[Congressional Record Volume 151, Number 51 (Monday, April 25, 2005)]
[Senate]
[Pages S4191-S4192]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. HUTCHISON (for herself, Mr. Bingaman, Mr. Brownback, Mr. 
        Kennedy, and Mr. Cochran):
  S. 898. A bill to amend the Public Health Service Act to authorize a 
demonstration grant program to provide patient navigator services to 
reduce barriers and improve health care outcomes, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mrs. HUTCHISON. Mr. President, I ask unanimous consent that the text 
of the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 898

       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 ``Patient Navigator Outreach 
     and Chronic Disease Prevention Act of 2005''.

     SEC. 2. PATIENT NAVIGATOR GRANTS.

       Subpart V of part D of title III of the Public Health 
     Service Act (42 U.S.C. 256) is amended by adding at the end 
     the following:

     ``SEC. 340A. PATIENT NAVIGATOR GRANTS.

       ``(a) Grants.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may make grants to eligible entities for the 
     development and operation of demonstration programs to 
     provide patient navigator services to improve health care 
     outcomes. The Secretary shall coordinate with, and ensure the 
     participation of, the Indian Health Service, the National 
     Cancer Institute, the Office of Rural Health Policy, and such 
     other offices and agencies as deemed appropriate by

[[Page S4192]]

