Page:United States Statutes at Large Volume 114 Part 4.djvu/264

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114 STAT. 2326 PUBLIC LAW 106-505—NOV. 13, 2000 (B) The prolonged period of clinical training required increases the accumulated debt burden. (C) The decreasing number of mentors and role models. (D) The perceived instability of funding from the National Institutes of Health and other Federal agencies. (E) The almost complete absence of clinical research training in the curriculum of training grant awardees. (F) Academic Medical Centers are experiencing difficulties in maintaining a proper environment for research in a highly competitive health care marketplace, which are compounded by the decreased willingness of third party payers to cover health care costs for patients engaged in research studies and research procedures. (10) In 1960, general clinical research centers were established under the Office of the Director of the National Institutes of Health with an initial appropriation of $3,000,000. (11) Appropriations for general clinical research centers in fiscal year 1999 equaled $200,500,000. (12) Since the late 1960s, spending for general clinical research centers has declined from approximately 3 percent to 1 percent of the National Institutes of Health budget. (13) In fiscal year 1999, there were 77 general clinical research centers in operation, supplying patients in the areas in which such centers operate with access to the most modern clinical research and clinical research facilities and technologies. (b) PURPOSE. — It is the purpose of this title to provide additional support for and to expand clinical research programs. SEC. 203. INCREASING THE INVOLVEMENT OF THE NATIONAL INSTITUTES OF HEALTH IN CLINICAL RESEARCH. Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et seq.) is amended by adding at the end the following: 42 USC 284k. «SEC. 409C. CLINICAL RESEARCH. "(a) IN GENERAL. —The Director of National Institutes of Health shall undertake activities to support and expand the involvement of the National Institutes of Health in clinical research. "(b) REQUIREMENTS.—In carrying out subsection (a), the Director of National Institutes of Health shall— "(1) consider the recommendations of the Division of Research Grants Clinical Research Study Group and other recommendations for enhancing clinical research; and "(2) establish intramural and extramural clinical research fellowship programs directed specifically at medical and dental students and a continuing education clinical research training program at the National Institutes of Health. "(c) SUPPORT FOR THE DIVERSE NEEDS OF CLINICAL RESEARCH.— The Director of National Institutes of Health, in cooperation with the Directors of the Institutes, Centers, and Divisions of the National Institutes of Health, shall support and expand the resources available for the diverse needs of the clinical research community, including inpatient, outpatient, and critical care clinical research. "(d) PEER REVIEW.— The Director of National Institutes of Health shall establish peer review mechanisms to evaluate applications for the awards and fellowships provided for in subsection (b)(2) and section 409D. Such review mechanisms shall include