efficiency of health manpower through more effective utilization of allied health personnel in various practice settings. "(3) Establishment of new or improved methods of credentialing allied health personnel, including techniques for appropriate recognition (through equivalency and proficiency testing or otherwise) of previously acquired training or experience, developed in coordination with the Secretary's program under section 1123 of the Social Security Act. 42 USC "(4) Establishment of methods of recruitment, training, and 1320a-2. retraining of allied health personnel.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/840

 90 STAT. 2308

Application.

"Eligible entities."

Appropriation authorization.

PUBLIC LAW 94-484—OCT. 12, 1976 "(5) Establishment of meaningful career ladders and programs of advancement for practicing allied health personnel. " (6) Establishment of continuing education programs for practicing allied health personnel. "(b)(1) No grant may be made or contract entered into under subsection (a) unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, submitted in such manner, and contain such information, as the Secretary shall by regulation prescribe. "(2) The amount of any grant under subsection (a) shall be determined by the Secretary. "(c) For purposes of subsection (a), the term 'eligible entities' means entities which are— "(1) schools, universities, or other educational entities which proviae for allied health personnel education and training and which meet such standards as the Secretary may by regulation prescribe; "(2) States, political subdivisions of States, or regional and other public bodies representing States or political subdivisions of States or both; or " (3) entities which have a working arrangement (meeting such requirements as the Secretary may by regulation prescribe) with an entity described in paragraph (1). "(d)(1) For the purpose of making payments under grants and contracts under subsection (a), there are authorized to be appropriated $22,000,000 for the fiscal year ending September 30, 1978; $24,000,000 for the fiscal year ending September 30, 1979; and $26,000,000 for the fiscal year ending September 30, 1980. " (2) In each fiscal year for which funds are authorized to be appropriated under this subsection, not less than 50 percent of the funds appropriated shall be reserved for award to training centers for allied health professions. a, TRAINEESHIPS FOR ADVANCED TRAINING OF ALLIED H E A L T H PERSONNEL

Grants.

42 USC 295h-6.

Application.

Appropriation authorization.

"SEC. 797. (a) The Secretary may make grants to public and nonprofit private entities for traineeships provided by such entities for the advanced training of allied health personnel to teach in training programs for such personnel or to serve in administrative or supervisory positions. "(b)(1) No grant may be made under subsection (a) unless an application therefor has been submitted to and approved by the Secretary. Such application shall be in such form, submitted in such manner, and contain such information as the Secretary shall by regulation prescribe. "(2) Payments under such grants shall be limited to such amounts as the Secretary finds necessary to cover the cost of tuition and fees of, and stipends and allowances (including travel and subsistence expenses and dependency allowances) for, the trainees. "(c) For the purposes of making payments under grants under subsection (a), there are authorized to be appropriated $4,500,000 for the fiscal year ending September 30, 1978; $5,000,000 for the fiscal year ending September 30, 1979; and $5,500,000 for the fiscal year ending September 30, 1980.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/841

 90 STAT. 2309

PUBLIC LAW 94-484—OCT. 12, 1976 'EDUCATIONAL

ASSISTANCE

TO DISADVANTAGED I N D IV I D U A L S

I N ALTiTKD

HEALTH TRAINING

"SEC. 798. (a)(1) For the purpose of assisting individuals who, due Grants. to socioeconomic factors, are financially or otherwise disadvantaged 42 USC 295h-7. (including individuals who are veterans of the Armed Forces with military training or experience in the health field) to undertake education to enter the allied health professions, the Secretary may make grants to and enter into contracts with schools of allied health, State and local educational agencies, and other public or private nonprofit entities to assist in meeting the costs described in paragraph (2). "(2) A grant or contract under paragraph (1) may be used by the school, agency, or entity to meet the costs of— " (A) identifying, recruiting, and selecting such disadvantaged individuals who have a potential for education or training in the allied health professions; "(B) facilitating the entry of such individuals into such a school, agency, or entity; "(C) providing counseling or other services designed to assist such individuals to complete successfully their education at such school, agency, or entity; "(D) providing, for a period prior to the entry of such individuals into the regular course of education of such a school, agency, or entity, preliminary education designed to assist them to complete successfully such regular course of education at such a school, agency, or entity, or referring such individuals to institutions providini^ such preliminary education; and " (E) publicizing existing sources of financial aid available to persons enrolled in the education program of such a school, agency, or entity or who are undertaking training necessary to qualify them to enroll in such a program, "(b)(1) No grant may be made or contract entered into under sub- Application section (a) unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, submitted in such manner, and contain such information, as the Secretary shall by regulation prescribe. "(2) The amount of any grant under subsection (a) shall be determined by the Secretary. "(c) For payments under grants and contracts under subsection Appropriation (a) there are authorized to be appropriated $1,000,000 for fiscal year authorization. ending September 30, 1978, $1,000,000 for fiscal year ending September 30, 1979, and $1,000,000 for fiscal year ending September 30, 1980.". STUDIES AND STATISTICAL REPORT ON ALLIED HEALTH PERSONNEL

