To provide for the establishment of Offices of Minority Health.

SA 2878. Mr. CARDIN submitted an amendment intended to be proposed to
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

At the appropriate place, insert the following:

TITLE __MINORITY HEALTH

SEC. __01. OFFICE OF MINORITY HEALTH.

(a) In General.--Section 1707 of the Public Health Service
Act (42 U.S.C. 300u-6) is amended--
(1) in subsection (a), by striking ``within the Office of
Public Health and Science and all that follows through the
end'' and inserting ``. The Office of Minority Health as
existing on the date of enactment of the Patient Protection
and Affordable Care Act shall be transferred to the Office of
the Secretary in such manner that there is established in the
Office of the Secretary, the Office of Minority Health, which
shall be headed by the Deputy Assistant Secretary for
Minority Health who shall report directly to the Secretary,
and shall retain and maintain an Advisory Committee on
Minority Health as provided for under subsection (c).'' and
(2) by striking subsection (b) and inserting the following:
``(b) Duties.--With respect to improving the health of
racial and ethnic minority groups, the Secretary, acting
through the Deputy Assistant Secretary, shall carry out the
following:
``(1) Establish, implement, monitor, and evaluate short-
range and long-range goals and objectives and oversee all
other activities within the Public Health Service that relate
to disease prevention, health promotion, service delivery,
and research concerning minority groups. The heads of each of
the agencies of the Service shall consult with the Deputy
Assistant Secretary to ensure the coordination of such
activities.
``(2) Oversee all activities within the Department of
Health and Human Services that relate to reducing or
eliminating disparities in health and health care in racial
and ethnic minority populations and in rural and underserved
communities, including coordinating--
``(A) the design of programs, support for programs, and the
evaluation of programs;
``(B) the monitoring of trends in health and health care;
``(C) research efforts;
``(D) the training of health providers; and
``(E) information and education programs and campaigns.
``(3) Enter into interagency and intra-agency agreements
with other agencies of the Public Health Service.
``(4) Ensure that the Federal health agencies and the
National Center for Health Statistics collect data on the
health status and health care of each minority group, using
at a minimum the categories specified in the 1997 OMB
Standards for Maintaining, Collecting, and Presenting Federal
Data on Race and Ethnicity as required under subtitle B and
available language standards.
``(5) Provide technical assistance to States, local
agencies, territories, Indian tribes, and entities for
activities relating to the elimination of racial and ethnic
disparities in health and health care.
``(6) Support a national minority health resource center to
carry out the following:
``(A) Facilitate the exchange of information regarding
matters relating to health information, health promotion and
wellness, preventive health services, clinical trials, health
information technology, and education in the appropriate use
of health services.
``(B) Facilitate timely access to culturally and
linguistically appropriate information.
``(C) Assist in the analysis of such information.
``(D) Provide technical assistance with respect to the
exchange of such information (including facilitating the
development of materials for such technical assistance).
``(7) Carry out programs to improve access to health care
services for individuals with limited English proficiency.
``(8) Carry out programs to improve access to health care
services and to improve the quality of health care services
for individuals with low functional health literacy. As used
in the preceding sentence, the term `functional health
literacy' means the ability to obtain, process, and
understand basic health information and services needed to
make appropriate health decisions.
``(9) Advise in matters related to the development,
implementation, and evaluation of health professions
education on decreasing disparities in health care outcomes,
with focus on cultural competency as a method of eliminating
disparities in health and health care in racial and ethnic
minority populations.
``(10) Assist health care professionals, community and
advocacy organizations, academic centers and public health
departments in the design and implementation of programs that
will improve the quality of health outcomes by strengthening
the provider-patient relationship.
``(11) In carrying our this subsection--
``(A) award grants, contracts, enter into memoranda of
understanding, cooperative,

[[Page S12347]]

