[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4230 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 4230

  To amend the Public Health Service Act to establish a school-based 
             health clinic program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 15, 2007

 Ms. Hooley (for herself, Mrs. Capito, Mr. Allen, Mr. Blumenauer, Ms. 
    Bordallo, Mr. Cleaver, Mr. Courtney, Mr. Engel, Mr. Honda, Mr. 
     McGovern, Mr. Michaud, Mr. Van Hollen, Mr. Wynn, Mr. Wu, Ms. 
  Kilpatrick, Mr. Al Green of Texas, Mr. Kildee, and Ms. Schakowsky) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to establish a school-based 
             health clinic program, 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 ``School-Based Health Clinic Act of 
2007''.

SEC. 2. FINDINGS; PURPOSE.

    (a) Findings.--The Congress finds as follows:
            (1) Nearly 8,700,000 children in the United States have no 
        health insurance, including an increase of over 600,000 in the 
        past year.
            (2) The American Medical Association rates adolescents aged 
        13 to 18 as the group of Americans with the poorest health 
        indicators.
            (3) More than 70 percent of children who need psychiatric 
        treatment do not receive services.
            (4) School-based health centers are located in over 1,700 
        schools in 43 States, the District of Columbia, and Puerto 
        Rico.
            (5) School-based health centers ensure access to health 
        care by providing care regardless of a child's ability to pay.
            (6) Forty-five percent of children and adolescents treated 
        at school-based health centers have no insurance.
            (7) Forty-four percent of children and adolescents treated 
        at school-based health centers are enrolled in Medicaid, SCHIP, 
        or other public coverage.
            (8) School-based health centers promote access to providers 
        for many children and adolescents who otherwise would have 
        difficulty seeing a provider.
            (9) School-based health centers effectively provide 
        primary, preventative, and mental health services to children 
        and adolescents.
            (10) School-based health centers effectively utilize 
        resources by often leveraging State and local government funds, 
        private contributions, and Medicaid, SCHIP, and private 
        insurance payments.
            (11) For school-based health centers' target demographic 
        (students with public insurance or who are uninsured), data 
        show that school-based health centers decrease school absences.
            (12) School-based health centers identify students at risk 
        for health and behavioral problems, thus reducing obstacles to 
        the learning process.
            (13) School-based health centers administer medication to 
        students with chronic illness, which reduces absences as well 
        as disciplinary action for students with behavioral health 
        problems.
            (14) Empirical analyses show that school-based health 
        centers reduce Medicaid costs by providing cost-effective and 
        timely care.
            (15) School-based health centers encourage parental 
        involvement to increase family participation in school- and 
        education-oriented activities.
    (b) Purpose.--The purpose of this Act is to fund the development 
and operation of school-based health clinics--
            (1) to provide comprehensive and accessible primary health 
        care services to medically underserved children, youth, and 
        families;
            (2) to improve the physical health, emotional well-being, 
        and academic performance of medically underserved children, 
        youth, and families; and
            (3) to work in collaboration with the school to integrate 
        health into the overall school environment.

SEC. 3. SCHOOL-BASED HEALTH CLINICS.

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

``SEC. 399Z-1. SCHOOL-BASED HEALTH CLINICS.

