[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3479 Introduced in Senate (IS)]

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117th CONGRESS
  2d Session
                                S. 3479

   To amend the Public Health Service Act with respect to awards to 
         support community health workers and community health.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

             January 11 (legislative day, January 10), 2022

   Mr. Casey (for himself, Mr. Tillis, Ms. Smith, and Ms. Murkowski) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act with respect to awards to 
         support community health workers and community health.

    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 ``Building a Sustainable Workforce for 
Healthy Communities Act''.

SEC. 2. AWARDS TO SUPPORT COMMUNITY HEALTH WORKERS AND COMMUNITY 
              HEALTH.

    Section 399V of the Public Health Service Act (42 U.S.C. 280g-11) 
is amended--
            (1) by amending the section heading to read as follows: 
        ``awards to support community health workers and community 
        health'';
            (2) by amending subsection (a) to read as follows:
    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention and in coordination with 
the Administrator of the Health Resources and Services Administration, 
shall award grants, contracts, or cooperative agreements to eligible 
entities to promote positive health behaviors and outcomes for 
populations in medically underserved communities through the use of 
community health workers, including by addressing ongoing and longer-
term community health needs, and by building the capacity of the 
community health worker workforce. Such grants, contracts, and 
cooperative agreements shall be awarded in alignment and coordination 
with existing funding arrangements supporting community health 
workers.'';
            (3) in subsection (b)--
                    (A) in the matter preceding paragraph (1)--
                            (i) by striking ``Grants awarded'' and 
                        inserting ``Subject to any requirements for the 
                        scope of licensure, registration, or 
                        certification of a community health worker 
                        under applicable State law, grants, contracts, 
                        and cooperative agreements awarded''; and
                            (ii) by striking ``support community health 
                        workers'';
                    (B) by redesignating paragraphs (3) through (5) as 
                paragraphs (4) through (6), respectively;
                    (C) by striking paragraphs (1) and (2) and 
                inserting the following:
            ``(1) recruit, hire, and train community health workers 
        that reflect the needs of the community;
            ``(2) support community health workers in providing 
        education and outreach, in a community setting, regarding--
                    ``(A) health conditions prevalent in--
                            ``(i) medically underserved communities (as 
                        defined in section 799B), particularly racial 
                        and ethnic minority populations; and
                            ``(ii) other such populations or geographic 
                        areas that may require additional support 
                        during public health emergencies, which may 
                        include counties identified by the Secretary 
                        using applicable measures developed by the 
                        Centers for Disease Control and Prevention or 
                        other Federal agencies; and
                    ``(B) addressing social determinants of health and 
                eliminating health disparities, including by--
                            ``(i) promoting awareness of services and 
                        resources to increase access to health care, 
                        mental health services, child services, 
                        technology, housing services, educational 
                        services, nutrition services, employment 
                        services, and other services; and
                            ``(ii) assisting in conducting individual 
                        and community needs assessments;
            ``(3) educate community members, including regarding 
        effective strategies to promote healthy behaviors;'';
                    (D) in paragraph (4), as so redesignated, by 
                striking ``to educate'' and inserting ``educate'';
                    (E) in paragraph (5), as so redesignated--
                            (i) by striking ``to identify'' and 
                        inserting ``identify'';
                            (ii) by striking ``healthcare agencies'' 
                        and inserting ``health care agencies''; and
                            (iii) by striking ``healthcare services and 
                        to eliminate duplicative care; or'' and 
                        inserting ``health care services and to 
                        streamline care, including serving as a liaison 
                        between communities and health care agencies; 
                        and''; and
                    (F) in paragraph (6), as so redesignated--
                            (i) by striking ``to educate, guide, and 
                        provide'' and inserting ``support community 
                        health workers in educating, guiding, or 
                        providing''; and
                            (ii) by striking ``maternal health and 
                        prenatal care'' and inserting ``chronic 
                        diseases, maternal health, prenatal, and 
                        postpartum care in order to improve maternal 
                        and infant health outcomes'';
            (4) in subsection (c), by striking ``Each eligible entity'' 
        and all that follows through ``accompanied by'' and inserting 
        ``To be eligible to receive an award under subsection (a), an 
        entity shall prepare and submit to the Secretary an application 
        at such time, in such manner, and containing'';
            (5) in subsection (d)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``grants'' and inserting ``awards'';
