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.
APPENDIX D
Statutory Authorities
The National Health Survey Act
The National Center for Health Statistics
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52
APPENDIX D
APPENDIX 11
NATIONAL HEALTH SURVEY ACT
PUBLIC LAw 652 - 84TH CONGRESS
CH AP T E R 510 - 2D S ESSION -S. 3076
AN ACT
To provide for a continuing survey and special studies of sicicocss and disability in the United States, and
for periodic reports of she results thereof, and for other purposes.
Be it enacted by the Senate an' House of Representatives of the United
States of America in Congress assembled That this Act may be cited as the
"national Health Survey Act".
Sec. 2. (a) The Congress hereby finds and declares
(1) that the latest information on the number and relevant charac-
teristics of persons in the country suffering from heart disease, cancer,
diabetes, arthritis and rheumatism, and other diseases, injuries, and hand-
icapping conditions is now seriously out of date; and
(2) that periodic inventories providing reasonably current informa-
tion on these matters are urgently needed for purposes such as (A) apprais-
al of the true state of health of our population (including both adults and
children), (B) adequate planning of any programs to improve their health,
(C) research in the field of chronic diseases, and (~) measurement of the
numbers of persons in the working ages so disabled as to be unable to per-
form gainful work.
(b) It is, therefore, the purpose of this Act to provide (1) for a continuing
survey and special studies to secure on a non-compulsory basis accurate and
current statistical information on the amount, distribution, and effects of illness
and disability in the United States and the services received for or because of
such conditions; and (2)for studying methods end survey techniques for securing
such statistical information, with a view toward their continuing improvement.
Sec. 3. Part A of title III of the Public Health Service Act (42 U. S. C. ch.
6A) is amended by adding after section 304 the following new section:
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'NATIONAL HEALTH SURVEYS AND STUDIES
Sec. 305. (a) The Surgeon General is authorized (1) to make, by sampling
or other appropriate means, surveys and special studies of the population of the
United States to determine the extent of illness and disability and related infor-
mation such as: (A) the number, age, sex, ability to work or engage in other
activities, and occupation or activities of persons afflicted with chronic or other
disease or injury or handicapping condition; (B)the type of disease or injury or
handicapping condition of each person so afflicted; (C) the length of time that
each such person has been prevented from carrying on his occupation or activ-
ities; (D) the amounts end types of cervices received for or because of such con-
ditions; and (E) the economic and other impacts of such conditions; and (2) in
connection therewith, to develop end test new or improved methods for obtaining
current data on illness and disability and related information.
"(b) The Surgeon General is authorized, at appropriate intervals, to make
available, through publications and otherwise, to any interested governmental or
other public or private agencies, organizations, or groups, or to Me public, the
results of surveys or studies made pursuant to subsection (a).
"(c) For each fiscal year beginning after June 30, 1956, there are authorized
to be appropriated such sums as the Congress may determine for carrying out
the provisions of this section.
"(d) To assist in carrying out the provisions of this section the Surgeon
General is authorized and directed to cooperate and consult with me Depart-
ments of Commerce and Labor and any other interested Federal Departments
or agencies and with State health departments. For such purpose he shall utilize
insofar as possible the services or facilities of any agency of the Federal Gov-
ernment and, without regard to section 3709 of the Revised Statutes, as
amended, of any appropriate State or other public agency, and may, without re-
gard to section 3709 ofthe Revised Statutes,as amended, utilize the services or
facilities of any private agency, organization, group, or individual, in accord-
ance with written agreements between the head of such agency, organization, or
group, or such individual, and the Secretary of Heals, Education, and Welfare.
Payment, if any, for such services or facilities shall be made in such amounts
as may be provided in such agreement."
Sec. 4. Section 301 of the Public Health Service Act (42 U. S. C. 241) is
amended by striking out the word "and" atthe end of paragraph `0 redesignat-
ing paragraph (g) as paragraph (h), and inserting immediately following para-
graph (f) the following new paragraph:
"(g) Make available, to health officials, scientists, and appropriate public
and other nonprofit institutions and organizations, technical advice and assist-
ance on the application of statistical methods to experiments, studies, and sur-
veys in health and medical fields: and".
Approved July 3, 1956.
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Excerpts from the
Public Health Service Act
General authority respecting research, evaluations, and
demonstrations in health statistics, health services, and
health care technology assessment
APPENDIX D
Sec. 304 [242b] (a) The Secretary may, through the Agency for Health Care Policy
and Research or the National Center for Health Statistics or using National
Research Service Awards or other appropriate authorities, undertake and support
training programs to provide for an expanded and continuing supply of individuals
qualified to perform the research, evaluation, and demonstration projects set forth
in section 306 and in title IX.
