[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 2378 Introduced in Senate (IS)]







106th CONGRESS
  2d Session
                                S. 2378

To amend titles XVIII and XIX of the Social Security Act to improve the 
 safety of the medicare and medicaid programs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 6, 2000

 Mr. Grassley (for himself, Mr. Lieberman, Mr. Kerrey, and Mr. Bryan) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend titles XVIII and XIX of the Social Security Act to improve the 
 safety of the medicare and medicaid programs, and for other purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Stop All Frequent 
Errors (SAFE) in Medicare and Medicaid Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Purposes.
Sec. 3. Improvement of patient safety under the medicare program.
  ``Part D--Additional Responsibilities for the Secretary in Order To 
                      Improve Health Care Quality

        ``Sec. 1860A. Definitions.
        ``Sec. 1860B. Establishment of patient safety programs.
        ``Sec. 1860C. Patient safety reporting system.
        ``Sec. 1860D. Confidentiality and privacy protections.
Sec. 4. Improvement of patient safety under the medicaid program.
Sec. 5. Establishment of the Center for Patient Safety.
Sec. 6. Grants to establish patient safety programs.

SEC. 2. PURPOSES.

    The purposes of this Act are as follows:
            (1) To develop a nonpunitive error reduction system under 
        the medicare and medicaid programs under titles XVIII and XIX 
        of the Social Security Act (42 U.S.C. 1395 et seq.; 1396 et 
        seq.) with pragmatic reporting requirements and adequate legal 
        protections to support the collection of information under such 
        systems.
            (2) To extend existing confidentiality and peer review 
        protections to the additional required reports of error under 
        such systems that are developed for safety and quality 
        improvement purposes under the medicare and medicaid programs.
            (3) To create leadership, research, tools, and protocols to 
        enhance the knowledge base concerning patient safety under the 
        medicare and medicaid programs.
            (4) To raise standards and expectations for improvements in 
        patient safety under the medicare and medicaid programs.
            (5) To reduce deaths, serious injuries, and other health 
        care errors under the medicare and medicaid programs through 
        the implementation of safe practices at the delivery level.

SEC. 3. IMPROVEMENT OF PATIENT SAFETY UNDER THE MEDICARE PROGRAM.

    (a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by redesignating part D as part E and by 
inserting after part C the following new part:

  ``Part D--Additional Responsibilities for the Secretary in Order To 
                      Improve Health Care Quality

                             ``definitions

    ``Sec. 1860A. In this part:
            ``(1) Additional error event.--The term `additional error 
        event' means an event other than a sentinel event that the 
        Secretary, in consultation with the Agency for Healthcare 
        Research and Quality, national accrediting organizations, 
        provider and consumer organizations, and peer review 
        organizations, determines is a health care error, such as a 
        medication error, that has been demonstrated to contribute 
        substantially to morbidity and mortality.
            ``(2) Applicable event.--The term `applicable event' 
        means--
                    ``(A) a sentinel event; and
                    ``(B) an additional error event.
            ``(3) Medicaid program.--The term `medicaid program' means 
        the health care program under title XIX.
            ``(4) Medicare program.--The term `medicare program' means 
        the health care program under this title.
            ``(5) Provider of services.--The term `provider of 
        services' means a hospital, critical access hospital, skilled 
        nursing facility, comprehensive outpatient rehabilitation 
        facility, home health agency, renal dialysis facility, 
        ambulatory surgical center, or hospice program.
            ``(6) Sentinel event.--
                    ``(A) In general.--The term `sentinel event' means 
                any of the following:
                            ``(i) An event that--
                                    ``(I) has resulted in an 
                                unanticipated death or major permanent 
                                loss of function; and
                                    ``(II) is not related to the 
                                natural course of the illness or 
                                underlying condition of the patient.
                            ``(ii) Any of the following events (even if 
                        the outcome of the event did not result in 
                        death or major permanent loss of function):
                                    ``(I) Surgery on the wrong patient 
                                or wrong body part.
                                    ``(II) Hemolytic transfusion 
                                reaction involving administration of 
                                blood or blood products that have blood 
                                group incompatibilities.
                                    ``(III) Suicide of a patient in a 
                                setting where the patient receives 
                                around-the-clock care.
                                    ``(IV) Discharge of an infant to 
                                the wrong family.
                    ``(B) Major permanent loss of function.--For 
                purposes of subparagraph (A), the term `major permanent 
                loss of function' means sensory, motor, physiologic, or 
                intellectual impairment that--
                            ``(i) requires continued treatment or 
                        imposes persistent major restrictions in 
                        activities of daily living; and
                            ``(ii) was not present--
                                    ``(I) on admission of the patient; 
                                or
                                    ``(II) in the case of a patient who 
                                was not admitted, at the initiation of 
                                the provision of items or services to 
                                the patient.

