2000
<PRE>[DOCID: f:s1281is.txt]






107th CONGRESS
  1st Session
                                S. 1281

 To amend the Public Health Service Act to reauthorize and strengthen 
 the health centers program and the National Health Service Corps, and 
 to establish the Healthy Communities Access Program, which will help 
 coordinate services for the uninsured and underinsured, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 31, 2001

Mr. Kennedy (for himself and Mr. Frist) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to reauthorize and strengthen 
 the health centers program and the National Health Service Corps, and 
 to establish the Healthy Communities Access Program, which will help 
 coordinate services for the uninsured and underinsured, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Health Care Safety 
Net Amendments of 2001''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
         TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS

Sec. 101. Health centers.
                         TITLE II--RURAL HEALTH

   Subtitle A--Rural Health Services Outreach, Rural Health Network 
 Development, and Small Health Care Provider Quality Improvement Grant 
                                Programs

Sec. 201. Grant programs.
               Subtitle B--Telehealth Grant Consolidation

Sec. 211. Short title.
Sec. 212. Consolidation and reauthorization of provisions.
            TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM

Sec. 301. National Health Service Corps.
Sec. 302. Designation of health professional shortage areas.
Sec. 303. Assignment of corps personnel.
Sec. 304. Priorities in assignment of Corps personnel.
Sec. 305. Cost-sharing.
Sec. 306. Eligibility for Federal funds.
Sec. 307. Facilitation of effective provision of Corps services.
Sec. 308. Authorization of appropriations.
Sec. 309. National Health Service Corps Scholarship Program.
Sec. 310. National Health Service Corps Loan Repayment Program.
Sec. 311. Obligated service.
Sec. 312. Private practice.
Sec. 313. Breach of scholarship contract or loan repayment contract.
Sec. 314. Authorization of appropriations.
Sec. 315. Grants to States for loan repayment programs.
Sec. 316. Demonstration grants to States for community scholarship 
                            programs.
Sec. 317. Demonstration project.
            TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM ACT

Sec. 401. Purpose.
Sec. 402. Creation of Healthy Communities Access Program.
                     TITLE V--RURAL HEALTH CLINICS

Sec. 501. Exemptions for rural health clinics.
                    TITLE VI--CONFORMING AMENDMENTS

Sec. 601. Conforming amendments.

         TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS

SEC. 101. HEALTH CENTERS.

    Section 330 of the Public Health Service Act (42 U.S.C. 254b) is 
amended--
            (1) in subsection (b)(1)(A)--
                    (A) in clause (i)(III)(bb), by striking ``screening 
                for breast and cervical cancer'' and inserting 
                ``appropriate cancer screening'';
                    (B) in clause (ii), by inserting ``(including 
                specialty referral when medically indicated)'' after 
                ``medical services''; and
                    (C) in clause (iii), by inserting ``housing,'' 
                after ``social,'';
            (2) in subsection (b)(2)--
                    (A) in subparagraph (A)--
                            (i) in clause (vi), by striking ``and'';
                            (ii) by redesignating clause (vii) as 
                        clause (x); and
                            (iii) by inserting after clause (vi) the 
                        following:
                            ``(vii) the detection and alleviation of 
                        chemical and pesticide exposures;
                            ``(viii) the promotion of indoor and 
                        outdoor air quality;
                            ``(ix) the detection and remediation of 
                        lead exposures; and'';
            (B) by redesignating subparagraphs (A) and (B) as 
        subparagraphs (D) and (E), respectively; and
            (C) by inserting before subparagraph (D) (as redesignated 
        by subparagraph (B)) the following:
                    ``(A) behavioral and mental health and substance 
                abuse services;
                    ``(B) recuperative care services;
                    ``(C) public health services;'';
            (3) in subsection (c)(1)--
                    (A) in subparagraph (B)--
                            (i) in the heading, by striking 
                        ``Comprehensive service delivery'' and 
                        inserting ``Managed care'';
                            (ii) in the matter preceding clause (i), by 
                        striking ``network or plan'' and all that 
                        follows to the period and inserting ``managed 
                        care network or plan''; and
                            (iii) in the matter following clause (ii), 
                        by striking ``Any such grant may include'' and 
                        all that follows through the period; and
                    (B) by adding at the end the following:
                    ``(C) Practice management networks.--The Secretary 
                may make grants to health centers that receive 
                assistance under this section to enable the centers to 
                plan and develop practice management networks that will 
                enable the centers to--
                            ``(i) reduce costs associated with the 
                        provision of health care services;
                            ``(ii) improve access to, and availability 
                        of, health care services provided to 
                        individuals served by the centers;
                            ``(iii) enhance the quality and 
                        coordination of health care services; or
                            ``(iv) improve the health status of 
                        communities.
                    ``(D) Use of funds.--The activities for which a 
                grant may be made under subparagraph (B) or (C) of this 
                paragraph may include the purchase or lease of 
                equipment, which may include data and information 
                systems (including the costs of amortizing the 
                principal of, and paying the interest on, loans for 
                equipment), the provision of training and technical 
                assistance related to the provision of health 
services on a prepaid basis or under another managed care arrangement, 
and other activities that promote the development of practice 
management or managed care networks and plans.'';
            (4) in subsection (d)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (B)--
                                    (I) in clause (i), by striking 
                                ``or'';
                                    (II) in clause (ii), by striking 
                                the period and inserting ``; or''; and
                                    (III) by adding at the end the 
                                following:
                            ``(iii) to refinance a loan to the center 
                        or centers, 
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if the Secretary determines that--
                                    ``(I) such refinancing will result 
                                in more favorable terms;
                                    ``(II) the savings resulting from 
                                the refinancing will be beneficial to 
                                both the center (or centers) and the 
                                Government; and
                                    ``(III) the center (or centers) can 
                                demonstrate an ability to repay the 
                                refinanced loan equal to or greater 
                                than the ability of the center (or 
                                centers) to repay the original loan, on 
                                the date the original loan was made.''; 
                                and
                            (ii) by adding at the end the following:
                    ``(D) Loan guarantees.--Notwithstanding any other 
                provision of law, the following funds shall be made 
                available until expended for loan guarantees under this 
                subsection:
                            ``(i) Funds appropriated for fiscal year 
                        1997 under the Departments of Labor, Health and 
                        Human Services, and Education, and Related 
                        Agencies Appropriations Act, 1997, which were 
                        made available for loan guarantees for loans 
                        made by non-Federal lenders for construction, 
                        renovation, and modernization of buildings or 
                        medical facilities that are owned and operated 
                        by health centers and for loan guarantees for 
                        loans to health centers for the costs of 
                        developing and operating managed care networks 
                        or plans and which have not been expended.
                            ``(ii) Funds appropriated for fiscal year 
                        1998 under the Departments of Labor, Health and 
                        Human Services, and Education, and Related 
                        Agencies Appropriations Act, 1998, which were 
                        made available for loan guarantees for loans 
                        made by non-Federal lenders for the 
                        construction, renovation, and modernization of 
                        buildings and for loan guarantees for loans for 
                        health centers.
                    ``(E) Provision directly to networks or plans.--At 
                the request of health centers receiving assistance 
                under this section, loan guarantees provided under this 
                paragraph may be made directly to networks or plans at 
                least majority controlled and, as applicable, at least 
                majority owned by those health centers.
                    ``(F) Federal credit reform.--The requirements of 
                the Federal Credit Reform Act of 1990 (2 U.S.C. 661 et 
                seq.) shall apply with respect to loans refinanced 
                under subparagraph (B)(iii).''; and
                    (B) by striking paragraphs (6) and (7) and 
                redesignating paragraph (8) as paragraph (6);
            (5) in subsection (e)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (B), by striking 
                        ``subsection (j)(3)'' and inserting 
                        ``subsection (k)(3)''; and
                            (ii) by adding at the end the following:
                    ``(C) Operation of networks and plans.--The 
                Secretary may make grants to health centers that 
                receive assistance under this section, or at the 
                request of the health center or centers, directly to a 
                network or plan (as described in subparagraphs (B) and 
                (C) of subsection (c)(1)) that is at least majority 
                controlled and, as applicable, at least majority owned 
                by such health center or centers receiving assistance 
                under this section, for the costs associated with the 
                operation of such network or plan, including the 
                purchase or lease of equipment (including the costs of 
                amortizing the principal of, and paying the interest 
                on, loans for equipment).''; and
                    (B) in paragraph (5)--
                            (i) in subparagraph (A), by inserting 
                        ``subparagraphs (A) and (B) of'' after ``any 
                        fiscal year under'';
                            (ii) by redesignating subparagraphs (B) and 
                        (C) as subparagraphs (C) and (D), respectively; 
                        and
                            (iii) by inserting after subparagraph (A) 
                        the following:
                    ``(B) Networks and plans.--The total amount of 
                grant funds made available for any fiscal year under 
                paragraph (1)(C) and subparagraphs (B) and (C) of 
                subsection (c)(1) to a health center or to a network at 
                least majority controlled and as applicable at least 
                majority owned by health centers shall be determined by 
                the Secretary, but may not exceed 2 percent of the 
                total amount appropriated under this section for such 
                fiscal year.'';
            (6) in subsection (h)--
                    (A) in paragraph (1), by striking ``homeless 
                children and children at risk of homelessness'' and 
                inserting ``homeless children and youth and children 
                and youth at risk of homelessness'';
                    (B)(i) by redesignating paragraph (4) as paragraph 
                (5); and
                    (ii) by inserting after paragraph (3) the 
                following:
            ``(4) Temporary continued provision of services to certain 
        former homeless individuals.--If any grantee under subsection 
        (h) has provided services described in this section to a 
        homeless individual, any such grantee may, notwithstanding that 
        the individual is no longer homeless as a result of becoming a 
        resident in permanent housing, expend the grant to continue to 
        provide such services to the individual for not more than 12 
        months.''; and
                    (C) in paragraph (5)(C) (as redesignated by 
                subparagraph (B)), by striking ``and residential 
                treatment'' and inserting ``, harm reduction, 
                outpatient treatment, residential treatment, and 
                rehabilitation'';
            (7) in subsection (j)(3)--
                    (A) in subparagraph (E)--
                            (i) in clause (i), by striking ``plan; or'' 
                        and inserting ``plan; and''; and
                            (ii) by striking clause (ii) and inserting 
                        the following:
                            ``(ii) has or will have a contractual or 
                        other arrangement with the State agency 
                        administering the program under title XXI of 
                        such Act with respect to individuals who are 
                        State children's health insurance program 
                        beneficiaries; or
                            ``(iii) has made or will make every 
                        reasonable effort to enter into such 
                        arrangements under clauses (i) and (ii);'';
                    (B) in subparagraph (G)--
                            (i) in clause (ii), by striking ``; and'' 
                        and inserting ``;'';
                            (ii) by redesignating clause (iii) as 
                  
