U.S. Congress - Text of H.R.3014 as Introduced in House Health Equity and Accountability Act of 2007
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To improve the health of minority individuals, and for other purposes.
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HR 3014 IHCommentsClose CommentsPermalink
To improve the health of minority individuals, and for other purposes.CommentsClose CommentsPermalink
July 12, 2007
Ms. SOLIS (for herself, Mr. ABERCROMBIE, Mr. BACA, Mr. BECERRA, Mr. BISHOP of Georgia, Ms. BORDALLO, Ms. CORRINE BROWN of Florida, Mr. BUTTERFIELD, Mr. CARDOZA, Ms. CARSON, Ms. CASTOR, Mrs. CHRISTENSEN, Ms. CLARKE, Mr. CLAY, Mr. CLEAVER, Mr. CLYBURN, Mr. CONYERS, Mr. COSTA, Mr. CROWLEY, Mr. CUELLAR, Mr. CUMMINGS, Mr. DAVIS of Alabama, Mr. DAVIS of Illinois, Mr. ELLISON, Mr. JOHNSON of Georgia, Mrs. JONES of Ohio, Mr. KILDEE, Ms. KILPATRICK, Ms. LEE, Ms. JACKSON-LEE of Texas, Mr. LEWIS of Georgia, Ms. MATSUI, Mr. MEEK of Florida, Mr. MEEKS of New York, Ms. MOORE of Wisconsin, Mrs. NAPOLITANO, Ms. NORTON, Mr. ORTIZ, Mr. PASTOR, Mr. PAYNE, Mr. RANGEL, Mr. REYES, Mr. RUSH, Mr. RODRIGUEZ, Ms. ROS-LEHTINEN, Ms. ROYBAL-ALLARD, Mr. SALAZAR, Mr. FATTAH, Mr. FORTUN.AE6O, Mr. GONZALEZ, Mr. AL GREEN of Texas, Mr. GENE GREEN of Texas, Mr. GRIJALVA, Mr. HASTINGS of Florida, Mr. HINOJOSA, Mr. HONDA, Mr. HOYER, Mr. JACKSON of Illinois, Mr. JEFFERSON, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. SCOTT of Georgia, Mr. SCOTT of Virginia, Mr. SERRANO, Mr. SIRES, Mr. THOMPSON of Mississippi, Mr. TOWNS, Ms. VELAZQUEZ, Ms. WATERS, Ms. WATSON, Mr. WATT, and Mr. WYNN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Natural Resources, and the Judiciary, 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 improve the health of minority individuals, 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 `Health Equity and Accountability Act of 2007'.CommentsClose CommentsPermalink
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:CommentsClose CommentsPermalink
Sec. 1. Short title.CommentsClose CommentsPermalink
Sec. 2. Table of contents.CommentsClose CommentsPermalink
TITLE I--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE
Sec. 101. Amendment to the Public Health Service Act.CommentsClose CommentsPermalink
Sec. 102. Standards for language access services.CommentsClose CommentsPermalink
Sec. 103. Federal reimbursement for culturally and linguistically appropriate services under the Medicare, Medicaid and State Children's Health Insurance Program.CommentsClose CommentsPermalink
Sec. 104. Increasing understanding of and improving health literacy.CommentsClose CommentsPermalink
Sec. 105. Report on Federal efforts to provide culturally and linguistically appropriate health care services.CommentsClose CommentsPermalink
Sec. 106. Definitions.CommentsClose CommentsPermalink
Sec. 107. Treatment of the Medicare part B program under title VI of the Civil Rights Act of 1964.CommentsClose CommentsPermalink
TITLE II--HEALTH WORKFORCE DIVERSITY
Sec. 201. Amendment to the Public Health Service Act.CommentsClose CommentsPermalink
Sec. 202. Health Careers Opportunity Program.CommentsClose CommentsPermalink
Sec. 203. Program of Excellence in Health Professions Education for Underrepresented Minorities.CommentsClose CommentsPermalink
Sec. 204. Minority-Serving Institutions and Hispanic-serving health professions schools.CommentsClose CommentsPermalink
Sec. 205. Health Professions Student Loan fund; authorizations of appropriations regarding students from underrepresented minority communities.CommentsClose CommentsPermalink
Sec. 206. National Health Service Corps; training programs.CommentsClose CommentsPermalink
Sec. 207. Loan Repayment Program of the Centers for Disease Control and Prevention.CommentsClose CommentsPermalink
Sec. 208. Strengthening and expanding rural health provider networks.CommentsClose CommentsPermalink
Sec. 209. McNair Postbaccalaureate Achievement program.CommentsClose CommentsPermalink
Sec. 210. Ensuring proportional representation of interests of rural areas on MedPAC.CommentsClose CommentsPermalink
TITLE III--DATA COLLECTION AND REPORTING
Sec. 301. Amendment to the Public Health Service Act.CommentsClose CommentsPermalink
Sec. 302. Collection of race and ethnicity data by the Social Security Administration.CommentsClose CommentsPermalink
Sec. 303. Revision of HIPAA claims standards.CommentsClose CommentsPermalink
Sec. 304. National Center for Health Statistics.CommentsClose CommentsPermalink
Sec. 305. Geo-access study.CommentsClose CommentsPermalink
Sec. 306. Racial, ethnic, and linguistic data collected by the Federal Government.CommentsClose CommentsPermalink
Sec. 307. Health information technology grants.CommentsClose CommentsPermalink
Sec. 308. Study of health information technology in medically underserved communities.CommentsClose CommentsPermalink
Sec. 309. Health information technology in medically underserved communities.CommentsClose CommentsPermalink
Sec. 310. Data collection and analysis grants to minority-serving institutions.CommentsClose CommentsPermalink
Sec. 311. Health information technology grants for rural health care providers.CommentsClose CommentsPermalink
TITLE IV--ACCOUNTABILITY AND EVALUATION
Subtitle A--General Provisions
Sec. 401. Federal agency plan to eliminate disparities and improve the health of minority populations.CommentsClose CommentsPermalink
Sec. 402. Accountability within the Department of Health and Human Services.CommentsClose CommentsPermalink
Sec. 403. Office of Minority Health.CommentsClose CommentsPermalink
Sec. 404. Establishment of the Indian Health Service as an agency of the Public Health Service.CommentsClose CommentsPermalink
Sec. 405. Establishment of individual offices of minority health within agencies of the Public Health Service.CommentsClose CommentsPermalink
Sec. 406. Office of Minority Health at the Centers for Medicare & Medicaid Services.CommentsClose CommentsPermalink
Sec. 407. Office of Minority Affairs at the Food and Drug Administration.CommentsClose CommentsPermalink
Sec. 408. Safety and effectiveness of drugs with respect to racial and ethnic background.CommentsClose CommentsPermalink
Sec. 409. United States Commission on Civil Rights.CommentsClose CommentsPermalink
Sec. 410. Sense of Congress concerning full funding of activities to eliminate racial and ethnic health disparities.CommentsClose CommentsPermalink
Sec. 411. Guidelines for disease screening for minority patients.CommentsClose CommentsPermalink
Sec. 412. National center for minority health and health disparities reauthorization.CommentsClose CommentsPermalink
Subtitle B--Improving Environmental Justice
Sec. 421. Codification of executive order 12898.CommentsClose CommentsPermalink
Sec. 422. Implementation of recommendations by environmental protection agency.CommentsClose CommentsPermalink
Sec. 423. Grant program.CommentsClose CommentsPermalink
Sec. 424. Additional research on the relationship between the built environment and the health of community residents.CommentsClose CommentsPermalink
TITLE V--IMPROVEMENT OF HEALTH CARE SERVICES
Sec. 501. Health empowerment zones.CommentsClose CommentsPermalink
Sec. 502. Amendment to the Public Health Service Act.CommentsClose CommentsPermalink
Sec. 503. Optional coverage of legal immigrants under the Medicaid program and SCHIP.CommentsClose CommentsPermalink
Sec. 504. Border health grants.CommentsClose CommentsPermalink
Sec. 505. Cancer prevention and treatment demonstration for ethnic and racial minorities.CommentsClose CommentsPermalink
Sec. 506. Grants to promote positive health behaviors in women and children.CommentsClose CommentsPermalink
Sec. 507. Exception for citizens of freely associated States.CommentsClose CommentsPermalink
Sec. 508. Medicare graduate medical education.CommentsClose CommentsPermalink
Sec. 509. HIV/AIDS reduction in racial and ethnic minority communities.CommentsClose CommentsPermalink
Sec. 510. Grants for racial and ethnic approaches to community health.CommentsClose CommentsPermalink
Sec. 511. Critical access hospital improvements.CommentsClose CommentsPermalink
Sec. 512. Coverage of marriage and family therapist services and mental health counselor services under part B of the Medicare program.CommentsClose CommentsPermalink
Sec. 513. Establishment of rural community hospital (RCH) program.CommentsClose CommentsPermalink
Sec. 514. Medicare remote monitoring pilot projects.CommentsClose CommentsPermalink
Sec. 515. Rural health quality advisory commission and demonstration projects.CommentsClose CommentsPermalink
Sec. 516. Rural health care services.CommentsClose CommentsPermalink
Sec. 517. Community health center collaborative access expansion.CommentsClose CommentsPermalink
Sec. 518. Facilitating the provision of telehealth services across State lines.CommentsClose CommentsPermalink
TITLE I--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE
SEC. 101. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
The Public Health Service Act (
`TITLE XXX--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE
`SEC. 3000. DEFINITIONS.
`In this title:CommentsClose CommentsPermalink
`(1) APPROPRIATE HEALTH CARE SERVICES- The term `appropriate health care services' includes services or treatments to address prevention and care of physical, mental, oral, and behavioral disorders or syndromes.CommentsClose CommentsPermalink
`(2) INDIAN TRIBE- The term `Indian tribe' means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or group or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688) (
`(3) LIMITED ENGLISH PROFICIENT- The term `limited English proficient' with respect to an individual means an individual who speaks a primary language other than English and cannot speak, read, write, or understand the English language at a level that permits them to effectively communicate with clinical or nonclinical staff at a health care organization.CommentsClose CommentsPermalink
`(4) MINORITY-CommentsClose CommentsPermalink
`(A) IN GENERAL- The terms `minority' and `minorities' refer to individuals from a minority group.CommentsClose CommentsPermalink
`(B) POPULATIONS- The term `minority', with respect to populations, refers to racial and ethnic minority groups.CommentsClose CommentsPermalink
`(5) MINORITY GROUP- The term `minority group' has the meaning given the term `racial and ethnic minority group'.CommentsClose CommentsPermalink
`(6) RACIAL AND ETHNIC MINORITY GROUP- The term `racial and ethnic minority group' means American Indians and Alaska Natives, African Americans (including Caribbean Blacks, Africans and other Blacks), Asian Americans, Hispanics (including Latinos), and Native Hawaiians and other Pacific Islanders.CommentsClose CommentsPermalink
`(7) STATE- The term `State' means each of the several states, the District of Columbia, the Commonwealth of Puerto Rico, the Indian tribes, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.CommentsClose CommentsPermalink
`SEC. 3001. IMPROVING ACCESS TO SERVICES FOR INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY.
`(a) Purpose- As provided in Executive Order 13166, it is the purpose of this section--CommentsClose CommentsPermalink
`(1) to improve access to federally conducted and federally assisted programs and activities for individuals who are limited in their English proficiency;CommentsClose CommentsPermalink
`(2) to require each Federal agency to examine the services it provides and develop and implement a system by which limited English proficient individuals can obtain meaningful access to those services consistent with, and without substantially burdening, the fundamental mission of the agency;CommentsClose CommentsPermalink
`(3) to require each Federal agency to ensure that recipients of Federal financial assistance provide meaningful access to their limited English proficient applicants and beneficiaries;CommentsClose CommentsPermalink
`(4) to ensure that recipients of Federal financial assistance take reasonable steps, consistent with the guidelines set forth in the Limited English Proficient Guidance of the Department of Justice (as issued on June 12, 2002), to ensure meaningful access to their programs and activities by limited English proficient individuals; andCommentsClose CommentsPermalink
`(5) to ensure compliance with title VI of the Civil Rights Act of 1964 and that health care providers and organizations do not discriminate in the provision of services.CommentsClose CommentsPermalink
`(b) Federally Conducted Programs and Activities-CommentsClose CommentsPermalink
`(1) IN GENERAL- Not later than 120 days after the date of enactment of this title, each Federal agency that carries out health care-related activities shall prepare a plan to improve access to the federally conducted health care-related programs and activities of the agency by limited English proficient individuals.CommentsClose CommentsPermalink
`(2) PLAN REQUIREMENT- Each plan under paragraph (1) shall be consistent with the standards set forth in section 102 of the Health Equity and Accountability Act of 2007, and shall include the steps the agency will take to ensure that limited English proficient individuals have access to the agency's health care-related programs and activities. Each agency shall send a copy of such plan to the Department of Justice, which shall serve as the central repository of the agencies' plans.CommentsClose CommentsPermalink
`(c) Federally Assisted Programs and Activities-CommentsClose CommentsPermalink
`(1) IN GENERAL- Not later than 120 days after the date of enactment of this title, each Federal agency providing health care-related Federal financial assistance shall ensure that the guidance for recipients of Federal financial assistance developed by the agency to ensure compliance with title VI of the Civil Rights Act of 1964 (
`(2) REQUIREMENTS- The agency-specific guidance developed under paragraph (1) shall--CommentsClose CommentsPermalink
`(A) detail how the general standards established under section 102 of the Health Equity and Accountability Act of 2007 will be applied to the agency's recipients; andCommentsClose CommentsPermalink
`(B) take into account the types of health care services provided by the recipients, the individuals served by the recipients, and other factors set out in such standards.CommentsClose CommentsPermalink
`(3) EXISTING GUIDANCES- A Federal agency that has developed a guidance for purposes of title VI of the Civil Rights Act of 1964 that the Department of Justice determines is consistent with the standards described in section 102 of the Health Equity and Accountability Act of 2007 shall examine such existing guidance, as well as the programs and activities to which such guidance applies, to determine if modification of such guidance is necessary to comply with this subsection.CommentsClose CommentsPermalink
`(4) CONSULTATION- Each Federal agency shall consult with the Department of Justice in establishing the guidances under this subsection.CommentsClose CommentsPermalink
`(d) Consultations-CommentsClose CommentsPermalink
`(1) IN GENERAL- In carrying out this section, each Federal agency that carriers out health care-related activities shall ensure that stakeholders, such as limited English proficient individuals and their representative organizations, recipients of Federal assistance, and other appropriate individuals or entities, have an adequate and comparable opportunity to provide input with respect to the actions of the agency.CommentsClose CommentsPermalink
`(2) EVALUATION- Each Federal agency described in paragraph (1) shall evaluate the--CommentsClose CommentsPermalink
`(A) particular needs of the limited English proficient individuals served by the agency, and by a recipient of assistance provided by the agency;CommentsClose CommentsPermalink
`(B) burdens of compliance with the agency guidance and its recipients of the requirements of this section; andCommentsClose CommentsPermalink
`(C) outcomes or effectiveness of services.CommentsClose CommentsPermalink
`SEC. 3002. NATIONAL STANDARDS FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES IN HEALTH CARE.
`Recipients of Federal financial assistance from the Secretary shall, to the extent reasonable and practicable after applying the 4-factor analysis described in title V of the Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited-English Proficient Persons (June 12, 2002)--CommentsClose CommentsPermalink
`(1) implement strategies to recruit, retain, and promote individuals at all levels of the organization to maintain a diverse staff and leadership that can provide culturally and linguistically appropriate health care to patient populations of the service area of the organization;CommentsClose CommentsPermalink
`(2) ensure that staff at all levels and across all disciplines of the organization receive ongoing education and training in culturally and linguistically appropriate service delivery;CommentsClose CommentsPermalink
`(3) offer and provide language assistance services, including trained bilingual staff and interpreter services, at no cost to each patient with limited English proficiency at all points of contact, in a timely manner during all hours of operation;CommentsClose CommentsPermalink
`(4) notify patients of their right to receive language assistance services in their primary language;CommentsClose CommentsPermalink
`(5) ensure the competence of language assistance provided to limited English proficient patients by interpreters and bilingual staff, and ensure that family, particularly minor children, and friends are not used to provide interpretation services--CommentsClose CommentsPermalink
`(A) except in case of emergency; orCommentsClose CommentsPermalink
`(B) except on request of the patient, who has been informed in his or her preferred language of the availability of free interpretation services;CommentsClose CommentsPermalink
`(6) make available easily understood patient-related materials, if such materials exist for non-limited English proficient patients, including information or notices about termination of benefits and post signage in the languages of the commonly encountered groups or groups represented in the service area of the organization;CommentsClose CommentsPermalink
`(7) develop and implement clear goals, policies, operational plans, and management accountability and oversight mechanisms to provide culturally and linguistically appropriate services;CommentsClose CommentsPermalink
`(8) conduct initial and ongoing organizational assessments of culturally and linguistically appropriate services-related activities and integrate valid linguistic competence-related measures into the internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations of the organization;CommentsClose CommentsPermalink
`(9) ensure that, consistent with the privacy protections provided for under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (
`(A) data on the individual patient's race, ethnicity, and primary language are collected in health records, integrated into the organization's management information systems, and periodically updated; andCommentsClose CommentsPermalink
`(B) if the patient is a minor or is incapacitated, the primary language of the parent or legal guardian is collected;CommentsClose CommentsPermalink
`(10) maintain a current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area of the organization;CommentsClose CommentsPermalink
`(11) develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient involvement in designing and implementing culturally and linguistically appropriate services-related activities;CommentsClose CommentsPermalink
`(12) ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients;CommentsClose CommentsPermalink
`(13) regularly make available to the public information about their progress and successful innovations in implementing the standards under this section and provide public notice in their communities about the availability of this information; andCommentsClose CommentsPermalink
`(14) if requested, regularly make available to the head of each Federal entity from which Federal funds are received, information about their progress and successful innovations in implementing the standards under this section as required by the head of such entity.CommentsClose CommentsPermalink
`SEC. 3003. ROBERT T. MATSUI CENTER FOR CULTURAL AND LINGUISTIC COMPETENCE IN HEALTH CARE.
`(a) Establishment- The Secretary, acting through the Director of the Office of Minority Health Disparity Elimination, shall establish and support a center to be known as the `Robert T. Matsui Center for Cultural and Linguistic Competence in Health Care' (referred to in this section as the `Center') to carry out the following activities:CommentsClose CommentsPermalink
`(1) REMOTE MEDICAL INTERPRETING- The Center shall provide remote medical interpreting, directly or through contracts, to health care providers who otherwise would be unable to provide language interpreting services, at reasonable or no cost as determined appropriate by the Director of the Center. Methods of interpretation may include remote, simultaneous or consecutive interpreting through telephonic systems, video conferencing, and other methods determined appropriate by the Secretary for patients with limited English proficiency. The quality of such interpreting shall be monitored and reported publicly. Nothing in this paragraph shall be construed to limit the ability of health care providers or organizations to provide medical interpreting services directly and obtain reimbursement for such services as provided for under the Medicare, Medicaid, or SCHIP programs under titles XVIII, XIX, or XXI of the Social Security Act.CommentsClose CommentsPermalink
`(2) MODEL LANGUAGE ASSISTANCE PROGRAMS- The Center shall provide for the collection and dissemination of information on current model language assistance programs and strategies to improve language access to health care for individuals with limited English proficiency, including case studies using de-identified patient information, program summaries, and program evaluations.CommentsClose CommentsPermalink
`(3) INTERNET HEALTH CLEARINGHOUSE- The Center shall develop and maintain an Internet clearinghouse to reduce medical errors and improve medical outcomes and reduce health care costs caused by miscommunication with individuals with limited English proficiency or low functional health literacy and reduce or eliminate the duplication of effort to translate materials by--CommentsClose CommentsPermalink
`(A) developing and making available templates for standard documents that are necessary for patients and consumers to access and make educated decisions about their health care, including--CommentsClose CommentsPermalink
`(i) administrative and legal documents such as informed consent, advanced directives, and waivers of rights;CommentsClose CommentsPermalink
`(ii) clinical information such as how to take medications, how to prevent transmission of a contagious disease, and other prevention and treatment instructions;CommentsClose CommentsPermalink
`(iii) patient education and outreach materials such as immunization notices, health warnings, or screening notices; andCommentsClose CommentsPermalink
`(iv) additional health or health care-related materials as determined appropriate by the Director of the Center;CommentsClose CommentsPermalink
`(B) ensuring that the documents posted in English and non-English languages are culturally appropriate;CommentsClose CommentsPermalink
`(C) allowing public review of the documents before dissemination in order to ensure that the documents are understandable and culturally appropriate for the target populations;CommentsClose CommentsPermalink
`(D) allowing health care providers to customize the documents for their use;CommentsClose CommentsPermalink
`(E) facilitating access to these documents;CommentsClose CommentsPermalink
`(F) providing technical assistance with respect to the access and use of such information; andCommentsClose CommentsPermalink
`(G) carrying out any other activities the Secretary determines to be useful to fulfill the purposes of the Clearinghouse.CommentsClose CommentsPermalink
`(4) PROVISION OF INFORMATION- The Center shall provide information relating to culturally and linguistically competent health care for minority populations residing in the United States to all health care providers and health care organizations at no cost. Such information shall include--CommentsClose CommentsPermalink
`(A) tenets of culturally and linguistically competent care;CommentsClose CommentsPermalink
`(B) cultural and linguistic competence self-assessment tools;CommentsClose CommentsPermalink
`(C) cultural and linguistic competence training tools;CommentsClose CommentsPermalink
`(D) strategic plans to increase cultural and linguistic competence in different types of health care organizations, including regional collaborations among health care organizations; andCommentsClose CommentsPermalink
`(E) resources for cultural and linguistic competence information for educators, practitioners and researchers.CommentsClose CommentsPermalink
`(b) Director- The Center shall be headed by a Director who shall be appointed by, and who shall report to, the Deputy Assistant Secretary for Minority Health.CommentsClose CommentsPermalink
`(c) Availability of Language Access- The Director shall collaborate with all agencies within the Department of Health and Human Services to notify health care providers and health care organizations about the availability of language access services by the Center.CommentsClose CommentsPermalink
`(d) Authorization of Appropriations- There is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2008 through 2012.CommentsClose CommentsPermalink
`SEC. 3004. INNOVATIONS IN CULTURAL AND LINGUISTIC COMPETENCE GRANTS.
`(a) In General- The Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, the Administrator of the Health Resources and Services Administration, the Secretary of Education, and the Deputy Assistant Secretary for Minority Health, shall award grants to eligible entities to enable such entities to design, implement, and evaluate innovative, cost-effective programs to improve cultural and linguistic competence in health care for individuals with limited English proficiency.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive a grant under subsection (a) an entity shall--CommentsClose CommentsPermalink
`(1) be a city, county, Indian tribe, State, territory, community-based and other nonprofit organization, health center or community clinic, university, college, or other entity designated by the Secretary; andCommentsClose CommentsPermalink
`(2) prepare and submit to the Secretary an application, at such time, in such manner, and accompanied by such additional information as the Secretary may require.CommentsClose CommentsPermalink
`(c) Use of Funds- An entity shall use funds received under a grant under this section to--CommentsClose CommentsPermalink
`(1) develop, implement, and evaluate models of providing real-time cultural competence and interpretation services through in-person interpretation, communications, and computer technology, including the Internet, teleconferencing, or video conferencing;CommentsClose CommentsPermalink
`(2) develop short-term medical interpretation training courses and incentives for bilingual health care staff who are asked to interpret in the workplace;CommentsClose CommentsPermalink
`(3) develop formal training programs for individuals interested in becoming dedicated health care interpreters and culturally competent providers;CommentsClose CommentsPermalink
`(4) provide staff language training instruction which shall include information on the practical limitations of such instruction for non-native speakers; andCommentsClose CommentsPermalink
`(5) develop other language assistance services as determined appropriate by the Secretary.CommentsClose CommentsPermalink
`(d) Priority- In awarding grants under this section, the Secretary shall give priority to entities that have developed partnerships with organizations or agencies with experience in culturally competent and language access services.CommentsClose CommentsPermalink
`(e) Evaluation- An entity that receives a grant under this section shall submit to the Secretary an evaluation that describes the activities carried out with funds received under the grant, and how such activities improved access to health care services and the quality of health care for individuals with limited English proficiency. Such evaluation shall be collected and disseminated through the Robert T. Matsui Center for Cultural and Linguistic Competence in Health Care established under section 3003.CommentsClose CommentsPermalink
`(f) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, $5,000,000 for each of fiscal years 2008 through 2012.CommentsClose CommentsPermalink
`SEC. 3005. RESEARCH ON CULTURAL AND LANGUAGE COMPETENCE.
`(a) In General- The Director of the Agency for Healthcare Research and Quality, in collaboration with the Deputy Assistant Secretary for Minority Health, shall expand research concerning--CommentsClose CommentsPermalink
`(1) the barriers to health care services including mental and behavioral services that are faced by limited English proficient individuals;CommentsClose CommentsPermalink
`(2) the impact of cultural and language barriers on the quality of health care and the health status of limited English proficient individuals and populations;CommentsClose CommentsPermalink
`(3) health care providers' and health administrators' attitudes, knowledge, and awareness of the barriers described in paragraphs (1) and (2);CommentsClose CommentsPermalink
`(4) the means by which language access services are provided to limited English proficient individuals and how such services are effective in improving the quality of care;CommentsClose CommentsPermalink
`(5) the cost-effectiveness of providing language access; andCommentsClose CommentsPermalink
`(6) optimal approaches for delivering language access.CommentsClose CommentsPermalink
`(b) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2012.CommentsClose CommentsPermalink
`SEC. 3006. INFORMATION ABOUT FEDERAL HEALTH PROGRAMS FOR LIMITED ENGLISH PROFICIENT POPULATIONS.
`The Secretary shall provide for a means by which limited English proficient individuals who are seeking information about, or assistance with, Federal health care programs may obtain such information or assistance.'.CommentsClose CommentsPermalink
SEC. 102. STANDARDS FOR LANGUAGE ACCESS SERVICES.
Not later than 120 days after the date of enactment of this Act, the head of each Federal agency that carries out health care-related activities shall develop and adopt a guidance on language services for those with limited English proficiency who attempt to have access to or participate in such activities that provides at the minimum the factors and principles set forth in the Department of Justice guidance published on June 12, 2002.CommentsClose CommentsPermalink
SEC. 103. FEDERAL REIMBURSEMENT FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES UNDER THE MEDICARE, MEDICAID AND STATE CHILDREN'S HEALTH INSURANCE PROGRAM.
(a) Demonstration Project Promoting Access for Medicare Beneficiaries With Limited English Proficiency-CommentsClose CommentsPermalink
(1) IN GENERAL- The Secretary shall conduct a demonstration project (in this subsection referred to as the `project') to demonstrate the impact on costs and health outcomes of providing reimbursement for interpreter services to certain Medicare beneficiaries who are limited English proficient in urban and rural areas.CommentsClose CommentsPermalink
(2) SCOPE- The Secretary shall carry out the project in not less than 30 States or territories through contracts with--CommentsClose CommentsPermalink
(A) MA plans (under part C of title XVIII of the Social Security Act);CommentsClose CommentsPermalink
(B) small providers;CommentsClose CommentsPermalink
(C) hospitals; andCommentsClose CommentsPermalink
(D) community-based clinics.CommentsClose CommentsPermalink
(3) DURATION- Each contract entered into under the project shall extend over a period of not longer than 2 years.CommentsClose CommentsPermalink
(4) REPORT- Upon completion of the project, the Secretary shall submit a report to Congress on the project which shall include recommendations regarding the extension of such project to the entire Medicare program.CommentsClose CommentsPermalink
(5) EVALUATION- The Director of the Agency for Healthcare Research and Quality, in consultation with the Office of Minority Health and the National Center on Minority Health and Health Disparities, shall award grants to public and private nonprofit entities that demonstrate experience and capability with respect to cultural and linguistic competence, including Historically Black Colleges and Universities, Hispanic-serving institutions, and other entities directed by and serving representatives of racial and ethnic minority groups, for the evaluation of the project. Such evaluations shall focus on access, utilization, efficiency, cost-effectiveness, patient satisfaction, and select health outcomes.CommentsClose CommentsPermalink
(b) Medicaid- Section 1903(a)(3) of the Social Security Act (
(1) in subparagraph (E), by striking `plus' at the end and inserting `and'; andCommentsClose CommentsPermalink
(2) by adding at the end the following:CommentsClose CommentsPermalink
`(F) 100 percent of the sums expended with respect to costs incurred during such quarter as are attributable to the provision of language services on behalf of individuals with limited English proficiency who apply for or receive medical assistance under the State plan under this title (including any provisions of the plan implemented pursuant to any waiver authority of the Secretary) or child health assistance under a State child health plan under title XXI; plus'.CommentsClose CommentsPermalink
(c) SCHIP- Section 2105(c)(2)(A) of the Social Security Act (
(d) Effective Date- The amendments made by this section take effect on October 1, 2007.CommentsClose CommentsPermalink
SEC. 104. INCREASING UNDERSTANDING OF AND IMPROVING HEALTH LITERACY.
