II
Calendar No. 548
110th CONGRESS
1st Session
S. 901
IN THE SENATE OF THE UNITED STATES
March 15, 2007
Mr. Kennedy (for himself, Mr. Hatch, Mr. Dodd, Mr. Roberts, Mr. Harkin, Mr. Bond, Ms. Mikulski, Ms. Snowe, Mr. Bingaman, Mr. Domenici, Mr. Reed, Ms. Murkowski, Mrs. Clinton, Mr. Bennett, Mr. Obama, Mr. Grassley, Mr. Brown, Mr. Burr, Mr. Menendez, Mr. Schumer, Mr. Lieberman, Mrs. Murray, Mr. Coleman, Mr. Smith, Mr. Conrad, Mr. Tester, Mr. Whitehouse, Mr. Baucus, Mr. Akaka, Mr. Inouye, Mr. Kerry, Mr. Durbin, Ms. Cantwell, Mr. Lautenberg, Ms. Collins, Mr. Isakson, Mr. Sununu, Mr. Sanders, Mr. Kohl, Mr. Johnson, Ms. Landrieu, Mr. Levin, Mr. Thune, Mrs. Feinstein, Mr. Pryor, Mr. Craig, Mr. Salazar, Mr. Leahy, Mrs. Lincoln, Mr. Biden, Mr. Cochran, Mr. Warner, Mr. Chambliss, Ms. Stabenow, Mr. Dorgan, Mr. Lugar, Mr. Voinovich, Mr. Nelson of Florida, Mrs. Boxer, Mr. Casey, Mrs. Dole, Ms. Klobuchar, Mr. Carper, Mr. Cardin, Mrs. McCaskill, Mr. Bayh, Mr. Webb, Mrs. Hutchison, and Mr. Specter) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
December 18, 2007
Reported by Mr. Kennedy, with an amendment and an amendment to the title
Strike out all after the enacting clause and insert the part printed in italic
A BILL
To amend the Public Health Service Act to provide additional authorizations of appropriations for the health centers program under section 330 of such Act.
Short title
This Act may be cited as the
Health Centers Renewal Act of
2007
.
Findings
Congress finds as follows:
Community, migrant, public housing, and homeless health centers are vital to thousands of communities across the United States.
There are more than 1,000 such health centers serving more than 16,000,000 people at more than 5,000 health delivery sites, located in all 50 States of the United States, the District of Columbia, and Puerto Rico, Guam, the Virgin Islands, and other territories of the United States.
Health centers provide cost-effective, quality health care to poor and medically underserved people in the States, the District of Columbia, and the territories, including the working poor, the uninsured, and many high-risk and vulnerable populations, and have done so for over 40 years.
Health centers provide care to 1 of every 8 uninsured Americans, 1 of every 4 Americans in poverty, and 1 of every 9 rural Americans.
Health centers provide primary and preventive care services to more than 700,000 homeless persons and more than 725,000 farm workers in the United States.
Health centers are community-oriented and patient-focused and tailor their services to fit the special needs and priorities of local communities, working together with schools, businesses, churches, community organizations, foundations, and State and local governments.
Health centers are built through community initiative.
Health centers encourage citizen participation and provide jobs for 50,000 community residents.
Congress established the program as a unique public-private partnership, and has continued to provide direct funding to community organizations for the development and operation of health centers systems that address pressing local health needs and meet national performance standards.
Federal grants assist participating communities in finding partners and recruiting doctors and other health professionals.
Federal grants constitute, on average, 24 percent of the annual budget of such health centers, with the remainder provided by State and local governments, Medicare, Medicaid, private contributions, private insurance, and patient fees.
Health centers make health care responsive and cost-effective through aggressive outreach, patient education, translation, and other enabling support services.
Health centers help reduce health disparities, meet escalating health care needs, and provide a vital safety net in the health care delivery system of the United States.
Health centers increase the use of preventive health services, including immunizations, pap smears, mammograms, and HBa1c tests for diabetes screenings.
