US Laws - Affordable Health Care Act (HR3950F)
TITLE V--HEALTH CARE WORKFORCE
Subtitle G--Improving Access to Health Care Services

Subtitle G--Improving Access to Health Care Services (8680)(1-click HTML)

SEC. 5601. SPENDING FOR FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). (8681)(1-click HTML)

(a) In General- Section 330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) is amended by striking paragraph (1) and inserting the following: (8682)

"(1) GENERAL AMOUNTS FOR GRANTS- For the purpose of carrying out this section, in addition to the amounts authorized to be appropriated under subsection (d), there is authorized to be appropriated the following: (8683)

"(A) For fiscal year 2010, $2,988,821,592. (8684)

"(B) For fiscal year 2011, $3,862,107,440. (8685)

"(C) For fiscal year 2012, $4,990,553,440. (8686)

"(D) For fiscal year 2013, $6,448,713,307. (8687)

"(E) For fiscal year 2014, $7,332,924,155. (8688)

"(F) For fiscal year 2015, $8,332,924,155. (8689)

"(G) For fiscal year 2016, and each subsequent fiscal year, the amount appropriated for the preceding fiscal year adjusted by the product of-- (8690)

"(i) one plus the average percentage increase in costs incurred per patient served; and (8691)

"(ii) one plus the average percentage increase in the total number of patients served.". (8692)

(b) Rule of Construction- Section 330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) is amended by adding at the end the following: (8693)

"(4) RULE OF CONSTRUCTION WITH RESPECT TO RURAL HEALTH CLINICS- (8694)

"(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 in section 1861(aa)(2) of the Social Security Act), a low-volume hospital (as defined for purposes of section 1886 of such Act), a critical access hospital, a sole community hospital (as defined for purposes of section 1886(d)(5)(D)(iii) of such Act), or a medicare-dependent share hospital (as defined for purposes of section 1886(d)(5)(G)(iv) of such Act) for the delivery of primary health care services that are available at the clinic or hospital 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 clinic or hospitals. (8695)

"(B) ASSURANCES- In order for a clinic or hospital to receive funds under this section through a contract with a community health center under subparagraph (A), such clinic or hospital shall establish policies to ensure-- (8696)

"(i) nondiscrimination based on the ability of a patient to pay; and (8697)

"(ii) the establishment of a sliding fee scale for low-income patients.". (8698)

SEC. 5602. NEGOTIATED RULEMAKING FOR DEVELOPMENT OF METHODOLOGY AND CRITERIA FOR DESIGNATING MEDICALLY UNDERSERVED POPULATIONS AND HEALTH PROFESSIONS SHORTAGE AREAS. (8699)(1-click HTML)

(a) Establishment- (8700)

(1) IN GENERAL- The Secretary of Health and Human Services (in this section referred to as the "Secretary") shall establish, through a negotiated rulemaking process under subchapter 3 of chapter 5 of title 5, United States Code, a comprehensive methodology and criteria for designation of-- (8701)

(A) medically underserved populations in accordance with section 330(b)(3) of the Public Health Service Act (42 U.S.C. 254b(b)(3)); (8702)

(B) health professions shortage areas under section 332 of the Public Health Service Act (42 U.S.C. 254e). (8703)

(2) FACTORS TO CONSIDER- In establishing the methodology and criteria under paragraph (1), the Secretary-- (8704)

(A) shall consult with relevant stakeholders who will be significantly affected by a rule (such as national, State and regional organizations representing affected entities), State health offices, community organizations, health centers and other affected entities, and other interested parties; and (8705)

(B) shall take into account-- (8706)

(i) the timely availability and appropriateness of data used to determine a designation to potential applicants for such designations; (8707)

(ii) the impact of the methodology and criteria on communities of various types and on health centers and other safety net providers; (8708)

(iii) the degree of ease or difficulty that will face potential applicants for such designations in securing the necessary data; and (8709)

(iv) the extent to which the methodology accurately measures various barriers that confront individuals and population groups in seeking health care services. (8710)

(b) Publication of Notice- In carrying out the rulemaking process under this subsection, the Secretary shall publish the notice provided for under section 564(a) of title 5, United States Code, by not later than 45 days after the date of the enactment of this Act. (8711)

(c) Target Date for Publication of Rule- As part of the notice under subsection (b), and for purposes of this subsection, the "target date for publication", as referred to in section 564(a)(5) of title 5, United Sates Code, shall be July 1, 2010. (8712)

(d) Appointment of Negotiated Rulemaking Committee and Facilitator- The Secretary shall provide for-- (8713)

