[Congressional Record Volume 165, Number 170 (Monday, October 28, 2019)]
[Senate]
[Pages S6191-S6193]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 2721. A bill to reduce violence and health disparities by 
addressing social determinants of health, enhancing health care 
recruitment, and improving the delivery of quality, coordinated care 
services, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr.  DURBIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2721

       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 ``Healing Communities through 
     Health Care Act''.

     SEC. 2. MEDICAID HOUSING AND HOSPITAL DEMONSTRATION PROJECT.

       (a) Authority.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary shall select States to 
     conduct demonstration projects under title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.) to test innovative 
     partnership programs between housing agencies and programs, 
     hospitals and health systems, and community-based 
     organizations, to establish screening, referral, and 
     supportive housing programs for individuals with behavioral 
     health needs who are experiencing housing insecurity, that 
     account for disproportionately high rates of emergency room 
     visits and associated Medicaid spending.
       (b) Requirements.--
       (1) Number of projects.--The Secretary shall select not 
     less than 6 States to conduct demonstration projects under 
     this section.
       (2) Eligibility.--In order to be eligible to conduct a 
     demonstration project under this section, a State shall 
     demonstrate the following:
       (A) The State has or will establish sufficient processes 
     for furnishing supportive housing services under the State 
     Medicaid program, working with managed care organizations as 
     applicable in the State, for Medicaid-eligible individuals 
     described in subsection (a).
       (B) The State Medicaid program has procedures in place to 
     coordinate care and services for Medicaid-eligible 
     individuals described in subsection (a), including those with 
     behavioral health needs, across settings, as appropriate, 
     which may include with law enforcement, hospitals and health 
     systems, housing authorities or agencies, mental health and 
     substance use treatment facilities, and community-based 
     organizations.
       (3) Priority.--In selecting States under this section, the 
     Secretary shall give priority to States with large urban 
     populations in which there are existing programs that deliver 
     housing, case management and service coordination, and 
     establishment of screening and referral processes in health 
     care settings, including programs that utilize public 
     hospitals and flexible housing pools to serve individuals who 
     are experiencing housing insecurity or have behavioral health 
     needs.
       (4) Duration.--Each demonstration project under this 
     section shall be conducted for a period of not less than 4 
     years.
       (c) Payment for Services Furnished Under Demonstration 
     Project.--
       (1) In general.--Subject to paragraph (2), amounts expended 
     by a State under a demonstration project under this section 
     on supportive housing services for Medicaid-eligible 
     individuals described in subsection (a) shall be treated as 
     medical assistance for purposes of section 1903(a) of the 
     Social Security Act (42 U.S.C. 1396b(a)).
       (2) Limitation on federal funding.--
       (A) In general.--The total amount certified by the 
     Secretary under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) for payment to a State with respect to 
     expenditures described in paragraph (1) shall not exceed the 
     amount allocated to the State by the Secretary under 
     subparagraph (B).
       (B) Allocation.--
       (i) In general.--The Secretary shall allocate to each State 
     selected to conduct a demonstration project under this 
     section an amount determined appropriate by the Secretary for 
     purposes of reimbursing the State for services furnished 
     under the demonstration project in accordance with paragraph 
     (1).
       (ii) Limitation.--The total amount allocated to States 
     under this subparagraph shall not exceed $75,000,000.
       (d) Waiver Authority.--The Secretary may waive the 
     following requirements as may be necessary to conduct 
     demonstration

[[Page S6192]]

     projects in accordance with the requirements of this section:
       (1) The requirements of section 1902(a)(1) of the Social 
     Security Act (42 U.S.C. 1396a(a)(1)) (relating to 
     statewideness).
       (2) The requirements of section 1902(a)(10)(B) of such Act 
     (42 U.S.C. 1396a(a)(10)(B)) (relating to comparability).
       (3) The requirements of section 1902(a)(10)(C)(i)(III) of 
     such (42 U.S.C. 1396a(a)(10)(C)(i)(III)) (relating to income 
     and resource rules applicable in the community).
       (e) Definitions.--In this section:
       (1) Medicaid.--The term ``Medicaid'' means the medical 
     assistance program established under title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.) and includes any 
     waivers of such program
       (2) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (3) State.--The term ``State'' has the meaning given that 
     term for purposes of title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.).
       (4) Supportive housing services.--The term ``supportive 
     housing services'' means--
       (A) financial assistance with rental payments, room and 
     board, or other housing costs, as appropriate;
       (B) case management and service coordination services; and
       (C) housing support screening and referral services 
     provided in a healthcare setting.