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      clause (iv); and
                            (iii) inserting after clause (ii) the 
                        following:
                            ``(iii)(I) will assure that no patient is 
                        denied health care services due to an 
                        individual's inability to pay for such 
                        services; and
                            ``(II) will assure that any fees or 
                        payments required by the center for such 
                        services shall be reduced or waived to enable 
                        the center to fulfill the assurance described 
                        in subclause (I); and''; and
                    (C) in subparagraph (H)--
                            (i) in clause (ii), by inserting ``approves 
                        any internal outreach plans for specific 
                        subpopulations served by the center,'' after 
                        ``such services will be provided,''; and
                            (ii) in the matter following clause (iii), 
                        by striking ``or (p)'' and inserting ``or 
                        (q)'';
            (8)(A) by redesignating subsections (j) through (q) as 
        subsections (k) through (r), respectively; and
            (B) by inserting after subsection (i) the following:
    ``(j) Environmental Concerns.--The Secretary may make grants to 
health centers for the purpose of assisting such centers in identifying 
and detecting environmental factors and conditions, and providing 
services, including environmental health services described in 
subsection (b)(2)(D), to reduce the disease burden related to 
environmental factors and exposure of populations to such factors, and 
alleviate environmental conditions that affect the health of 
individuals and communities served by health centers funded under this 
section.'';
            (9) by striking subsection (l) (as redesignated by 
        paragraph (8)(A)) and inserting the following:
    ``(l) Technical Assistance.--The Secretary shall establish a 
program through which the Secretary shall provide technical and other 
assistance to eligible entities to assist such entities to meet the 
requirements of subsection (k)(2). Services provided through the 
program may include necessary technical and nonfinancial assistance, 
including fiscal and program management assistance, training in program 
management, operational and administrative support, and the provision 
of information to the entities of the variety of resources available 
under this title and how those resources can be best used to meet the 
health needs of the communities served by the entities.'';
            (10) in subsection (m) (as redesignated by paragraph 
        (8)(A))--
                    (A) in paragraph (1), by striking ``$802,124,000'' 
                and all that follows to the period and inserting 
                ``$1,369,000,000 for fiscal year 2002 and such sums as 
                may be necessary for each of the fiscal years 2003 
                through 2006''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (A)--
                                    (I) by striking ``(j)(3))'' and 
                                inserting ``(k)(3))''; and
                                    (II) by striking ``(j)(3)(G)(ii)'' 
                                and inserting ``(k)(3)(H)''; and
                            (ii) by striking subparagraph (B) and 
                        inserting the following:
                    ``(B) Distribution of grants.--For fiscal year 2002 
                and each of the following fiscal years, the Secretary, 
                in awarding grants under this section, shall ensure 
                that the proportion of the amounts made available under 
                each of subsections (g), (h), and (i), relative to the 
                total amount appropriated to carry out this section for 
                that fiscal year, is equal to the proportion of the 
                amounts made available under that subsection for fiscal 
                year 2001, relative to the total amount appropriated to 
                carry out this section for fiscal year 2001.'';
            (11) in subsection (q), by striking ``(j)(3)(G)'' and 
        inserting ``(k)(3)(G)''; and
            (12) by adding at the end the following:
    ``(r) Linguistic Access Grants.--
            ``(1) In general.--The Administrator of the Health 
        Resources and Services Administration (referred to in this 
        subsection as the `Administrator') may award grants to eligible 
        health centers to provide translation, interpretation, and 
        other such services for clients of the centers for whom English 
        is a second language.
            ``(2) Eligible health center.--The term `eligible health 
        center' means an entity that--
                    ``(A) is a health center as defined under 
                subsection (a); and
                    ``(B) provides health services for clients for whom 
                English is a second language.
            ``(3) Grant amount.--The amount of a grant awarded to a 
        center under this subsection shall be determined by the 
        Administrator. Such determination of such amount shall be based 
        on the number of clients for whom English is a second language 
        that is served by such center, and larger grant amounts shall 
        be awarded to centers serving a larger number of such clients.
            ``(4) Use of funds.--An eligible health center that 
        receives a grant under this subsection may use funds received 
        through such grant to--
                    ``(A) provide translation and interpretation 
                services for clients for whom English is a second 
                language, including hiring professional translation and 
                interpretation services; and
                    ``(B) compensate bilingual or multilingual staff 
                for language assistance services provided by the staff 
                for such clients.
            ``(5) Application.--An eligible health center desiring a 
        grant under this subsection shall submit an application to the 
        Administrator at such time, in such manner, and containing such 
        information as the Administrator may reasonably require, 
        including--
                    ``(A) an estimate of the number of clients that the 
                center serves for whom English is a second language;
                    ``(B) the ratio of the number of clients for whom 
                English is a second language to the total number of 
                clients served by the center; and
                    ``(C) a description of any language-assisting 
                services that the center proposes to provide to aid 
                clients for whom English is a second language.
            ``(6) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection, in addition to 
        any funds authorized to be appropriated or appropriated for 
        health centers under this section, $10,000,000 for fiscal year 
        2002, and such sums as may be necessary for each of fiscal 
        years 2003 through 2006.''.

