[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7546 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 7546

  To direct the Secretary of Health and Human Services to ensure that 
  minority and medically underserved communities have meaningful and 
immediate access to public health interventions and medically necessary 
   health care services during the COVID-19 pandemic, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 9, 2020

  Mr. Lewis introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, 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 direct the Secretary of Health and Human Services to ensure that 
  minority and medically underserved communities have meaningful and 
immediate access to public health interventions and medically necessary 
   health care services during the COVID-19 pandemic, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Minority Community 
Public Health Emergency Response Act of 2020''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
                 TITLE I--RAPID RESPONSE GRANT PROGRAM

Sec. 101. Rapid response grant program.
         TITLE II--EQUALITY IN MEDICARE AND MEDICAID TREATMENT

Sec. 201. Improving access to care for Medicare and Medicaid 
                            beneficiaries.

                 TITLE I--RAPID RESPONSE GRANT PROGRAM

SEC. 101. RAPID RESPONSE GRANT PROGRAM.

    Title XXVIII of the Public Health Service Act (42 U.S.C. 300hh et 
seq.) is amended by adding at the end the following new subtitle:

                      ``Subtitle D--Rapid Response

``SEC. 2831. RAPID RESPONSE GRANT PROGRAM.

    ``(a) Establishment of Program.--The Secretary of Health and Human 
Services shall award grants to eligible entities described in 
subsection (b) for COVID-19 preparedness and response efforts.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall be a qualified government entity seeking 
a grant for a qualified community within its jurisdiction that--
            ``(1) is, or contains, a medically underserved community; 
        and
            ``(2) has a percentage of COVID-19 cases, hospitalizations, 
        or deaths for any racial and ethnic minority group that is 
        greater than the percentage of such cases in the State or 
        county in which the community is located.
    ``(c) Application.--To be eligible for a grant under this section, 
an eligible entity shall submit to the Secretary an application at such 
time, in such form, and containing such information as the Secretary 
determines appropriate, including--
            ``(1) documentation that the entity is an eligible entity;
            ``(2) a plan for carrying out the activities described in 
        subsection (f) with amounts received under this section;
            ``(3) an oversight plan for tracking and security of 
        resources and supplies; and
            ``(4) a schedule for resource expenditure and response 
        readiness.
    ``(d) Certification.--Prior to awarding a grant under this section, 
the Secretary shall obtain a certification from the Deputy Assistant 
Secretary for Minority Health, the Deputy Assistant Secretary for 
Women's Health, and the Director of the Office of Rural Health Policy 
that the application involved addresses health disparities and social 
determinants of health as appropriate for populations to be cared for 
through the grant.
    ``(e) Priority.--In making grants under this section, the Secretary 
shall give priority to eligible entities that are local governments and 
county health departments.
    ``(f) Grant Uses.--A recipient of a grant under this section may 
use grant funds with respect to COVID-19 preparedness and rapid 
response efforts for any of the following:
            ``(1) Purchasing medical supplies.
            ``(2) Providing nutrition assistance.
            ``(3) Warehousing stockpiled supplies, including rent and 
        security costs.
            ``(4) Constructing and operating testing sites.
            ``(5) Providing quarantine housing.
            ``(6) Providing public education related to the pandemic, 
        including misinformation response.
            ``(7) Contact tracing.
            ``(8) Providing vaccinations.
            ``(9) Distributing, dispensing, and administering antiviral 
        medications.
            ``(10) Providing community mitigation.
            ``(11) Performing laboratory epidemiology.
            ``(12) Performing surveillance.
    ``(g) Reporting.--
            ``(1) Grant recipients.--Not later than 1 month after the 
        date of enactment of this subtitle, 6 months after such date of 
        enactment, and 1 year after such date of enactment, and 
        annually thereafter, the recipient of a grant under this 
        section shall report to the Secretary on the program funded 
        through the grant, with respect to--
                    ``(A) program oversight as described in subsection 
                (c)(3);
                    ``(B) delays in funding expenditures; and
                    ``(C) resource distribution.
            ``(2) Secretary.--Not later than 6 months after the date of 
        enactment of this subtitle and 1 year after such date of 
        enactment, and annually thereafter, the Secretary shall report 
        to the Congress on the programs funded by grants under this 
        section, with respect to--
                    ``(A) program oversight as described in subsection 
                (c)(3); and
                    ``(B) unmet needs in grant recipient pandemic 
                response infrastructure.

``SEC. 2832. PLANNING GRANT PROGRAM.

