B&E3 ImFmRmikriom & lm@E 300 "Ild=C M=M=C*S SOU ARD Ulafacm Z077Z 0 US^ 0 taol) 24@l 10 Status Report: Regional Medical Pro,-rams Leuislation Legislation extending and amendina Regional Medical Prograins passed C> in the House on October 13 and the Senate on October 14 and is now awaiting the President's signature. Included for your information on the current status and major changes in the new legislation are the following items: (1) Chronology of Legislative Action for Regional Medical Programs Extension of 1970. (2) S=ary of Major Changes in New RMP Legislatio n. (3) Copy of the Conference Report on H.R. 17570, listina actual changes (Pages 1-4 and 17-18 of the Conference Report pertain directly to @IP.) (4) Copy of the 1968 legislative extension for purposes of com- parison. Chronology of Legislative Action for Regional @ledical Pro(,Trar@is Extension'of 1970 Of the 14 bills introduced concerning the extension of Regional @ledical 5 Programs, action centered on two, namely: . S. 3355 - Sen. Rdlph W.. Yarborough (D.-Texas) Jan. 29, 1970 . H.R. 17570 - Rep. John Jarman (D.-Oklahoma) May 11, 1970 Action Taken in House - H.R. 17570 1. Legislation introduced May 11, 1970 2. Hearings before the Subcommittee on Public Health ---- and IVelfare of the House Comittee on Interstate and Foreign Commerce. June 1, 2, 3, 4, 1970 3. Subcommittee approved for full committee action H.R. 17570 amended June 16, 1970 4. House Comittee on Interstate and Foreign Com- merce ordered favorably reported H.R. 17570. July 13, 1970 (Report No. 91-1297) S. Passed in House by vote of 365-0 August 12, 1970 Action Taken in Senate - S. 3355 1. Legislation introduced January 29, 1970 2. Hearings before the Health Subcomittee of the Senate Committee on Labor and Public IVelfare. February 17, 18, 1970 3. Subcommittee approved for full Senate committee consideration, with amendments, S. 3355 June 4, 1970 4. Senate Committee ordered favorably reported, with .amendments, S. 3355 June 11, 1970 S. Senate Report issued. (Report No. 91-1090) August 11, 1970 6.-Senate inserted the text of S. 3355 and then passed its version of H.R. 17570 by a vote of 56-1. September 9, 1970 Conference 1. Conference Report submitted (H. Report 91-1590) October 8, 1970 2. House agrees to Conference Report on H.R. 17570 October 13, 1970 3. Senate agrees to Conference Report on H.R. 17570 October 14, 1970 Presidential Action Major Changes in New @IP Legislation Present Legislation eg station as passed in P.L. 89-239; P.L. 90-574 House and Senate 1. Categorical Heart disease, cancer, stroke Adds kidney disease, and other Emphasis and related diseases. related diseases. 2. Additional Emphasis.on makina available * Promotes medical data ex- p ases the latest advances in diag- change as well as -r&search, nosis and treatment, and on training, and demonstrations cooperative arrangements for of patient care; medical data research., training and re- exchange relates directly to lated demonstrations of patient kidney transplants to include care. data exchange between tissue typing banks and, on a re- gional basis, among medical schools, hospitals and other institutions and providers. * Adds prevention and rehabil- itation explicitly. * Gives additional emphasis to regionalization of health care resources and services in order to strengthen and improve (1) primary care and (2) the relationship between primary care and specialized care. * Concerned with increasing capacity as well as quality, and with areas with limited health services. 3. Construction Limited to "alteration, Tqajor Adds authority to include "new Authority repair, remodeling an(i reno- construction of facilities for vation of existina buildings... demonstrations, research and and replacement of obsolete training when necessary to carry built-in equipment of existing out Regional Medical Programs." buildings," up to 90% of cost. 2 Present Legislation P.L. 89-239; P.L. 90-574 Legislation as Passed in n(i qpnntp- 4. Relationships None specified in law. Requires that the appropriate to Compre- regional, metropolitan, or hensTve-Health local areawide comprehensive Planning health planning acenc), 314(b), have an opportunity to consider operational grant proposals before the RAG may recommend approval. S. Duration Three-year extension Authorization FY'71 $125 Levels (in FY'72 150 @lillions FY'73 250 Includes provision that no more than $15 million shall be available for kidney disease activities in FY'71, and also includes a $5 million discretiona-n earmarking for new construction. Funding Grant.S with two-year Adds contract authority as well @lech@ism availability of funds. as RMP grant authority, and would permit Regions to obtain services in-kind from Federal agencies. One-year availability of funds. 7. Regional Composition: Requires official health and visory RequiremeHt there must include health plaTmina agency repre- Groups practicing physicians, medical sentation on such.advisory groups; center officials, hospital ad- requires that public members ministrators, representatives include persons familiar with from appropriate medical the financing of, as well as the societies, voluntary health ... need for services, and that such and other health-related public members be sufficient in agencies..." and members number to insure adequate com- of the public... "familiar munity orientation. with health needs. Also includes a representative of the Veteran's administration as an ex officio member, if there is a VA institution in the Region. 3 Present Legislation Legislation as Passed in P.L. 89-239; P.L. 90-574 House and Senate 8. National Advisory Council responsible Provides that the Assistant Tdvisory for RMP matters, Sixteen Secretary for Health and Council members - leaders in fields of Scientific Affairs of FMV-shall fundamental sciences, medical be Chairman, replacing the sciences,or public affairs. Surgeon General in th@l@ position. At least 2 practicing physicians, one expert each Makes the Chief Medical Director for heart disease, cancer of the Veterans' Administration and stroke. an ex officio member of the Council. Increases the size of the Council from 16-20 members. Provides for: (1) one member who is out- standing in the study or care of kidney disease; (2) leaders in the field of health care administration as well as the fundamental and medical sciences; (3) tivo members outstanding in the field of prevention of heart disease, cancer, strokc or kidney disease; (4) four of the twenty should be members of the public. 9. Listing of Lists of facilities equipped Adds a similar -requirement for Advanced and staffed to provide the kidney disease. Facilities most advanced methods of diagnosis and treatment in heart disease, cancer and stroke are to be established. 4 Present Legislation Legislation as passed in P.L. 89-239; P.L. 90-574 House and Senate .10. Multiprogram Provides for grants for Provides for both grants and Tervices - services needed by, or which contracts for a broad variety Section 910 will be of substantial use to,, of activities including: any two or more regional activities of use to two 'or more medical programs. regional medical programs, devel- opment or demonstration projects, collection of epidemiologic data, development of training, and conduct of cooperative clinical field trials. Also authorizes assistance in meeting the costs of special projects for improving or developing new means for the delivery of health services concerned with the diseases included in this title. Authorizes support for research, studies, investigations, trainina and demonstrations designed to maximize the utilization of man- in the delivery of health power services. 11. General All authorities and de- Authorities and determinations Aut orities terminations under Title IX., exercised by Secretary rather including the awarding of than Surgeon General. grants to Regional Medical Programs, are exercised by the Surgeon General of the Public Health Service. ----------------------------------------------------------------------------------------- 12. Joint None specified in law l@Then a single project receives Fundia grants from two or more sources within certain parts of @IHA, the Secretary may issue regulation under which administrative functions with respect to such projects will be performed by a single administrative unit; ap- plications may be consolidated; and duplicative requirements revised I rji)O LiEGIONAL.N,@IEDI(I'Al, PROGRAN,'IS AND ('OMPREHEN@lil@'E IIEAI,Tfl PI,ANNING AND SERN71C'ES A(,T OF .1970 0(@TOIIER 8, 1970.-Ord(@ (@d to I)e 1)rinted front tll(' Of ('Ollfel'(,@TI slil)rylitte(i t'll(@ folloNN,ill- CONFERENCE REPORT [To accompany 175701 of (-oiif(@i-en(t(@ On i,ii(@ vot(,.,4 of tli(, i%N-0 flotis@es on the of tli(@ to the bill (H.R. 17570) to IIITI(Iil(l title TX of tli(@ Ptibli(@ [I(,alt.ii S(@rvie(@ A(@t so as to extend tin(] iiiil)roN-(, (-lie. (,xistiTi(r program i-elat!irig to (@(itt(-,zition, research, trairtinL),. -iii(i ticiiioiistrittioii,:, iii the fiet(is of b(-tti-t caii(-er, st ke, iiii(f ro otti(@r r(,Itttei-l itti(i for other 1)tirl)os(@s, liaN,iiig met, after ftill a(,-re(@(i to re(,oyyim(@ii(i tin(] (lo r(@coninieii(i to t li@,ir x-(@,spective Ilotise,4 its folioNl-s: That the Hoiise from it.,; (iiiti-r(@emetit. to the aineii(iiiient of ili(@ S(-titite to the text of the bill aiit(1 it-ree to the same i%-itli an itilittil(iiiik,iit as follows: lit li(@ii of the matter propose([ to be by the Senate amend- iii(-iit. insert the following: T17IE I-AMENDMENTS TO TITLE IX OF THE PUBLIC HEALTH SERTRICE ACT ,-@.Ec. 101. Thistitlemaybecitedas the "HeartDisedse, Cancer, Stroke, an(Ili[idneyDi8easeArnendment@ of 1970". 8--c. 102. Section 900 of the Pu@lic Health Serz@ce Act is amended to r(,a(l as folloivs: "PURPOSP, s "SEc. 900. The s oj this title ai,e-- ti and contracts, to e@two-ii,,rage an(I as,@i,8t in the e,q i medical @C) training (i c Conti ta xchange, and fo d tra disease, can- cer, stroke, a,& ses; 48-406-70-1 2 "(b) to afford to the medical profession and the medical institutions qf the ATa-tio?z, tht,o?tgh. siieh cooperative arrangements, the 01)1)01-tll??,.@'ty of ?making available to their patients the latest advances i?i the pre- v8ntion, diagnosis, and treatment and rehabilitation o persons sufferiitgfrom these diseases; I((c) to promote and fo@i, regional linkages among health care institutions and proz,@,dii@s so as to strengthen and iinpi-oz?e pi,,imai,y care and the relationghi'p between specialized a-ad primary care; an@l "(d) by these means, to i'mprove generally the quality and enhance the capacity of the health manpower and -facilities available to the Nation aml to impro@ve healtlt services 'for persons residing i7i areas with, limited. health services, and to acco?nplish th(-,.,?e ends v@th(,,tff interfering with the patterns, or the metho(1,3 of.finartcillg, (?f pat;tlit care or professional practice, or with the admimi,.3tratioil of ho@p;f(jtq, and iii, c, J,q, ;bool))ei-aaltion with practicing physicians, O'@l I' t ad7niiit'.,;ti-ator.