1.This Act may be cited as
the Nurse-Managed Health Clinic
Investment Act of 2007
.
2.
(a)Congress
makes the following findings:
(1)Nurse-managed
health clinics (referred to in this section as NMHCs
) offer
their patients primary care based on the nursing model, which emphasizes the
protection, promotion, and optimization of health along with the prevention of
illness, and the alleviation of suffering in conjunction with diagnosis and
treatment. Nurses are advocates and educators providing care for individuals,
families, communities, and populations.
(2)More than 200
NMHCs are currently in operation across the United States. These clinics record
over 2,000,000 client encounters annually.
(3)NMHCs meet the
Institute of Medicine’s definition of safety-net provider by providing care
regardless of their patient’s ability to pay. A substantial share of their
patient mix is made up of uninsured individuals, Medicaid recipients, and other
vulnerable populations. A recent study funded by the Centers for Medicare &
Medicaid Services reported that more than 45 percent of the payor mix for NMHCs
is uninsured, and 37 percent are Medicaid recipients.
(4)NMHCs provide a
medical home for the underserved, and are viable partners with the Federal
Government to reduce health disparities. They provide a full range of health
care services, including primary care, health promotion, disease prevention,
and behavioral health care to the residents of rural and urban underserved
communities. Because NMHCs are often located in public housing developments,
senior living arrangements, schools, and community centers, they help remove
barriers preventing access to care and are instrumental in addressing and
eliminating the factors contributing to health disparities.
(5)Nurse-managed
clinics are playing an ever-increasing role in the Nation’s health care
safety-net, and are currently being under-utilized and under-funded by both
Federal and State governments.
(6)Lack of adequate
funding has caused 39 percent of the NMHCs established between 1993 and 2001 to
close. These clinics are frequently the only source of health care for their
patients. These closures have had a negative impact on the ability of the
underserved to access primary care.
(7)The goal of this
Act is to provide NMHCs with access to a stable source of funding that will
enable them to continue expanding primary care services in underserved
communities, while reducing the level of health disparities suffered by
vulnerable populations.
(b)It
is the purpose of this Act to fund the development and operation of
nurse-managed health clinics to—
(1)provide
comprehensive and accessible primary health care services to vulnerable
populations living in underserved communities around the Nation; and
(2)reduce the level
of health disparities experienced by vulnerable populations.
3.Nurse-managed
health clinicsTitle III of
the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at
the end the following:
SNurse-managed
health clinic program
399JJ.Grants to
nurse-managed health clinics
(a)Definition;
establishment of criteriaIn this section:
(1)Comprehensive
primary health care servicesThe term comprehensive primary
health care services means health care related to adult, family, and
pediatric health consisting of adult health, pediatrics, obstetrics, or
gynecology services that are furnished by nurse practitioners, physician
assistants, physicians, nurse midwives, and other qualified health care
professionals. In addition to primary care services, specific services may
include—
(A)preventive health
services;
(B)prenatal and
perinatal services;
(C)appropriate
cancer screening;
(D)well-child
services;
(E)immunizations
against vaccine-preventable diseases;
(F)screenings for
elevated blood lead levels;
(G)screening for
communicable diseases;
(H)cholesterol
screenings;
(I)pediatric eye and
ear screenings to determine the need for vision and hearing correction;
(J)emergency medical
services;
(K)diagnostic
laboratory and radiologic services;
(L)care navigation
services;
(M)pharmaceutical
services as may be appropriate for each clinic; and
(N)voluntary family
planning.
(2)Health
promotion and disease prevention servicesThe term health
promotion and disease prevention services means the full continuum of
educational services as well as physical and mental assessment services
designed to enable patients to take control over and improve their health
through the prevention of disease as well as the reduction of existing
symptoms.
(3)Medically
underserved populationsThe term medically underserved
population has the meaning given such term in section 330(b)(3).
(4)Nurse-managed
health clinicThe term nurse-managed health clinic
means a nurse-practice arrangement, managed by advanced practice nurses, that
provides primary care for underserved or vulnerable populations and is
associated with a school, college, or department of nursing, federally
qualified health center, or an independent nonprofit health or social services
agency.
(5)The term vulnerable population means a
population that lacks access to adequate primary care or suffers from increased
health disparities due to factors such as health, age, race, ethnicity, sex,
insurance status, income level, or ability to communicate effectively.
(b)Authority To
award grantsThe Secretary shall award grants for the cost of the
operation of nurse-managed health clinics that meet the requirements of this
section.
(c)To
be eligible to receive a grant under this section, an entity shall—
(1)be a
nurse-managed health clinic (as defined in subsection (a)(4)); and
(2)submit to the
Secretary an application at such time, in such manner, and containing an
assurance that—
(A)the nurse-managed
health clinic will continue providing comprehensive primary care services (as
defined in subsection (a)(1)) for the duration of the grant period; and
(B)the nurse-managed
health clinic will establish, within 90 days of receiving a grant under this
section, a community advisory committee composed of individuals, a majority of
whom are being served by the clinic, the purpose of which is to provide input
into the nurse-managed health clinic decisionmaking process.
(d)The Secretary may, upon a showing of good cause,
waive the requirement that the nurse-managed health clinic provide all required
comprehensive primary health services for a period of not to exceed 2
years.
(e)
(1)Funds awarded under a grant under this section may be
used for the provision of primary care services and additional health services,
for the management of nurse-managed health clinic programs, for the payment of
salaries for nurse-managed health clinic personnel, and for providing training
for the provision of required health services. Funds may also be used for
acquiring, and the leasing of, buildings and equipment (including the cost of
amortizing the principle of, and paying interest on, loans for such buildings
and equipment).
(2)The
amount of any grant made in any fiscal year to a nurse-managed health clinic
shall be determined by the Secretary, taking into account—
(A)the financial
need of the nurse-managed health clinic;
(B)State, local, and
other operational funding provided to the nurse-managed health clinic;
and
(C)other factors as
determined appropriate by the Secretary.
(f)The Secretary shall establish a program through which
the Secretary shall provide (either through the Department of Health and Human
Services or by grant or contract) technical and other assistance to
nurse-managed health clinics to assist such clinics in meeting the requirements
of this section. Services provided under this section 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 nurse-managed
health clinics regarding the various resources available under this section and
how those resources can best be used to meet the health needs of the
communities served by nurse-managed health clinics.
(g)The
Secretary shall develop and implement a plan for evaluating nurse-managed
health clinics funded under this section. Such evaluations shall monitor and
track the performance of the grantee as well as the quality of the services
that are provided under the grant.
(h)Authorization
of appropriationsFor the purposes of carrying out this section,
there are authorized to be appropriated $50,000,000 for the fiscal year 2008,
and such sums as may be necessary for each of the fiscal years 2009 through
2012.
.