SEC. 702. (a) The Secretary of Health, Education, and Welfare 42 USC 295h-^t shall conduct and complete, not later than two years after the date of note. enactment of this Act, studies— (1) to identify the various types of allied health personnel and the activities in which such personnel are engaged and the various training programs currently offered for allied health personnel; (2) to establish classifications of allied health personnel on the basis of their activities, responsibilities, and training; (3) using appropriate methodologies, to determine the cost of educating and training allied health personnel in each such classification: and

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Page:United States Statutes at Large Volume 90 Part 2.djvu/842

 90 STAT. 2310

Report.

42 USC 242k.

Personal data.

Consent for transfer of data.

Disclosure.

"Program entity."

PUBLIC LAW 94-484—OCT. 12, 1976 (4) to identify the classifications in which there are a critical shortage of such personnel and the training programs which should be assisted to meet that shortage, (b) In addition, the Secretary shall, in coordination with the National Center for Health Statistics (established under section 306 of the Public Health Service Act), develop, publish, and disseminate on a nationwide basis a report containing statistics and other information respecting allied health personnel, including— (1) detailed descriptions of the various types of such personnel and the activities in which such personnel are engaged, (2) the current and anticipated needs for the various types of such health personnel, and (3) the number, employment, geographic locations, salaries, and surpluses and shortages of such personnel. (c)(1) The Secretary and each program entity shall in securing and maintaining any record of individually identifiable personal data (hereinafter in this subsection referred to as 'personal data') for purposes of this section— (A) inform any individual who is asked to supply personal data whether he is legally required, or may refuse, to supply such data and inform him of any specific consequences known to the Secretary or program entity, as the case may be, of providing or not providing such data; (B) upon request, inform any individual if he is the subject of personal data secured or maintained by the Secretary or program entity, as the case may be, and make the data available to him in a form comprehensible to him; (C) assure that no use is made of personal data which is not within the purposes of this section unless an informed consent has been obtained from the individual who is the subject of such data; and (D) upon request, inform any individual of the use being made of personal data respecting such individual and of the identity of the individuals and entities which will use the data and their relationship to the studies made or information collected under this section. (2) Any entity which maintains a record of personal data and which receives a request from the Secretary or a program entity for data for purposes of this section shall not transfer any such data to the Secretary or to a program entity unless the individual whose personal data is to be so transferred gives an informed consent for such transfer. (3)(A) Notwithstanding any other provision of law, personal data collected by the Secretary or any program entity for purposes of this section may not be made available or disclosed by the Secretary or any program entity to any person other than the individual who is the subject of such data unless (i) such person requires such data for purposes of this section, or (ii) in response to a demand for such data made by means of compulsory legal process. Any individual who is the subject of personal data made available or disclosed under clause (ii) shall be notified of the demand for such data. (B) Subject to all applicable laws regarding confidentiality, only the data collected by the Secretary under this section which is not personal data shall be made available to bona fide researchers and policy analysts (including the Congress) for the purposes of assisting in the conduct of studies respecting health professions personnel. (4) For purposes of this subsection, the term "program entity" means any public or private entity which collects, compiles, or analyzes health

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Page:United States Statutes at Large Volume 90 Part 2.djvu/843

