Additional material submitted for the record by-Continuea Idaho Department of Health, telegram from A. W. Clotz, doctor of Idaho Health Association, telegram from Jack Jelke, president... International Society of Clinical Laboratory Technologists, proposed model State licensure statute... Kaiser Foundation Hospital Plan, Inc.: Proposed amendment to H.R. 6418- Kerner, Hon. Otto, Governor of the State of Illinois, letter- Louisiana Tuberculosis and Respiratory Disease Association, letter Maddox, Hon. Lester, Governor of the State of Georgia, telegram__ Budget estimate-medical information system.. Missouri Division of Health, telegram from Dr. L. M. Garner, acting National Association for Mental Health, Inc., statement_ National Association for Retarded Children, statement.. National Association of State Mental Health Program Directors: Mental health program statistics for four typical States: Cali- National Committee for Careers in Medical Technology: Letter dated June 27, 1967, re proposed language to amend section 795(1) (A) (ii) National Consumers League, letter from Sarah H. Newman, general Page 354 358 365 353 248 243 103 97 National Cystic Fibrosis Research Foundation, letter from Dr. Milton 365 New Mexico Department of Public Health, letter from Dr. Edwin O. 362 O'Rourke, Dr. Edward, Commissioner of Health, New York City, 324 Pima County (Ariz.) Health Department, letter from Dr. Frederick J. 364 Planned Parenthood-World Population: Resolution adopted by the 323 PARTNERSHIP FOR HEALTH AMENDMENTS OF 1967 TUESDAY, MAY 2, 1967 HOUSE OF REPRESENTATIVES, COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D.C. The committee met at 10 a.m., pursuant to notice, in room 2123, Rayburn House Office Building, Hon. Harley O. Staggers (chairman) presiding. The CHAIRMAN. The committee will come to order. The hearings today are on H.R. 6418 which I introduced at the request of the administration, known as the Partnership for Health Amendments of 1967. Last year in the closing days of the 89th Congress, our committee reported out a 1-year bill providing for comprehensive health planning, and eliminating the categorical grants for public health services within the States, providing instead authority for formula grants and project grants for public health programs generally. The current legislation would extend through fiscal 1972 the authorizations for comprehensive health planning and public health services grants; would broaden and consolidate authorizations for research, experiments and demonstrations relating to the development and financing of health services and facilities; authorize cooperation with States and localities in emergency health planning; provide for licensing clinical laboratories, make permanent the existing temporary authorization for research contracts; and delete the authority currently in the law for the Commission of Education to accredit schools of nursing. This is a very important, a very complicated bill. We expect that the hearings will last at least 2 weeks, in view of the large number of witnesses who have asked to be heard. I might say at this time that the committee faces a rather difficult problem. I stated on the floor yesterday that if we received recommendations from the President dealing with the threatened railroad strike we would promptly start hearings on that legislation. That legislation will take some time for the committee to consider, and I regret to have to say that it may be necessary to suspend these hearings when we get the President's recommendation. It was some years ago that Teddy Roosevelt stirred the Nation with his call for a vigorous and healthy life. We have come a long way since that time, and the medical world has been stimulated to prodigious efforts to increase the control of science over the physical man. That is the purpose of this proposed legislation today, to tie together the achievements of medical science and put behind them whatever resources of the Government may be available to reach the goal of universal health. 1 A healthy nation will be able to take advantage of our enormous opportunities. Although we have many problems, perplexing problems facing us and the Congress and even the Nation such as the Vietnam war, the threatened railroad strike, and many other things, we, as a committee, are determined to carry on in the field of health and do what we can to improve the lot of the medical man and medical science in getting the achievement of science to the public of the nation. (The bill, H.R. 6418, and departmental reports thereon, follow :) [H.R. 6418, 90th Cong., 1st sess.] A BILL To amend the Public Health Service Act to extend and expand the authorizations for grants for comprehensive health planning and services, to broaden and improve the authorization for research and demonstrations relating to the delivery of health services, to improve the performance of clinical laboratories, and to authorize cooperative activities between the Public Health Service hospitals and community facilities, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Partnership for Health Amendments of 1967". GRANTS FOR COMPREHENSIVE HEALTH PLANNING AND PUBLIC HEALTH SERVICES SEC. 2. (a) (1) Subsection (a) (1) of section 314 of the Public Health Service Act (42 U.S.C. 246, as amended by section 3 