[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3003 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 3003

 To amend the Public Health Service Act to establish the School-Based 
             Health Clinic program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 23, 2009

    Mrs. Capps (for herself, Mr. Rogers of Michigan, Mrs. Davis of 
California, Mrs. Capito, Mrs. Napolitano, Mr. Berman, Mr. Hare, and Ms. 
 Schakowsky) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to establish the School-Based 
             Health Clinic program, and for other purposes.

    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 ``School-Based Health Clinic 
Establishment Act of 2009''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) More than 8,000,000 children in the United States have 
        no form of health insurance and are therefore unable to access 
        preventive health care which may lead to untreated conditions, 
        unnecessary diseases, and death.
            (2) The American Medical Association rates adolescents aged 
        13-18 as the group of Americans with the poorest health 
        indicators.
            (3) More than 70 percent of the children who need 
        psychiatric treatment do not receive services.
            (4) Children who are in poor health or are victims of child 
        abuse, poverty, malnutrition, alcohol, and drug abuse are at 
        risk for academic and social failure.
            (5) Without health and social intervention, at-risk 
        children are often unable to improve academic performance.
            (6) School-based health clinics are effective in bringing 
        preventive and primary care to children and adolescents.
            (7) School-based health clinics are effective in decreasing 
        academic failure resulting from poor health.
    (b) Purpose.--The purpose of this Act is to fund the development 
and operation of school-based health clinics to--
            (1) provide comprehensive and accessible primary health 
        care services to medically underserved children, youth, and 
        families;
            (2) improve the physical health, emotional well-being, and 
        academic performance of medically underserved children, youth, 
        and families; and
            (3) work in collaboration with the school to integrate 
        health into the overall school environment.

SEC. 3. SCHOOL-BASED HEALTH CLINICS.

    Part Q of title III of the Public Health Service Act (42 U.S.C. 
280h et seq.) is amended by adding at the end the following:

``SEC. 399Z-1. SCHOOL-BASED HEALTH CLINICS.

