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S.1880
Health Care Fairness Act of 1999 (Introduced in the
Senate)
TITLE II--MEDICAL EDUCATION
SEC. 201. GRANTS FOR HEALTH CARE EDUCATION CURRICULA 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 PROFESSIONS EDUCATION CURRICULA DEVELOPMENT.
`(a) GRANTS FOR GRADUATE
EDUCATION CURRICULA
DEVELOPMENT-
`(1) IN GENERAL- The Secretary, acting through the Administrator for 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 and faculty development for cultural competency in graduate and undergraduate health
professions 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 of osteopathic medicine, school
of dentistry, school of public health, school of nursing, school of
pharmacy, school of allied health, 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 . 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 not to
exceed 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 CURRICULA 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,
contracts or cooperative agreements to eligible entities for the
establishment of demonstration 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, contract, or
cooperative agreement under paragraph (1) an entity shall--
`(A) be a school of medicine, school of osteopathic medicine, school
of dentistry, school of public health, school of nursing, school of
pharmacy, school of allied health, 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,
contract, or cooperative agreement 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
systemic level.
`(4) NUMBER OF GRANTS AND GRANT TERM- The Secretary shall award not to
exceed 20 grants, contracts, or cooperative 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 address
issues associated with different 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) 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. 202. 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 health professions 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 201),
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 and health professions faculty. 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. 203. ADVISORY COMMITTEE.
(a) ESTABLISHMENT- The Secretary of Health and Human Services shall
establish an advisory committee to 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) unless otherwise specified, are not officers or employees of the
Federal Government;
(2) are experienced in issues relating to health disparity; and
(3) 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. The Secretary shall ensure that
members of minority communities are well represented on the advisory
committee. 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. 204. 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 contract
provide for the establishment of, an information clearinghouse for curricula
to reduce racial and ethnic 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 minority and ethnic
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 201), 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 III--MINORITY HEALTH RESEARCH BY THE AGENCY FOR HEALTH CARE POLICY
AND RESEARCH
SEC. 301. MINORITY HEALTH RESEARCH BY THE AGENCY FOR HEALTH CARE POLICY AND
RESEARCH.
(a) IN GENERAL- Part A of title IX of the Public Health Service Act (42
U.S.C. 299 et seq.) is amended by adding at the end the following:
`SEC. 906. RESEARCH ON MINORITY HEALTH DISPARITIES.
`(a) IN GENERAL- The Administrator of the Agency for Health Care Policy
and Research shall--
`(1) conduct and support research to identify how to improve the quality
and outcomes of health care services for minority populations and the causes
of health disparities for minority populations, including barriers to health
care access;
`(2) conduct and support research and support demonstration projects to
identify, test, and evaluate strategies for eliminating the disparities
described in paragraph (1) and promoting effective interventions;
`(3) develop measures for the assessment and improvement of the quality
and appropriateness of health care services provided to minority
populations; and
`(4) in carrying out 902(c), provide support to increase the number of
minority health care researchers and the health services research capacity
of institutions that train minority health care researchers.
`(b) RESEARCH AND DEMONSTRATION PROJECTS-
`(1) IN GENERAL- In carrying out subsection (a), the Administrator shall
conduct and support research to--
`(A) identify the clinical, cultural, socioeconomic, and
organizational factors that contribute to health disparities for minority
populations (including examination of patterns of clinical decisionmaking
and of the availability of support services);
`(B) identify and evaluate clinical and organizational strategies to
improve the quality, outcomes, and access to care for minority
populations;
`(C) support demonstrations to test such strategies; and
`(D) widely disseminate strategies for which there is scientific
evidence of effectiveness.
