NW 0 0 - dical ty-i e SPECIAL ISSUE rograms FOR LIMITED DISTRIBUTION ,Service o ii evv s 0 ilifor atioll 00 lk 0 0 0 d@at a A fit-vic(. ilq.siggit-ti tfw ilig. ()f III-WS, 1-1--,GISIATION l@x'fT"N])]"]) AM) AMI.@,NI)F,,]) I-or Regional Mcd@icil Programs - Public l,aw 91.-SIS November 20, ]@970 Vol.. 4, No. 51S on October 30, 1970, the President signed Publit Law 91-SI5 which extOnds ,uid amend nal Medical Programs legisl tion as well as that of s @ Regio a (.,otTlprehensive flealth Planning and Services, the National. Center for flealtli Services Research and Development and the National Center for Health statistics. To reflect the details of this action, a copy of Title 1 of the n ew law (P.11. 9l-sl5) referring to Regional Medical Programs specifically, and parts of certain other titles relevant to Regional @dical Programs, are reproduced in the first part of this issue. 'I'o indicate how the total. Regional Medical Programs law now reads a,, part of the lkiblic Health Service Act, all changes have been interpolated into the original law (Publi c Law 89-239, as C.Hiien(led by Public Law 90-S74) on the p4g6@ that follow. Del6tions in the previous I.aw are shown in (I)racketsj, while the new legislative language is underscored. I)istr:ll)uiion- Coordinators of Regional Medical Programs Members of National Advisory Council and Review Committee on Regional@ Medical Programs Staff of Regional Wdical Programs Servi,ce Regional licaAth'Directors and Regional. Medical Programs Servi.te Representatives of Health, @eati.on, and Welfare Regional Off-ices (I.S. I)EPAR'I'MENI' OF HFAl,'I'if, El)t)(;A'I'ION, ANI) WEI.,FARF itillio. health Scrvit-t- o [fealth Servieef4'anti Mental health Adminigtration flockv'ille, Nlitr,,,Iiitl4l 2011.-v2 Public Law 91-515 91st Congress, H. R. 17570 October 30, 1970 !an 5ict Tro iiiiieitd titlei4 III ati(I IX of the Ilubii(! llealtli kct so its to revi.4e, exit,tiql. jtjiti iiiil)ri,i,e the I)rt)graitis (if rt-seiti,f-ii, iti@4-@tigalloti, e(ltit,-ittiozi, trititiirlg, nittl deitit,tistratiotis iiuthf)rize(I tijert-iiii(If@, iirid for t) jer I)ilrl)oqo-s. Ite, it i,tiet(,tetl b?/ the (t,)sel Hoit." r)f of the A,@t, I- .@tAIENI),NfEN'I'S T(.) i,i,rf,E IX ()F TI[li, I[EAI,'fli Si@,'[tV[(!E k("l' SF,('. 101. title 1)1! :18 III(,, "il(l:kl't, Citatinti of r(ilct-, itii(i lki(iticy Aiiieji(litii@lits of I!) i-O". @,itl,e. sr(.. ](IC). @-tioll 90(i of tile is ;tiiieii(le(i 7') @;tnt. to i-i-itd follo,.%-s: 42 ll@(: 91)9. !100. The ])ui-I)os(-,,., of tlii,4 title ..(It) @i-,tiits tiid to aii(I ttL,,si,'4t iii tiii@ est:ibli,,Iiiijeiit of i-eLiotial (,ooi)er:tii%,(,, :tijioiig llletliC.11 'A-iloOls, iiist,ittiti(;Ils, :kll(l llosl)itit'is for I-e.,i(,itr(!Ii itiiii tr-.tlitijig (ijiciii4litil" iiiiii1ig e(lil(!:ktioll), fot- t-xoliaiig,i,,, kji(i for (](-III (),=tioIls of 1):Lt@ielit ill tile fi(@1418 of stroke, itiid L-i4iii(@y relitted (liseiiscls 4 12'o 7 (1)@) t :I to tilo@ I)i-ofessloii itii(I tile iiie(li(!,tl itisti-' 4 -S i A7-,*@ I ?'i fijt,ioit,, of file N@ttioii, t,lirotigii ,u(-Ii f-ool)(-t-@Ltive tlj(- I)I@I)ollliiiit -@- of iii;ik'll)ff ltv:til:tt)le tt) I)ftti(@iits 111(@ litt,("t ill lilt' l)l'('V4'llliikii, (ii:igll(@'iS, :Ili(l "(I-,) to I ,i-4)lllot(@, tliil ft)s -,r r(tgioji:tl Iiiik@t,,(@s ;titi(iii.,4 li4-;Lltl) iiistiti,it,ioll.., till([ 1)1.()Vi(leiN So its to sti-l,,Iigtll(@ll fill(] )rf)%,@, ttil(I illit@ ritlittioiisliii) ))ttt%No!eii to iltil)l.ove g(@ll(',?-Illly t,lit@ 4 I itil(I tII4, Nitl.ii)ti 3iii(i to Iit@itit'll fol. I,(@si(liliLr ill ill@i@it,4 witik I ifilit(@(I li(,Ititlk tell to t@ii4l,, witliotit itit(,-i-fii-iiig witli the 1)ii@tt(@riis, or tli(, iiieflio([:@ of liii:tiiciiig, of 1)at@ietit or or @vitli tile :t(tillillistl.:ttion of liosl)ititl@, itjkd let -itioll %%-i 11 I)IIV'iicittlis, t t(liniiiistrtttors, itiia r(,,I)ris-entittiv@ from itpl)l,ol)rilte(@ voliitttary lte;tltli it@i-i@iicies." - (a)( 1) Tile" first ,(,,ntence of s(x@tion 91)1 (it) of such .k(.t is I)v strikiiiL, oiit "ttii(ill after 6, Jun(3 30, 12 -,tat. ]!)tio,", .111(i I)Y illsol-tiiig itrillif@41i:iteiv 1)(,@fore for. gr:tiit,,i" 42 7@;'c III(, folitwl%.illg $I:),.@'),Ooo,(')O() for ih(@ y(@,ftr (@ii(Iiiilr.June 19711 ,@it.f@,ooll,floo for the v(@:kr I!)N, i@(I $2r)o,ooo,o(g) I'l))- the yt@ilt t!ll(liii,r -fitile.30, Slit.II Am@t is fill-til(@l- I)y striking otit I)itrjrpil "ii(le" tire(] iti,,(-rtiiig ill ]left t@:(@l.(.of "iiiiil for (@oritrit(@ts i,o art-y I)Ilt tll(-, I)III-1)(Y-i(.s of t-Iiis iitle. ) Siiili ot)l (:I.) is itilli'liti(@(i I)Y !