HR 1601 IHCommentsClose CommentsPermalink

To facilitate the provision of telehealth services, and for other purposes.CommentsClose CommentsPermalink

March 20, 2007

Mr. JEFFERSON introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedCommentsClose CommentsPermalink

To facilitate the provision of telehealth services, and for other purposes.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the `Telehealth and Medically Underserved and Advancement Act of 2007'.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

The Congress finds as follows:CommentsClose CommentsPermalink





(1) Studies state that telehealth improves access to medical care for geographically or socio-economically isolated patients.CommentsClose CommentsPermalink





(2) Research has consistently shown that the use of telehealth is a major factor in preventing unnecessary patient travel to secondary or tertiary health care centers.CommentsClose CommentsPermalink





(3) Literature states that the use of telehealth can augment the quality, continuity, and affordability of medical care.CommentsClose CommentsPermalink





(4) The practice of telehealth preserves the patient's current provider-to-patient relationship while facilitating access to specialty care.CommentsClose CommentsPermalink





(5) The use of telehealth will ensure educational and training support for rural-based providers and remove the obstacle of professional isolation.CommentsClose CommentsPermalink





(6) Telehealth allows patients to obtain medical consultation in their own communities, and the expanded use of telehealth technology will improve the quality of chronic disease care, increase wellness initiatives, and reduce health disparities for patients.CommentsClose CommentsPermalink

SEC. 3. INCREASING TYPES OF ORIGINATING TELEHEALTH SITES AND FACILITATING THE PROVISION OF TELEHEALTH SERVICES ACROSS STATE LINES.

(a) Increasing Types of Originating Sites- Section 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following:CommentsClose CommentsPermalink





`(VI) A skilled nursing facility (as defined in section 1819(a)).CommentsClose CommentsPermalink





`(VII) An assisted-living facility (as defined by the Secretary).CommentsClose CommentsPermalink





`(VIII) A board-and-care home (as defined by the Secretary).CommentsClose CommentsPermalink





`(IX) A county or community health clinic (as defined by the Secretary).CommentsClose CommentsPermalink





`(X) A community mental health center (as defined in section 1861(ff)(3)(B)).CommentsClose CommentsPermalink





`(XI) A facility operated by the Indian Health Service or by an Indian tribe, tribal organization, or an urban Indian organization (as such terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)) directly, or under contract or other arrangement.CommentsClose CommentsPermalink





`(XII) A site in a State in which the respective State medical board has adopted a formal policy regarding licensing or certification requirements for providers at distant sites who do not have a license to practice medicine at the originating site.'.CommentsClose CommentsPermalink





(b) Expanding Eligibility for Reimbursement- Section 1834(m)(4)(C)(i)(I) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(i)(I)) is amended by striking `rural'.CommentsClose CommentsPermalink

SEC. 4. STRENGTHENING TELEHEALTH SERVICES IN RURAL AND UNDERSERVED URBAN AMERICA.

Subpart I of part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended--CommentsClose CommentsPermalink





(1) in section 330L--CommentsClose CommentsPermalink





(A) by redesignating subsection (b) as subsection (c); andCommentsClose CommentsPermalink





(B) by inserting after subsection (a) the following:CommentsClose CommentsPermalink





`(b) Conference- Within 2 years of the date of enactment of the Telehealth Medically Underserved and Advancement Act of 2007, the Secretary shall convene a conference of State licensing boards, local telehealth projects, health care practitioners, and patient advocates to promote interstate licensure for telehealth projects.'; andCommentsClose CommentsPermalink





(2) by inserting after section 330L the following:CommentsClose CommentsPermalink

`SEC. 330M. INTEGRATIVE ELDERCARE TELEHEALTH DEMONSTRATION PROJECT.

`(a) Purposes- The purposes of this section are to encourage the creation of programs to--CommentsClose CommentsPermalink





`(1) evaluate the use of telehealth services in an integrative eldercare setting;CommentsClose CommentsPermalink





`(2) eliminate fragmented service delivery while promoting enhanced continuity of care, elimination of health disparities, and more simplified access to services;CommentsClose CommentsPermalink





`(3) develop community-based options that promote patient independence and leverage telehealth services and equipment to enable the use of the most cost-effective, least restrictive care settings; andCommentsClose CommentsPermalink





`(4) promote access for elderly patients in rural and underserved urban areas to improvements in medical technology and training across an integrated spectrum of care; andCommentsClose CommentsPermalink





`(5) make health care services more flexible and responsive to the diverse and changing needs of elderly patients in rural areas.CommentsClose CommentsPermalink