                         TITLE II--RURAL HEALTH

   Subtitle A--Rural Health Services Outreach, Rural Health Network 
 Development, and Small Health Care Provider Quality Improvement Grant 
                                Programs

SEC. 201. GRANT PROGRAMS.

    Section 330A of the Public Health Service Act (42 U.S.C. 254c) is 
amended to read as follows:

``SEC. 330A. RURAL HEALTH SERVICES OUTREACH, RURAL HEALTH NETWORK 
              DEVELOPMENT, AND SMALL HEALTH CARE PROVIDER QUALITY 
              IMPROVEMENT GRANT PROGRAMS.

    ``(a) Purpose.--The purpose of this section is to provide grants 
for expanded delivery of health services in rural areas, for the 
planning and implementation of integrated health care networks in rural
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areas, and for the planning and implementation of small health care 
provider quality improvement activities.
    ``(b) Definitions.--
            ``(1) Director.--The term `Director' means the Director 
        specified in subsection (d).
            ``(2) Federally qualified health center; rural health 
        clinic.--The terms `Federally qualified health center' and 
        `rural health clinic' have the meanings given the terms in 
        section 1861(aa) of the Social Security Act (42 U.S.C. 
        1395x(aa)).
            ``(3) Health professional shortage area.--The term `health 
        professional shortage area' means a health professional 
        shortage area designated under section 332.
            ``(4) Medically underserved community.--The term `medically 
        underserved community' has the meaning given the term 
        `medically underserved area' in section 799B.
            ``(5) Medically underserved population.--The term 
        `medically underserved population' has the meaning given the 
        term in section 330(b)(3).
    ``(c) Program.--The Secretary shall establish, under section 301, a 
small health care provider quality improvement grant program.
    ``(d) Administration.--
            ``(1) Programs.--The rural health services outreach, rural 
        health network development, and small health care provider 
        quality improvement grant programs established under section 
        301 shall be administered by the Director of the Office of 
        Rural Health Policy of the Health Resources and Services 
        Administration, in consultation with State offices of rural 
        health or other appropriate State government entities.
            ``(2) Grants.--
                    ``(A) In general.--In carrying out the programs 
                described in paragraph (1), the Director may award 
                grants under subsections (e), (f), and (g) to expand 
                access to, coordinate, and improve the quality of 
                essential health services, and enhance the delivery of 
                health care, in rural areas.
                    ``(B) Types of grants.--The Director may award the 
                grants--
                            ``(i) to promote expanded delivery of 
                        health services in rural areas under subsection 
                        (e);
                            ``(ii) to provide for the planning and 
                        implementation of integrated health care 
                        networks in rural areas under subsection (f); 
                        and
                            ``(iii) to provide for the planning and 
                        implementation of small health care provider 
                        quality improvement activities under subsection 
                        (g).
    ``(e) Rural Health Services Outreach Grants.--
            ``(1) Grants.--The Director may award grants to eligible 
        entities to promote rural health services outreach by expanding 
        the delivery of health services to include new and enhanced 
        services in rural areas. The Director may award the grants for 
        periods of not more than 3 years.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        this subsection for a project, an entity--
                    ``(A) shall be a rural public or rural nonprofit 
                private entity;
                    ``(B) shall represent a consortium composed of 
                members--
                            ``(i) that include 3 or more health care 
                        providers or providers of services; and
                            ``(ii) that may be nonprofit or for-profit 
                        entities; and
                    ``(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.
            ``(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 
        Secretary an application, at such time, in such manner, and 
        containing such information as the Secretary may require, 
        including--
                    ``(A) a description of the project that the 
                applicant will carry out using the funds provided under 
                the grant;
                    ``(B) a description of the manner in which the 
                project funded under the grant will meet the health 
                care needs of rural underserved populations in the 
                local community or region to be served;
                    ``(C) a description of how the local community or 
                region to be served will be involved in the development 
                and ongoing operations of the project;
                    ``(D) a plan for sustainability of the project 
                after Federal support for the project has ended; and
                    ``(E) a description of how the project will be 
                evaluated.
    ``(f) Rural Health Network Development Grants.--
            ``(1) Grants.--
                    ``(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--
                            ``(i) achieve efficiencies;
                            ``(ii) expand access to, coordinate, and 
                        improve the quality of essential health 
                        services; and
                            ``(iii) strengthen the rural health care 
                        system as a whole.
                    ``(B) Grant periods.--The Director may award such a 
                rural health network development grant for 
                implementation activities for a period of 3 years. The 
                Director may also award such a rural health network 
                development grant for planning activities for a period 
                of 1 year, to assist in the 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.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        this subsection, an entity--
                    ``(A) shall be a rural public or rural nonprofit 
                private entity;
                    ``(B) shall represent a network composed of 
                members--
                            ``(i) that include 3 or more health care 
                        providers or providers of services; and
                            ``(ii) that may be nonprofit or for-profit 
                        entities; and
                    ``(C) shall not previously have received a grant 
                under this subsection (other than a grant for planning 
                activities) for the same or a similar project.
            ``(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 
        Secretary an application, at such time, in such manner, and 
        containing such information as the Secretary may require, 
        including--
                    ``(A) a description of the project that the 
                applicant will carry out using the funds provided
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 under 
                the grant;
                    ``(B) an explanation of the reasons why Federal 
                assistance is required to carry out the project;
                    ``(C) a description of--
                            ``(i) the history of collaborative 
                        activities carried out by the participants in 
                        the network;
                            ``(ii) the degree to which the participants 
                        are ready to integrate their functions; and
                            ``(iii) how the local community or region 
                        to be served will benefit from and be involved 
                        in the activities carried out by the network;
                    ``(D) a description of how the local community or 
                region to be served will experience increased access to 
                quality health services across the continuum of care as 
                a result of the integration activities carried out by 
                the network;
                    ``(E) a plan for sustainability of the project 
                after Federal support for the project has ended; and
                    ``(F) a description of how the project will be 
                evaluated.
    ``(g) Small Health Care Provider Quality Improvement Grants.--
            ``(1) Grants.--The Director may award grants to provide for 
        the planning and implementation of small health care provider 
        quality improvement activities. The Director may award the 
        grants for periods of 1 to 3 years.
            ``(2) Eligibility.--In order to be eligible for a grant 
        under this subsection, an entity--
                    ``(A)(i) shall be a rural public or rural nonprofit 
                private health care provider or provider of health 
                services, such as a critical access hospital or a rural 
                health clinic; or
                    ``(ii) shall be another rural provider or network 
                of small rural providers identified by the Secretary as 
                a key source of local care; and
                    ``(B) shall not previously have received a grant 
                under this subsection for the same or a similar 
                project.
            ``(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, another 
        appropriate State entity, or a hospital association, shall 
        prepare and submit to the Secretary an application, at such 
        time, in such manner, and containing such information as the 
        Secretary may require, including--
                    ``(A) a description of the project that the 
                applicant will carry out using the funds provided under 
                the grant;
                    ``(B) an explanation of the reasons why Federal 
                assistance is required to carry out the project;
                    ``(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;
                    ``(D) a description of how the local community or 
                region to be served will experience increased access to 
                quality health services across the continuum of care as 
                a result of the activities carried out by the entity;
                    ``(E) a plan for sustainability of the project 
                after Federal support for the project has ended; and
                    ``(F) a description of how the project will be 
                evaluated.
            ``(4) Expenditures for small health care provider quality 
        improvement grants.--In awarding a grant under this subsection, 
        the Director shall ensure that the funds made available through 
        the grant will be used to provide services to residents of 
        rural areas. The Director shall award not less than 50 percent 
        of the funds made available under this subsection to providers 
        located in and serving rural areas.
    ``(h) General Requirements.--
            ``(1) Prohibited uses of funds.--An entity that receives a 
        grant under this section may not use funds provided through the 
        grant--
                    ``(A) to build or acquire real property; or
                    ``(B) for construction, except that such funds may 
                be expended for minor renovations relating to the 
                installation of equipment.
            ``(2) Coordination with other agencies.--The Secretary 
        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.
            ``(3) Preference.--In awarding grants under this section, 
        the Secretary shall give preference to entities that--
                    ``(A) are located in health professional shortage 
                areas or medically underserved communities, or serve 
                medically underserved populations; or
                    ``(B) propose to develop projects with a focus on 
                primary care, and wellness and prevention strategies.
    ``(i) Report.--Not later than September 30, 2005, 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 (e), (f), and (g).
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $40,000,000 for fiscal year 
2002, and such sums as may be necessary for each of fiscal years 2003 
through 2006.''.