(b) To implement subsection (a), and section 306, the Secretary may, in addition
to any other authority which under other provisions of this Act or any other law may
be used by him to implement such subsection, do the following:
(1) Utilize personnel and equipment, facilities, and other physical resources
of the Department of Health and Human Services, permit appropriate (as
determined by the Secretary) entities and individuals to utilize the physical
resources of such Department, provide technical assistance and advice, make
grants to public and nonprofit private entities and individuals, and, when
appropriate, enter into contracts with public and private entities and individ-
uals.
(2) Admit and treat at hospitals and other facilities of the Service persons not
otherwise eligible for admission and treatment at such facilities.
(3) Secure, from time to time and for such periods as the Secretary deems
advisable but in accordance with section 3109 of title 5, United States Code, the
assistance and advice of consultants from the United States or abroad. The
Secretary may for the purpose of carding out the functions set forth in sections
305, 306, and 309, obtain (in accordance with section 3109 of title 5 of the
United States Code, but without regard to the limitation in such section on the
number of days or the period of service) for each of the centers the services of
not more than fifteen experts who have appropriate scientific or professional
qualifications. ,
(4) Acquire, construct, improve, repair, operate, and maintain laboratory,
research, and other necessary facilities and equipment, and such other real or
personal property (including patents) as the Secretary deems necessary; and
acquire, without regard to the Act of March 3, 1877 (40 U.S.C. 34), by lease or
otherwise, through the Administrator of General Services, buildings or parts of
buildings in the District of Columbia or communities located adjacent to the
District of Columbia.
(c)(l) The Secretary shall coordinate all health services research, evaluations, and
demonstrations, all health statistical and epidemiological activities, and all research,
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155
evaluations, and demonstrations respecting the assessment of health care
technology undertaken and supported through units of the Department of Health
feasible such coordination shall be
carried out through the Agency for Health Care Policy and Research and the
National Center for Health Statistics.
(2) The Secretary shall coordinate the health services research, evaluations, and
demonstrations, the health statistical and (where appropriate) epidemiological
activities, and the research, evaluations, and demonstrations respecting the assess-
ment of health care technology authorized by this Act through the Agency for
Health Care Policy and Research and the National Center for Health Statistics.
(d)~1) The Secretary, with the advice and assistance of the National Academy of
Sciences (acting through the Institute of Medicine and other appropriate units),
shall, in cooperation with the Administrator of the Environmental Protection
Agency, the Secretary of Labor, the Consumer Product Safety Commission, the
Council of Economic Advisers, the Council on Wage and Price Stability, the Council
on Environmental Quality, and other entities of the Federal Government which the
Secretary determines have the expertise in the subject of the study prescribed by this
paragraph, conduct, with funds appropriated under section 308(i)~2), an ongoing
study of the present and projected future health costs of pollution and other
environmental conditions resulting from human activity (including human activity in
any place in the indoor or outdoor environment, including places of employment
and residence). In conducting the study, the Secretary shall, to the extent feasible—
(A) identify the pollution (and the pollutants responsible for the pollution)
and other environmental conditions which are, or may reasonably be antici-
pated to be, responsible for causing, contributing to, increasing susceptibility to,
or aggravating human diseases and adverse effects on humans;
(B) identify each such disease and adverse effect on humans and specifically
determine whether cancer, birth defects, genetic damage, emphysema, asthma,
bronchitis, and other respiratory diseases, heart disease, stroke, and mental
illness and impairment are such a disease or effect;
(C) identify (on a national, regional, or other geographical basis) the source
or sources of such pollutants and conditions and estimate the portion of each
pollutant and the extent of each condition which can be traced to a specific type
of source;
(D) ascertain (i) the extent to which the pollutants and conditions identified
under subparagraph (A) are, or may reasonably be anticipated to be, respon-
sible, individually or collectively, for causing, contributing to, increasing
susceptibility to, or aggravating the diseases and effects identified under
subparagraph (B), and (ii) the effect upon the incidence or severity of specific
diseases and effects of individual or collective, as appropriate, incremental
reductions in the pollutants and changes in such conditions; and
(E) quantify (i) the present and projected future health costs of the diseases
and effects identified under subparagraph (B), and (ii) the reduction in health
costs which would result from each incremental reduction and change referred
to in subparagraph (D)(ii).
(2) The Secretary shall enter into appropriate arrangements with the Academy
under which the Secretary shall be responsible for expenses incurred by the
Academy in connection with the study prescribed by paragraph (1~.
