[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 918 Reported in House (RH)]






                                                 Union Calendar No. 447
108th CONGRESS
  2d Session
                                H. R. 918

                      [Report No. 108-727, Part I]

  To authorize the Health Resources and Services Administration, the 
National Cancer Institute, and the Indian Health Service to make grants 
   for model programs to provide to individuals of health disparity 
  populations prevention, early detection, treatment, and appropriate 
 follow-up care services for cancer and chronic diseases, and to make 
  grants regarding patient navigators to assist individuals of health 
           disparity populations in receiving such services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 26, 2003

 Mr. Menendez (for himself, Ms. Pryce of Ohio, Mr. Green of Texas, Ms. 
 Ros-Lehtinen, Mr. Thompson of Mississippi, Mr. Lincoln Diaz-Balart of 
 Florida, Mr. Rodriguez, Mrs. Wilson of New Mexico, Mrs. Christensen, 
  Mr. Quinn, Mr. Serrano, Mr. McCotter, Mr. Pallone, Mr. Pearce, Mr. 
 Udall of New Mexico, and Mr. Mario Diaz-Balart of Florida) introduced 
 the following bill; which was referred to the Committee on Energy and 
Commerce and in addition to the Committee on Resources, for a period to 
      be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

                            October 5, 2004

 Additional sponsors: Ms. Ginny Brown-Waite of Florida, Mr. Frost, Mr. 
Ford, Mr. Norwood, Mr. Kildee, Mr. Renzi, Mr. Rangel, Mr. Ramstad, Ms. 
 Kilpatrick, Mr. Pickering, Mr. Capuano, Mrs. Capito, Mr. Matsui, Mr. 
    Fletcher, Mr. Israel, Mr. Grijalva, Mr. Green of Wisconsin, Mr. 
 Oberstar, Mr. LaHood, Mr. Meehan, Mr. Rogers of Michigan, Mr. Stupak, 
   Mr. Pascrell, Mr. Holt, Ms. McCollum, Ms. Baldwin, Mr. Payne, Mr. 
Whitfield, Mr. Kind, Mr. Goss, Mr. Peterson of Minnesota, Mr. Boozman, 
Mrs. McCarthy of New York, Mr. Upton, Mr. Burns, Mr. King of New York, 
 Mr. Cunningham, Mrs. Myrick, Mr. Tiberi, Mr. Smith of Washington, Mr. 
Cox, Mr. Wicker, Mr. Castle, Mr. LaTourette, Ms. Hooley of Oregon, Mrs. 
 Emerson, Mr. Kirk, Mr. Kleczka, Mr. Shimkus, Mr. Weller, Mr. Simmons, 
  Mr. Nethercutt, Mr. Ryan of Wisconsin, Mr. Ross, Mr. Costello, Mr. 
Walsh, Mr. Rogers of Kentucky, Mr. Smith of New Jersey, Mr. Camp, Mrs. 
Jones of Ohio, Mr. Boswell, Mr. Barton of Texas, Mr. Gillmor, Mr. Hall, 
  Mr. Marshall, Mr. Sessions, Mr. Bass, Mr. Johnson of Illinois, Mr. 
   Terry, Mr. Ferguson, Mr. McDermott, Mr. Hayworth, Mr. Leach, Mr. 
  Ehlers, Mr. Kingston, Mr. Bradley of New Hampshire, Mr. Kennedy of 
  Minnesota, Mr. Graves, Mr. Schrock, Mr. Clay, Mrs. Jo Ann Davis of 
 Virginia, Ms. Jackson-Lee of Texas, Mr. Bishop of Georgia, Mr. Hyde, 
Mr. Moore, Mr. Issa, Mr. Waxman, Mr. Kline, Mr. Greenwood, Mr. Davis of 
Florida, Mr. Scott of Virginia, Mr. Cramer, Mr. Filner, Mr. McHugh, Mr. 
Andrews, Mr. Reyes, Mr. Michaud, Ms. Berkley, Ms. McCarthy of Missouri, 
 Mr. Towns, Mr. Cummings, Mrs. Kelly, Mr. Bell, Mr. Platts, Mr. Allen, 
   Mr. Kennedy of Rhode Island, Mr. Bishop of Utah, Mr. Shays,  Mr. 
 Vitter, Mr. Carson of Oklahoma, Mr. Wynn, Ms. Herseth, Mr. Walden of 
Oregon, Mr. Rothman, Mr. Deal of Georgia, Mr. Gonzalez, and Mr. McNulty

