,,­,

90'I'H CONGRESS20 SESSION

'j" .'

k,y 4; 19'78:M;r,ll,OGERS (for himself, ,¥,'.) I'REYER,,:\\1;r,/SClrEUERi¥i,.,;WA'<l\iA'f,Mr. FLOR'!P,

Mr. MAGmRE, Mr. MARKEY, Mr. On'INGER, Mr. 'VALGREN, and Mr. CARTER)inprcod,lcedtlW} fo!lowiIlg .bill ; .whichwas 'rc~f¢rr~q. ito, the, ;Cpmmittee,onr;'terstate' and Foreign Commerce' . '," . U '. '

"ABll..t~To ame~d.the'F~blic Healthif5~l:vfce Xgt to re~is~ a~d extel~J

"tliiiauthol'iti€s uhderLthat' Actliglating' tdihealtli's~rvices rei

'isearchand,health,statisticSlJ,nd t9,e~ta;bUshia.WIJ,t,iQ)i1ll Oentt\l!

. for Health , OareTechnolqgy, and for other p~rposes.

1 lh it f~qctecl by the Senate H1~dHp1.fseqf l}~presenta~

2 ,tiVe.s (JUhe [J1fited States ofAmerica in ()(J1Jgress a,ssemblecl,

;4 ~]]CTION.l. (a) 'rhisAct maybe cited ~s}h() "HealtM

5 .Services Research, HealthStati~ncs,Qon~ Hea1t.b.Qare Tech:,;,", ',.,""', c; \ " : ,.,: i.', ':' ',' ,.,- ; ""_">"" ",,':, .';, .' ." :.:. i ' . :": . .' -C __,'-"',. : ". .' " .... '.'"., .' ['.'

nology.Act ,of 1978"...;0 ,·c,,: "",.,:, ;.:"" ,,:.-':......, "..,,,.:'.

7 (b) Whenever in this .A,yt (pth,er than ,i11,s?ction 11)

8. anarnendment or repeaLisexpressedin terms of anamend-,.-, ',',:.. ,;;.-.'.' ! .' ' ." .' : '. .' '. .' c"'" < . '; "., «, i .' 1: ~"".'

,9 ment or repeal is e~presse~ in ten:ns,or all ,!lJfen~~tlnt.}o,Pf

r

.3

i ("tUe'i'easorts:for such increases)1j;;: i ,('

1" a'comma.and the following: :"$60;000,000 .fnrrthe fiscal

--2iy;ear:endingSeptell1ber 30; 191,9,$75;000,000 Jot. the fiscal

3: yearending.SeptemberBu; ;L98,Q,:and~80,000,OOOfor tile

r4:' fiscal .year ,endiiig <September ,,30, 1981'":(3)::ib.y adding

5 at the end the following: "Of the amonntjappropriated

Q .undor thepre:ceding "selltenceforiany!.fiscp'1)year, at least

7 $1,000,000 in the fiscal year ending Septomber i30, 19~9,

!:8 :$2;000,000 ill :-the fiscaLyearellding'Septeilib~r, )30, 1980,

9ancl$2,OOO,000in t,herfiscalyear:end[llg September 30,

10 1981, shall be available only::~ordiealth"statistics:training

:l1·!;Jiuiie'pidemiology andbiostatistics:lmdm1section 304 (h)

20~'(E) 'health:care,costs;:lncreasesin:such costs, alIa

'(1) '('B) ,,,.-1·2·····; "" '," '", ',,/ ,';".' \. ,;;, "" .'-.. ..

113': )T--- ')il,j

';22' (b)8ubsection (,b}( 1) (BY of suehisection is amended

23 'by inserting after i f'training;)' th~ Mlowlngi: : "through the

'24; NatlOl1al·"Oenter£or Health:Services :Research! and the

25 National Oenter for Health Statistics".

!Hi '<SEC; 3,' ita); 'Subsectionii{a)d( 2) ;;'0£: :sectionn304 ,lis

15 nalllendl:Jd (Ii) by striking out: "andf';atithe:end:wtsUll,par,{­

16 graph (0), (2) by striking outthe-period. at'tlH:l endto]

17; 'sllbparagraph' :.(D:):darrdinserting, iiIi;;lieu,,'theJ;epf ", and.",

18 .aM{i3): by adding at the end the .Iollowingtnewileuhpara­

19 graph:'

5

7

i.l: (c.) Th0 first isentence olsuhsection (f)(QJ seGtion 306

:21S,amellded .hyinserting ,':,iitcting Ith~'oilgJt.,Jhe Oente).J,":, after

.4 (d ) faragraph(.(2) (A)· .ofsuhsection ('(i) ;0'£' .seotion

5 . 306 i is rameJidedby , inserting /'healt4 i planning,::;; after

.7)[, .'. (e )!Section306.is .amended. bYlliedilsigl).l~~ingstlibsec­

8tit)ll" (i) as subsection (k)uandby inserting, itftili'lSIU;bsectiqn

"9 (n). the-fcllowingncw subsectioil'::;··

10 ':(i).:TheGehtilf 'maY;PFoyidildopublioandr nonprofit

11 private entities"epgaged: im,healthrplu.t!.t!wg' !\,ctipities tech~

!12ii nical.. assistance- in,.lthe iefIectiye·)1se Iin) sueh activities rof

!13iiSt!j.tistics' !collected .or..eompiled .by theG.entern1.,·; i,:

M·.'i{ f)1[!Sectioil .306 •is. amended.by, iadding. :aftilr;EUbsection

15 Ii) (added by subsection '(e) .0fthisisection);-tnilJollowing::

i!.6";(j) (1). (A) The.Se'cretarY;iac.ting t4I'o;rrgh the Center,

:17 -shallby regulation est:i15lish;Jllotflati.m thitildwoyi3ars after

1.8 .thil date·oftheenactmenk<i£:ithis; is,ubsecJiop""gl1illelines for

19 the collection" compilation; I,apalysis,lipubli!JittiQ)1ij and d.is~

20 tribution of statistics and information lJec,;;ss[1,ryJop.,determip"

21 iIigthe 'ilfIectso£:flonditions,of ,eITlploymeD.t )aJid indoor a.t!~

22 outdoor,enWQnITlental.collditiQ)1s;; jOj},,#le,p\\91ip health.