of the Comprehensive Health Planning and Public Health Services Amendments of 1966, Public Law 89749) is amended (1) by striking out "1968" the first time it appears and inserting in lieu thereof "1972" and (2) by striking out "and $5,000,000 for the fiscal year ending June 30, 1968" and inserting in lieu thereof "$7,000,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for the next four fiscal years." (2) Subsection (a) (2) of such section is amended by redesignating subparagraphs (I) and (J) as subparagraphs (J) and (K), respectively, and by inserting after subparagraph (H) the following new paragraph: "(I) effective July 1, 1968, (i) provide for assisting each health care facility in the State to develop a program for capital expenditures for replacement, modernization, and expansion which is consistent with an overall State plan developed in accordance with criteria which the Secretary determines will meet the needs of the State for health care facilities, equipment, and services without duplication and otherwise in the most efficient and economical manner, and (ii) provide that the State agency furnishing such assistance will periodically review the program (developed pursuant to clause (i)) of each health care facility in the State and recommend appropriate modifications thereof;". (3) The last sentence of subsection (a) (4) of such section is amended by inserting before the period at the end thereof ", except that in the case of the allotments for the fiscal year ending June 30, 1970, and for each of the next two fiscal years, it shall not exceed 75 per centum of such cost". (b) Subsection (b) of such section is amended by striking out "1968" the first time it appears and inserting in lieu thereof "1972" and by striking out "and $7,500,000 for the fiscal year ending June 30, 1968", and inserting in lieu thereof "$7,500,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for the next four fiscal years". (c) Subsection (c) of such section is amended by striking out "1968" the first time it appears and inserting in lieu thereof "1972" and by striking out "and $2,500,000 for the fiscal year ending June 30, 1968" and inserting in lieu thereof "$2,500,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for the next four fiscal years". (d) (1) Subsection (d)(1) of such section is amended by striking out "$62,500,000 for the fiscal year ending June 30, 1968," and inserting in lieu thereof "$70,000,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for the next four fiscal years,". (2) Subsection (d) (7) of such section is amended by adding at the end thereof the following new stentence: "Effective with respect to allotments under this subsection for fiscal years ending after June 30, 1968, at least 70 per centum of such amount reserved for mental health services and at least 70 per centum of the remainder of a State's allotment under this subsection shall be available only for the provision under the State plan of services in communities of the State." (e) Subsection (e) of such section is amended by striking out "$62,500,000 for the fiscal year ending June 30, 1968," and inserting in lieu thereof "$70,000,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for the next four fiscal years". (f) Effective July 1, 1967, subsection (c) of section 309 of such Act (42 U.S.C. 242g(c)), as amended by section 4 of the Comprehensive Health Planning and Public Health Services Admendments of 1966 (Public Law 89-749), is amended by striking out "each" after "$5,000,000" and by inserting after "the fiscal year ending June 30, 1968," the following: "and such sums as may be necessary for the next four fiscal years,". RESEARCH AND DEMONSTRATIONS RELATING TO HEALTH FACILITIES AND SERVICES SEC. 3. (a) Section 304 (42 U.S.C. 242b) of the Public Health Service Act is amended to read as follows: "RESEARCH AND DEMONSTRATIONS RELATING TO HEALTH FACILITIES AND SERVICES "SEC. 304. (a) The Secretary is authorized "(1) to make grants to States, political subdivisions, universities, hospitals, and other public or nonprofit private agencies, institutions, or organizations for projects for the conduct of research, experiments, or demonstrations (and related training), and "(2) to make contracts with public or private agencies, institutions, or organizations for the conduct of research, experiments, or demonstrations (and related training), relating to the development, utilization, quality, organization, and financing of services, facilities, and resources of hospitals or other medical facilities (including, for purposes of this section, facilities for the mentally retarded, as defined in the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963), agencies, institutions, or organizations or to development of new methods or improvement of existing methods of organization, delivery, or financing of health services, including, among others "(A) projects for the construction of units of hospitals or other medical facilities which involve experimental architectural designs or functional layout or use of new materials or new methods of construction, the efficiency of which can be tested and evaluated, or which involve the demonstration of such efficiency, particularly projects which also involve research, experiments, or demonstrations relating to delivery of health