     SEC. 3. ESTABLISHING NIH CLINICAL TRIALS RESEARCH NETWORK ON 
                   VIOLENCE RECOVERY.

       Part B of title IV of the Public Health Service Act (42 
     U.S.C. 284 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 409K. CLINICAL TRIALS RESEARCH NETWORK ON VIOLENCE 
                   RECOVERY.

       ``(a) Network.--The Director of NIH shall develop and 
     support a regional clinical research center network, by 
     awarding funding to participants in accordance with 
     subsection (b) through grants, contracts, or other 
     mechanisms, to study and evaluate hospital- and community-
     based interventions for victims of violent or penetrating 
     injuries to prevent, mitigate, and furnish treatments to 
     address the trauma and mental health impacts of those 
     injuries on such victims and prevent re-injury.
       ``(b) Participants.--
       ``(1) In general.--An entity seeking funding under this 
     section shall--
       ``(A) be a university or hospital; and
       ``(B) submit an application to the Director of NIH at such 
     time, in such manner, and containing such information as the 
     Director may require, including the information described in 
     paragraph (2).
       ``(2) Demonstrated expertise.--An application submitted 
     under paragraph (1)(B) shall include information 
     demonstrating that the applicant has multidisciplinary 
     expertise in--
       ``(A) furnishing hospital- or community-based interventions 
     to improve outcomes for patients suffering a violent or 
     penetrating injury;
       ``(B) quality improvement research;
       ``(C) linking clinical research with practice and community 
     outcomes and activities; and
       ``(D) providing, linking to, or otherwise facilitating 
     community-based care, case management, and treatment.
       ``(3) Selection.--The Director of NIH shall, subject to 
     available funding, select not less than 15 entities meeting 
     the requirements of this subsection to receive funding under 
     this section (provided that 15 or more entities meeting such 
     requirements apply for such funding).
       ``(c) Activities and Use of Funds.--An entity that receives 
     funding under this section shall use the funds to provide 
     support for a trauma-informed and violence re-injury 
     prevention research center, including funding for--
       ``(1) clinical, behavioral, or translational research to 
     test and evaluate trauma-informed interventions for trauma 
     recovery in an effort to prevent and reduce violence-related 
     re-injury, readmission, and mortality;
       ``(2) the provision of screening, delivery of post-injury 
     mental health counseling, trauma-informed care, education, 
     discharge planning, skills building, and long-term case 
     management; and
       ``(3) training researchers, clinicians, case workers, 
     mental health professionals, community health workers, and 
     other appropriate providers to provide appropriate 
     interventions described in paragraph (2).
       ``(d) Outcomes Measurements.--Any activity supported under 
     this section shall be furnished with the aim of preventing 
     and mitigating the impact of trauma and mental health 
     consequences associated with a violent or penetrative injury, 
     improve the overall health and well-being of individuals with 
     a violent or penetrative injury, and prevent re-injury, 
     readmission, and mortality.
       ``(e) Coordination of Consortia Activities.--The Director 
     of NIH shall, as appropriate--
       ``(1) provide for the coordination of activities (including 
     the exchange of information and regular communication) among 
     the entities receiving funding under this section; and
       ``(2) require each entity receiving funding under this 
     section to prepare and submit to the Director periodic 
     reports on the activities of the entity that are supported by 
     this section.''.

     SEC. 4. HEALTH PROFESSIONS OPPORTUNITY GRANTS.

