4 1 ending June 30, 1971, $140,000,000 for the fiscal year end2 ing June 30, 1972, and $160,000,000 for the fiscal year 3 ending June 30, 1973,". 4 (b) Section 314 (d) (2) (C) of such Act is amended. 5 by striking out "and (iii)" and inserting in lieu thereof 6"(iii)" and by inserting before the semicolon at the end 7 thereof the following: "; and (iv) the plan is compatible 8 with the total health program of the State". 9 SEC. 6. (a) Section 314 (e) of the Public Health Serv10 ice Act is amended by striking out "and" immediately after 11 "June 30, 1969," and by inserting after "June 30, 1970," 12 the following: "$70,000,000 for the fiscal year ending 13 June 30, 1971, $60,000,000 for the fiscal year ending 14 June 30, 1972, and $50,000,000 for the fiscal year ending 15 June 30, 1973,". 16 (b) The second sentence of such section is amended to 17 read as follows: "Any grant made pursuant to clause (1) 18 or (2) of the preceding sentence with respect to projects 19 involving the furnishing of public health services may be 20 made only if the application for such grant has been referred 21 for review and comment to the appropriate areawide health 22 planning agency or agencies (or, if there is no such agency 23 in the area, then to such other public or nonprofit private 24 agency or organization (if any) which performs similar func25 tions) and only if the services will be provided in accordance 5 1 with such plans as have been developed pursuant to sub 2 section (a)." 3 SEC. 7. Part B of title III of the Public Health Service 4 Act is amended by striking out "Surgeon General" each 5 place it appears and inserting in lieu thereof "Secretary". EXECUTIVE OFFICE OF THE PRESIDENT, BUREAU OF THE BUDGET, Washington, D.C., February 27, 1970. Hon. HARLEY O. STAGGERS, Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Rayburn House Office Building, Washington, D.C. DEAR MR. CHAIRMAN: This is in response to your requests for the views of the Bureau of the Budget on H.R. 14284, H.R. 15895, and H.R. 15960, bills which would amend various provisions of the Public Health Service Act relating to the organization and delivery of health services. The Secretary of Health, Education, and Welfare recently submitted to the Congress legislation, which is the same as H.R. 15960, to be cited as the "Health Services Improvement Act of 1970." This bill would extend, integrate, and make certain other improvements in three health services programs-the Comprehensive Health Planning and Services Program, the Regional Medical Program, and the National Center for Health Services Research and Development. The bill would also enlarge the scope of the National Health Survey authorized under the Public Health Service Act. Accordingly, we recommend that your Committee favorably consider H.R. 15960, in lieu of H.R. 14284 or H.R. 15895. The enactment of H.R. 15960 would be in accord with the program of the President. DEAR MR. CHAIRMAN: This is in response of March 18, 1970, for the views of the Bureau of the Budget on H.R. 16425, a bill "To amend title IX of the Public Health Service Act so as to extend and improve the existing program relating to education, research, training, and demonstrations in the fields of heart disease, cancer, stroke, and other major diseases and conditions, and for other purposes." The Secretary of Health, Education, and Welfare recently submitted to the Congress legislation, which is the same as H.R. 15960, the "Health Services Improvement Act of 1970." This bill would extend, integrate, and make certain other improvements in three health services programs-the Comprehensive Health Planning and Services Programs, the Regional Medical Program, and the National Center for Health Services Research and Development. The bill would also enlarge the scope of the National Health Survey authorized under the Public Health Service Act. Accordingly, we recommend that your Committee favorably consider H.R. 15960, in lieu of H.R. 16425. The enactment of H.R. 15960 would be in accord with the program of the President. Sincerely, WILFRED H. ROMMEL, Assistant Director for Legislative Reference. EXECUTIVE OFFICE OF THE PRESIDENT, BUREAU OF THE BUDGET, Washington, D.C., June 3, 1970. Hon. HARLEY O. STAGGERS, Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. CHAIRMAN: This is in response to your request of May 13, 1970, for the views of the Bureau of the Budget on H.R. 17570, a bill "To amend title IX of the Public Health Service Act so as to extend and improve the existing program relating to education, research, training and demonstrations in the fields of heart disease, cancer, stroke, and other major diseases and conditions, and for other purposes." The Secretary of Health, Education, and Welfare recently submitted to the Congress legislation, which has been introduced as H.R. 15960, the "Health Services Improvement Act of 1970." This bill would extend, integrate, and make certain other improvements in three health services programs-the Comprehensive Health Planning and Services Program, the Regional Medical Program, and the National Center for Health Services Research and Development. The bill would also enlarge the scope of the National Health Survey authorized under the Public Health Service Act. Accordingly, we recommend that your Committee favorably consider H.R. 15960, in lieu of H.R. 17570. The enactment of H.R. 15960 would be in accord with the program of the President. Sincerely, WILFRED H. ROMMEL, Assistant Director for Legislative Reference. OFFICE OF THE COMPTROLLER GENERAL OF THE UNITED STATES, Hon. HARLEY O. STAGGERS, GENERAL ACCOUNTING OFFICE, Washington, D.C., May 8, 1970. Chairman, Committee on Interstate and Foreign Commerce, Washington, D.C. DEAR MR. CHAIRMAN: By letter of February 19, 1970, you requested our comments on H.R. 15960, 