(a) In General- The Secretary, acting through the Director of the Agency for Healthcare Research and Quality and the Administrator of the Health Resources and Services Administration, in consultation with the Office of Minority Health, shall award grants to eligible entities to improve health care for patient populations that have low functional health literacy.CommentsClose CommentsPermalink
(b) Eligibility- To be eligible to receive a grant under subsection (a), an entity shall--CommentsClose CommentsPermalink
(1) be a hospital, health center or clinic, health plan, or other health entity (including a nonprofit minority health organization or association); andCommentsClose CommentsPermalink
(2) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
(c) Use of Funds-CommentsClose CommentsPermalink
(1) AGENCY FOR HEALTHCARE RESEARCH AND QUALITY- Grants awarded under subsection (a) through the Agency for Healthcare Research and Quality shall be used--CommentsClose CommentsPermalink
(A) to define and increase the understanding of health literacy;CommentsClose CommentsPermalink
(B) to investigate the correlation between low health literacy and health and health care;CommentsClose CommentsPermalink
(C) to clarify which aspects of health literacy have an effect on health outcomes; andCommentsClose CommentsPermalink
(D) for any other activity determined appropriate by the Director of the Agency.CommentsClose CommentsPermalink
(2) HEALTH RESOURCES AND SERVICES ADMINISTRATION- Grants awarded under subsection (a) through the Health Resources and Services Administration shall be used to conduct demonstration projects for interventions for patients with low health literacy that may include--CommentsClose CommentsPermalink
(A) the development of new disease management programs for patients with low health literacy;CommentsClose CommentsPermalink
(B) the tailoring of existing disease management programs addressing mental, physical, oral, and behavioral health conditions for patients with low health literacy;CommentsClose CommentsPermalink
(C) the translation of written health materials for patients with low health literacy;CommentsClose CommentsPermalink
(D) the identification, implementation, and testing of low health literacy screening tools;CommentsClose CommentsPermalink
(E) the conduct of educational campaigns for patients and providers about low health literacy; andCommentsClose CommentsPermalink
(F) other activities determined appropriate by the Administrator of the Health Resources and Services Administration.CommentsClose CommentsPermalink
(d) Definitions- In this section, the term `low health literacy' means the inability of an individual to obtain, process, and understand basic health information and services needed to make appropriate health decisions.CommentsClose CommentsPermalink
(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2012.CommentsClose CommentsPermalink
SEC. 105. REPORT ON FEDERAL EFFORTS TO PROVIDE CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE SERVICES.
Not later than 1 year after the date of enactment of this Act and annually thereafter, the Secretary of Health and Human Services shall enter into a contract with the Institute of Medicine for the preparation and publication of a report that describes Federal efforts to ensure that all individuals have meaningful access to culturally and linguistically appropriate health care services. Such report shall include--CommentsClose CommentsPermalink
(1) a description and evaluation of the activities carried out under this Act;CommentsClose CommentsPermalink
(2) a description of best practices, model programs, guidelines, and other effective strategies for providing access to culturally and linguistically appropriate health care services; andCommentsClose CommentsPermalink
(3) an assessment of the implementation of the Department of Health and Human Services National Standards on Culturally and Linguistically Appropriate Services (CLAS) in Health Care, in particular the implementation of CLAS mandates by recipients of Federal funds.CommentsClose CommentsPermalink
SEC. 106. DEFINITIONS.
In this title:CommentsClose CommentsPermalink
(1) INCORPORATED DEFINITIONS- The definitions contained in section 3000 of the Public Health Service Act, as added by section 101, shall apply.CommentsClose CommentsPermalink
(2) SECRETARY- The term `Secretary' means the Secretary of Health and Human Services.CommentsClose CommentsPermalink
SEC. 107. TREATMENT OF THE MEDICARE PART B PROGRAM UNDER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964.
A payment provider of services or physician or other supplier under part B of title XVIII of the Social Security Act shall be deemed a grant, and not a contract of insurance or guaranty, for the purposes of title VI of the Civil Rights Act of 1964.CommentsClose CommentsPermalink
TITLE II--HEALTH WORKFORCE DIVERSITY
SEC. 201. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
Title XXX of the Public Health Service Act, as added by section 101, is amended by adding at the end the following:CommentsClose CommentsPermalink
`Subtitle A--Diversifying the Health Care Workplace
`SEC. 3011. REPORT ON WORKFORCE DIVERSITY.
`(a) In General- Not later than July 1, 2008, and biannually thereafter, the Secretary, acting through the director of each entity within the Department of Health and Human Services, shall prepare and 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 a report on health workforce diversity.CommentsClose CommentsPermalink
`(b) Requirement- The report under subsection (a) shall contain the following information:CommentsClose CommentsPermalink
`(1) A description of any grant support that is provided by each entity for workforce diversity initiatives with the following information--CommentsClose CommentsPermalink
`(A) the number of grants made;CommentsClose CommentsPermalink
`(B) the purpose of the grants;CommentsClose CommentsPermalink
`(C) the populations served through the grants;CommentsClose CommentsPermalink
`(D) the organizations and institutions receiving the grants, including specification of the number of Hispanic health professions schools and minority-serving institutions; andCommentsClose CommentsPermalink
`(E) the tracking efforts that were used to follow the progress of participants.CommentsClose CommentsPermalink
`(2) A description of the entity's plan to achieve workforce diversity goals that includes, to the extent relevant to such entity--CommentsClose CommentsPermalink
`(A) the number of underrepresented minority health professionals that will be needed in various disciplines over the next 10 years to achieve population parity;CommentsClose CommentsPermalink
`(B) the level of funding needed to fully expand and adequately support health professions pipeline programs;CommentsClose CommentsPermalink
`(C) the impact such programs have had on the admissions practices and policies of health professions schools;CommentsClose CommentsPermalink
`(D) the management strategy necessary to effectively administer and institutionalize health profession pipeline programs;CommentsClose CommentsPermalink
`(E) the impact that the Government Performance and Results Act (GPRA) has had on evaluating the performance of grantees and whether the GPRA is the best assessment tool for programs under titles VII and VIII; andCommentsClose CommentsPermalink
`(F) an examination of the role and support for minority-serving institutions and Hispanic health professions schools in training minority health professionals and in increasing their representation at all levels in the Department of Health and Human Services.CommentsClose CommentsPermalink
`(3) A description of measurable objectives of each entity relating to workforce diversity initiatives.CommentsClose CommentsPermalink
`(c) Public Availability- The report under subsection (a) shall be made available for public review and comment.CommentsClose CommentsPermalink
`SEC. 3012. TECHNICAL CLEARINGHOUSE FOR HEALTH WORKFORCE DIVERSITY.
`(a) In General- The Secretary, acting through the Office of Minority Health, and in collaboration with the Bureau of Health Professions within the Health Resources and Services Administration, shall establish a technical clearinghouse on health workforce diversity within the Office of Minority Health and coordinate current and future clearinghouses.CommentsClose CommentsPermalink
`(b) Information and Services- The clearinghouse established under subsection (a) shall offer the following information and services:CommentsClose CommentsPermalink
`(1) Information on the importance of health workforce diversity.CommentsClose CommentsPermalink
`(2) Statistical information relating to underrepresented minority representation in health and allied health professions and occupations.CommentsClose CommentsPermalink
`(3) Model health workforce diversity practices and programs.CommentsClose CommentsPermalink
`(4) Admissions policies that promote health workforce diversity and are in compliance with Federal and State laws.CommentsClose CommentsPermalink
`(5) Lists of scholarship, loan repayment, and loan cancellation grants as well as fellowship information for underserved populations for health professions schools.CommentsClose CommentsPermalink
`(6) Foundation and other large organizational initiatives relating to health workforce diversity.CommentsClose CommentsPermalink
`(c) Consultation- In carrying out this section, the Secretary shall consult with non-Federal entities, which shall include minority health professional associations to help ensure thoroughness and accuracy of information.CommentsClose CommentsPermalink
`(d) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3013. EVALUATION OF WORKFORCE DIVERSITY INITIATIVES.
`(a) In General- The Secretary, acting through the Bureau of Health Professions within the Health Resources and Services Administration, shall award grants to eligible entities for the conduct of an evaluation of current health workforce diversity initiatives funded by the Department of Health and Human Services.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive a grant under subsection (a) an entity shall--CommentsClose CommentsPermalink
`(1) be a city, county, Indian tribe, State, territory, community-based nonprofit organization, health center, university, college, or other entity determined appropriate by the Secretary;CommentsClose CommentsPermalink
`(2) with respect to an entity that is not an academic medical center, university, or private research institution, carry out activities under the grant in partnership with an academic medical center, university, or private research institution; andCommentsClose CommentsPermalink
`(3) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(c) Use of Funds- Amounts awarded under a grant under subsection (a) shall be used to support the following evaluation activities:CommentsClose CommentsPermalink
`(1) Determinations of measures of health workforce diversity success.CommentsClose CommentsPermalink
`(2) Assessments of the effects of health workforce diversity on quality, including--CommentsClose CommentsPermalink
`(A) language access;CommentsClose CommentsPermalink
`(B) cultural competence;CommentsClose CommentsPermalink
`(C) patient satisfaction;CommentsClose CommentsPermalink
`(D) timeliness of care;CommentsClose CommentsPermalink
`(E) safety of care;CommentsClose CommentsPermalink
`(F) effectiveness of care;CommentsClose CommentsPermalink
`(G) efficiency of care;CommentsClose CommentsPermalink
`(H) patient outcomes;CommentsClose CommentsPermalink
`(I) community engagement;CommentsClose CommentsPermalink
`(J) resource allocation;CommentsClose CommentsPermalink
`(K) organizational structure; andCommentsClose CommentsPermalink
`(L) other topics determined appropriate by the Secretary.CommentsClose CommentsPermalink
`(3) The short- and long-term tracking of participants in health workforce diversity pipeline programs funded by the Department of Health and Human Services.CommentsClose CommentsPermalink
`(4) Assessments of partnerships formed through activities to increase health workforce diversity.CommentsClose CommentsPermalink
`(5) Assessments of barriers to health workforce diversity.CommentsClose CommentsPermalink
`(6) Assessments of policy changes at the Federal, State, and local levels.CommentsClose CommentsPermalink
`(7) Assessments of coordination within and between Federal agencies and other institutions.CommentsClose CommentsPermalink
`(8) Other activities determined appropriate by the Secretary.CommentsClose CommentsPermalink
`(d) Report- Not later than 1 year after the date of enactment of this title, the Bureau of Health Professions within the Health Resources and Services Administration shall prepare and make available for public comment a report that summarizes the findings made by entities under grants under this section.CommentsClose CommentsPermalink
`(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3014. DATA COLLECTION AND REPORTING BY HEALTH PROFESSIONAL SCHOOLS.
`(a) In General- The Secretary, acting through the Bureau of Health Professions of the Health Resources and Services Administration and the Office of Minority Health, shall establish an aggregated database on health professional students.CommentsClose CommentsPermalink
`(b) Requirement To Collect Data- Each health professional school (including medical, dental, and nursing schools) and allied health profession school and program that receives Federal funds shall collect race, ethnicity, and language proficiency data concerning those students enrolled at such schools or in such programs. In collecting such data, a school or program shall--CommentsClose CommentsPermalink
`(1) at a minimum, use the categories for race and ethnicity described in the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity and available language standards; andCommentsClose CommentsPermalink
`(2) if practicable, collect data on additional population groups if such data can be aggregated into the minimum race and ethnicity data categories.CommentsClose CommentsPermalink
`(c) Use of Data- Data on race, ethnicity, and primary language collected under this section shall be reported to the database established under subsection (a) on an annual basis. Such data shall be available for public use.CommentsClose CommentsPermalink
`(d) Privacy- The Secretary shall ensure that all data collected under this section is protected from inappropriate internal and external use by any entity that collects, stores, or receives the data and that such data is collected without personally identifiable information.CommentsClose CommentsPermalink
`(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3015. SUPPORT FOR INSTITUTIONS COMMITTED TO WORKFORCE DIVERSITY.
`(a) In General- The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants to eligible entities that demonstrate a commitment to health workforce diversity.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive a grant under subsection (a), an entity shall--CommentsClose CommentsPermalink
`(1) be an educational institution or entity that historically produces or trains meaningful numbers of underrepresented minority health professionals, including--CommentsClose CommentsPermalink
`(A) Historically Black Colleges and Universities;CommentsClose CommentsPermalink
`(B) Hispanic-serving health professions schools;CommentsClose CommentsPermalink
`(C) Hispanic-serving institutions;CommentsClose CommentsPermalink
`(D) Tribal Colleges and Universities;CommentsClose CommentsPermalink
`(E) Asian American and Pacific Islander-serving institutions;CommentsClose CommentsPermalink
`(F) institutions that have programs to recruit and retain underrepresented minority health professionals, in which a significant number of the enrolled participants are underrepresented minorities;CommentsClose CommentsPermalink
`(G) health professional associations, which may include underrepresented minority health professional associations; andCommentsClose CommentsPermalink
`(H) institutions--CommentsClose CommentsPermalink
`(i) located in communities with predominantly underrepresented minority populations;CommentsClose CommentsPermalink
`(ii) with whom partnerships have been formed for the purpose of increasing workforce diversity; andCommentsClose CommentsPermalink
`(iii) in which at least 20 percent of the enrolled participants are underrepresented minorities; andCommentsClose CommentsPermalink
`(2) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(c) Use of Funds- Amounts received under a grant under subsection (a) shall be used to expand existing workforce diversity programs, implement new workforce diversity programs, or evaluate existing or new workforce diversity programs, including with respect to mental as well as oral health care professions. Such programs shall enhance diversity by considering minority status as part of an individualized consideration of qualifications. Possible activities may include--CommentsClose CommentsPermalink
`(1) educational outreach programs relating to opportunities in the health professions;CommentsClose CommentsPermalink
`(2) scholarship, fellowship, grant, and loan repayment programs;CommentsClose CommentsPermalink
`(3) post-baccalaureate programs;CommentsClose CommentsPermalink
`(4) academic enrichment programs, particularly targeting those who would not be competitive for health professions schools;CommentsClose CommentsPermalink
`(5) kindergarten through 12th grade and other health pipeline programs;CommentsClose CommentsPermalink
`(6) mentoring programs;CommentsClose CommentsPermalink
`(7) internship or rotation programs involving hospitals, health systems, health plans and other health entities;CommentsClose CommentsPermalink
`(8) community partnership development for purposes relating to workforce diversity; orCommentsClose CommentsPermalink
`(9) leadership training.CommentsClose CommentsPermalink
`(d) Reports- Not later than 1 year after receiving a grant under this section, and annually for the term of the grant, a grantee shall submit to the Secretary a report that summarizes and evaluates all activities conducted under the grant.CommentsClose CommentsPermalink
`(e) Definition- In this section, the term `Asian American and Pacific Islander-serving institutions' means institutions--CommentsClose CommentsPermalink
`(1) that are eligible institutions under section 312(b) of the Higher Education Act of 1965; andCommentsClose CommentsPermalink
`(2) that, at the time of their application, have an enrollment of undergraduate students that is made up of at least 10 percent Asian American and Pacific Islander students.CommentsClose CommentsPermalink
`(f) Authorization of Appropriations- There is authorized to be appropriated to carry out this section $100,000,000 for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3016. CAREER DEVELOPMENT FOR SCIENTISTS AND RESEARCHERS.
`(a) In General- The Secretary, acting through the Director of the National Institutes of Health, the Director of the Centers for Disease Control and Prevention, the Commissioner of Food and Drugs, and the Director of the Agency for Healthcare Research and Quality, shall award grants that expand existing opportunities for scientists and researchers and promote the inclusion of underrepresented minorities in the health professions.CommentsClose CommentsPermalink
`(b) Research Funding- The head of each entity within the Department of Health and Human Services shall establish or expand existing programs to provide research funding to scientists and researchers in-training. Under such programs, the head of each such entity shall give priority in allocating research funding to support health research in traditionally underserved communities, including underrepresented minority communities, and research classified as community or participatory.CommentsClose CommentsPermalink
`(c) Data Collection- The head of each entity within the Department of Health and Human Services shall collect data on the number (expressed as an absolute number and a percentage) of underrepresented minority and nonminority applicants who receive and are denied agency funding at every stage of review. Such data shall be reported annually to the Secretary and the appropriate committees of Congress.CommentsClose CommentsPermalink
`(d) Student Loan Reimbursement- The Secretary shall establish a student loan reimbursement program to provide student loan reimbursement assistance to researchers who focus on racial and ethnic disparities in health. The Secretary shall promulgate regulations to define the scope and procedures for the program under this subsection.CommentsClose CommentsPermalink
`SEC. 3017. CAREER SUPPORT FOR NON-RESEARCH HEALTH PROFESSIONALS.
`(a) In General- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, the Administrator of the Substance Abuse and Mental Health Services Administration, the Administrator of the Health Resources and Services Administration, and the Administrator of the Centers for Medicare & Medicaid Services shall establish a program to award grants to eligible individuals for career support, including leadership training, in non-research-related health care.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive a grant under subsection (a) an individual shall--CommentsClose CommentsPermalink
`(1) be a student in a health professions school, a graduate of such a school who is working in a health profession, or a faculty member of such a school; andCommentsClose CommentsPermalink
`(2) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(c) Use of Funds- An individual shall use amounts received under a grant under this section to--CommentsClose CommentsPermalink
`(1) support the individual's health activities or projects that involve underserved communities, including rural communities and racial and ethnic minority communities;CommentsClose CommentsPermalink
`(2) support health-related career advancement activities; andCommentsClose CommentsPermalink
`(3) to pay, or as reimbursement for payments of, student loans for individuals who are health professionals and are focused on health issues affecting underserved communities, including rural communities and racial and ethnic minority communities.CommentsClose CommentsPermalink
`(d) Definition- In this section, the term `career in non-research-related health care' means employment or intended employment in the field of public health, health policy, health management, health administration, medicine, nursing, pharmacy, allied health, community health, or other fields determined appropriate by the Secretary, other than in a position that involves research.CommentsClose CommentsPermalink
`(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3018. CULTURAL COMPETENCE TRAINING FOR HEALTH CARE PROFESSIONALS.
`(a) In General- The Secretary, acting through the Administrator of the Health Resources and Services Administration, the Deputy Assistant Secretary for Minority Health, and the Director of the National Center for Minority Health and Health Disparities, shall award grants to eligible entities to test, implement, and evaluate models of cultural competence training, including continuing education, for health care providers.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive a grant under subsection (a), an entity shall--CommentsClose CommentsPermalink
`(1) be an academic medical center, a health center or clinic, a hospital, a health plan, a health system, or a health care professional guild (including a mental health care professional guild);CommentsClose CommentsPermalink
`(2) partner with a minority-serving institution, minority health professional association, or community-based organization representing minority populations, in addition to a research institution to carry out activities under this grant; andCommentsClose CommentsPermalink
`(3) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(c) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3019. REGIONAL MINORITY CENTERS OF EXCELLENCE PROGRAMS.
`(a) Establishment- The Office of Minority Health, in collaboration with the Health Resources and Services Administration and the National Center on Minority Health and Health Disparities, shall establish and jointly fund Regional Minority Centers of Excellence Programs in medically underserved regions through the award of major funded, long-term cooperative agreements to eligible minority community-based organizations, school districts, and health professions organizations.CommentsClose CommentsPermalink
`(b) Use of Funds- The Office of Minority Health shall not award a cooperative agreement to an entity for a Regional Minority Centers of Excellence Program under subsection (a) unless the entity agrees that its program will include--CommentsClose CommentsPermalink
`(1) recruitment of minority students and faculty; andCommentsClose CommentsPermalink
`(2) development of curriculum on minority health for health professions students, allied health students, and other health professionals.CommentsClose CommentsPermalink
`(c) Eligibility- To be eligible to receive a cooperative agreement under subsection (a), a minority community-based organization, school district, or profession organization must be recognized for its demonstrated ability to engage minority community involvement in health care programs.CommentsClose CommentsPermalink
`(d) Priority- In awarding cooperative agreements under subsection (a), the Office of Minority Health shall give priority to entities that--CommentsClose CommentsPermalink
`(1) will use the agreement in a geographic area that has a large medically underserved minority population; andCommentsClose CommentsPermalink
`(2) will use a regional approach through partnerships with other health professions schools, private sector entities, school districts, and community-based organizations that serve the area.'.CommentsClose CommentsPermalink
SEC. 202. HEALTH CAREERS OPPORTUNITY PROGRAM.
(a) Purpose- It is the purpose of this section to diversify the health care workforce by increasing the number of individuals from disadvantaged backgrounds in the health and allied health professions by enhancing the academic skills of students from disadvantaged backgrounds and supporting them in successfully competing, entering, and graduating from health professions training programs.CommentsClose CommentsPermalink
(b) Authorization of Appropriations- Section 740(c) of the Public Health Service Act (
SEC. 203. PROGRAM OF EXCELLENCE IN HEALTH PROFESSIONS EDUCATION FOR UNDERREPRESENTED MINORITIES.
(a) Purpose- It is the purpose of this section to diversify the health care workforce by supporting programs of excellence in designated health professions schools with a demonstrated set of effective policies, criteria, programs, performance standards, and measures that document commitment and capacity to underrepresented minority populations with a focus on minority health issues, cultural and linguistic competence, and eliminating racial and ethnic disparities in health and health care.CommentsClose CommentsPermalink
(b) Authorization of Appropriation- Section 736(h)(1) of the Public Health Service Act (
`(1) AUTHORIZATION OF APPROPRIATIONS- For the purpose of making grants under subsection (a), there are authorized to be appropriated $50,000,000 for fiscal year 2008, and such sums as may be necessary for each of the fiscal years 2009 through 2013.'.CommentsClose CommentsPermalink
SEC. 204. MINORITY-SERVING INSTITUTIONS AND HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.
Part B of title VII of the Public Health Service Act (
`SEC. 742. MINORITY-SERVING INSTITUTIONS AND HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.
`(a) In General- The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants to minority-serving institutions and Hispanic-serving health professions schools for the purpose of carrying out programs to recruit underrepresented individuals to enroll in and graduate from such schools, which may include providing scholarships and other financial assistance as appropriate.CommentsClose CommentsPermalink
`(b) Definitions- In this section:CommentsClose CommentsPermalink
`(1) The term `Hispanic-serving health professions school' means an entity that--CommentsClose CommentsPermalink
`(A) is a school or program under section 799B;CommentsClose CommentsPermalink
`(B) has an enrollment of full-time equivalent students that is made up of at least 9 percent Hispanic students;CommentsClose CommentsPermalink
`(C) has been effective in carrying out programs to recruit Hispanic individuals to enroll in and graduate from the school;CommentsClose CommentsPermalink
`(D) has been effective in recruiting and retaining Hispanic faculty members; andCommentsClose CommentsPermalink
`(E) has a significant number of graduates who are providing health services to medically underserved populations or to individuals in health professional shortage areas.CommentsClose CommentsPermalink
`(2) The term `historically Black college or university' means a part B institution (as defined in section 322(2) of the Higher Education Act of 1965).CommentsClose CommentsPermalink
`(3) The term `minority-serving institution' means an entity that is--CommentsClose CommentsPermalink
`(A) an historically Black college or university;CommentsClose CommentsPermalink
`(B) an Hispanic-serving institution (as defined in section 502(a)(5) of the Higher Education Act of 1965);CommentsClose CommentsPermalink
`(C) a tribally controlled college or university (as defined in section 2(a)(4) of the Tribally Controlled College or University Assistance Act of 1978);CommentsClose CommentsPermalink
`(D) an Alaska Native-serving institution (as defined in section 317(b)(2) of the Higher Education Act of 1965); orCommentsClose CommentsPermalink
`(E) a Native Hawaiian-serving institution (as defined in section 317(b)(4) of the Higher Education Act of 1965).'.CommentsClose CommentsPermalink
SEC. 205. HEALTH PROFESSIONS STUDENT LOAN FUND; AUTHORIZATIONS OF APPROPRIATIONS REGARDING STUDENTS FROM UNDERREPRESENTED MINORITY COMMUNITIES.
Section 724(f) of the Public Health Service Act (
`(1) IN GENERAL- With respect to making Federal capital contributions to student loan funds for purposes of subsection (a), there is authorized to be appropriated $50,000,000 for fiscal year 2008, and such sums as may be necessary for each of the fiscal years 2009 through 2013.'.CommentsClose CommentsPermalink
SEC. 206. NATIONAL HEALTH SERVICE CORPS; TRAINING PROGRAMS.
(a) In General- Section 331(b) of the Public Health Service Act (
`(3) The Secretary shall ensure that the individuals with respect to whom activities under paragraphs (1) and (2) are carried out include individuals from disadvantaged backgrounds, including activities carried out to provide health professions students with information on the Scholarship and Repayment Programs.'.CommentsClose CommentsPermalink
(b) Assignment of Corps Personnel-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 333(a)(3) of the Public Health Service Corps (
`(3)(A) In approving applications for assignment of members of the Corps the Secretary shall not discriminate against application from entities which are not receiving Federal financial assistance under this Act.CommentsClose CommentsPermalink
`(B) In approving such applications, the Secretary shall--CommentsClose CommentsPermalink
`(i) give preference to applications in which a nonprofit entity or public entity shall provide a site to which Corps members may be assigned; andCommentsClose CommentsPermalink
`(ii) give highest preference to applications--CommentsClose CommentsPermalink
`(I) from entities described in clause (i) that are federally qualified health centers as defined in section 1905(l)(2)(B) of the Social Security Act; andCommentsClose CommentsPermalink
`(II) from entities described in clause (i) that primarily serve rural communities, racial and ethnic minorities, and other health disparity populations with annual incomes at or below twice those set forth in the most recent poverty guidelines issued by the Secretary pursuant to section 673(2) of the Community Services Block Grant Act (
(2) PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL- Section 333A of the Public Health Service Act (
(A) in subsection (a)--CommentsClose CommentsPermalink
(i) by redesignating paragraphs (1), (2), and (3) as paragraphs (2), (3), and (4), respectively; andCommentsClose CommentsPermalink
(ii) by striking `shall--' and inserting `shall--CommentsClose CommentsPermalink
`(1) give preference to applications as set forth in subsection (a)(3) of section 333;';CommentsClose CommentsPermalink
(B) in subsection (b)(1), by striking `subsection (a)(1)(A)' and inserting `subsection (a)(2)(A)'; andCommentsClose CommentsPermalink
(C) by striking `subsection (a)(1)' each place it appears and inserting `subsection (a)(2)'.CommentsClose CommentsPermalink
(3) CONFORMING AMENDMENT- Section 338I(c)(3)(B)(ii) of the Public Health Service Act (
(c) Reauthorization of National Health Service Corps Scholarship Program and Loan Repayment Program-CommentsClose CommentsPermalink
(1) REAUTHORIZATION OF APPROPRIATIONS- Section 338H(a) of the Public Health Service Act (
(2) SCHOLARSHIPS FOR MEDICAL STUDENTS- Section 338H of such Act is further amended by adding at the end the following:CommentsClose CommentsPermalink
`(d) Scholarships for Medical Students- For contracts for scholarships under this subpart to individuals who are accepted for enrollment, or enrolled, in a course of study or program described in section 338A(b)(1)(B) that leads to a degree in medicine, osteopathic medicine, dentistry, or mental health services, the Secretary shall, of the amounts appropriated under subsection (a) for a fiscal year, obligate the greater of 10 percent or such amount as necessary to fund ongoing activities related to such contracts.'.CommentsClose CommentsPermalink
(d) Reauthorization of Certain Programs Providing Grants for Health Professions Training for Diversity-CommentsClose CommentsPermalink
(1) GRANTS FOR CENTERS OF EXCELLENCE- Section 736(h)(1) of the Public Health Service Act (
(2) EDUCATIONAL ASSISTANCE FOR INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS- Section 740(c) of such Act (
(e) Expansion of Residency Training Programs and Primary Care Services Offered by Community Health Centers- Part C of title VII of the Public Health Service Act (
(1) by adding before section 747 the following:CommentsClose CommentsPermalink
`Subpart I--In General'; and
(2) by adding after section 748 the following:CommentsClose CommentsPermalink
`Subpart II--Additional Programs
`SEC. 749. GRANTS TO EXPAND MEDICAL RESIDENCY TRAINING PROGRAMS AT COMMUNITY HEALTH CENTERS.
`(a) Program Authorized- The Secretary may make grants to community health centers--CommentsClose CommentsPermalink
`(1) to establish, at the centers, new or alternative-campus accredited medical residency training programs affiliated with a hospital or other health care facility; orCommentsClose CommentsPermalink
`(2) to fund new residency positions within existing accredited medical residency training programs at the centers and their affiliated partners.CommentsClose CommentsPermalink
`(b) Use of Funds- Amounts from a grant under this section shall be used to cover the costs of establishing or expanding a medical residency training program described in subsection (a), including costs associated with--CommentsClose CommentsPermalink
`(1) curriculum development;CommentsClose CommentsPermalink
`(2) equipment acquisition;CommentsClose CommentsPermalink
`(3) recruitment, training, and retention of residents and faculty; andCommentsClose CommentsPermalink
`(4) residency stipends.CommentsClose CommentsPermalink
`(c) Applications- A community health center seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(d) Preference- In selecting recipients for a grant under this section, the Secretary shall give preference to funding medical residency training programs focusing on primary health care.CommentsClose CommentsPermalink
`(e) Definitions- In this section:CommentsClose CommentsPermalink
`(1) The term `accredited', as applied to a new or alternative-campus medical residency training program, means a program that is accredited by a recognized body or bodies approved for such purpose by the Accreditation Council for Graduate Medical Education, except that a new medical residency training program that, by reason of an insufficient period of operation, is not eligible for accreditation on or before the date of submission of an application under subsection (c) shall be deemed accredited if the Accreditation Council for Graduate Medical Education finds, after consultation with the appropriate accreditation body or bodies, that there is reasonable assurance that the program will meet the accreditation standards of such body or bodies prior to the date of graduation of the first entering class in that program.CommentsClose CommentsPermalink
`(2) The term `community health center' means a health center as defined in section 330.CommentsClose CommentsPermalink
`SEC. 749A. GRANTS TO IMPROVE DELIVERY OF PRIMARY CARE SERVICES IN COMMUNITY HEALTH CENTERS.