               Subtitle B--Telehealth Grant Consolidation

SEC. 211. SHORT TITLE.

    This subtitle may be cited as the ``Telehealth Grant Consolidation 
Act of 2001''.

SEC. 212. 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 by adding at the end the following:

``SEC. 330I. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS GRANT 
              PROGRAMS.

    ``(a) Definitions.--In this section:
            ``(1) Director; office.--The terms `Director' and `Office' 
        mean the Director and Office specified in subsection (c).
            ``(2) Federally qualified health center and rural health 
        clinic.--The term `Federally qualified health center' and 
        `rural health clinic' have the meanings given the terms in 
        section 1861(aa) of the Social Security Act (42 U.S.C. 
        1395x(aa)).
            ``(3) Frontier community.--The term `frontier community' 
        means a community that has a population of less than 6 per 
        square mile.
            ``(4) Medically underserved area.--The term `medically 
        underserved area' has the meaning given the term in section 
        799B.
            ``(5) Medically underserved population.--The term 
        `medically underserved population' has the meaning given the 
        term in section 330(b)(3).
            ``(6) Telehealth services.--The term `telehealth services' 
        means services provided through telehealth technologies.
            ``(7) Telehealth technologies.--The term `telehealth 
        technologies' means technologies relating to the use of 
        electronic information, and telecommunications technologies, to 
        support and promote, at a distance, health care, patient and 
        professional health-related education, health administration, 
        and public health.
    ``(b) Programs.--The Secretary shall establish, under section 301, 
telehealth network and telehealth resource centers grant programs.
    ``(c) Administration.--
 
