[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3158 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 3158

To reform health care delivery by providing incentives for place-based 
  health care, which seeks to bring health services to the patient by 
locating community health centers, federally qualified health centers, 
   and community integrated health centers in or near settings that 
    already serve a particular target population, such as schools, 
              workplaces, and senior services facilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 9, 2009

 Mr. Sarbanes introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
Ways and Means and Education and Labor, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To reform health care delivery by providing incentives for place-based 
  health care, which seeks to bring health services to the patient by 
locating community health centers, federally qualified health centers, 
   and community integrated health centers in or near settings that 
    already serve a particular target population, such as schools, 
              workplaces, and senior services facilities.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Place Based Health 
Care Act of 2009''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
              TITLE I--COMMUNITY INTEGRATED HEALTH CENTERS

Sec. 101. Definitions.
Sec. 102. Funding benefits.
                 TITLE II--SCHOOL-BASED HEALTH CENTERS

Sec. 201. Assurance of payment under Medicaid and CHIP for covered 
                            items and services furnished by certain 
                            school-based health clinics.
    TITLE III--TAX CREDIT FOR EMPLOYER-PROVIDED HEALTH AND WELLNESS 
                                BENEFITS

Sec. 301. Credit for employer-provided health and wellness benefits.
   TITLE IV--EVIDENCE-BASED DISEASE PREVENTION AND HEALTH PROMOTION 
              PROGRAM; SENIOR HOUSING FACILITY PLAN OPTION

Sec. 301. Evidence-based disease prevention and health promotion grant 
                            program.
Sec. 302. Offering Medicare Advantage plan in a senior housing 
                            facility.
        TITLE V--COMMUNITY HEALTH CENTER EXPANSION OF PRIORITIES

Sec. 401. Community health center expansion.

              TITLE I--COMMUNITY INTEGRATED HEALTH CENTERS

SEC. 101. DEFINITIONS.

    In this Act:
            (1) Community integrated health center.--The term 
        ``Community Integrated Health Center'' means an organization 
        that--
                    (A) seeks to fully integrate its services into the 
                community by locating in or near settings that serve 
                particular target populations, such as schools, 
                workplaces, or senior service facilities;
                    (B) is owned or controlled by, or comprised of, two 
                or more institutional providers or groups of health 
                care professionals that are eligible for participation 
                in part A or part B of Medicare;
                    (C) is organized for the purpose of providing 
                health care, improving the quality of health care, and 
                reducing costs associated with the provision of health 
                care provided to Center patients;
                    (D) participates in Medicare and Medicaid;
                    (E) requires all of its participating providers to 
                participate in Medicare and Medicaid;
                    (F) is not excluded or precluded from participation 
                in any Federal or State health care program;
                    (G) is organized to receive payment from government 
                and private health plans in a manner that promotes cost 
                reductions, including--
                            (i) accepting global or bundled payments; 
                        and
                            (ii) accepting fixed-fee or capitated 
                        payments;
                    (H) accepts all patients enrolled in Medicare and 
                Medicaid;
                    (I) does not discriminate on the basis of any 
                prohibited criteria;
                    (J) does not discriminate with respect to the 
                provision of care to patients of the Center on the 
                basis of the patient's insurance status or ability to 
                pay;
                    (K) maintains an affiliation with an acute care 
                hospital;
                    (L) maintains an affiliation with health care 
                providers as necessary to meet the needs of its 
                enrollees;
                    (M) maintains a qualified workforce;
                    (N) has a qualified medical director;
                    (O) coordinates inpatient and outpatient care for 
                its enrollees, including coordination of wellness and 
                prevention services and care for chronic disease;
                    (P) offers wellness, prevention, and health-
                promotion services;
                    (Q) develops, and requires its participating 
                providers to follow, guidelines, protocols, evidence-
                based medicine, and clinical pathways;
                    (R) utilizes electronic medical records by the 
                deadline set forth in the amendments made by the 
                American Recovery and Reinvestment Act of 2009;
                    (S) requires its participating providers to utilize 
                electronic medical records by such deadlines; and
                    (T) qualifies as an ``organized health care 
                arrangement'' pursuant parts 160, 162, and 164 of title 
                45, Code of Federal Regulations.
            (2) Medicare; medicaid.--The terms ``Medicare'' and 
        ``Medicaid'' mean the programs under titles XVIII and XIX, 
        respectively, of the Social Security Act.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 102. FUNDING BENEFITS.