 PUBLIC LAW 94-484—OCT. 12, 1976 professions data under an arrangement with the Secretary for purposes of this section. (d) The Secretary shall submit, not later than two years after the date of enactment of this Act, to the Committee on Interstate and Foreign Commerce of the House of Representatives and to the Committee on Labor and Public Welfare of the Senate— (1) a report on the results of the studies conducted under subsection (a); (2) the report developed under subsection (b); and (3) a report on, including an evaluation of, activities conducted under subpart II of part G of title VII of the Public Health Service Act (relating to allied health personnel). The report described in paragraph (3) shall contain such recommendations for legislation as the Secretary determines are needed to improve the programs authorized under such subpart. The Office of Management and Budget may review such report before its submission to such Committees, b u t the Office may not revise the report or delay its submission beyond the date prescribed for its submission and may submit to such Committees its comments respecting such report. (e) For the purposes of this section, the term "allied health personnel" means individuals with t r a i n i n g and responsibilities for (1) supporting, complementing, or supplementing the professional functions of physicians, dentists, and other health professionals in the delivery of health care to patients, or (2) assisting environmental engineers and other personnel in environmental health control and preventive medicine activities.

90 STAT. 2311

Reports to congressional committees.

Ante, p. 2306. Legislative recommendations.

"Allied health personnel."

TITLE VIII—SPECIAL PROJECTS GRANTS AND CONTRACTS

SEC. 801. (a) Effective October 1, 1976, part F of title VII is amended to read as follows: " P A R T F — G R A N T S AND CONTRACTS FOR PROGRAMS AND PROJECTS "PROJECT G R A N T S FOR ESTABLISHMENT OF DEPARTMENTS OF FAMILY MEDICINE

" SEC. 780. (a) The Secretary may make grants to schools of medi- 42 USC 295g. cine and osteopathy to meet the costs of projects to establish and maintain academic administrative units (which may be departments, divisions, or other units) to provide clinical instruction in family medicine. " (b) The Secretary may not approve an application for a grunt Application, under subsection (a) unless such application contains— " (1) assurance satisfactory to the Secretary that the academic administrative unit with respect to which the application is made will (A) be comparable to academic administrative units for other major clinical specialties offered by the applicant, (B) be responsible for directing an amount of the curriculum for each member of the student body engaged in an education program leading to the awarding of the degree of doctor of medicine or doctor of osteopathy which amount is determined by the Secretary to be comparable to the amount of curriculum required for other major clinical specialties in the school, (C) have a number

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Page:United States Statutes at Large Volume 90 Part 2.djvu/844

 90 STAT. 2312

Appropriation authorization.

PUBLIC LAW 94-484—OCT. 12, 1976 of full-time faculty which is determined by the Secretary to be sufficient to conduct the instruction required by clause (B) and to be comparable to the number of faculty assigned to other major clinical specialties in the school, and (D) have control over a three-year approved or provisionally approved residency t r a i n i n g program in family practice or its equivalent as determined by the Secretary which shall have the capacity to enroll a total of no less than twelve interns or residents per year; and " (2) such other information as the Secretary shall by regulation prescribe. " (c) There are authorized to be appropriated $10,000,000 for the fiscal year ending September 30, 1978, $15,000,000 for the fiscal year ending September 30, 1979, and $20,000,000 for the fiscal year ending September 30, 1980, for payments under g r a n t s under subsection (a). a AREA

Contracts. 42 USC 295g-l.

Ante, p. 2247. 42 USC 296m.

H E A L T H EDUCATION

CENTERS

" SEC. 781. (a) For the purpose of improving the distribution, supply, quality, utilization, and efficiency of health personnel in the health services delivery system and for the purpose of encouraging the regionalization of educational responsibilities of health professions schools, the Secretary may enter into contracts for projects to assist in the planning, development, and operation of area health education center programs. " (b) A n area health education center program shall be a cooperative program of one or more medical or osteopathic schools and one or more nonprofit private or public area health education centers. " (c) E a c h medical or osteopathic school participating in an area health education center program shall— " (1) provide for the active participation in such program by individuals who are associated with the administration of the school and each of the departments (or specialties if the school has no such departments) of internal medicine, pediatrics, obstetrics and gynecology, surgery, psychiatry, and family medicine; " (2) provide that no less than 10 percent of all undergraduate medical or osteopathic clinical education of the school will be conducted in an area health education center and at locations under the sponsorship of such center; " (3) be responsible for, or conduct, a program for the training of physician assistants (as defined in section 701(7)) or nurse practitioners (as defined in section 822) which gives special consideration to the enrollment of individuals from, or intending to practice in, the area served by the area health education center of the program; and " (4) provide for the active participation of at least 2 schools or programs of other health professions (including a school of dentistry if there is one affiliated with the university with which the school of medicine or osteopathy is affiliated) in the educational program conducted in the area served by the area health education center. " (d)(1) E a c h area health education center shall specifically designate a geographic area in which it will serve, or shall specifically designate a medically underserved population it will serve (such area or population with respect to such center in this section I'oferred to as 'the area served by the center'), which area or population is in a location remote from the main site of the teaching facilities of the school or schools which participate in the program with such center.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/845