(3) The first report on the study prescribed by paragraph (1) shall be made to the
Committee on Human Resources of the Senate and the Committee on Energy and
Commerce of the House of Representatives by the Secretary not later than eighteen
and Human Services. To the maximum extent
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APPENDIX D
months after the date of the enactment of this subsection. Subsequent reports on the
study shall be made by the Secretary every three years after the date the first report
is submitted. Each report shall (A) identify deficiencies and limitations in the data
on the matters considered in the study and recommend actions which may be taken
to eliminate such deficiencies and limitations, (B) include such recommendations
for legislation as the Secretary detainee appropriate, (C) include recommenda-
tions for facilitating studies of the effects of hazardous substances on humans, and
(D) include a description of any administrative action proposed to be taken by the
Secretary, the Administrator of the Environmental Protection Agency, the Secretary
of Labor, and the Consumer Product Safety Commission to reduce the costs which
have been quantified under paragraph (l)(E)(i). In conducting the study, the
Secretary shall seek assistance from public and private health financing entities in
securing the data needed for the study.
(4) For purposes of paragraph (1), the term "health costs of pollution and other
environmental conditions" means the costs of human diseases and other adverse
effects on humans which pollution and other environmental conditions are, or may
reasonably be anticipated to be, responsible for causing, contributing to, increasing
susceptibility to, or aggravating, including the costs of preventing such diseases and
effects, the costs of the treatment, cure, convalescence, and rehabilitation of persons
afflicted by such diseases, costs reasonably attributable to pain and suffering from
such diseases and effects, loss of income and future earnings resulting from such
diseases and effects, adverse effects on productivity (and thus increases in produc-
tion costs and consumer prices) resulting from such diseases and effects, loss of tax
revenues resulting from such decreases in earnings and productivity, costs to the
welfare and unemployment compensation systems and the programs of health
benefits under titles XVIII and XIX of the Social Security Act resulting from such
diseases and effects, the overall increases in costs throughout the economy resulting
from such diseases and effects, and other related direct and indirect costs.
National Center for Health Statistics
Sec. 306 [242k] (a) There is established in the Department of Health and Human
Services the Nat'~-;;`al Center for Health Statistics (hereinafter in this section
referred to as tip Renter") which shall be under the direction of a Director who
shall be appointee by the Secretary. Ike Secretary, acting through the Center, shall
conduct and support statistical and epidemiological activities for the purpose of
improving the effectiveness, efficiency, and quality of health services in the United
States.
(b) In carrying out subsection (a), the Secretary, acting through the Center—
(1) shall collect statistics on—
(A) the extent and nature of illness and disability of the population of
the United States (or of any groupings of the people included in the
population), including life expectancy, the incidence of various acute and
chronic illnesses, and infant and maternal morbidity and mortality,
(B) the impact of illness and disability of the population on the economy
of the United States and on other aspects of the well-being of its
population (or of such groupings),
(C) environmental, social, and other health hazards,
(D) determinants of health,
(E) health resources, including physicians, dentists, nurses, and other
health professionals by specialty and type of practice and the supply of
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services by hospitals, extended care facilities, home health agencies, and
other health institutions,
(F) utilization of health care, including utilization of (i) ambulatory
health services by specialties and types of practice of the health profes-
sionals providing such services, and (ii) services of hospitals, extended care
facilities, home health agencies, and other institutions,
(G) health care costs and financing, including the trends in health care
prices and cost, the sources of payments for health care services, and
Federal, State, and local governmental expenditures for health care
services, and
(H) family formation, growth, and dissolution;
(2) shall undertake and support (by grant or contract) research, demonstra-
tions, and evaluations respecting new or improved methods for obtaining
current data on the matters referred to in paragraph (1~;
(3) may undertake and support (by grant or contract) epidemiological
research, demonstrations, and evaluations on the matters referred to in
paragraph (1~; and
(4) may collect, furnish, tabulate, and analyze statistics, and prepare studies
on matters referred to in paragraph (1) upon request of public and nonprofit
private entities under arrangements under which the entities will pay the cost
of the service provided.
Amounts appropriated to the Secretary from payments made under arrangements
made under paragraph (4) shall be available to the Secretary for obligation until
expended.
(c) The Center shall furnish such special statistical and epidemiological compila-
tions and surveys as the Committee on Human Resources and the Committee on
Appropriations of the Senate and the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives may request. Such
statistical and epidemiological compilations and surveys shall not be made subject to
the payment of the actual or estimated cost of the preparation of such compilations
and surveys.
(d) To insure comparability and reliability of health statistics, the Secretary shall,
through the Center, provide adequate technical assistance to assist State and local
jurisdictions in the development of model laws dealing with issues of confidentiality
and comparability of data.
