I 111th CONGRESS 1st Session H. R. 2599 IN THE HOUSE OF REPRESENTATIVES May 21, 2009 Ms. Herseth Sandlin (for herself, Mr. Walden, and Mr. Pomeroy) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To provide for the establishment of the Rural Health Quality Advisory Commission, and for other purposes.

1.

Short title

This Act may be cited as the Rural Health Quality Advisory Commission Act of 2009.

2.

Rural health quality advisory commission and demonstration projects

(a)

Rural Health Quality Advisory Commission

(1)

Establishment

Not later than 6 months after the date of the enactment of this section, the Secretary of Health and Human Services (in this section referred to as the Secretary) shall establish a commission to be known as the Rural Health Quality Advisory Commission (in this section referred to as the Commission). (2)

Duties of commission

(A)

National plan

The Commission shall develop, coordinate, and facilitate implementation of a national plan for rural health quality improvement. The national plan shall— (i)identify objectives for rural health quality improvement; (ii)identify strategies to eliminate known gaps in rural health system capacity and improve rural health quality; and (iii)provide for Federal programs to identify opportunities for strengthening and aligning policies and programs to improve rural health quality. (B)

Demonstration projects

The Commission shall design demonstration projects to test alternative models for rural health quality improvement, including with respect to both personal and population health. (C)

Monitoring

The Commission shall monitor progress toward the objectives identified pursuant to paragraph (1)(A). (3)

Membership

(A)

Number

The Commission shall be composed of 11 members appointed by the Secretary. (B)

Selection

The Secretary shall select the members of the Commission from among individuals with significant rural health care and health care quality expertise, including expertise in clinical health care, health care quality research, population or public health, or purchaser organizations. (4)

Contracting authority

Subject to the availability of funds, the Commission may enter into contracts and make other arrangements, as may be necessary to carry out the duties described in paragraph (2). (5)

Staff

Upon the request of the Commission, the Secretary may detail, on a reimbursable basis, any of the personnel of the Office of Rural Health Policy of the Health Resources and Services Administration, the Agency for Health Care Quality and Research, or the Centers for Medicare & Medicaid Services to the Commission to assist in carrying out this subsection. (6)

Reports to congress

Not later than 1 year after the establishment of the Commission, and annually thereafter, the Commission shall submit a report to the Congress on rural health quality. Each such report shall include the following: (A)An inventory of relevant programs and recommendations for improved coordination and integration of policy and programs. (B)An assessment of achievement of the objectives identified in the national plan developed under paragraph (2) and recommendations for realizing such objectives. (C)Recommendations on Federal legislation, regulations, or administrative policies to enhance rural health quality and outcomes. (b)

Rural Health Quality Demonstration Projects

(1)

In general

Not later than 270 days after the date of the enactment of this section, the Secretary, in consultation with the Rural Health Quality Advisory Commission, the Office of Rural Health Policy of the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, and the Centers for Medicare & Medicaid Services, shall make grants to eligible entities for 5 demonstration projects to implement and evaluate methods for improving the quality of health care in rural communities. Each such demonstration project shall include— (A)alternative community models that— (i)will achieve greater integration of personal and population health services; and (ii)address safety, effectiveness, patient- or community-centeredness, timeliness, efficiency, and equity (the six aims identified by the Institute of Medicine of the National Academies in its report entitled Crossing the Quality Chasm: A New Health System for the 21st Century released on March 1, 2001); (B)innovative approaches to the financing and delivery of health services to achieve rural health quality goals; and (C)development of quality improvement support structures to assist rural health systems and professionals (such as workforce support structures, quality monitoring and reporting, clinical care protocols, and information technology applications). (2)

Eligible entities

In this subsection, the term eligible entity means a consortium that— (A)shall include— (i)at least one health care provider or health care delivery system located in a rural area; and (ii)at least one organization representing multiple community stakeholders; and (B)may include other partners such as rural research centers. (3)

Consultation

In developing the program for awarding grants under this subsection, the Secretary shall consult with the Administrator of the Agency for Healthcare Research and Quality, rural health care providers, rural health care researchers, and private and non-profit groups (including national associations) which are undertaking similar efforts. (4)

Expedited waivers

The Secretary shall expedite the processing of any waiver that— (A)is authorized under title XVIII or XIX of the Social Security Act (42 U.S.C. 1395 et seq.); and (B)is necessary to carry out a demonstration project under this subsection. (5)

Demonstration project sites

The Secretary shall ensure that the 5 demonstration projects funded under this subsection are conducted at a variety of sites representing the diversity of rural communities in the Nation. (6)

Duration

Each demonstration project under this subsection shall be for a period of 4 years. (7)

Independent evaluation

The Secretary shall enter into an arrangement with an entity that has experience working directly with rural health systems for the conduct of an independent evaluation of the program carried out under this subsection. (8)

Report

Not later than one year after the conclusion of all of the demonstration projects funded under this subsection, the Secretary shall submit a report to the Congress on the results of such projects. The report shall include— (A)an evaluation of patient access to care, patient outcomes, and an analysis of the cost effectiveness of each such project; and (B)recommendations on Federal legislation, regulations, or administrative policies to enhance rural health quality and outcomes. (c)

Appropriation

(1)

In general

Out of funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out this section $30,000,000 for the period of fiscal years 2010 through 2014. (2)

Availability

(A)

In general

Funds appropriated under paragraph (1) shall remain available for expenditure through fiscal year 2014. (B)

Report

For purposes of carrying out subsection (b)(8), funds appropriated under paragraph (1) shall remain available for expenditure through fiscal year 2015. (3)

Reservation

Of the amount appropriated under paragraph (1), the Secretary shall reserve— (A)$5,000,000 to carry out subsection (a); and (B)$25,000,000 to carry out subsection (b), of which— (i)2 percent shall be for the provision of technical assistance to grant recipients; and (ii)5 percent shall be for independent evaluation under subsection (b)(7).