5 1 a guideline, the Secretary shall, with respect to such pro2 posed guideline or revision,". 3 (b)(1) Section 1513(b)(1) is amended by adding after and 4 below subparagraph (F) the following: 5 "The agency shall also assemble and report to the Secretary 6 such data (including data on the personnel, facilities, and 7 other resources needed to meet the goals set forth in the 8 agency's health system plan) as the Secretary may require to 9 carry out his responsibilities under section 1501(e). The Sec10 retary may not require the assembling and reporting of data 11 under this paragraph which is regularly collected by any 12 entity of the Department of Health, Education, and Welfare 13 under a provision of law other than this title.". 14 (2) Section 1522(b)(10) is amended by inserting after 15 "require the State agency to" the following: “(A) assemble 16 and report to the Secretary data (other than data which is 17 regularly collected by any entity of the Department of 18 Health, Education, and, Welfare under a provision of law 19 other than this title) which the Secretary may require to 20 carry out his responsibilities under section 1501(e), including 21 data on the personnel, facilities, and other resources needed 22 to meet the goals set forth in the State health plan, and (B)". 23 24 NATIONAL HEALTH PRIORITIES SEC. 102. Section 1502 is amended by adding at the 25 end the following: 1 2 3 4 5 6 7 8 9 10 11 12 23 13 14 15 16 17 18 19 6 "(11) The identification and discontinuance of du plicative or unneeded services and facilities. "(12) The adoption of policies which will (A) con tain the rapidly rising costs of health care delivery, (B) insure more appropriate use of health care services, and (C) promote greater efficiency in the health care delivery system. "(13) The elimination of inappropriate placement in institutions of persons with mental health problems and the improvement of the quality of care provided those with mental health problems for whom institutional care is appropriate. "(14) Assurance of access to community mental health centers and other mental health care providers for needed mental health services to emphasize the provision of outpatient as a preferable alternative to inpatient mental health services.". DESIGNATION OF HEALTH SERVICE AREAS SEC. 103. (a) The first sentence of section 1511(b)(4) is 20 amended by striking out "if he determines that a boundary 21 for a health service area no longer meets the requirements of 22 subsection (a), he may revise the boundaries" and inserting in 23 lieu thereof the following: "if he determines, after providing 24 reasonable opportunity for a public hearing— 1 2 3 4 5 6 7 8 7 "(A) that a health service area does not meet the requirement of paragraph (1) of subsection (a) relating to effective planning and development of health serv ices, and "(B) revision of the boundaries would establish an area which meets such requirement and which better meets at least one other requirement of such subsection, 9 he may revise the boundaries". 11 (c) The last sentence of section 1511(a) is amended by 12 striking out "each State" and inserting in lieu thereof "any 13 State". 14 (d)(1)(A) Section 1536(a) is amended by inserting "the 15 Commonwealth of Puerto Rico," before "the Virgin Is16 lands". 17 (B) Section 1531(1) is amended by striking out “and the 18 Commonwealth of Puerto Rico". 19 (2) The amendments made by paragraph (1) shall apply 20 on and after the date the designation agreements (under sec21 tion 1515 of the Public Health Service Act) in effect on the 22 date of the enactment of this Act for the health systems 23 agencies in the Commonwealth of Puerto Rico expire. 1 2 8 DESIGNATION OF HEALTH SYSTEMS AGENCIES SEC. 104. (a) Section 1515(b)(4) is amended by striking 3 out the last sentence and inserting in lieu thereof: "In consid4 ering such applications, the Secretary shall give priority to 5 any application which has been recommended by a Governor 6 for approval. When the Secretary enters into an agreement 7 with an entity under paragraph (1), the Secretary shall notify 8 the Governor of the State in which such entity is located of 9 such agreement.". 10 (b) The last sentence of section 1515(c)(2) is amended to 11 read as follows: "In considering such applications, the Secre12 tary shall give priority to any application which has been 13 recommended by a Governor for approval.". 14 (c) Section 1515(c) is amended by adding after para15 graph (3) the following: 16 "(4) Before renewing an agreement with a health sys17 tems agency under this subsection, the Secretary shall pro18 vide the State health planning and development agency of 19 the State in which the health systems agency is located an 20 opportunity to comment on the performance of such agency 21 and to provide a recommendation on whether such agreement 22 should be renewed and whether its renewal should be made 23 subject to conditions as authorized by paragraph (3). 24 "(5) If the Secretary enters into an agreement under 25 this subsection with an entity or renews such an agreement, 9 1 the Secretary shall notify the Governor of the State in which 2 such entity is located of the agreement, its renewal, and, if 3 any conditions have been imposed under paragraph (3), such 4 conditions.". 5 (d)(1) Paragraphs (1) and (3) of section 1515(c) are each 6 amended by striking out "twelve months" and inserting in 7 lieu thereof "thirty-six months". 8 9 10 11 12 13 14 15 16 17 18 19 (2) Section 1515(c)(1) is amended (A) by inserting "(A)" after "(c)(1)", (B) by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, (C) by amending clause (ii) (as so redesignated) to read as follows: "(ii) by the Secretary if the Secretary determines, in accordance with subparagraph (B), that the entity is not complying with the provisions of such agreement.", and (D) by adding at the end the following: "(B) Before the Secretary may terminate, under subpar 20 agraph (A)(ii), an agreement with an entity for designation as 21 the health systems agency for a health service area, the Sec22 retary shall 23 24 "(i) consult with the Governor and the Statewide Health Coordinating Council of each State in which is 46-585 - 79 - 2 |