@-, and representatives froin appl,e)- p voluntary healflb afl(@ncies." SEe. 103. (a)(1) 7he.fii-,,?f sentence of sectio7t 901(a) of ,;?ich @let i-K ame-7i.(Ie.d. by sti-,iki?tg out im,,irie(liafel?l qfter "Jitnt, 30, I!)(;9,", and by ;,iisertin-ri i-i@i-ine(liately before, ",.for gra?it.,?" the f(-dlow@rkq: ", $125,000,- ooo .fo), tili.fi,,?cal year end' ig Jitiie 30, 1,971, @150,000,000 for th,(!fi8cal yt@at ending Jit7ie 30, 19i-2, an(l, @250,000,000for the.A,,?cafyeai, en(li@ng Jii)i,e 30, 1.973". (2) Such fi7-st sentence is fiii,tltei, amended by striking o,itt the period qfter "title" and -inserting iit. lie?i thereof "and for contracts to carry o?tt the purposes of this title." (3) Such section .901 (a) is amended by .3triking out the .5ecoll(I Sentence and inserting in- lieu thereo the following: "Of the @iqlms a I)ropriateil f p ii.nd,er th,is sectionfor thefiscal year en(li@(7 Jitne 30, 1971, not more than $15,000,000 shall be at,ailable.for activities in thefield of k;(Iii.e?l disease. the sitms appropriated iin(ler this section.for any@.@-cal year ending 'i97O, not more than @5,000,000 -may be rna(le, available ;?i a ter Jiine 30, any siichfiscal ?Iearfor grants.for Tbeiv construction." (b) Section 901 of such Act is further, amended by adding at the end thereof the.following new subsection: "(e) ,It the request of any recipient of a grant under this title., the pay- men@g to such recipient ma?/ be reduced by the 'fair maki-et ?!alite of any equ iinneitt, si4ppl i'es, or sei,t7,i.ces furnished b?l the secretary t'i) @iieh and by the amount o the pa allowance, traveling expenses, and any .f Y, oth(i, costs in connection w'th the detail o an officer or e?@il)loyee o th6 Government to the recipient when sitch fiirnighiizg oi- .3?ich d(;ta;l, as the case may be, isfor the convenience of and at the reqziest of such recipient awl for the purpose of carrying out the regional medical progiain to which the grant under this title is 7nade." SEc. 101t. Section 902(a) (If such Act is anten(le(I by 3triking out diagnosis, and treatment relatititl to heart (lisea8e, cancei-, or vii-oke, and, at the option, of the applicants related disease or (liqeases" aii(I ;.iivei-tlag iii near, thereof prevention, treatment, (tnel ,i,ehab-iiii,(zti'olit relating io heart cancer, stroke, or I,-i(iney disease, a?ul, at the ol)tioit of the applicant, othe@t- related diseases". (b) )'?ectiolb 902(@) is am' ended by 8frik-,i,,ng out "i?tclqtde.@" and inserting air, treat thereof "m'ea@iis new construction o '.f(ieilitie-3fo?@ demonstrations, i-e-@etti-ch, a@ii@l training ivlicti necessary 70 carry out regional medical programs". . 3 lo,,7. ,@rt ''oil .1?03(b)(,tl@ (1) by o@ll '4i,ol,iiitai-y li@r(iltli anil" ari(i,iiz,'?ertt,,ng iii ll'(,ii thi,i-eof "i)olitittai-y or offici'(il health health, 111(itiri;ftg (2) by iii.,@ei-ti'liti 1',tiztyie,(Iiatctii (ifte,i, "itti(Iti, the pt,(@gram", wh,el(- it_fi)-.,zt appears the@-eiii,, the following "(iii,elit(ling as an ex offic;u member, if there is located late ,??tch, rerl;o@i one ot- more hospit(il,,; ot- othet- hea h facilties of the l(imi7iistrafio?t, the i2i,(117,i(lii(il wil"om tliezlilministi-a@i@ of 11'etera?i@' @Iffaii-s @hall haiie Neillie on, .1tich adi;iNory gi-oill) as tht, rt,pt-esentative of the or other health care facilities of ,;ticit@ .1(1,7ninistra[i,(@ll whic'h (ii,e lot-atetl in ,?iicli, ret)ioii,)"; an(I (3) by striding o?it "7ice(l.foi, the ce.@ pl@ovi.(le(I ?in(lei, the @,o- p an(I ia,,?trtitig ill, I;eii, tli.ei,eo "ner(i foi- andf7tancirig of the .3ervi.ces.pro?,,i(le(l, ?t@ti(ler tht, P-rogi-ag@i, (iii(l v,,@t,;ch ativi3o-@71 groijl) shall be @tiffwient in ?igimber to iit8itre a(l(,qiiate conim7inity oi,ieiitat@ion (as (letermiite(I by the Secretary)". SEc. 106. 7'ltat part of the sect)@i.(l sentence of section 904(b) of s?iclt Fact paragraph (1) is amen(le(I by ,It,@,king oqjt ",qection f)0,3(b) (.If) an(/" anii inserting iii, lie-?i, thei-eqf the "followin(j: "section 903(b)(1i), i pl)l)oi-tii-nity has been pi-oviele(l, I)i@;or to Nqich i-ec@)mmert(lOtion, fol- ct)n- si,(I,ei-atioii of the al)plica?ion by ea@h I)qtblic or itori.pro t pr;vate agency I))' organization uhic7t has (tei,elope(I a co7ti'I)reheitsii@e regional, metrope)l;fart, (it-ea, (i7- other local a?-ea 1)lan, reftri-e(I to iii. section 31/1(b) cozel,' '?Ig tiny (ii-ea in it)hich the i-egioti(it ine(li@(il i)ro ),a?i@,.fe)r which the (il)plicatiorl is ina(le qi,ill be located, an@(I if the (ipl)li(-atioii". Si,,(,. 107. (a) !)O'5(a) oi'slleh , lct 1'.,; (ttyicii(le(I to i-ea,(t as '4SE('. !)05. (a.) 7'lte ,@e-ei-etailliiitt?l apl)t)iiil, qiiith,oiit 7-@(lar@l in 'ihe e-;t,;l a A'(ition(il, (oiiric;l on R(igioii(il Af(lilical I'i,o(IraiiiN. 7'lte (otiitell shall consist of the Str-i-elai-y o f I-le(jltlb, N(itl@atioti, and li elfitre foi, Ilealfh (iii(I Sc;etit@fic ti)ho shall be the (ha;.t-ma-7t, the Olt-iej il@dical I)ii-ector of the 1etei-(tns' @l(I'M-i,@tistration gi)ho vh,all be (in -x officio me-titbei-, a-ti(I tivetif?l 7nembei-s, riot otherwise in the i-eqiila,7, .ftill-fim@em,ploy qf the 17-n.,ite(I )St(ite8, qi7ho are leaders in. tliefiet(lv ('@f th-e .fit.7i,(I(tiri,enfal @cieitces, the medical sciences, health@ care (Ull'tiiniWration, 07- pi.ibl,ic qlTairs. At least two of the al)poiiite(I members shall be practicing plt,.qsic,ia.n8, one shall be oiitsi@?t(ling,in the stil(ly or health care @f persons ,qi@ffei,,ing from heart disease, one shall be o?it,,:tan,(Iing in the'sludy or health care of person.- s-iiffer,ing.f-rom ca?ice?,, one shall be oqitstan,(Iin(i @in the qtit(l?l o7- health, care of'persons sii'ffering.fi-ogri sti@ok-e, one shall be O?lt- .@tandizig rate, the stit(]?l or health care of er-3ons suffering from kidney isease, t,ivo shall be oiiistan(li7@g in the. .. p (I flel(I (If prevention of heart disease, sf7-oke, or kidney disease, andfoitr shall be members'of the p@tbl;c." (b) Of the perqons..first appointed qi.,n(ler @ction 905(a) 'Qf th'e l@7ibl;.c Health Service Act to serve as tite.foiir additional members: of the N-atioital Advisory Cou?ie,il on Re(jional LVedieal Programs aiitkorized by the amendment made by subsection (a) of thisr qection- (1) one shall serve -for a term of one year, (2) one shall serve-for a term of two years, (8) one shall serve for a term of three years, and (./i) one Rhall serve Yor d term i;f foui, years, as designated by the Secretary of rlelilt@, Edqication, and Welfare at the time of appointment. b!i re,lesiflii(ttiti.,(l all ((,') a-Y (ii), aii(I (i;,i), i-oN,)ectivoly. (2) '30li(b) ,Ic@t i,,: (@,I) ly" ,;trilr,itty'oitt " (b) " aal iii @(@rtintl 'iit lieii, thereof (B) @?/ ,:tril, i7lfl Olit "tlii.@ each place it al)-pe(ii-,v tltere-i-ii, (tit ti @inNeititig in lieil.thei-eof "t!tiN @tibvect;o7l.. 30.11(c) of stich A(li ;.,; (itylell(led-- - (.e't) by -vt/-ikititi oitt "(e) " oil(/ @tiNet-ttiifl in lieii thereof an(I lk; 171, ('?) by stri4-ing out @ectio;,," c.,lch, PI(ice it ay)p(,ai,.N there' iitser-fi@ig i?,t li(fit thereof "tliiN (b) @ieft'oii 301, t)f.,;ilch, Art i,@'ftii-thei, ai)i.en(led by a(l(liiig aftet- the prn- i@o . thereof (3) by s,i-tb.,;Pction ((t)(3)(A) qf ill@t'.fultolvilig -viib.@et@tiott: "System,,? Analysi.,; of Nat,t'ottal Health Cilre I'lan8 "(b)(1)(A) Y'Ite Secretary 8hall develop titro?igh Utilization of the sy.qtetn8 analy,@,is method, planq foi, health care systems des@lt)cel-ade- (12iate@71 to meet the Itealth nee(Is o@ the , liiiericart people. Foi- of the preceding sentence, the sy,@tcin-s aiialy8l's met&)(I 'means th@ ai;alyfical ?Ptetht)(I by winch, iai,,ioit.,; m(!a@ii.,? (@f obtai?ii-nfl a desired res?ilt (,,, !I(Oal asll;toeiate(i with the cost,@ an4l beitc;6,'.,? -;.ni,olt)e(l. "(B) The @eci-clary,@hall complete, the (leii,,Io ment of the I-ef@ried p to i" bpai-agi-al)h (. 1.), willtiii, xii@-h 1)(!7, o(I a.@ may be necessary to #ratable hi-iii to) .4)lbmit to th,(, itot il?,att September 3(i, 1971, a report thei-eo.,i. wlt.,ich, sILall describe each ,;o ele?,elopeet -in terms of--, "(i) the 7i@en2bei- of people'ii)ho ivottl(l be covered itnd@l, the plan - ii(,ii) the kind a?i@ft?lpe n health, cai,e vyltich uould be covei@e(i,ittt(te?- the plan,; "(@ii) the cost in2,olied -i)i. ea?-iy;iig o;it the plan and how costs 7110 itld be.fi?ta7tced; i'(,iv) the 7i.,?tmber of att(litiortal ph. ;ciaas and other health care personnel and the niimbet- alth care facilities @iiee(ted it) enable th-e plan. to become "(v) the new and improt iveily of health care services which woWI(i b t?iaie the plan; "(vi) the accessibility o i vario-?i.@ 8octo- economic clou4 11(v't) the an.d e I Iciedn,,c, o@ 8itch plan av compared to e i nein 'd er?,ng heaitit care; anrl cc (viii) the legL,31atiie, a(imin iit?-ative, and other actions wlt icl( ?t-t)-lild be necessary to implement the plan. (1) 1.4 order to a,"?ii,e that the a(lvice and sertice of expri-tn iii the -i.,(i,rioii8fields concerned will be obtained lit the, plamq a?ltlto@ize(i by ii(ii-agraph.,and that the ptiry)o,,?ei of th,i,,? pat,atiraph will.f?dly be car,i,,I'ed (i) the Secretary ,?hall ittilize, v7hc7Le,ler Appropriate, personnel .fri@m the various (ifiencies, btii-eaii.N, an(/ ottter (lepart?nental &?ib- i@ivi@iioiis of the I)epat-t-meiit i!f I-lealth, ff,'ditcation, a?td IVelfalre; ,,(ii) a@ Secretary is aitthori::e(l, ?i7tilt, the con@-ent of flie /),Ca(/ f!f the @lepartrnent or agency to Utilize (On a reii)ibiii-.qable basis) tG personnel and otlici, resource,,; of other depai-t?ne7ii.N aii(I agencies of the Federal Govi-i-nme7it; and 6 (iii) the Secretary is atitliol-ized to coli&?tlt with al)l)rol)t.iate State or local public agencies, private organizations, and "Cost and Coverage Report on Existing Le.@lative Proposals (2) (A) The Secretary shall, in, accordance with this Paragraph, con- (Iitct a study of each legislative proposal whichis introduced in the Senate or the Hoiise'of Representatives diir@ing the. N-inet,.y- t Cong7-fsg, and firs 'WA-ich ?,tndertakes to establish a national heaittb insurance plan or 8'1'7n I'I(ir I)la;,b des@ned to ffieet the needs of health in.3?irance or for health se.,-?-,ices of (ill or tWe overwhelming Ina oi-iiy qf the people o the'tjnite(l, AStaffN. "(B) [7t co?tdtfcfi.?ifl ;@icl6 ,:tii(ly with respect to each such legislative, proposal, the i%c7,eta@t,y shall evabi(ite and analy.