[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1968 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 1968

  To amend the Public Health Service Act to provide grants to promote 
            positive health behaviors in women and children.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 19, 2007

  Ms. Solis (for herself and Mr. Wynn) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to provide grants to promote 
            positive health behaviors in women and children.

    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 ``Community Health Workers Act of 
2007''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Over 9,000,000 children in the United States remain 
        uninsured, although two-thirds of uninsured children are 
        eligible for public programs such as Medicaid and the State 
        Children's Health Insurance Program.
            (2) Language, cultural barriers, and lack of information 
        may delay or block enrollment in public programs.
            (3) Community health workers are effective in significantly 
        increasing health insurance coverage, screening, and medical 
        follow-up visits among residents with limited access or 
        underutilization of health care services.
            (4) A study published in the ``Journal of the American 
        Academy of Pediatrics'' found that families who interacted with 
        community health workers are 8 times more likely to obtain 
        health insurance for their children. Almost 96 percent of 
        children who worked with community health workers obtained 
        health insurance, and 78 percent were insured continuously.
            (5) Chronic diseases, defined as any condition that 
        requires regular medical attention or medication, are the 
        leading cause of death and disability for women in the United 
        States across racial and ethnic groups.
            (6) According to the National Vital Statistics Report of 
        2001, the 5 leading causes of death among Hispanic, American 
        Indian, and African-American women are heart disease, cancer, 
        diabetes, cerebrovascular disease, and unintentional injuries.
            (7) Unhealthy behaviors alone lead to more than 50 percent 
        of premature deaths in the United States.
            (8) Poor diet, physical inactivity, tobacco use, and 
        alcohol and drug abuse are the health risk behaviors that most 
        often lead to disease, premature death, and disability, and are 
        particularly prevalent among many groups of minority women.
            (9) Over 60 percent of Hispanic and African-American women 
        are classified as overweight, and over 30 percent are 
        classified as obese. Over 60 percent of American Indian women 
        are classified as obese.
            (10) American Indian women have the highest mortality rates 
        related to alcohol and drug use of all women in the United 
        States.
            (11) High poverty rates coupled with barriers to health 
        preventive services and medical care contribute to racial and 
        ethnic disparities in health factors, including premature 
        death, life expectancy, risk factors associated with major 
        diseases, and the extent and severity of illnesses.
            (12) There is increasing evidence that early life 
        experiences are associated with adult chronic disease and that 
        prevention and intervention services provided within the 
        community and the home may lessen the impact of chronic 
        outcomes, while strengthening families and communities.
            (13) Community health workers, who are primarily women, can 
        be a critical component in conducting health promotion and 
        disease prevention efforts in medically underserved 
        populations.
            (14) Recognizing the difficult barriers confronting 
        medically underserved communities (poverty, geographic 
        isolation, language and cultural differences, lack of 
        transportation, low literacy, and lack of access to services), 
        community health workers are in a unique position to reduce 
        preventable morbidity and mortality, improve the quality of 
        life, and increase the utilization of available preventive 
        health services for community members.

SEC. 3. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS IN WOMEN.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399R. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS IN WOMEN AND 
              CHILDREN.