(e) For the purpose of producing comparable and uniform health information and
statistics, there is established the Cooperative Health Statistics System. The
Secretary, acting through the Center, shall—
(1) coordinate the activities of Federal agencies involved in the design and
implementation of the System;
(2) undertake and support (by grant or contract) research, development,
demonstrations, and evaluations respecting the System;
(3) make grants to and enter into contracts with State and local health
agencies to assist them in meeting the costs of data collection and other
activities carried out under the System; and
(4) review the statistical activities of the Department of Health and Human
Services to assure that they are consistent with the System.
States participating in the System shall designate a State agency to administer or be
responsible for the administration of the statistical activities within the State under
the System. The Secretary, acting through the Center, shall prescribe guidelines to
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APPENDIX D
assure that statistical activities within States participating in the System produce
uniform and timely data and assure appropriate access to such data.
(f) To assist in carrying out this section, the Secretary, acting through the Center,
shall cooperate and consult with the Departments of Commerce and Labor and any
other interested Federal depot lments or agencies and with State and local health
departments and agencies. For such purpose he shall utilize insofar as possible the
services or facilities of any agency, of the Federal Government and, without regard
to section 3709 of ~£n~e Revised Statutes (41 U.S.C. 5), of any appropriate State or
other public agency, and may, without regard to such section, utilize the services or
facilities of any private agency, organization, group, or individual, in accordance
with written agreements between the head of such agency, organization, or group
and the Secretary or between such individual and the Secretary. Payment, if any, for
such services or facilities shall be made in such amounts as may be provided in such
agreement.
(g) To secure uniformity in the registration and collection of mortality, morbidity,
and other health data, the Secretary shall prepare and distribute suitable and
necessary fonns for the collection and compilation of such data which shall be
published as a part of the health reports published by the Secretary.
(h)~1) There shall be an annual collection of data from the records of births,
deaths, marriages, and divorces in registration areas. The data shall be obtained only
from and restricted to such records of the States and municipalities which the
Secretary, in his discretion, determines possess records affording satisfactory data in
necessary detail and form. The Secretary shall encourage States and registration
areas to obtain detailed data on ethnic and racial populations, including subpopu-
lations of Hispanics, Asian Americans, and Pacific Islanders with significant
representation in the State or registration area. Each State or registration area shall
be paid by the Secretary the Federal share of its reasonable costs (as determined by
the Secretary) for collecting and transcribing (at the request of the Secretary and by
whatever method authorized by him) its records for such data.
(2) There shall be an annual collection of data from a statistically valid sample
concerning the general health, illness, and disability status of the civilian noninsti-
tutionalized population. Specific topics to be addressed under this paragraph, on an
annual or periodic basis, shall include the incidence of illness and accidental
injuries, prevalence of chronic diseases and impairments, disability, physician visits,
hospitalizations, and the relationship between demographic and socioeconomic
characteristics and health characteristics.
(i) The Center may provide to public and nonprofit private entities engaged in
health planning activities technical assistance in the effective use in such activities of
statistics collected or compiled by the Center.
(I) In carrying out the requirements of section 304(c) and paragraph (1) of
subsection (e) of this section, the Secretary shall coordinate health statistical and
epidemiological activities of the Department of Health and Human Services by—
(1) establishing standardized means for the collection of health information
and statistics under laws administered by the Secretary;
(2) developing, in consultation with the National Committee on Vital and
Health Statistics, and maintaining the minimum sets of data needed on a
continuing basis to fulfill the collection requirements of subsection (b)~19;
(3) after consultation with the National Committee on Vital and Health
Statistics, establishing standards to assure the quality of health statistical and
epidemiological data collection, processing, and analysis;
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STATUTORY AUTHORITIES
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(4) in the case of proposed health data collections of the Department which
are required to be reviewed by the Director of the Office of Management and
Budget under section 3509 of title 44, United States Code, reviewing such
proposed collections to determine whether they conform with the minimum
sets of data and the standards promulgated pursuant to paragraphs (2) and (3),
and if any such proposed collection is found not to be in conformance, by taking
such action as may be necessary to assure that it will conform to such sets of
data and standards, and
(5) periodically reviewing ongoing health data collections of the Department,
subject to review under such section 3509, to detains if the collections are
being conducted in accordance with the minimum sets of data and the
standards promulgated pursuant to paragraphs (2) and (3) and, if any such
collection is found not to be in conformance, by taking such action as may be
necessary to assure that the collection will conform to such sets of data and
standards not later than the nineteenth day after the date of the completion of
the review of the collection.