    ``(a) In General.--The Secretary may award a planning grant to any 
entity that certifies that--
            ``(1) it is an eligible entity under section 2831(b); and
            ``(2) it intends to submit to the Secretary an application 
        for a grant under section 2831.
    ``(b) Use of Funds.--Any grant awarded under this section, for 
purposes of developing an application for a grant under section 2831, 
shall be used to--
            ``(1) identify community needs to rapidly and effectively 
        respond to the COVID-19 pandemic;
            ``(2) estimate the cost of such a response and maintaining 
        a state of readiness; and
            ``(3) hire staff to carry out paragraphs (1) and (2).
    ``(c) Timing.--Not later than 30 days after receipt of an 
application for an award under this section, the Secretary shall 
determine whether to award the grant.
    ``(d) Funding Condition.--As a condition on receipt of a planning 
grant under this section, an applicant shall agree to submit to the 
Secretary an application for a grant under section 2831 no later than 
90 days after receiving the planning grant.

``SEC. 2833. COMMUNITY INFECTIOUS DISEASE HEALTH SERVICES PLANNING 
              COUNCIL.

    ``(a) Establishment.--To be eligible for assistance under this 
subtitle, the chief elected official of the qualified government entity 
applying for such assistance shall establish or designate a COVID-19/
infectious disease health services planning council (in this section 
referred to as a `COVID-19/infectious disease health services planning 
council') that shall reflect in its composition the demographics of the 
populations of individuals with COVID-19 and other infectious diseases 
in the qualified community involved, with particular consideration 
given to disproportionately affected and historically underserved 
groups and subpopulations.
    ``(b) Selection Criteria.--Nominations for membership on a COVID-
19/infectious disease health services planning council shall be 
identified through an open process and candidates shall be selected 
based on locally delineated and publicized criteria. Such criteria 
shall include a conflict-of-interest standard that is in accordance 
with subsection (f).
    ``(c) Representation.--A COVID-19/infectious disease health 
services planning council--
            ``(1) shall include representatives of--
                    ``(A) health care providers, including federally 
                qualified health centers;
                    ``(B) community-based organizations serving 
                affected populations and AIDS service organizations;
                    ``(C) social service providers, including providers 
                of housing and homeless services;
                    ``(D) mental health and substance abuse providers;
                    ``(E) local public health agencies;
                    ``(F) hospital planning agencies or health care 
                planning agencies;
                    ``(G) affected communities, including--
                            ``(i) individuals with COVID-19 or another 
                        infectious disease designated by the council as 
                        having a disproportionate effect on a racial 
                        and ethnic minority group;
                            ``(ii) members of a federally recognized 
                        Indian Tribe as represented in the affected 
                        communities; and
                            ``(iii) historically underserved groups and 
                        subpopulations;
                    ``(H) nonelected community leaders;
                    ``(I) State government (including the State 
                Medicaid agency);
                    ``(J) grantees under this subtitle, or, if none are 
                operating in the area, representatives of organizations 
                with a history of serving children, youth, women, and 
                families living with COVID-19 or other infectious 
                diseases and operating in the area;
                    ``(K) grantees who receive funding from other 
                Federal COVID-19 or other infectious disease programs; 
                and
                    ``(L) representatives of individuals who formerly 
                were Federal, State, or local prisoners, were released 
                from the custody of the penal system during the 
                preceding 3 years, and had COVID-19 or another 
                infectious disease as of the date on which the 
                individuals were so released; and
            ``(2) to the extent possible, shall include individuals who 
        have had COVID-19.
    ``(d) Method of Providing for Council.--
            ``(1) In general.--In providing for a council for purposes 
        of subsection (a), a chief elected official of a qualified 
        government entity receiving a grant under this subtitle may 
        establish the council directly or designate an existing entity 
        to serve as the council, subject to paragraph (2).
            ``(2) Consideration regarding designation of council.--In 
        making a determination of whether to establish or designate a 
        council under paragraph (1), a chief elected official of a 
        qualified government entity receiving a grant under this 
        subtitle shall give priority to the designation of an existing 
        entity that has demonstrated experience in planning for the 
        COVID-19 and other infectious diseases health care service 
        needs within the qualified community and in the implementation 
        of such plans in addressing those needs. Any existing entity so 
        designated shall be expanded to include a broad representation 
        of the full range of entities that provide such services within 
        the geographic area to be served.
    ``(e) Duties.--A COVID-19/infectious disease health services 
planning council shall--
            ``(1) determine the size and demographics of the population 
        of individuals who have or had COVID-19 or other infectious 
        disease, as well as the size and demographics of the estimated 
        population of individuals with COVID-19 or other infectious 
        disease who are unaware of their COVID-19 or other infectious 
        disease status;
            ``(2) determine the needs of such population, with 
        particular attention to--
                    ``(A) individuals who have or had COVID-19 or other 
                infectious disease and are not receiving health care 
                with respect to COVID-19 or such disease;
                    ``(B) disparities in access and services among 
                affected subpopulations and historically underserved 
                communities; and
                    ``(C) individuals who are unaware that such 
                individual has or had COVID-19 or other infectious 
                disease;
            ``(3) establish priorities for the allocation of funds 
        within the qualified community, including how best to meet each 
        such priority and additional factors that a grantee should 
        consider in allocating funds under a grant based on the--
                    ``(A) size and demographics of the population of 
                individuals who have or had COVID-19 (as determined 
                under paragraph (1)) or other infectious disease and 
                the needs of such population (as determined under 
                paragraph (2));
                    ``(B) demonstrated (or probable) cost effectiveness 
                and outcome effectiveness of proposed strategies and 
                interventions, to the extent that data are reasonably 
                available;
                    ``(C) priorities of the communities of individuals 
                who have or had COVID-19 or other infectious disease 
