mu medical SPECIAL ISSUE FOR LIMITED DISTRIBUTION ee service O__service -NeWwsS einformation A communication device edata designed to speed the exchange of news, LEGISLATION EXTENDED AND AMENDED For Regional Medical information and data on Regional Medical Progra Programs - Public Law 91-515 and related activities. November 20, 1970 - Vol. 4, No. 515 On October 30, 1970, the President signed Public Law 91-515 which extends and amends the Regional Medical Programs legislation, as well as that of Comprehensive Health Planning and Services, the National Center for Health Services Research and Development and the National Center for Health Statistics. To reflect the details of this action, a copy of Title I of the new law (P.L. 91-515) referring to Regional Medical Programs specifically, and parts of certain other titles relevant to Regional Medical Programs, are reproduced in the first part of this issue. To indicate how the total Regional Medical Programs law now reads as part. ofthe Public Health Service Act, all changes have been interpolated into the original law (Public Law 89-239, as amended by Public Law 90-574) on the pages that follow. Deletions in the previous law are shown’ in {brackets} , while the new legislative language is underscored. Distribution: . Coordinators of Regional Medical Programs : Members of National Advisory Council. and Review Committee on Regional Medical Programs . Staff of Regional Medical Programs Service Regional Health ‘Directors and Regional Medical Programs Service Representatives of Health, Education, and Welfare Regional Offices. — U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public: thealth Service «© Health Services and Mental Health Administration ¢ Rockville, Maryland 20852 Public Law 91-515 91st Congress, H. R. 17570 October 30, 1970 An Act To nmend titles TIT and IX of the Public Health Service Act so as to revise, extend, and improve the programs of research, investigation, education, training, and demonstrations authorized thereunder, and for other purposes. Be it enacted by the Senate and House of Lepresentatiues af the United States of America in Congress assembled, Public Health Service Aut, TITLE [--AMENDMENTS TO TVPELE TX OF THK PUBLIC aumariineritt » ITEALTIL SERVICE ACT : Sec. (Of. This tithe may be cited as the “Heart Disease, Cancer, Citation of Stroke, aid Kidney Diserse Amendments of L970". title. See. 102. Section 900 of the Public Health Servier Act is amended 79 Stat. 926. to read as follows: 42 ISU 299. “PURPOSES See. 900. The purposes of this title are—- Gt) Chreough grants and contracts, to encourage and assist in the establistuuent of regional cooperative arrangements ‘mong medical sehools, research institutions, nnd hospitals for research "pte and training (including continuing education), for medical data | aad exchange, and for demonstrations of patient care in the fields of er heart disease, cancer, stroke, and kidney disease, and other | .- related diseases ; Ba Satay Ley? “(b) to afford To the medical profession and the medical tast) 94 -STAT. 125% tutions of dhe Nation, through such cooperative arrangements, the opportunity of making available to their patients the latest addyarices in the prevenGon, diagnosis, ancl treatment and rela. bilitation of persons suffering from these diseases ; “(c) to promote and foster regional linkages among health cure tistitutions and providers so as to strengthen and improve primary care and the relationship between specialized antl pri- mary care; and Sf “(d) by these means, to improve generally the quality and enhance the capacity of the health manpower ‘and facilities availible to the Nation and to improve health services for persoms residing in arents with Hinited 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 cooper- ation with practicing physicians, medical centér officials, hospi- tal adininistrators, and representatives from appropriate voluntary. health agencies.” Sec. 103. (a) (1) The. first sentence of section 901(a) of such appropriations, Actois amended: by striking out “and” immediately after “June 30, 82° Stat, leo, 1969," and by “inserting immediately before’ “, for . grants? 42 0 770. the following: “, $125,000,000 for the fiscal year ending June 30, 1971, e. $150,000,000 for the fiseal year ending June 30, 1972, and $250,000,000 for the fiscal year ending Sune 30, 1972”, (2) Such first sentence is further amended by striking out the period after “tithe? and inserting in lieu thereof “and for contracts to carry out the purposes of this title.” (3) Such section 901 (ay is amended by striking out the second: Funds, Vint sentence and inserting in View thereof the following: “Of the sums tatton, appropriated under this section for the fiseal year ending June 30, 1971, notmore Chan $14,000,000 shall be available for activities in the field H2-O67 OF 79 Stat. 9263 82 Stat, 1006. 