23 Guidelines established under this subslfPti\Wiis]}i¥l not (1)

24 authorize' or. require ;tp.edisClqsw,e;,qf: aI,ty matter described:~n

-,

~.

',' r,'. 1.1;

1

5

6

7

" (~)' t()asstiregreaterl;e~ponsivel{bs~Hy the' De­

partment of'Health,'Educ~tioh, 'andWelfate "andother

executive departhHllltsirrmebtihg infonriational aria

analytibal needsf6i' determining the effects of'efuiJloJ­ment and indoor and outdoor environmental conditions

dripuHlib hea:ltll.

,..,"( O)'Tn'estaHlishillg andrevisillg~uiueliiIesrtn'del;'suh-

8 paragraph (A)theS'eb1'etary shall 'cbfisult 'with/and"take

9 illtocoitsideratidn" an'y'recommelldati6nS 'ofthe'%sk"Fori:k

10 oIl"Eirviroll:inelltalOancer'and Heart alllFLrihgDisea's'e, tliltn Administrator of the Envirorrillkllt:i:lPi'(jtbctiolligelldy; the'

12,' Secretal'y' ofIJaHol" the' Consumer' PrbduCtSafkiy 'Oommi~"

13 sion, the'UnitedStates NatiorraFOoll:iillittt3b Oit'Vit'a'F'add'

14, Health':si:i:ti'stics,')arid jth'e··' Natibli:i:l iclidCIllyl iif 'Sdencks'

15throllghit~ Irtsfitu.te'6fMkdidlle! >,

16 "(D) F.dinplll~bseil'of 'this' 'inrb'sectidii;the'tenn

1L5guideIillks" mballs the'~uidblihes,eitli'e£'as 'initially estaH-'

18 Iished 01' 'asth'ei·baftei· 'iHised, 'iii effeCt"Slilldei;;!; this'

2O':"'('2j)'The Oelltbi'shail'iseiv~';arJui (jleai-highOusll' fof

211" ;statisti&s andlllfbi1ni":i:fioll#ijjh;; resp\):ct'1'fbWhich,t',gltideline's

22 i; hav'e';;Heeirbest~Hlishedullde'i-i);patil:g+~phu; (1')' rthd shall

23 dassist[iiexe6uli"b [ldepin'tillehJS!!'li1!3litdiJiHg"sudh >h~~istids'

24 and informatidll"M 'pili+pdiles' bf'aiIiAiWist~iqhg' i~Ws \iJid~i

. JT '1"'1'2'58'4',; ;;'2', ''ie ...." "I1.'.l:b' ' . -,--'

11

L: is.amended byinsertingafter.o'unless authorized? the: follow­

2 ing: "byguidelim!s in:effect'undtll'isection:306(j:j !or";

3 STUDY OF COSTS OF; ]HSE.ASESi~~DiCONDITIONS:W'rnOII ARE

4 ENVIRONMENTALLY: RELATED

. 5 SEC. 6; (a) Section 304 is. amended by adding at the

6 endthe.following:

·7 "(d) (1) The Secretary, in-cooperation with the Ad­

.s;miriistrator of. the Environmental Prote0tionAgency; the

.,9 Secretary of Labor; the GonsimierProduct SafetyCommis­

10 sion, the Council of Economic/Advisers,: the Council on

11 Wage and-Price Stability, the; GOUJlciL on.i Environmental

12 ; Qriality,and>other .entities ofthe; Federal (}ov,ernment which

13. theSeoretary-dotermines ha\'eie:li"pertise in .thesubject of the

14 study;prescribed by. this subseetion;shall cQndrictarr ongoing

15studyoLthe present.and-projected futureroostsrof diseases

16 and conditions which are. .environmentally related. The first

17:report on such study shallobeamadectoeae Congress by the

18 Secretary not .Iatorfharu.eighteen months after:the date Of

19 ;.enaofment, of this subsection. Subsequent reports on the

20 study shall be made.by the Secretary to the :Congress every

21 two years after the date; the first: report-is submitted. Each

22 reportilhallfiriclude(A)anidentmcationoLthe effects re"

23 ·latedtothe:diseases.and oonditiona-studies.i.the.: costs of24 which cannot reasonably .bequahtified; :(R) recommends­

qQ, :!tronscf()Lsuc~legislatiYe actiOlis;asthe.Secretary,the Ad-

1

2

3.

4

5,

.6

7

10

11

12

13

14

15

13

as the Secretary or the Administrator of the~)l",il'on­

mental Protection Agllncy determines, after consultation' .. ;,'.> .. ' -- -.'-- >_ .. ~ ..:,- .. ,',

with. theDirecton .of the National Institutes. of Health,;";,,0 ; .. " ' ... , '," .,' _: .• ', .... ' __ .. " - _0" .... '.', ,"," __ ,.', : " ... '/' ,",

to b.e.eJilV!r0J.llllentaJly.relate.d;aIl4,

"(B) thll term ~c.osts !pfd.iseas~s and9Pnditiol~Sc:

~hiqhare ~nvirOl11llWltally related' llleilPs the directand.. .- -'- ...•. ' '.-,'.- ""'" ,,-'-', .,.-.... -.' .. ',.' j (i

indirllctcosts of diseases and..conditionswAicA/!{E) eu­

viroIlII.lentally. rela~ed,~11lJluding t~~cost,s,.o~preventil}g, .... :' , ".,"":: .. :." , .. " c" ; .. ', .. ' - ," "." ...... .""""., '0; .. ,,, '," , i ,"',

" S1lch diseasesand cp~di.~io!lS, .. thecostaofthediagncsi«,'-..

tr~ll,~II.lE)l}t, 911rll, GOIlyalesceIlct(,ill,Il4 .Jiehll,pilitationoJ peF~,::'-'""'" '" ..- ..' :,- ; .. ".; ,- .. :..-.,.. , .' •. :,.,., ' ,.,.-,-'.-; _,:.~~! '.'S), < "·i.,:;.: _'}::->; 1).L

SOIlsll,fIlicted. by.such .4isll,~se,s ll,n,d. COIldi~!0J.l~,. cqst~, re~:.-'-.:..

ings resulting from such diseaBes. andcpIl4iti9IlS,lf4yerst(.0.. .; ',.' .. : ' .. J ,.' .. "':" _ ,,::. ",", _,.','0,:>.. ...... ." ,'< .:;: .'.

ef1't(ets OIl productivity: (andthusincreases. in. production

16epsts and .()olls)1111e~·pl'icesJ.:reslll~~ng from su~l;t4is~as()~

17 ... ··.'lfIld e.onditions,loss of. tax revenues resultingfromsuch

18 d.ecrells()s inearnings and. productivity, costs tothe.wel-. ., .. ,",. '...... . , -,,,."',,,,. ',"", -- '.' , '.' ".

