[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1533 Placed on Calendar Senate (PCS)]
Calendar No. 192
107th CONGRESS
1st Session
S. 1533
[Report No. 107-83]
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.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 11, 2001
Mr. Kennedy, from the Committee on Health, Education, Labor, and
Pensions, reported the following original bill; which was read twice
and placed on the calendar
_______________________________________________________________________
A BILL
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 2001''.
(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.
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.
Subtitle D--School-Based Health Center Networks
Sec. 231. Networks.
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 ACT
Sec. 401. Purpose.
Sec. 402. Creation of Healthy Communities Access Program.
Sec. 403. Expanding availability of dental services.
TITLE V--RURAL HEALTH CLINICS
Sec. 501. Exemptions for rural health clinics.
TITLE VI--STUDY
Sec. 601. Guarantee study.
TITLE VII--CONFORMING AMENDMENTS
Sec. 701. 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) in clause (vi), by striking ``and'';
(ii) by redesignating clause (vii) as
clause (x); and
(iii) by inserting after clause (vi) the
following:
``(vii) the detection and alleviation of
chemical and pesticide exposures;
``(viii) the promotion of indoor and
outdoor air quality;
``(ix) the detection and remediation of
lead exposures; and'';
(B) by redesignating subparagraphs (A) and (B) as
subparagraphs (D) and (E), respectively; and
(C) by inserting before subparagraph (D) (as
redesignated by subparagraph (B)) the following:
``(A) behavioral and mental health and substance
abuse services;
``(B) recuperative care services;
``(C) public health services;'';
(3) in subsection (c)(1)--
(A) in subparagraph (A), in the matter preceding
clause (i), by striking ``and lease of buildings'' and
all that follows through ``include--'' and inserting
``, lease, modernization, and expansion of buildings,
the construction of buildings, and the purchase or
lease of equipment (including the costs of amortizing
the principal of, and paying the interest on, loans for
buildings and equipment) and shall include--'';
(B) 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
(C) 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), and for the
costs of acquiring, leasing, modernizing, or
expanding buildings, construction of buildings,
or purchasing or leasing equipment.'';
(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 such
refinancing will be beneficial to the health
center and the Federal Government and will
result in more favorable terms.''; and
(iii) by adding at the end the following:
``(D) Loan guarantees.--Notwithstanding any other
provision of law, the following funds shall be made
available until expended for loan guarantees under this
subsection:
``(i) Funds appropriated for fiscal year
1997 under the Departments of Labor, Health and
Human Services, and Education, and Related
Agencies Appropriations Act, 1997, which were
made available for loan guarantees for loans
made by non-Federal lenders for construction,
renovation, and modernization of medical
facilities that are owned and operated by
health centers and for loan guarantees for
loans to health centers for the costs of
developing and operating managed care networks
or plans, and which have not been expended.
``(ii) Funds appropriated for fiscal year
1998 under the Departments of Labor, Health and
Human Services, and Education, and Related
Agencies Appropriations Act, 1998, which were
made available for loan guarantees for loans
made by non-Federal lenders for construction,
renovation, and modernization of medical
facilities that are owned or operated by health
centers and for loan guarantees for loans to
health centers under this subsection (as in
effect on the day before the date of enactment
of the Health Care Safety Net Amendments of
2001), and which have not been expended.
``(E) 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.
``(F) 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);
(5) in subsection (e)--
(A) in paragraph (1)--
(i) in subparagraph (B), by striking
``subsection (j)(3)'' and inserting
``subsection (l)(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 (2)--
(i) by striking ``acquiring and leasing''
and inserting ``acquiring, leasing,
modernizing, and expanding'';
(ii) by striking ``and equipment'' and
inserting ``, constructing buildings, and
purchasing or leasing equipment'';
(iii) by striking ``loans)'' and inserting
``loans for buildings and equipment)''; and
(iv) by adding at the end the following:
``The costs for which a grant may be made under
paragraph (1)(C) may include the costs of
providing such training.'';
(C) by striking paragraph (3);
(D) 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
(E) by redesignating paragraphs (4) and (5) as
paragraphs (3) and (4), respectively;
(6) 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'';
(7) 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'';
(8) 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''; and
(C) in subparagraph (H)--
(i) in clause (ii), by inserting ``reviews
any internal outreach plans for specific
subpopulations served by the center,'' after
``such services will be provided,''; and
(ii) in the matter following clause (iii),
by striking ``or (p)'' and inserting ``or
(q)'';
(9)(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 (l), (m), and (n) through (r), respectively;
and
(C) by inserting after subsection (i) the following:
``(j) Environmental Concerns.--The Secretary may make grants to
health centers for the purpose of assisting such centers in identifying
and detecting environmental factors and conditions, and providing
services, including environmental health services described in
subsection (b)(2)(D), to reduce the disease burden related to
environmental factors and exposure of populations to such factors, and
alleviate environmental conditions that affect the health of
individuals and communities served by health centers funded under this
section.
