II 110th CONGRESS 1st Session S. 2333 IN THE SENATE OF THE UNITED STATES November 8, 2007 Mr. Kennedy introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to reauthorize the Community Health Centers program, the National Health Service Corps, and rural health care programs.

1.

Short title

This Act may be cited as the Health Care Safety Net Act of 2007.

2.

Community health centers program of the Public Health Service Act

(a)

Additional authorizations of appropriations for the health centers program of Public Health Service Act

Section 330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) is amended by amending paragraph (1) to read as follows: (1)

In general

For the purpose of carrying out this section, in addition to the amounts authorized to be appropriated under subsection (d), there are authorized to be appropriated— (A)$2,213,020,000 for fiscal year 2008; (B)$2,451,394,400 for fiscal year 2009; (C)$2,757,818,700 for fiscal year 2010; (D)$3,116,335,131 for fiscal year 2011; and (E)$3,537,040,374 for fiscal year 2012. . (b)

Studies relating to community health centers

(1)

Definitions

For purposes of this subsection— (A)the term community health center means a health center receiving assistance under section 330 of the Public Health Service Act (42 U.S.C. 254b); and (B)the term medically underserved population has the meaning given that term in such section 330. (2)

School-based health study

(A)

In general

Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall issue a study of the economic costs and benefits of school-based health centers and the impact on the health of students of these centers. (B)

Content

In conducting the study under subparagraph (A), the Comptroller General of the United States shall analyze— (i)the impact that Federal funding could have on the operation of school-based health centers; (ii)any cost savings to other Federal programs derived from providing health services in school-based health centers; (iii)the potential impact on Federal budget and the health of students of providing Federal funds to school-based health clinics; and (iv)the impact of access to health care from school-based health clinics in rural or underserved areas. (3)

Health care quality study

(A)

In general

Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, and in collaboration with the Agency for Healthcare Research and Quality, shall prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report that describes agency efforts to expand and accelerate quality improvement activities in community health centers. (B)

Content

The report under subparagraph (A) shall include focus on— (i)Federal efforts, as of the date of enactment of this Act, regarding health care quality in community health centers, including quality data collection, analysis, and reporting requirements; (ii)identification of effective models for quality improvement in community health centers, which may include models that— (I)incorporate care coordination, disease management, and other services demonstrated to improve care; (II)are designed to address multiple, co-occurring diseases and conditions; (III)improve access to providers through non-traditional means, such as the use of remote monitoring equipment; (IV)target various medically underserved populations, including uninsured patient populations; (V)increase access to specialty care, including referrals and diagnostic testing; and (VI)enhance the use of electronic health records to improve quality; (iii)efforts to determine how effective quality improvement models may be adapted for implementation by community health centers that vary by size, budget, staffing, services offered, populations served, and other characteristics determined appropriate by the Secretary of Health and Human Services; (iv)types of technical assistance and resources provided to community health centers that may facilitate the implementation of quality improvement interventions; (v)proposed or adopted methodologies for community health center evaluations of quality improvement interventions, including any development of new measures that are tailored to safety-net, community-based providers; (vi)successful strategies for sustaining quality improvement interventions in the long-term; and (vii)partnerships with other Federal agencies and private organizations or networks as appropriate, to enhance health care quality in community health centers. (C)

Dissemination

The Administrator of the Health Resources and Services Administration shall establish a formal mechanism or mechanisms for the ongoing dissemination of agency initiatives, best practices, and other information that may assist health care quality improvement efforts in community health centers. (4)

GAO study on integrated health systems model for the delivery of health care services to medically underserved populations

(A)

Study

The Comptroller General of the United States shall conduct a study on integrated health system models at not more than 10 sites for the delivery of health care services to medically underserved populations. The study shall include an examination of— (i)health care delivery models sponsored by public or private non-profit entities that— (I)integrate primary, specialty, and acute care; and (II)serve medically underserved populations; and (ii)such models in rural and urban areas. (B)

Report

Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the study conducted under subparagraph (A). The report shall include— (i)an evaluation of the models, as described in subparagraph (A), in— (I)expanding access to primary and preventive services for medically underserved populations; and (II)improving care coordination and health outcomes; and (ii)an assessment of— (I)challenges encountered by such entities in providing care to medically underserved populations; and (II)advantages and disadvantages of such models compared to other models of care delivery for medically underserved populations.

3.

National Health Service Corps

(a)

Funding

To carry out the programs authorized under sections 331 through 338G of the Public Health Service Act (42 U.S.C. 254d–254p), there are authorized to be appropriated— (1)for fiscal year 2008, $131,500,000; (2)for fiscal year 2009, $143,335,000; (3)for fiscal year 2010, $156,235,150; (4)for fiscal year 2011, $170,296,310; and (5)for fiscal year 2012, $185,622,980. (b)

Elimination of 6-year demonstration requirement

Section 332(a)(1) of the Public Health Service Act (42 U.S.C. 254e(a)(1)) is amended by striking Not earlier than 6 years and all that follows through purposes of this section.. (c)

Assignment to shortage area

Section 333(a)(1)(D)(ii) of the Public Health Service Act (42 U.S.C. 254f(a)(1)(D)(ii)) is amended— (1)in subclause (IV), by striking and; (2)in subclause (V), by striking the period at the end and inserting ; and; and (3)by adding at the end the following: (VI)the entity demonstrates willingness to support mentorship, professional development, and training opportunities for Corps members. . (d)

Professional development and training

Subsection (d) of section 336 of the Public Health Service Act (42 U.S.C. 254h–1) is amended to read as follows: (d)

Professional development and training

(1)

In general

The Secretary shall assist Corps members in establishing and maintaining professional relationships and development opportunities, including by— (A)establishing appropriate professional relationships between the Corps member involved and the health professions community of the geographic area with respect to which the member is assigned; (B)establishing professional development, training, and mentorship linkages between the Corps member involved and the larger health professions community, including through distance learning, direct mentorship, and development and implementation of training modules designed to meet the educational needs of offsite Corps members; (C)establishing professional networks among Corps enrollees; and (D)engaging in other professional development, mentorship, and training activities for Corps members, at the discretion of the Secretary. (2)

Assistance in establishing professional relationships

In providing such assistance under paragraph (1), the Secretary shall focus on establishing relationships with hospitals, with academic medical centers and health professions schools, with area health education centers under section 781, with health education and training centers under such section, and with border health education and training centers under such section. Such assistance shall include assistance in obtaining faculty appointments at health professions schools. .

4.

Reauthorization of rural health care programs

Section 330A(j) of the Public Health Service Act (42 U.S.C. 254c(j)) is amended by striking $40,000,000 and all that follows and inserting $45,000,000 for each of fiscal years 2008 through 2012..