NVSReport Att A LegisAuth

Current Legislative
Authorities
of the National Center for
Health Statistics
Enacted as of November 1999

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Center for Health Statistics
Hyattsville, Maryland
February 2000

Public laws establishing or
amending authorities for the National
Center for Health Statistics
Public law
number
July 3, 1956
October 30, 1970
June 18, 1973
July 23, 1974

August 1, 1977
November 9, 1978
August 13, 1981
January 4, 1983
October 30, 1984
December 1, 1987
December 19, 1989
November 6, 1990
December 14, 1993
August 21, 1996
October 31, 1998
November 13, 1998

National Health Survey Act
Heart Disease, Cancer, Stroke, and Kidney
Disease Amendments of 1970
Health Programs Extension Act of 1973
Health Services Research and
Evaluation and Health Statistics Act of
1974
Health Planning and Health Services and
Statistics Extension Act of 1977
Health Services Research, Health
Statistics, and Health Care
Technology Act of 1978
Omnibus Budget Reconciliation Act of 1981
Orphan Drug Act
Health Promotion and Disease
Prevention Amendments of 1984
Public Health Service Amendments of 1987
Omnibus Budget Reconciliation Act of 1989
Disadvantaged Minority Health
Improvement Act of 1990
Preventive Health Amendments of 1993
Health Insurance Portability and
Accountability Act of 1996
Women’s Health Research and Prevention
Amendments of 1998
Health Professions Education
Partnerships Act of 1998

84–652
91–515
93–45
93–353

95–83
95–623
97–35
97–414
98–551
100–177
101–239
101–527
103–183
104–191
105–340
105–392

Citation of legislative authorities for the National
Center for Health Statistics
The following are preferred citations for National Center for Health Statistics legislative
authority and can be used interchangeably:
+

Section 306 of the Public Health Service Act, as amended

+ 42 U.S.C. 242k
The second citation is a reference to the United States Code, the codification of laws.
ii

Contents

Background
Public laws establishing or amending authorities for the National Center for
Health Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Citation of legislative authorities for the National Center for Health Statistics . . .
Legislative history of the National Center for Health Statistics . . . . . . . . . . . . . . . .

ii
ii
v

Highlights
section
Excerpts from the Public Health Service Act
General authority respecting research, evaluations, and
demonstrations in health statistics, health services, and
health care technology assessment . . . . . . . . . . . . . . . . . . . .
Coordination of research, evaluation, and statistics . . . .

page

304 . . . . . . . . . . . .
(c) . . . . . . . . . . . .

1
2

National Center for Health Statistics . . . . . . . . . . . . . . . . . . .
Establishment of the National Center for Health
Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Statistical, research, and epidemiological activities . . . .
Reimbursable work program . . . . . . . . . . . . . . . . . . . . . .
Model State laws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cooperative Health Statistics System . . . . . . . . . . . . . . .
Standard vital statistics certificates . . . . . . . . . . . . . . . . .
Collection of vital statistics . . . . . . . . . . . . . . . . . . . . . . .
Annual sample survey . . . . . . . . . . . . . . . . . . . . . . . . . . .
Technical assistance in use of statistics . . . . . . . . . . . . .
Coordination of statistics within Health and
Human Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
National Committee on Vital and Health Statistics . . . .
Data on ethnic and racial populations . . . . . . . . . . . . . . .
Minority health statistics grants program . . . . . . . . . . . .
Authorization of funds . . . . . . . . . . . . . . . . . . . . . . . . . . .

306 . . . . . . . . . . . . .

2

(a) . . . . . . . . . . . . .
(b) . . . . . . . . . . . . .
(b)(4) . . . . . . . . . . .
(d) . . . . . . . . . . . . . .
(e) . . . . . . . . . . . . . .
(g) . . . . . . . . . . . . . .
(h)(1) . . . . . . . . . . .
(h)(2) . . . . . . . . . . .
(i) . . . . . . . . . . . . . .

