H. R. 3003
IN THE HOUSE OF REPRESENTATIVES
June 23, 2009
Mrs. Capps (for herself, Mr. Rogers of Michigan, Mrs. Davis of California, Mrs. Capito, Mrs. Napolitano, Mr. Berman, Mr. Hare, and Ms. Schakowsky) introduced the following bill; which was referred to the Committee on Energy and Commerce
To amend the Public Health Service Act to establish the School-Based Health Clinic program, and for other purposes.
This Act may be cited as the
School-Based Health Clinic
Establishment Act of 2009.
Findings and purpose
Congress makes the following findings:
More than 8,000,000 children in the United States have no form of health insurance and are therefore unable to access preventive health care which may lead to untreated conditions, unnecessary diseases, and death.
The American Medical Association rates adolescents aged 13–18 as the group of Americans with the poorest health indicators.
More than 70 percent of the children who need psychiatric treatment do not receive services.
Children who are in poor health or are victims of child abuse, poverty, malnutrition, alcohol, and drug abuse are at risk for academic and social failure.
Without health and social intervention, at-risk children are often unable to improve academic performance.
School-based health clinics are effective in bringing preventive and primary care to children and adolescents.
School-based health clinics are effective in decreasing academic failure resulting from poor health.
The purpose of this Act is to fund the development and operation of school-based health clinics to—
provide comprehensive and accessible primary health care services to medically underserved children, youth, and families;
improve the physical health, emotional well-being, and academic performance of medically underserved children, youth, and families; and
work in collaboration with the school to integrate health into the overall school environment.
School-based health clinics
Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:
School-based health clinics
Definitions; Establishment of Criteria
In this section:
The term community includes parents, patients, local leaders, and community based organizations.
Comprehensive primary health services
The term comprehensive primary health services means the core services offered by school-based health clinics, which shall include the following:
Comprehensive health assessments, diagnosis, and treatment of minor, acute, and chronic medical conditions and referrals to, and follow-up for, specialty care.
Mental health assessments, crisis intervention, counseling, treatment, and referral to a continuum of services including emergency psychiatric care, community support programs, inpatient care, and outpatient programs.
Additional services, which may include oral health, social, and age-appropriate health education services, including nutritional counseling.
Medically underserved children and adolescents
The term medically underserved children and adolescents means a population of children and adolescents who are residents of an area designated by the Secretary as an area with a shortage of personal health services and health infrastructure for such children and adolescents.
The Secretary shall prescribe criteria for determining the specific shortages of personal health services for medically underserved children and adolescents under subparagraph (A) that shall—
take into account any comments received by the Secretary from the chief executive officer of a State and local officials in a State; and
include factors indicative of the health status of such children and adolescents of an area, including the ability of the residents of such area to pay for health services, the accessibility of such services, the availability of health professionals to such children and adolescents, and other factors as determined appropriate by the Secretary.
School-based health clinic
The term school-based health clinic means a health clinic that—
is located in, or is adjacent to, a school facility of a local educational agency;
is organized through school, community, and health provider relationships;
is administered by a sponsoring facility; and
provides, at a minimum, comprehensive primary health services during school hours to children and adolescents by health professionals in accordance with State and local laws and regulations, established standards, and community practice.
The term sponsoring facility is—
a public health department;
a community health center;
a nonprofit health care agency;
a local educational agency; or
a program administered by the Indian Health Service or the Bureau of Indian Affairs or operated by an Indian tribe or a tribal organization under the Indian Self-Determination and Education Assistance Act, a Native Hawaiian entity, or an urban Indian program under title V of the Indian Health Care Improvement Act.
Authority To Award Grants
The Secretary shall award grants for the costs of
the operation of school-based health clinics (referred to in this section as
SBHCs) that meet the requirements of this section.
To be eligible to receive a grant under this section, an entity shall—
be an SBHC (as defined in subsection (a)(4)); and
submit to the Secretary an application at such time, in such manner, and containing—
evidence that the applicant meets all criteria necessary to be designated an SBHC;
evidence of local need for the services to be provided by the SBHC;
an assurance that—
SBHC services will be provided to those children and adolescents for whom parental or guardian consent has been obtained in accordance with Federal, State, and local laws governing health care service provision to children and adolescents;
the SBHC has made and will continue to make every reasonable effort to establish and maintain collaborative relationships with other health care providers in the catchment area of the SBHC;
the SBHC will provide on-site access during the academic day when school is in session and has an established network of support and access to services with backup health providers when the school or SBHC is closed;
the SBHC will be integrated into the school environment and will coordinate health services with school personnel, such as administrators, teachers, nurses, counselors, and support personnel, as well as with other community providers co-located at the school;
the SBHC sponsoring facility assumes all responsibility for the SBHC administration, operations, and oversight; and
the SBHC will comply with Federal, State, and local laws concerning patient privacy and student records, including the HIPAA and Section 444 of the General Education Provisions Act; and
such other information as the Secretary may require.
In reviewing applications, the Secretary may give preference to applicants who demonstrate an ability to serve the following:
Communities that have evidenced barriers to primary health care and mental health services for children and adolescents.
Communities with high percentages of children and adolescents who are uninsured, underinsured, or enrolled in public health insurance programs.
Populations of children and adolescents that have historically demonstrated difficulty in accessing health and mental health services.
Waiver of Requirements
The Secretary may—
under appropriate circumstances, waive the application of all or part of the requirements of this section with respect to an SBHC for no more than 2 years; and
upon a showing of good cause, waive the requirement that the SBHC provide all required comprehensive primary health services for a designated period of time to be determined by the Secretary.
Use of Funds
Funds awarded under a grant under this section may be used for—
acquiring and leasing equipment (including the costs of amortizing the principle of, and paying interest on, loans for such equipment),
providing training related to the provision of required comprehensive primary health services and additional health services,
the management and operation of health center programs, and
the payment of salaries for physicians, nurses, and other personnel of the SBHC.
The Secretary may award grants which may be used to pay the costs associated with expanding and modernizing existing buildings for use as an SBHC, including the purchase of trailers or manufactured building to install on the school property.
The amount of any grant made in any fiscal year to an SBHC shall be determined by the Secretary, taking into account—
the financial need of the SBHC;
State, local, or other operation funding provided to the SBHC; and
other factors as determined appropriate by the Secretary.
Each recipient of a grant under this section shall provide, from non-Federal sources, an amount equal to 20 percent of the amount of the grant (which may be provided in cash or in kind) to carry out the activities supported by the grant.
The Secretary may waive all or part of the matching requirement described in paragraph (1) for any fiscal year for an SBHC if the Secretary determines that applying the matching requirement to the SBHC would result in serious hardship or an inability to carry out the purposes of this section.
Supplement, not supplant
Grant funds provided under this section shall be used to supplement, not supplant, other Federal or State funds.
The Secretary shall establish a program through which the Secretary shall provide (either through the Department of Health and Human Services or by grant or contract) technical and other assistance to SBHCs to assist such SBHCs to meet the requirements of subsection (c)(2)(C). Services provided through the program may include necessary technical and nonfinancial assistance, including fiscal and program management assistance, training in fiscal and program management, operational and administrative support, and the provision of information to the entities of the variety of resources available under this title and how those resources can be best used to meet the health needs of the communities served by the entities.
The Secretary shall develop and implement a plan for evaluating SBHCs and monitoring quality performances under the awards made under this section.
Authorization of Appropriations
For purposes of carrying out this section, there are authorized to be appropriated $50,000,000 for fiscal year 2010 and such sums as may be necessary for each of the fiscal years 2011 through 2014.