interagency, intra-agency and other agreements with public
and nonprofit private entities, agencies, as well as
Departmental and Cabinet agencies and organizations; and
``(B) award grants, contracts, enter into memoranda of
understanding, cooperative and other agreements with
organizations that are indigenous human resource providers in
communities of color to assure improved health status of
racial and ethnic minorities.
``(12) Directly or through contracts with public and
private entities, agencies, and nonprofit organizations,
provide for evaluations of projects carried out with awards
made the Office and for the dissemination of information
developed as a result of such projects.'';
(3) by redesignating subsections (f) through (h) as
subsections (g) through (i), respectively;
(4) by inserting after subsection (e) the following:
``(f) Preparation of Health Professionals To Provide Health
Care to Minority Populations.--The Secretary, in
collaboration with the Director of the Bureau of Health
Professions and the Deputy Assistant Secretary for Minority
Health, shall require that health professional schools that
receive Federal funds train future health professionals to
provide culturally and linguistically appropriate health care
to diverse populations.''; and
(5) by striking subsection (i) (as so redesignated) and
inserting the following:
``(i) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for each of fiscal
years 2011 through 2016.''.
(b) Transfer of Functions.--There are transferred to the
Office of Minority Health in the office of the Secretary of
Health and Human Services, the Deputy Assistant Secretary for
Minority Health who shall report directly to the Secretary of
Health and Human Services. All duties, responsibilities,
accountabilities and functions exercised by the Deputy
Assistant Secretary for Minority Health and by the Office of
Minority Health of the Public Health Service prior to the
date of enactment of this section shall transfer with the
Office and the Deputy Assistant Secretary for Minority
Health, including all personnel and compensation authority,
all delegation and assignment authority, all committees
including the Advisory Committee on Minority Health and other
committees, entities and councils, and all remaining
appropriations. All orders, determinations, rules,
regulations, permits, agreements, grants, contracts,
certificates, licenses, registrations, privileges, and other
administrative actions that--
(1) have been issued, made, granted, or allowed to become
effective by the President, any Federal agency or official
thereof, or by a court of competent jurisdiction, in the
performance of functions transferred under this paragraph;
and
(2) transfers with the Deputy Assistant Secretary for
Minority Health are in effect at the time this section takes
effect, or were final before the date of enactment of this
section and are to become effective on or after such date,
transfers with and to the Office of Minority Health within
the Office of the Secretary and remain the authority,
responsibility and accountability of the Office;
shall continue in effect according to their terms until
modified, terminated, superseded, set aside, or revoked in
accordance with law by the President, the Secretary, a court
of competent jurisdiction, or by operation of law.
(c) Reports.--
(1) In general.--Not later than 1 year after the date of
enactment of this section, and every second year thereafter,
the Secretary of Health and Human Services shall prepare and
submit to the appropriate committees of Congress a report
describing the activities carried out under section 1707 of
the Public Health Service Act (as amended by this section)
during the period for which the report is being prepared.
(2) Agency reports.--Not later than 1 year after the date
of enactment of this section, and biennially thereafter, the
heads of each of the agencies of the Public Health Service
shall submit to the Deputy Assistant Secretary for Minority
Health a report summarizing the minority health activities of
each of the respective agencies.

SEC. __02. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MINORITY
HEALTH WITHIN AGENCIES OF THE PUBLIC HEALTH
SERVICE.

Title XVII of the Public Health Service Act (42 U.S.C. 300u
et seq.) is amended by inserting after section 1707 the
following section:

``SEC. 1707A. INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN
PUBLIC HEALTH SERVICE.

``(a) In General.--The head of each agency specified in
subsection (b)(1) shall establish within the agency an office
to be known as the Office of Minority Health. The head of
each such Office shall be appointed by the head of the agency
within which the Office is established, and shall report
directly to the head of the agency. The head of such agency
shall carry out this section (as this section relates to the
agency) acting through such Director.
``(b) Specified Agencies.--
``(1) In general.--The agencies referred to in subsection
(a) are the following:
``(A) The Centers for Disease Control and Prevention.
``(B) The Health Resources and Services Administration.
``(C) The Substance Abuse and Mental Health Services
Administration.
``(D) The Agency for Healthcare Research and Quality.
``(E) The Food and Drug Administration.
``(c) Composition.--The head of each specified agency shall
ensure that the officers and employees of the minority health
office of the agency are, collectively, experienced in
carrying out community-based health programs for each of the
various racial and ethnic minority groups that are present in
significant numbers in the United States.
``(d) Duties.--Each head of a minority health office shall
establish and monitor the programs of the specified agency of
such office in order to carry out the following:
``(1) Determine the extent to which the purposes of the
programs are being carried out with respect to racial and
ethnic minority groups;
``(2) Determine the extent to which members of such groups
are represented among the Federal officers and employees who
administer the programs; and
``(3) Make recommendations to the head of such agency on
carrying out the programs with respect to such groups. In the
case of programs that provide services, such recommendations
shall include recommendations toward ensuring that--
``(A) the services are equitably delivered with respect to
racial and ethnic minority groups; and
``(B) the programs provide the services in the language and
cultural context that is most appropriate for the individuals
for whom the services are intended.
``(e) Funding.--
``(1) Allocations.--Of the amounts appropriated for a
specified agency for a fiscal year, the Secretary must
designate an appropriate amount of funds for the purpose of
carrying out activities under this section through the
minority health office of the agency. In reserving an amount
under the preceding sentence for a minority health office for
a fiscal year, the Secretary shall reduce, by substantially
the same percentage, the amount that otherwise would be
available for each of the programs of the designated agency
involved.
``(2) Availability of funds for staffing.--The purposes for
which amounts made available under paragraph may be expended
by a minority health office include the costs of employing
staff for such office.''.