(1) the appointment of a negotiated rulemaking committee under section 565(a) of title 5, United States Code, by not later than 30 days after the end of the comment period provided for under section 564(c) of such title; and (8714)

(2) the nomination of a facilitator under section 566(c) of such title 5 by not later than 10 days after the date of appointment of the committee. (8715)

(e) Preliminary Committee Report- The negotiated rulemaking committee appointed under subsection (d) shall report to the Secretary, by not later than April 1, 2010, regarding the committee"s progress on achieving a consensus with regard to the rulemaking proceeding and whether such consensus is likely to occur before one month before the target date for publication of the rule. If the committee reports that the committee has failed to make significant progress toward such consensus or is unlikely to reach such consensus by the target date, the Secretary may terminate such process and provide for the publication of a rule under this section through such other methods as the Secretary may provide. (8716)

(f) Final Committee Report- If the committee is not terminated under subsection (e), the rulemaking committee shall submit a report containing a proposed rule by not later than one month before the target publication date. (8717)

(g) Interim Final Effect- The Secretary shall publish a rule under this section in the Federal Register by not later than the target publication date. Such rule shall be effective and final immediately on an interim basis, but is subject to change and revision after public notice and opportunity for a period (of not less than 90 days) for public comment. In connection with such rule, the Secretary shall specify the process for the timely review and approval of applications for such designations pursuant to such rules and consistent with this section. (8718)

(h) Publication of Rule After Public Comment- The Secretary shall provide for consideration of such comments and republication of such rule by not later than 1 year after the target publication date. (8719)

SEC. 5603. REAUTHORIZATION OF THE WAKEFIELD EMERGENCY MEDICAL SERVICES FOR CHILDREN PROGRAM. (8720)(1-click HTML)

Section 1910 of the Public Health Service Act (42 U.S.C. 300w-9) is amended-- (8721)

(1) in subsection (a), by striking "3-year period (with an optional 4th year" and inserting "4-year period (with an optional 5th year"; and (8722)

(2) in subsection (d)-- (8723)

(A) by striking "and such sums" and inserting "such sums"; and (8724)

(B) by inserting before the period the following: ", $25,000,000 for fiscal year 2010, $26,250,000 for fiscal year 2011, $27,562,500 for fiscal year 2012, $28,940,625 for fiscal year 2013, and $30,387,656 for fiscal year 2014". (8725)

SEC. 5604. CO-LOCATING PRIMARY AND SPECIALTY CARE IN COMMUNITY-BASED MENTAL HEALTH SETTINGS. (8726)(1-click HTML)

Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb-31 et seq.) is amended by adding at the end the following: (8727)

SEC. 520K. AWARDS FOR CO-LOCATING PRIMARY AND SPECIALTY CARE IN COMMUNITY-BASED MENTAL HEALTH SETTINGS. (8728)

"(a) Definitions- In this section: (8729)

"(1) ELIGIBLE ENTITY- The term "eligible entity" means a qualified community mental health program defined under section 1913(b)(1). (8730)

"(2) SPECIAL POPULATIONS- The term "special populations" means adults with mental illnesses who have co-occurring primary care conditions and chronic diseases. (8731)

"(b) Program Authorized- The Secretary, acting through the Administrator shall award grants and cooperative agreements to eligible entities to establish demonstration projects for the provision of coordinated and integrated services to special populations through the co-location of primary and specialty care services in community-based mental and behavioral health settings. (8732)

"(c) Application- To be eligible to receive a grant or cooperative agreement under this section, an eligible entity shall submit an application to the Administrator at such time, in such manner, and accompanied by such information as the Administrator may require, including a description of partnerships, or other arrangements with local primary care providers, including community health centers, to provide services to special populations. (8733)

"(d) Use of Funds- (8734)

"(1) IN GENERAL- For the benefit of special populations, an eligible entity shall use funds awarded under this section for-- (8735)

"(A) the provision, by qualified primary care professionals, of on site primary care services; (8736)

"(B) reasonable costs associated with medically necessary referrals to qualified specialty care professionals, other coordinators of care or, if permitted by the terms of the grant or cooperative agreement, by qualified specialty care professionals on a reasonable cost basis on site at the eligible entity; (8737)

"(C) information technology required to accommodate the clinical needs of primary and specialty care professionals; or (8738)

"(D) facility modifications needed to bring primary and specialty care professionals on site at the eligible entity. (8739)

"(2) LIMITATION- Not to exceed 15 percent of grant or cooperative agreement funds may be used for activities described in subparagraphs (C) and (D) of paragraph (1). (8740)