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           ``(1) Establishment.--There is established in the Health 
        and Resources and Services Administration an Office for the 
        Advancement of Telehealth. The Office shall be headed by a 
        Director.
            ``(2) Duties.--The telehealth network and telehealth 
        resource centers grant programs established under section 301 
        shall be administered by the Director, in consultation with the 
        State offices of rural health, State offices concerning primary 
        care, or other appropriate State government entities.
    ``(d) Grants.--
            ``(1) Telehealth network grants.--The Director may, in 
        carrying out the telehealth network grant program referred to 
        in subsection (b), award grants to eligible entities for 
        projects to demonstrate how telehealth technologies can be used 
        through telehealth networks in rural areas, frontier 
        communities, and medically underserved areas, and for medically 
        underserved populations, to--
                    ``(A) expand access to, coordinate, and improve the 
                quality of health services;
                    ``(B) improve and expand the training of health 
                care providers; and
                    ``(C) expand and improve the quality of health 
                information available to health care providers, and 
                patients and their families, for decisionmaking.
            ``(2) Telehealth resource centers grants.--The Director 
        may, in carrying out the telehealth resource center grant 
        program referred to in subsection (b), award grants to eligible 
        entities for projects to demonstrate how telehealth 
        technologies can be used in the areas and communities, and for 
        the populations, described in paragraph (1), to establish 
        telehealth resource centers.
    ``(e) Grant Periods.--The Director may provide grants under this 
section for periods of not more than 4 years.
    ``(f) Eligible Entities.--
            ``(1) Telehealth network grants.--
                    ``(A) Grant recipient.--To be eligible to receive a 
                grant under subsection (d)(1), an entity shall be a 
                nonprofit entity.
                    ``(B) Telehealth networks.--
                            ``(i) In general.--To be eligible to 
                        receive a grant under subsection (d)(1), an 
                        entity shall demonstrate that the entity will 
                        provide services through a telehealth network.
                            ``(ii) Nature of entities.--Each entity 
                        participating in the telehealth network may be 
                        a nonprofit or for-profit entity.
                            ``(iii) Composition of network.--The 
                        telehealth network shall include at least 2 of 
                        the following entities (at least 1 of which 
                        shall be a community-based health care 
                        provider):
                                    ``(I) Community or migrant health 
                                centers or other Federally qualified 
                                health centers.
                                    ``(II) Health care providers, 
                                including pharmacists, in private 
                                practice.
                                    ``(III) Entities operating clinics, 
                                including rural health clinics.
                                    ``(IV) Local health departments.
                                    ``(V) Nonprofit hospitals, 
                                including community access hospitals.
                                    ``(VI) Other publicly funded health 
                                or social service agencies.
                                    ``(VII) Long-term care providers.
                                    ``(VIII) Providers of health care 
                                services in the home.
                                    ``(IX) Providers of outpatient 
                                mental health services and entities 
                                operating outpatient mental health 
                                facilities.
                                    ``(X) Local or regional emergency 
                                health care providers.
                                    ``(XI) Institutions of higher 
                                education.
                                    ``(XII) Entities operating dental 
                                clinics.
            ``(2) Telehealth resource centers grants.--To be eligible 
        to receive a grant under subsection (d)(2), an entity shall be 
        a nonprofit entity.
    ``(g) Applications.--To be eligible to receive a grant under 
subsection (d), an eligible entity, in consultation with the 
appropriate State office of rural health or another appropriate State 
entity, shall prepare and submit to the Secretary an application, at 
such time, in such manner, and containing such information as the 
Secretary may require, including--
            ``(1) a description of the project that the applicant will 
        carry out using the funds provided under the grant;
            ``(2) a description of the manner in which the project 
        funded under the grant will meet the health care needs of rural 
        or other populations to be served through the project, or 
        improve the access to services of, and the quality of the 
        services received by, those populations;
            ``(3) evidence of local support for the project, and a 
        description of how the areas, communities, or populations to be 
        served will be involved in the development and ongoing 
        operations of the project;
            ``(4) a plan for sustainability of the project after 
        Federal support for the project has ended;
            ``(5) information on the source and amount of non-Federal 
        funds that the entity will provide for the project;
            ``(6) information demonstrating the long-term viability of 
        the project, and other evidence of institutional commitment of 
        the entity to the project; and
            ``(7) in the case of an application for a project involving 
        a telehealth network, information demonstrating how the project 
        will promote the integration of telehealth technologies into 
        the operations of health care providers, to avoid redundancy, 
        and improve access to and the quality of care.
    ``(h) Terms; Conditions; Maximum Amount of Assistance.--The 
Secretary shall establish the terms and conditions of each grant 
program described in subsection (b) and the maximum amount of a grant 
to be awarded to an individual recipient for each fiscal year under 
this section. The Secretary shall publish, in a publication of the 
Health Resources and Services Administration, notice of the application 
requirements for each grant program described in subsection (b) for 
each fiscal year.
    ``(i) Preferences.--
            ``(1) Telehealth networks.--In awarding grants under 
        subsection (d)(1) for projects involving telehealth networks, 
        the Secretary shall give preference to an applicant that meets 
        at least 1 of the following requirements:
                    ``(A) Organization.-- The applicant is a rural 
                community-based organization or another community-based 
                organization.
                    ``(B) Services.--The applicant proposes to use 
                Federal funds made available through such a grant to 
                develop plans for, or to establish, telehealth networks 
                that provide mental health, public health, long-term 
                care, home care, preventive, or case management 
                services.
                    ``(C) Coordination.--The applicant demonstrates how 
                the project to be carried
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 out under the grant will be 
                coordinated with other relevant federally funded 
                projects in the areas, communities, and populations to 
                be served through the grant.
                    ``(D) Network.--The applicant demonstrates that the 
                project involves a telehealth network that includes an 
                entity that--
                            ``(i) provides clinical health care 
                        services, or educational services for health 
                        care providers and for patients or their 
                        families; and
                            ``(ii) is--
                                    ``(I) a public school;
                                    ``(II) a public library;
                                    ``(III) an institution of higher 
                                education; or
                                    ``(IV) a local government entity.
                    ``(E) Connectivity.--The applicant proposes a 
                project that promotes local connectivity within areas, 
                communities, or populations to be served through the 
                project.
                    ``(F) Integration.--The applicant demonstrates that 
                health care information has been integrated into the 
                project.
            ``(2) Telehealth resource centers.--In awarding grants 
        under subsection (d)(2) for projects involving telehealth 
        resource centers, the Secretary shall give preference to an 
        applicant that meets at least 1 of the following requirements:
                    ``(A) Provision of services.--The applicant has a 
                record of success in the provision of telehealth 
                services to medically underserved areas or medically 
                underserved populations.
                    ``(B) Collaboration and sharing of expertise.--The 
                applicant has a demonstrated record of collaborating 
                and sharing expertise with providers of telehealth 
                services at the national, regional, State, and local 
                levels.
                    ``(C) Broad range of telehealth services.--The 
                applicant has a record of providing a broad range of 
                telehealth services, which may include--
                            ``(i) a variety of clinical specialty 
                        services;
                            ``(ii) patient or family education;
                            ``(iii) health care professional education; 
                        and
                            ``(iv) rural residency support programs.
    ``(j) Distribution of Funds.--
            ``(1) In general.--In awarding grants under this section, 
        the Director shall ensure, to the greatest extent possible, 
        that such grants are equitably distributed among the 
        geographical regions of the United States.
            ``(2) Telehealth networks.--In awarding grants under 
        subsection (d)(1) for a fiscal year, the Director shall ensure 
        that--
                    ``(A) not less than 50 percent of the funds awarded 
                shall be awarded for projects in rural areas; and
                    ``(B) the total amount of funds awarded for such 
                projects for that fiscal year shall be not less than 
                the total amount of funds awarded for such projects for 
                fiscal year 2001 under section 330A (as in effect on 
                the day before the date of enactment of the Health Care 
                Safety Net Amendments of 2001).
    ``(k) Use of Funds.--
            ``(1) Telehealth network program.--The recipient of a grant 
        under subsection (d)(1) may use funds received through such 
        grant for salaries, equipment, and operating or other costs, 
        including the cost of--
                    ``(A) developing and delivering clinical telehealth 
                services that enhance access to community-based health 
                care services in rural areas, frontier communities, or 
                medically underserved areas, or for medically 
                underserved populations;
                    ``(B) developing and acquiring, through lease or 
                purchase, computer hardware and software, audio and 
                video equipment, computer network equipment, 
                interactive equipment, data terminal equipment, and 
                other equipment that furthers the objectives of the 
                telehealth network grant program;
                    ``(C)(i) developing and providing distance 
                education, in a manner that enhances access to care in 
                rural areas, frontier communities, or medically 
                underserved areas, or for medically underserved 
                populations; or
                    ``(ii) mentoring, precepting, or supervising health 
                care providers and students seeking to become health 
                care providers, in a manner that enhances access to 
                care in the areas and communities, or for the 
                populations, described in clause (i);
                    ``(D) developing and acquiring instructional 
                programming;
                    ``(E)(i) providing for transmission of medical 
                data, and maintenance of equipment; and
                    ``(ii) providing for compensation (including travel 
                expenses) of specialists, and referring health care 
                providers, providing telehealth services through the 
                telehealth network, if no third party payment is 
                available for the telehealth services delivered through 
                the telehealth network;
                    ``(F) developing projects to use telehealth 
                technology to facilitate collaboration between health 
                care providers;
                    ``(G) collecting and analyzing usage statistics and 
                data to document the cost-effectiveness of the 
                telehealth services; and
                    ``(H) carrying out such other activities as are 
                consistent with achieving the objectives of this 
                section, as determined by the Secretary.
            ``(2) Telehealth resource centers.--The recipient of a 
        grant under subsection (d)(2) may use funds received through 
        such grant for salaries, equipment, and operating or other 
        costs for--
                    ``(A) providing technical assistance, training, and 
                support, and providing for travel expenses, for health 
                care providers and a range of health care entities that 
                provide or will provide telehealth services;
                    ``(B) disseminating information and research 
                findings related to telehealth services;
                    ``(C) promoting effective collaboration among 
                telehealth resource centers and the Office;
                    ``(D) conducting evaluations to determine the best 
                utilization of telehealth technologies to meet health 
                care needs;
                    ``(E) promoting the integration of the technologies 
                used in clinical information systems with other 
                telehealth technologies;
                    ``(F) fostering the use of telehealth technologies 
                to provide health care information and education for 
                health care providers and consumers in a more effective 
                manner; and
                    ``(G) implementing special projects or studies 
                under the direction of the Office.
    ``(l) Prohibited Uses of Funds.--An entity that receives a grant 
under this section may not use funds made available through the grant--
            ``(1) to acquire real property;
            ``(2) for expenditures to purchase or lease equipment, t
2000
o 
        the extent that the expenditures would exceed 40 percent of the 
        total grant funds;
            ``(3) in the case of a project involving a telehealth 
        network, to purchase or install transmission equipment (such as 
        laying cable or telephone lines, or purchasing or installing 
        microwave towers, satellite dishes, amplifiers, or digital 
        switching equipment), except on the premises of an entity 
        participating in the telehealth network;
            ``(4) to pay for any equipment or transmission costs not 
        directly related to the purposes for which the grant is 
        awarded;
            ``(5) to purchase or install general purpose voice 
        telephone systems;
            ``(6) for construction, except that such funds may be 
        expended for minor renovations relating to the installation of 
        equipment; or
            ``(7) for expenditures for indirect costs (as determined by 
        the Secretary), to the extent that the expenditures would 
        exceed 20 percent of the total grant funds.
    ``(m) Collaboration.--In providing services under this section, an 
eligible entity shall collaborate, if feasible, with entities that--
            ``(1)(A) are private or public organizations, that receive 
        Federal or State assistance; or
            ``(B) public or private entities that operate centers, or 
        carry out programs, that receive Federal or State assistance; 
        and
            ``(2) provide telehealth services or related activities.
    ``(n) Coordination With Other Agencies.--The Secretary shall 
coordinate activities carried out under grant programs described in 
subsection (b), to the extent practicable, with Federal and State 
agencies and nonprofit organizations that are operating similar 
programs, to maximize the effect of public dollars in funding 
meritorious proposals.
    ``(o) Outreach Activities.--The Secretary shall establish and 
implement procedures to carry out outreach activities to advise 
potential end users of telehealth services in rural areas, frontier 
communities, medically underserved areas, and medically underserved 
populations in each State about the grant programs described in 
subsection (b).
    ``(p) Telehealth.--It is the sense of Congress that, for purposes 
of this section, States should develop reciprocity agreements so that a 
provider of services under this section who is a licensed or otherwise 
authorized health care provider under the law of 1 or more States, and 
who, through telehealth technology, consults with a licensed or 
otherwise authorized health care provider in another State, is exempt, 
with respect to such consultation, from any State law of the other 
State that prohibits such consultation on the basis that the first 
health care provider is not a licensed or authorized health care 
provider under the law of that State.
    ``(q) Report.--Not later than September 30, 2005, 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 subsection (b).
    ``(r) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section--
            ``(1) for grants under subsection (d)(1), $40,000,000 for 
        fiscal year 2002, and such sums as may be necessary for each of 
        fiscal years 2003 through 2006; and
            ``(2) for grants under subsection (d)(2), $20,000,000 for 
        fiscal year 2002, and such sums as may be necessary for each of 
        fiscal years 2003 through 2006.

