[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1273 Introduced in Senate (IS)]
107th CONGRESS
1st Session
S. 1273
To amend the Public Health Service Act to provide for rural health
services outreach, rural health network planning and implementation,
and small health care provider quality improvement grant programs, and
telehomecare demonstration projects.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 31, 2001
Mr. Harkin introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to provide for rural health
services outreach, rural health network planning and implementation,
and small health care provider quality improvement grant programs, and
telehomecare demonstration projects.
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 ``Improving Health Care in Rural
America Act''.
SEC. 2. GRANT PROGRAMS.
Section 330A of the Public Health Service Act (42 U.S.C. 254c) is
amended to read as follows:
``SEC. 330A. RURAL HEALTH SERVICES OUTREACH, RURAL HEALTH NETWORK
DEVELOPMENT, AND SMALL HEALTH CARE PROVIDER QUALITY
IMPROVEMENT GRANT PROGRAMS.
``(a) Purpose.--The purpose of this section is to provide grants
for expanded delivery of health services in rural areas, for the
planning and implementation of integrated health care networks in rural
areas, and for the planning and implementation of small health care
provider quality improvement activities.
``(b) Definitions.--
``(1) Director.--The term `Director' means the Director
specified in subsection (d).
``(2) Federally qualified health center; rural health
clinic.--The terms `Federally qualified health center' and
`rural health clinic' have the meanings given the terms in
section 1861(aa) of the Social Security Act (42 U.S.C.
1395x(aa)).
``(3) Health professional shortage area.--The term `health
professional shortage area' means a health professional
shortage area designated under section 332.
``(4) Health services.--The term `health services' includes
mental and behavioral health services and substance abuse
services.
``(5) Medically underserved area.--The term `medically
underserved area' has the meaning given the term in section
799B.
``(6) Medically underserved population.--The term
`medically underserved population' has the meaning given the
term in section 330(b)(3).
``(c) Program.--The Secretary shall establish, under section 301, a
small health care provider quality improvement grant program.
``(d) Administration.--
``(1) Programs.--The rural health services outreach, rural
health network development, and small health care provider
quality improvement grant programs established under section
301 shall be administered by the Director of the Office of
Rural Health Policy of the Health Resources and Services
Administration, in consultation with State offices of rural
health or other appropriate State government entities.
``(2) Grants.--
``(A) In general.--In carrying out the programs
described in paragraph (1), the Director may award
grants under subsections (e), (f), and (g) to expand
access to, coordinate, and improve the quality of
essential health services, and enhance the delivery of
health care, in rural areas.
``(B) Types of grants.--The Director may award the
grants--
``(i) to promote expanded delivery of
health services in rural areas under subsection
(e);
``(ii) to provide for the planning and
implementation of integrated health care
networks in rural areas under subsection (f);
and
``(iii) to provide for the planning and
implementation of small health care provider
quality improvement activities under subsection
(g).
``(e) Rural Health Services Outreach Grants.--
``(1) Grants.--The Director may award grants to eligible
entities to promote rural health services outreach by expanding
the delivery of health services to include new and enhanced
services in rural areas. The Director may award the grants for
periods of not more than 3 years.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection for a project, an entity--
``(A) shall be a rural public or nonprofit private
entity;
``(B) shall represent a consortium composed of
members--
``(i) that include 3 or more health care
providers or providers of services; and
``(ii) that may be nonprofit or for-profit
entities; and
``(C) shall not previously have received a grant
under this subsection or section 330A for the project.
``(3) Applications.--To be eligible to receive a grant
under this subsection, an eligible entity, in consultation with
the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including--
``(A) a description of the project that the
applicant will carry out using the funds provided under
the grant;
``(B) a description of the manner in which the
project funded under the grant will meet the health
care needs of rural underserved populations in the
local community or region to be served;
``(C) a description of how the local community or
region to be served will be involved in the development
and ongoing operations of the project;
``(D) a plan for sustainability of the project
after Federal support for the project has ended; and
``(E) a description of how the project will be
evaluated.
``(f) Rural Health Network Development Grants.--
``(1) Grants.--
``(A) In general.--The Director may award rural
health network development grants to eligible entities
to promote, through planning and implementation, the
development of integrated health care networks that
have integrated the functions of the entities
participating in the networks in order to--
``(i) achieve efficiencies;
``(ii) expand access to, coordinate, and
improve the quality of essential health
services; and
``(iii) strengthen the rural health care
system as a whole.
``(B) Grant periods.--The Director may award such a
rural health network development grant for
implementation activities for a period of 3 years. The
Director may also award such a rural health network
development grant for planning activities for a period
of 1 year, to assist in the development of an
integrated health care networks, if the proposed
participants in the network have a history of
collaborative efforts and a 3-year implementation grant
would be inappropriate.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection, an entity--
``(A) shall be a rural public or nonprofit private
entity;
``(B) shall represent a network composed of
members--
``(i) that include 3 or more health care
providers or providers of services; and
``(ii) that may be nonprofit or for-profit
entities; and
``(C) shall not previously have received a grant
(other than a 1-year grant for planning activities)
under this subsection or section 330A for the project.