42 USC 2998, 1298 1299 G4 STAT. 84 STAT. 42 USC 799b, 42 USC. 299.4 42 USC 299d. National Ad= visory Courctl on Regional Medical Prow gramss 42 USC 299e, Pub. Law 91-515 October 30, 1970 of. kidney disease. Of the sums appropriated under this section for any fiscal year ending after June 30, 1970, not move than $4,000Q00 mary be made available in any such fiseal year for prants for new construction.” (b) Section 901 of such Aet is further amended by adding at the end thereof the following new subsection ; “(o) At the reqnest of any recipient of a prant under this title, the payments to such recipient may be reduced by the fair market value of any equipment, supplies, or services furnished by Che Secretary to such recipient and by (he amount of the pay, allowance, {reveling expenses, and any other costs in convection with (he detail of un officer or em- ployee of the Government to the recipient. when such furnisling or such detail, as the case may be, is for the convenience of and nt the request. of such recipient. and for the purpose of carrying out the regions] medical program to which the grant under this title 1s made.” Src. 104, Section 902(a) of such Act is amendéd by striking out “training, diagnosis, and treatment relating to heart disense, cancer, or stroke, and, at the option of the applicant, related disease or diseases” and inserting in lieu thereof “training, preveution, diagnosis, treatment, and rehabilitation relating to heart disease, cancer, st rokes or kidtiey disease and, at the option of the applicant, other relates diseases”, . (b) Section 902(¢1) is amended. by striking ont “inchides”. and inserting in lieu thereof “means new construction of facilities for demonstrations, research, and training: when necessary to carry ont regional medical programs”. Sec. 105. Section. 903(b) (4) of such Act is amended-—- (1). by striking out “voluntary health agencies, and” and insert- ing in lieu thereof “voluntary or official health agencies, health planning agencies, and”; (2) by inserting immediately after “under the program”, where it first appears therein, the following : “(including as an ex officio member, if there is located in such region one or more hospitals er other health facilities of the Veterans’ Administration, the indi- vidual whom the Administrator of Veterans’ Affairs shall have designated to serve on such advisory group as the representative of the hospitals or other. health care facilities of such Admin- istration which are located in such region)”; and (3) by striking out “need for the services provided under the program” and inserting in lien thereof “need for and financing of the services provided under the program, and which advisory group shall be sufficient. in number to insure adequate community orientation (as determined by the Secretary)”. Sec. 106. That part of the second sentence of section 904(b) of such Act preceding paragraph (1) is amended by striking out. “section 903(b) (4) and” and inserting in lieu thereof the following : “section 903(b) (4), if opportunity has been provided, prior to such recom- mendation, for consideration of the application by each public or non- profit, private agency or organization which has developed a compre- hensive: regional, metropolitan area, or other local area plan referred to in section 314(1) covering any area in which the regional medical program for which the application is made will be located, and if the application”. Sec. 107. (a) Section 905(a) of such Act is amended to read as follows: “Sec. 905. (a) The Secretary may appoint, without regard to the civil service laws, a National Advisory Conneil on Regional Medical Programs. The Council shall consist of the Assistant Secretary of Tlealth, Education, and Welfare for Health and Scientific Affairs, who ( ( October 30, 1970 | Pub, Law 91-515 shall be the Chairman, the Chief Medical Director of the Veterans’ Administration who. shall be an ex officio member, and. twenty mene bers, not otherwise in the regular full-time employ of the United States, who are leaders in the fields.of the fundatnental sciences, the inedical sciences, hientth care administration, or public aitiirs. At least twoof the appointed members shall be practicing plysiciins, one shall be outstanding de the study or health ere of persons suffering fror henrt disease, one shall be joutstanding in the study or health eare of persons saffering from cancer, one shall be outstanding tthe study or health care of persons.suffering from stroke, one sliall be outst and ing in the study or health care of persons sulfering from kidney disease, dwo shill be outstanding in-the field of prevention of heart disease, enticer, stroke, or kidney disease, and four shall be members of the pablie.? (hy be the persons first appointed under section 905(a) of the Pubbie Tfealth Service Act to servecas the four additional members of the National Advisory Council on Regional Medical Programs author. ized by the amendinent. made by subsection (a) of this seetion (1). one shathserve fora term of one year, (2) one shall serve for’a ferm of two years, (3) one shall serve for a term of three years, and . Cd) one shall serve for aterm of four years, as designated by the Secretary of Health, Mducation, and Welfare at the tine of appoimtuient. (e) Mombers ofthe Natioual Advisory Councifon Regional Medical Programs (other than the Surgeon General) in oflice on the date of enactinent of this Act shall continue in office in accordance with the terin of office for which they were last appointed to the Council. SEC. 108, Seetion 107 of such Act is amended by striking out “or stroke,” and inserting in lieu thereof “stroke, or kidney disease”. See. 100, Section 909(a) of such Act is amended by inserting contract” after “grant” each place if. appears therein. See: 110, (a) Section 910 of such Act is amended te read as follows : aoe “SSEUCTEPROURAM KERVICES ese UI (a) To facilitate interregional cooperation, tnd develop improved national capability for delivery of health services, the Secre- tary is authorized to utilize funds appropriated ander this title to niatke grants to public or nonprofit private agencies: or inst itutions or com binations thereof-and to contract. for— “(1) programs, services, and activities: of substantial use to two or more regional medical programs ; “(2) development, trial, or demonstration of inethods for con- trol of heart disease, cancer, stroke, kidney disease, ov other related . disvases: “(3) the collection and study ‘of epidemiologic data related to any of the. diseases referred to in paragraph (2) ; “(F) development of training specifically related to. the pre- vention, diagnosis, or treatment of any of the diseases re ferred to in paragraph (2), or to the rehabilitation of persons suffering from any of stitch diseases; and for continuing programs of such training where shortage of trated, personne! would cother wise limit application of knowledge and skills important to Cie control of any of such diseases: tnd “(5). the. conduct, of cooperative clinical field trials: “(by The: Secretary is authorized to assist. in meeting the costs of special projects for improving or developing new means for the deliv- ery of health services concerned with the disenses with which this title is concerned, 84 Stal, 1300 Tarn of affine. Tt State F406 42 SO 299K. AP UOT 8994, 62 Htat,. 1OG4, 42 USC 2994. Pub, Law 91-515 October 30, 1970 ‘. tea SVAT. LSUL _ “(e) The Secretary is authorized to support research, studies, investigaiighs, training, and demonstrations desipned to maximize the utilization of manpower in the delivery of health services.” See. TEL. (a) The heading to title EX of such Act is- amended by striking out “STROKE, AND RELATED DISEASES” and insert- ing in lieu thereof “STROKE, KIDNEY DISEASE, AND OTHER RELATED DISEASES”. 42° SC 299n— (b) Sections 902(a), 908(u), 9O3(b), oni (a), 04 (b), 905(b), 2599Ry 29914 105 (d), 906, 907, and 909(a) of such Act (as amended by the preceding provisions of this Act) are each further amended by striking out “Surgeon General”, each place it appears therein and inserting in Jieu thereof “Sccretary”. & * * x * : * Other New Provisions Relevant to Regional Medical Programs: In P.L. 91-515 . TITLE TH AMENDMENTS TO ‘TEPTLE ED OF THE PUBLIC HEALTH SERVICE ACT * k * * x ee a © Paar HH Apminisirnarion or Grants in Critrarn Murrigrant Progecrs See 270, Part Avof Gthe TEE of the Public Health Service. Act is 5! -tet. fds ameidéd by adding atthe end thereof the following new section: to rie : Oo CA jw “Administration of Grants in Certain Multigrant Projects 24Phe “Sec. SIOA. For the purpose of facilitating the administration of, tied expediting the carrying out of the purposes, of, the programs established by tithe TX, and sections 304, 314(a), 314(b), 314(e), ALE(d), and SLE(e) of this Act in situations in which prants are sought date, pre 147, 6r made under two or more of such programs with respect fo a single 1404. — project, the Secretary is authorized to promulgate regulations “(Ly under which. the administrative functions under such programs with respect to sueh project: will be performed by a single administrative unit which is the administrative anit charged with the administration of any of such programs or is the administrative unit charged with the supervision of two or = tpore of snely programs > “(2) designed to reduce the munber of applications, reports, ad other anaterinds required. under such programs to be sub- anitted with respect..to such project, and otherwise to simplify, . consolidate, ind make uniform (to the extent feasible), the data and information required ‘to be contained in such applications, “ Yeporis. and ot her materials; and - “Os) under which meonsistent or duplicative requirements im- posed by sueh programs will be revised and made uniform with crespeet. to such project; : except that. nothing inthis seetion shall be construed to authorize the ~ Seeretary to waive or suspend, with respect to any such project, any reqitirenient with: respect to any of stteh programs tf such requirement is impored by law or by dny-regulation required by law.” ~ 46 c 84 STAT. 1307 Anke, ppe leo7, 1304, Pub. Law 91-515 October 30, 1970 Parr J—Anwear Revort, Nvmonan Apvisory Counen, Ere. Sec. 280. Part A of title III of the Public Health Service Act. is further amended by adding after section 310. thereof (as added by section 270 of this Act) the following new section: “Annual Report “3102. On or before January tof each year, the Secretary shall transmit. to the Congress a report of the activities carried on under the provisions of tithe TX of this Act and sections 301, 805, S14 (0), 3H thy. BLA(e), 314 (d), and SEE(e) of this ttle (ogether with (1) an evaluation of the effectivencss of such activities in improving the elfi- ciotiey and: effectiveness of The researeh, planning, and delivery of health services in carrying oul. the purposes for which such provisions were enacted, (2) a statement of the relationship between Federal linuieing and financing from other sources of the activities under. tuken pursuant to such provisions (including the possibilities for more efficient support of such activities through use of allernate: sonrees -of financing after