``SEC. 330J. TELEHOMECARE DEMONSTRATION PROJECT.

    ``(a) Definitions.--In this section:
            ``(1) Distant site.--The term `distant site' means a site 
        at which a certified home care provider is located at the time 
        at which a health service (including a health care item) is 
        provided through a telecommunications system.
            ``(2) Telehomecare.--The term `telehomecare' means the 
        provision of health services through technology relating to the 
        use of electronic information, or through telemedicine or 
        telecommunication technology, to support and promote, at a 
        distant site, the monitoring and management of home health 
        services for a resident of a rural area.
    ``(b) Establishment.--Not later than 9 months after the date of 
enactment of the Health Care Safety Net Amendments of 2001, the 
Secretary may establish and carry out a telehomecare demonstration 
project.
    ``(c) Grants.--In carrying out the demonstration project referred 
to in subsection (b), the Secretary shall make not more than 5 grants 
to eligible certified home care providers, individually or as part of a 
network of home health agencies, for the provision of telehomecare to 
improve patient care, prevent health care complications, improve 
patient outcomes, and achieve efficiencies in the delivery of care to 
patients who reside in rural areas.
    ``(d) Periods.--The Secretary shall make the grants for periods of 
not more than 3 years.
    ``(e) Applications.--To be eligible to receive a grant under this 
section, a certified home care provider shall submit an application to 
the Secretary at such time, in such manner, and containing such 
information as the Secretary may require.
    ``(f) Use of Funds.--A provider that receives a grant under this 
section shall use the funds made available through the grant to carry 
out objectives that include--
            ``(1) improving access to care for home care patients 
        served by home health care agencies, improving the quality of 
        that care, increasing patient satisfaction with that care, and 
        reducing the cost of that care through direct 
        telecommunications links that connect the provider with 
        information networks;
            ``(2) developing effective care management practices and 
        educational curricula to train home care registered nurses and 
        increase their general level of competency through that 
        training; and
            ``(3) developing curricula to train health care 
        professionals, particularly registered nurses, serving home 
        care agencies in the use of telecommunications.
    ``(g) Coverage.--Nothing in this section shall be construed to 
supercede or modify the provisions relating to exclusion of coverage 
under section 1862(a) of the Social Security Act (42 U.S.C 1395y(a)), 
or the provisions relating to the amount payable to a home health 
agency under section 1895 of that Act (42 U.S.C. 1395fff).
    ``(h) Report.--
            ``(1) Interim report.--The Secretary shall submit to 
        Congress an interim report describing the results of the 
        demonstration project.
            ``(2) Final report.--Not later than 6 months after the end 
        of the last grant period for a grant made under this section, 
        the Secretary shall submit to Congress a final report--
                    ``(A) describing the results of the demonstration 
                project; and
                    ``(B) including an evaluation of the impact of the 
                use of telehomecare, including telemedicine and 
                telecommunications, on--
                            ``(i) access to care for home care 
                        patients; and
                            ``(ii) the quality of, patient satisfaction 
                        with, and the cost of, that care.
    ``(i) 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 2002 through 2006.''.

            TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM

SEC. 301. NATIONAL HEALTH SERVICE CORPS.

    Section 331 of the Public Health Service Act (42 U.S.C. 254d) is 
amended--
            (1) by adding at the end of subsection (a)(3) the 
        following:
            ``(E) The term `graduate programs of behavioral and mental 
        health' means programs that train health service ps
2000
ychologists, 
        licensed clinical social workers, licensed professional 
        counselors, marriage and family therapists, psychiatric nurse 
        specialists, and psychiatrists.'';
            (2) in subsection (b)--
                    (A) in paragraph (1), by striking ``health 
                professions,'' and inserting ``health professions, 
                including schools at which graduate programs of 
                behavioral and mental health are offered,''; and
                    (B) in paragraph (2), by inserting ``behavioral and 
                mental health professionals,'' after ``dentists,''; and
            (3) by striking subsection (c) and inserting the following:
    ``(c)(1) The Secretary may reimburse an applicant for a position in 
the Corps (including an individual considering entering into a written 
agreement pursuant to section 338D) for actual and reasonable expenses 
incurred in traveling to and from the applicant's place of residence to 
an eligible site to which the applicant may be assigned under section 
333 for the purpose of evaluating such site with regard to being 
assigned at such site. The Secretary may establish a maximum total 
amount that may be paid to an individual as reimbursement for such 
expenses.
    ``(2) The Secretary may also reimburse the actual and reasonable 
expenses incurred for the travel of 1 family member to accompany the 
applicant to such site. The Secretary may establish a maximum total 
amount that may be paid to an individual as reimbursement for such 
expenses.
    ``(3) In the case of an individual who has entered into a contract 
for obligated service under the Scholarship Program or under the Loan 
Repayment Program, the Secretary may reimburse such individual for all 
or part of the actual and reasonable expenses incurred in transporting 
the individual, the individual's family, and the family's possessions 
to the individual's assignment under section 333. The Secretary may 
establish a maximum total amount that may be paid to an individual as 
reimbursement for such expenses.''.

SEC. 302. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS.

    (a) In General.--Section 332 of the Public Health Service Act (42 
U.S.C. 254e) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)(C), by striking ``determines 
                has such a shortage.'' and inserting ``determines has 
                such a shortage. All Federally qualified health centers 
                and rural health clinics, as defined by section 
                1861(aa) of the Social Security Act, that meet the 
                requirements of section 334 shall be automatically 
                designated, on the date of enactment of the Health Care 
                Safety Net Amendments of 2001, as having such a 
                shortage. Not later than 3 years after such date of 
                enactment, and every 3 years thereafter, each such 
                center or clinic shall demonstrate that the center or 
                clinic meets the applicable requirements of any Federal 
                regulation, issued after the date of enactment of this 
                Act, that revises the definition of a health 
                professional shortage area for purposes of this 
                section.''; and
                    (B) in paragraph (3), by striking ``340(r)'' and 
                inserting ``330(h)(4), seasonal and migratory 
                agricultural workers (as defined in section 330(g)(3)), 
                and residents of public housing (as defined in section 
                3(b)(1) of the United States Housing Act of 1937)'';
            (2) in subsection (b)(2), by striking ``with special 
        consideration to the indicators of'' and all that follows 
        through ``services.''; and
            (3) in subsection (c)(2)(B), by striking ``XVIII or XIX'' 
        and inserting ``XVIII, XIX, or XXI''.
    (b) Regulations.--
            (1) Report.--
                    (A) In general.--The Secretary shall submit the 
                report described in subparagraph (B) if the Secretary, 
                acting through the Administrator of the Health 
                Resources and Services Administration, issues--
                            (i) a regulation that revises the 
                        definition of a health professional shortage 
                        area for purposes of section 332 of the Public 
                        Health Service Act (42 U.S.C. 254e); or
                            (ii) a regulation that revises the 
                        standards concerning priority of such an area 
                        under section 333A of that Act (42 U.S.C. 254f-
                        1).
                    (B) Report.--On issuing a regulation described in 
                subparagraph (A), the Secretary shall prepare and 
                submit to the Committee on Energy and Commerce of the 
                House of Representatives and the Committee on Health, 
                Education, Labor, and Pensions of the Senate a report 
                that describes the regulation.
            (2) Effective date.--Each regulation described in paragraph 
        (1)(A) shall take effect 180 days after the committees 
        described in paragraph (1)(B) receive a report referred to in 
        paragraph (1)(B) describing the regulation.

SEC. 303. ASSIGNMENT OF CORPS PERSONNEL.