«,

19 fare and unemployment compensation syst(jms an,d tl;tll

:20 ,progrll,llls of health benefits. under titles XVIII and

21 XIX of the Soeial Security Act mlllti11g frOll1suc4,,". ,c' ": .. .- ": .. ,,' .:', '... ,",',:'... _,;.,;. ': ... , ': ..'" "".

22 .diseases and conditions, the overall inflationary impact......... ,.., .. ,. ' , , ..'."'.-',' .'.:., '. .,,, - .. ' , :j',-:,:--, .. ' -: " ".-,

23 of such diseases and oonditions, and ?~her related. qireM

24 and indirect costs.".

H.R. 12584-3

1.5

.Cli\~,,,d:riAT1bNAtJ: d'E1NTERFO~:Imi&LTItlcliliFJ:('.rECB-'N-o~'Y· r- ..- , -"-

-2<::; ;l jlmiLTB: diJiE' 'rEG:Ei:NOtOO,¥h,~:OV1ISOR'Y~OOl\TQ\1jIW!'E:t1J "

3 SEC. 8. (a) Section 309 is amended- . \

d'ff)" liy"'allien<liilg',tlie\;se~tlon/.ueMtllkfto' read as

Jfc!llows:: n .' . r:

->.,.j ~

6

'7

; '1 . :.:' '\

thereof "310?'Tj')·)[,fq if

'9"

1'0 f,f i·"f ;.'.{3"ufJJyi strikitig'::ou!t:HB09:'I"'ll,nd 'fihgel'ting':itJY lieu.

11

12":) i (b) 'Sectihii:3 ~6iiiPltmended' "i');; (i) "

1::)': (I) ;; ®5rcsfriking6ti't the's~cti(jt! l1e~ilitig';j and

14 (2) by striking out "'SEC',j1310:.?'iilind:Lirtsert1ng in

1'6'i' ,?:J (ci):Part":AUdf:titlef HI Lis'iafneJilled.ffj)y" adding after:

17!u~()ct10n:308 thefoll(l)wir\.g!Ii~w·sectidI1:' h !! ). YJ

is'! '!'#1i1':tONAL bEN·TER FOR iHEALTiH5iliECTEO'H:NOLOGY j31

h) -: :i.I)\;k.LTtt j'clffiJ\i TfE!O:aNOt6GY! 'AIiVIsoJiYICOJlf!:M:Ji±rtEE Cr.

~fd: ,: i>'iSBC! i 309;"(3:)" 'There' ~slfestablisi1~di'ih'ah~!;[D'e!pmtj£

21 ment of Health, Education, and Welfare the'Nat!iOiiar:OimtlJif'

22' for:,HeaTth 'Oa:reTeclllology(hel'einafter,eirt this'section :tie\;

23 .' 'ferrea 'to'ias' the::/;Cehter")"'whicEtl'shaill be/under 'the! tlcitectie'i1

~4) i 'Ofa' :'DiI'eCto't' wlIijlsllall'b'eliap:p:oint(j(jr; b~j 'thti :iSeb'i'etltl'y ant'!:

2'5';/stijjeNi~e!ar 'by't1J'tP .Assista.I1tnSecrdiirY;'.fof,HeilTtl¥!\dr,fsuiiH

17

1 fields andonly. after: the Heilltll Care" Technolog',Y Advisory

2 'Committee has . had ltnnpportQnity. tc'review the project

. with respcot.to which-the gr<J,nt:or>contract' is to be made.

4 (2) ,rrhe, Becrehlry/acting through-the Center, shall

5 undertake and: 'suppbrt{by ,gntntbrcdntru'ctY research in,

and .delnonsiratiollS!ancl)evalLUitiori~:0£ ,.. ,.;,

'7 f"( Ac)" ;fhe,faClDrs! tliatafl'ect( the ;us~.dfhealth care

8 technologies in the UnitetYSt!ltes jahcl>

9. . "TB) l'lleilYods· for clis~eminating . information on

101 :Ihealth care 'tecIrtlologiJs '. to" health' proicssionals.

llIJ"(3)TheOelltel' shallmalce recommendations to the

12 Secretary respecting health' 'carcitechnology'Jssucs in the

13administratioliof the laws tindel' the , Secretary's jurisdie­

14 tion;: 'inc1u.clhlgrecoIllmdclatiolls'\vith respect: to -reimlmrse­

15 ments'uncler '. tiHes.xVIII J'ahcl J XIX Of the Social 'Security

16' :Act:.

17 (0)(1) Ndtlatef than December 1, 1979, and De­

18 :;cehlbei' 1 dfdachsuccdecling yeril" the Secretary shallreport

19 to Congress, a comprehehsive'descriptionoftheaetivities

20 Of theCel1terll:ndersubsectidn(b)a:l:~ring the preceding

21fiscalyeat.

22" ; "'(2)'No't'latdi'thallltwO yeai'saftet"theclate Of the

. 23 cnaetmentof the' Health Sei'vicesResehrch, Health' Statis':

24tic8; and Health CareTebhnology Aet0f1978, the Secretary

25 Tshall submit a report t6J)tne ':Cdm.mitte~ ott ritterstkte and

19

1reimbursernent,and:in such installments.andon such eondi­

.2 tions, as the Secretary mayprescribe,

3 ".(e) (J) There is>established:the Health OareTech-

i4 11010gy Advisory Committee (hereinafter .in. this subsection

5 referred to as the. 'Oomnllttee') itO' advise the Secretary: and

6 the Director of the ..Center. with respect tofhe-performance

70f the functions prescribed-by subsection (h) ,including the

8 establishment of priorities Ior.ithe.assessments to he under­

9 takenQrsupported runderparagraphi (1) ofsuck subsection.

10 " (2) 'I'heCommiucc.shall; oonsist.of'-;..· .

