S 319 ISCommentsClose CommentsPermalink

To amend the Public Health Service Act to provide grants to promote positive health behaviors in women and children.CommentsClose CommentsPermalink

January 26, 2009CommentsClose CommentsPermalink

Mr. BINGAMAN (for himself and Mr. DURBIN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and PensionsCommentsClose CommentsPermalink

To amend the Public Health Service Act to provide grants to promote positive health behaviors in women and children.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 ‘Community Health Workers Act of 2009’.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

Congress makes the following findings:CommentsClose CommentsPermalink





(1) Chronic diseases, defined as any condition that requires regular medical attention or medication, are the leading cause of death and disability for women in the United States across racial and ethnic groups.CommentsClose CommentsPermalink





(2) According to the National Vital Statistics Report of 2001, the 5 leading causes of death among Hispanic, American Indian, and African-American women are heart disease, cancer, diabetes, cerebrovascular disease, and unintentional injuries.CommentsClose CommentsPermalink





(3) Unhealthy behaviors alone lead to more than 50 percent of premature deaths in the United States.CommentsClose CommentsPermalink





(4) Poor diet, physical inactivity, tobacco use, and alcohol and drug abuse are the health risk behaviors that most often lead to disease, premature death, and disability, and are particularly prevalent among many groups of minority women.CommentsClose CommentsPermalink





(5) Over 60 percent of Hispanic and African-American women are classified as overweight and over 30 percent are classified as obese. Over 60 percent of American Indian women are classified as obese.CommentsClose CommentsPermalink





(6) American Indian women have the highest mortality rates related to alcohol and drug use of all women in the United States.CommentsClose CommentsPermalink





(7) High poverty rates coupled with barriers to health preventive services and medical care contribute to racial and ethnic disparities in health factors, including premature death, life expectancy, risk factors associated with major diseases, and the extent and severity of illnesses.CommentsClose CommentsPermalink





(8) There is increasing evidence that early life experiences are associated with adult chronic disease and that prevention and intervention services provided within the community and the home may lessen the impact of chronic outcomes, while strengthening families and communities.CommentsClose CommentsPermalink





(9) Community health workers, who are primarily women, can be a critical component in conducting health promotion and disease prevention efforts in medically underserved populations.CommentsClose CommentsPermalink





(10) Recognizing the difficult barriers confronting medically underserved communities (poverty, geographic isolation, language and cultural differences, lack of transportation, low literacy, and lack of access to services), community health workers are in a unique position to reduce preventable morbidity and mortality, improve the quality of life, and increase the utilization of available preventive health services for community members.CommentsClose CommentsPermalink





(11) Research has shown that community health workers have been effective in significantly increasing health insurance coverage, screening and medical follow-up visits among residents with limited access or underutilization of health care services.CommentsClose CommentsPermalink





(12) States on the United States-Mexico border have high percentages of impoverished and ethnic minority populations: border States accommodate 60 percent of the total Hispanic population and 23 percent of the total population below 200 percent poverty in the United States.CommentsClose CommentsPermalink

SEC. 3. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS IN WOMEN.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended--CommentsClose CommentsPermalink





(1) by redesignating the second section 399R (relating to the amyotrophic lateral sclerosis registry (42 U.S.C. 280g-7)) and the third section 399R (relating to support for patients receiving a positive diagnosis of down syndrome or other prenatally or postnatally diagnosed conditions (42 U.S.C. 280g-8)) as sections 399S and 399T respectively; andCommentsClose CommentsPermalink





(2) by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 399U. GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS IN WOMEN.

‘(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 States or local or tribal units, 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, 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





‘(2) 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; andCommentsClose CommentsPermalink





‘(H) mental health problems;CommentsClose CommentsPermalink





‘(3) to educate and guide regarding effective strategies to promote positive health behaviors within the family;CommentsClose CommentsPermalink





‘(4) 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





‘(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 State or local or tribal unit (including federally recognized tribes and Alaska native villages) 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;CommentsClose CommentsPermalink





‘(B) with a high percentage of families for whom English is not their primary language; andCommentsClose CommentsPermalink





‘(C) that encompass the United States-Mexico border region;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. 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 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) MEDICALLY UNDERSERVED COMMUNITY- The term ‘medically underserved community’ means a community identified by a State--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





‘(4) 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





‘(5) 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 2010, 2011, and 2012.’.CommentsClose CommentsPermalink