(k)~1) There is established in the Office of the Secretary a committee to be known
as the National Committee on Vital and Health Statistics (hereinafter in this
subsection, referred to as the "Committee") which shall consist of 16 members.
(2~(A) The members of the Committee shall be appointed by the Secretary from
among persons who have distinguished themselves in the fields of health statistics,
health planning, epidemiology, and the provision of health services. Except as
provided in subparagraph (B), members of the Committee shall be appointed for
terms of 4 years.
(B)(i) In the case of membership terms on the Committee under this subsection (as
in effect prior to January 1, 1988) that expire in calendar year 1988, the appoint-
ments to three such terms in such calendar year shall be for a period of 4 years and
the appointments to two such terms in such calendar year shall be for a period of 3
years, as designated by the Secretary.
(ii) In the case of membership terms on the Committee under this subsection
(as In effect prior to January 1, 1988) that expire in calendar year 1989, one such
tea shall be extended for an additional consecutive 1-year period, as designated by
the Secretary.
(iii) In the case of membership terms on the Committee under this subsection
(as in effect prior to January 1, 1988) that expire in calendar year 1990, two of such
terms shall each be extended for an additional consecutive 1-year period, as
designated by the SecretaIy.
(3) Members of the Committee shall be compensated in accordance with section
208(c).
(4) It shall be the function of the Committee to assist and advise the Secretary—
(A) to delineate statistical problems bearing on health and health services
which are of national or international interest;
(B) to stimulate studies of such problems by other organizations and agencies
whenever possible or to make investigations of such problems through subcom-
mittees;
(C) to detel~ine, approve, and revise the terms, definitions, classifications,
and guidelines for assessing health status and health services, their distribution
and costs, for use (i) within the Department of Health and Human Services, (ii)
by all programs administered or funded by the Secretary, including the Federal-
State-local cooperative health statistics system referred to in subsection (e), and
(iii) to the extent possible as determined by the head of the agency involved, by
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APPENDIX D
the Veterans' Administration, the Department of Defense, and other Federal
agencies concerned with health and health services;
(D) with respect to the design of and approval of health statistical and health
information systems concerned with the collection, processing, and tabulation
of health statistics within the Department of Health and Human Services, with
respect to the Cooperative Health Statistics System established under subsec-
tion (e), and with respect to the standardized means for the collection of health
information and statistics to be established by the Secretary under subsection
~;
(E) to review and comment on findings and proposals developed by other
organizations and agencies and to make recommendations for their adoption or
implementation by local, State, national, or international agencies;
(F) to cooperate with national committees of other countries and with the
World Health Organization and other national agencies in the studies of
problems of mutual interest; and
(G) to issue an annual report on the state of the Nation's health, its health
services, their costs and distributions, and to make proposals for improvement
of the Nation's health statistics and health information systems.
(5) In carrying out health statistical activities under this part, the Secretary shall
consult with, and seek the advice of, the Committee and other appropriate
professional advisory groups.
(1~1) The Secretary, acting through the Center, shall develop a plan for the
collection and coordination of statistical and epidemiological data on the effects of
the environment on health. Such plan shall include a review of the data now
available on health effects, deficiencies in such data, and methods by which existing
data deficiencies can be corrected. The Secretary shall submit such plan to the
Congress not later than January 1, 1980.
(2~(A) The Secretary, acting through the Center and in cooperation with the
Office of Federal Statistical Policy and Standards, shall establish, not later than two
years after the date of the enactment of this subsection, guidelines for the collection,
compilation, analysis, publication, and distribution of statistics and information
necessary for determining the effects of conditions of employment and indoor and
outdoor environmental conditions on the public health. Guidelines established
under this subparagraph shall not (i) authorize or require the disclosure of any
matter described in section 552(b)~6) of title 5, United States Code, and (ii)
authorize or require the disclosure of any statistics or other information which is
exempt from disclosure pursuant to subsection (a) of section 552 of title 5, United
States Code, by reason of subsection (b)~4) of such section. The guideii.nes shall be
reviewed and, if appropriate, revised at least every three years after the date they are
initially established. Guidelines shall take effect on the date of the promulgation of
the regulation establishing or revising the guidelines or such later date as may be
specified in the guidelines.
