i 0 Public Law 89-239 89th Congress, S. 596 October 6, 1965 2(o 2irt @@ To aniend the Public Health Service Act W assist in combating heart disease, cancer, stroke, and related diseases. Be it enacted by the @enate and Houie of Representatives of the United States of A?mrica in Congress a,3,q@led, That this Act may Heart Diseases be cited as the "Heart Disease, Cancer, and Stroke Amendments of Ca-er, and 1965". Stroke Amend- SEC. 2. The Public Health Service Act (42 U.S.C., ch. 6A) is ents of 1965. amended by addinc,, at the end thereof the following new title: 56 Stat. 682. 42 USC 201 note. "TITLE IX-EDUCAT10N, RESEARCH, TRAINING, AND DEIIONSTRATIO-NS IN THE FIELDS OF HEART DIS- EASE, CANCER, STROKE, AND RELATED DISEASES 44 P@SES "SEC. 900. The purposes of this title are- "(a) Through grant-,,, to encoiiralre and tssist in the establishment of ive arrangements among medical schools, research ins ospitils for research and training (including con- tin and for related demonstrations of patient care in thi disease, roke, and related -diseases; (b) To afford to the in and the medical institu- 1. tions of the Nation, throuo, e arrangements, the oppor- tunity of making available the latest advances in the diagnosis and treatment of I d (c) By these means, to imprc the health mtnpower and facilities available to the Na accomplish these ends without interfering with the pattE ethods-of financing, of atient care or professional pr or with the administration of EosT)itals, and in cooperation @i cticing physicians, medical cen- ter offici@ls, hospital adnainist-ra nd representatives from appro- priate voluntary health aoencies. 4CAUTHORIZATION OF APPROPRIATIONS "SEC. 901. (a) There are authorized to be appropriated $50,000,000 for the fiscal year ending Juiie,30, 1966, $90,000,00( for the fiscal year ending June 30,1967, a@d $200,000,000 for the fisct vear ending June 30, 1968, for grant,, to assist public or nonprofit private universities, medical schools, research institutions, and'other public or nonprofit private institutions tnd agencies in planning, in conducting feasibility studies, and in opemtinipi!ot T)r6iects for the establishment, of re- gional'medical programs ot research, training, and demonstration activities for carrying out the purposes of this title. Sums appro- ated under this section for any fiscal tlear shall remain available @or making such gmnts until the end of e fiscal year following the fiscal year for w@ich the appropriation is made. (b) A grant under this title shall be for part or all of the cost of the planning or other activities with respect to which the application is made, except that any such grant with respect to construction of, or provision of built-in (as determined in accordance with re,,@a- tions) equipment for, any facility may not exceed 90 per centum of the cost of such construction or equipment. (c) Funds appropriated pursuant to this title shall not be avail- able to pay the cost of hospital, medical, or other care of patients Pub. Law 89-239 - 2 - October 6, 1965 79 STAT. 927 except to the extent it is, as determined in accordance with reaul-,i- tions, incident to those re' arch, traiiiin tioii activities se or demonstr@t O,i this title. . No which are encompassed 0 patient shall be fumished hospital, care at any facility incident to research, training, n activities carried- out with funds appr?priated pursuant to this title, unless he has been referred to such iaciiity by a practicing physician. "DEFINICTIONS "SEc. 902. For the purposes of this title- "(a) The term Iregi@nal medical program' means a cooperative arrangement among a @oup of public or nonprofit private institu- tions or agencies engaged m research, training. diagnosis, and treat- ment relating to heart disease, cancer, or stroke, and, at the option of the ap li@ont@, related disease or diseases; but only if such group- "'I ' within a geoarapliie area, composed of any s i Ituale p f part 0 any one or more States, which the Surgeon Gen- or p S, i eral dete ne n accordance with regulations, to be appropri- ateforcarryingoutthepurposesof t-hisiitle; " (2) con@is@ of one or more medical centers, one or more clin- ical research centers, and one or more hospitals; and "(3) has in effect cooperative arrangements among its corn ponen-t units which the Surgeon General finds will be adequate for effectively carrying out the purposes of this title. rm- 'me (b) The te dical center' means a medical school or other medical institution inv ved in postgraduate medical training and one or more hospitals affiliated therewith for teaching, research, and demonstration purposes. ct - ter' means an institution (or (e) The term 'clinical research cen part of an institution) the primary function of which is research, training of specialists, and demonstrations and which' in connection therewit diagnostic and treat- ment sei ei 4@ (d) il as defilied in section 625(c) a. other health ii ability for diionosis and treatment is supported a: program established under this title. (e) The term 'non rofit' as applied to any institution or t-ency p t, means an institution or alyenev @ich is owned ,tnd operated by one or more nonprofit corporations or associations Do part of the net earn- ings of whi@h inures, or may lawfully inure, to the benefit of any private shareholder or individual. 