`(2) USE OF CERTAIN STRATEGIES- In carrying out this section the
Administrator shall implement research strategies and mechanisms that will
enhance the involvement of minority health services researchers,
institutions that train minority researchers, and members of minority
populations for whom the Agency is attempting to improve the quality and
outcomes of care, including--
`(A) centers of excellence that can demonstrate, either individually
or through consortia, a combination of multi-disciplinary expertise in
outcomes or quality improvement research and a demonstrated capacity to
engage minority populations in the planning, conduct and translation of
research, with linkages to relevant sites of care;
`(B) provider-based research networks, including health plans,
facilities, or delivery system sites of care (especially primary care),
that make extensive use of minority health care providers or serve
minority patient populations and have the capacity to evaluate and promote
quality improvement; and
`(C) other innovative mechanisms or strategies that will facilitate
the translation of past research investments into clinical practices that
can reasonably be expected to benefit these populations.
`(c) QUALITY MEASUREMENT DEVELOPMENT-
`(1) IN GENERAL- To ensure that minority populations benefit from the
progress made in the ability of individuals to measure the quality of health
care delivery, the Administrator of the Agency for Health Care Policy and
Research shall support the development of quality of health care measures
that assess the experience of minority populations with health care systems,
such as measures that assess the access of minority populations to health
care, the cultural competence of the care provided, the quality of the care
provided, the outcomes of care, or other aspects of health care practice
that the Administrator determines to be important.
`(2) REPORT- Not later than 24 months after the date of enactment of
this section, the Secretary, acting through the Administrator, shall prepare
and submit to the appropriate committees of Congress a report describing the
state-of-the-art of quality measurement for minority populations which will
identify critical unmet needs, the current activities of the Department to
address those needs, and a description of related activities in the private
sector.'.
(b) FUNDING- Section 926 of the Public Health Service Act (42 U.S.C.
299c-5) is amended by adding at the end the following:
`(f) MINORITY HEALTH DISPARITIES RESEARCH- For the purpose of carrying out
the activities under section 906, there are authorized to be appropriated such
sums as may be necessary for each of the fiscal years 2000 through 2004.'.
TITLE IV--DATA COLLECTION RELATING TO RACE OR ETHNICITY
SEC. 401. STUDY AND REPORT BY NATIONAL ACADEMY OF SCIENCES.
(a) STUDY- The Secretary of Health and Human Services shall enter into a
contract with the National Academy of Sciences for the conduct of a
comprehensive study of the Department of Health and Human Services' data
collection systems and practices, and any data collection or reporting systems
required under any of the programs or activities of the Department, relating
to the collection of data on race or ethnicity, including other Federal data
collection systems (such as the Social Security Administration) with which the
Department interacts to collect relevant data on race and ethnicity.
(b) REPORT- Not later than 1 year after the date of enactment of this Act,
the National Academy of Sciences shall prepare and submit to the Committee on
Health, Education , Labor, and
Pensions of the Senate and the Committee on Commerce of the House of
Representatives, a report that--
(1) identifies the data needed to support efforts to evaluate the
effects of race and ethnicity on access to and quality of health care and
other services and on disparity in health and other social outcomes, the
data needed to define appropriate quality of care measures to assess the
equivalence of health care outcomes in health care payer systems, and the
data needed to enforce existing protections for equal access to health
care;
(2) examines the effectiveness of the systems and practices of the
Department of Health and Human Services described in subsection (a),
including demonstration projects of the Department, and the effectiveness of
selected systems and practices of other Federal and State agencies and the
private sector, in collecting and analyzing such data;
(3) contains recommendations for ensuring that the Department of Health
and Human Services, in administering its entire array of programs and
activities, collects, or causes to be collected, accurate and complete
information relating to race and ethnicity as may be necessary to monitor
access to and quality of health care and to ensure the capability to monitor
and enforce civil rights laws; and
(4) includes projections about the costs associated with the
implementation of the recommendations described in paragraph (3), and the
possible effects of the costs on program operations.
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated such sums as may be necessary for fiscal year 2000 to carry out
this section.
TITLE V--PUBLIC AWARENESS
SEC. 501. PUBLIC AWARENESS.
(a) PUBLIC AWARENESS CAMPAIGN- The Secretary of Health and Human Services,
acting through the Surgeon General and the Director of the Office for Civil
Rights, shall conduct a national media campaign for the purpose of informing
the public about racial and ethnic disparities in health care and health
outcomes.
(b) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out
subsection (a), there are authorized to be appropriated
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