`(a) Primary Care Access Grants-CommentsClose CommentsPermalink
`(1) PROGRAM AUTHORIZED- The Secretary, acting through the Administrator of the Health Resources and Services Administration, may make grants to community health centers for the purpose of increasing the number of medical service providers associated with such centers.CommentsClose CommentsPermalink
`(2) GRANTS- A recipient of a grant under this subsection shall be eligible to receive such grants for a total of 5 fiscal years.CommentsClose CommentsPermalink
`(3) USE OF FUNDS- A recipient of a grant under this subsection shall use amounts from the grant for one or more of the following activities:CommentsClose CommentsPermalink
`(A) To recruit residents for medical residency training programs at the community health center.CommentsClose CommentsPermalink
`(B) To establish a multi-community physician mentoring program to encourage upper level residents to remain in the State or Territory in which the community health center and medical residency training program are located.CommentsClose CommentsPermalink
`(C) To enter into contracts for technical assistance for the purpose of recruiting or retaining primary health care staff.CommentsClose CommentsPermalink
`(D) To enter into contracts for technical assistance in preparing contracts with local providers of primary health care to provide services for medically underserved communities.CommentsClose CommentsPermalink
`(E) To enter into contracts for the development and implementation of strategies to identify and retain health care professionals and specialists, including oral and mental health providers, who are willing and able to provide direct actual service to the community health center on a referral basis.CommentsClose CommentsPermalink
`(4) APPLICATION- A community health center seeking a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(b) Grants for Primary Care Facility Capital Expenditures-CommentsClose CommentsPermalink
`(1) PROGRAM AUTHORIZED- The Secretary, acting through the Administrator of the Health Resources and Services Administration, may make grants to community health centers for the purpose of increasing primary health care capabilities through the construction, expansion, or renovation of facilities.CommentsClose CommentsPermalink
`(2) GRANTS- A recipient of a grant under this subsection shall be eligible to receive such grants for a total of 5 fiscal years.CommentsClose CommentsPermalink
`(3) USE OF FUNDS- A recipient of a grant under this subsection shall use amounts from the grant for one or more of the following activities:CommentsClose CommentsPermalink
`(A) To acquire or lease facilities.CommentsClose CommentsPermalink
`(B) To construct new facilities.CommentsClose CommentsPermalink
`(C) To repair or modernize existing facilities.CommentsClose CommentsPermalink
`(D) To purchase or lease medical equipment.CommentsClose CommentsPermalink
`(c) Definition- The term `community health center' means a health center as defined in section 330.CommentsClose CommentsPermalink
`SEC. 749B. AUTHORIZATION OF APPROPRIATIONS.
`There is authorized to be appropriated $200,000,000 for fiscal year 2008 and such sums as may be necessary for each fiscal year thereafter to carry out this subpart.'.CommentsClose CommentsPermalink
(f) Interdisciplinary, Community-Based Programs-CommentsClose CommentsPermalink
(1) AREA HEALTH EDUCATION CENTERS- Section 751(a) of the Public Health Service Act (
(A) in paragraph (1)(A)--CommentsClose CommentsPermalink
(i) in clause (i), by inserting at the end before the semicolon the following: `, with an emphasis on such personnel who focus on primary care';CommentsClose CommentsPermalink
(ii) by redesignating clauses (ii) through (vii) as clauses (iii) through (viii), respectively; andCommentsClose CommentsPermalink
(iii) by inserting after clause (i) the following:CommentsClose CommentsPermalink
`(ii) foster and provide community-based training and education for health professions students in underserved communities and among underserved populations, including but not limited to the National Health Service Corps, community and migrant health centers, rural health clinics, critical access hospitals, tribal health clinics, and public health departments;'; andCommentsClose CommentsPermalink
(B) by adding at the end the following:CommentsClose CommentsPermalink
`(3) POINT OF SERVICE ENHANCEMENT GRANTS-CommentsClose CommentsPermalink
`(A) IN GENERAL- The Secretary may award grants to entities receiving an award under paragraph (1) or (2) to improve the effectiveness of the programs operated by such entities or to enable the entities to respond to changes affecting such entities arising since the date of the receipt of the award under paragraph (1) or (2).CommentsClose CommentsPermalink
`(B) APPLICATION- To receive an award under this paragraph, an entity described under subparagraph (A) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including an explanation of the changes affecting such entity arising since the date of the receipt by the entity of the award under paragraph (1) or (2), such as changes in the demographics of the area served, the needs of the population served, and the situations encountered by such population and such entity.'.CommentsClose CommentsPermalink
(2) AUTHORIZATION OF APPROPRIATIONS- Section 757 of the Public Health Service Act (
(A) in subsection (a), by striking `$55,600,000' and all that follows through `2002' and inserting `$125,000,000 for fiscal year 2008 and such sums as may be necessary for each of fiscal years 2009 through 2012';CommentsClose CommentsPermalink
(B) by striking subsection (b) and inserting the following:CommentsClose CommentsPermalink
`(b) Allocation-CommentsClose CommentsPermalink
`(1) IN GENERAL- Of the amounts appropriated under subsection (a) that the Secretary makes available for each fiscal year to carry out section 751, the Secretary shall obligate--CommentsClose CommentsPermalink
`(A) for awards under paragraph (1) of section 751(a), not more than 25 percent of such amounts in each fiscal year; andCommentsClose CommentsPermalink
`(B) for awards under paragraphs (2) and (3) of section 751(a), not less than 60 percent of such amounts in each fiscal year.'; andCommentsClose CommentsPermalink
(C) in subsection (c), by--CommentsClose CommentsPermalink
(i) striking the subsection designation and heading and inserting the following:CommentsClose CommentsPermalink
`(c) Sense of the Congress- It is the sense of the Congress that--'.CommentsClose CommentsPermalink
(ii) striking paragraph (1); andCommentsClose CommentsPermalink
(iii) in paragraph (2), by--CommentsClose CommentsPermalink
(I) striking the paragraph designation and all that follows through `Congress that--'; andCommentsClose CommentsPermalink
(II) redesignating subparagraphs (A) and (B) as paragraphs (1) and (2) and indenting appropriately.CommentsClose CommentsPermalink
SEC. 207. LOAN REPAYMENT PROGRAM OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION.
Section 317F(c) of the Public Health Service Act (
(1) by striking `and' after `1994,'; andCommentsClose CommentsPermalink
(2) by inserting before the period the following: `$750,000 for fiscal year 2008, and such sums as may be necessary for each of the fiscal years 2009 through 2013.'.CommentsClose CommentsPermalink
SEC. 208. STRENGTHENING AND EXPANDING RURAL HEALTH PROVIDER NETWORKS.
Section 330A of the Public Health Service Act (
(1) in subsection (h), by adding at the end the following:CommentsClose CommentsPermalink
`(4) RURAL MINORITY, BORDER, AND INDIAN POPULATIONS- In making grants under this section, the Director of the Office of Rural Health Policy of the Health Resources and Services Administration, in coordination with the Director of the Indian Health Service and the Deputy Assistant Secretary for Minority Health, shall make grants to entities that serve rural minority, border, and Indian populations.CommentsClose CommentsPermalink
`(5) DIVERSITY HEALTH TRAINING PROGRAMS- The Director of the Office of Rural Health Policy of the Health Resources and Services Administration, in coordination with the Director of the Indian Health Service and the Deputy Assistant Secretary for Minority Health, shall coordinate the awarding of grants under this section with the awarding of grants and contracts under section 765 to connect and integrate diversity health training programs.'; andCommentsClose CommentsPermalink
(2) in subsection (j), by striking `and such sums as may be necessary for each of fiscal years 2003 through 2006' and inserting `, such sums as may be necessary for each of fiscal years 2008 through 2010, and $60,000,000 for each of fiscal years 2011 through 2015'.CommentsClose CommentsPermalink
SEC. 209. MCNAIR POSTBACCALAUREATE ACHIEVEMENT PROGRAM.
Section 402E of the Higher Education Act of 1965 (
`(f) Collaboration in Health Profession Diversity Training Programs- The Secretary of Education shall coordinate with the Secretary of Health and Human Services to ensure that there is collaboration between the goals of the program under this section and programs of the Health Resources and Services Administration that promote health workforce diversity. The Secretary of Education shall take such measures as may be necessary to encourage participants in programs under this section to consider health profession careers.CommentsClose CommentsPermalink
`(g) Funding- From amounts appropriated pursuant to the authority of section 402A(f), the Secretary shall, to the extent practicable, allocate funds for projects authorized by this section in an amount which is not less than $31,000,000 for each of the fiscal years 2008 through 2014.'.CommentsClose CommentsPermalink
SEC. 210. ENSURING PROPORTIONAL REPRESENTATION OF INTERESTS OF RURAL AREAS ON MEDPAC.
(a) In General- Section 1805(c)(2) of the Social Security Act (
(1) in subparagraph (A), by inserting `consistent with subparagraph (E)' after `rural representatives'; andCommentsClose CommentsPermalink
(2) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
`(E) PROPORTIONAL REPRESENTATION OF INTERESTS OF RURAL AREAS- In order to provide a balance between urban and rural representatives under subparagraph (A), the proportion of members who represent the interests of health care providers and Medicare beneficiaries located in rural areas shall be no less than the proportion, of the total number of Medicare beneficiaries, who reside in rural areas.'.CommentsClose CommentsPermalink
(b) Effective Date- The amendments made by subsection (a) shall apply with respect to appointments made to the Medicare Payment Advisory Commission after the date of the enactment of this Act.CommentsClose CommentsPermalink
TITLE III--DATA COLLECTION AND REPORTING
SEC. 301. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
(a) Purpose- It is the purpose of this section to promote data collection, analysis, and reporting by race, ethnicity, and primary language among federally supported health programs.CommentsClose CommentsPermalink
(b) Amendment- Title XXX of the Public Health Service Act, as amended by title II of this Act, is further amended by adding at the end the following:CommentsClose CommentsPermalink
`Subtitle B--Strengthening Data Collection, Improving Data Analysis, and Expanding Data Reporting
`SEC. 3031. DATA ON RACE, ETHNICITY, AND PRIMARY LANGUAGE.
`(a) Requirements-CommentsClose CommentsPermalink
`(1) IN GENERAL- Each health-related program operated by or that receives funding or reimbursement, in whole or in part, either directly or indirectly from the Department of Health and Human Services shall--CommentsClose CommentsPermalink
`(A) require the collection, by the agency or program involved, of data on the race, ethnicity, and primary language of each applicant for and recipient of health-related assistance under such program--CommentsClose CommentsPermalink
`(i) using, at a minimum, the categories for race and ethnicity described in the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity;CommentsClose CommentsPermalink
`(ii) using the standards developed under subsection (e) for the collection of language data;CommentsClose CommentsPermalink
`(iii) collecting data for additional population groups if such groups can be aggregated into the minimum race and ethnicity categories; andCommentsClose CommentsPermalink
`(iv) where practicable, through self-report;CommentsClose CommentsPermalink
`(B) with respect to the collection of the data described in subparagraph (A) for applicants and recipients who are minors or otherwise legally incapacitated, require that--CommentsClose CommentsPermalink
`(i) such data be collected from the parent or legal guardian of such an applicant or recipient; andCommentsClose CommentsPermalink
`(ii) the preferred language of the parent or legal guardian of such an applicant or recipient be collected;CommentsClose CommentsPermalink
`(C) systematically analyze such data using the smallest appropriate units of analysis feasible to detect racial and ethnic disparities in health and health care and when appropriate, for men and women separately, and report the results of such analysis to the Secretary, the Director of the Office for Civil Rights, the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate, and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives;CommentsClose CommentsPermalink
`(D) provide such data to the Secretary on at least an annual basis; andCommentsClose CommentsPermalink
`(E) ensure that the provision of assistance to an applicant or recipient of assistance is not denied or otherwise adversely affected because of the failure of the applicant or recipient to provide race, ethnicity, and primary language data.CommentsClose CommentsPermalink
`(2) RULES OF CONSTRUCTION- Nothing in this subsection shall be construed to--CommentsClose CommentsPermalink
`(A) permit the use of information collected under this subsection in a manner that would adversely affect any individual providing any such information; andCommentsClose CommentsPermalink
`(B) require health care providers to collect data.CommentsClose CommentsPermalink
`(b) Protection of Data- The Secretary shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to subsection (a) is protected--CommentsClose CommentsPermalink
`(1) under the same privacy protections as the Secretary applies to other health data under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (
`(2) from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.CommentsClose CommentsPermalink
`(c) National Plan of the Data Council- The Secretary shall develop and implement a national plan to ensure the collection of data in a culturally appropriate and competent manner, and to improve the collection, analysis, and reporting of racial, ethnic, and primary language data at the Federal, State, territorial, Tribal, and local levels, including data to be collected under subsection (a). The Data Council of the Department of Health and Human Services, in consultation with the National Committee on Vital Health Statistics, the Office of Minority Health, and other appropriate public and private entities, shall make recommendations to the Secretary concerning the development, implementation, and revision of the national plan. Such plan shall include recommendations on how to--CommentsClose CommentsPermalink
`(1) implement subsection (a) while minimizing the cost and administrative burdens of data collection and reporting;CommentsClose CommentsPermalink
`(2) expand awareness among Federal agencies, States, territories, Indian tribes, health providers, health plans, health insurance issuers, and the general public that data collection, analysis, and reporting by race, ethnicity, and primary language is legal and necessary to assure equity and non-discrimination in the quality of health care services;CommentsClose CommentsPermalink
`(3) ensure that future patient record systems have data code sets for racial, ethnic, and primary language identifiers and that such identifiers can be retrieved from clinical records, including records transmitted electronically;CommentsClose CommentsPermalink
`(4) improve health and health care data collection and analysis for more population groups if such groups can be aggregated into the minimum race and ethnicity categories, including exploring the feasibility of enhancing collection efforts in States for racial and ethnic groups that comprise a significant proportion of the population of the State;CommentsClose CommentsPermalink
`(5) provide researchers with greater access to racial, ethnic, and primary language data, subject to privacy and confidentiality regulations; andCommentsClose CommentsPermalink
`(6) safeguard and prevent the misuse of data collected under subsection (a).CommentsClose CommentsPermalink
`(d) Compliance With Standards- Data collected under subsection (a) shall be obtained, maintained, and presented (including for reporting purposes) in accordance with the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (at a minimum).CommentsClose CommentsPermalink
`(e) Language Collection Standards- Not later than 1 year after the date of enactment of this title, the Deputy Assistant Secretary for Minority Health, in consultation with the Office for Civil Rights of the Department of Health and Human Services, shall develop and disseminate Standards for the Classification of Federal Data on Preferred Written and Spoken Language.CommentsClose CommentsPermalink
`(f) Technical Assistance for the Collection and Reporting of Data-CommentsClose CommentsPermalink
`(1) IN GENERAL- The Secretary may, either directly or through grant or contract, provide technical assistance to enable a health care program or an entity operating under such program to comply with the requirements of this section.CommentsClose CommentsPermalink
`(2) TYPES OF ASSISTANCE- Assistance provided under this subsection may include assistance to--CommentsClose CommentsPermalink
`(A) enhance or upgrade computer technology that will facilitate racial, ethnic, and primary language data collection and analysis;CommentsClose CommentsPermalink
`(B) improve methods for health data collection and analysis including additional population groups beyond the Office of Management and Budget categories if such groups can be aggregated into the minimum race and ethnicity categories;CommentsClose CommentsPermalink
`(C) develop mechanisms for submitting collected data subject to existing privacy and confidentiality regulations; andCommentsClose CommentsPermalink
`(D) develop educational programs to inform health insurance issuers, health plans, health providers, health-related agencies, and the general public that data collection and reporting by race, ethnicity, and preferred language are legal and essential for eliminating health and health care disparities.CommentsClose CommentsPermalink
`(g) Analysis of Racial and Ethnic Data- The Secretary, acting through the Director of the Agency for Healthcare Research and Quality and in coordination with the Administrator of the Centers for Medicare & Medicaid Services, shall provide technical assistance to agencies of the Department of Health and Human Services in meeting Federal standards for race, ethnicity, and primary language data collection and analysis of racial and ethnic disparities in health and health care in public programs by--CommentsClose CommentsPermalink
`(1) identifying appropriate quality assurance mechanisms to monitor for health disparities;CommentsClose CommentsPermalink
`(2) specifying the clinical, diagnostic, or therapeutic measures which should be monitored;CommentsClose CommentsPermalink
`(3) developing new quality measures relating to racial and ethnic disparities in health and health care;CommentsClose CommentsPermalink
`(4) identifying the level at which data analysis should be conducted; andCommentsClose CommentsPermalink
`(5) sharing data with external organizations for research and quality improvement purposes.CommentsClose CommentsPermalink
`(h) Report- Not later than 2 years after the date of enactment of this title, and biennially thereafter, the Secretary shall submit to the appropriate committees of Congress a report on the effectiveness of data collection, analysis, and reporting on race, ethnicity, and primary language under the programs and activities of the Department of Health and Human Services and under other Federal data collection systems with which the Department interacts to collect relevant data on race and ethnicity. The report shall evaluate the progress made in the Department with respect to the national plan under subsection (c) or subsequent revisions thereto.CommentsClose CommentsPermalink
`(i) Definition- In this section, the term `health-related program' mean a program--CommentsClose CommentsPermalink
`(1) under the Social Security Act (
`(2) under this Act that provide Federal financial assistance for health care, biomedical research, health services research, and programs designed to improve the public's health.CommentsClose CommentsPermalink
`(j) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3032. PROVISIONS RELATING TO NATIVE AMERICANS.
`(a) Establishment of Epidemiology Centers- The Secretary shall establish an epidemiology center in each service area to carry out the functions described in subsection (b). Any new center established after the date of the enactment of the Health Equity and Accountability Act of 2007 may be operated under a grant authorized by subsection (d), but funding under such a grant shall not be divisible.CommentsClose CommentsPermalink
`(b) Functions of Centers- In consultation with and upon the request of Indian Tribes, Tribal Organizations, and Urban Indian Organizations, each service area epidemiology center established under this subsection shall, with respect to such service area--CommentsClose CommentsPermalink
`(1) collect data relating to, and monitor progress made toward meeting, each of the health status objectives of the Service, the Indian Tribes, Tribal Organizations, and Urban Indian Organizations in the service area;CommentsClose CommentsPermalink
`(2) evaluate existing delivery systems, data systems, and other systems that impact the improvement of Indian health;CommentsClose CommentsPermalink
`(3) assist Indian Tribes, Tribal Organizations, and Urban Indian Organizations in identifying their highest priority health status objectives and the services needed to achieve such objectives, based on epidemiological data;CommentsClose CommentsPermalink
`(4) make recommendations for the targeting of services needed by the populations served;CommentsClose CommentsPermalink
`(5) make recommendations to improve health care delivery systems for Indians and Urban Indians;CommentsClose CommentsPermalink
`(6) provide requested technical assistance to Indian Tribes, Tribal Organizations, and Urban Indian Organizations in the development of local health service priorities and incidence and prevalence rates of disease and other illness in the community; andCommentsClose CommentsPermalink
`(7) provide disease surveillance and assist Indian Tribes, Tribal Organizations, and Urban Indian Organizations to promote public health.CommentsClose CommentsPermalink
`(c) Technical Assistance- The Director of the Centers for Disease Control and Prevention shall provide technical assistance to the centers in carrying out the requirements of this subsection.CommentsClose CommentsPermalink
`(d) Grants for Studies-CommentsClose CommentsPermalink
`(1) IN GENERAL- The Secretary may make grants to Indian Tribes, Tribal Organizations, Urban Indian Organizations, and eligible intertribal consortia to conduct epidemiological studies of Indian communities.CommentsClose CommentsPermalink
`(2) ELIGIBLE INTERTRIBAL CONSORTIA- An intertribal consortium is eligible to receive a grant under this subsection if--CommentsClose CommentsPermalink
`(A) the intertribal consortium is incorporated for the primary purpose of improving Indian health; andCommentsClose CommentsPermalink
`(B) the intertribal consortium is representative of the Indian Tribes or urban Indian communities in which the intertribal consortium is located.CommentsClose CommentsPermalink
`(3) APPLICATIONS- An application for a grant under this subsection shall be submitted in such manner and at such time as the Secretary shall prescribe.CommentsClose CommentsPermalink
`(4) REQUIREMENTS- An applicant for a grant under this subsection shall--CommentsClose CommentsPermalink
`(A) demonstrate the technical, administrative, and financial expertise necessary to carry out the functions described in paragraph (5);CommentsClose CommentsPermalink
`(B) consult and cooperate with providers of related health and social services in order to avoid duplication of existing services; andCommentsClose CommentsPermalink
`(C) demonstrate cooperation from Indian tribes or Urban Indian Organizations in the area to be served.CommentsClose CommentsPermalink
`(5) USE OF FUNDS- A grant awarded under paragraph (1) may be used--CommentsClose CommentsPermalink
`(A) to carry out the functions described in subsection (b);CommentsClose CommentsPermalink
`(B) to provide information to and consult with tribal leaders, urban Indian community leaders, and related health staff on health care and health service management issues; andCommentsClose CommentsPermalink
`(C) in collaboration with Indian Tribes, Tribal Organizations, and urban Indian communities, to provide the Service with information regarding ways to improve the health status of Indians.CommentsClose CommentsPermalink
`(e) Access to Information- An epidemiology center operated by a grantee pursuant to a grant awarded under subsection (d) shall be treated as a public health authority for purposes of the Health Insurance Portability and Accountability Act of 1996 (
SEC. 302. COLLECTION OF RACE AND ETHNICITY DATA BY THE SOCIAL SECURITY ADMINISTRATION.
Part A of title XI of the Social Security Act (
`SEC. 1150A. COLLECTION OF RACE AND ETHNICITY DATA BY THE SOCIAL SECURITY ADMINISTRATION.
`(a) Requirement- The Commissioner of Social Security, in consultation with the Administrator of the Centers for Medicare & Medicaid Services, shall--CommentsClose CommentsPermalink
`(1) require the collection of data on the race, ethnicity, and primary language of all applicants for social security account numbers or benefits under title II or part A of title XVIII and all individuals with respect to whom the Commissioner maintains records of wages and self-employment income in accordance with reports received by the Commissioner or the Secretary of the Treasury--CommentsClose CommentsPermalink
`(A) using, at a minimum, the categories for race and ethnicity described in the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity and available language standards; andCommentsClose CommentsPermalink
`(B) where practicable, collecting data for additional population groups if such groups can be aggregated into the minimum race and ethnicity categories;CommentsClose CommentsPermalink
`(2) with respect to the collection of the data described in paragraph (1) for applicants who are under 18 years of age or otherwise legally incapacitated, require that--CommentsClose CommentsPermalink
`(A) such data be collected from the parent or legal guardian of such an applicant; andCommentsClose CommentsPermalink
`(B) the primary language of the parent or legal guardian of such an applicant or recipient be used;CommentsClose CommentsPermalink
`(3) require that such data be uniformly analyzed and reported at least annually to the Commissioner of Social Security;CommentsClose CommentsPermalink
`(4) be responsible for storing the data reported under paragraph (3);CommentsClose CommentsPermalink
`(5) ensure transmission to the Centers for Medicare & Medicaid Services and other Federal health agencies;CommentsClose CommentsPermalink
`(6) provide such data to the Secretary on at least an annual basis; andCommentsClose CommentsPermalink
`(7) ensure that the provision of assistance to an applicant is not denied or otherwise adversely affected because of the failure of the applicant to provide race, ethnicity, and primary language data.CommentsClose CommentsPermalink
`(b) Protection of Data- The Commissioner of Social Security shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant subsection (a) is protected--CommentsClose CommentsPermalink
`(1) under the same privacy protections as the Secretary applies to health data under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (
`(2) from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.CommentsClose CommentsPermalink
`(c) Rule of Construction- Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual providing any such information.CommentsClose CommentsPermalink
`(d) Technical Assistance- The Secretary may, either directly or by grant or contract, provide technical assistance to enable any health entity to comply with the requirements of this section.CommentsClose CommentsPermalink
`(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.'.CommentsClose CommentsPermalink
SEC. 303. REVISION OF HIPAA CLAIMS STANDARDS.
(a) In General- Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall revise the regulations promulgated under part C of title XI of the Social Security Act (
(1) the use, at a minimum, of the categories for race and ethnicity described in the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity;CommentsClose CommentsPermalink
(2) the establishment of a new data code set for primary language; andCommentsClose CommentsPermalink
(3) the designation of the racial, ethnic, and primary language code sets as `required' for claims and enrollment data.CommentsClose CommentsPermalink
(b) Dissemination- The Secretary of Health and Human Services shall disseminate the new standards developed under subsection (a) to all health entities that are subject to the regulations described in such subsection and provide technical assistance with respect to the collection of the data involved.CommentsClose CommentsPermalink
(c) Compliance- The Secretary of Health and Human Services shall require that health entities comply with the new standards developed under subsection (a) not later than 2 years after the final promulgation of such standards.CommentsClose CommentsPermalink
SEC. 304. NATIONAL CENTER FOR HEALTH STATISTICS.
Section 306(n) of the Public Health Service Act (
(1) in paragraph (1), by striking `2003' and inserting `2012';CommentsClose CommentsPermalink
(2) in paragraph (2), in the first sentence, by striking `2003' and inserting `2012'; andCommentsClose CommentsPermalink
(3) in paragraph (3), by striking `2002' and inserting `2012'.CommentsClose CommentsPermalink
SEC. 305. GEO-ACCESS STUDY.
The Administrator of the Substance Abuse and Mental Health Services Administration shall--CommentsClose CommentsPermalink
(1) conduct a study to--CommentsClose CommentsPermalink
(A) determine which geographic areas of the United States have shortages of specialty mental health providers; andCommentsClose CommentsPermalink
(B) assess the preparedness of speciality mental health providers to deliver culturally and linguistically appropriate services; andCommentsClose CommentsPermalink
(2) submit a report to the Congress on the results of such study.CommentsClose CommentsPermalink
SEC. 306. RACIAL, ETHNIC, AND LINGUISTIC DATA COLLECTED BY THE FEDERAL GOVERNMENT.
(a) Collection; Submission- Not later than 90 days after the date of the enactment of this Act, and January 31st of each year thereafter, each department, agency, and office of the Federal Government that has collected racial, ethnic, or linguistic data during the preceding calendar year shall submit such data to the Secretary of Health and Human Services.CommentsClose CommentsPermalink
(b) Analysis; Public Availability; Reporting- Not later than April 30, 2008, and each April 30th thereafter, the Secretary of Health and Human Services, acting through the Director of the National Center on Minority Health and Health Disparities and the Deputy Assistant Secretary for Minority Health, shall--CommentsClose CommentsPermalink
(1) collect and analyze the racial, ethnic, and linguistic data submitted under subsection (a) for the preceding calendar year;CommentsClose CommentsPermalink
(2) make publicly available such data and the results of such analysis; andCommentsClose CommentsPermalink
(3) submit a report to the Congress on such data and analysis.CommentsClose CommentsPermalink
SEC. 307. HEALTH INFORMATION TECHNOLOGY GRANTS.
(a) Authority- The Deputy Assistant Secretary for Minority Health, in coordination with the Office of the National Coordinator for Health Information Technology, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and the National Center on Minority Health and Health Disparities, may award grants to appropriate entities for the purpose of ensuring appropriate and best practices to collect appropriate data and documents on the reduction of health disparities.CommentsClose CommentsPermalink
(b) Use of Funds- A grant received under subsection (a) shall be used to achieve the purpose described in such subsection through one or more of the following:CommentsClose CommentsPermalink
(1) Purchasing new, or enhancing existing, health information technology.CommentsClose CommentsPermalink
(2) Providing support and training to providers concerning such technology.CommentsClose CommentsPermalink
(3) Conducting outreach and education on health information technology and its benefits to patients, physicians, allied health professionals, and advocacy groups in medically underserved communities (as defined in section 799B of the Public Health Service Act (
(c) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated $20,000,000 for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
SEC. 308. STUDY OF HEALTH INFORMATION TECHNOLOGY IN MEDICALLY UNDERSERVED COMMUNITIES.
(a) Study- The National Coordinator for Health Information Technology shall conduct a study on the development and implementation of health information technology in medically underserved communities. The study shall--CommentsClose CommentsPermalink
(1) identify barriers to successful implementation of health information technology in these communities;CommentsClose CommentsPermalink
(2) examine the impact of health information technology on providing quality care and reducing the cost of care to these communities;CommentsClose CommentsPermalink
(3) examine urban and rural community health systems and determine the impact that health information technology may have on the capacity of primary health providers; andCommentsClose CommentsPermalink
(4) assess the feasibility and the costs of associated with the use of health information technology in these communities.CommentsClose CommentsPermalink
(b) Report- Not later than 18 months after the date of the enactment of this Act, the National Coordinator for Health Information Technology shall submit to the Congress a report on the study conducted under subsection (a) and shall include in such report such recommendations for legislation or administrative action as the Coordinator determines appropriate.CommentsClose CommentsPermalink
SEC. 309. HEALTH INFORMATION TECHNOLOGY IN MEDICALLY UNDERSERVED COMMUNITIES.
The National Coordinator for Health Information Technology shall--CommentsClose CommentsPermalink
(1) identify sources of funds that will be made available to promote and support the planning and adoption of health information technology in medically underserved communities (as defined in section 799B of the Public Health Service Act (
(2) coordinate with the funding sources to help such communities connect to identified funding; andCommentsClose CommentsPermalink
(3) collaborate with the Agency for Healthcare Research and Quality, the Health Resources and Services Administration, and other Federal agencies to support technical assistance, knowledge dissemination, and resource development, to such communities seeking to plan for and adopt technology and establish electronic health information networks across providers.CommentsClose CommentsPermalink
SEC. 310. DATA COLLECTION AND ANALYSIS GRANTS TO MINORITY-SERVING INSTITUTIONS.
(a) Authority- The Secretary of Health and Human Services, acting through the Center on Minority Health and Health Disparities and the Office of Minority Health, may award grants to access and analyze racial and ethnic, and where possible, primary language data to monitor and report on progress to reduce and eliminate racial and ethnic disparities in health and health care.CommentsClose CommentsPermalink
(b) Eligible Entity- In this section, the term `eligible entity' means a historically Black college or university, an Hispanic-serving institution, a tribal college or university, or an Asian American and Pacific Islander-serving institution with an accredited public health, health policy, or health services research program.CommentsClose CommentsPermalink
SEC. 311. HEALTH INFORMATION TECHNOLOGY GRANTS FOR RURAL HEALTH CARE PROVIDERS.
Title II of the Public Health Service Act is amended by adding at the end the following new part:CommentsClose CommentsPermalink
`PART D--HEALTH INFORMATION TECHNOLOGY GRANTS
`SEC. 271. GRANTS TO FACILITATE THE WIDESPREAD ADOPTION OF INTEROPERABLE HEALTH INFORMATION TECHNOLOGY IN RURAL AREAS.