2
2
3
3
3
4
4
4
4

(j) . . . . . . . . . . . . . .
(k) . . . . . . . . . . . . . .
(l) . . . . . . . . . . . . . .
(m) . . . . . . . . . . . . .
(n) . . . . . . . . . . . . . .

4
5
7
7
7

International cooperation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

307 . . . . . . . . . . . . .

8

General provisions respecting effectiveness, efficiency, and
quality of health services . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health, United States . . . . . . . . . . . . . . . . . . . . . . . . . . . .

308 . . . . . . . . . . . . . 8
(a) . . . . . . . . . . . . . . 8
iii

section
Grants, contracts, and peer review . . . . . . . . . . . . . . . . .
Standards for statistics . . . . . . . . . . . . . . . . . . . . . . . . . . .
Confidentiality protections . . . . . . . . . . . . . . . . . . . . . . . .

(b,e,f) . . . . . . . . 9, 10
(c) . . . . . . . . . . . . . . 9
(d) . . . . . . . . . . . . . . 9

Selected authorities outside the Public Health Service Act . . . . . . . . . . . . . . . . . . .

iv

page

11

Legislative history of the National
Center for Health Statistics

The National Center for Health Statistics (NCHS) is the Federal Government’s principal
health statistics agency. The NCHS mandate from Congress addresses the full spectrum of
concerns in the health field from birth to death, including overall health status, life style
and exposure to unhealthful influences, the onset and diagnosis of illness and disability,
and the use and financing of health care and rehabilitation services. The authorizing
legislation, reprinted in this book, is the accumulation of over 40 years and a dozen public
laws. The key milestones in the evolution of NCHS authorities include the following:
+

The initial basis for NCHS surveys was the National Health Survey Act (P.L.
84–652), enacted on July 3, 1956. This Act called for a continuing survey and special
studies on the Nation’s health. It also provided for studying methods and survey
techniques for securing this statistical information and for disseminating results of
these surveys or studies.

+

The NCHS was administratively established as an organizational entity in the Public
Health Service in 1960. The Center was created through a merging of the National
Health Survey and the National Office of Vital Statistics. Responsibility for vital
statistics had been transferred to the Public Health Service from the U.S. Bureau of
the Census in 1946.

+

The NCHS confidentiality protections and a cooperative system for collecting
national statistics were legislated in 1970. The Heart Disease, Cancer, Stroke, and
Kidney Disease Amendments of 1970 (P.L. 91–515) established confidentiality
provisions for national health surveys that remain (with minor amendments) in the
current authority (section 308(d)). These amendments also called for the design and
implementation of a cooperative system for Federal and State level data collection.

+

The Health Services Research and Evaluation and Health Statistics Act of 1974 (P.L.
93–353) established NCHS in law and codified its mandate and authorities under
section 306 of the Public Health Service Act. Although this section (and sections 304
and 308, which also relate to NCHS) have been amended numerous times since 1974,
this law contained the preponderance of what is currently the Center’s legislative
authority. The Act called for NCHS to collect a broad range of statistics on the illness
and disability of the population of the United States.
It also provided for the annual collection of data from records of births, deaths,
marriages, and divorces. In addition, the Act called for the Center to undertake and
support research, demonstrations, and evaluations regarding survey methods and to
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provide technical assistance to State and local jurisdictions. The Act also established
the National Committee on Vital and Health Statistics, an expert advisory committee
to the Secretary.
+

Building on authority established in 1970, the Cooperative Health Statistics System
was formally instituted in 1978 (P.L. 95–623). Authority for this program included the
support, coordination, and evaluation of State and Federal health statistics systems.

+

In 1989 the Congress established the Agency for Health Care Policy and Research to
support studies of health care effectiveness and outcomes. In the process legislative
authority for the National Center for Health Services Research (NCHSR) was deleted.
Because NCHS and NCHSR were jointly authorized by portions of the Public Health
Service Act, a number of technical and conforming amendments were made to NCHS
authorities by this law, P.L. 101–239.

