[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1533 Enrolled Bill (ENR)]

        S.1533

                      One Hundred Seventh Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

         Begun and held at the City of Washington on Wednesday,
          the twenty-third day of January, two thousand and two


                                 An Act


 
To amend the Public Health Service Act to reauthorize and strengthen the 
  health centers program and the National Health Service Corps, and to 
   establish the Healthy Communities Access Program, which will help 
 coordinate services for the uninsured and underinsured, 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 ``Health Care Safety 
Net Amendments of 2002''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:
Sec. 1. Short title; table of contents.

         TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS

Sec. 101. Health centers.
Sec. 102. Telemedicine; incentive grants regarding coordination among 
          States.

                         TITLE II--RURAL HEALTH

 Subtitle A--Rural Health Care Services Outreach, Rural Health Network 
 Development, and Small Health Care Provider Quality Improvement Grant 
                                Programs

Sec. 201. Grant programs.

               Subtitle B--Telehealth Grant Consolidation

Sec. 211. Short title.
Sec. 212. Consolidation and reauthorization of provisions.

    Subtitle C--Mental Health Services Telehealth Program and Rural 
   Emergency Medical Service Training and Equipment Assistance Program

Sec. 221. Programs.

            TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM

Sec. 301. National Health Service Corps.
Sec. 302. Designation of health professional shortage areas.
Sec. 303. Assignment of Corps personnel.
Sec. 304. Priorities in assignment of Corps personnel.
Sec. 305. Cost-sharing.
Sec. 306. Eligibility for Federal funds.
Sec. 307. Facilitation of effective provision of Corps services.
Sec. 308. Authorization of appropriations.
Sec. 309. National Health Service Corps Scholarship Program.
Sec. 310. National Health Service Corps Loan Repayment Program.
Sec. 311. Obligated service.
Sec. 312. Private practice.
Sec. 313. Breach of scholarship contract or loan repayment contract.
Sec. 314. Authorization of appropriations.
Sec. 315. Grants to States for loan repayment programs.
Sec. 316. Demonstration grants to States for community scholarship 
          programs.
Sec. 317. Demonstration project.

              TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM

Sec. 401. Purpose.
Sec. 402. Creation of Healthy Communities Access Program.
Sec. 403. Expanding availability of dental services.
Sec. 404. Study regarding barriers to participation of farmworkers in 
          health programs.

               TITLE V--STUDY AND MISCELLANEOUS PROVISIONS

Sec. 501. Guarantee study.
Sec. 502. Graduate medical education.

                     TITLE VI--CONFORMING AMENDMENTS

Sec. 601. Conforming amendments.

         TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS

SEC. 101. HEALTH CENTERS.

    Section 330 of the Public Health Service Act (42 U.S.C. 254b) is 
amended--
        (1) in subsection (b)(1)(A)--
            (A) in clause (i)(III)(bb), by striking ``screening for 
        breast and cervical cancer'' and inserting ``appropriate cancer 
        screening'';
            (B) in clause (ii), by inserting ``(including specialty 
        referral when medically indicated)'' after ``medical 
        services''; and
            (C) in clause (iii), by inserting ``housing,'' after 
        ``social,'';
        (2) in subsection (b)(2)--
            (A) in subparagraph (A)(i), by striking ``associated with 
        water supply;'' and inserting the following: ``associated 
        with--

                    ``(I) water supply;
                    ``(II) chemical and pesticide exposures;
                    ``(III) air quality; or
                    ``(IV) exposure to lead;'';

            (B) by redesignating subparagraphs (A) and (B) as 
        subparagraphs (C) and (D), respectively; and
            (C) by inserting before subparagraph (C) (as so 
        redesignated by subparagraph (B)) the following:
            ``(A) behavioral and mental health and substance abuse 
        services;
            ``(B) recuperative care services;'';
        (3) in subsection (c)(1)--
            (A) in subparagraph (B)--
                (i) in the heading, by striking ``Comprehensive service 
            delivery'' and inserting ``Managed care'';
                (ii) in the matter preceding clause (i), by striking 
            ``network or plan'' and all that follows to the period and 
            inserting ``managed care network or plan.''; and
                (iii) in the matter following clause (ii), by striking 
            ``Any such grant may include'' and all that follows through 
            the period; and
            (B) by adding at the end the following:
            ``(C) Practice management networks.--The Secretary may make 
        grants to health centers that receive assistance under this 
        section to enable the centers to plan and develop practice 
        management networks that will enable the centers to--
                ``(i) reduce costs associated with the provision of 
            health care services;
                ``(ii) improve access to, and availability of, health 
            care services provided to individuals served by the 
            centers;
                ``(iii) enhance the quality and coordination of health 
            care services; or
                ``(iv) improve the health status of communities.
            ``(D) Use of funds.--The activities for which a grant may 
        be made under subparagraph (B) or (C) may include the purchase 
        or lease of equipment, which may include data and information 
        systems (including paying for the costs of amortizing the 
        principal of, and paying the interest on, loans for equipment), 
        the provision of training and technical assistance related to 
        the provision of health care services on a prepaid basis or 
        under another managed care arrangement, and other activities 
        that promote the development of practice management or managed 
        care networks and plans.'';
        (4) in subsection (d)--
            (A) by striking the subsection heading and inserting ``Loan 
        Guarantee Program.--'';
            (B) in paragraph (1)--
                (i) in subparagraph (A), by striking ``the principal 
            and interest on loans'' and all that follows through the 
            period and inserting ``up to 90 percent of the principal 
            and interest on loans made by non-Federal lenders to health 
            centers, funded under this section, for the costs of 
            developing and operating managed care networks or plans 
            described in subsection (c)(1)(B), or practice management 
            networks described in subsection (c)(1)(C).'';
                (ii) in subparagraph (B)--

                    (I) in clause (i), by striking ``or'';
                    (II) in clause (ii), by striking the period and 
                inserting ``; or''; and
                    (III) by adding at the end the following:

                ``(iii) to refinance an existing loan (as of the date 
            of refinancing) to the center or centers, if the Secretary 
            determines--

                    ``(I) that such refinancing will be beneficial to 
                the health center and the Federal Government;
                    ``(II) that the center (or centers) can demonstrate 
                an ability to repay the refinanced loan equal to or 
                greater than the ability of the center (or centers) to 
                repay the original loan on the date the original loan 
                was made.''; and

                (iii) by adding at the end the following:
            ``(D) Provision directly to networks or plans.--At the 
        request of health centers receiving assistance under this 
        section, loan guarantees provided under this paragraph may be 
        made directly to networks or plans that are at least majority 
        controlled and, as applicable, at least majority owned by those 
        health centers.
            ``(E) Federal credit reform.--The requirements of the 
        Federal Credit Reform Act of 1990 (2 U.S.C. 661 et seq.) shall 
        apply with respect to loans refinanced under subparagraph 
        (B)(iii).''; and
            (C)(i) by striking paragraphs (6) and (7); and
            (ii) by redesignating paragraph (8) as paragraph (6);
        (4) in subsection (e)--
            (A) in paragraph (1)--
                (i) in subparagraph (B), by striking ``subsection 
            (j)(3)'' and inserting ``subsection (k)(3)''; and
                (ii) by adding at the end the following:
            ``(C) Operation of networks and plans.--The Secretary may 
        make grants to health centers that receive assistance under 
        this section, or at the request of the health centers, directly 
        to a network or plan (as described in subparagraphs (B) and (C) 
        of subsection (c)(1)) that is at least majority controlled and, 
        as applicable, at least majority owned by such health centers 
        receiving assistance under this section, for the costs 
        associated with the operation of such network or plan, 
        including the purchase or lease of equipment (including the 
        costs of amortizing the principal of, and paying the interest 
        on, loans for equipment).'';
            (B) in paragraph (5)--
                (i) in subparagraph (A), by inserting ``subparagraphs 
            (A) and (B) of'' after ``any fiscal year under'';
                (ii) by redesignating subparagraphs (B) and (C) as 
            subparagraphs (C) and (D), respectively; and
                (iii) by inserting after subparagraph (A) the 
            following:
            ``(B) Networks and plans.--The total amount of grant funds 
        made available for any fiscal year under paragraph (1)(C) and 
        subparagraphs (B) and (C) of subsection (c)(1) to a health 
        center or to a network or plan shall be determined by the 
        Secretary, but may not exceed 2 percent of the total amount 
        appropriated under this section for such fiscal year.''; and
            (C) by redesignating paragraphs (4) and (5) as paragraphs 
        (3) and (4), respectively;
        (5) in subsection (g)--
            (A) in paragraph (2)--
                (i) in subparagraph (A), by inserting ``and seasonal 
            agricultural worker'' after ``agricultural worker''; and
                (ii) in subparagraph (B), by striking ``and members of 
            their families'' and inserting ``and seasonal agricultural 
            workers, and members of their families,''; and
            (B) in paragraph (3)(A), by striking ``on a seasonal 
        basis'';
        (6) in subsection (h)--
            (A) in paragraph (1), by striking ``homeless children and 
        children at risk of homelessness'' and inserting ``homeless 
        children and youth and children and youth at risk of 
        homelessness'';
            (B)(i) by redesignating paragraph (4) as paragraph (5); and
            (ii) by inserting after paragraph (3) the following:
        ``(4) Temporary continued provision of services to certain 
    former homeless individuals.--If any grantee under this subsection 
    has provided services described in this section under the grant to 
    a homeless individual, such grantee may, notwithstanding that the 
    individual is no longer homeless as a result of becoming a resident 
    in permanent housing, expend the grant to continue to provide such 
    services to the individual for not more than 12 months.''; and
            (C) in paragraph (5)(C) (as redesignated by subparagraph 
        (B)), by striking ``and residential treatment'' and inserting 
        ``, risk reduction, outpatient treatment, residential 
        treatment, and rehabilitation'';
        (7) in subsection (j)(3)--
            (A) in subparagraph (E)--
                (i) in clause (i)--

                    (I) by striking ``(i)'' and inserting ``(i)(I)'';
                    (II) by striking ``plan; or'' and inserting ``plan; 
                and''; and
                    (III) by adding at the end the following:
                    ``(II) has or will have a contractual or other 
                arrangement with the State agency administering the 
                program under title XXI of such Act (42 U.S.C. 1397aa 
                et seq.) with respect to individuals who are State 
                children's health insurance program beneficiaries; 
                or''; and