       (a) Funding.--Section 2008(c)(1) of the Social Security Act 
     (42 U.S.C. 1397g(c)(1)) is amended by inserting ``, and 
     $170,000,000 for each of fiscal years 2021 through 2025'' 
     after ``2019''.
       (b) Making Hospitals Eligible.--Section 2008(a)(4)(A) of 
     such Act (42 U.S.C. 1397g(a)(4)(A)) is amended by striking 
     ``or a community-based organization'' and inserting ``, a 
     community-based organization, or a hospital (as defined in 
     section 1861(e))''.
       (c) Aid and Supportive Services.--Section 2008(a)(2)(A)(i) 
     of such Act (42 U.S.C. 1397g(a)(2)(A)(i)) is amended--
       (1) by inserting ``affordable'' before ``child care''; and
       (2) by inserting ``transportation, basic skills and English 
     language proficiency training,''after ``case management,''.

     SEC. 5. HEALTH PROFESSIONS TRAINING FOR DIVERSITY PROGRAMS.

       (a) Centers of Excellence.--Section 736(c) of the Public 
     Health Service Act (42 U.S.C. 293(c)) is amended by adding at 
     the end the following:
       ``(4) Preference.--
       ``(A) In general.--In making grants under subsection (a), 
     the Secretary shall give preference to designated health 
     professions schools, or other public or nonprofit health or 
     educational entities, meeting the requirements of this 
     section that propose to--
       ``(i) carry out the activities supported by this section in 
     communities with a high rate of community trauma; or
       ``(ii) recruit participants for activities supported by 
     this section from communities with a high rate of community 
     trauma.
       ``(B) Community with a high rate of community trauma.--For 
     purposes of subparagraph (A), the term `community with a high 
     rate of community trauma' means a community with a high rate 
     of intergenerational poverty, civil unrest, or 
     discrimination, and may include--
       ``(i) a community with an age-adjusted rate of drug 
     overdose deaths that is above the national average for age-
     adjusted rates of drug overdose deaths, as determined by the 
     Director of the Centers for Disease Control and Prevention; 
     and
       ``(ii) a community with an age-adjusted rate of violence-
     related (or intentional) injury deaths that is above the 
     national average for age-adjusted rates of violence-related 
     (or intentional) injury deaths, as determined by the Director 
     of the Centers for Disease Control and Prevention.''.
       (b) Scholarships for Disadvantaged Students.--Section 
     737(b) of the Public Health Service Act (42 U.S.C. 293a(b)) 
     is amended--
       (1) in the subsection heading by striking ``in Providing 
     Scholarships' ''
       (2) by striking ``The Secretary'' and inserting the 
     following:
       ``(1) Preference in providing scholarships.--The 
     Secretary''; and
       (3) by adding at the end the following:
       ``(2) Preference to eligible entities proposing to serve 
     communities with high rates of community trauma.--
       ``(A) In general.--In making grants under this subsection 
     (a), the Secretary shall give preference to eligible entities 
     that propose to--
       ``(i) carry out the activities supported by this section in 
     communities with a high rate of community trauma; or
       ``(ii) award scholarships under this section to full-time 
     students who are eligible individuals from communities with a 
     high rate of community trauma.
       ``(B) Community with a high rate of community trauma.--For 
     purposes of subparagraph (A), the term `community with a high 
     rate of community trauma' has the meaning given that term in 
     section 736(c)(4)(B).''.
       (c) Health Careers Opportunity Program.--Section 739(b) of 
     the Public Health Service Act (42 U.S.C. 293c(b)) is 
     amended--
       (1) by redesignating paragraphs (1) through (4) as 
     subparagraphs (A) through (D), respectively, and indenting 
     appropriately;
       (2) by striking ``In making'' and inserting the following:
       ``(1) In general.--In making''; and
       (3) by adding at the end the following:
       ``(2) Preference to eligible entities proposing to serve 
     communities with high rates of community trauma.--
       ``(A) In general.--In making awards to eligible entities 
     under subsection (a)(1), the Secretary shall give preference 
     to approved applications for programs proposing to--
       ``(i) carry out the activities supported by this section in 
     communities with a high rate of community trauma; or
       ``(ii) recruit for activities supported by this section 
     individuals from disadvantaged backgrounds, as so determined, 
     from communities with a high rate of community trauma.
       ``(B) Community with a high rate of community trauma.--For 
     purposes of subparagraph (A), the term `community with a high 
     rate of community trauma' has the meaning given that term in 
     section 736(c)(4)(B).''.
       (d) Area Health Education Centers.--Section 751(b) of the 
     Public Health Service Act (42 U.S.C. 294a(b)) is amended by 
     adding at the end the following:
       ``(3) Preference to eligible entities proposing to serve 
     communities with high rates of community trauma.--
       ``(A) In general.--In awarding grants under subsection 
     (a)(1) or (a)(2), the Secretary shall give preference to 
     eligible entities that propose to--
       ``(i) carry out the activities supported by this section in 
     communities with a high rate of community trauma; or
       ``(ii) recruit participants for activities supported by 
     this section from communities with a high rate of community 
     trauma.