    ``(a) Definitions; Establishment of Criteria.--In this section:
            ``(1) Community.--The term `community' includes parents, 
        patients, local leaders, and community based organizations.
            ``(2) Comprehensive primary health services.--The term 
        `comprehensive primary health services' means the core services 
        offered by school-based health clinics, which shall include the 
        following:
                    ``(A) Physical.--Comprehensive health assessments, 
                diagnosis, and treatment of minor, acute, and chronic 
                medical conditions and referrals to, and follow-up for, 
                specialty care.
                    ``(B) Mental health.--Mental health assessments, 
                crisis intervention, counseling, treatment, and 
                referral to a continuum of services including emergency 
                psychiatric care, community support programs, inpatient 
                care, and outpatient programs.
                    ``(C) Optional services.--Additional services, 
                which may include oral health, social, and age-
                appropriate health education services, including 
                nutritional counseling.
            ``(3) Medically underserved children and adolescents.--
                    ``(A) In general.--The term `medically underserved 
                children and adolescents' means a population of 
                children and adolescents who are residents of an area 
                designated by the Secretary as an area with a shortage 
                of personal health services and health infrastructure 
                for such children and adolescents.
                    ``(B) Criteria.--The Secretary shall prescribe 
                criteria for determining the specific shortages of 
                personal health services for medically underserved 
                children and adolescents under subparagraph (A) that 
                shall--
                            ``(i) take into account any comments 
                        received by the Secretary from the chief 
                        executive officer of a State and local 
                        officials in a State; and
                            ``(ii) include factors indicative of the 
                        health status of such children and adolescents 
                        of an area, including the ability of the 
                        residents of such area to pay for health 
                        services, the accessibility of such services, 
                        the availability of health professionals to 
                        such children and adolescents, and other 
                        factors as determined appropriate by the 
                        Secretary.
            ``(4) School-based health clinic.--The term `school-based 
        health clinic' means a health clinic that--
                    ``(A) is located in, or is adjacent to, a school 
                facility of a local educational agency;
                    ``(B) is organized through school, community, and 
                health provider relationships;
                    ``(C) is administered by a sponsoring facility; and
                    ``(D) provides, at a minimum, comprehensive primary 
                health services during school hours to children and 
                adolescents by health professionals in accordance with 
                State and local laws and regulations, established 
                standards, and community practice.
            ``(5) Sponsoring facility.--The term `sponsoring facility' 
        is--
                    ``(A) a hospital;
                    ``(B) a public health department;
                    ``(C) a community health center;
                    ``(D) a nonprofit health care agency;
                    ``(E) a local educational agency; or
                    ``(F) a program administered by the Indian Health 
                Service or the Bureau of Indian Affairs or operated by 
                an Indian tribe or a tribal organization under the 
                Indian Self-Determination and Education Assistance Act, 
                a Native Hawaiian entity, or an urban Indian program 
                under title V of the Indian Health Care Improvement 
                Act.
    ``(b) Authority To Award Grants.--The Secretary shall award grants 
for the costs of the operation of school-based health clinics (referred 
to in this section as `SBHCs') that meet the requirements of this 
section.
    ``(c) Applications.--To be eligible to receive a grant under this 
section, an entity shall--
            ``(1) be an SBHC (as defined in subsection (a)(4)); and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing--
                    ``(A) evidence that the applicant meets all 
                criteria necessary to be designated an SBHC;
                    ``(B) evidence of local need for the services to be 
                provided by the SBHC;
                    ``(C) an assurance that--
                            ``(i) SBHC services will be provided to 
                        those children and adolescents for whom 
                        parental or guardian consent has been obtained 
                        in accordance with Federal, State, and local 
                        laws governing health care service provision to 
                        children and adolescents;
                            ``(ii) the SBHC has made and will continue 
                        to make every reasonable effort to establish 
                        and maintain collaborative relationships with 
                        other health care providers in the catchment 
                        area of the SBHC;
                            ``(iii) the SBHC will provide on-site 
                        access during the academic day when school is 
                        in session and has an established network of 
                        support and access to services with backup 
                        health providers when the school or SBHC is 
                        closed;
                            ``(iv) the SBHC will be integrated into the 
                        school environment and will coordinate health 
                        services with school personnel, such as 
                        administrators, teachers, nurses, counselors, 
                        and support personnel, as well as with other 
                        community providers co-located at the school;
                            ``(v) the SBHC sponsoring facility assumes 
                        all responsibility for the SBHC administration, 
                        operations, and oversight; and
                            ``(vi) the SBHC will comply with Federal, 
                        State, and local laws concerning patient 
                        privacy and student records, including the 
                        HIPAA and Section 444 of the General Education 
                        Provisions Act; and
                    ``(D) such other information as the Secretary may 
                require.
    ``(d) Preferences.--In reviewing applications, the Secretary may 
give preference to applicants who demonstrate an ability to serve the 
following:
            ``(1) Communities that have evidenced barriers to primary 
        health care and mental health services for children and 
        adolescents.
            ``(2) Communities with high percentages of children and 
        adolescents who are uninsured, underinsured, or enrolled in 
        public health insurance programs.
            ``(3) Populations of children and adolescents that have 
        historically demonstrated difficulty in accessing health and 
        mental health services.
    ``(e) Waiver of Requirements.--The Secretary may--
            ``(1) under appropriate circumstances, waive the 
        application of all or part of the requirements of this section 
        with respect to an SBHC for no more than 2 years; and
            ``(2) upon a showing of good cause, waive the requirement 
        that the SBHC provide all required comprehensive primary health 
        services for a designated period of time to be determined by 
        the Secretary.
    ``(f) Use of Funds.--
            ``(1) Funds.--Funds awarded under a grant under this 
        section may be used for--
                    ``(A) acquiring and leasing equipment (including 
                the costs of amortizing the principle of, and paying 
                interest on, loans for such equipment),
                    ``(B) providing training related to the provision 
                of required comprehensive primary health services and 
                additional health services,
                    ``(C) the management and operation of health center 
                programs, and
                    ``(D) the payment of salaries for physicians, 
                nurses, and other personnel of the SBHC.
            ``(2) Construction.--The Secretary may award grants which 
        may be used to pay the costs associated with expanding and 
        modernizing existing buildings for use as an SBHC, including 
        the purchase of trailers or manufactured building to install on 
        the school property.
            ``(3) Amount.--The amount of any grant made in any fiscal 
        year to an SBHC shall be determined by the Secretary, taking 
        into account--
                    ``(A) the financial need of the SBHC;
                    ``(B) State, local, or other operation funding 
                provided to the SBHC; and
                    ``(C) other factors as determined appropriate by 
                the Secretary.
    ``(g) Matching Requirement.--
            ``(1) Requirement.--Each recipient of a grant under this 
        section shall provide, from non-Federal sources, an amount 
        equal to 20 percent of the amount of the grant (which may be 
        provided in cash or in kind) to carry out the activities 
        supported by the grant.
            ``(2) Waiver.--The Secretary may waive all or part of the 
        matching requirement described in paragraph (1) for any fiscal 
        year for an SBHC if the Secretary determines that applying the 
        matching requirement to the SBHC would result in serious 
        hardship or an inability to carry out the purposes of this 
        section.
    ``(h) Supplement, Not Supplant.--Grant funds provided under this 
section shall be used to supplement, not supplant, other Federal or 
State funds.
    ``(i) Technical Assistance.--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 SBHCs to assist such SBHCs to meet 
the requirements of subsection (c)(2)(C). Services provided through the 
program 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 the entities of the variety of resources 
available under this title and how those resources can be best used to 
meet the health needs of the communities served by the entities.
    ``(j) Evaluation.--The Secretary shall develop and implement a plan 
for evaluating SBHCs and monitoring quality performances under the 
awards made under this section.
    ``(k) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated $50,000,000 
for fiscal year 2010 and such sums as may be necessary for each of the 
fiscal years 2011 through 2014.''.
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