    ``(a) Definitions; Establishment of Criteria.--In this section:
            ``(1) Community.--The term `community' includes parents, 
        consumers, local leaders, and organizations.
            ``(2) Comprehensive primary health services.--The term 
        `comprehensive primary health services' means the core services 
        offered by school-based health clinics, which--
                    ``(A) shall include physical health services and 
                mental health services; and
                    ``(B) may include optional health services such as 
                nutrition, oral health, health education, and case 
                management services.
            ``(3) Mental health services.--The term `mental health 
        services' means mental health assessments, crisis intervention, 
        counseling, treatment, and referral to a continuum of services 
        including emergency psychiatric care, community support 
        programs, inpatient care, and outpatient programs.
            ``(4) Physical health services.--The term `physical health 
        services' means comprehensive health assessments; diagnosis and 
        treatment of minor, acute, and chronic medical conditions; and 
        referrals to, and follow-up for, specialty care.
            ``(5) School-based health clinic.--The term `school-based 
        health clinic' means a health clinic that--
                    ``(A) is located on school property;
                    ``(B) is organized through school, community, and 
                health provider relationships;
                    ``(C) is administered by a sponsoring facility; and
                    ``(D) provides, at a minimum, comprehensive primary 
                health services during school hours to children and 
                adolescents by health professionals in accordance with 
                State and local laws and regulations, established 
                standards, and community practice.
            ``(6) Sponsoring facility.--The term `sponsoring facility' 
        is a community-based organization, which may include--
                    ``(A) a hospital;
                    ``(B) a public health department;
                    ``(C) a community health center;
                    ``(D) a nonprofit health care agency;
                    ``(E) a school or school system; and
                    ``(F) a program administered by the Indian Health 
                Service or the Bureau of Indian Affairs or operated by 
                an Indian tribe or a tribal organization under the 
                Indian Self-Determination and Education Assistance Act, 
                a Native Hawaiian entity, or an urban Indian program 
                under title V of the Indian Health Care Improvement 
                Act.
    ``(b) Authority To Award Grants.--The Secretary shall award grants 
for the costs of the operation of school-based health clinics that meet 
the requirements of this section.
    ``(c) Applications.--To be eligible to receive a grant under this 
section, an entity shall--
            ``(1) be a school-based health clinic; and
            ``(2) submit to the Secretary an application at such time 
        and in such manner as the Secretary may require containing--
                    ``(A) evidence that the applicant meets all 
                criteria necessary to be designated as a school-based 
                health clinic;
                    ``(B) evidence of local need for the services to be 
                provided by the clinic;
                    ``(C) an assurance that--
                            ``(i) school-based health clinic services 
                        will be provided to those children and 
                        adolescents for whom parental or guardian 
                        consent has been obtained in cooperation with 
                        Federal, State, and local laws governing health 
                        care services provision to children and 
                        adolescents;
                            ``(ii) the clinic has made and will 
                        continue to make every reasonable effort to 
                        establish and maintain collaborative 
                        relationships with other health care providers 
                        in the catchment area of the clinic;
                            ``(iii) the clinic will provide on-site 
                        access during the academic day when school is 
                        in session and 24-hour coverage through an on-
                        call system and through its backup health 
                        providers to ensure access to services on a 
                        year-round basis when the clinic is closed;
                            ``(iv) the clinic will be integrated into 
                        the school environment and will coordinate 
                        health services with school personnel, such as 
                        administrators, teachers, nurses, counselors, 
                        and support personnel, as well as with other 
                        community providers co-located at the school; 
                        and
                            ``(v) the clinic sponsoring facility 
                        assumes all responsibility for the clinic's 
                        administration, operations, and oversight; and
                    ``(D) such other information as the Secretary may 
                require.
    ``(d) Preferences.--In reviewing applications under this section, 
the Secretary may give preference to applicants who demonstrate an 
ability to serve the following:
            ``(1) Communities with evidence of barriers to primary 
        health care and mental health services for children and 
        adolescents.
            ``(2) Communities that have consistently scored poorly on 
        child and adolescent standardized health indicator reports.
            ``(3) Communities with high percentages of children and 
        adolescents who are uninsured, underinsured, or enrolled in 
        public health insurance programs.
            ``(4) Populations of children and adolescents that have 
        demonstrated difficulty historically in accessing physical and 
        mental health services.
    ``(e) Waiver of Requirements.--The Secretary may, under appropriate 
circumstances, waive the application of all or part of the requirements 
of this section with respect to a school-based health clinic for a 
designated period of time to be determined by the Secretary.
    ``(f) Use of Funds.--
            ``(1) Funds.--Funds awarded under a grant under this 
        section may be used for--
                    ``(A) acquiring and leasing buildings and equipment 
                (including the costs of amortizing the principle of, 
                and paying interest on, loans for such buildings and 
                equipment);
                    ``(B) providing training related to the provision 
                of comprehensive primary health services and additional 
                health services;
                    ``(C) managing a school-based health clinic;
                    ``(D) paying the salaries of physicians and other 
                personnel; and
                    ``(E) purchasing medical supplies, medical 
                equipment, office supplies, and office equipment.
            ``(2) Amount.--The amount of any grant made under this 
        section in any fiscal year to a school-based health clinic 
        shall be determined by the Secretary, taking into account--
                    ``(A) the financial need of the clinic;
                    ``(B) State, local, or other operation funding 
                provided to the clinic; and
                    ``(C) other factors as determined appropriate by 
                the Secretary.
    ``(g) Technical Assistance.--The Secretary shall establish a 
program through which the Secretary provides (either through the 
Department of Health and Human Services or by grant or contract) 
technical and other assistance to school-based health clinics to assist 
such clinics to meet the requirements of subsection (c)(2)(C). 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.
    ``(h) Evaluation.--The Secretary shall develop and implement a plan 
for evaluating school-based health clinics receiving funds under this 
section and monitoring the quality of their performance.
    ``(i) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated $50,000,000 
for fiscal year 2009, $55,000,000 for fiscal year 2010, $60,500,000 for 
fiscal year 2011, $66,550,000 for fiscal year 2012, and $73,200,000 for 
fiscal year 2013.''.
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