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US Laws | Affordable Health Care Act (HR3950F)
Subtitle E--Supporting the Existing Health Care Workforce

"(e) Authorization- There is authorized to be appropriated to carry out this section $5,000,000 for each of the fiscal years 2010 through 2014, and such sums as may be necessary for each subsequent fiscal year.". (8259)


Section 821 of the Public Health Service Act (42 U.S.C. 296m) is amended-- (8261)

(1) in subsection (a)-- (8262)

(A) by striking "The Secretary may" and inserting the following: (8263)

"(1) AUTHORITY- The Secretary may"; (8264)

(B) by striking "pre-entry preparation, and retention activities" and inserting the following: "stipends for diploma or associate degree nurses to enter a bridge or degree completion program, student scholarships or stipends for accelerated nursing degree programs, pre-entry preparation, advanced education preparation, and retention activities"; and (8265)

(2) in subsection (b)-- (8266)

(A) by striking "First" and all that follows through "including the" and inserting "National Advisory Council on Nurse Education and Practice and consult with nursing associations including the National Coalition of Ethnic Minority Nurse Associations,"; and (8267)

(B) by inserting before the period the following: ", and other organizations determined appropriate by the Secretary". (8268)


Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 5313, is further amended by adding at the end the following: (8270)


"(a) Establishment, Purpose and Definition- (8272)

"(1) IN GENERAL- The Secretary, acting through the Director of the Agency for Healthcare Research and Quality, shall establish a Primary Care Extension Program. (8273)

"(2) PURPOSE- The Primary Care Extension Program shall provide support and assistance to primary care providers to educate providers about preventive medicine, health promotion, chronic disease management, mental and behavioral health services (including substance abuse prevention and treatment services), and evidence-based and evidence-informed therapies and techniques, in order to enable providers to incorporate such matters into their practice and to improve community health by working with community-based health connectors (referred to in this section as "Health Extension Agents"). (8274)

"(3) DEFINITIONS- In this section: (8275)

"(A) HEALTH EXTENSION AGENT- The term "Health Extension Agent" means any local, community-based health worker who facilitates and provides assistance to primary care practices by implementing quality improvement or system redesign, incorporating the principles of the patient-centered medical home to provide high-quality, effective, efficient, and safe primary care and to provide guidance to patients in culturally and linguistically appropriate ways, and linking practices to diverse health system resources. (8276)

"(B) PRIMARY CARE PROVIDER- The term "primary care provider" means a clinician who provides integrated, accessible health care services and who is accountable for addressing a large majority of personal health care needs, including providing preventive and health promotion services for men, women, and children of all ages, developing a sustained partnership with patients, and practicing in the context of family and community, as recognized by a State licensing or regulatory authority, unless otherwise specified in this section. (8277)

"(b) Grants To Establish State Hubs and Local Primary Care Extension Agencies- (8278)

"(1) GRANTS- The Secretary shall award competitive grants to States for the establishment of State- or multistate-level primary care Primary Care Extension Program State Hubs (referred to in this section as "Hubs"). (8279)

"(2) COMPOSITION OF HUBS- A Hub established by a State pursuant to paragraph (1)-- (8280)

"(A) shall consist of, at a minimum, the State health department, the entity responsible for administering the State Medicaid program (if other than the State health department), the State-level entity administering the Medicare program, and the departments of 1 or more health professions schools in the State that train providers in primary care; and (8281)

"(B) may include entities such as hospital associations, primary care practice-based research networks, health professional societies, State primary care associations, State licensing boards, organizations with a contract with the Secretary under section 1153 of the Social Security Act, consumer groups, and other appropriate entities. (8282)

"(c) State and Local Activities- (8283)

"(1) HUB ACTIVITIES- Hubs established under a grant under subsection (b) shall-- (8284)

"(A) submit to the Secretary a plan to coordinate functions with quality improvement organizations and area health education centers if such entities are members of the Hub not described in subsection (b)(2)(A); (8285)

"(B) contract with a county- or local-level entity that shall serve as the Primary Care Extension Agency to administer the services described in paragraph (2); (8286)

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