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S. 1045 (is) To amend the National Foundation on the Arts and the Humanities Act of [Introduced in Senate] ...
Calendar No. 279 104th CONGRESS 1st Session S. 1044 [Report No. 104-186] _______________________________________________________________________ A BILL To amend title III of the Public Health Service Act to consolidate and reauthorize provisions relating to health centers, and for other purposes. _______________________________________________________________________ December 15, 1995 Reported with amendments Calendar No. 279 104th CONGRESS 1st Session S. 1044 [Report No. 104-186] To amend title III of the Public Health Service Act to consolidate and reauthorize provisions relating to health centers, and for other purposes. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES July 17 (legislative day, July 10), 1995 Mrs. Kassebaum, (for herself, Mr. Kennedy, Mr. Jeffords, Mr. Pell, and Mr. Simon) introduced the following bill; which was read twice and referred to the Committee on Labor and Human Resources December 15, 1995 Reported by Mrs. Kassebaum, with amendments [Omit the part struck through and insert the part printed in italic] _______________________________________________________________________ A BILL To amend title III of the Public Health Service Act to consolidate and reauthorize provisions relating to health centers, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Health Centers Consolidation Act of 1995''. SEC. 2. CONSOLIDATION AND REAUTHORIZATION OF PROVISIONS. Subpart I of part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended to read as follows: ``Subpart I--Health Centers ``SEC. 330. HEALTH CENTERS. ``(a) Definition of Health Center.-- ``(1) In general.--For purposes of this section, the term `health center' means an entity that serves a population that is medically underserved, or a special medically underserved population comprised of migratory and seasonal agricultural workers, the homeless, and residents of public housing, by providing, either through the staff and supporting resources of the center or through contracts or cooperative arrangements-- ``(A) required primary health services (as defined in subsection (b)(1)); and ``(B) as may be appropriate for particular centers, additional health services (as defined in subsection (b)(2)) necessary for the adequate support of the primary health services required under subparagraph (A); for all residents of the area served by the center (hereafter referred to in this section as the `catchment area'). ``(2) Limitation.--The requirement in paragraph (1) to provide services for all residents within a catchment area shall not apply in the case of a health center receiving a grant only under subsection (f), (g), or (h). ``(b) Definitions.--For purposes of this section: ``(1) Required primary health services.-- ``(A) In general.--The term `required primary health services' means-- ``(i) basic health services which, for purposes of this section, shall consist of-- ``(I) health services related to family medicine, internal medicine, pediatrics, obstetrics, or gynecology that are furnished by physicians and where appropriate, physician assistants, nurse practitioners, and nurse midwives; ``(II) diagnostic laboratory and radiologic services; ``(III) preventive health services, including-- ``(aa) prenatal and perinatal services; ``(bb) screening for breast and cervical cancer; ``(cc) well-child services; ``(dd) immunizations against vaccine-preventable diseases; ``(ee) screenings for elevated blood lead levels, communicable diseases, and cholesterol; ``(ff) pediatric eye, ear, and dental screenings to determine the need for vision and hearing correction and dental care; ``(gg) voluntary family planning services; and ``(hh) preventive dental services; ``(IV) emergency medical services; and ``(V) pharmaceutical services as may be appropriate for particular centers; ``(ii) referrals to providers of medical services and other health-related services (including substance abuse and mental health services); ``(iii) patient case management services (including counseling, referral, and follow-up services) and other services designed to assist health center patients in establishing eligibility for and gaining access to Federal, State, and local programs that provide or financially support the provision of medical, social, educational, or other related services; ``(iv) services that enable individuals to use the services of the health center (including outreach and transportation services and, if a substantial number of the individuals in the population served by a center are of limited English-speaking ability, the services of appropriate personnel fluent in the language spoken by a predominant number of such individuals); and ``(v) education of patients and the general population served by the health center regarding the availability and proper use of health services. ``(B) Exception.--With respect to a health center that receives a grant only under subsection (f), the Secretary, upon a showing of good cause, shall-- ``(i) waive the requirement that the center provide all required primary health services under this paragraph; and ``(ii) approve, as appropriate, the provision of certain required primary health services only during certain periods of the year. ``(2) Additional health services.