+

In the Disadvantaged Minority Health Improvement Act of 1990 (P.L. 101–527),
NCHS was given a new mandate to obtain more detailed data on racial and ethnic
populations and subpopulations. New authorities in this Act called for NCHS to
improve racial and ethnic detail through vital statistics and national surveys and to
establish a grants program for special studies, analyses, and methodological research
on minority populations.

Like many other programs of the Public Health Service, NCHS is authorized for a
certain number of years by act of Congress. A dozen public laws have established,
amended, or extended NCHS authorities; many of these laws have made only minor
changes or extended the authorization without change.

vi

Excerpts from the
Public Health Service Act

General authority respecting research, evaluations, and
demonstrations in health statistics, health services, and
health care technology assessment
Sec. 304 [242b] (a) The Secretary may, through the Agency for Health Care Policy and
Research or the National Center for Health Statistics or using National Research Service
Awards or other appropriate authorities, undertake and support training programs to
provide for an expanded and continuing supply of individuals qualified to perform the
research, evaluation, and demonstration projects set forth in section 306 and in title IX.
(b) To implement subsection (a) and section 306, the Secretary may, in addition to any
other authority which under other provisions of this Act or any other law may be used by
him to implement such subsection, do the following:
(1) Utilize personnel and equipment, facilities, and other physical resources of the
Department of Health and Human Services, permit appropriate (as determined by the
Secretary) entities and individuals to utilize the physical resources of such Department, provide technical assistance and advice, make grants to public and nonprofit
private entities and individuals, and, when appropriate, enter into contracts with
public and private entities and individuals.
(2) Admit and treat at hospitals and other facilities of the Service persons not
otherwise eligible for admission and treatment at such facilities.
(3) Secure, from time to time and for such periods as the Secretary deems advisable
but in accordance with section 3109 of title 5, United States Code, the assistance and
advice of consultants from the United States or abroad. The Secretary may for the
purpose of carrying out the functions set forth in sections 305, 306, and 309, obtain
(in accordance with section 3109 of title 5 of the United States Code, but without
regard to the limitation in such section on the number of days or the period of service)
for each of the centers the services of not more than fifteen experts who have
appropriate scientific or professional qualifications.
(4) Acquire, construct, improve, repair, operate, and maintain laboratory, research,
and other necessary facilities and equipment, and such other real or personal property
(including patents) as the Secretary deems necessary; and acquire, without regard to
the Act of March 3, 1877 (40 U.S.C. 34), by lease or otherwise, through the
Administrator of General Services, buildings or parts of buildings in the District of
Columbia or communities located adjacent to the District of Columbia.

1

(c) (1) The Secretary shall coordinate all health services research, evaluations, and
demonstrations, all health statistical and epidemiological activities, and all research,
evaluations, and demonstrations respecting the assessment of health care technology
undertaken and supported through units of the Department of Health and Human Services.
To the maximum extent feasible such coordination shall be carried out through the Agency
for Health Care Policy and Research and the National Center for Health Statistics.
(2) The Secretary shall coordinate the health services research, evaluations, and
demonstrations, the health statistical and (where appropriate) epidemiological activities,
and the research, evaluations, and demonstrations respecting the assessment of health care
technology authorized by this Act through the Agency for Health Care Policy and
Research and the National Center for Health Statistics.