`(a) Competitive Grants to Eligible Entities in Rural Areas-CommentsClose CommentsPermalink
`(1) IN GENERAL- The Secretary may award competitive grants to eligible entities in rural areas to facilitate the purchase and enhance the utilization of qualified health information technology systems to improve the quality and efficiency of health care.CommentsClose CommentsPermalink
`(2) ELIGIBILITY- To be eligible to receive a grant under paragraph (1) an entity shall--CommentsClose CommentsPermalink
`(A) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require;CommentsClose CommentsPermalink
`(B) submit to the Secretary a strategic plan for the implementation of data sharing and interoperability measures;CommentsClose CommentsPermalink
`(C) be a rural health care provider;CommentsClose CommentsPermalink
`(D) adopt any applicable core interoperability guidelines (endorsed under other provisions of law);CommentsClose CommentsPermalink
`(E) agree to notify patients if their individually identifiable health information is wrongfully disclosed;CommentsClose CommentsPermalink
`(F) demonstrate significant financial need; andCommentsClose CommentsPermalink
`(G) provide matching funds in accordance with paragraph (4).CommentsClose CommentsPermalink
`(3) USE OF FUNDS- Amounts received under a grant under this subsection shall be used to facilitate the purchase and enhance the utilization of qualified health information technology systems and training personnel in the use of such technology.CommentsClose CommentsPermalink
`(4) MATCHING REQUIREMENT- To be eligible for a grant under this subsection an entity shall contribute non-Federal contributions to the costs of carrying out the activities for which the grant is awarded in an amount equal to $1 for each $3 of Federal funds provided under the grant.CommentsClose CommentsPermalink
`(5) LIMIT ON GRANT AMOUNT- In no case shall the payment amount under this subsection with respect to the purchase or enhanced utilization of qualified health information technology for a rural health care provider, in addition to the amount of any loan made to the provider from a grant to a State under subsection (b) for such purpose, exceed 100 percent of the provider's costs for such purchase or enhanced utilization (taking into account costs for training, implementation, and maintenance).CommentsClose CommentsPermalink
`(6) PREFERENCE IN AWARDING GRANTS- In awarding grants to eligible entities under this subsection, the Secretary shall give preference to each of the following types of applicants:CommentsClose CommentsPermalink
`(A) An entity that is located in a frontier or other rural underserved area as determined by the Secretary.CommentsClose CommentsPermalink
`(B) An entity that will link, to the extent practicable, the qualified health information system to a local or regional health information plan or plans.CommentsClose CommentsPermalink
`(C) A rural health care provider that is a nonprofit hospital or a Federally qualified health center.CommentsClose CommentsPermalink
`(D) A rural health care provider that is an individual practice or group practice.CommentsClose CommentsPermalink
`(b) Authorization of Appropriations-CommentsClose CommentsPermalink
`(1) IN GENERAL- For the purpose of carrying out this section, there is authorized to be appropriated $20,000,000 for fiscal year 2008, $30,000,000 for fiscal year 2009, and such sums as may be necessary, but not to exceed $30,000,000 for each of fiscal years 2010 through 2012.CommentsClose CommentsPermalink
`(2) AVAILABILITY- Amounts appropriated under paragraph (1) shall remain available through fiscal year 2011.CommentsClose CommentsPermalink
`(c) Definitions- In this section:CommentsClose CommentsPermalink
`(1) FEDERALLY QUALIFIED HEALTH CENTER- The term `Federally qualified health center' has the meaning given that term in section 1861(aa)(4) of the Social Security Act (
`(2) GROUP PRACTICE- The term `group practice' has the meaning given that term in section 1877(h)(4) of the Social Security Act (
`(3) HEALTH CARE PROVIDER- The term `health care provider' means a hospital, skilled nursing facility, home health agency (as defined in subsection (o) of section 1861 of the Social Security Act,
`(4) HEALTH INFORMATION; INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION- The terms `health information' and `individually identifiable health information' have the meanings given those terms in paragraphs (4) and (6), respectively, of section 1171 of the Social Security Act (
`(5) LABORATORY- The term `laboratory' has the meaning given that term in section 353.CommentsClose CommentsPermalink
`(6) PHARMACIST- The term `pharmacist' has the meaning given that term in section 804(a)(2) of the Federal Food, Drug, and Cosmetic Act (
`(7) QUALIFIED HEALTH INFORMATION TECHNOLOGY- The term `qualified health information technology' means a system or components of health information technology that meet any applicable core interoperability guidelines (endorsed under applicable provisions of law) when in use or that use interface software that allows for interoperability in accordance with such guidelines.CommentsClose CommentsPermalink
`(8) RURAL AREA- The term `rural area' has the meaning given such term for purposes of section 1886(d)(2)(D) of the Social Security Act (
`(9) RURAL HEALTH CARE PROVIDER- The term `rural health care provider' means a health care provider that is located in a rural area.'.CommentsClose CommentsPermalink
TITLE IV--ACCOUNTABILITY AND EVALUATION
Subtitle A--General Provisions
SEC. 401. FEDERAL AGENCY PLAN TO ELIMINATE DISPARITIES AND IMPROVE THE HEALTH OF MINORITY POPULATIONS.
(a) In General- Not later than September 1, 2008, each Federal health agency shall develop and implement a national strategic action plan to eliminate disparities on the basis of race, ethnicity, and primary language and improve the health and health care of minority populations, through programs relevant to the mission of the agency.CommentsClose CommentsPermalink
(b) Publication- Each action plan described in paragraph (1) shall--CommentsClose CommentsPermalink
(1) be publicly reported in draft form for public review and comment;CommentsClose CommentsPermalink
(2) include a response to the review and comment described in paragraph (1) in the final plan;CommentsClose CommentsPermalink
(3) include the agency response to the 2002 Institute of Medicine report, Unequal Treatment--Confronting Racial and Ethnic Disparities in Healthcare;CommentsClose CommentsPermalink
(4) respond to data and analyses presented in the National Healthcare Disparities Report and the National Healthcare Quality Report published annually by the Agency for Healthcare Research and Quality;CommentsClose CommentsPermalink
(5) demonstrate progress in meeting the Healthy People 2010 objectives; andCommentsClose CommentsPermalink
(6) be updated, including progress reports, for inclusion in an annual report to Congress.CommentsClose CommentsPermalink
SEC. 402. ACCOUNTABILITY WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES.
Title XXX of the Public Health Service Act, as amended by titles II and III of this Act, is further amended by adding at the end the following:CommentsClose CommentsPermalink
`Subtitle C--Strengthening Accountability
`SEC. 3041. ELEVATION OF THE OFFICE OF CIVIL RIGHTS.
`(a) In General- The Secretary shall establish within the Office for Civil Rights an Office of Health Disparities, which shall be headed by a director to be appointed by the Secretary.CommentsClose CommentsPermalink
`(b) Purpose- The Office of Health Disparities shall ensure that the health programs, activities, and operations of health entities which receive Federal financial assistance are in compliance with title VI of the Civil Rights Act, which prohibits discrimination on the basis of race, color, or national origin. The activities of the Office shall include the following:CommentsClose CommentsPermalink
`(1) The development and implementation of an action plan to address racial and ethnic health care disparities, which shall address concerns relating to the Office for Civil Rights as released by the United States Commission on Civil Rights in the report entitled `Health Care Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equity' (September, 1999) in conjunction with the reports by the Institute of Medicine entitled `Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care', `Crossing the Quality Chasm: A New Health System for the 21st Century', and `In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce' and other related reports by the Institute of Medicine. This plan shall be publicly disclosed for review and comment and the final plan shall address any comments or concerns that are received by the Office.CommentsClose CommentsPermalink
`(2) Investigative and enforcement actions against intentional discrimination and policies and practices that have a disparate impact on minorities.CommentsClose CommentsPermalink
`(3) The review of racial, ethnic, and primary language health data collected by Federal health agencies to assess health care disparities related to intentional discrimination and policies and practices that have a disparate impact on minorities.CommentsClose CommentsPermalink
`(4) Outreach and education activities relating to compliance with title VI of the Civil Rights Act.CommentsClose CommentsPermalink
`(5) The provision of technical assistance for health entities to facilitate compliance with title VI of the Civil Rights Act.CommentsClose CommentsPermalink
`(6) Coordination and oversight of activities of the civil rights compliance offices established under section 3042.CommentsClose CommentsPermalink
`(7) Ensuring compliance with the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race, Ethnicity and the available language standards.CommentsClose CommentsPermalink
`(c) Funding and Staff- The Secretary shall ensure the effectiveness of the Office of Health Disparities by ensuring that the Office is provided with--CommentsClose CommentsPermalink
`(1) adequate funding to enable the Office to carry out its duties under this section; andCommentsClose CommentsPermalink
`(2) staff with expertise in--CommentsClose CommentsPermalink
`(A) epidemiology;CommentsClose CommentsPermalink
`(B) statistics;CommentsClose CommentsPermalink
`(C) health quality assurance;CommentsClose CommentsPermalink
`(D) minority health and health disparities;CommentsClose CommentsPermalink
`(E) cultural and linguistic competency; andCommentsClose CommentsPermalink
`(F) civil rights.CommentsClose CommentsPermalink
`(d) Report- Not later than December 31, 2008, and annually thereafter, the Secretary, in collaboration with the Director of the Office for Civil Rights and the Director of the Office of Minority Health, shall submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives that includes--CommentsClose CommentsPermalink
`(1) the number of cases filed, broken down by category;CommentsClose CommentsPermalink
`(2) the number of cases investigated and closed by the office;CommentsClose CommentsPermalink
`(3) the outcomes of cases investigated;CommentsClose CommentsPermalink
`(4) the staffing levels of the office including staff credentials;CommentsClose CommentsPermalink
`(5) the number of other lingering and emerging cases in which civil rights inequities can be demonstrated; andCommentsClose CommentsPermalink
`(6) the number of cases remaining open and an explanation for their open status.CommentsClose CommentsPermalink
`(e) Authorization of Appropriations- There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3042. ESTABLISHMENT OF HEALTH PROGRAM OFFICES FOR CIVIL RIGHTS WITHIN FEDERAL HEALTH AND HUMAN SERVICES AGENCIES.
`(a) In General- The Secretary shall establish civil rights compliance offices in each agency within the Department of Health and Human Services that administers health programs.CommentsClose CommentsPermalink
`(b) Purpose of Offices- Each office established under subsection (a) shall ensure that recipients of Federal financial assistance under Federal health programs administer their programs, services, and activities in a manner that--CommentsClose CommentsPermalink
`(1) does not discriminate, either intentionally or in effect, on the basis of race, national origin, language, ethnicity, sex, age, or disability; andCommentsClose CommentsPermalink
`(2) promotes the reduction and elimination of disparities in health and health care based on race, national origin, language, ethnicity, sex, age, and disability.CommentsClose CommentsPermalink
`(c) Powers and Duties- The offices established in subsection (a) shall have the following powers and duties:CommentsClose CommentsPermalink
`(1) The establishment of compliance and program participation standards for recipients of Federal financial assistance under each program administered by an agency within the Department of Health and Human Services including the establishment of disparity reduction standards to encompass disparities in health and health care related to race, national origin, language, ethnicity, sex, age, and disability.CommentsClose CommentsPermalink
`(2) The development and implementation of program-specific guidelines that interpret and apply Department of Health and Human Services guidance under title VI of the Civil Rights Act of 1964 to each Federal health program administered by the agency.CommentsClose CommentsPermalink
`(3) The development of a disparity-reduction impact analysis methodology that shall be applied to every rule issued by the agency and published as part of the formal rulemaking process under sections 555, 556, and 557 of title 5, United States Code.CommentsClose CommentsPermalink
`(4) Oversight of data collection, analysis, and publication requirements for all recipients of Federal financial assistance under each Federal health program administered by the agency, and compliance with the 1997 Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity and the available language standards.CommentsClose CommentsPermalink
`(5) The conduct of publicly available studies regarding discrimination within Federal health programs administered by the agency as well as disparity reduction initiatives by recipients of Federal financial assistance under Federal health programs.CommentsClose CommentsPermalink
`(6) Annual reports to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives on the progress in reducing disparities in health and health care through the Federal programs administered by the agency.CommentsClose CommentsPermalink
`(d) Relationship to Office for Civil Rights in the Department of Justice-CommentsClose CommentsPermalink
`(1) DEPARTMENT OF HEALTH AND HUMAN SERVICES- The Office for Civil Rights in the Department of Health and Human Services shall provide standard-setting and compliance review investigation support services to the Civil Rights Compliance Office for each agency.CommentsClose CommentsPermalink
`(2) DEPARTMENT OF JUSTICE- The Office for Civil Rights in the Department of Justice shall continue to maintain the power to institute formal proceedings when an agency Office for Civil Rights determines that a recipient of Federal financial assistance is not in compliance with the disparity reduction standards of the agency.CommentsClose CommentsPermalink
`(e) Definition- In this section, the term `Federal health programs' mean programs--CommentsClose CommentsPermalink
`(1) under the Social Security Act (
`(2) under this Act that provide Federal financial assistance for health care, biomedical research, health services research, and programs designed to improve the public's health.'.CommentsClose CommentsPermalink
SEC. 403. OFFICE OF MINORITY HEALTH.
Section 1707 of the Public Health Service Act (
(1) by striking subsection (b) and inserting the following:CommentsClose CommentsPermalink
`(b) Duties- With respect to improving the health of racial and ethnic minority groups, the Secretary, acting through the Deputy Assistant Secretary for Minority Health (in this section referred to as the `Deputy Assistant Secretary'), shall carry out the following:CommentsClose CommentsPermalink
`(1) Establish, implement, monitor, and evaluate short-range and long-range goals and objectives and oversee all other activities within the Public Health Service that relate to disease prevention, health promotion, service delivery, and research concerning minority groups. The heads of each of the agencies of the Service shall consult with the Deputy Assistant Secretary to ensure the coordination of such activities.CommentsClose CommentsPermalink
`(2) Oversee all activities within the Department of Health and Human Services that relate to reducing or eliminating disparities in health and health care in racial and ethnic minority populations and in rural and underserved communities, including coordinating--CommentsClose CommentsPermalink
`(A) the design of programs, support for programs, and the evaluation of programs;CommentsClose CommentsPermalink
`(B) the monitoring of trends in health and health care;CommentsClose CommentsPermalink
`(C) research efforts;CommentsClose CommentsPermalink
`(D) the training of health providers; andCommentsClose CommentsPermalink
`(E) information and education programs and campaigns.CommentsClose CommentsPermalink
`(3) Enter into interagency and intra-agency agreements with other agencies of the Public Health Service.CommentsClose CommentsPermalink
`(4) Ensure that the Federal health agencies and the National Center for Health Statistics collect data on the health status and health care of each minority group, using at a minimum the categories specified in the 1997 OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity as required under subtitle B and available language standards.CommentsClose CommentsPermalink
`(5) Provide technical assistance to States, local agencies, territories, Indian tribes, and entities for activities relating to the elimination of racial and ethnic disparities in health and health care.CommentsClose CommentsPermalink
`(6) Support a national minority health resource center to carry out the following:CommentsClose CommentsPermalink
`(A) Facilitate the exchange of information regarding matters relating to health information, health promotion and wellness, preventive health services, clinical trials, health information technology, and education in the appropriate use of health services.CommentsClose CommentsPermalink
`(B) Facilitate timely access to culturally and linguistically appropriate information.CommentsClose CommentsPermalink
`(C) Assist in the analysis of such information.CommentsClose CommentsPermalink
`(D) Provide technical assistance with respect to the exchange of such information (including facilitating the development of materials for such technical assistance).CommentsClose CommentsPermalink
`(7) Carry out programs to improve access to health care services for individuals with limited English proficiency, including developing and carrying out programs to provide bilingual or interpretive services through the development and support of the Robert T. Matsui Center for Cultural and Linguistic Competence in Health Care as provided for in section 3003.CommentsClose CommentsPermalink
`(8) Carry out programs to improve access to health care services and to improve the quality of health care services for individuals with low functional health literacy. As used in the preceding sentence, the term `functional health literacy' means the ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions.CommentsClose CommentsPermalink
`(9) Advise in matters related to the development, implementation, and evaluation of health professions education on decreasing disparities in health care outcomes, with focus on cultural competency as a method of eliminating disparities in health and health care in racial and ethnic minority populations.CommentsClose CommentsPermalink
`(10) Assist health care professionals, community and advocacy organizations, academic centers and public health departments in the design and implementation of programs that will improve the quality of health outcomes by strengthening the provider-patient relationship.';CommentsClose CommentsPermalink
(2) by redesignating subsections (f) through (h) as subsections (g) through (i) , respectively;CommentsClose CommentsPermalink
(3) by inserting after subsection (d) the following:CommentsClose CommentsPermalink
`(f) Preparation of Health Professionals to Provide Health Care to Minority Populations- The Secretary, in collaboration with the Director of the Bureau of Health Professions and the Deputy Assistant Secretary for Minority Health, shall require that health professional schools that receive Federal funds train future health professionals to provide culturally and linguistically appropriate health care to diverse populations.'; andCommentsClose CommentsPermalink
(4) by striking subsection (i) (as so redesignated) and inserting the following:CommentsClose CommentsPermalink
`(i) Authorization of Appropriations- For the purpose of carrying out this section, there are authorized to be appropriated $100,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2009 through 2013.'.CommentsClose CommentsPermalink
SEC. 404. ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN AGENCY OF THE PUBLIC HEALTH SERVICE.
(a) Establishment-CommentsClose CommentsPermalink
(1) IN GENERAL- In order to more effectively and efficiently carry out the responsibilities, authorities, and functions of the United States to provide health care services to Indians and Indian tribes, as are or may be hereafter provided by Federal statute or treaties, there is established within the Public Health Service of the Department of Health and Human Services the Indian Health Service.CommentsClose CommentsPermalink
(2) ASSISTANT SECRETARY OF INDIAN HEALTH- The Service shall be administered by an Assistant Secretary of Indian Health, who shall be appointed by the President, by and with the advice and consent of the Senate. The Assistant Secretary shall report to the Secretary. Effective with respect to an individual appointed by the President, by and with the advice and consent of the Senate the term of service of the Assistant Secretary shall be 4 years. An Assistant Secretary may serve more than 1 term.CommentsClose CommentsPermalink
(b) Agency- The Service shall be an agency within the Public Health Service of the Department, and shall not be an office, component, or unit of any other agency of the Department.CommentsClose CommentsPermalink
(c) Functions and Duties- The Secretary shall carry out through the Assistant Secretary of the Service--CommentsClose CommentsPermalink
(1) all functions which were, on the day before the date of enactment of the Indian Health Care Amendments of 1988, carried out by or under the direction of the individual serving as Director of the Service on such day;CommentsClose CommentsPermalink
(2) all functions of the Secretary relating to the maintenance and operation of hospital and health facilities for Indians and the planning for, and provision and utilization of, health services for Indians;CommentsClose CommentsPermalink
(3) all health programs under which health care is provided to Indians based upon their status as Indians which are administered by the Secretary, including programs under--CommentsClose CommentsPermalink
(A) the Indian Health Care Improvement Act;CommentsClose CommentsPermalink
(B) the Act of November 2, 1921 (
(C) the Act of August 5, 1954 (
(D) the Act of August 16, 1957 (
(E) the Indian Self-Determination Act (
(F) title XXX of the Public Health Service Act, as added by this Act; andCommentsClose CommentsPermalink
(4) all scholarship and loan functions carried out under title I of the Indian Health Care Improvement Act.CommentsClose CommentsPermalink
(d) Authority-CommentsClose CommentsPermalink
(1) IN GENERAL- The Secretary, acting through the Assistant Secretary, shall have the authority--CommentsClose CommentsPermalink
(A) except to the extent provided for in paragraph (2), to appoint and compensate employees for the Service in accordance with title 5, United States Code;CommentsClose CommentsPermalink
(B) to enter into contracts for the procurement of goods and services to carry out the functions of the Service; andCommentsClose CommentsPermalink
(C) to manage, expend, and obligate all funds appropriated for the Service.CommentsClose CommentsPermalink
(2) PERSONNEL ACTIONS- Notwithstanding any other provision of law, the provisions of section 12 of the Act of June 18, 1934 (48 Stat. 986;
(e) Rate of Pay-CommentsClose CommentsPermalink
(1) POSITIONS AT LEVEL IV-
(2) POSITIONS AT LEVEL V- Section 5316 of such title is amended by striking the following: `Director, Indian Health Service, Department of Health and Human Services.'.CommentsClose CommentsPermalink
(f) Duties of Assistant Secretary for Indian Health- Section 601 of the Indian Health Care Improvement Act (
(1) by inserting `(1)' after `(a)';CommentsClose CommentsPermalink
(2) in the second sentence of paragraph (1), as so designated, by striking `a Director,' and inserting `the Assistant Secretary for Indian Health,';CommentsClose CommentsPermalink
(3) by striking the third sentence of paragraph (1), as so designated, and all that follows through the end of the subsection (a) of such section and inserting the following: `The Assistant Secretary for Indian Health shall carry out the duties specified in paragraph (2).'; andCommentsClose CommentsPermalink
(4) by adding after paragraph (1) the following:CommentsClose CommentsPermalink
`(2) The Assistant Secretary for Indian Health shall--CommentsClose CommentsPermalink
`(A) report directly to the secretary concerning all policy and budget-related matters affecting Indian health;CommentsClose CommentsPermalink
`(B) collaborate with the Assistant Secretary for Health concerning appropriate matters of Indian health that affect the agencies of the Public Health Service;CommentsClose CommentsPermalink
`(C) advise each Assistant Secretary of the Department of Health and Human Services concerning matters of Indian health with respect to which that Assistant Secretary has authority and responsibility;CommentsClose CommentsPermalink
`(D) advise the heads of other agencies and programs of the Department of Health and Human Services concerning matters of Indian health with respect to which those heads have authority and responsibility; andCommentsClose CommentsPermalink
`(E) coordinate the activities of the Department of Health and Human Services concerning matters of Indian health.'.CommentsClose CommentsPermalink
(g) Continued Service by Incumbent- The individual serving in the position of Director of the Indian Health Service on the date preceding the date of enactment of this Act may serve as Assistant Secretary for Indian Health, at the pleasure of the President after the date of enactment of this Act.CommentsClose CommentsPermalink
(h) Conforming Amendments-CommentsClose CommentsPermalink
(1) AMENDMENTS TO INDIAN HEALTH CARE IMPROVEMENT ACT- The Indian Health Care Improvement Act (
(A) in section 601--CommentsClose CommentsPermalink
(i) in subsection (c), by striking `Director of the Indian Health Service' both places it appears and inserting `Assistant Secretary for Indian Health'; andCommentsClose CommentsPermalink
(ii) in subsection (d), by striking `Director of the Indian Health Service' and inserting `Assistant Secretary for Indian Health'; andCommentsClose CommentsPermalink
(B) in section 816(c)(1), by striking `Director of the Indian Health Service' and inserting `Assistant Secretary for Indian Health'.CommentsClose CommentsPermalink
(2) AMENDMENTS TO OTHER PROVISIONS OF LAW- The following provisions are each amended by striking `Director of the Indian Health Service' each place it appears and inserting `Assistant Secretary for Indian Health':CommentsClose CommentsPermalink
(A) Section 203(a)(1) of the Rehabilitation Act of 1973 (
(B) Subsections (b) and (e) of section 518 of the Federal Water Pollution Control Act (
(C) Section 803B(d)(1) of the Native American Programs Act of 1974 (
(i) References- Reference in any other Federal law, Executive order, rule, regulation, or delegation of authority, or any document of or relating to the Director of the Indian Health Service shall be deemed to refer to the Assistant Secretary for Indian Health.CommentsClose CommentsPermalink
(j) Definitions- For purposes of this section, the definitions contained in section 4 of the Indian Health Care Improvement Act shall apply.CommentsClose CommentsPermalink
SEC. 405. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN AGENCIES OF THE PUBLIC HEALTH SERVICE.
Title XVII of the Public Health Service Act (
`INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN PUBLIC HEALTH SERVICE
`Sec. 1707A.CommentsClose CommentsPermalink
`(a) In General- The head of each agency specified in subsection (b)(1) shall establish within the agency an office to be known as the Office of Minority Health. Each such Office shall be headed by a director, who shall be appointed by the head of the agency within which the Office is established, and who shall report directly to the head of the agency. The head of such agency shall carry out this section (as this section relates to the agency) acting through such Director.CommentsClose CommentsPermalink
`(b) Specified Agencies-CommentsClose CommentsPermalink
`(1) IN GENERAL- The agencies referred to in subsection (a) are the following:CommentsClose CommentsPermalink
`(A) The Centers for Disease Control and Prevention.CommentsClose CommentsPermalink
`(B) The Health Resources and Services Administration.CommentsClose CommentsPermalink
`(C) The Substance Abuse and Mental Health Services Administration; andCommentsClose CommentsPermalink
`(D) The Administration on Aging.CommentsClose CommentsPermalink
`(c) Composition- The head of each specified agency shall ensure that the officers and employees of the minority health office of the agency are, collectively, experienced in carrying out community-based health programs for each of the various racial and ethnic minority groups that are present in significant numbers in the United States.CommentsClose CommentsPermalink
`(d) Duties- Each Director of a minority health office shall establish and monitor the programs of the specified agency of such office in order to carry out the following:CommentsClose CommentsPermalink
`(1) Determine the extent to which the purposes of the programs are being carried out with respect to racial and ethnic minority groups;CommentsClose CommentsPermalink
`(2) Determine the extent to which members of such groups are represented among the Federal officers and employees who administer the programs; andCommentsClose CommentsPermalink
`(3) Make recommendations to the head of such agency on carrying out the programs with respect to such groups. In the case of programs that provide services, such recommendations shall include recommendations toward ensuring that--CommentsClose CommentsPermalink
`(A) the services are equitably delivered with respect to racial and ethnic minority groups;CommentsClose CommentsPermalink
`(B) the programs provide the services in the language and cultural context that is most appropriate for the individuals for whom the services are intended; andCommentsClose CommentsPermalink
`(C) the programs utilize racial and ethnic minority community-based organizations to deliver services.CommentsClose CommentsPermalink
`(e) Biennial Reports to Secretary- The head of each specified agency shall submit to the Secretary for inclusion in each biennial report describing--CommentsClose CommentsPermalink
`(1) the extent to which the minority health office of the agency employs individuals who are members of racial and ethnic minority groups, including a specification by minority group of the number of such individuals employed by such office.CommentsClose CommentsPermalink
`(f) Funding-CommentsClose CommentsPermalink
`(1) ALLOCATIONS- Of the amounts appropriated for a specified agency for a fiscal year, the Secretary must designate an appropriate amount of funds for the purpose of carrying out activities under this section through the minority health office of the agency. In reserving an amount under the preceding sentence for a minority health office for a fiscal year, the Secretary shall reduce, by substantially the same percentage, the amount that otherwise would be available for each of the programs of the designated agency involved.CommentsClose CommentsPermalink
`(2) AVAILABILITY OF FUNDS FOR STAFFING- The purposes for which amounts made available under paragraph may be expended by a minority health office include the costs of employing staff for such office.'.CommentsClose CommentsPermalink
SEC. 406. OFFICE OF MINORITY HEALTH AT THE CENTERS FOR MEDICARE & MEDICAID SERVICES.
(a) In General- Not later than 60 days after the date of enactment of this Act, the Secretary of Health and Human Services shall establish within the Centers for Medicare & Medicaid Services an Office of Minority Health (referred to in this section as the `Office').CommentsClose CommentsPermalink
(b) Duties- The Office shall be responsible for the coordination and facilitation of activities of the Centers for Medicare & Medicaid Services to improve minority health and health care and to reduce racial and ethnic disparities in health and health care, which shall include--CommentsClose CommentsPermalink
(1) creating a strategic plan, which shall be made available for public review, to improve the health and health care of Medicare, Medicaid, and SCHIP beneficiaries;CommentsClose CommentsPermalink
(2) promoting agency-wide policies relating to health care delivery and financing that could have a beneficial impact on the health and health care of minority populations;CommentsClose CommentsPermalink
(3) assisting health plans, hospitals, and other health entities in providing culturally and linguistically appropriate health care services;CommentsClose CommentsPermalink
(4) increasing awareness and outreach activities for minority health care consumers and providers about the causes and remedies for health and health care disparities;CommentsClose CommentsPermalink
(5) developing grant programs and demonstration projects to identify, implement and evaluate innovative approaches to improving the health and health care of minority beneficiaries in the Medicare, Medicaid, and SCHIP programs;CommentsClose CommentsPermalink
(6) considering incentive programs relating to reimbursement that would reward health entities for providing quality health care for minority populations using established benchmarks for quality of care;CommentsClose CommentsPermalink
(7) collaborating with the compliance office to ensure compliance with the anti-discrimination provisions under title VI of the Civil Rights Act of 1964;CommentsClose CommentsPermalink
(8) identifying barriers to enrollment in public programs under the jurisdiction of the Centers for Medicare & Medicaid Services;CommentsClose CommentsPermalink
(9) monitoring and evaluating on a regular basis the success of minority health programs and initiatives;CommentsClose CommentsPermalink
(10) publishing an annual report about the activities of the Centers for Medicare & Medicaid Services relating to minority health improvement; andCommentsClose CommentsPermalink
(11) other activities determined appropriate by the Secretary of Health and Human Services.CommentsClose CommentsPermalink
(c) Staff- The staff at the Office shall include--CommentsClose CommentsPermalink
(1) one or more individuals with expertise in minority health and racial and ethnic health disparities; andCommentsClose CommentsPermalink
(2) one or more individuals with expertise in health care financing and delivery in underserved communities.CommentsClose CommentsPermalink
(d) Coordination- In carrying out its duties under this section, the Office shall coordinate with--CommentsClose CommentsPermalink
(1) the Office of Minority Health in the Office of the Secretary of Health and Human Services;CommentsClose CommentsPermalink
(2) the National Centers for Minority Health and Health Disparities in the National Institutes of Health; andCommentsClose CommentsPermalink
(3) the Office of Minority Health in the Centers for Disease Control and Prevention.CommentsClose CommentsPermalink
(e) Authorization of Appropriations- For the purpose of carrying out this section, there are authorized to be appropriated $10,000,000 for fiscal year 2008, and such sums may be necessary for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink
SEC. 407. OFFICE OF MINORITY AFFAIRS AT THE FOOD AND DRUG ADMINISTRATION.
Chapter IX of the Federal Food, Drug, and Cosmetic Act (
`SEC. 910. OFFICE OF MINORITY AFFAIRS.