11 ''(A) the DirectoriofitM·iN:ationallnstitutes Of:

12 Health, the Ohief MedicalUfflcerof the .Veterans'<Ad-.

13: ministration, the Assistant 'Secretary for Hcalthand!

14 Environment ofthe Department Of: Defense, the Ohail\-

15 . man of the :National: Professional Standards Review

16 Council; the Ohairman <;If the National: Council. on

17.Hea~thPlannirigiand> Development (established .under:

18 section 1503) , the Director of theOfficeOf:. Scienceiand'

19 Technolo.gyPolicy; the Commissioner .oftlie .Food and.

20

21:

22

23

24

25

Drug Administration (or the successor to suoh entity):(

the.Director of the CenterforDiscaso Control (or the

··successorto Sllch.ientity), and ·thelieadof :the Healthi

Oare· ]'inancingAdwinistrat,ion,{or.:the successor to:

such entity) who (or their .designces) .shall be ex!

officio members, and; '-' ....... ' ",.'. .'.. '.',- "". "

21

23.

:1 . them. in obtainingvappropriate -medieal > care" and

2 treatment.

3 ,Inconducti]]gs)lch/study,theOom:mittee; shall consult with

4 .,the4dIninistl'ator. o£tlhe Environmental. Protection Agency,

5 . the Director of the National OancerInstitute, the Council on

,'6. . EnvironmentalQuality, the Director .ofthe:Natio]]al Institute

7 On EnvironmentaIHealtllf3ciell(je§,.the Director of the

j'8 "Nationw .Institute for Occllpa#ollal:,Sl1fl3ty and Health, tlJ,e

:9 '. S\3(j,retlllY: of ~abor,arr4tllel:(ead:oq)J,C Qcq\lpa,ti(j!J.lJ,l:f3l1fety

10 ,and Health Administration, a!J.,d :tlle .Committee may consnlt

11 ., with 3f),y, other' public an4mtvate,e,ntity Wllich, itdetermines

12 lrlJ:Se:l\Wtl-1tise in allY ,;mlJ:tter}obec(j!J.sidered~ thestudYi

13 (b):'WQt late,rtlllJ:n.oI\eyel1r.l1ft(jr: tlJ,edate,(j£ jenaqt:

14, J11.ent. of1Jh.is.Act, the. QQIllpitte,e 'shall,,(joJ11.pletethes,tudy

15, required by subsection (11)11114 l'tJ:Port t(jth(j Q9ngres,§ the

1? results of,tIre stu.4Y:l1lld lffi-y recommendations for legi§l\l'tion

17 or administrasiva.aotion,

18 SEC. 10. (a) SUb§ectior;r(,g) of sl3ctiQn 20Sis amended "

20 ing in lieu thereof "one hundred and seventy-nine", {4} by

21 :stri~ir;rg9ut "<llldnotll3§sth!tII'il1nMnsel]ting iII .Iieu thereof

22 ",notles§}han", and (3lby ju§erting.. !tfter"~l11(jo;hpl~sm,,, .

23 .the fol)0'I'Ying: "not)ess than ~en, shall be for th,e :'Wl1~ional

24 Center for HealthBervicos R,eS\3l1rch, ,llotles§thal1,: twelve

25 shall be for ..the. National Qent.erfQr:If.l3alth $tMi§ti(j§,: and

25

;1 otherfundsreceived byor allocated to the .projcct or; under­

2 taking for which such grant or contract was made. For pur­

. ,3, poses ohassuring accurate; current; and 'complete .disclosure

4 fofthe;disp()sition :oruseof the funds received, each such audit

5 shall be conducted in accordance with such requirements con­

"6icerning:the: individual .or agency. which .conduets the audit,

7 and such standards applicable-to the performance oMhe audit,

'8;asth~;Secretaryma'y by regulation provide;:A. report of each

"'9 :; such audit 'shall be.filedwith the'Secretary a,t .such time and

10 .insuchmannor-as he may require."

f1 (d) '8ection.771(d;} is amended by addingattheend the

12 following: ,i

13 (p}i'IlheSecretary;may w~iv:e·,·(in;:whole or in part)

;L:4 ;applicationto.a;sdiool of dentistry of therequh'oment.of any

15 paragraph of this subsection if the Secretary determlaes, after

10 receivingtheWirittenrecommelidi1tionofthe .appropriate

17accreditatiori: body or-bodies {apprOi\[ed .for such purpose by

18 the Commissioner of Education} that compliance byi;such

1:9 school with such ri3quirementW;ilLprei\[entitfrom(~naintaining

20 itsaccteditation.'~,

21 HE;U.THP'ROiF.J'tltl~0NSREPQR~S.

22 SEC. 11. (a) Section708(d} is;i1mended(J} by:strik.,

23 ing out "notli,lte'rthaifSeptember 10feachy.eat!~; and (2)

24 i; byinsertingii1t,;the end;:the. foll.owing: ' fjSuch' report. shall be

27

1 lieu thereof "not later than October 1, 1979, and October 1

2 of each odd-numberedyear thereafter".

3 (i) (1) Section 702 (d) of the Health Professions Edu-

4 cational Assistance Act of 1976 is amended by striking out

5 "not later than two years after the date of enactment of this

6 Act" and inserting in lieu thereof "not later than October 1,

7 1979".

8 j 2) Section 903 (a) (2) of the Health Professions Edu­

9 cati6hal.Assi~ta.ilce .A6t~F1976 fs amended by striking out

10 "January. i, 1979"alldins~rtin!l; in lieu thereof "April 1,

11 ,1979!'

95TH CONGRESS H R 125842D SESSION •• .

:..._,

A BILLJ'oalllenctthe BUblic Health Service Act to re-

',',I vise and extend the authorities under thatAyt relating to health services research andhealth-statistics and to establish a 1"ationalG~ntertorHealth Care Technology, and forat/leI' purposes.

'By Mr. ROGERS, MI'. PREYER, Mr. SCHEUER, Mr."\,yAnfA;N, Mr. FLOmo, Mr. MAGUiRE, Mr.~X~RKE,i, 1\1:1'. OTTINGER, 111'. 1YALGREN, and

",' Mr. CARTER

MAY 4,1978

-i-Ref'erred teethe Committee on Interstate and Foreign-', 'c' Commerce

26

submitted.biennially; and .the first' suchreport .shall:be due

2 nctlaterthanOotoherj, 1979Y.