National Center for Health Statistics
Sec. 306 [242k] (a) There is established in the Department of Health and Human
Services the National Center for Health Statistics (hereinafter in this section referred to as
the ‘‘Center’’) which shall be under the direction of a Director who shall be appointed by
the Secretary. The Secretary, acting through the Center, shall conduct and support
statistical and epidemiological activities for the purpose of improving the effectiveness,
efficiency, and quality of health services in the United States.
(b) In carrying out subsection (a), the Secretary, acting through the Center—
(1) shall collect statistics on—
(A) the extent and nature of illness and disability of the population of the
United States (or of any groupings of the people included in the population),
including life expectancy, the incidence of various acute and chronic illnesses,
and infant and maternal morbidity and mortality,
(B) the impact of illness and disability of the population on the economy of
the United States and on other aspects of the well-being of its population (or
of such groupings),
(C) environmental, social, and other health hazards,
(D) determinants of health,
(E) health resources, including physicians, dentists, nurses, and other health
professionals by specialty and type of practice and the supply of services by
hospitals, extended care facilities, home health agencies, and other health
institutions,
(F) utilization of health care, including utilization of (i) ambulatory health
services by specialties and types of practice of the health professionals
providing such services, and (ii) services of hospitals, extended care facilities,
home health agencies, and other institutions,
(G) health care costs and financing, including the trends in health care
prices and cost, the sources of payments for health care services, and Federal,
State, and local governmental expenditures for health care services, and
(H) family formation, growth, and dissolution;
(2) shall undertake and support (by grant or contract) research, demonstrations, and
evaluations respecting new or improved methods for obtaining current data on the
matters referred to in paragraph (1);

2

(3) may undertake and support (by grant or contract) epidemiological research,
demonstrations, and evaluations on the matters referred to in paragraph (1); and
(4) may collect, furnish, tabulate, and analyze statistics, and prepare studies, on
matters referred to in paragraph (1) upon request of public and nonprofit private
entities under arrangements under which the entities will pay the cost of the service
provided.
Amounts appropriated to the Secretary from payments made under arrangements made
under paragraph (4) shall be available to the Secretary for obligation until expended.
(c) The Center shall furnish such special statistical and epidemiological compilations
and surveys as the Committee on Labor and Human Resources and the Committee on
Appropriations of the Senate and the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives may request. Such
statistical and epidemiological compilations and surveys shall not be made subject to the
payment of the actual or estimated cost of the preparation of such compilations and
surveys.
(d) To insure comparability and reliability of health statistics, the Secretary shall,
through the Center, provide adequate technical assistance to assist State and local
jurisdictions in the development of model laws dealing with issues of confidentiality and
comparability of data.
(e) For the purpose of producing comparable and uniform health information and
statistics, there is established the Cooperative Health Statistics System. The Secretary,
acting through the Center, shall—
(1) coordinate the activities of Federal agencies involved in the design and
implementation of the System;
(2) undertake and support (by grant or contract) research, development, demonstrations, and evaluations respecting the System;
(3) make grants to and enter into contracts with State and local health agencies to
assist them in meeting the costs of data collection and other activities carried out
under the System; and
(4) review the statistical activities of the Department of Health and Human Services
to assure that they are consistent with the System.
States participating in the System shall designate a State agency to administer or be
responsible for the administration of the statistical activities within the State under the
System. The Secretary, acting through the Center, shall prescribe guidelines to assure that
statistical activities within States participating in the System produce uniform and timely
data and assure appropriate access to such data.
(f) To assist in carrying out this section, the Secretary, acting through the Center, shall
cooperate and consult with the Departments of Commerce and Labor and any other
interested Federal departments or agencies and with State and local health departments
and agencies. For such purpose he shall utilize insofar as possible the services or facilities
of any agency of the Federal Government and, without regard to section 3709 of the
Revised Statutes (41 U.S.C. 5), of any appropriate State or other public agency, and may,