`(a) In General- Not later than 60 days after the date of enactment of this section, the Secretary shall establish within the Office of the Commissioner of Food and Drugs an Office of Minority Affairs (referred to in this section as the `Office').CommentsClose CommentsPermalink
`(b) Duties- The Office shall be responsible for the coordination and facilitation of activities of the Food and Drug Administration to improve minority health and health care and to reduce racial and ethnic disparities in health and health care, which shall include--CommentsClose CommentsPermalink
`(1) promoting policies in the development and review of medical products that reduce racial and ethnic disparities in health and health care;CommentsClose CommentsPermalink
`(2) encouraging appropriate data collection, analysis, and dissemination of racial and ethnic differences using, at a minimum, the categories described in the 1997 Office of Management and Budget standards, in response to different therapies in both adult and pediatric populations;CommentsClose CommentsPermalink
`(3) providing, in coordination with other appropriate government agencies, education, training, and support to increase participation of minority patients and physicians in clinical trials;CommentsClose CommentsPermalink
`(4) collecting and analyzing data using, at a minimum, the categories described in the 1997 Office of Management and Budget standards, on the number of participants from minority racial and ethnic backgrounds in clinical trials used to support medical product approvals;CommentsClose CommentsPermalink
`(5) the identification of methods to reduce language and literacy barriers; andCommentsClose CommentsPermalink
`(6) publishing an annual report about the activities of the Food and Drug Administration pertaining to minority health.CommentsClose CommentsPermalink
`(c) Staff- The staff of the Office shall include--CommentsClose CommentsPermalink
`(1) one or more individuals with expertise in the design and conduct of clinical trials of drugs, biological products, and medical devices; andCommentsClose CommentsPermalink
`(2) one or more individuals with expertise in therapeutic classes or disease states for which medical evidence suggests a difference based on race or ethnicity.CommentsClose CommentsPermalink
`(d) Coordination- In carrying out its duties under this section, the Office shall coordinate with--CommentsClose CommentsPermalink
`(1) the Office of Minority Health in the Office of the Secretary of Health and Human Services;CommentsClose CommentsPermalink
`(2) the National Center for Minority Health and Health Disparities in the National Institutes of Health; andCommentsClose CommentsPermalink
`(3) the Office of Minority Health in the Centers for Disease Control and Prevention.CommentsClose CommentsPermalink
`(e) Authorization of Appropriations- For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2008 through 2013.'.CommentsClose CommentsPermalink
SEC. 408. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND ETHNIC BACKGROUND.
(a) In General- Chapter V of the Federal Food, Drug, and Cosmetic Act (
`SEC. 505C. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND ETHNIC BACKGROUND.
`(a) Pre-Approval Studies- If there is evidence that there may be a disparity on the basis of racial or ethnic background as to the safety or effectiveness of a drug, then--CommentsClose CommentsPermalink
`(1)(A) the investigations required under section 505(b)(1)(A) shall include adequate and well-controlled investigations of the disparity; orCommentsClose CommentsPermalink
`(B) the evidence required under section 351(a) of the Public Health Service Act for approval of a biologics license application for the drug shall include adequate and well-controlled investigations of the disparity; andCommentsClose CommentsPermalink
`(2) if the investigations confirm that there is a disparity, the labeling of the drug shall include appropriate information about the disparity.CommentsClose CommentsPermalink
`(b) Post-Market Studies-CommentsClose CommentsPermalink
`(1) IN GENERAL- If there is evidence that there may be a disparity on the basis of racial or ethnic background as to the safety or effectiveness of a drug for which there is an approved application under section 505 or a license under section 351 of the Public Health Service Act, the Secretary may by order require the holder of the approved application or license to conduct, by a date specified by the Secretary, post-marketing studies to investigate the disparity.CommentsClose CommentsPermalink
`(2) LABELING- If the Secretary determines that the post-market studies confirm that there is a disparity described in paragraph (1), the labeling of the drug shall include appropriate information about the disparity.CommentsClose CommentsPermalink
`(3) STUDY DESIGN- The Secretary may specify all aspects of study design, including the number of studies and study participants, in the order requiring post-market studies of the drug.CommentsClose CommentsPermalink
`(4) MODIFICATIONS OF STUDY DESIGN- The Secretary may by order modify any aspect of the study design as necessary after issuing an order under paragraph (1).CommentsClose CommentsPermalink
`(5) STUDY RESULTS- The results from studies required under paragraph (1) shall be submitted to the Secretary as supplements to the drug application or biological license application.CommentsClose CommentsPermalink
`(c) Disparity- The term `evidence that there may be a disparity on the basis of racial or ethnic background for adult and pediatric populations as to the safety or effectiveness of a drug' includes--CommentsClose CommentsPermalink
`(1) evidence that there is a disparity on the basis of racial or ethnic background as to safety or effectiveness of a drug in the same chemical class as the drug;CommentsClose CommentsPermalink
`(2) evidence that there is a disparity on the basis of racial or ethnic background in the way the drug is metabolized; andCommentsClose CommentsPermalink
`(3) other evidence as the Secretary may determine.CommentsClose CommentsPermalink
`(d) Applications Under Section 505(b)(2) and 505(j)-CommentsClose CommentsPermalink
`(1) IN GENERAL- A drug for which an application has been submitted or approved under section 505(j) shall not be considered ineligible for approval under that section or misbranded under section 502 on the basis that the labeling of the drug omits information relating to a disparity on the basis of racial or ethnic background as to the safety or effectiveness of the drug, whether derived from investigations or studies required under this section or derived from other sources, when the omitted information is protected by patent or by exclusivity under clause (iii) or (iv) of section 505(j)(5)(B).CommentsClose CommentsPermalink
`(2) LABELING- Notwithstanding clauses (iii) and (iv) of section 505(j)(5)(B), the Secretary may require that the labeling of a drug approved under section 505(j) that omits information relating to a disparity on the basis of racial or ethnic background as to the safety or effectiveness of the drug include a statement of any appropriate contraindications, warnings, or precautions related to the disparity that the Secretary considers necessary.'.CommentsClose CommentsPermalink
(b) Enforcement- Section 502 of the Federal Food, Drug, and Cosmetic Act (
`(y) If it is a drug and the holder of the approved application under section 505 or license under section 351 of the Public Health Service Act for the drug has failed to complete the investigations or studies, or comply with any other requirement, of section 505C.'.CommentsClose CommentsPermalink
(c) Drug Fees- Section 736(a)(1)(A)(ii) of the Federal Food, Drug, and Cosmetic Act (
SEC. 409. UNITED STATES COMMISSION ON CIVIL RIGHTS.
(a) Coordination Within Department of Justice of Activities Regarding Health Disparities- Section 3 of the Civil Rights Commission Act of 1983 (
(1) in paragraph (1)(B), by striking `and' at the end;CommentsClose CommentsPermalink
(2) in paragraph (2), in the matter after and below subparagraph (D), by striking the period and inserting `; and'; andCommentsClose CommentsPermalink
(3) by adding at the end the following:CommentsClose CommentsPermalink
`(3) shall, with respect to activities carried out in health care and correctional facilities toward the goal of eliminating health disparities between the general population and members of racial or ethnic minority groups, coordinate such activities of--CommentsClose CommentsPermalink
`(A) the Office for Civil Rights within the Department of Justice;CommentsClose CommentsPermalink
`(B) the Office of Justice Programs within the Department of Justice;CommentsClose CommentsPermalink
`(C) the Office for Civil Rights within the Department of Health and Human Services; andCommentsClose CommentsPermalink
`(D) the Office of Minority Health within the Department of Health and Human Services (headed by the Deputy Assistant Secretary for Minority Health).'.CommentsClose CommentsPermalink
(b) Authorization of Appropriations- Section 5 of the Civil Rights Commission Act of 1983 (
SEC. 410. SENSE OF CONGRESS CONCERNING FULL FUNDING OF ACTIVITIES TO ELIMINATE RACIAL AND ETHNIC HEALTH DISPARITIES.
(a) Findings- Congress makes the following findings:CommentsClose CommentsPermalink
(1) The health status of the American populace is declining and the United States currently ranks below most industrialized nations in health status measured by longevity, sickness, and mortality.CommentsClose CommentsPermalink
(2) Racial and ethnic minority populations tend have the poorest health status and face substantial cultural, social, and economic barriers to obtaining quality health care.CommentsClose CommentsPermalink
(3) Efforts to improve minority health have been limited by inadequate resources (funding, staffing, and stewardship) and accountability.CommentsClose CommentsPermalink
(b) Sense of Congress- It is the sense of Congress that--CommentsClose CommentsPermalink
(1) funding should be doubled by fiscal year 2008 for the National Center for Minority Health Disparities, the Office of Civil Rights in the Department of Health and Human Services, the National Institute of Nursing Research, and the Office of Minority Health;CommentsClose CommentsPermalink
(2) adequate funding by fiscal year 2008, and subsequent funding increases, should be provided for health professions training programs, the Racial and Ethnic Approaches to Community Health (REACH) at the Center for Disease Control and Prevention, the Minority HIV/AIDS Initiative, and the Excellence Centers to Eliminate Ethnic/Racial Disparities (EXCEED) Program at the Agency for Healthcare Research and Quality;CommentsClose CommentsPermalink
(3) current and newly-created health disparity elimination incentives, programs, agencies, and departments under this Act (and the amendments made by this Act) should receive adequate staffing and funding by fiscal year 2008; andCommentsClose CommentsPermalink
(4) stewardship and accountability should be provided to Congress and the President for measurable and sustainable progress toward health disparity elimination.CommentsClose CommentsPermalink
SEC. 411. GUIDELINES FOR DISEASE SCREENING FOR MINORITY PATIENTS.
(a) In General- The Secretary, acting through the Director of the Agency for Healthcare Research and Quality, shall convene a series of meetings to develop guidelines for disease screening for minority patient populations which have a higher than average risk for many chronic diseases and cancers.CommentsClose CommentsPermalink
(b) Participants- In convening meetings under subsection (a), the Secretary shall ensure that meeting participants include representatives of--CommentsClose CommentsPermalink
(1) professional societies and associations;CommentsClose CommentsPermalink
(2) minority health organizations;CommentsClose CommentsPermalink
(3) health care researchers and providers, including those with expertise in minority health;CommentsClose CommentsPermalink
(4) Federal health agencies, including the Office of Minority Health and the National Institutes of Health; andCommentsClose CommentsPermalink
(5) other experts determined appropriate by the Secretary.CommentsClose CommentsPermalink
(c) Diseases- Screening guidelines for minority populations shall be developed under subsection (a) for--CommentsClose CommentsPermalink
(1) hypertension;CommentsClose CommentsPermalink
(2) hypercholesterolemia;CommentsClose CommentsPermalink
(3) diabetes;CommentsClose CommentsPermalink
(4) cardiovascular disease;CommentsClose CommentsPermalink
(5) cancers, including breast, prostate, colon, cervical, and lung cancer;CommentsClose CommentsPermalink
(6) asthma;CommentsClose CommentsPermalink
(7) diabetes;CommentsClose CommentsPermalink
(8) kidney diseases;CommentsClose CommentsPermalink
(9) eye diseases and disorders, including glaucoma;CommentsClose CommentsPermalink
(10) HIV/AIDS and sexually transmitted diseases;CommentsClose CommentsPermalink
(11) uterine fibroids;CommentsClose CommentsPermalink
(12) autoimmune disease;CommentsClose CommentsPermalink
(13) mental health conditions;CommentsClose CommentsPermalink
(14) dental health conditions and oral diseases;CommentsClose CommentsPermalink
(15) environmental and related health illnesses and conditions;CommentsClose CommentsPermalink
(16) Sickle cell disease;CommentsClose CommentsPermalink
(17) violence and injury prevention and control;CommentsClose CommentsPermalink
(18) genetic and related conditions;CommentsClose CommentsPermalink
(19) heart disease and stroke;CommentsClose CommentsPermalink
(20) tuberculosis;CommentsClose CommentsPermalink
(21) chronic obstructive pulmonary disease; andCommentsClose CommentsPermalink
(22) other diseases determined appropriate by the Secretary.CommentsClose CommentsPermalink
(d) Dissemination- Not later than 24 months after the date of enactment of this title, the Secretary shall publish and disseminate to health care provider organizations the guidelines developed under subsection (a).CommentsClose CommentsPermalink
(e) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
SEC. 412. NATIONAL CENTER FOR MINORITY HEALTH AND HEALTH DISPARITIES REAUTHORIZATION.
(a) In General- Section 485E of the Public Health Service Act (
(1) by striking subsection (e) and inserting the following:CommentsClose CommentsPermalink
`(e) Duties of the Director-CommentsClose CommentsPermalink
`(1) INTERAGENCY COORDINATION OF MINORITY HEALTH AND HEALTH DISPARITIES ACTIVITIES- With respect to minority health and health disparities, the Director of the Center shall plan, coordinate, and evaluate research and other activities conducted or supported by the agencies of the National Institutes of Health. In carrying out the preceding sentence, the Director of the Center shall evaluate the minority health and health disparity activities of each of such agencies and shall provide for the timely periodic re-evaluation of such activities.CommentsClose CommentsPermalink
`(2) CONSULTATIONS- The Director of the Center shall carry out this subpart (including developing and revising the plan and budget required in subsection (f)) in consultation with the Directors of the agencies (or a designee of the Directors) of the National Institutes of Health, with the advisory councils of the agencies, and with the advisory council established under section (j).CommentsClose CommentsPermalink
`(3) COORDINATION OF ACTIVITIES- The Director of the Center shall act as the primary Federal official with responsibility for coordinating all minority health disparities research and other health disparities research conducted or supported by the National Institutes of Health and shall--CommentsClose CommentsPermalink
`(A) represent the health disparities research program of the National Institutes of Health including the minority health disparities research program at all relevant executive branch task forces, committees, and planning activities;CommentsClose CommentsPermalink
`(B) maintain communications with all relevant Public Health Service agencies, including the Indian Health Service and various other departments of the Federal Government, to ensure the timely transmission of information concerning advances in minority health disparities research and other health disparities research between these various agencies for dissemination to affected communities and health care providers;CommentsClose CommentsPermalink
`(C) undertake research to further refine and develop the conceptual, definitional, and methodological issues involved in health disparities research and to further the understanding of the cause of disparities; andCommentsClose CommentsPermalink
`(D) engage with national and community-based organizations and health provider groups, led by and serving racial and ethnic minorities, to--CommentsClose CommentsPermalink
`(i) increase education, awareness, and participation with respect to the Center's activities and areas of research focus; andCommentsClose CommentsPermalink
`(ii) accelerate the translation of research findings into programs including those carried out by community-based organizations.';CommentsClose CommentsPermalink
(2) in subsection (f)--CommentsClose CommentsPermalink
(A) by striking the subsection heading and inserting the following: `Comprehensive Plan for Research; Budget Estimate; Allocation of Appropriations- ';CommentsClose CommentsPermalink
(B) in paragraph (1)--CommentsClose CommentsPermalink
(i) by striking the paragraph designation, the paragraph heading, the matter preceding subparagraph (A), and subparagraph (A) and inserting the following:CommentsClose CommentsPermalink
`(1) IN GENERAL- Subject to the provisions of this section and other applicable law, the Director of the Center, in consultation with the Director of NIH, the Directors of the other agencies of the National Institutes of Health, and the advisory council established under subsection (j) shall--CommentsClose CommentsPermalink
`(A) annually review and revise a comprehensive plan (referred to in this section as `the plan') and budget for the conduct and support of all minority health and health disparities research and other health disparities research activities of the agencies of the National Institutes of Health that includes time-based targeted objectives with measurable outcomes and assure that the annual review and revision of the plan uses an established trans-NIH process subject to timely review, approval, and dissemination;';CommentsClose CommentsPermalink
(ii) in subparagraph (D), by striking `, with respect to amounts appropriated for activities of the Center,';CommentsClose CommentsPermalink
(iii) by striking subparagraph (F) and inserting the following:CommentsClose CommentsPermalink
`(F) ensure that the plan and budget are presented to and considered by the Director in a clear and timely process during the formulation of the overall annual budget for the National Institutes of Health;';CommentsClose CommentsPermalink
(iv) by redesignating subparagraphs (G) and (H) as subparagraphs (I) and (J), respectively; andCommentsClose CommentsPermalink
(v) by inserting after subparagraph (F), the following:CommentsClose CommentsPermalink
`(G) annually submit to the Congress a report on the progress made with respect to the plan;CommentsClose CommentsPermalink
`(H) create and implement a plan for the systematic review of research activities supported by the National Institutes of Health that are within the mission of both the Center and other agencies of the National Institutes of Health, by establishing mechanisms for--CommentsClose CommentsPermalink
`(i) tracking minority health and health disparity research conducted within the agencies and assessing the appropriateness of this research with regard to the overall goals and objectives of the plan;CommentsClose CommentsPermalink
`(ii) the early identification of applications and proposals for grants, contracts, and cooperative agreements supporting extramural training, research, and development, that are submitted to the agencies and that are within the mission of the Center;CommentsClose CommentsPermalink
`(iii) providing the Center with the written descriptions and scientific peer review results of such applications and proposals;CommentsClose CommentsPermalink
`(iv) enabling the agencies to consult with the Director of the Center prior to final approval of such applications and proposals; andCommentsClose CommentsPermalink
`(v) reporting to the Director of the Center all such applications and proposals that are approved for funding by the agencies;'; andCommentsClose CommentsPermalink
(C) in paragraph (2)--CommentsClose CommentsPermalink
(i) in subparagraph (D), by striking `and' at the end;CommentsClose CommentsPermalink
(ii) in subparagraph (E), by striking the period and inserting `; and'; andCommentsClose CommentsPermalink
(iii) by adding at the end the following:CommentsClose CommentsPermalink
`(F) the number and type of personnel needs of the Center.';CommentsClose CommentsPermalink
(3) in subsection (h)--CommentsClose CommentsPermalink
(A) in paragraph (1), by striking `endowments at centers of excellence under section 736.' and inserting the following: `endowments at--CommentsClose CommentsPermalink
`(A) centers of excellence under section 736; andCommentsClose CommentsPermalink
`(B) centers of excellence under section 485F.'; andCommentsClose CommentsPermalink
(B) in paragraph (2)(A), by striking `average' and inserting `median'; andCommentsClose CommentsPermalink
(4) by inserting after subsection (j), the following:CommentsClose CommentsPermalink
`(k) Representation of Minorities Among Researchers- The Secretary, in collaboration with the Director of the Center, shall determine, by means of the collection and reporting of aggregated and disaggregated data, the extent to which racial and ethnic minority groups are represented among senior physicians and scientists of the national research institutes and among physicians and scientists conducting research with funds provided by such institutes, and as appropriate, carry out activities to increase the extent of such representation, including developing a pipeline of minority researchers interested in the study of health and health disparities, as well as attracting minority scientists in social and behavioral science fields who can bring their expertise to the study of health disparities.CommentsClose CommentsPermalink
`(l) Cancer Research- The Secretary, in collaboration with the Director of the Center, shall designate and support a cancer prevention, control, and population science center to address the significantly elevated rate of morbidity and mortality from cancer in racial and ethnic minority populations. Such designated center shall be housed within an existing, stand-alone cancer center at a minority-serving institution that has a demonstrable commitment to and expertise in cancer research in the basic, clinical, and population sciences.'.CommentsClose CommentsPermalink
(b) Authorization of Appropriations-CommentsClose CommentsPermalink
(1) IN GENERAL- To carry out section 485E of the Public Health Service Act (42 U.S.C.287c-31), as amended by subsection (a), there are authorized to be appropriated $240,000,000 for fiscal year 2008 and such sums as may be necessary for each of fiscal years 2009 through 2012.CommentsClose CommentsPermalink
(2) EXPENDITURE- The Director of the National Center on Minority Health and Health Disparities shall expend amounts appropriated for activities under such section 485E in accordance with such section and other applicable law and in collaboration with the Director of National Institutes of Health and the directors of other institutes and centers of the National Institutes of Health.CommentsClose CommentsPermalink
(3) MANAGEMENT- All amounts expended for minority health and health disparities research activities under this subsection shall be reported programmatically to and approved by the Director of the National Center on Minority Health and Health Disparities under such section 485E, in accordance with the plan described under subsection (f)(1)(A) of such section 485E.CommentsClose CommentsPermalink
Subtitle B--Improving Environmental Justice
SEC. 421. CODIFICATION OF EXECUTIVE ORDER 12898.
(a) In General- The President of the United States is authorized and directed to execute, administer, and enforce as a matter of Federal law the provisions of Executive Order 12898, dated February 11, 1994, (`Federal Actions To Address Environmental Justice In Minority Populations and Low-Income Populations') with such modifications as are provided in this section.CommentsClose CommentsPermalink
(b) Definition of Environmental Justice- For purposes of carrying out the provisions of Executive Order 12898, the following definitions shall apply:CommentsClose CommentsPermalink
(1) The term `environmental justice' means the fair treatment and meaningful involvement of all people regardless of race, color, national origin, educational level, or income with respect to the development, implementation, and enforcement of environmental laws and regulations in order to ensure that--CommentsClose CommentsPermalink
(A) minority and low-income communities have access to public information relating to human health and environmental planning, regulations, and enforcement; andCommentsClose CommentsPermalink
(B) no minority or low-income population is forced to shoulder a disproportionate burden of the negative human health and environmental impacts of pollution or other environmental hazard.CommentsClose CommentsPermalink
(2) The term `fair treatment' means policies and practices that ensure that no group of people, including racial, ethnic, or socioeconomic groups bear disproportionately high and adverse human health or environmental effects resulting from Federal agency programs, policies, and activities.CommentsClose CommentsPermalink
(c) Judicial Review and Rights of Action- The provisions of section 6-609 of Executive Order 12898 shall not apply for purposes of this Act.CommentsClose CommentsPermalink
SEC. 422. IMPLEMENTATION OF RECOMMENDATIONS BY ENVIRONMENTAL PROTECTION AGENCY.
(a) Inspector General Recommendations- The Administrator of the Environmental Protection Agency shall, as promptly as practicable, carry out each of the following recommendations of the Inspector General of the agency as set forth in Report No. 2006-P-00034 entitled `EPA needs to conduct environmental justice reviews of its programs, policies and activities':CommentsClose CommentsPermalink
(1) The recommendation that the Agency's program and regional offices identify which programs, policies, and activities need environmental justice reviews and require these offices to establish a plan to complete the necessary reviews.CommentsClose CommentsPermalink
(2) The recommendation that the Administrator of the Agency ensure that these reviews determine whether the programs, policies, and activities may have a disproportionately high and adverse health or environmental impact on minority and low-income populations.CommentsClose CommentsPermalink
(3) The recommendation that each program and regional office develop specific environmental justice review guidance for conducting environmental justice reviews.CommentsClose CommentsPermalink
(4) The recommendation that the Administrator designate a responsible office to compile results of environmental justice reviews and recommend appropriate actions.CommentsClose CommentsPermalink
(b) Gao Recommendations- In developing rules under laws administered by the Environmental Protection Agency, the Administrator of the Agency shall, as promptly as practicable, carry out each of the following recommendations of the Comptroller General of the United States as set forth in GAO Report numbered GAO-05-289 entitled `EPA Should Devote More Attention to Environmental Justice when Developing Clean Air Rules':CommentsClose CommentsPermalink
(1) The recommendation that the Administrator ensure that workgroups involved in developing a rule devote attention to environmental justice while drafting and finalizing the rule.CommentsClose CommentsPermalink
(2) The recommendation that the Administrator enhance the ability of such workgroups to identify potential environmental justice issues through such steps as providing workgroup members with guidance and training to helping them identify potential environmental justice problems and involving environmental justice coordinators in the workgroups when appropriate.CommentsClose CommentsPermalink
(3) The recommendation that the Administrator improve assessments of potential environmental justice impacts in economic reviews by identifying the data and developing the modeling techniques needed to assess such impacts.CommentsClose CommentsPermalink
(4) The recommendation that the Administrator direct appropriate Agency officers and employees to respond fully when feasible to public comments on environmental justice, including improving the Agency's explanation of the basis for its conclusions, together with supporting data.CommentsClose CommentsPermalink
(c) 2004 Inspector General Report- The Administrator of the Environmental Protection Agency shall, as promptly as practicable, carry out each of the following recommendations of the Inspector General of the Agency as set forth in the report entitled `EPA Needs to Consistently Implement the Intent of the Executive Order on Environmental Justice' (Report No. 2004-P-00007):CommentsClose CommentsPermalink
(1) The recommendation that the Agency clearly define the mission of the Office of Environmental Justice (OEJ) and provide Agency staff with an understanding of the roles and responsibilities of the Office.CommentsClose CommentsPermalink
(2) The recommendation that the Agency establish (through issuing guidance or a policy statement from the Administrator) specific time frames for the development of definitions, goals, and measurements regarding environmental justice and provide the regions and program offices a standard and consistent definition for a minority and low-income community, with instructions on how the Agency will implement and operationalize environmental justice into the Agency's daily activities.CommentsClose CommentsPermalink
(3) The recommendation that the Agency ensure the comprehensive training program currently under development includes standard and consistent definitions of the key environmental justice concepts (such as `low-income', `minority', and `disproportionately impacted') and instructions for implementation of those concepts.CommentsClose CommentsPermalink
(d) Report- The Administrator shall submit an initial report to Congress within 6 months after the enactment of this Act regarding the Administrator's strategy for implementing the recommendations referred to in subsections (a), (b), and (c). Thereafter, the Administrator shall provide semi-annual reports to Congress regarding the Administrator's progress in implementing such recommendations and modifying the Administrator's emergency management procedures to incorporate environmental justice in the Agency's Incident Command Structure (in accordance with the December 18, 2006, letter from the Deputy Administrator to the Acting Inspector General of the agency).CommentsClose CommentsPermalink
SEC. 423. GRANT PROGRAM.
(a) Definitions- In this section:CommentsClose CommentsPermalink
(1) DIRECTOR- The term `Director' means the Director of the Centers for Disease Control and Prevention, acting in collaboration with the Administrator of the Environmental Protection Agency and the Director of the National Institute of Environmental Health Sciences.CommentsClose CommentsPermalink
(2) ELIGIBLE ENTITY- The term `eligible entity' means a State or local community that--CommentsClose CommentsPermalink
(A) bears a disproportionate burden of exposure to environmental health hazards;CommentsClose CommentsPermalink
(B) has established a coalition--CommentsClose CommentsPermalink
(i) with not less than 1 community-based organization; andCommentsClose CommentsPermalink
(ii) with not less than 1--CommentsClose CommentsPermalink
(I) public health entity;CommentsClose CommentsPermalink
(II) health care provider organization; orCommentsClose CommentsPermalink
(III) academic institution, including any minority-serving institution (including an Hispanic-serving institution, a historically Black college or university, and a tribal college or university);CommentsClose CommentsPermalink
(C) ensures planned activities and funding streams are coordinated to improve community health; andCommentsClose CommentsPermalink
(D) submits an application in accordance with subsection (c).CommentsClose CommentsPermalink
(b) Establishment- The Director shall establish a grant program under which eligible entities shall receive grants to conduct environmental health improvement activities.CommentsClose CommentsPermalink
(c) Application- To receive a grant under this section, an eligible entity shall submit an application to the Director at such time, in such manner, and accompanied by such information as the Director may require.CommentsClose CommentsPermalink
(d) Cooperative Agreements- An eligible entity may use a grant under this section--CommentsClose CommentsPermalink
(1) to promote environmental health; andCommentsClose CommentsPermalink
(2) to address environmental health disparities.CommentsClose CommentsPermalink
(e) Amount of Cooperative Agreement-CommentsClose CommentsPermalink
(1) IN GENERAL- The Director shall award grants to eligible entities at the 2 different funding levels described in this subsection.CommentsClose CommentsPermalink
(2) LEVEL 1 COOPERATIVE AGREEMENTS-CommentsClose CommentsPermalink
(A) IN GENERAL- An eligible entity awarded a grant under this paragraph shall use the funds to identify environmental health problems and solutions by--CommentsClose CommentsPermalink
(i) establishing a planning and prioritizing council in accordance with subparagraph (B); andCommentsClose CommentsPermalink
(ii) conducting an environmental health assessment in accordance with subparagraph (C).CommentsClose CommentsPermalink
(B) PLANNING AND PRIORITIZING COUNCIL-CommentsClose CommentsPermalink
(i) IN GENERAL- A prioritizing and planning council established under subparagraph (A)(i) (referred to in this paragraph as a `PPC') shall assist the environmental health assessment process and environmental health promotion activities of the eligible entity.CommentsClose CommentsPermalink
(ii) MEMBERSHIP- Membership of a PPC shall consist of representatives from various organizations within public health, planning, development, and environmental services and shall include stakeholders from vulnerable groups such as children, the elderly, disabled, and minority ethnic groups that are often not actively involved in democratic or decision-making processes.CommentsClose CommentsPermalink
(iii) DUTIES- A PPC shall--CommentsClose CommentsPermalink
(I) identify key stakeholders and engage and coordinate potential partners in the planning process;CommentsClose CommentsPermalink
(II) establish a formal advisory group to plan for the establishment of services;CommentsClose CommentsPermalink
(III) conduct an in-depth review of the nature and extent of the need for an environmental health assessment, including a local epidemiological profile, an evaluation of the service provider capacity of the community, and a profile of any target populations; andCommentsClose CommentsPermalink
(IV) define the components of care and form essential programmatic linkages with related providers in the community.CommentsClose CommentsPermalink
(C) ENVIRONMENTAL HEALTH ASSESSMENT-CommentsClose CommentsPermalink
(i) IN GENERAL- A PPC shall carry out an environmental health assessment to identify environmental health concerns.CommentsClose CommentsPermalink
(ii) ASSESSMENT PROCESS- The PPC shall--CommentsClose CommentsPermalink
(I) define the goals of the assessment;CommentsClose CommentsPermalink
(II) generate the environmental health issue list;CommentsClose CommentsPermalink
(III) analyze issues with a systems framework;CommentsClose CommentsPermalink
(IV) develop appropriate community environmental health indicators;CommentsClose CommentsPermalink
(V) rank the environmental health issues;CommentsClose CommentsPermalink
(VI) set priorities for action;CommentsClose CommentsPermalink
(VII) develop an action plan;CommentsClose CommentsPermalink
(VIII) implement the plan; andCommentsClose CommentsPermalink
(IX) evaluate progress and planning for the future.CommentsClose CommentsPermalink
(D) EVALUATION- Each eligible entity that receives a grant under this paragraph shall evaluate, report, and disseminate program findings and outcomes.CommentsClose CommentsPermalink
(E) TECHNICAL ASSISTANCE- The Director may provide such technical and other non-financial assistance to eligible entities as the Director determines to be necessary.CommentsClose CommentsPermalink
(3) LEVEL 2 COOPERATIVE AGREEMENTS-CommentsClose CommentsPermalink
(A) ELIGIBILITY-CommentsClose CommentsPermalink
(i) IN GENERAL- The Director shall award grants under this paragraph to eligible entities that have already--CommentsClose CommentsPermalink
(I) established broad-based collaborative partnerships; andCommentsClose CommentsPermalink
(II) completed environmental assessments.CommentsClose CommentsPermalink
(ii) NO LEVEL 1 REQUIREMENT- To be eligible to receive a grant under this paragraph, an eligible entity is not required to have successfully completed a Level 1 Cooperative Agreement (as described in paragraph (2).CommentsClose CommentsPermalink
(B) USE OF GRANT FUNDS- An eligible entity awarded a grant under this paragraph shall use the funds to further activities to carry out environmental health improvement activities, including--CommentsClose CommentsPermalink
(i) addressing community environmental health priorities in accordance with paragraph (2)(C)(ii), including--CommentsClose CommentsPermalink
(I) air quality;CommentsClose CommentsPermalink
(II) water quality;CommentsClose CommentsPermalink
(III) solid waste;CommentsClose CommentsPermalink
(IV) land use;CommentsClose CommentsPermalink
(V) housing;CommentsClose CommentsPermalink
(VI) food safety;CommentsClose CommentsPermalink
(VII) crime;CommentsClose CommentsPermalink
(VIII) injuries; andCommentsClose CommentsPermalink
(IX) healthcare services;CommentsClose CommentsPermalink
(ii) building partnerships between planning, public health, and other sectors, to address how the built environment impacts food availability and access and physical activity to promote healthy behaviors and lifestyles and reduce overweight and obesity, asthma, respiratory conditions, dental, oral and mental health conditions, and related co-morbidities;CommentsClose CommentsPermalink
(iii) establishing programs to address--CommentsClose CommentsPermalink
(I) how environmental and social conditions of work and living choices influence physical activity and dietary intake; orCommentsClose CommentsPermalink
(II) how those conditions influence the concerns and needs of people who have impaired mobility and use assistance devices, including wheelchairs and lower limb prostheses; andCommentsClose CommentsPermalink
(iv) convening intervention programs that examine the role of the social environment in connection with the physical and chemical environment in--CommentsClose CommentsPermalink
(I) determining access to nutritional food; andCommentsClose CommentsPermalink
(II) improving physical activity to reduce morbidity and increase quality of life.CommentsClose CommentsPermalink
(f) Authorization of Appropriations- There are authorized to be appropriated to carry out this section--CommentsClose CommentsPermalink
(1) $25,000,000 for fiscal year 2008; andCommentsClose CommentsPermalink
(2) such sums as may be necessary for fiscal years 2009 through 2012.CommentsClose CommentsPermalink
SEC. 424. ADDITIONAL RESEARCH ON THE RELATIONSHIP BETWEEN THE BUILT ENVIRONMENT AND THE HEALTH OF COMMUNITY RESIDENTS.
