1 * a regional medical SPECIAL ISSUE FOR LIMITED DISTRIBUTION programs service ii evv s 0 ififorinatioll data A et)iiiniuiiicatioii tl(.,vice ilesigiie(i to BPCC(L LEGISLATION EXTENDED IND AMENDED FOR Regional Medical tli(- exchaiitre of news, Progr@ Public Law'91-SlS inforiiiatioti in(I (lata on iiegioiial Nle(fical Pro.-,rai-n-s an(] related activities. Vol. 4, No. 51S November 20, 1970 N October 30, 1970, the President signed Public Law 91-SIS which extends -is well as that of and amends the Regional Medical Program legislation, Services, the National Center for Health comprehensive Health Planning and Services Research and Development and the National Center for Ifealth Statistics.. To reflect the details of this action, a copy of Title i of the new law S) referring to Regional Medical Program specifically, and (P.L. 91-Sl Regional Medical Programs, are Parts of certain other titles relevant to ep oduced in the first part of this issue. r r To indicate how the toial,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, as am(,%nded by Public Law 90-574) on the page@that follow. Deletions in the previous law are shown in Lbracketj while the new legislative language is underscored. Distribution: Coordinators of Regional Medical Progrwns Members of National Advisory Council and Review Comittee on Regional Medi.cal Programs Staff of R6gional Medical Programs Service Regional Health Di-rectors and Regional Wdital Programs Service Representatives of Health Education, and Welfare Regional Offices IJ.S. I)EPAII'I'MEN'I' OF El)tl(:A'I'ION, ANI) -WEI,FARI@ NIkl-%-Iltii(i 201152 Public Law 91-515 gist Congress, H. R. 17570 October 30, 1970 !aii 2tct Ti) aiiieiid titles III aiid ix of tile Publi@ iiL.iti, SLr,i(.(! Act so ,I.,; ii) r(.vise, ,xteii(l, told inil)rove the I)rograiiis of reseiir(-Ii, training, aiid demonstrations authorized tliereiiii(l(-r, laid for other 1)urlx),s(@s. Be ;f, enacted bil the ?(,,n47te a-itd House of Rep?-est?tt,it;VG8 of the filri;ted,@tate.@ of A7,ttei-ica;n Congt-ey8 (tssetitble(l, Pul)li,, fir-alth Service Act, 13LI(, ainencbnents. TITLE I-AMENI)'@NIENTS TO TITLE IX OF TIIE I'li IIEALTII Sl@,ItN"I(,E AC'F SFc. 101. Tiiis title may be cited is the "lle;trt Dis(,,,ise, ('aiie(@r, Citation of Stroke, iiid Kidnev Disease Amendments of 1970!1. title. SiEc. 102. Iiecti(@ii 900 of the public Ileiltli @SLr%-ice Act is tiiieiided 79 Stat. 926. to read as follows: 42 USC 299. I(PURPOSFS "SEc. 900. The purposes of this title fire titroli@,,Ii grints itlid contracts, to ciicoiti-itge tiid assist in tile establishment of regional cool)ei-,ttive arj-:tiigeiii(,-iits ,tiyioiig medical selioois, institutions, :tied liosl)ittls for resoai-eli and tritiiiin@r (including continuing education), for i)iedical data exe.illtlige, Iiid for (leiiioiistriiiioils'-Of 1);ttieiit @,ii-e iii@: tile fields of lietrt -diseist@. ctncer, stroke, and kidney disefise, -.laid otlier related disetises; 84 @"PAT. 1297 (1)) to iiroi.(] 84 S'PAT. I-el-4ti til tiolis of tii(@ Nition, tlir tli(,- o))I)ortuiiit-v of making icii- tile ltt(.St ill tile i)reveiitioll I treatment :111(l I.(tlllL- bilitttioii of t)et-.,@)iissufftrii s@LSL@- ; l(c) to 1)@oinote tiid f( @irliolig ]IC-,Lltli eal..c institutions -,tnd I)rovi i s s to sl it tiid improve l@i-itilary care tiid tlie-i-el,,ttionsliij) betwe( tlize(I and I)ri- late y, i -,tre; ttn(i me, improve generally the quality and @(l; I)v tlie.@ tiis,. to citiltilce the capacity of the liealth manpower and facilities :til- a tbIC@ to the N tioli and to init)rove health services for I)cr.s()iis rLsi(Iiiig in aretts with limit-efl health services, and to @'tceoilll)lisli these ends without interfering with the patterns; oi- the method,, of fiiiiiii(,ing. o.-f patient oi- 1)rof(t.,;Siorlitl I)I-Itclie,e, or with tlit- t(i,niiliisti-:ttit)tl of hospitals, &Lll(l ill (!ool)(-,I-- .Itioll wi(.Il I)IIysiciltlls, ilit@tli(',Itl Zolit(@,r olli(,ials, lio,,I)i- t.tt Ldiiiiiiistrttot-s, tii(I " rel)resent@ttiv@ 1'rOnl ILI)prol)ri-,tte voluntary 11(@,ititil ageitei(-.S. ,9EV.. 10,'I. (11)(1) rlle, fit-St scnterim- i)f ,(-(:tiori 901 (it) of Sli4,li Apl)r,opy-itt@,iorts. A(-t, is I)y stri@til(,r (Wait iiiiiii(@(litLt,(@ly after "Jun(,- 30, 8 2 ' ;(,;.Lt. 1005. I!)