3

without regard to such section, utilize the services or facilities of any private agency,
organization, group, or individual, in accordance with written agreements between the
head of such agency, organization, or group and the Secretary or between such individual
and the Secretary. Payment, if any, for such services or facilities shall be made in such
amounts as may be provided in such agreement.
(g) To secure uniformity in the registration and collection of mortality, morbidity, and
other health data, the Secretary shall prepare and distribute suitable and necessary forms
for the collection and compilation of such data.
(h)(1) There shall be an annual collection of data from the records of births, deaths,
marriages, and divorces in registration areas. The data shall be obtained only from and
restricted to such records of the States and municipalities which the Secretary, in his
discretion, determines possess records affording satisfactory data in necessary detail and
form. The Secretary shall encourage States and registration areas to obtain detailed data
on ethnic and racial populations, including subpopulations of Hispanics, Asian Americans,
and Pacific Islanders with significant representation in the State or registration area. Each
State or registration area shall be paid by the Secretary the Federal share of its reasonable
costs (as determined by the Secretary) for collecting and transcribing (at the request of the
Secretary and by whatever method authorized by him) its records for such data.
(2) There shall be an annual collection of data from a statistically valid sample
concerning the general health, illness, and disability status of the civilian noninstitutionalized population. Specific topics to be addressed under this paragraph, on an annual or
periodic basis, shall include the incidence of illness and accidental injuries, prevalence of
chronic diseases and impairments, disability, physician visits, hospitalizations, and the
relationship between demographic and socioeconomic characteristics and health characteristics.
(i) The Center may provide to public and nonprofit private entities technical assistance
in the effective use in such activities of statistics collected or compiled by the Center.
(j) In carrying out the requirements of section 304(c) and paragraph (1) of subsection
(e) of this section, the Secretary shall coordinate health statistical and epidemiological
activities of the Department of Health and Human Services by—
(1) establishing standardized means for the collection of health information and
statistics under laws administered by the Secretary;
(2) developing, in consultation with the National Committee on Vital and Health
Statistics, and maintaining the minimum sets of data needed on a continuing basis to
fulfill the collection requirements of subsection (b)(1);
(3) after consultation with the National Committee on Vital and Health Statistics,
establishing standards to assure the quality of health statistical and epidemiological
data collection, processing, and analysis;
(4) in the case of proposed health data collections of the Department which are
required to be reviewed by the Director of the Office of Management and Budget
under section 3509 of title 44, United States Code, reviewing such proposed
collections to determine whether they conform with the minimum sets of data and the
standards promulgated pursuant to paragraphs (2) and (3), and if any such proposed
collection is found not to be in conformance, by taking such action as may be
necessary to assure that it will conform to such sets of data and standards, and
4

(5) periodically reviewing ongoing health data collections of the Department,
subject to review under such section 3509, to determine if the collections are being
conducted in accordance with the minimum sets of data and the standards promulgated pursuant to paragraphs (2) and (3) and, if any such collection is found not to be
in conformance, by taking such action as may be necessary to assure that the
collection will conform to such sets of data and standards not later than the nineteenth
day after the date of the completion of the review of the collection.
(k)(1) There is established in the Office of the Secretary a committee to be known as the
National Committee on Vital and Health Statistics (hereinafter in this subsection, referred
to as the ‘‘Committee’’) which shall consist of 18 members.
(2) The members of the Committee shall be appointed from among persons who
have distinguished themselves in the fields of health statistics, electronic interchange
of health care information, privacy and security of electronic information, populationbased public health, purchasing or financing health care services, integrated computerized health information systems, health services research, consumer interests in
health information, health data standards, epidemiology, and the provision of health
services. Members of the Committee shall be appointed for terms of 4 years.
(3) Of the members of the Committee—
(A) 1 shall be appointed, not later than 60 days after the date of the enactment
of the Health Insurance Portability and Accountability Act of 1996, by the Speaker
of the House of Representatives after consultation with the Minority Leader of the
House of Representatives;
(B) 1 shall be appointed, not later than 60 days after the date of the enactment
of the Health Insurance Portability and Accountability Act of 1996, by the
President pro tempore of the Senate after consultation with the Minority Leader of
the Senate; and
(C) 16 shall be appointed by the Secretary.
(4) Members of the Committee shall be compensated in accordance with section
208(c).
(5) The Committee—
(A) shall assist and advise the Secretary—
(i) to delineate statistical problems bearing on health and health services
which are of national or international interest;
(ii) to stimulate studies of such problems by other organizations and
agencies whenever possible or to make investigations of such problems
through subcommittees;
(iii) to determine, approve, and revise the terms, definitions, classifications, and guidelines for assessing health status and health services, their
distribution and costs, for use (I) within the Department of Health and
Human Services, (II) by all programs administered or funded by the
Secretary, including the Federal-State-local cooperative health statistics
system referred to in subsection (e), and (III) to the extent possible as
determined by the head of the agency involved, by the Department of
Veterans Affairs, the Department of Defense, and other Federal agencies
concerned with health and health services;

