[Congressional Record Volume 162, Number 175 (Tuesday, December 6, 2016)]
[House]
[Pages H7198-H7199]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               EXPANDING CAPACITY FOR HEALTH OUTCOMES ACT

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the 
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 Clerk read the title of the bill.
  The text of the bill is as follows:

                                S. 2873

       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 ``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.
       (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 SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Burgess) and the gentlewoman from California (Ms. Matsui) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of S. 2873, the Expanding 
Capacity for Health Outcomes Act, also known as the ECHO Act. This 
bipartisan legislation by Senators Hatch and Schatz passed the Senate 
97-0 on November 29. House companion legislation has been introduced 
and championed by Representative Matsui and me.
  This legislation requires the Secretary of Health and Human Services 
to examine technology-enabled collaborative learning and capacity 
building models and their impact on the healthcare workforce, the 
implementation of public health programs, and the delivery of health 
services in rural and underserved areas to underserved populations. The 
bill would require the Secretary to consult with public and private 
stakeholders with expertise in these delivery models to evaluate their 
potential and larger adoption in States and within the Federal 
Government.
  Within 2 years, the Secretary then would submit to Congress and 
publicly post a report that includes an analysis of these programs 
which utilize technology in a novel manner. One such method these 
programs may employ is using a hub-and-spoke approach to connecting 
specialty and primary care workers for health surveillance and

[[Page H7199]]

proper intervention. This holds particular promise for rural and 
underserved areas where it can be difficult to recruit and retain 
health professionals but could offer opportunities for continuing 
provider education and engagement.
  This legislation enjoys broad bipartisan support. It has been 
endorsed by a number of health professional organizations, including 
America's Essential Hospitals, the American Academy of Pediatrics, the 
American Medical Association, the American Nurses Association, and the 
National Association of Community Health Centers, to name but a few.
  This legislation does not impact direct spending or revenues. It 
offers a means by which to evaluate successful models in the private 
sector and opportunities to build upon them and adopt them if 
successful.
  Mr. Speaker, I urge my colleagues to vote ``yes'' on S. 2873.
  I reserve the balance of my time.
  Ms. MATSUI. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of S. 2873, the ECHO Act, that I 
co-led with my colleague Representative Burgess in the House and 
Senators Hatch and Schatz in the Senate.
  The ECHO Act elevates the successful Project ECHO model, which uses 
technology to remotely connect healthcare providers to one another so 
they can communicate best practices and new techniques.
  UC Davis Medical Center, in my district of Sacramento, has some of 
the best and brightest doctors, and they are working hard to share 
their expertise across our region and the country. We are also 
fortunate in Sacramento to have a strong safety net of top-notch 
community health centers that work to provide the primary care needs of 
underserved populations. However, primary care is a big job, and often 
these providers have not received the education or training they need 
in specialty areas such as pain management.

                              {time}  1300

  UC Davis is successfully partnering with over 125 community health 
centers in California, to provide that collaborative education on 
responsible and safe pain management, resulting in increased use of 
evidence-based tools and reduced prescriptions for high-dose opioids. 
Better understanding of pain and effective pain management will 
contribute toward combating our Nation's devastating opioid abuse and 
heroin epidemic.
  This Project ECHO bill is a first step in scaling approaches like 
this nationwide to ensure that every provider has access to the best 
information on a variety of topics, from pain to addiction, 
dermatology, infectious diseases, neurology, and much more.
  We need to build on this progress to ensure that we are harnessing 
the power of technology to improve patient care and save lives. I urge 
my colleagues to support S. 2873.
  Mr. Speaker, I want to thank Congressman Burgess for his work on 
this, and I urge my colleagues to send S. 2873 to the President's desk 
for signature.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, only 10 percent of physicians practice in rural areas in 
this country, but those areas contain 25 percent of the population. 
Obviously, there is a mismatch.
  Access to care in underserved areas is especially challenging for 
patients with chronic or complex conditions. Overburdened primary care 
providers often will have to refer complex patients to hospitals or 
specialists for care that actually could just as well be delivered at 
home. These unnecessary referrals delay care and increase costs for 
patients in the system. The Project Extension for Community Health 
Outcomes, or Project ECHO, is one example of an innovative model that 
is being used to address this challenge.
  Project ECHO uses interactive videoconferencing to link specialist 
teams with primary care providers in medical education clinics that 
include didactic teaching and case-based learning.
  Project ECHO has equipped local providers across the country with the 
extraordinary skills necessary to take on healthcare challenges 
threatening our communities. Project ECHO has been used to increase the 
number of docs able to prescribe for opioid abuse, to rapidly educate 
providers on public health crises, such as a novel flu outbreak, and to 
train providers to address complex mental health disorders.
  This bipartisan, bicameral bill has broad support from healthcare 
providers and systems. It passed the Senate 97-0 last week. Again, I 
want to thank Congresswoman Matsui of California for her partnership on 
the bill. I encourage my colleagues to support its passage.
  Mr. Speaker, I yield back the balance of my time.
  Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of S. 
2873, Expanding Capacity for Health Outcomes Act, which would increase 
access to health care services in rural areas.
  This bill authorizes the Department of Health and Human Services to 
study the Project ECHO model, which launched a revolutionary long 
distance health care model that uses videoconferencing for 
collaboration and case-learning.
  The Project ECHO model has proven to be successful in bringing much 
needed health care to some of our nation's most remote regions.
  By taking study of this model to the national level, we have the 
opportunity to fully harness emerging technologies to transform the way 
health care is practiced.
  As a life long health care professional from a district with rural 
and underserved areas, I know firsthand how challenging it can be to 
provide access to high quality health care to these areas.
  Connecting primary care providers with specialists through video 
streaming helps bridge the gap in both distance and access, reducing 
travel and costs for both patient and provider alike.
  I urge my colleagues to support this legislation so that we can 
continue working to provide specialty care to all Americans across the 
nation.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
pass the bill, S. 2873.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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