II a regional medical SPECIAL ISSUE programs FOR LIMITED DISTRIIIUTION service evv s 0 Illf orniatiori data A coitiniiiiii(-ation (](!vic(- (icsigtl(-(] to SI)eq.(l tiio- ex(-hiii,,e of news, STAI'US RE-PORT: Regional Medical. Programs Legislation iyifortiiatioti irt(l (lata oii Itegiotial Me(li4-.ii I"ro,,rains aii(i r(@late(i activities. October 21, 1970 - Vol. 4, No. 44S Legislation extending and amending Regional Medical Programs passed in the House on October 13 and the Senate on October 14 and is now awaiting the P-resident's signature. We will have to wait on the printing of the final Bill before we can distribute copies. In the interim, we are forwarding'a run-down of the major changes in the new legislation and a copy of the Conference Report which reflects the final Bill as passed. (Pages 1-4 and 17-18 of the Conference Report pertain directly to Regional Medical Programs) Distribution: Coordinators of Regional Medical Ilrograms Members of National Advisory Council and Review Committee on Regional Medical Programs 'Staff of Regional Medical Programs Service Regional Health Directors of Department of Health, Education, and Welfare Regional Offices U.S. DEPARTMEN']P OF JIFAUI'll, EDtJ(,ATION, AND WELFARE Major Changes in New DV L6Rislation Present Legislation P.L. 89-239; P.L. 90-S74 by H(use and Senate 1. CateEorical Heart disease, cancer, stroke Adds kidney disease, and other Emphasis and related diseases. related diseases. 2. Additional Emphasis on making available Promotes medical data ex- Emphases the latest advanced in diag- change as well as research, nosis and treatment, and on training, and demonstrations cooperative arrangements for of patient care. research, training and related demonstrations of Adds prevention and re- habilitation. patient care. Gives additional emphasis to regionalization of health care resources and services in order to strengthen and improve primary care and 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, major Adds authority to include"new Author repair, remodeling and reno- construction of facilities for vation of existing buildings... demonstrations, research and and -replacement of obsolete training when necessary to built-in...equipment of carry out Regional Medical existing buildings," up Programs," but only up to a to 90% of cost. level of $5 million per year. 4. Non-Interfer- To accomplish the goals of the No Change. ence Clause program "without interfering with patterns or the methods of financing, or patient care or professional practice or with the administration of hospitals..." 2 Present Legislation Legislation as Passed P.L. 89-239; P.L. 90-S74 bv House and Senate Relationships None specified in law. Requires that the appropriate to CTpre- regional, metropolitan, or Fe-nsive Health local areawide comprehensive Planning health planning agency 314(b), have a opportunity to consider operational grant proposals before the RAG may recommend approval. Duration - Three-),ear extension Au orization FY'71 $12S Levels (in FY"72 ISO glil':Lons) FY'73 250 Includes provision that no more than $IS million shall be, available for kidney disease activities in FY'71. Funding Grants with two-year Adds contract authority as well,@.@--l@,. Mechanism availability-of funds. as @IP grant authority, and would permit Regions to obtain services in-kind from Federal agencies. One-year availability of funds. Re.Rional Composition @Tory Requirement there must Requires official health and Tro-ups include "practicing phy- health planning agency repre- sicians, medical center sentation on such advisory groups; officials, hospital requires that public members administrators, repre- include persons familiar with sentatives from approp- the financing of, as well as riate medical societies, the need for services, and voluntary health..." and that such public members be other health-related sufficient in number to insure agencies ... 11 and members adequate community orientation. of the public..." fam- iliar with health needs. Also includes a representative of the Veteran's administration as Procedures an ex officio member, if there is a VA institution in the Region. Has responsibility for approval of operational grants at regional level. 3 Legislation as Passed P.L. 89-239; P.L. go-S74 9. National isory Council responsible ljncreases the size of the for RMP matters. Sixteen Council from 16-20 members. Viso-ry members - leaders in fields Provides for: mcii of fundamental sciences, medical sciences, or public (1) one member who is Out affairs. At least 2 prac- standing in the study or ticing physicians, one care of kidney disease; expert each for heart ke. (2) leaders in the field of disease, cancer and stro health care administration as well as the fundamental and medical sciences (3) two members outstanding in the field of prevention of heart disease, cancer) stroke or kidney diseasel (4) four of the tiqenty should be members of the public. 10. Listim of Lists of facilities equipped Adds a requirement that a A vanc and staffed to provide the listing of the most advanced most advanced methods of facilities for the diagnosis Facrli-tieS diagnosis and treatment and treatment of kidney disease in heart disease, cancer including the availability of advanced specialty training and stroke are to be be established and maintained. established. 11. Multiprogram Provides for grants for Provides for both grant, and ervices- services needed by, or which contracts for a broad variety ection 910 will be of substantial use of activities including: to, any two or more regional activities of use to two or more medical programs. regional medical programs, clevel opment or demonstration projects collection of epidemiologic data, development of training, and conduct of cooperative clinical field trials. 4 Legislat 01 89-239; P.L- 90- by House and Senate rities and determinations rities and ised by Secretary rather under Gener"-L ities determinations than Surgeon General. Title IX, including the awarding Of grants to Re tonal Medical cised Programs, are exer by the Surgeon General of the public Health ice. llqhen a single project receives specified in law- grants frm two or @ore ,3.. Joint - ces within certain parts @ding sour of @, the Secretary may issue -regulations under which functions administrative projects wi res,oect to such be @erformed by a single Administrative unit; applications may be consolidated; and duplicative requirements -revised. Limited to projects funded under Title III and IX Of the Public Health Service Act. This includes Regional Medical Programs, Comprehensive Health Planning and Services, National center for Health Services Research and Development- N(,. f)i- ItF,(j'IONAT, PRO(irRA.N,IS ANI) (@O@NIPREIIENSII"E IIEAI,'I'll I)I,ANNING ANI) SERNT f(-'ES A(@l' OF ]()70 Ot-TOIII-;R 8, 1970.--Oi,dt@r(,(] to I)C' fl-olli tli(, of CONFERENCF, REPORT [To accoznl)aiiy 175701 of ol fll(' N'ot(", of tll(! tl%@o on flie of (,Ii(@ to t,li(, bill (H.R. 17570) l@(i till(, TX (if i,ii(, 1)(ibli(! 11(@tiltli S(,rvi(-(@ A(,t so as to extell(i fit)(I [)I-ogriiiii to research, ti-iiiiiirj@,,, il(@,iiioii@t'rittioit@ in the fiel(is of ii(@til-t stroke, iiii(I iLti(I for other illiN 1119 met, aft(@r@ fall to ro(,oriirii(@ii(i t ii(@ (lo t-(,conini(@i)(I to Ilotl.,w.,; its folloNl-s: 'I'I)at the Hottse from iL,, (ii,.,ii to the .9inei)(1111clit; of ol 111(@ s(@@ilitto to tl)e text of tile, bill itli(I to the sain(, N@-iiii itii lifil(til(Ilil(,llt as follolvs: ,fit li(.Il of the matter i)i,ol)o,.,t@(I to be by the Senate amen(l- iiieilt. the followillo.: 777'1.E I-,4MENDiVIENTS TO TIY'IE IX 01" THEF P(JBLIC HEALTII SERT,'ICfi,' ACT ,@Ec. 101. This title mav be cited as the "Heart Disease, Cancer, Stroke, aiitl l@idney Disease Amincl?nent,-? of 1970". SEe. 102. Section 900 of the Pu6li,c I-Iealtlt Service Act is amended to r(;a(l as folloivs: "PURPOSES "SEc. 900. The ;p?trT)oses oj this title are.- "(a) through grants and contracts, to eitcoitt,age and asqist @,a the establishment @/ regional cooperative at,range7nerits among medical schools, research institutions, and hos ital,3 for research and training (incltidi)tg ,in e a n an(/ c 0 for demons can- i t 'are 'o" ". g c atioz a '5n r 0 p cer, stroke, an n7y d tgtea et, and 4S-00@70 I -d to the medical 1)?-o ssion and the ine(lical iiistitittiolis "(b) to affoi of the ATatioiz, thi-oitqh siich cooperative at,i,ai@gi@)izeitts, the opi)@'tilil'itY labl' to their 1- ti(,ii@ts the latest adta?ices ' i the. pl'e,- 6f making ai-ai e )a ntion, diagnosis, and, t)-eatinctit and rehabilitation of pei@solis ve S?,t.ffer,iitg fi,oiii these d4seases; - reflio?ia i i ((c) to' 'promote an,(l fostei 1 1',nlca!les arnotig health care iiistitii.t,i(,rn,; and p?