(a) Definition of Eligible Institution- In this section, the term `eligible institution' means a public or private nonprofit institution that submits to the Secretary of Health and Human Services (in this section referred to as the `Secretary') and the Administrator of the Environmental Protection Agency (in this section referred to as the `Administrator') an application for a grant under the grant program authorized under subsection (b)(2) at such time, in such manner, and containing such agreements, assurances, and information as the Secretary and Administrator may require.CommentsClose CommentsPermalink
(b) Research Grant Program-CommentsClose CommentsPermalink
(1) DEFINITION OF HEALTH- In this section, the term `health' includes--CommentsClose CommentsPermalink
(A) levels of physical activity;CommentsClose CommentsPermalink
(B) consumption of nutritional foods;CommentsClose CommentsPermalink
(C) rates of crime;CommentsClose CommentsPermalink
(D) air, water, and soil quality;CommentsClose CommentsPermalink
(E) risk of injury;CommentsClose CommentsPermalink
(F) accessibility to healthcare services; andCommentsClose CommentsPermalink
(G) other indicators as determined appropriate by the Secretary.CommentsClose CommentsPermalink
(2) GRANTS- The Secretary, in collaboration with the Administrator, shall provide grants to eligible institutions to conduct and coordinate research on the built environment and its influence on individual and population-based health.CommentsClose CommentsPermalink
(3) RESEARCH- The Secretary shall support research that--CommentsClose CommentsPermalink
(A) investigates and defines the causal links between all aspects of the built environment and the health of residents;CommentsClose CommentsPermalink
(B) examines--CommentsClose CommentsPermalink
(i) the extent of the impact of the built environment (including the various characteristics of the built environment) on the health of residents;CommentsClose CommentsPermalink
(ii) the variance in the health of residents by--CommentsClose CommentsPermalink
(I) location (such as inner cities, inner suburbs, and outer suburbs); andCommentsClose CommentsPermalink
(II) population subgroup (such as children, the elderly, the disadvantaged); orCommentsClose CommentsPermalink
(iii) the importance of the built environment to the total health of residents, which is the primary variable of interest from a public health perspective;CommentsClose CommentsPermalink
(C) is used to develop--CommentsClose CommentsPermalink
(i) measures to address health and the connection of health to the built environment; andCommentsClose CommentsPermalink
(ii) efforts to link the measures to travel and health databases; andCommentsClose CommentsPermalink
(D) distinguishes carefully between personal attitudes and choices and external influences on observed behavior to determine how much an observed association between the built environment and the health of residents, versus the lifestyle preferences of the people that choose to live in the neighborhood, reflects the physical characteristics of the neighborhood; andCommentsClose CommentsPermalink
(E)(i) identifies or develops effective intervention strategies to promote better health among residents with a focus on behavioral interventions and enhancements of the built environment that promote increased use by residents; andCommentsClose CommentsPermalink
(ii) in developing the intervention strategies under clause (i), ensures that the intervention strategies will reach out to high-risk populations, including racial and ethnic minorities and low-income urban and rural communities.CommentsClose CommentsPermalink
(4) PRIORITY- In providing assistance under the grant program authorized under paragraph (2), the Secretary and the Administrator shall give priority to research that incorporates--CommentsClose CommentsPermalink
(A) Minority-serving institutions as grantees;CommentsClose CommentsPermalink
(B) interdisciplinary approaches; orCommentsClose CommentsPermalink
(C) the expertise of the public health, physical activity, urban planning, and transportation research communities in the United States and abroad.CommentsClose CommentsPermalink
TITLE V--IMPROVEMENT OF HEALTH CARE SERVICES
SEC. 501. HEALTH EMPOWERMENT ZONES.
(a) Health Empowerment Zone Programs-CommentsClose CommentsPermalink
(1) GRANTS- The Secretary, acting through the Administrator of the Health Resources and Services Administration and the Deputy Assistant Secretary for Minority Health, and in cooperation with the Director of the Office of Community Services and the Director of the National Center for Minority Health and Health Disparities, shall make grants to partnerships of private and public entities to establish health empowerment zone programs in communities that disproportionately experience disparities in health status and health care for the purpose described in paragraph (2).CommentsClose CommentsPermalink
(2) USE OF FUNDS-CommentsClose CommentsPermalink
(A) IN GENERAL- Subject to subparagraph (B), the purpose of a health empowerment zone program under this section shall be to assist individuals, businesses, schools, minority health associations, non-profit organizations, community-based organizations, hospitals, health care clinics, foundations, and other entities in communities that disproportionately experience disparities in health status and health care which are seeking--CommentsClose CommentsPermalink
(i) to improve the health or environment of minority individuals in the community and to reduce disparities in health status and health care by assisting individuals in accessing Federal programs;CommentsClose CommentsPermalink
(ii) to coordinate the efforts of governmental and private entities regarding the elimination of racial and ethnic disparities in health status and health care; andCommentsClose CommentsPermalink
(iii) to increase the adoption and use of health information technology by providers in racial and ethnic minority and rural communities to improve quality of care; enhance minority and rural consumer awareness; understand, adopt, and use health information technology to improve health literacy and health self-management; and foster improved coordination of health services and care quality.CommentsClose CommentsPermalink
(B) MEDICARE AND MEDICAID- A health empowerment zone program under this section shall not provide any assistance (other than referral and follow-up services) that is duplicative of programs under title XVIII or XIX of the Social Security Act (
(3) DISTRIBUTION- The Secretary shall make at least 1 grant per Health and Human Services region under this section to a partnership for a health empowerment zone program in communities that disproportionately experience disparities in health status and health care that is located in a territory or possession of the United States.CommentsClose CommentsPermalink
(4) APPLICATION- To obtain a grant under this section, a partnership shall submit to the Secretary an application in such form and in such manner as the Secretary may require. An application under this paragraph shall--CommentsClose CommentsPermalink
(A) demonstrate that the communities to be served by the health empowerment zone program are those that disproportionately experience disparities in health status and health care;CommentsClose CommentsPermalink
(B) set forth a strategic plan for accomplishing the purpose described in paragraph (2), by--CommentsClose CommentsPermalink
(i) describing the coordinated health, economic, human, community, and physical development plan and related activities proposed for the community;CommentsClose CommentsPermalink
(ii) describing the extent to which local institutions and organizations have contributed and will contribute to the planning process and implementation;CommentsClose CommentsPermalink
(iii) identifying the projected amount of Federal, State, local, and private resources that will be available in the area and the private and public partnerships to be used (including any participation by or cooperation with universities, colleges, foundations, non-profit organizations, medical centers, hospitals, health clinics, school districts, or other private and public entities);CommentsClose CommentsPermalink
(iv) identifying the funding requested under any Federal program in support of the proposed activities;CommentsClose CommentsPermalink
(v) identifying benchmarks for measuring the success of carrying out the strategic plan;CommentsClose CommentsPermalink
(vi) demonstrating the ability to reach and service the targeted underserved minority community populations in a culturally appropriate and linguistically responsive manner; andCommentsClose CommentsPermalink
(vii) demonstrating a capacity and infrastructure to provide long-term community response that is culturally appropriate and linguistically responsive to communities that disproportionately experience disparities in health and health care; andCommentsClose CommentsPermalink
(C) include such other information as the Secretary may require.CommentsClose CommentsPermalink
(5) PREFERENCE- In awarding grants under this subsection, the Secretary shall give preference to proposals from indigenous community entities that have an expertise in providing culturally appropriate and linguistically responsive services to communities that disproportionately experience disparities in health and health care.CommentsClose CommentsPermalink
(b) Federal Assistance for Health Empowerment Zone Grant Programs- The Secretary, the Administrator of the Small Business Administration, the Secretary of Agriculture, the Secretary of Education, the Secretary of Labor, and the Secretary of Housing and Urban Development shall each--CommentsClose CommentsPermalink
(1) where appropriate, provide entity-specific technical assistance and evidence-based strategies to communities that disproportionately experience disparities in health status and health care to further the purposes served by a health empowerment zone program established with a grant under subsection (a);CommentsClose CommentsPermalink
(2) identify all programs administered by the Department of Health and Human Services, Small Business Administration, Department of Agriculture, Department of Education, Department of Labor, and the Department of Housing and Urban Development, respectively, that may be used to further the purpose of a health empowerment zone program established with a grant under subsection (a); andCommentsClose CommentsPermalink
(3) in administering any program identified under paragraph (2), consider the appropriateness of giving priority to any individual or entity located in communities that disproportionately experience disparities in health status and health care served by a health empowerment zone program established with a grant under subsection (a), if such priority would further the purpose of the health empowerment zone program.CommentsClose CommentsPermalink
(c) Health Empowerment Zone Coordinating Committee-CommentsClose CommentsPermalink
(1) ESTABLISHMENT- For each health empowerment zone program established with a grant under subsection (a), the Secretary acting through the Director of Office of Minority Health and the Administrator of the Health Resources and Services Administration shall establish a health empowerment zone coordinating committee.CommentsClose CommentsPermalink
(2) DUTIES- Each coordinating committee established, in coordination with the Deputy Assistant Secretary for Minority Health and the Administrator of the Health Resources and Services Administration, shall provide technical assistance and evidence-based strategies to the grant recipient involved, including providing guidance on research, strategies, health outcomes, program goals, management, implementation, monitoring, assessment, and evaluation processes.CommentsClose CommentsPermalink
(3) MEMBERSHIP-CommentsClose CommentsPermalink
(A) APPOINTMENT- The Deputy Assistant Secretary for Minority Health and the Administrator of the Health Resources and Services Administration, in consultation with the respective grant recipient shall appoint the members of each coordinating committee.CommentsClose CommentsPermalink
(B) COMPOSITION- The Deputy Assistant Secretary for Minority Health, and the Administrator of the Health Resources and Services Administration shall ensure that each coordinating committee established--CommentsClose CommentsPermalink
(i) has not more than 20 members;CommentsClose CommentsPermalink
(ii) includes individuals from communities that disproportionately experience disparities in health status and health care;CommentsClose CommentsPermalink
(iii) includes community leaders and leaders of community-based organizations;CommentsClose CommentsPermalink
(iv) includes representatives of academia and lay and professional organizations and associations including those having expertise in medicine (including dental and oral medicine), technical, social, and behavioral science, health policy, health information technology, advocacy, cultural and linguistic competency, research management, and organization; andCommentsClose CommentsPermalink
(v) represents a reasonable cross-section of knowledge, views, and application of expertise on societal, ethical, behavioral, educational, policy, legal, cultural, linguistic, and technological workforce issues related to eliminating disparities in health and health care.CommentsClose CommentsPermalink
(C) INDIVIDUAL QUALIFICATIONS- The Deputy Assistant Secretary for Minority Health and the Administrator of the Health Resources and Services Administration may not appoint an individual to serve on a coordinating committee unless the individual meets the following qualifications:CommentsClose CommentsPermalink
(i) The individual is not employed by the Federal Government.CommentsClose CommentsPermalink
(ii) The individual has appropriate experience, including experience in the areas of community development, cultural and linguistic competency, reducing and eliminating racial and ethnic disparities in health and health care, or minority health.CommentsClose CommentsPermalink
(D) SELECTION- In selecting individuals to serve on a coordinating committee, the Deputy Assistant Secretary for Minority Health and the Administrator Health Resources and Services Administration shall give due consideration to the recommendations of the Congress, industry leaders, the scientific community (including the Institute of Medicine), academia, community based non-profit organizations, minority health and related organizations, the education community, State and local governments, and other appropriate organizations.CommentsClose CommentsPermalink
(E) CHAIRPERSON- The Deputy Assistant Secretary for Minority Health and the Administrator of the Health Resources and Services Administration, in consultation with the members of the coordinating committee involved, shall designate a chairperson of the coordinating committee, who shall serve for a term of 3 years and who may be reappointed at the expiration of each such term.CommentsClose CommentsPermalink
(F) TERMS- Each member of a coordinating committee shall be appointed for a term of 1 to 3 years in overlapping staggered terms, as determined by the Deputy Assistant Secretary for Minority Health and the Administrator of the Health Resources and Services Administration at the time of appointment, and may be reappointed at the expiration of each such term.CommentsClose CommentsPermalink
(G) VACANCIES- A vacancy on a coordinating committee shall be filled in the same manner in which the original appointment was made.CommentsClose CommentsPermalink
(4) MEETINGS- A coordinating committee shall meet at least twice each year, at the call of the coordinating committee's chairperson and in consultation with the Deputy Assistant Secretary for Minority Health and the Administrator Health Resources and Services Administration.CommentsClose CommentsPermalink
(5) REPORT- Each coordinating committee shall transmit to the Congress an annual report that, with respect to the health empowerment zone program involved, includes the following:CommentsClose CommentsPermalink
(A) A review of the program's effectiveness in achieving stated goals and outcomes.CommentsClose CommentsPermalink
(B) A review of the program's management and the coordination of the entities involved, including the representation and involvement of communities experiencing health disparities.CommentsClose CommentsPermalink
(C) A review of the activities in the program's portfolio and components.CommentsClose CommentsPermalink
(D) An identification of policy issues raised by the program.CommentsClose CommentsPermalink
(E) An assessment of the program's capacity, infrastructure, and number of underserved minority communities engaged.CommentsClose CommentsPermalink
(F) Recommendations for new program goals, research areas, enhanced approaches, partnerships, coordination and management mechanisms, and projects to be established to achieve the program's stated goals, to improve outcomes, monitoring, and evaluation.CommentsClose CommentsPermalink
(G) A review of the degree of minority entity participation in the program, and an identification of a strategy to increase such participation.CommentsClose CommentsPermalink
(H) Any other reviews or recommendations determined to be appropriate by the coordinating committee.CommentsClose CommentsPermalink
(d) Report- The Deputy Assistant Secretary for Minority Health and the Administrator of the Health Resources and Services Administration shall submit a joint annual report to the appropriate committees of Congress on the results of the implementation of programs under this section.CommentsClose CommentsPermalink
(e) Authorization of Appropriations- There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
SEC. 502. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
Title XXX of the Public Health Service Act, as amended by titles II, III, and IV of this Act, is further amended by adding at the end the following:CommentsClose CommentsPermalink
`Subtitle D--Reconstruction and Improvement Grants for Public Health Care Facilities Serving Pacific Islanders and the Insular Areas
`SEC. 3051. GRANT SUPPORT FOR QUALITY IMPROVEMENT INITIATIVES.
`(a) In General- The Secretary, in collaboration with the Administrator of the Health Resources and Services Administration, the Director of the Agency for Healthcare Research and Quality, and the Administrator of the Centers for Medicare & Medicaid Services, shall award grants to eligible entities for the conduct of demonstration projects to improve the quality of and access to health care.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive a grant under subsection (a), an entity shall--CommentsClose CommentsPermalink
`(1) be a health center, hospital, health plan, health system, community clinic. or other health entity determined appropriate by the Secretary--CommentsClose CommentsPermalink
`(A) that, by legal mandate or explicitly adopted mission, provides patients with access to services regardless of their ability to pay;CommentsClose CommentsPermalink
`(B) that provides care or treatment for a substantial number of patients who are uninsured, are receiving assistance under a State program under title XIX of the Social Security Act, or are members of vulnerable populations, as determined by the Secretary; andCommentsClose CommentsPermalink
`(C)(i) with respect to which, not less than 50 percent of the entity's patient population is made up of racial and ethnic minorities; orCommentsClose CommentsPermalink
`(ii) that--CommentsClose CommentsPermalink
`(I) serves a disproportionate percentage of local, minority racial and ethnic patients, or that has a patient population, at least 50 percent of which is limited English proficient; andCommentsClose CommentsPermalink
`(II) provides an assurance that amounts received under the grant will be used only to support quality improvement activities in the racial and ethnic population served; andCommentsClose CommentsPermalink
`(2) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
`(c) Priority- In awarding grants under subsection (a), the Secretary shall give priority to applicants under subsection (b)(2) that--CommentsClose CommentsPermalink
`(1) demonstrate an intent to operate as part of a health care partnership, network, collaborative, coalition, or alliance where each member entity contributes to the design, implementation, and evaluation of the proposed intervention; orCommentsClose CommentsPermalink
`(2) intend to use funds to carry out systemwide changes with respect to health care quality improvement, including--CommentsClose CommentsPermalink
`(A) improved systems for data collection and reporting;CommentsClose CommentsPermalink
`(B) innovative collaborative or similar processes;CommentsClose CommentsPermalink
`(C) group programs with behavioral or self-management interventions;CommentsClose CommentsPermalink
`(D) case management services;CommentsClose CommentsPermalink
`(E) physician or patient reminder systems;CommentsClose CommentsPermalink
`(F) educational interventions; orCommentsClose CommentsPermalink
`(G) other activities determined appropriate by the Secretary.CommentsClose CommentsPermalink
`(d) Use of Funds- An entity shall use amounts received under a grant under subsection (a) to support the implementation and evaluation of health care quality improvement activities or minority health and health care disparity reduction activities that include--CommentsClose CommentsPermalink
`(1) with respect to health care systems, activities relating to improving--CommentsClose CommentsPermalink
`(A) patient safety;CommentsClose CommentsPermalink
`(B) timeliness of care;CommentsClose CommentsPermalink
`(C) effectiveness of care;CommentsClose CommentsPermalink
`(D) efficiency of care;CommentsClose CommentsPermalink
`(E) patient centeredness; andCommentsClose CommentsPermalink
`(F) health information technology; andCommentsClose CommentsPermalink
`(2) with respect to patients, activities relating to--CommentsClose CommentsPermalink
`(A) staying healthy;CommentsClose CommentsPermalink
`(B) getting well;CommentsClose CommentsPermalink
`(C) living with illness or disability; andCommentsClose CommentsPermalink
`(D) coping with end of life issues.CommentsClose CommentsPermalink
`(e) Common Data Systems- The Secretary shall provide financial and other technical assistance to grantees under this section for the development of common data systems.CommentsClose CommentsPermalink
`(f) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3052. CENTERS OF EXCELLENCE.
`(a) In General- The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall designate centers of excellence at public hospitals, and other health systems serving large numbers of minority patients, that--CommentsClose CommentsPermalink
`(1) meet the requirements of section 3051(b)(1);CommentsClose CommentsPermalink
`(2) demonstrate excellence in providing care to minority populations; andCommentsClose CommentsPermalink
`(3) demonstrate excellence in reducing disparities in health and health care.CommentsClose CommentsPermalink
`(b) Requirements- A hospital or health system that serves as a Center of Excellence under subsection (a) shall--CommentsClose CommentsPermalink
`(1) design, implement, and evaluate programs and policies relating to the delivery of care in racially, ethnically, and linguistically diverse populations;CommentsClose CommentsPermalink
`(2) provide training and technical assistance to other hospitals and health systems relating to the provision of quality health care to minority populations; andCommentsClose CommentsPermalink
`(3) develop activities for graduate or continuing medical education that institutionalize a focus on cultural competence training for health care providers.CommentsClose CommentsPermalink
`(c) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2008 through 2013.CommentsClose CommentsPermalink
`SEC. 3053. RECONSTRUCTION AND IMPROVEMENT GRANTS FOR PUBLIC HEALTH CARE FACILITIES SERVING PACIFIC ISLANDERS AND THE INSULAR AREAS.
`(a) In General- The Secretary shall provide direct financial assistance to designated health care providers and community health centers in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii for the purposes of reconstructing and improving health care facilities and services.CommentsClose CommentsPermalink
`(b) Eligibility- To be eligible to receive direct financial assistance under subsection (a), an entity shall be a public health facility or community health center located in American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii that--CommentsClose CommentsPermalink
`(1) is owned or operated by--CommentsClose CommentsPermalink
`(A) the government of American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii or a unit of local government; orCommentsClose CommentsPermalink
`(B) a nonprofit organization; andCommentsClose CommentsPermalink
`(2)(A) provides care or treatment for a substantial number of patients who are uninsured, receiving assistance under a State program under a title XVIII of the Social Security Act, or a State program under title XIX of such Act, or who are members of a vulnerable population, as determined by the Secretary; orCommentsClose CommentsPermalink
`(B) serves a disproportionate percentage of local, minority racial and ethnic patients.CommentsClose CommentsPermalink
`(c) Report- Not later than 180 days after the date of enactment of this title and annually thereafter, the Secretary shall submit to the Congress and the President a report that includes an assessment of health resources and facilities serving populations in American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii. In preparing such report, the Secretary shall--CommentsClose CommentsPermalink
`(1) consult with and obtain information on all health care facilities needs from the entities described in subsection (b); andCommentsClose CommentsPermalink
`(2) include all amounts of Federal assistance received by each entity in the preceding fiscal year;CommentsClose CommentsPermalink
`(3) review the total unmet needs of each jurisdiction for health care facilities, including needs for renovation and expansion of existing facilities; andCommentsClose CommentsPermalink
`(4) include a strategic plan for addressing the needs of each jurisdiction identified in the report.CommentsClose CommentsPermalink
`(d) Authorization of Appropriations- There is authorized to be appropriated such sums as necessary to carry out this section.'.CommentsClose CommentsPermalink
SEC. 503. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER THE MEDICAID PROGRAM AND SCHIP.
(a) Medicaid Program- Section 1903(v) of the Social Security Act (
(1) in paragraph (1), by striking `paragraph (2)' and inserting `paragraphs (2) and (4)'; andCommentsClose CommentsPermalink
(2) by adding at the end the following new paragraph:CommentsClose CommentsPermalink
`(4)(A) A State may elect (in a plan amendment under this title) to provide medical assistance under this title, notwithstanding sections 401(a), 402(b), 403, and 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, for undocumented residents who are lawfully residing in the United States (including battered undocumented residents described in section 431(c) of such Act) and who are otherwise eligible for such assistance, within either or both of the following eligibility categories:CommentsClose CommentsPermalink
`(i) PREGNANT WOMEN- Women during pregnancy (and during the 60-day period beginning on the last day of the pregnancy).CommentsClose CommentsPermalink
`(ii) CHILDREN- Individuals under 21 years of age, including optional targeted low-income children described in section 1905(u)(2)(B).CommentsClose CommentsPermalink
`(B) In the case of a State that has elected to provide medical assistance to a category of undocumented residents under subparagraph (A), no debt shall accrue under an affidavit of support against any sponsor of such an undocumented resident on the basis of provision of assistance to such category and the cost of such assistance shall not be considered as an unreimbursed cost.'.CommentsClose CommentsPermalink
(b) SCHIP- Section 2107(e)(1) of such Act (
`(C) Section 1903(v)(4) (relating to optional coverage of categories of lawfully residing immigrant children), but only if the State has elected to apply such section to the category of children under title XIX.'.CommentsClose CommentsPermalink
(c) Effective Date- The amendments made by this section take effect on October 1, 2007, and apply to medical assistance and child health assistance furnished on or after such date.CommentsClose CommentsPermalink
SEC. 504. BORDER HEALTH GRANTS.
(a) Eligible Entity Defined- In this section, the term `eligible entity' means a State, public institution of higher education, local government, tribal government, nonprofit health organization, community health center, or community clinic receiving assistance under section 330 of the Public Health Service Act (
(b) Authorization- From funds appropriated under subsection (f), the Secretary of Health and Human Services (in this section referred to as the `Secretary'), acting through the United States members of the United States-Mexico Border Health Commission, shall award grants to eligible entities to address priorities and recommendations to improve the health of border area residents that are established by--CommentsClose CommentsPermalink
(1) the United States members of the United States-Mexico Border Health Commission;CommentsClose CommentsPermalink
(2) the State border health offices; andCommentsClose CommentsPermalink
(3) the Secretary.CommentsClose CommentsPermalink
(c) Application- An eligible entity that desires a grant under subsection (b) shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink
(d) Use of Funds- An eligible entity that receives a grant under subsection (b) shall use the grant funds for--CommentsClose CommentsPermalink
(1) programs relating to--CommentsClose CommentsPermalink
(A) maternal and child health;CommentsClose CommentsPermalink
(B) primary care and preventative health;CommentsClose CommentsPermalink
(C) public health and public health infrastructure;CommentsClose CommentsPermalink
(D) health education and promotion;CommentsClose CommentsPermalink
(E) oral health;CommentsClose CommentsPermalink
(F) mental and behavioral health;CommentsClose CommentsPermalink
(G) substance abuse;CommentsClose CommentsPermalink
(H) health conditions that have a high prevalence in the border area;CommentsClose CommentsPermalink
(I) medical and health services research;CommentsClose CommentsPermalink
(J) workforce training and development;CommentsClose CommentsPermalink
(K) community health workers or promotoras;CommentsClose CommentsPermalink
(L) health care infrastructure problems in the border area (including planning and construction grants);CommentsClose CommentsPermalink
(M) health disparities in the border area;CommentsClose CommentsPermalink
(N) environmental health; andCommentsClose CommentsPermalink
(O) outreach and enrollment services with respect to Federal programs (including programs authorized under titles XIX and XXI of the Social Security Act (
(2) other programs determined appropriate by the Secretary.CommentsClose CommentsPermalink
(e) Supplement, Not Supplant- Amounts provided to an eligible entity awarded a grant under subsection (b) shall be used to supplement and not supplant other funds available to the eligible entity to carry out the activities described in subsection (d).CommentsClose CommentsPermalink
(f) Authorization of Appropriations- There is authorized to be appropriated to carry out this section, $200,000,000 for fiscal year 2008, and such sums as may be necessary for each succeeding fiscal year.CommentsClose CommentsPermalink
SEC. 505. CANCER PREVENTION AND TREATMENT DEMONSTRATION FOR ETHNIC AND RACIAL MINORITIES.