--The term `additional health services' means services that are not included as required primary health services and that are appropriate to meet the health needs of the population served by the health center involved. Such term may include-- ``(A) environmental health services, including-- ``(i) the detection and alleviation of unhealthful conditions associated with water supply; ``(ii) sewage treatment; ``(iii) solid waste disposal; ``(iv) rodent and parasitic infestation; ``(v) field sanitation; ``(vi) housing; and ``(vii) other environmental factors related to health; and ``(B) in the case of health centers receiving grants under subsection (f), special occupation-related health services for migratory and seasonal agricultural workers, including-- ``(i) screening for and control of infectious diseases, including parasitic diseases; and ``(ii) injury prevention programs, including prevention of exposure to unsafe levels of agricultural chemicals including pesticides. ``(3) Medically underserved populations.-- ``(A) In general.--The term `medically underserved population' means the population of an urban or rural area designated by the Secretary as an area with a shortage of personal health services or a population group designated by the Secretary as having a shortage of such services. ``(B) Criteria.--In carrying out subparagraph (A), the Secretary shall prescribe criteria for determining the specific shortages of personal health services of an area or population group. Such criteria shall-- ``(i) take into account comments received by the Secretary from the chief executive officer of a State and local officials in a State; and ``(ii) include factors indicative of the health status of a population group or residents of an area, the ability of the residents of an area or of a population group to pay for health services and their accessibility to them, and the availability of health professionals to residents of an area or to a population group. ``(C) Limitation.--The Secretary may not designate a medically underserved population in a State or terminate the designation of such a population unless, prior to such designation or termination, the Secretary provides reasonable notice and opportunity for comment and consults with-- ``(i) the chief executive officer of such State; ``(ii) local officials in such State; and ``(iii) the organization, if any, which represents a majority of health centers in such State. ``(D) Permissible designation.--The Secretary may designate a medically underserved population that does not meet the criteria established under subparagraph (B) if the chief executive officer of the State in which such population is located and local officials of such State recommend the designation of such population based on unusual local conditions which are a barrier to access to or the availability of personal health services. ``(c) Planning Grants.-- ``(1) In general.-- ``(A) Centers.--The Secretary may make grants to public and nonprofit private entities for projects to plan and develop health centers which will serve medically underserved populations. A project for which a grant may be made under this subsection may include the cost of the acquisition, expansion, and modernization of existing buildings and construction of new buildings (including the costs of amortizing the principal of, and paying the interest on, loans) and shall include-- ``(i) an assessment of the need that the population proposed to be served by the health center for which the project is undertaken has for required primary health services and additional health services; ``(ii) the design of a health center program for such population based on such assessment; ``(iii) efforts to secure, within the proposed catchment area of such center, financial and professional assistance and support for the project; ``(iv) initiation and encouragement of continuing community involvement in the development and operation of the project; and ``(v) proposed linkages between the center and other appropriate provider entities, such as health departments, local hospitals, and rural health clinics, to provide better coordinated, higher quality, and more cost-effective health care services. ``(B) Comprehensive service delivery networks and plans.--The Secretary may make grants to health centers that receive assistance under this section to enable the centers to plan and develop a network or plan for the provision of health services, which may include the provision of health services on a prepaid basis or through another managed care arrangement, to some or to all of the individuals which the centers serve. Such a grant may only be made for such a center if-- ``(i) the center has received grants under subsection (d)(1)(A) for at least 2 consecutive years preceding the year of the grant under this subparagraph or has otherwise demonstrated, as required by the Secretary, that such center has been providing primary care services for at least the 2 consecutive years immediately preceding such year; and ``(ii) the center provides assurances
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