(;9,", @tii(i I)y iii,,t-rttiig irxitrie(ii:ttely 1)(-,foi-e ", for irriiiitS" 42 IJSC 2c)ga. .,(@ foll(k%villg:'@, $12.:'),01)0,000 for the 197 1, I fiscal year ending June t tl yetr ending June .30 all $150,01)0 000 for the lise, 1972) (I $250,000,000 l(t '10, lf fol- t] liA.,:Il Year ciidiiig.f title )7i@". (2) qii4-lifirst,;(,,iit(@ilc(.isful-tli@riiiieii(le(II)y,,trikiii,routtlieperio(I tifter"'titic" tiid iii,,(-rting in licti thereof "itnd for constricts to carry out the of this title." (3) section 901 (.1) is tmeikded by striking out the second Funds, lirril- 44-111@itce :t)141 iiikt-ting in Iran thereof the following: t,of the, sums tation. ltl)l)rol)rittie(I under this section for the fiscal year ending June 30,1971, not more th,,tii $I.,-),000,000 slitll be tvailable for activities in tli'c field f,2-f)F.7 October 30, 11970 pub. L Iaw gi-515 fol - itity (of kititi(@y tll(@ sull's lol't, $,r),(H)O,Ooo iii;ty (-ii(liligtftel'.1111, :11), IS)70, not (.,II, fOl, fol. lltw .Id 'I -11(-Il fis(,Ill Y i-otistrtic,tioll.! I,y -.141(lilig -,It tile, (Ill SC(!tioll S)OI of siicll 79 StELt- 925; kction: 82 St&t- 1006. end @iter('Of t,lie following lelv tinder this title, tl'B cc(e) At tilt! reqikl,"t- of air jii-.trket, vLIUL' Of 42 TJSC 21)9&. I),tylllellt.., to II(.II sit(.,II r(!t'il)it'llt II(,- Se(-.r(-t-.try t,(' s - it, slil)pl les, or owtll(!e, t rit-VOI ilig ex)),-,nqLs, tile amount detail'of an offi(,,t@r or en]- in COn! when steel, f@rniSh .nL, or roverliment tile nit, ix. for tile convellellce Of out tb(,, id. for the, Pi] s iiiade." ch t)ie gra uch Act i riking out 42 USC 299b. 104. eiit relftt-ii ase, cancer, "tritining, d disease or or stroke, gnosis, disei@' an stroke, ,]It, v sease, CT, related treittnl(, lie al)t)licallt, c Or kidney @ @-tse an( att .1 (.Iiides" and i-ikifig out '-Ill (b) Se(!tioll 902(f) is Imelld ,t@(I ')y 'trll('.ti'n of facilities for '@nl(,iiii.; new et))", ill lien ili(treof to Carry Olit. demonstrations, @ar(,.b, ti id training wll(',". II(.,cesstry I-(.gioititi Die is anieiided- I A(@t SF,(!. 105. . find" ,,id in--A-i't- 42 IJSC earn) a holes, itig in plitnnir ertliel)rogi-atn (2) x otn(-io it first ills ot, nietiilm inini indi- t have other I istrator of rans' iititive vidual -,tted tf) serve oil -;u(-]'i advisory gT,lp R, the rep@e Admill- de-,i e facilities of Si'(',) of t other health (!ttr located in such region)"-, .tlid i@tri ut Igneed for the services Provided tinder tile, g in ]fell thereof "i@@d for and fin-,it)eilig of ivii tidviw)ry prograin, ti@d wh pro, the to iii-,ure ft(ieqitate (-oinmxinitv gr@ .9erretitry) orici e. secon sell se.(-tion 904(b) of sl!(-It SF.C,. 1 ( (1) is ,Imeii( striking olit '4.-wtiOll . . . 42 USC 299d. Act prP,('e(i ]real til lie, following: reaction . I. .I . ( .1 Y)rior to recoll)- .)o, (1)) (4) lip, , 1)(wit I)rovi(l(,(I, !)o,i (1) (4), tll(@ ft@l)ii(..Itioll I;.v eii(,b )ii(til )ills (](@velol)(@(i tgmii(ty or OT iz-,Ition w )I itrpit, or t)tii(tr )ittiisiv(t rtLiolknl. ins-,trf)l)( .11 Wlli(!Il tiit@ regional iiiedi(-itl to ill 314(1,) !,),,eritiLr any area 1 3 e(l, ;tied if ill(k iii,oi-rrani for which tbt' Rpplicftioii is in,,td(,, Will 1)(t loc it tl) - of A(-t is Illlelliii@41 NaLtione,l Ad- 107. (-.t) to tile i,,ry counci I follow on RegioneLl rally itl)Poiiit, '%%it" iotial A(Ivisor,v'Coiint!il 0), Medloal Pro t-ivil .9 - f the As-;ist,tlif stq.retltry of gramgo Ilroirr coil.;i%t 0i(l) Afritir-,, -,vllo 42 USC 299a. iteFLItl r(- for He@l Octbber 30, 1970 Pub. Law 91-515 4 13UU )i ol' Of' I I )it \'('I Atljiiiiii,,Ii-;tti(iii sli@ill (@x oili(@io @ill(I III(-III 't;ttt-ls, %Vill) I(.:I (it-I'S ill til(! fit',](IS Of tilt@ lie;tltli ()I- I)III)Iii! two of fliL-,tl)l)oijite(i itieiril)ei@, sli;ill Ile I)i-iteti(-iiig -'Jlllll I)(., otitst;tiidiii,, iii tli(@ stti(ly oi- liealtl) t.,,tre of I)ei-soijs siiii(,j-iii@r el-oirl (li@t-;Ise, 011(@ Sli:lll be olltst.,tlldiiig it, the stii(ly oi- lk(@@iltli (,;ii-e of 1)(Itl,4)i)S stiffei-ilia fi@Olli oiie sliill'i)(, otitst:t@i(iiitg iii tli(, siii(]3r oi- lietitli of I)ei-sojis stiffei-iiiA., froiii ,tilt)ke, ()lie sliifl lie oiitst;tii(l- Ill,f iii the @tii(lv or liealtli i-:xi-e of -,oiis ,itill'eriiig fi-oiii ki(Iiiev (li,(,:ise. two sliill I)L@ oiitstaiidiii,, iii ti@,@ field of I)re%-ent,ioll of lieq@t stro@-e. oi, L-i( (I i., :111(i foill- still] 1)(' of the (b) ()f the first :tl)l)oliit(@d s(@(-tioii 905(@t) Of tli(@ Tenn of l'itillil. It(..Iitil @ket to serve :is tll(@ foill. ;I(I(Iitioll:ll or ttio iNT-,itioiitl Advisot-v oil Regionti iz(-(l i)y tli(, :iiiieii(Iiii(@lit iii:ttle by subsection (:I) of this S(-(@tioll (1) oil(! sliiii for t tei-iii of oii(@ (2) oite sliill sei-%-e f4)i- :I tei-iii of two y(!@ii-S. (:',) oll(k sli-ill foi- ;I tei-iii (If (4) oiie sli:ill fill- @t tariff of foill' :is iii,sigli;tt('(l I)Y t,l)(@ St-i-l-t-,t:ii-y of :kill] ;II oil Ill(. (I:Itf@ tkr Ill 9 ills (otil(@t- I lt;ili t Ile ill II :1 I .1 I ii(@i it, ( or llii,, A(-l -Ji:tll i-olitiiiiit,, ill ollit.(. ill will) tll(@ t(@i-iii of fol. %viiif.ll til(@y %vi@l-t! ]list to ili(t SFI.. 10@. Se(.tioli !)07 of sit(-Ii k(-t. is I)y s(I-ilzilit', 4,llt "Oi' 71) 030. ,I i,(ike," li(!ii i.liet@t@of "St t-()kt@, oi- l(i:fli(@y 4? U2C 299g. SF,(.. 10!). @(@(.tioll !)O!) -II A(-( is @(i I)Y "oi, 42 USC 299i (it) of siii Sr(-. 110. (,I) Se(.tioll !)IO of St[(.Ii A(-t is to i-e;i(I :is follo%v,,: 82 Stat. 1006. 