@ti-ilot-tiiititv lia,4 1)(@en t)roN@i(li@(1, i)rior to (little itiendatioti, for i-t@iisitler:ttioii of tilt', fti;l>li(.Iktioll I)v pit(-Ii or iii)ri 1)rofit. prii,:tte aiiet)(-y or orgttikizittiot; 'Wlii(-Ii b.-t.4 11 9 t lo(.;II t)litn t,(-ferri-(l rt@ ioiiii]. iii@troi)ol')taii ai-e4, or ()tli(@r lo in section 314fl)) (,overiiiiy, Stay fire-it ill %vliii@ll til(@ -h ",.Ite fill(] if tile I for hi tli(s api.@li atioii is Tiiii(i@@ will I)e, It "I' ,:I oL),raii) w NeLtioneLl Ad- Srx-,. 1()7. (11) 905(ti) of St)(.II k(.t is ;Ini@11(le(I to I-(-$id :i,4 sory Counoil fciliows: on Regional "'@qFc,. !)Or). (it) I'lie S(-(-r(@t-,irv niity itl)i)o)iiit, without rt-gslt-(l i(@ tile Medloal Pro- (.evil law,4, it Natinitlil of) l@(@trional Nf(,di(@iii grwoo llri)&rrjttiis. 'rbe .,Iittll consist of' tfi4, A,,,iii4tittit S(A(.l.tt3irv of 42 USC 299e. Ife@lt,b, Ediieatioti, and W(-Ifitile for T14,itltli :tii(i S(-;Ptitifle Aff)iir,;I'Wlio October 30, 1970 Pub. Law 91-515 94 @I'A'I'. 13OU "litill I)(, tli4k tile ('Iiief of tile l,i@ ;III (.x ofli4,io liot ill 11)(@ I.(@giiiiii- i@ilil,li,y of tl)4@ Sl:it(,S, :11-4. ill l@ill@lif- oil.. @;lfilli ill tllt@ -4(1141@' 4)1- Ill';iltli of Silll,(@l-iilLr 4.11 olle Slilill I)(- olitst;iji(lillg ill till- stil4ly lit-iiltli fl-(Plii ()lit. sli@ill 114i I)III@t@11141 litg ill 1114. .,tli(iv ill- lteillf,it of I ig I%vgl ,Iiitll 114. I)Ilt,.4tikil(lifig ill Ill(, fif-l@l of of ;I I I I 11 ()I- lil('Illl)l'I'S of (11(@ l@(i (II) (@f fifth fii-4t liti(it-l- !)Or)(:t) 1114- ()f I'lilviiti lit@ititli A(4 to :Is 1,11(, ft)llt. or Oil ltel-'iOll@tl M(@(11(@:11 lii:t(It. I)v stll),A,.Ctioll (;I) of falls se(,tif)?) .1 ttI'lil of 4)11(- yt@@it-, ti it@i-iii of t%%.o yi,@lt-s, silitil :1 ti!lilll (of :is liv t,lit- Se(,rtttii-%- (if ;it (ii(@ Nittioiiiii oil lk'f.git@ilill (otiltl. them tile ofti(@i@ till til(@ (I:tt(. of i,li;ti@tillel)t (of this %(it sli@til o.olititill(@ ill offi(.e ill witli till- I%!Ill(ql tII4,v wt@i-e ]:Ist tile ('ollll(-il, t 4( -k Illy It "Ol' 7'@ -t il@il .1 )7 of iti4-li (it is l@N, ;ti-ikiitg oi iii,-k-i-liiig I'll i(.Il illel.(Af)f (,I, kiii'lli-Y 4P 2')')P. @1;44.tioli !)Ot)( t) @of '411(.Il X(.t is 1).@' 4'@ 2'i@)l. "gl.,.Illt,@ i lit-)I I)III(.e il@ ;11)1)e@ti-s till-ilt'lli. .t ) ;is !i 0 if sii4-li A( Sy 42 I;:;(; 299J. it tl;itioli:li II' i,,;:iiiili(ll.izt.tl tits t4@ l@ililli4. fit- lioiki)]'f)lit of- iiisi ittiti()IIS ()I- 4-oill- t4)(.olltl.lll.t ft)l.-- itli(i It(.t,ivitit'S of "ill)st@tiifi@ll lis(@ to) W4) lit, iioi-e r(,Lriollti t @ll, 01. (lettioii,4tr-.%(ioii of foi- (-4)11- t 1.1ii 4) f lie.11-t tili@ 4.011(,i!i io)ll :111(l Stli(IV (lilt it .Illy of I iie- tli-4@;lst-s to i@il (2) liv til 11 I4@ 1) I.(@, (it. ti-i-,-iiliiellt ) Italy (of 't lit, glise@tli(@@ I,(@ lei-i-t@il l@:11-ttgt-ttl)lt (2), foi- ti) file ii,li@tloilit:ktiolk of -lillll'(@i-ifig fi-titii tiiiy of sti(.Il (i@("Isi.s; Fiji([ f(ii- 4-t)trliiiiiijig I)t-ogritrti,; (if iI-iti[iiilg wltet-t, (If tilltitit-(] W(Pill(i liiiiit iil)i)li4-.titioti t@f kii(j%vielige -iii(i skills iiiil)i)i-t@tilt to (li(@ 4!4)fltif)l itilv )f "11(.I I "(.@) tile Coll(ill(it of (-ool)(!I.Itt,ive 4-iiiii("Il lii@1(i II-iiiiH. 44 ( i)) ri)e, st@t@t.(@t4ti@v is ittitii(wi-ize(i tt) @L,,,4ist iii iii4,4@tilitr tile of 1)ri)j(@i-is for- iri ,tl)it)vitily or dov6l()])ing iii@%v lll(!@tris fol. tlkt@ (](@,li-V- Pub. Law 91-515 October 30, 1970 -L'u, it I is to iii:txil t)lti litilizilt.ioll of of' llf-Ititli sr4@'. I t'it l(t IX of,,,ii(@ii A(@t. is iiiiieri(l(,Il I)y ,it ikiii 'S" iiii(i r (_r out I,,, A,@ 1) It I) i tig ill full thereof "S'I'ICOK I,' , l@l I)N l@,Y 1) I SI@,AS 14,5 A NI) 0'1'11 P,'R 42 29f)b- S,-ttioll,, 9f)2(:t), )Oij(l)) 905(b), 29')g 1)4)5(d),Do(',,!)07,itiid Ot)!)(4t) of I)Y tile 29ql. I)]-Ovlsiol)s of this ikct) -itre filter ttytieii(lptl !)y str kiiig otg I)III(,.e it tiiereiti -,tii(I ii),,(!rti i ill lieu there( )f "SL@ei-etitryyt. 9 Otlier New Provisions Relevant to ]Zegional Medical Programs fn P.L. 91-SIS 11 AMI!',NI)MI@:N'I'S 'I'() Ill ()F lt;XN'I'.S IN ('Illt']'AIN titlic III of tli(. ilitl)iif! ll(,itltli A(,@t is @iiiii@j@tleti i)y :td(iiiig tit -tile i-ii(i tiiei-et)f tile I'tollowitig. lie%v wA!(@-,tioll: 42 IIS', ?4.'I- (iratitsiit('(.-rt@tiii Mtiltigt'ltl)t I't@oje(-t.,) 24@1)). :I IOA@ For the puypo.