[United States Statutes at Large, Volume 119, 109th Congress, 1st Session]
[From the U.S. Government Publishing Office, www.gpo.gov]

119 STAT. 340

Public Law 109-18
109th Congress

An Act

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. NOTE: June
29, 2005 -  [H.R. 1812]

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress NOTE: Patient Navigator Outreach
and Chronic Disease Prevention Act of 2005. assembled,


This Act may be cited as the ``Patient Navigator Outreach and
Chronic Disease Prevention Act of 2005''.


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:


``(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 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).

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``(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

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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,
``(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) Interim 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) 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).

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``(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.''.

Approved June 29, 2005.


HOUSE REPORTS: No. 109-104 (Comm. on Energy and Commerce).
SENATE REPORTS: No. 109-73 accompanying S. 898 (Comm. on Health,
Education, Labor, and Pensions).
June 13, considered and passed House.
June 22, considered and passed Senate.