-e ,??ich proposal u,,itli, i!it??v to (leferirtiiiiiitl---- "(i) the of carrying not the proposal; and "(,i,i) the a(leq?iacy (?f the proposal in tei,7ti8 of (1) the portion the 7)optt.1(7.tioti coi7tre(I by t[te.i)i-opo@,;al, (II) ikc type health care pai(i.foi-, or ins,iire(I agai,7ist lin(ler the pro o.@al, (111) llr(l@le(l, . p whether, an(/ i so, to tthaf exte?it, the pi,o7)o8al for tle .f o new a?iel ititpi-oied niethodi fo-r the tIeli2-ery (@@ Health care an.(l Not late@t- than Ma)-ch, 31, lf)71, the Secretary shall submit to the (!ongres,? a report on each legislative PrO'PO8al which he has bee-it directed to study q'i?tder this paragraph, to-gethe?- u)ith an analysis and evaluation of such proposal." (c) Subsection. (d) @f -ect-ioti. 304 of .3,tich Act is hereby redesignated a-St subsection (c) and is amende(i to reail as Ilows: "(c)(1) There are agithorizo or ?tnder contracts ?.in4r sti, out the provisions of siibseetio 9 JiAne 30, 1971 (qf which not .for 7nir?)oses 0 f cdmying out provisions qf subsection (b)), @82,000,000 r the @cal year end@ng Jttr, 30, lD72, @ @94,000,000 for the , ca, .fo fi'? I year ending Ju7ie 80, 1078. "(2) In addition to the fitruu- authorized to be approp?-iated zirt,(I@er ))at-a.qraph (1) to carry oiit the provisions of sub.-eit?On (b) there are hereby authorized to be appropriated to carry out such provisions for eacl&.flqcdl year such s?tms az may be necessary." ((I) The a?nen(lnient,3 made by subjection (c) of this section shall be e (-tiLe only with, respect to.kzcal years ending after Jzine 30, 1970. .!fe SEc. 202. That provision of ,;ection 304 of the, Pitblic T:.Tealth Service Act i-e(les@qibated by section 201((&) of thiv A'ct as paragraph (3) (@f ,illb- ,:e(!tio.)t (a) is.firrthe), ainen.(Ie(.1- (1) by inqet-tin.g "(A)" -ini.?Yie(liatelql after "(3)"; and (2) by addin.g after aiid below provision the following new lillb.pa.7-(zflraph: CZ(B) The aino7ttzt,-z otherwise payable to any person under a grant or C(?t)tt-(ict nia(It, iii@de-i- this siibqection A-hall be reduced bil- 11(i) eq?ial to the.f(iir market ?,,al7ie of any eq?ti.pinent or lit,s fqir-ti.;sheTt to v-itch Z;ei-,,?oit by the Secre@aryfpr the purpose C(IlIrlill.o@iit the p7,oj(!(-t with Y-eqy)ect to u)hich. such grant or cf),it- tract .18 marine, (171(i 7 11(ii) a?ttoittit@ e(Iiial to 1/t(,, pay, allowances, traveling erl)etime8, aii,(l rel(ite(t per&otiii,el atti,ibitt(ible to the Performance of A,et,i@ices by all, officer or e"17)loyee (!f th(,, (,oi)ertime?ti connection 7vitli, sticli project, if steel ojicet, or employee wag assigned or detailed by the Secretary to perfo7-in ,:iiclb veri)ices, bitt only @f such person requested the Secretary tofi?i',n,iqlb S?Lcli, equipment or s?i'1)'plies, or ,titclt set-i,icev, as the c(&,:e may be." SEc. 203. lItat provision of ,?ecti(in 301i. o the P-tiblic Healtlt Service If ,let i-e(le.,?ignate(I b'y section -261 (a) of this@ @l(,t as paragraph (1) of q7ib- .v(,clioii (a) -i3.fiti-thei, amended by@ (1) qi,ikizig out the period at tlte end thereof and ili8ertingt'a lieu thereof ", and (2) adding ajter and below llie clwiive thereof redesignated by such Ive(,tl'olt 20.1 (a) m,? clatise (iil') the following new clau,@e.@: " (iv) Prqieetgfor reRearch, expet,ime@nt,,?, and dem(yngtrations dealing with, the e#ective combination or coordination of public, private, or combined @tblic-prii,ate methods or sygtems.for the delivery of health services at reqi , o7tal, State, or local levels, aid (v) pr(@i@t8 for research and demonstrations -in the provision o lbome health, sees." PART 11-NATIONAL 1:IL-ALTH SURV.EYS AND STUDIES Sp,c. 210. (a) (1) CIlaiise (1) of viib8ectioit (a) qf section 305 of the I)iibl-ic Ilt-alth Sei-?,ice Act is amended by striking out "an(7" before an(/ by iii.@fi-fi@izg qftei- the se.-aticolon at the end o @uch cla7lge the followin(i: .f "(,P) healfli. care -resource.,?: (0) environmental and qocial health haza7,(i.@- il))(l (fl-)'familyformation, gi@oulth, and (tivgol?,ttion;' . (2) Stich subsection. ;.g fitrther amended by adding at th-e end thereof than f,)Ilowi@(i 7teu) sentence: "No information obtained irt, accordance it,ifli th i,,? paragraph may be iisedfor @;,y purpose other than the statistical for it,,Ii ich it was -quppliea except ?ir-3uant to regulations of thek@eci@i,t(zr?l:,ii,oi-mayaiiys,tich-?@nformat.;@nblplp?iblishedift,he articti@r or person @itpl)lyi-n,.q'it is i(lent@fia6le except -with t@e consent ol'.%@iwh, establishment or I)ergon." (b) Section, 80@5 i,-?.f?.t.,ther amended by -i-e(lesignating siib.3ection.- (b) and (d) as subsections (c), (d), and (e), respectively, and by adding (ifti't' @itb8cetiort, (a) the follow-ina new -tib.-ection,: "(b) The Secretary 7s authorized, directly or by contract, to undertake )-,,.search., development, (leinonst7,ation, and evaluation, relating to the (tesign and implementation o a cooperative qystem for producing com- If I)ai@able and ?@niform health information. and statistics at fh.e Pederal, @tate, an(/ local levels.2 , (e) The 9?.,,bsection of s-ucib section 805 redesignated (by subsection (b) o th,;,.v sectt 'on) as subsection ((/) is ainentied to read as followv: i,( There are authorized to be appropriated to carry out this section ,S'15,000,000.foi- the.fiscal year ending 7titie 30, 1,1)71, @20,000,000.foi- the,fi,gcal year emliii.9 J?i-ite 30, 1,07',9, ati(l,@!),r),000,000.foi- thefiscal year eii(li?tg Jtine 80, 197,3.pl I'ART (' GRANTS TO STATES FOR (@ONI@PEIIE.NSIVE STATC HR@ALTH PLANNING SEc. -920. (a)(1) The.yFi-st sentence of section, 314(a)(1) of the 117iblic Ilealth Service ,Ict 'is a,?neii(ie(i by st7,@king oiit "Jti?,te 30, 1,970" and inserting in l@,ieii thei-enf "Jitne 30, 197@3". (2) 7'ltt' Necort(I N(,nteyice (if @tlch t@ct;ot, 31,11 ('a) (1) R (i),tiende(I b-v 1'7i out "aii(i $15,000,000 for tht., fiNCal Y(,171' 011111;71!1 Jiti@F 30, I! .i7O" are inserting 1.7i lieu thereof the ",@15,000,000.fi)r thc-Yi.,zcal uea)- e,ritl@i?tg June 30, 1!)70,-,S'15,60 0 for the 9 _fiscal yea@ e-n(.Iin Jiiii@'30, 1,971, $17,000,000 y eat@ ending Jiii?e 30, lD72 (II?(/ "@207- 000,000 for the fisca June 30, 1973@' (b) Siction I,-h Icf is aineii(led by Nii-il-ii?(i out "State and local a'ge et-titig iii, licil thereof State, and local agen-cie.@ (inet?i(li7ig aq an ex o7Wcio incniber,'if tlie?-e is locate(@ in .such, @tate one oil -inoi-c hospitals or ()-iher health, c@.r@ fac;titii@,%- of the 1'eteran,@' whoty, the "IlTaii-8 @hall hai,e (lesitinate(I to .3ei-ile, on such c(iii7trit (t,; the representative of th(. hi)@I)itals t;i- otliei- health (,are faco'l.1t;cs of such ,I(Ini.iii@isti-ation a-i-e'located iii, @?ich State)". (e) )-@ctio?t 814(a)(2)(I?) (!f -siiclt @ict (as a,,i@ie7t(led by (b) of this section) iN .further ai??,e?i(led by itive/,ting "(inct?idi71Y rep? the regional nie(li(-al program or proqra7yi.3 in.PI?ideil itliole or ;it 7)(ti'l qt)itlbi,n the State)" i?,nme(li(ttel?l al'ter "corwei-ne,(i with hea/f./i". ((I) Sectioii. @f @@itch Act i.,: ame7u/ed (1) b?l )"tt8et-Iiit!j inclit(liibg latrine health care" i7rme(liatelit after "priz7af(,", art,(/ (2) by imerlitig imme(liaf@ly be re ilbe @micolo7t at t@ en(J tl;,ereoj the ,fo .folloit;i,,n,!I: "aii(I eiiz)iroiime-iit(il co7wi(@ratio7tq as they ?-Plate 11) Public health". ]'ART I)-I'ROJIeCT GRAN7',9 POR IIP@PAWIDE I-IrALTri I'L.4,VvrA'ri SEC. 230. Sectiori Sl.lt(b) qf the ]'?jblic I-](,,alth,,@,i-vice ,Ict iv anieluteel,--- (1) by 8ti@iking out, in the-first sentence thereof, "Jtiite 30, 1!)70" and in8ertiikq in lieu tlbereof "June 30, 1973"; . (2) by inserting after The word ",services" the second place it appears therein, the phrase "and invlii,(liaq the provision of such services throitfil6 home health care"; (3) by 8triOng o itt, in. the second sentence thereof, "and $15,000,000 foi- the _fiscal year eruling June 30, 1970" and inserting ;n. lieu thereof the,..follow?,ng: "$15,000,000.for the _fiscal year en(l--;ng June so, 1970, @20,000,000 for the -fiscal year ending June 30, l@)71, ,@30,000,000.fo@ the_fiscd! year ending June 30, 197,9, an(/ @/fO,000,- OOO.for thejiscal year eruling J-?jne 30, 1973"; (4) by in.-ei-fing "(1)(A)" immediately a ei@ "(b)"; and (5) by adding after and below the existing language contained ther@ the following; "(B) Projec(grants -may be made by the Secretary under subparagraph (A) to the State agency administering or supervising the administration of -the State plan approved under subsection (d) with res'pect to a particular region. or area, but only if (i) no application for such a grant with respect to such regi.on or area him been..fi@d by any @ther agency or organization, Y"'a' lo receive such a grant', and (ii) suck State agen-cy certifies, and the @!ei@etary_find@v, th rtuttity has been afforded to qualified agencies and organiza ?)Iication for such a grant with res-pect to such region or are( o6able that, in theforeseeable jtititre, any agency or o@qaitizatioi is qitaliftedfor such a grant v;ill.file application therefor. (A) I7i oi,(Iei, to be@ (IPpl.ol,((/ .11,71 (IC/. tll, i'@ ti b@(, for a g?-(i-tit ii@,n(ler tltiv 8ubgeci,[on 7nt@.,;t (,@ontain oi, be supported by reasonable as&ii?,a ??(-es tltat tliei-e ha-, been or will be establi,@lt,(!cl, iW or for the area with. re.i 'pect to which ,;itch. grant is .3o?tglbt, an a,@rea,-wide I&ealfl(, planning coit?ze-ii. Tll'e nti,.rnbei-shil) qf such council shall inclutle. representatives of public, ilol,tt,,ntary, and n,o-)t.Profit.private agencies, institu(ions, and organizations concerned with health including representatives of tlte interests of local !Ioi,ei-time,nt, of the regional medical progra7n fo7- sUclb area, and of con,- ffulmer8 of health sei,,vices). A majority of the members of such counc;i qhall consist of representatives ()f co@vu-7ners of health serz'wes. "(B) I?i addition, an applicationfo7, a grant under this subsection must contain or be s?tpportet-I by reasonable assurances that the a,7,eawide health planning agency has made provision for as8igting health care .I'(Icii-it,ies i7i, its area to develop a progrant.foi capital expenditures for I-e7)lacement, mo(lernizat@ion, and expansion whiccig consistent with an oi,,erall State plan wlbich, will meet the needs of the 5tate and the area for health care and 8er ' '8 without du lication inrl .' facilities, equipment, 2YbCe p otherwise -in the -ino-it effic.;ent and economical manner." PART 9--.