    ``(a) Grants Authorized.--The Secretary, in collaboration with the 
Director of the Centers for Disease Control and Prevention and other 
Federal officials determined appropriate by the Secretary, is 
authorized to award grants to eligible entities to promote positive 
health behaviors for women and children in target populations, 
especially racial and ethnic minority women and children in medically 
underserved communities.
    ``(b) Use of Funds.--Grants awarded pursuant to subsection (a) may 
be used to support community health workers--
            ``(1) to educate and provide outreach regarding enrollment 
        in health insurance including the State Children's Health 
        Insurance Program under title XXI of the Social Security Act, 
        Medicare under title XVIII of such Act, and Medicaid under 
        title XIX of such Act;
            ``(2) to educate, guide, and provide outreach in a 
        community setting regarding health problems prevalent among 
        women and children and especially among racial and ethnic 
        minority women and children;
            ``(3) to educate, guide, and provide experiential learning 
        opportunities that target behavioral risk factors including--
                    ``(A) poor nutrition;
                    ``(B) physical inactivity;
                    ``(C) being overweight or obese;
                    ``(D) tobacco use;
                    ``(E) alcohol and substance use;
                    ``(F) injury and violence;
                    ``(G) risky sexual behavior; and
                    ``(H) mental health problems;
            ``(4) to educate and guide regarding effective strategies 
        to promote positive health behaviors within the family;
            ``(5) to promote community wellness and awareness; and
            ``(6) to educate and refer target populations to 
        appropriate health care agencies and community-based programs 
        and organizations in order to increase access to quality health 
        care services, including preventive health services.
    ``(c) Application.--
            ``(1) In general.--Each eligible entity that desires to 
        receive a grant under subsection (a) shall submit an 
        application to the Secretary, at such time, in such manner, and 
        accompanied by such additional information as the Secretary may 
        require.
            ``(2) Contents.--Each application submitted pursuant to 
        paragraph (1) shall--
                    ``(A) describe the activities for which assistance 
                under this section is sought;
                    ``(B) contain an assurance that with respect to 
                each community health worker program receiving funds 
                under the grant awarded, such program provides training 
                and supervision to community health workers to enable 
                such workers to provide authorized program services;
                    ``(C) contain an assurance that the applicant will 
                evaluate the effectiveness of community health worker 
                programs receiving funds under the grant;
                    ``(D) contain an assurance that each community 
                health worker program receiving funds under the grant 
                will provide services in the cultural context most 
                appropriate for the individuals served by the program;
                    ``(E) contain a plan to document and disseminate 
                project description and results to other States and 
                organizations as identified by the Secretary; and
                    ``(F) describe plans to enhance the capacity of 
                individuals to utilize health services and health-
                related social services under Federal, State, and local 
                programs by--
                            ``(i) assisting individuals in establishing 
                        eligibility under the programs and in receiving 
                        the services or other benefits of the programs; 
                        and
                            ``(ii) providing other services as the 
                        Secretary determines to be appropriate, that 
                        may include transportation and translation 
                        services.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to those applicants--
            ``(1) who propose to target geographic areas--
                    ``(A) with a high percentage of residents who are 
                eligible for health insurance but are uninsured or 
                underinsured; and
                    ``(B) with a high percentage of families for whom 
                English is not their primary language.
            ``(2) with experience in providing health or health-related 
        social services to individuals who are underserved with respect 
        to such services; and
            ``(3) with documented community activity and experience 
        with community health workers.
    ``(e) Collaboration With Academic Institutions.--The Secretary 
shall encourage community health worker programs receiving funds under 
this section to collaborate with academic institutions. Nothing in this 
section shall be construed to require such collaboration.
    ``(f) Quality Assurance and Cost-Effectiveness.--The Secretary 
shall establish guidelines for assuring the quality of the training and 
supervision of community health workers under the programs funded under 
this section and for assuring the cost-effectiveness of such programs.
    ``(g) Monitoring.--The Secretary shall monitor community health 
worker programs identified in approved applications and shall determine 
whether such programs are in compliance with the guidelines established 
under subsection (f).
    ``(h) Technical Assistance.--The Secretary may provide technical 
assistance to community health worker programs identified in approved 
applications with respect to planning, developing, and operating 
programs under the grant.
    ``(i) Report to Congress.--
            ``(1) In general.--Not later than 4 years after the date on 
        which the Secretary first awards grants under subsection (a), 
        the Secretary shall submit to Congress a report regarding the 
        grant project.
            ``(2) Contents.--The report required under paragraph (1) 
        shall include the following:
                    ``(A) A description of the programs for which grant 
                funds were used.
                    ``(B) The number of individuals served.
                    ``(C) An evaluation of--
                            ``(i) the effectiveness of these programs;
                            ``(ii) the cost of these programs; and
                            ``(iii) the impact of the project on the 
                        health outcomes of the community residents.
                    ``(D) Recommendations for sustaining the community 
                health worker programs developed or assisted under this 
                section.
                    ``(E) Recommendations regarding training to enhance 
                career opportunities for community health workers.
    ``(j) Definitions.--In this section:
            ``(1) Community health worker.--The term `community health 
        worker' means an individual who promotes health or nutrition 
        within the community in which the individual resides--
                    ``(A) by serving as a liaison between communities 
                and health care agencies;
                    ``(B) by providing guidance and social assistance 
                to community residents;
                    ``(C) by enhancing community residents' ability to 
                effectively communicate with health care providers;
                    ``(D) by providing culturally and linguistically 
                appropriate health or nutrition education;
                    ``(E) by advocating for individual and community 
                health or nutrition needs; and
                    ``(F) by providing referral and followup services.
            ``(2) Community setting.--The term `community setting' 
        means a home or a community organization located in the 
        neighborhood in which a participant resides.
            ``(3) Eligible entity.--The term `eligible entity' means--
                    ``(A) a unit of State, local or tribal government 
                (including a federally recognized tribe or Alaska 
                native villages); or
                    ``(B) a community-based organization.
            ``(4) Medically underserved community.--The term `medically 
        underserved community' means a community--
                    ``(A) that has a substantial number of individuals 
                who are members of a medically underserved population, 
                as defined by section 330(b)(3); and
                    ``(B) a significant portion of which is a health 
                professional shortage area as designated under section 
                332.
            ``(5) Support.--The term `support' means the provision of 
        training, supervision, and materials needed to effectively 
        deliver the services described in subsection (b), reimbursement 
        for services, and other benefits.
            ``(6) Target population.--The term `target population' 
        means women of reproductive age, regardless of their current 
        childbearing status and children under 21 years of age.
    ``(k) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $15,000,000 for each of fiscal 
years 2008, 2009, 2010, 2011, and 2012.''.
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