``(k) Linguistic 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); and
``(B) provides health care services for clients for
whom English is a second language.
``(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; and
``(C) a description of any language assistance
services that the center proposes to provide to aid
clients for whom English is a second language.
``(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, $10,000,000 for fiscal year 2002, and such sums
as may be necessary for each of fiscal years 2003 through
2006.'';
(10) in subsection (l)(3) (as redesignated by paragraph
(9)(B))--
(A) in subparagraph (K), by striking ``and'' at the
end;
(B) in subparagraph (L), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(M) in the case of a project involving
modernization of a building, the application contains a
reasonable assurance that all laborers and mechanics
employed by contractors or subcontractors in the
performance of work on the modernization of the
building described in the application will be paid
wages at rates not less than the rates prevailing on
similar work in the locality involved as determined by
the Secretary of Labor in accordance with the labor
standards specified in the Act of March 3, 1931
(commonly known as the `Davis-Bacon Act') (46 Stat.
1494, chapter 411; 40 U.S.C. 276a et seq.), and the
Secretary of Labor shall have with respect to such
labor standards and such project the authority and
functions set forth in Reorganization Plan No. 14 of
1950 (5 U.S.C. App.) and section 2 of the Act of June
13, 1934 (48 Stat. 948, chapter 482; 40 U.S.C.
276c).'';
(11) 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) in developing plans for, or
operating, health centers. 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.'';
(12) in subsection (q) (as redesignated by paragraph
(9)(B)), by striking ``(j)(3)(G)'' and inserting ``(l)(3)(G)'';
and
(13) 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
``$1,369,000,000 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.''; and
(C) by striking paragraph (3) and inserting the
following:
``(3) Limitation.--The total amount of grant funds made
available in any fiscal year under subsections (c)(1)(A) and
(e)(2), to support the costs of building construction or
building expansion or modernization projects shall not exceed 5
percent of the total amount appropriated to carry out this
section for such fiscal year.''.
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, such as a hospital association, 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, except that such funds may
be expended for minor renovations relating to the
installation of equipment.
``(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 2001''.
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 school;
``(II) a public library;
``(III) an institution of higher
education; or
``(IV) 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 2001).
``(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), except on the premises of an entity
participating in the telehealth network;
``(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, except that such funds may be
expended for minor renovations relating to the installation of
equipment; or
``(7) for expenditures for indirect costs (as determined by
the Secretary), to the extent that the expenditures would
exceed 20 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.
``SEC. 330J. TELEHOMECARE DEMONSTRATION PROJECT.
``(a) Definitions.--In this section:
``(1) Distant site.--The term `distant site' means a site
at which a certified home care provider is located at the time
at which a health care service (including a health care item)
is provided through a telecommunications system.
``(2) Telehomecare.--The term `telehomecare' means the
provision of health care services through technology relating
to the use of electronic information, or through telemedicine
or telecommunication technology, to support and promote, at a
distant site, the monitoring and management of home health care
services for a resident of a rural area.
``(b) Establishment.--Not later than 9 months after the date of
enactment of the Health Care Safety Net Amendments of 2001, the
Secretary shall establish and carry out a telehomecare demonstration
project.
``(c) Grants.--In carrying out the demonstration project referred
to in subsection (b), the Secretary shall make not more than 5 grants
to eligible certified home care providers, individually or as part of a
network of home health agencies, for the provision of telehomecare to
improve patient care, prevent health care complications, improve
patient outcomes, and achieve efficiencies in the delivery of care to
patients who reside in rural areas.
``(d) Periods.--The Secretary shall make the grants for periods of
not more than 3 years.
``(e) Applications.--To be eligible to receive a grant under this
section, a certified home care provider shall submit an application to
the Secretary at such time, in such manner, and containing such
information as the Secretary may require.