-ovide'i-s so as to strengthen and i?nl)t-ot,e pit.in a?,y care and the relationship between spec?at@zett ai?d primary care: and 11(d) b7/ these means, to in?pi-ot-e ge7@ci@ally the q@iality and enhance the capa@ity of. the health niart 'I)ower an@l -fac@'l@'t)'es a?;ailable to the ,,Vatioib and to ?7nprot,,c health qe ,,@ fol- i,esi(lin ri@ec q areas it,,ith, limiteil health and to th@.@e ends u.@-iti@rillf iii.tei:fet-in(I with the of- the methods 1?f P(iii(,Ilt care oi, I)i,@fes.@ional practice, oi- @i-ith the ol'ho.@p;f(ils, aiul iib t!;@ol)ei-ation gi)ith I;t,acticirtg physician,,;, 7tiertl,c(lt ci@iitii, officials, hospital and i-epi-t-@ttitati've,3 fi,oin al)l)i-o- I)i-iaf(! volii,,ii,@ry health SBC. 103. ((t)(1) 7'tte.fti-st seittefice i).,f sect;t,),ii @)OI(a) of such O'.1; by 8ti-ik;ti(I i)@it "and" i',rlil@if,(Ii'atel?l aftei, "Jitrtf, 3(i, a7i(l b(,.fot-(@ ",.I'or tll,atits" the ,SI2,,5,000,- al il(.,ai- cn(Iiitfl J@iii,, 30, 1,1)7i. @j,@o,ooo,ooo.lo@@ iliefi8c(Ll iie'30, 191'2, aitil @,-'?.50,000,060.for thi@fi,@cal'?Ieai, en(l;n!l .St sentence -i.@ fiii-thet- aine7t(/e(i by o?tt the period real tlei-co (Lfter "tit e' a id ii?sei-t@t@g iii, 1 f "and foi, coati-acts to carr?l o?it amended by sti,ik-i7i@!l (,itt the sentence .f,)Ilowin(j: "Of the s?i7y@s a?, endl,71.@i Jitib@ 30, 191 1, ri(;t-inoi,e than activities in the field of disease. this section foi- ai-t?l fi sc(i,l yeai, e?id;i@ti r l 7 than $,5,000,000 rural be 7t?a(le at,a;labl(@ ;ii any sitt ?Ieal, f(ii- iieiv conqr,itct?'o?t.@' 901 is fit7-thet- amentle(I by adding at the en(] t followilit) clioll: the reqiiest (!f.an recipient oi (t @i@ant tindet- this title, the pay- I lich 7-e-cipient m6 the faii- m-oki-et i.!aljie Qf (in?i Sil])Pli'e@, or sei,@ the sec)-ftai,y to Glitch t-(,c;p;ent a by the (iinoiint of the ti-avel'ii(i expei@ses, a?iii any other costs i.,n connection, 9A a?t officei@ o?- ei?il)loyce qf the (Tovet-itmetit to the ),ec.;,pient when slick fil ii,ishiiig oi- @itch detal't, as tl,,e case, may be, -is.for the coni!eii,,ie?tce Qf and at th,e i,e(i?iest of siich i-ecil)t'eiii a,it(I fol- the plirt)ose of cari,ii,i,t@a oiit the i,egio7iat medical pi,ogi,a)n to which the grant i@iitle?- (his title i,@7na(le. Src. 10@l. Sectiott 902((t) of s?lch zict is an@en(tc(l by striking o?it (in(I tl,c(it merit i-el(titlifl to lic(irt (lise(i8(, cancer, oi, .,di-oke, (vii(l, at the ol)lion, (!I'the al)l)llca?it, i-(,Iate(l (ii-vase, or ft/l(l here. th,e)-eof "ti-aiiii'lttl, 1)).Cve?itioll, (I;a(litosi,,;, (lead i-(@h,abiti.tulti)ltl i-elatiti,g to heart cancer-, or 1-i(.lii,ey disease, a,iul, at the "')fiolt of tltc al),i)li(!(itit, t)th(@). -i-elateel (b) A'4ecti(,ib .902(.t) is a7rtirt,(Ietl by sfrili@i-rig o,iit -i-iiget-tilig in hear tltct,ei)f "ineaits new eoiisti-iletio7i ()I',f(teilitiesfoi, (lemonsti'at'o?ls, 1'e-setti-ch, and training ivheii ?tecessui-y 'io carry oiit regional medical 3 Sr(,. 105. Se,(@tioii f)03(b)(.@) I(-t I'.,; (1) b? g olit ll,e(ittli (Lri(l" II fhf,i-e,(jf ot- I)I(iii-ii;it!f (2) by it@NCI-Iil)!l (I fi(i- the gi)hei-c it @ii-st al)p(,ai,.,; the),(,iit,, the @t(,i et,@ an ex o.flict'o 711(inb - if ere 1.8 tor(lic(l I'll NI(cli oil(, f)l' 'llilol'e hos.1);I(it,@ (ii- t@l,,aitlillft(ICiliies (if ilte l(lini'it the qi@lioi@z the toi- o I ff(iii,s @h(ill haile (tl(,(l to .f on siirh arli)I"Nory global) a.@ tlt(, 11111)1-(RP?lt(itive of the o)i, otliei, health care facilities of qvhi'ch (He in ,;,,ch (iitil (3) by strl,'IL I'tifl oill the the an(I inserting I"ii, 11'e@t thei-eol' I'(@i, an(l.fiittinct'tig of the I)rorl'(Ie(l, the tiii(I tt,,@t)'ch flro?tp shall be @@ifflcietit irt i).?imbe?, to) c@),n?,niiinity orientation (as ilWter@in't.',ite(i by the Seci-etai-? Src. 106. lItat part of the seci@i@(I of gectt'o?i .904(b) of @7telt .@ict i)),e(,t,(Ii?ig par(t!lraph (1) ig anien(It!(t by o@@it "section f)03(b) (,@) an(l" fin(l -insetting i@ii, lie.@i, thereof the folloiL7;iig: ",qect;,o7? 903(b)(!,), ol)l)o)-t@inity h(ts been pi-ov)'(Ie(l, i)),-ior to s?i(-h, -fol- CO)TL- of the (i,-I)plica@iott by e(tch l@,iiblt'(- ot, iiot@pt-ofit pt-i'v(if(', agency oi, orflaiii-@(ifl'ol? v,,hi'Ch-has (Ici,elope(I a i-e@li'oiial, meti-op(;Iitart, (ii,ea, (it- othei- local at-ea litaii, referred to iii, @(!ti'otl 314(b) any (il-ca )'ii ?t)hich the i-t-flioti(it tneili(,al 1)ro!l)-(ti@i,.for Ulhl'Clt the (ipplieall'ot@ ina(li, ?t,ill be loc(ife(l, (it?rl @f the SE('. 107. ((I) let ;'.@ (iiii(,ti(le(I i(i '@SK('. !)O,'3. (il) 7/te 111(t? @171,tlloilt to the fit icil la@/@,,;, a A'titioriiil oil /,'(;, 'oiieil Afeiiical l'i,ofiraills. 7,16e of the of He(iltli, l@(lilc(li oll' and It elfil,e fo?- I-Iealfli. ati(I ScientificI ii@ho be the the ('161'ey Af@dical I)it-ector of the [(Itnliiist7.atl'ori ii)ho ,:hall be (in ,x. officio meiiibei-, alit f,ij)ei;,ty inetnbei,s, i@.ot -in flie i,eqiilai- l'illt-ti.iiie e7yiploy qf the 17,n;ite(I St(tie,@, il)ho are leaders in thefiet(ts of the fit.-,ifi(titie,ntal sellei6ces, the medical sciences, l@ealth care a,(I?iiini8trati .oil, (j?- 1)ttbli'c affait@s. @4t least two ol' the aj)po)'ti,te(I ?@?et-nbe7-s @/?,all be practicing ))hy.@t'cians, one shall be oiftsia7i,(Iirig the 8tijely or health care o persons .f. ,glittering from heart disease, one shall be o?it,@tan(lintl in the study or health care of persons floor? caiicei,, t)i@ic shall be oittsfan(l;,,tig -in the st@i(ly oi, health, ca7-e q.f.persoii,@ @?@ rinti.fi@t))Yi sti-ok-e, one shall be o7it- .Standing iii, the stiidy ot, health (-ai, itffering from k?'dney disease, fivo shall be oiitstan(li7itl In, ti tion of heart disease, cal)(.,el" Stiloke, or kidney (lisea,@e, and, tnnl)e,@@@ of the I)itbl'i"e." (b) 0 the persons fi?,st appointed 905(a) Qf the I'-libl;c Health Service Act to serve as the fo@ti, a(lditio?t,alrnembe7,,@ o th@ the Nat'ortal ,4dvi,qoi-y Coititcil on I?egional medical Programs air, by the amendment made by subsection, (a) of thick section,- (1) one ,:hall sei,-ve.for a term of o,iie yeai@, (2) one shall seri)e.foi, a ter7n of two years, (8) one shall serve.for a term of three years, and (/i) one shall serve'fo@, a f(@i-,in foui, years, t'IS 4tesigitated by the Secreta7-y of I'lea h, EI(liication" and Welfare at the time of al)pointme?tt. 4 A,fernberx of the N(jt'oii,(jl (,'O)lltc;l oil, l@ro!ll.am.@ (other than Ile 'it i-)ffice ott the date of ciiart- 7ne,tti of thi.@ let -shall iit o#ire itt acct)t,(](jrice v7illi the I,-m of o@e i@r vjlticlt they were laNt uppo;@tetl to the (oijitcil. EC. 10,V.Section9O7ofsiich2let "orsti-ok-e," am], ;t@ lie7t. thereof of, 4-;ftiiey disease,". ISE('. 109. Section 90,9@a) of @4ci is ameiifled by iii,,;ei-tiii,(l "ol, contract" after "grant" tacit ))Iacc ;'/ c,i)l)cai-s therein. SEC. 116. (a) SeCtIO71 910 of @iich Act Is amended to a.@fi)ltoii-N: "';Ec. @)IO. (a) To facilitate ;titct,i-@lioital II(/ (I.-I,(lop cooperatio7i, a ',@tnl)t,oi,ed itational cal)@bility.fi)i- (letirery @f h,calth sei,z,ices, the S(.cl-cfal-?l is (u)tthoi-l'ze(i to ittilize.f?jn(l,,; appi-ol)l-iate(I tin(ler this t;tie to make flrattt.,; to pttbli'c Oil noapi-ofit private afl(,iici'cs i)t, o?- ef)mb@'iialt'oliR tl&ei-eqf @",'I to contract foil-- (, programs, services, and activities of s?ibstantial ij,8e to two oi- more regional medical pi,o!fra?ns; (2) development, oi- (lt,7non8ti,ation (!f methods fo7- control of heart disease, cancer, stroke, disease, or other 7-elate(i " (8) the collection aii,(l St let ogic data ?-plate(] to rirty of the (Ii,@eaqes i-eferre(I to ;gi, p developmei@t of lateil i(i the pi,et)eziliori., (liagi@o-4i,,:, Oil ti.e(itmetit of any ef.,I-re(i to i,,n par,,(jr,,,)Ill -ehab,it,it(t,ti,O'it 0 y (2) i or if) the i from are, it - cont Iran III? 9 1)) 1.6 diseases; and )i whe ties of fraitted personnel would oth -wise I,ilnit a, @f ktiowli.,tt,!je, @n,(t skills important to the control of any (@fI es; and "(5) the conduct of cooperative cit'nical..fieki trials. (b) The Secretary is duthoi-,ize(i to ass 1.3t in meeting the costs Of special pt-(@jects for improving or develol)t'?iti new meaits for the deliveru of health services concerned with the diseases with ivhlch this title is co'nce?-7ied. (c) The Secretary is authorized to support research, studies, investiga- tioas, training, and derno?,tsti-ations desi@ned to max7,m,ize the iitiliizat,ion of manpower in the delivery of health services." SEC. 111. (a) The heading to title IX of such Act is amended by striking out "STROKE, AND ]?ELATED DISEASES" ti7id inserting iit lie@t thereof "STROKE, KIDNE, Y DISEASE, AND OTHER R-PL,-l TED DISRASES". (b) Sections 902 (a), 9Q3 (a),., 905 (b) , 905(d) @ 906, 907, and 909(a) of &uch Act ceding provisions of this Act) are eack.further am 'Surgeon Ge@neral", c each pla e it appears therein c reof "Secretai-," TITLE II-AMEINDMENTS TO TITLE III OF THE P(JBLI(,' HEALTH SFRl,'ICF, ACT I.-'AieT A--]?ESEARCiY AND DEmoYSTRATIONs RELATIVO TO I-IE.4LTH FACILITIES AND SERVICES sEr. 201. (a)(1) Section 804(a) of the lublic I-Iealth Service Act is ameiale(l- (.it) by i,&Rer(i?tg "(1)" immediately after "SE('. 30/i. (a)"; (11) by rede,:-fnating clauses (1) and (2) as clauie,,: (A) a?ul (B), respectively; a b.