[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1883 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 1883

 To require the Secretary of Health and Human Services to carry out a 
      demonstration grants program to provide for certain patient 
 coordination, outreach, and assistance services to reduce barriers to 
        receiving health care and improve health care outcomes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 2, 2009

 Mr. Scott of Virginia (for himself, Ms. Jackson-Lee of Texas, and Ms. 
Lee of California) introduced the following bill; which was referred to 
                  the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To require the Secretary of Health and Human Services to carry out a 
      demonstration grants program to provide for certain patient 
 coordination, outreach, and assistance services to reduce barriers to 
        receiving health care and improve health care outcomes.

    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 ``Patient Advocate Act of 2009''.

SEC. 2. PATIENT ASSISTANCE GRANTS DEMONSTRATION PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a demonstration program under which the Secretary may make 
grants to States, local and tribal entities, and public or private non-
profit organizations for the development and operation of programs to 
provide services for patients to resolve health insurance, job 
retention, and debt crisis matters related to the patients' diagnosis 
and illness, including services described in subsection (b), to improve 
health care outcomes.
    (b) Use of Funds.--A recipient of a grant under this section shall 
use the grant for the purposes of recruiting, assigning, training, and 
employing patient health advocates (as defined in subsection (m)(2)) 
who have direct knowledge of the communities they serve to facilitate 
the care of individuals, including by performing each of the following 
services (and by ensuring that such services are available to such 
communities):
            (1) Acting as contacts, including by assisting in the 
        coordination of health care services and provider referrals, 
        for individuals who are seeking prevention or early detection 
        services for, or who following a screening or early detection 
        service are found to have a symptom, abnormal finding, or 
        diagnosis of, an adverse health condition.
            (2) Facilitating the involvement of community organizations 
        in assisting individuals who are at risk for or who have an 
        adverse health condition to receive better access to high-
        quality health care services (such as by creating partnerships 
        with patient advocacy groups, charities, health care centers, 
        community hospice centers, other health care providers, or 
        other organizations in the targeted community).
            (3) Notifying individuals of clinical trials and, upon 
        request, facilitating enrollment of eligible individuals in 
        these trials.
            (4) Anticipating, identifying, and helping individuals to 
        overcome barriers within the health care system to ensure 
        prompt diagnosis and treatment.
            (5) Coordinating with the relevant health insurance 
        ombudsman programs to provide information to individuals about 
        health coverage, including private insurance, health care 
        savings accounts, and other publicly funded programs (such as 
        the Medicare, the Medicaid, and State children's health 
        insurance programs under titles XVIII, XIX, and XXI of the 
        Social Security Act, respectively, health programs operated by 
        the Department of Veterans Affairs or the Department of 
        Defense, and any private or governmental prescription 
        assistance programs).
            (6) Conducting ongoing outreach to health disparity 
        populations, including the uninsured, rural populations, and 
        other medically underserved populations, in addition to 
        assisting other individuals to seek preventive care.
A recipient of a grant under subsection (a) may use such grant for 
operational costs of any activity carried out by such entity for the 
purposes described in the previous sentence.
    (c) Prohibitions.--
            (1) Referral fees.--The Secretary of Health and Human 
        Services shall require each recipient of a grant under this 
        section to prohibit any patient health advocate providing 
        services under the grant from accepting any referral fee, 
        kickback, or other thing of value in return for referring an 
        individual to a particular health care provider.
            (2) Legal fees and costs.--The Secretary of Health and 
        Human Services shall prohibit the use of any grant funds 
        received under this section to pay any fees or costs resulting 
        from any litigation, arbitration, mediation, or other 
        proceeding to resolve a legal dispute.
    (d) Grant Period.--
            (1) Initial grant period and permissible extensions.--
        Subject to paragraph (2), the Secretary of Health and Human 
        Services--
                    (A) may award grants under this section for initial 
                periods of not more than 3 years; and
                    (B) may extend the period of a grant under this 
                section so long as each such extension is for a period 
                of not more than 1 year.
            (2) Limitation.--In no case may the Secretary award an 
        initial grant or extend the period of a grant under this 
        section for a period ending after the date that is 5 years 
        after the date of the enactment of this Act.
    (e) Application.--
            (1) In general.--To seek a grant under this section, an 
        entity or organization described in subsection (a) shall submit 
        an application to the Secretary of Health and Human Services in 
        such form, in such manner, and containing such information as 
        the Secretary may require.
            (2) Contents.--At a minimum, the Secretary shall require 
        each such application to outline how the entity or organization 
        involved will establish baseline measures and benchmarks that 