42 USC 299J. !110. (;I) TI) f.,I(-ilit-,tte iiit(Tregioil;tl (-ool)(!I-@itioll, @111(i ilill.ii-ove(I ti@itioit-,tl (-,tl),tl)ility foi- cleli%f(','y of sei-vi(!es, t;tt-v is tiitlioi-iz(@d to iitilize filli(is iiii(lei-tliis title to iiitk(@, ,rl,;Illts to I)III)li(t of- llolli)lofit J)I.ivitte oi- iiistitiitiotis oi- (-Olll- air(] to for- I)].ogi-itills, S(Ill%'i(,(,Sl :11)d I(.tivitit@s Of siil)sf;tlltiill Its(" to (wo oil itiol-t@ I.(@Lyi4) fall I)I-ogi.-tills; 111(@lit, trial, oil (lettiolisli.;Illf)ii of iiielliotis foi- (lis(@:lse, St I -(@, l@i(lli( - ol I)(![. I.( (I ol !I@tf(, .11141 silitly or :Ill of (Ike ill ;it(-(I lo lilt- I)f 11-:iiililig oil -.til (if (I)(. (lis(@ilsf!s y to ill I):tl.ltgl.ltl)li (2), Ill. to tll(-, or I(-II li.@!,ts(ks; til(I foil (;olll ifillilig I)li(igl.;tflis of sli(..Il fi-olli :illy of St wliei,t-, sliol.iig(@ of tl-,till(-tl 1)(@i-solit)(@l %%.olil(l oill(tl.%Vis(t limit ti)l)lieitioii of ktiowlt@(ige -,Ili(l SI(IIIS iltll)Ol'tLllt, to i II(' (!()Iltlol -,tiiy -r sii(-,Ii diseit-x-.,;; tli4l 11(f)) tile coll(itl(.,t, of (tool)(@,i-;ttive s(.,(.m@tii-y is it,itiioi.ize(i to iii lll(-(@tiiig tile (.osts special 1)i-oi(@(-ts for ltiil)i-ovitig ?r developing ii(!w nicins foil tile. (leliv- 4.!.y of ('OlkCel'll(!(l Witli tile (lis(@,tses witli wili(li this title 3 Pub. Law 91-515 October 30, 1970 f14 f,'I'AT. 1301 Tile Se(. I.et,.,,.y is tillilol.iz(-@(i to siil)l)ort r@-ar(!]I, Stud,,,, in ti iLtioll", training, itil(i (leilloitstrittioits (tesi led -to iiiitxiiiiize V@'4 tile litifizittioll of ill-.Illl)ow(.I. in the deliv(@ry of lieatltli si,(!. it i. (:t) riie totiti(@ ix of Act, is itni(@iide(I by sti ikiiig out A,14'1) I)IS14,ASFS" and iit,-*rt.- iiig ill lieti tlit-i-tof "STICOI@l,,, ANI) O'I'IIEI,'. I)ISFASI,',S". 42 1,T::(,' 299b- 00:@(aL), 903(b), of sii(-Ii Act (its 299g, 299i. I)I,OvlslOlls of ttiis Act) atr(@ eit(-Ii ftirtli(@r citcli it ttl)l)eai-s tit Other New Provisions Relevant to Regional Medical Programs @In P.L. 91-sis 11-ANIE-NI)ME'@,\T@-3 TO TITLE III OF THE llUBLIC la,'Al,'rll SERVICE ACT H-AD-'%IIWISTI@ITIO-@ OF GIL%NTS IN ("ERTAl, PitOJE(,-rs A of title Ill of the Public I-lealtli Service Act is 58 Stat. 691; @SF.il. 270. I'll @iiii(,jiiled lay td4LIiilg it the end thereof the following new @etion: 76 Stat. 59?. 42 USC 241- 242h. "A(Iiiiiiiistratiott of Cxmjits in Certtin Miiltigi-,tnt Proje(@ts f, a iliL, thetdiiiit)is "SFt,. :110A. For tli(-, ptir[)OSL@ t(,.ilit tr:ttion of, ettri-yiiig Olit of Lli(@ )urloos(@, i of, the I)ri)(,,ranii 314(it), '@14(i)), .314(i-), IX :111(l se(ttions :10 i IIL,,Ilt n@e, pp. 12!)7, 304. or itiol-C of sll(!Ii programs witli re--;I)ect to I singleI 1'roj(-.(-I, the Si-ci el ary is itutlioi-izt,,d to 1)i-oiyiul ttc regulat.iolls- the -,t(lininistrLtiV(@ functions iiii(](@r sii(-Ii lit'091,;Inls will, i@f) I)roj(@,ct. will 1)@-, IA-rfi,i-iiie(I by a siiil,,Ie. t(Iiiiiiiistrittiv@ killit Wil@(.,Ik is file unit I wit,li iii(- tdiriiiiisti-:ttif)ii of iiiiv of 4tic)i I)r4)grani,; or is tile (,Iitt-gt,-d with t,It(-, stil)ervisioti.()f two or iiiot-cof,iii(,Ii prt),,rains; (I s 'II(. -edu(%@ the number of al)l)lictttioiis, reports, -.1ii(I otile:' required under such programs to be sub- init,,ted -,with respect to each project, itnd otherwise to simplify, con-,oli(late; and make uniform (to the extent feasible), the (late tained in such rtpl)lications, ;Ill(l iiifoi-ii)atioii required to be con i-e,p its, aii(I other materials; and 0 49 (3) iiiidei- which inconsistent or duplicative requirements im- I)osed I)v such programs will be revised and made uniform with r@,I)ect t; io such 1)rbjec e,x(.-t-,i)t tbsit-iiotitin@ ill-tz@is section sli,,til be const-;ucd to authorize the eel.p.tat-Y to waive or spsr)eDd, jxith respect to any such pro rt, any wif)i to itti@ of sit(-.h programs if,,ijeb r,("(Itiirernf,nt is itti )ost,-ii toy law or by triy rt,.gulittif)ll re(iiiii-e(i lpy law." 4 1970 -ober 30 Pub. Law 91-515 0 ct 84 STAT I 1307 PART I-ANNUAL IRFroRT, @,iTIONAL ADI-ISORY CO.UNCII,, I",'rC. Si.-,c. 280. Part A of title III of the Public Health Service Act is further amended by adding ifter section 310A thereof (as Idded bv section 2iO of this Act) the following new section: "31013. On or before Taiiuarv 1 of eitcli i-e,.ir, the Secretary sh.-ill tr,iiisn-iit to the Congress a re,@ort of the activities carric(l on under An@te pp. 1297, the provisions of title IX of this Act and sections 304, 305, 1304. 314(b),314(c),314(d),aiid 314(c) of this title to(retlici- with (1) iii evtlii-,itioji of the of such tfti%-ities )li improving the efli- cieticy -tiid effectiveness of the t-(,s(@arcl), 1)laiiiiiiiL,, iijid of Health services in carrying oitt the 1)iii-r)oses foi- wall stl(.Il I)rovisioiis IN-ei-c oii:tc-t(-(I, (2) it of the 1.4!llltiolisIlil) Iiii@iii(,infr ttiil fiiiiiii,!iiig from oi,li(,r of tli(@, IL(,tivitif,,s taken I)iir,,ttmnt to sii(-,Ii I)rt)vi,,iot , (ill(!Ill(lilllr t,li(,@ possibilities for more efficie@t support of sti(-Ii :iflivi ie.,; tlirotigfi' ii.