@l @cclioi@ 3011 (b) tltel,cof (,,J) b!l (B) by oil e(t(,h 1)1,(ico @'t there,iit th,el-co'f "t!ti"4 @llb,@ectioll. (3) o,@,(c) (@f xiich.A(:I, (tincti(lc(l- (,"t) by ofit f@llift I;t,ii thereof b@l stt-ik-i@ I)Ilt "th 's place, it a))])(,(zi.8 tliel-e@ilb itt th,et.(,Of of 'Slich, Ar ;.S, tl(li?)g (ift(,t- th(' P?@0- (b) t f,,ii,th(,i- (ti)i,(@ti(led by a a.,; (3) by @itbsectiotb ((i)(,3)(A) (If th, I'.,; Nt,ctl'()tt ofnat'oital liealtlt t 7'lbe Seei,et(i,i,il @h,alt, (lei,,elop, titi,oii(ih 7itilizati(,n of the slyst@1128 analy,@ils method, plans for health ctit-e syst(m.@ (ide- qiiately to meet the /tealtlb ttee(Is o@ the , ltnei-,,(@art, pe,@)ple. foi- Qf the I)recedirtg settfe!nce, tl?,e sy,,:tr?ns 7ri(!thoil ?neans ili@ ai@(ilytical iii,,tbi)il by which, 7neiiiis of obta ii@;tifl a 7@esillt ;;5 (I ,?.soc'afett ivith the cost:, and be7ic@i,,'.@ itti!olvett. ;i(;?) The Seei-elat-it shall ct)7ni)le te the elei,elol)?,ne-At (!f the pl(li@.,4 @?ibi)(ii-a!li-a'I)h (:'I), ivi!h,@,ii, ,4ii@-h l@(,,)-;oel a.@ inay be 7tece8sti?,il lo enable lii'jii, /i) qlibmit I() the not thait Scl)tpinbei, 30, 1971, a i,el)ort thei,eo,,i. ii)h@ich ,;hall (le.,xi,lbe each I)iaii @o -ifb terms of--- lid') the it@i7i?.bei- of people ivoii.l(l be, covered the plart; " (-I i) the kind a?t(l ti e of health c(ii-e wo,al(I be covered the @an, I (ii"i) the cost involved it? (!ai-t,yiiifl o;it the plan, a7id hoit7 s)iclb costs 11)0)1.ld be fi7bariced,; 9'(iv) tle it!)tmbet, 0 atl(l?'tiorial ph,?I,@iciallns and other health, care f personnel and the n?iinbet, and t,i I)c (@f health care facilities needed to enable the Plan to becoinefitlly @ffeclive,. "(v) the ?few and improved metho(l,@, any, of delivery @f he@lth care services whicib world be developed i7l, order to e ctiiate the ptan; ffe, "(vi) the accessibility qf th-e be?tefit-3 of sitch plan to vat,i .o@?i.3 socio- economzc classes o Persons; "(vii) the relative effectiveness and efficiency of sliciz I)la?i as compared to existing mea?is of.fii@ancing and detiverin, .q health care; (and "(viii) the leg@lati?,e, administrative, ai?.(l other actions which it-,)iild be necessary to ii@ipletnent th,e plan. 1-it order to a,@siti-c that the a(lvi.ce and service of expet-f,@ ;ti the rtirio)i,@ fiekls concerned it?ill be obtained in the plans authorized by this p(ti-ag),aph and that the pttrl)o,@e,@ of this p(il,agi-aph u)ill.fidly be cai,j,-ied ol@t-- "(1) the Secretary shall it-fil@ize, u)h(@tiet.@er appropriate, personnel .fro)ni. the various biti,e(tti,@, amid other departmental qii-b- (I.irisiotis i@f the I)epat-tinetit (!f Ilea.ltlt,, l@,'(Ittcation, ait(.l We@f(ire; "(ii) the k@eci-etary is aiifltoi-i,-e(l, ii)itli, tlte consent of f[ii, head of th,e department or age-?icy i-til'otile(I le) i,tilize (oit a rei-i)ibiti-*able 6asi,@) the persoibnel own(/, other oj other del)a7-ttne?its and af)encies oj ilte Pedei-al Govi!t,ttme7if; alit(I 6 "(ii,i) the Secretary is authorized to consult with appropriate State or local public agencies, private organizations, and itidit-?'@llials. "Cost and Cove?,age I?epoi-t on Fxi8ting Legislative Proposals (2) (A) The Secretary shall, in accordance with this paragraph. con - (Iiict a study of each legislatures 'proposal which is introduced in the Sen(ite Of I?ep7'eSe7ttatil,C8 (1111-i'nfl the Ninety- or the Hoitse fii-st Congt-(@s, aii(I ?vh,t.ch iin(le?-takes to establish a natioiial health ins?trance plan oi- -iinil'l(ir I)la.?b (leqigite(I to nicet the neefl.@ of health in.,5tirance (@r for health sti-t-,icei of (ill or the oz,erwhelin,@ng ?ntioi-ity (@f the people qt'the (Jnit(,d States. "(B) [,ft coii,(Ittcfi??y sitclb ,;tij(ly u)/'Ih, re,@l)ret te) each such legislat;l-tl, 1)i-t)po8al, the. L@cci-et(Il-y shall evalit(ite a-ti(I anal!lz:e ,?iich pi-opoxal (t, to (leteriiiiiiii)!I- "(i) the ri)stv ofeai-i-yirig o)it the I)i-opo@(it: a7i(I 11(i,i) tht, a(leq?tacy (?f the @)i-opo.Val i'li tei-,t@is of (1) the 1)(,I-ti'oii o the 7)opitlatioii coiyt,.i@e,,l by the proposal, (II) 116(@ type healtl6 care provi,(.Ie(l, pa;tl foi-, or a!laitist gin(let- the proposal, (11/) whether, a,2ifl if so, It) ii,,hat extent, the 7,o,opova Pi,ovi(le.,; ft)l' thin (le?,(@toly7ne,tit o ',it-ew aiirl iitilit-oi,e(.1 tiietht)(I'8.fi)l- tlte. (I(,Iivel.y (@i Ite(ilfl" .f (,are an(I Not later than March 31, If)71, the Secretary shall submit to the (ongrest a report on each legislative proposal which he has beeii, tlii-ecte(i to study ;Order this pai,(igral)h, to-gethei, with an analysis and exaltation o (e) S-itbsicft"t?o"n"h(y), of sect,io?,il 304 qf s-tich Act is hereby redesignate,l u,@ Subsection (c) and is amen(le(l, to i-eatl as follows: "(c)(1) There are agithorize(I to be appropriate(l,.for payment of granted or -Under contract,& ?tnder sii@bsection. (a), and for l@i,7,poses of cal-],Yf,t@fl o,itt the provisions of subsection (b), $71,000,000for the fiscal ?Ieat, cii(litig Ji@nc 30, 1971 (of which itot less than @2,000,000 shall be available only .fol. isiotis of subsection (b)), $82,000,000 .for 1,972, and ,S'94,000,000 _for the _fi,@cal yea i atitho?-;_,ed to be appropriated ziti(ler 7 - provisions of subsection (b) there are her riated to carry out such provisions for each year s@ich s?tj s be necessary." t a?nen(I-nient3 ma(le subjection (c) oj this section shall be it with 'respect to.-h years ending aftei@ J?.iite 80, 19i-O. SEC. 20,@ That proi)igi(. section 301, of the Public -Tle(dtt,, Service Act i-etles@qibated by sectio-i ((t) of tlbi,@ Act as paragraph (3) (@f @llb- @ei!tioit (a) is fitrthei, (1) bli in,,?et,tiiig "(A)" lt)i.,ttie(liately after "(3)"; and (2) by adding after aii(I below 8?lch provision the following new sitbpa?-(ii7raph: '@(B) The aittoitiits otherwise I)a?lable to (ini/ per.Roib ztndei, a grant or -nia(lt@ tittdei- this subjection' shall be i-e@lit-ced by--- a-inoittit,,: eq?ial ti) the.' f(iii- mai-let 7,@aliie of any eq)(ipinettt or fitriiishi-il to s-tich J)e;-,@oib by the Secretary for the I)itrpose t@ caii-yi.ttg o,iit the pj.()j(@(-t ?vith. respect to u@hich such grant or c(,rrb- ti-act -is iii(ide, (i7i(l 7 tr(ii)eling (,,qit(yt if) th(,, paii, Lee Ali (@t' l'bll"l,ble to tli(,, I)et-.forrit(ii aii,l 11' Lt. ;,,' or employee itf ti@ Nei.,,ces bit art, (@ffi(!ei sigiteil or (lelait(,(I, ,vitro sitch office,. or f!lnptoy(?(, was as b!l the, See"cta@il to I)e@forin ,4itch qeri)ices, tiltbliR/6 siicli,. eqtiipinell.I (1 the Seci,etar,ii to b@it ot@IY if stt(,h person i,eqiieste or @iich set-t,ieev, as the case ina,i oe. ./ the Pitblic Healtib Se-vice )i' section 304 OJ raph (1) oj s,,b- ., (a) 0 this ,I(@t as p(t,,rag igizate(I b,@l i.?ection 201 f fiti-thei, (iiiieTtde(,l by-@ (1))@ti-i'k-itig oti-I the )erio(i at the erb(l, iliereoj and inserting 11 "a I ie 't atb(I a(](It,ll(i after and below the cla,ii8e tlbereof redesignated by s,itclb as clatise (iii') the jollowt,,a(i new claiivs: 20.1 (@l h. exl)et-imeats, an(l, (ieM(171.itraf,?,ons dealing (iv) pi-Qiec@9 for 7-esearc , - th the e ectiiTe co?nbi,bat,'on. or coor(lilt(,ttion of piibl;,c, private, or C(Ylylbined piiblic-priz)at.- me"tho(I.9 or ,;?I,3tents.for ihe- (lelivpt7/ of l@ealth services at regi,(atal, State, or local levels, a7id h and (leinoiist . s i7,@ the l@rovisioit o it (v pr(@ie@ Pi- researc rat-ioib home health se Mces." PART B-NATIOIVAL I-ILIALTH SURVFYS AIVD STUDIFS (a (,'Iaitse (1) o@ !iibsectioib (a) of section 305 (@f the, SE('. 210. Iltibl,' Sci-i,-i'ce ,le/ -is anten,(Iett by strik-in(i oiii an(/," before "(E)", ?C ati.(l by ql'tet, the Reryticolon, at. the end of Such claiise the followit@g: "(I,') health care (G) en,,iiroitinental and social health h(tzai-d-@; fO7-matiort, growth, ait(l (2) Stich si,@b-ection. .;s.fit7,ther ame7t(le b?l adding at the end thereoj 8 (1 tht, follott,iiig i@eu) sentence: "No i',nj()?,-mation obtained in accordance itlill; th is 1)aragraphrnay be iised-foi- any 1) @ii-pose other tha7-t the statist;cal foi, qvhi'ch it was sit,p@lied except,' viir.@ua7it to i-e.(iijlati@g oj the -)for, may aiiy 3,ttch information be pi(blishe(l @f tke pai@tictilar or person. sitpl)lyi@(i .it is identifiable concept with the C071-mrit 0 s@ich establishment or person.)) 305 is further amende(,l by i,e(le-signating subsections (b), 4 s subseitioits (c), (d), an( I (e) respectively, and by a(l(l@@,ng (I Tb (a) the.folloi@inq new stiosection,: Secretary is atitaorized, directly or by coi@,tract, to undertake I veloli)ment, demonstration, att(l, evaliiatiou, relating to the (I (hill implem(,atatioll of a cooperative @ystem for producing coin- Ij e aii(i iiniform health-i,,tt on'tion, and statistics at the I4ederal, ,@l'ate, an.il local [levels." (c@ 7'lte -stibsect@ion qf @ucti, section 30r) ?,e(.Ies-igiiated (by st)bsectiort (b of this; section) as subsection ((I) is (rtyten(led to read There are'authoi-ized to be appropri,ate(.1 to carry n .