[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 901 Reported in Senate (RS)]






                                                       Calendar No. 548
110th CONGRESS
  1st Session
                                 S. 901

     To amend the Public Health Service Act to provide additional 
 authorizations of appropriations for the health centers program under 
                        section 330 of such Act.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 15, 2007

Mr. Kennedy (for himself, Mr. Hatch, Mr. Dodd, Mr. Roberts, Mr. Harkin, 
  Mr. Bond, Ms. Mikulski, Ms. Snowe, Mr. Bingaman, Mr. Domenici, Mr. 
    Reed, Ms. Murkowski, Mrs. Clinton, Mr. Bennett, Mr. Obama, Mr. 
     Grassley, Mr. Brown, Mr. Burr, Mr. Menendez, Mr. Schumer, Mr. 
Lieberman, Mrs. Murray, Mr. Coleman, Mr. Smith, Mr. Conrad, Mr. Tester, 
   Mr. Whitehouse, Mr. Baucus, Mr. Akaka, Mr. Inouye, Mr. Kerry, Mr. 
  Durbin, Ms. Cantwell, Mr. Lautenberg, Ms. Collins, Mr. Isakson, Mr. 
 Sununu, Mr. Sanders, Mr. Kohl, Mr. Johnson, Ms. Landrieu, Mr. Levin, 
   Mr. Thune, Mrs. Feinstein, Mr. Pryor, Mr. Craig, Mr. Salazar, Mr. 
Leahy, Mrs. Lincoln, Mr. Biden, Mr. Cochran, Mr. Warner, Mr. Chambliss, 
   Ms. Stabenow, Mr. Dorgan, Mr. Lugar, Mr. Voinovich, Mr. Nelson of 
 Florida, Mrs. Boxer, Mr. Casey, Mrs. Dole, Ms. Klobuchar, Mr. Carper, 
Mr. Cardin, Mrs. McCaskill, Mr. Bayh, Mr. Webb, Mrs. Hutchison, and Mr. 
   Specter) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

                           December 18, 2007

  Reported by Mr. Kennedy, with an amendment and an amendment to the 
                                 title
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
     To amend the Public Health Service Act to provide additional 
 authorizations of appropriations for the health centers program under 
                        section 330 of such Act.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Health Centers Renewal Act 
of 2007''.</DELETED>

<DELETED>SEC. 2. FINDINGS.</DELETED>

<DELETED>    Congress finds as follows:</DELETED>
        <DELETED>    (1) Community, migrant, public housing, and 
        homeless health centers are vital to thousands of communities 
        across the United States.</DELETED>
        <DELETED>    (2) There are more than 1,000 such health centers 
        serving more than 16,000,000 people at more than 5,000 health 
        delivery sites, located in all 50 States of the United States, 
        the District of Columbia, and Puerto Rico, Guam, the Virgin 
        Islands, and other territories of the United States.</DELETED>
        <DELETED>    (3) Health centers provide cost-effective, quality 
        health care to poor and medically underserved people in the 
        States, the District of Columbia, and the territories, 
        including the working poor, the uninsured, and many high-risk 
        and vulnerable populations, and have done so for over 40 
        years.</DELETED>
        <DELETED>    (4) Health centers provide care to 1 of every 8 
        uninsured Americans, 1 of every 4 Americans in poverty, and 1 
        of every 9 rural Americans.</DELETED>
        <DELETED>    (5) Health centers provide primary and preventive 
        care services to more than 700,000 homeless persons and more 
        than 725,000 farm workers in the United States.</DELETED>
        <DELETED>    (6) Health centers are community-oriented and 
        patient-focused and tailor their services to fit the special 
        needs and priorities of local communities, working together 
        with schools, businesses, churches, community organizations, 
        foundations, and State and local governments.</DELETED>
        <DELETED>    (7) Health centers are built through community 
        initiative.</DELETED>
        <DELETED>    (8) Health centers encourage citizen participation 
        and provide jobs for 50,000 community residents.</DELETED>
        <DELETED>    (9) Congress established the program as a unique 
        public-private partnership, and has continued to provide direct 
        funding to community organizations for the development and 
        operation of health centers systems that address pressing local 
        health needs and meet national performance standards.</DELETED>
        <DELETED>    (10) Federal grants assist participating 
        communities in finding partners and recruiting doctors and 
        other health professionals.</DELETED>
        <DELETED>    (11) Federal grants constitute, on average, 24 
        percent of the annual budget of such health centers, with the 
        remainder provided by State and local governments, Medicare, 
        Medicaid, private contributions, private insurance, and patient 
        fees.</DELETED>
        <DELETED>    (12) Health centers make health care responsive 
        and cost-effective through aggressive outreach, patient 
        education, translation, and other enabling support 
        services.</DELETED>
        <DELETED>    (13) Health centers help reduce health 
        disparities, meet escalating health care needs, and provide a 
        vital safety net in the health care delivery system of the 
        United States.</DELETED>
        <DELETED>    (14) Health centers increase the use of preventive 
        health services, including immunizations, pap smears, 
        mammograms, and HBa1c tests for diabetes screenings.</DELETED>
        <DELETED>    (15) Expert studies have demonstrated the impact 
        that these community-owned and patient-controlled primary care 
        delivery systems have achieved both in the reduction of 
        traditional access barriers and the elimination of health 
        disparities among their patients.</DELETED>