% of ,tlternitt(@ soiii-(-A@s of financing itfter in initial 1 criod of siil)l)ort under such I)rovi- sioiis), ind -(3) such reconinieii( nations wi(@li respect to such provisions -tl)propriatc." as he deems, TITLE VI-MISCEI,LINEOUS NATIONAI, ADVISORY COUNCIL (b) (1) Subsection (c) of section 208 of the Public Health Service Compensation. Act is amended to retd 64 Stat. 447. (e) Members of the National Advisory Health Council and MeM- 42 USC 210. bers of other national advisory or review councils or committees estab- I allied under this Act,, incliidi-na member-, of the Technical Electronic Product IZa(li-,vtioti Sifeky Stindards Comniittee aLzid the lioard of IZ4aLreiit.,; of Library of Medicine, but excluding ex officio members, while atteiidiiiir coiiferenms or me@tinLrs of tbei@resl)ective, cotinei'l,i or committees Or while otherwise servi@g at the request of the, sliitll be entitled to receive corril)cnsittion tut rates to be fixed by the @Secrettry, but tt riti%- not ex(!e(@dii ivalent of tli6 late specified at the time of such service of the ('Yeii6ial Sclied le, including traveltime; and their 35. F. R. 6247. homes or regular-l)laces of-business they may vel ex- 5 tisc 5332 note. 84 STAT. 1311 I)ensL@s, including i)cr dieni in I ieu of ,;ubsistence, as ftittliot-ized by see- - tion 5703(b) of title 5 of the United States Code for persoiis in the 80 Stai. 499; Government service employed intermittently." 83 Stat. 190. (2) Tite.@Tond sentence of subsection (d) of section 30C), the @ecoii(I 42 USC 242d. Sentence of subsection (d) of section 301, the first sentence of 1)@ra- 42 Use 242e. gnll)li (2) of subsection (f) of section 358, subsection (d) of section 42 UsC 263f, 373, subsection (e) of section 641, subsection of section 703, sub- Ante, pp.66,344. 'ioii 72r .section ((I) ofsect subs6ctioii (d I of s@ti n 774, subsection (e) 2@YJSC 292b. of sect ion 841 and subsection (e) oi section 0905 of such Act tire 42 Use 293e, deleted. 295V-4, 298, of of -liciligotit 1.70. tli(3 s(@oll(I Of tll(- (',oltll(littt-,43 ill(tl.(!I)f3iii(i I;y illatil,iligiii liell I)IOV(-,(-,'i of tll(,, I lili(t@(I @Stat("i I)III@-tiitit tx), wilf) ]lot oflicei-, or elit. sill).@t(!tion (c,) of station 208 ot tiiis Act" 7') StELt. 920. (4) 4til) ' '-tioll ((I) of sm-tioii uo.,) of sticii Act is red(Nsigiii@d tt-s sill)SCctioii (c). LEGISLATRVE tUSTORYt MUSE RFPORTST No. 91-1297 (C@,,. on Interstate and Foreigi Commerce) and No. 91-1590 (Cme. of Conference). SEtiAl-E RL?ORT No. 91-1090 acoompar(Ying S. 3355 (Cmm. on labor and Pub]-to We'lfeLre). CON(;RESSIOIIAL RECORD, Vol. 116 (1970)t Aug. 12, considered and passed flouos. Sept. 91 considered and passed Senate, amended, In lieu of S. 3355. Oct. 13, House agreed to conference report. Oct. 14, Senate agreed to conference report. A(,T IX-EDUCA,rION, RI,@l@;AI'Cil, 'J'@AIINING, AND TIl .N[ONS'PRA'rIONS IN rp[Ili, FIELDS O,[,' HEART DIS- DE -1@, STROI-E. CAND3 'CANCE KIDIVE(Y DISE,,ISrf,. OTIIE[? ItEl.,ATED DISEASES PLIKPOSES Sec. 900. The purposes of this title are (a) through grants and contracts, to encourage and assist in of , cooperative arrangements among the establishment region medical schools, research institutions, ind hospitals for research and training (including continuing education), for medical data exchange;' and for [related] demonstrations of patient care in @c -iel s of heart disease, cancer, stroke and kidney disease, and other related diseases; to afford to the medical profession and the medical in- stitutions of the Nation, through such cooperative arrangements, the opportunity of making available to their patients the latest advances in-the Idiagnosis.and treatment of these diseases] Drevention, dia treatment and rehabilitation of nersons suffer ses; ter regional linkages among health care ins and improve'-prima car (d) by these means, to improv [c o generally the quality and enhance the capacity of the health manpower and ai @ties 'aval able improve health services for persons residing to the Nat: in areas W to accomp. ends without- nt@e-rfei or the methods of .financing, of patient practice, or witlithe administration of hospitals, and i cooperation with practicing physician@, medical center officials, hospital administrators' -and representatives from appropriate voluntary health agencies. AUTHORIZATIONS OF APPROPRIATIONS Sec'. 901. (a) 'There are authorized to be appropriated $SO,000,000 for the fiscal year ending June 30, 1966, $90,000,000 for the fiscal year ending June 30, 1967, '$200,000,000 for the@fiscal year ending 65,000,000 for the fiscalyear ending June 30, 1969 June 30,@ 1968, $ [anj] $120,000,000 for the next fiscal yea@, $125,000,000 for the fiscal year ending June 30. 1971, 0 for he fiscal.year eT 3 . 