
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC297q]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
              SUBCHAPTER VI--NURSING WORKFORCE DEVELOPMENT
 
                             Part F--Funding
 
Sec. 297q. Funding


(a) Authorization of appropriations

    For the purpose of carrying out parts B, C, and D of this subchapter 
(subject to section 297t(g) of this title), there are authorized to be 
appropriated $65,000,000 for fiscal year 1998, and such sums as may be 
necessary for each of the fiscal years 1999 through 2002.

(b) Allocations for fiscal years 1998 through 2002

               (1) Nurse practitioners; nurse midwives

        (A) Fiscal year 1998

            Of the amount appropriated under subsection (a) of this 
        section for fiscal year 1998, the Secretary shall reserve not 
        less than $17,564,000 for making awards of grants and contracts 
        under section 296m of this title as such section was in effect 
        for fiscal year 1998.

        (B) Fiscal years 1999 through 2002

            Of the amount appropriated under subsection (a) of this 
        section for fiscal year 1999 or any of the fiscal years 2000 
        through 2002, the Secretary, subject to subsection (d) of this 
        section, shall reserve for the fiscal year involved, for making 
        awards of grants and contracts under part B of this subchapter 
        with respect to nurse practitioners and nurse midwives, not less 
        than the percentage constituted by the ratio of the amount 
        appropriated under section 296m of this title as such section 
        was in effect for fiscal year 1998 to the total of the amounts 
        appropriated under this subchapter for such fiscal year. For 
        purposes of the preceding sentence, the Secretary, in 
        determining the amount that has been reserved for the fiscal 
        year involved, shall include any amounts appropriated under 
        subsection (a) of this section for the fiscal year that are 
        obligated by the Secretary to continue in effect grants or 
        contracts under section 296m of this title as such section was 
        in effect for fiscal year 1998.

                       (2) Nurse anesthetists

        (A) Fiscal year 1998

            Of the amount appropriated under subsection (a) of this 
        section for fiscal year 1998, the Secretary shall reserve not 
        less than $2,761,000 for making awards of grants and contracts 
        under section 297-1 of this title as such section was in effect 
        for fiscal year 1998.

        (B) Fiscal years 1999 through 2002

            Of the amount appropriated under subsection (a) of this 
        section for fiscal year 1999 or any of the fiscal years 2000 
        through 2002, the Secretary, subject to subsection (d) of this 
        section, shall reserve for the fiscal year involved, for making 
        awards of grants and contracts under part B of this subchapter 
        with respect to nurse anesthetists, not less than the percentage 
        constituted by the ratio of the amount appropriated under 
        section 297-1 of this title as such section was in effect for 
        fiscal year 1998 to the total of the amounts appropriated under 
        this subchapter for such fiscal year. For purposes of the 
        preceding sentence, the Secretary, in determining the amount 
        that has been reserved for the fiscal year involved, shall 
        include any amounts appropriated under subsection (a) of this 
        section for the fiscal year that are obligated by the Secretary 
        to continue in effect grants or contracts under section 297-1 of 
        this title as such section was in effect for fiscal year 1998.

(c) Allocations after fiscal year 2002

                           (1) In general

        For fiscal year 2003 and subsequent fiscal years, amounts 
    appropriated under subsection (a) of this section for the fiscal 
    year involved shall be allocated by the Secretary among parts B, C, 
    and D of this subchapter (and programs within such parts) according 
    to a methodology that is developed in accordance with paragraph (2). 
    The Secretary shall enter into a contract with a public or private 
    entity for the purpose of developing the methodology. The contract 
    shall require that the development of the methodology be completed 
    not later than February 1, 2002.

