NEW © FILE BEGINS B&B INFORMATION & IMAGE MANAGEMENT 3009 Pemce Seorar’s BouLlevarp UPecR MARLSORD, MaryLanpd 20772 ° UBA © (351) 2449-50110 Public Law 89-239 89th Congress, S. 596 October 6, 1965 An Act To amend the Public Health Service Act to assist in combating heart disease, cancer, stroke, and related diseases. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled. That this Act may be cited as the “Heart Disease, Cancer, and Stroke Amendments of 1965”. Src. 2. The Public Health Service Act (42 U.S.C., ch. 6A) is amended by adding at the end thereof the following new title: “TITLE IX—EDUCATION, RESEARCH, TRAINING, AND DEMONSTRATIONS IN THE FIELDS OF HEART DIS- EASE, CANCER, STROKE, AND RELATED DISEASES “PURPOSES “Sec. 900. The purposes of this title are— “(a) Through grants, to encourage and assist in the establishment of regional cooperative arrangements among medical schools, research institutions, and hospitals for research an training (including con- tinuing education) and for related demonstrations of patient care in the fields of heart disease, cancer, stroke, and related diseases ; “(b) To afford to the medical profession and the medical institu- tions of the Nation, through such cooperative arrangements, the oppor- tunity of making available to their patients the latest advances in the diagnosis and treatment of these diseases; and “(c) By these means, to improve generally the health manpower and facilities available to the Nation, 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 ospitals, and in cooperation with practicing physicians, medical cen- ter officials, hospital administrators, and representatives from appro- priate voluntary health agencies. “AUTHORIZATION OF APPROPRIATIONS “Sec. 901. (a) There are authorized to be appropriated $50,000,000 for the fiscal year ending June 30, 1966, $90,000,000 for the fiscal year ending June 30, 1967, and $200,000,000 for the fiscal year ending June 30, 1968, for grants to assist public or nonprofit private universities, medical schodls, research institutions, and other public or nonprofit private institutions and agencies in lanning, in conducting feasi ility studies, and in operating pilot projects for the establishment, of re- gional medical programs of research, training, and demonstration activities for carrying out the purposes of this title. Sums appro- priated under this section for any fiscal year shall remain available for making such grants until the end of the fiscal year following the fiscal year for which the appropriation is made. “(bp A grant under this title shall be for part or all of the cost of the planning or other activities with respect to which the application is made, except that any such grant with respect to construction of, or provision of built-in (as determined in accordance with regula- tions) equipment for, any facility may not exceed 90 per centum of the cost of such construction or equipment. “(c) Funds appropriated pursuant to this title shall not be avail- able to pay the cost of hospital, medical, or other care of patients 79 STAT, 926 Heart Disease, Cancer, and Stroke Amend» ments of 1965, 58 Stat. 682. 42 USC 201 note. Pub. Law 89-239 -~2- October 6, 1965 - 79 STAT. 927 _79 STAN. 927 except to the extert it is, as determined in accordance with regule- tions, incident to those research, training, or demonstration activities which are encompassed by the purposes of this title. No patient shal) be furnished hospital, medical, or other care at any facility incident to research, training, or demonstration activities carried out with funds appropriated pursuant to this title, unless he has been referred to such facility by a practicing physician. “DEFINITIONS “Sec, 902. For the purposes of this title— “(a) The term ‘regional medical program’ means a cooperative arrangement among @ group of public or nonprofit: private institu- tions or agencies engaged in research, training, diagnosis, and treat- ment relating to heart disease, cancer, or stroke, and, at the option . of the applicant, related disease or diseases; but only if such group— “(1) is situated within a geographic area, composed of any part or parts of any one or more States, which the Surgeon Gen- eral determines, in accordance with regulations, to be appropri- ate for carrying out the purposes of this title; “(2) consists of one or more medical centers, one or more clin- ical research centers, and one or more hospitals; and “(3) has in effect coo erative arrangements among its com- ponent units which the Surgeon General finds will be adequate for effectively carrying out the purposes of this title. “(b) The term ‘medical center’ means a medical school or other medical institution involved in postgraduate medical training and one or more hospitals affiliated therewith for teaching, research, and demonstration purposes. “(¢) The term ‘clinical research center’ means an institution (or part of an institution) the primary function of which is research, training of specialists, and emonstrations and which, in connection therewith, provides specialized, high-quality diagnostic and treat- ment 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 is 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 which is owned and operated by one or more nonprofit corporations or associations no part of the net earn- ings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual. “(f) The term ‘construction’ includes alteration, major repair (to the extent permitted by regulations), remodeling and renovation of existing buildings (including initial equipment thereof), and replace- ment of obsolete, built-in. (as determined in accordance with regula- tions) equipment of existing buildings. “GRANTS FOR PLANNING “So, 908. (a) The Surgeon General, upon the recommendation of the National Advisory Council on Regional Medical Programs estab- lished by section 905 (hereafter in this title referred to as the ‘Council’), is authorized to make grants to public or nonprofit private universities, medical schools, research institutions, and other public or nonprofit private agencies and institutions to assist them in planning the development of regional medical programs. October 6, 1965 -3- Pub. Law 89-239 79 STAT, 928 *(b) Grants under this section may be made only upon application therefor approved by the Surgeon General. Any such application may be approved only if it contains or is supported by— «¢ DD reasonable assurances that Federal 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 procedures as are required by the Surgeon General to assure proper disbursement of and ~ accounting for such Federal funds; “(8) reasonable assurances that the applicant will make such reports, in such form and containing such information as the Surgeon General may from time to time reasonably require, and will keep such records and afford such access thereto as the Sur- , geon General may find necessary to assure the correctness and verification of such reports; and “(4) a satisfactory showing that the applicant has designated an advisory group, to advise the applicant (and the institutions and agencies participating in the resulting regional medical program) in formulating and carrying out the plan for the estab- ishment and operation of such regional medical program, which advisory group includes practicing physicians, medical center officials, hospital administrators, representatives from appropri- ate medical societies, voluntary ealth agencies, and representa- tives of other organizations, institutions, and agencies concerned with activities of the kind to be carried on under the program and members of the public familiar with the need for the services provided under the program. “GRANTS FOR ESTABLISHMENT AND OPERATION OF REGIONAL MEDICAL PROGRAMS “Suc. 904. (2) The Surgeon General, upon the recommendation - of the Council, is authorized to make grants to public or nonprofit private universities, medical schools, research institutions, and other public or nonprofit private agencies and institutions to assist. in establishment and operation of regional medical programs, including construction and equipment of facilities in connection therewith. “(b) Grants under this section may be made only upon application therefor approved by the Surgeon General. Any such application may be approved only if it is recommended by the advisory group described in section 903(b) (4) and contains or is supported by reason- able assurances that— “(1) Federal funds paid pursuant to any such t (A) will be used only for the purposes for which paid and in accordance with the applicable provisions of this title and the regulations thereunder, and (B) will not supplant funds that are otherwise available for establishment or operation of the regional medical program with respect to which the grant is made; “(2) the applicant will provide for such fiscal control and fund accounting procedures as are required by the Surgeon General to ae proper disbursement of and accounting for such Federal unds; - “(3) the applicant will make such reports, in such form and Records, containing such information as the Surgeon General may from time to time reasonably require, and wil keep such records and 79 STAT, 929 49 Stat, 1011; 78 Stat. 238, 64 Stat. 1267, 63 Stat. 108, Appointment of members, Term of office, Compensation, 60 Stat. 8083 75 State 339,340, Applieations for grants, recom= mendations, Pub. Law 89-239 74-0 October 6, 1965_ afford such access thereto as the Surgeon General May find neces- sary to assure the correctuess and Verification of such reports; and “(4) any laborer or mechanic employed by any contractor or subcontractor in the performance of work on any construction aided by payments pursuant to any grant under this section will be paid wages at rates not less than those prevailin on similar construction in the locality as determined by the ecretary of Labor in accordance with the Davis-Bacon Act, as amended (40 U.S.C. 276a—276a-5) ; and the Secretary of Labor shall have, with respect to the labor standards specified in this paragraph, the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 F.R. 3176; 5 U.S.C. 133z-15) and sec- tion 2 of the Act of June 13, 1934, as amended (40 U.S.C. 276c). “NATIONAL ADVISORY COUNCIL ON REGIONAL MEDICAL PROGRAMS _, SEC. 905. (a) The Surgeon General, with the approval of the Secretary, may appoint, without regard to the civil service laws, a National Advisory Council on. Regional Medical Programs. The Council shall consist of the Surgeon General, who shall be the chair- man, and twelve members, not otherwise in the regular full-time employ of the United States, who are leaders in the fields of the fundamental sciences, the medical sciences, or public affairs, At least two of the appointed members shall be practicing physicians, one shall be outstanding in the study, diagnosis, or treatment of heart disease, one shall be outstanding