Expert studies have demonstrated the impact that these community-owned and patient-controlled primary care delivery systems have achieved both in the reduction of traditional access barriers and the elimination of health disparities among their patients.
Additional authorizations of appropriations for health centers program of Public Health Service Act
Section 330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) is amended by amending paragraph (1) to read as follows:
In general
For the purpose of carrying out this section, in addition to the amounts authorized to be appropriated under subsection (d), there are authorized to be appropriated—
$2,188,745,000 for fiscal year 2008;
$2,451,394,400 for fiscal year 2009;
$2,757,818,700 for fiscal year 2010;
$3,116,335,131 for fiscal year 2011; and
$3,537,040,374 for fiscal year 2012.
.
Short title
This Act may be cited as the
Health Care Safety Net Act of
2007
.
Community health centers program of the Public Health Service Act
Additional authorizations of appropriations for the health centers program of Public Health Service Act
Section 330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) is amended by amending paragraph (1) to read as follows:
In general
For the purpose of carrying out this section, in addition to the amounts authorized to be appropriated under subsection (d), there are authorized to be appropriated—
$2,213,020,000 for fiscal year 2008;
$2,451,394,400 for fiscal year 2009;
$2,757,818,700 for fiscal year 2010;
$3,116,335,131 for fiscal year 2011; and
$3,537,040,374 for fiscal year 2012.
.
Studies relating to community health centers
Definitions
For purposes of this subsection—
the term community health center means a health center receiving assistance under section 330 of the Public Health Service Act (42 U.S.C. 254b); and
the term medically underserved population has the meaning given that term in such section 330.
School-based health center study
In general
Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall issue a study of the economic costs and benefits of school-based health centers and the impact on the health of students of these centers.
Content
In conducting the study under subparagraph (A), the Comptroller General of the United States shall analyze—
the impact that Federal funding could have on the operation of school-based health centers;
any cost savings to other Federal programs derived from providing health services in school-based health centers;
the effect on the Federal Budget and the health of students of providing Federal funds to school-based health centers and clinics, including the result of providing disease prevention and nutrition information;
the impact of access to health care from school-based health centers in rural or underserved areas; and
other sources of Federal funding for school-based health centers.
Health care quality study
In general
Not later than 1 year after the date of enactment of this
Act, the Secretary of Health and Human Services (referred to in this Act as the
Secretary
), acting through the Administrator of the Health
Resources and Services Administration, and in collaboration with the Agency for
Healthcare Research and Quality, shall prepare and submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives a report that describes
agency efforts to expand and accelerate quality improvement activities in
community health centers.
Content
The report under subparagraph (A) shall focus on—
Federal efforts, as of the date of enactment of this Act, regarding health care quality in community health centers, including quality data collection, analysis, and reporting requirements;
identification of effective models for quality improvement in community health centers, which may include models that—
incorporate care coordination, disease management, and other services demonstrated to improve care;
are designed to address multiple, co-occurring diseases and conditions;
improve access to providers through non-traditional means, such as the use of remote monitoring equipment;
target various medically underserved populations, including uninsured patient populations;
increase access to specialty care, including referrals and diagnostic testing; and
enhance the use of electronic health records to improve quality;
efforts to determine how effective quality improvement models may be adapted for implementation by community health centers that vary by size, budget, staffing, services offered, populations served, and other characteristics determined appropriate by the Secretary;
types of technical assistance and resources provided to community health centers that may facilitate the implementation of quality improvement interventions;
proposed or adopted methodologies for community health center evaluations of quality improvement interventions, including any development of new measures that are tailored to safety-net, community-based providers;
successful strategies for sustaining quality improvement interventions in the long-term; and
partnerships with other Federal agencies and private organizations or networks as appropriate, to enhance health care quality in community health centers.