                (ii) by striking clause (ii) and inserting the 
            following:
                ``(ii) has made or will make every reasonable effort to 
            enter into arrangements described in subclauses (I) and 
            (II) of clause (i);'';
            (B) in subparagraph (G)--
                (i) in clause (ii)(II), by striking ``; and'' and 
            inserting ``;'';
                (ii) by redesignating clause (iii) as clause (iv); and
                (iii) by inserting after clause (ii) the following:
                ``(iii)(I) will assure that no patient will be denied 
            health care services due to an individual's inability to 
            pay for such services; and
                ``(II) will assure that any fees or payments required 
            by the center for such services will be reduced or waived 
            to enable the center to fulfill the assurance described in 
            subclause (I); and'';
            (C) in subparagraph (H), in the matter following clause 
        (iii), by striking ``or (p)'' and inserting ``or (q)'';
            (D) in subparagraph (K)(ii), by striking ``and'' at the 
        end;
            (E) in subparagraph (L), by striking the period and 
        inserting ``; and''; and
            (F) by inserting after subparagraph (L), the following:
            ``(M) the center encourages persons receiving or seeking 
        health services from the center to participate in any public or 
        private (including employer-offered) health programs or plans 
        for which the persons are eligible, so long as the center, in 
        complying with this subparagraph, does not violate the 
        requirements of subparagraph (G)(iii)(I).'';
        (8)(A) by redesignating subsection (l) as subsection (s) and 
    moving that subsection (s) to the end of the section;
        (B) by redesignating subsections (j), (k), and (m) through (q) 
    as subsections (n), (o), and (p) through (s), respectively; and
        (C) by inserting after subsection (i) the following:
    ``(j) Access Grants.--
        ``(1) In general.--The Secretary may award grants to eligible 
    health centers with a substantial number of clients with limited 
    English speaking proficiency to provide translation, 
    interpretation, and other such services for such clients with 
    limited English speaking proficiency.
        ``(2) Eligible health center.--In this subsection, the term 
    `eligible health center' means an entity that--
            ``(A) is a health center as defined under subsection (a);
            ``(B) provides health care services for clients for whom 
        English is a second language; and
            ``(C) has exceptional needs with respect to linguistic 
        access or faces exceptional challenges with respect to 
        linguistic access.
        ``(3) Grant amount.--The amount of a grant awarded to a center 
    under this subsection shall be determined by the Administrator. 
    Such determination of such amount shall be based on the number of 
    clients for whom English is a second language that is served by 
    such center, and larger grant amounts shall be awarded to centers 
    serving larger numbers of such clients.
        ``(4) Use of funds.--An eligible health center that receives a 
    grant under this subsection may use funds received through such 
    grant to--
            ``(A) provide translation, interpretation, and other such 
        services for clients for whom English is a second language, 
        including hiring professional translation and interpretation 
        services; and
            ``(B) compensate bilingual or multilingual staff for 
        language assistance services provided by the staff for such 
        clients.
        ``(5) Application.--An eligible health center desiring a grant 
    under this subsection shall submit an application to the Secretary 
    at such time, in such manner, and containing such information as 
    the Secretary may reasonably require, including--
            ``(A) an estimate of the number of clients that the center 
        serves for whom English is a second language;
            ``(B) the ratio of the number of clients for whom English 
        is a second language to the total number of clients served by 
        the center;
            ``(C) a description of any language assistance services 
        that the center proposes to provide to aid clients for whom 
        English is a second language; and
            ``(D) a description of the exceptional needs of such center 
        with respect to linguistic access or a description of the 
        exceptional challenges faced by such center with respect to 
        linguistic access.
        ``(6) Authorization of appropriations.--There are authorized to 
    be appropriated to carry out this subsection, in addition to any 
    funds authorized to be appropriated or appropriated for health 
    centers under any other subsection of this section, such sums as 
    may be necessary for each of fiscal years 2002 through 2006.'';
        (9) by striking subsection (m) (as redesignated by paragraph 
    (9)(B)) and inserting the following:
    ``(m) Technical Assistance.--The Secretary shall establish a 
program through which the Secretary shall provide technical and other 
assistance to eligible entities to assist such entities to meet the 
requirements of subsection (l)(3). 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.'';
        (10) in subsection (q) (as redesignated by paragraph (9)(B)), 
    by striking ``(j)(3)(G)'' and inserting ``(l)(3)(G)''; and
        (11) in subsection (s) (as redesignated by paragraph (9)(A))--
            (A) in paragraph (1), by striking ``$802,124,000'' and all 
        that follows through the period and inserting ``$1,340,000,000 
        for fiscal year 2002 and such sums as may be necessary for each 
        of the fiscal years 2003 through 2006.'';
            (B) in paragraph (2)--
                (i) in subparagraph (A)--

                    (I) by striking ``(j)(3))'' and inserting 
                ``(l)(3))''; and
                    (II) by striking ``(j)(3)(G)(ii)'' and inserting 
                ``(l)(3)(H)''; and

                (ii) by striking subparagraph (B) and inserting the 
            following:
            ``(B) Distribution of grants.--For fiscal year 2002 and 
        each of the following fiscal years, the Secretary, in awarding 
        grants under this section, shall ensure that the proportion of 
        the amount made available under each of subsections (g), (h), 
        and (i), relative to the total amount appropriated to carry out 
        this section for that fiscal year, is equal to the proportion 
        of the amount made available under that subsection for fiscal 
        year 2001, relative to the total amount appropriated to carry 
        out this section for fiscal year 2001.''.
    SEC. 102. TELEMEDICINE; INCENTIVE GRANTS REGARDING COORDINATION 
      AMONG STATES.
    (a) In General.--The Secretary of Health and Human Services may 
make grants to State professional licensing boards to carry out 
programs under which such licensing boards of various States cooperate 
to develop and implement State policies that will reduce statutory and 
regulatory barriers to telemedicine.
    (b) Authorization of Appropriations.--For the purpose of carrying 
out subsection (a), there are authorized to be appropriated such sums 
as may be necessary for each of the fiscal years 2002 through 2006.

                         TITLE II--RURAL HEALTH
 Subtitle A--Rural Health Care Services Outreach, Rural Health Network 
 Development, and Small Health Care Provider Quality Improvement Grant 
                                Programs

SEC. 201. 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 CARE 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 care 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) Medically underserved community.--The term `medically 
    underserved community' has the meaning given the term in section 
    799B.
        ``(5) 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 care 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 care 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 care 
            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 Care Services Outreach Grants.--
        ``(1) Grants.--The Director may award grants to eligible 
    entities to promote rural health care services outreach by 
    expanding the delivery of health care 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 rural nonprofit private 
        entity;
            ``(B) shall represent a consortium composed of members--
                ``(i) that include 3 or more health care providers; and
                ``(ii) that may be nonprofit or for-profit entities; 
            and
            ``(C) shall not previously have received a grant under this 
        subsection for the same or a similar project, unless the entity 
        is proposing to expand the scope of the project or the area 
        that will be served through 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 eligible entity 
        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 sustaining the project after Federal 
        support for the project has ended;
            ``(E) a description of how the project will be evaluated; 
        and
            ``(F) other such information as the Secretary determines to 
        be appropriate.
    ``(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 combined 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 care 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 network, if the proposed participants in 
        the network do not have a history of collaborative efforts and 
        a 3-year 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 rural nonprofit private 
        entity;
            ``(B) shall represent a network composed of participants--
                ``(i) that include 3 or more health care providers; and
                ``(ii) that may be nonprofit or for-profit entities; 
            and
            ``(C) shall not previously have received a grant under this 
        subsection (other than a grant for planning activities) for the 
        same or a similar 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 eligible entity 
        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 
        care services across the continuum of care as a result of the 
        integration activities carried out by the network;
            ``(E) a plan for sustaining the project after Federal 
        support for the project has ended;
            ``(F) a description of how the project will be evaluated; 
        and
            ``(G) other such information as the Secretary determines to 
        be appropriate.
    ``(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.--To be eligible for a grant under this 
    subsection, an entity--
            ``(A)(i) shall be a rural public or rural nonprofit private 
        health care provider or provider of health care services, such 
        as a critical access hospital or a rural health clinic; or
            ``(ii) shall be another rural provider or network of small 
        rural providers identified by the Secretary as a key source of 
        local care; and
            ``(B) shall not previously have received a grant under this 
        subsection for the same or a similar 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 eligible entity 
        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 
        care services across the continuum of care as a result of the 
        activities carried out by the entity;
            ``(E) a plan for sustaining the project after Federal 
        support for the project has ended;
            ``(F) a description of how the project will be evaluated; 
        and
            ``(G) other such information as the Secretary determines to 
        be appropriate.
        ``(4) Expenditures for small health care provider quality 
    improvement grants.--In awarding a grant under this subsection, the 
    Director shall ensure that the funds made available through the 
    grant will be used to provide services to residents of rural areas. 
    The Director shall award not less than 50 percent of the funds made 
    available under this subsection to providers located in and serving 
    rural areas.
    ``(h) General Requirements.--
        ``(1) Prohibited uses of funds.--An entity that receives a 
    grant under this section may not use funds provided through the 
    grant--
            ``(A) to build or acquire real property; or
            ``(B) for construction.
        ``(2) 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.
        ``(3) Preference.--In awarding grants under this section, the 
    Secretary shall give preference to entities that--
            ``(A) are located in health professional shortage areas or 
        medically underserved communities, or serve medically 
        underserved populations; or
            ``(B) propose to develop projects with a focus on primary 
        care, and wellness and prevention strategies.
    ``(i) Report.--Not later than September 30, 2005, the Secretary 
shall prepare and submit to the appropriate committees of Congress a 
report on the progress and accomplishments of the grant programs 
described in subsections (e), (f), and (g).
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $40,000,000 for fiscal year 
2002, and such sums as may be necessary for each of fiscal years 2003 
through 2006.''.

               Subtitle B--Telehealth Grant Consolidation

SEC. 211. SHORT TITLE.

    This subtitle may be cited as the ``Telehealth Grant Consolidation 
Act of 2002''.

SEC. 212. 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. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS GRANT 
PROGRAMS.
    ``(a) Definitions.--In this section:
        ``(1) Director; office.--The terms `Director' and `Office' mean 
    the Director and Office specified in subsection (c).
        ``(2) Federally qualified health center and rural health 
    clinic.--The term `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) Frontier community.--The term `frontier community' shall 
    have the meaning given the term in regulations issued under 
    subsection (r).
        ``(4) Medically underserved area.--The term `medically 
    underserved area' has the meaning given the term `medically 
    underserved community' in section 799B.
        ``(5) Medically underserved population.--The term `medically 
    underserved population' has the meaning given the term in section 
    330(b)(3).
        ``(6) Telehealth services.--The term `telehealth services' 
    means services provided through telehealth technologies.
        ``(7) Telehealth technologies.--The term `telehealth 
    technologies' means technologies relating to the use of electronic 
    information, and telecommunications technologies, to support and 
    promote, at a distance, health care, patient and professional 
    health-related education, health administration, and public health.
    ``(b) Programs.--The Secretary shall establish, under section 301, 
telehealth network and telehealth resource centers grant programs.
    ``(c) Administration.--
        ``(1) Establishment.--There is established in the Health and 
    Resources and Services Administration an Office for the Advancement 
    of Telehealth. The Office shall be headed by a Director.
        ``(2) Duties.--The telehealth network and telehealth resource 
    centers grant programs established under section 301 shall be 
    administered by the Director, in consultation with the State 
    offices of rural health, State offices concerning primary care, or 
    other appropriate State government entities.
    ``(d) Grants.--
        ``(1) Telehealth network grants.--The Director may, in carrying 
    out the telehealth network grant program referred to in subsection 
    (b), award grants to eligible entities for projects to demonstrate 
    how telehealth technologies can be used through telehealth networks 
    in rural areas, frontier communities, and medically underserved 
    areas, and for medically underserved populations, to--
            ``(A) expand access to, coordinate, and improve the quality 
        of health care services;
            ``(B) improve and expand the training of health care 
        providers; and
            ``(C) expand and improve the quality of health information 
        available to health care providers, and patients and their 
        families, for decisionmaking.
        ``(2) Telehealth resource centers grants.--The Director may, in 
    carrying out the telehealth resource centers grant program referred 
    to in subsection (b), award grants to eligible entities for 
    projects to demonstrate how telehealth technologies can be used in 
    the areas and communities, and for the populations, described in 
    paragraph (1), to establish telehealth resource centers.
    ``(e) Grant Periods.--The Director may award grants under this 
section for periods of not more than 4 years.
    ``(f) Eligible Entities.--
        ``(1) Telehealth network grants.--
            ``(A) Grant recipient.--To be eligible to receive a grant 
        under subsection (d)(1), an entity shall be a nonprofit entity.
            ``(B) Telehealth networks.--
                ``(i) In general.--To be eligible to receive a grant 
            under subsection (d)(1), an entity shall demonstrate that 
            the entity will provide services through a telehealth 
            network.
                ``(ii) Nature of entities.--Each entity participating 
            in the telehealth network may be a nonprofit or for-profit 
            entity.
                ``(iii) Composition of network.--The telehealth network 
            shall include at least 2 of the following entities (at 
            least 1 of which shall be a community-based health care 
            provider):

                    ``(I) Community or migrant health centers or other 
                Federally qualified health centers.
                    ``(II) Health care providers, including 
                pharmacists, in private practice.
                    ``(III) Entities operating clinics, including rural 
                health clinics.
                    ``(IV) Local health departments.
                    ``(V) Nonprofit hospitals, including community 
                access hospitals.
                    ``(VI) Other publicly funded health or social 
                service agencies.
                    ``(VII) Long-term care providers.
                    ``(VIII) Providers of health care services in the 
                home.
                    ``(IX) Providers of outpatient mental health 
                services and entities operating outpatient mental 
                health facilities.
                    ``(X) Local or regional emergency health care 
                providers.
                    ``(XI) Institutions of higher education.
                    ``(XII) Entities operating dental clinics.