    Section 333 of the Public Health Service Act (42 U.S.C. 254f) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)--
                            (i) in the matter before subparagraph (A), 
                        by striking ``(specified in the agreement 
                        described in section 334)'';
                            (ii) in subparagraph (A), by striking 
                        ``nonprofit''; and
                            (iii) by striking subparagraph (C) and 
                        inserting the following:
                    ``(C) the entity agrees to comply with the 
                requirements of section 334; and''; and
                    (B) in paragraph (3), by adding at the end ``In 
                approving such applications, the Secretary shall give 
                preference to applications in which a nonprofit entity 
                or public entity shall serve as a placement site.''; 
                and
            (2) in subsection (d)--
                    (A) in paragraphs (1), (2), and (4), by striking 
                ``nonprofit'' each place it appears; and
                    (B) in paragraph (1)--
                            (i) in the first sentence, by striking 
                        ``may'' and inserting ``shall'';
                            (ii) in the second sentence--
                                    (I) in subparagraph (C), by 
                                striking ``and'' at the end; and
                                    (II) by striking the period and 
                                inserting ``, and (E) developing long-
                                term plans for addressing health 
                                professional shortages and improving 
                                access to health care.''; and
                            (iii) by adding at the end the following: 
                        ``The Secretary shall encourage entities that 
                        receive technical assistance under this 
                        paragraph to communicate with other 
                        communities, State Offices of Rural Health, 
                        State Primary Care Associations and Offices, 
                        and other entities concerned with site 
                        development and community needs assessment.''.

SEC. 304. PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL.

    Section 333A of the Public Health Service Act (42 U.S.C. 254f-1) is 
amended--
            (1) by striking subsection (b);
            (2) in subsection (d)--
                    (A) by redesignating paragraphs (1
2000
) through (3) as 
                paragraphs (2) through (4), respectively;
                    (B) by inserting before paragraph (2) (as 
                redesignated by subparagraph (A)) the following:
            ``(1) Proposed list.--The Secretary shall prepare and 
        publish a proposed list of health professional shortage areas 
        and entities that would receive priority under subsection 
        (a)(1) in the assignment of Corps members. The list shall 
        contain the information described in paragraph (2), and the 
        relative scores and relative priorities of the entities 
        submitting applications under section 333, in a proposed 
        format. All entities that have submitted applications under 
        section 333 shall have 30 days after the date of publication of 
        the list to provide additional data and information in support 
        of inclusion on the list or in support of a higher priority 
        determination and the Secretary shall reasonably consider such 
        data and information in preparing the final list under 
        paragraph (2).'';
                    (C) in paragraph (2) (as redesignated by 
                subparagraph (A)), in the matter before subparagraph 
                (A)--
                            (i) by striking ``paragraph (2)'' and 
                        inserting ``paragraph (3)'';
                            (ii) by striking ``prepare a list of health 
                        professional shortage areas'' and inserting 
                        ``prepare and, as appropriate, update a list of 
                        health professional shortage areas and 
                        entities''; and
                            (iii) by striking ``for the period 
                        applicable under subsection (f)'';
                    (D) by striking paragraph (3) (as redesignated by 
                subparagraph (A)) and inserting the following:
            ``(3) Notification of affected parties.--
                    ``(A) Entities.--Not later than 30 days after the 
                Secretary has added to a list under paragraph (2) an 
                entity specified as described in subparagraph (A) of 
                such paragraph, the Secretary shall notify such entity 
                that the entity has been provided an authorization to 
                receive assignments of Corps members in the event that 
                Corps members are available for the assignments.
                    ``(B) Individuals.--In the case of an individual 
                obligated to provide service under the Scholarship 
                Program, not later than 3 months before the date 
                described in section 338C(b)(5), the Secretary shall 
                provide to such individual the names of each of the 
                entities specified as described in paragraph (2)(B)(i) 
                that is appropriate for the individual's medical 
                specialty and discipline.''; and
                    (E) by striking paragraph (4) (as redesignated by 
                subparagraph (A)) and inserting the following:
            ``(4) Revisions.--If the Secretary proposes to make a 
        revision in the list under paragraph (2), and the revision 
        would adversely alter the status of an entity with respect to 
        the list, the Secretary shall notify the entity of the 
        revision. Any entity adversely affected by such a revision 
        shall be notified in writing by the Secretary of the reasons 
        for the revision and shall have 30 days to file a written 
        appeal of the determination involved which shall be reasonably 
        considered by the Secretary before the revision to the list 
        becomes final. The revision to the list shall be effective with 
        respect to assignment of Corps members beginning on the date 
        that the revision becomes final.'';
            (3) by striking subsection (e) and inserting the following:
    ``(e) Limitation on Number of Entities Offered as Assignment 
Choices in Scholarship Program.--
            ``(1) Determination of available corps members.--By April 1 
        of each calendar year, the Secretary shall determine the number 
        of participants in the Scholarship Program who will be 
        available for assignments under section 333 during the program 
        year beginning on July 1 of that calendar year.
            ``(2) Determination of number of entities.--At all times 
        during a program year, the number of entities specified under 
        subsection (c)(2)(B)(i) shall be--
                    ``(A) not less than the number of participants 
                identified with respect to that program year in 
                paragraph (1); and
                    ``(B) not greater than twice the number of 
                participants identified with respect to that program 
                year in paragraph (1).'';
            (4) by striking subsection (f); and
            (5) by redesignating subsections (c), (d), and (e) as 
        subsections (b), (c), and (d) respectively.

SEC. 305. COST-SHARING.

    Subpart II of part D of title III of the Public Health Service Act 
(42 U.S.C. 254d et seq.) is amended by striking section 334 and 
inserting the following:

``SEC. 334. CHARGES FOR SERVICES BY ENTITIES USING CORPS MEMBERS.

    ``(a) Availability of Services Regardless of Ability To Pay or 
Payment Source.--An entity to which a Corps member is assigned shall 
not deny requested health services, and shall not discriminate in the 
provision of services to an individual--
            ``(1) because the individual is unable to pay for the 
        services; or
            ``(2) because payment for the services would be made 
        under--
                    ``(A) the medicare program under title XVIII of the 
                Social Security Act;
                    ``(B) a medicaid plan under title XIX of such Act; 
                or
                    ``(C) the State children's health insurance program 
                under title XXI of such Act.
    ``(b) Charges for Services.--The following rules shall apply to 
charges for services provided by an entity to which a Corps member is 
assigned:
            ``(1) In general.--Except as provided in paragraphs (2) and 
        (3), the entity shall charge the usual and customary rate for 
        such services that is prevailing in the area in which the 
        services are provided.
            ``(2) Services to beneficiaries of federal and federally-
        assisted programs.--In the case of health services furnished to 
        an individual who is a beneficiary of a program or plan listed 
        in subsection (a)(2), the entity--
                    ``(A) shall accept an assignment pursuant to 
                section 1842(b)(3)(B)(ii) of the Social Security Act 
                with respect to an individual who is a medicare 
                beneficiary; and
                    ``(B) shall enter into an appropriate agreement 
                with--
                            ``(i) the State agency administering the 
                        program under title XIX of such Act with 
                        respect to individuals who are medicaid 
                        beneficiaries; and
                            ``(ii) the State agency administering the 
                        program under title XXI of such Act with 
                        respect to individuals who are State children's 
                        health insurance program beneficiaries.
            ``(3) Individuals unable to pay.--In the case of health 
        services furnished to an individual who is unable, as 
        determined under regulations promulgated by the Secretary, to 
        pay the charge assessed in accordance with paragraph (1), the 
        entity shall, as prescribed by such regulations, waive or 
        reduce such charges.
            ``(4) Collection of payments.--The entity shall take 
        reasonable and appropriate steps to collect all payments due 
        f
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or health services provided by the entity, including payments 
        from any third party (including a Federal, State, or local 
        government agency and any other third party) that is 
        responsible for part or all of the charge for such services.''.

SEC. 306. ELIGIBILITY FOR FEDERAL FUNDS.

    Section 335(e)(1)(B) of the Public Health Service Act (42 U.S.C. 
254h(e)(1)(B)) is amended by striking ``XVIII or XIX'' and inserting 
``XVIII, XIX, or XXI''.

SEC. 307. FACILITATION OF EFFECTIVE PROVISION OF CORPS SERVICES.