"(e) Evaluation- Not later than 90 days after a grant or cooperative agreement awarded under this section expires, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement. (8741)

"(f) Authorization of Appropriations- There are authorized to be appropriated to carry out this section, $50,000,000 for fiscal year 2010 and such sums as may be necessary for each of fiscal years 2011 through 2014.". (8742)

SEC. 5605. KEY NATIONAL INDICATORS. (8743)(1-click HTML)

(a) Definitions- In this section: (8744)

(1) ACADEMY- The term "Academy" means the National Academy of Sciences. (8745)

(2) COMMISSION- The term "Commission" means the Commission on Key National Indicators established under subsection (b). (8746)

(3) INSTITUTE- The term "Institute" means a Key National Indicators Institute as designated under subsection (c)(3). (8747)

(b) Commission on Key National Indicators- (8748)

(1) ESTABLISHMENT- There is established a "Commission on Key National Indicators". (8749)

(2) MEMBERSHIP- (8750)

(A) NUMBER AND APPOINTMENT- The Commission shall be composed of 8 members, to be appointed equally by the majority and minority leaders of the Senate and the Speaker and minority leader of the House of Representatives. (8751)

(B) PROHIBITED APPOINTMENTS- Members of the Commission shall not include Members of Congress or other elected Federal, State, or local government officials. (8752)

(C) QUALIFICATIONS- In making appointments under subparagraph (A), the majority and minority leaders of the Senate and the Speaker and minority leader of the House of Representatives shall appoint individuals who have shown a dedication to improving civic dialogue and decision-making through the wide use of scientific evidence and factual information. (8753)

(D) PERIOD OF APPOINTMENT- Each member of the Commission shall be appointed for a 2-year term, except that 1 initial appointment shall be for 3 years. Any vacancies shall not affect the power and duties of the Commission but shall be filled in the same manner as the original appointment and shall last only for the remainder of that term. (8754)

(E) DATE- Members of the Commission shall be appointed by not later than 30 days after the date of enactment of this Act. (8755)

(F) INITIAL ORGANIZING PERIOD- -Not later than 60 days after the date of enactment of this Act, the Commission shall develop and implement a schedule for completion of the review and reports required under subsection (d). (8756)

(G) CO-CHAIRPERSONS- The Commission shall select 2 Co-Chairpersons from among its members. (8757)

(c) Duties of the Commission- (8758)

(1) IN GENERAL- The Commission shall-- (8759)

(A) conduct comprehensive oversight of a newly established key national indicators system consistent with the purpose described in this subsection; (8760)

(B) make recommendations on how to improve the key national indicators system; (8761)

(C) coordinate with Federal Government users and information providers to assure access to relevant and quality data; and (8762)

(D) enter into contracts with the Academy. (8763)

(2) REPORTS- (8764)

(A) ANNUAL REPORT TO CONGRESS- Not later than 1 year after the selection of the 2 Co-Chairpersons of the Commission, and each subsequent year thereafter, the Commission shall prepare and submit to the appropriate Committees of Congress and the President a report that contains a detailed statement of the recommendations, findings, and conclusions of the Commission on the activities of the Academy and a designated Institute related to the establishment of a Key National Indicator System. (8765)

(B) ANNUAL REPORT TO THE ACADEMY- (8766)

(i) IN GENERAL- Not later than 6 months after the selection of the 2 Co-Chairpersons of the Commission, and each subsequent year thereafter, the Commission shall prepare and submit to the Academy and a designated Institute a report making recommendations concerning potential issue areas and key indicators to be included in the Key National Indicators. (8767)

(ii) LIMITATION- The Commission shall not have the authority to direct the Academy or, if established, the Institute, to adopt, modify, or delete any key indicators. (8768)

(3) CONTRACT WITH THE NATIONAL ACADEMY OF SCIENCES- (8769)

(A) IN GENERAL- -As soon as practicable after the selection of the 2 Co-Chairpersons of the Commission, the Co-Chairpersons shall enter into an arrangement with the National Academy of Sciences under which the Academy shall-- (8770)

(i) review available public and private sector research on the selection of a set of key national indicators; (8771)

(ii) determine how best to establish a key national indicator system for the United States, by either creating its own institutional capability or designating an independent private nonprofit organization as an Institute to implement a key national indicator system; (8772)

(iii) if the Academy designates an independent Institute under clause (ii), provide scientific and technical advice to the Institute and create an appropriate governance mechanism that balances Academy involvement and the independence of the Institute; and (8773)