(B) The guidelines shall be designed—
(i) to improve coordination of environmental and health studies, statistics,
and information, and to prevent overlap and unnecessary duplication with
respect to such studies, statistics, and inflation;
(ii) to assure that such studies, statistics, and information will be available
to executive departments responsible for the administration of laws relating to
the protection of the public health and safety or the environment;
(iii) to encourage the more effective use of executive departments of such
studies, statistics, and inflation;
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STATUTORY AUTHORITIES
161
(iv) to improve the statistical validity and reliability of such studies,
statistics, and information; and
(v) to assure greater responsiveness by the Department of Health and
Human Services and other executive departments in meeting informational and
analytical needs for determining the effects of employment and indoor and
outdoor environmental conditions on public health
(C) In establishing and revising guidelines under subparagraph (A), the
Secretary shall take into consideration the plan developed pursuant to para-
graph aid.
(D)(i) Each executive department shall comply with the substantive and
procedural requirements of the guidelines.
(ii) The President shall by Executive order require each executive depart-
ment to comply with requests, made in accordance with the guidelines, by the
Secretary, the Administrator of the Environmental Protection Agency, the
Consumer Product Safety Commission, or the Secretary of Labor for statistics
and inflation.
(iii) The President may by Executive order exempt any executive depart-
ment from compliance with a requirement of the guidelines respecting specific
statistics or other information if the President determines that the exemption is
necessary in the interest of national security.
(E) In carrying out his duties under this paragraph, the Secretary, acting
through the Center, shall, insofar as practicable, provide for coordination of his
activities with those of other Federal agencies and interagency task forces
relating to the collection, analysis, publication, or distribution of statistics and
information necessary for determining the effects of conditions of employment
and indoor and outdoor environmental conditions on the public health.
(F) For purposes of this paragraph, the term "guidelines" means the
guidelines, either as initially established or as revised, in effect under this
paragraph.
(3) The Secretary, acting through the Center, shall conduct a study of the issues
respecting, and the recommendations for, establishing a Federal system to assist, in
a manner designed to avoid invasion of personal privacy, Federal, State, and other
entities in locating individuals who have been or may have been exposed to
hazardous substances to determine the effect on their health of such exposure and
to assist them in obtaining appropriate medical care and treatment. In conducting
such study, the Secretary may consult with any public and private entity which it
determines has expertise on any matter to be considered in the study. Not later than
one year after the date of the enactment of this subsection, the Secretary shall
complete the study and report to the Congress the results of the study and any
recommendations for legislation or administrative action.
(4) In carrying out paragraphs (1), (2), and (3), the Secretary shall consult with and
take into consideration any recommendations of the Task Force on Environmental
Cancer and Heart and Lung Disease, the Administrator of the Environmental
Protection Agency, the Secretary of Labor, the Consumer Product Safety Commis-
sion, the Council on Environmental Quality, the National Committee on Vital and
Health Statistics, and the National Academy of Sciences (including the Institute of
Medicine and any other unit of the Academy).
(m) In carrying out this section, the Secretary, acting through the Center, shall
collect and analyze adequate health data that is specific to particular ethnic and
racial populations, including data collected under national health surveys. Activities
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APPENDIX D
carried out under this subsection shall be in addition to any activities carried out
under subsection (n).
(n)(l)The Secretary, acting through the Center, may make grants to public and
nonprofit private entities for—
(A) the conduct of special surveys or studies on the health of ethnic and racial
populations or subpopulations;
(B) analysis of data on ethnic and racial populations and subpopulations; and
(C) research on improving methods for developing statistics on ethnic and
racial populations and subpopulations.
(2) The Secretary, acting through the Center, may provide technical assistance,
standards, and methodologies to grantees supported by this subsection in order to
maximize the data quality and comparability with other studies.
(3) Provisions of section 308 (d) do not apply to surveys or studies conducted by
grantees under this subsection unless the Secretary, in accordance with regulations
the Secretary may issue, determines that such provisions are necessary for the
conduct of the survey or study and receives adequate assurance that the grantee will
enforce such provisions.
(o)~1) For health statistical and epidemiological activities undertaken or supported
under subsections (a) through (m), there are authorized to be appropriated such
sums as may be necessary for each of the fiscal years 1991 through 1993.
(2) For activities authorized in subsection (n), there are authorized to be
appropriated $S,000,000 for fiscal year 1991, $7,500,000 for fiscal year 1992, and
$10,000,000 for fiscal year 1993. Of such amounts, the Secretary shall use not more
than 10 percent for administration and for activities described in subsection (n)~2~.
International cooperation
Sec. 307 [2421] (a) For the purpose of advancing the status of the health sciences
in the United States (and thereby the health of the American people), the Secretary
may participate with other countries in cooperative endeavors in biomedical
research, health care technology, and the health services research and statistical
activities authorized by section 306 and by title IX.
