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TITLE IV--MEDICAL EDUCATION

SEC. 401. GRANTS FOR HEALTH CARE EDUCATION CURRICULUM DEVELOPMENT.

Part F of title VII of the Public Health Service Act (42 U.S.C. 295j et seq.) is amended by inserting after section 791 the following:

`SEC. 791A. GRANTS FOR HEALTH PROFESSIONAL EDUCATION CURRICULUM DEVELOPMENT.

`(a) GRANTS FOR GRADUATE EDUCATION CURRICULUM DEVELOPMENT-

`(1) IN GENERAL- The Secretary, acting through the Administrator of the Health Resources and Services Administration and in collaboration with the Administrator for Health Care Policy and Research and the Deputy Assistant Secretary for Minority Health, may make awards of grants, contracts, or cooperative agreements to public and nonprofit private entities for the purpose of carrying out research projects and demonstration projects to develop curricula to reduce disparity in health care outcomes, including curricula for cultural competency in graduate medical education .

`(2) ELIGIBILITY- To be eligible to receive a grant, contract or cooperative agreements under paragraph (1), an entity shall--

`(A) be a school of medicine, school or osteopathic medicine, school or dentistry, school of public health, school of nursing, or other recognized health profession school; and

`(B) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

`(3) USE OF FUNDS- An entity shall use amounts received under a grant under paragraph (1) to carry out research projects and demonstration projects to develop curricula to reduce disparity in health care outcomes, including curricula for cultural competency in graduate medical education .

`(4) NUMBER OF GRANTS AND GRANT TERM- The Secretary shall award 20 grants, contracts or cooperative agreements (or combination thereof) under paragraph (1) in each of the first and second fiscal years for which funds are available under subsection (f). The term of each such grant, contract or cooperative agreement shall be 3 years.

`(b) GRANTS FOR CONTINUING HEALTH PROFESSIONAL EDUCATION CURRICULUM DEVELOPMENT-

`(1) IN GENERAL- The Secretary, acting through the Health Resources and Services Administration and the Agency for Health Care Policy and Research and in collaboration with the Office of Minority Health, shall award grants to eligible entities for the establishment of demonstration and pilot projects to develop curricula to reduce disparity in health care and health outcomes, including curricula for cultural competency, in continuing medical education .

`(2) ELIGIBILITY- To be eligible to receive a grant under paragraph (1) an entity shall--

`(A) be a school of medicine, osteopathic medicine, public health, dentistry, optometry, pharmacy, allied health, chiropractic, podiatric medicine, nursing, and public health and health administration, public or nonprofit private school that offers graduate programs in behavioral and mental health, program for the training of physician assistants, health professional association, or other public or nonprofit health educational entity, or any consortium of entities described in this subparagraph; and

`(B) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

`(3) USE OF FUNDS- An entity shall use amounts received under a grant under paragraph (1) to develop and evaluate the effect and impact of curricula for continuing medical education courses or programs to provide education concerning issues relating to disparity in health care and health outcomes, including cultural competency of health professionals. Such curricula shall focus on the need to remove bias from health care at a personal level as well as at a systematic level.

`(4) NUMBER OF GRANTS AND GRANT TERM- The Secretary shall award 20 grants under paragraph (1) in each of the first and second fiscal years for which funds are available under subsection (f). The term of each such grant shall be 3 years.

`(c) DISTRIBUTION OF PROJECTS- The Secretary shall ensure that, to the extent practicable, projects under subsections (a) and (b) are carried out in each of the principal geographic regions of the United States and involve different racial and ethnic minority groups and health professions.

`(d) MONITORING- An entity that receives a grant, contract or cooperative agreement under subsection (a) or (b) shall ensure that procedures are in place to monitor activities undertaken using grant, contract or cooperative agreement funds. Such entity shall annually prepare and submit to the Secretary a report concerning the effectiveness of curricula developed under the grant contract or cooperative agreement.

`(e) REPORT TO CONGRESS- Not later than January 1, 2002, the Secretary shall prepare and submit to the appropriate committees of Congress, a report concerning the effectiveness of programs funded under this section and a plan to encourage the implementation and utilization of curricula to reduce disparity in health care and health outcomes. A final report shall be submitted by the Secretary not later than January 1, 2004.

`(f) DEFINITION- For purposes of this section, the term `racial and ethnic minority group' has the meaning given such term in section 1707.

