[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1774 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 1774

To amend the Public Health Service Act to establish a program of grants 
                       for rural health outreach.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 21, 1993

 Mr. Gunderson (for himself, Mr. Slattery, Mr. Roberts, Ms. Snowe, Mr. 
   Emerson, Mr. Thomas of Wyoming, and Mr. Stenholm) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to establish a program of grants 
                       for rural health outreach.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Health Outreach Grants 
Amendments Act''.

SEC. 2. ESTABLISHMENT OF PROGRAM OF GRANTS FOR RURAL HEALTH OUTREACH.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following new part:

             ``Part P--Rural Health Outreach Grant Program

``SEC. 399B. RURAL HEALTH OUTREACH GRANT PROGRAM.

    ``(a) In General.--The Secretary may make grants to demonstrate new 
and innovative models of outreach and health care services delivery in 
rural areas that lack basic health services. Grants will be awarded for 
one of the following: direct provision of health services to rural 
populations (especially for those who are not currently receiving those 
services), or to enhance access to and utilization of existing 
available services.
    ``(b) Missions of the Outreach Projects.--Projects under subsection 
(a) should be designed to address the needs of a wide range of 
populations living in rural communities including, but not limited to, 
the poor, farmers, farm workers, senior citizens, individuals with 
disabilities, pregnant women, infants, adolescents, and rural 
populations with special health care needs. The program could include 
projects to:
            ``(1) Provide, enhance, or revitalize emergency medical 
        services in rural communities.
            ``(2) Provide ambulatory health and/or mental health 
        services in health professional shortage areas and in frontier 
        areas.
            ``(3) Enhance the health and safety of farmers through 
        direct health services for farm families, and migrant and 
        seasonal farm workers.
            ``(4) Provide direct health services to enhance health care 
        services to senior citizens.
            ``(5) Provide direct health services that will reduce 
        infant mortality in rural communities.
    ``(c) Composition of Program.--
            ``(1) Consortium arrangements.--Participation in the 
        program established in subsection (a) requires the formation of 
        consortium arrangements among three or more separate and 
        distinct entities to carry out an outreach project.
            ``(2) Certain requirements.--
                    ``(A) A consortium under paragraph (1) must be 
                composed of three or more existing health care 
                providers or a combination of three or more health care 
                and social service providers. Consortium members may 
                include such entities as: hospitals, public health 
                agencies, home health providers, mental health centers, 
                rural health clinics, social service agencies, health 
                profession(s) schools, educational institutions, 
                emergency medical centers/providers, and community and 
                migrant health centers.
                    ``(B) All public and private entities, both 
                nonprofit and for-profit may participate as members of 
                a consortium arrangement under paragraph (1).
                    ``(C) A grant under subsection (a) will be made to 
                only one entity in a consortium under paragraph (1). 
                The grant recipient must be a nonprofit or public 
                entity which meets one of the following requirements:
                            ``(i) Applicants must be located outside of 
                        a Metropolitan Statistical Area as defined by 
                        the Federal Government.
                            ``(ii) Applicant must be located in a rural 
                        census tract. (This provision applies to 
                        counties that are technically classified as 
                        Metropolitan Statistical Areas or considered as 
                        part of a Metropolitan Statistical Area but 
                        large parts of the counties are rural.) 
                        Organizations located in the rural areas of the 
                        counties mentioned previously are eligible for 
                        participation in the program.
    ``(d) Review Criteria.--An outreach application under this section 
may be evaluated based on the following criteria:
            ``(1) The extent to which the applicant has proposed a new 
        and innovative approach to health care in the rural area. 
        Services shall be directed as population groups that are 
        unserved or underserved.
            ``(2) The extent to which the applicant has justified and 
        documented the needs for the project and developed measurable 
        goals for meeting the needs.
            ``(3) The extent to which the applicant has clearly defined 
        the roles and responsibilities for each member of the 
        consortium and developed a workable plan for managing the 
        consortium's activities.
            ``(4) The level of local commitment and involvement with 
        the project, including the extent of cost participation by the 
        applicant and/or other organizations.
            ``(5) The feasibility of the project to continue after 
        Federal grant support is completed.
            ``(6) The extent of the evaluation component.
    ``(e) How Project Funds Are To Be Expended.--
            ``(1) Grantees under subsection (a) will be required to use 
        at least 85 percent of the total amount awarded for outreach 
        and care services.
            ``(2) 60 percent of funds must be spent in rural areas. 
        This provision is designed accordingly--when a consortium is 
        purchasing goods and services, priority should be given to 
        purchases in rural areas.
            ``(3) Grant funds may not be used for purchase, 
        construction, or renovation of real property or to support the 
        delivery of inpatient services.
            ``(4) Grant funds may be used for equipment and vehicles 
        when such equipment is essential to carrying out the outreach 
        project.
            ``(5) Individual grant awards will be limited to a total 
        amount of $300,000 per year. Projects will be federally funded 
        for three years.
            ``(6) Applicants must demonstrate that existing levels of 
        institutional and other support are not reduced or supplanted 
        by the availability of these grant funds.
    ``(f) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $25,000,000 
for fiscal year 1994, and such sums as may be necessary for each fiscal 
year thereafter.''.

                                 <all>