[Congressional Record Volume 162, Number 170 (Tuesday, November 29, 2016)]
[Senate]
[Pages S6525-S6526]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               EXPANDING CAPACITY FOR HEALTH OUTCOMES ACT

  The PRESIDING OFFICER. Under the previous order, the Committee on 
Health, Education, Labor, and Pensions is discharged from and the 
Senate will proceed to the consideration of S. 2873, which the clerk 
will report.
  The legislative clerk read as follows:

       A bill (S. 2873) to require studies and reports examining 
     the use of, and opportunities to use, technology-enabled 
     collaborative learning and capacity building models to 
     improve programs of the Department of Health and Human 
     Services, and for other purposes.

  The PRESIDING OFFICER. Under the previous order, there will be 30 
minutes of debate, equally divided in the usual form.
  The Senator from Hawaii.
  Mr. SCHATZ. Mr. President, I ask unanimous consent that the time be 
equally divided between both sides during the quorum call.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SCHATZ. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DAINES. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 5110

  Mr. DAINES. Mr. President, I call up amendment No. 5110 and ask 
unanimous consent that it be reported by number.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will report the amendment by number.
  The legislative clerk read as follows:

       The Senator from Montana [Mr. Daines], for Mr. Alexander, 
     proposes an amendment numbered 5110.

  The amendment is as follows:

                (Purpose: In the nature of a substitute)

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Expanding Capacity for 
     Health Outcomes Act'' or the ``ECHO Act''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Health professional shortage area.--The term ``health 
     professional shortage area'' means a health professional 
     shortage area designated under section 332 of the Public 
     Health Service Act (42 U.S.C. 254e).
       (2) Indian tribe.--The term ``Indian tribe'' has the 
     meaning given the term in section 4 of the Indian Self-
     Determination and Education Assistance Act (25 U.S.C. 5304).
       (3) Medically underserved area.--The term ``medically 
     underserved area'' has the meaning given the term ``medically 
     underserved community'' in section 799B of the Public Health 
     Service Act (42 U.S.C. 295p).
       (4) Medically underserved population.--The term ``medically 
     underserved population'' has the meaning given the term in 
     section 330(b) of the Public Health Service Act (42 U.S.C. 
     254b(b)).
       (5) Native americans.--The term ``Native Americans'' has 
     the meaning given the term in section 736 of the Public 
     Health Service Act (42 U.S.C. 293) and includes Indian tribes 
     and tribal organizations.
       (6) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (7) Technology-enabled collaborative learning and capacity 
     building model.--The term ``technology-enabled collaborative 
     learning and capacity building model'' means a distance 
     health education model that connects specialists with 
     multiple other health care professionals through simultaneous 
     interactive videoconferencing for the purpose of facilitating 
     case-based learning, disseminating best practices, and 
     evaluating outcomes.
       (8) Tribal organization.--The term ``tribal organization'' 
     has the meaning given the term in section 4 of the Indian 
     Self-Determination and Education Assistance Act (25 U.S.C. 
     5304).

     SEC. 3. EXAMINATION AND REPORT ON TECHNOLOGY-ENABLED 
                   COLLABORATIVE LEARNING AND CAPACITY BUILDING 
                   MODELS.

       (a) Examination.--
       (1) In general.--The Secretary shall examine technology-
     enabled collaborative learning and capacity building models 
     and their impact on--
       (A) addressing mental and substance use disorders, chronic 
     diseases and conditions, prenatal and maternal health, 
     pediatric care, pain management, and palliative care;
       (B) addressing health care workforce issues, such as 
     specialty care shortages and primary care workforce 
     recruitment, retention, and support for lifelong learning;
       (C) the implementation of public health programs, including 
     those related to disease prevention, infectious disease 
     outbreaks, and public health surveillance;
       (D) the delivery of health care services in rural areas, 
     frontier areas, health professional shortage areas, and 
     medically underserved areas, and to medically underserved 
     populations and Native Americans; and
       (E) addressing other issues the Secretary determines 
     appropriate.

[[Page S6526]]