`(b) Grants Authorized-CommentsClose CommentsPermalink





`(1) IN GENERAL- The Director may award grants to eligible providers for projects to demonstrate how telehealth technologies can be used through telehealth networks in rural areas, frontier communities, and medically underserved areas, and for medically underserved populations, to--CommentsClose CommentsPermalink





`(A) expand access to, coordinate, and improve the quality of health care services;CommentsClose CommentsPermalink





`(B) improve and expand the training of health care providers;CommentsClose CommentsPermalink





`(C) expand and improve the quality of health information available to health care providers, and patients and their families, for decision making; andCommentsClose CommentsPermalink





`(D) expand and improve efforts to eliminate health care disparities.CommentsClose CommentsPermalink





`(2) GRANT PERIOD- The Director shall award grants under this subsection for a period of up to 5 years.CommentsClose CommentsPermalink





`(3) NUMBER OF GRANTS- Not to exceed 50 grants shall be awarded under this subsection, of which at least 1/2 shall be dedicated to providing services in rural communities.CommentsClose CommentsPermalink





`(c) Use of Funds- Grants awarded pursuant to subsection (b) may be used for activities including--CommentsClose CommentsPermalink





`(1) improving access to coordinated health care services and resource levels of care consistent with quality health care services and optimal patient outcomes, improving the quality of such care, increasing patient satisfaction with such care, and reducing the cost of such care through advanced telecommunication technologies;CommentsClose CommentsPermalink





`(2) developing effective care management practices and educational curricula to train health care professionals, paraprofessionals, and caregivers, including family members, and to increase the general level of competency of such individuals through such training; andCommentsClose CommentsPermalink





`(3) developing culturally competent curricula to train health care professionals, paraprofessionals, and caregivers, including family members, serving integrative eldercare patients in the use of telecommunications.CommentsClose CommentsPermalink





`(d) Applications- To be eligible to receive a grant under subsection (b), an eligible provider, in consultation with the appropriate State office of rural health or another appropriate State entity, shall prepare and submit to the Director an application, at such time, in such manner, and containing such information as the Director may require, including--CommentsClose CommentsPermalink





`(1) a description of the project that the eligible entity will carry out using the funds provided under the grant;CommentsClose CommentsPermalink





`(2) a description of the manner in which the project funded under the grant will meet the health care needs of rural or other populations to be served through the project, or improve the access to services of, and the quality of the services received by, those populations;CommentsClose CommentsPermalink





`(3) evidence of local support for the project, and a description of how the areas, communities, or populations to be served will be involved in the development and ongoing operations of the project;CommentsClose CommentsPermalink





`(4) a plan for sustaining the project after Federal support for the project has ended;CommentsClose CommentsPermalink





`(5) information on the source and amount of non-Federal funds that the entity will provide for the project;CommentsClose CommentsPermalink





`(6) information demonstrating the long-term viability of the project, and other evidence of institutional commitment of the entity to the project;CommentsClose CommentsPermalink





`(7) information on how services will be used to eliminate health care disparities;CommentsClose CommentsPermalink





`(8) in the case of an application for a project involving a telehealth network, information demonstrating how the project will promote the integration of telehealth technologies into the operations of health care providers, to avoid redundancy, and improve access to and the quality of care; andCommentsClose CommentsPermalink





`(9) other such information as the Director determines to be appropriate.CommentsClose CommentsPermalink





`(e) Report-CommentsClose CommentsPermalink





`(1) FINAL REPORT- Not later than 1 year after the date of termination of the last grant to be awarded under this section, the Director shall submit to Congress a final report--CommentsClose CommentsPermalink





`(A) describing the results of the programs funded by grants awarded pursuant to this section; andCommentsClose CommentsPermalink





`(B) evaluating the impact of the use of telehealth services in an integrative eldercare setting on--CommentsClose CommentsPermalink





`(i) access to care for patients served by integrative eldercare programs; andCommentsClose CommentsPermalink





`(ii) the quality of, patient satisfaction with, and the cost of, such care.CommentsClose CommentsPermalink





`(2) ENSURING ACCESS TO QUALITY CARE- In conducting the evaluation under paragraph (1)(B), the Director shall--CommentsClose CommentsPermalink





`(A) give special consideration to the impact of programs funded under this section on face-to-face access to medical providers; andCommentsClose CommentsPermalink





`(B) develop specific measures to evaluate the quality of care provided to those participating in such programs to ensure that telehealth augments the plan of care.CommentsClose CommentsPermalink





`(f) Eligible Provider- The term `eligible provider' means a consortia of home and facility-based care providers that includes providers from no less than 2 of the following:CommentsClose CommentsPermalink