5

(iv) with respect to the design of and approval of health statistical and
health information systems concerned with the collection, processing, and
tabulation of health statistics within the Department of Health and Human
Services, with respect to the Cooperative Health Statistics System established under subsection (e), and with respect to the standardized means for
the collection of health information and statistics to be established by the
Secretary under subsection (j)(1);
(v) to review and comment on findings and proposals developed by other
organizations and agencies and to make recommendations for their
adoption or implementation by local, State, national, or international
agencies;
(vi) to cooperate with national committees of other countries and with
the World Health Organization and other national agencies in the studies of
problems of mutual interest;
(vii) to issue an annual report on the state of the Nation’s health, its
health services, their costs and distributions, and to make proposals for
improvement of the Nation’s health statistics and health information
systems; and
(viii) in complying with the requirements imposed on the Secretary
under part C of title XI of the Social Security Act;
(B) shall study the issues related to the adoption of uniform data standards for
patient medical record information and the electronic exchange of such information;
(C) shall report to the Secretary not later than 4 years after the date of the
enactment of the Health Insurance Portability and Accountability Act of 1996
recommendations and legislative proposals for such standards and electronic
exchange; and
(D) shall be responsible generally for advising the Secretary and the Congress
on the status of the implementation of part C of title XI of the Social Security Act.
(6) In carrying out health statistical activities under this part, the Secretary shall
consult with, and seek the advice of, the Committee and other appropriate professional advisory groups.
(7) Not later than 1 year after the date of the enactment of the Health Insurance
Portability and Accountability Act of 1996, and annually thereafter, the Committee
shall submit to the Congress, and make public, a report regarding the implementation
of part C of title XI of the Social Security Act. Such report shall address the following
subjects, to the extent that the Committee determines appropriate:
(A) The extent to which persons required to comply with part C of title XI of
the Social Security Act are cooperating in implementing the standards adopted
under such part.
(B) The extent to which such entities are meeting the security standards
adopted under such part and the types of penalties assessed for noncompliance
with such standards.
(C) Whether the Federal and State Governments are receiving information of
sufficient quality to meet their responsibilities under such part.
(D) Any problems that exist with respect to implementation of such part.

6

(E) The extent to which timetables under such part are being met.
(l) In carrying out this section, the Secretary, acting through the Center, shall collect and
analyze adequate health data that is specific to particular ethnic and racial populations,
including data collected under national health surveys. Activities carried out under this
subsection shall be in addition to any activities carried out under subsection (m).
(m)(1) The Secretary, acting through the Center, may make grants to public and
nonprofit private entities for—
(A) the conduct of special surveys or studies on the health of ethnic and racial
populations or subpopulations;
(B) analysis of data on ethnic and racial populations and subpopulations; and
(C) research on improving methods for developing statistics on ethnic and racial
populations and subpopulations.
(2) The Secretary, acting through the Center, may provide technical assistance,
standards, and methodologies to grantees supported by this subsection in order to
maximize the data quality and comparability with other studies.
(3) Provisions of section 308(d) do not apply to surveys or studies conducted by
grantees under this subsection unless the Secretary, in accordance with regulations the
Secretary may issue, determines that such provisions are necessary for the conduct of
the survey or study and receives adequate assurance that the grantee will enforce such
provisions.
(4)(A) Subject to subparagraph (B), the Secretary, acting through the Center, shall
collect data on Hispanics and major Hispanic subpopulation groups and American
Indians, and for developing special area population studies on major Asian American
and Pacific Islander populations.
(B) The provisions of subparagraph (A) shall be effective with respect to a fiscal
year only to the extent that funds are appropriated pursuant to paragraph (3) of
subsection (n), and only if the amounts appropriated for such fiscal year pursuant
to each of paragraphs (1) and (2) of subsection (n) equal or exceed the amounts so
appropriated for fiscal year 1997.
(n)(1) For health statistical and epidemiological activities undertaken or supported
under subsections (a) through (l), there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 1991 through 2003.
(2) For activities authorized in paragraphs (1) through (3) of subsection (m), there
are authorized to be appropriated such sums as may be necessary for each of the fiscal
years 1999 through 2003. Of such amounts, the Secretary shall use not more than
10 percent for administration and for activities described in subsection (m)(2).
(3) For activities authorized in subsection (m) (4), there are authorized to be appropriated $1,000,000 for fiscal year 1998, and such sums as may be necessary for each of
the fiscal years 1999 through 2002.