               ``establishment of patient safety programs

    ``Sec. 1860B. (a) Establishment of Requirements.--The Secretary 
shall establish requirements for the establishment and implementation 
of patient safety programs for providers of services participating in 
the medicare program. Such requirements shall ensure that a patient 
safety program--
            ``(1) targets applicable events;
            ``(2) targets at least 1 additional source of health care 
        errors, to be determined by the provider of services, that 
        contributes significantly to morbidity and mortality in the 
        service area of the provider or in patients receiving care from 
        the provider;
            ``(3) analyzes the organizational processes, functions, and 
        services that are relevant to applicable events;
            ``(4) utilizes active investigation of medical records, 
        medication utilization, laboratory results, and other 
        information to discover health care errors; and
            ``(5) achieves significant measurable improvement in rates 
        of health care errors.
    ``(b) Establishment and Implementation of a Patient Safety Program 
as a Condition of Participation for Providers of Services.--The 
Secretary shall ensure that each provider of services participating in 
the medicare program (as a condition of such participation) has 
established and implemented a patient safety program that is in 
compliance with the requirements established under subsection (a).

                   ``patient safety reporting system

    ``Sec. 1860C. (a) Establishment.--The Secretary shall establish a 
patient safety reporting system that provides for the collection and 
analysis of standardized information concerning applicable events 
(including any root cause analysis of, or corrective actions taken with 
respect to, such events) under the medicare program.
    ``(b) Reports by Providers of Services to Agencies and Entities.--
            ``(1) In general.--Under the system established under 
        subsection (a), a provider of services shall report each 
        applicable event that occurs to an individual while the 
        individual is in the care or custody of the provider to--
                    ``(A) the State health agency or other appropriate 
                State agency of the State in which the provider of 
                services is furnishing the services involved;
                    ``(B) in the case of a provider of services 
                participating in the medicare program as a result of 
                accreditation by a national accrediting body, the 
                national accrediting body for the provider; and
                    ``(C) the appropriate peer review organization 
                under part B of title XI.
            ``(2) Standardized data for reports submitted to agencies 
        and entities.--
                    ``(A) Reporting standards.--The Secretary, in 
                consultation with the Agency for Healthcare Research 
                and Quality, national accrediting organizations, 
                provider and consumer organizations, and peer review 
                organizations, shall, after consideration of existing 
                reporting systems and standards, establish and maintain 
                a core set of reporting standards to be used by 
                providers of services in submitting the reports 
                required under paragraph (1) to the agencies and 
                entities described in such paragraph.
                    ``(B) Requirements for standards.--The reporting 
                standards developed under subparagraph (A) shall--
                            ``(i) require the inclusion of a 
                        description of the applicable events occurring 
                        during the period covered by the report;
                            ``(ii) except as provided in subparagraph 
                        (D), require the inclusion of the root cause 
                        analysis of each applicable event included in 
                        the report and a description of any corrective 
                        action taken by the provider of services with 
                        respect to such event or any other measures 
                        necessary to prevent similar applicable events 
                        from occurring in the future;
                            ``(iii) require that all provider of 
                        services provide the data required under this 
                        section;
                            ``(iv) require that the privacy of 
                        individuals whose treatment is the subject of a 
                        report is protected;
                            ``(v) include a nomenclature and taxonomy 
                        for the collection and reporting of such data; 
                        and
                            ``(vi) meet such other requirements as the 
                        Secretary determines appropriate.
                    ``(C) Medication errors.--In developing the 
                reporting standards under this paragraph, the Secretary 
                shall give immediate priority to the establishment of 
                taxonomies and reporting protocols relating to 
                medication errors.
                    ``(D) Waiver of certain reporting requirements.--If 
                determined appropriate by the Secretary, the standards 
                developed under this paragraph may permit a provider of 
                services to waive the reporting requirement described 
                in subparagraph (B)(ii) with respect to an additional 