11(f) The term 'construction' includes alteration, major repair (to the extent permitted remodeling and-renov,,ttion of' existing buildings (in ment thereof), and replace- in accordance with regul,%- inent of.obsolete, buil tions) equipment of e "GRANTS FOR PLANNINC; "SEc. 903. (a) The Surgeon General. upon the recommendation of the National Advisory Council on Regional Medi@ Pro--rams estal)- lislied by section 905 (hereafter in this title referred to as the 'Councilf'), is authorized to make grants to public or nonprofit private universities, medical schools, research institutions, and other public or iion@rofitopriva a enciens and institutions to assist them in -Planning ev(,, pme@ t o@ the r@go &I medical programs. October 6, 1965 - 3 - Pub. Law 89-239' 79 STAT. 928 "(b) Grants under this section may be made only up@ii aspiration therefor approved by the Surgeon General. Any such application may be approved only if it contains or is supported by- 11(l) reasonable assurances that Fjcferal fu@ds paid pursuant to aiiy such grant will be used only for the purpises f6r which paid and in accordance with the applicable- provisions of this title and the regulations thereunder; tc (2) reasonable assurances that the applicant will provide for such fiscal control and fund accounting procedures as are required by the Surgeon General to assure proper disbursement of and accounting for such Federal fund (3) reasonable assurances tha will make such ta rmation as the, e @ and d such acce., the t Sur- ary to assure the correctness and d that the applicant has designated e applicant (and the institutions and agen the resultin' ical p program) for uttb tab- lisliment and I med icli advisory grol includes pi act@ vsici ter officials, hosp@ administrator pi-i- ate medical societies, voluntary and rep senta- tives of other organizations, in! concerned with activities 6i the kind to be carried oi the program and members of the public familiar with the need for the services provided under the program. GRANTS FOR ESTARR.JSHMENT AND OPFP-4,'nON OF REGIONAL 'AIEDICAL PROGRAMS "SEC. 904. (a) The Surgeon General, upon the recommendation of the Council, is authorized to make grants to public or nonprofi't private universities, medical schools, research institutions, and other public or nonprofit private agencies and institutions to assist in establishment and operation of'iegional medical pro--rams, including construction and equipment of facilities in connection t@erewith. " (b) Grants under this section may be made only up@n app!!cation therefor approved by the Surgeon General. Any such application may be approved only if it is -recommended by the advisory group described in section 963 (b) (4) and contains or is supported by reason- able assurances that- 4c (1) Federal funds paid pursuant to any such grant (A will be Used only for the purposes for which paid and in accor)dance with the ap licable @ro@isions of this title and the regulations p thereunder, and (B) will not supplant funds that are otherwise available for establishment or operation of the regional medical program with respect to which the grant is made-, (2) the applicant will provide ?or such fiscal control and fund accounting procedures as are required by the Surgeon General to assure proper disbursement of and accounting for such Federal funds; the applicant %vill make such reports, in such form and Records. 'ontainin information as the Surgeon General may. from tig sucn time to me reasonably require, and wiFl keep such records and Pub. Law 89-239 - 4 - October 6, 1965 79 STAT. 929 afford such access thereto as the Surgeon General may find neces- sary to assure the correctness and verification of such reports; and "(4) any laborer or mechanic employed by any contractor or subcontractor in the performance of work on a@v construction ,tided by payments pursuant to aiiv grant under tfiis section will be paid wtges at rates not less tli@those prevailing on similar construction in the locality as detennined-by the secretary of Labor in ,iccordaiice with the Davis-B-,icon Act, as amended (40 49 Stat. 1011; U.S.C. 276-,t-276,,i-5) ; and the Secretary of Labor shall have, 78 Stat. 238. with respect to the labor standards specified in the authority and functions set forth in r-,eor 64 Stat. 1267. LN'umbered li of 1950 (15 F.R. 3176; 5 U.S.C. 1 63 Stat. 108. tion 2 of the Act of Julie 13, 1934, as amended 94NATIONAL ADVISORY COUNCIL ON REGIONAL 31EDICAL rRoGR.4.ms Appointment of "SEC. 905. (a) Th.e Surgeon General, with the approval of the members. @Secretary, may appoint, without regard to the civil s-ervice laws, a '.