Public Health Service Amendments of 1987

(Senate agreed to House amendments with an amendment)

Public Health Service Amendments of 1987 - Title I: Health Research, Technology, Statistics, and Preventive Health Programs - Amends title III (General Powers and Duties of Public Health Service) of the Public Health Service Act to direct the Secretary of Health and Human Services, acting through the National Center for Health Services Research and Health Care Technology Assessment (Center for Health Services Research), to undertake and support research, evaluation, and demonstration projects respecting the delivery of health care services in rural areas.

Changes the duties of the National Advisory Council on Health Care Technology Assessment to require the Council to make recommendations to the Director of the Center for Health Services Research with respect to the development of criteria and methods to be used by the Center for Health Services Research in certain matters. (Current law requires the Council to assist the Director in developing such criteria and methods.) Changes the composition of the Council.

Prohibits the Secretary from altering the administrative relationship between the Assistant Secretary for Health and the Director of the Center for Health Services Research, as in effect during FY 1986.

Removes provisions specifying who shall supervise the Director of the National Center for Health Statistics (Center for Health Statistics).

Changes the composition and terms of office of the National Committee on Vital and Health Statistics.

Changes from December 1 to March 15 the due date for specified annual health care reports by the Secretary to the President and the Congress.

Amends the Health Services and Centers Amendments of 1978 to change from December 1 to March 15 the due date for a national disease prevention data profile required by current law to be submitted by the Center for Health Statistics to the Congress every third year.

Amends the Public Health Service Act to require certain grants exceeding $50,000 (relating to health statistics, health services, health care technology assessment, the Center for Health Services Research, the Center for Health Statistics, international cooperation in such areas, and the Council on Health Care Technology) to be submitted to a peer review group for evaluation. Requires that the Secretary act through the Director of the Center for Health Services Research or, as appropriate, the Director of the Center for Health Statistics when establishing the peer groups, making appointments to the groups, and receiving reports from the groups. (Current law requires that the Secretary establish, make appointments to, and receive reports from the peer groups.)

Authorizes appropriations for health service research, evaluation, and demonstration and for health statistical and epidemiological activities undertaken or supported under specified provisions for FY 1988 through 1990.

States that the Secretary, for FY 1988 and 1989, may only require, with regard to a grant relating to a council on health care technology, expenditures from non-Federal sources in an amount not less than the amount of the grant applied for. (Current law requires applicants for the grant to give assurances they will expend from non-Federal sources at least twice the amount of the grant applied for.)

Authorizes appropriations for FY 1988 through 1990 for preventive health service programs: (1) to immunize without charge individuals against vaccine-preventable diseases; and (2) for provision without charge of immunizations with vaccines approved for use, and recommended for routine use, after a specified date. Authorizes, upon implementation of subtitle 2 (National Vaccine Injury Compensation Program) of title XXI of the Public Health Service Act, appropriations for FY 1988 through 1990 for grants for preventive health services.

Directs the Secretary, acting through the Director of the Centers for Disease Control, to acquire and maintain a supply of vaccines sufficient to provide vaccinations throughout a six-month period. Authorizes appropriations for FY 1988 through 1990.

Authorizes appropriations for FY 1988 through 1990 for grants for preventive health service programs for tuberculosis and for certain activities relating to prevention and control of diseases which may be prevented through vaccination. States that no more than ten percent of the total amount appropriated under this authorization shall be available for programs relating to preventable tuberculosis.

Authorizes the Secretary to make grants to States and other public and nonprofit private entities, regarding diseases which may be prevented through vaccination, the prevention and control of drug-resistant and other forms of tuberculosis, and the prevention and control of diseases and conditions, for: (1) research; (2) demonstration projects; (3) public information and education; and (4) education, training, and clinical skills improvement activities.

Applies provisions of existing law relating to grant amounts and, reductions and recordkeeping by the recipient to grants for vaccine-preventable diseases, tuberculosis, and other diseases and conditions under this provision.