    (a) Listing.--A facility may obtain the benefits of this section by 
becoming listed as a Community Integrated Health Center by the 
Secretary. The Secretary shall list such a facility that--
            (1) certifies to the Secretary that it meets the 
        requirements for a Community Integrated Health Center under 
        section 101(1); and
            (2) every three years demonstrates to the satisfaction of 
        the Secretary that the facility continues to meet such 
        requirements.
    (b) Community Integrated Health Center Assistance.--
            (1) Eligible community integrated health center defined.--
        In this subsection, the term ``Eligible Community Integrated 
        Health Center'' means an Community Integrated Health Center 
        that has been listed under subsection (a).
            (2) Grant program.--
                    (A) In general.--The Secretary shall use such sums 
                as may be necessary to carry out a program of grants to 
                assist Eligible Community Integrated Health Centers 
                with start-up and operating costs.
                    (B) Administration.--The Secretary shall make 
                grants to Eligible Community Integrated Health Centers 
                under this subsection on a competitive basis, to such 
                Centers that demonstrate to the satisfaction of the 
                Secretary that the Center will--
                            (i) use the funds to--
                                    (I) promote the integration of 
                                health care providers;
                                    (II) promote coordination of 
                                patient care;
                                    (III) provide greater access to 
                                health care by patients within the 
                                Center's geographic service area;
                                    (IV) locate services in or near a 
                                setting that serves their target 
                                population, such as schools, 
                                workplaces, or senior services 
                                facilities;
                                    (V) reduce the cost of providing 
                                care; and
                                    (VI) improve the quality of care 
                                provided to patients within the 
                                Center's geographic service area; and
                            (ii) not later than 12 months after the 
                        date on which the Secretary provides assistance 
                        to the Center, submit to the Secretary a report 
                        that describes--
                                    (I) the manner in which the 
                                assistance was spent;
                                    (II) the manner in which the 
                                factors outlined in clause (i) have 
                                been monitored; and
                                    (III) any measurable change in the 
                                factors outlined in such clause as a 
                                result of the Center's receipt of 
                                assistance.
                    (C) Timing.--Not later than 180 days after the date 
                of enactment of this Act, the Secretary shall make 
                grants to provide assistance under this subsection.
            (3) Report to congress.--Not later than 18 months after the 
        date of enactment of this Act, the Secretary shall submit to 
        the appropriate committees of Congress a report that--
                    (A) describes in detail the manner in which this 
                grant program has been carried out; and
                    (B) includes the information reported to the 
                Secretary under paragraph (2)(B)(ii).

                 TITLE II--SCHOOL-BASED HEALTH CENTERS

SEC. 201. ASSURANCE OF PAYMENT UNDER MEDICAID AND CHIP FOR COVERED 
              ITEMS AND SERVICES FURNISHED BY CERTAIN SCHOOL-BASED 
              HEALTH CLINICS.