                error event.
            ``(3) Phase-in of reporting.--
                    ``(A) In general.--The Secretary shall establish a 
                phase-in period with respect to the submission of data 
                by various providers of services pursuant to paragraph 
                (1).
                    ``(B) Requirements.--The phase-in period described 
                in subparagraph (A) shall require that--
                            ``(i) all hospitals submit the data 
                        required under this section beginning not later 
                        than 1 year after the date of enactment of the 
                        Stop All Frequent Errors (SAFE) in Medicare and 
                        Medicaid Act of 2000; and
                            ``(ii) all other providers of services 
                        submit such data beginning at a time determined 
                        appropriate by the Secretary.
    ``(c) Designation of Agency or Entity.--
            ``(1) In general.--Each provider of services shall 
        designate 1 of the agencies or entities described in subsection 
        (b)(1) to determine compliance with the patient safety 
        reporting system established under this section with respect to 
        applicable events for which reports are required under such 
        subsection.
            ``(2) Disapproval by secretary.--
                    ``(A) In general.--The Secretary may disapprove the 
                designation made under paragraph (1) if the Secretary 
                determines such disapproval to be appropriate.
                    ``(B) Designation of another agency or entity.--In 
                the case of a disapproval under subparagraph (A), the 
                provider of services shall designate another of the 
                agencies or entities described in subsection (b)(1) to 
                have designated authority.
    ``(d) Investigation of Applicable Events by Agency or Entity With 
Designated Authority.--The agency or entity designated by a provider of 
services under subsection (c) shall--
            ``(1) ensure that the provider of services, with respect to 
        any reported applicable event--
                    ``(A) conducts an investigation of the applicable 
                event;
                    ``(B) determines the root cause or causes of the 
                applicable event; and
                    ``(C) establishes and implements a time-limited 
                plan or strategy--
                            ``(i) to correct the problem or problems 
                        that resulted in the applicable event;
                            ``(ii) that leads to the reduction of the 
                        risk of such event happening in the future; and
                            ``(iii) that allows the agency or entity to 
                        determine the appropriateness of the root cause 
                        analyses and any corrective actions proposed or 
                        taken by the provider of services; and
            ``(2) prepare and submit the reports required under 
        subsection (e).
    ``(e) Reports to the Secretary by Agency or Entity With Designated 
Authority.--
            ``(1) In general.--The agency or entity with designated 
        authority shall submit a report containing the information 
        described in paragraph (3) to the Secretary in such form and 
        manner, and by such date, as the Secretary prescribes.
            ``(2) Frequency.--The report described in paragraph (1) 
        shall be submitted to the Secretary at regular intervals, but 
        not less frequently than annually.
            ``(3) Information to be reported.--
                    ``(A) In general.--The report described in 
                paragraph (1) shall include--
                            ``(i) a description of the applicable 
                        events occurring during the period covered by 
                        the report;
                            ``(ii) a description of any corrective 
                        action taken by the providers of services with 
                        respect to the applicable events or any other 
                        measures necessary to prevent similar 
                        applicable events from occurring in the future;
                            ``(iii) a description of proposed systems 
                        changes identified as a result of analysis of 
                        events from multiple providers; and
                            ``(iv) such additional information as the 
                        Secretary determines to be essential to ensure 
                        compliance with the requirements of this 
                        section.
                    ``(B) Information excluded.--The report submitted 
                under paragraph (1) shall not identify any provider of 
                services, practitioner or other health care worker, or 
                patient.
            ``(4) Additional reporting requirements when a provider has 
        been identified as having a pattern of poor performance.--
                    ``(A) Report to secretary.--
                            ``(i) In general.--Notwithstanding any 
                        other provision of law, in addition to the 
                        report required under paragraph (1), the agency 
                        or entity with designated authority shall 
                        report to the Secretary the name and address of 
                        any provider of services with a pattern of poor 
                        performance.