@15,000,000 for the.fiscal ?iear eft,(Iiiifl 30, 1971, the fiscal ?Iear, etaiiiifl Jitite 30, 1,972, atitl @@95,000,00o.fo citill7ig Jtine 30 , 1973." I)ARR (@GRANTS TO STATES FOR (,'O,Xfl'PEHE.N,4IVE STATE I,[rALTII. I-'LANNING SEc. 220. (a)(1) The.fit-st sentence of seet'on, 31/1(a)(1) of the l'itblic - ealth Service. 11 @'ict is aineit(le(i bit st7iking oitt "Jiiiie 30 l!j7O" a@tt.(/ inserting ia rich thei-en "Ji(ne 36, 1973". (2) oitt "aitit ,S'16,000,000 for th(!.fi.3cal J,ti-,@ 30, I!)70" (iii,l iii,.@et-firt!l ti?. lieu th(,re(;j ';,S-15,(,,00,000 f,)r the.fi-scal year Clft(li)ig 30, If)70, @5,000,000.for th.e_fi@cal year el@(l@'iig J@itic 30, I,.971, $17,000,000 'for the 'fiscal year (,nt()'tig J@?iie 30, 1,972, (iii(I ,S'20,- 000,000.for thefi,@cal year ending J@tt@e 30, 1973@'. (b) @ectit)n Sllf(a)(2)(I3) Qf sich let i.@ aiyieii(le(I 1)1,, o@it "State and local agencie.@" an(I ;iisel-t@'itt in lici@ thereof Siate, aiifl local agencies.,; (';,ncliitliiifl as (in ex (Lffict'o ?@t(iitber, if there is locate(I I?i @ii@h State one or inoi,(? hi@p?'tal,@ or others health. care of the, i'eterait.@' the @'ii(ll:t-iiliial wh,oi)t the, of .I Ifaii-,@ @hall hai!e to sei-i,e on @ileit (t,4 tli,(, representative of the (;i, other h,ealtl(, (@ai,e of such, ,Itlni.;ti'sti-atit)n it,h'ch are located 'ti @@t(@h State)". (e) L@ctioit 81,11(a)(2)(1@) of such @let (as arlteit(le(I 1) (b) of tltis @(@ction,) i,@.fiti-ther (iiiirit(te(l, by lit-vi'tinti (!'I'th,e regional p)-ogi,atyi or pro!jrartis tn@rlit(leil in or 'ilt 1)(ti'l ii,,ithi-i@ the State)" iiiiitte(li(tte.171 after "concerned, w,;th hralilt". (el) Sectioyi. f'sitch ilct @is aine7vlc(l (1) k7/ ((and -inclit(l@it(i h@j)ne Health c(tre" im7?ic(liatelil ajter "pr;@-at(,I@ ay,,(/ b? iine(liately b@fore the scirt'coloit (it the ert(i thereof the inserting it? I "aitel iii,(@lii(Ii.,ti4j ett,?,,iroti7neitt(il corisi(@ratio7t8 a.R tltt@?@ i-elate, to public health". I)-I,Roji,.(,T GRAN7',9 P'OR ,II?FAWIDE IlrALTII SEc. 2,30. Secti'oii 31.li(b) Qf the l'iiblo'c I-lealth Sri-vice , let ;,v (1) by sti-;k' 'itei ozit. in the first sentence thereof, "Jitite 30, 1,970" and iasertin f "J?ine 30, 1973"; .q irb lieu thei,eo (2) by insert?'Ing after [he word "seri)ices" the .3ceot@d place it appears therein, the phrase "and ''iicl?t,(Iing the prot-t'sioii o such services throitylt home health care" - (3) by striking ottt, in the second sentence thereof, "an(I $15,000,000 0" -@ iiisei-ting @in. lie,it .for the ..fiscal year ending June 30, 197 an( thereqf thefollowing: ",@15,000,000for the@.@calyear,,e7z(l;,ng Jtine 30, 1970, 520,000,000 for the _fiscal yeai, n(li g j tie 30, l@)71, ,@30,000,000.for thefiscal year en(ling J)ifte 80, 1972, an(I $./10,000,- OOO.for thefiscal year en.(Iiny J?jne 30, 1973"; (-/f) by iasei-fing "(1)(A)" immediately aftet- "(b)"; and (5) by adding after and below the existing langiage contained therein the follou7in g; "(B) 1roject gran.ts -may be made by the Secretai@71 qintle?- subparagraph (A) to the State a(ie7@.e,ii atlrninisterittg or stil)erv@3,Cng the administration of the State plan appi-oved,tindei- stibsectio?t (a) with respect to a.particulai, region or area, biii @?ilk if (i) no applicatio7t@r such a q7-ant with respect to $itch region or area has beertfiled by any other agency ni- orqan,izatioi qualified to receive stick a grant, and (ii) such State agency ce@tifies, and the ,qec,-etary.finds, that smile opportu.,ttity has been afforded to qualifier] agencies and organizations tofile application for s?ich a grant with respect to ,zitch region or at-ea and that it is impro6able that, in the'foreseeable jittitre, any agency or o@(lattization v)hlc'h is qualified for such a grant viill.file ap2)licatioti@ therefor. (A) Iti to b(@ reasonable that has been oru,,ill be establi,@lit!(I, iii-oi- for the area with l,e.ipect to it@hich,@itcli, grant is sought, an ai@ea-w@'de lbealth co.zi?ic.it. 7'lie iii(mbc?-,qhip of @7ic1b council &hall include, i-epreset@tatives qf public, i,olit,ntai-y, and, no-itprofit p7-ivate agene?.e,3, t.nstit-iitions, and organizations (loiieet-ii,(,rl with Itealth. (including representatives of the interests of local 'Jort@l'll?tlcllt, 0 f the regional medical program for such area, and of con- .Itttmer,v of health services). A 7najority qf the members of sqtch, counc;l shall consist (@f representatii,,es of con,3?irne?,s o healtlb sert,'w-es. tt(B) Iit wlditioi@, an applicati.on for a grant under this subsection tnitst contain or be by reasonable assurances that the ai-ea@de health Plannina age,7icy has tnade proz,,iiioTt foil as8,isting'healtli care in it,;at,ca to flevelop a i)rogrant for capital expenditures for replacement, mo(lei,7tization, and expansion which is consistent with an oi!ei-all @tate plan. wlt ielt, will meet, f[be needs oj the 5tate and the area for health care facilities, equipment, and 8erti"8 without duplication, and otherwise in theino.@t effic;ent and economical manner." PART Ef-----I'ROJECT GRANTS FOR YRAI@'Vr.-VO, STUDII@8 [.VD DFMO.7VSY'J?AT]OiVS SEC. ?//O. @ectioti. 81//(e) i@f the l'ijbli(! Ilealtli, Se7-vice Act is a7neit(le4l,-- (1) by (,fit, 'rt tltejii,.q sentence thereof, "June 30, 1970" (111(1,i")18el.tl,llg in lieif, "June. 30, 1,07,3"; a7t,(l (2) by sti-it-iiig out, in, the ,wcond scnicitcf,, thereqf, "and $7,500,000 -foil the hv(il year Jitne 30, 1970" and inserting in hear, thereof i@.follf)'U)iilg: '@$7,500,000 joi, the finical ?Iea7- ending June 30, 1970, $8,000,00O..foi- Il?e,fi..scal year ending June 30, 1971, .@10,000,- 000 for the, fiscal year ending June 30, 1972, av,(/ $12,000,000.for tlte_Ascal yea?- eittling June 30, l@)73". ]'ART IF@GBA@VTS FOR COIfPRBHEN,?II'E PUBLIC HEALTH ;.@BRVICES ,@Ec. 250. (a) Section 814(d)(1) of the Public Healtlt @ei@vice Act-i.9 amended by striking out "and foil the fiscal year ending June 30, 1970" and ingert,.ing.i 00'000'000 for ihefi-3cal year ending June 30, 1970, the !,gcajl year ,nciinq Jttiie 30, 1971, elt(i? g line 30, 1972, and $16,5,000,06 e 80, 1978'). (b) Section 8i suc Act is amended (1) by sti,ik,@',ng out '-'an4l and lieu thereof "(iii)" and (2) by insert' before the s,-mico eof the.followi@q: "; an(/ (i?)) the p;lnz7gl, I.9 compatible with the total he, ti program qf the State". PART (x'-PROJECT GRAVTS FOR HRALTII Sr@RVIC-Ps,DEVELOPk[ENT SBC. 260. (a' Section 314(e) of the Public Healflb Ser@ Act i8 amended by striking out "and" immediately after "June 80, 1969," and by inserting qfter "June 80, 1970," the following: ('$109,600,000 for the, fi8c . fi,3cal year ending June 80, 1,@71, sis5,ooo,ooo fo@ the , al year ending J@ne 30, 1972, and $167,000,000.for the fiscal year Fine June 30, 1978,". H. Rel)t. 9l-lrj9(@2 10 (b) sentence of i.,; antenel,,d, bi 7itediatel?l qftei- "cost" the following: "(includi7ig eqttitu i-e(luii,eiite?tts and facilities acqi(it@ed from the0 of Fxotiamic a7ii,o?tizat,@.o-n of loans o7b Opl)ortii,,itity or C071'sti-iictton iii connection with (iiiy I)i-oflt-(znt ot- I)i-ojeet ti,@,4sfei-red Ji,om the Office of fi,'co n ain ic ol,tu"l? ity) (c)(1) I'he second sentence of sitch sectioib is ai-neii(le(i to i-tia(l as .follows; "Any grant made tltl's siibsectio?tt@iall be ?)iacle only if the le le a, 'ation for sitch qrant has been ),e i-re(I fo?- ret,' iv and co?@@7ticlit to ,fe p t p late ai-ea@e health planning ageitcy!)i- agencies (or, if there 'Ile ropr is no s@.tch agency in the area, then to siielb other P?iblic oi- nonprofit private agency or oi,,qanizatiorb (if any) which pe@foi-ins si?nilat, ftitictio7ts) hnd anl?i if the services a,"@te(I -un,(Iei, s,itelb grant will be provided il-i accorda@,ce',witit siiclb plans ,is hai-c beei?, developed piiis@tant to subsection, (a). (2) 7'lic alitlell(litie,,t@t m(i(le by liat,@(li-a7)lb (1) ,?hall be (@ffective ii),itlb to (IrallIts under v(,ctiori, 3lJi(e) of the P"Ubl@'f-lealth VeTi;ice Act a?-P, ,)n@(le after the. date (If enactment of this Act. I'ARI' It -.elf)MINIST]eA7'1(@N oi,, Gie,iNY'S IN (,'],'I.7',i/N Alt,,I,Tl(lf,'IA"l' I'l,@OJ J,.-C TS SEc. 270. II(trt A of title III of the Health, Sri-ot'ce .@'Ict is amended by adding at the end tltei,eoy flie.followt'ny new section: .Iltl,lnillisti,atio7l, (@f Gratit,@ in (!ei-tain IIitltigrant Projects '4 "SEc. SIOA. ],or the p7t7-pose of facilitating the administration of, and e ii .na out of the ourI-poses of, the programs estab- T@"'t,i 314(c) and lish ed y thong 36il, 314(a)-, Blli(b), 31li(e) of i atiotis in which giant,? are sought or made tender two or -inoi@e of such programs with respect to a single project,. the Secretary is authorized to promulgate regulations- ii(i ) u@r wlbich the wlin inisti-ati?,@e f unctiopq s?iclt p)-ogi-ain.9 w'th respect to such project will be per@07,med by a single adr(iiiiistra- ti,t;e u,tvii which is the administrative unit charged with the ti-at-ion of any qf suck programs or is the -a(l@ministiative,izri,it charged 7.vitlt the supervision of two or ?nore of such programs; 11(2) designed to reduce the n@imbe?, of application, reports, and other materials required iindet- such pi,og7,a7ns to be szib?ii.