Title II: National Health Service Corps Loan Repayment Program - Amends subpart II (National Health Service Corps Program) of part D of title III of the Public Health Service Act to direct the Secretary to establish the National Health Service Corps Loan Repayment Program (Loan Repayment Program) to assure an adequate supply of certain trained medical personnel. Sets forth eligibility requirements individuals must meet in order to participate in the Program. Mandates inclusion with application and contract forms sent to potential applicants by the Secretary: (1) a summary of the rights and liabilities of individuals whose applications are approved; and (2) information regarding meeting the service obligation through private practice. Directs the Secretary to give priority to certain types of applicants.

Specifies elements the contract is required to contain, including: (1) that the Secretary will pay loans on behalf of the individual; (2) that the individual will serve for a period of time (period of obligated service) in a health manpower shortage area; and (3) the damages to which the United States is entitled for the individual's breach of the contract.

States that loan payment shall include payment of principal, interest, and related expenses on governmental and commercial loans for tuition and educational and living expenses. Authorizes the Secretary to make loan repayment to a maximum of $20,000 for each year the recipient individual contracts to serve in the Corps. Sets the maximum at $25,000 for each year the individual contracts to serve in the Indian Health Service. Requires arrangements made by the Secretary for loan repayments to provide that any repayments for a year of obligated service be made no later than the end of the fiscal year in which the individual completes such year of service. Authorizes the Secretary to pay any increased Federal, State or local income tax liability resulting from such loan payments.

Prohibits counting individuals who have entered into loan repayment contracts under provisions of this Act against any employment ceiling affecting the Department of Health and Human Services.

Directs the Secretary to submit an annual report to the Congress regarding the individuals receiving loan payments under the Program, the educational institutions at which such individuals are receiving their training, the applications filed, and the amount of loan payments made.

Requires damages for breach of service obligation contracts to be paid within one year of the breach. Directs the Secretary, if damages are delinquent for three months, to use collection agencies or to enter into contracts for the recovery of the damages. Directs the Secretary, to the extent not otherwise prohibited by law, to disclose to credit reporting agencies information relating to damages of more than $100 that are entitled to be recovered and that are delinquent by more than 60 days.

Provides that certain individuals who do not complete their education shall, in lieu of any service obligation, be liable to the United States for the amount which has been paid on their behalf under the contract. Provides a formula for determining the liability of other individuals who breach the contract.

Directs the Secretary to report annually to the Committee on Labor and Human Resources of the Senate and the Committee on Energy and Commerce of the House of Representatives, and the Committees on Appropriations of the Senate and the House of Representatives. Requires the reports to contain information on the number of health care providers needed and the number of people the Secretary proposes to use to meet that need from scholarships, loan repayments, and other sources. Authorizes appropriations for scholarships and loan repayments.

Authorizes the Secretary to make grants to States for programs similar to the Loan Repayment Program. Prohibits making a grant unless an application is submitted to the Secretary. Declares that the Federal share of the costs of any State program under this provision shall not exceed 75 percent. Authorizes appropriations for FY 1988 through 1990.

Allows individuals who have breached their contract by failing to begin or complete their service obligation to contract with the Secretary to serve out their period of obligation at a site which: (1) is on either the Health Manpower Shortage Area Placement Opportunity List or on the Supplemental Health Manpower Shortage Area Placement Opportunity List; and (2) meets other stated criteria. Describes sites which the Secretary is required or allowed to include on the supplemental list. Authorizes the Secretary to assign individuals who have not breached their contract to such sites in certain circumstances.

Declares that individuals who have, by failing to complete their service obligations, breached a written contract under provisions of the Public Health Service Act, as in effect before the amendment made by provisions of the Health Professional Educational Assistance Act of 1976, to be relieved of their liability to the United States under these provisions.

Title III: National Health Service Corps - Amends the Public Health Service Act to require the Secretary, in assigning members of the Corps to health manpower shortage areas, to: (1) give priority to meeting the needs of the Indian Health Service and the needs of health programs or facilities operated by tribes or tribal organizations; and (2) provide special consideration to the homeless populations who do not have access to primary health care services.