        ``(2) Telehealth resource centers grants.--To be eligible to 
    receive a grant under subsection (d)(2), an entity shall be a 
    nonprofit entity.
    ``(g) Applications.--To be eligible to receive a grant under 
subsection (d), 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--
        ``(1) a description of the project that the eligible entity 
    will carry out using the funds provided under the grant;
        ``(2) a description of the manner in which the project funded 
    under the grant will meet the health care needs of rural or other 
    populations to be served through the project, or improve the access 
    to services of, and the quality of the services received by, those 
    populations;
        ``(3) evidence of local support for the project, and a 
    description of how the areas, communities, or populations to be 
    served will be involved in the development and ongoing operations 
    of the project;
        ``(4) a plan for sustaining the project after Federal support 
    for the project has ended;
        ``(5) information on the source and amount of non-Federal funds 
    that the entity will provide for the project;
        ``(6) information demonstrating the long-term viability of the 
    project, and other evidence of institutional commitment of the 
    entity to the project;
        ``(7) in the case of an application for a project involving a 
    telehealth network, information demonstrating how the project will 
    promote the integration of telehealth technologies into the 
    operations of health care providers, to avoid redundancy, and 
    improve access to and the quality of care; and
        ``(8) other such information as the Secretary determines to be 
    appropriate.
    ``(h) Terms; Conditions; Maximum Amount of Assistance.--The 
Secretary shall establish the terms and conditions of each grant 
program described in subsection (b) and the maximum amount of a grant 
to be awarded to an individual recipient for each fiscal year under 
this section. The Secretary shall publish, in a publication of the 
Health Resources and Services Administration, notice of the application 
requirements for each grant program described in subsection (b) for 
each fiscal year.
    ``(i) Preferences.--
        ``(1) Telehealth networks.--In awarding grants under subsection 
    (d)(1) for projects involving telehealth networks, the Secretary 
    shall give preference to an eligible entity that meets at least 1 
    of the following requirements:
            ``(A) Organization.--The eligible entity is a rural 
        community-based organization or another community-based 
        organization.
            ``(B) Services.--The eligible entity proposes to use 
        Federal funds made available through such a grant to develop 
        plans for, or to establish, telehealth networks that provide 
        mental health, public health, long-term care, home care, 
        preventive, or case management services.
            ``(C) Coordination.--The eligible entity demonstrates how 
        the project to be carried out under the grant will be 
        coordinated with other relevant federally funded projects in 
        the areas, communities, and populations to be served through 
        the grant.
            ``(D) Network.--The eligible entity demonstrates that the 
        project involves a telehealth network that includes an entity 
        that--
                ``(i) provides clinical health care services, or 
            educational services for health care providers and for 
            patients or their families; and
                ``(ii) is--

                    ``(I) a public library;
                    ``(II) an institution of higher education; or
                    ``(III) a local government entity.

            ``(E) Connectivity.--The eligible entity proposes a project 
        that promotes local connectivity within areas, communities, or 
        populations to be served through the project.
            ``(F) Integration.--The eligible entity demonstrates that 
        health care information has been integrated into the project.
        ``(2) Telehealth resource centers.--In awarding grants under 
    subsection (d)(2) for projects involving telehealth resource 
    centers, the Secretary shall give preference to an eligible entity 
    that meets at least 1 of the following requirements:
            ``(A) Provision of services.--The eligible entity has a 
        record of success in the provision of telehealth services to 
        medically underserved areas or medically underserved 
        populations.
            ``(B) Collaboration and sharing of expertise.--The eligible 
        entity has a demonstrated record of collaborating and sharing 
        expertise with providers of telehealth services at the 
        national, regional, State, and local levels.
            ``(C) Broad range of telehealth services.--The eligible 
        entity has a record of providing a broad range of telehealth 
        services, which may include--
                ``(i) a variety of clinical specialty services;
                ``(ii) patient or family education;
                ``(iii) health care professional education; and
                ``(iv) rural residency support programs.
    ``(j) Distribution of Funds.--
        ``(1) In general.--In awarding grants under this section, the 
    Director shall ensure, to the greatest extent possible, that such 
    grants are equitably distributed among the geographical regions of 
    the United States.
        ``(2) Telehealth networks.--In awarding grants under subsection 
    (d)(1) for a fiscal year, the Director shall ensure that--
            ``(A) not less than 50 percent of the funds awarded shall 
        be awarded for projects in rural areas; and
            ``(B) the total amount of funds awarded for such projects 
        for that fiscal year shall be not less than the total amount of 
        funds awarded for such projects for fiscal year 2001 under 
        section 330A (as in effect on the day before the date of 
        enactment of the Health Care Safety Net Amendments of 2002).
    ``(k) Use of Funds.--
        ``(1) Telehealth network program.--The recipient of a grant 
    under subsection (d)(1) may use funds received through such grant 
    for salaries, equipment, and operating or other costs, including 
    the cost of--
            ``(A) developing and delivering clinical telehealth 
        services that enhance access to community-based health care 
        services in rural areas, frontier communities, or medically 
        underserved areas, or for medically underserved populations;
            ``(B) developing and acquiring, through lease or purchase, 
        computer hardware and software, audio and video equipment, 
        computer network equipment, interactive equipment, data 
        terminal equipment, and other equipment that furthers the 
        objectives of the telehealth network grant program;
            ``(C)(i) developing and providing distance education, in a 
        manner that enhances access to care in rural areas, frontier 
        communities, or medically underserved areas, or for medically 
        underserved populations; or
            ``(ii) mentoring, precepting, or supervising health care 
        providers and students seeking to become health care providers, 
        in a manner that enhances access to care in the areas and 
        communities, or for the populations, described in clause (i);
            ``(D) developing and acquiring instructional programming;
            ``(E)(i) providing for transmission of medical data, and 
        maintenance of equipment; and
            ``(ii) providing for compensation (including travel 
        expenses) of specialists, and referring health care providers, 
        who are providing telehealth services through the telehealth 
        network, if no third party payment is available for the 
        telehealth services delivered through the telehealth network;
            ``(F) developing projects to use telehealth technology to 
        facilitate collaboration between health care providers;
            ``(G) collecting and analyzing usage statistics and data to 
        document the cost-effectiveness of the telehealth services; and
            ``(H) carrying out such other activities as are consistent 
        with achieving the objectives of this section, as determined by 
        the Secretary.
        ``(2) Telehealth resource centers.--The recipient of a grant 
    under subsection (d)(2) may use funds received through such grant 
    for salaries, equipment, and operating or other costs for--
            ``(A) providing technical assistance, training, and 
        support, and providing for travel expenses, for health care 
        providers and a range of health care entities that provide or 
        will provide telehealth services;
            ``(B) disseminating information and research findings 
        related to telehealth services;
            ``(C) promoting effective collaboration among telehealth 
        resource centers and the Office;
            ``(D) conducting evaluations to determine the best 
        utilization of telehealth technologies to meet health care 
        needs;
            ``(E) promoting the integration of the technologies used in 
        clinical information systems with other telehealth 
        technologies;
            ``(F) fostering the use of telehealth technologies to 
        provide health care information and education for health care 
        providers and consumers in a more effective manner; and
            ``(G) implementing special projects or studies under the 
        direction of the Office.
    ``(l) Prohibited Uses of Funds.--An entity that receives a grant 
under this section may not use funds made available through the grant--
        ``(1) to acquire real property;
        ``(2) for expenditures to purchase or lease equipment, to the 
    extent that the expenditures would exceed 40 percent of the total 
    grant funds;
        ``(3) in the case of a project involving a telehealth network, 
    to purchase or install transmission equipment (such as laying cable 
    or telephone lines, or purchasing or installing microwave towers, 
    satellite dishes, amplifiers, or digital switching equipment);
        ``(4) to pay for any equipment or transmission costs not 
    directly related to the purposes for which the grant is awarded;
        ``(5) to purchase or install general purpose voice telephone 
    systems;
        ``(6) for construction; or
        ``(7) for expenditures for indirect costs (as determined by the 
    Secretary), to the extent that the expenditures would exceed 15 
    percent of the total grant funds.
    ``(m) Collaboration.--In providing services under this section, an 
eligible entity shall collaborate, if feasible, with entities that--
        ``(1)(A) are private or public organizations, that receive 
    Federal or State assistance; or
        ``(B) are public or private entities that operate centers, or 
    carry out programs, that receive Federal or State assistance; and
        ``(2) provide telehealth services or related activities.
    ``(n) Coordination With Other Agencies.--The Secretary shall 
coordinate activities carried out under grant programs described in 
subsection (b), to the extent practicable, with Federal and State 
agencies and nonprofit organizations that are operating similar 
programs, to maximize the effect of public dollars in funding 
meritorious proposals.
    ``(o) Outreach Activities.--The Secretary shall establish and 
implement procedures to carry out outreach activities to advise 
potential end users of telehealth services in rural areas, frontier 
communities, medically underserved areas, and medically underserved 
populations in each State about the grant programs described in 
subsection (b).
    ``(p) Telehealth.--It is the sense of Congress that, for purposes 
of this section, States should develop reciprocity agreements so that a 
provider of services under this section who is a licensed or otherwise 
authorized health care provider under the law of 1 or more States, and 
who, through telehealth technology, consults with a licensed or 
otherwise authorized health care provider in another State, is exempt, 
with respect to such consultation, from any State law of the other 
State that prohibits such consultation on the basis that the first 
health care provider is not a licensed or authorized health care 
provider under the law of that State.
    ``(q) Report.--Not later than September 30, 2005, the Secretary 
shall prepare and submit to the appropriate committees of Congress a 
report on the progress and accomplishments of the grant programs 
described in subsection (b).
    ``(r) Regulations.--The Secretary shall issue regulations 
specifying, for purposes of this section, a definition of the term 
`frontier area'. The definition shall be based on factors that include 
population density, travel distance in miles to the nearest medical 
facility, travel time in minutes to the nearest medical facility, and 
such other factors as the Secretary determines to be appropriate. The 
Secretary shall develop the definition in consultation with the 
Director of the Bureau of the Census and the Administrator of the 
Economic Research Service of the Department of Agriculture.
    ``(s) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section--
        ``(1) for grants under subsection (d)(1), $40,000,000 for 
    fiscal year 2002, and such sums as may be necessary for each of 
    fiscal years 2003 through 2006; and
        ``(2) for grants under subsection (d)(2), $20,000,000 for 
    fiscal year 2002, and such sums as may be necessary for each of 
    fiscal years 2003 through 2006.''.

    Subtitle C--Mental Health Services Telehealth Program and Rural 
  Emergency Medical Service Training and Equipment Assistance Program

SEC. 221. PROGRAMS.