@ of f@t(-ilititting! the it(.Irriiiiisti-ation of, vxl)(@(litiiig tile e:t@yltig otit of the purl)osps (if, the I)ri)grmrris 1.),v title IX, :iiiii :10,t, 'tl,t(a), :@14(t)), :@14((,), of tliisaftt iii situations iii wlii(@ii grtj)ts itr4@ si)iitrhi, 'illgl ill. fil@ttle, iiii(It@i- t,,%-o or illoile of 1)rogriiiis with lo i -., e l@ro)jt@t@t, tit(, St-cretarv is atitlioj,iz(td fa 1)t-oiiiullnit(@, r(!gitltktio)kS-,-@ I i'v)ticlt the -ii(iiiiiiiisti-ittive fiiii@t!ti(,jii iiii(lo-t- ivitli to sii(@ii will liti 1)i@rfoi@rt)f!tl I)y a :t(Iniiiiistrittiv(- uitit wiii't-li 'ii fli(@, unit io)ii@ (@f ikiiv (@f sit(@ii I)i,ogritiii,; or is iliiit %vitit ilit, qu@I)el.visioll of i,wo or (14-sigrilt@tt lo tile iiiiiiilj(-,r t,r ILI)Illi('I@,tiOlIS, @iiit) iiiitto@t-litiq Sll(-Il il(; lg; sill)- tifil'te-41 %Vill% ff) al)(I otil(@i-%vist to .9i ili@y, It I I itialip tit iforiii (t@) tlit- t@x s e) I,,:" 4@t) @4)1"ttit4t, still I fell il)i , I e, (IntiL iii@-,i)jisisteikt or (Iiil)li(.Ittiv(- t@e(iiiirt@ni(@ilts ']M- li sii(!Ii 1)i-ogrrfims will ]xi reviqo(l and itiade-tiniforryk with y to ititil@iiotliiiig ill this sef@tioll '4111111 I)o (Construed to itiitliorive the t4) waive or su@nd, N-,-ith respect to ativ siieli r)ro@(@t, itriy with n@@i)Mt @f,) 1-tny of.,;il(.Il I)rolrt,ltfyls if ie(iiiirpm(!iit is iiiil)otle(i I-v law or by atfy ro--,,gulitti(@ii required I)y law." Pubi Law 91-515 Oc-t@ober 30, 1970 84 S'I'AT. 1307 SE(.i. 28o. Ili@t-t k of t,itle III (of tike I)III)li(. Ile.,tltli Sei-vi(,e A(-t is fitrtliet ttitieitded a(ldilil-r iiftel- section thereof (lie tiddett bv Ndioit 270 of tlllsqct) @lic"@follo%%,iiig new section: ()II of. 1)(,foi-(t Iiiiiii:ir@, I:, r I I., ti,:tii,,iliit, to I'lit, (',t)llgl.i@ss :1 1.1 )f tl pp. of fx @l, t,lli,; -kt@t, III)([ :1111((I), ttt)fl of illi', tillf-, log(,tll@-1- Willi 1) :tll tl%,:ilti@it,ioll of (II(. 4@ili- .@'llig oill, tl::@ I,(il. %vli -II s lillitlit-ilig :il,)(l ftit ltli4.illLr ff-(iiii ollit-l- SOIII-(-(", of tiff', liti4lo@ll titki-ii tlil-, I)tjsiiililiiitt@,4 rt)w@ of iviti(@,,, tlkrotilft' itA! '(if ltlil,i-ii@it(@ "oil[-l-i's lvftei- :III illiti@tl of siit@t)ol!t s@icit 1)1-0%.i-: (.1) siicb re,(-onitti(-ii(l@ttions iviiii to :IS fie TITLE Wi,'I'TONAL AI)VISORY COTTN(',Il, (1k) (1) Sijl)s(@t@tioii (e) of section 24)8 of the Pitblic Itertitli Servi(,e k(,t i,,ayiien(le(i to refid: i I liat. -1.1 7. '@((!) of the Nit,tiojiitl Advisory Ifeilltrb (@otiticil and M(,,Iyl- I? !I::(,' 211. t)ft)llicr national itdvisoty or review cotin(,ils i)t- (,ommitt(-(-,s (istal)- liti(i(@r thi,., A(@l, iri(-Iii(iiiig ineytiixr,; of tli(@ T@linieal ICII(ii1tti4)tt Saf(-t,y ',4t4tiidards ('oriiiiiitl-o(- ati(I tit(, ItosLt-(l of h'4kL,i@tits iif t lit@ Nitt it)ji:tl fil)t-itry of Me(liciiif-,, ))tit i@x(@,iii(lirig (tx ofli(-it) %@ liiie itt,ti-ii(lifig or iiigs of tlipir ill, l'ortinlit.li@(@s or wliile !-i@r-viilg iti, th4. of fixit(I by tlii-, I)iit itt I-ILtA@q )lot (litily (til1iivitletit 4@f til(i i-itte t@t,tit4i tiil)4! of fi@r iri-itde (i,@. 18 of ti)i(@ (t(tii4-ral S(-fiediiie, itj(-Itidiriir travel:tiriie; art([ w)iil(i itwtiy frt)iri tli4@ir l@@ li'. R. f,2,17. Itoiii(,-,s or regilitir 1)litees of ,btisin@ss they miiy lie itllo%ve(I trtkv(@l (,-x. [I.';C @,'il2 @,4 Sl'Al'. J311 ill(-Ill(iilkA" li(!r (lielki ill li(.kl of IS ;till I)Y tii)ti @P70;"(I)) of titit@ r) of tli(5 St@tit,es for i,ii (II(' 4'jli; of (d) i-f s(@(Aioti :@07, t@tie lii,st, titeiiee of ))Ili,a- .12 IISR, 242C. gi-.l li (2) (pf sittiqectioii f) t@f sect-ioil -';III)S(@tioll ((I) of -9(@Cl@ioll 4) TJ@,C 263f, I :17:' , t@f @t,ioii @4;@l I, stil),,tictioii (d) of se@.i@n 74):i, siil)- A@ te, pp.6r),344. st@t-t 14 I,, 01 0 2@Irr 29?h. ;iiiox-ti I ((I)@ of secti'ti 774, si (if: A-,(!tit)ii .4119 itiiti stiLow,(,t.ioti (c.) i)f.sectioii got) of At@t ltrL' 42@@JrC 2@)3ct 2,05f-4, n ",58 is ftirtlv4,,r -s@rtigt-itj)li (2) of (f) of w-kt,io 8? Stat. 1170. ltliieijde4i l,v,4t;t-ikiikLy otit llitiificr t,)kiH subtw@tion" iri tiie SKOr$41 tlii@roof tLji;i I)v iiigeAiiig in lieii tliet-et)f "to iiieiillwr.s of Cli(@ Coitinjittee wito itre iiot @)fficc-rfi t)j, enil)lt)y(it-,s of tlit! Uni@-(i kUtem I)ut-buttnt to subwt,-tio)n ft,,) of section 20@ ol t[iis Act": 79 Stat. 92910 (4) @,@II)se(4tiati (d) of s(,(tiott 90.r) of- Hiieh Act is ri,,deA4ignaW'as 0 ibsection .11 (c LLQISLATRVE MSLOR-Y, HDUSE REMMSS go* 91-1297 (COW. ovi Interstate and Foreign Cmueres) and No. -91-1590 (Cow. of Conforenoe). SENATE ROORT No. 91-1090 @aoookparqing S. 3355 (Cmm. on TAbor and Publio welfare). CONGRESSIONAL RECORD, Vol. 116 (1970)2 Aug. 12i considered and paoised Hougie. Sept. 9s, ooneidered and pa*oed SeruLte, amended, in lieu of S. 3355. Oot. 13, House @ed to oonferenoo report. Oot. 140 Sersto agreed to conference report, PUJ3Ltc HEAL'I'flSERv,,:P.,. ACT TITI,E IX-EDUCATION,. RESEATICII, TRAININC,,, AND DE.N4[ONSTRA'VIONS IN TFIE FTI@"[,DS OF HEA@T DIS- EASE, CANCER, STROKE, [AND] IIIDNII,-Y L)I@5FA,99. AN]) OTfIleR ITFI,ATED I)JSI@,ASES PWSES .Sec. 900. The purposes of this title @ire (a) through gtants and contracts, to encourage and assist in the establishment of,'regional co6p-irat@ive arrangements among medical schools research institutions, and hospitals &lo researc and training (including continuing education), for medical data. exchanger and for [related] demonstrations of patient care in the le s of heart disease, cancer, stroke, and ki@e disease, and other related diseases; (b) to afford to the medical profession,and the medical in- stitutions of the Nation, through such cooperative arrangements, the opportunity of m aking available to their patients the latest advances in the Idiagnosis and treatment of these diseas6s] prevention. diagnosis and treatment and rebabilitdtion.of persons -if ' I from these diseases; §t - er (C) to te Yn-d fogte-r regional linkages among health care EOIMO insi'itutiom and providers so as to stronzth n and imrove primary care and the relationship betwe n@special.ized and primary care,,- -[c] (d) by these means, to improve generally the quality and enhance the capacity of the health manpower and facilities available to the Nation tj and to lth servic ons residilig @rove hea -68 for eers in areas with limited health services, and to accomplish these ends without interfering with the patterns, or the methods of financing, of patient care or professional practice, or with the administration of hospitals, and in cooperation with practicing physicians, medical center officials hospital administrators, representatives from appropriate voluntary health agOncies. AUTHORIZATIONS OF APPROPRIATIONS Sec. 901. (a) Ther6'are authorized to be appropriated $50,0003,000 for the fiscal year enai.n@,- June 30, 1966., $90','000,000 for the fiscal. year ins June 30, 19670 $200,000,000 for the fiscal year ending June 31, 1§68, $65,000@000 for the fiscal year ending June 30, 19(,)9 [and] :120 000,000 for the next fiscal year, $125,000,000 for the fiscal Year ending June 30, 1971,_$lSO,000,000 for the fiscal year ending Jti-ne @0: 1§72,'and $256 000,000 for the fiscal year etidi@ June 30, 1973, -for erants to assist p@ lic or nonprofit private universities, medical schools, research institutions, and other public or nonprofit private 1'elSil)ility StlAdies, institutions ,.ind agencies iii plwinifig, ii-I 0 of- re iorial and in operating pilot projects for tile c.;tai)Lisinn iity 9 medical progranLs of research, training, Cold demonstration activities for carrying out the purposes of this titl-e and for contracts to but the purposes of this title. (II)I@ appropri a vail.able for nizikin@', such Ilowilng the fiscal year the SLUTIS Id lot a 0 old the sums a id-La-i r tf, for not mor 00 ts@or of tile appropri,, ion!; pu-rsuai e ecrelary may determine, but not exceeding I per centLnn thereof, shall be available to the Secretary for evaluation (directly or. by grants or contracts) of the program authorized by this title. (b) A arant 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 togu@lations) equipment lot, any facility may not exceed 90 pet centum of the cost of such construction or equip- nient. (c) Fund.-, app-r )riated Pursuant to this titl.e shall ri ot be 01 available to pay the cost of hospital, Diedica-1, or other, circ of patients except to the extent it is, .is determined in @iccordiiice, with re5-,ulation.,,, incident to those traiiiin@,, or deiiion- stration activities which are encompassed by the purposes Of' tills title. N6 patient shall be furnished hospital, medical, or Other care at any facility incident, to research, training, or demon-. strati6n activities carried out with funds appropriated pursuant to this title, unless he has been referred to such facility by d practicing physician or, where appropriate, a practicing dentist. (d) Grants under this title to any agency or institution, or completion thereof, for a regional medical program may be used by it to assist in meeting the cost of partitipatibn in such program by any Federal hospital. t of any recipient of a grant under this o such r( j@r t or service@'@u nisie r ip:L ei expenses ion w I officer C.