-PRojpep GRANTS Fo.R TRAi-?vrNG, STUDIE@Q A.VD DEmoNSTRAPIOIVS SEC. @40.,5ect-ioit. 81// (e) of the Ptiblic Health, A3ervice.Act is ameyt(ie(/- (1) by ,d?,iking out, irt the, vt sentence tltereof, "June 30, 1970" ftr and -i.,iisertittfl,ilt l@ielt thereof "June 30, 1,1)73"; and (2) by out, in the Yecond senteitee thereof, "and $7,500,000 fo2l ai- ending June 80, 1070" and inserting in lieu the ending June 80, 19, 1971, @10,000,- 001 c $12,000,00o.for tile PART If'-GBANTS FOR COMPRBHENSIT'E PUBLIC HBALTH SERVIC.ES SEC. 250. (a) Sectio-n Service Act iq a7nended by striking out fi8cal year ending J@une 80, 1970" and in8e fiigcal yeai- eiaing June 30, j ?tding Jitne 30, 1971, $145,00( 1972, and $165,000,000.for the (b) Section'S@4(d,)(2)( of s Ae amended (1) by striking out awl (i-ii)" and. insertin in lieu there< "(ii!i)" and (2) by in-gert,@ng @,fore, the semicolon at the end thereof the un7kq: "; and (i?,) the plan, is compatible with the total health program of the State". PAW G-P.ROr.ECT GRANTS FOR HBALTtf SFRVIC--S DZVBLOPMENT SEC. 260. (a' ) Section 814(e) of the Public Health Ser@ Act is amended by striking out "and" immediately after "Jvne 30, 1969," and by insertin after "June 80, 1970," the following. "$109,500,000 _foi- the.. . ding June 80, 1971, $185,000,000 for the fiscal year enc 1972, and $157,,000,000 for the @ca year @ing J,u@,ne 80 H. Rept. 10 (b) I'/tc fiist 8eittence of 3111 (e) @ fttrtlie?, amended by ilt,- ?Itediately aftei, '(lost" the.@ollf)vitig: "(,@ncbuding eqwity rcqwii-eikients and amo?,tization oj loans on facilit@ a(,-qii ''i@e(i froin the f)ffice o Economic Opl)ortti,,itity or consti,iietion @ll collection. with ait,y lorogi-(zm oi- project tra,nsferredfrom the Office of Econom@ic Oppoi@tu.,iiity)". (c)(1) I'he second sentence of such 3eetio7t is ameii(le4i to i-eatl as follows; "Any grant made ?i.,ndei: this subsection ?nai be ?)2a(le, oi2lq if tlte b,i,c,ation for such qrant has been. ?,efe2-re(I fo?, rettiew and corn?iic,7it t(.) p t7i e@a propriate areawide health plaa?zit?,g agency o-i- agencies (or, if there is no such agency in the area, then, to such other publ-ir oil 2lottvi-oft private agency or organization (if any) wl@ichperforms &imilai- - fvitetioiti) and only @f the services asR@ist&i an,(Iei- s,uch@g@ant iiyill be pi-ovi4led iTi accordance with such plans as have been. developed pat,.-iiant to subsection (2) Tli,e ai@teiidiiient made by lial @a(ti@a!)It (1) shall be effective ljqth 7,e.-?7)ect to I blic H(@atili, qer7)ice Actii;lii(:Ii, ai,.- .qrants under 3 14 (e) (!f ,in@de a er the date of ettactme;nt n this Act. .ft f I'A)?P 71---.ell)MINI@'ITIIATION OP (IllANI'.q 12V (,'],I,7'AIN '11171,Tl(il'.lNl' I'.t@oj]?CTS SEc. 270. Part A o .f t@ifle III of the I-ubl'c I'leattli, Sei-,aim Fact is a?ne,nded by adding at the end thei-eoy the.followi@(I new'sect-lon: ".zlil,,ini7tisti-atio,n, of Grant,,; i,,ti O@ei-tain jl![,itltigrant Projects "S.Bc. SIOA. ]?or the ?trpose of facilitating the a(l@inist7,ation of, -p and expediting the carmmg out of the pu?,,pO8eS of; the programs e@b- -ish,ed by title (b , 1 l@, and sections 304, Sl./@ 314(c), 314(d), and 3lJt(e) of this Act in situations in which gi@ant,,? are -sought or made iinder two or more of such progra?ns with respect to a single project, the Secretary is Authorized to promulgate regulatiom- (1) under which the a(linini,,?tiafi?,efunctionR qtfi@ler s?ich p)-ogra.,rng with respect to such project will be performed by a single ad,;rtinistra- tive u-nii which is t& ddministiatief, 'ung't charged with the adm@;,Itis- tration of any of such programs or is the -administrative .7irtit charged with the supervision of two or ?nore of such programs; "(2) designed to reduce the number o@f applications, reports, and other materials 7,eqwired under such programs to be @ub?nitte(I WI.th respect to such project, and otherwise to si?n@l,@fy, consolidate, and make -uniform (to the ext6,ybt feasible), the data and infor7nation. regv,,ired to be contained in such applications, reports, @n.(l other materials; and (3) under which ;,nco rtsistent or duplicative requirements imposed by such progt,a?n@,; will be revise(I anal made unifoi-rit with respect to such ?)roject; sectioi-i, shall be construed to authorize the C?Ul, with respect to any such project, an?/ any oj siwh program.- if 3veh requirement is ?zlatioib required by law." PART .1 e@INNU.4L ]&'EPORT, NATIONAL ADVISORY COUNCIL, E?TC. SEC. 280. I:lart !-[ of title III- of the, Pitbli.,c.Tlealth @ervice Act is furtltei, (i,i@ientledbyad(lin@gaftei-sectiott,310@lthereo (asa(l(ledby.%ectiort,270o this Act) tl@e.followl now seciio?b: f 12 (((d) T-lt(, Cr)tlztcil sltall and assist the Seci.ctary irt flic pl,epal,ati,,t@l oJ general regulations J4,)i, air,,] as to policy matters al.isitig with respect f U), he atlministration of section Slfp of th;s title, with increased em7)ha,,-;,v on cooperation in thi coordination of prograniq fli-tr(...7.tnder wCth. tlt., Ali-ftional A(lv,@orij (ouncil on l,'egt'onal Ifedical Progra7ns, with p(zi-- ticiii(Lr attention to the relationship betiveen the improved orqan-izaticii Wild delivery of health -services and tCefirtaTicing of s?ltch@ services: and ,zhal7. ?,n ca7"j?,ng out &Ych 'functions, 7-eview, not less often than annually, t@ grants made under section 314 to determine their '(.,ffectivcne-3.@ in ea?-ry@ng oii,t its purposes." Src. 282. Part B of title III of the Pvblic Hudth Sertice Act is atyiended by -3t,,iki"g O;lt ('Siti,fieon 'General" each. place it appears an-d lie inserting in 'It thereof "k@,cre[a?,Y". PART I--I?BGULAT.[O.?V OF T7A(,CINI@,@, 13LOoi), BLOOI) ('OAIPO.Vr@IVTS, AND ,ILLEItOBArIC ]'ROI)IICT,@ SEc. Seefi(o7b 851 o the I-Itible'c I-Ie-alth AVei,,i!;ce @ict ;.,; ainentle(I If by,in,qerti?i.g, aftei- "iTtititoxiii", each time.Nuch ivoi-(l "i@accine, blo(@(7, blood component or PAR5r K-FxTr@,vsioN or, 1?1,,SEAR(,'Ir (,'OiVTRAC7' ZIU7'1101112'Y SEc. P,92. llai-a .qrapli, (h) of vect,ioti 301 of the 1,itblic HPalth Sei@tice ,let i amended by -str-ik io?it "fli,e viiccee(lin(I fiscal yea7,,@" amid i7@- setting in 1-ie?i theieo "eight v fiscal ?I;@@8". illfi-,,'NTAI, HEAITll SLPC. 301. Section, 201 of the (,Iomt&it@bity Ale@ntal .Health, zlme@,(Iinent,,: of 1970,i,@ ame,n@le(l@ by ad(li,7ig at the efiti thereof the.followi7ig -new sitb.,;ection.., "(c) In the case. o any comnt-?inity mental health ct,7tter--.. - .f 'c(i) for which a staffing gra-rit was made qin(ler part B Qf- the ('o?yimii,,n.ity Mental Health (enier.@- Act.for any period which began on or be re June 30, 1970; and .fo "(2) (A) witib respect to which the portion of flip costs (a.,v in, section 220 (a) of'such Act) whic@ may be- vi-et franc f7i rtds ii n-der a grant ii7ider suck part B is increased (by reason of the enactment In -for a qf the preceding s of this section) n?j period qftt,,- '77ine 80, 1970; or "(B) v)it7b respect to qi)li,,;,ch the '7)er,iod (Iiiri.,ng which a ,4itc1t p(tit Bmay be madf,, iq e n(led by reason of the eiiact@men-t of t xte Itilbs:ectioii. (a) qf thi,.v the I)roviRions of 3ectio?i, 221(a)(11) of siieh ,let be, (I#,,i,-ined to have been. complied ilylth.for any period after Jiine 80, 1970, if the Secretary (leternt-@n,e.,t that there i3 ,?ati@fact(@ry a.,:,wirance that the amoii-rit of total costs, li'ed(-,ral and non-Iie(l(@al, (as described in section 220(a) qf &Uch Act) v)hich will be incurred by simh certter.for stqffing pitry)o8e.,.?.t@r any -will not be less th,an the amo?jnt of total m@t commenced on or before Jiine 80, 1970, n@)t be reqvired to increase the a-moitnt con.- share @A the event the aino?tnt of the Federal participation is ?-ed,,uced." 13 SEC. 401. (a) Tibe Secretary qf Health, E(.Izicat't'on., and Wellfa7-e may, i,-n accordance wit& the provisions of this section. authorize wAY cam.er, which -is a party to a contract eizte7'e(I into iinder chapter 89 of title 5, United States Code (i-elating to h,ealth benefitsfoi, Federal employees), or tintlei, the Retired Federal E7nployees Health Benefits Act, or'wkich par- tic,@pates in the cat,)-yi.ng out of any such coiit?,aef, to igsqte in, any State contracts entitling ai?y person as a bene iary to receive c(nnprehensi?,,e :fi-- medical 8er?,ices (as (le ii,e(I '? q-iibsection. (b)).fram a gro?tT) practi.ce -7in't .fi -17 I 01, o@(ITnizat,io7i (as (lefitiectin ,:iibsectio?i, (c)) with which slic7@ carrier ha,@ contracted oi- oth(,i,?j)isf,, (7,ri-aarie(l.for the pi,o?)-ision of 8itch -Rerv;ce..,;. (b) -Is itNeel In this ,?ectio?@, thi? term 7,n(,(I;c(il CO?tlpi."helisi.I,e (liagtio.,?t;@, ant/ flitrapeut,;(: medi,-al (as in o ilte AV(?cretai-y Jiirrii8@(I t)7i a ba.,;;8: and at the (;pt;on, t)f a carrier, @qiich other health 81'r-vt'ces 11.iielti(li,ng mental health @ervic(,s, and e(Iii,,ipment and supplies, furnished oil, terms and condition with respect to copaynient (i@l other matters, as ?ilay be authorized in regulations -of the Secretary. (c) As,imed in this section.- (1) The fet-tn. "g),o?fp y)ractict, it?vit or oQ(an;zat@n" means a no7t- p?,ofit agency, cooperative, or other o?,ganization undertaking to provide, through direct employment of, or other arrangements with the membe@i-s of a medical ffro?@p, comprehensive medical services (or such services and (itlier lwalth ser?)?,ces) to members, 3?tbscriber8, or other persons protected it.laet- contracts of carriers. (2) The tei-n? @'7rtedical groitp",,rteans a partnership or other association or group of persons who are licensed to practice me-dicine in a State (or qf sach persons and persons I tice dentistry or optometry) who (Aj as there, p?,i,?tcipal pr sibility engagein tAe coordina@ one oi- more group practice.fac a,,q ?n.embet-s of the gi-oitp and, d,, prearranged plan, or eitter,into a??, employme pracitce,unit or onqanization.for the provisio commo?t overhead expenses (if and to the extent such expenses are paid by ,members of the gro?ip), medic-al and other records, a?ul substantial Abortions of the equipment and professional, technical, and atlm@iiistrat;ve 8t,,a6, a-ad (D) inilu,,de within -thiqroitp at least 3?tch professional personnel, -make available at least 37tek health services, as may be -pecTfied in re'gida- lions of the Secretary. @(1) Nothing in this section 81ball preclude any State oi- State agency from ),egulati,,ng the a,,movnts cha2,fledjor contracts issued pursuant to sub- section (a) or the manri-er of soliciting and Issuing sitch contracts, or,from r@gztlati@(7 any carri',ei- -issui,,ng s,iich contracts in any nianner not ?'n'con- swtent witlb the provisions of ihi.- section. TITLE V-STM' I?EfL.Irl'l,.VCz 7'0 ENVIPiONMEfATTAL POLLUTION SEc. 501. (a) I'he (,Iottgt-ess fi?tds- that fltere is gene?-at agreement that. water, and other common e@tiv;,ro-rtinentat lioaution. may be hazardous to the health of i-76(iivictiial8 -i-esi(le7itb'n the Uiill'ted States, but that despite tlbe existence if variaii& research papers and other technical reports on the 14 lt(,alth hazai,(Iv o .3iich pollution, flt@ci,e ii o a!ifht?r;tat;i,l- )f i'l, 7nation about (1 ) the nature and grav;ty @,f these hazards. t"2) th@, ara;la- bit-it?l of medical and other aq.3istayicc to pei@,q,7,ns a-ffected bv steel potbile'(,Il,. O,.qpo,@iilly iiihen .97/,Clt pollliti,'(,m, reaches omer-7encit levels. and t3l t,, e n-(ea-s@- (ilAer than this( relyf@lig solel!l tc, a@ate@ctit ci tAc 'Ittzi ma?i be talen to arrt; ./ or rerjllcf the f T,,ce,3 ?f si?ch p(Wit@tion i)?? f@i-c hf tililb of (b) 77te Pre@iierit, Rhall ;?izinedia4f.l?l co7)ii?