                for whom the services are intended;
                    ``(D) availability of other governmental and 
                nongovernmental resources, including the State Medicaid 
                plan under title XIX of the Social Security Act and the 
                State Children's Health Insurance Program under title 
                XXI of such Act to cover health care costs of eligible 
                individuals and families with respect to COVID-19 or 
                other infectious disease; and
                    ``(E) capacity development needs resulting from 
                disparities in the availability of COVID-19 or other 
                infectious disease-related services in historically 
                underserved communities;
            ``(4) develop a comprehensive plan for the organization and 
        delivery of health and support services described in section 
        2831 that--
                    ``(A) includes a strategy for identifying 
                individuals who have or had COVID-19 or other 
                infectious disease and for informing the individuals of 
                and enabling the individuals to utilize the services, 
                giving particular attention to eliminating disparities 
                in access and services among affected subpopulations 
                and historically underserved communities, and including 
                discrete goals, a timetable, and an appropriate 
                allocation of funds;
                    ``(B) includes a strategy to coordinate the 
                provision of such services with programs to prevent the 
                spread of COVID-19 or other infectious disease;
                    ``(C) is compatible with any State or local plan 
                for the provision of services to individuals who have 
                COVID-19 or other infectious disease; and
                    ``(D) includes a strategy, coordinated as 
                appropriate with other community strategies and 
                efforts, including discrete goals, a timetable, and 
                appropriate funding, for identifying individuals who 
                have COVID-19 or other infectious disease or who are 
                unaware that such individuals have COVID-19 or other 
                infectious disease, making such individuals aware of 
                such status, and enabling such individuals to use the 
                health and support services described in section 2831, 
                with particular attention to reducing barriers to 
                routine testing and disparities in access and services 
                among affected subpopulations and historically 
                underserved communities;
            ``(5) assess the efficiency of the administrative mechanism 
        in rapidly allocating funds to the areas of greatest need 
        within the qualified community, and at the discretion of a 
        COVID-19/infectious disease health services planning council, 
        assess the effectiveness, either directly or through 
        contractual arrangements, of the services offered in meeting 
        the identified needs;
            ``(6) establish methods for obtaining input on community 
        needs and priorities which may include public meetings (in 
        accordance with subsection (h)), conducting focus groups, and 
        convening ad-hoc panels; and
            ``(7) coordinate with Federal grantees that provide COVID-
        19 or other infectious disease-related services in the 
        qualified community.
    ``(f) Conflicts of Interest.--
            ``(1) In general.--A COVID-19/infectious disease health 
        services planning council may not be directly involved in the 
        administration of a grant under this subtitle. With respect to 
        compliance with the preceding sentence, a COVID-19/infectious 
        disease health services planning council may not designate (or 
        otherwise be involved in the selection of) particular entities 
        as recipients of any of the amounts provided in the grant.
            ``(2) Required agreements.--An individual may serve on a 
        COVID-19/infectious disease health services planning council 
        only if the individual agrees that if the individual has a 
        financial interest in an entity, if the individual is an 
        employee of a public or private entity, or if the individual is 
        a member of a public or private organization, and such entity 
        or organization is seeking amounts from a grant under this 
        subtitle, the individual will not, with respect to the purpose 
        for which the entity seeks such amounts, participate (directly 
        or in an advisory capacity) in the process of selecting 
        entities to receive such amounts for such purpose.
            ``(3) Composition of council.--The following applies 
        regarding the membership of a COVID-19/infectious disease 
        health services planning council:
                    ``(A) Not less than 33 percent of the council shall 
                be individuals who--
                            ``(i) are not officers, employees, or 
                        consultants to any entity that receives amounts 
                        from such a grant, and do not represent any 
                        such entity; and
                            ``(ii) reflect the demographics of the 
                        population of individuals who have COVID-19 or 
                        other infectious diseases as determined under 
                        subsection (e)(1).
                    ``(B) With respect to membership on a COVID-19/
                infectious disease health services planning council, 
                subparagraph (A) may not be construed as having any 
                effect on entities that receive any Federal funds with 
                respect to COVID-19 or other infectious disease but do 
                not receive funds from grants under section 2831, on 
                officers or employees of such entities, or on 
                individuals who represent such entities.
    ``(g) Grievance Procedures.--A COVID-19/infectious disease health 
services planning council shall develop procedures for addressing 
grievances with respect to funding under this subtitle, including 
procedures for submitting grievances that cannot be resolved to binding 
arbitration. Such procedures shall be described in the by-laws of a 
COVID-19/infectious disease health services planning council and be 
consistent with the requirements of subsection (c).
    ``(h) Public Deliberations.--With respect to a planning council 
under subsection (a), the following applies:
            ``(1) The council may not be chaired solely by an employee 
        of the grantee under this subtitle.
            ``(2) In accordance with criteria established by the 
        Secretary:
                    ``(A) The meetings of the council shall be open to 
                the public and shall be held only after adequate notice 
                to the public.
                    ``(B) The records, reports, transcripts, minutes, 
                agenda, or other documents which were made available to 
                or prepared for or by the council shall be available 
                for public inspection and copying at a single location.
                    ``(C) Detailed minutes of each meeting of the 
                council shall be kept. The accuracy of all minutes 
                shall be certified to by the chair of the council.
                    ``(D) This paragraph does not apply to any 
                disclosure of information of a personal nature that 
                would constitute a clearly unwarranted invasion of 
                personal privacy, including any disclosure of medical 
                information or personnel matters.