``(3) Applications.--To be eligible to receive a grant
under this subsection, an eligible entity, in consultation with
the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including--
``(A) a description of the project that the
applicant will carry out using the funds provided under
the grant;
``(B) an explanation of the reasons why Federal
assistance is required to carry out the project;
``(C) a description of--
``(i) the history of collaborative
activities carried out by the participants in
the network;
``(ii) the degree to which the participants
are ready to integrate their functions; and
``(iii) how the local community or region
to be served will benefit from and be involved
in the activities carried out by the network;
``(D) a description of how the local community or
region to be served will experience increased access to
quality health services across the continuum of care as
a result of the integration activities carried out by
the network;
``(E) a plan for sustainability of the project
after Federal support for the project has ended; and
``(F) a description of how the project will be
evaluated.
``(g) Small Health Care Provider Quality Improvement Grants.--
``(1) Grants.--The Director may award grants to provide for
the planning and implementation of small health care provider
quality improvement activities. The Director may award the
grants for periods of 1 to 3 years.
``(2) Eligibility.--In order to be eligible for a grant
under this subsection, an entity--
``(A) shall be a rural public or nonprofit private
health care provider, such as a critical access
hospital or a rural health clinic;
``(B) shall be another rural provider or network of
small rural providers identified by the Secretary as a
key source of local care; or
``(C) shall not previously have received a grant
under this subsection for the project.
``(3) Applications.--To be eligible to receive a grant
under this subsection, an eligible entity, in consultation with
the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including--
``(A) a description of the project that the
applicant will carry out using the funds provided under
the grant;
``(B) an explanation of the reasons why Federal
assistance is required to carry out the project;
``(C) a description of the manner in which the
project funded under the grant will assure continuous
quality improvement in the provision of services by the
entity;
``(D) a description of how the local community or
region to be served will experience increased access to
quality health services across the continuum of care as
a result of the activities carried out by the entity;
``(E) a plan for sustainability of the project
after Federal support for the project has ended; and
``(F) a description of how the project will be
evaluated.
``(4) Preference.--In awarding grants under this
subsection, the Secretary shall give preference to entities
that--
``(A) are located in health professional shortage
areas or medically underserved areas, or serve
medically underserved populations; or
``(B) propose to develop projects with a focus on
primary care, and wellness and prevention strategies.
``(h) Coordination With Other Agencies.--The Secretary shall
coordinate activities carried out under grant programs described in
this section, to the extent practicable, with Federal and State
agencies and nonprofit organizations that are operating similar grant
programs, to maximize the effect of public dollars in funding
meritorious proposals.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2002 through 2006.''.
SEC. 3. CONSOLIDATION AND REAUTHORIZATION OF PROVISIONS.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:
``SEC. 330I. TELEHOMECARE DEMONSTRATION PROJECT.
``(a) Definitions.--In this section:
``(1) Distant site.--The term `distant site' means a site
at which a certified home care provider is located at the time
at which a health service (including a health care item) is
provided through a telecommunications system.
``(2) Telehomecare.--The term `telehomecare' means the
provision of health services through technology relating to the
use of electronic information, or through telemedicine or
telecommunication technology, to support and promote, at a
distant site, the monitoring and management of home health
services for a resident of a rural area.
``(b) Establishment.--Not later than 9 months after the date of
enactment of the Health Care Safety Net Amendments of 2001, the
Secretary may establish and carry out a telehomecare demonstration
project.
``(c) Grants.--In carrying out the demonstration project referred
to in subsection (b), the Secretary shall make not more than 5 grants
to eligible certified home care providers, individually or as part of a
network of home health agencies, for the provision of telehomecare to
improve patient care, prevent health care complications, improve
patient outcomes, and achieve efficiencies in the delivery of care to
patients who reside in rural areas.
``(d) Periods.--The Secretary shall make the grants for periods of
not more than 3 years.
``(e) Applications.--To be eligible to receive a grant under this
section, a certified home care provider shall submit an application to
the Secretary at such time, in such manner, and containing such
information as the Secretary may require.
``(f) Use of Funds.--A provider that receives a grant under this
section shall use the funds made available through the grant to carry
out objectives that include--
``(1) improving access to care for home care patients
served by home health care agencies, improving the quality of
that care, increasing patient satisfaction with that care, and
reducing the cost of that care through direct
telecommunications links that connect the provider with
information networks;
``(2) developing effective care management practices and
educational curricula to train home care registered nurses and
increase their general level of competency through that
training; and
``(3) developing curricula to train health care
professionals, particularly registered nurses, serving home
care agencies in the use of telecommunications.
``(g) Coverage.--Nothing in this section shall be construed to
supercede or modify the provisions relating to exclusion of coverage
under section 1862(a) of the Social Security Act (42 U.S.C. 1395y(a)),
or the provisions relating to the amount payable to a home health
agency under section 1895 of that Act (42 U.S.C. 1395fff).
``(h) Report.--
``(1) Interim report.--The Secretary shall submit to
Congress an interim report describing the results of the
demonstration project.
``(2) Final report.--Not later than 6 months after the end
of the last grant period for a grant made under this section,
the Secretary shall submit to Congress a final report--
``(A) describing the results of the demonstration
project; and
``(B) including an evaluation of the impact of the
use of telehomecare, including telemedicine and
telecommunications, on--
``(i) access to care for home care
patients; and
``(ii) the quality of, patient satisfaction
with, and the cost of, that care.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2002 through 2006.''.
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