::i (b) Ejection709'(h) is amended by<striking out-I'Jan­

4 uary 1, 1979"and inserting in lieuthei'eof"Febl'uary 1,

5'· 1980U

{J (c) Section'751 (i) is amended by"striking-out. F'De-

7:' ecmber'vand.inserting in lieu thereof "March".

is (a) Section 77L(b} (2) (B) is amended by striking

9; out.:"45 ,days after the date 'for .which. the .determination is

10 made'tand inserting inliellthereof'FthefirskDeeember 31

11: OCCUlting . after theidste for ",hidhthe determination is

12 made".

).3 ':: (e) Se'ction782 tcl is .amendedby st!,ikirigout "Sep­

H tember30, 1979'? iandinserting in'lieuthereof.'fJfarch 1,

15'·1980";

16 (f)Seetion788(b) (6') is amended by striking out

17\\September 30, 1978F and 'inserting 'in lieu thereof"Oc~

1S tober 1, 1979".

19 . (g): Section 793(ejis amended (1) by striking out

20 "annually" and inserting in lieu thereof:S'hiehnially"V and

21 (2) by strikihgouf "Decemb'erl,1978" and inserting in

22 lieultliereof "October 1,19791'.

23 (h)'Section951 (b ) ohhe Nurse Training Act of 1975

24 is amended.byetrikingout '(not later than' FebruaryI,1977,

25 and February 1 of each succeeding year" and inserting in

24:

notloss thanaevenshallbeIor the Nitional Center for Health

2 Care Technology,".

B(b) Sectioll453'isamenrredby adding'attheend the

.4 ," follewing: ,\,j'The' Seci'etatYiithroughthe: ilnstitrtte, may,

•5without'r'egard' tosectiori405, •catryollt·aprogramofgrants

6 for publioundnonprofitprivatevisiou \'esearch\'facilities.».

'7 (c) (1) The seeoiidsenteIlce bfsUbseetioil (a) of sec­

S tfol1:7()5is 'amended' W'i:eadasfollows :.•'iSI1Cl1 iecol'd~shidl

i9iriclildelt8cohls' wl1ieh ifilllYdisclose. i(A) theamOllllt and

10 disposition'by' silch~rttity of thefundspaidt() it under

11su.cligl;afit} loan, :roan ·gu.aran'tee, iriteresfsubsidy,"61' con­

12ttact\ (B jthit()taldbstofthe' 'pl'ojectofUJidertakiHg {oi·

13 '. which Slldh grant,'10ai1i 10an.igllaI'itnfee,iIitef~stsubsidy, 3i·

14 'con.tracti~,riiade,tC )th&\alliottIlf3£ thatpbrtiori ofthe cost

15 oftheptoject tit lln.d€rtakirig i€6ei+edb.\rOI' allbca£edtosueli

16 entityfroIil ii3thbr sources, an.d(IY)sllchother rec()l·ds tis

1'7 will facilitate an audit conducted'iri'acddliifah:ceWitli geml:i-L

18 iallYac;cept~diillditill,g sttiridards.".

19' (2)SJbsb6tion i(b)dfse6tiott 705isatt{elldedtoi'ead \is

20 followsr'

'''(b) :EilclfiefitityWhich received a g'l"ant 01' ente'red intg

22 a contract u'I1derthi~ title shan pro~ide for ltbieniiial financlal

23 ~U'ait or'kIijT'bbdks,'accollI1ts; finaIlcial'l:ecords,files,arla othe~:

24. papel'S'andprdperty~vliiiilr'T(;ltitltb the' dis~ositioII'31' usebf

25' theflillds recei~edililcliJ'llsuch'gi{.iHt Or 60nttact a,ild<sucll

22.

12 STUDy"

13S.i!)C, 9.; (a) :[I;h€J U"llited,$t\l;te.S:,CQIllD1itteeon Vital and

14 .Health Stasisties, ... (establishi'ld;:by isection,3;Q6 i of tl;1e. Public

15 HealthServipe:A.ct) .s1Iallcon,dnct .. (1stlldy :lOr, the issues

16 . respecti'lg and t1Ie }·ecpnlD1en,dl1tiq!!:s}or.llst!)jplishinga Fed,

17 .era} system-.

(1) to..facilitate s.tudies oft1Ie ,eJIe9ts of hazardous

snhstanceson p,umll:IJ,s"ll:IJ,d,:

(2) to assist, in a manner design,ed. to avoid in-

... vasion ,of personal. privaoy, }i1ederal,State, and other

entities WlqCll:ting individuals who have .been or. may.

have been exposed to hazardous substances to. determine.

the. effect qn their health of such .exposuro and to assist

20

22

21

23

24

1 "(6) Section 14 of the :E'ederalAdvisory Act shall not

'2 apply with.rospeot to .the duration ofthe Committee.

3 Y. (e) There areauthorized to be appropriated to carry

4 out this section$15,OQO,qoo for.Jh€J. fiscalyear ending Sep­

5 . tember 30, 1979,$25,000,QOO for.rthefisoal-year ending

6 September 30, 1980, and $35,000,000 for,tlte fiscal

7 year, eildingSeptember30,. 1981.<N:otless than 20 per

8 centum of the amount appropriated £01' the fiscal year ending

.:9 ·Septelllb€Jr 3Q,: 1981, shall be 'Obligatellfor~ssessments

10directlYlllldertakenpy the: Secretary. under subsection

11 (b) (1) r.

19

18··

20

l' "(B) sixteenmerribersappointedby the:iSeci·etary.

2 The Secretary shall make his initial appointments to the

3 Committee 'within One hundred and twentydays of the date

4 otfhe enaotmentt.ofcthia section. Seven 01' the appointed

5 members shall be selected-frcmrindividuals who are dis­

6 tinguished .in.: the .fields .of medicine; .engineering, or' SCI"

7 ence(includingsocial science); .of such 'seven members,

8 at least two shall be physicians. Two of the appointed

9 members shall be selsctedfromiridividuals whoare.hospital

10 administrators, two. of the appointedrmembers shall be

11 selected from individuals•who are distinguished in the field

120feconornics; two of the appointed members shall be

13 . selected from individuals whoare distinguished ill the field

14 .of law, one of the appointed membei's,shallube' selected

15 from .individuals' who.rare: distin,guished in the field of

16 ethics, and two ,of thcappointedmernbees shal1heseJected

17·fromrnember$ of thE) 'gene'ral, .publio who l'epresent the

18 interests of consumers Of healthc:1re.