`(g) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated to carry out this section, $3,500,000 for fiscal year 2000, $7,000,000 for fiscal year 2001, $7,000,000 for fiscal year 2002, and $3,500,000 for fiscal year 2003.'.

SEC. 402. NATIONAL CONFERENCE ON CONTINUING HEALTH PROFESSIONAL EDUCATION AND DISPARITY IN HEALTH OUTCOMES.

(a) IN GENERAL- Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall convene a national conference on continuing medical education as a method for reducing disparity in health care and health outcomes, including continuing medical education on cultural competency. The conference shall include sessions to address measurements of outcomes to assess the effectiveness of curricula in reducing disparity.

(b) PARTICIPANTS- The Secretary of Health and Human Services shall invite minority health advocacy groups, health education entities described in section 741(b)(1) of the Public Health Service Act (as added by section 401), and other interested parties to attend the conference under subsection (a).

(c) ISSUES- The national conference convened under subsection (a) shall address issues relating to the role of continuing medical education in the effort to reduce disparity in health care and health outcomes, including the role of continuing medical education in improving the cultural competency of health professionals. The conference shall focus on methods to achieve reductions in the disparities in health care and health outcomes through continuing medical education courses or programs and on strategies for measuring the effectiveness of curricula to reduce disparities.

(d) PUBLICATION OF FINDINGS- Not later than 6 months after the convening of the national conference under subsection (a), the Secretary of Health and Human Services shall publish in the Federal Register a summary of the proceedings and the findings of the conference.

(e) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated such sums as may be necessary to carry out this section.

SEC. 403. CONTINUING MEDICAL EDUCATION INCENTIVE PROGRAM.

(a) IN GENERAL- The Secretary of Health and Human Services shall develop and implement a program to provide incentives to health maintenance organizations, community health centers, rural health centers, and other entities providing services under title XVIII or XIX of the Social Security Act (42 U.S.C. 1395 et seq. or 1396 et seq.) to encourage health care professionals employed by, or under contract with, such entities to participate in continuing medical education programs designed to decrease the disparity of health across racial and ethnic minority groups.

(b) EFFECTIVE PROGRAMS- In developing the program under subsection (a), the Secretary of Health and Human Services shall ensure that incentives are targeted at programs that address each of the following issues:

(1) Implementing new curricula or strategies for continuing medical education programs designed to decrease the disparity of health across racial and ethnic minority groups or of continuing medical education curricula or strategies that have been proven effective in decreasing the disparity of health across racial and ethnic minority groups.

(2) Encouraging health professionals to participate in such curricula.

(3) Monitoring health care and health outcomes as a way in which to evaluate the effectiveness of continuing medical education programs in decreasing the disparity of health across racial and ethnic minority groups.

(c) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated such sums as may be necessary to carry out this section.

SEC. 404. ADVISORY COMMITTEE.

(a) ESTABLISHMENT- The Secretary of Health and Human Services shall establish an advisory committee the provide advice to the Secretary on matters related to the development, implementation, and evaluation of graduate and continuing education curricula for health care professionals to decrease the disparity in health care and health outcomes, including curricula on cultural competency as a method of eliminating health disparity.

(b) MEMBERSHIP- Not later than 3 months after the date on which amounts are appropriated to carry out this section, the Secretary of Health and Human Services shall appoint the members of the advisory committee. Such members shall be appointed from among individuals who--

(1) are not officers or employees of the Federal Government;

(2) are experienced in issues relating to health disparity;

(3) are minorities or representatives of racial and ethnic minority groups; and

(4) meet such other requirements as the Secretary determines appropriate;

and shall include a representative of the Office of Minority Health under section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) and such other representatives of offices and agencies of the Public Health Service as the Secretary determines to be appropriate. Such representatives shall include 1 or more individuals who serve on the advisory committee under section 1707(c) of such Act.

(c) COLLABORATION- The advisory committee shall carry out its duties under this section in collaboration with the Office of Minority Health of the Department of Health and Human Services, and other offices centers and institutes of the Department of Health and Human Services, and other Federal agencies.

(d) TERMINATION- The advisory committee shall terminate on the date that is 4 years after the date on which the first member of the committee is appointed.

(e) EXISTING COMMITTEE- The Secretary may designate an existing advisory committee operating under the authority of the Office of Minority Health of the Department of Health and Human Services to serve as the advisory committee under this section.