`(1) An adult congregate care facility.CommentsClose CommentsPermalink





`(2) A continuing care retirement community.CommentsClose CommentsPermalink





`(3) An assisted living facility.CommentsClose CommentsPermalink





`(4) An Alzheimer's facility.CommentsClose CommentsPermalink





`(5) An institutional hospice facility.CommentsClose CommentsPermalink





`(6) A residential care facility.CommentsClose CommentsPermalink





`(7) An adult foster home.CommentsClose CommentsPermalink





`(8) A State-licensed nursing home, including a skilled nursing facility, an intermediate care facility, licensed home health provider or other health care provider that the Director deems appropriate and consistent with the purposes of this section.CommentsClose CommentsPermalink





`(g) Definitions- In this section:CommentsClose CommentsPermalink





`(1) DIRECTOR; OFFICE- The terms `Director' and `Office' mean the Director of the Office for the Advancement of Telehealth and the Office for the Advancement of Telehealth, respectively.CommentsClose CommentsPermalink





`(2) INTEGRATIVE ELDERCARE- The term `integrative eldercare' includes case management and coordination of care for elderly patients recovering from acute illness or coping with chronic disease at the lowest intensity and resource level of care consistent with quality health care services and optimal patient outcomes.CommentsClose CommentsPermalink





`(3) TELEHEALTH SERVICES- The term `telehealth services' means services provided through telehealth technologies.CommentsClose CommentsPermalink





`(4) TELEHEALTH TECHNOLOGIES- The term `telehealth technologies' means technologies relating to the use of electronic information, and telecommunications technologies, to support and promote, at a distance, health care, patient and professional health-related education, health administration, and public health.CommentsClose CommentsPermalink





`(h) Authorization of Appropriations- There are authorized to be appropriated to the Office for the Advancement of Telehealth to carry out this section $45,000,000 for fiscal year 2008 and such sums as may be necessary for each of fiscal years 2009 through 2013.CommentsClose CommentsPermalink

`SEC. 330N. ORAL HEALTH TELEHEALTH DEMONSTRATION PROJECT.

`(a) Purpose- The purpose of this section is to evaluate the use of telehealth services to expand access to oral health services and improve oral health outcomes among rural and underserved urban patients.CommentsClose CommentsPermalink





`(b) Grants Authorized-CommentsClose CommentsPermalink





`(1) IN GENERAL- The Director is authorized to award competitive grants to eligible providers, individually or as part of a network of eligible providers, for the provision of oral health services to improve patient care, prevent health care complications, improve patient outcomes, and achieve efficiencies in the delivery of oral health care to patients who reside in rural areas.CommentsClose CommentsPermalink





`(2) GRANT PERIOD- The Director shall award grants under this section for a period of up to 5 years.CommentsClose CommentsPermalink





`(3) NUMBER OF GRANTS- The number of grants awarded under this section shall not exceed 30 grants.CommentsClose CommentsPermalink





`(c) Use of Funds- Grants awarded pursuant to subsection (b) may be used for activities including--CommentsClose CommentsPermalink





`(1) improving access to care for rural and underserved urban patients served by eligible providers, improving the quality of that care, increasing patient satisfaction with that care, and reducing the cost of that care through advanced telecommunication technologies;CommentsClose CommentsPermalink





`(2) developing effective oral telehealth care management practices and culturally competent educational curricula to train oral health professionals and paraprofessionals and increase their general level of competency through that training; andCommentsClose CommentsPermalink





`(3) developing culturally competent curricula to train health care professionals and paraprofessionals, serving rural and underserved urban patients in the use of telecommunications.CommentsClose CommentsPermalink





`(d) Applications- To be eligible to receive a grant under subsection (b), an eligible entity, in consultation with the appropriate State office of rural health or another appropriate State entity, shall prepare and submit to the Director an application, at such time, in such manner, and containing such information as the Director may require, including--CommentsClose CommentsPermalink





`(1) a description of the project that the eligible entity will carry out using the funds provided under the grant;CommentsClose CommentsPermalink





`(2) a description of the manner in which the project funded under the grant will meet the health care needs of rural or other populations to be served through the project, or improve the access to services of, and the quality of the services received by, those populations;CommentsClose CommentsPermalink





`(3) evidence of local support for the project, and a description of how the areas, communities, or populations to be served will be involved in the development and ongoing operations of the project;CommentsClose CommentsPermalink





`(4) a plan for sustaining the project after Federal support for the project has ended;CommentsClose CommentsPermalink





`(5) information on the source and amount of non-Federal funds that the entity will provide for the project;CommentsClose CommentsPermalink





`(6) information demonstrating the long-term viability of the project, and other evidence of institutional commitment of the entity to the project;CommentsClose CommentsPermalink