SEC. __03. OFFICE OF MINORITY HEALTH AT THE CENTERS FOR
MEDICARE & MEDICAID SERVICES.

(a) In General.--Not later than 60 days after the date of
enactment of this Act, the Secretary of Health and Human
Services shall establish within the Centers for Medicare &
Medicaid Services an Office of Minority Health (referred to
in this section as the ``Office'').
(b) Duties.--The Office shall be responsible for the
coordination and facilitation of activities of the Centers
for Medicare & Medicaid Services to improve minority health
and health care and to reduce racial and ethnic disparities
in health and health care, which shall include--
(1) creating a strategic plan, which shall be made
available for public review, to improve the health and health
care of Medicare, Medicaid, and SCHIP beneficiaries;
(2) promoting agency-wide policies relating to health care
delivery and financing that could have a beneficial impact on
the health and health care of minority populations;
(3) assisting health plans, hospitals, and other health
entities in providing culturally and linguistically
appropriate health care services;
(4) increasing awareness and outreach activities for
minority health care consumers and providers about the causes
and remedies for health and health care disparities;
(5) developing grant programs and demonstration projects to
identify, implement and evaluate innovative approaches to
improving the health and health care of minority
beneficiaries in the Medicare, Medicaid, and SCHIP programs;
(6) considering incentive programs relating to
reimbursement that would reward health entities for providing
quality health care for minority populations using
established benchmarks for quality of care;
(7) collaborating with the compliance office to ensure
compliance with the anti-discrimination provisions under
title VI of the Civil Rights Act of 1964;
(8) identifying barriers to enrollment in public programs
under the jurisdiction of the Centers for Medicare & Medicaid
Services;
(9) monitoring and evaluating on a regular basis the
success of minority health programs and initiatives;
(10) publishing an annual report about the activities of
the Centers for Medicare & Medicaid Services relating to
minority health improvement; and
(11) other activities determined appropriate by the
Secretary of Health and Human Services.
(c) Staff.--The staff at the Office shall include--
(1) one or more individuals with expertise in minority
health and racial and ethnic health disparities; and
(2) one or more individuals with expertise in health care
financing and delivery in underserved communities.
(d) Coordination.--In carrying out its duties under this
section, the Office shall coordinate with--

[[Page S12348]]

(1) the Office of Minority Health in the Office of the
Secretary of Health and Human Services;
(2) the National Institute for Minority Health and Health
Disparities (as so redesignated by section _05) in the
National Institutes of Health; and
(3) the Office of Minority Health in the Centers for
Disease Control and Prevention.
(e) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums may be necessary for each of fiscal
years 2011 through 2016.

SEC. __04. OFFICE OF MINORITY AFFAIRS AT THE FOOD AND DRUG
ADMINISTRATION.

Chapter X of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 391 et seq.) is amended by adding at the end the
following:

``SEC. 1011. OFFICE OF MINORITY AFFAIRS.

``(a) In General.--Not later than 60 days after the date of
enactment of this section, the Secretary shall establish
within the Office of the Commissioner of Food and Drugs an
Office of Minority Affairs (referred to in this section as
the `Office').
``(b) Duties.--The Office shall be responsible for the
coordination and facilitation of activities of the Food and
Drug Administration to improve minority health and health
care and to reduce racial and ethnic disparities in health
and health care, which shall include--
``(1) promoting policies in the development and review of
medical products that reduce racial and ethnic disparities in
health and health care;
``(2) encouraging appropriate data collection, analysis,
and dissemination of racial and ethnic differences using, at
a minimum, the categories described in the 1997 Office of
Management and Budget standards, in response to different
therapies in both adult and pediatric populations;
``(3) providing, in coordination with other appropriate
government agencies, education, training, and support to
increase participation of minority patients and physicians in
clinical trials;
``(4) collecting and analyzing data using, at a minimum,
the categories described in the 1997 Office of Management and
Budget standards, on the number of participants from minority
racial and ethnic backgrounds in clinical trials used to
support medical product approvals;
``(5) the identification of methods to reduce language and
literacy barriers; and
``(6) publishing an annual report about the activities of
the Food and Drug Administration pertaining to minority
health.
``(c) Staff.--The staff of the Office shall include--
``(1) one or more individuals with expertise in the design
and conduct of clinical trials of drugs, biological products,
and medical devices; and
``(2) one or more individuals with expertise in therapeutic
classes or disease states for which medical evidence suggests
a difference based on race or ethnicity.
``(d) Coordination.--In carrying out its duties under this
section, the Office shall coordinate with--
``(1) the Office of Minority Health in the Office of the
Secretary of Health and Human Services;
``(2) the National Institute for Minority Health and Health
Disparities in the National Institutes of Health; and
``(3) the Office of Minority Health in the Centers for
Disease Control and Prevention.
``(e) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2011 through 2016.''.