-;.tte(I with 'e ct to such project, and othe7,wise to si?)ipl,@,fy, consolidate. and ' "r 'a ina e 'It?tifoi-m (to the extent fea,3ible), the, Ja'@ arid ii@forin tiO7l, requ-irt,d io be contained 't'It qltc/6 applications, reports, and other materials ; and "(S) qilulei- which inconsistent or (lizplicatii,,e requii-e?nents imposed by such pi-ogl,aini will be revised an(! ?nade ui@'ifoi@itt with respect to such 7)ro.ject; except that nothiik(l in this section shall be construed to authorize the Seci,et,a,r?l to watoe or with t-espect to any such project, an?/ requ,i,re@men-t witl@ -respect to any oj such programs if such requireme7it is imposed by la-ti; or by any reg?tlatioib required by law." I'AR7' I-- -,"INIVUAL ]A'EPORT, NATIONAL ADVISORY (,'OUNCIL, EITC. SEe. 280. Pa?-t ,,[ of title -III of th,(,, Pitbli.@ Health Service Act iifurthei- (i.?)ientle(i by adding aftei- @ectioib 310.:'i the),eo (as added by sectiott 270 o this Act) tl@e.following itew sect,io?t: "Ariit,?t(tl li'epoi-I "310B. On or before Ja7tita7"Y I of each year, the. S(,ci,eta),yiliall ii-atll- rnlit to the Congress ai-el)ort o the activities carried on, Under, the pri),t,-isioizs of title IX of this @ztct and sections 3011, 305, 314(a), 3ilf(k), 3111.(C), 1314(d), an(/ 81/f (e) qf this title Together, with (1) (zn evaluation qf the @,ffec- i,iveness of such activities in improving the efficiency and effectiveness of the reseal ch., planning, and delivery (@f health ,qer-i@ces in cai-ru,i7tq out the purposes.foi, which s?tch were enacted, (2) a statement of the relationship between Fe(teralfiita-(tcing an(Ifinartciritlfrom other sources of the activities itrulertaken pursuant to such prov,isions (,inet'?,iding the pos- s,i,bil,itie,@ for more efficie?2t su PO)-t of such activities thro,it(jh use of alte),- P. itate,,zoitrces offinancing after an iititial period of support it!nfler @itch pi-o- and (3) suclt recommendations with respect to sitch provisions as lie deems appt,()I)i,iate." 281. 7""Ile, III of the l@?tbli(@ Health Sei@v.ice Act t'8 annealed by (I'll!@litifl qffei- @ectio7? 315 the@i-eo the.folloit)i7?g new wctioll.. .f "-VAI'IO,VAL AI)I'IqO]?I' COU2VCII, ON COA[IllellifEV@S'IVI,,' JILI@tll'lf PI,ATVNING I'leOGI?AAIS ",@EC. 31(;. ((I') 7he @liall apj)o@iitt, Without ),e@lai-(l to tl,,c civil a ,Vatioiial On ('(Mprelbeit8,;i,r, Health 7'lie NA(ill contest of the Se(-i,etdi-y or hi.,( ii(,c, -Ohio shall be the- (!hairina-ri, art(/ ,;ixlecii, me fibers, riot t)thet-w,i,@(!,,Illl, the employ o the l'In-ile(I @tates, wlto are (/) leaders in theficl(t.,; of the.fitiiilain(,tital sciences, th,e sciences, ot. /lb(,. .7(itia7t, elelivei-!I, a,nifiti(iticintl qf health care, (',)) t)@ial.3 I'lit ).S'tat,,, (tit(I (u-e(zttyi(le heatilb plai)iitii!l (S) leaders in health care ti-atio,it,, or State or t!o?yi7)i,,iiii-ity e)i- other public affai)-s, qvlio are State or 110(1(11/ officials, or (/i) representatives of cons-ii-t@er.@ oj health cai-(@. At least q'7'x o the appoiittp.(l mcml)ci-,v shall be representing 'Ilte .f consiti@ic@,8 (If heattli. ca),e, one shall be an o ial of a State health plaii-it in g agency. !Icnc,,i , one shall be an, ogicia-I of an, ai,eauii(le health 2)la, find one ,:h,all be a utembell of the @%Tatioi?al A(It,-I'sory Coiiii(I-it on Reflioi-tal Ife(l,,ical Ili,ofli-ams. "(b) I,,ach al)l)oi??,te(.Imembei- of the @16all hotel o.fiicc.fo?- ti. ter-in "ifoitr years, e:rcel)t that any member appointed to fill a i@acancy prior to the expiration of the, te),mfoi- which his predecessorw@,.z al).Ipoi?lfe(l shall b( (tppo;;tte(I c .for the remai7i(-ler of such term, and ex ept that the lei-rfis )f I!Oce e)j the 7ne-mber8firq taking q#ice shall 'as (Icsiqnate(l, by the ,@,ct,(,Iary at the time of a7)1)ointmeii.f, fo?lt- at the end of iltefi?-St ?Iear,.f(l?@l- at the end of the gecon@l Ilear,.foiir at the end of the thill(I year, at i h (, en (1, of the .1o,?ii-th year after the (/at., qf appointment. An (tl@poinfe(I -iiieinbe?,,@iall r)ot be, eligible to qerve conii7?,itoqist?l.fo?, more than two terms. zl7)pointe(I members Of flt,(, qiyli,,ite attending ineetinfl.@ or (Conferences thereof or othe?,iai.s(, settle.riti on the of the (council, be eat!itled, tn'rece-ive c(ympen,,@ation at 7-ale,,:.fixe(i by the .1 b7it at rates not exceeding the daily eqit;t,(tletit o the i-(tte ,?pec@,fied .f fit the time of ,;ei@t;;,ce for .95--18 of the fleriey,al sched,,ttle, fi,atel- time, and u;iiile so sense .rig away.fit)7n their homes or i-e(I'UIar 7)laces of business they may be allowed e;rpe7i,ses, i?zclitding pe?, eltein in liell, of subsistence as authorized by 8ectll'oh, 5703(b) (!f title 5 of the IJti,ite(I @tates (o(l.(@fo), air, the (;r'oVel.It?nelil Sell'@)r;Ce ti?iplo,i e(.1 12 ci,l shall and assist litt' Seci-etaty in the pi-epai,atii)ib iqth respect "(d) T.@te (otirt matters al'Isititi tio7t,@ foi-, atil 0,3 to policy ze(I eml)ha,@@ 'i I f Of (ietterat regilla tl,,;@ title, w;tT, inei,ea, ' 'ihe to, ants th.,-r(,,,itnder it)@th, thF Olt coopertition n tlte coorrf.,,n N(i I ;Cal Program s, ivith 1)(i,6- ti,@(LI Atlvisory on tictil(tr, attention to the relat''), sei@,-ices: art4l shall. aitd delivery services an , alli , the than arinit i,n. cai@rytn,g O@Ultl(l@Cthh fii?t'ctions, gi@ant,s rna(l,, u,ade7, sect-ion 814 to etertf 1', e tivcne.@.@ carrying oi,t,t,its pitrposes.py alih Act is Sre. 282. Part B qf title III f the Public He ears an@l aiyte,,nde(l, bit striking olit,""Sili,yeonojGe'rieral" eaxh, place, it al)l? i," treat thereof ,@ecreta?-?I" - 1-10 S r,.,V T,.i, PART I---]?EG(ILATIO-?V OF I'A(,'CINI,,,;, 13LO01), 13LO01) AiVD,'ILLfi,'ROFZVI(,' I'ROD117CTS ect,;,o7b 861 f)f the I)-iibli,C ll(,Illfli, SEC. ccine, blo((@, bloo(l (i)m )ot?ent oi, ia K- Fi PAR@' XTf@IfSIOIV OF 1?1,,,3EARCII of S(@Cl'iO'h '301 of the 1,itbl@c fl(,alth 29@ ai,oqi-api@, S c . I fi,@al, , a,ri,(l Act Iq arn,en.de(i by oitt ,.five, siic ng 'I.I 1, -eof "e ?Ieai-s". sert,i, 6 I,,eli tite) lght TI, C. 3OJ. Section, 201 (@f the (.!omiqllytitu Aletttal Iltattli, n(I t '4e eii,d thei,e(p the followi,,Ylg Imeii,(Iine of 1970 -is am ee(I by a(l(liitg a t -io,n new .: . " (e) In, th titity mental health ecai( Qf the r u tiratit was -made, 117"let' award B tlct for aTt?/ perio(I vlbich b,,.qarb oil oi, bfore an(I t to ivhich the poi,ttor, of thp costs (as (2) h Act) wh.ick -titay be ?net ft,,)m. fitid.@ iin.(@l. secti i?ict,eued (by re.,a,@o@ (@f tl(C a gr!,,n S of this sectiot@) .'for any pei-toa aft,,i, qf the Ii tn e v)ltielt a til,(1,71t 4@( l@l ii)h,ich the I)er 0 the itiact-nzent, Of B adi@ is exfp,,rt(lt(l, by reason f (11ein(,d to Italle the I)@-(Yvtsions (a) (4) if the Secretat,?i b(,el;, coinplie(l, erit)d @Moliiit (@f total th(i 220(a) of stich. costs, Il'ederal for an,, t iiet) v)hich ivi' rich otal i)ei4.od qfter .7iin(, 0, -will ?to e e 0, 1970, ,(!ost"4 fo). rate vel-i, last corantence(i ol amount con- * "Iitat tlte grant 11 not be 7,eqqj@red i the Federal ';rxi"b'iipt'ed ax the n..on,-j. participat,ioit is i-edt(ced." 13 7111[li't" ]"Oli' ("I?O(,,'P IIRA(-@'TI('E Si@c. /fOl. (a) -rii@e @cei,etai,y qf Health, ],,(1@icat-iop, and TV6,ljai,e ma y I.it, accoi,flarice. 7'vitit the provisions of this section, authorize any carrier, ,ivhi(@h. is a I)ai-tti to a contract e?itet,e(I iltito chaptei, 89 of title, 5, I.,'nite(I States (@o(le (i,clating to health bene eral fits.fo, Fle(i employees), o7, lin(le,t- the Rf@tii-e(I Fc(lei,al 14.?Pl)loyee-3 Health Benefits Act, or which pat-- tic;i)ales iii th,(? carrying oitt of' an?/ -s-itch contract, to 9 .ssiie in. any State col-i'ti-ac@@ etil'tlintl a@iy I)er-3ott as a beneficiaril to receive comprehensive sef-l'icts (a,,; (lefille(l qilb.@ection'(b)).fi,(Ytn a groqir) pr@,ctice .7init ot, orga;nL'atiori, (as (t@lle(i in @iib,3ectioit, (c)) with ii)hll.'cli. Rllc7b carrier has C@)titr(Icle(I oi, tlte I)t,f)ilisiott, oj s)tch (b) -Is irt sect;,t)7i, the teriyi, )iicai@s c(ytripi-cho@ii,,@ive an(/ medical (as tl(,tiiteil ;ii. oTi a 1)i-epaiel and ?na? at the (il)tiort, of a cai-i-' ch other healtlb .1 - ier,,Rii t?clii(litiq tyietbtat li-ealilt ,4e@rvict.