1.This Act may be cited as the
School-Based Health Clinic
Establishment Act of 2009
.
2.
(a)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)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.
3.School-based
health clinicsPart 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:
399Z–1.School-based
health clinics
(a)Definitions;
Establishment of CriteriaIn this section:
(1)The
term community includes parents, patients, local leaders, and
community based organizations.
(2)Comprehensive
primary health servicesThe term comprehensive primary
health services means the core services offered by school-based health
clinics, which shall include the following:
(A)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 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)Additional services, which may include oral health,
social, and age-appropriate health education services, including nutritional
counseling.
(3)Medically
underserved children and adolescents
(A)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)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 clinicThe 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)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 GrantsThe 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)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)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)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)
(1)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)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)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)
(1)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)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)Grant funds provided under this section shall be used to
supplement, not supplant, other Federal or State funds.
(i)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)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
AppropriationsFor 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.
.