``SEC. 2834. DEFINITIONS.

    ``In this subtitle:
            ``(1) Medically underserved community.--The term `medically 
        underserved community' has the meaning given the term in 
        section 799B(6).
            ``(2) Qualified community.--The term `qualified community' 
        means either of the following:
                    ``(A) A political subdivision of a State.
                    ``(B) A group of political subdivisions of one or 
                more States.
            ``(3) Qualified government entity.--The term `qualified 
        government entity' means any of the following:
                    ``(A) A State.
                    ``(B) A political subdivision of a State.
                    ``(C) A group of political subdivisions of one or 
                more States.
                    ``(D) A county health department.
            ``(4) Racial and ethnic minority group.--The term `racial 
        and ethnic minority group' has the meaning given the term in 
        section 1707(g).
            ``(5) Secretary.--The term `Secretary' means the Secretary 
        of Health and Human Services.
            ``(6) State.--The term `State' means each of the several 
        States, the District of Columbia, and the territories and 
        possessions of the United States.

``SEC. 2835. AUTHORIZATION OF APPROPRIATION.

    ``There is authorized to be appropriated to carry out this subtitle 
$1,000,000,000, to remain available until expended.''.

         TITLE II--EQUALITY IN MEDICARE AND MEDICAID TREATMENT

SEC. 201. IMPROVING ACCESS TO CARE FOR MEDICARE AND MEDICAID 
              BENEFICIARIES.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a) is 
amended--
            (1) in subsection (a)(3)--
                    (A) by inserting after ``relevant Federal 
                agencies,'' the following: ``including the Office of 
                Minority Health of the Centers for Medicare & Medicaid 
                Services, the Office of Rural Health Policy of the 
                Health Resources and Services Administration, and the 
                Office on Women's Health in the Office of the 
                Secretary,''; and
                    (B) by inserting after ``medicine'' the following: 
                ``, the causes of health disparities and social 
                determinants of health,'';
            (2) in subsection (b)--
                    (A) in paragraph (2)--
                            (i) in subparagraph (A)--
                                    (I) by inserting after the first 
                                sentence, the following new sentence: 
                                ``Prior to model selection, the 
                                Secretary shall consult with the Office 
                                of Minority Health of the Centers for 
                                Medicare & Medicaid Services, the 
                                Federal Office of Rural Health Policy, 
                                and the Office on Women's Health to 
                                ensure that models under consideration 
                                address health disparities and social 
                                determinants of health as appropriate 
                                for populations to be cared for under 
                                the model.'';
                                    (II) by inserting ``, as well as 
                                improving access to care received by 
                                individuals receiving benefits under 
                                such title,'' after ``title''; and
                                    (III) by adding at the end the 
                                following new sentence: ``The models 
                                selected under this subparagraph shall 
                                include the social determinants of 
                                health payment model described in 
                                subparagraph (D), the testing of which 
                                shall begin not later than December 31, 
                                2020.'';
                            (ii) in subparagraph (C), by adding at the 
                        end the following new clauses:
                            ``(ix) Whether the model will affect access 
                        to care from providers and suppliers caring for 
                        high-risk patients or operating in underserved 
                        areas.
                            ``(x) Whether the model has the potential 
                        to produce reductions in minority and rural 
                        health disparities.''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
                    ``(D) Social determinants of health payment 
                model.--
                            ``(i) In general.--The social determinants 
                        of health payment model described in this 
                        subparagraph is a payment model that tests each 
                        of the payment and service delivery innovations 
                        described in clause (ii) in a region determined 
                        appropriate by the Secretary.
                            ``(ii) Payment and service delivery 
                        innovations described.--For purposes of clause 
                        (i), the payment and service delivery 