\7ational Advisory Co'ncil on Regional Medical Pro-arams. The u Council shall consist of the Surgeon General, who shall be the chair- man, and twelve members, not otherwise in the regular full-time employ of the United States, who are leaders in the fields of the fundamentalsciences,tliemedicalsciences,orpublicaffairs. -Atl@-ist two of the appointed members shall be'pr@ticing physicians, one .zliall be outsfcCnding in the study, diagnosis, or treatment of heart disease, one shall be outstanding in the @tudy; diagnosis, or treatment of cancer, and one shall be oiYstanding in the study,'diagnosis, or treatment of stroke. Tenn of office. "(b) Each appointed member of the Council shall hold office for ,,t term of four years, except that anv member appointed to fill a vacancy prior to the ex iracion of the term for wbi-cfi his predecessor n was ted shall Eaplpolinted for the remainder of such term, and exce the term ? flice of the members first taking office shall expi Surgeon General at the time of appoint- men first year, four at the end of the second year I the tliird year after the date of appoint- men d member shall not be eligible to serve continu- ously for more t an two terms. Compensation. . "(c) Appointed members of the Council, while attending meet- ings or conferences thereof or otherwise serving on business of the S, @u"cil, shall be entitled to receive compen 'ttion at rates fixed by the Secretary udinly tr,,tveltime, . , but not exceeding $100 per day, incl ,ind while so serving away frim their homes or re.Lrurir places of business thev may be allowed travel expenses, includ nL, pe@ them in lieu of subsistence, as authorized bv se-ction 5 of the A4-ministrative 60 Stat. 808; expenses Act of i946 (5 U.S.C. 7@b-2) for persons in the Govern- 75 Stat. 339,340. ment service employed intermittently. Appliaations for 11 (d) The Council shall advise an&assist the Surgeon General in the grants, reoom- preparation of regulations for, and as to policy matters arising with mendations. respect to, the administration of this title. The Council shall consider all ,tpplications for grants under this title and shall make recommen- dati6xis to the Surg@on General with respect to ,tpproval of applica- t ions for ,tnd the amounts of grants under this title. October 6, 1965 - 5 - Pub. Law 89-23 ?g STAT. 930 ii REGULATIONS ''SEC. 906. The Suraeon General, after consultation with the Couii- cil, shall prescribe g@neril regulations covering the terms and coii- ditions for approving applications for graiits under this title and the is coordination of programs assisted under this title with programs for training, r@,tFcii, tl)d demonstrations relating to the same diseases ,issisted or authorized under other titles of this Act or other Acts of Congress. 4(INFORMAnON' O.\ SPECIAL TREAT31ENT AND TRAINING CENTERS "SEC. 907. The Surzeon General shall establish, and maintain oii @'t current basis, a list o@lists of facilities in the United Stites equipped and staffed to provide the most advanced methods and techniques in t)ie diagnosis ,tzid treatment of heart disease, cancer, or stroke, itli such related information, including together N@ the availability of advanced specialty trqinin-a in such facilities, as lie deems useful, ,,laid shall make such list or fi'sts and related inforin,-ttion readily avail- able to licensed practitioners and other persons requiring sucfi iiifor- mation. To the- end of making such Iiit or lists and other informa- tion most useful, the SurLyeon General shall from time to time consult, with interested national professional organizations. T@PORT "SEC. 908. On or before June 30, 1967, the Surgeon General, after Report to consultation with the Council, shall submit to the @ecretary for ti-,tns- President and mission to the President and then to the Con@ a report of the Congress. a.ctivities under this title tog@ther with (1).a statement of the relation- ship betaveen 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 effectiveness in carrying out the purposes of this title, a@d recommendations with respect to extension or modification of this title in the light thereof. (CRECORDS AND AUDIT "SEC. 909. (a) Each recipient of a grant under this title shall keep s such records a the Surgeon General may prescribe, including records which fully disclose the amount and di@@ition bv such recipient of the h a=t, the, total cost of the project oi under- eeds of suc takinp@ connectin @vith which such grant is made or used, and the a@ount of that portion of the cost of the project or undertaking supplied by other sources, and such records as will facilitate an effee- t.ive audit. 11(b) The Secretary of Health Education, and Welfare and the C,o@piroller General -of the United States, or any of their duly author- ized representatives, shall have access for the purpose of audit and examination to any books, documents, papers, and records of the recipient of any grant under this title which are pertinent to any such grant." SEC. 3. (a) Section 1 of the Public Health Service Act is amended 58 Stat. 682. to read as follows: "SECTION 1. Titles I to IX, inclusive, of this Act may be cited as 42 USC 201- the'Public Health Service Act'." 298b. 79 STAT. 931 Pub. Law 89-239 - 6 - October 6, 1965 (b) The Act of July 1, 1944 (58 Stat. 682), as amended. is further 42 USC 201 amp note. @ded by renumbering title IX (as in eff@t prior to the enactment of this AcC) as title X, and by reiiumbering sections 901 through 914 (as in effect prior to th@ enactment of this @t), and references thereto, as sections fOOl through 1014, respectively. Approved October 6, 1965, 10:15 a.m. LEGISLATIVE HISTO@. HOUSE REPOFA No. 963 aooomparqing H. R. 3140 (Comm. on Interstate & Foreign Commerce). SENATE REPORR No. 368 (Com. on labor & Public Welfare). CONGRESSIONAL RECORD, Vol. 111 (1965): June 25, Considered in Senate. June 28: Considered and passed Senate. Sept. 23: H. R. 3140 considered in House. Sept. 24: Considered and passed House, amended, in lieu of H. R. 3140. S@. 29: Senate concurred in House amendments.