services, and "(B) projects for development and testing of new equipment and systems, including automated equipment, and other new technology systems or concepts for the delivery of health services. "(b) Except where the Secretary determines that unusual circumstances make a larger percentage necessary in order to effectuate the purposes of this section, a grant or contract under this section 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, experimental, or demonstration purposes. The provisions of clause (5) of the third sentence of section 605(a) and such other conditions as the Secretary may determine shall apply with respect to grants or contracts under this section for projects for construction of a facility or for acquisition of equipment. "(c) Payments of any grants or under any contracts under this section 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 this section. "(d) There are authorized to be appropriated for payment of grants or under contracts under this section $20,000,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for succeeding fiscal years; except that, for any fiscal year ending after June 30, 1968, such portions of such sums as the Secretary may determine, but not exceeding 1 per centum thereof, shall be available to the Secretary for evaluation (directly or by grants or contracts) of the program authorized by this section." (b) Effective with respect to appropriations for fiscal years ending after June 30, 1967 (1) section 624 of such Act is repealed; and (2) the first sentence of section 314(e) of such Act is amended by inserting "or" at the end of clause (1), by striking out clause (3), by striking out", or" at the end of clause (2), by inserting "(including related training)" after "providing services" in clause (1), and by amending clause (2) to read: "(2) developing and supporting for an initial period new programs of health services (including related training)"; and (3) the second sentence of such section 314(e) is amended by striking out "or (2)". Any sums appropriated for the fiscal year ending June 30, 1968, for carrying out such sections 624 and 314(e) (3) which remain unobligated on the date of enactment of this Act shall be available for carrying out section 304 of the Public Health Service Act, and the total of such sums (and any portion of the appropriations for such year for such purpose obligated prior to such date of enactment in carrying out such sections) shall be deducted from the authorization for such year contained in such section 304. COOPERATION WITH STATES IN EMERGENCIES SEC. 4. Section 311 of the Public Health Service Act (42 U.S.C. 243) is amended by inserting at the end thereof the following new subsection : "(c) The Secretary may enter into agreements providing for cooperative planning between Public Health Service medical facilities and community health facilities to cope with health problems resulting from disasters, and for participation by Public Health Service medical facilities in carrying out such planning. He may also, at the request of the appropriate State or local authority, extend temporary (not in excess of forty-five days) assistance to States or localities in meeting health emergencies of such a nature as to warrant Federal assistance. The Secretary may require such reimbursement of the United States for aid (other than planning) under the preceding sentences of this subsection as he may determine to be reasonable under the circumstances. Any reimbursement so paid shall be credited to the applicable appropriation of the Public Health Service for the year in which such reimbursement is received." CLINICAL LABORATORIES IMPROVEMENT SEC. 5. (a) Part F of title III of the Public Health Service Act (42 U.S.C. 262-3) is amended by changing the title to read: "LICENSING-BIOLOGICAL PRODUCTS AND CLINICAL LABORATORIES”, and by adding after section 352 (42 U.S.C. 263) the following new section: "LICENSING OF LABORATORIES "SEC. 353. (a) As used in this section "(1) the term 'laboratory' or 'clinical laboratory' means a facility for the biological, microbiological, serological, chemical, immuno-hematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body, for the purpose of obtaining information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of the health of, man; "(2) the term 'interstate commerce' means trade, traffic, commerce, transportation, transmission, or communication between any State, territory, or possession of the United States, the Commonwealth of Puerto Rico, or the District of Columbia and any place outside thereof; or within the District of Columbia, the Commonwealth of Puerto Rico, or any territory or possession of the United States. "(b) No person may solicit or accept in interstate commerce, directly or indirectly, any specimen for laboratory examination, nor introduce or deliver for introduction into interstate commerce, directly or indirectly, any specimen with respect to which a laboratory has performed, or alleges to have performed, one or more laboratory procedures, or introduce, or deliver for introduction into interstate commerce, directly or indirectly, the results of or any report on any such procedures, unless there is in effect a license for such laboratory issued by the Secretary under this section applicable to such procedures. |