19 "(3) (A) Each appointed membertof theOommitte'e

20: shall be,; appointed for a term of four years, except that-'-'..

21 H(i) any snember. appointed to filla, vacan8y occur-

22 riligpdorto the oxpirafion-oftho terrn<fol' which his

23 predecessor wasappoirlted shall :beapp'ohited' for the"

24 remainderofsuch term; and

25 "(ii) of the members firstappointed aftei"fhe date'

18

,1 Foreign Commerceofthe HouseofHepresontativcs arid the

2 .. Committee onHuman Resources, of the Senate-..

3" (A)descl'ibingthe various types of activities

4l<ndertakenandsupported under subsection (b) (1) for

5 the assessment of health care technology,

6 " (B) describing the recommendations made under

.7 subsection (I:]) (3) and the action taken with respect to

8 such reoommendationaand

.9 "(G)desCl'il:]ing, any additional authority or orga-

10 nizationalchanges which the. Secl'etary determines are

11 required to more effectively carryouttho functions pre-

12 scribed bysubsection (b).

13 The Office of Management and Budget may review the l'e~

14 . port required by th.isparagraph~efore itssubmission to the

15 .Committee on Interstate and Foreign Commerce-and 'the

16 Committee on Human Resources, but the Office may not re~

17 vise such report or. delay its -suhmission beyond the date

18 prescribed for its submissionand may submit to Congress

19 its.comments respectingthe report.

20 " (d,) U) ·No grant or contrao] may be made under

21 this section unless an application therefor has been submitted

22 to theSecretaryin such manner, and containing such infer­

23 rrratioll, as the .Scerctarymay byregulatlon prescribe,

24; I (2 )faymi:1nts of allY, ,grant or under.any contract

2f:j, ullrlerthls ~~ctif)]LmflyAwrrra(l(( ill!\dyallce()r,~y,;WaY 6f

1(!

1 ' othev/officerof.theDepartment:as may he designated:hy the

2 :Secvetary" as .the •principal,. adviser ·to •• him Jor,]lealth pro-

3 grams).

4 '{(bHl) (A).Whe Secretary, actjngthro1,J.gh the Center,

5 shall undertake and support (by grant or COJ;ltract)lcompre­

6 hensiye.assessments of· health. ,ca,re technology.• $uch assess­

7 ments shall takeiiito"aoCQunt the safety, effectiveness, and

;8; Jlost"effeotiyenesS" of, ltIld ,:the;soci:yl,.leth.ioak and economic

9 impact of health care technologies. In determining if the

10 aS$e~~Ili.ent ,pf J!l" particular ;]wal~h. cafe technology should ~e

11 given priority, emphasis shall be place9'~J:l--c'

12

13

14

15

"(i) theactual"QrpQteJ;itillil!risks and the actual

LOr P9!t(j:Qtia,ll ben.efrts'to patientsassQoiated with the use~.' .. . . '.'.::' - .. -:,-. ','" :,',

of:the:technology,

" (ii) the actual or poteI).til~.l:9ostof thetechnology,

16 "(iii) th.e a(jtut;tl. Or potl:)ntialrateof its useyand, .

17 "(iv) the: st(l,geoLgeveloPnrepctof th.et~ch,nology,

16 "(BJT:l;ie ;$eoretarymay by grantoL'contract assist

19 publicand-privatenonprofit entities iJ;lmeet~gt!l!3 costs of

20. /i planning, (jstlj,bl)shing, and operafingeenters to-assess health

21: i: (ja,r(jte<\11l10Iogy.

22: ':'(0) Any,grMtorcontra,ot @derthis p~'agraph, the

23 girect(jOst'ofwhich.iWilleA'c.ee4!$~5,{)o(), maybe made or

24 en(;eredintg: (mly' alter aPPX9pr iate review fOJ;. scientiilc merit

gi.l ,.:. by,peIJr,l'eXieW: grollPs:compose<l..of eA'perts in.: t!lIJ relevant

2

14

-l()f£t;(~i "]it)lieE'j'hN'ENViti<kii'iENTAL···.iCANC~R" fiiND

'),r, ") " 'iI" iIANOD if:dNO"' hISERs:E"'(T'0 ,',

HEART

3

4 Health Statistics ak\Fjth'~'OJntet' ferr' :Drs~j~Je 'Ooiitrol (or the

?5(;;~~h!2~;lsJiJ% iiii6h>~Jiti&)~h~n s~Fv~ as'iliehib'ers of the Task

I~"; Fdt6g 'oh! EH~h'h~hlehtM(J1iri&eFaitail't~aHartd"Jjung Dr~­

It) g~Me 'bs~·~bliiiHe<f'[iH([~rr\U!6tib)1'?4t;~6£ Ptiblic'ta'~i~5-95.;·'.' __ ', ',,_ " _ _ _' _' _,,:, _ " ( __ ' _' t, __ " _ !; , 1 _" _ _.' _, •

;W r: ,u'Yb Y'The' 'Task Fiir2iJ '&fetie'd't6 iiri!snbiie6tioi'i' i(a) shall

"g""b'6b'diic{'a'ij'tI1aY'to iidehtffyf hiH;;· tM:h1 ,. f6F'a'rid,itgcommend"-'~'! >:. ;"_-',:1,-,:':;;-,f:-~r,:;·, fd'(' '-':j",\::",.,r,>,:,f':.' t"'i'-i ,'~'.:;:i_,.,,;; ':'~i6' igUidelmes for the collectioii,"COl1lpilation, 'analysis', publica-

_-:'~,'" ':i:':,l.'_' '<'''',;:;'"_:,, ;\1';- _,"~.<.,,>:f:> .i:iJ'''" ,,·i [""')';;::"" ,:." t t11 "tion, .ailddisttihution: o£ s'tatistics 'and' irif6rmatioti'necessaiy