    Subpart I of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) (as amended by section 212) is further amended 
by adding at the end the following:
``SEC. 330J. RURAL EMERGENCY MEDICAL SERVICE TRAINING AND EQUIPMENT 
ASSISTANCE PROGRAM.
    ``(a) Grants.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration (referred to in this 
section as the `Secretary') shall award grants to eligible entities to 
enable such entities to provide for improved emergency medical services 
in rural areas.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section, an entity shall--
        ``(1) be--
            ``(A) a State emergency medical services office;
            ``(B) a State emergency medical services association;
            ``(C) a State office of rural health;
            ``(D) a local government entity;
            ``(E) a State or local ambulance provider; or
            ``(F) any other entity determined appropriate by the 
        Secretary; and
        ``(2) prepare and submit to the Secretary an application at 
    such time, in such manner, and containing such information as the 
    Secretary may require, that includes--
            ``(A) a description of the activities to be carried out 
        under the grant; and
            ``(B) an assurance that the eligible entity will comply 
        with the matching requirement of subsection (e).
    ``(c) Use of Funds.--An entity shall use amounts received under a 
grant made under subsection (a), either directly or through grants to 
emergency medical service squads that are located in, or that serve 
residents of, a nonmetropolitan statistical area, an area designated as 
a rural area by any law or regulation of a State, or a rural census 
tract of a metropolitan statistical area (as determined under the most 
recent Goldsmith Modification, originally published in a notice of 
availability of funds in the Federal Register on February 27, 1992, 57 
Fed. Reg. 6725), to--
        ``(1) recruit emergency medical service personnel;
        ``(2) recruit volunteer emergency medical service personnel;
        ``(3) train emergency medical service personnel in emergency 
    response, injury prevention, safety awareness, and other topics 
    relevant to the delivery of emergency medical services;
        ``(4) fund specific training to meet Federal or State 
    certification requirements;
        ``(5) develop new ways to educate emergency health care 
    providers through the use of technology-enhanced educational 
    methods (such as distance learning);
        ``(6) acquire emergency medical services equipment, including 
    cardiac defibrillators;
        ``(7) acquire personal protective equipment for emergency 
    medical services personnel as required by the Occupational Safety 
    and Health Administration; and
        ``(8) educate the public concerning cardiopulmonary 
    resuscitation, first aid, injury prevention, safety awareness, 
    illness prevention, and other related emergency preparedness 
    topics.
    ``(d) Preference.--In awarding grants under this section the 
Secretary shall give preference to--
        ``(1) applications that reflect a collaborative effort by 2 or 
    more of the entities described in subparagraphs (A) through (F) of 
    subsection (b)(1); and
        ``(2) applications submitted by entities that intend to use 
    amounts provided under the grant to fund activities described in 
    any of paragraphs (1) through (5) of subsection (c).
    ``(e) Matching Requirement.--The Secretary may not award a grant 
under this section to an entity unless the entity agrees that the 
entity will make available (directly or through contributions from 
other public or private entities) non-Federal contributions toward the 
activities to be carried out under the grant in an amount equal to 25 
percent of the amount received under the grant.
    ``(f) Emergency Medical Services.--In this section, the term 
`emergency medical services'--
        ``(1) means resources used by a qualified public or private 
    nonprofit entity, or by any other entity recognized as qualified by 
    the State involved, to deliver medical care outside of a medical 
    facility under emergency conditions that occur--
            ``(A) as a result of the condition of the patient; or
            ``(B) as a result of a natural disaster or similar 
        situation; and
        ``(2) includes services delivered by an emergency medical 
    services provider (either compensated or volunteer) or other 
    provider recognized by the State involved that is licensed or 
    certified by the State as an emergency medical technician or its 
    equivalent (as determined by the State), a registered nurse, a 
    physician assistant, or a physician that provides services similar 
    to services provided by such an emergency medical services 
    provider.
    ``(g) Authorization of Appropriations.--
        ``(1) In general.--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.
        ``(2) Administrative costs.--The Secretary may use not more 
    than 10 percent of the amount appropriated under paragraph (1) for 
    a fiscal year for the administrative expenses of carrying out this 
    section.

``SEC. 330K. MENTAL HEALTH SERVICES DELIVERED VIA TELEHEALTH.

    ``(a) Definitions.--In this section:
        ``(1) Eligible entity.--The term `eligible entity' means a 
    public or nonprofit private telehealth provider network that offers 
    services that include mental health services provided by qualified 
    mental health providers.
        ``(2) Qualified mental health professionals.--The term 
    `qualified mental health professionals' refers to providers of 
    mental health services reimbursed under the medicare program 
    carried out under title XVIII of the Social Security Act (42 U.S.C. 
    1395 et seq.) who have additional training in the treatment of 
    mental illness in children and adolescents or who have additional 
    training in the treatment of mental illness in the elderly.
        ``(3) Special populations.--The term `special populations' 
    refers to the following 2 distinct groups:
            ``(A) Children and adolescents in mental health underserved 
        rural areas or in mental health underserved urban areas.
            ``(B) Elderly individuals located in long-term care 
        facilities in mental health underserved rural or urban areas.
        ``(4) Telehealth.--The term `telehealth' means the use of 
    electronic information and telecommunications technologies to 
    support long distance clinical health care, patient and 
    professional health-related education, public health, and health 
    administration.
    ``(b) Program Authorized.--
        ``(1) In general.--The Secretary, acting through the Director 
    of the Office for the Advancement of Telehealth of the Health 
    Resources and Services Administration, shall award grants to 
    eligible entities to establish demonstration projects for the 
    provision of mental health services to special populations as 
    delivered remotely by qualified mental health professionals using 
    telehealth and for the provision of education regarding mental 
    illness as delivered remotely by qualified mental health 
    professionals using telehealth.
        ``(2) Populations served.--The Secretary shall award the grants 
    under paragraph (1) in a manner that distributes the grants so as 
    to serve equitably the populations described in subparagraphs (A) 
    and (B) of subsection (a)(4).
    ``(c) Use of Funds.--
        ``(1) In general.--An eligible entity that receives a grant 
    under this section shall use the grant funds--
            ``(A) for the populations described in subsection 
        (a)(4)(A)--
                ``(i) to provide mental health services, including 
            diagnosis and treatment of mental illness, as delivered 
            remotely by qualified mental health professionals using 
            telehealth; and
                ``(ii) to collaborate with local public health entities 
            to provide the mental health services; and
            ``(B) for the populations described in subsection 
        (a)(4)(B)--
                ``(i) to provide mental health services, including 
            diagnosis and treatment of mental illness, in long-term 
            care facilities as delivered remotely by qualified mental 
            health professionals using telehealth; and
                ``(ii) to collaborate with local public health entities 
            to provide the mental health services.
        ``(2) Other uses.--An eligible entity that receives a grant 
    under this section may also use the grant funds to--
            ``(A) pay telecommunications costs; and
            ``(B) pay qualified mental health professionals on a 
        reasonable cost basis as determined by the Secretary for 
        services rendered.
        ``(3) Prohibited uses.--An eligible entity that receives a 
    grant under this section shall not use the grant funds to--
            ``(A) purchase or install transmission equipment (other 
        than such equipment used by qualified mental health 
        professionals to deliver mental health services using 
        telehealth under the project involved); or
            ``(B) build upon or acquire real property.
    ``(d) Equitable Distribution.--In awarding grants under this 
section, the Secretary shall ensure, to the greatest extent possible, 
that such grants are equitably distributed among geographical regions 
of the United States.
    ``(e) Application.--An entity that desires a grant under this 
section shall submit an application to the Secretary at such time, in 
such manner, and containing such information as the Secretary 
determines to be reasonable.
    ``(f) Report.--Not later than 4 years after the date of enactment 
of the Health Care Safety Net Amendments of 2002, the Secretary shall 
prepare and submit to the appropriate committees of Congress a report 
that shall evaluate activities funded with grants under this section.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $20,000,000 for fiscal year 
2002 and such sums as may be necessary for fiscal years 2003 through 
2006.''.

            TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM

SEC. 301. NATIONAL HEALTH SERVICE CORPS.

    (a) In General.--Section 331 of the Public Health Service Act (42 
U.S.C. 254d) is amended--
        (1) by adding at the end of subsection (a)(3) the following:
        ``(E)(i) The term `behavioral and mental health professionals' 
    means health service psychologists, licensed clinical social 
    workers, licensed professional counselors, marriage and family 
    therapists, psychiatric nurse specialists, and psychiatrists.
        ``(ii) The term `graduate program of behavioral and mental 
    health' means a program that trains behavioral and mental health 
    professionals.'';
        (2) in subsection (b)--
            (A) in paragraph (1), by striking ``health professions'' 
        and inserting ``health professions, including schools at which 
        graduate programs of behavioral and mental health are 
        offered,''; and
            (B) in paragraph (2), by inserting ``behavioral and mental 
        health professionals,'' after ``dentists,''; and
        (3) by striking subsection (c) and inserting the following:
    ``(c)(1) The Secretary may reimburse an applicant for a position in 
the Corps (including an individual considering entering into a written 
agreement pursuant to section 338D) for the actual and reasonable 
expenses incurred in traveling to and from the applicant's place of 
residence to an eligible site to which the applicant may be assigned 
under section 333 for the purpose of evaluating such site with regard 
to being assigned at such site. The Secretary may establish a maximum 
total amount that may be paid to an individual as reimbursement for 
such expenses.
    ``(2) The Secretary may also reimburse the applicant for the actual 
and reasonable expenses incurred for the travel of 1 family member to 
accompany the applicant to such site. The Secretary may establish a 
maximum total amount that may be paid to an individual as reimbursement 
for such expenses.
    ``(3) In the case of an individual who has entered into a contract 
for obligated service under the Scholarship Program or under the Loan 
Repayment Program, the Secretary may reimburse such individual for all 
or part of the actual and reasonable expenses incurred in transporting 
the individual, the individual's family, and the family's possessions 
to the site of the individual's assignment under section 333. The 
Secretary may establish a maximum total amount that may be paid to an 
individual as reimbursement for such expenses.''.
    (b) Demonstration Projects.--Section 331 of the Public Health 
Service Act (42 U.S.C. 254d) is amended--
        (1) by redesignating subsection (i) as subsection (j); and
        (2) by inserting after subsection (h) the following:
    ``(i)(1) In carrying out subpart III, the Secretary may, in 
accordance with this subsection, carry out demonstration projects in 
which individuals who have entered into a contract for obligated 
service under the Loan Repayment Program receive waivers under which 
the individuals are authorized to satisfy the requirement of obligated 
service through providing clinical service that is not full-time.
    ``(2) A waiver described in paragraph (1) may be provided by the 
Secretary only if--
        ``(A) the entity for which the service is to be performed--
            ``(i) has been approved under section 333A for assignment 
        of a Corps member; and
            ``(ii) has requested in writing assignment of a health 
        professional who would serve less than full time;
        ``(B) the Secretary has determined that assignment of a health 
    professional who would serve less than full time would be 
    appropriate for the area where the entity is located;
        ``(C) a Corps member who is required to perform obligated 
    service has agreed in writing to be assigned for less than full-
    time service to an entity described in subparagraph (A);
        ``(D) the entity and the Corps member agree in writing that the 
    less than full-time service provided by the Corps member will not 
    be less than 16 hours of clinical service per week;
        ``(E) the Corps member agrees in writing that the period of 
    obligated service pursuant to section 338B will be extended so that 
    the aggregate amount of less than full-time service performed will 
    equal the amount of service that would be performed through full-
    time service under section 338C; and
        ``(F) the Corps member agrees in writing that if the Corps 
    member begins providing less than full-time service but fails to 
    begin or complete the period of obligated service, the method 
    stated in 338E(c) for determining the damages for breach of the 
    individual's written contract will be used after converting periods 
    of obligated service or of service performed into their full-time 
    equivalents.
    ``(3) In evaluating a demonstration project described in paragraph 
(1), the Secretary shall examine the effect of multidisciplinary 
teams.''.

SEC. 302. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS.

    (a) In General.--Section 332 of the Public Health Service Act (42 
U.S.C. 254e) is amended--
        (1) in subsection (a)--
            (A) in paragraph (1), by inserting after the first sentence 
        the following: ``All Federally qualified health centers and 
        rural health clinics, as defined in section 1861(aa) of the 
        Social Security Act (42 U.S.C. 1395x(aa)), that meet the 
        requirements of section 334 shall be automatically designated 
        as having such a shortage. Not earlier than 6 years after such 
        date of enactment, and every 6 years thereafter, each such 
        center or clinic shall demonstrate that the center or clinic 
        meets the applicable requirements of the Federal regulations, 
        issued after the date of enactment of this Act, that revise the 
        definition of a health professional shortage area for purposes 
        of this section.''; and
            (B) in paragraph (3), by striking ``340(r)) may be a 
        population group'' and inserting ``330(h)(4)), seasonal 
        agricultural workers (as defined in section 330(g)(3)) and 
        migratory agricultural workers (as so defined)), and residents 
        of public housing (as defined in section 3(b)(1) of the United 
        States Housing Act of 1937 (42 U.S.C. 1437a(b)(1))) may be 
        population groups'';
        (2) in subsection (b)(2), by striking ``with special 
    consideration to the indicators of'' and all that follows through 
    ``services.'' and inserting a period; and
        (3) in subsection (c)(2)(B), by striking ``XVIII or XIX'' and 
    inserting ``XVIII, XIX, or XXI''.
    (b) Regulations.--
        (1) Report.--
            (A) In general.--The Secretary shall submit the report 
        described in subparagraph (B) if the Secretary, acting through 
        the Administrator of the Health Resources and Services 
        Administration, issues--
                (i) a regulation that revises the definition of a 
            health professional shortage area for purposes of section 
            332 of the Public Health Service Act (42 U.S.C. 254e); or
                (ii) a regulation that revises the standards concerning 
            priority of such an area under section 333A of that Act (42 
            U.S.C. 254f-1).
            (B) Report.--On issuing a regulation described in 
        subparagraph (A), the Secretary shall prepare and submit to the 
        Committee on Energy and Commerce of the House of 
        Representatives and the Committee on Health, Education, Labor, 
        and Pensions of the Senate a report that describes the 
        regulation.
        (2) Effective date.--Each regulation described in paragraph 
    (1)(A) shall take effect 180 days after the committees described in 
    paragraph (1)(B) receive a report referred to in paragraph (1)(B) 
    describing the regulation.
    (c) Scholarship and Loan Repayment Programs.--The Secretary of 
Health and Human Services, in consultation with organizations 
representing individuals in the dental field and organizations 
representing publicly funded health care providers, shall develop and 
implement a plan for increasing the participation of dentists and 
dental hygienists in the National Health Service Corps Scholarship 
Program under section 338A of the Public Health Service Act (42 U.S.C. 
254l) and the Loan Repayment Program under section 338B of such Act (42 
U.S.C. 254l-1).
    (d) Site Designation Process.--
        (1) Improvement of designation process.--The Administrator of 
    the Health Resources and Services Administration, in consultation 
    with the Association of State and Territorial Dental Directors, 
    dental societies, and other interested parties, shall revise the 
    criteria on which the designations of dental health professional 
    shortage areas are based so that such criteria provide a more 
    accurate reflection of oral health care need, particularly in rural 
    areas.
        (2) Public health service act.--Section 332 of the Public 
    Health Service Act (42 U.S.C. 254e) is amended by adding at the end 
    the following:
    ``(i) Dissemination.--The Administrator of the Health Resources and 
Services Administration shall disseminate information concerning the 
designation criteria described in subsection (b) to--
        ``(1) the Governor of each State;
        ``(2) the representative of any area, population group, or 
    facility selected by any such Governor to receive such information;
        ``(3) the representative of any area, population group, or 
    facility that requests such information; and
        ``(4) the representative of any area, population group, or 
    facility determined by the Administrator to be likely to meet the 
    criteria described in subsection (b).''.
    (e) GAO Study.--Not later than February 1, 2005, the Comptroller 
General of the United States shall submit to the Congress a report on 
the appropriateness of the criteria, including but not limited to 
infant mortality rates, access to health services taking into account 
the distance to primary health services, the rate of poverty and 
ability to pay for health services, and low birth rates, established by 
the Secretary of Health and Human Services for the designation of 
health professional shortage areas and whether the deeming of federally 
qualified health centers and rural health clinics as such areas is 
appropriate and necessary.