                            October 5, 2004

   Reported from the Committee on Energy and Commerce with amendments
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                            October 5, 2004

Referral to the Committee on Resources extended for a period ending not 
                       later than October 5, 2004

                            October 5, 2004

 Committee on Resources discharged; committed to the Committee of the 
    Whole House on the State of the Union and ordered to be printed
    [For text of introduced bill, see copy of bill as introduced on 
                           February 26, 2003]

_______________________________________________________________________

                                 A BILL


 
  To authorize the Health Resources and Services Administration, the 
National Cancer Institute, and the Indian Health Service to make grants 
   for model programs to provide to individuals of health disparity 
  populations prevention, early detection, treatment, and appropriate 
 follow-up care services for cancer and chronic diseases, and to make 
  grants regarding patient navigators to assist individuals of health 
           disparity populations in receiving such services.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patient Navigator Outreach and 
Chronic Disease Prevention Act of 2004''.

SEC. 2. PATIENT NAVIGATOR GRANTS.

    Subpart V of part D of title III of the Public Health Service Act 
(42 U.S.C. 256) is amended by adding at the end the following:

``SEC. 340A. PATIENT NAVIGATOR GRANTS.

    ``(a) Grants.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, may make grants to 
eligible entities for the development and operation of demonstration 
programs to provide patient navigator services to improve health care 
outcomes. The Secretary shall coordinate with, and ensure the 
participation of, the Indian Health Service, the National Cancer 
Institute, the Office of Rural Health Policy, and such other offices 
and agencies as deemed appropriate by the Secretary, regarding the 
design and evaluation of the demonstration programs.
    ``(b) Use of Funds.--A condition on the receipt of a grant under 
this section is that the grantee agree to use the grant to recruit, 
assign, train, and employ patient navigators who have direct knowledge 
of the communities they serve to facilitate the care of individuals, 
including by performing each of the following duties:
            ``(1) Acting as contacts, including by assisting in the 
        coordination of health care services and provider referrals, 
        for individuals who are seeking prevention or early detection 
        services for, or who following a screening or early detection 
        service are found to have a symptom, abnormal finding, or 
        diagnosis of, cancer or other chronic disease.
            ``(2) Facilitating the involvement of community 
        organizations providing assistance to individuals who are at 
        risk for or who have cancer or other chronic diseases to 
        receive better access to high-quality health care services 
        (such as by creating partnerships with patient advocacy groups, 
        charities, health care centers, community hospice centers, 
        other health care providers, or other organizations in the 
        targeted community).
            ``(3) Notifying individuals of clinical trials and 
        facilitating enrollment in these trials if requested and 
        eligible.
            ``(4) Anticipating, identifying, and helping patients to 
        overcome barriers within the health care system to ensure 
        prompt diagnostic and treatment resolution of an abnormal 
        finding of cancer or other chronic disease.
            ``(5) Coordinating with the relevant health insurance 
        ombudsman programs to provide information to individuals who 
        are at risk for or who have cancer or other chronic diseases 
        about health coverage, including private insurance, health care 
        savings accounts, and other publicly funded programs (such as 
        Medicare, Medicaid, and the State children's health insurance 
        program).
            ``(6) Conducting ongoing outreach to health disparity 
        populations, including the uninsured, rural populations, and 
        other medically underserved populations, in addition to 
        assisting other individuals who are at risk for or who have 
        cancer or other chronic diseases to seek preventative care.
    ``(c) Grant Period.--
            ``(1) In general.--Subject to paragraphs (2) and (3), the 
        Secretary may award grants under this section for periods of 
        not more than 3 years.
            ``(2) Extensions.--Subject to paragraph (3), the Secretary 
        may extend the period of a grant under this section, except 
        that--
                    ``(A) each such extension shall be for a period of 
                not more than 1 year; and
                    ``(B) the Secretary may make not more than 4 such 
                extensions with respect to any grant.
            ``(3) End of grant period.--In carrying out this section, 
        the Secretary may not authorize any grant period ending after 
        September 30, 2010.
    ``(d) Application.--
            ``(1) In general.--To seek a grant under this section, an 
        eligible entity shall submit an application to the Secretary in 
        such form, in such manner, and containing such information as 
        the Secretary may require.
            ``(2) Contents.--At a minimum, the Secretary shall require 
        each such application to outline how the eligible entity will 