SEC. __05. NATIONAL INSTITUTE FOR MINORITY HEALTH AND HEALTH
DISPARITIES.

(a) Redesignation.--
(1) In general.--Title IV of the Public Health Service Act
(42 U.S.C. 281 et seq.) is amended--
(A) in section 401(b)(24), by striking ``National Center on
Minority Health and Health Disparities'' and inserting
``National Institute for Minority Health and Health
Disparities''; and
(B) in subpart 6 of part E--
(i) in the subpart heading, by striking ``Center'' and
inserting ``Institute'';
(ii) in the headings of sections 485E and 485H, by striking
``CENTER'' and inserting ``INSTITUTE''; and
(iii) by striking (other than in section 485E(i)(1)) the
term ``Center'' each place it appears and inserting
``Institute''.
(2) References.--Any reference in any law, map, regulation,
document, paper, or other record of the United States to the
National Center on Minority Health and Health Disparities
shall be deemed to be a reference to the National Institute
for Minority Health and Health Disparities.
(b) Duties; Authorities; Funding.--Section 485E of the
Public Health Service Act (42 U.S.C. 287c-31) is amended--
(1) by amending subsection (e) to read as follows:
``(e) Duties of the Director.--
``(1) Interagency coordination of minority health and
health disparity activities.--With respect to minority health
and health disparities, the Director of the Institute shall
plan, coordinate, and evaluate research and other activities
conducted or supported by the institutes and centers of the
National Institutes of Health. In carrying out the preceding
sentence, the Director of the Institute shall evaluate the
minority health and health disparity activities of each of
such institutes and centers and shall provide for the
periodic reevaluation of such activities. Such institutes and
centers shall be responsible for providing information to the
Institute, including data on clinical trials funded or
conducted by these institutes and centers.
``(2) Consultations.--The Director of the Institute shall
carry out this subpart (including developing and revising the
plan and budget required by subsection (f) in consultation
with the heads of the institutes and centers of the National
Institutes of Health, the advisory councils of such
institutes and centers, and the advisory council established
pursuant to subsection (j).
``(3) Coordination of activities.--The Director of the
Institute--
``(A) shall act as the primary Federal official with
responsibility for coordinating all research and activities
conducted or supported by the National Institutes of Health
on minority or other health disparities;
``(B) shall represent the health disparities research
program of the National Institutes of Health, including the
minority health and other health disparities research
program, at all relevant executive branch task forces,
committees, and planning activities; and
``(C) shall maintain communications with all relevant
agencies of the Public Health Service, including the Indian
Health Service, and various other departments and agencies of
the Federal Government to ensure the timely transmission of
information concerning advances in minority health
disparities research and other health disparities research
among these various agencies for dissemination to affected
communities and health care providers.'';
(2) by amending subsection (f) to read as follows:
``(f) Strategic Plan.--
``(1) In general.--Subject to the provisions of this
section and other applicable law, the Director of the
Institute, in consultation with the Director of NIH, the
Directors of the other institutes and centers of the National
Institutes of Health, and the advisory council established
pursuant to subsection (j), shall--
``(A) annually review and revise a strategic plan (referred
to in this section as `the plan') and budget for the conduct
and support of all minority health disparity research and
other health disparity research activities of the institutes
and centers of the National Institutes of Health that include
time-based targeted objectives with measurable outcomes and
assure that the annual review and revision of the plan uses
an established trans-National Institutes of Health process
subject to timely review, approval, and dissemination;
``(B) ensure that the plan and budget establish priorities
among the health disparities research activities that such
agencies are authorized to carry out;
``(C) ensure that the plan and budget establish objectives
regarding such activities, describe the means for achieving
the objectives, and designate the date by which the
objectives are expected to be achieved;
``(D) ensure that all amounts appropriated for such
activities are expended in accordance with the plan and
budget;
``(E) annually submit to Congress a report on the progress
made with respect to the plan; and
``(F) create and implement a plan for the systemic review
of research activities supported by the National Institutes
of Health that are within the mission of both the Institute
and other institutes and centers of the National Institutes
of Health, including by establishing mechanisms for--
``(i) tracking minority health and health disparity
research conducted within the institutes and centers
assessing the appropriateness of this research with regard to
the overall goals and objectives of the plan;
``(ii) the early identification of applications and
proposals for grants, contracts, and cooperative agreements
supporting extramural training, research, and development,
that are submitted to the institutes and centers that are
within the mission of the Institute;
``(iii) providing the Institute with the written
descriptions and scientific peer review results of such
applications and proposals;
``(iv) enabling the institutes and centers to consult with
the Director of the Institute prior to final approval of such
applications and proposals; and
``(v) reporting to the Director of the Institute all such
applications and proposals that are approved for funding by
the institutes and centers.
``(2) Certain components of plan and budget.--With respect
to health disparities research activities of the agencies of
the National Institutes of Health, the Director of the
Institute shall ensure that the plan and budget under
paragraph (1) provide for--
``(A) basic research and applied research, including
research and development with respect to products;
``(B) research that is conducted by the agencies;
``(C) research that is supported by the agencies;
``(D) proposals developed pursuant to solicitations by the
agencies and for proposals developed independently of such
solicitations; and
``(E) behavioral research and social sciences research,
which may include cultural and linguistic research in each of
the agencies.