SEC. 303. ASSIGNMENT OF CORPS PERSONNEL.

    Section 333 of the Public Health Service Act (42 U.S.C. 254f) is 
amended--
        (1) in subsection (a)--
            (A) in paragraph (1)--
                (i) in the matter before subparagraph (A), by striking 
            ``(specified in the agreement described in section 334)'';
                (ii) in subparagraph (A), by striking ``nonprofit''; 
            and
                (iii) by striking subparagraph (C) and inserting the 
            following:
            ``(C) the entity agrees to comply with the requirements of 
        section 334; and''; and
            (B) in paragraph (3), by adding at the end ``In approving 
        such applications, the Secretary shall give preference to 
        applications in which a nonprofit entity or public entity shall 
        provide a site to which Corps members may be assigned.''; and
        (2) in subsection (d)--
            (A) in paragraphs (1), (2), and (4), by striking 
        ``nonprofit'' each place it appears; and
            (B) in paragraph (1)--
                (i) in the second sentence--

                    (I) in subparagraph (C), by striking ``and'' at the 
                end; and
                    (II) by striking the period and inserting
                ``, and (E) developing long-term plans for addressing 
                health professional shortages and improving access to 
                health care.''; and

                (ii) by adding at the end the following: ``The 
            Secretary shall encourage entities that receive technical 
            assistance under this paragraph to communicate with other 
            communities, State Offices of Rural Health, State Primary 
            Care Associations and Offices, and other entities concerned 
            with site development and community needs assessment.''.

SEC. 304. PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL.

    Section 333A of the Public Health Service Act (42 U.S.C. 254f-1) is 
amended--
        (1) in subsection (a)(1)(A), by striking ``, as determined in 
    accordance with subsection (b)'';
        (2) by striking subsection (b);
        (3) in subsection (c), by striking the second sentence;
        (4) in subsection (d)--
            (A) by redesignating paragraphs (1) through (3) as 
        paragraphs (2) through (4), respectively;
            (B) by inserting before paragraph (2) (as redesignated by 
        subparagraph (A)) the following:
        ``(1) Proposed list.--The Secretary shall prepare and publish a 
    proposed list of health professional shortage areas and entities 
    that would receive priority under subsection (a)(1) in the 
    assignment of Corps members. The list shall contain the information 
    described in paragraph (2), and the relative scores and relative 
    priorities of the entities submitting applications under section 
    333, in a proposed format. All such entities shall have 30 days 
    after the date of publication of the list to provide additional 
    data and information in support of inclusion on the list or in 
    support of a higher priority determination and the Secretary shall 
    reasonably consider such data and information in preparing the 
    final list under paragraph (2).'';
            (C) in paragraph (2) (as redesignated by subparagraph (A)), 
        in the matter before subparagraph (A)--
                (i) by striking ``paragraph (2)'' and inserting 
            ``paragraph (3)'';
                (ii) by striking ``prepare a list of health 
            professional shortage areas'' and inserting ``prepare and, 
            as appropriate, update a list of health professional 
            shortage areas and entities''; and
                (iii) by striking ``for the period applicable under 
            subsection (f)'';
            (D) by striking paragraph (3) (as redesignated by 
        subparagraph (A)) and inserting the following:
        ``(3) Notification of affected parties.--
            ``(A) Entities.--Not later than 30 days after the Secretary 
        has added to a list under paragraph (2) an entity specified as 
        described in subparagraph (A) of such paragraph, the Secretary 
        shall notify such entity that the entity has been provided an 
        authorization to receive assignments of Corps members in the 
        event that Corps members are available for the assignments.
            ``(B) Individuals.--In the case of an individual obligated 
        to provide service under the Scholarship Program, not later 
        than 3 months before the date described in section 338C(b)(5), 
        the Secretary shall provide to such individual the names of 
        each of the entities specified as described in paragraph 
        (2)(B)(i) that is appropriate for the individual's medical 
        specialty and discipline.''; and
            (E) by striking paragraph (4) (as redesignated by 
        subparagraph (A)) and inserting the following:
        ``(4) Revisions.--If the Secretary proposes to make a revision 
    in the list under paragraph (2), and the revision would adversely 
    alter the status of an entity with respect to the list, the 
    Secretary shall notify the entity of the revision. Any entity 
    adversely affected by such a revision shall be notified in writing 
    by the Secretary of the reasons for the revision and shall have 30 
    days to file a written appeal of the determination involved which 
    shall be reasonably considered by the Secretary before the revision 
    to the list becomes final. The revision to the list shall be 
    effective with respect to assignment of Corps members beginning on 
    the date that the revision becomes final.'';
        (5) by striking subsection (e) and inserting the following:
    ``(e) Limitation on Number of Entities Offered as Assignment 
Choices in Scholarship Program.--
        ``(1) Determination of available corps members.--By April 1 of 
    each calendar year, the Secretary shall determine the number of 
    participants in the Scholarship Program who will be available for 
    assignments under section 333 during the program year beginning on 
    July 1 of that calendar year.
        ``(2) Determination of number of entities.--At all times during 
    a program year, the number of entities specified under subsection 
    (c)(2)(B)(i) shall be--
            ``(A) not less than the number of participants determined 
        with respect to that program year under paragraph (1); and
            ``(B) not greater than twice the number of participants 
        determined with respect to that program year under paragraph 
        (1).'';
        (6) by striking subsection (f); and
        (7) by redesignating subsections (c), (d), and (e) as 
    subsections (b), (c), and (d) respectively.

SEC. 305. COST-SHARING.

    Subpart II of part D of title III of the Public Health Service Act 
(42 U.S.C. 254d et seq.) is amended by striking section 334 and 
inserting the following:
``SEC. 334. CHARGES FOR SERVICES BY ENTITIES USING CORPS MEMBERS.
    ``(a) Availability of Services Regardless of Ability To Pay or 
Payment Source.--An entity to which a Corps member is assigned shall 
not deny requested health care services, and shall not discriminate in 
the provision of services to an individual--
        ``(1) because the individual is unable to pay for the services; 
    or
        ``(2) because payment for the services would be made under--
            ``(A) the medicare program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.);
            ``(B) the medicaid program under title XIX of such Act (42 
        U.S.C. 1396 et seq.); or
            ``(C) the State children's health insurance program under 
        title XXI of such Act (42 U.S.C. 1397aa et seq.).
    ``(b) Charges for Services.--The following rules shall apply to 
charges for health care services provided by an entity to which a Corps 
member is assigned:
        ``(1) In general.--
            ``(A) Schedule of fees or payments.--Except as provided in 
        paragraph (2), the entity shall prepare a schedule of fees or 
        payments for the entity's services, consistent with locally 
        prevailing rates or charges and designed to cover the entity's 
        reasonable cost of operation.
            ``(B) Schedule of discounts.--Except as provided in 
        paragraph (2), the entity shall prepare a corresponding 
        schedule of discounts (including, in appropriate cases, 
        waivers) to be applied to such fees or payments. In preparing 
        the schedule, the entity shall adjust the discounts on the 
        basis of a patient's ability to pay.
            ``(C) Use of schedules.--The entity shall make every 
        reasonable effort to secure from patients fees and payments for 
        services in accordance with such schedules, and fees or 
        payments shall be sufficiently discounted in accordance with 
        the schedule described in subparagraph (B).
        ``(2) Services to beneficiaries of federal and federally 
    assisted programs.--In the case of health care services furnished 
    to an individual who is a beneficiary of a program listed in 
    subsection (a)(2), the entity--
            ``(A) shall accept an assignment pursuant to section 
        1842(b)(3)(B)(ii) of the Social Security Act (42 U.S.C. 
        1395u(b)(3)(B)(ii)) with respect to an individual who is a 
        beneficiary under the medicare program; and
            ``(B) shall enter into an appropriate agreement with--
                ``(i) the State agency administering the program under 
            title XIX of such Act with respect to an individual who is 
            a beneficiary under the medicaid program; and
                ``(ii) the State agency administering the program under 
            title XXI of such Act with respect to an individual who is 
            a beneficiary under the State children's health insurance 
            program.
        ``(3) Collection of payments.--The entity shall take reasonable 
    and appropriate steps to collect all payments due for health care 
    services provided by the entity, including payments from any third 
    party (including a Federal, State, or local government agency and 
    any other third party) that is responsible for part or all of the 
    charge for such services.''.

SEC. 306. ELIGIBILITY FOR FEDERAL FUNDS.