 PUBLIC LAW 94-484—OCT. 12, 1976 " (2) Each area health education center shall— "(A) provide for or conduct training in health education services, including education in nutrition evaluation and counseling, in the area served by the center; "(B) assess the health manpower needs of the area served by the center and assist in the planning and development of training programs to meet such needs; "(C) provide for or conduct a medical residency training program in family medicine or general internal medicine in which no fewer than six individuals are enrolled in first-year positions in such program; "(D) provide opportunities for continuing medical education (including education in disease prevention) to all physicians and other health professionals (including allied health personnel) practicing within the area served by the center; " (E) provide continuing medical education and other support services to the National Health Service Corps members serving within the area served by the center; " (F) encourage the utilization of nurse practitioners and physician assistants within the area served by the center and the recruitment of individuals for training in such professions at the participating medical or osteopathic schools; "(G) arrange and support educational opportunities for medical and other students at health facilities, ambulatory care centers, and health agencies throughout the area served by the center; and " (K) have an advisory board of which at least 75 percent of the members shall be individuals, including both health service providers and consumers, from the area served by the center. Any area health education center which is participating in an area health education center program in which another center has a medical residency training program described in subparagraph (C) need not provide for or conduct such a medical residency training program. "(e) The Secretary is authorized to enter into contracts with medical and osteopathic schools, which have cooperative arrangements with area health education centers, for the planning, development, and operation of area health education center programs. In entering into contracts under this section the Secretary shall assure that— "(1) at least 75 percent of the total funds provided to any school shall be expended by an area health education center program in the area health education centers; "(2) not more than 75 percent of the total operating funds of a program in any year shall be provided by the Secretary; and " (3) no contract shall provide funds solely for the planning or development of such a program for a period of longer than two years. "(f) For the purpose of this section the term 'area health education center program' means a program which is organized and operated in a manner described in subsection (b) and which is capable, as determined by the Secretary, of performing each of the functions described in subsection (d)(2). The Secretary shall, by regulation, establish standards and criteria for the requirements of this section. "(g) There are authorized to be appropriated to carry out the provisions of this section $20,000,000 for the fiscal year ending September 30, 1978, $30,000,000 for the fiscal year ending September 30, 1979, and $40,000,000 for the fiscal year ending September 30, 1980.

90 STAT. 2313

Contracts.

"Area health education center program."

Appropriation authorization.

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Page:United States Statutes at Large Volume 90 Part 2.djvu/846

 90 STAT. 2314

PUBLIC LAW 94-484—OCT. 12, 1976 EDUCATION o r RETURNING UNITED STATES STUDENTS FROM FOREIGN MEDICAL SCHOOLS

Grants. 42 USC 295g-2.

Ante, p. 2243.

Report.

Appropriation authorization.

"SEC. 782. (a) The Secretary may make grants to schools of medicine and osteopathy in the States to plan, develop, and operate programs— "(1) to train United States citizens who were students in medical schools in foreign countries before the date of enactment of the Health Professions Educational Assistance Act of 1976 to enable them to meet the requirements for enrolling in schools of medicine or osteopathy in the States as full-time students with advanced standing; or " (2) to train United States citizens who have transferred from medical schools in foreign countries in which they were enrolled before the date of enactment of the Health Professions Educational Assistance Act of 1976, and who have enrolled in schools of medicine or osteopathy in the States as full-time students with advanced standing. The costs for which a grant under this subsection may be made may include the costs of identifying deficiencies in the medical school education of the United States citizens who were students in foreign medical schools, the development of materials and methodology for correcting such deficiencies, and specialized training designed to prepare such United States citizens for enrollment in schools of medicine or osteopathy in the States as full-time students with advanced standing. "(b) More than one school of medicine or osteopathy may join in the submission of an application for a grant under subsection (a). "(c) Any school of medicine or osteopathy which receives a grant under this subsection in the fiscal year ending September 30, 1978, shall submit to the Secretary before June 30, 1979, a report on the deficiencies (if any) identified by the school in the foreign medical education of the students trained by such school under the program for which such grant was made. The Secretary shall compile the reports submitted under the preceding sentence, and before September 30, 1979 submit to the Congress his analysis and evaluation of the information contained in such reports. "(d) There are authorized to be appropriated for the purposes of this section $2,000,000 for the fiscal year ending September 30, 1977, $2,000,000 for the fiscal year ending September 30, 1978, $3,000,000 for the fiscal year ending September 30, 1979, and $4,000,000 for the fiscal year ending September 30, 1980. " P R O G R A M S FOR PHYSICIAN ASSISTANTS, EXPANDED F U N C T I O N DENTAL AUXILIARIES AND DENTAL TEAM PRACTICE