@, and eqiiipmet@,t and -stipl@liev, fijrtt;she(i fill Nlielb terms and conditions witlb respect to copaynient awl other matters, as i@tay be authorized, ;n 7-egiilations of the Secretary. (c) As used, in thin; ,3ectioll: (1) The tei-in, practi .cc it?bb't or i)rflanization" means a noib- .on undertakinq to provide, profit agency, co-op(@7-ative, or other 07,gattizati th:ri)ql.qlb direct employment th the embers qf, or other arrangements un m of a medical flrt)@)p. cornprehensiq@e medical services (or such services and other health seriyiceq) to inember@3, subscribers, or other persons protected finger, contracts of t!a)-i-iers. (2) The term "medical gro up " -Yteans a partnership or other association or qroi@1) of persons who are licensed to practice me@icine in a 5tate (or 0s,olcl& licensed to practice dentistry or optometry) w@o (A n,al activity and as a group re8pon- si.b-itity, of their profession primarily in, olbe 0), I pool their income from practice as ?n.em among themselves according to a preai-i-a t arrangement with a group praet ice u of there, services, (0) -.SA@ie common ovei,h, d i t @,uch expenses are paia oy ,members o@th( 1 and other records ' and sitbsta?ttial portionq of the equip7r, ssional, technical, and administrative staff, and (D),inctuf at least s?,tch professional personnel, and in c -vailabl6 ( t 'ak a t sit services, as may be spe@fied in regitla- lions of the Secretary. ((I) Alothinfl in this sections sl&all I)t,ectit(le any State or State agency -fi-ot@t )-efii(lating the atnoants chai,(ie(I-lot, coitti,aets,issue(I pijrsiiaitt to sub- sect-ion (a) or the mani-icr of soltc@filag and i,@SUi'tbg 87tch contracts, orfi-om regulating any cai,r?,ei- stich contracts 'in any manner not incon- .S,i,gten-t witlb the provisions of this section. TITLE V-STUDI' I?rf,LA.'I'ING 7'0 fl,NVII@)ONMEfATAL LOLLUTION SEC. 501. (a) 7he (,'oitgi-essfi?tds that there is general that air, uater, and other common etiviroyii7nentat Pollution, mal t(i the healtlb of iib(l,ivi(Iiiat8 the IJ,@t-ite(l States, I the existence of varto@tis research I)al)ei-,,; a?td other technical 14 h(.alth ha,-ai-(I,@ o 8ijeh pollittioti, itiei@e i.@ 110 ination about (1 the nature and tii-a.,,;ty of thc.3e ha_va?ltl,,z, ;@l,) th@, at,a;la- biti,ty ofrne(licala7iclothera.,z.9,;staiic6 ti) react,,7..@ @l 'u.@ than thr)@( rolg,(:ii.,7 -iotel.!i oba!etqf-itt of Poll!(4;oli. 'r,trc" 7f@ay be taken to or re(Ilic,7 tho7 of (b) Tl(,- Presifl,,, (ii i;hall c(it)?i Retire. (.1) a of ti@ t?(ill an(] gravity qf the ha-,ar(Is to h.)iTt?ait b(alth and sa-fet!l ci-co,ted by air, liwlte-j-, and other comm-oi@ t,ni,tronrnciital pollution, (2) a s@ire,ey qf the tnC(Itcal and other assistance available to I)erso7is qffected by such pollit- tion,, especially v)hen s?tcl& pollution reaches eme@(ieticy levels, and (3) a ,,;?II.Vey of thetneasvi,es, other tlta,.it tltose relating solely to abatelli('.Itt of the pollution, that may be taken to a?ioi(i ot, reduce the@ effects of sijclb I)ol(,Ilt;oii. on the lwalth of in(l@?)id@itals, (c) The President ghall, ij)itht*?b iiio7itlis of the ellacittlelbt of this i(:t, ii-iwttsmit to the Congress a re7)()i-t of tl@,e stitdil arid s?lrveysi,eqitii-e(I by subsection (b) of this section, (1) his conclusions regartling the and graviti n the hazai-d.5 to hit7naib health aizl .3a ty created by ./ f . ft, eni!ii-onmeittal pollution, (2) his evaluation o the 7(te(iteal and other .f assistance available to pei-so,its atTected b?l such I)oll,@it7,o@n, especially iiheit such I)ollzition reaches emi,t,fjency levels, (@) his assessment oj tl@,e other-tha,n those relating solel to abatemeTtt of the Pollution, that may be taken to ai@oi(,-l or reduce the effects oj sitch po/7iition- on the health of vidit@, and (It) @iich legislative or other rpcommewlations as he niay (learn appropriate. ((/) 7he P7-e,3ident shall, o?te yeai, of his transmittal to the (,'oit- of the report rcqzt ii-ed b -s u bsect ion (c) @)f this section, art d an,?t Really tliereajtei,, that ck new (lata, ev(ilil(tt!ioitq, oi, reco-aimeTt,(Ialto,n@s as he Tna?l ate. (e) 'I'Itei-c are riale(I qitcli, (I.,: bi@ iiecessa)@9 to carry oitt the I)i, NATIOA'AL 11)VI8011Y COUNCIL SEC. 601. (a)(1) Secit'aits 217(b), 1132(a), 443(.b), art 703(c) of the Piiblic I-lealfh Se?,vice Act are ameTtded by insert;,iig "o/, con2,mittees" after "coiincils" whei-ever it appears thereiti,. (2) Sectiot?,,@ li8l, 482(b), 498, @43, and 452 of sliclt Act are ame7idetl by inserting "i)i- ca)n?itlittee" after wherevei, it appears therein. (8) S,?ibsections (b) and (@) oj section 222 of s@tch Act are (t?nert(le(I by inserting ot,"@be ?,e "committee" wCei-eve-i- it appears therein. 0 (/p) Such section @ YI !@h,' amende(i by in the heading ol e 7 thereof "(,@ouzvciLs OR" b 'coirArl7'TEI,,S". (b)(1) Sttbsect,ioit. (c) qf section 208 o the I-',iibli'c Healtli, Sei-v,ice.,Ict is aine,nde(l to 7-ea(l,: f "(c) Alembe?-,,4 t)f the AI(ttif)ital .41(lvi8ot-y Health (,otin,c?'l an(/ 7icmbet-.!; O/' other National advisory or i,evicit) co,@tncits (Pr coinin,,ittees establi,@ltei trader, this ztct, i,,iii!litflin.(i ?ne-tnbers o the Teel?,nical Electi,o@nic P)-odilet It'a-(Iiatioil Safeill C"o)@@?@l;ttee an(i the Boai@it of Ii'e(jents of the Natio,ptil Lit)?,ar,@ o 21letlit!@lie, but ex aften(liti,!l coil-fe),e?it!es oi, of their i-e.,,Z)ectire, coitnci&@ or cam- illiffees or iiili.ile sei,i)i7itl (it the i-eilize,@t o the Secretary, be CO)I@,'7)ett,?at ion (it rate8 to be fixe(i by the Seci,et(t),y, but at rates not excee(Iii@g the daily equivalent ()j the i,ate 8pecifted at the time t@/ @7/c/6 for (trade GS-JS of the Geiteral Schediil@, ?,'nclu(lii@g ti,arel- ti7ite; (ii@(I av@aii fi,on6 the;r lbome,3 or regular places oj business th,ey may be alloued travel Expenses, including per dlein lieu of subsistence, as authorized by sectio?i 5703@b) oj title 5 of the finite(! S(at6s Code for I)cr,@oii.@ in the Go?,,ei,n,,inent scri@ive employed, ?,,ittermittentlil.yy Y'lie qecond sentence of subsection ((I) of section 306, the second of subjection ((I) qf section t')07, the sentence oj paragraph (2) qf (f) (?f section 358, subsection ((/) (?f section 373, @ilb- .@et,tio7i (e) (@f s(-et'l'on O'// 1, o section 703, s7.1,b,@ectio7@ (d) (?f section 725, .9@ibse(-I,,ii)n ((/) of vct'i.on 7'7//, ,iitbsectioii, ((!) of ,;Pction 841, (t7lil, Rllbs(.Ttiolt (e) of section 90r) of A(@t (lelele(l. (3) I'(tra,,qr(i7)lt (,9,) sttbycetion,'(f) of vectioti, 358 i.,i.ftii-thei, (tin(!,n,(Ie(I by I "Itil(lel, tit@is the sentence tlb(,,t-eo (ind by in I'ett, thereof "to ?rieinbet-,g of the (,'onlltlittee li@ho are ?lot, officers or employees of the United x@tate.@ to subsection (c) of 208 of this Act". (4) Subsection ((l) (@f ,?ect,ion 1)05 of such Act is redesignated as sub- section (c). (c) (1) S?,tbsectio?t (a) qf section 222 of such Act is amended to read: "(a) 'I'lic Secretary may, without regard to the, rooisions o title 5, p @f L,'nited States (@ode, governing appointments iii, the competitive service, and withoitt regard to'the provisions of chapter 51 and sitbchapter III o chapter i)3 of such title relating to classification and Ceiterdl Schedule pay rates, time to time, appoint such advisory councils or com- ni ittees (in, =ion to those authorized to be established under other pro- visio??8 of law),for &itch periodic of time, as he deems desirable with such period co?ninencing at?, a date -pecified by the Secretary.for the purpose of him in, connection with a?-zu of his functions." (,O) Sitb,3ectioti, (c) qf stichsectio?b,is(imen(led, byinse?-Iing "orprogi,am-g" (iftei- "projects". ((I,)(1) S?ibsection, (!I) )f section lfO8 of the Ifoo(l, Dr?tg, an(l, (@'osnietic -let is (amended by sti,' ces a tl,-iitg oitt, "as compensators for their servi reasonable per (liem.,.for time act?tallu spent in the work of the committee, and shall ,an, addition be for their necessary traveling and Nitbsistence expenses while so ser?:Pi.nqaway.fi-omtheii, lacesofres@i(lence." p q,ftcl, "shall receive" aiitt, by insertilig in lieu thereof "compensation and travel expenses in. (.tcco?,dance will vitb,@eetio,7i. (b)(5)(D) of-sectioit 706." (2) S,@,bpatagiaph (1)) of paragraph (5) qf subsection' (b) qf section 706 of such 4ct is amended by striding out the third sentence there and by inserting in lieu thereof the following n,eiD sentence: "A.,fembers any advisory committee establiilted under this Act, while attend 'n( c onj,,, ,ngs of their committees or otherwise @erving at ilb p or meeti e real t 0 'tled to receive compensation at i. te's. t) X(, Secreta7,y, shall be entt, a be the Secretary but at rates not exceeding the daily etiqjivalent of the rate specified at the time of such service for (ira(le 8 of the Gerier(itSche(lide, including traveltime; and, tlbeir homes or regular places of business they may be alloi ises, inclqtdinq Per d@ 9,-ti lie'u of &?tb,3i3fence,, as authority 5703(b) of title 5 of the United ,Vfafes Codefor persons in t e vernment service employed intermittently." SF(,,, 602, @ectioii, IiJt2 of the I-)ablic Ileattli, Act b?l ,striking out "7-eseateli," befi)i@e "trainin-ti". Aii(fthe Senate i-tgree to 0am(@. That tli(@, Hous(, recede froin its disagreCDlc-nt to the amendiuciit of the Senate to the title. of the bill nii(i to the saD-ie. ITA]TLL@Y 0. ,)oil,,; J.A.IZAIAN, .PAIJL Cl. Ro(,.E;IZ6, Wli,l,IA.Ni I,. SPItIN(@lplt, ANCIlEtt i\L'I,SkN, ilfaria!lei,x ort, th.(@ of 1/1(' ItAl,]'Ii liAltitiSON A. Wll,l,IA.\lS, 111'.1 P,'I)WAlti) '\I. KFNN'fI)Y, P. EA(JI,E'I'ON, AT,AN ("it,@N','I'ON, (,'I,AiliOltNF Pl@,],T,, l-'.ETI@R II. f)o@\IINI('K, ,IA(!Oli l@. JAVI'I'S, WINS'I'UN li. PROIJTY, WILI,IA'.