@)Tcrru-fl(-Irit- to ot@ case for ri nf4 out dical e@4ht under this title is 8 1)1: F IN l'I'l ONS Sec. 902. l,or tfie.ptirposes of this title (a) the term "regional medical. I)rogram" means a cooperative iirran),Ycmcnt among a group of )tjl)l-ic or nonprofit-. private i.nsti- ttitions or agencies eiigal.,,cd iii re@,c,,.ircli, Straining, diagnosis, and treatment relating t:o hetrt disease, cancer, or stroke, and at tlic, option of the applicant, related disease or disc@sesj.traipi.ng, prevention, diagnosis, treatment, trid rehabilitation relating to ficart disease, cancer, stro@e,-or kidney disease and, at the @ption of the licant, other related d@isoasos; but only If such gro UP (1) is situated within a geographic area, composed of any part or parts of any one or more States (which for purposes -of this title includes the District of ColLmil)ia, the (,otynnoli- wealth of Puerto Rico, the Virgin Islands, Guain, Pinericwi Samoa,' and the Trust Territory of the Pacific Islands), which the [,Surgeon General] Secretary determines, in accordance with regulations, to be appropriate for car@ing out the purposes of this title; (2) consists of one or more medical cent6rs; one or more clinical research centers, and one or more hospitals-, and (3) has in effect cooperative arrangements among its com- pon6nt units which the [,Surgeon General) Secretary finds will be adequate for effectively carrying out the purposes of this title. (1)) the term "wdical. center" means a medical school or otJicr medical institution involved in postgraduate medical training and one or more hospitals affiliated therewith for teaching, research, and demonstration purposes. (c) the term "clinical researcli,ceiiter" means an institution (or part of an institution) the primary function of which is research, training of specialists, @md demonstrations and wili(-Ii, in connection therewith provides specialized' lilgii-quality 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 wlii.ch is owned and operated by one or more non-p@fit corporations or@a-ssociatibns no part Of the net eamin gs of which inurcs, or may lawfully 'i.nure to the benefit of any private shareholder or individual.. (f) the term "construction" [includes] means new construction of' I'zicil@it'Les for demonstrations, researcli,-aii-(T t-i iiecessaa to care out regional inedi-cal programs alteration, major repair (to the extent permitted by regu.l,at@tolis), remodeling and renovation of existing buildings (including initial equirNiicnt thereof) and replacement of obsolete, built-in (as determined ill accordance with regulations) equipment of existing buildings. GRANTS FOR PIANNING SOC4 90.3 (a) I'he [,Surgeon General] Secretary, upon the recom- mend,.ition of the National Advisory Cotuicil Tii-kegional t\ledical Programs established by section 90S (lierea ter in this title i-efei@- red to as the "CoLmcil"), is authorized to make grants to public or nOnDr6fi@t private universities, med@icil schools, research institutions, and other public or nonprofit private agencies and i.iist@i.ttitions, and combination.-, thereof, to assist them in planning the development of regional medical programs. (;r@iiits under this section may I)c made only lipoli appl-ic.1t@iort thei-efoi- ipproved by the [Surgcori, GOTIeral] ,;ecret@r . Any such if)- pli.c;itiori may be apprbv(-,d-oiily if it contains or -is .,uf)ported by -- (-I.) reasonable assurances that Feddral@ 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; (2) reasonable assurances that the applicant will provide for such fiscal control and fund accounting T)rocedtires as are required by the [,Surgeon General] S creta to assure proper disbursement of and accounting for suc F eral funds; (3) reasonable assurances that the applicant will make such reports, in such form and containing such information as the [Surgeon General) Secretary may from time to time reasonably require, and will keep such records and afford such access thereto as th [,Surgeon General] Secretary may find necessary to assure e the Correctness and verification of such reports; and (4) d satisfactory shoking@thqt the applicant has designated an advisory group, to advise the applicant (and the institutions and agencies participating in the resulting regional Medical program) ill formulating and carrying out the plan I .or the estal)lishmbnt and oper@i- tion of such regional medical program, which advisory group inclu(.Ies practicing physicians, medical center officials, hospital administrators, representatives from appropriate medical societies, Evolutitary health agencies. and] voluntary or official health apenci.6s. health pl.anning and representatives of oi and agencies concerned with activities of the kind to be carried on under the program (inr-luding as an ex offi.cio member, if there is located in such rE or (- ities Of the Vete-rans' P I w@om the tor of VOtbrans' Attai ted to sei inisir lic fa ervices Provided tinder the programs need for a@ d financing of the -,e-rvices provided under tli an w ic i ficieiit @iii nuiiber 10 MD 01)1',MI'ION Of,' I)R)GIZMIS Sec. 904. (a) the [Surgeon General] Secretan(, upon