:i~' 'kfoF'a~teffu'ihill~ (it)" tH~"Jxf~nt 'to"WhteJi 'coffaititln.s of en11

if f;p16yll't6hl'ii¥uf'iliifciHr! :aIidb1ifa6b~' 'IMi!iti!tiin~nt~l '6\mditioBJ

:f4'}4~yr'Ja§bha'blyi 1:\~ ati£i6ip~ted 'to Hi~s~,' 60httibut~t6, aggr~­

it;' ;iV:~tg," 'oJ:' iIt6r~ti~~" :S1iY6~p~Mli ty" ~o; ;cah66t 6t h~aie or lungii( ;c'fi~~aJJ~;ahif(i)'; ~hJ\;ther6~e'6t~'6ht@'pJ1Jijc 11earth which!L~ij'';' ?i;,.','i ~,;,!:~ir,.;.,·:' ·'."i'ii'-;",,: '..c,:, 'j .•• :<_<:.r ,,:'-"'1;'::,=':" '_ ~':.r!, --::-,t-17 ..'rriayreasoriably be ariticipated to result'frorn suchcdnditions:.:.. ',,;.' .-,:> ~< ~:.;..i'·l·,l'j~'l;j";';·ii·;;!t,)," /',t";,!,,,·:\ I:: ·.'i.-:"':"/\:\ ',-:.J18 Within eighteen months' ofthe date of the emi,ctmeilt of this

19': ~rilJsecti6h,th6(l ;Ta~k 'iFbr6e' iYHa;llb'ompretlt1ie'~thdy pr~l'~\' ; . r :r :. ,f:" ,r, "":':'",_, r ,~:: _: __ ' .

20 jS61~bMby this ~hb~e6ti6il'aIla; repol't; fh~' restiifir'h'f'fhe studY

21" 'to'; 'the cbhkess, 'the A~ritiIlfstiatot~ofth~'Eh~i?onmentiJ

22' ,ProteCti'on .A.g'EmJy, theSeCl'etal'yof Hea1th,Eauc~tion, arid,·:T r\'lt~<f v, "'jilL, r ''-'.,f~">;L",, '!;.:, '-,:,'., .:; ;1 ':1: ') _ '-\-

23 .Welfate, .the .Secretary'of Labor, and tneCoIrswnet Product

24 Safety Commission.

,."-, L •

24'

15

12

22

20,

13

1 ministrator of the Environroentald'rotection •Agency, tho

2 Secrctary of Labor,or the:Consumer Product: Safety C(jmmis-

::3 siorrrdetermines :are 'require:dito're:ducethe"costs 'of diseases

4 and conditions which 'are environmentally related, and (C)a

:5 'description;.• bfhthe·:admiinist1'ative"aetiollS proposed to be

6 taken by the Secretary, the Administrator;. tELe:Secretary :of

·7 LailJ01';:ior the: Consumer' prouuctSafetji CpInmi~sibn to til­

eS: duceus,uch,cdstSiDlfi conducting :the study under-this sub­

·9:usection; the Secretary. 'shall: 'seek:' assistance from •public and

10 'private hcalthfinanoingeacitios..

11: '::i'u'E(2i)TF:or tliepurpose' ofparitgl'aph (1)-+

'!:'{fA.)' 'tIre.term. :'diseases and conditions .whioh ate

'.' .environmentally.related'.means' anydiscasecimpairmcnt,

diSaibility:,,,dl;,,conditil')llui'(i) which ImayreasOl1aOly be

antieipetcd.to.rcsult.rinpart or whole, from'exposure to

:Tcohtaminants:oEotherhazards'ill the work.vhome, or

:othcr:ihdoor ensironmentuoe inrthe ambient environ;'

ment.; '(Ii) ,'towhich,pei'sons.may. become more suscep­

tihleas aresultofsuehexposure ;'01' (iii) the effects of

which .may :bec(jme':inol'e'sevel'e;'asa .resitlt of such ex...

posure; and' such, term includes; to the extent they may

Ibe:environnientallYl;elated,cahce'r;birth defects,genet'"

iCi:damage,emphyst)llla,' asthma, chronic bronchitis, arid

other respiratoij illnesses,heart disease, mental illness

an~:il11pairment,i lHid: :such other-diseases.and:conditions

21

16,

17

IS .::

19,:

10

12 (' (Q)The 'J:'wsjdellt'Illay)hy[Exequtive order exempt:

13.. anyexecutive qepa,rtmcn.tfr91Il complianoewith a require­

14 .ment R~ the·glliao1inC~respootiIlg~pl:lcific sta~is~ic~ or other'

15 information if the President,detefrnines.,thatthe. exemption

1,6, is necessaryintheinterest of national.security,

17 "(4) In carrying oU,t his duties under this ~ub.~ection,; .. ,'... ': .... '.,' ..

lE1rthe. ~;ecreta,ry,actingt~f()ughth.C.qeIlter,shaJI.,in~qf!!-r as

19 practicable, provide for coordination of his aCtiyitie~ .with

20 thRs,e [of Rth.Cr :E;edcral,3;g\lnciC~.aIfd,interagenoy~ask forces>

21 , fe1a:tlIlg ~q the collection, aJ,l~lyst~'Pllblica:tion"or.distributiorr.

22 .of statistics. aIl4<tnfRrJ;p3;tiqllcllecess!\fyfor .detCl"lllining. the

23 effects ;qfconditiRll~; Rf <lrnPlRW)'iCJ;ltand ind,oorandoutdoor:

24eJ;lVll"Rfl;m~llt\ll,[cRn:d,ition s on tlW IlJ1plic llea:ltll,"

25 (g) The first sentence of subsection Cd, ).qf section 308

8

] section 552 (b) (6) oftitle 5, United ,Sta,tesCode; and (ti)

"2 "autlrOl'ize orrequire ithe disclosure; bfany:statistics' or-other

3 information which is exempt from disolosure.pursuant.to sub-

"~section' (a) ofsection 5520ftitle 5; United States Code, by

5 .reasou of subsection (b) (4) of such section; .The guidelines

6 shall be reviewed and, if appropriate; revisedatleastevery

7tln:°ee 'years after 'the date 'they Uare initially testablishcd.

'8 Guidelines shall.take ,eflectonthe'dateofthe promulgation

9 of the regulation establishing'or revising the guidelhies 'or

10' such later date as may',be specified in theguidelir'tes.'