SEC. 405. CULTURAL COMPETENCY CLEARINGHOUSE.

(a) ESTABLISHMENT- The Director of the Office of Minority Health of the Department of Health and Human Services shall establish within the Resource Center of the Office of Minority Health, or through the awarding of a grant provide for the establishment of, an information clearinghouse for curricula to reduce disparity in health care and health outcomes. The clearinghouse shall facilitate and enhance, through the effective dissemination of information, knowledge and understanding of practices that lead to decreases in the disparity of health across racial and ethnic minority groups, including curricula for continuing medical education to develop cultural competency in health care professionals.

(b) AVAILABILITY OF INFORMATION- Information contained in the clearinghouse shall be made available to minority health advocacy groups, health education entities described in section 791A(b)(2)(A) of the Public Health Service Act (as added by section 401), health maintenance organizations, and other interested parties.

(c) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated such sums as may be necessary to carry out this section.

TITLE V--MISCELLANEOUS PROVISIONS

SEC. 501. OFFICE FOR CIVIL RIGHTS.

(a) PUBLIC AWARENESS CAMPAIGN-

(1) IN GENERAL- The Secretary of Health and Human Services shall conduct a national media campaign for the purpose of informing the public of the programs and activities of the Office for Civil Rights, Department of Health and Human Services. The campaign shall--

(A) have a specific focus on racial and ethnic minority communities, as well as the general public; and

(B) involve racial and ethnic media as participants in the design and conduct of the campaign.

(2) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out paragraph (1), there are authorized to be appropriated such sums as may be necessary for fiscal year 2000.

(b) OMBUDSMAN DEMONSTRATION PROGRAM-

(1) IN GENERAL- The Secretary of Health and Human Services (in this subsection referred to as the `Secretary') shall carry out a demonstration program under which the Secretary makes grants to States for the purpose of establishing and operating State offices to identify, investigate, and facilitate the resolution of complaints relating to civil rights, and to carry out functions authorized pursuant to paragraph (3) (which office is referred to in this subsection as the `State Ombudsman Office').

(2) OMBUDSMAN- The Secretary shall require that each State Ombudsman Office under paragraph (1) be headed by an individual with expertise and experience in the field of civil rights and advocacy.

(3) CERTAIN REQUIREMENTS AND AUTHORITIES- In carrying out paragraph (1), the Secretary shall consider the requirements and authorities that apply to the operation of State offices under chapter 2 of subtitle A of title VII of the Older Americans Act of 1965 (relating to State Long-Term Care Ombudsman Programs). In providing for State Ombudsman Offices under paragraph (1), the Secretary may establish requirements and authorities with respect to civil rights that are the same as or similar to the requirements and authorities that apply under such chapter 2 with respect to residents of long-term care facilities.

(c) FUNDING- There are authorized to be appropriated for the Office for Civil Rights, Department of Health and Human Services, $36,000,000 for fiscal year 2000 and each subsequent fiscal year.

SEC. 502. DEVELOPMENT OF STANDARDS; STUDY TO MEASURE PATIENT OUTCOMES UNDER THE MEDICARE AND MEDICAID PROGRAMS BY RACE AND ETHNICITY.

(a) DEVELOPMENT OF STANDARDS- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services, acting through the Administrator of the Health Care Financing Administration, shall develop outcome measures to evaluate, by race and ethnicity, the performance of health care programs and projects that provide health care to individuals under the medicare and medicaid programs (under titles XVIII and XIX, respectively, of the Social Security Act (42 U.S.C. 1395 et seq. and 1396 et seq.).

(b) STUDY- After the Secretary develops the outcome measures under subsection (a), the Secretary shall conduct a study that evaluates, by race and ethnicity, the performance of health care programs and projects referred to in subsection (a).

(c) REPORT TO CONGRESS- Not later that 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report describing the outcome measures developed under subsection (a), and the results of the study conducted pursuant to subsection (b).

SEC. 503. DEPARTMENTAL DEFINITION REGARDING MINORITY INDIVIDUALS.

Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-6) is amended--

(1) by striking `Asian Americans and' and inserting `Asian Americans;'; and

(2) by inserting `Native Hawaiians and other' before `Pacific Islanders;'.

SEC. 504. CONFORMING PROVISION REGARDING DEFINITIONS.

For purposes of this Act, the term `racial and ethnic minority group' has the meaning given such term in section 1707 of the Public Health Service Act.

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