[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4537 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 4537

  To amend the Public Health Service Act to improve the provision of 
 mobile medical health care services to certain underserved areas and 
                  populations, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 26, 2019

Ms. Velazquez introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to improve the provision of 
 mobile medical health care services to certain underserved areas and 
                  populations, 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 ``Mobile Health Clinics Act of 2019''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to the Mobile Health Map report, 
        approximately 1,500 mobile health clinics (MHCs) operate 
        nationwide.
            (2) MHCs can effectively provide care in areas where health 
        care infrastructure is limited because of distance, financial 
        capabilities, or inadequate supporting infrastructure, 
        including lack of public transportation resources.
            (3) MHCs can offer services such as primary care, 
        screenings, dental care, medications, behavioral health care, 
        immunizations, laboratory tests, case management, triage, and 
        assistance for public benefit programs.
            (4) MHCs help improve community health and access to 
        medical services in underserved communities across the United 
        States, including urban, rural, and suburban areas.
            (5) Such clinics are cost-effective and help reduce the 
        burden on hospitals, insurers, and government entities managing 
        health programs by providing prevention services, which also 
        reduces unnecessary emergency department visits.
            (6) The average cost of a visit to a provider of mobile 
        medical health care services is significantly lower than the 
        average cost of an emergency department visit. Visiting an MHC 
        instead of the emergency department can result in a cost 
        savings of more than $800 per visit.
            (7) Several studies have shown that the return on 
        investment generated by MHCs ranges from $20 to $36 for every 
        $1 spent.
            (8) MHCs are successful when they engage with other local 
        stakeholders who can provide insight, knowledge, and strategies 
        to help meet public health challenges that are immediately 
        relevant to the communities receiving services from MHC 
        providers.
            (9) Funding has been the largest barrier to the development 
        and maintenance of MHCs and their resources.
            (10) With additional Federal support, health systems would 
        be able to better invest in purchasing, maintaining, and 
        upgrading mobile units, increasing the number of staff, 
        dispensing more medication, and advancing the use of efficient 
        information technology for health purposes.

SEC. 3. IMPROVING ACCESS TO MOBILE MEDICAL HEALTH CARE SERVICES.

    (a) In General.--Subpart I of part D of title III of the Public 
Health Service Act (42 U.S.C. 254b et seq.) is amended by adding at the 
end the following new section:

``SEC. 330N. PARTNERSHIPS TO IMPROVE ACCESS TO MOBILE MEDICAL HEALTH 
              CARE SERVICES.