[[Page S6193]]

       ``(B) Community with a high rate of community trauma.--For 
     purposes of subparagraph (A), the term `community with a high 
     rate of community trauma' has the meaning given that term in 
     section 736(c)(4)(B).''.

     SEC. 6. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS; 
                   FUNDING FOR THE NATIONAL HEALTH SERVICE CORPS.

       (a) Designation of Health Professional Shortage Areas.--
     Section 332(a)(2) of the Public Health Service Act (42 U.S.C. 
     254e(a)(2)) is amended--
       (1) in subparagraph (A), by inserting ``(including for the 
     delivery of care provided by a city or county health 
     department to inmates of a county or municipal jail)'' after 
     ``county health department''; and
       (2) in subparagraph (B), by striking ``State correctional 
     institution'' and inserting ``State, county, or municipal 
     correctional institution.''.
       (b) Funding for the National Health Service Corps.--Section 
     10503(b)(2) of the Patient Protection and Affordable Care Act 
     (42 U.S.C. 254b-2(b)(2)) is amended--
       (1) in subparagraph (F), by striking ``; and'' and 
     inserting a semicolon;
       (2) in subparagraph (G), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(G) $360,000,000 for the period beginning on November 22, 
     2019, and ending on September 30, 2020, and for each of 
     fiscal years 2021 through 2025.''.

     SEC. 7. INCUMBENT WORKER TRAINING.

       Section 134(d)(4)(A) of the Workforce Innovation and 
     Opportunity Act of 1998 (29 U.S.C. 3174(d)(4)(A)) is 
     amended--
       (1) by redesignating clauses (ii) and (iii) as clauses 
     (iii) and (iv), respectively;
       (2) by inserting after clause (i) the following:
       ``(ii) Greater reservation of funds.--The local board may 
     reserve and use more than 20 percent of the funds so 
     allocated, to pay for the Federal share of the cost described 
     in clause (i), if the Secretary determines that the local 
     board has demonstrated that--

       ``(I) there is a need and demand in the local area for 
     additional incumbent worker training program positions 
     (beyond the positions that could be offered through the 
     reservation described in clause (i)), including specifying 
     the number of employers and workers that could be served 
     through the additional program positions;
       ``(II) training through an incumbent worker training 
     program that is in existence on the day on which information 
     is submitted for the demonstration (referred to in this 
     clause as an `existing incumbent worker training program') 
     has resulted in an incumbent worker of an employer acquiring 
     new skills that allow the worker to obtain a position with 
     such employer requiring higher skills or a higher-paid 
     position than the pre-training position of the incumbent 
     worker, and the employer intends to hire an additional worker 
     to fill the pre-training position of the incumbent worker; 
     and
       ``(III) the effectiveness of the existing incumbent worker 
     training program of the employer referred to in subclause 
     (II), as evaluated on local performance measures based on the 
     primary indicators of performance specified in section 
     116(b)(2)(A)(i).''; and

       (3) in clause (iii), as redesignated by paragraph (1) of 
     this subsection, by striking ``clause (i)'' and inserting 
     ``clause (i) or (ii)''.

                          ____________________