                        innovations described in this clause are the 
                        following:
                                    ``(I) Payment and service delivery 
                                innovations for behavioral health 
                                services, focusing on gathering 
                                actionable data to address the higher 
                                costs associated with beneficiaries 
                                with diagnosed behavioral conditions.
                                    ``(II) Payment and service delivery 
                                innovations targeting conditions or 
                                comorbidities of individuals entitled 
                                or enrolled under the Medicare program 
                                under title XVIII and enrolled under a 
                                State plan under the Medicaid program 
                                under title XIX to increase capacity in 
                                underserved areas.
                                    ``(III) Payment and service 
                                delivery innovations targeted on 
                                Medicaid-eligible pregnant and 
                                postpartum women, up to one year after 
                                delivery.
                                    ``(IV) Payment and service delivery 
                                innovations targeted on communities 
                                where a percentage of COVID-19 cases, 
                                hospitalizations, or deaths for any 
                                racial or ethnic minority group that is 
                                greater than the percentage of such 
                                cases in the State or county in which 
                                the community is located.''; and
                    (B) in paragraph (4)(A)--
                            (i) in clause (i) at the end, by striking 
                        ``and'';
                            (ii) in clause (ii), at the end, by 
                        striking the period and inserting ``; and''; 
                        and
                            (iii) by adding at the end the following 
                        new clause:
                            ``(iii) the extent to which the model 
                        improves access to care or the extent to which 
                        the model improves care for high-risk patients, 
                        patients from racial or ethnic minorities, or 
                        patients in underserved areas.'';
            (3) in subsection (c)--
                    (A) in paragraph (2), by striking at the end 
                ``and'';
                    (B) by redesignating paragraph (3) as paragraph 
                (4);
                    (C) by inserting after paragraph (2) the following 
                new paragraph:
            ``(3) the Office of Minority Health of the Centers for 
        Medicare & Medicaid Services certifies that such expansion will 
        not reduce access to care for low-income, minority, or rural 
        beneficiaries; and'';
                    (D) in paragraph (4), as redesignated by 
                subparagraph (B), by inserting before the period at the 
                end the following: ``nor increase health disparities 
                experienced by low-income, minority, or rural 
                beneficiaries''; and
                    (E) in the matter following paragraph (4), as 
                redesignated by subparagraph (B), by inserting ``, 
                improve access to care,'' after ``care''; and
            (4) in subsection (g)--
                    (A) by inserting ``(or, beginning with 2021, once 
                every year thereafter)'' after ``thereafter''; and
                    (B) by adding at the end the following new 
                sentence: ``For reports for 2021 and each subsequent 
                year, each such report shall include information on the 
                following:
            ``(1) The extent and severity of minority and rural health 
        disparities in Medicare and Medicaid beneficiaries.
            ``(2) The interventions that address social determinants of 
        health in payment models selected by the Center for Medicare 
        and Medicaid Innovation for testing.
            ``(3) The interventions that address social determinants of 
        health in payment models not selected by the Center for 
        Medicare and Medicaid Innovation for testing.
            ``(4) The effectiveness of interventions in mitigating 
        negative health outcomes and higher costs associated with 
        social determinants of health within models selected by the 
        Center for Medicare and Medicaid Innovation for testing.
            ``(5) Changes in disparities among minorities and Medicare 
        and Medicaid beneficiaries in underserved areas that are 
        attributable to provider and supplier participation in a Phase 
        II model.
            ``(6) In consultation with the Comptroller General of the 
        United States, estimated Federal savings achieved through the 
        reduction of rural and minority health disparities.
            ``(7) Other areas determined appropriate by the 
        Secretary.''.
                                 <all>