the rec0iii- niciidation of the Council is authorize to make grants to public or nonprofit private universities, medical schools, research institutions, and other public or nonprofit private ageiic ics and institutions. and cml)inations thereof, to assist in establishment and operation of regional medical rogram , including construction and equipment p of facilities in connection therewith. (.1)) (;rants under this section may f)e made only upon application therefor anproved by -the [Surgeon Generil] Secretary. Any such application may be approved only if it is rcconmtCnU6Z by the advisory green) described in (section 903(i)) (/I) and I Section 903 (1)) (4), if' opportunity has been provi,de(l,p-rior to sucli-l@ rccoiiuiicjiditi.oii, -Tor Consideration :)r the lt)plicatioji I)y eaclll pul)l.ic or nonprofit private age 0 rgaiizatiori whi.cli has developed a coil reg iolial., ,mctropolitwi area, or other local area P.Im r(.@f.erred to in section covering area in wh!E the regional medical program for which the application is made will be located, mid if t Fion -- rted by reasonable assurances iFTia-t -- (I)Federal.funds paid pursuant to any such grant (A) will be used only for tJie purposes for which paid and in accordance with the applicable. provisions of this title and the regulations there- under, and (B) will not supplant funds that are otherwise avail- able for establishment or operation of the regional medical program with -respect to which the grant is made; (2)the applicant will provide for sucJi fiscal control and fund accounting procedures as are required b the [Suikeoh General] y Secretary to assure proper disbursement of and accounting for such Federal Ctu-ids ; (3)the ap.plicant wil.1 make 5tiL]i reports, in such I.onn and containing such information as the [Surgeon (;ericrall Secretary may from time to time reasonably require, and will keep n e n@ records and afford such access thereto as the I$urgeo al) Secretary may find necessary to assure the correctness and verification of such reports; and (4)any laborer or meclianic employed by any contractor or subcontractor in the performance of work on any construction aided by payments pursuant to any grant under tlii-,, section will be paid wages at rates not less than those prevailing on similar construction in the locality as determined by the Secretary of Labor in accordance with the Davis-Bacon Act, as amended (40 U.S.C. 276a -- 276a - 5); and the Secretary of Labor shAlI have, with respect to the labor standards specified in this paragraph, the authority and functions set forth in Reorgwiizatioii Plan Numbered 14 of 1.950 (IS F-t@. 3176; S U.S.C. 13.3z - IS) and section 2 of the Act of JLme 13, 1934, a.,; amended' (40 LJ.S.(,. 276c). -L 'I)ICAI, PROMKNIS .NATIONAL ADVISORY COUNCII, ON REGIONA', i%lf.; Sec. 90S. (a) The E,@urgeo-n General, with the approval of the .SecretAry,l y appoint, without regard to the civil service laws Advisory Council on ]Zegion,,il Medical l'Irogr,inis. The Council shall consi.st of the LSt.trgeon General] Ilealtli, " Assistant Secretary ol .-.@ucat@iori, and tl(,,I.fare for Health ,Scie(itif'ic Affairs, who shall be I the Chief M@@c@il 1) irector of the Veterans I Adm i ii i st rat i on who 71ii7i-@)e .1 I'l x orricio member, and [sixteen] twenty members, not otherwise in tic r g@ular full-time emp] States, who are OY le@ide@i-s in the fields of the fwld,@,uiicntil SCICTICCS, the medical sciences, health care administration, or public affairs. At least two of th appointed members shall be practicing f)fiysici.ans, one shal.1 be outstanding in the study [, diagnosis, or treatments or health care of persons stiffe om Eof] heart disease, one yi@ fr shall be outstanding in the study 1, diagnosis, or treatment) or health care of persons suffering from [of] cancer, Lind] OTIC be o6t-staiiding in the study E, i@ignosis, or treatment] or healthcare of persons suffering from [of] stroke one shall be outstaiicinp, in the study or health care of: persons Ing @f-'roiii kidney discas 11-be outstandinp, in the field of prevention of heart di.,-;base, cancer, stroke, or ML iiey i.-,ease., To-U-r- -sFall be me hers @ the public. I-,acli appointed mbm@@ of the (oiiiicil. shall hold office for .a to-nil of four years, except that any member appointed to fill 0 - the term for which his pre- a vacanc,y prior to the expi.