[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1812 Enrolled Bill (ENR)]
H.R.1812
One Hundred Ninth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Tuesday,
the fourth day of January, two thousand and five
An Act
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.
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 2005''.
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.--The Secretary shall require each recipient of
a grant under this section 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
in assisting 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, on request,
facilitating enrollment of eligible individuals in these trials.
``(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, health
programs operated by the Department of Veterans Affairs or the
Department of Defense, the State children's health insurance
program, and any private or governmental prescription assistance
programs).
``(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) Prohibitions.--
``(1) Referral fees.--The Secretary shall require each
recipient of a grant under this section to prohibit any patient
navigator providing services under the grant from accepting any
referral fee, kickback, or other thing of value in return for
referring an individual to a particular health care provider.
``(2) Legal fees and costs.--The Secretary shall prohibit the
use of any grant funds received under this section to pay any fees
or costs resulting from any litigation, arbitration, mediation, or
other proceeding to resolve a legal dispute.
``(d) 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. Each such
extension shall be for a period of not more than 1 year.
``(3) Limitations on grant period.--In carrying out this
section, the Secretary--
``(A) shall ensure that the total period of a grant does
not exceed 4 years; and
``(B) may not authorize any grant period ending after
September 30, 2010.
``(e) 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.
``(f) Uniform Baseline Measures.--The Secretary shall establish
uniform baseline measures in order to properly evaluate the impact of
the demonstration projects under this section.
``(g) 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.
``(h) Duplication of Services.--An eligible entity that is
receiving Federal funds for activities described in subsection (b) on
the date on which the entity submits an application under subsection
(e) may not receive a grant under this section unless the entity can
demonstrate that amounts received under the grant will be utilized to
expand services or provide new services to individuals who would not
otherwise be served.
``(i) 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.
``(j) 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) Reports by grantees.--The Secretary may require grant
recipients under this section to submit interim and final reports
on grant program outcomes.
``(k) 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)).
``(l) 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).
``(m) 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.''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.