\l B. SAX13E, @t,fanager.q on the 13'art of the SeTb(ife. S'FA'I'E'.\IEN'I' OF THE NIANAGERS ON THE PART OF ']'HE HOUSE oil (,lie 1)atrt of tire House it tile (.oiifereii(@e oil the Vote,, of (,lie t,\i,o Hoiises oil the iiiiieii(Iiiieiits of the, Seiiiit@e tl() the bitI 17570) I,o lllifieliti t,it@le IX of, tile Piit)lif@ FI(@ilitil -,t, so @li I , 1,11(@ existing, A( itti(I to 2111(i ill ot'll(@t. (lise@IS(',S, ill (@XI)Iltllltt,ioll of tile effe4,f, !))fl tl)le a(,,i-ced tii)oii by i,lit, iiii(i i-e(@oiiinieii(ted iii t,ii(- Tile Seiitit,e iiiiiendiileiit t,o tile text, ()I, t'lie bill struck otit till of t.lic House bill aft@e[. t,lic, etitt(.,Lil IL' CI-,Ilise till(I ti stil)stittite tirrion(]- iiieil t.. The (,,oniiiiittee of' (@oiifer(,@it(@e li@is ii.!-@i-eed to it sill).-;tittite for both (,lie House bill and the Seiiitte tiiieiidiiient to the text (,r ,,he bill. I",X('Cl)t fot- tectilli(!Iti, (@l@ti-ifyiiig, find (,oliforining tile folio"-ill,-, statement C.'Zl)lttitis tile differences 1.)et",een the bill and the -substitute agreed to in conference,. ,rii(@ has )ttss(@(i two st@I)ai-at,(@ bills (I(@tilifig with tli(@! -kibj(,(!t-, (-iiibt-ii(-cd in tile Senitt(@ ttiiieiidiii(@,iit; B.It. 17570, and H.R. t8iio, a bill (@xt(@iidiiig titid (Expanding tli(! of (@oinl)reliellsi\,(. 11(@,titil i)ltiiitiiii@,, and research ItTid d(@iiioiisti-atioIis i-(,Iittiiig to tti(@ d(@]iN-(@i-v of It,,tiltli st@rviet@.s. The Senate itineiidiyielit deals \Vit,li the 1)1.o",ritrns (,.oiitaiii(@d in both House bills. REC.IONAL r,]E])ICAL PIIOGRA'J\IS .@cope qf program Both the Hoiis(@ bill and tli(, S(@iiitte @iiiieiidiii(@iit expanded tii(@ scol)(@ of tile, program to include, kidney discits(@ its well as heart cit icei-,and s -ok(,. Ho%vever, tile Seiiat(, I ti I itiTicildm(,nt cliaiig(@,d (,-ov(@i,tioe of i)ther @i-elate(I di,,vases to other mq:ior tliieases atb(I con(lit,io?@,s ' 'File substitute is the .,kiintt tis tli(-@, Iloits(,@ bill. N'ttili- tigers for both House.,, were in doubt tis to tll(, of t.11(@ )rograni should be Iiiiiited (its in the, House bill) to dis(@,i.se.-i related to di,,ea-,(,,, kidney disease, tnd stroke or \\@liethei- it ,Iioiii(i be Iiinited (as in t,h@, Sciittte, ai-n(@ndm(,@lit) to itiajor dis(@as4@s Field (:oil- (litioll" other than heart disease, kidney disease, c Iiiiic(,,r, tiiid .,,tj-ok(@ find expect tile Secretary of Health, Edtictitioii, and Welfare to coii(lit(-t it study of the scope of the reviontit iii(@diezil 1)i-ogrtti-n and to j-(,,I)()rt tt) the ii.pl)i-ol)ri@it(@ committe(@s a Ct)rigi-(iss his recoint-nendatioii-4. The @Seiitite ai)iett(lmpiit (Continued ti provision not in tile floiise bill \\-hicti expanded tissist-aii(,Ie foi- (,.oiisti-ii(-tioii to in(,Itt(le assiittitice for new (-oiist@rtictioii of fu(tilities for demonstrations, find training when iie(@essary to (,,ai-i,y out regional iiie(ii(,ttl I)i-o&i,iliiis. (,(liifereiiec ,ttbstittite is i(leiitic@il \%-itli the Seiizite Ililleli(imeilt exile t It )t 112't it is that 'lot ''lose tliziii $5 nil y be iiiide tiviiiltible iyi aiiy fisetil yezii, foil -@i-iiiits foil sit(-.1i iie@%- coiisti,ii(@tioll. P(ti,ticipatio)i of 1eterang' A(Imini.,.-,fi,atioi? ])el-8011111'1 The Seiiite iiii(@ii(lineiit (-oiit2iiiie(i i 1)].O\@isioii i)ot iii the House bill %I-liicli "-olli(i (1) iiiike tl)e ('Iii(-.f '\Ie(ll(!@il Dii-e(,toi, of the Nleteriiiis' A(iiiiiiii,.,ti-,ttioii tiii ex offi(-io iiieiiil)ej- of' the Nt-tti(iiitil A(18,isoi-v (' @otiii(-il for file i-e(,ioiitil i)ie(lictil kill(] (2) i-e(ltiii-e to(@til'a,(Ivisol.y (,,t-otil)s to iii(@llittle its tii ex t)fficio iiieiiiber the I)ei-soil (lesiglittie(I fi-orli the lo(,til Voteriiiis' Atltiiiiii-,t,j-ittioTi health f.,tcilit-v. JOINT Al)viINISTItATfON OF PROJECTS bill I NN-otil(i iiiii(@iicl tli(@ A(-l to (lilt[ ill tli(@ (!IISC. of' J)I.oj(,(-Is fiiiid(@(i (,it(! to tt(iriiiiiisti@r- fiiiiiii(@iitl ii.,si.,- foil Sil(-Il Shia](, iioii-Fc(l(@t-til foil sit,-Ii IL[ICI (@olifli(@tiiig graiiii. of. (.olltl.ll(@t I,(.- Tli(@ ittilljoi-ity itin(,i)din(,nt @%-oiii(I b(, liiiiit(@(i to I)rojf!ctm fttiid(!d iiii(](.r titit@ Ill oil JX of' i,lift Ptibli(, 11(@,tittli Act, iiiid no ittitlioritv foil ii sliiii,(@, r(!(4tiii-eiticiit or for of (,onfli(-ting i-e- rc,(Iitir(@(i by ()-r by i-ectilittioxis required by la@v %%,oitld be I)ro%,id(@d. The coiifei-eiiee si@ibstittit(@ is Nvitti the 1)i-oN,isioll of tll(@ S(@iiiite aiii(@iidnieiit. RESI',AR(,'If AND DEATONSTRATIONS ITELATING TO HEAI,Ttf FACILITIES AND SERVICES ,,I iiihorizatt'on of app?,opriations The House- bill would exteii(I for three fiscal vears (through fiscal year 1973) the authoriztitioii of al)j)ropriations ?or the I)i-ograni-s of Fe(leriil fiiiaiicial assistance iiii(lei- sectioji 304 of the Public fleitltb Service Act (i,eltiting to research tii(i (leiiionstratiori'@). TI)c f(,Ilo@viiig aiiiotiilts xN-otild be authorized: $58 ii-.lillioii for fiscal vear 1971, $79 filiflit)ii ft)i- fiscal 3,etir 1972, aii(i S94 inillion for fis(.al year 1973. ']'lie Seiiii,te iiiiieii(In-ient Should e-,teii(i such i)roc-,rkiiii for five vefir,,4 (through fist@4il yeii- 1975) @iii(I N%-otil(i ,tiitliorize fire tolloNN-111c,, an-JoUI)ts: $80 iiiillioii foil fis(@zil years 1971, 885 ii)illioli for fis("ii yeai- 1972, $94 iiiillion foil fiscal ve:tr 1973, $1 10 iiiillioii foil fiscal fear 1974, aiicl $130 i)iillion foil fiscal yeiii- 197-D. 'rite (.01iferen(@,e substitute I%'O Lild ext@eii(i such for three yc,ti,.,4 (t,hi-oii,)-h year 1973) Ull(-[ \VOLII(L tititliorize the folloN@-ing: iii1lotilits to be 11 I)I)rol)riti.te(l fOl' SLI(.',Il I)i-ogrtityi: $69 iiiillioii for fis@i 1971, $82 iiiliioii foil fiscal 1972, aiid $94 iiiillioii for fiscal 1973. off (leli"lle)-y qf sei-vi(@8 cojit.iiirit,(l ii, I)i-ovisioii iiol iii tl)e Hotise bill \%.Ilicll N\.ottl(l itittilol.iz(, gi,iiiii.@ iii(I (-.oiit,i-ii(:ts iiii(loi- sti(@li section :@04 for research, xl)eriiiieiit@', and (1plllollstrziti( us, relatilig to the e effective conibiiititioll or coordination of methods or systems for the delivery of lie@iltli services. 'rlie'conferetice substitute contItiD, tile I)i-ovisioii of the Senate tLineii(Iiiient. lIome health sci,vice,3 '['lie. Senat'e tmori(iiiieiit cotit@iiiie(I iL I)i-o%risioii not in the Ilotise I)ill iviiieh would ttittliorize gi-iLnts tLn(i (,-oritrti(-ts UTI(ICI' Such section ,'iO4 rol, project." fol' titi(I (letyioii,.,t,i-iLtiorii in the provision of li(iiiie health 'I'lie ,iil)stittiL(, (!outlines tile I)I,ovisioll of tile Sclillt,(. tilli(it)(Iii1olit'. of lti,atilt (,(la-( I)Iaiis 'I'lic s(@tilLto itilloll(tilielit (!ollt,llitle4l it 1:1-ovisioll lll)t, it) tile House bill N% Ili(.II would Illicit] @tic-li ,,ecti(iii :304 tio Iii-(@(,t tile Seci-etal.y.of lietiltil, and Welfare to (I(.Velol), t,ill-olivil kitiliziltioli of ,iysteII)s ,Illttly.,is itietli(i(I tilt,ei-ii@itive i)12i.iis for li(@itli,it ctti-e systems designed iti[eqtitttoly to iiieet, tile 11(411t)i iiec(is of the American i)eoi)le and to re[)()-i.t, to Congress not Ittter than June 30, 1971, oil such i)l@iis. Uti(let- tile ttiiieii(itneiit, the @'3e(!i,etiti-y %@,oiil(l also study bills introduced in the 91st Congress Nvilicii 1)ro[)ose a national lieTdth insurance plan oi- similar plan to (letet-iriiiie the costs of such plans and their adequacy. 'I'he Secretary would report to Congress not later than Decemlier 31, 1970, the results of such stil(tv. $@-illillion %votild be authorized for fi,,eitl 'yetir 1971 for the (levelol;nient of such plans and for the conduct of such study. The conference substitute is the stinie as the Senate amendment ex(-,el)t that (1) it is made clear that the Secretary is to develol) more t,hai@ one plan foi- health care systems, (2) the Secretarv' s repoit with ilesl)ec.t to plans for health care systems is to be made not later than Sel;tember 30, 1971, (3) the Secretttl,,v 7s i-el)ort on bills introduced in tile 91st Congress is to be made not, later -than March 31, 1971, and (4) $2 million is atit-liorized'foi- fiscal yetir 1971. THE NATIONAL HEALTH SURVEYS AND STUDIES q'lie House bill Another aiiieti(I se(-,tioii 305 of the Public Health Sci-i-ice Act to extend foi- three years (through fi-,cal vear 1973) the )i-ogi-titii of national health ,;iir%,eys and stu(Ii@es and woul(i authorize lor such programs the follo%@-iiio, amounts: $lo millioii for fiscal year 1971, $21- million for fiscal year 1972, @iiid $22 Dlillion for fisctit year 1973. The Seiitte ttiieiidineiit would continue the open-ended tiutlioi-iztt- tioll foi- such I)rograri!. The conference substitute extends sti(,Il 1)roLrtim foi- three fiscal -l, years find aittlioriyes tile folloxviii(, ttiiiotii1ts: $15 million for fiscal yetir 1971, $20 million for fiscal year L1972, itii(.1 $25 million for fiscal year 1973. REPORT ON ACTIVITIE-, U-,DFft 'I'ITLT@S llf ANT) IX OF THE Pul3i,ic HEALTH SERVICE ACT Tile Senate ftn)endment cozittiin(@d a )rovision not in the Hous(,, I bill -%which -%votil(i amend the Public B(@tilt'h Service Act to (lire(-.t that oil or before. January I of each year the Secretary of Health, Educa- 20 t,ioll, it.11(l W4-]fU]'(' 1'(-I)ol.t to ()I-l (II x of t [I(., 'I'til)lic II ("Llt@l A(-( %@ it] I(I) tti't (--,vitlitat.loii (ifIIi(, of ill iiiil)l.oN-ill$,r til(@ Ill ill, J)la,llllill,.. fol., till(I of, ll(',Iltil (2) itit ziTitLlysis (if tli(i i-el@itioti,;Iill) aiid local ttiid (3) siteli re(@.oiittxioiid:ttioii,, tli(@ de(,iiis C'O-vIPTIE@IIEN',I\-E 141,Al,'ril PI,ANNING I'LAN ,;']'ATE IIEAL'PI-I of i)ill loti:')14(@i.) (@r ol' ill St@tt(@', l'ol. xk,olll(t lliit,llol.izl@ ill(, @titiotl!lt": $10 iiiiiiii)ll i'l)l. li)71, $15 iiiillioii f'()i- fis4!iLl y(@ii,i- l@)72, itti(i $20 1975 :t,ii(I woiilil iII4. itilloillits: $15 IYI'IiioIl t'()I. y(@iti- 1971, $17 inillioii l'oi- y4@itt, lq72, $20 iiiillioll I'()]- l@)7:3, $:30 iiii1li4)ii for fis(,til 1974, ii,ii(I $:35 iiiillloii l'oi- 19i'5. sti(-Ii I)ro(Irl-ii,iri lis(-itl 1973 iLii(I tli(@ folloiviii,, irTiotiiit,,: $I,") iiiillii)ii for lis(-ztl N,("l I- 1,971, $17 inillioii for fis(-itl y(,@ti, I()72, iii(I ',s2O iiiillioti for v(@@i I- 1973. l,'etcra,n,,@' Adm@'n@',@t-rat;on i@epi,e.