(b) In connection with the cooperative endeavors authorized by subsection (a),
the Secretary may—
(1) make such use of resources offered by participating foreign countries as
he may find necessary and appropriate;
(2) establish and maintain fellowships in the United States and in participat-
ing foreign countries;
(3) make grants to public institutions or agencies and to nonprofit private
institutions or agencies in the United States and in participating foreign
countries for the purpose of establishing and maintaining the fellowships
authorized by paragraph (2~;
(4) make grants or loans of equipment and materials, for use by public or
nonprofit private institutions or agencies, or by individuals, in participating
foreign countries;
(5) participate and otherwise cooperate in any international meetings,
conferences, or other activities concerned with biomedical research, health
services research, health statistics, or health care technology;
(6) facilitate the interchange between the United States and participating
foreign countries, and among participating foreign countries, of research
scientists and experts who are engaged in experiments or programs of biomed-
ical research, health services research, health statistical activities, or health care
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STATUTORY AUTHORITIES
163
technology activities, and in carrying out such purpose may pay per diem
compensation, subsistence, and travel for such scientists and experts when away
from their places of residence at rates not to exceed those provided in section
5703(b) of title 5, United States Code, for persons in the Government service
employed intermittently; and
(7) procure, in accordance with section 3109 of title 5, United States Code,
the temporary or intermittent services of experts or consultants.
The Secretary may not, in the exercise of his authority under this section, provide
financial assistance for the construction of any facility in any foreign country.
General provisions respecting effectiveness, efficiency,
and quality of health services
Sec. 308 [242m] (apt) Not later than March 15 of each year, the Secretary shall
submit to the President and Congress the following reports:
(A) A report on—
(i) the administration of sections 304, 306, and 307 and title IX during
the preceding fiscal year; and
(ii) the current state and progress of health services research, health
statistics, and health care technology.
(B) A report on health care costs and financing. Such report shall include a
description and analysis of the statistics collected under section 306(b)~1~(G).
(C) A report on health resources. Such report shall include a description and
analysis, by geographical area, of the statistics collected under section
306(b)~1~(E).
(D) A report on the utilization of health resources. Such report shall include
a description and analysis, by age, sex, income, and geographic area, of the
statistics collected under section 306(b)~1~(F).
(E) A report on the health of the Nation's people. Such report shall include
a description and analysis, by age, sex, income, and geographic area, of the
statistics collected under section 306(b)~1~(A).
(2) The reports required by subparagraphs (B) through (E) of paragraph (2) shall
be prepared through the Agency for Health Care Policy and Research and the
National Center for Health Statistics.
(3) The Office of Management and Budget may review any report required by
paragraph (1) of this subsection before its submission to Congress, but the Office
may not revise any such report or delay its submission beyond the date prescribed
for its submission, and may submit to Congress its comments respecting any such
report.
(b)(1) No grant or contract may be made under section 304, 306, or 307, unless
an application therefor has been submitted to the Secretary in such form and
manner, and containing such information, as the Secretary may by regulation
prescribe and unless a peer review group referred to in paragraph (2) has
recommended the application for approval.
(IDA) Each application submitted for a grant or contract under section 306 in
an amount exceeding $50,000 of direct costs and for a health services research,
evaluation, or demonstration project, or for a grant under section 306(n), shall be
submitted to a peer review group for an evaluation of the technical and scientific
merits of the proposals made in each such application. The Director of the National
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APPENDIX
Center for Health Statistics shall establish such peer review groups as may be
necessary to provide for such an evaluation of each such application.
(B) A peer review group to which an application is submitted pursuant to
subparagraph (A) shall report its finding and recommendations respecting the
application to the Secretary, acting through the Director of the locational Center for
Health Statistics, in such form and manner as the Secretary shall by regulation
prescribe. The Secretary may not approve an application described in such
subparagraph unless a peer review group has recommended the application for
approval.
(C) The Secretary, acting through the Director of the National Center for
Health Statistics, shall make appointments to the peer review groups required in
subparagraph (A) from among persons who are not officers or employees of the
United States and who possess appropriate technical and scientific qualifications,
except that peer review groups regarding grants under section 306(n) may include
appropriately qualified such officers and employees.
(c) The aggregate number of grants and contracts made or entered into under
sections 304 and 305 for any fiscal year respecting a particular means of delivery of
health services or another particular aspect of health services may not exceed
twenty; and the aggregate amount of funds obligated under grants and contracts
under such sections for any fiscal year respecting a particular means of delivery of
health services or another particular aspect of health services may not exceed
$5,000,000.
