[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2721 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  1st Session
                                S. 2721

    To reduce violence and health disparities by addressing social 
    determinants of health, enhancing health care recruitment, and 
 improving the delivery of quality, coordinated care services, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 28, 2019

  Mr. Durbin introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
    To reduce violence and health disparities by addressing social 
    determinants of health, enhancing health care recruitment, and 
 improving the delivery of quality, coordinated care services, 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 ``Healing Communities through Health 
Care Act''.

SEC. 2. MEDICAID HOUSING AND HOSPITAL DEMONSTRATION PROJECT.

    (a) Authority.--Not later than 1 year after the date of enactment 
of this Act, the Secretary shall select States to conduct demonstration 
projects under title XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) to test innovative partnership programs between housing agencies 
and programs, hospitals and health systems, and community-based 
organizations, to establish screening, referral, and supportive housing 
programs for individuals with behavioral health needs who are 
experiencing housing insecurity, that account for disproportionately 
high rates of emergency room visits and associated Medicaid spending.
    (b) Requirements.--
            (1) Number of projects.--The Secretary shall select not 
        less than 6 States to conduct demonstration projects under this 
        section.
            (2) Eligibility.--In order to be eligible to conduct a 
        demonstration project under this section, a State shall 
        demonstrate the following:
                    (A) The State has or will establish sufficient 
                processes for furnishing supportive housing services 
                under the State Medicaid program, working with managed 
                care organizations as applicable in the State, for 
                Medicaid-eligible individuals described in subsection 
                (a).
                    (B) The State Medicaid program has procedures in 
                place to coordinate care and services for Medicaid-
                eligible individuals described in subsection (a), 
                including those with behavioral health needs, across 
                settings, as appropriate, which may include with law 
                enforcement, hospitals and health systems, housing 
                authorities or agencies, mental health and substance 
                use treatment facilities, and community-based 
                organizations.
            (3) Priority.--In selecting States under this section, the 
        Secretary shall give priority to States with large urban 
        populations in which there are existing programs that deliver 
        housing, case management and service coordination, and 
        establishment of screening and referral processes in health 
        care settings, including programs that utilize public hospitals 
        and flexible housing pools to serve individuals who are 
        experiencing housing insecurity or have behavioral health 
        needs.
            (4) Duration.--Each demonstration project under this 
        section shall be conducted for a period of not less than 4 
        years.
    (c) Payment for Services Furnished Under Demonstration Project.--
            (1) In general.--Subject to paragraph (2), amounts expended 
        by a State under a demonstration project under this section on 
        supportive housing services for Medicaid-eligible individuals 
        described in subsection (a) shall be treated as medical 
        assistance for purposes of section 1903(a) of the Social 
        Security Act (42 U.S.C. 1396b(a)).
            (2) Limitation on federal funding.--
                    (A) In general.--The total amount certified by the 
                Secretary under title XIX of the Social Security Act 
                (42 U.S.C. 1396 et seq.) for payment to a State with 
                respect to expenditures described in paragraph (1) 
                shall not exceed the amount allocated to the State by 
                the Secretary under subparagraph (B).
                    (B) Allocation.--
                            (i) In general.--The Secretary shall 
                        allocate to each State selected to conduct a 
                        demonstration project under this section an 
                        amount determined appropriate by the Secretary 
                        for purposes of reimbursing the State for 
                        services furnished under the demonstration 
                        project in accordance with paragraph (1).
                            (ii) Limitation.--The total amount 
                        allocated to States under this subparagraph 
                        shall not exceed $75,000,000.
    (d) Waiver Authority.--The Secretary may waive the following 
requirements as may be necessary to conduct demonstration projects in 
accordance with the requirements of this section:
            (1) The requirements of section 1902(a)(1) of the Social 
        Security Act (42 U.S.C. 1396a(a)(1)) (relating to 
        statewideness).
            (2) The requirements of section 1902(a)(10)(B) of such Act 
        (42 U.S.C. 1396a(a)(10)(B)) (relating to comparability).
            (3) The requirements of section 1902(a)(10)(C)(i)(III) of 
        such (42 U.S.C. 1396a(a)(10)(C)(i)(III)) (relating to income 
        and resource rules applicable in the community).
    (e) Definitions.--In this section:
            (1) Medicaid.--The term ``Medicaid'' means the medical 
        assistance program established under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.) and includes any waivers 
        of such program.
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (3) State.--The term ``State'' has the meaning given that 
        term for purposes of title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.).
            (4) Supportive housing services.--The term ``supportive 
        housing services'' means--
                    (A) financial assistance with rental payments, room 
                and board, or other housing costs, as appropriate;
                    (B) case management and service coordination 
                services; and
                    (C) housing support screening and referral services 
                provided in a healthcare setting.