                            ``(ii) Information to the public.--The 
                        Secretary shall make the information described 
                        in clause (i) available to the public if the 
                        pattern of poor performance continues for more 
                        than 2 years.
                    ``(B) Determination of pattern.--The agency or 
                entity with designated authority shall determine if a 
                pattern of poor performance exists with respect to a 
                provider of services in accordance with the definition 
                of pattern of poor performance developed by the 
                Secretary under subparagraph (C).
                    ``(C) Development of definition.--
                            ``(i) In general.--The Secretary, in 
                        consultation with the Agency for Healthcare 
                        Research and Quality, national accrediting 
                        organizations, provider and consumer 
                        organizations, and peer review organizations, 
                        shall develop a definition to identify a 
                        provider of services with a pattern of poor 
                        performance. In developing such definition, the 
                        Secretary shall ensure that a provider of 
                        services described in clause (ii) is deemed to 
                        be a provider of services with a pattern of 
                        poor performance.
                            ``(ii) Provider described.--A provider of 
                        services described in this clause is a provider 
of services that has a pattern of--
                                    ``(I) failing to report applicable 
                                events pursuant to this part; or
                                    ``(II) except for events described 
                                in subsection (b)(2)(D), failing to 
                                implement corrective actions with 
                                respect to applicable events or 
                                significantly delaying such 
                                implementation.
                    ``(D) Effective date.--An agency or entity with 
                designated authority shall not submit a report to the 
                Secretary pursuant to this paragraph until the 
                Secretary has established the definition under 
                paragraph (C).
    ``(f) Enforcement of Requirements for Entities.--
            ``(1) Part of contract for peer review organizations.--
        Pursuant to section 1154(a)(17)(A), the requirements under this 
        part with respect to a peer review organization shall be 
        considered to be requirements under a contract between the 
        Secretary and the organization under part B of title XI.
            ``(2) Failure of accrediting body to comply with 
        requirements.--If an accrediting body refuses to comply with 
        the requirements under this part, the Secretary, after notice 
        to the accrediting body and opportunity to comply, may revoke 
        the authority of the accrediting body to serve as an agent of 
        the medicare or medicaid program for certification purposes.
            ``(3) Failure of health department of a state to comply 
        with requirements.--If a State health agency or other 
        appropriate State agency refuses to comply with the 
        requirements under this part, the Secretary, after notice to 
        the agency and opportunity to comply, shall revoke the ability 
        of a provider of services to designate such agency as the 
        agency with designated authority with respect to such provider 
        pursuant to subsection (c).
    ``(g) Limitation on Use of Information.--
            ``(1) State.--Any State health agency or other appropriate 
        State agency that receives information regarding applicable 
        events with respect to a provider of services pursuant to this 
        part (or a congregate care provider pursuant to the application 
        of this part to such a provider under title XIX) shall not 
        permit such information to be utilized in conjunction with the 
        survey, certification, or enforcement process conducted by, or 
        on behalf of, the agency with respect to such provider.
            ``(2) Secretary.--The Secretary shall not permit any 
        information received by the Secretary regarding applicable 
        events with respect to a provider of services pursuant to this 
        part (or a congregate care provider pursuant to the application 
        of this part to such a provider under title XIX) to be utilized 
        in conjunction with the survey, certification, or enforcement 
        process conducted by, or on behalf of, the Secretary with 
        respect to such provider.
    ``(h) Analysis of Reported Information by the Secretary.--The 
Secretary shall analyze the data received under this part with respect 
to the medicare program in a manner that permits the Secretary to 
identify pertinent patient safety issues that require more intensive 
analysis.
    ``(i) Provision of Information to Center for Patient Safety.--The 
Secretary shall provide the director of the Center for Patient Safety, 
established under section 5 of the Stop All Frequent Errors (SAFE) in 
Medicare and Medicaid Act of 2000, with any information obtained under 
this part (or under title XIX pursuant to the application of this part 
to congregate care providers under such title) that the director of the 
Center determines is necessary in order to carry out the mission of the 
Center.

