[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1609 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1609

 To require the Secretary of Health and Human Services to establish a 
  demonstration program to award grants to, and enter into contracts 
with, medical-legal partnerships to assist patients and their families 
          to navigate health-related programs and activities.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 22, 2011

  Mr. Harkin (for himself, Mr. Leahy, and Mr. Inouye) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To require the Secretary of Health and Human Services to establish a 
  demonstration program to award grants to, and enter into contracts 
with, medical-legal partnerships to assist patients and their families 
          to navigate health-related programs and activities.

    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 ``Medical-Legal Partnership for Health 
Act''.

SEC. 2. FINDINGS; PURPOSE.

    (a) Findings.--Congress finds the following:
            (1) Numerous studies and reports, including the annual 
        National Healthcare Disparities Report and Unequal Treatment, 
        the 2002 Institute of Medicine Report, document the 
        extensiveness to which vulnerable populations suffer from 
        health disparities across the country.
            (2) These studies have found that, on average, racial and 
        ethnic minorities and low-income populations are 
        disproportionately afflicted with chronic and acute conditions 
        such as asthma, cancer, diabetes, and hypertension and suffer 
        worse health outcomes, worse health status, and higher 
        mortality rates.
            (3) Several recent studies also show that health and 
        healthcare quality are a function of not only access to 
        healthcare, but also the social determinants of health, 
        including the environment, the physical structure of 
        communities, socio-economic status, nutrition, educational 
        attainment, employment, race, ethnicity, geography, and 
        language preference, that directly and indirectly affect the 
        health, healthcare, and wellness of individuals and 
        communities.
            (4) Formally integrating medical and legal professionals in 
        the health setting can more effectively address the health 
        needs of vulnerable populations and ultimately reduce health 
        disparities.
            (5) All over the United States, healthcare providers who 
        take care of low-income individuals and families are partnering 
        with legal professionals to assist them in providing better 
        quality of healthcare.
            (6) Medical-legal partnerships integrate lawyers in a 
        health setting to help patients navigate the complex 
        government, legal, and service systems in addressing social 
        determinants of health, such as income supports for food 
        insecure families and mold removal from the home of asthmatics.
    (b) Purposes.--The purposes of this Act are to--
            (1) support and advance opportunity for medical-legal 
        partnerships to be more fully integrated in healthcare settings 
        nationwide;
            (2) to improve the quality of care for vulnerable 
        populations by reducing health disparities among health 
        disparities populations and addressing the social determinants 
        of health; and
            (3) identify and develop cost-effective strategies that 
        will improve patient outcomes and realize savings for 
        healthcare systems.

SEC. 3. MEDICAL-LEGAL PARTNERSHIPS.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a nationwide demonstration project consisting of--
            (1) awarding grants to, and entering into contracts with, 
        medical-legal partnerships to assist patients and their 
        families to navigate programs and activities; and
            (2) evaluating the effectiveness of such partnerships.
    (b) Technical Assistance.--The Secretary may, directly or through 
grants or contracts, provide technical assistance to grantees under 
subsection (a)(1) to support the establishment and sustainability of 
medical-legal partnerships. Not to exceed 5 percent of the amount 
appropriated to carry out this section in a fiscal year may be used for 
purposes of this subsection.
    (c) Funding.--
            (1) Use of funds.--Amounts received as a grant or pursuant 
        to a contract under this section shall be used to assist 
        patients and their families to navigate health-related programs 
        and activities for purposes of achieving one or more of the 
        following goals:
                    (A) Enhancing access to healthcare services.
                    (B) Improving health outcomes for low-income 
                individuals, as defined in subsection (g).
                    (C) Reducing health disparities among health 
                disparities populations.
                    (D) Enhancing wellness and prevention of chronic 
                conditions and other health problems.
                    (E) Reducing cost of care to the healthcare system.
                    (F) Addressing the social determinants of health.
                    (G) Addressing situational contributing factors.
            (2) Authorization of appropriations.--There are authorized 
        to be appropriated to carry out this section such sums as may 
        be necessary, but not to exceed $10,000,000, for each of the 
        fiscal years 2012 through 2016.
            (3) Matching requirement.--For each fiscal year, the 
        Secretary may not award a grant or contract under this section 
        to an entity unless the entity agrees to make available non-
        Federal contributions (which may include in-kind contributions) 
        toward the costs of a grant or contract awarded under this 
        section in an amount that is not less than $1 for each $10 of 
        Federal funds provided under the grant or contract.
            (4) Allocation.--Of the amounts appropriated pursuant to 
        paragraph (2) for a fiscal year, the Secretary may obligate not 
        more than 5 percent for the administrative expenses of the 
        Secretary in carrying out this section.
    (d) Eligible Entities.--To be eligible to receive a grant or 
contract under this section, an entity shall--
            (1) be an organization experienced in bridging the medical 
        and legal professions on behalf of vulnerable populations 
        nationally; and
            (2) submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require, including information demonstrating that the 
        applicant has experience in bridging the medical and legal 
        professions or a strategy or plan for cultivating and building 
        medical-legal partnerships.
    (e) Prohibitions.--No funds under this section may be used--
            (1) for any medical malpractice action or proceeding;
            (2) to provide any support to an alien who is not--
                    (A) a qualified alien (as defined in section 431 of 
                the Immigration and Nationality Act);
                    (B) a nonimmigrant under the Immigration and 
                Nationality Act; or
                    (C) an alien who is paroled into the United States 
                under section 212(d)(5) of such Act for less than one 
                year;
            (3) to provide legal assistance with respect to any 
        proceeding or litigation which seeks to procure an abortion or 
        to compel any individual or institution to perform an abortion, 
        or assist in the performance of an abortion; or
            (4) to initiate or participate in a class action lawsuit.
    (f) Reports.--
            (1) Final report by secretary.--Not later than 6 months 
        after the date of the completion of the demonstration program 
        under this section, the Secretary 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) a description of the extent to which 
                        medical-legal partnerships funded through this 
                        section achieved the goals described in 
                        subsection (b);
                            (ii) quantitative and qualitative analysis 
                        of baseline and benchmark measures; and
                            (iii) 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 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 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.
    (g) Definitions.--In this section:
            (1) The term ``health disparities populations'' has the 
        meaning given such term in section 485E(d) of the Public Health 
        Service Act.
            (2) The term ``low-income individuals'' refers to the 
        population of individuals and families who earn up to 200 
        percent of the Federal poverty level.
            (3) The term ``medical-legal partnership'' means an 
        entity--
                    (A) that is a partnership between--
                            (i) a community health center, public 
                        hospital, children's hospital, or other 
                        provider of healthcare services to a 
                        significant number of low-income beneficiaries; 
                        and
                            (ii) one or more legal professionals; and
                    (B) whose primary mission is to assist patients and 
                their families navigate health-related programs, 
                activities, and services through the provision of 
                relevant civil legal assistance on-site in the 
                healthcare setting involved, in conjunction with 
                regular training for healthcare staff and providers 
                regarding the connections between legal interventions, 
                social determinants, and health of low-income 
                individuals.
            (4) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
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