(a) Demonstration-CommentsClose CommentsPermalink
(1) IN GENERAL- The Secretary of Health and Human Services (in this section referred to as the `Secretary') shall conduct demonstration projects (in this section referred to as `demonstration projects') for the purpose of developing models and evaluating methods that--CommentsClose CommentsPermalink
(A) improve the quality of items and services provided to target individuals in order to facilitate reduced disparities in early detection and treatment of cancer;CommentsClose CommentsPermalink
(B) improve clinical outcomes, satisfaction, quality of life, and appropriate use of Medicare-covered services and referral patterns among those target individuals with cancer;CommentsClose CommentsPermalink
(C) eliminate disparities in the rate of preventive cancer screening measures, such as pap smears, prostate cancer screenings, and CT scans for lung cancer among target individuals; andCommentsClose CommentsPermalink
(D) promote collaboration with community-based organizations to ensure cultural competency of health care professionals and linguistic access for persons with limited English proficiency.CommentsClose CommentsPermalink
(2) TARGET INDIVIDUAL DEFINED- In this section, the term `target individual' means an individual of a racial and ethnic minority group, as defined by section 1707 of the Public Health Service Act (
(b) Program Design-CommentsClose CommentsPermalink
(1) INITIAL DESIGN- Not later than 1 year after the date of the enactment of this Act, the Secretary shall evaluate best practices in the private sector, community programs, and academic research of methods that reduce disparities among individuals of racial and ethnic minority groups in the prevention and treatment of cancer and shall design the demonstration projects based on such evaluation.CommentsClose CommentsPermalink
(2) NUMBER AND PROJECT AREAS- Not later than 2 years after the date of the enactment of this Act, the Secretary shall implement at least nine demonstration projects, including the following:CommentsClose CommentsPermalink
(A) Two projects for each of the four following major racial and ethnic minority groups:CommentsClose CommentsPermalink
(i) American Indians and Alaska Natives, Eskimos and Aleuts.CommentsClose CommentsPermalink
(ii) Asian Americans.CommentsClose CommentsPermalink
(iii) Blacks/African Americans.CommentsClose CommentsPermalink
(iv) Hispanic/Latino Americans.CommentsClose CommentsPermalink
(v) Native Hawaiians and other Pacific Islanders.CommentsClose CommentsPermalink
The two projects must target different ethnic subpopulations.CommentsClose CommentsPermalink
(B) One project within the Pacific Islands or United States insular areas.CommentsClose CommentsPermalink
(C) At least one project each in a rural area and inner-city area.CommentsClose CommentsPermalink
(3) EXPANSION OF PROJECTS; IMPLEMENTATION OF DEMONSTRATION PROJECT RESULTS- If the initial report under subsection (c) contains an evaluation that demonstration projects--CommentsClose CommentsPermalink
(A) reduce expenditures under the Medicare program under title XVIII of the Social Security Act; orCommentsClose CommentsPermalink
(B) do not increase expenditures under the Medicare program and reduce racial and ethnic health disparities in the quality of health care services provided to target individuals and increase satisfaction of beneficiaries and health care providers;CommentsClose CommentsPermalink
the Secretary shall continue the existing demonstration projects and may expand the number of demonstration projects.CommentsClose CommentsPermalink
(c) Report to Congress-CommentsClose CommentsPermalink
(1) IN GENERAL- Not later than 2 years after the date the Secretary implements the initial demonstration projects, and biannually thereafter, the Secretary shall submit to Congress a report regarding the demonstration projects.CommentsClose CommentsPermalink
(2) CONTENTS OF REPORT- Each report under paragraph (1) shall include the following:CommentsClose CommentsPermalink
(A) A description of the demonstration projects.CommentsClose CommentsPermalink
(B) An evaluation of--CommentsClose CommentsPermalink
(i) the cost-effectiveness of the demonstration projects;CommentsClose CommentsPermalink
(ii) the quality of the health care services provided to target individuals under the demonstration projects; andCommentsClose CommentsPermalink
(iii) beneficiary and health care provider satisfaction under the demonstration projects.CommentsClose CommentsPermalink
(C) Any other information regarding the demonstration projects that the Secretary determines to be appropriate.CommentsClose CommentsPermalink
(d) Waiver Authority- The Secretary shall waive compliance with the requirements of title XVIII of the Social Security Act to such extent and for such period as the Secretary determines is necessary to conduct demonstration projects.CommentsClose CommentsPermalink
SEC. 506. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS IN WOMEN AND CHILDREN.
Part P of title III of the Public Health Service Act (
`SEC. 399R. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS IN WOMEN AND CHILDREN.
`(a) Grants Authorized- The Secretary, in collaboration with the Director of the Centers for Disease Control and Prevention and other Federal officials determined appropriate by the Secretary, is authorized to award grants to eligible entities to promote positive health behaviors for women and children in target populations, especially racial and ethnic minority women and children in medically underserved communities.CommentsClose CommentsPermalink
`(b) Use of Funds- Grants awarded pursuant to subsection (a) may be used to support community health workers--CommentsClose CommentsPermalink
`(1) to educate and provide outreach regarding enrollment in health insurance including the State Children's Health Insurance Program under title XXI of the Social Security Act, Medicare under title XVIII of such Act, and Medicaid under title XIX of such Act;CommentsClose CommentsPermalink
`(2) to educate, guide, and provide outreach in a community setting regarding health problems prevalent among women and children and especially among racial and ethnic minority women and children;CommentsClose CommentsPermalink
`(3) to educate, guide, and provide experiential learning opportunities that target behavioral risk factors including--CommentsClose CommentsPermalink
`(A) poor nutrition;CommentsClose CommentsPermalink
`(B) physical inactivity;CommentsClose CommentsPermalink
`(C) being overweight or obese;CommentsClose CommentsPermalink
`(D) tobacco use;CommentsClose CommentsPermalink
`(E) alcohol and substance use;CommentsClose CommentsPermalink
`(F) injury and violence;CommentsClose CommentsPermalink
`(G) risky sexual behavior;CommentsClose CommentsPermalink
`(H) mental health problems;CommentsClose CommentsPermalink
`(I) dental and oral health problems; andCommentsClose CommentsPermalink
`(J) understanding informed consent;CommentsClose CommentsPermalink
`(4) to educate and guide regarding effective strategies to promote positive health behaviors within the family;CommentsClose CommentsPermalink
`(5) to promote community wellness and awareness; andCommentsClose CommentsPermalink
`(6) to educate and refer target populations to appropriate health care agencies and community-based programs and organizations in order to increase access to quality health care services, including preventive health services.CommentsClose CommentsPermalink
`(c) Application-CommentsClose CommentsPermalink
`(1) IN GENERAL- Each eligible entity that desires to receive a grant under subsection (a) shall submit an application to the Secretary, at such time, in such manner, and accompanied by such additional information as the Secretary may require.CommentsClose CommentsPermalink
`(2) CONTENTS- Each application submitted pursuant to paragraph (1) shall--CommentsClose CommentsPermalink
`(A) describe the activities for which assistance under this section is sought;CommentsClose CommentsPermalink
`(B) contain an assurance that with respect to each community health worker program receiving funds under the grant awarded, such program provides training and supervision to community health workers to enable such workers to provide authorized program services;CommentsClose CommentsPermalink
`(C) contain an assurance that the applicant will evaluate the effectiveness of community health worker programs receiving funds under the grant;CommentsClose CommentsPermalink
`(D) contain an assurance that each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individuals served by the program;CommentsClose CommentsPermalink
`(E) contain a plan to document and disseminate project description and results to other States and organizations as identified by the Secretary; andCommentsClose CommentsPermalink
`(F) describe plans to enhance the capacity of individuals to utilize health services and health-related social services under Federal, State, and local programs by--CommentsClose CommentsPermalink
`(i) assisting individuals in establishing eligibility under the programs and in receiving the services or other benefits of the programs; andCommentsClose CommentsPermalink
`(ii) providing other services as the Secretary determines to be appropriate, that may include transportation and translation services.CommentsClose CommentsPermalink
`(d) Priority- In awarding grants under subsection (a), the Secretary shall give priority to those applicants--CommentsClose CommentsPermalink
`(1) who propose to target geographic areas--CommentsClose CommentsPermalink
`(A) with a high percentage of residents who are eligible for health insurance but are uninsured or underinsured; andCommentsClose CommentsPermalink
`(B) with a high percentage of families for whom English is not their primary language.CommentsClose CommentsPermalink
`(2) with experience in providing health or health-related social services to individuals who are underserved with respect to such services; andCommentsClose CommentsPermalink
`(3) with documented community activity and experience with community health workers.CommentsClose CommentsPermalink
`(e) Collaboration With Academic Institutions- The Secretary shall encourage community health worker programs receiving funds under this section to collaborate with academic institutions, including minority-serving institutions. Nothing in this section shall be construed to require such collaboration.CommentsClose CommentsPermalink
`(f) Quality Assurance and Cost-Effectiveness- The Secretary shall establish guidelines for assuring the quality of the training and supervision of community health workers under the programs funded under this section and for assuring the cost-effectiveness of such programs.CommentsClose CommentsPermalink
`(g) Monitoring- The Secretary shall monitor community health worker programs identified in approved applications and shall determine whether such programs are in compliance with the guidelines established under subsection (f).CommentsClose CommentsPermalink
`(h) Technical Assistance- The Secretary may provide technical assistance to community health worker programs identified in approved applications with respect to planning, developing, and operating programs under the grant.CommentsClose CommentsPermalink
`(i) Report to Congress-CommentsClose CommentsPermalink
`(1) IN GENERAL- Not later than 4 years after the date on which the Secretary first awards grants under subsection (a), the Secretary shall submit to Congress a report regarding the grant project.CommentsClose CommentsPermalink
`(2) CONTENTS- The report required under paragraph (1) shall include the following:CommentsClose CommentsPermalink
`(A) A description of the programs for which grant funds were used.CommentsClose CommentsPermalink
`(B) The number of individuals served.CommentsClose CommentsPermalink
`(C) An evaluation of--CommentsClose CommentsPermalink
`(i) the effectiveness of these programs;CommentsClose CommentsPermalink
`(ii) the cost of these programs; andCommentsClose CommentsPermalink
`(iii) the impact of the project on the health outcomes of the community residents.CommentsClose CommentsPermalink
`(D) Recommendations for sustaining the community health worker programs developed or assisted under this section.CommentsClose CommentsPermalink
`(E) Recommendations regarding training to enhance career opportunities for community health workers.CommentsClose CommentsPermalink
`(j) Definitions- In this section:CommentsClose CommentsPermalink
`(1) COMMUNITY HEALTH WORKER- The term `community health worker' means an individual who promotes health or nutrition within the community in which the individual resides--CommentsClose CommentsPermalink
`(A) by serving as a liaison between communities and health care agencies;CommentsClose CommentsPermalink
`(B) by providing guidance and social assistance to community residents;CommentsClose CommentsPermalink
`(C) by enhancing community residents' ability to effectively communicate with health care providers;CommentsClose CommentsPermalink
`(D) by providing culturally and linguistically appropriate health or nutrition education;CommentsClose CommentsPermalink
`(E) by advocating for individual and community health, including dental, oral, mental, and environmental health, or nutrition needs; andCommentsClose CommentsPermalink
`(F) by providing referral and followup services.CommentsClose CommentsPermalink
`(2) COMMUNITY SETTING- The term `community setting' means a home or a community organization located in the neighborhood in which a participant resides.CommentsClose CommentsPermalink
`(3) ELIGIBLE ENTITY- The term `eligible entity' means--CommentsClose CommentsPermalink
`(A) a unit of State, territorial, local, or tribal government (including a federally recognized tribe or Alaska native villages); orCommentsClose CommentsPermalink
`(B) a community-based organization.CommentsClose CommentsPermalink
`(4) MEDICALLY UNDERSERVED COMMUNITY- The term `medically underserved community' means a community--CommentsClose CommentsPermalink
`(A) that has a substantial number of individuals who are members of a medically underserved population, as defined by section 330(b)(3); andCommentsClose CommentsPermalink
`(B) a significant portion of which is a health professional shortage area as designated under section 332.CommentsClose CommentsPermalink
`(5) SUPPORT- The term `support' means the provision of training, supervision, and materials needed to effectively deliver the services described in subsection (b), reimbursement for services, and other benefits.CommentsClose CommentsPermalink
`(6) TARGET POPULATION- The term `target population' means women of reproductive age, regardless of their current childbearing status and children under 21 years of age.CommentsClose CommentsPermalink
`(k) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2008, 2009, 2010, 2011, and 2012.'.CommentsClose CommentsPermalink
SEC. 507. EXCEPTION FOR CITIZENS OF FREELY ASSOCIATED STATES.
(a) In General- Section 402(a)(2) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (
`(M) EXCEPTION FOR CITIZENS OF FREELY ASSOCIATED STATES- With respect to eligibility for benefits for the specified Federal programs described in paragraph (3), paragraph (1) shall not apply to any individual who lawfully resides in the United States (including territories and possessions of the United States) in accordance with--CommentsClose CommentsPermalink
`(i) section 141 of the Compact of Free Association between the Government of the United States and the Government of the Federated States of Micronesia, approved by Congress in the Compact of Free Association Amendments Act of 2003;CommentsClose CommentsPermalink
`(ii) section 141 of the Compact of Free Association between the Government of the United States and the Government of the Republic of the Marshall Islands, approved by Congress in the Compact of Free Association Amendments Act of 2003; orCommentsClose CommentsPermalink
`(iii) section 141 of the Compact of Free Association between the Government of the United States and the Government of Palau, approved by Congress in
(b) Medicaid Exception- Section 402(b)(2) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (
`(G) MEDICAID EXCEPTIONS FOR CITIZENS OF FREELY ASSOCIATED STATES- With respect to eligibility for benefits for the programs defined in subparagraphs (A) and (C) of paragraph (3) (relating to Medicaid), paragraph (1) shall not apply to any individual who lawfully resides in the United States (including territories and possessions of the United States) in accordance with a Compact of Free Association referred to in subsection (a)(2)(M).'.CommentsClose CommentsPermalink
(c) Qualified Alien- Section 431(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (
(1) in paragraph (6), by striking `or' at the end;CommentsClose CommentsPermalink
(2) in paragraph (7), by striking the period at the end and inserting `; or'; andCommentsClose CommentsPermalink
(3) by adding at the end the following:CommentsClose CommentsPermalink
`(8) an individual who lawfully resides in the United States (including territories and possessions of the United States) in accordance with a Compact of Free Association referred to in section 402(a)(2)(M).'.CommentsClose CommentsPermalink
(d) Financial Treatment Under Medicaid- Section 1108 of the Social Security Act (
(1) in subsection (f), by striking `subsection (g)' and inserting `subsections (g) and (h)'; andCommentsClose CommentsPermalink
(2) by adding at the end the following new subsection:CommentsClose CommentsPermalink
`(h) The limitations of subsections (f) and (g) shall not apply with respect to medical assistance provided to an individual described in section 431(b)(8) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.'.CommentsClose CommentsPermalink
(e) Increased FMAP- The third sentence of section 1905(b) of the Social Security Act (
SEC. 508. MEDICARE GRADUATE MEDICAL EDUCATION.
(a) Clarification of Congressional Intent Regarding the Counting of Residents in a Nonhospital Setting-CommentsClose CommentsPermalink
(1) D-GME- Section 1886(h)(4)(E) of the Social Security Act (
(2) IME- Section 1886(d)(5)(B)(iv) of the Social Security Act (
(3) EFFECTIVE DATE- The amendments made by this subsection shall take effect on January 1, 2008.CommentsClose CommentsPermalink
(b) Clarification of Eligibility of a Nonrural Hospital That Has a Training Program With an Integrated Rural Track-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1886(h)(4)(H) of the Social Security Act (
(A) in clause (iv), by inserting `(as defined in clause (v))' after `an integrated rural track'; andCommentsClose CommentsPermalink
(B) by adding at the end the following new clause:CommentsClose CommentsPermalink
`(v) DEFINITION OF ACCREDITED TRAINING PROGRAM WITH AN INTEGRATED RURAL TRACK- For purposes of clause (iv), the term `accredited training program with an integrated rural track' means an accredited medical residency training program located in an urban area which offers a curriculum for all residents in the program that includes the following characteristics:CommentsClose CommentsPermalink
`(I) A minimum of 3 block months of rural rotations. During such 3 block months, the resident is in a rural area for 4 weeks or a month.CommentsClose CommentsPermalink
`(II) A stated mission for training rural physicians.CommentsClose CommentsPermalink
`(III) A minimum of 3 months of obstetrical training, or an equivalent longitudinal experience.CommentsClose CommentsPermalink
`(IV) A minimum of 4 months of pediatric training that includes neonatal, ambulatory, inpatient, and emergency experiences through rotations, or an equivalent longitudinal experience.CommentsClose CommentsPermalink
`(V) A minimum of 2 months of emergency medicine rotations, or an equivalent longitudinal experience.'.CommentsClose CommentsPermalink
(2) EFFECTIVE DATE- The amendments made by this subsection apply with respect to--CommentsClose CommentsPermalink
(A) payments to hospitals under section 1886(h) of the Social Security Act (
(B) payments to hospitals under section 1886(d)(5)(B)(v) of such Act (
SEC. 509. HIV/AIDS REDUCTION IN RACIAL AND ETHNIC MINORITY COMMUNITIES.
(a) Expanded Funding- The Secretary, in collaboration with the Director of the Office of Minority Health, the Director of the Centers for Disease Control and Prevention, the Administrator of the Health Resources and Services Administration, and the Administrator of the Substance Abuse and Mental Health Services Administration, shall provide funds and carry out activities to expand the Minority HIV/AIDS Initiative.CommentsClose CommentsPermalink
(b) Use of Funds- The additional funds made available under this section may be used, through the Minority AIDS Initiative, to support the following activities:CommentsClose CommentsPermalink
(1) Providing technical assistance and infrastructure support to reduce HIV/AIDS in minority populations.CommentsClose CommentsPermalink
(2) Increasing minority populations' access to HIV/AIDS prevention and care services.CommentsClose CommentsPermalink
(3) Building strong community programs and partnerships to address HIV prevention and the health care needs of specific racial and ethnic minority populations.CommentsClose CommentsPermalink
(c) Priority Interventions- Within the racial and ethnic minority populations referred to in subsection (b), priority in conducting intervention services shall be given to--CommentsClose CommentsPermalink
(1) women;CommentsClose CommentsPermalink
(2) youth;CommentsClose CommentsPermalink
(3) men who engage in homosexual activity;CommentsClose CommentsPermalink
(4) persons who engage in intravenous drug abuse;CommentsClose CommentsPermalink
(5) homeless individuals; andCommentsClose CommentsPermalink
(6) individuals incarcerated or in the penal system.CommentsClose CommentsPermalink
(d) Authorization of Appropriations- For carrying out this section, there are authorized to be appropriated $610,000,0000 for fiscal year 2008 and such sums as may be necessary for each of fiscal years 2009 through 2012.CommentsClose CommentsPermalink
SEC. 510. GRANTS FOR RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH.
(a) Purpose- It is the purpose of this section to provide for the awarding of grants to assist communities in mobilizing and organizing resources in support of effective and sustainable programs that will reduce or eliminate disparities in health and health care experienced by racial and ethnic minority individuals.CommentsClose CommentsPermalink
(b) Authority- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, in consultation with the Office of Minority Health, shall award grants to eligible entities to assist in designing, implementing, and evaluating culturally and linguistically appropriate, evidence-based, and community-driven sustainable strategies to eliminate racial and ethnic health and health care disparities.CommentsClose CommentsPermalink
(c) Eligible Entities- To be eligible to receive a grant under this section, an entity shall--CommentsClose CommentsPermalink
(1) represent a coalition--CommentsClose CommentsPermalink
(A) whose principal purpose is to develop and implement interventions to reduce or eliminate a health or health care disparity in a targeted racial or ethnic minority group in the community served by the coalition; andCommentsClose CommentsPermalink
(B) that includes--CommentsClose CommentsPermalink
(i) at least 3 members selected from among--CommentsClose CommentsPermalink
(I) public health departments;CommentsClose CommentsPermalink
(II) community-based organizations;CommentsClose CommentsPermalink
(III) university and research organizations;CommentsClose CommentsPermalink
(IV) Indian tribes, tribal organizations, urban Indian organizations, national or regional Indian organizations, or the Indian Health Service;CommentsClose CommentsPermalink
(V) organizations serving Native Hawaiians;CommentsClose CommentsPermalink
(VI) organizations serving Pacific Islanders; andCommentsClose CommentsPermalink
(VII) interested public or private health care providers or organizations as deemed appropriate by the Secretary; andCommentsClose CommentsPermalink
(ii) at least 1 member from a community-based organization that represents the targeted racial or ethnic minority group; andCommentsClose CommentsPermalink
(2) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, which shall include--CommentsClose CommentsPermalink
(A) a description of the targeted racial or ethnic populations in the community to be served under the grant;CommentsClose CommentsPermalink
(B) a description of at least 1 health disparity that exists in the racial or ethnic targeted populations, including infant mortality, breast and cervical cancer screening and management, cardiovascular disease, diabetes, child and adult immunization levels, HIV/AIDS, hepatitis B, tuberculosis, or asthma, or other health priority areas as designated by the Secretary; andCommentsClose CommentsPermalink
(C) a demonstration of a proven record of accomplishment of the coalition members in serving and working with the targeted community.CommentsClose CommentsPermalink
(d) Sustainability- The Secretary shall give priority to an eligible entity under this section if the entity agrees that, with respect to the costs to be incurred by the entity in carrying out the activities for which the grant was awarded, the entity (and each of the participating partners in the coalition represented by the entity) will maintain its expenditures of non-Federal funds for such activities at a level that is not less than the level of such expenditures during the fiscal year immediately preceding the first fiscal year for which the grant is awarded.CommentsClose CommentsPermalink
(e) Nonduplication- Funds provided through this grant program should supplement, not supplant, existing Federal funding, and the funds should not be used to duplicate the activities of the other health disparity grant programs in this Act.CommentsClose CommentsPermalink
(f) Technical Assistance- The Secretary may, either directly or by grant or contract, provide any entity that receives a grant under this section with technical and other non-financial assistance necessary to meet the requirements of this section.CommentsClose CommentsPermalink
(g) Dissemination- The Secretary shall encourage and enable grantees to share best practices, evaluation results, and reports using the Internet, conferences, and other pertinent information regarding the projects funded by this section, including the outreach efforts of the Office of Minority Health and the Centers for Disease Control and Prevention. Such information shall be publicly available, and posted on the Internet website of relevant Government agencies.CommentsClose CommentsPermalink
(h) Administrative Burdens- The Secretary shall make every effort to minimize duplicative or unnecessary administrative burdens on grantees.CommentsClose CommentsPermalink
SEC. 511. CRITICAL ACCESS HOSPITAL IMPROVEMENTS.
(a) Clarification of Payment for Clinical Laboratory Tests Furnished by Critical Access Hospitals-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1834(g)(4) of the Social Security Act (
(A) in the heading, by striking `NO BENEFICIARY COST-SHARING' and inserting `TREATMENT OF'; andCommentsClose CommentsPermalink
(B) by adding at the end the following new sentence: `For purposes of the preceding sentence and section 1861(mm)(3), clinical diagnostic laboratory services furnished by a critical access hospital shall be treated as being furnished as part of outpatient critical access services without regard to whether--CommentsClose CommentsPermalink
`(A) the individual with respect to whom such services are furnished is physically present in the critical access hospital at the time the specimen is collected;CommentsClose CommentsPermalink
`(B) such individual is registered as an outpatient on the records of, and receives such services directly from, the critical access hospital; orCommentsClose CommentsPermalink
`(C) payment is (or, but for this subsection, would be) available for such services under the fee schedule established under section 1833(h).'.CommentsClose CommentsPermalink
(2) EFFECTIVE DATE- The amendments made by paragraph (1) shall apply to cost reporting periods beginning on or after October 1, 2008.CommentsClose CommentsPermalink
(b) Elimination of Isolation Test for Cost-Based Ambulance Reimbursement-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1834(l)(8) of the Social Security Act (
(A) in subparagraph (B)--CommentsClose CommentsPermalink
(i) by striking `owned and'; andCommentsClose CommentsPermalink
(ii) by inserting `(including when such services are provided by the entity under an arrangement with the hospital)' after `hospital'; andCommentsClose CommentsPermalink
(B) by striking the comma at the end of subparagraph (B) and all that follows and inserting a period.CommentsClose CommentsPermalink
(2) EFFECTIVE DATE- The amendments made by this subsection shall apply to services furnished on or after January 1, 2008.CommentsClose CommentsPermalink
(c) Provision of a More Flexible Alternative to the CAH Designation 25 Inpatient Bed Limit Requirement-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1820(c)(2) of the Social Security Act (
(A) in subparagraph (B)(iii), by striking `provides not more than' and inserting `subject to subparagraph (F), provides not more than'; andCommentsClose CommentsPermalink
(B) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
`(F) ALTERNATIVE TO 25 INPATIENT BED LIMIT REQUIREMENT-CommentsClose CommentsPermalink
`(i) IN GENERAL- A State may elect to treat a facility, with respect to the designation of the facility for a cost reporting period, as satisfying the requirement of subparagraph (B)(iii) relating to a maximum number of acute care inpatient beds if the facility elects, in accordance with a method specified by the Secretary and before the beginning of the cost reporting period, to meet the requirement under clause (ii).CommentsClose CommentsPermalink
`(ii) ALTERNATE REQUIREMENT- The requirement under this clause, with respect to a facility and a cost reporting period, is that the total number of inpatient bed days described in subparagraph (B)(iii) during such period will not exceed 7,300. For purposes of this subparagraph, an individual who is an inpatient in a bed in the facility for a single day shall be counted as one inpatient bed day.CommentsClose CommentsPermalink
`(iii) WITHDRAWAL OF ELECTION- The option described in clause (i) shall not apply to a facility for a cost reporting period if the facility (for any two consecutive cost reporting periods during the previous 5 cost reporting periods) was treated under such option and had a total number of inpatient bed days for each of such two cost reporting periods that exceeded the number specified in such clause.'.CommentsClose CommentsPermalink
(2) EFFECTIVE DATE- The amendments made by paragraph (1) shall apply to cost reporting periods beginning on or after the date of the enactment of this Act.CommentsClose CommentsPermalink
SEC. 512. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES UNDER PART B OF THE MEDICARE PROGRAM.
(a) Coverage of Services-CommentsClose CommentsPermalink
(1) IN GENERAL- Section 1861(s)(2) of the Social Security Act (
(A) in subparagraph (Z), by striking `and' at the end;CommentsClose CommentsPermalink
(B) in subparagraph (AA), by inserting `and' at the end; andCommentsClose CommentsPermalink
(C) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink
`(BB) marriage and family therapist services (as defined in subsection (ccc)(1)) and mental health counselor services (as defined in subsection (ccc)(3));'.CommentsClose CommentsPermalink
(2) DEFINITIONS- Section 1861 of such Act (
`Marriage and Family Therapist Services; Marriage and Family Therapist; Mental Health Counselor Services; Mental Health Counselor
`(ccc)(1) The term `marriage and family therapist services' means services performed by a marriage and family therapist (as defined in paragraph (2)) for the diagnosis and treatment of mental illnesses, which the marriage and family therapist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as an incident to a physician's professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.CommentsClose CommentsPermalink
`(2) The term `marriage and family therapist' means an individual who--CommentsClose CommentsPermalink
`(A) possesses a master's or doctoral degree which qualifies for licensure or certification as a marriage and family therapist pursuant to State law;CommentsClose CommentsPermalink
`(B) after obtaining such degree has performed at least 2 years of clinical supervised experience in marriage and family therapy; andCommentsClose CommentsPermalink
`(C) in the case of an individual performing services in a State that provides for licensure or certification of marriage and family therapists, is licensed or certified as a marriage and family therapist in such State.CommentsClose CommentsPermalink
`(3) The term `mental health counselor services' means services performed by a mental health counselor (as defined in paragraph (4)) for the diagnosis and treatment of mental illnesses which the mental health counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician's professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.CommentsClose CommentsPermalink
`(4) The term `mental health counselor' means an individual who--CommentsClose CommentsPermalink
`(A) possesses a master's or doctor's degree in mental health counseling or a related field;CommentsClose CommentsPermalink
`(B) after obtaining such a degree has performed at least 2 years of supervised mental health counselor practice; andCommentsClose CommentsPermalink
`(C) in the case of an individual performing services in a State that provides for licensure or certification of mental health counselors or professional counselors, is licensed or certified as a mental health counselor or professional counselor in such State.'.CommentsClose CommentsPermalink
(3) PROVISION FOR PAYMENT UNDER PART B- Section 1832(a)(2)(B) of such Act (
`(v) marriage and family therapist services and mental health counselor services;'.CommentsClose CommentsPermalink
(4) AMOUNT OF PAYMENT- Section 1833(a)(1) of such Act (
(A) by striking `and (V)' and inserting `(V)'; andCommentsClose CommentsPermalink
(B) by inserting before the semicolon at the end the following: `, and (W) with respect to marriage and family therapist services and mental health counselor services under section 1861(s)(2)(BB), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 75 percent of the amount determined for payment of a psychologist under subparagraph (L)'.CommentsClose CommentsPermalink
(5) EXCLUSION OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES FROM SKILLED NURSING FACILITY PROSPECTIVE PAYMENT SYSTEM- Section 1888(e)(2)(A)(ii) of such Act (
(6) INCLUSION OF MARRIAGE AND FAMILY THERAPISTS AND MENTAL HEALTH COUNSELORS AS PRACTITIONERS FOR ASSIGNMENT OF CLAIMS- Section 1842(b)(18)(C) of such Act (
`(vii) A marriage and family therapist (as defined in section 1861(ccc)(2)).CommentsClose CommentsPermalink
`(viii) A mental health counselor (as defined in section 1861(ccc)(4)).'.CommentsClose CommentsPermalink
(b) Coverage of Certain Mental Health Services Provided in Certain Settings-CommentsClose CommentsPermalink
(1) RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS- Section 1861(aa)(1)(B) of the Social Security Act (
(2) HOSPICE PROGRAMS- Section 1861(dd)(2)(B)(i)(III) of such Act (
(c) Authorization of Marriage and Family Therapists To Develop Discharge Plans for Post-Hospital Services- Section 1861(ee)(2)(G) of the Social Security Act (
(d) Effective Date- The amendments made by this section shall apply with respect to services furnished on or after January 1, 2008.CommentsClose CommentsPermalink
SEC. 513. ESTABLISHMENT OF RURAL COMMUNITY HOSPITAL (RCH) PROGRAM.