<DELETED>SEC. 3. ADDITIONAL AUTHORIZATIONS OF APPROPRIATIONS FOR HEALTH 
              CENTERS PROGRAM OF PUBLIC HEALTH SERVICE ACT.</DELETED>

<DELETED>    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:</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) $2,188,745,000 for fiscal year 
                2008;</DELETED>
                <DELETED>    ``(B) $2,451,394,400 for fiscal year 
                2009;</DELETED>
                <DELETED>    ``(C) $2,757,818,700 for fiscal year 
                2010;</DELETED>
                <DELETED>    ``(D) $3,116,335,131 for fiscal year 2011; 
                and</DELETED>
                <DELETED>    ``(E) $3,537,040,374 for fiscal year 
                2012.''.</DELETED>

SECTION 1. SHORT TITLE.

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

SEC. 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 center 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 effect on the Federal Budget and 
                        the health of students of providing Federal 
                        funds to school-based health centers and 
                        clinics, including the result of providing 
                        disease prevention and nutrition information;
                            (iv) the impact of access to health care 
                        from school-based health centers in rural or 
                        underserved areas; and
                            (v) other sources of Federal funding for 
                        school-based health centers.
            (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 (referred to in this Act as the 
                ``Secretary''), 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 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;
                            (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.

SEC. 3. NATIONAL HEALTH SERVICE CORPS.

    (a) Funding.--
            (1) National health service corps program.--Section 338(a) 
        of the Public Health Service Act (42 U.S.C. 254k(a)) is amended 
        by striking ``2002 through 2006'' and inserting ``2008 through 
        2012''.
            (2) Scholarship and loan repayment programs.--Section 
        338H(a) of the Public Health Service Act (42 U.S.C. 254q(a)) is 
        amended by striking ``appropriated $146,250,000'' and all that 
        follows through the period and inserting the following: 
        ``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 or facilitate 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 members; or
                    ``(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 751, with health education and training centers under 
        section 752, and with border health education and training 
        centers under such section 752. Such assistance shall include 
        assistance in obtaining faculty appointments at health 
        professions schools.
            ``(3) Supplement not supplant.--Such efforts under this 
        subsection shall supplement, not supplant, non-government 
        efforts by professional health provider societies to establish 
        and maintain professional relationships and development 
        opportunities.''.

SEC. 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.''.
            Amend the title so as to read: ``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.''.
                                                       Calendar No. 548

110th CONGRESS

  1st Session

                                 S. 901

_______________________________________________________________________

                                 A BILL

     To amend the Public Health Service Act to provide additional 
 authorizations of appropriations for the health centers program under 
                        section 330 of such Act.

_______________________________________________________________________

                           December 18, 2007

        Reported with an amendment and an amendment to the title