``(f) Use of Funds.--A provider that receives a grant under this
section shall use the funds made available through the grant to carry
out objectives that include--
``(1) improving access to care for home care patients
served by home health care agencies, improving the quality of
that care, increasing patient satisfaction with that care, and
reducing the cost of that care through direct
telecommunications links that connect the provider with
information networks;
``(2) developing effective care management practices and
educational curricula to train home care registered nurses and
increase their general level of competency through that
training; and
``(3) developing curricula to train health care
professionals, particularly registered nurses, serving home
care agencies in the use of telecommunications.
``(g) Coverage.--Nothing in this section shall be construed to
supersede or modify the provisions relating to exclusion of coverage
under section 1862(a) of the Social Security Act (42 U.S.C 1395y(a)),
or the provisions relating to the amount payable to a home health
agency under section 1895 of that Act (42 U.S.C. 1395fff).
``(h) Report.--
``(1) Interim report.--The Secretary shall submit to
Congress an interim report describing the results of the
demonstration project.
``(2) Final report.--Not later than 6 months after the end
of the last grant period for a grant made under this section,
the Secretary shall submit to Congress a final report--
``(A) describing the results of the demonstration
project; and
``(B) including an evaluation of the impact of the
use of telehomecare, including telemedicine and
telecommunications, on--
``(i) access to care for home care
patients; and
``(ii) the quality of, patient satisfaction
with, and the cost of, that care.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2002 through 2006.''.
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. 330K. 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. 330L. 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 education professionals.--The
term `qualified mental health education professionals' refers
to teachers, community mental health professionals, nurses, and
other entities as determined by the Secretary who have
additional training in the delivery of information on mental
illness to children and adolescents or who have additional
training in the delivery of information on mental illness to
the elderly.
``(3) 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.
``(4) Special populations.--The term `special populations'
refers to the following 2 distinct groups:
``(A) Children and adolescents located in public
elementary and public secondary schools 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 areas.
``(5) 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 and qualified mental
health education 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) Amount.--Each entity that receives a grant under subsection
(b) shall receive not less than $1,200,000 under the grant, and shall
use not more than 40 percent of the grant funds for equipment.
``(d) 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, in public elementary and public
secondary schools as delivered remotely by
qualified mental health professionals using
telehealth;
``(ii) to provide education regarding
mental illness (including suicide and violence)
in public elementary and public secondary
schools as delivered remotely by qualified
mental health professionals and qualified
mental health education professionals using
telehealth, including education regarding early
recognition of the signs and symptoms of mental
illness, and instruction on coping and dealing
with stressful experiences of childhood and
adolescence (such as violence, social
isolation, and depression); and
``(iii) 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;
``(ii) to provide education regarding
mental illness to primary staff (including
physicians, nurses, and nursing aides) as
delivered remotely by qualified mental health
professionals and qualified mental health
education professionals using telehealth,
including education regarding early recognition
of the signs and symptoms of mental illness,
and instruction on coping and dealing with
stressful experiences of old age (such as loss
of physical and cognitive capabilities, death
of loved ones and friends, social isolation,
and depression); and
``(iii) 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) acquire telehealth equipment to use in public
elementary and public secondary schools and long-term
care facilities for the objectives of this section;
``(B) develop curricula to support activities
described in subparagraphs (A)(ii) and (B)(ii) of
paragraph (1);
``(C) pay telecommunications costs; and
``(D) pay qualified mental health professionals and
qualified mental health education 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 (except
for minor renovations related to the installation of
reimbursable equipment).
``(e) 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.
``(f) 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.
``(g) Report.--Not later than 4 years after the date of enactment
of the Health Care Safety Net Amendments of 2001, the Secretary shall
prepare and submit to the appropriate committees of Congress a report
that shall evaluate activities funded with grants under this section.
``(h) 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.''.
Subtitle D--School-Based Health Center Networks
SEC. 231. NETWORKS.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.), as amended in section 221, is further amended
by adding at the end the following:
``SEC. 330M. SCHOOL-BASED HEALTH CENTER NETWORKS.
``(a) Eligible Entity.--In this section, the term `eligible entity'
means a nonprofit organization, such as a State school-based health
center association, academic institution, or primary care association,
that has experience working with low-income communities, schools,
families, and school-based health centers.
``(b) Program Authorized.--The Secretary shall award grants to
eligible entities to establish statewide technical assistance centers
and carry out activities described in subsection (c) through the
centers.