@eriee (1) a stittiti of the tie,, and gravit?l of the hazards to htiTnan health and sqfety @ea-ted b? .1 a) t,, awl other common environmental pollution, (2) a s?irt,e?l Qf the. medical and other assistance available to persons affected by such poll7i- tion, especially when such pollution reac&s'eme@(ieac?l lei@els, an(l-(S) a ,,;?ii-ve,u of the. measv.7-es, othet- than thoqe 2-elati,7"i solely to abatet)z(,ttt of the io e e- poll,liT n, that may be taken to a?@oi(i or ?@ed,?tc the .effects of SUC/6 Poltlltio7l. on the health of iidii)idiials. (c) The P@si(lent -hall, witlz;in ikionths of the etiactine-lbt of this lct, ti-wn&mit to the Congress a report of the sttid?l'wttd s?irvei e(I by subsection (b) of this section, iniltidi7b-g (1) his coaclwions"re the ,nature and g@a;it?l qf the hazards to human health and sc by environmental pollution, (2) his evaluation of the .7ned r assistance available to pei@so-its affected by such pollution, especially iihffi, such tion reaches e (3) his assessment of the other t those relati,,n the pollution, that may be taken to avoid or redqtci ition on the health of viditals, and, (/p) such ista or ot r recommendations as [w, may (Iee?n appropriate. ((/) The President shall, withi,,tb one year of his transmittal to the (,ort.- !Iress of the report required by subsectioib (c) @f this section, and avn-itallil thereafter, .&?@I)plement that report v@,th 8?tc@ new data, eval.7i4itioit.,?, or recovirnev.dat,t.f),n,s (is 7w, mail d@em, appropriate. (e) Tlte?v are aiiithorigell to be apZ) d q.itch 8,tttti,4 (j..,: iyt(Ly be@, -opi ions (@ necessary to cari,!l o?tt the y)i 8 th - eciion,. - LANif,'O US NATIONAL AI)VISOIZY (IOU@VC/L SEc. 601. (a)(1) Sect;io?ts 217(b), /132(a), 443(b), and 703(c) of the Ptiblic I-lealth Service Act are amended by insert;,ng "or committees" after "ccqtncils" wherever it appears therein,. (2) Sections 481, 482(b), ties, lill3, and 452 of 8,zch Act are amended by ins= Igor co?nt)vittee" after wherevei, it appears tlberei?t. (13) otions (b) and (@) of section 222 of siich Ait are amended by inserting "council or" before "committee" wfirever,;t appears therein. (If) Such sectioi6 is further amended by inse7-tin,g ia-the headline thereof I'VOUNCILS OR" before "COArMtl'T-r,],,S". (b) @1) Stibsectiott (e) @f section 208 of the Piibl;c Health, Service -ilct Is amended to 7-@: "(c) Membe?,s of the Alatiotial Idvisot,?l -T-lealth Coti@n.cil and members,; othei- national advisory or review councils or coinin-ittees.establishe(i this ztct, iiielu(Iina in-embers o the Teclt,,nical Electronic Product ]?ad-iat-io-i-i. Sa-f,,ty Stantldi,(I,3 0,@in?71.;.ttee and the Boa?@el of li'e(jents of the -@il of Afetli(!i?i.e, but ex(,Ill.(I-i,,nl -ivhile Natio,n(zl TiKi' aft@n(I-iiig co@-fe)-e?i(les or qf their 7, ci&@ or com- at the i-etl,ize "hall be 7nittees or uiliile oth,cru@i,,?c 15 (it rate,@ to be fit-e(I by the Seci-et(xi-y, but at 7ate@ -not exce&liizg'tl&e dail? c 'I'M e oj v?ich service / equ@?)alent of the rate spe ified at the t' 'foi- tirade GS-18 of the Ge7teral Sched?ll@@, including trarel- t,i7ne; a)@(I white awa,?I.fi,ont th(,ir-liomes or regular places of busi@ss they n in lieu Of subsistence may be allowed t2,avel expenses, includi@it per (fie? ' a8 authoi@ized by @ection, 570,' f the United States Code for persons -in the Go?,,e7,nment 8, ii@fermittently.y@ (2) The -second sentence o- of ,?ection 306, the second senten.(!c of s?ib.@ efirgt sentenc (2) of .3?t6sectio se .vecti6n (e) qf s(- cction (rl) o) m ,veetion 72,9, 8?il o7i, 77//, rt.2,id Yubseet'wn f N-71,Cli Act fll,e (161cle(l. I'(tra,.qra7) of.@iib8ee (if section Si)-,9 i8.furtltei, by O?tt "II sijbv i@" iii the ,iecoit(I sentence thereof (ind by i "to ?ne7nbe?-8 o i-e -7iot f the (."om7t@,ittee who a office?-,q or eini q) i United @tateg 1),iir.-zuant to subsection (c) of @ect,,Iotb 208 oi t)). (4) Subsection (.,I) qf ,?ection ')Or@ of quc/6 Act is redesignated as sub- section (c) - (C) (1) Subsection (a) of section 222 of such Act is amended to read: " (a) The Se thout regard to the provisions of title 5, Ernited States Appointments in, thi com etitiie service, and without reg qf chapter 51 and ;u ,,Lceh'@a I' ter III of -3 of s p chapter classijicat,,ion and eral Schedule pay rates, from time to time, t such advisory councils or com- 7n.ittees (in addition to those d to be established under other Pro- qf law), for such periods qf time, as he deems (,Iesirable with vlch pei,-i.oa commencing on a date @pecified by the Secretar7ifor the purpose of (z(lvi.si,n,g him in, connection wit& any of hi@q.fitnctions.7' Sqtbsection, (c) qf such secti,'oni.- amended byinserting "or prom-ams" PI.qiects, (d) (1) Subse@@@.!)n, (fl) (@f section lpO8 o the r(oo(l, Dr?ig, an(l, C,'oS7net'iC .-let is amen(le-d by sti,ilr@i!ag o, ib ..,for their services a reasonable 'per diem.,.for t@ime a work of the committee, and shall i',n, addition, be 2-eiin ii, neces8ar? d ./ traveling an 8?tbRistence ex-pen8e,@ while so se, m their plac@s of re.-,idence." qftel, "shall receive" amid by i7t, nsation an(I ti,at;el exz)eti-ses in accordance i subsection ect-ion 706." h (D) of p 706 by sentence: "M@ adv while attendir4 es t the reqqtest of the rece,ive comp6 -rates t@befixe,,l by ot exceeding the rate 7icefor Schediile, e away.from regular places of including per them itt lieu s,iL 3@stenee, as authorize( I (b) of title 5 o the Unite,,l !f Zates Codefo'r persons in thf t employed intermittently." SEc. 602. .'5eclio?b 4lt2 of the Public I-leattit, Serin.'ce Act i-i a7reridetl b?l striking o?tt "7-eseatclt," before "trainin.!.I". Aiid the Scriate agree to same. That the House recede from its disa_greeme,,it to the aniendrneiit of the Senate to the title of the bill an(i a,-ree to the same. HAITLEY 0. STAGC;EPS, ,JOHN TAlt,-\IAN, PAIJL Ci. RoGlEit,3, ANCIlEit NEI,SEN, t)ti, the I'at@t of fli(@ ItAl,llli IIA]tit]SON A. WILLIA.\IS, P,'[)WAltl) '\I. KFNNI-,J)Y, P. FA(AI,ETON, AI,AN (J'ItAN@'I'ON, IJAItOl,I) l@i. flU(,JIT,,'.'A, ('@1,AillOltNE Pl,,LL, PETF,R 'I-1. 1)0.\l[NICK, I.IA(!Oli l@. JA-Vl'l'-,, ('XEOR(ll,, INTITRI'HY, WINI,TON I,. PROIJTY, WILI,IAII B. SAXBF,, @Vfanager,,? on the Part.r)f the Senate. sTA,rETVIENT OF THE AIANAGERS 0,N THE PART OF THE HOUSE 'I'lie. oil (.lie I)ttrt of tile House tit the (-oiiferell(-e oil the (ii,,ttgr(-eiiig votes of tile 1,NN,o Hoiises oil the iiiiieiidiiieiit.s of tile @Seiisit@e t.o the bill 17570) t,o jiiricii(I t,it-le TX of the Piii)li(- Helittli Ser%,i(!(@ A(-.1, so its t,o ext,(@ii(I iiii(i 1,11(@ existing I)I.ogl.,Llll I-ellilill,-, t.1-ilillitl(', @111(i (lotiloll,.,tl.lltiolis ill tile ii(tl(IS ()-f ficitt-L tlisellse, li,ii(i of,ii(@i- i-eitit,c(l (lise2l,.,es, iLii(I foi- ot liet- submit, tile follo%@'itig st,ittkitictit, in (@xl)litiiiii,ioii of the efff@i!f, of tile action agreed til)oii by i,li(@ conferees iiii(i i-e(,,oiiimen(led in tli(! it(,(!oliil)it,nyitio, (,,oiifereii(-e rel)oi,(,: The Senate iltiiendiileiit t,t) the text, of' the bill struck oiit ill or t,lie House bill after the etitt(ttijig elttttse iiii(i iiii(@rte(.1 a substitute itillen(l- iiieiit. The (-oniiiiittee of (-,oiifereii(@e, has agreed to a substitute for both the House bill a-tiid the Seiittte itnieridiiient to tile text of itle bill. Except foi- teciiiii(-,itf, (Nitrifying, and conforming chtlll(_,e.;, tile folio%%-itig statement explains the differences between the Ho'iise bill i),iid t-lie ,ttbstittite a(ri-eed to in conference. rii(@ Botts(@ iiaLl; )ttss(@d two separate bills dealing with tile eliibrtt(-ed in t,ii(-, Aentit,t@ ttiyieildiii(@iit; I-I.R. 17570, and H.R. 18110, a bill ext(@ndiiig and (Expanding tli(@ I)rogriiiii of coml)relteiisiv(, li(-Ititli 1)ltiiiiiiiig and research arid demonstrations r(@latiiig t,() tli(@, de]iN-(@l-V of health services. The Senate amendment deals with tht, 1)i-o(,@lims coiitain(-d in both House bills. REGIONAL 'AIEI)ICAL PROGRAMs ,@cope of program Both the House bill ttiid t-li(@ S(@iittt(-, aiiieiidiyient expanded tli(@ s(-ol)(, of tile, program to include kidney disease its well as heart, disease, ettneei-, and strok(@. However, the Seiiat(@ ttmendm(@nt changed Coverage of other related diseases to othfr mq:ior (liieases and con(litiw?.s. The, conference substitute is the same as the Hotis(@, bill. Tlii@, NItiii- tigers foi- both Houses were in doubt as to whether the s(@ot)(@ of tile )roo,rani should be limited (as in the House bill) to dis(@a,,(@ r(@iat(@d to Heart disease., kidney disease, cancer, and stroke or wheth(-i- it ;flolil(l be limited (as in the Senate, amc@ndmeiit) to major dis(-as(@s find (,-oil- (iitioiis otlif@r than heart disease, kidney disease, cancer, and sti-ok(@ and expect the Secretary of Health, EdticfLtioii, and NVelfare to coii(lit(-i at study of the scope of the re-giontil in(@dictil I)rogram and to i-(!I)()rt to tli(, apl)rol)riiit(t committees of Congress his recommendations. The Senate aiyieiidmoiit (-contained a provision not in the Eloise bill which expanded assist,ai)ce foi, (!oiistrii(-.tioii, to include assistttti(-e foi- new (construction of fa(@ilities- for (leiiioiistratioi)s, resea-i-(-Ii, find training when necessary to (!airy out regional iiiedi(!itl programs. 18 'I'lie (,(jiifereiiee stibstitiite is i(lenti(-zil %x-itli the @eiiite anieii(Lmeiit -ovi(leil tllat 11 (@t iiioi-e than $5 millioii iiiiv be i-nit(le -It it is I)i teixv(l!ieil)tltbtllel@iii iny fisetil@ ye@,ii@ foi- @,i,tiiits foi- ,;tieli lieNN- coiistrii("tioll. Pai,ticipatioii of 1eteran-s' A(Im-in,ist?,atioiz I)ersoiiiiel The Seiiite aiii(@iidiiieiit (-oiitaiiiie(i i ))i-oN-ision not iii tile House bill %%-Iiicli wotil(i (1) tiiiike the C'Iiief Dire(@tor of the Veterziiis' A(iiiiiiiisti-tition iiii ex offi(-io iiieml)ei- of the Ntitiotitil A(tvisorv (.'oiiii(-il for t@lie i-e,@ioiial ine(lical 1)rocl-ziin, @iii(i (2) require local ' a(ivisol..y gl.()Ill)s to ill(-Ilt(le as ttli ex officio iiiember the I)ersoll (lesigiiate(i fl-()rri tile lo(@iil Veterittis' A(Ittiiiii-,t,i-ittion health facility. JOINT AI)MINISTILATION OF PROJECTS i(le tlittt. iii t@ii(@ ol' 1)i-ojf@(-,ts fiiiid(-(l illor(@ than oll(. (!otll(l I)(- (I(@sic,-tittt,ed to for Sit(-II lioll-Fed(-.rtil forstt(-Ii I)i-oj(@ct,s (-oill(i b(@ (-,4titblisli(,(I, tttid c(iiifli(-,tiiig grailt. or (-oiii(I 1)(@ delet(@,d. ri 11(. itiyl(,Ii(lllleTlt. (.,oiit@iiii(!d ti@ sityiiiiii- 1)rovisi(@ti. Tli(! ittitl)ority iii tlit@ itin(-i)dment @%-oitid b(@ lititit.