        meet the Secretary's requirements to evaluate program outcomes.
    (f) Uniform Baseline Measures.--The Secretary of Health and Human 
Services shall establish uniform baseline measures in order to properly 
evaluate the impact of the programs funded under this section.
    (g) Preference.--In making grants under this section, the Secretary 
of Health and Human Services shall give preference to eligible entities 
that demonstrate in their applications plans to utilize services 
described in subsection (b) to overcome significant barriers in order 
to improve health care outcomes in their respective communities.
    (h) Duplication of Services.--An entity or organization that is 
receiving Federal funds for services described in subsection (b) on the 
date on which the entity or organization, respectively, submits an 
application under subsection (e) may not receive a grant under this 
section unless the entity or organization, respectively, can 
demonstrate that amounts received under the grant will be utilized to 
expand services or provide new services to individuals who would not 
otherwise be served.
    (i) Coordination With Other Programs.--The Secretary of Health and 
Human Services shall ensure coordination of the demonstration program 
under this section with existing authorized programs in order to 
facilitate access to high-quality health care services.
    (j) Study; Reports.--
            (1) Final report by secretary.--Not later than 6 months 
        after the completion of the demonstration program under this 
        section, the Secretary of Health and Human Services shall 
        conduct a study of the results of the program and submit to the 
        Congress a report on such results that includes the following:
                    (A) An evaluation of the program outcomes, 
                including--
                            (i) quantitative analysis of baseline and 
                        benchmark measures; and
                            (ii) aggregate information about the 
                        individuals served and program activities.
                    (B) Recommendations on whether the programs funded 
                under this section could be used to improve patient 
                outcomes in other public health areas.
            (2) Interim reports by secretary.--The Secretary of Health 
        and Human Services may provide interim reports to the Congress 
        on the demonstration program under this section at such 
        intervals as the Secretary determines to be appropriate.
            (3) Reports by grantees.--The Secretary of Health and Human 
        Services may require each recipient of a grant under this 
        section to submit interim and final reports on the programs 
        carried out by such recipient with such grant.
    (k) Rule of Construction.--This section shall not be construed to 
authorize funding for the delivery of health care services (other than 
the services listed in subsection (b)).
    (l) Nondiscrimination.--
            (1) Treatment as federal financial assistance.--For the 
        purpose of applying the prohibitions against discrimination on 
        the basis of age under the Age Discrimination Act of 1975 (42 
        U.S.C. 6101 et seq.), on the basis of disability under section 
        504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), on the 
        basis of sex under title IX of the Education Amendments of 1972 
        (20 U.S.C. 1681 et seq.), or on the basis of race, color, or 
        national origin under title VI of the Civil Rights Act of 1964 
        (42 U.S.C. 2000d et seq.), programs and activities funded or 
        otherwise financially assisted in whole or in part under this 
        Act (whether through grant, contract, or otherwise) are 
        considered to be programs and activities receiving Federal 
        financial assistance.
            (2) Prohibition of discrimination regarding participation, 
        benefits, and employment.--
                    (A) In general.--No individual shall be excluded 
                from participation in, denied the benefits of, 
                subjected to discrimination under, or denied employment 
                in the administration of or in connection with, any 
                program or activity funded or otherwise financially 
                assisted in whole or in part under this Act because of 
                race, color, religion, sex, national origin, age, 
                disability, or political affiliation or belief.
                    (B) Enforcement.--The powers, remedies, and 
                procedures set forth in title VI of the Civil Rights 
                Act of 1964 (42 U.S.C. 2000d et seq.) shall be the 
                powers, remedies, and procedures this paragraph 
                provides to the Secretary concerning a violation of 
                subparagraph (A).
    (m) Definitions.--In this section:
            (1) Health disparity population.--The term ``health 
        disparity population'' means a population that, as determined 
        by the Secretary of Health and Human Services, has a 
        significant disparity in the overall rate of disease incidence, 
        prevalence, morbidity, mortality, or survival rates as compared 
        to the health status of the general population.
            (2) Patient health advocate.--The term ``patient health 
        advocate'' means, with respect to a program developed by a 
        recipient of a grant under this section, an individual who has 
        completed a certified social work program (or program in a 
        related field) approved by such recipient, or has attained an 
        equivalent level of proficiency through organization-sponsored 
        training or work experience in areas of social work, case work, 
        or nursing.
    (n) Authorization of Appropriations.--
            (1) In general.--To carry out this section, there are 
        authorized to be appropriated $10,000,000 for each of the 
        fiscal years 2010 through 2014.
            (2) Availability.--The amounts appropriated pursuant to 
        paragraph (1) shall remain available for obligation through the 
        end of fiscal year 2014.
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