    (a) State Plan Requirement.--Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)), as amended by section 5006(e)(2)(A) of 
division B of the American Recovery and Reinvestment Act of 2009 
(Public Law 111-5), is amended--
            (1) in paragraph (72), by striking ``and'' at the end;
            (2) in paragraph (73)(B), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (73), the following new 
        paragraph:
            ``(74) provide that the State shall certify to the 
        Secretary that the State has implemented procedures to pay for 
        medical assistance (including care and services described in 
        subsections (a)(4)(B) and (r) of section 1905 and provided in 
        accordance with section 1902(a)(43)) furnished in a school-
        based health clinic, if payment would be made under the State 
        plan for the same items and services if furnished in a 
        physician's office or other outpatient clinic (including if 
        such payment would be included in the determination of a 
        prepaid capitation or other risk-based rate of payment to an 
        entity under a contract pursuant to section 1903(m)).''.
    (b) School-based Health Clinic Defined.--Section 1905 of such Act 
(42 U.S.C. 1396d) is amended by adding at the end the following new 
subsection:
    ``(y)(1) The term `school-based health clinic' means a health 
clinic that--
            ``(A) is located in or near a school facility of a school 
        district or board or of an Indian tribe or tribal organization;
            ``(B) is organized through school, community, and health 
        provider relationships;
            ``(C) is administered by a sponsoring facility;
            ``(D) provides through health professionals primary health 
        services to children in accordance with State and local law, 
        including laws relating to licensure and certification; and
            ``(E) satisfies such other requirements as a State may 
        establish for the operation of such a clinic.
    ``(2) For purposes of paragraph (1)(D), the term `primary health 
services' means the core services offered by a school-based health 
clinic, 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 health education services.
    ``(3) For purposes of paragraph (1)(C), the term `sponsoring 
facility' is a community-based organization, which may include--
            ``(A) a hospital;
            ``(B) a public health department;
            ``(C) a community health center;
            ``(D) a nonprofit health care agency;
            ``(E) a school or school system; 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 (25 U.S.C. 450), a Native Hawaiian 
        entity, or an Urban Indian program under title V of the Indian 
        Health Care Improvement Act (25 U.S.C. 1601).''.
    (c) Application to CHIP.--Section 2107(e)(1) of the Social Security 
Act (42 U.S.C. 1397gg(e)(1)) is amended--
            (1) by redesignating subparagraphs (B) through (D) as 
        subparagraphs (C) through (E), respectively; and
            (2) by inserting after subparagraph (A), the following new 
        subparagraph:
                    ``(B) Section 1902(a)(74) (relating to procedures 
                to ensure payment for covered services furnished in a 
                school-based health clinic, as defined in section 
                1905(y)).''.
    (d) Rule of Construction.--Nothing in this section or the 
amendments made by this section shall be construed to preempt or 
supersede State or local law with respect to whether a school-based 
health clinic provides family planning services and supplies.
    (e) Effective Date.--The amendments made by this section take 
effect on October 1, 2009.

    TITLE III--TAX CREDIT FOR EMPLOYER-PROVIDED HEALTH AND WELLNESS 
                                BENEFITS

SEC. 301. CREDIT FOR EMPLOYER-PROVIDED HEALTH AND WELLNESS BENEFITS.

    (a) In General.--Subpart D of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to business-related 
credits) is amended by adding at the end the following new section:

``SEC. 45R. CREDIT FOR EMPLOYER-PROVIDED HEALTH AND WELLNESS BENEFITS.

    ``(a) In General.--For purposes of section 38, the employer-
provided health and wellness benefits credit determined under this 
section for the taxable year is an amount equal to 25 percent of the 
qualified health and wellness expenditures of the taxpayer for such 
taxable year.
    ``(b) Dollar Limitation.--The credit allowable under subsection (a) 
for any taxable year shall not exceed $150,000.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Qualified health and wellness expenditure.--
                    ``(A) In general.--The term `qualified health and 
                wellness expenditure' means any amount paid or 
                incurred--
                            ``(i) to acquire, construct, rehabilitate, 
                        or expand property--
                                    ``(I) which is to be used as part 
                                of a qualified health and wellness 
                                facility of the taxpayer, and
                                    ``(II) with respect to which a 
                                deduction for depreciation (or 
                                amortization in lieu of depreciation) 
                                is allowable,
                            ``(ii) for the operating costs of a 
                        qualified health and wellness facility of the 
                        taxpayer, or
                            ``(iii) under a contract with a qualified 
                        health and wellness facility to provide health 
                        and wellness services to employees of the 
                        taxpayer.
                    ``(B) Fair market value.--The term `qualified 
                health and wellness expenditures' shall not include 
                expenses in excess of the fair market value of such 
                care.
            ``(2) Qualified health and wellness facility.--
                    ``(A) In general.--The term `qualified health and 
                wellness facility' means a facility--
                            ``(i) the principal use of which is to 
                        provide medical care (including preventive 
                        care), and
                            ``(ii) which meets the requirements of all 
                        applicable laws and regulations of the State or 
                        local government in which it is located.
                    ``(B) Special rules with respect to a taxpayer.--A 
                facility shall not be treated as a qualified health and 
                wellness facility with respect to a taxpayer unless--
                            ``(i) enrollment in the facility is open to 
                        employees of the taxpayer during the taxable 
                        year, and
                            ``(ii) the use of such facility (or the 
                        eligibility to use such facility) does not 
                        discriminate in favor of employees of the 
                        taxpayer who are highly compensated employees 
                        (within the meaning of section 414(q)).
    ``(d) Recapture of Acquisition and Construction Credit.--
            ``(1) In general.--If, as of the close of any taxable year, 
        there is a recapture event with respect to any qualified health 
        and wellness facility of the taxpayer, then the tax of the 
        taxpayer under this chapter for such taxable year shall be 
        increased by an amount equal to the product of--
                    ``(A) the applicable recapture percentage, and
                    ``(B) the aggregate decrease in the credits allowed 
                under section 38 for all prior taxable years which 
                would have resulted if the qualified health and 
                wellness expenditures of the taxpayer described in 
                subsection (c)(1)(A) with respect to such facility had 
                been zero.
            ``(2) Applicable recapture percentage.--
                    ``(A) In general.--For purposes of this subsection, 
                the applicable recapture percentage shall be determined 
                from the following table:

``If the recapture event occurs in: The applicable recapture percentage 
                                                                   is: 
         Years 1-3.........................................         100
        Year 4.............................................          85
        Year 5.............................................          70
         Year 6............................................          55
        Year 7.............................................          40
        Year 8.............................................          25
        Years 9 and 10.....................................          10
        Years 11 and thereafter............................          0.
                    ``(B) Years.--For purposes of subparagraph (A), 
                year 1 shall begin on the first day of the taxable year 
                in which the qualified health and wellness facility is 
                placed in service by the taxpayer.
            ``(3) Recapture event defined.--For purposes of this 
        subsection, the term `recapture event' means--
                    ``(A) Cessation of operation.--The cessation of the 
                operation of the facility as a qualified health and 
                wellness facility.
                    ``(B) Change in ownership.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), the disposition of a taxpayer's 
                        interest in a qualified health and wellness 
                        facility with respect to which the credit 
                        described in subsection (a) was allowable.
                            ``(ii) Agreement to assume recapture 
                        liability.--Clause (i) shall not apply if the 
                        person acquiring such interest in the facility 
                        agrees in writing to assume the recapture 
                        liability of the person disposing of such 
                        interest in effect immediately before such 
                        disposition. In the event of such an 
                        assumption, the person acquiring the interest 
                        in the facility shall be treated as the 
                        taxpayer for purposes of assessing any 
                        recapture liability (computed as if there had 
                        been no change in ownership).
            ``(4) Special rules.--
                    ``(A) Tax benefit rule.--The tax for the taxable 
                year shall be increased under paragraph (1) only with 
                respect to credits allowed by reason of this section 
                which were used to reduce tax liability. In the case of 
                credits not so used to reduce tax liability, the 
                carryforwards and carrybacks under section 39 shall be 
                appropriately adjusted.
                    ``(B) No credits against tax.--Any increase in tax 
                under this subsection shall not be treated as a tax 
                imposed by this chapter for purposes of determining the 
                amount of any credit under this chapter or for purposes 
                of section 55.
                    ``(C) No recapture by reason of casualty loss.--The 
                increase in tax under this subsection shall not apply 
                to a cessation of operation of the facility as a 
                qualified child care facility by reason of a casualty 
                loss to the extent such loss is restored by 
                reconstruction or replacement within a reasonable 
                period established by the Secretary.
    ``(e) Special Rules.--For purposes of this section--
            ``(1) Aggregation rules.--All persons which are treated as 
        a single employer under subsections (a) and (b) of section 52 
        shall be treated as a single taxpayer.
            ``(2) Pass-thru in the case of estates and trusts.--Under 
        regulations prescribed by the Secretary, rules similar to the 
        rules of subsection (d) of section 52 shall apply.
            ``(3) Allocation in the case of partnerships.--In the case 
        of partnerships, the credit shall be allocated among partners 
        under regulations prescribed by the Secretary.
    ``(f) No Double Benefit.--
            ``(1) Reduction in basis.--For purposes of this subtitle--
                    ``(A) In general.--If a credit is determined under 
                this section with respect to any property by reason of 
                expenditures described in subsection (c)(1)(A), the 
                basis of such property shall be reduced by the amount 
                of the credit so determined.
                    ``(B) Certain dispositions.--If, during any taxable 
                year, there is a recapture amount determined with 
                respect to any property the basis of which was reduced 
                under subparagraph (A), the basis of such property 
                (immediately before the event resulting in such 
                recapture) shall be increased by an amount equal to 
                such recapture amount. For purposes of the preceding 
                sentence, the term `recapture amount' means any 
                increase in tax (or adjustment in carrybacks or 
                carryovers) determined under subsection (d).
            ``(2) Other deductions and credits.--No deduction or credit 
        shall be allowed under any other provision of this chapter with 
        respect to the amount of the credit determined under this 
        section.''.
    (b) Credit To Be Part of General Business Credit.--Subsection (b) 
of section 38 of such Code (relating to general business credit) is 
amended by striking ``plus'' at the end of paragraph (34), by striking 
the period at the end of paragraph (35) and inserting ``, plus'' , and 
by adding at the end the following new paragraph:
            ``(36) the employer-provided health and wellness benefits 
        credit determined under section 45R(a).''.
    (c) Clerical Amendment.--The table of sections for subpart D of 
part IV of subchapter A of chapter 1 of such Code is amended by 
inserting after the item relating to section 45Q the following new 
item:

``Sec. 45R. Credit for employer-provided health and wellness 
                            benefits.''.
    (d) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

   TITLE IV--EVIDENCE-BASED DISEASE PREVENTION AND HEALTH PROMOTION 
              PROGRAM; SENIOR HOUSING FACILITY PLAN OPTION

SEC. 301. EVIDENCE-BASED DISEASE PREVENTION AND HEALTH PROMOTION GRANT 
              PROGRAM.

    Part D of title III of the Older Americans Act of 1965 (42 U.S.C. 
3030m et seq.) is amended--
            (1) by inserting the following before section 361:

                      ``Subpart 1--Services''; and

            (2) by adding at the end the following:

  ``Subpart 2--Evidence-based Disease Prevention and Health Promotion 
                                Program

``SEC. 365. EVIDENCE-BASED DISEASE PREVENTION AND HEALTH PROMOTION 
              GRANTS PROGRAM.

    ``(a) Grant Program.--From a portion of the funds allotted to carry 
out this part, the Assistant Secretary shall establish an evidence-
based disease prevention and health promotion program to make grants to 
States to carry out--
            ``(1) evidence-based disease prevention programs;
            ``(2) evidence-based chronic disease management programs;
            ``(3) evidence-based chronic disease self-management 
        programs;
            ``(4) evidence-based health services and health promotion 
        services and supports;
            ``(5) a disease self-management program such as the 
        Stanford University Chronic Disease Self-Management Program 
        (CDSMP).
    ``(b) Application for Grant.--To request a grant under subsection 
(a), a State shall, after consulting and coordinating with area 
agencies on aging in the State involved, submit an application to the 
Secretary at such time, in such manner, and containing the following 
information:
            ``(1) A description of the evidence-based disease 
        prevention and health promotion programs the State agency 
        proposes to carry out with such grant.
            ``(2) Sufficient information to demonstrate that the 
        infrastructure exists to support the proposed programs.
            ``(3) Such other information as the Secretary determines 
        appropriate.
    ``(c) Subgrants.--
            ``(1) Grants to area agencies on aging.--With funds 
        received under subsection (b), the State agency shall make 
        grants to area agencies on aging that demonstrate performance 
        capacity to carry out programs and activities described in 
        subsection (a), to carry out evidence-based disease prevention 
        and health promotion programs under this section either 
        directly or through contracts with--
                    ``(A) organizations that are providers of direct 
                services to older individuals and that receive funding 
                under this Act; or
                    ``(B) Federally Qualified Health Centers or 
                Community Health Centers (as such terms are used in 
                relation to section 330 of the Public Health Service 
                Act) or Community Integrated Health Centers (as defined 
                in section 101 of the Place Based Health Care Act of 
                2009).
            ``(2) Direct grants to other entities.--If an area agency 
        on aging does not receive a grant under paragraph (1), the 
        State agency may make a subgrant to carry out evidence-based 
        disease prevention and health promotion programs under this 
        section in the planning and service area of such agency, to--
                    ``(A) organizations that are providers of direct 
                services to older individuals and that receive funding 
                under this Act; or
                    ``(B) Federally Qualified Health Centers or 
                Community Health Centers (as such terms are used in 
                relation to section 330 of the Public Health Service 
                Act) or Community Integrated Health Centers (as defined 
                in section 101 of the Place Based Health Care Act of 
                2009).
        that demonstrate performance capacity to carry out the programs 
        and activities described in subsection (a).
    ``(d) Uses of Funds.--A grant or subgrant received under this 
section may be used to carry out--
            ``(1) an evidence-based chronic disease management program;
            ``(2) an evidence-based chronic disease self-management 