       (2) Consultation.--In the examination required under 
     paragraph (1), the Secretary shall consult public and private 
     stakeholders with expertise in using technology-enabled 
     collaborative learning and capacity building models in health 
     care settings.
       (b) Report.--
       (1) In general.--Not later than 2 years after the date of 
     enactment of this 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, and post on the appropriate website of 
     the Department of Health and Human Services, a report based 
     on the examination under subsection (a).
       (2) Contents.--The report required under paragraph (1) 
     shall include findings from the examination under subsection 
     (a) and each of the following:
       (A) An analysis of--
       (i) the use and integration of technology-enabled 
     collaborative learning and capacity building models by health 
     care providers;
       (ii) the impact of such models on health care provider 
     retention, including in health professional shortage areas in 
     the States and communities in which such models have been 
     adopted;
       (iii) the impact of such models on the quality of, and 
     access to, care for patients in the States and communities in 
     which such models have been adopted;
       (iv) the barriers faced by health care providers, States, 
     and communities in adopting such models;
       (v) the impact of such models on the ability of local 
     health care providers and specialists to practice to the full 
     extent of their education, training, and licensure, including 
     the effects on patient wait times for specialty care; and
       (vi) efficient and effective practices used by States and 
     communities that have adopted such models, including 
     potential cost-effectiveness of such models.
       (B) A list of such models that have been funded by the 
     Secretary in the 5 years immediately preceding such report, 
     including the Federal programs that have provided funding for 
     such models.
       (C) Recommendations to reduce barriers for using and 
     integrating such models, and opportunities to improve 
     adoption of, and support for, such models as appropriate.
       (D) Opportunities for increased adoption of such models 
     into programs of the Department of Health and Human Services 
     that are in existence as of the report.
       (E) Recommendations regarding the role of such models in 
     continuing medical education and lifelong learning, including 
     the role of academic medical centers, provider organizations, 
     and community providers in such education and lifelong 
     learning.

  The PRESIDING OFFICER. Under the previous order, amendment No. 5110 
is agreed to.
  Mr. DAINES. Mr. President, Montanans have always been on the cutting 
edge of frontier medicine, using ingenuity to overcome the challenges 
in frontier and rural America to make sure we have access to high-
quality health care. In fact, going back to the time my great-great-
grandmother homesteaded near Conrad, MT, our health care providers have 
worked and continue to work to increase access despite geography, 
weather, limited resources, and government regulation.
  Rural Montanans are often hours away from a hospital and even farther 
away from any kind of trauma center. Our local providers are the first-
line responders. They tackle everything from the common cold to 
emergency situations. It is their actions that can make the difference 
between life and death. Rural providers give Montanans access to 
preventive and behavioral health services. They help ward off chronic 
illness with early detection and provide care and support through 
cancer and other debilitating diseases. They deserve our respect and 
the resources that will help them better serve Montanans. That is why I 
am honored to join my colleagues in supporting the ECHO Act and making 
sure it is passed and signed into law. I am thankful for the leadership 
of the senior Senator from Utah, Senator Hatch, who has been out front 
leading in this effort.
  Geographic location should not dictate the quality of care. This bill 
will promote opportunities to improve access to high-quality care in 
rural communities, such as access to specialists and support and 
training for rural health care providers. In fact, this year the 
Billings Clinic launched the Montana-based Project ECHO hub in an 
effort to address a lack of access to mental health and substance abuse 
resources. The hub connects rural providers with a team of specialists 
to collaborate, share case studies, and offer support. The hub is built 
to be flexible, allowing teleclinics on any topic or any disease. It 
also allows Montana's providers to collaborate with specialists at 
academic centers, such as the University of Washington and the 
University of New Mexico. Because of the success of this first hub, the 
Billings Clinic will launch two more teleclinics next year to help 
primary care sites across Montana integrate behavioral health services 
in their practices.
  The ECHO Act will promote these programs throughout the country and 
increase access for all Americans. I am thankful to see strong 
bipartisan support on the passage of this bill as we work together to 
improve rural health care.
  I thank the Presiding Officer.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. VITTER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. VITTER. Mr. President, I ask unanimous consent all time be 
yielded back.
  The PRESIDING OFFICER. Without objection, all time is yielded back.
  The bill was ordered to be engrossed for a third reading and was read 
the third time.
  The PRESIDING OFFICER. Under the previous order, the bill having been 
read the third time, the question is, Shall it pass?
  Mr. VITTER. Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Tennessee (Mr. Corker) and the Senator from Colorado (Mr. 
Gardner).
  Further, if present and voting, the Senator from Tennessee (Mr. 
Corker) would have voted ``yea'' and the Senator from Colorado (Mr. 
Gardner) would have voted ``yea.''
  Mr. DURBIN. I announce that the Senator from Vermont (Mr. Sanders) is 
necessarily absent.
  The PRESIDING OFFICER (Mr. Cruz). Are there any other Senators in the 
Chamber desiring to vote?
  The result was announced--yeas 97, nays 0, as follows:

                      [Rollcall Vote No. 154 Leg.]

                                Yeas--97

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Coats
     Cochran
     Collins
     Coons
     Cornyn
     Cotton
     Crapo
     Cruz
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Franken
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     King
     Kirk
     Klobuchar
     Lankford
     Leahy
     Lee
     Manchin
     Markey
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Perdue
     Peters
     Portman
     Reed
     Reid
     Risch
     Roberts
     Rounds
     Rubio
     Sasse
     Schatz
     Schumer
     Scott
     Sessions
     Shaheen
     Shelby
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Vitter
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--3

     Corker
     Gardner
     Sanders
  The bill (S. 2873), as amended, was passed.

                          ____________________