in the study, diagnosis, or treatment of cancer, and one shall be oustanding in the study, diagnosis, or treatment of stroke, “(b) Each appointed member of the Council shall hold office for a term of four years, except that any member appointed to fill a vacancy prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term, and except that the terms of office of the members first taking office shall expire, as designated by the Surgeon General at the time of appoint- ment, four at the end of the first year, four at the end of the second year, and four at the end of the third year after the date of appoint- ment. An appointed member shall not be eligible to serve continu- ously for more than two terms. &Ce) Appointed members of the Council, while attending meet- ings or conferences thereof or otherwise serving on business of the Council, shall be entitled to receive compensation at rates fixed b the Secretary, but not exceeding $100 per day, includin traveltime, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per diem in Neu of subsistence, as authorized by section 5 of the Administrative Expenses Act of 1946 (5 U.S.C. %3b-2) for persons in the Govern. ment service employed intermittently. “(d) The Council shall advise and assist the Surgeon General in the preparation of regulations for, and as to policy matters arising with respect to, the administration of this title. The Council shall consider all applications for grants under this title and shall make recommen- dations to the Surgeon General with respect to approval of applica- tions for and the amounts of grants under this title, October 6, 1965 ~ 5 - Pub. Law 89-239 79 STAT, 930 “REGULATION & ., SEC. 906. The Surgeon General, after consultation with the Coun- ceil, shall prescribe general regulations covering the terms and con- ditions for approving applications for grants under this title and the coordination of programs assisted under this title with programs for training, research, and demonstrations relating to the same diseases assisted or authorized under other titles of this Act or other Acts of Congress. “INFORMATION ON SPECIAL TREATMENT AND TRAINING CENTERS “Sec. 907. The Surgeon General shall establish, and maintain on a current basis, a list or lists of facilities in the United States uipped and staffed to provide the most advanced methods and tec niques in the diagnosis and treatment of heart disease, cancer, or stroke, together with such related information, including the availability of ‘ - advanced specialty training in such facilities, as he deems useful, and shall make such list or lists and related information readily avail- able to licensed practitioners and other persons requiring such infor- mation. To the end of making such list or lists and other informa- tion most useful, the Surgeon General shall from time to time consult. with interested national professional organizations, “REPORT “Sec. 908. On or before June 30, 1967, the Surgeon General, after Report to consultation with the Council, shall submit to the ecretary for trans- President and mission to the President and then to the Congress, a report of the Congress. activities under this title together with (1) a statement of the relation- ship between Federal financing and financing from other sources of the activities undertaken pursuant to this title, (2) an appraisal of the activities assisted under this title in the light of their effectiveness in carrying out the purposes of this title, and (8) recommendations with respect to extension or modification of this title in the light thereof. “RECORDS AND AUDIT “Sxc. 909. (a) Each recipient of a grant under this title shall keep such records as the Surgeon General may prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such grant, the total cost of the project. or under- taking in connection with which such grant is made or used, and the amount of that portion of the cost of the project or undertaking supplied by other sources, and such records as will facilitate an effec- tive audit. “(b) The Secretary of Health, Education, and Welfare and the Comptroller General of the United States, or any of their duly author- ized representatives, shall have access for the purpose of audit and examination to any books, documents, papers, and records of the recipient of any grant under this title which are pertinent to any such grant.” Src. 3. (a) Section 1 of the Public Health Service Act is amended 58 Stat. 682, to read as follows: “Section 1. Titles I to IX, inclusive, of this Act may be cited as 42 USC 201+ the ‘Public Health Service Act?.” 29Bbe 79 STAT, 931 Pub, Law 89-239 -6- October 6, 1965 42 usc 201 notee (b) The Act of July 1, 1944 (58 Stat. 682), as amended, is further amended by renumbering title IX (as in effect prior to the enactment of this Act) as title X, and by renumbering sections 901 through 914 (as in effect prior to the enactment of this Act), and references thereto, as sections 1001 through 1014, respectively. Approved October 6, 1965, 10:15 a.m. LEGISLATIVE HISTORYs HOUSE REPORT No. 963 accompanying H. R. 3140 (Comm, on Interstate & Foreign Commerce). SENATE REPORT No, 368 (Comm, on Labor & Public Welfare). CONGRESSIONAL RECORD, Vol. 111 (1965): June 252 Considered in Senate. June 28! Considered and passed Senate. Sept. 23: H. R. 3140 considered in Houses Sept. 24: Considered and passed House, amended, in lieu of H. R. 3140, Sept. 29: Senate concurred in House amendments. GPO S0.139