    Section 335(e)(1)(B) of the Public Health Service Act (42 U.S.C. 
254h(e)(1)(B)) is amended by striking ``XVIII or XIX'' and inserting 
``XVIII, XIX, or XXI''.
    SEC. 307. FACILITATION OF EFFECTIVE PROVISION OF CORPS SERVICES.
    (a) Health Professional Shortage Areas.--Section 336 of the Public 
Health Service Act (42 U.S.C. 254h-1) is amended--
        (1) in subsection (c), by striking ``health manpower'' and 
    inserting ``health professional''; and
        (2) in subsection (f)(1), by striking ``health manpower'' and 
    inserting ``health professional''.
    (b) Technical Amendment.--Section 336A(8) of the Public Health 
Service Act (42 U.S.C. 254i(8)) is amended by striking ``agreements 
under''.
    SEC. 308. AUTHORIZATION OF APPROPRIATIONS.
    Section 338(a) of the Public Health Service Act (42 U.S.C. 254k(a)) 
is amended--
        (1) by striking ``(1) For'' and inserting ``For'';
        (2) by striking ``1991 through 2000'' and inserting ``2002 
    through 2006''; and
        (3) by striking paragraph (2).
    SEC. 309. NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM.
    Section 338A of the Public Health Service Act (42 U.S.C. 254l) is 
amended--
        (1) in subsection (a)(1), by inserting ``behavioral and mental 
    health professionals,'' after ``dentists,'';
        (2) in subsection (b)(1)(B), by inserting ``, or an appropriate 
    degree from a graduate program of behavioral and mental health'' 
    after ``other health profession'';
        (3) in subsection (c)(1)--
            (A) in subparagraph (A), by striking ``338D'' and inserting 
        ``338E''; and
            (B) in subparagraph (B), by striking ``338C'' and inserting 
        ``338D'';
        (4) in subsection (d)(1)--
            (A) in subparagraph (A), by striking ``and'' at the end;
            (B) by redesignating subparagraph (B) as subparagraph (C); 
        and
            (C) by inserting after subparagraph (A) the following:
            ``(B) the Secretary, in considering applications from 
        individuals accepted for enrollment or enrolled in dental 
        school, shall consider applications from all individuals 
        accepted for enrollment or enrolled in any accredited dental 
        school in a State; and'';
        (5) in subsection (f)--
            (A) in paragraph (1)(B)--
                (i) in clause (iii), by striking ``and'' after the 
            semicolon;
                (ii) by redesignating clause (iv) as clause (v); and
                (iii) by inserting after clause (iii) the following new 
            clause:
                ``(iv) if pursuing a degree from a school of medicine 
            or osteopathic medicine, to complete a residency in a 
            specialty that the Secretary determines is consistent with 
            the needs of the Corps; and''; and
            (B) in paragraph (3), by striking ``338D'' and inserting 
        ``338E''; and
        (6) by striking subsection (i).
    SEC. 310. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM.
    Section 338B of the Public Health Service Act (42 U.S.C. 254l-1) is 
amended--
        (1) in subsection (a)--
            (A) in paragraph (1), by inserting ``behavioral and mental 
        health professionals,'' after ``dentists,''; and
            (B) in paragraph (2), by striking ``(including mental 
        health professionals)'';
        (2) in subsection (b)(1), by striking subparagraph (A) and 
    inserting the following:
        ``(A) have a degree in medicine, osteopathic medicine, 
    dentistry, or another health profession, or an appropriate degree 
    from a graduate program of behavioral and mental health, or be 
    certified as a nurse midwife, nurse practitioner, or physician 
    assistant;'';
        (3) in subsection (e), by striking ``(1) In general.--''; and
        (4) by striking subsection (i).

SEC. 311. OBLIGATED SERVICE.

    Section 338C of the Public Health Service Act (42 U.S.C. 254m) is 
amended--
    (1) in subsection (b)--
            (A) in paragraph (1), in the matter preceding subparagraph 
        (A), by striking ``section 338A(f)(1)(B)(iv)'' and inserting 
        ``section 338A(f)(1)(B)(v)''; and
            (B) in paragraph (5)--
                (i) by striking all that precedes subparagraph (C) and 
            inserting the following:
    ``(5)(A) In the case of the Scholarship Program, the date referred 
to in paragraphs (1) through (4) shall be the date on which the 
individual completes the training required for the degree for which the 
individual receives the scholarship, except that--
        ``(i) for an individual receiving such a degree after September 
    30, 2000, from a school of medicine or osteopathic medicine, such 
    date shall be the date the individual completes a residency in a 
    specialty that the Secretary determines is consistent with the 
    needs of the Corps; and
        ``(ii) at the request of an individual, the Secretary may, 
    consistent with the needs of the Corps, defer such date until the 
    end of a period of time required for the individual to complete 
    advanced training (including an internship or residency).'';
                (ii) by striking subparagraph (D);
                (iii) by redesignating subparagraphs (C) and (E) as 
            subparagraphs (B) and (C), respectively; and
                (iv) in clause (i) of subparagraph (C) (as redesignated 
            by clause (iii)) by striking ``subparagraph (A), (B), or 
            (D)'' and inserting ``subparagraph (A)''; and
        (2) by striking subsection (e).

SEC. 312. PRIVATE PRACTICE.

    Section 338D of the Public Health Service Act (42 U.S.C. 254n) is 
amended by striking subsection (b) and inserting the following:
    ``(b)(1) The written agreement described in subsection (a) shall--
        ``(A) provide that, during the period of private practice by an 
    individual pursuant to the agreement, the individual shall comply 
    with the requirements of section 334 that apply to entities; and
        ``(B) contain such additional provisions as the Secretary may 
    require to carry out the objectives of this section.
    ``(2) The Secretary shall take such action as may be appropriate to 
ensure that the conditions of the written agreement prescribed by this 
subsection are adhered to.''.
    SEC. 313. BREACH OF SCHOLARSHIP CONTRACT OR LOAN REPAYMENT 
      CONTRACT.
    (a) In General.--Section 338E of the Public Health Service Act (42 
U.S.C. 254o) is amended--
        (1) in subsection (a)(1)--
            (A) in subparagraph (A), by striking the comma and 
        inserting a semicolon;
            (B) in subparagraph (B), by striking the comma and 
        inserting ``; or'';
            (C) in subparagraph (C), by striking ``or'' at the end; and
            (D) by striking subparagraph (D);
        (2) in subsection (b)--
            (A) in paragraph (1)(A)--
                (i) by striking ``338F(d)'' and inserting ``338G(d)'';
                (ii) by striking ``either'';
                (iii) by striking ``338D or'' and inserting ``338D,''; 
            and
                (iv) by inserting ``or to complete a required residency 
            as specified in section 338A(f)(1)(B)(iv),'' before ``the 
            United States''; and
            (B) by adding at the end the following new paragraph:
    ``(3) The Secretary may terminate a contract with an individual 
under section 338A if, not later than 30 days before the end of the 
school year to which the contract pertains, the individual--
        ``(A) submits a written request for such termination; and
        ``(B) repays all amounts paid to, or on behalf of, the 
    individual under section 338A(g).'';
        (3) in subsection (c)--
            (A) in paragraph (1)--
                (i) in the matter preceding subparagraph (A), by 
            striking ``338F(d)'' and inserting ``338G(d)''; and
                (ii) by striking subparagraphs (A) through (C) and 
            inserting the following:
            ``(A) the total of the amounts paid by the United States 
        under section 338B(g) on behalf of the individual for any 
        period of obligated service not served;
            ``(B) an amount equal to the product of the number of 
        months of obligated service that were not completed by the 
        individual, multiplied by $7,500; and
            ``(C) the interest on the amounts described in 
        subparagraphs (A) and (B), at the maximum legal prevailing 
        rate, as determined by the Treasurer of the United States, from 
        the date of the breach;
    except that the amount the United States is entitled to recover 
    under this paragraph shall not be less than $31,000.'';
            (B) by striking paragraphs (2) and (3) and inserting the 
        following:
    ``(2) The Secretary may terminate a contract with an individual 
under section 338B if, not later than 45 days before the end of the 
fiscal year in which the contract was entered into, the individual--
        ``(A) submits a written request for such termination; and
        ``(B) repays all amounts paid on behalf of the individual under 
    section 338B(g).''; and
            (C) by redesignating paragraph (4) as paragraph (3);
        (4) in subsection (d)(3)(A), by striking ``only if such 
    discharge is granted after the expiration of the five-year period'' 
    and inserting ``only if such discharge is granted after the 
    expiration of the 7-year period''; and
        (5) by adding at the end the following new subsection:
    ``(e) Notwithstanding any other provision of Federal or State law, 
there shall be no limitation on the period within which suit may be 
filed, a judgment may be enforced, or an action relating to an offset 
or garnishment, or other action, may be initiated or taken by the 
Secretary, the Attorney General, or the head of another Federal agency, 
as the case may be, for the repayment of the amount due from an 
individual under this section.''.
    (b) Effective Date.--The amendment made by subsection (a)(4) shall 
apply to any obligation for which a discharge in bankruptcy has not 
been granted before the date that is 31 days after the date of 
enactment of this Act.

SEC. 314. AUTHORIZATION OF APPROPRIATIONS.

    Section 338H of the Public Health Service Act (42 U.S.C. 254q) is 
amended to read as follows:

``SEC. 338H. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Authorization of Appropriations.--For the purposes of 
carrying out this subpart, there are authorized to be appropriated 
$146,250,000 for fiscal year 2002, and such sums as may be necessary 
for each of fiscal years 2003 through 2006.
    ``(b) Scholarships for New Participants.--Of the amounts 
appropriated under subsection (a) for a fiscal year, the Secretary 
shall obligate not less than 10 percent for the purpose of providing 
contracts for--
        ``(1) scholarships under this subpart to individuals who have 
    not previously received such scholarships; or
        ``(2) scholarships or loan repayments under the Loan Repayment 
    Program under section 338B to individuals from disadvantaged 
    backgrounds.
    ``(c) Scholarships and Loan Repayments.--With respect to 
certification as a nurse practitioner, nurse midwife, or physician 
assistant, the Secretary shall, from amounts appropriated under 
subsection (a) for a fiscal year, obligate not less than a total of 10 
percent for contracts for both scholarships under the Scholarship 
Program under section 338A and loan repayments under the Loan Repayment 
Program under section 338B to individuals who are entering the first 
year of a course of study or program described in section 338A(b)(1)(B) 
that leads to such a certification or individuals who are eligible for 
the loan repayment program as specified in section 338B(b) for a loan 
related to such certification.''.

SEC. 315. GRANTS TO STATES FOR LOAN REPAYMENT PROGRAMS.

    Section 338I of the Public Health Service Act (42 U.S.C. 254q-1) is 
amended--
        (1) in subsection (a), by striking paragraph (1) and inserting 
    the following:
        ``(1) Authority for grants.--The Secretary, acting through the 
    Administrator of the Health Resources and Services Administration, 
    may make grants to States for the purpose of assisting the States 
    in operating programs described in paragraph (2) in order to 
    provide for the increased availability of primary health care 
    services in health professional shortage areas. The National 
    Advisory Council established under section 337 shall advise the 
    Administrator regarding the program under this section.'';
        (2) in subsection (e), by striking paragraph (1) and inserting 
    the following:
        ``(1) to submit to the Secretary such reports regarding the 
    States loan repayment program, as are determined to be appropriate 
    by the Secretary; and''; and
        (3) in subsection (i), by striking paragraph (1) and inserting 
    the following:
        ``(1) In general.--For the purpose of making grants under 
    subsection (a), there are authorized to be appropriated $12,000,000 
    for fiscal year 2002 and such sums as may be necessary for each of 
    fiscal years 2003 through 2006.''.
    SEC. 316. DEMONSTRATION GRANTS TO STATES FOR COMMUNITY SCHOLARSHIP 
      PROGRAMS.
    Section 338L of the Public Health Service Act (42 U.S.C. 254t) is 
repealed.

SEC. 317. DEMONSTRATION PROJECT.

    Subpart III of part D of title III of the Public Health Service Act 
(42 U.S.C. 254l et seq.) is amended by adding at the end the following:

``SEC. 338L. DEMONSTRATION PROJECT.

    ``(a) Program Authorized.--The Secretary shall establish a 
demonstration project to provide for the participation of individuals 
who are chiropractic doctors or pharmacists in the Loan Repayment 
Program described in section 338B.
    ``(b) Procedure.--An individual that receives assistance under this 
section with regard to the program described in section 338B shall 
comply with all rules and requirements described in such section (other 
than subparagraphs (A) and (B) of section 338B(b)(1)) in order to 
receive assistance under this section.
    ``(c) Limitations.--
        ``(1) In general.--The demonstration project described in this 
    section shall provide for the participation of individuals who 
    shall provide services in rural and urban areas.
        ``(2) Availability of other health professionals.--The 
    Secretary may not assign an individual receiving assistance under 
    this section to provide obligated service at a site unless--
            ``(A) the Secretary has assigned a physician (as defined in 
        section 1861(r) of the Social Security Act) or other health 
        professional licensed to prescribe drugs to provide obligated 
        service at such site under section 338C or 338D; and
            ``(B) such physician or other health professional will 
        provide obligated service at such site concurrently with the 
        individual receiving assistance under this section.
        ``(3) Rules of construction.--
            ``(A) Supervision of individuals.--Nothing in this section 
        shall be construed to require or imply that a physician or 
        other health professional licensed to prescribe drugs must 
        supervise an individual receiving assistance under the 
        demonstration project under this section, with respect to such 
        project.
            ``(B) Licensure of health professionals.--Nothing in this 
        section shall be construed to supersede State law regarding 
        licensure of health professionals.
    ``(d) Designations.--The demonstration project described in this 
section, and any providers who are selected to participate in such 
project, shall not be considered by the Secretary in the designation of 
a health professional shortage area under section 332 during fiscal 
years 2002 through 2004.
    ``(e) Rule of Construction.--This section shall not be construed to 
require any State to participate in the project described in this 
section.
    ``(f) Report.--
        ``(1) In general.--The Secretary shall evaluate the 
    participation of individuals in the demonstration projects under 
    this section and prepare and submit a report containing the 
    information described in paragraph (2) to--
            ``(A) the Committee on Health, Education, Labor, and 
        Pensions of the Senate;
            ``(B) the Subcommittee on Labor, Health and Human Services, 
        and Education of the Committee on Appropriations of the Senate;
            ``(C) the Committee on Energy and Commerce of the House of 
        Representatives; and
            ``(D) the Subcommittee on Labor, Health and Human Services, 
        and Education of the Committee on Appropriations of the House 
        of Representatives.
        ``(2) Content.--The report described in paragraph (1) shall 
    detail--
            ``(A) the manner in which the demonstration project 
        described in this section has affected access to primary care 
        services, patient satisfaction, quality of care, and health 
        care services provided for traditionally underserved 
        populations;
            ``(B) how the participation of chiropractic doctors and 
        pharmacists in the Loan Repayment Program might affect the 
        designation of health professional shortage areas; and
            ``(C) whether adding chiropractic doctors and pharmacists 
        as permanent members of the National Health Service Corps would 
        be feasible and would enhance the effectiveness of the National 
        Health Service Corps.
    ``(g) Authorization of Appropriations.--
        ``(1) in general.--There are authorized to be appropriated to 
    carry out this section, such sums as may be necessary for fiscal 
    years 2002 through 2004.
        ``(2) Fiscal year 2005.--If the Secretary determines and 
    certifies to Congress by not later than September 30, 2004, that 
    the number of individuals participating in the demonstration 
    project established under this section is insufficient for purposes 
    of performing the evaluation described in subsection (f)(1), the 
    authorization of appropriations under paragraph (1) shall be 
    extended to include fiscal year 2005.''.

              TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM

SEC. 401. PURPOSE.

    The purpose of this title is to provide assistance to communities 
and consortia of health care providers and others, to develop or 
strengthen integrated community health care delivery systems that 
coordinate health care services for individuals who are uninsured or 
underinsured and to develop or strengthen activities related to 
providing coordinated care for individuals with chronic conditions who 
are uninsured or underinsured, through the--
        (1) coordination of services to allow individuals to receive 
    efficient and higher quality care and to gain entry into and 
    receive services from a comprehensive system of care;
        (2) development of the infrastructure for a health care 
    delivery system characterized by effective collaboration, 
    information sharing, and clinical and financial coordination among 
    all providers of care in the community; and
        (3) provision of new Federal resources that do not supplant 
    funding for existing Federal categorical programs that support 
    entities providing services to low-income populations.

SEC. 402. CREATION OF HEALTHY COMMUNITIES ACCESS PROGRAM.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by inserting after subpart IV the following 
new subpart:

            ``Subpart V--Healthy Communities Access Program

``SEC. 340. GRANTS TO STRENGTHEN THE EFFECTIVENESS, EFFICIENCY, AND 
COORDINATION OF SERVICES FOR THE UNINSURED AND UNDERINSURED.
    ``(a) In General.--The Secretary may award grants to eligible 
entities to assist in the development of integrated health care 
delivery systems to serve communities of individuals who are uninsured 
and individuals who are underinsured--
        ``(1) to improve the efficiency of, and coordination among, the 
    providers providing services through such systems;
        ``(2) to assist communities in developing programs targeted 
    toward preventing and managing chronic diseases; and
        ``(3) to expand and enhance the services provided through such 
    systems.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall be an entity that--
        ``(1) represents a consortium--
            ``(A) whose principal purpose is to provide a broad range 
        of coordinated health care services for a community defined in 
        the entity's grant application as described in paragraph (2); 
        and
            ``(B) that includes at least one of each of the following 
        providers that serve the community (unless such provider does 
        not exist within the community, declines or refuses to 
        participate, or places unreasonable conditions on their 
        participation)--
                ``(i) a Federally qualified health center (as defined 
            in section 1861(aa) of the Social Security Act (42 U.S.C. 
            1395x(aa)));
                ``(ii) a hospital with a low-income utilization rate 
            (as defined in section 1923(b)(3) of the Social Security 
            Act (42 U.S.C. 1396r-4(b)(3)), that is greater than 25 
            percent;
                ``(iii) a public health department; and
                ``(iv) an interested public or private sector health 
            care provider or an organization that has traditionally 
            served the medically uninsured and underserved; and
        ``(2) submits to the Secretary an application, in such form and 
    manner as the Secretary shall prescribe, that--
            ``(A) defines a community or geographic area of uninsured 
        and underinsured individuals;
            ``(B) identifies the providers who will participate in the 
        consortium's program under the grant, and specifies each 
        provider's contribution to the care of uninsured and 
        underinsured individuals in the community, including the volume 
        of care the provider provides to beneficiaries under the 
        medicare, medicaid, and State child health insurance programs 
        and to patients who pay privately for services;
            ``(C) describes the activities that the applicant and the 
        consortium propose to perform under the grant to further the 
        objectives of this section;
            ``(D) demonstrates the consortium's ability to build on the 
        current system (as of the date of submission of the 
        application) for serving a community or geographic area of 
        uninsured and underinsured individuals by involving providers 
        who have traditionally provided a significant volume of care 
        for that community;
            ``(E) demonstrates the consortium's ability to develop 
        coordinated systems of care that either directly provide or 
        ensure the prompt provision of a broad range of high-quality, 
        accessible services, including, as appropriate, primary, 
        secondary, and tertiary services, as well as substance abuse 
        treatment and mental health services in a manner that assures 
        continuity of care in the community or geographic area;
            ``(F) provides evidence of community involvement in the 
        development, implementation, and direction of the program that 
        the entity proposes to operate;
            ``(G) demonstrates the consortium's ability to ensure that 
        individuals participating in the program are enrolled in public 
        insurance programs for which the individuals are eligible or 
        know of private insurance programs where available;
            ``(H) presents a plan for leveraging other sources of 
        revenue, which may include State and local sources and private 
        grant funds, and integrating current and proposed new funding 
        sources in a way to assure long-term sustainability of the 
        program;
            ``(I) describes a plan for evaluation of the activities 
        carried out under the grant, including measurement of progress 
        toward the goals and objectives of the program and the use of 
        evaluation findings to improve program performance;
            ``(J) demonstrates fiscal responsibility through the use of 
        appropriate accounting procedures and appropriate management 
        systems;
            ``(K) demonstrates the consortium's commitment to serve the 
        community without regard to the ability of an individual or 
        family to pay by arranging for or providing free or reduced 
        charge care for the poor; and
            ``(L) includes such other information as the Secretary may 
        prescribe.
    ``(c) Limitations.--
        ``(1) Number of awards.--
            ``(A) In general.--For each of fiscal years 2003, 2004, 
        2005, and 2006, the Secretary may not make more than 35 new 
        awards under subsection (a) (excluding renewals of such 
        awards).
            ``(B) Rule of construction.--This paragraph shall not be 
        construed to affect awards made before fiscal year 2003.
        ``(2) In general.--An eligible entity may not receive a grant 
    under this section (including with respect to any such grant made 
    before fiscal year 2003) for more than 3 consecutive fiscal years, 
    except that such entity may receive such a grant award for not more 
    than 1 additional fiscal year if--
            ``(A) the eligible entity submits to the Secretary a 
        request for a grant for such an additional fiscal year;
            ``(B) the Secretary determines that extraordinary 
        circumstances (as defined in paragraph (3)) justify the 
        granting of such request; and
            ``(C) the Secretary determines that granting such request 
        is necessary to further the objectives described in subsection 
        (a).
        ``(3) Extraordinary circumstances.--
            ``(A) In general.--In paragraph (2), the term 
        `extraordinary circumstances' means an event (or events) that 
        is outside of the control of the eligible entity that has 
        prevented the eligible entity from fulfilling the objectives 
        described by such entity in the application submitted under 
        subsection (b)(2).
            ``(B) Examples.--Extraordinary circumstances include--
                ``(i) natural disasters or other major disruptions to 
            the security or health of the community or geographic area 
            served by the eligible entity; or
                ``(ii) a significant economic deterioration in the 
            community or geographic area served by such eligible 
            entity, that directly and adversely affects the entity 
            receiving an award under subsection (a).
    ``(d) Priorities.--In awarding grants under this section, the 
Secretary--
        ``(1) shall accord priority to applicants that demonstrate the 
    extent of unmet need in the community involved for a more 
    coordinated system of care; and
        ``(2) may accord priority to applicants that best promote the 
    objectives of this section, taking into consideration the extent to 
    which the application involved--
            ``(A) identifies a community whose geographical area has a 
        high or increasing percentage of individuals who are uninsured;
            ``(B) demonstrates that the applicant has included in its 
        consortium providers, support systems, and programs that have a 
        tradition of serving uninsured individuals and underinsured 
        individuals in the community;
            ``(C) shows evidence that the program would expand 
        utilization of preventive and primary care services for 
        uninsured and underinsured individuals and families in the 
        community, including behavioral and mental health services, 
        oral health services, or substance abuse services;
            ``(D) proposes a program that would improve coordination 
        between health care providers and appropriate social service 
        providers;
            ``(E) demonstrates collaboration with State and local 
        governments;
            ``(F) demonstrates that the applicant makes use of non-
        Federal contributions to the greatest extent possible; or
            ``(G) demonstrates a likelihood that the proposed program 
        will continue after support under this section ceases.
    ``(e) Use of Funds.--
        ``(1) Use by grantees.--
            ``(A) In general.--Except as provided in paragraphs (2) and 
        (3), a grantee may use amounts provided under this section only 
        for--
                ``(i) direct expenses associated with achieving the 
            greater integration of a health care delivery system so 
            that the system either directly provides or ensures the 
            provision of a broad range of culturally competent 
            services, as appropriate, including primary, secondary, and 
            tertiary services, as well as substance abuse treatment and 
            mental health services; and
                ``(ii) direct patient care and service expansions to 
            fill identified or documented gaps within an integrated 
            delivery system.
            ``(B) Specific uses.--The following are examples of 
        purposes for which a grantee may use grant funds under this 
        section, when such use meets the conditions stated in 
        subparagraph (A):
                ``(i) Increases in outreach activities and closing gaps 
            in health care service.
                ``(ii) Improvements to case management.
                ``(iii) Improvements to coordination of transportation 
            to health care facilities.
                ``(iv) Development of provider networks and other 
            innovative models to engage physicians in voluntary efforts 
            to serve the medically underserved within a community.
                ``(v) Recruitment, training, and compensation of 
            necessary personnel.
                ``(vi) Acquisition of technology for the purpose of 
            coordinating care.
                ``(vii) Improvements to provider communication, 
            including implementation of shared information systems or 
            shared clinical systems.
                ``(viii) Development of common processes for 
            determining eligibility for the programs provided through 
            the system, including creating common identification cards 
            and single sliding scale discounts.
                ``(ix) Development of specific prevention and disease 
            management tools and processes.
                ``(x) Translation services.
                ``(xi) Carrying out other activities that may be 
            appropriate to a community and that would increase access 
            by the uninsured to health care, such as access initiatives 
            for which private entities provide non-Federal 
            contributions to supplement the Federal funds provided 
            through the grants for the initiatives.
        ``(2) Direct patient care limitation.--Not more than 15 percent 
    of the funds provided under a grant awarded under this section may 
    be used for providing direct patient care and services.
        ``(3) Reservation of funds for national program purposes.--The 
    Secretary may use not more than 3 percent of funds appropriated to 
    carry out this section for providing technical assistance to 
    grantees, obtaining assistance of experts and consultants, holding 
    meetings, developing of tools, disseminating of information, 
    evaluation, and carrying out activities that will extend the 
    benefits of programs funded under this section to communities other 
    than the community served by the program funded.
    ``(f) Grantee Requirements.--
        ``(1) Evaluation of effectiveness.--A grantee under this 
    section shall--
            ``(A) report to the Secretary annually regarding--
                ``(i) progress in meeting the goals and measurable 
            objectives set forth in the grant application submitted by 
            the grantee under subsection (b); and
                ``(ii) the extent to which activities conducted by such 
            grantee have--