91st Congress, which if enacted into law would be known as the "Health Services Improvement Act of 1970.” While we have no special information as to the advantages or disadvantages of this measure and, therefore, make no comments regarding its merits, we recommend revision of the maintenance of records and access to records provisions in subsections 947 (a) and (b). The bill would, among other things, amend title IX of the Public Health Service Act, as amended, 42 U.S.C. 299-299j (Supp. IV), to authorize several grant and contract programs. The proposed subsection 947(a) would require "Each recipient of a grant under this title (other than section 921 or 924)" to keep such accounting records as the Secretary of Health, Education, and Welfare may prescribe. Subsection 947(b) provides: "The Secretary and the Comptroller General of the United States, or any of their duly authorized representatives, shall have access for the purpose of audit and examination to any books, documents, papers, and records of the recipient of any such grant which are pertinent thereto." (Emphasis supplied.) The phrase "any such grant" in subsection 947 (b) apparently refers back to the phrase "a grant under this title (other than section 921 or 924)” in subsection 947 (a) with the possible effect of exempting grants to States under sections 921 and 924 from the access to records authority of the Comptroller General not only under this proposed legislation but also under the provisions of section 202 of the Intergovernmental Cooperation Act of 1968. We recommend deletion of the language "(other than section 921 or 924)" in order to preclude this construction of subsection 947(b) and make applicable all the provisions of section 947 to State grants under sections 921 and 924. Further, the committee may want to consider making section 947 applicable to contracts as well as grants, since both forms of financial assistance are authorized in title IX. These changes can be accomplished by revising subsections 947 (a) and (b) to read as follows: "947 (a) Each recipient of assistance under this title pursuant to grants received or contracts entered into under other than competitive bidding procedures (including recipients of such assistance from a State) shall keep such records as the Secretary shall prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such assistance, the total cost of the project or undertaking in connection with which such assistance is given or used, and the amount of that portion of the cost of the project or undertaking supplied by other sources, and such other records as will facilitate an effective audit. "(b) The Secretary and the Comptroller General of the United States, or any of their duly authorized representatives, shall have access for the purpose of audit and examination to any books, documents, papers, and records of the recipients that are pertinent to the grants received or contracts entered into under this title under other than competitive bidding procedures." If these language changes are not desired, we recommend that the committee indicate in the legislative history an intent that the grants to States authorized in sections 921 and 924 will be subject to the provisions of section 202 of the Intergovernmental Cooperation Act of 1968, Pub. L. 90-577, 82 Stat. 1101, 42 U.S.C. 4212, which provides generally for the Comptroller General's access to records pertinent to State grants. The increased emphasis of our Office on evaluation of grant program results shows a need for the establishment of more specific criteria which will be the basis for approval of grants. Unless such criteria are incorporated in the various provisions authorizing grants in H.R. 15960, we suggest that the committee reports accompanying H.R. 15960 include a paragraph emphasizing the responsibility of the Secretary under section 946 to develop and publish detailed and specific terms and conditions for approving applications for assistance, including, for example, evidence that the grantee has examined the public information available from prior closely related developments and has determined that additional knowledge will be obtained from the proposed plan. Sincerely yours, R. F. KELLER, Assistant Comptroller General of the United States. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Washington, D.C., April 7, 1970. Hon. HARLEY O. STAGGERS, Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Washington, D.C. DEAR MR. CHAIRMAN: This is in response to your request of February 19, 1970, for a report on H.R. 15960, a bill "To amend and improve the Public Health Service Act to aid in the development of integrated, effective, consumer-oriented health care systems by extending and improving regional medical programs, supporting comprehensive planning of public health services and health services development on a State and areawide level, promoting research and demonstrations relating to health care delivery, encouraging experimentation in the development of co-operative local, State, or regional health care delivery systems, enlarging the scope of the National Health survey, facilitating the development of comparable health information and statistics at the Federal, State, and local levels, and for other purposes." This bill embodies the provisions of a draft bill submitted to the Speaker of the House of Representatives by this Department on February 16, 1970. The details of the bill are explained in a letter of the same date to the Speaker, a copy of which is enclosed for your convenience. For the reasons stated in the enclosed letter, we urge enactment of the bill. The Bureau of the Budget advises that enactment of this proposed legislation would be in accord with the programs of the President. Sincerely, Enclosure. ROBERT H. FINCH, Secretary. |