[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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