-rati ri ol deces,,-or was appointed shall be appointed For the remainder of such term, and except that the terms of office of the members first taking office -;ha'll expire, as dcsigiuited by the Vurgeon Cenet4l] Secretary at the time of appointment, four at the end of the first yedr-, four at,tftelend of the second year, four at ,the end of the third year, and four at the end of the fourth year after the date of appointment. An appointed member sl-iall not be eligible to serv.e continuousl for more than two terms. y 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 p aces of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section .5 of the Administrative lixpenses Act of 1946 (S IJ.S.C. 73b-2) for persons @in the Government service employed ititcmittentlyj f(d)] (c) l@c Cotinci.1 shall advi.se Cited assist tire rtirgcon (;Cjici-,ill Secretary in the preparation of regulations for, and is to policy matters arising wi,th respect to the administration of thi.s title. The Council shall consider ill. application for grants ui or this title and shall 'make recommendations to the Uurgeon wi I n (lenerall SocretaEz tli respect to @ipproval of appl'catio s for a the-aniotmts of grants under this title. 'See explanatory addenda page 10. 12 RI-.C)UUrIONS Sec. 906. 'llic E,%Ygeon General] Secretary, after Consultation with the Council shall prescribe go eral regulations covering the terms and conditions for approving applications for grants under this title and the coordination of programs assisted under this title with prograitis, for training, research, and deiTionstrations relating to the same diseases assisted or Authorized under titles of this Act or other Acts of Congress. INFOIMTION ON Slll;cIAL IRE-ATMFM' AND MINING Cl-@,RS Sec. 907. The [,Si,irgeon General] Secretary, shal.1 establish, and. maintain on a current basis, a list or list@ 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, tor stroke.1 stroke, or kidney disease, together with such related information, including the a of advanced specialty training in such facilities, as lie deeiii-,, useful, and shall make such list or list.-, and related i-nfonaition 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 rurgeon Generall Secretary shall from time to tinie@con,-;u'lt with interested nati-o@@ro essi.onal organizations. RFPOI@l' Sec. 908. On or before Jtjjic 30, l@)67, the Surgeon ,iftet- consultation with the Council, shall submit to the Soci-etarv for transmission to the President and then to the (,otigress, 6 report of the activities under this title together with (1) a statement of the relationship between Federal financing and fim-incing 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, and (3) recommendations with respect to extension or modification of this title in the light thereof. RECOIZDS ANI) Atfl)ll' sec. @)09. (a) Each recipient of a grant or coritrj(,t tender tlii.,; title ;Iiall keep such record.,; as the LSurgoo Secr(@t@,ii, esttibe, inc -C may I)r lLiditig records wfiic.-Ii fully disc.I Os 0 t@ o@iTcl 6L 6 t and disposition by such recipient Of the proceeds of such grant or contract, the total cost of the project or undertaking in confection with whi@h.such grant or contract is made or used, ,Ind the imc)tiiit of that portion of the cost o t e project or undertaking ,upplied by other sources, and such records as will facilitate an effective it. 13 (1)) 'I'lic Secretary of Ifealth, Education, @iiici Wel.4-arc, and the (,:oniptrollor General of the United States, or any of their duly author- 1.zed representatives,, shall have access for the purpose of audit and examination to any books, documents, papers, aInd records of the t6cipient of any grant under this title which are pertinent to any Stich grant. LPROJECT GRANTS FOR MULTIPROGRAM SERVICES ESec. 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 (Ise to any two or more regional medical progi@,ims.) KJLTIIIROGRAM SERVICES Sec. 9@tO. (a) 'ro facilitate interregional cooperation, and develop 1.1111)1,ovcd national cijpal)ilit alth services, the 'Secrctai-y is authorized to Litilize -funds appropriat d under this title to ni,.ike grants to public or nonprofit private a@encies@or institutions or cojnl)inations thereof- and to contract for programs, services, and activities of substantial use to two or more regional m i@al programs; (2) devel@ent, trial, or demonstration of methods for control 01- heart'disease, cancer, stroke, kidnjy- disease, or other related and study of epidemiologic data related to eferred to in paragr (2); (4) development of training specifically e@atod to the pre- vention, diagnosis, or treatment of any of the diseases ref-orred to in paragraph (2),, or to the rehabilitation o=er8Ons su.f-- feri@g from,an-Y of such diseases; and for continuing programs of -such trai.ning where shortag of trainefp-ersonnel would ot e i.