     the Secretary, regarding the design and evaluation of the 
     demonstration programs.
       ``(b) Use of Funds.--The Secretary shall require each 
     recipient of a grant under this section to use the grant to 
     recruit, assign, train, and employ patient navigators who 
     have direct knowledge of the communities they serve to 
     facilitate the care of individuals, including by performing 
     each of the following duties:
       ``(1) Acting as contacts, including by assisting in the 
     coordination of health care services and provider referrals, 
     for individuals who are seeking prevention or early detection 
     services for, or who following a screening or early detection 
     service are found to have a symptom, abnormal finding, or 
     diagnosis of, cancer or other chronic disease.
       ``(2) Facilitating the involvement of community 
     organizations in assisting individuals who are at risk for or 
     who have cancer or other chronic diseases to receive better 
     access to high-quality health care services (such as by 
     creating partnerships with patient advocacy groups, 
     charities, health care centers, community hospice centers, 
     other health care providers, or other organizations in the 
     targeted community).
       ``(3) Notifying individuals of clinical trials and, on 
     request, facilitating enrollment of eligible individuals in 
     these trials.
       ``(4) Anticipating, identifying, and helping patients to 
     overcome barriers within the health care system to ensure 
     prompt diagnostic and treatment resolution of an abnormal 
     finding of cancer or other chronic disease.
       ``(5) Coordinating with the relevant health insurance 
     ombudsman programs to provide information to individuals who 
     are at risk for or who have cancer or other chronic diseases 
     about health coverage, including private insurance, health 
     care savings accounts, and other publicly funded programs 
     (such as Medicare, Medicaid, health programs operated by the 
     Department of Veterans Affairs or the Department of Defense, 
     the State children's health insurance program, and any 
     private or governmental prescription assistance programs).
       ``(6) Conducting ongoing outreach to health disparity 
     populations, including the uninsured, rural populations, and 
     other medically underserved populations, in addition to 
     assisting other individuals who are at risk for or who have 
     cancer or other chronic diseases to seek preventative care.
       ``(c) Prohibitions.--
       ``(1) Referral fees.--The Secretary shall require each 
     recipient of a grant under this section to prohibit any 
     patient navigator providing services under the grant from 
     accepting any referral fee, kickback, or other thing of value 
     in return for referring an individual to a particular health 
     care provider.
       ``(2) Legal fees and costs.--The Secretary shall prohibit 
     the use of any grant funds received under this section to pay 
     any fees or costs resulting from any litigation, arbitration, 
     mediation, or other proceeding to resolve a legal dispute.
       ``(d) Grant Period.--
       ``(1) In general.--Subject to paragraphs (2) and (3), the 
     Secretary may award grants under this section for periods of 
     not more than 3 years.
       ``(2) Extensions.--Subject to paragraph (3), the Secretary 
     may extend the period of a grant under this section. Each 
     such extension shall be for a period of not more than 1 year.
       ``(3) Limitations on grant period.--In carrying out this 
     section, the Secretary--
       ``(A) shall ensure that the total period of a grant does 
     not exceed 4 years; and
       ``(B) may not authorize any grant period ending after 
     September 30, 2010.
       ``(e) Application.--
       ``(1) In general.--To seek a grant under this section, an 
     eligible entity shall submit an application to the Secretary 
     in such form, in such manner, and containing such information 
     as the Secretary may require.
       ``(2) Contents.--At a minimum, the Secretary shall require 
     each such application to outline how the eligible entity will 
     establish baseline measures and benchmarks that meet the 
     Secretary's requirements to evaluate program outcomes.
       ``(f) Uniform Baseline Measures.--The Secretary shall 
     establish uniform baseline measures in order to properly 
     evaluate the impact of the demonstration projects under this 
     section.
       ``(g) Preference.--In making grants under this section, the 
     Secretary shall give preference to eligible entities that 
     demonstrate in their applications plans to utilize patient 
     navigator services to overcome significant barriers in order 
     to improve health care outcomes in their respective 
     communities.
       ``(h) Duplication of Services.--An eligible entity that is 
     receiving Federal funds for activities described in 
     subsection (b) on the date on which the entity submits an 
     application under subsection (e), may not receive a grant 
     under this section unless the entity can demonstrate that 
     amounts received under the grant will be utilized to expand 
     services or provide new services to individuals who would not 
     otherwise be served.
       ``(i) Coordination With Other Programs.--The Secretary 
     shall ensure coordination of the demonstration grant program 
     under this section with existing authorized programs in order 
     to facilitate access to high-quality health care services.
       ``(j) Study; Reports.--
       ``(1) Final report by secretary.--Not later than 6 months 
     after the completion of the demonstration grant 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) quantitative analysis of baseline and benchmark 
     measures; and
       ``(ii) aggregate information about the patients served and 
     program activities.
       ``(B) Recommendations on whether patient navigator programs 
     could be used to improve patient outcomes in other public 
     health areas.
       ``(2) Reports by secretary.--The Secretary may provide 
     interim reports to the Congress on the demonstration grant 
     program under this section at such intervals as the Secretary 
     determines to be appropriate.
       ``(3) Interim reports by grantees.--The Secretary may 
     require grant recipients under this section to submit interim 
     and final reports on grant program outcomes.
       ``(k) Rule of Construction.--This section shall not be 
     construed to authorize funding for the delivery of health 
     care services (other than the patient navigator duties listed 
     in subsection (b)).
       ``(l) Definitions.--In this section:
       ``(1) The term `eligible entity' means a public or 
     nonprofit private health center (including a Federally 
     qualified health center (as that term is defined in section 
     1861(aa)(4) of the Social Security Act)), a health facility 
     operated by or pursuant to a contract with the Indian Health 
     Service, a hospital, a cancer center, a rural health clinic, 
     an academic health center, or a nonprofit entity that enters 
     into a partnership or coordinates referrals with such a 
     center, clinic, facility, or hospital to provide patient 
     navigator services.
       ``(2) The term `health disparity population' means a 
     population that, as determined by the Secretary, has a 
     significant disparity in the overall rate of disease 
     incidence, prevalence, morbidity, mortality, or survival 
     rates as compared to the health status of the general 
     population.
       ``(3) The term `patient navigator' means an individual who 
     has completed a training program approved by the Secretary to 
     perform the duties listed in subsection (b).
       ``(m) Authorization of Appropriations.--
       ``(1) In general.--To carry out this section, there are 
     authorized to be appropriated $2,000,000 for fiscal year 
     2006, $5,000,000 for fiscal year 2007, $8,000,000 for fiscal 
     year 2008, $6,500,000 for fiscal year 2009, and $3,500,000 
     for fiscal year 2010.
       ``(2) Availability.--The amounts appropriated pursuant to 
     paragraph (1) shall remain available for obligation through 
     the end of fiscal year 2010.''.
                                 ______