(@(i to i)roj(!cts fiiiid(,d iiiider t,itl(, TTI oi- IX of t,iii-, Public H(@ttltli S(@t-%,i(-(@ Act and no authority foi- a siti@lt@ tioii-F(@d(@rttl slitirf@ r(!(4uireiiieiit or for @,aivc-,i- of confli(!ting i-e- qiiir( '@iiieiitis rcqiiir(-d by lttn%- ()'r by rogtilittioris required by law would 1)(@ 1)rox,id(-d. Tli(@ eojifei-eiie-c ,ubstitiit(@ is id(3titi(,ill with the 1)i-t)visioii of til(@ aixit@iidmeiit. RESI,',ARCH AND DEAIONSTRATIONS RELATING TO HEALTEI FACILITIES AND SERVICES .z-1 iithorization of app?,opriatiom@ The House@ bill would exteii(t for three fiscal years (through fiscal year 1973) the authorization of al)l)ropriations ?or the 1)rogram.,,- of Federtil financial assistance under sectioil 304 of the Pu-bli-c Hetiltb Service Act (relating to research in(i demonstrations). TI)c following amounts NN-otild be authorized: $58 million for fi--cal vear 1971, $79 million for fiscal yetir 1972, and $94 million for fiscal vear 1973. The Senate tiiiien(Inient in-otild extend such ])rograin for five vefir.@ (t.hi-otiLvii veiii- 1975) find ivoiild ,tiitliorize ilie follo-,N-ii-la amo'uiits: $80 million for-fis(!a,l year 1971, $85 million for fiscal yearL 1972, $94 million f(@i- fi,-(,al veir 1973, $110 Million foi, fiscal year 1974, aiid $I")O iiiillit)n foi- fiscal year 1975. rlie (-,otiferen(-.e substitute Nvotild exteii(I such 1)rogi-iini.,., for tl)ree yetirs (throii!,)-li fis(!itl year 1973) aiid wotil(i ttutliorize the followino- tL.Illotilits to be ai.I)I)roliriti,te(I for sLi(,,,Ii I)rograin: $69 iniltion for fiscnl Ilio - fi votir 1971, $82 iiii n for fiscal yeiii- 1972, and $94 million for seal year 1973. (,te., on detii)e?-y (@f h(,(ilth sei,i)tces Tile @@eiittte amendment, cojit,iiiri(@(I a I)t,ovisioti not iii the Holt,,-,e [)ill which N@-otti(i ittittioriz(@ gi-ttiit,s-.iii(i (@oiiti-ii(-,t,s t@iti(lei- sii(@li ,ectioii 19 '@04 for research, exl)eriinetit,;, ttnd demonstrations, relatiiig to the effective combination or coordination of methods or systems for the delivery of health services. The conference substitute contains the provision of the Senate titi-ieiidnient. IIome health services 'rlie. Senate amendment contained it I)i-o-,@-isioii riot in the Hoitse I)ill Axiiieh would ttittliorize gi-itnts and contracts under such section ,304 l'Ol- [)I.oject's fol. 1,@-eati-cli an(] demonstrations in the 1)rox-ision of home health (!ollfol.otl(.,e sili)st.it.lit(@ (,.olit'llitis 1,110 J)I.ovisioll of tile Sciiilt(@ -inalyn' of -ti(itioii,(il Itealth plate.,; Tile s(it litte it provision riot in the lio(ise bill Nx.lli(.Il would illitoll(i "11(!Il section 304 to'(Iii-e(,t tire LSecretaiy.of liettltii, fi-ii(i welfiti-e to develol), through utilization of systems 2i,iiztlysi-, method alternative i)12i,iis f'or 11(@,itit,ii care systems designed @t(leqtitttely to meet, the fietiltli needs of the American t)eol)le and to rel)oi-t, to Cotigi-es,.@, riot Ititer than June 30, 397i, on sticfi plans. under. the ttiiiezidrneiit, the Se(.-i-etary would also study bills introduced in the 9]st Congress which 1)ropose a national health insurance plan or similar I)I@n to deterii,iiiie the costs of such plans and their ad@quacy. The Secretarv would rel)ort to Congress riot later than December @l, 1970, the results of such study. $4 million would be authorized for fisetil year 1971 for the development of such plans and for the conduct of such study. The conference substitute is the same as the Senate amendment ex(-.el)t that (1) it is made clear that the Secretail- is to develol) more than one plan for health care systems, (2) the Se@retary's report with resl)ec,t t,o plans for bettlth care systems is to be made not later than September 30, 1971, (3) the Secretary's report on bills introduced in tile 91st Cong:i-ess is t,o be made not later than March 31, 1971, and (4) $2 million is autliorized'for fiscal year 1971. THE NATIONAL HEALTH SURVEYS AND STUDIES The House bill would anieti(I section 305 of the Public Health SerN-ice Act to extend for three years (tliro@gli fiscal year 1973) tile )ro,graui of nat-ional health stirn,eys uil(i stu(iies and would authorize for such program the following ai-noiirits: $10 million for fiscal year 1971, $21 million for fiscal year 1972, and $22 million for fiscal year 1973. The Seiittte amendment NVOLII(L continue the open-ended ttutlioi-izil- tioii for such I)rogram. The conference substitute extends such I)rograni for three risen] years and authorizes the follo%@,iii- iiiiiottiit.,i: $15 million for fiscitl yetti- 1971, $20 million for fiscal year tl'972, 2i,tlfl $25 million for fiscal year 1973. REPORT ON ACTIVITIE-, UNDER TITLES ]If AND IX OF TTIE PUT31,[C IIEALTII SEltVl(,,E ACT The Senate amendment coilttlin(id a T)rovision riot in the Hous(! bill which woitl(l amend the Public. H(ktil@h Servic(@, Act to that on or before January I of each yeir t,lic Socrtitary of Health, Educa- 20 I io II, 1 .,II (I Io it t ,Lli(I IX (If t,ii(@ I'til)lic 11(@,titli A(-l NNitli I 1) III (@vitlitatioll (If till' of sit(.ii ,,ctl\,Itl(.s ill tli(@ iiid ill i!l, J)la,iiiiiiic,, for, itti(I of. (2) itti @tTliLl sis of tll(@ I-elttioii,.41il) Ft@(lel-tt'l iiiid locitl y aiid (3) siicli re(@oiiiiiioiid,,.tioii,,, t@lt(- de(@iii,,; COMPRD,Ilr,N'.,IN-E IIFA1,Tll PLA-@,NING ';TATE ILEALTII I'LAN ,Iiltll.ol.i@(ttioti of or I-lit@ I)iii)li(- Il")Lill) 1)].O"I.Illll of I)I;llltlillg it-ii(I tile l'olloNN-ifig $10 iiiiiijoll 11)71, $15 iilillioii ft)i- fis(-tli y(@iLi- li)72, itti(I $20 iiiillioIi I'()t- lis(-Ill 1 9 7:i. "11(.Ii y(,iii- 1975 iiii(i kN-otil(I ittititoi-iz(@. t,ii(@ I'()Ilok%,ill(r ILIII()Illlts: $1,5 ltlilli()Il t'()I- (is(-itl y(-ti.i- 1971, $17 inillioii for ll:s(-iil y4@itr 1972, $20 titiltioti l'i)i, li)7:3, $:30 iiiillioii f(@i- fis(-tLl y(ttti- 1974, itit(I $35 iiiiilioti for 1973 itii(i iLtitlioi-iz(@s tli(! followiii, itniotiiit@: $],") million for 1971, $17 inillioii for fiscal y(@.ii- 1972, tti(I $20 inillioii for I- 1973. l,'eteran,8' AdminiNtration i@,,pi-esentation o7t ,-state ltealth planni@ig coliltc;l 'rlio Senate ariietidiii(@tit4 (- -oiitztiiied a 1)rovi,,ioji not in thf,, HOLt,(@ [)ill wotild I)i-ovid(,, that tli(, State ])Ittii iiiider sucli s(@(.-tioti 314(@t) Wolil(i iii(,Itld(-, State I)Iiiiiiiiilg for liom(-, ]i(@altli car(.@. ,ri,t@ (-onf,-,reii(-c substittit(- (-ontztin-., the I)rovisioii of tii(, aiiieiidin(@tit. PITOJECT GRA-NTS 17OR AREAWIDE REALTIT PLA\.NI\G ,Iiithoriza,tio?-i, of al)propt-'at;oit.-z t 11oll,@ i)ill woiil(l 314(i)) of tli(@ Piibl@i(- 114,tilth Act, to (,xt,(@tid fis(-ttl 1973 t-li@@ of J- ('(-t, foi- Ii(@ltltll I)IIIII11iti and wotild 'atitliol.iz(@ tile IOIIONN'ill@' Lill0lillt.@@: $15 million for fis(-ttry(,itr 1971, $25 iiiillioIi ft)i- ye@iti- 1972, titid $40 riiillioii foi- fisciti y(,ttT- 1973. St,iittto ttiii(@iidin(@tit@ Nvoiild (@xt(@i,i(i 1)i-ogi-am tlirotigii 1975 iiii(I would aittlioi-iz(@ tii(t following aiiioiiiits: $20 million for @scal y(@ar 1971, $30 millioii foi- fis(,-ibi yi@ar 1972, $40 i-nillion for fis(@al your 1973, $50 million foi- fi,,(-al y(@tti- 1974, itrid $60 million for yt,tlr 1975. ,rllc (@xt,("Il(ls Sll(-Il I)I'o,71LIYI t'lli-otigli fls(!al 1973 ati(i itlititoriz(@s 1-ii(- f(@llowiii(,, tltiik)titits: $20 million for .@,(@atr 1971, $.30 million loi- fis(,tLI y(ijtr 1972, ttji(i $40 for 21 'II tile I)ill tilli@t @treit I)ItLils iiii(lei- si-,(-tioii 314(i)) \\-otil(I iii(-Iti(le home health (-tire services. (.ollfel-ell(.e ,;Iil)st,it,lite i-,, i(letiti(,,ti "-itli the Seiiitte artietidiiieiii. to State age-n.cy 'I'lic @iiitt,e iiiiiezidiiieiit (!oiitaiiied it I)i,o%,i@ioii not, in the liotisc I)ill N\-oiild 1)i-ovi(te that iiii(lei- (-ert,@tiji (-ii-eitriistaii(-c,, the State I)Iitiiiiiii,o,- t.-eti(,y coitld receive a gritiit tizidei- sti(-Ii ,,-ectiol) 314(i)). 'I'lie (,oiiferetice stil),,,(ittite is i(teiiti(@@ti Aritli the Sei)ttte amendment. health plaitniii!l council 'I'lie lfoitse [)ill @votil(i itincii(I sit(-Ii se(-tioii, 314(b) to 1)ro\,i(le til2tt tile llcLltfl I)Ittlliiiii,, (-oiii)(,il Avotild include representatives of (-otisiiiiiei-s of' fie@tliti services 'I'lie Seiiat-e amendment I.e(lilire t-fittt, it iriajorit3r of the (-,otlll(-il be i-el)t-esetitittiN,e.@ of coti,;itmers of fietitti ,riie, (-,oiiferen(-.o sitbstit,iit,e is i(lciit@ictLi I%-itll the Senate alliell(ittiolit. GitANTI, I,'Olt (@OMI'llEffl,,NSIVE IFEAI,'I'fl SERVICES ,.Iiithoi,iz(zti(oti of al)l@ropriatiorts( flotise I)ill \\-otil(i ext,eii(i Iiii-oti(,Ii fis(@,ii li)73 the I)i-ogi-itrii ttii(lei- section 314((I) of tile Fl(-2titli Sci-x-ice Act for grants for Foilll)l.eilellsi@@e. lieltlt,ii sei-vi(,es iiii(I N%-otil(I tiitliorize the fol[oN\-- ing aiitioiiiits: $125 million foi- fis(itti yetir 1971, $140 million for fiscal year 1972, aii(i $160 niillioi) for fis(,iti year 1973. The Senate amendment %\-otil(i extend -,tt(tli I)i-ooram through fiscal yeni- 1975 and woul(i ttitthorize the follon\-lrig amounts: $130 million for fiscil 'year 1971, $145 million for fiscal year 1972, $165 million for fis(-.tl yeir 1973, $180 riiillioii for fiscal year 1974, and $200 million for fis(-,il veir 1975. 'I'lic conference substitute extends stieli program through fiscal year 1973 an(] authorizes the following amounts: $130 million for fiscal year 1971, $145 million for fiscal year 1972, and $165 million for fiscal year 1973. PROJECT GRANTS FOR HEALTH SERVICES DEVELOPMENT Bot-li t,he Seiiite and Hoti,,e bills, and the (Conference Sul).,,-titute, provide a contintititioii of the existing program of project grants for betiltli services develo )ment tinder section 314(e) of the Piibli(- Health Service Act,, Avith autlii)riztttions for fiscal year 1971 of $109,500,000, $135 million for fiscal yetir 1972, and $157 million for fiscal year 1973. I'lie conference substitute does not coiitttiii the further authorization of ul)l)ropriations for fiscal years 1974 and 1975 contained in I-lie Senate version. ,riie con ference ;tib,,titute also ititt-lioi-izes t,lie itse of ftiild--, tlpl)r(@- I)ria'Led for sect,ioii 314(e) for meeting obligations heretofore iii(-tirred ia-itli respect to certain facilities of tile Offi(-e of Ecoiiorni(! 01)1)or- ttinity wlikh liaN,e been, or are in t,lie 1)ro(-ess of being, transferred to t,he jurisdiction of the Department of Health, Editetttion, and Welfare. RE(IULA'rfON OF CEftI'AIN ItIOI.O(;I('.tL i,Roi)i7c!,r.; 'I'lie, Set)itie iiiiieii(litietit tii inien(lilleilt to se(!tioil 35 ()f' the lie@ilt.li Servi(@e A(-t riiitkiii,,,- iliii tile tiiitlioiitk@ (if tiiitt se(!tioIl ill(.,Itl(ies authority to li(-eiie blood, I)[()od (-oiii- I)oiierit,s t)r itt)(I itilergeiii(,, I)i-o(Iii(.