(a) In General- Section 1861 of the Social Security Act (
`Rural Community Hospital; Rural Community Hospital Services
`(ddd)(1) The term `rural community hospital' means a hospital (as defined in subsection (e)) that--CommentsClose CommentsPermalink
`(A) is located in a rural area (as defined in section 1886(d)(2)(D)) or treated as being so located pursuant to section 1886(d)(8)(E);CommentsClose CommentsPermalink
`(B) subject to paragraph (2), has less than 51 acute care inpatient beds, as reported in its most recent cost report;CommentsClose CommentsPermalink
`(C) makes available 24-hour emergency care services;CommentsClose CommentsPermalink
`(D) subject to paragraph (3), has a provider agreement in effect with the Secretary and is open to the public as of January 1, 2008; andCommentsClose CommentsPermalink
`(E) applies to the Secretary for such designation.CommentsClose CommentsPermalink
`(2) For purposes of paragraph (1)(B), beds in a psychiatric or rehabilitation unit of the hospital which is a distinct part of the hospital shall not be counted.CommentsClose CommentsPermalink
`(3) Subparagraph (1)(D) shall not be construed to prohibit any of the following from qualifying as a rural community hospital:CommentsClose CommentsPermalink
`(A) A replacement facility (as defined by the Secretary in regulations in effect on January 1, 2008) with the same service area (as defined by the Secretary in regulations in effect on such date).CommentsClose CommentsPermalink
`(B) A facility obtaining a new provider number pursuant to a change of ownership.CommentsClose CommentsPermalink
`(C) A facility which has a binding written agreement with an outside, unrelated party for the construction, reconstruction, lease, rental, or financing of a building as of January 1, 2008.CommentsClose CommentsPermalink
`(4) Nothing in this subsection shall be construed as prohibiting a critical access hospital from qualifying as a rural community hospital if the critical access hospital meets the conditions otherwise applicable to hospitals under subsection (e) and section 1866.CommentsClose CommentsPermalink
`(5) Nothing in this subsection shall be construed as prohibiting a rural community hospital participating in the demonstration program under Section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (
(b) Payment-CommentsClose CommentsPermalink
(1) INPATIENT HOSPITAL SERVICES- Section 1814 of the Social Security Act (
`Payment for Inpatient Services Furnished in Rural Community Hospitals
`(m) The amount of payment under this part for inpatient hospital services furnished in a rural community hospital, other than such services furnished in a psychiatric or rehabilitation unit of the hospital which is a distinct part, is, at the election of the hospital in the application referred to in section 1861(ddd)(1)(E)--CommentsClose CommentsPermalink
`(1) 101 percent of the reasonable costs of providing such services, without regard to the amount of the customary or other charge, orCommentsClose CommentsPermalink
`(2) the amount of payment provided for under the prospective payment system for inpatient hospital services under section 1886(d).'.CommentsClose CommentsPermalink
(2) OUTPATIENT SERVICES- Section 1834 of such Act (
`(n) Payment for Outpatient Services Furnished in Rural Community Hospitals- The amount of payment under this part for outpatient services furnished in a rural community hospital is, at the election of the hospital in the application referred to in section 1861(ddd)(1)(E)--CommentsClose CommentsPermalink
`(1) 101 percent of the reasonable costs of providing such services, without regard to the amount of the customary or other charge and any limitation under section 1861(v)(1)(U), orCommentsClose CommentsPermalink
`(2) the amount of payment provided for under the prospective payment system for covered OPD services under section 1833(t).'.CommentsClose CommentsPermalink
(3) EXEMPTION FROM 30-PERCENT REDUCTION IN REIMBURSEMENT FOR BAD DEBT- Section 1861(v)(1)(T) of such Act (
(c) Beneficiary Cost-Sharing for Outpatient Services- Section 1834(n) of such Act (as added by subsection (b)(2)) is amended--CommentsClose CommentsPermalink
(1) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;CommentsClose CommentsPermalink
(2) by inserting `(1)' after `(n)'; andCommentsClose CommentsPermalink
(3) by adding at the end the following:CommentsClose CommentsPermalink
`(2) The amounts of beneficiary cost-sharing for outpatient services furnished in a rural community hospital under this part shall be as follows:CommentsClose CommentsPermalink
`(A) For items and services that would have been paid under section 1833(t) if provided by a hospital, the amount of cost-sharing determined under paragraph (8) of such section.CommentsClose CommentsPermalink
`(B) For items and services that would have been paid under section 1833(h) if furnished by a provider or supplier, no cost-sharing shall apply.CommentsClose CommentsPermalink
`(C) For all other items and services, the amount of cost-sharing that would apply to the item or service under the methodology that would be used to determine payment for such item or service if provided by a physician, provider, or supplier, as the case may be.'.CommentsClose CommentsPermalink
(d) Conforming Amendments-CommentsClose CommentsPermalink
(1) PART A PAYMENT- Section 1814(b) of such Act (
(2) PART B PAYMENT- Section 1833(a) of such Act (
(A) in paragraph (2), in the matter before subparagraph (A), by striking `and (I)' and inserting `(I), and (K)';CommentsClose CommentsPermalink
(B) by striking `and' at the end of paragraph (8);CommentsClose CommentsPermalink
(C) by striking the period at the end of paragraph (9) and inserting `; and'; andCommentsClose CommentsPermalink
(D) by adding at the end the following:CommentsClose CommentsPermalink
`(10) in the case of outpatient services furnished by a rural community hospital, the amounts described in section 1834(n).'.CommentsClose CommentsPermalink
(3) TECHNICAL AMENDMENTS-CommentsClose CommentsPermalink
(A) CONSULTATION WITH STATE AGENCIES- Section 1863 of such Act (
(B) PROVIDER AGREEMENTS- Section 1866(a)(2)(A) of such Act (
(e) Effective Date- The amendments made by this section shall apply to items and services furnished on or after October 1, 2007.CommentsClose CommentsPermalink
SEC. 514. MEDICARE REMOTE MONITORING PILOT PROJECTS.
(a) Pilot Projects-CommentsClose CommentsPermalink
(1) IN GENERAL- Not later than 9 months after the date of enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the `Secretary') shall conduct pilot projects under title XVIII of the Social Security Act for the purpose of providing incentives to home health agencies to utilize home monitoring and communications technologies that--CommentsClose CommentsPermalink
(A) enhance health outcomes for Medicare beneficiaries; andCommentsClose CommentsPermalink
(B) reduce expenditures under such title.CommentsClose CommentsPermalink
(2) SITE REQUIREMENTS-CommentsClose CommentsPermalink
(A) URBAN AND RURAL- The Secretary shall conduct the pilot projects under this section in both urban and rural areas.CommentsClose CommentsPermalink
(B) SITE IN A SMALL STATE- The Secretary shall conduct at least 3 of the pilot projects in a State with a population of less than 1,000,000.CommentsClose CommentsPermalink
(3) DEFINITION OF HOME HEALTH AGENCY- In this section, the term `home health agency' has the meaning given that term in section 1861(o) of the Social Security Act (
(b) Medicare Beneficiaries Within the Scope of Projects- The Secretary shall specify the criteria for identifying those Medicare beneficiaries who shall be considered within the scope of the pilot projects under this section for purposes of the application of subsection (c) and for the assessment of the effectiveness of the home health agency in achieving the objectives of this section. Such criteria may provide for the inclusion in the projects of Medicare beneficiaries who begin receiving home health services under title XVIII of the Social Security Act after the date of the implementation of the projects.CommentsClose CommentsPermalink
(c) Incentives-CommentsClose CommentsPermalink
(1) PERFORMANCE TARGETS- The Secretary shall establish for each home health agency participating in a pilot project under this section a performance target using one of the following methodologies, as determined appropriate by the Secretary:CommentsClose CommentsPermalink
(A) ADJUSTED HISTORICAL PERFORMANCE TARGET- The Secretary shall establish for the agency--CommentsClose CommentsPermalink
(i) a base expenditure amount equal to the average total payments made to the agency under parts A and B of title XVIII of the Social Security Act for Medicare beneficiaries determined to be within the scope of the pilot project in a base period determined by the Secretary; andCommentsClose CommentsPermalink
(ii) an annual per capita expenditure target for such beneficiaries, reflecting the base expenditure amount adjusted for risk and adjusted growth rates.CommentsClose CommentsPermalink
(B) COMPARATIVE PERFORMANCE TARGET- The Secretary shall establish for the agency a comparative performance target equal to the average total payments under such parts A and B during the pilot project for comparable individuals in the same geographic area that are not determined to be within the scope of the pilot project.CommentsClose CommentsPermalink
(2) INCENTIVE- Subject to paragraph (3), the Secretary shall pay to each participating home care agency an incentive payment for each year under the pilot project equal to a portion of the Medicare savings realized for such year relative to the performance target under paragraph (1).CommentsClose CommentsPermalink
(3) LIMITATION ON EXPENDITURES- The Secretary shall limit incentive payments under this section in order to ensure that the aggregate expenditures under title XVIII of the Social Security Act (including incentive payments under this subsection) do not exceed the amount that the Secretary estimates would have been expended if the pilot projects under this section had not been implemented.CommentsClose CommentsPermalink
(d) Waiver Authority- The Secretary may waive such provisions of titles XI and XVIII of the Social Security Act as the Secretary determines to be appropriate for the conduct of the pilot projects under this section.CommentsClose CommentsPermalink
(e) Report to Congress- Not later than 5 years after the date that the first pilot project under this section is implemented, the Secretary shall submit to Congress a report on the pilot projects. Such report shall contain a detailed description of issues related to the expansion of the projects under subsection (f) and recommendations for such legislation and administrative actions as the Secretary considers appropriate.CommentsClose CommentsPermalink
(f) Expansion- If the Secretary determines that any of the pilot projects under this section enhance health outcomes for Medicare beneficiaries and reduce expenditures under title XVIII of the Social Security Act, the Secretary may initiate comparable projects in additional areas.CommentsClose CommentsPermalink
(g) Incentive Payments Have No Effect on Other Medicare Payments to Agencies- An incentive payment under this section--CommentsClose CommentsPermalink
(1) shall be in addition to the payments that a home health agency would otherwise receive under title XVIII of the Social Security Act for the provision of home health services; andCommentsClose CommentsPermalink
(2) shall have no effect on the amount of such payments.CommentsClose CommentsPermalink
SEC. 515. RURAL HEALTH QUALITY ADVISORY COMMISSION AND DEMONSTRATION PROJECTS.
(a) Rural Health Quality Advisory Commission-CommentsClose CommentsPermalink
(1) ESTABLISHMENT- Not later than 6 months after the date of the enactment of this section, the Secretary of Health and Human Services (in this section referred to as the `Secretary') shall establish a commission to be known as the Rural Health Quality Advisory Commission (in this section referred to as the `Commission').CommentsClose CommentsPermalink
(2) DUTIES OF COMMISSION-CommentsClose CommentsPermalink
(A) NATIONAL PLAN- The Commission shall develop, coordinate, and facilitate implementation of a national plan for rural health quality improvement. The national plan shall--CommentsClose CommentsPermalink
(i) identify objectives for rural health quality improvement;CommentsClose CommentsPermalink
(ii) identify strategies to eliminate known gaps in rural health system capacity and improve rural health quality; andCommentsClose CommentsPermalink
(iii) provide for Federal programs to identify opportunities for strengthening and aligning policies and programs to improve rural health quality.CommentsClose CommentsPermalink
(B) DEMONSTRATION PROJECTS- The Commission shall design demonstration projects to test alternative models for rural health quality improvement, including with respect to both personal and population health.CommentsClose CommentsPermalink
(C) MONITORING- The Commission shall monitor progress toward the objectives identified pursuant to paragraph (1)(A).CommentsClose CommentsPermalink
(3) MEMBERSHIP-CommentsClose CommentsPermalink
(A) NUMBER- The Commission shall be composed of 11 members appointed by the Secretary.CommentsClose CommentsPermalink
(B) SELECTION- The Secretary shall select the members of the Commission from among individuals with significant rural health care and health care quality expertise, including expertise in clinical health care, health care quality research, population or public health, or purchaser organizations.CommentsClose CommentsPermalink
(4) CONTRACTING AUTHORITY- Subject to the availability of funds, the Commission may enter into contracts and make other arrangements, as may be necessary to carry out the duties described in paragraph (2).CommentsClose CommentsPermalink
(5) STAFF- Upon the request of the Commission, the Secretary may detail, on a reimbursable basis, any of the personnel of the Office of Rural Health Policy of the Health Resources and Services Administration, the Agency for Health Care Quality and Research, or the Centers for Medicare & Medicaid Services to the Commission to assist in carrying out this subsection.CommentsClose CommentsPermalink
(6) REPORTS TO CONGRESS- Not later than 1 year after the establishment of the Commission, and annually thereafter, the Commission shall submit a report to the Congress on rural health quality. Each such report shall include the following:CommentsClose CommentsPermalink
(A) An inventory of relevant programs and recommendations for improved coordination and integration of policy and programs.CommentsClose CommentsPermalink
(B) An assessment of achievement of the objectives identified in the national plan developed under paragraph (2) and recommendations for realizing such objectives.CommentsClose CommentsPermalink
(C) Recommendations on Federal legislation, regulations, or administrative policies to enhance rural health quality and outcomes.CommentsClose CommentsPermalink
(b) Rural Health Quality Demonstration Projects-CommentsClose CommentsPermalink
(1) IN GENERAL- Not later than 270 days after the date of the enactment of this section, the Secretary, in consultation with the Rural Health Quality Advisory Commission, the Office of Rural Health Policy of the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, and the Centers for Medicare & Medicaid Services, shall make grants to eligible entities for 5 demonstration projects to implement and evaluate methods for improving the quality of health care in rural communities. Each such demonstration project shall include--CommentsClose CommentsPermalink
(A) alternative community models that--CommentsClose CommentsPermalink
(i) will achieve greater integration of personal and population health services; andCommentsClose CommentsPermalink
(ii) address safety, effectiveness, patient- or community-centeredness, timeliness, efficiency, and equity (the six aims identified by the Institute of Medicine of the National Academies in its report entitled `Crossing the Quality Chasm: A New Health System for the 21st Century' released on March 1, 2001);CommentsClose CommentsPermalink
(B) innovative approaches to the financing and delivery of health services to achieve rural health quality goals; andCommentsClose CommentsPermalink
(C) development of quality improvement support structures to assist rural health systems and professionals (such as workforce support structures, quality monitoring and reporting, clinical care protocols, and information technology applications).CommentsClose CommentsPermalink
(2) ELIGIBLE ENTITIES- In this subsection, the term `eligible entity' means a consortium that--CommentsClose CommentsPermalink
(A) shall include--CommentsClose CommentsPermalink
(i) at least one health care provider or health care delivery system located in a rural area; andCommentsClose CommentsPermalink
(ii) at least one organization representing multiple community stakeholders; andCommentsClose CommentsPermalink
(B) may include other partners such as rural research centers.CommentsClose CommentsPermalink
(3) CONSULTATION- In developing the program for awarding grants under this subsection, the Secretary shall consult with the Administrator of the Agency for Healthcare Research and Quality, rural health care providers, rural health care researchers, and private and non-profit groups (including national associations) which are undertaking similar efforts.CommentsClose CommentsPermalink
(4) EXPEDITED WAIVERS- The Secretary shall expedite the processing of any waiver that--CommentsClose CommentsPermalink
(A) is authorized under title XVIII or XIX of the Social Security Act (
(B) is necessary to carry out a demonstration project under this subsection.CommentsClose CommentsPermalink
(5) DEMONSTRATION PROJECT SITES- The Secretary shall ensure that the 5 demonstration projects funded under this subsection are conducted at a variety of sites representing the diversity of rural communities in the Nation.CommentsClose CommentsPermalink
(6) DURATION- Each demonstration project under this subsection shall be for a period of 4 years.CommentsClose CommentsPermalink
(7) INDEPENDENT EVALUATION- The Secretary shall enter into an arrangement with an entity that has experience working directly with rural health systems for the conduct of an independent evaluation of the program carried out under this subsection.CommentsClose CommentsPermalink
(8) REPORT- Not later than one year after the conclusion of all of the demonstration projects funded under this subsection, the Secretary shall submit a report to the Congress on the results of such projects. The report shall include--CommentsClose CommentsPermalink
(A) an evaluation of patient access to care, patient outcomes, and an analysis of the cost effectiveness of each such project; andCommentsClose CommentsPermalink
(B) recommendations on Federal legislation, regulations, or administrative policies to enhance rural health quality and outcomes.CommentsClose CommentsPermalink
(c) Appropriation-CommentsClose CommentsPermalink
(1) IN GENERAL- Out of funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out this section $30,000,000 for the period of fiscal years 2008 through 2012.CommentsClose CommentsPermalink
(2) AVAILABILITY-CommentsClose CommentsPermalink
(A) IN GENERAL- Funds appropriated under paragraph (1) shall remain available for expenditure through fiscal year 2012.CommentsClose CommentsPermalink
(B) REPORT- For purposes of carrying out subsection (b)(8), funds appropriated under paragraph (1) shall remain available for expenditure through fiscal year 2013.CommentsClose CommentsPermalink
(3) RESERVATION- Of the amount appropriated under paragraph (1), the Secretary shall reserve--CommentsClose CommentsPermalink
(A) $5,000,000 to carry out subsection (a); andCommentsClose CommentsPermalink
(B) $25,000,000 to carry out subsection (b), of which--CommentsClose CommentsPermalink
(i) 2 percent shall be for the provision of technical assistance to grant recipients; andCommentsClose CommentsPermalink
(ii) 5 percent shall be for independent evaluation under subsection (b)(7).CommentsClose CommentsPermalink
SEC. 516. RURAL HEALTH CARE SERVICES.
Section 330A of the Public Health Service Act (
`SEC. 330A. RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT, DELTA RURAL DISPARITIES AND HEALTH SYSTEMS DEVELOPMENT, AND SMALL RURAL HEALTH CARE PROVIDER QUALITY IMPROVEMENT GRANT PROGRAMS.
`(a) Purpose- The purpose of this section is to provide for grants--CommentsClose CommentsPermalink
`(1) under subsection (b), to promote rural health care services outreach;CommentsClose CommentsPermalink
`(2) under subsection (c), to provide for the planning and implementation of integrated health care networks in rural areas;CommentsClose CommentsPermalink
`(3) under subsection (d), to assist rural communities in the Delta Region to reduce health disparities and to promote and enhance health system development; andCommentsClose CommentsPermalink
`(4) under subsection (e), to provide for the planning and implementation of small rural health care provider quality improvement activities.CommentsClose CommentsPermalink
`(b) Rural Health Care Services Outreach Grants-CommentsClose CommentsPermalink
`(1) GRANTS- The Director of the Office of Rural Health Policy of the Health Resources and Services Administration may award grants to eligible entities to promote rural health care services outreach by expanding the delivery of health care services to include new and enhanced services in rural areas. The Director may award the grants for periods of not more than 3 years.CommentsClose CommentsPermalink
`(2) ELIGIBILITY- To be eligible to receive a grant under this subsection for a project, an entity--CommentsClose CommentsPermalink
`(A) shall be a rural public or rural nonprofit private entity, a facility that qualifies as a rural health clinic under title XVIII of the Social Security Act, a public or nonprofit entity existing exclusively to provide services to migrant and seasonal farm workers in rural areas, or a tribal government whose grant-funded activities will be conducted within federally recognized tribal areas;CommentsClose CommentsPermalink
`(B) shall represent a consortium composed of members--CommentsClose CommentsPermalink
`(i) that include 3 or more independently-owned health care entities; andCommentsClose CommentsPermalink
`(ii) that may be nonprofit or for-profit entities; andCommentsClose CommentsPermalink
`(C) shall not previously have received a grant under this subsection for the same or a similar project, unless the entity is proposing to expand the scope of the project or the area that will be served through the project.CommentsClose CommentsPermalink
`(3) APPLICATIONS- To be eligible to receive a grant under this subsection, an eligible 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
`(A) a description of the project that the eligible entity will carry out using the funds provided under the grant;CommentsClose CommentsPermalink
`(B) a description of the manner in which the project funded under the grant will meet the health care needs of rural populations in the local community or region to be served;CommentsClose CommentsPermalink
`(C) a plan for quantifying how health care needs will be met through identification of the target population and benchmarks of service delivery or health status, such as--CommentsClose CommentsPermalink
`(i) quantifiable measurements of health status improvement for projects focusing on health promotion; orCommentsClose CommentsPermalink
`(ii) benchmarks of increased access to primary care, including tracking factors such as the number and type of primary care visits, identification of a medical home, or other general measures of such access;CommentsClose CommentsPermalink
`(D) a description of how the local community or region to be served will be involved in the development and ongoing operations of the project;CommentsClose CommentsPermalink
`(E) a plan for sustaining the project after Federal support for the project has ended;CommentsClose CommentsPermalink
`(F) a description of how the project will be evaluated;CommentsClose CommentsPermalink
`(G) the administrative capacity to submit annual performance data electronically as specified by the Director; andCommentsClose CommentsPermalink
`(H) other such information as the Director determines to be appropriate.CommentsClose CommentsPermalink
`(c) Rural Health Network Development Grants-CommentsClose CommentsPermalink
`(1) GRANTS-CommentsClose CommentsPermalink
`(A) IN GENERAL- The Director may award rural health network development grants to eligible entities to promote, through planning and implementation, the development of integrated health care networks that have combined the functions of the entities participating in the networks in order to--CommentsClose CommentsPermalink
`(i) achieve efficiencies and economies of scale;CommentsClose CommentsPermalink
`(ii) expand access to, coordinate, and improve the quality of the health care delivery system through development of organizational efficiencies;CommentsClose CommentsPermalink
`(iii) implement health information technology to achieve efficiencies, reduce medical errors, and improve quality;CommentsClose CommentsPermalink
`(iv) coordinate care and manage chronic illness; andCommentsClose CommentsPermalink
`(v) strengthen the rural health care system as a whole in such a manner as to show a quantifiable return on investment to the participants in the network.CommentsClose CommentsPermalink
`(B) GRANT PERIODS- The Director may award such a rural health network development grant--CommentsClose CommentsPermalink
`(i) for a period of 3 years for implementation activities; orCommentsClose CommentsPermalink
`(ii) for a period of 1 year for planning activities to assist in the initial development of an integrated health care network, if the proposed participants in the network do not have a history of collaborative efforts and a 3-year grant would be inappropriate.CommentsClose CommentsPermalink
`(2) ELIGIBILITY- To be eligible to receive a grant under this subsection, an entity--CommentsClose CommentsPermalink
`(A) shall be a rural public or rural nonprofit private entity, a facility that qualifies as a rural health clinic under title XVIII of the Social Security Act, a public or nonprofit entity existing exclusively to provide services to migrant and seasonal farm workers in rural areas, or a tribal government whose grant-funded activities will be conducted within federally recognized tribal areas;CommentsClose CommentsPermalink
`(B) shall represent a network composed of participants--CommentsClose CommentsPermalink
`(i) that include 3 or more independently-owned health care entities; andCommentsClose CommentsPermalink
`(ii) that may be nonprofit or for-profit entities; andCommentsClose CommentsPermalink
`(C) shall not previously have received a grant under this subsection (other than a 1-year grant for planning activities) for the same or a similar project.CommentsClose CommentsPermalink
`(3) APPLICATIONS- To be eligible to receive a grant under this subsection, 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
`(A) a description of the project that the eligible entity will carry out using the funds provided under the grant;CommentsClose CommentsPermalink
`(B) an explanation of the reasons why Federal assistance is required to carry out the project;CommentsClose CommentsPermalink
`(C) a description of--CommentsClose CommentsPermalink
`(i) the history of collaborative activities carried out by the participants in the network;CommentsClose CommentsPermalink
`(ii) the degree to which the participants are ready to integrate their functions; andCommentsClose CommentsPermalink
`(iii) how the local community or region to be served will benefit from and be involved in the activities carried out by the network;CommentsClose CommentsPermalink
`(D) a description of how the local community or region to be served will experience increased access to quality health care services across the continuum of care as a result of the integration activities carried out by the network, including a description of--CommentsClose CommentsPermalink
`(i) return on investment for the community and the network members; andCommentsClose CommentsPermalink
`(ii) other quantifiable performance measures that show the benefit of the network activities;CommentsClose CommentsPermalink
`(E) a plan for sustaining the project after Federal support for the project has ended;CommentsClose CommentsPermalink
`(F) a description of how the project will be evaluated;CommentsClose CommentsPermalink
`(G) the administrative capacity to submit annual performance data electronically as specified by the Director; andCommentsClose CommentsPermalink
`(H) other such information as the Director determines to be appropriate.CommentsClose CommentsPermalink
`(d) Delta Rural Disparities and Health Systems Development Grants-CommentsClose CommentsPermalink
`(1) GRANTS- The Director may award grants to eligible entities to support reduction of health disparities, improve access to health care, and enhance rural health system development in the Delta Region.CommentsClose CommentsPermalink
`(2) ELIGIBILITY- To be eligible to receive a grant under this subsection, an entity shall be a rural public or rural nonprofit private entity, a facility that qualifies as a rural health clinic under title XVIII of the Social Security Act, a public or nonprofit entity existing exclusively to provide services to migrant and seasonal farm workers in rural areas, or a tribal government whose grant-funded activities will be conducted within federally recognized tribal areas.CommentsClose CommentsPermalink
`(3) APPLICATIONS- To be eligible to receive a grant under this subsection, an eligible 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
`(A) a description of the project that the eligible entity will carry out using the funds provided under the grant;CommentsClose CommentsPermalink
`(B) an explanation of the reasons why Federal assistance is required to carry out the project;CommentsClose CommentsPermalink
`(C) a description of the manner in which the project funded under the grant will meet the health care needs of the Delta Region;CommentsClose CommentsPermalink
`(D) a description of how the local community or region to be served will experience increased access to quality health care services as a result of the activities carried out by the entity;CommentsClose CommentsPermalink
`(E) a description of how health disparities will be reduced or the health system will be improved;CommentsClose CommentsPermalink
`(F) a plan for sustaining the project after Federal support for the project has ended;CommentsClose CommentsPermalink
`(G) a description of how the project will be evaluated including process and outcome measures related to the quality of care provided or how the health care system improves its performance;CommentsClose CommentsPermalink
`(H) a description of how the grantee will develop an advisory group made up of representatives of the communities to be served to provide guidance to the grantee to best meet community need; andCommentsClose CommentsPermalink
`(I) other such information as the Director determines to be appropriate.CommentsClose CommentsPermalink
`(e) Small Rural Health Care Provider Quality Improvement Grants-CommentsClose CommentsPermalink
`(1) GRANTS- The Director may award grants to provide for the planning and implementation of small rural health care provider quality improvement activities. The Director may award the grants for periods of 1 to 3 years.CommentsClose CommentsPermalink
`(2) ELIGIBILITY- To be eligible for a grant under this subsection, an entity--CommentsClose CommentsPermalink
`(A) shall be--CommentsClose CommentsPermalink
`(i) a rural public or rural nonprofit private health care provider or provider of health care services, such as a rural health clinic; orCommentsClose CommentsPermalink
`(ii) another rural provider or network of small rural providers identified by the Director as a key source of local care; andCommentsClose CommentsPermalink
`(B) shall not previously have received a grant under this subsection for the same or a similar project.CommentsClose CommentsPermalink
`(3) PREFERENCE- In awarding grants under this subsection, the Director shall give preference to facilities that qualify as rural health clinics under title XVIII of the Social Security Act.CommentsClose CommentsPermalink
`(4) APPLICATIONS- To be eligible to receive a grant under this subsection, an eligible 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
`(A) a description of the project that the eligible entity will carry out using the funds provided under the grant;CommentsClose CommentsPermalink
`(B) an explanation of the reasons why Federal assistance is required to carry out the project;CommentsClose CommentsPermalink
`(C) a description of the manner in which the project funded under the grant will assure continuous quality improvement in the provision of services by the entity;CommentsClose CommentsPermalink
`(D) a description of how the local community or region to be served will experience increased access to quality health care services as a result of the activities carried out by the entity;CommentsClose CommentsPermalink
`(E) a plan for sustaining the project after Federal support for the project has ended;CommentsClose CommentsPermalink
`(F) a description of how the project will be evaluated including process and outcome measures related to the quality of care provided; andCommentsClose CommentsPermalink
`(G) other such information as the Director determines to be appropriate.CommentsClose CommentsPermalink
`(f) General Requirements-CommentsClose CommentsPermalink
`(1) PROHIBITED USES OF FUNDS- An entity that receives a grant under this section may not use funds provided through the grant--CommentsClose CommentsPermalink
`(A) to build or acquire real property; orCommentsClose CommentsPermalink
`(B) for construction.CommentsClose CommentsPermalink
`(2) COORDINATION WITH OTHER AGENCIES- The Director shall coordinate activities carried out under grant programs described in this section, to the extent practicable, with Federal and State agencies and nonprofit organizations that are operating similar grant programs, to maximize the effect of public dollars in funding meritorious proposals.CommentsClose CommentsPermalink
`(g) Report- Not later than September 30, 2010, the Secretary shall prepare and submit to the appropriate committees of Congress a report on the progress and accomplishments of the grant programs described in subsections (b), (c), (d), and (e).CommentsClose CommentsPermalink
`(h) Definitions- In this section:CommentsClose CommentsPermalink
`(1) The term `Delta Region' has the meaning given to the term `region' in section 382A of the Consolidated Farm and Rural Development Act (
`(2) The term `Director' means the Director of the Office of Rural Health Policy of the Health Resources and Services Administration.CommentsClose CommentsPermalink
`(i) Authorization of Appropriations- There are authorized to be appropriated to carry out this section $40,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2009 through 2012.'.CommentsClose CommentsPermalink
SEC. 517. COMMUNITY HEALTH CENTER COLLABORATIVE ACCESS EXPANSION.
Section 330 of the Public Health Service Act (
`(s) Miscellaneous Provisions-CommentsClose CommentsPermalink
`(1) RULE OF CONSTRUCTION WITH RESPECT TO RURAL HEALTH CLINICS-CommentsClose CommentsPermalink
`(A) IN GENERAL- Nothing in this section shall be construed to prevent a community health center from contracting with a federally certified rural health clinic (as defined by section 1861(aa)(2) of the Social Security Act) for the delivery of primary health care services that are available at the rural health clinic to individuals who would otherwise be eligible for free or reduced cost care if that individual were able to obtain that care at the community health center. Such services may be limited in scope to those primary health care services available in that rural health clinic.CommentsClose CommentsPermalink
`(B) ASSURANCES- In order for a rural health clinic to receive funds under this section through a contract with a community health center under paragraph (1), such rural health clinic shall establish policies to ensure--CommentsClose CommentsPermalink
`(i) nondiscrimination based upon the ability of a patient to pay; andCommentsClose CommentsPermalink
`(ii) the establishment of a sliding fee scale for low-income patients.'.CommentsClose CommentsPermalink
SEC. 518. FACILITATING THE PROVISION OF TELEHEALTH SERVICES ACROSS STATE LINES.
(a) In General- For purposes of expediting the provision of telehealth services, for which payment is made under the Medicare program, across State lines, the Secretary of Health and Human Services shall, in consultation with representatives of States, physicians, health care practitioners, and patient advocates, encourage and facilitate the adoption of provisions allowing for multistate practitioner practice across State lines.CommentsClose CommentsPermalink
(b) Definitions- In subsection (a):CommentsClose CommentsPermalink
(1) TELEHEALTH SERVICE- The term `telehealth service' has the meaning given that term in subparagraph (F) of section 1834(m)(4) of the Social Security Act (
(2) PHYSICIAN, PRACTITIONER- The terms `physician' and `practitioner' have the meaning given those terms in subparagraphs (D) and (E), respectively, of such section.CommentsClose CommentsPermalink
(3) MEDICARE PROGRAM- The term `Medicare program' means the program of health insurance administered by the Secretary of Health and Human Services under title XVIII of the Social Security Act (
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