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International cooperation
Sec. 307 [242l] (a) For the purpose of advancing the status of the health sciences in the
United States (and thereby the health of the American people), the Secretary may
participate with other countries in cooperative endeavors in biomedical research, health
care technology, and the health services research and statistical activities authorized by
section 306 and by title IX.
(b) In connection with the cooperative endeavors authorized by subsection (a), the
Secretary may—
(1) make such use of resources offered by participating foreign countries as he may
find necessary and appropriate;
(2) establish and maintain fellowships in the United States and in participating
foreign countries;
(3) make grants to public institutions or agencies and to nonprofit private
institutions or agencies in the United States and in participating foreign countries for
the purpose of establishing and maintaining the fellowships authorized by paragraph
(2);
(4) make grants or loans of equipment and materials, for use by public or nonprofit
private institutions or agencies, or by individuals, in participating foreign countries;
(5) participate and otherwise cooperate in any international meetings, conferences,
or other activities concerned with biomedical research, health services research,
health statistics, or health care technology;
(6) facilitate the interchange between the United States and participating foreign
countries, and among participating foreign countries, of research scientists and
experts who are engaged in experiments or programs of biomedical research, health
services research, health statistical activities, or health care technology activities, and
in carrying out such purpose may pay per diem compensation, subsistence, and travel
for such scientists and experts when away from their places of residence at rates not
to exceed those provided in section 5703(b) of title 5, United States Code, for persons
in the Government service employed intermittently;
(7) procure, in accordance with section 3109 of title 5, United States Code, the
temporary or intermittent services of experts or consultants; and
The Secretary may not, in the exercise of his authority under this section, provide financial
assistance for the construction of any facility in any foreign country.
(8) enter into contracts with individuals for the provision of services (as defined in
section 104 of part 37 of title 48, Code of Federal Regulations (48 CFR 37.104)) in
participating foreign countries, which individuals may not be deemed employees of
the United States for any purpose.
(c) The Secretary may provide to personnel appointed or assigned by the Secretary to
serve abroad, allowances and benefits similar to those provided under chapter 9 of title I
of the Foreign Service Act of 1990 (22 U.S.C. 4081 et seq.). Leaves of absence for
personnel under this subsection shall be on the same basis as that provided under
subchapter I of chapter 63 of title 5, United States Code, to individuals serving in the
Foreign Service.