1972, and 2 3 Trants fo- assist me( schools,.researc. or nonprofit private 7 es in planning, in conducting feasibility studies, institutions and agenci tp of -regional rojects for the establishmen and in operatingPilOt P . . ing, and demonstration activities medical programs of research, train tracts to for carrying out tjlc purposes of this title and for c iis ry out the T)urposes_ if this title. [Sums approprl Ca rei in available for making such @c I vear following the fiscal year grants until rooriated -rop-riation is inadc.1 of the sums for which the app t under this s ction for the fisca r ac ivi eld not more new uant to this sE ie ropriations Pul centum thereof , but not exceeding 1-oer e Secreta-rv for evaluation (directly or th by grants oi con rac ) of the program authorized by this title (b) A grant under this title shall be for part or all of the ivities with respect to which cost of the planning or other act the application is made, except that any such grant with respect to construction,of' or provision of built-in (as determined in, cordance with regulations) equipment for, any facility may ac not exceed 90 per centm of the cost of such construction Ior equip- ment. (c)@ Funds appropriated pursuant to this title shall not be available to pay the cost of hospi,,-al, medical, or other care of -extent it is, as determined in accordance patients except to the with regulations, incident to those research, training, or demon.- stration activities which are encompassed by the.purposes of this title. No patient shall be furnished hospital, medical, or other facility incident to research training, or demon- care at any out with funds appropriated pursuant striation activities-carried -- X to this title, unless he has been referred to such facility by a.practicing physician or, where appropriate, a practicing dentist. Grants under, this title to any agency or institution, or@ (d) for a regional medical program may be used combination thereof by it to assist in meeting the cost of participation in such program by any Federal hospital. (e) At the reque t of any -r idient of a Qrant under this ir e)cr)ense n 0 8 DEFINITIONS Sec. 902. For the purposes of this title (a) the term "regional medical pro-raiii" means a cooperative arrangement among a group of public or nonprofit private insti- .tutions or agencies engaged in research, [trdining, diagnosis, and treatment relating to heart disease, cancer, or stroke, and at ,the option of the applicant, related disease or.diseases) prevention. di atmont, and rehabilitation relating to heart iscase, o-f the applica I group ic area, composed of part or parts of any one or more States (wlii any ch for purposes of this title includes the Distri'ct of Columbia, the Conunon- wealth of Puerto Rico the Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands), which the [Surgeon General] determines, in accordance with regulations to be appropriate for carrying out the purposes of this title; (2) consists of one or more medical centers, one or more clinical research centers, and one or more hospitals; and (3) has in effect cooperative arrangements among its com- onent units which the [Surgeon General) Secretary finds p will be adequate for effectively carrying out e purposes of this title. (b) the term medical cente:C' means a medical school or other medical institution involved in post-graduate medical training Iand 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 research, Itraining of specialists, and demonstrations and which, in connection therewith, provides specialized, higli-quality , 7.. . m diagnostic and treatment services for inpatients and-outpatients. (d) the-term "hospital" means a hospital as defined in section 625(c) or other health facility in which local capability for diagnosis and treatment in supported and augmented by the program established under this title. (e) the term "nonprofit" as applied to any institution or. agency means an institution or agency which is owned and operated by one or more non-profit corporations or associations no part of the net earnings of which inures, or may lawfully inure, to the benefit of Iny private shareholder or individual. (f) the term "construction" [includes] means new construction of facilities for demonstrations, research, an, necessary o carry out r( ical programs, altcra i-on, ext( c remodeling sting building (inclu ng initial equipment thereof), and replacementlof obsolete, built-in (as determined in accordance with regulations) equipment of existing buildings. 