               ``confidentiality and privacy protections

    ``Sec. 1860D. (a) Confidentiality.--
            ``(1) In general.--Notwithstanding any other provision of 
        law, any information (including any data, reports, records, 
        memoranda, analyses, statements, and other communications) 
        developed by or on behalf of a provider of services with 
        respect to an applicable event pursuant to this part--
                    ``(A) shall be privileged, strictly confidential, 
                and may not be disclosed by any other person to which 
                such information is transferred pursuant to this part 
                without the authorization of the provider of services; 
                and
                    ``(B) shall--
                            ``(i) be protected from disclosure by civil 
                        or administrative subpoena;
                            ``(ii) not be subject to discovery or 
                        otherwise in connection with a civil, criminal, 
                        or administrative proceeding;
                            ``(iii) not be subject to disclosure 
                        pursuant to the Freedom of Information Act (5 
                        U.S.C. 552) or any other similar Federal or 
                        State statute or regulation; and
                            ``(iv) not be admissible as evidence in any 
                        civil or administrative proceeding;
                without regard to whether such information is held by 
                the provider of services or by another person to which 
                such information was transferred pursuant to this part.
            ``(2) Rules of construction.--Nothing in this subsection 
        shall be construed as prohibiting--
                    ``(A) subject to confidentiality laws, disclosure 
                of a patient's medical record;
                    ``(B) an entity or agency from requiring a provider 
                of services to transfer information to the entity or 
                agency to the extent required by law;
                    ``(C) an agency or entity described in section 
                1860C(b)(1), the Secretary, or the Center for Patient 
                Safety from transferring information received pursuant 
                to this part to another such agency or entity, the 
                Secretary, or such Center; or
                    ``(D) the Center for Patient Safety from releasing 
                data received pursuant to this part in a form that does 
                not identify or permit the identification of providers 
                of services, practitioners or other health care 
                workers, or patients.
    ``(b) Protection of Patient Information.--The Secretary shall 
establish procedures to ensure that the privacy of individuals whose 
treatment is the subject of a report submitted under subsections (b) or 
(e) of section 1860C is protected.
    ``(c) Liability.--Nothing in this section shall be construed as 
limiting the liability of an individual, provider of services, agency, 
or entity for damages relating to the occurrence of an applicable 
event, including an applicable event that results in death.''.
    (b) Contract for Peer Review Organization.--
            (1) In general.--Section 1154(a) of the Social Security Act 
        (42 U.S.C. 1320c-3(a)) is amended by adding at the end the 
        following:
            ``(17) The organization shall--
                    ``(A) comply with the requirements for peer review 
                organizations under part D of title XVIII; and
                    ``(B) assist providers of services (as defined in 
                section 1860A(5)) and congregate care providers (as 
                defined in section 1905(x)) in identifying health care 
                errors by utilizing the clinical indicators that the 
                Secretary, in consultation with the Agency for 
                Healthcare Research and Quality, national accrediting 
                organizations, provider and consumer organizations, and 
                peer review organizations, determines are most 
                frequently associated with preventable morbidity and 
                mortality.''.
            (2) Effective date.--The amendment made by this subsection 
        shall apply to contracts entered into or renewed on or after 
        the date of enactment of this Act.

SEC. 4. IMPROVEMENT OF PATIENT SAFETY UNDER THE MEDICAID PROGRAM.

    (a) State Plans for Medical Assistance.--Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)) is amended--
            (1) in paragraph (64), by striking ``and'' at the end;
            (2) in paragraph (65), by striking the period and inserting 
        ``; and''; and
            (3) by inserting immediately after paragraph (65) the 
        following new paragraph:
            ``(66) provide that the State will ensure that any 
        congregate care provider (as defined in section 1905(x)) that 
        provides services to an individual for which medical assistance 
        is available shall--
                    ``(A) establish and implement a patient safety 
                program described in subsection (b) of section 1860B in 
                the same manner as a provider of services under that 
                section is required to establish and implement such a 
                system; and
                    ``(B) submit the reports required under subsection 
                (b) of section 1860C (relating to applicable events) in 
                the same manner as a provider of services under that 
                section is required to submit such reports.''.
    (b) Definition of Congregate Care Provider.--Section 1905 of the 
Social Security Act (42 U.S.C. 1396d) is amended by adding at the end 
the following new subsection:
    ``(x) The term `congregate care provider' means an entity that 
provides hospital services, nursing facility services, services of 
intermediate care facilities for the mentally retarded, hospice care, 
residential treatment centers for children, services in an institution 
for mental diseases, inpatient psychiatric hospital services for 
individuals under age 21, or congregate care services under a waiver 
authorized under section 1915(c).''.
    (c) Application of Medicare Part D Rules and Requirements to 
Congregate Care Providers.-- Title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) is amended--
            (1) by redesignating section 1935 as section 1936; and
            (2) by inserting after section 1934 the following new 
        section:

 ``application of medicare part d rules and requirements to congregate 
                             care providers

    ``Sec. 1935. The Secretary shall promulgate such regulations as are 
necessary in order to apply the rules and requirements that are 
applicable to providers of services under part D of title XVIII to 
congregate care providers (as defined in section 1905(x)) pursuant to 
section 1902(a)(66) and shall provide an analysis described in section 
1860C(g) with respect to the program under this title.''.

SEC. 5. ESTABLISHMENT OF THE CENTER FOR PATIENT SAFETY.