8

General provisions respecting effectiveness, efficiency, and quality of
health services
Sec. 308 [242m] (a)(1) Not later than March 15 of each year, the Secretary shall submit
to the President and Congress the following reports:
(A) A report on health care costs and financing. Such report shall include a
description and analysis of the statistics collected under section 306(b)(1)(G).
(B) A report on health resources. Such report shall include a description and
analysis, by geographical area, of the statistics collected under section
306(b)(1)(E).
(C) A report on the utilization of health resources. Such report shall include a
description and analysis, by age, sex, income, and geographic area, of the statistics
collected under section 306(b)(1)(F).
(D) A report on the health of the Nation’s people. Such report shall include a
description and analysis, by age, sex, income, and geographic area, of the statistics
collected under section 306(b)(1)(A).
(2) The reports required in paragraph (1) shall be prepared through the National
Center for Health Statistics.
(3) The Office of Management and Budget may review any report required by
paragraph (1) of this subsection before its submission to Congress, but the Office may
not revise any such report or delay its submission beyond the date prescribed for its
submission, and may submit to Congress its comments respecting any such report.
(b)(1) No grant or contract may be made under section 304, 306, or 307, unless an
application therefor has been submitted to the Secretary in such form and manner, and
containing such information, as the Secretary may by regulation prescribe and unless a
peer review group referred to in paragraph (2) has recommended the application for
approval.
(2)(A) Each application submitted for a grant or contract under section 306 in an
amount exceeding $50,000 of direct costs and for a health services research,
evaluation, or demonstration project, or for a grant under section 306(m), shall be
submitted to a peer review group for an evaluation of the technical and scientific
merits of the proposals made in each such application. The Director of the National
Center for Health Statistics shall establish such peer review groups as may be
necessary to provide for such an evaluation of each such application.
(B) A peer review group to which an application is submitted pursuant to
subparagraph (A) shall report its finding and recommendations respecting the
application to the Secretary, acting through the Director of the National Center for
Health Statistics, in such form and manner as the Secretary shall by regulation
prescribe. The Secretary may not approve an application described in such
subparagraph unless a peer review group has recommended the application for
approval.
(C) The Secretary, acting through the Director of the National Center for Health
Statistics, shall make appointments to the peer review groups required in
subparagraph (A) from among persons who are not officers or employees of the
United States and who possess appropriate technical and scientific qualifications,

9

except that peer review groups regarding grants under section 306(m) may include
appropriately qualified such officers and employees.
(c) The Secretary shall take such action as may be necessary to assure that statistics
developed under sections 304 and 306 are of high quality, timely, comprehensive as well
as specific, standardized, and adequately analyzed and indexed, and shall publish, make
available, and disseminate such statistics on as wide a basis as is practicable.
(d) No information, if an establishment or person supplying the information or
described in it is identifiable, obtained in the course of activities undertaken or supported
under section 304, 306, or 307 may be used for any purpose other than the purpose for
which it was supplied unless such establishment or person has consented (as determined
under regulations of the Secretary) to its use for such other purpose and in the case of
information obtained in the course of health statistical or epidemiological activities under
section 304 or 306, such information may not be published or released in other form if the
particular establishment or person supplying the information or described in it is
identifiable unless such establishment or person has consented (as determined under
regulations of the Secretary) to its publication or release in other form.
(e)(1) Payments of any grant or under any contract under section 304, 306, or 307 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 such section.
(2) The amounts otherwise payable to any person under a grant or contract made
under section 304, 306, or 307 shall be reduced by—
(A) amounts equal to the fair market value of any equipment or supplies
furnished to such person by the Secretary for the purpose of carrying out the
project with respect to which such grant or contract is made, and
(B) amounts equal to the pay, allowances, traveling expenses, and related
personnel expenses attributable to the performance of services by an officer or
employee of the Government in connection with such project, if such officer or
employee was assigned or detailed by the Secretary to perform such services,
but only if such person requested the Secretary to furnish such equipment or supplies,
or such services, as the case may be.
(f) Contracts may be entered into under section 304 or 306 without regard to section
3324 of title 31, United States Code, and section 3709 of the Revised Statutes (41 U.S.C.
5).

10

Selected authorities outside the Public Health
Service Act
Public Law
number

Date

Title

101–445

10/22/90

102–531

10/27/92

104–208

9/30/96

National Nutrition Monitoring and Related Research
Act of 1990
Mandated a coordinated, 10-year program to
improve the data for monitoring nutrition status, and
to improve the comparability of nutrition
monitoring data collected by DHHS and USDA;
established a National Nutrition Monitoring
Advisory Council; and established new procedures
for review and clearance of dietary guidance.
Preventive Health Amendments of 1992
Authorized the funding of activities related to State
efforts to meet Year 2000 Objectives through the
preventive health and health services block grant.
Illegal Immigration Reform and Immigrant
Responsibility Act of 1996
Required the development of standards for copies of
birth certificates. Birth certificates issued 4 years
after enactment are required to conform to these
standards. The law also created grant programs to
assist States in meeting these standards and in
improving their death records.

11

PHS 2000-1303
9-0796 (2/2000)