(d) No information, if an establishment or person supplying the information or
described in it is identifiable, obtained in the course of activities undertaken or
supported under section 304, 306, or 307 may be used for any purpose other than the
purpose for which it was supplied unless such establishment or person has consented
(as determined under regulations of the Secretary) to its use for such other purpose
and in the case of information obtained in the course of health statistical or
epidemiological activities under section 304 or 306, such information may not be
published or released in other form if the particular establishment or person
supplying the information or described in it is identifiable unless such establishment
or person has consented (as determined under regulations of the Secretary) to its
publication or release in other form.
(e)~1) Payments of any grant or under any contract under section 304, 306, or
307 may be made in advance or by way of reimbursement, and in such installments
and on such conditions, as the Secretary deems necessary to carry out the purposes
of such section.
(2) The amounts otherwise payable to any person under a grant or contract made
under section 304, 306, or 307 shall be reduced by—
(A) amounts equal to the fair market value of any equipment or supplies
furnished to such person by the Secretary for the purpose of carrying out the
project with respect to which such grant or contract is made, and
(B) amounts equal to the pay, allowances, traveling expenses, and related
personnel expenses attributable to the performance of services by an officer or
employee of the Government in connection with such project, if such officer or
employee was assigned or detailed by the Secretary to perform such services,
but only if such person requested the Secretary to furnish such equipment or
supplies, or such services, as the case may be.
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STATUTORY AUTHORITIES
165
(f) Contracts may be entered into under section 304 or 306 without regard to
sections 3648 and 3709 of the Revised Statutes (31 U.S.C. 529; 41 U.S.C. 5~.
(g)~1) The Secretary shall—
(A) publish, make available, and disseminate, promptly in understandable
form and on as broad a basis as practicable, the results of health services
research, demonstrations, and evaluations undertaken and supported under
sections 304 and 305;
(B) make available to the public data developed in such research, demon-
strations, and evaluations; and
(C) provide indexing, abstracting, translating, publishing, and other services
leading to a more effective and timely dissemination of information on health
services research, demonstrations, and evaluations in health care delivery to
public and private entities and individuals engaged in the improvement of
health care delivery and the general public; and undertake programs to develop
new or improved methods for making such information available.
(2) The Secretary shall (A) take such action as may be necessary to assure that
statistics developed under sections 304 and 306 are of high quality, timely,
comprehensive as well as specific, standardized, and adequately analyzed and
indexed, and (B) publish, make available, and disseminate such statistics on as wide
a basis as is practicable.
(h)~1) Except where the Secretary determines that unusual circumstances make a
larger percentage necessary in order to effectuate the purposes of section 306, a
grant or contract under any of such sections with respect to any project for
construction of a facility or for acquisition of equipment may not provide for
payment of more than 50 per centum of so much of the cost of the facility or
equipment as the Secretary determines is reasonably attributable to research,
evaluation, or demonstration purposes.
(2) Laborers and mechanics employed by contractors and subcontractors in the
construction of such a facility shall be paid wages at rates not less than those
prevailing on similar work in the locality, as determined by the Secretary of Labor
in accordance with the Act of March 3, 1931 (40 U.S.C. 267a—267a-5, known as the
Davis-Bacon Act); and the Secretary of Labor shall have with respect to any labor
standards specified in this paragraph the authority and functions set forth in
Reorganization Plan Numbered 14 of 1950 (5 U.S.C. Appendix) and section 2 of the
Act of June 13, 1934 (40 U.S.C. 276c).
(3) Such grants and contracts shall be subject to such additional requirements as
the Secretary may by regulation prescribe.
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166
Related authorities outside the Public Health Service Act:
Public Law
Number Date
95-626 11/10/78
101-239 12/19/89
101~45 10/22/90
10~-582 11/15/90
APPENDIX D
Title
Health Services and Centers Amendments of 1978
Section 404 mandated the publication of a
"Prevention Profile" on every three years,
presenting data on health promotion and disease
prevention.
Omnibus Budget Reconciliation Act of 1989
Section 6507 required the development of a
national system to link data from birth, infant
death, and Medicaid records.
National Nutrition Monitoring and Related
Research Act of 1990
Mandated a coordinated, 10-year program to
improve the data for monitoring nutrition status,
and to improve the comparability of nutrition
monitoring data collected by DHHS and USDA;
established a National Nutrition Monitoring
Advisory Council; and established new procedures
for review and clearance of dietary guidance.
Year 2000 Health Objectives Planning Act of 1990
Provides for grants to States for the development
of plans to implement the Year 2000 Health
Objectives within each State, including the
assessment of health within the State; and
mandates the development of uniform health status
indicators for use by Federal, State, and local
health agencies, along with model methods of
collecting and reporting data.
Representative terms from entire chapter:
services research