    (a) Establishment.--
            (1) Center.--There is established within the Agency for 
        Healthcare Research and Quality, a center to be known as the 
        Center for Patient Safety (in this section referred to as the 
        ``Center'').
            (2) Director.--The Secretary of Health and Human Services 
        shall appoint a director of the Center. The director shall 
        administer the Center and carry out the duties of the director 
        under this section subject to the authority, direction, and 
        control of the Secretary.
    (b) Mission.--The mission of the Center is to improve patient 
safety and reduce the incidence of errors in the provision of health 
care.
    (c) Duties.--In carrying out the mission of the Center, the 
director of the Center shall provide for the following:
            (1) The establishment of national goals for patient safety 
        and mechanisms to track the progress of the Nation in meeting 
        such goals.
            (2) The provision of recommendations to the Secretary of 
        Health and Human Services regarding--
                    (A) the establishment of additional error events 
                under section 1860A(1) of the Social Security Act (as 
                added by section 3); and
                    (B) the development of a definition of a--
                            (i) provider of services with a pattern of 
                        poor performance under section 1860C(e)(3)(C) 
                        of the Social Security (as so added); and
                            (ii) congregate care provider with a 
                        pattern of poor performance (by reason of the 
                        application of such section to such a provider 
                        pursuant to section 1902(a)(66) of the Social 
                        Security Act (42 U.S.C. 1396a(a)(66)) (as added 
                        by section 4)).
            (3) The preparation and submission to the President and 
        Congress of an annual report and recommendations concerning 
        patient safety.
            (4) The development of knowledge and understanding 
        concerning errors in health care through--
                    (A) the development of a national health care 
                patient safety research agenda;
                    (B) the provision of funding for dissemination and 
                communication activities to improve patient safety;
                    (C) the evaluation of methods for identifying and 
                preventing health care errors; and
                    (D) the provision of funding for computerized 
                decision support systems to reduce health care errors 
                and to improve care.
            (5) The dissemination of information concerning existing 
        patient safety reporting programs.
            (6) The conduct of activities to track the development of 
        new, or modification of existing, patient safety reporting 
        programs.
            (7) The convening of panels of patient safety reporting 
        program coordinators and users to evaluate reporting practices 
        that are effective in improving patient safety.
            (8) The periodic assessment of whether additional efforts 
        are needed to--
                    (A) address gaps in patient safety information; and
                    (B) encourage organizations to voluntarily 
                participate in patient safety reporting programs.
            (9) The provision of funding for pilot projects for the 
        establishment or operation of new or innovative patient safety 
        reporting systems.
            (10) The provision of funding for pilot projects that 
        reduce health care errors.
            (11) The provision of funding for the review of existing 
        databases of medical errors in order to identify best 
        practices.
            (12) The provision of funding for research to identify the 
        attributes of high-risk organizations and processes.
            (13) The conduct of activities to encourage all entities 
        and health care providers to demonstrate continuous 
        improvements in patient safety to the public and private 
        purchasers of the health care services provided by such 
        entities or providers.
            (14) The conduct of other activities determined appropriate 
        by the director of the Center.
    (d) Protection of Patient Information.--The director of the Center 
shall establish procedures to ensure that the privacy of individuals 
whose treatment is described in any information received by the 
director pursuant to this part is protected.

SEC. 6. GRANTS TO ESTABLISH PATIENT SAFETY PROGRAMS.

    (a) In General.--The director of the Center for Patient Safety 
(established under section 5) may award grants to providers of services 
(as defined in section 1860A(5) of the Social Security Act (as added by 
section 3)), congregate care providers (as defined in section 1905(x) 
of such Act (42 U.S.C. 1396d(x)) (as added by section 4)), and health 
professionals affiliated with such providers of services or congregate 
care providers for the establishment and operation of patient safety 
programs.
    (b) Application.--To be eligible to receive a grant under 
subsection (a), a provider of services, a congregate care provider, or 
a health professional affiliated with such a provider of services or 
congregate care provider shall prepare and submit to the director of 
the Center an application at such time, in such manner, and containing 
such information as the director may require.
    (c) Authorization of Appropriations.--There are authorized to be 
appropriated the following amounts to carry out this section:
            (1) For fiscal year 2001, $30,000,000.
            (2) For fiscal year 2002, $35,000,000.
            (3) For fiscal year 2003, $40,000,000.
            (4) For each fiscal year thereafter, such sums as may be 
        necessary.
                                 <all>