” £0 ee a 320 8 ee ~ Calendar No. 357 897ra CONGRESS ist SESSION. S. 59 6 [Report No. 368] IN THE SENATE OF THE UNITED STATES | January 19, 1965 ‘Mr. Hin introduced the following bill; which was read twice and referred to the Committee on Labor and Public Welfare June 24, 1965 Reported by Mr. Hix, with amendments _ [Omit the part struck through and insert the part printed in italic] | A BILL To amend the Public Health Service Act to assist in combating heart disease, cancer, and stroke, and other major diseases. Be it enacted by the Senate and House of Representa- tives of the United States of America in Congress assembled, That this Act may be cited as the “Heart Disease, Cancer, and Stroke Amendments of 1965”. SEO. 2. The Public Health Service Act 42 v. 8.C., ch. 6A) is amended by adding at the end thereof the following new title: It L © OQ A PF w wD eh ek eth ow bo -& © 14 15 16 ‘17 18 19 20 1 22, 23 4 2 “TITLE IX—REGIONAL MEDICAL COMPLEXES FOR RESEARCH AND TREATMENT IN HEART DISEASE, CANCER, STROKE, AND OTHER MAJOR DISEASES Pe “PURPOSES “SEc. 900. The purposes of this title are— a “(a) Through grants, | to encourage and assist in the establishment of regionally coordinated arrangements among medical schools, research institutions, and hospitals for re- search and training and for demonstrations of patient care in _ the fields of heart disease, cancer, stroke, and other major diseases ; “(b) To afford to the medical profession and the med- ical institutions of the Nation, through such coordinated arrangements, the a more abundant opportunity of making available to their patients the latest advanced in the © diagnosis and treatment of these diseases; ‘and | “(0 ) To -aooomplish these ends without interfering with the pattoms, or the methods of financing, of patient care or professional pr actice, or with the administration of hospitals “AUTHORIZATION OF APPROPRIATIONS . “BEC. 901. (a) There are authorized to be appropriated $50, 000, 000 for the fiscal year ending June 30, 1966, and such sums an may bo neseseny for each of the next fou 8 2 3 4 | 6 7 8 9 10 i 12 °13 14. 15 16 17 18 19 20 21 22 23 38 _fiseal, years $100,000,000 for: the. fiscal ‘year ,ending. June 30, 1967, $200,000,000 for the fiscal year ending June 30, 1968, and $300,000,000 for the fiscal year ending June 30, 1969, for grants to assist public or non- profit private universities, medical schools, research institutions, hospitals, and other public or nonprofit private institutions and agencies, or associations thereof, in plan- ning, establishing, and operating regional medical complexes for research, training, and demonstration activities for carry- ing out the purposes of this title. Sums appropriated under ‘this section for any fiscal year shall remain available for making such grants until the end of the fiscal year following the fiscal year for which the appropriation is made. “(b) A grant under this title shall be for part or all of the cost of the planning or and other activities with respect to which the application is made, except that any such grant with respect to construction of, or provision of built-in (as _ determined in accordance with regulations) equipment for, any facility may not exceed 90 per centum of the cost of such construction or equipment. __ (¢) Funds appropriated pursuant to this title shall not “be available to pay the cost of hospital, medical, or other ‘care of patients except to the extent it is, as determined in - a 7 ke OW DY FE oO wma 10 11 12 13 14 15 16 AT 18 19 20 21 22 2380. 20 4 \:decordance with regulations, incident to research, training, or -demonstration activities. > ‘DEFINITIONS “Sxo. 902. For the purposes of this title— ' “(a) The ‘term ‘regional medical complex’ means a ‘group of public or nonprofit private institutions or agencies eseh ef whieh is engaged in research, training, prevention, diagnosis, and treatment relating to’ heart disease, cancer, -or stroke and, at the option of the applicant, any other disease ‘found by the Surgeon General to be of major significance to the health ef the Nation aforesaid objectives of such re- gional medical complex; but only if such group— “(1) is situated within a geographic area, composed of any part or parts of any one or more States, which. the Surgeon General determines, in accordance with regulations, to be appropriate for carrying out the pur- poses of this title; | “(2) consists of one or more medical centers, one - or more categorical research centers, and one or more diagnostic and treatment stations; and “(8) has in effect arrangements for the coordina- tion of the activities of its component units which the Surgeon General finds will be adequate for effectively carrying out the purposes of this title. “(b) The term ‘medical center’ means a medical school say us Ve wo bo Or aon 10 11 12 13 14 16 17 18 19 20 21 23 24 5 , or. other medical institution involved in post-graduate medical training and one or more hospitals. affiliated therewith for teaching, research, and demonstration purposes. . _s.“(e) The term ‘categorical research center’ means an in- ‘stitution. (or part of an institution) the primary function of which is research (including clinical research) , training of specialists, and demonstrations and which, in connection therewith, provides specialized, high-quality diagnostic and treatment services for inpatients and outpatients. .