                    (B) by amending paragraph (1) to read as follows:
            ``(1) propose to serve--
                    ``(A) areas with populations that have a high rate 
                of chronic disease, infant mortality, or maternal 
                morbidity and mortality;
                    ``(B) low-income populations, including medically 
                underserved populations (as defined in section 
                330(b)(3));
                    ``(C) populations residing in health professional 
                shortage areas (as defined in section 332(a));
                    ``(D) populations residing in maternity care health 
                professional target areas identified under section 
                332(k); or
                    ``(E) rural or traditionally underserved 
                populations, including racial and ethnic minority 
                populations or low-income populations;'';
                    (C) in paragraph (2), by striking ``; and'' and 
                inserting ``, including rural populations and racial 
                and ethnic minority populations;'';
                    (D) in paragraph (3), by striking ``with community 
                health workers.'' and inserting ``and established 
                relationships with community health workers in the 
                communities expected to be served by the program; or'' 
                and
                    (E) by adding at the end the following:
            ``(4) develop a plan for providing services to the extent 
        practicable, in the language and cultural context most 
        appropriate to individuals expected to be served by the 
        program.'';
            (6) in subsection (e)--
                    (A) by striking ``community health worker 
                programs'' and inserting ``eligible entities''; and
                    (B) by striking ``and one-stop delivery systems 
                under section 121(e)'' and inserting ``, health 
                professions schools, minority-serving institutions 
                (defined, for purposes of this subsection, as 
                institutions and programs described in section 
                326(e)(1) of the Higher Education Act of 1965 and 
                institutions described in section 371(a) of such Act), 
                area health education centers under section 751 of this 
                Act, and one-stop delivery systems under section 121'';
            (7) by striking subsections (f), (g), (h), (i), and (j) and 
        inserting the following:
    ``(f) Technical Assistance.--The Secretary may provide to eligible 
entities that receive awards under subsection (a) technical assistance 
with respect to planning, development, and operation of community 
health worker programs authorized or supported under this section.
    ``(g) Dissemination of Best Practices.--Not later than 4 years 
after the date of enactment of the Building a Sustainable Workforce for 
Healthy Communities Act, the Secretary shall, based on activities 
carried out under this section and in consultation with relevant 
stakeholders, identify and disseminate evidence-based or evidence-
informed practices regarding recruitment and retention of community 
health workers and paraprofessionals to address ongoing public health 
and community health needs, and to prepare for, and respond to, future 
public health emergencies.
    ``(h) Report to Congress.--Not later than 4 years after the date of 
enactment of the Building a Sustainable Workforce for Healthy 
Communities Act, the Secretary shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report concerning 
the effectiveness of the program under this section in addressing 
ongoing public health and community health needs. Such report shall 
include recommendations regarding any improvements to such program, 
including recommendations for how to improve recruitment, training, and 
retention of the community health workforce.
    ``(i) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of fiscal years 2023 through 2027.'';
            (8) by redesignating subsection (k) as subsection (j); and
            (9) in subsection (j), as so redesignated--
                    (A) by striking paragraphs (1), (2), and (4);
                    (B) by redesignating paragraph (3) as paragraph 
                (1);
                    (C) in paragraph (1), as so redesignated--
                            (i) by striking ``entity (including a State 
                        or public subdivision of a State'' and 
                        inserting ``entity, including a State or 
                        political subdivision of a State, an Indian 
                        Tribe or Tribal organization, an urban Indian 
                        organization, a community-based organization''; 
                        and
                            (ii) by striking ``as defined in section 
                        1861(aa) of the Social Security Act))'' and 
                        inserting ``(as described in section 
                        1861(aa)(4)(B) of the Social Security Act)''; 
                        and
                    (D) by adding at the end the following:
            ``(2) Indian tribe; tribal organization.--The terms `Indian 
        Tribe' and `Tribal organization' have the meanings given the 
        terms `Indian tribe' and `tribal organization', respectively, 
        in section 4 of the Indian Self-Determination and Education 
        Assistance Act.
            ``(3) Urban indian organization.--The term `urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.''.

SEC. 3. GAO STUDY AND REPORT.

    Not later than 4 years after the date of enactment of this Act, the 
Comptroller General of the United States shall submit to the Committee 
on Health, Education, Labor, and Pensions of the Senate and the 
Committee on Energy and Commerce of the House of Representatives a 
report on the program authorized under section 399V of the Public 
Health Service Act (42 U.S.C. 280g-11) (as amended by section 2), 
including a review of the outcomes and effectiveness of the program and 
coordination with applicable programs of the Health Resources and 
Services Administration to ensure there is no unnecessary duplication 
of efforts among such programs.
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