-,c limit application of knowledge and s ills important to the control of any o suc diseases;; and rr conduct of cooperative clinical field trials. (b) T retary is authorized@to assist in meeti costs of )eci4l projects for. roving or developing new means for the delivery Ol.., liOAlth services concerned with the diseases with which this title is toncerned. reta authorized to's@ort research, studies, Inv ations, tra:Lnipg, and demonstrations designed to maximize the utilization of Wpower in the delivery of health services. 14 ORITIE-R NEW PROVISIONS RELL-VANF l'O l@-GIONAL MEDICAL PROCP,41S IN P.L. 91.-515 TITLE II - PART fi ADMINISTRATION OF GRANTS IN Cl@R'rAIN MIITl('@PANT I-R(IJE(,-FS @ec. 310A. l@',or the purpose of- 1',tci I it,,@itij-ig the ,A(bnitilsty-;jtjori of, and c)cpc(li-ting the carrying out o(' @tlic purposes of, the progT-@l,fT)S established b title IX and sections 304,314(,i), il4(l@)) 314(c), y p I 314(d), and 314(c) of thi,s Act in situations in which grants are sought or made under two or more of' such programs with respect to a single reject, the Secretary is authorized to promulgate regu- p rations -- (1) under which the a(bninistrati.ve functions under s 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 sul)- miited with respect to such project, and otherwise to S3-inplify, consolidate and make uniform (to the extent feasible), the data and information required to be contained in such appil- cations, reports, and other materials; ind (3) under which inconsistent or duplicative requirements im- posed@by such programs will be revised and made uniform with respect to such project; except that nothin2 in this section shall be construed to authorize the Secretary to @ive or suspend, with respect to any such project, any requirement with respect to any of such programs if -;uch require- ment is imposed by law or by any regulation required by law. TITLE 11 - PART 1 ANMJAL REPORT 310B. On.or before January I of each year, the Secretary shall@ transmit to the Congress a report of the Activities carried on under the.provisions of title IX of this Act and sections 304, 305, 314(a),, 314(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@effectivenp,ss 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 relati.onsliip.betweeri Federal financing and financing from other sources of the Ictivities undertaken pursuant to such provisions (including the possibilities @foi- more efficient Support of such activities thrOLILh use o-f" ,ilterTuito. sources of financing after an initial period of support under such DIrovi-,i.ons), and@(3) such recomenclitions with respect to such pro- visions,as he deems appropriate. - 15 - VT ('OMf'FNSATION FOR NATIONAL ADVISORY COIN(',Iils Amends sect.-'Lon 208 of the Public'Health Services Act to read: "(C) Members of the National Advisory tlealth Council and mem- bet5 of other national advisory or review councils or committees estab- lished under this Act, including members of' the Technical Electronic Product Radiation Safety Sta-ndaPds Committee and the ]3oard of 96g6 t§ of the National Library of Medicine, but excluding ex officio m ts, while attending conferences or meetings of their respective cou iis or committees or while otherwise serving at the request of the et4ry. shall be entitled to receive compensation at rates to be fix by the Secretary, but at rates not exceeding the daily c uiv ent of the rate specified at the tim of such service for ad6 4 el gT ('IS-18 of the Genera,I Schedul.e, 'Including ti-aveltime; and while away from their homes or regular Places of business they may be allowed tr cl@ ex-penses,,including-per them in lieu of subsistence, as iuth6rii6d by section 5703(b) of title 5 of the United States'Code for sons in the Goverrmeni service employed intermi.ttentlY.".@, r@ tory Addenda to Section 905 National Advisory Council. e persons first appointed under section 905,(a) of the lic Health Service Act to serve as the four additional members 6 @t e tional Advisory Council on Regional! Medical Programs au orized by the amendment made by subsection (a) of.this section 7- (1) one shall serve for aterm of one year, (2) one shall serve for aterm of tivo years, (3) one shall serve for aterm of three years, and (4) one shall ser've for aterm of four years, as designated by'the Secretary of flealth, Education, and Wclfatb at the time of appointment." ers of the@National Advisory Council on Regional Medical PT6g am5 (other than the Surgeon General) in office on the date Of@e ctneiat of this,Act shall continue in offi,ce in accordance i the term of office for which, they were last appointed to, he Counciltv 16