                    ``(I) improved the effectiveness, efficiency, and 
                coordination of services for uninsured and underinsured 
                individuals in the communities or geographic areas 
                served by such grantee;
                    ``(II) resulted in the provision of better quality 
                health care for such individuals; and
                    ``(III) resulted in the provision of health care to 
                such individuals at lower cost than would have been 
                possible in the absence of the activities conducted by 
                such grantee; and

            ``(B) provide for an independent annual financial audit of 
        all records that relate to the disposition of funds received 
        through the grant.
        ``(2) Progress.--The Secretary may not renew an annual grant 
    under this section for an entity for a fiscal year unless the 
    Secretary is satisfied that the consortium represented by the 
    entity has made reasonable and demonstrable progress in meeting the 
    goals and measurable objectives set forth in the entity's grant 
    application for the preceding fiscal year.
    ``(g) Maintenance of Effort.--With respect to activities for which 
a grant under this section is authorized, the Secretary may award such 
a grant only if the applicant for the grant, and each of the 
participating providers, agree that the grantee and each such provider 
will maintain its expenditures of non-Federal funds for such activities 
at a level that is not less than the level of such expenditures during 
the fiscal year immediately preceding the fiscal year for which the 
applicant is applying to receive such grant.
    ``(h) Technical Assistance.--The Secretary may, either directly or 
by grant or contract, provide any entity that receives a grant under 
this section with technical and other nonfinancial assistance necessary 
to meet the requirements of this section.
    ``(i) Evaluation of Program.--Not later than September 30, 2005, 
the Secretary shall prepare and submit to the appropriate committees of 
Congress a report that describes the extent to which projects funded 
under this section have been successful in improving the effectiveness, 
efficiency, and coordination of services for uninsured and underinsured 
individuals in the communities or geographic areas served by such 
projects, including whether the projects resulted in the provision of 
better quality health care for such individuals, and whether such care 
was provided at lower costs, than would have been provided in the 
absence of such projects.
    ``(j) Demonstration Authority.--The Secretary may make 
demonstration awards under this section to historically black health 
professions schools for the purposes of--
        ``(1) developing patient-based research infrastructure at 
    historically black health professions schools, which have an 
    affiliation, or affiliations, with any of the providers identified 
    in subsection (b)(1)(B);
        ``(2) establishment of joint and collaborative programs of 
    medical research and data collection between historically black 
    health professions schools and such providers, whose goal is to 
    improve the health status of medically underserved populations; or
        ``(3) supporting the research-related costs of patient care, 
    data collection, and academic training resulting from such 
    affiliations.
    ``(k) 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.
    ``(l) Date Certain for Termination of Program.--Funds may not be 
appropriated to carry out this section after September 30, 2006.''.

SEC. 403. EXPANDING AVAILABILITY OF DENTAL SERVICES.

    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:

                  ``Subpart X--Primary Dental Programs

``SEC. 340F. DESIGNATED DENTAL HEALTH PROFESSIONAL SHORTAGE AREA.
    ``In this subpart, the term `designated dental health professional 
shortage area' means an area, population group, or facility that is 
designated by the Secretary as a dental health professional shortage 
area under section 332 or designated by the applicable State as having 
a dental health professional shortage.

``SEC. 340G. GRANTS FOR INNOVATIVE PROGRAMS.

    ``(a) Grant Program Authorized.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, is 
authorized to award grants to States for the purpose of helping States 
develop and implement innovative programs to address the dental 
workforce needs of designated dental health professional shortage areas 
in a manner that is appropriate to the States' individual needs.
    ``(b) State Activities.--A State receiving a grant under subsection 
(a) may use funds received under the grant for--
        ``(1) loan forgiveness and repayment programs for dentists 
    who--
            ``(A) agree to practice in designated dental health 
        professional shortage areas;
            ``(B) are dental school graduates who agree to serve as 
        public health dentists for the Federal, State, or local 
        government; and
            ``(C) agree to--
                ``(i) provide services to patients regardless of such 
            patients' ability to pay; and
                ``(ii) use a sliding payment scale for patients who are 
            unable to pay the total cost of services;
        ``(2) dental recruitment and retention efforts;
        ``(3) grants and low-interest or no-interest loans to help 
    dentists who participate in the medicaid program under title XIX of 
    the Social Security Act (42 U.S.C. 1396 et seq.) to establish or 
    expand practices in designated dental health professional shortage 
    areas by equipping dental offices or sharing in the overhead costs 
    of such practices;
        ``(4) the establishment or expansion of dental residency 
    programs in coordination with accredited dental training 
    institutions in States without dental schools;
        ``(5) programs developed in consultation with State and local 
    dental societies to expand or establish oral health services and 
    facilities in designated dental health professional shortage areas, 
    including services and facilities for children with special needs, 
    such as--
            ``(A) the expansion or establishment of a community-based 
        dental facility, free-standing dental clinic, consolidated 
        health center dental facility, school-linked dental facility, 
        or United States dental school-based facility;
            ``(B) the establishment of a mobile or portable dental 
        clinic; and
            ``(C) the establishment or expansion of private dental 
        services to enhance capacity through additional equipment or 
        additional hours of operation;
        ``(6) placement and support of dental students, dental 
    residents, and advanced dentistry trainees;
        ``(7) continuing dental education, including distance-based 
    education;
        ``(8) practice support through teledentistry conducted in 
    accordance with State laws;
        ``(9) community-based prevention services such as water 
    fluoridation and dental sealant programs;
        ``(10) coordination with local educational agencies within the 
    State to foster programs that promote children going into oral 
    health or science professions;
        ``(11) the establishment of faculty recruitment programs at 
    accredited dental training institutions whose mission includes 
    community outreach and service and that have a demonstrated record 
    of serving underserved States;
        ``(12) the development of a State dental officer position or 
    the augmentation of a State dental office to coordinate oral health 
    and access issues in the State; and
        ``(13) any other activities determined to be appropriate by the 
    Secretary.
    ``(c) Application.--
        ``(1) In general.--Each State desiring a grant under this 
    section shall submit an application to the Secretary at such time, 
    in such manner, and containing such information as the Secretary 
    may reasonably require.
        ``(2) Assurances.--The application shall include assurances 
    that the State will meet the requirements of subsection (d) and 
    that the State possesses sufficient infrastructure to manage the 
    activities to be funded through the grant and to evaluate and 
    report on the outcomes resulting from such activities.
    ``(d) Matching Requirement.--The Secretary may not make a grant to 
a State under this section unless that State agrees that, with respect 
to the costs to be incurred by the State in carrying out the activities 
for which the grant was awarded, the State will provide non-Federal 
contributions in an amount equal to not less than 40 percent of Federal 
funds provided under the grant. The State may provide the contributions 
in cash or in kind, fairly evaluated, including plant, equipment, and 
services and may provide the contributions from State, local, or 
private sources.
    ``(e) Report.--Not later than 5 years after the date of enactment 
of the Health Care Safety Net Amendments of 2002, the Secretary shall 
prepare and submit to the appropriate committees of Congress a report 
containing data relating to whether grants provided under this section 
have increased access to dental services in designated dental health 
professional shortage areas.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $50,000,000 for the 5-fiscal 
year period beginning with fiscal year 2002.''.
    SEC. 404. STUDY REGARDING BARRIERS TO PARTICIPATION OF FARMWORKERS 
      IN HEALTH PROGRAMS.
    (a) In General.--The Secretary shall conduct a study of the 
problems experienced by farmworkers (including their families) under 
Medicaid and SCHIP. Specifically, the Secretary shall examine the 
following:
        (1) Barriers to enrollment.--Barriers to their enrollment, 
    including a lack of outreach and outstationed eligibility workers, 
    complicated applications and eligibility determination procedures, 
    and linguistic and cultural barriers.
        (2) Lack of portability.--The lack of portability of Medicaid 
    and SCHIP coverage for farmworkers who are determined eligible in 
    one State but who move to other States on a seasonal or other 
    periodic basis.
        (3) Possible solutions.--The development of possible solutions 
    to increase enrollment and access to benefits for farmworkers, 
    because, in part, of the problems identified in paragraphs (1) and 
    (2), and the associated costs of each of the possible solutions 
    described in subsection (b).
    (b) Possible Solutions.--Possible solutions to be examined shall 
include each of the following:
        (1) Interstate compacts.--The use of interstate compacts among 
    States that establish portability and reciprocity for eligibility 
    for farmworkers under the Medicaid and SCHIP and potential 
    financial incentives for States to enter into such compacts.
        (2) Demonstration projects.--The use of multi-state 
    demonstration waiver projects under section 1115 of the Social 
    Security Act (42 U.S.C. 1315) to develop comprehensive migrant 
    coverage demonstration projects.
        (3) Use of current law flexibility.--Use of current law 
    Medicaid and SCHIP State plan provisions relating to coverage of 
    residents and out-of-State coverage.
        (4) National migrant family coverage.--The development of 
    programs of national migrant family coverage in which States could 
    participate.
        (5) Public-private partnerships.--The provision of incentives 
    for development of public-private partnerships to develop private 
    coverage alternatives for farmworkers.
        (6) Other possible solutions.--Such other solutions as the 
    Secretary deems appropriate.
    (c) Consultations.--In conducting the study, the Secretary shall 
consult with the following:
        (1) Farmworkers affected by the lack of portability of coverage 
    under the Medicaid program or the State children's health insurance 
    program (under titles XIX and XXI of the Social Security Act).
        (2) Individuals with expertise in providing health care to 
    farmworkers, including designees of national and local 
    organizations representing migrant health centers and other 
    providers.
        (3) Resources with expertise in health care financing.
        (4) Representatives of foundations and other nonprofit entities 
    that have conducted or supported research on farmworker health care 
    financial issues.
        (5) Representatives of Federal agencies which are involved in 
    the provision or financing of health care to farmworkers, including 
    the Health Care Financing Administration and the Health Research 
    and Services Administration.
        (6) Representatives of State governments.
        (7) Representatives from the farm and agricultural industries.
        (8) Designees of labor organizations representing farmworkers.
    (d) Definitions.--For purposes of this section:
        (1) Farmworker.--The term ``farmworker'' means a migratory 
    agricultural worker or seasonal agricultural worker, as such terms 
    are defined in section 330(g)(3) of the Public Health Service Act 
    (42 U.S.C. 254c(g)(3)), and includes a family member of such a 
    worker.
        (2) Medicaid.--The term ``Medicaid'' means the program under 
    title XIX of the Social Security Act.
        (3) SCHIP.--The term ``SCHIP'' means the State children's 
    health insurance program under title XXI of the Social Security 
    Act.
    (e) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall transmit a report to the 
President and the Congress on the study conducted under this section. 
The report shall contain a detailed statement of findings and 
conclusions of the study, together with its recommendations for such 
legislation and administrative actions as the Secretary considers 
appropriate.

              TITLE V--STUDY AND MISCELLANEOUS PROVISIONS

SEC. 501. GUARANTEE STUDY.

    The Secretary of Health and Human Services shall conduct a study 
regarding the ability of the Department of Health and Human Services to 
provide for solvency for managed care networks involving health centers 
receiving funding under section 330 of the Public Health Service Act. 
The Secretary shall prepare and submit a report to the appropriate 
Committees of Congress regarding such ability not later than 2 years 
after the date of enactment of the Health Care Safety Net Amendments of 
2002.

SEC. 502. GRADUATE MEDICAL EDUCATION.

    Section 762(k) of the Public Health Service Act (42 U.S.C. 294o(k)) 
is amended by striking ``2002'' and inserting ``2003''.

                    TITLE VI--CONFORMING AMENDMENTS

SEC. 601. CONFORMING AMENDMENTS.

    (a) Homeless Programs.--Subsections (g)(1)(G)(ii), (k)(2), and 
(n)(1)(C) of section 224, and sections 317A(a)(2), 317E(c), 318A(e), 
332(a)(2)(C), 340D(c)(5), 799B(6)(B), 1313, and 2652(2) of the Public 
Health Service Act (42 U.S.C. 233, 247b-1(a)(2), 247b-6(c), 247c-1(e), 
254e(a)(2)(C), 256d(c)(5), 295p(6)(B), 300e-12, and 300ff-52(2)) are 
amended by striking ``340'' and inserting ``330(h)''.
    (b) Homeless Individual.--Section 534(2) of the Public Health 
Service Act (42 U.S.C. 290cc-34(2)) is amended by striking ``340(r)'' 
and inserting ``330(h)(5)''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.