Grants. 42 USC 295g-3.

Ante, p. 2247.

"SEC. 783. (a) The Secretary may make grants to and enter into contracts with public or nonprofit private schools of medicine, osteopathy, and dentistry and other public or nonprofit private entities to meet the costs of projects to— "(1) plan, develop, and operate or maintain programs for the training of physician assistants (as defined in section 701(7)); "(2) plan, develop, and operate or maintain programs for the training of expanded function dental auxiliaries (as defined in section 701(8)); and " (3) plan, develop, and operate or maintain a program to train dental students in the organization and management of multiple

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Page:United States Statutes at Large Volume 90 Part 2.djvu/847

 PUBLIC LAW 94-484—OCT. 12, 1976

90 STAT. 2315

auxiliary dental team practice in accordance with regulations of the Secretary. "(b) No grant or contract may be made under subsection (a) Application unless the application therefor contains or is supported by assurances satisfactory to the Secretary that the school or entity receiving the grant or contract has appropriate mechanisms for placing graduates of the training program with respect to which the application is submitted, in positions for which they have been trained. "(c) The Secretary shall ensure that the making of grants and entering into contracts under this section shall be integrated with the making of grants and entering into contracts under section 830. 42 USC 297. "(d) The costs for which a grant or contract under this section may be made include costs of preparing faculty members to teach in programs for the training of physician assistants and expanded function dental auxiliaries. "(e) For payments under grants and contracts under this section, Appropriation there is authorized to be appropriated $25,000,000 for the fiscal year authorization. ending September 30, 1978, $30,000,000 for the fiscal year ending September 30, 1979, and $35,000,000 for the fiscal year ending September 30, 1980. "GRANTS FOR TRAINING, T R A I N E E S H I P S, A N D FELLOWSHIPS IN GENERAL I N T E R N A L M E D I C I N E A N D GENERAL PEDIATRICS

"SEC. 784. (a) The Secretary may make grants to and enter into 42 USC 295g~4. contracts with schools of medicine and osteopathy to meet the costs of projects— "(1) to plan, develop, and operate approved residency training programs in internal medicine or pediatrics, which emphasize the training of residents for the practice of general internal medicine or general pediatrics (as defined by the Secretary in regulations); and "(2) which provide financial assistance (in the form of traineeships and fellowships) to residents who are participants in any such program, and who plan to specialize or work in the practice of general internal medicine or general pediatrics. "(b) There are authorized to be appropriated to carry out the pro- Appropriation visions of this section $10,000,000 for the fiscal year ending Septem- authorization, ber 30, 1977, $15,000,000 for the fiscal year ending September 30, 1978, $20,000,000 for the fiscal year ending September 30, 1979, and $25,000,000 for the fiscal year ending September 30, 1980. OCCUPATIONAL ((.

H E A L T H TRAINING AND EDUCATION CENTERS

"SEC. 785. (a)(1) The Secretary shall, by grants, assist public or private nonprofit colleges or universities to establish, operate, and administer occupational health training and education centers through cooperative arrangements between schools of medicine and schools of public health (or other qualified departments or schools within such colleges or universities which are qualified to participate in carrying out activities set forth in this section). "(2) To be eligible for a grant under this section, the applicant must demonstrate to the Secretary that it has or will have available full-time faculty members with training and experience in the field of occupational health and support from other faculty members

Grants. 42 USC 295g-5.

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