``(c) Use of Funds.--An eligible entity that receives a grant under
this section may use funds received through such grant to--
``(1) establish a statewide technical assistance center
that shall coordinate local, State, and Federal health care
services, including primary, dental, and behavioral and mental
health services, that contribute to the delivery of school-
based health care for medically underserved individuals;
``(2) conduct operational and administrative support
activities for statewide school-based health center networks to
maximize operational effectiveness and efficiency;
``(3) provide technical support training, including
training on topics regarding--
``(A) identifying parent and community interests
and priorities;
``(B) assessing community health needs and
resources;
``(C) implementing accountability and management
information systems;
``(D) integrating school-based health centers with
care provided by any other school-linked provider, and
with community-based primary and specialty health care
systems;
``(E) securing third party payments through
effective billing and collection systems;
``(F) developing shared services and joint
purchasing arrangements across provider networks;
``(G) linking services with health care services
provided by other programs, especially services
provided under the medicaid program under title XIX of
the Social Security Act (42 U.S.C. 1396 et seq.) and
the State Children's Health Insurance Program under
title XXI of the Social Security Act (42 U.S.C. 1397aa
et seq.);
``(H) contracting with managed care organizations;
and
``(I) assuring and improving clinical quality and
improvement; and
``(4) provide to interested communities technical
assistance for the planning and implementation of school-based
health centers.
``(d) Application.--An eligible entity 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, including--
``(1) a description of the region that will receive service
and the potential partners in such region;
``(2) a description of the policy and program environment
and the needs of the community that will receive service;
``(3) a 1- to 3-year work plan that describes the goals and
objectives of the entity, and any activities that the entity
proposes to carry out; and
``(4) a description of the organizational capacity of the
entity and its experience in serving the region's school-based
health center community.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $5,000,000 for fiscal year
2002, and such sums as may be necessary for subsequent fiscal years.''.
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, on the date of
enactment of the Health Care Safety Net Amendments of
2001, as having such a shortage. Not later than 5 years
after such date of enactment, and every 5 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 the American Dental
Association, the American Dental Education Association, the American
Dental Hygienists Association, the American Academy of Pediatric
Dentistry, the Association of State and Territorial Dental Directors,
and the National Association of Community Health Centers, 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).''.
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 first sentence, by striking
``may'' and inserting ``shall'';
(ii) 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
(iii) 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.'';
(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 30 percent for the purpose of providing
contracts for scholarships under this subpart to individuals who have
not previously received such scholarships.
``(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.--The demonstration project described in this
section shall provide for the participation of individuals who shall
provide services in rural and urban areas, and shall also provide for
the participation of enough individuals to allow the Secretary to
properly analyze the effectiveness of such project.
``(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 prepare and submit a
report describing 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) the feasibility of adding chiropractic
doctors and pharmacists as permanent members of the
National Health Service Corps.
``(g) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for fiscal years 2002 through 2004.''.
TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM ACT
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 a public or nonprofit 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 a provider (unless such
provider does not exist within the community, declines
or refuses to participate, or places unreasonable
conditions on their participation) that--
``(i) serves the community; and
``(ii)(I) is a Federally qualified health
center (as defined in section 1861(aa) of the
Social Security Act (42 U.S.C. 1395x(aa)));
``(II) is 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) is a public health department; and
``(IV) is an interested public or private
sector health care provider or an organization
that has traditionally served the medically
uninsured and underserved;
``(2) submits to the Secretary an application, in such form
and manner as the Secretary shall prescribe, that--
``(A) defines a community of uninsured and
underinsured individuals that consists of all such
individuals--
``(i) in a specified geographical area,
such as a rural area; or
``(ii) in a specified population within
such an area, such as American Indians, Native
Alaskans, Native Hawaiians, Hispanics, homeless
individuals, migrant and seasonal farmworkers,
individuals with disabilities, and public
housing residents;
``(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 carried out
under titles XVIII, XIX, and XXI of the Social Security
Act (42 U.S.C. 1395 et seq., 1396 et seq., and 1397aa
et seq.) 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
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;
``(F) demonstrates the consortium's ability to
create comprehensive programs to address the prevention
and management of chronic diseases of high importance
within the community, where applicable;
``(G) provides evidence of community involvement in
the development, implementation, and direction of the
program that the entity proposes to operate;
``(H) 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;
``(I) 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;
``(J) 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;
``(K) demonstrates fiscal responsibility through
the use of appropriate accounting procedures and
appropriate management systems;
``(L) 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
``(M) includes such other information as the
Secretary may prescribe;
``(3) agrees along with each of the participating providers
identified under paragraph (2)(B) that each will commit to use
grant funds awarded under this section to supplement, not
supplant, any other sources of funding (including the value of
any in-kind contributions) available to cover the expenditures
of the consortium and of the participating providers in
carrying out the activities for which the grant would be
awarded; and
``(4) has established or will establish before the receipt
of any grant under this section, a decision-making body that
has full and complete authority to determine and oversee all
the activities undertaken by the consortium with funds made
available through such grant and that includes representation
from each of the following providers listed in (b)(1)(B) if
they participate in the consortium.