- __“(d) The term ‘diagnostic and treatment station’ means a unit of a hospital or other health facility, the primary func: tion of which is to support and augment local capability for diagnosis and treatment by providing specialized, high- quality preventive, diagnostic, and treatment services to out- patients and inpatients. “(e) The term ‘nonprofit’ as applied to any institution or agency means an institution or agency which is owned and operated by one or more nonprofit corporations or associa- tions no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual. saitiel equi of new buildings, Lom: Jeling, oe a ee ee bo to ns ee Se ee &® S&S & & PE BR BREE SF ND b 6 “ dees; bist esol offsite improvements and the sesquston | of land. “(f) ‘The term ‘construction’ includes alteration, major repair (to the extent permitted by regulations), remodeling, ‘replacement, and renovation of existing buildings ( including initial equipment thereof), and replacement of obsolete, built- “in (as determined in accordance with regulations) equipment | of existing buildings. | “GRANTS FOR PLANNING AND DEVELOPMENT | “SHC. 903. (a) The Surgeon General, after consultation with upon the recommendation of the National Advisory Council on Medical Complexes established by section 905 (hereinafter in this title referred to as the ‘Council’) , is au- thorized to make grants to public or nonprofit private. uni- versities, medical schools, research institutions, hospitals, and other public or nonprofit private agencies and institutions , or associations thereof, to assist them in planning the devel- opment of regional medical complexes. “(b) Grants under this section may be made only upon application therefor approved by the Surgeon General. Any such application may be approved only if it contains or 1s supported by reasonable assurances that— “(1) Federal funds paid pursuant to any such grant We fend, Oo ar ra oO DB A OA TH RW Ne _ fat. 42°. : : 13°. 14 bee we. 17. . 18 19 2 20. 21 22 23.7 7 £0) “MIT bé ised ‘Only. for the purposes for which paid and in accordaiice with’ the applicable provisions of this title ‘cslueand the regulations‘thereunder; ©: art sis ™(2) the applicant will provide-for'such fiscal con- ' «trol and fund accounting procedures as are required by - the ‘Surgeon General to assure proper disbursement of “and accounting for such Federal. funds; 7° (3) the applicant will make such reports, in such “form-and containing such information as the Surgeon General may from time to time reasonably require, and ~ will keep such records -and afford such access thereto. --ag the Surgeon General may find necessary to assure thé “eorrectness and verification of such reports; and ~~ “ (4) the applicant will preride for the désigzation 6f désignate an‘ advisory group, to advise the applicant: (and the resulting regional medical complex and its com- ‘ponent units) in formulating and carrying out the plan for the establishment and operation of such regional ~. medical complex, which includes representatives of or- ve ganizations, institutions, and agencies concerned with activities of the kind to be carried on by. the: complex - and members of the public familiar with the need for ” the services provided by the complex. — 8 h- b“GRANTS FOR ESTABLISHMENT AND OPERATION OF ; sifdy ja ..+3) REGIONAL MEDICAL COMPLEXES. G “So, 904. (a) The Surgeon General, after consultation . with upon the: recommendation of the Council, ig authorized to make grants to public or nonprofit private universities, -medical. schools, research institutions, hospitals, and other public or nonprofit private. agencies and institutions , or .. associations thereof, to assist in establishment and operation of regional medical complexes, including construction and equipment; of facilities in connection therewith. . .-. (bh) Grants under this section may be made only upon " application therefor approved by the Surgeon General. Any such application may be approved only if it contains or is - supported by reasonable assurances that— _ “(1) Federal funds paid pursuant to any such grant (A) will be used only for the purposes for which paid and in accordance with the applicable provisions of this : .. title and the regulations thereunder, and (B) will not supplant funds that are otherwise available for establish- ~ ment or operation of the regional medical complex with . respect to which the grant is made; (2) the applicant will provide for such fiscal con- trol and fund accounting procedures as are requited by ~ oa yf 10 11 12 13 14 15°. 16° 17 18 19 20 21 22 23 2 the: Surgeon General to assure proper disbursement of and accounting for such Federal funds; :.:'. pears, (3), the applicant will make such reports, in such - form and containing such information as the Surgeon _ General may from. time to. time reasonably require,. and will keep such records and afford such access thereto as + the Surgeon General may find necessary to assure the correctness and verification of. such reports ;. - - (4). the applicant has designated or will designate an advisory group, described in paragraph (4), of sec: ‘tion 908 (b), to advise in. carrying out the plan for the - regional medical complex; and ~ “(5) any laborer or mechanic employed by any contractor or subcontractor in the performance of work on any construction aided by payments pursuant to any grant under this section will be paid wages at rates not Jess than those prevailing on similar construction in the locality as determined by the Secretary of Labor in ac- ~ cordance with the Davis-Bacon Act, as amended (40 U.S.C. 276a—276a-5) ; and the Secretary of Labor - shall have, with respect to the labor standards specified - in this paragraph, the authority and functions set forth -in Reorganization Plan Numbered 14 of 1950 (15 F.R. 14 15 16 17 18 19. 