                     (2) Use of certain factors

        The contract under paragraph (1) shall provide that the 
    methodology under such paragraph will be developed in accordance 
    with the following:
            (A) The methodology will take into account the need for and 
        the distribution of health services among medically underserved 
        populations, as determined according to the factors that apply 
        under section 254b(b)(3) of this title.
            (B) The methodology will take into account the need for and 
        the distribution of health services in health professional 
        shortage areas, as determined according to the factors that 
        apply under section 254e(b) of this title.
            (C) The methodology will take into account the need for and 
        the distribution of mental health services among medically 
        underserved populations and in health professional shortage 
        areas.
            (D) The methodology will be developed in consultation with 
        individuals in the field of nursing, including registered 
        nurses, nurse practitioners, nurse midwives, nurse anesthetists, 
        clinical nurse specialists, nursing educators and educational 
        institutions, nurse executives, pediatric nurse associates and 
        practitioners, and women's health, obstetric, and neonatal 
        nurses.
            (E) The methodology will take into account the following 
        factors with respect to the States:
                (i) A provider population ratio equivalent to a managed 
            care formula of 1/1,500 for primary care services.
                (ii) The use of whole rather than fractional counts in 
            determining the number of health care providers.
                (iii) The counting of only employed health care 
            providers in determining the number of health care 
            providers.
                (iv) The number of families whose income is less than 
            200 percent of the official poverty line (as established by 
            the Director of the Office of Management and Budget and 
            revised by the Secretary in accordance with section 9902(2) 
            of this title).
                (v) The rate of infant mortality and the rate of low-
            birthweight births.
                (vi) The percentage of the general population 
            constituted by individuals who are members of racial or 
            ethnic minority groups, stated both by minority group and in 
            the aggregate.
                (vii) The percentage of the general population 
            constituted by individuals who are of Hispanic ethnicity.
                (viii) The number of individuals residing in health 
            professional shortage areas, and the number of individuals 
            who are members of medically underserved populations.
                (ix) The percentage of the general population 
            constituted by elderly individuals.
                (x) The extent to which the populations served have a 
            choice of providers.
                (xi) The impact of care on hospitalizations and 
            emergency room use.
                (xii) The number of individuals who lack proficiency in 
            speaking the English language.
                (xiii) Such additional factors as the Secretary 
            determines to be appropriate.

                       (3) Report to Congress

        Not later than 30 days after the completion of the development 
    of the methodology required in paragraph (1), the Secretary shall 
    submit to the Committee on Commerce of the House of Representatives, 
    and to the Committee on Labor and Human Resources of the Senate, a 
    report describing the methodology and explaining the effects of the 
    methodology on the allocation among parts B, C, and D of this 
    subchapter (and programs within such parts) of amounts appropriated 
    under subsection (a) of this section for the first fiscal year for 
    which the methodology will be in effect. Such explanation shall 
    include a comparison of the allocation for such fiscal year with the 
    allocation made under this section for the preceding fiscal year.

(d) Use of methodology before fiscal year 2003

    With respect to the fiscal years 1999 through 2002, if the report 
required in subsection (c)(3) of this section is submitted in accordance 
with such subsection not later than 90 days before the beginning of such 
a fiscal year, the Secretary may for such year implement the methodology 
described in the report (rather than implementing the methodology in 
fiscal year 2003), in which case subsection (b) of this section ceases 
to be in effect. The authority under the preceding sentence is subject 
to the condition that the fiscal year for which the methodology is 
implemented be the same fiscal year identified in such report as the 
fiscal year for which the methodology will first be in effect.

(e) Authority for use of additional factors in methodology

                           (1) In general

        The Secretary shall make the determinations specified in 
    paragraph (2). For any fiscal year beginning after the first fiscal 
    year for which the methodology under subsection (c)(1) of this 
    section is in effect, the Secretary may alter the methodology by 
    including the information from such determinations as factors in the 
    methodology.

                     (2) Relevant determinations

        The determinations referred to in paragraph (1) are as follows:
            (A) The need for and the distribution of health services 
        among populations for which it is difficult to determine the 
        number of individuals who are in the population, such as 
        homeless individuals; migratory and seasonal agricultural 
        workers and their families; individuals infected with the human 
        immunodeficiency virus, and individuals who abuse drugs.
            (B) In the case of a population for which the determinations 
        under subparagraph (A) are made, the extent to which the 
        population includes individuals who are members of racial or 
        ethnic minority groups and a specification of the skills needed 
        to provide health services to such individuals in the language 
        and the educational and cultural context that is most 
        appropriate to the individuals.
            (C) Data, obtained from the Director of the Centers for 
        Disease Control and Prevention, on rates of morbidity and 
        mortality among various populations (including data on the rates 
        of maternal and infant mortality and data on the rates of low-
        birthweight births of living infants).
            (D) Data from the Health Plan Employer Data and Information 
        Set, as appropriate.

(July 1, 1944, ch. 373, title VIII, Sec. 841, as added Pub. L. 105-392, 
title I, Sec. 123(5), Nov. 13, 1998, 112 Stat. 3569.)

                       References in Text

    Section 296m of this title, referred to in subsec. (b)(1), was 
repealed and a new section 296m was enacted by Pub. L. 105-392, title I, 
Sec. 123(1), (4), Nov. 13, 1998, 112 Stat. 3562, 3568.
    Section 297-1 of this title, referred to in subsec. (b)(2), was 
repealed by Pub. L. 105-392, title I, Sec. 123(1), Nov. 13, 1998, 112 
Stat. 3562.


                            Prior Provisions

    A prior section 841 of act July 1, 1944, was classified to section 
297h of this title prior to repeal by Pub. L. 99-92.