``(c) 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, including local
and regional human services agencies, school systems,
and agencies on aging;
``(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.
``(d) 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
planning and developing the greater integration
of a health care delivery system, and operating
the resulting 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.
``(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, such as
telehealth technologies to increase access to
tertiary care.
``(vii) Identifying and closing gaps in
health care services being provided.
``(viii) Improvements to provider
communication, including implementation of
shared information systems or shared clinical
systems.
``(ix) Development of common processes for
determining eligibility for the programs
provided through the system, including creating
common identification cards and single sliding
scale discounts.
``(x) Creation of a triage system to
coordinate referrals and to screen and route
individuals to appropriate locations of
primary, specialty, and inpatient care.
``(xi) Development of specific prevention
and disease management tools and processes,
including--
``(I) carrying out a protocol or
plan for each individual patient
concerning what needs to be done,
at what intervals, and by whom, for the patient;
``(II) redesigning practices to
incorporate regular patient contact,
collection of critical data on health
and disease status, and use of
strategies to meet the educational and
psychosocial needs of patients who may
need to make lifestyle and other
changes to manage their diseases;
``(III) the promotion of the
availability of specialized expertise
through the use of--
``(aa) teams of providers
with specialized knowledge;
``(bb) collaborative care
arrangements;
``(cc) computer decision
support services; or
``(dd) telehealth
technologies.
``(IV) providing patient
educational and support tools that are
culturally competent and meet
appropriate health literacy and
literacy requirements; and
``(V) the collection of data
related to patient care and outcomes.
``(xii) Translation services.
``(xiii) 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, development of tools,
dissemination of information, evaluation, and carrying out
activities that will extend the benefits of a program funded
under this section to communities other than the community
served by the program funded.
``(e) Grantee Requirements.--
``(1) In general.--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) such additional information as the
Secretary may require; 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.
``(f) 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.
``(g) 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 this section.
``(h) Demonstration Authority.--The Secretary may make
demonstration awards under this section to historically black medical
schools for the purposes of--
``(1) developing patient-based research infrastructure at
historically black medical schools, which have an affiliation,
or affiliations, with any of the providers identified in
section (b)(1)(B);
``(2) establishment of joint and collaborative programs of
medical research and data collection between historically black
medical 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.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $125,000,000 for fiscal year
2002 and such sums as may be necessary for each of fiscal years 2003
through 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 2001, 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.''.
TITLE V--RURAL HEALTH CLINICS
SEC. 501. EXEMPTIONS FOR RURAL HEALTH CLINICS.
(a) Exemptions From Coinsurance Requirements.--Section
1128B(b)(3)(D) of the Social Security Act (42 U.S.C. 1320a-7b(b)(3)(D))
is amended by striking ``a Federally qualified health care center'' and
inserting ``a rural health clinic (as defined in section 1861(aa)) to
which members of the National Health Service Corps are assigned under
section 333 of the Public Health Service Act, or a Federally qualified
health center (as defined in section 1861(aa))''.
(b) Exemptions From Deductible Requirements.--Section 1833(b)(4) of
the Social Security Act (42 U.S.C. 1395l(b)(4)) is amended by striking
``such deductible shall not apply to Federally qualified health center
services.'' and inserting ``such deductible shall not apply to rural
health clinic services made available through a rural health clinic to
which members of the National Health Service Corps are assigned under
section 333 of the Public Health Service Act, provided to an individual
who qualifies for subsidized services under the Public Health Service
Act or Federally qualified health center services,''.
TITLE VI--STUDY
SEC. 601. 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
2001.
TITLE VII--CONFORMING AMENDMENTS
SEC. 701. 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)''.
Calendar No. 192
107th CONGRESS
1st Session
S. 1533
[Report No. 107-83]
_______________________________________________________________________
A BILL
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.
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October 11, 2001
Read twice and placed on the calendar