Dissemination
The Administrator of the Health Resources and Services Administration shall establish a formal mechanism or mechanisms for the ongoing dissemination of agency initiatives, best practices, and other information that may assist health care quality improvement efforts in community health centers.
GAO study on integrated health systems model for the delivery of health care services to medically underserved populations
Study
The Comptroller General of the United States shall conduct a study on integrated health system models at not more than 10 sites for the delivery of health care services to medically underserved populations. The study shall include an examination of—
health care delivery models sponsored by public or private non-profit entities that—
integrate primary, specialty, and acute care; and
serve medically underserved populations; and
such models in rural and urban areas.
Report
Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the study conducted under subparagraph (A). The report shall include—
an evaluation of the models, as described in subparagraph (A), in—
expanding access to primary and preventive services for medically underserved populations; and
improving care coordination and health outcomes; and
an assessment of—
challenges encountered by such entities in providing care to medically underserved populations; and
advantages and disadvantages of such models compared to other models of care delivery for medically underserved populations.
National Health Service Corps
Funding
National Health Service Corps Program
Section 338(a) of the Public Health Service Act (42
U.S.C. 254k(a)) is amended by striking 2002 through 2006
and
inserting 2008 through 2012
.
Scholarship and Loan Repayment Programs
Section 338H(a) of
the Public Health Service Act (42 U.S.C. 254q(a)) is amended by striking
appropriated $146,250,000
and all that follows through the
period and inserting the following: “appropriated—
for fiscal year 2008, $131,500,000;
for fiscal year 2009, $143,335,000;
for fiscal year 2010, $156,235,150;
for fiscal year 2011, $170,296,310; and
for fiscal year 2012, $185,622,980.
.
Elimination of 6-year demonstration requirement
Section 332(a)(1) of the Public Health
Service Act (42 U.S.C. 254e(a)(1)) is amended by striking Not earlier
than 6 years
and all that follows through purposes of this
section.
.
Assignment to shortage area
Section 333(a)(1)(D)(ii) of the Public Health Service Act (42 U.S.C. 254f(a)(1)(D)(ii)) is amended—
in subclause (IV), by
striking and
;
in subclause (V), by
striking the period at the end and inserting ; and
; and
by adding at the end the following:
the entity demonstrates willingness to support or facilitate mentorship, professional development, and training opportunities for Corps members.
.
Professional development and training
Subsection (d) of section 336 of the Public Health Service Act (42 U.S.C. 254h–1) is amended to read as follows:
Professional development and training
In general
The Secretary shall assist Corps members in establishing and maintaining professional relationships and development opportunities, including by—
establishing appropriate professional relationships between the Corps member involved and the health professions community of the geographic area with respect to which the member is assigned;
establishing professional development, training, and mentorship linkages between the Corps member involved and the larger health professions community, including through distance learning, direct mentorship, and development and implementation of training modules designed to meet the educational needs of offsite Corps members;
establishing professional networks among Corps members; or
engaging in other professional development, mentorship, and training activities for Corps members, at the discretion of the Secretary.
Assistance in establishing professional relationships
In providing such assistance under paragraph (1), the Secretary shall focus on establishing relationships with hospitals, with academic medical centers and health professions schools, with area health education centers under section 751, with health education and training centers under section 752, and with border health education and training centers under such section 752. Such assistance shall include assistance in obtaining faculty appointments at health professions schools.
Supplement not supplant
Such efforts under this subsection shall supplement, not supplant, non-government efforts by professional health provider societies to establish and maintain professional relationships and development opportunities.
.
Reauthorization of rural health care programs
Section 330A(j) of the Public Health Service
Act (42 U.S.C. 254c(j)) is amended by striking $40,000,000
and
all that follows and inserting $45,000,000 for each of fiscal years 2008
through 2012.
.
Amend the title so as to read:
A bill to amend the Public Health Service Act to reauthorize the
Community Health Centers program, the National Health Service Corps, and rural
health care programs.
.
December 18, 2007
Reported with an amendment and an amendment to the title