[[Page S12349]]

``(3) Minority health disparities research.--The plan and
budget under paragraph (1) shall include a separate statement
of the plan and budget for minority health disparities
research.'';
(3) by amending subsection (h) to read as follows:
``(h) Research Endowments.--
``(1) In general.--The Director of the Institute shall
carry out a program to facilitate minority health and health
disparities research and other health disparities research by
providing research endowments at--
``(A) centers of excellence under section 736; and
``(B) centers of excellence under section 485F.
``(2) Eligibility.--The Director of the Institute shall
provide for a research endowment under paragraph (1) only if
the institution involved meets the following conditions:
``(A) The institution does not have an endowment that is
worth in excess of an amount equal to 50 percent of the
national average of endowment funds at institutions that
conduct similar biomedical research or training of health
professionals.
``(B) The application of the institution under paragraph
(1) regarding a research endowment has been recommended
pursuant to technical and scientific peer review and has been
approved by the advisory council established pursuant to
subsection (j).
``(C) The institution at any time was deemed to be eligible
to receive a grant under section 736 and at any time received
a research endowment under paragraph (1).''; and
(4) by adding at the end the following:
``(k) Funding.--
``(1) Full funding budget.--
``(A) In general.--With respect to a fiscal year, the
Director of the Institute shall prepare and submit directly
to the President, for review and transmittal to Congress, a
budget estimate for carrying out the plan for the fiscal
year, after reasonable opportunity for comment (but without
change) by the Secretary, the Director of the National
Institutes of Health, the directors of the other institutes
and centers of the National Institutes of Health, and the
advisory council established pursuant to subsection (j). The
budget estimate shall include an estimate of the number and
type of personnel needs for the Institute.
``(B) Amounts necessary.--The budget estimate submitted
under subparagraph (A) shall estimate the amounts necessary
for the institutes and centers of the National Institutes of
Health to carry out all minority health and health
disparities activities determined by the Director of the
Institute to be appropriate, without regard to the
probability that such amounts will be appropriated.
``(2) Alternate budgets.--
``(A) In general.--With respect to a fiscal year, the
Director of the Institute shall prepare and submit to the
Secretary and the Director of the National Institutes of
Health the budget estimates described in subparagraph (B) for
carrying out the plan for the fiscal year. The Secretary and
such Director shall consider each of such estimates in making
recommendations to the President regarding a budget for the
plan for such year.
``(B) Description.--With respect to the fiscal year
involved, the budget estimates referred to in subparagraph
(A) for the plan are as follows:
``(i) The budget estimate submitted under paragraph (1).
``(ii) A budget estimate developed on the assumption that
the amounts appropriated will be sufficient only for--

``(I) continuing the conduct by the institutes and centers
of the National Institutes of Health of existing minority
health and health disparity activities (if approved for
continuation), and continuing the support of such activities
by the institutes and centers in the case of projects or
programs for which the institutes or centers have made a
commitment of continued support; and
``(II) carrying out activities that are in addition to
activities specified in subclause (I), only for which the
Director determines there is the most substantial need.

``(iii) Such other budget estimates as the Director of the
Institute determines to be appropriate.''.
______