`(7) information on how services will be used to eliminate health care disparities;CommentsClose CommentsPermalink





`(8) in the case of an application for a project involving a telehealth network, information demonstrating how the project will promote the integration of telehealth technologies into the operations of health care providers, to avoid redundancy, and improve access to and the quality of care; andCommentsClose CommentsPermalink





`(9) other such information as the Director determines to be appropriate.CommentsClose CommentsPermalink





`(e) Report-CommentsClose CommentsPermalink





`(1) FINAL REPORT- Not later than 1 year after the date of termination of the last grant to be awarded under this section, the Director shall submit to Congress a final report--CommentsClose CommentsPermalink





`(A) describing the results of the programs funded by grants awarded pursuant to this section; andCommentsClose CommentsPermalink





`(B) including an evaluation of the impact of the use of oral telehealth services on--CommentsClose CommentsPermalink





`(i) access to oral health care for rural patients; andCommentsClose CommentsPermalink





`(ii) the quality of, patient satisfaction with, and the cost of, that care.CommentsClose CommentsPermalink





`(2) ENSURING ACCESS TO QUALITY CARE- In conducting the evaluation under paragraph (1)(B), the Director shall--CommentsClose CommentsPermalink





`(A) give special consideration to the impact of programs funded under this section on face-to-face access to medical providers; andCommentsClose CommentsPermalink





`(B) develop specific measures to evaluate the quality of care provided to those participating in such programs to ensure that telemedicine augments the plan of care.CommentsClose CommentsPermalink





`(f) Definition of Eligible Provider- In this section, the term `eligible provider' includes dentists, periodontists, orthodontists, dental and oral health clinics, and schools of dentistry and oral health, where a majority of the patient population resides in a rural area, and may include other rural oral health providers that the Director deems appropriate.CommentsClose CommentsPermalink





`(g) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $30,000,000 for fiscal year 2008 and such sums as may be necessary for each of fiscal years 2009 through 2011.'.CommentsClose CommentsPermalink

SEC. 5. JOINT WORKING GROUP ON TELEHEALTH.

(a) In General-CommentsClose CommentsPermalink





(1) REPRESENTATION OF RURAL AND URBAN AREAS- The Secretary of Health and Human Services shall establish, within the Office for the Advancement of Telehealth in the Health Resources and Services Administration, and under the leadership of the Director of such Office, a Joint Working Group on Telehealth. In establishing such Group, the Secretary shall ensure that all relevant Federal agencies are represented and that input from relevant industry groups, including representatives of rural areas and medically underserved areas, is fully considered.CommentsClose CommentsPermalink





(2) MISSION- The mission of the Joint Working Group on Telehealth is--CommentsClose CommentsPermalink





(A) to identify, monitor, and coordinate Federal telehealth projects, data sets, and programs in rural and urban areas;CommentsClose CommentsPermalink





(B) to analyze--CommentsClose CommentsPermalink





(i) how telehealth systems are expanding access to health care services, education, and information;CommentsClose CommentsPermalink





(ii) the clinical, educational, or administrative efficacy and cost-effectiveness of telehealth applications; andCommentsClose CommentsPermalink





(iii) the quality of the telehealth services delivered;CommentsClose CommentsPermalink





(iv) how telehealth systems can advance the improvement of health care quality and the elimination of health care disparities; andCommentsClose CommentsPermalink





(v) the level of Federal resources needed to accomplish the stated objectives of telehealth programs as established under this Act; andCommentsClose CommentsPermalink





(C) to make further recommendations for coordinating Federal and State efforts to increase access to health services, education, and information in rural and urban medically underserved areas.CommentsClose CommentsPermalink





(3) ANNUAL REPORTS- Not later than 2 years after the date of enactment of this Act, and each January 1 thereafter, the Joint Working Group on Telehealth shall submit to Congress a report on the status of the Group's mission and the state of the telehealth field generally.CommentsClose CommentsPermalink





(b) Report Specifics- The annual report required under subsection (a)(3) shall provide--CommentsClose CommentsPermalink





(1) an analysis of--CommentsClose CommentsPermalink





(A) the matters described in subsection (a)(2)(B);CommentsClose CommentsPermalink





(B) Federal activities with respect to telehealth; andCommentsClose CommentsPermalink





(C) the process of the Joint Working Group on Telehealth's efforts to coordinate Federal telehealth programs; andCommentsClose CommentsPermalink





(2) recommendations for a coordinated Federal strategy to increase health care access through telehealth.CommentsClose CommentsPermalink





(c) Authorization of Appropriations- There are authorized to be appropriated such sums as may be necessary to enable the Joint Working Group on Telehealth to carry out this section.CommentsClose CommentsPermalink