@eittatl'on oil Sta,te Itealth I)lanTili'l)@l co@ilici'l 'l.'I)o S(,,iittte ariieii(iiii(@titi (-oiitztiiicd -,t I)i-ok,isioii iiot ill th(k I-loit-,(@ I)iil would i)i-ovidc,, ttitit tli(@, Stat(, 1)litii ittid(@r sticli (,(@t,loti 314(it) VN@oltl(l ill(-Itide'Stai(-, I)Iitiiiiiii(, for lioni(,, )i(@tiltit car(@. (-onf(,,ren(!e stibstititti@ tli(@ 1)rovisit)it of tli(@ S(,iiiti(, PIIOJECT GRA.NTS I-'OR AIZEANI-IDE IT.EALTIJ PL.IN-SIN(@ @Iiitl@or@'zat@'oTt, of al)propt-@'ati'olt.@ lioiis(i i)ill woiii(i of tli(@ 114,@iltli S4@i-vi(-o Act, to (@xt(@it(i f;s(-tLi y(titi- 1973 tIL(@ (if I)i-oi- (,(-t for J)Iilllllill@, and wotild tititll()I.iz(, tll(@ lollowiii(, Litioiiiits: $15 iii'llioii foi- iiiiiii4)11 for l I y4@iti- 1971, $25 tis(.Itl yetti- 1972, it,iid $40 iiiillioii l'oi- fi,@&LI y(,aT- 1973. iiiiieiidin(@iit, NVoiild (@xt(,Yi(i sii(-Ii I)t-ogi-ani tlll@oiigit y(@iti- 1975 @iii(I woiild itittlioi-ize tli(t following iiiiiotiiit,s: $20 n,iillioti l'oi- y(@ai' 1971, $30 niillioii foi- fis(@tLI year 1972, $40 iiiiiiioti foi- fis(@,i] your 1973, $50 iiiillioti foi- y(@,iti, 1974, itti(I $60 iiii1lioll fol. fis(@al y(@ttr 1975. ikxt,(-,ii(is sii(-Ii I)i,ogi,jLiti t,iii-oii(,Ii fis(@al yoai- 1973 itii(i tttititoriz(@,s 1-ii(@ followiii,, tttiiotiiit-,: $20 iiii[lioll for fi,4(-til 1971, $:30 iiiillioii for y(@tir 1972, tA@ild $40 iiiillioii f(ii- 197:3. 2 1 till(tel, Sll(-Il se(.tioli 314(t)) NN'Olll(l iiii-111(ic ],Ollie lie@tit,ii (!tire (.olifei.e[l(!e sttl)stlit,lite is i(leliti(.Itl %%.itit tile Senate aiiietidiiieiit,. @E ON to State agency "leti ;' I)ri,\ . . I 'II tile liotis Senate ,amendment 110 I I\,Ili(.h %would provide ti@zit @,7itier i-ertaiiii the @tate @ld r(4-et-@-e iiii(lei- -se(-tioi) 314(t)). The @n cm' (ieiitl(-ttl with the @itate timen(Iiiieiit. .4rm@, @fk 'llie lt-@tie bill w(-tilti tineiiti -ii(-Ii 314(b) to 1)ro\-ide tllltt the -t@- *-]de health i,faiiiiiii-r t-,,iitit-ii A%-oii](I incline i-el)re(.,eiit;atives Of ,of health 'I'lie @ate anien(itileiit \%"Iilii I.e(filil-e that, l@ ly1ttiol-itv Of, tile llieiiii@hip g,f @icii t--iiiii(-Il I)e j-(@l)t-esetititi ives of coIistl;ners of lictiltil -..iiferen(-e is i(teflt,i(.ttl witil the Senate aiiiell(litictit@. (iliANI"@, P'Olt (@OMI'LtEHI-'NSIVE IIEAI,'I'H SEltvi(IFS O)f al)propr,;,atiott,,i lloti,@e t)ill x\,oiii(i extend iliroti@l,li fis(-.il 11)73 the I)i-ogi-itfii tiii(i.er sect,ioTi 314((I) of (lie Ptit)li(- tl(-ziltli Set- \-i(-e Act for ,]-ttiits for t, conil)relieti,;ive I)iibli(- health servile., ;tii(I tiitliorize the folloN\-- ing aiiioiiiits: $125 iiiilll(iit foi- lis4--.tl veakr 1971, $140 i-nilli(@ii fill- fis(@al .vear 1972. and S160 itillil(iii for fi-,(-itl N-etti- 1973. 'I'lie @nate anieii(iniciit extend sii(.Ii 1)i-o,@iii-i tliroit(li fis(.al 'veiii- 1975 Ekiiti wotil(i authorize the folioN%-iiig ainoiiiits: $130 million for fis(@,ii yeai- 1971, $145 million for fis(-,itt veai- 1972, $165 million for fi:,(-,,il yeir 1973, $180 million for fiscal yea@ 1974, and $200 million for ve,.ir 1975. 'I'lic coi)ference substitute extends sii(,Ii I)rogrttin through fiscal year 1973 and ituthoi-izes tile 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 Both the Senate find Hoti,.,e I)ills, and the (Conference substitute, J)rovide a contintitttioii of the existing I)rogriiiii of 1)roje(,,t grants for health services development tindei- se(@t,ioy) 314(e) of the Piji)li(- Healt,li Service A(@,t,, with authorizations for fiscal ye@it- 1.971 of $109,500,000, $135 iniiii(-)n for fis(,al year 1.972, and $157 i'tiillioti for fiscal year 197,i. 'I'lie confereii(,T substitute does ikot (-,oiit,ttiii the further autlioriztttioil Of ai)l)ropiiatioiii for fis(,,al years 1974 and 1975 (-,()ntatine(i in the Seiiat,e version. ,riie c(-)iiference stibstittite ,tlso itittlioi,ize,, tile iise of ftii)d.-4 ail)l)ro- I)riated for section 314(e) for meeting oblis-,attioTi,, heretofore iii(,,tii,red Keith respect to certain facilities of t,fie Offi(.e of Ecotiottii(! 01)1)oj-- ttinity which have been, or are itt the I)ro(-es., of beiiiz, transferred to the jurisdiction of the Del)artineiit of health, Editeation, and Welfare. alth Servi(-es and Men""' FDIJ(@ATIOIN, AMD V;'EIFARF la, neal lilol,o(;I(,Al, I-ROI)tj(.@,r,,; ItE(IUI,A'rioN Or' Cfft'J'AfN to se(@tioll A(,ti tile Pill blo(,(I, I)Iood joill- that to li(!ell@e \.@l( This ikiiieiidiiielit i@ I)I)Ilctlt" or d I)v tile iloii-e. II.R, i,li-eidy passe 11 t,o tile, I)I'ON@l, 1) itl,.te iz the Avitil to this ttiiieti(linelit,, the (,oiifei,eii('e st, tile, SCIltite N'CI'SiOll. Searle as AUTIIORITY l,'OR GitOUP PRACTICE ,I,Ile riot. ill i-V or lll.@@titil, E(Illf-,Itt.ioll, s t,(), 01' tt) ttlttllol,iz(l I , cr to ll(,;ilLll olit of (Ioiitl,zt(,[,, I)tti't icil)Dt( 1 .-,@ (, ill any State for ti(@tiv(@ or retii-(,,ti I;re(l "'-"I (tlllt)loyc"(@', @o eiititlitig to i,e("Cive, it flat \Vitti wili(.,Il tile. 1)1,4)visioll Of .ticll stib,;tit-lite colitititi,, th(, provision Of til(@' 01, INCREA,-Et) "i,,AIFING ]@OR CURitl@:NTLY FLJ,41)EI) IIE('FIPT COMMUNITY I%IPNTAI, liEAI,TH (-'ENTER@ (1111(@ ' aiii(,@ii ',It et@Ilt@till(@ll a ),.ovisioii not in tilf- to (,Iitliige Llic application of tii(@ initiiitenatice of (,,ffort requit,(,,In(,,Ilt,, litl(l(lr tti(I comilluilit,@y 7ivfeiit,,il H(,,ttltli Cent(,r.@ Act to [)Y -r(,iit@ly coiiiiniiiiity in(@tittl lictilth of tll(" vi(le(I titi(i(-r tli(., Cornmtinity of ,ttiffitig (.()"t", I)ro Aiii(@11(lin(!Ilts 'of I()70 (Plil)lic T,aw 91-211). rii(@ (-oiifereiice stibstitiite (-,oTitailis the provision of tile Scii1it(! CONIPEN,A,riON Ol,'AI)VISOJI@' COT'NCIT, ME,\IBEIIS, ETC. S(@ntLte (,olltltiii(@d it I)i-o\!isi(oll riot in tll(' @loll@(. bill \\-ould :iryi(tild tli(,, Ptii)li(@ S(!i-\-i(-(, A(-t and tti(@ Fi@(I(lrttl Food, Di-ti,,, and ('@o@ni(,ti(- A(-t to I)i-ovi(l(- i,inif4)1,j)l (-)TI n li(),, of advisory iii(,Iyli)t@i-s ttil(i to alltliol'iZ(@. ('ODIIllitt('('@ to 1)4' (@ttti)lislie,(l wb(,r(,, t,li(,r(@ i,, itittlioi-it.@7 to (,stttl)lisll tl(lvi-ol,v 'Plie ,)ILI)Stit,lit(@ I of @il(?, S(-Ilttt(@ ]tF',EAR(@ll (!ON'I'ItA(@l'ING AUTHORITY Solitit(@ Ltmell(Illl(, irio(i t I)]'oViSiOT) Tiof in tli(@ Hous(! bill 'Ilt C-olit II 301 (II) of t I'(@ Pttbli(., 11(@aitli S(@rvict) Act. to t,ll(.t fi,,cttl v(@aT liiiiit@ttioll Y(@tll' 1971) oil the reseal-ell it o litioll, '111(l litilol-it-v of tll(@ 11(@itit,li, E(iii(@ titt(3 stieli authority ti rotic, I Welfare. The (,onfL@r@iic(@ ,Lil)st'i I @l ftsc-,i@l your 1973. 23 TRAINING AUTHORITY OF NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES ,riif,@ sciiat(,, itin(@n(Iment coiitaiiicid a ])I-Ovisioll not in the Hott,.,e bill A%@iiic@li woiild am(@nd section 442 of the- Pitblic Health S(,@rvice Act to I)I.Ovid(@ that the National Iii,,,tittit(l, of Gell(Ilral 'i%icdical Scieiicc-s cotild idii(,t tend siti)l)ort cliniciLl its its I-(@s(,,iir(-,h tritiniiic,. The coil- stibstittit.(@ is identical to the S(stiat(@, ain(@zidmerit. F;'rUI)Y ItELA,r)NG '1'0 ENVIltON;NIENI'Al, POLLIT'RION' ']'lie Sciittte ttiiieiidiiierit coritaiiie(i it 1)rovisioll not ill the Ifoiise bill Avlti(-It dire(,t,e(l t,fie Se(!i-ettii-y to si,tidy (I tile liettltli and sitfety littziti-d,, I)reseiit,ed by eiivii-oiiiiielit,til (2) iyiedi(!ul iiii(i otlier ltlisi,,tititt!e it,,,iiilttble to 1.)er,4(iiii ttffe(tted 1) I)olltttioii, itrid (,i) ()tllel. tllttll ttl)t itellicilt, t,litit (-Itll @)c taken to fivoid effc(-,I, of Sti(-Ii 1)olliit-ioii oil Iiiiriiiiii health. 'I'lle (Conference substitute is the sti,iiie 4t,, the Senate iiiiietidrnotit ex(,ej)t Chat the study is to be eoyi(Iti(,ted by the President. HAIII,F,Y 0. STACGER,, JOI-IN JARMAN, PAUL G. ROGERS, W. L. SPRINGER, ANCHER NELSEN, Managers on the Part of the House.