-ts. This @iiiiejidnieiit 1!4 i(letit,ictil to the provision of 11. R. 159c) 1, passed I)v the House. Witli "P-1" )ect to tlii,4 aiiieii(linetit, file (-onfereii(@,e substitute i@ tile sailiLl as tile! Senitte version. AUTIIORITY FOR GIIOUP PRACTICE S(@iittt(@ itiii(,.ii(lineiit ti I)I.ovisioll ll(,t, ill t,ll(' lioll',(- bill N@-ilieli %N,Otll(l tilitilol.iz(@ 1,11(, of II(-,Itltil, E(III(@lit,ioll, .111(i W(']- to itittlioriz(@, wlii(,,Il tLl-(@ t,@), of. ill tile (-Itl-I-Yitl(r out of, r(,Iatitig to ti(@itltli for tictiv(@ or retired Federtl (@tnl)loy(@es, to isslic ill any Stat(@ ciit,itling b(@neficiai-i(@s to i-e(-.eive (-,om fiensive services fi-oiii it gt.olll) unit with wi,i(.,Il t@ire" catrriei- has iLrrtLii-(!(l 1',)i- t-ii(@ J)I.ovisioll of such S(@l-vices. 'rli(, (,oiiferenc(, substi(,ttte countries the provision of I.-fie iiiri(@tidi-n(@nt. RECEIPT OF INCREAsUl) STAFFING GRANTS FOR CURITENTLY FUNI)EI) COMMUNITY MENTAL IIEALTH CENTERS ,rji(,, Sonat(,@ aineti(Iiii(-iit coiititiii(@(i a provision not in the House bill tlo (@liatig(3 the application ()f tti(@, initititenaiic(,@ of (@,ffort requir(@,rn(-Iit-; itti(](@r t]T(@ Comi@diiity Metitii HeiLltit Centers Act to facilitate by ell]-reiitly fuil(le(I c-oiyimxit)itly in(-,tititl health of the F(,(I(@riil sii@t-i-c of staffing costs provided iiii(i(@r the Community Ile-atitli C(@nters Aiii('@ti(linetits ()f 1970 (Public Law 91-21 I). Tii(@ (-otiference substitute (!oiitaiii.-, the provision of tile Sciitite COMPENSATION 010 AT)VTSORY COUNCIL MENIBERS, ETC. , 'Pit(@ S(@n.Lte ain(@ti(Irti(@iit (-oiitititi(,,d it j)r(j,-isi(iii rif)t in tile I-loti;4(@ bill AN,Iii(qi ,N-ould tin(@ti(I the Piii)li(-@ II(,,tltli A(-t and tli(- F(@df,rit Food, Drti@,, and (lo,,ni(@ti(- Act to 1)i-ovi .(I(, i.iniforryi rules ()r) coIlll)eii,,,i- t-ioii of' it.(Ivisory (-oitii(-ii iii(@trii)t@i's find to aittlioriz(, (-oniiiiitt(@e,, to 1),@ (Established where tti(@re is ttittlioiit,y to advisory coiiii(-il@. Tli(@ coiif(@ron(-,e, (-oiitttitis t-ii(@ I)ro%,isioxi of file. Seiii),t(@ I?ESEARCH (!ON'I'ItACI'ING AUTHORITY Sonlit(@ amell(III)OIlt (.o IIt,ttiTI(@d t I)i-ovision flof in tli(@ House bill Nvoiild fiine-ii(I .@ctioii 3()l (ii) of t,@(@ Public 1-1(@alth Service Act, to t@Iiiiiiiiitt,o t,ii(,@ fiscal[ year Iiiiiittttioii (fis(-al y(@iiii- 1971) on the research (;oiit-i-it(@t,ing authority of tti(@ Se(l@t-t@t,iti-y (;f 11(@ltltll, E(tti(-atioli, Ind W(ilfal-e. The. conferences ;ubstititte (.@-xteii(Is such authority tlirotic,),Ii fi-.;cti-I year 1973. 23 TRAINING kUTHORITY OF NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES The Senate amendment contained a I)rovision not in the House bill would amend section 442 of the- Public Health Service Act to I)rovid(@ that the National lustittit(@ of Geii(@ral Nledical Sciences could conduct and support clinical as as trttining. The Coli- f(ir(-,tice substitute is identical to tll(,@ Senate amendment. STUDY RELATING TO ENVIltONMENI'AL POLLI,'TIO',\ The Senate itmeiidiiient coritaiiie(I it I)rovisioD not iii the House bill @viii(-,It directed the @Seei-ettii-y to st,tid (1) the health aiid sitfe @y (ly t littziti-d,,, presented 1) eiiviroiitlielitl 1)()IliiLioii, (2) medi(!ul iii)(I otlier y "I ttn-ttilitble to I)ersoiis ttf (,.te i re 'd by such pollution, and t)tliei- thait ttl)ateirieiit,, t,litit (,,an be taken Lo avoid effe(,I, of sti(-Ii pollution on human health. 'I'lle Conference substitute is the -sttiiie its the @Senate amendment ex(-.el)t that the study is to be conducted by the President. HA]TLFY 0. STAGGERS, JOHN JARMAN, PAUL G. ROGERS, W. L. SPRINGER, ANCHER NELSEN, Managers on the Part of the House. rograms .7 A communication device Deceirber LEGISLATION EXTENDED AND AMENDED By The Congress For Regional Medical Progr On October 15, 1968, the President signed Public Law 90-574 which extends and amends the original Regional Medical Programs legislation. To reflect the details of this action, a copy of Title I of the new law (Public Law 90-574) which refers to Regional @ledical Programs, is reproduced on the inside front cover of this issue. To indicate how the total Regional Medical Programs law now reads as part of the Public Health Service Act, all changes have been interpolated into the original law (Public Law 89-239) on the pages that follow. I I 4 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service 0 Health Services and Mental Health Administration 0 Bethesda. Maryland 20014 .1 I Public Law 90-574 90th Congress, H. R. 15758 October 15., 1968 82 STAT. 1005 To aniend the Public Health Service Act so as to extend and improve the provi- sions relating to regional medical programs, to extend the authorization Of grants for health of migratory agricultural workers, to provide for specialized facilities for alcoholics and narcotic addicts, and for other purposes. Be it enacted by the Senate and House of Represmtatiq,,eg of the U,n7'ted SWes of Znwrica in Congress av8embZed, Public Health Service Aetp TITLE I-REGIONKL MEDICAL PROGRAMS amendment. EXTENSION OF REGIONAL MEDICAL PROGRAMS SEC. 101. Section 901 (a) of the Public Health Service Act (42 Appropriations. U.S.C. 299,i) is amended by strikin-- out "and" before 41$200 000,000" 79 Stat.,926. and by inserting after "J@ne "DO, 17968," the following: '1$65,000,000 for the fiscal year eiidin June 30, 1969, and $120,000,000 for the next fiscal year,l@. 9 EV.XLU.TTION OF REGIO@NAL MEDICAL PROGRAMS SEC. l@2. Section 901 (a) of the Public Health Service Act is further amended by inserting at the end thereof the following new sentence: "For any fiscal year-endilig after June 30, 1969. such portion of the ,tl?prol),riat-ioils pursuant, ti) this section as the Secretary Ml deter- mine, but not exceedinz I per centum thereof, shall be availab@e to the S, 'retary for evaluation (directly or by -rants or contracts) of the program tuthorized by this title.'F l@NCLUSION OF TERRITORIES SEC. 103. Section 902 (a) (1) of the Public Health Service Act (42 U.S.C. 299b) is amended by insertin after "States I the followi@ which for purposes of this title includes the Distr'ict of Columbiga, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, Amer- icui Samoa, and the Trust Territo' ry of thep-,tcific Islands)". COMBINATIONS OF REGIONAL MEDICAL PRC)GRA3f AGENCIES SEC. 10-1. Section 903 (a) and section 904 (a) of the Public Health Service Act (42 U.S.C. 299c, 299d) are each amended by inserting after ii other public or nonprofit 1>rivate'a--encies and institutions" the follow- iiig: and combinations iliereof,'@' ADVISORY COUNCM HEMBEIM SEC. 10.5. (a) Section 905 (a) of the Public Health Service Act (42 U.S.C. 299e) is amended by Striking out "twelve7l and inserting in lieu thereof "-,ixteen". (b) Section9O5(b) ofsuchActisamendedbvstrikingout"andfour Tenn of at the end of the third year" and inserting in lieu the@f "four at the office. end of the third year, and four at the end-of the fourth year''. MUL@IROGRAN SERVICES SEC. 106. Title IX of the Public I-lealth Service Act is further 42 USC 900- amended by adding at the end thereof the-following new section: 909. PROJE(,R GRANTS FOR MULTIPROGRAM SERVICES "SEC. 910. Funds appropriated under this title shall also be available for -rants to any PuSfic or nonprofit private agency or institution for services needed by-, or which will be of substantial-use to, any two or more regional mi;d@ic,%l programs.'' CLARIFYING AND TECIINICAL AMENDMENTS SEC. 107. (a) Section 901 (e) o f the Public H@th Service Act is 79 Stat. 926. ,tmended by inserting before the period at the end thereof "or, where- 42 USC 299a. e, a practicing dentist'. r" ' 601 of suct Act is further amended by adding at the end "Ppro at b Section r ftl f the e),p ie allowing new subsection: c4 (d) Grants und-er this title to @y.ageney or institution, or com- bination thereof, for a regional m,?,ileal program may be used by it to -issist in meeting the cost of participation in such program by any Federal hospitaT." Public Law 89-239 As amended by 89th Congress, S. 596 Public Law 90-574 October 6, 1965 .an.wt 79 STAT, 926 To am6nd the Public Health Service Act to assist in combating heart d@a.-,e, cancer, f4troke, and:related diseases. Be it ertacted by the Senate and House of Representative8 of the 17nited Statm of Anw@a in Conqress a8@qe@Zed, That this Act'may Heart Disease, 4 be cited as the "Heart Disease, Cancer, and Stroke Amendments (;I Canoer, and 19651, Stroke Amend- SEC. 2. the Public Health Service Act (42 U.S.C., ch. 6A) is ments of 1965. amende(. by adding at the end thereof the following new title: 58 Stab. 682. 42 USC 201 note. "TITLE IX-EDUCATION, RESEARCH, TRAINING, AND DEMONSTRATIONS IN THE FIELDS OF HEART DIS- EASE, CANCER, STROKE, AND RELATED DISEASES CIP@ES "SEC. 900. The purposes of this title are- t4 (a@ T@rough grants, to encourage and assist in the establishment of regional cooperative arrangements among medical schools, research institutions, aiid hospitals for research an(T training (including con- tinuing education) and for related demonstrations of patient care in the fi@lds of heaA disease, cancer, stroke, and related diseases; "(b) To afford to the medical profession and the medical in'stitu- ti ' 6f the Nation, through such cooperative arrangements, the oppor- ons tunitv of makin-- availa6fe to their @atienLg the latest advances in the diagnosis and tr;atment of these diseases; and "(c) By these means, to improve Lrenerallv the health manpower and facilities available to the Natio@, and t; accomplish these ends without interfering with the patterns. or the methods-of financing, of gatient care or professional i)raetick; or with the administrative of ospitals, and in7coope@ion ivith practicing physicians, medical'een- ter officials, hospital-administmtors, and representatives from appro- priate voluntary health agencies. tc,U'rHORlIZATION OF "PROPRIATIOIQS "SEC. 901. (a) There are authorized to be appropriated $50,000,000 for the fiscal year ending June 30, 1966 $90,OWW for the fiscal year ending June @0, 1967,, $200,009,000 ior the fiscal vear ending june 30,1968, . $65,000,000 for the-fiscal year ending June 30, 1969, and $120,000,000 for the next fiscal year, onprofit private universities, medical other public or nonprofit private i g, in conducting feasibility studies, r the establishment, of re- gional n training, and demonstration activities of thrs'title. Sums appro- priated , I vear shall remain available for making such nts until t i d of Che fiscal year following the fiscal year for wCimh the appro@iiition is made. For any fiscal year ending after June 30, 1969, such portion of the appropriations pursuant to this section as the Secretary may determine, but not exceeding 1 per centum thereof, shall be available to the Secretary for evaluation (directly or by grants or contracts) of the program authorized by this title. "(b) A.grant under ihis title shall b@ for part or all of the cost of the planning or other activities with respect to which the application is made, ex6ept to construction of, or provision -of ance with regula- tions) equipmen 90 per eentum of the cost of such "(c) Funds a] shall not be avail- able to pay the care of patients 79 STAT. 927 Pub. Law 89-239 - 2 - October 6, 1965 except to the extent it is, as determined in accordance NN-itli regult- tions. incident to those researc i, raiiiin@, or dezi)onstratio@i activities -vvhlcii are eiironipassed by the )iirpt):,e-; of tlii.,z title. @o part be fumished hospitals m@dical or-other care at any facility incident to research, t@aming, or dem )nstration activities-carried out with funds appropriated pursuant to this title, unless he has been referred to such facility by a practicing physician Dr, where appropriate, a practicin ,g dentist. "(d) Grants under this title to any agency or institution, or combination thereof, for a regional medical program may be used by it to assist in meeting the cost of participation in such program by any Federal hospital. 