SEC. 3. ESTABLISHING NIH CLINICAL TRIALS RESEARCH NETWORK ON VIOLENCE 
              RECOVERY.

    Part B of title IV of the Public Health Service Act (42 U.S.C. 284 
et seq.) is amended by adding at the end the following:

``SEC. 409K. CLINICAL TRIALS RESEARCH NETWORK ON VIOLENCE RECOVERY.

    ``(a) Network.--The Director of NIH shall develop and support a 
regional clinical research center network, by awarding funding to 
participants in accordance with subsection (b) through grants, 
contracts, or other mechanisms, to study and evaluate hospital- and 
community-based interventions for victims of violent or penetrating 
injuries to prevent, mitigate, and furnish treatments to address the 
trauma and mental health impacts of those injuries on such victims and 
prevent re-injury.
    ``(b) Participants.--
            ``(1) In general.--An entity seeking funding under this 
        section shall--
                    ``(A) be a university or hospital; and
                    ``(B) submit an application to the Director of NIH 
                at such time, in such manner, and containing such 
                information as the Director may require, including the 
                information described in paragraph (2).
            ``(2) Demonstrated expertise.--An application submitted 
        under paragraph (1)(B) shall include information demonstrating 
        that the applicant has multidisciplinary expertise in--
                    ``(A) furnishing hospital- or community-based 
                interventions to improve outcomes for patients 
                suffering a violent or penetrating injury;
                    ``(B) quality improvement research;
                    ``(C) linking clinical research with practice and 
                community outcomes and activities; and
                    ``(D) providing, linking to, or otherwise 
                facilitating community-based care, case management, and 
                treatment.
            ``(3) Selection.--The Director of NIH shall, subject to 
        available funding, select not less than 15 entities meeting the 
        requirements of this subsection to receive funding under this 
        section (provided that fifteen or more entities meeting such 
        requirements apply for such funding).
    ``(c) Activities and Use of Funds.--An entity that receives funding 
under this section shall use the funds to provide support for a trauma-
informed and violence re-injury prevention research center, including 
funding for--
            ``(1) clinical, behavioral, or translational research to 
        test and evaluate trauma-informed interventions for trauma 
        recovery in an effort to prevent and reduce violence-related 
        re-injury, readmission, and mortality;
            ``(2) the provision of screening, delivery of post-injury 
        mental health counseling, trauma-informed care, education, 
        discharge planning, skills building, and long-term case 
        management; and
            ``(3) training researchers, clinicians, case workers, 
        mental health professionals, community health workers, and 
        other appropriate providers to provide appropriate 
        interventions described in paragraph (2).
    ``(d) Outcomes Measurements.--Any activity supported under this 
section shall be furnished with the aim of preventing and mitigating 
the impact of trauma and mental health consequences associated with a 
violent or penetrative injury, improve the overall health and well-
being of individuals with a violent or penetrative injury, and prevent 
re-injury, readmission, and mortality.
    ``(e) Coordination of Consortia Activities.--The Director of NIH 
shall, as appropriate--
            ``(1) provide for the coordination of activities (including 
        the exchange of information and regular communication) among 
        the entities receiving funding under this section; and
            ``(2) require each entity receiving funding under this 
        section to prepare and submit to the Director periodic reports 
        on the activities of the entity that are supported by this 
        section.''.

SEC. 4. HEALTH PROFESSIONS OPPORTUNITY GRANTS.