Prohibits the Secretary from removing an area from the areas designated as health manpower shortage areas until interested parties have had a chance to provide data and information in support of designation. Adds ability to pay for health services as a criterion the Secretary must consider when making determinations regarding such designations.

Directs the Secretary, in determining the priority for the placement of members of the Corps under specified provisions in medically underserved areas, to consider: (1) whether the areas are served by at least one health professional and the effectiveness of non-Federal programs in recruiting health professionals for the areas; (2) the geographic isolation of the areas; and (3) the economic need of the populations of the areas and the association of the areas with a high infant mortality rate.

Directs the Secretary, in assigning family physicians, to take account of the needs of urban areas and place special attention on urban areas in which there are serious incidences of infant mortality, adolescent pregnancy, drug and alcohol abuse, sexually transmitted diseases, and other acute urban health care needs.

Authorizes appropriations for the general operations of the National Health Service Corps for FY 1988 through 1990.

Sets forth regulations regarding dates by which the Secretary must, for individuals receiving scholarships under the Scholarship Program or under contract to receive loan repayment under the Loan Repayment Program, make certain determinations, provide information, make certain appointments, or make designations of individuals as members of the Corps. Authorizes the Secretary, at the request of individuals receiving scholarships or under contract for loan repayment, to defer such dates.

Adds individuals under contract for loan repayment to provisions allowing the Secretary to release individuals from their service obligation if they agree to engage in private practice in a health manpower shortage area.

Removes a provision authorizing the Secretary to make arrangements, for individuals engaging in private practice in lieu of their service obligation, for the use of equipment and supplies and for the lease or acquisition of other equipment and supplies.

Adds to the requirements for a discharge in bankruptcy a requirement that bankruptcy courts, with respect to the discharge of an individual from damages for breach of a service obligation contract under the National Health Service Corps Scholarship Program, must find that nondischarge of the obligation would be unconscionable.

Removes a provision authorizing the Secretary to make one grant or one loan to individuals who have completed at least two years of their period of obligation.

Authorizes the Secretary to make one loan to a Corps member who has entered into specified agreements regarding private practice in a health manpower shortage area. Requires the loan to be used for the costs of beginning the practice, including acquired equipment and renovating facilities, and hiring of nurses and other personnel. Prohibits use of the loan for purchase or construction of any building. Limits the amount and interest rate of the loan.

Title IV: Miscellaneous - Amends title VII (Health Research and Teaching Facilities and Training of Professional Health Personnel) of the Public Health Service Act to state that current law providing for grants to and contracts with schools of medicine, schools of osteopathy, teaching hospitals, and graduate medical education programs for geriatric medicine training projects, includes traineeships and fellowships.

Requires each project for which a grant or contract is made to be based in a department of geriatrics in existence as of enactment of this Act, or to be based in other programs as specified in current law. Allows projects for which a grant or contract is made to provide one-year retraining programs in geriatrics to physicians who are faculty members in departments of geriatrics as well as in other departments and in other programs as specified by current law.

Amends the Health Care Quality Improvement Act of 1986 to remove a provision allowing, with respect to medical malpractice actions, disclosure of information concerning previous medical malpractice action or claim payments. Allows disclosure, as necessary, to carry out provisions relating to failure of a hospital to obtain such information and relating to reliance by a hospital on the information provided under the Act.

Declares that information which does not permit the identification of any particular health care entity, health care practitioner, or patient is not confidential. Requires such information to be prepared and disclosed, on application, to any person.

States that provisions relieving a person or entity from civil liability with respect to reporting, without knowledge, false information include: (1) any public or private agency designated by the Secretary of Health and Human Services to receive certain reports required by the Act; and (2) reports to State licensing boards and other health entities.

Authorizes the Secretary to establish or approve reasonable fees for disclosure of information under specified provisions of the Act. Prohibits such fees from exceeding the costs of processing the requests for disclosure and of providing the information.