        program; or
            ``(3) an evidence-based disease prevention and health 
        promotion program.
    ``(e) Definition.--In this section, the term `health services and 
health promotion services and supports' means any service, any onsite 
primary care service, any in-home service, a case management service, 
or any evidence-based intervention that is--
            ``(1) furnished in settings that serve the population of 
        older individuals such as--
                    ``(A) a private home or residence;
                    ``(B) a community based organization (as defined in 
                section 1901 of the Elementary and Secondary Education 
                Act of 1965 (20 U.S.C. 7801));
                    ``(C) a Community Integrated Health Center (as 
                defined in section 101(1) of the Place Based Health 
                Care Act of 2009);
                    ``(D) a faith-based organization;
                    ``(E) a community-care setting (including a small 
                community care setting as defined in subsection (g)(1), 
                and a large community care setting as defined in 
                subsection (h)(1), of section 1929 of the Social 
                Security Act (42 U.S.C. 1396t));
                    ``(F) a board and care facility;
                    ``(G) a long-term care facility;
                    ``(H) a multi-purpose senior center; or
                    ``(I) a community center (as defined in section 
                670G of the State Dependent Care Development Grants Act 
                (42 U.S.C. 9877));
            ``(2) furnished to diagnose, treat, or cure a medical 
        disease or condition; and
            ``(3) intended to assist older individuals with carrying 
        out activities of daily living (as defined in section 802 of 
        the Cranston-Gonzalez National Affordable Housing Act (42 
        U.S.C. 8011).''.

SEC. 302. OFFERING MEDICARE ADVANTAGE PLAN IN A SENIOR HOUSING 
              FACILITY.

    Section 1851(b)(1) of the Social Security Act (42 U.S.C. 1395w-
21(b)(1)) is amended by adding at the end the following new 
subparagraph:
                    ``(D) Special rule for senior citizen facilities.--
                Notwithstanding any other provision of this part, a 
                Medicare Advantage organization may operate a Medicare 
                Advantage plan exclusively within a geographic area 
                that is limited to a senior housing facility if the 
                plan--
                            ``(i) provides services only to 
                        beneficiaries who either--
                                    ``(I) are under a long-term 
                                residency contract as described in 
                                section 1919(c)(5)(B)(v); or
                                    ``(II) reside in supportive housing 
                                for the elderly as described in section 
                                202 of the Housing Act of 1959 or 
                                housing supported by the low income 
                                housing tax credit program described in 
                                section 42 of the Internal Revenue Code 
                                of 1986, and qualify for assistance 
                                under section 8 of the United States 
                                Housing Act of 1937;
                            ``(ii) provides onsite primary care 
                        services with a ratio of accessible physicians 
                        to beneficiaries that is deemed to be adequate 
                        by the Secretary;
                            ``(iii) provides transportation services 
                        for patients to specialty providers outside the 
                        community;
                            ``(iv) makes meaningful use of health 
                        information technology; and
                            ``(v) if offered to continuing care 
                        retirement or life care community residents as 
                        described in clause (i)(I), has participated in 
                        a Centers for Medicare & Medicaid Services 
                        demonstration initiative for a minimum of one 
                        year.''.

        TITLE V--COMMUNITY HEALTH CENTER EXPANSION OF PRIORITIES

SEC. 401. COMMUNITY HEALTH CENTER EXPANSION.

