PRIA, Government Policy, Made Personal

Summary

The Director must lead and pay for research to find groups that get worse health care, worse results, higher costs, or have less access or satisfaction than most people. The Director must study why those differences happen, looking at things like income, health attitudes, language, schooling, and where people live. The Director must test and show ways to reduce these gaps, make tools to measure and improve care, help train more researchers who come from those groups, and strengthen the institutions that train them. Starting with fiscal year 2003, the Director must send Congress a yearly report on racial and socioeconomic gaps in health care for priority groups. The research must find clinical, cultural, geographic, and organizational causes, test fixes that work, figure out how to spread them, and involve affected people, community groups, and researchers from those communities using centers of excellence, provider networks, health service models (like health centers and the Indian Health Service), and other practical methods. The Director must also create ways to measure how these groups experience health care — such as access, cultural fit of services, quality, and outcomes. The Director must study providers who have reduced disparities or who give culturally competent care and must report on the state of quality measurement for minority and other disparity populations not later than 36 months after November 22, 2000, including unmet needs and related public and private activities. Definitions: “health disparity population” — groups with significant differences in care or access, as described above; “minority” — racial and ethnic minority groups as defined in law.

Title 42, §299a–1

The Public Health and Welfare, Source: USLM XML via OLRC

(a)The Director shall—

(1)conduct and support research to identify populations for which there is a significant disparity in the quality, outcomes, cost, or use of health care services or access to and satisfaction with such services, as compared to the general population;

(2)conduct and support research on the causes of and barriers to reducing the health disparities identified in paragraph (1), taking into account such factors as socioeconomic status, attitudes toward health, the language spoken, the extent of formal education, the area or community in which the population resides, and other factors the Director determines to be appropriate;

(3)conduct and support research and support demonstration projects to identify, test, and evaluate strategies for reducing or eliminating health disparities, including development or identification of effective service delivery models, and disseminate effective strategies and models;

(4)develop measures and tools for the assessment and improvement of the outcomes, quality, and appropriateness of health care services provided to health disparity populations;

(5)in carrying out section 299a(c) of this title, provide support to increase the number of researchers who are members of health disparity populations, and the health services research capacity of institutions that train such researchers; and

(6)beginning with fiscal year 2003, annually submit to the Congress a report regarding prevailing disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations.

(b)(1)In carrying out subsection (a), the Director shall conduct and support research and support demonstrations to—

(A)identify the clinical, cultural, socioeconomic, geographic, and organizational factors that contribute to health disparities, including minority health disparity populations, which research shall include behavioral research, such as examination of patterns of clinical decisionmaking, and research on access, outreach, and the availability of related support services (such as cultural and linguistic services);

(B)identify and evaluate clinical and organizational strategies to improve the quality, outcomes, and access to care for health disparity populations, including minority health disparity populations;

(C)test such strategies and widely disseminate those strategies for which there is scientific evidence of effectiveness; and

(D)determine the most effective approaches for disseminating research findings to health disparity populations, including minority populations.

(2)In carrying out this section, the Director shall implement research strategies and mechanisms that will enhance the involvement of individuals who are members of minority health disparity populations or other health disparity populations, health services researchers who are such individuals, institutions that train such individuals as researchers, members of minority health disparity populations or other health disparity populations for whom the Agency is attempting to improve the quality and outcomes of care, and representatives of appropriate tribal or other community-based organizations with respect to health disparity populations. Such research strategies and mechanisms may include the use of—

(A)centers of excellence that can demonstrate, either individually or through consortia, a combination of multi-disciplinary expertise in outcomes or quality improvement research, linkages to relevant sites of care, and a demonstrated capacity to involve members and communities of health disparity populations, including minority health disparity populations, in the planning, conduct, dissemination, and translation of research;

(B)provider-based research networks, including health plans, facilities, or delivery system sites of care (especially primary care), that make extensive use of health care providers who are members of health disparity populations or who serve patients in such populations and have the capacity to evaluate and promote quality improvement;

(C)service delivery models (such as health centers under section 254b of this title and the Indian Health Service) to reduce health disparities; and

(D)innovative mechanisms or strategies that will facilitate the translation of past research investments into clinical practices that can reasonably be expected to benefit these populations.

(c)(1)To ensure that health disparity populations, including minority health disparity populations, benefit from the progress made in the ability of individuals to measure the quality of health care delivery, the Director shall support the development of quality of health care measures that assess the experience of such populations with health care systems, such as measures that assess the access of such populations to health care, the cultural competence of the care provided, the quality of the care provided, the outcomes of care, or other aspects of health care practice that the Director determines to be important.

(2)The Director shall examine the practices of providers that have a record of reducing health disparities or have experience in providing culturally competent health services to minority health disparity populations or other health disparity populations. In examining such practices of providers funded under the authorities of this chapter, the Director shall consult with the heads of the relevant agencies of the Public Health Service.

(3)Not later than 36 months after November 22, 2000, the Secretary, acting through the Director, shall prepare and submit to the appropriate committees of Congress a report describing the state-of-the-art of quality measurement for minority and other health disparity populations that will identify critical unmet needs, the current activities of the Department to address those needs, and a description of related activities in the private sector.

(d)For purposes of this section:

(1)The term “health disparity population” has the meaning given such term in section 285t of this title, except that in addition to the meaning so given, the Director may determine that such term includes populations for which there is a significant disparity in the quality, outcomes, cost, or use of health care services or access to or satisfaction with such services as compared to the general population.

(2)The term “minority”, with respect to populations, refers to racial and ethnic minority groups as defined in section 300u–6 of this title.

Notes & Related Subsidiaries

Editorial Notes

Prior Provisions

A prior section 299a–1, act

July 1, 1944, ch. 373, title IX, § 903, as added Pub. L. 101–239, title VI, § 6103(a), Dec. 19, 1989, 103 Stat. 2190; amended Pub. L. 102–410, § 3, Oct. 13, 1992, 106 Stat. 2094; Pub. L. 103–43, title XIV, § 1422(a),

June 10, 1993, 107 Stat. 172, related to public dissemination of information about studies and projects prior to the general amendment of this subchapter by Pub. L. 106–129. See section 299c–3 of this title. A prior section 903 of act

July 1, 1944, was classified to section 299c of this title prior to repeal by Pub. L. 99–117. Prior section 299a–2 and 299a–3 were omitted in the general amendment of this subchapter by Pub. L. 106–129. section 299a–2, act

July 1, 1944, ch. 373, title IX, § 904, as added Pub. L. 101–239, title VI, § 6103(a), Dec. 19, 1989, 103 Stat. 2191; amended Pub. L. 102–410, § 4(a), Oct. 13, 1992, 106 Stat. 2095; Pub. L. 103–43, title XX, § 2013(1),

June 10, 1993, 107 Stat. 214, related to health care technology assessment. See section 299b–5 of this title. section 299a–3, act

July 1, 1944, ch. 373, title IX, § 905, as added Pub. L. 105–115, title IV, § 409, Nov. 21, 1997, 111 Stat. 2371, established demonstration program regarding centers for education and research on therapeutics. See section 299b–1(b) of this title.

Amendments

2010—Subsec. (d)(1). Pub. L. 111–148 substituted “285t” for “287c–31”.

§299a–1 Research on Health Disparities