94 DEFI.W]I'UONS "SEc. 902. For the purposes of this title- "(a) The term 'regional medical program' means a cooperative arrangement among a group of public or nonprofit Private institu- tions or agencies engaged in research, training, diagnosis, and trett- ment relating to heart disease, cancer, or stroke, and, at the option of the applicants related disease or diseases; but only if such group- " (1) is situated within -i geooTaphic area, compoted of any part or parts of any one or more States,.' (Which' for purposes of this title includes the District of Col@ia, the Camonwealth of Puerto Rico, the Virgin-,,Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands) .Nvhi6h the Surgeon Gen- eral detei@in6s, in accordance with re,-iilations, to be appropri- ate for carry ing out the purposes of this title; '9 (2) Cnsists of one or more medical centers, one or more clid- ical research centers, and one or more hospitals; and "(3) has in effect cooperative arrangements imong its com- yoonent units which the Surgeon General finds will be adequate r effectively carrying out the purposes of this title. (b) The te@ 'medi'cal center' m-eans a medical school or other medical institution involved in Postgraduate medical training and one or more hospitals affiliated therewith for teaching, research, and demonstration purposes. "(c) The term 'clinical research center' means an institution (or part of an institution) the primary function of which is reseaireli, training of specialists,'and demonstrations and which, in connection therewith, provides specialized. hizh-quality diagnostic and treat- ment services for inpatients and outpatients. "(d) The term 'hospit@il' means a hospital as defined in section 625(c) or other health facility in which lo-cal capability for diao_no--,is and treatment is supported and augmented by th-e progr-,%m estib'rislied under this title. (e) The term 'nonprofit' as applied to any institution or agency means an institution or a ncy which is owned and operated by one gel or more nonprofit corporations or associations no part. of the net e-ir!i- ings of which inures ' or may lawfully inure, to the benefit of ,tny private shareholder or individu.%I. includes alteration, m@ior repair (to of e- October 6, 1965 - 3 - Pub. Law 89-239 79 STAT. 928 GRANTS FOR PLANNING "SEC. 90 the recommendation of the Nation @Afedical Programs estal)- lislied by title referred to as the 'Councilf), public or nonprofit private universities S, and other public or nonprofit I and combinations thereof,, to assist them in planning the development of regional medicaf programs. (b) Grants under this section may be made only upon application therefor approved by the Surgeon -General. -A-nv Such application in or is supported by_ that FWeral fu@ds paid pursuant ly for the pu ises for which rp, applicable provisions of this t applicant will provide for procedures as are required by the Sur-aeon to assure pro r disbursement of and accounting Tor such Federa " (3) reasonable assurane icant will make such !Ieports, in such form and information as the and such acce t ur- to assure the correctness and at the applicant has designated applicant (and the institutions the resulting regional medical p in for the estlib- ii and oper program, which ai group includE -m@ical center ol from appropi-i- al lives of ot with actiN nd to be carri and members of the public familiar wit provided under the program. GPAWTLQ FM ESTABLISH@ AND O@NOW OF REGIONAL MEDICAL PROGRAXS "SiFc. @. (a) The Surgeon'Geneml, upon the recommendation of the Council, -is authorized to make grants to jpublic or nonprofit private universities, medical schools, research institutions, and other public or nonprofit private agencies and institutions and combinations thereof, to assist in establishment and operation of regional medical pro--rams, including construction and equipment of facilities in connection therewith. be made onlv upon application An s h a lic"tion recomme by ti Edvis p i ory grou s sup@ d dontai by reason_ (1) Federal funds paid pursuant to any such @t (A @ will be used only for the purp6ses for which p7aid anct in accordance wit)i th visions of this title and the regulations thereun supplant funds that are otherwise 'lab] operation of the regional medical ava,i program with respect t the nt is made; (2) 'the appli&nt v ide Orr such fiscal control and fund accounting procedures re req'uired by the S@geon General to assure proper disburse: t of and accounting for such Federal funds;- ,3) the applicant will make such reports, in such form and Reoo@. c ontainm t,g such information as the Sur@eon General may from time to me reasonably require, and will keep such records and 79 STAT. 929 Pub. IAw 89-239 - 4 - October 6, 1965 afford such access thereto as the Surgeon General may find neces- sary to assure the correctness and verification of such reports; and '@(4) any laborer or mechanic employed by any contractor or subcontractor in the performance of work on any wnstructioil aided.@y payments pursuant to any grant under this section will be paict wages at rates not less than those prevailing on similar - construction in the locality as determined-by the Secretary of Labor in accordance with ihe Davis-Bacon Act, as amended (40 49 Stat. 1011; U.S.C. 276a-276a-5) ; and the Secretary of Labor shall have, 78.Stat. 238. with respect to the labor standards specified in this paragraph. the authority and functions set forth in Reortraniz-ation- Plan' (>4 Stat. 1267. Numbered 14 of 1950 (15 F.R. 3176; 5 U.S.C. 13-3z-15) and sec- 63 Stat. los. tion 2 of the Act of June 13, 1934, as amended (40 U.S.C. 27@) - ":WA'nONAL ADVISORY COUNCIL ON REGIONAL MMICAL PROGRAMS Appointment of "SEC. 905. (a) The Surgeon General, with the approval of the members. Secretary without regard to the civil service laws, a Nationaf I on Reiional Medical Pro,-rams. The Council Surgeon General, who shall be the chair- man, and " s ikteen members, not otherwise in the regular full-time employ of the United States, who are leaders in the fields of the fundamental sciences, the medical sciences, or public affairs. - At least two of the appointed members shall be practicing physicians, one ,Qllall be outstanding in the disease, one shall b@outstand of cancer, and one shall be treatment of stroke. Tenn of bffioe. "(b) Each appointed member of the Council shall hold office for a term of four -years, except that any member appointed to fill a vacancy prior to tihee ex 'rafion of the term for whi-cfi his predecessor "'rL all Eapplorpaoti"no was appointed sli ted for the remainder of such term, and exce t that the trm f ffi e of the members first taking office Shall .p (.Xpire, as designated by the Surgeon General at the time of appoint- nie.nt, four at the end of the first year, four at the end of the-s-econd Y,,,ir. :C6ur at the end of the third year, and four at the end of the fourth year After the date of appoint- ment. An appointed member shall not be eligible to serve continu- ously for more than two terms. Compensation. "(c) Appointed members of the Council, while attending meet- ings or conferences thereof or otherwise serving on business of the (-,@oiincil, shall be entitled to receive compensation at rates fixed by the Secretary, but.not exceeding $100 per day, including tr,,tveltim@, ay from their homes or regular places of .ind while so serving aw business they may b@ allowed travel expenses, includ p@r them in lieu of subsistence, as authorized bv section 5 of tbeirdministrative 60 Stat. 608; Expenses Act of 1946 (5 U.S.C. 7Ab-2) for persons in the Govern- 75 Stat. 339,340. ment service employed intermittently. Applioations for c4 (d) The Council shall advise and assist the Surgeon General in the grants, reoorn- preparation of regulations for, and as to policy matters arisi-iLr with mendations. respect to, the d a ministration of this title. The Council shall consider all applications for grants under this title and shall make recommen- dations to the Surgeon General with respect to approval of applica- tions for and the amounts of grants under this title.- 79 STAT. 931 Pub. Law 89-239 - 6 - October 6, 1965 42 USC 201 (L) The Act of July 1, 1944 (r)S Stat. 682), as amended. is further note. aiiien(ied by renumbering title IX (as in effect prior to tile enactment of this Act as title X, d by remembering sections 901 through 914 ) an (as in e t prior to the enactment of this Act), and references thereto, as sections 1001 through 1014, respectively. Approved October 6, 1965, 10:15 a. m. "PROJECT GRANTS FC)R MULTIPROGRAM SERVICES "SEC. 910. Funds appropriated under this title shall also be available for grants to any public or nonprofit private agency or institution for services needed by, or' which will be of substantial use to, any two or more regional iwdical programs. LEGISLATIVE HISTORY: P.L'. 89-239 HOUSE REPORT No. 963 aooomparq,@ H. R. 3140 (Cmn. on Interstate & Foreign Commerce). SENATE REPORT No. 368 (Comm. on labor & Public Welfare). CONGRESSIONAL RECORD, Vol. 111 (1965)2 June 25: Considered in Senate. June 28: Considered and passed Senate. Sept. 23: H. R. 3140 considered in House. Sept. 24t Considered and passed House, amended, in lieu of H. R. 3140. Sept. 29: Senate concurred in House amendments. LEGISLATIVE HISTORY: P.L. 90-574 HOUSE REPORTS: No. 1536 (Comm. on Inter-state & Foreign commerce) and No.1924 (Comm. of Conference). SENATE REPORT No. 1454 (Comm. an Labor & Public Welfare)'. CONGRESSIONAL RECORD, Vol. 114 (1968): July 122 Considered and passed House. July 27: Considered and passed Senate, amended. Sept.27: Senate agreed to conference report. Oct. 1: House agreed to conference report.