    (a) Funding.--Section 2008(c)(1) of the Social Security Act (42 
U.S.C. 1397g(c)(1)) is amended by inserting ``, and $170,000,000 for 
each of fiscal years 2021 through 2025'' after ``2019''.
    (b) Making Hospitals Eligible.--Section 2008(a)(4)(A) of such Act 
(42 U.S.C. 1397g(a)(4)(A)) is amended by striking ``or a community-
based organization'' and inserting ``, a community-based organization, 
or a hospital (as defined in section 1861(e))''.
    (c) Aid and Supportive Services.--Section 2008(a)(2)(A)(i) of such 
Act (42 U.S.C. 1397g(a)(2)(A)(i)) is amended--
            (1) by inserting ``affordable'' before ``child care''; and
            (2) by inserting ``transportation, basic skills and English 
        language proficiency training,'' after ``case management,''.

SEC. 5. HEALTH PROFESSIONS TRAINING FOR DIVERSITY PROGRAMS.

    (a) Centers of Excellence.--Section 736(c) of the Public Health 
Service Act (42 U.S.C. 293(c)) is amended by adding at the end the 
following:
            ``(4) Preference.--
                    ``(A) In general.--In making grants under 
                subsection (a), the Secretary shall give preference to 
                designated health professions schools, or other public 
                or nonprofit health or educational entities, meeting 
                the requirements of this section that propose to--
                            ``(i) carry out the activities supported by 
                        this section in communities with a high rate of 
                        community trauma; or
                            ``(ii) recruit participants for activities 
                        supported by this section from communities with 
                        a high rate of community trauma.
                    ``(B) Community with a high rate of community 
                trauma.--For purposes of subparagraph (A), the term 
                `community with a high rate of community trauma' means 
                a community with a high rate of intergenerational 
                poverty, civil unrest, or discrimination, and may 
                include--
                            ``(i) a community with an age-adjusted rate 
                        of drug overdose deaths that is above the 
                        national average for age-adjusted rates of drug 
                        overdose deaths, as determined by the Director 
                        of the Centers for Disease Control and 
                        Prevention; and
                            ``(ii) a community with an age-adjusted 
                        rate of violence-related (or intentional) 
                        injury deaths that is above the national 
                        average for age-adjusted rates of violence-
                        related (or intentional) injury deaths, as 
                        determined by the Director of the Centers for 
                        Disease Control and Prevention.''.
    (b) Scholarships for Disadvantaged Students.--Section 737(b) of the 
Public Health Service Act (42 U.S.C. 293a(b)) is amended--
            (1) in the subsection heading by striking ``in Providing 
        Scholarships'';
            (2) by striking ``The Secretary'' and inserting the 
        following:
            ``(1) Preference in providing scholarships.--The 
        Secretary''; and
            (3) by adding at the end the following:
            ``(2) Preference to eligible entities proposing to serve 
        communities with high rates of community trauma.--
                    ``(A) In general.--In making grants under this 
                subsection (a), the Secretary shall give preference to 
                eligible entities that propose to--
                            ``(i) carry out the activities supported by 
                        this section in communities with a high rate of 
                        community trauma; or
                            ``(ii) award scholarships under this 
                        section to full-time students who are eligible 
                        individuals from communities with a high rate 
                        of community trauma.
                    ``(B) Community with a high rate of community 
                trauma.--For purposes of subparagraph (A), the term 
                `community with a high rate of community trauma' has 
                the meaning given that term in section 736(c)(4)(B).''.
    (c) Health Careers Opportunity Program.--Section 739(b) of the 
Public Health Service Act (42 U.S.C. 293c(b)) is amended--
            (1) by redesignating paragraphs (1) through (4) as 
        subparagraphs (A) through (D), respectively, and indenting 
        appropriately;
            (2) by striking ``In making'' and inserting the following:
            ``(1) In general.--In making''; and
            (3) by adding at the end the following:
            ``(2) Preference to eligible entities proposing to serve 
        communities with high rates of community trauma.--
                    ``(A) In general.--In making awards to eligible 
                entities under subsection (a)(1), the Secretary shall 
                give preference to approved applications for programs 
                proposing to--
                            ``(i) carry out the activities supported by 
                        this section in communities with a high rate of 
                        community trauma; or
                            ``(ii) recruit for activities supported by 
                        this section individuals from disadvantaged 
                        backgrounds, as so determined, from communities 
                        with a high rate of community trauma.
                    ``(B) Community with a high rate of community 
                trauma.--For purposes of subparagraph (A), the term 
                `community with a high rate of community trauma' has 
                the meaning given that term in section 736(c)(4)(B).''.
    (d) Area Health Education Centers.--Section 751(b) of the Public 
Health Service Act (42 U.S.C. 294a(b)) is amended by adding at the end 
the following:
            ``(3) Preference to eligible entities proposing to serve 
        communities with high rates of community trauma.--
                    ``(A) In general.--In awarding grants under 
                subsection (a)(1) or (a)(2), the Secretary shall give 
                preference to eligible entities that propose to--
                            ``(i) carry out the activities supported by 
                        this section in communities with a high rate of 
                        community trauma; or
                            ``(ii) recruit participants for activities 
                        supported by this section from communities with 
                        a high rate of community trauma.
                    ``(B) Community with a high rate of community 
                trauma.--For purposes of subparagraph (A), the term 
                `community with a high rate of community trauma' has 
                the meaning given that term in section 736(c)(4)(B).''.