20 21 22 23 24 25 10 03176; 5 U.S.C. 1332-15) and section 2 ‘of the Act of June 13; 1934, as amended (40 U.S.C. 276c). i) “NATIONAL ADVISORY COUNCIL ON MEDICAL COMPLEXES -“8n0, 905. (a) Bhe Surgeon General: with the ap- eivil service laws, There is hereby established in: the Public Health Service 2 National Advisory Council on Medical Complexes. The Council shall consist of the Surgeon Gen- eral, who shall be the Chairman, and the Chief Medical Di- * rector of the Veterans’ Administration, ex officio, and twelve "members, not otherwise in the employ of the United States, appointed by the Surgeon General, with the approval of the Secretary and without regard to the civil service laws, who are leaders in the fields of the fundamental sciences, the medical sciences, hospital administration, or public affairs. At least one of the appointed members shall be outstanding in the study, diagnosis, or treatment of heart disease, one shall be outstanding in the study, diagnosis, or treatment of cancer, and one shall be outstanding in the study, diagnosis, or treatment of stroke. “(b) Each appointed member of the Council shall hold office for a term of four years, except that any member ap- for which his predecessor was appointed shall be appointed for the remainder of such term, and except that the terms of pointed to fill a vacancy prior to the expiration of the term — ‘ t % ; aed | | | ti 1" officd of “the ‘members firsttaking “office ‘shall’ expire, as 2 designated by thé’ Stirgéon’ General at the’ titié: of appoint- 3 ment, four at the end of-the'first year, four at the end of 4° the’ second: year; ‘atid four atthe end ‘of the third year after ‘5 ‘the date of appointment. ‘Art appointed member shall not 6 be eligible to serve continuoiisly for more than'two terms. 7." () Appointed ‘members of the Council, ‘while attend- 8 ing ‘iméetings or conferences thereof or otherwise serving on 9° business of the Council, shiall’be entitled to receive compen- 10 gation at’ rates -fixed by the Secretary, but not exceeding 11 $100 per day, including travel time, and while so serving 12 away from their homes’ or regular places of business they 13 may be allowed travel expenses, including per diem in lieu 14° of subsistence, as authorized by section 5 of the Administra- 15 tive: Expenses Act of 1946 (5 U.S.C. 73b-2) for persons 16 "in the Government service employed intermittently. 17. “(d) The Council shall advise and assist the Surgeon 18 General in the preparation of regulations for, and as to policy 19 matters arising with respect to, the administration of this 20 title. The Council shall consider all applications for grants 21 ‘under this title and shall make recommendations to the 22 Surgeon General with respect to approval of applications 23 for and the amounts of grants under this title; and such recom= 24! mendations shall also be transmitted to any advisory council me Ww oe A ® 10, 11 12 ,. 13 14 15 16 17. 18 19- 20 21 22. 23 24 25 12 or,.committee, established by or pursuant to this Act, which ; the Surgeon General deems appropriate. 7 _ “REGULATIONS “Suc. 906. The. Surgeon General, after consultation with the Council, shall prescribe general regulations cover- ing the terms and conditions for approving applications for grants. under this title and the coordination of programs assisted under this title with programs for training, research, .and demonstrations: relating to the same diseases assisted or. authorized under other titles of this Act or other Acts of Congress... tas “REPORT . “Sno. 907. On or before June 30, +969; 1967, the Sur- geon General, after consultation with the Council, shall sub- mit to the Secretary for transmission to the President and then to the Congress, a report of the activities under this title together with (1) a statement of the relationship between Federal financing and financing from other sources of the ac- tivities undertaken pursuant to this title, (2) an appraisal of the activities assisted under this title in the light of their effec- tiveness in carrying out the purposes of this title, and (3) recommendations with respect to extension or modification of this title in the light thereof.” Sxc. 3. (a) Section 1 of the Public Health Service Act is amended to read as follows: no ® & dD a «1B “Srorion 1. Titles I to IX, inclusive, of this Act may be cited as the ‘Public Health Service Act’.” (b) The Act of July 1, 1944 (58 Stat. 682), as amended, is further amended by renumbering title TX (as in effect prior to the enactment of this Act) as title X, and by renumbering sections 901 through 914 (as in effect prior to the enactment of this Act), and references thereto, as sections 1001 through 1014, respectively. S}USUIPUOUTY YITM poz10doy GOGT ‘FG INOL \ OABTOA BANE pus JOGVT UO SoFUMMED OY} 0} PoTIEJeT PUB BoP} PBZ GOCT ‘6T 2aVONVE Toy ‘wy 4g ‘sesvestp roleur seq}0 pure ‘oyxor4s pues ‘xeouvo ‘esvestp J1vEY, SUTZVQUIOD UT 9SIS “8B OF PY MLAIG YI[VoH OANA 94} Pusure oF, TIId V [s9¢ “ON Hodey] 965 °S gS Se LSE *ON epueye)