    ``(a) Authority Established.--
            ``(1) In general.--The Secretary may award grants, 
        contracts, or cooperative agreements to eligible entities to 
        provide mobile medical health care services in accordance with 
        subsection (e).
            ``(2) Limitation.--A hospital or health care facility may 
        not be eligible for a grant, contract, or cooperative agreement 
        under this section with respect to more than one partnership 
        described in subsection (b)(1).
    ``(b) Eligible Entities.--To be eligible for a grant, contract, or 
cooperative agreement under this section, an entity shall--
            ``(1) be a partnership consisting of--
                    ``(A) one or more hospitals; or
                    ``(B) one or more other local health care 
                facilities, including clinics, rural health clinics, 
                federally qualified health centers, health centers, 
                primary care facilities, mental health centers, 
                pharmacies, or other mobile medical assets, without 
                regard to whether or not such a local health care 
                facility is owned (either in whole or in part) by a 
                hospital in a partnership described in subparagraph (A) 
                or another local health care facility as described in 
                this subparagraph; and
            ``(2) provide services for any one of the following:
                    ``(A) A medically underserved community (as defined 
                in section 799B(6)).
                    ``(B) A medically underserved population (as 
                defined in section 330(b)(3)).
    ``(c) Application.--An eligible entity seeking funding under this 
section shall submit to the Secretary an application at such time, in 
such manner, and containing such information as the Secretary may 
require, including, at a minimum, the following:
            ``(1) A long-term strategy and detailed implementation plan 
        developed in consultation with community groups and appropriate 
        stakeholders.
            ``(2) A demonstration of a specific public health need that 
        is relevant to a community or population described in 
        subsection (b)(2).
            ``(3) A description of the services that the entity will 
        provide directly with funds under this section, and, if 
        applicable, a description of the services that the eligible 
        entity will provide indirectly with such funds through 
        contracts or cooperative agreements.
            ``(4) An explanation of the entity's inability to address 
        the need in paragraph (2) without Federal assistance.
            ``(5) An identification of any related governmental or 
        community initiative that compliments or will be coordinated 
        with the long-term strategy and detailed implementation plan 
        required under paragraph (1).
            ``(6) A plan detailing the methodologies that will be used 
        to evaluate the access and quality of mobile medical health 
        care services provided by the entity to a community or 
        population described in subsection (b)(2).
            ``(7) A description of community outreach mechanisms that 
        the entity will employ to ensure the participation of a 
        community or population described in subsection (b)(2).
            ``(8) An identification of best practices for treatment, 
        outreach, and data collection that the entity will employ to 
        track program participation and program effectiveness.
            ``(9) A plan for providing mobile medical health care 
        services to individuals of limited English-speaking ability. 
        Such plan shall--
                    ``(A) take into account data from the Bureau of the 
                Census and previously documented qualitative or 
                quantitative observations from community service 
                providers offering health care services in the areas in 
                which the entity will provide mobile medical health 
                care services; and
                    ``(B) outline which languages are most prevalent 
                and commonly requested for translation services in such 
                areas.
            ``(10)(A) Subject to subparagraph (B), an assurance that, 
        if the entity receives a grant, contract, or cooperative 
        agreement or a renewal of such grant, contract, or cooperative 
        agreement under this section, the entity will develop a plan to 
        secure other public or private funding resources to ensure the 
        continued operation and maintenance of mobile medical health 
        care services provided under this section after funds under 
        such grant, contract, or cooperative agreement, or renewal, are 
        no longer available.
            ``(B) The Secretary shall waive the requirement under 
        subparagraph (A) for the entity if the entity demonstrates that 
        complying with such requirement would create an undue burden 
        and result in significant disruption of the provision of mobile 
        medical health care services.
            ``(11) Any additional information required by the 
        Secretary.
    ``(d) Requirements.--
            ``(1) Amount.--A grant contract, or cooperative agreement 
        awarded under this section may not exceed $750,000.
            ``(2) Duration.--A grant, contract, or cooperative 
        agreement awarded under this section shall be for a period of 3 
        years.
            ``(3) Renewals.--
                    ``(A) In general.--The Secretary may renew a grant, 
                contract, or cooperative agreement awarded under this 
                section with respect to an eligible entity if the 
                entity--
                            ``(i) submits to the Secretary an 
                        application for renewal at such time, in such 
                        manner, and containing such information as the 
                        Secretary may require; and
                            ``(ii) demonstrates in such application 
                        that--
                                    ``(I) grant, contract, or 
                                cooperative agreement funds made 
                                available to the entity were used in a 
                                manner required under the most recently 
                                approved application of the entity 
                                under this section; and
                                    ``(II) the entity has made 
                                significant progress in achieving the 
                                objectives of the initial application 
                                approved for the entity under this 
                                section.
                    ``(B) Duration.--An initial renewal for an eligible 
                entity under subparagraph (A) shall, at a minimum, be 
                for a period of 2 years. Any subsequent renewal for 
                such an entity shall be for a period of 1 year.
    ``(e) Use of Funds.--A grant, contract, or cooperative agreement 
awarded under this section may be expended for--
            ``(1) purchases of mobile medical health care service 
        vehicles;
            ``(2) maintenance or upgrade of mobile medical health care 
        service vehicles;
            ``(3) hiring of casework staff, physicians, practitioners, 
        pharmacists, nursing personnel, or similar medical 
        professionals;
            ``(4) hiring and professional development of 
        administrative, oversight, clerical, or other support staff 
        managing the operations or care provided by mobile medical 
        health care service vehicles;
            ``(5) professional development, including appropriate 
        training for medical professionals specified in paragraph (3);
            ``(6) distributing or dispensing prescriptions;
            ``(7) advancing the use of information technology for 
        treatment purposes, including the employment of appropriate 
        staff required for maintenance to ensure the secure and stable 
        operations of computers, servers, and other appropriate 
        information technology infrastructure; and
            ``(8) increasing access of medically underserved 
        communities (as defined in section 799B(6)) or medically 
        underserved populations (as defined in section 330(b)(3)) to 
        mobile medical health care services, including required primary 
        health services (as defined in section 330(b)(1)), substance 
        use disorder services (as defined in section 330(h)(5)(C)), and 
        mental health counseling.
    ``(f) Supplement, Not Supplant, Requirement.--A grant, contract, or 
cooperative agreement awarded under this section shall be expended to 
supplement, and not supplant, the expenditures of the eligible entity 
involved and the value of in-kind contributions for the delivery of 
services to medically underserved communities or medically underserved 
populations.
    ``(g) Annual Report.--An eligible entity that receives funds under 
this section during a fiscal year shall submit to the Secretary, on a 
date specified by the Secretary, an annual report detailing the 
progress in addressing the public health need specified in subsection 
(c)(2).
    ``(h) Mobile Medical Health Care Service Defined.--In this section, 
the term `mobile medical health care service' means any health care-
related service provided in a moveable vehicle or a non-permanent 
clinic.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $15,000,000 for fiscal year 2020 
and each succeeding fiscal year.''.
    (b) Rulemaking.--Not later than the date that is one year after the 
date of enactment of this Act, the Secretary of Health and Human 
Services shall, through notice and comment rulemaking, establish--
            (1) a process for awarding grants, contract, and 
        cooperative agreement including renewing and terminating 
        grants, contract, and cooperative agreement under section 330N 
        of the Public Health Service Act, as added by subsection (a);
            (2) benchmarks for measuring significant progress as 
        described in subsection (d)(3)(A)(ii)(II) of such section; and
            (3) a process for providing entities described in such 
        section a fair hearing and appellate review regarding any 
        decision by the Secretary to renew or terminate a grant, 
        contract, or cooperative agreement under such section.
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