(iv) provide an annual report to the Commission addressing scientific and technical issues related to the key national indicator system and, if established, the Institute, and governance of the Institute"s budget and operations. (8774)

(B) PARTICIPATION- In executing the arrangement under subparagraph (A), the National Academy of Sciences shall convene a multi-sector, multi-disciplinary process to define major scientific and technical issues associated with developing, maintaining, and evolving a Key National Indicator System and, if an Institute is established, to provide it with scientific and technical advice. (8775)

(C) ESTABLISHMENT OF A KEY NATIONAL INDICATOR SYSTEM- (8776)

(i) IN GENERAL- In executing the arrangement under subparagraph (A), the National Academy of Sciences shall enable the establishment of a key national indicator system by-- (8777)

(I) creating its own institutional capability; or (8778)

(II) partnering with an independent private nonprofit organization as an Institute to implement a key national indicator system. (8779)

(ii) INSTITUTE- If the Academy designates an Institute under clause (i)(II), such Institute shall be a non-profit entity (as defined for purposes of section 501(c)(3) of the Internal Revenue Code of 1986) with an educational mission, a governance structure that emphasizes independence, and characteristics that make such entity appropriate for establishing a key national indicator system. (8780)

(iii) RESPONSIBILITIES- Either the Academy or the Institute designated under clause (i)(II) shall be responsible for the following: (8781)

(I) Identifying and selecting issue areas to be represented by the key national indicators. (8782)

(II) Identifying and selecting the measures used for key national indicators within the issue areas under subclause (I). (8783)

(III) Identifying and selecting data to populate the key national indicators described under subclause (II). (8784)

(IV) Designing, publishing, and maintaining a public website that contains a freely accessible database allowing public access to the key national indicators. (8785)

(V) Developing a quality assurance framework to ensure rigorous and independent processes and the selection of quality data. (8786)

(VI) Developing a budget for the construction and management of a sustainable, adaptable, and evolving key national indicator system that reflects all Commission funding of Academy and, if an Institute is established, Institute activities. (8787)

(VII) Reporting annually to the Commission regarding its selection of issue areas, key indicators, data, and progress toward establishing a web-accessible database. (8788)

(VIII) Responding directly to the Commission in response to any Commission recommendations and to the Academy regarding any inquiries by the Academy. (8789)

(iv) GOVERNANCE- Upon the establishment of a key national indicator system, the Academy shall create an appropriate governance mechanism that incorporates advisory and control functions. If an Institute is designated under clause (i)(II), the governance mechanism shall balance appropriate Academy involvement and the independence of the Institute. (8790)

(v) MODIFICATION AND CHANGES- The Academy shall retain the sole discretion, at any time, to alter its approach to the establishment of a key national indicator system or, if an Institute is designated under clause (i)(II), to alter any aspect of its relationship with the Institute or to designate a different non-profit entity to serve as the Institute. (8791)

(vi) CONSTRUCTION- Nothing in this section shall be construed to limit the ability of the Academy or the Institute designated under clause (i)(II) to receive private funding for activities related to the establishment of a key national indicator system. (8792)

(D) ANNUAL REPORT- As part of the arrangement under subparagraph (A), the National Academy of Sciences shall, not later than 270 days after the date of enactment of this Act, and annually thereafter, submit to the Co-Chairpersons of the Commission a report that contains the findings and recommendations of the Academy. (8793)

(d) Government Accountability Office Study and Report- (8794)

(1) GAO STUDY- The Comptroller General of the United States shall conduct a study of previous work conducted by all public agencies, private organizations, or foreign countries with respect to best practices for a key national indicator system. The study shall be submitted to the appropriate authorizing committees of Congress. (8795)

(2) GAO FINANCIAL AUDIT- If an Institute is established under this section, the Comptroller General shall conduct an annual audit of the financial statements of the Institute, in accordance with generally accepted government auditing standards and submit a report on such audit to the Commission and the appropriate authorizing committees of Congress. (8796)

(3) GAO PROGRAMMATIC REVIEW- The Comptroller General of the United States shall conduct programmatic assessments of the Institute established under this section as determined necessary by the Comptroller General and report the findings to the Commission and to the appropriate authorizing committees of Congress. (8797)

(e) Authorization of Appropriations- (8798)

(1) IN GENERAL- -There are authorized to be appropriated to carry out the purposes of this section, $10,000,000 for fiscal year 2010, and $7,500,000 for each of fiscal year 2011 through 2018. (8799)

(2) AVAILABILITY- -Amounts appropriated under paragraph (1) shall remain available until expended. (8800)

  

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