SEC. 6. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS; FUNDING FOR 
              THE NATIONAL HEALTH SERVICE CORPS.

    (a) Designation of Health Professional Shortage Areas.--Section 
332(a)(2) of the Public Health Service Act (42 U.S.C. 254e(a)(2)) is 
amended--
            (1) in subparagraph (A), by inserting ``(including for the 
        delivery of care provided by a city or county health department 
        to inmates of a county or municipal jail)'' after ``county 
        health department''; and
            (2) in subparagraph (B), by striking ``State correctional 
        institution'' and inserting ``State, county, or municipal 
        correctional institution.''.
    (b) Funding for the National Health Service Corps.--Section 
10503(b)(2) of the Patient Protection and Affordable Care Act (42 
U.S.C. 254b-2(b)(2)) is amended--
            (1) in subparagraph (F), by striking ``; and'' and 
        inserting a semicolon;
            (2) in subparagraph (G), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(G) $360,000,000 for the period beginning on 
                November 22, 2019, and ending on September 30, 2020, 
                and for each of fiscal years 2021 through 2025.''.

SEC. 7. INCUMBENT WORKER TRAINING.

    Section 134(d)(4)(A) of the Workforce Innovation and Opportunity 
Act of 1998 (29 U.S.C. 3174(d)(4)(A)) is amended--
            (1) by redesignating clauses (ii) and (iii) as clauses 
        (iii) and (iv), respectively;
            (2) by inserting after clause (i) the following:
                            ``(ii) Greater reservation of funds.--The 
                        local board may reserve and use more than 20 
                        percent of the funds so allocated, to pay for 
                        the Federal share of the cost described in 
                        clause (i), if the Secretary determines that 
                        the local board has demonstrated that--
                                    ``(I) there is a need and demand in 
                                the local area for additional incumbent 
                                worker training program positions 
                                (beyond the positions that could be 
                                offered through the reservation 
                                described in clause (i)), including 
                                specifying the number of employers and 
                                workers that could be served through 
                                the additional program positions;
                                    ``(II) training through an 
                                incumbent worker training program that 
                                is in existence on the day on which 
                                information is submitted for the 
                                demonstration (referred to in this 
                                clause as an `existing incumbent worker 
                                training program') has resulted in an 
                                incumbent worker of an employer 
                                acquiring new skills that allow the 
                                worker to obtain a position with such 
                                employer requiring higher skills or a 
                                higher-paid position than the pre-
                                training position of the incumbent 
                                worker, and the employer intends to 
                                hire an additional worker to fill the 
                                pre-training position of the incumbent 
                                worker; and
                                    ``(III) the effectiveness of the 
                                existing incumbent worker training 
                                program of the employer referred to in 
                                subclause (II), as evaluated on local 
                                performance measures based on the 
                                primary indicators of performance 
                                specified in section 
                                116(b)(2)(A)(i).''; and
            (3) in clause (iii), as redesignated by paragraph (1) of 
        this subsection, by striking ``clause (i)'' and inserting 
        ``clause (i) or (ii)''.
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