9 R PLN"L ING GRA,NTS FO n the recm Surgeon Generall Secretary, uPO Sec. 903 (a) I'he onal Advisory (fo cil on Regional Medical mendation of the Nati 905 (hereafter in this title refer- Programs established by section red to as the "Council"), is authorized to make grants to public or medical schools, research institutions,- nonprofit private universities, ,tnd other public or nonP ofit private agencies and institutions, and r combinations thereof, to assi-,;t them in planning the development of -regional medical programs. (b) Grants under this section mav be made only upon application therefor approved by the ESprgeon General] Secretary. Any such ap-7 plicatioii may be approved only if it contains or is.supported by -- (1) reasonable assurances that Federal funds paid pursuant to any such grant will be used only for the purposes for which paid and in accordance with the applicable provisions of this title- and the regulations,thereunder; es that the applicant will provide for (2) reasonable assuranc rol and fund accounting procedures as are such fiscal cont -required by the [Silrgeon Generall Secretary to assure proper disbursement of and accounting fo@ ral funds;,.. (3) reasonable assurances that the applicant will make such reports, in such form and containing such information as the [Surgeon Genera-11 Secretary nay from time to time reasonab ly @uire, and will eep such records and afford such access thereto as the [Surgeo' General3,Secretary may find necessary to assure n the correctness and veri@ such reports; and (4) a satisfactory showing that the licant has designated an ad-.,isory-group, to advise the applican and the institutions and agencies participating in the resulting regional medical program) in formulating and carrying out the plan for the establishmentI-and opera- tion of such regional medical program, which advisory group includes practicing physicians, medical center officials, hospital administrators, representatives from appropriate medical societies, rvolunta health -.Les, and tticial health agencies age-nc voluntary or o 0 and agencies co activities of th kind to e carried on under the program (including as an ex officio member, if there is located in such rel ities o e Vcteran@A( trator care provided under the progran3 need for and fi the services under the sory gr OUP I - 10 - I . GRANTS FOR E-S-FABLISIMN'r AND OPIl-RAI'101\' OF REGIONAL ML-'DICAL PROGRAMS Sec. 904. (a) the LSurgeon General] Secretary, upon the rbcom- on of the Council is authorize to make grants to public or mendati medical schools, research institutions universities nonprofit private 1 "- ? and other public or non-profit private agencies and institutions. and combinations thereof, to assist in establishment and operation of -regional medical program, including construction and equipment of facilities in connection therewith. (b) Grants under this section may be made only upon application therefor approved by the [Surgeon General] Secretary. Any such application may be approved only if it i* refommended by the advisory group described in [section 903(b) (4) and I section 903 (b) (4), en provided,prior tb su r ate ell! al, e 1 onal conta le as at (1)Feder, t to any such grant (A) will be ich paid and in accordance with the applic is title and the regulations there under, an wi t funds.that are otherwise avail- able 'for establishment -i ation of the regional medical rogram with,respect to u the grant is made; p (2)the applica'ntwill provide for such fiscal-control and fund ccoluiting procedures as are required by the [Surgeon General] a Secretary to assure proper disbursement of and accounting for su Federal funds; (3)the applicant will make such r orts, in such form an containing such information as the ipsurgeon General] Secretary may from time to time reasonably require, and will ki records and afford such access thereto as the (Surgei Secretary may find necessary to assure the correctness and veri :Lcation of such reports; and (4)any laborer or mechanic employed 1.)y any contractor or subcontractor in the performance of work on any construction aided by payments pursuant to any grant under this section will be paid wages at rates not less than those prevailing oil similar construction in the locality as determined by the Secretary of cordance with the Davis-Bacon Act, as amended Labor in at (40 U.S.C. 276a -- 276a - 5); and the Secretary of Labor shall have, with respect to the labor standards specified in this . aragraph, the authority and functions set forth in Reorganization p Plan Numbered 14 of 19SO (15 F. R. 3176; 5, U.S. C. 133z - 15) and section 2 of the Act of June 13, 1934, as amended (40 U.S.C. 276c). K,KTIONNL ADVISORY COUNCIL ON RECIONAL MEDICAL PROGRAMS Sec. 90S. (a) The ESurgeon General, with the approval of the Secretary,] Secretary may appoint, without regard to the civil service law , a National Advisory Council on Regional Medical Programs. I'he Council shall consist of.the [Surgeon General] /@sistant Secretary of Ilealth, Education . and Welfare for Health and Scientific Afrairs, w 0 f Veterans' Administration v e an ers, not otherwise imc employ o d States, who are leaders in the fiel s of the fun(Imneiital sciences, the medical sciences, health care adviinistrat.Loii, or public affairs. At least. two of th appoint practicing physicians, one shall be outstanding in the study r, diagnosis or treatment] or health care of -persons suffering from [of) heart disease, one. hall be outstandi nosis, or treatment) or health care of