11 ' " I~(B') TIre; guidelihes shall bed,esigned=

12 "(i) to improveieoordination ofeuvironmental aiiil

13 healthstudiesrstatisticsF and informationvand to .prevent

14 ,'oveI'lapand .unnecessary .: duplioation-with.. tespectito

15 ' '~uelistudies; sta£istics,!1nd information;'

16 "(1i ); to assurs that such stUdies, statistics, aiid

17inforrtiation will 'be;available to executive departments

18 responsible for the, administration .of laws relating; to the

19' protection: 'of theipublic health and<safetyoi' the

'2(Y'" ;"environrtient;,

21' "(iii');'W encouragethe'mol'eefl"ectivetrse,by ex- ,

22 eoutivevdepartments 'of such studies; statistics; aha

2il illfbl'niatidn'; "

24 ' "(iv) to iIDprov'ethest~tistical!validity and reli-

25 ability of such studies, statistics, and information; and

6

,1 'tract), 'research," development, :demortstrl]>tions,:arideval-

2 ' nationsTespectingthe System;

3 "(0) make grants to .State. and Idcal'health agen-

(4ciestoassist .them.in-meeting the costs of" data collection

if)'(; 'cdnied'6ut'\lnderthe Systelll;~rid

'6f: fll(D) 'review the statistical acti'vities'ofthe Depart-

7 'ment o;f Ifealth, .Edueation, .andWelfuro-tonssnre that

'8 ..: i' theyar« consistentwiththeSystem.

9 fStates (participating, in the Sy'stemshalLdesignate'a:State

10 ','. agency, to:administeu.orbe responsiblefor theadministrntion

11 lofthestatistical activities:within the Stateunderthe System;

12 The Secretary, acting through the Center.shall prescribe the

13, :types :of:QJ[ganizat~onhs:ystemsn{iricludiiig;consortia of en:

14, i titiesvwhioh: .:use 'health information and statistics and

15: :entities! whichpiooduce health informa tion-and statistics)'

16 for statistical activities which may be used by,States 'pare

:).7, ti&patingin the System.'1.

18:dl(2) Paragraph (4) l(D) ofsubsecti6n(i) ofsection

19 ',306· is amende'll 'byinserting befo'rethe semicolomthefdllow­

20 ing: ", with respect to the Ooopel'ativeIfealthStatistics

21i "System'est3JbIished:Uridersribsecti6in ,( e) (2) ,and with re~.

22: spectto' the',startdardized meansfonthe collection of health

23 information and statistics to be established bytheSecretary

24urtdet subsection (e) C(1l

;1 NkTIONAl);bENT]IRFORHEALITm SEm?[OESRESEARQH

" SEb.4{i(a)'Sribsectioll (:b)ofsectio1l305' isamended:-

:3 ' :(1) "by )sttiking/out i"may .•undertake andsupport"

.and 'insCliihg: inlieu;tnereof;:ishljlFundertak,e and sup-

>6'/ ,(2»By /strikirigout'iconstruction;" jill paragraph

7"0 ;;(3)/)'

(b); Subsoction T(e);ofsection 305isiiedesigiuitedas

9 subsection (g)!;;and;th~ ;following new subsections are in­

10;) sorted, 'after; subsection-(d)::

11 "(e:) :No.upplioation.for.a grant oucoritraot.Iorhealth

12 services research under a law administered"by; LJih$ ;Secre:­

13 tary may be appro;ved;;Beforei:the;Oenter and the Health

44 .L,Ol1re 'Financing Ailmillistration:'(or i~s:sl\lccessor)has been

Ii'!;;qg'ivefia .reasonable opportnnity .to review tho application for

lo6 ;technical: competence.:

17,; '1i(f);To"avoid unnecessary. duplication; tlleSecretaty

18) .shallvcoordinate;'all-health, services-research undertaken or

19 supported under laws administered by the Secretary.".

]20,; ;NATIONAL;"OE~TER!'FOR'IIEAI,TlI ;STATISTICS

21 SEO. 5. (a) Subs,ectipn;;(b h@f section·306,is; amended

;22;(1;) ;bystriking:ouU'ljiay'ln(2,) by insertihg';shall" after

2'1 "(l}'i: andafter'f'(2);'\C~;)hy;striking out;':aud" at the

·24, end oIIH11'aghLph; (1), (4): byistrikingout)theipel)iodat the

2

1 repeal of, a section or other provision, the reference shall be

2 considered to be made toa section or other provision of the

8[( "commaandifthefollilwing:"$36,000,000 for tho-fiscal

5

6

7

'9

10

11

12

+3

14;

15

SEC. 2. (a )'8ection 308 (i) (1-) is amended-

(1) in the first sentence (A) by striking out "and"lJ-LI,'I'>«{>";:':ljC'f«-;{ :".f:' :') - (,i!( ::-:rC::,T >\I

after "1976,", and(!3) byinserting before the period a

"yearilndmgSepteinbel" 30, 1979, '$44,OOOjOOOfor the-,,' ,",,'.-! 'F\:',-(" ,: - ,- c',', 'O-:>,'!)!.!::

fiscal year ending 'September 30, 1980, and $49,000,000

for the fiscal year endingSeptemberBo, 1981"; and

(2) by striking; outrt~e second sentence and insert­

.ing inlieu thereof thlj following: "Atleast 20 per centum

...p~tlr(J f[l,IfWl,llltapp~,qpril}ye~uIfd(jl~tl1eprece(lin,g .sentcnce

rfor fany fisoalyearor i$6;000,000, whichever is 'less,shall

16 IJeavailiible onlyfor healthsei'vices research' evaluation

17' ,'n \d~adillh()l1~'ti·~tioridctMcids'direchjlihdertak~nby the

v '\ '\;'(Jerltet:Thkl:e'; are Irithori'zed't6\berdppropri~t~d$'2,00d;-

19

20'

21

22

2324'

000' for' tile' ifitcal'Y~~f eridini SJptdIhber 30, 1979,

$~,'o00,000 fortlle Wical yeaf. elldinl September 30,_:)\: ~;'-::"i; r i v ; ,. >';:,i ,:,:-!,_ :,': ::/;:-;; .:','-.,,;;>,_., '; :"-,.-,"!,,.:; .:

19S0',arid $4,000,000 for the fiscal year ending septem-

ber 30, 1981, for health services rese'arclitrain.ing lkd~r

sJ!ctirih '304' (bY' (1) (Bl/".';'(b)'S~~tion '308 (i) (2) IS amended (1')' J)y striking