    Section 330 of the Public Health Service Act (42 U.S.C. 254b) is 
amended by adding at the end the following new subsections:
    ``(s) School-based Health Centers.--
            ``(1) In general.--The Secretary may award grants for the 
        purposes described in subparagraphs (c), (e), and (f) of this 
        section for the planning and delivery of services to a special 
        medically underserved population comprised of school-aged 
        children in a school-based health center.
            ``(2) School-based health center defined.--In this section, 
        the term `school-based health center' means a health center 
        that--
                    ``(A) is located within an elementary or secondary 
                school facility;
                    ``(B) is operated in collaboration with the school 
                in which such center is located;
                    ``(C) is administered by a community-based 
                organization including a hospital, public health 
                department, community health center, or nonprofit 
                health care agency;
                    ``(D) at a minimum, provides to school-aged 
                children--
                            ``(i) primary health care services, 
                        including comprehensive health assessments, and 
                        diagnosis and treatment of minor, acute, and 
                        chronic medical conditions and Healthy Start 
                        benefits;
                            ``(ii) mental health services, including 
                        crisis intervention, counseling, and emergency 
                        psychiatric care at the school or by referral;
                            ``(iii) the availability of services at the 
                        school when the school is open and 24-hour 
                        coverage through an on-call system with other 
                        providers to ensure access when the school or 
                        health center is closed;
                            ``(iv) services through the use of a 
                        qualified and appropriately credentialed 
                        individual, including a nurse practitioner or 
                        physician assistant, a mental health 
                        professional, a physician, and a health 
                        assistant; and
                    ``(E) may provide optional preventive dental 
                services, consistent with State licensure law, through 
                the use of dental hygienists or dental assistants that 
                provide preventive services such as basic oral exams, 
                cleanings, and sealants.
            ``(3) Supplement not supplant.--A grant awarded under this 
        subsection shall be expended to supplement, and not supplant, 
        the expenditures of the health center and the value of in kind 
        contributions for the delivery of services to the population 
        described in paragraph (1).
            ``(4) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection, in 
        addition to any funds authorized to be appropriated or 
        appropriated for health centers under any other subsection of 
        this section, such sums as may be necessary for each of fiscal 
        years 2009 through 2014.
    ``(t) Residents of Naturally Occurring Retirement Communities, 
Rapidly Aging Communities, Patrons of Multipurpose Senior Centers.--
            ``(1) In general.--The Secretary may award grants for the 
        purposes described in subsections (c), (e), and (f) of this 
        section for the planning and delivery of services to a special 
        medically underserved population comprised of residents of 
        Naturally Occurring Retirement Communities and patrons of 
        multipurpose senior centers and individuals living in areas and 
        facilities immediately accessible to such Naturally Occurring 
        Retirement Communities and such centers.
            ``(2) Supplement not supplant.--A grant awarded under this 
        subsection shall be expended to supplement, and not supplant, 
        the expenditures of the health center and the value of in kind 
        contributions for the delivery of services to the population 
        described in paragraph (1).
            ``(3) Consultation with area agencies on aging.--The 
        Secretary may not make a grant under paragraph (1) unless, with 
        respect to the residents of Naturally Occurring Retirement 
        Communities and patrons of multipurpose senior centers 
        involved, the applicant for the grant--
                    ``(A) has consulted with the Area Agency on Aging 
                in the preparation of the application for the grant; 
                and
                    ``(B) agrees to provide for ongoing consultation 
                with the Area Agency on Aging regarding the planning 
                and administration of the program carried out with the 
                grant.
            ``(4) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection, in 
        addition to any funds authorized to be appropriated or 
        appropriated for health centers under any other subsection of 
        this section, such sums as may be necessary for each of fiscal 
        years 2009 through 2014.
            ``(5) Naturally occurring retirement community and 
        multipurpose senior center defined.--In this subsection, the 
        terms `Naturally Occurring Retirement Community' and 
        `multipurpose senior center' have the meanings given such terms 
        for purposes of the Older Americans Act of 1965 (42 U.S.C. 3001 
        et seq).''.
                                 <all>