r)eisons su erinR fr( [oil cancer, Land] one shall be outstandi@ agnosis or treatment] or health care of 1)erso suffering [of] stroke. one shall. be outsl e of -persons suffering rom ki( be outstani cancer, stro. ers of il shall hold office for a term of four yea s, except that any i-nember appointed to fill, a vacancy prior to the @,piration of the term for which his pre- decessor was appointed shall be appointed for the remainder of such term, and except th4t-the term-, of office of the members first taking office shall expire, as designated by the Lsurgeon General] ta at the time of appointment, four at the end, of the f irst year, four at the end of the second year, four at the end of the third year, and fou-c at-, the end of the fourth year after the date of appointment. ,@ appointed member shall not be eligible to serve continuously for more than two terms. f(c) Appointed members of the Council, while attending meetings or conferences thereof or otherwise serving on business of the .. Council, shall be entitled to receive compensation at rates fixed by the Secretary, but not exceeding $100 per day, including-travel- time, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per them in lieu of subsistence, as authorized by section 5 of the Administrative Fxpenses Act of 1946 (5 U.S.C. 73b-2) for persons in the Government service employed intermittentlyl f(d)] (c) The Council shall ach-ise and assist i]Te rurgeon (icnerall .Se reta in the preparation of regulations for, and as to policy matters arising with respect to the administration of. this title. I'he Council shall consider all application for grants tinder this title and shall make recomendations to the f,)urgeon C,cnQrall Secretary with respect to approval of applications for and the amounts oZ grants under this title. I * See explanatory addenda page 10. - 12 - REGULATIONS Sec. 906. The Purgeon General) Secretary, after consultation with the Council. shall prescribe g neral rei6lations covering the terms and conditions for approving applications for grants under,this title and the coordination of programs assisted under this title with programs for training, research, and demonstrations relating to the same diseases assisted or authorized under titles of this Act or other Acts of Congress. INFORMATION ON SPECIAL -TRE-AIMENT AND 'I'RAINING CENITRS Sec..907. The [Surgeon General] Secretary,, shall establish, and maintain.on a current basis, a list or lists of facilities in the United States,equipped.and staffed to provide the most advanced methods and techniques in.the diagnosis and treatment of heart disease, .Cancer, [or strokel stroke, or kidne-Y disease, together with such related information, inclu ing tle availability of advanced specialty training in such facilities, as he deems useful, and shall make @s-uch@list or lists ancl related information readily available to licensed practitioners and other persons requiring such information. To the'end of making such list or-lists and other information most useful,@the @geon Generall Secretary shall from time to time consult 'withlinterested national-professi6@l organizations. REPORT Sec. 908. On or before June 30, 1967, the Surgeon GeneraL after consultation with the Council, shall submit to the Secretary.for transmission to the President and then to the Congress, a report of the activities under this title toQether w4th (1) a statement of the relationship between Federal financing and financing from other sources of the activities undertaken pursuant to this-title,. (2) an appraisal of the activities assisted under this title in the-light of their.effectiv6ness in carrying@'out the purposes of -(3) recommendations with.'.Tespect to extension or. this;title,.ahd .modification of this title in the light thereof. @ORI)S AND AUDIT Sec. 909. (a) Each recipient of a grant or contract under this title shall keep such records as the [Surgeon.Generall Secretary may Drescribe.. including records which fully disclo-se te am6u@t and disposition by such recipient of the proceeds of such Rrant or contract, the total cost of the project or undertaking in conn'ec7t'lon wit w i@h such grant or contract is made or used, and the amount po- t .of that r ion of the cost o 't e supplied project or undertaking 1 by other sources, and uch 'records as will facilitate'an effective s audit 13 on, and We (b) The Secretary of flealth, Educati ifare and the Comptroller General of the.United States, or any of their duly author- i.zed representatives, shall have access for the purpose of audit and exami any books, documents, papers and records of the -nation to y recipient of- any grant under this title which are pertinent to any such grant. LPIZOJE-CT GRANTS FOR @RJLTIPROGRAM SERVICES Occ. 