        establish baseline measures and benchmarks that meet the 
        Secretary's requirements to evaluate program outcomes.
    ``(e) Uniform Baseline Measures.--The Secretary shall establish 
uniform baseline measures in order to properly evaluate the impact of 
the demonstration projects under this section.
    ``(f) Preference.--In making grants under this section, the 
Secretary shall give preference to eligible entities that demonstrate 
in their applications plans to utilize patient navigator services to 
overcome significant barriers in order to improve health care outcomes 
in their respective communities.
    ``(g) Coordination With Other Programs.--The Secretary shall ensure 
coordination of the demonstration grant program under this section with 
existing authorized programs in order to facilitate access to high-
quality health care services.
    ``(h) Study; Reports.--
            ``(1) Final report by secretary.--Not later than 6 months 
        after the completion of the demonstration grant program under 
        this section, the Secretary shall conduct a study of the 
        results of the program and submit to the Congress a report on 
        such results that includes the following:
                    ``(A) An evaluation of the program outcomes, 
                including--
                            ``(i) quantitative analysis of baseline and 
                        benchmark measures; and
                            ``(ii) aggregate information about the 
                        patients served and program activities.
                    ``(B) Recommendations on whether patient navigator 
                programs could be used to improve patient outcomes in 
                other public health areas.
            ``(2) Interim reports by secretary.--The Secretary may 
        provide interim reports to the Congress on the demonstration 
        grant program under this section at such intervals as the 
        Secretary determines to be appropriate.
            ``(3) Interim reports by grantees.--The Secretary may 
        require grant recipients under this section to submit interim 
        reports on grant program outcomes.
    ``(i) Rule of Construction.--This section shall not be construed to 
authorize funding for the delivery of health care services (other than 
the patient navigator duties listed in subsection (b)).
    ``(j) Definitions.--In this section:
            ``(1) The term `eligible entity' means a public or 
        nonprofit private health center (including a Federally 
        qualified health center (as that term is defined in section 
        1861(aa)(4) of the Social Security Act)), a health facility 
        operated by or pursuant to a contract with the Indian Health 
        Service, a hospital, a cancer center, a rural health clinic, an 
        academic health center, or a nonprofit entity that enters into 
        a partnership or coordinates referrals with such a center, 
        clinic, facility, or hospital to provide patient navigator 
        services.
            ``(2) The term `health disparity population' means a 
        population that, as determined by the Secretary, has a 
        significant disparity in the overall rate of disease incidence, 
        prevalence, morbidity, mortality, or survival rates as compared 
        to the health status of the general population.
            ``(3) The term `patient navigator' means an individual who 
        has completed a training program approved by the Secretary to 
        perform the duties listed in subsection (b).
    ``(k) Authorization of Appropriations.--
            ``(1) In general.--To carry out this section, there are 
        authorized to be appropriated $2,000,000 for fiscal year 2006, 
        $5,000,000 for fiscal year 2007, $8,000,000 for fiscal year 
        2008, $6,500,000 for fiscal year 2009, and $3,500,000 for 
        fiscal year 2010.
            ``(2) Availability.--The amounts appropriated pursuant to 
        paragraph (1) shall remain available for obligation through the 
        end of fiscal year 2010.''.

            Amend the title so as to read: ``A bill to amend the Public 
        Health Service Act to authorize a demonstration grant program 
        to provide patient navigator services to reduce barriers and 
        improve health care outcomes, and for other purposes.''.




                                                 Union Calendar No. 447

108th CONGRESS

  2d Session

                               H. R. 918

                      [Report No. 108-727, Part I]

_______________________________________________________________________

                                 A BILL

  To authorize the Health Resources and Services Administration, the 
National Cancer Institute, and the Indian Health Service to make grants 
   for model programs to provide to individuals of health disparity 
  populations prevention, early detection, treatment, and appropriate 
 follow-up care services for cancer and chronic diseases, and to make 
  grants regarding patient navigators to assist individuals of health 
           disparity populations in receiving such services.

_______________________________________________________________________

                            October 5, 2004

   Reported from the Committee on Energy and Commerce with amendments

                            October 5, 2004

Referral to the Committee on Resources extended for a period ending not 
                       later than October 5, 2004

                            October 5, 2004

 Committee on Resources discharged; committed to the Committee of the 
    Whole House on the State of the Union and ordered to be printed