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 n,.edicdl programs.) MULTIPROGRANI SERVICES Sec. 910. (a) To facilitate interregional cooperation nd develop iwrov ated u-nde' te agencies or ices stantial use to r mo ation of methods for control or collection and study of el)idemiolo ic data related to loya ed to. the -pre- diseases reterrecL e@rii of such TILM@ tant to 1 c)nduc ive clinical field trl ls. reta etinR t e costs of cts m@ TC ry ices concerned is title rt research, studies,. maximize ervices. 14 O'n[E-R PROVISIONS RELF-,VANR TO REGIONAI, MEDICAL lIROGfMS IN P.L. 91-515 TITLE II - PART H ADMINISTRATION OF GRANTS IN CERTAIN MULTIGRANT PROFECTS Sec. 310A. For the purpose of facilitating the administration of,, and expediting the carrying out of the purposes of, the programs established by title IX, and sections 304)314(a), 314(b), 314(c), 314(d), and 314(e) of this Act in situations in which grants are sought or made under two or more of@such programs with respect to a single project, the Secretay is authorized to promulgate regu- lations (1) under which the administrative functions under such programs with respect to such project will be performed by a single administrative unit which is the administrative unit charged with the administration.of any of such programs or is the administrative unit charged with the supervision of two or more of such programs; (2) designed to reduce the number of applications, reports, and other materials required under such programs to be sub- mitted with respect to such project, 'and otherwise to simplify, consolidate, and make uniform (to the extent feasible), the data and information required to be contained in such appli- cations, reports, and other materials; and or duplicative requirements im- (3) under which inconsistent posed b such programs will be revised and made uniform with y respect to such project; except that nothing in this section shall be construed to authorize the Secretary-to@waive or sets end, with respect to any such project, p any, requirement with respect to any of such programs if such require ment is imposed by law or b any regulation required by law. y TITLE II - PART I ANNUAL REPORT 310B. On or before January 1 of each year, the Secretary shall transmit to the Congress a report of the activities carried on under the provisionslof title IX of this Act a@d sections 304, 305, 314(a),- 514(b), 314(c), 314(d), and 314(e) of this title together with (1) an evaluation of the effectiveness of such activities in improving the efficiency and effectiveness of the research, planning, and delivery of,health services in carrying out the purposes for which such pro- visions were enacted, (2) a statement of the relationship between Federal financing and financing from other-sources of the activities undertaken.pursuant to such.provisions (including the possibilities for more efficient support of such activities through use of alternate sources of financing after an-initial period of support under such provisions), and (3) such recommendations with respect to such pro- visions as he deems appropriate. TITLY: VI NATIONAL ADVISORY COUNCILS CCMPEN,SATION FOR Amends section 208 of the Public Health Services Act to rea4: tt(c) Members of the National Advisory Health Council and mem- bers of other national advisory or review councils.or committees estab- lished under this Act, including members of the Technical Electronic Product Radiation Safety.Standards Committee and the Board of Regents of the National Library of Medicine, but excluding ex officio members, while attending conferences or meetings of their respective councils or committees or while otherwise serving at the request of the Secretary, shall be entitled to receive compensation at rates to be fixed by the Secretary, but at rates not exceeding the daily equivalent of the rate specified at the time of such service for grade GS-18 of the General Schedule, including traveltime; and while away from their homes or regular places of business they may be allowed travel expenses, including per them in lieu of subsistence, as authorized by section S703(b) of title 5 ok the United'States Code for persons in the Goverment service employed intemittently.It @anatory Addenda to Section 90S National Advisory Council ."Of the persons first appointed under section 9OS(a) of the Public Health Service Act to serve as the four additional members of'the National Advisory Council on Regional Medical Programs authorized by the amendment made by subsection (a) of this section (1) one shall serve for a term of one year, (2) one shall serve for a term of two years, (3) one shall serve for a term of three years, and (4) one shall serve for a term of four years, as designated by the Secretary of Health, 'Education, and Welfare at the time of appointment ."Members of the NF-tiona@ Advisory Council on Regional Medical Program (other than tne Surgeon General) in office on the date of enactment of this Act shall continue in office in accordance with the term of office for which they were last appointed, to the Council." 16