    Section 336 of the Public Health Service Act (42 U.S.C. 254h-1) is 
amended--
            (1) in subsection (c), by striking ``health manpower'' and 
        inserting ``health professional''; and
            (2) in subsection (f)(1), by striking ``health manpower'' 
        and inserting ``health professional''.

SEC. 308. AUTHORIZATION OF APPROPRIATIONS.

    Section 338(a) of the Public Health Service Act (42 U.S.C. 254k(a)) 
is amended--
            (1) by striking ``(1) For'' and inserting ``For'';
            (2) by striking ``1991 through 2000'' and inserting ``2002 
        through 2006''; and
            (3) by striking paragraph (2).

SEC. 309. NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM.

    Section 338A of the Public Health Service Act (42 U.S.C. 254l) is 
amended--
            (1) in subsection (a)(1), by inserting ``mental and 
        behavioral health professionals,'' after ``dentists,'';
            (2) in subsection (b)(1)(B), by inserting ``, or an 
        appropriate degree from a graduate program in mental and 
        behavioral health'' after ``other health profession'';
            (3) in subsection (c)(1)--
                    (A) in subparagraph (A), by striking ``338D'' and 
                inserting ``338E''; and
                    (B) in subparagraph (B), by striking ``338C'' and 
                inserting ``338D'';
            (4) in subsection (d)(1)--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end;
                    (B) by redesignating subparagraph (B) as 
                subparagraph (C); and
                    (C) by inserting after subparagraph (A) the 
                following:
                    ``(B) the Secretary, in considering applications 
                from individuals accepted for enrollment or enrolled in 
                dental school, shall consider applications from all 
                individuals accepted for enrollment or enrolled in any 
                accredited dental school in a State; and'';
            (5) in subsection (f)--
                    (A) in paragraph (1)(B)--
                            (i) in clause (iii), by striking ``and'' 
                        after the semicolon;
                            (ii) by redesignating clause (iv) as clause 
                        (v); and
                            (iii) by inserting after clause (iii) the 
                        following new clause:
                            ``(iv) if pursuing a degree from a school 
                        of medicine or osteopathic medicine, to 
                        complete a residency in a specialty that the 
                        Secretary determines is consistent with the 
                        needs of the Corps; and''; and
                    (B) in paragraph (3), by striking ``338D'' and 
                inserting ``338E''; and
            (6) by striking subsection (i).

SEC. 310. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM.

    Section 338B of the Public Health Service Act (42 U.S.C. 254l-1) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by inserting ``mental and 
                behavioral health professionals,'' after ``dentists,''; 
                and
                    (B) in paragraph (2), by striking ``(including 
                mental health professionals)'';
            (2) in subsection (b)(1), by striking subparagraph (A) and 
        inserting the following:
            ``(A) have a degree in medicine, osteopathic medicine, 
        dentistry, or other health profession, or an appropriate degree 
        from a graduate program in mental and behavioral health, or be 
        certified as a nurse midwife, nurse practitioner, or physician 
        assistant;'';
            (3) in subsection (e), by striking ``(1) In general.--''; 
        and
            (4) by striking subsection (i).

SEC. 311. OBLIGATED SERVICE.

    Section 338C of the Public Health Service Act (42 U.S.C. 254m) is 
amended--
    (1) in subsection (b)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by striking ``section 
                338A(f)(1)(B)(iv)'' and inserting ``section 
                338A(f)(1)(B)(v)''; and
                    (B) in paragraph (5)--
                            (i) by striking all that precedes 
                        subparagraph (C) and inserting the following:
    ``(5)(A) In the case of the Scholarship Program, the date referred 
to in paragraphs (1) through (4) shall be the date on which the 
individual completes the training required for the degree for which the 
individual receives the scholarship, except that--
            ``(i) for an individual receiving such a degree after 
        September 30, 2000, from a school of medicine or osteopathic 
        medicine, such date shall be the date the individual completes 
        a residency in a specialty that the Secretary determines is 
        consistent with the needs of the Corps; and
            ``(ii) at the request of an individual, the Secretary may, 
        consistent with the needs of the Corps, defer such date until 
        the end of a period of time required for the individual to 
        complete advanced training (including an internship or 
        residency).'';
                            (ii) by striking subparagraph (D);
                            (iii) by redesignating subparagraphs (C) 
                        and (E) as subparagraphs (B) and (C), 
                        respectively; and
                            (iv) in clause (i) of subparagraph (C) (as 
                        redesignated by clause (iii)) by striking 
                        ``subparagraph (A), (B), or (D)'' and inserting 
                        ``subparagraph (A)''; and
            (2) by striking subsection (e).

SEC. 312. PRIVATE PRACTICE.

    Section 338D of the Public Health Service Act (42 U.S.C. 254n) is 
amended by striking subsection (b) and inserting the following:
    ``(b)(1) The written agreement described in subsection (a) shall--
            ``(1) provide that during the period of private practice by 
        an individual pursuant to the agreement that the individual 
        complies with section 334; and
            ``(2) contain such additional provisions as the Secretary 
        may require to carry out the purposes of this section.
    ``(2) The Secretary shall take such action as may be appropriate to 
ensure that the conditions of the written agreement prescribed by this 
subsection are adhered to.''.

SEC. 313. BREACH OF SCHOLARSHIP CONTRACT OR LOAN REPAYMENT CONTRACT.

    (a) In General.--Section 338E of the Public Health Service Act (42 
U.S.C. 254o) is amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (A), by striking the comma and 
                inserting a semicolon;
                    (B) in subparagraph (B), by striking the comma and 
                inserting ``; or'';
                    (C) in subparagraph (C), by striking ``or'' at the 
                end; and
                    (D) by striking subparagraph (D);
            (2) in subsection (b)--
                    (A) in paragraph (1)(A)--
                            (i) by striking ``338F(d)'' and inserting 
                        ``338G(d)'';
                            (ii) by striking ``either'';
                            (iii) by striking ``338D or'' and inserting 
                        ``338D,''; and
                            (iv) by inserting ``or to complete 
2000
a 
                        required residency as specified in section 
                        338A(f)(1)(B)(iv),'' before ``the United 
                        States''; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(3) The Secretary may terminate a contract with an individual 
under section 338A if, not later than 30 days before the end of the 
school year to which the contract pertains, the individual--
            ``(A) submits a written request for such termination; and
            ``(B) repays all amounts paid to, or on behalf of, the 
        individual under section 338A(g).'';
            (3) in subsection (c)--
                    (A) in paragraph (1)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``338F(d)'' and inserting 
                        ``338G(d)''; and
                            (ii) by striking subparagraphs (A) through 
                        (C) and inserting the following:
                    ``(A) the total of the amounts paid by the United 
                States under section 338B(g)(2) on behalf of the 
                individual for any period of obligated service not 
                served;
                    ``(B) an amount equal to the product of the number 
                of months of obligated service that were not completed 
                by the individual, multiplied by $7,500; and
                    ``(C) the interest on the amounts described in 
                subparagraphs (A) and (B), at the maximum legal 
                prevailing rate, as determined by the Treasurer of the 
                United States, from the date of the breach.'';
                    (B) by striking paragraphs (2) and (3) and 
                inserting the following:
    ``(2) The Secretary may terminate a contract with an individual 
under section 338B if, not later than 45 days before the end of the 
fiscal year in which the contract was entered into, the individual--
            ``(A) submits a written request for such termination; and
            ``(B) repays all amounts paid on behalf of the individual 
        under section 338B(g).''; and
                    (C) by redesignating paragraph (4) as paragraph 
                (3);
            (4) in subsection (d)(3)(A), by striking ``only if such 
        discharge is granted after the expiration of the five-year 
        period'' and inserting ``only if such discharge is granted 
        after the expiration of the 7-year period''; and
            (5) by adding at the end the following new subsection:
    ``(e) Notwithstanding any other provision of Federal or State law, 
there shall be no limitation on the period within which suit may be 
filed, a judgment may be enforced, or an action relating to an offset 
or garnishment, or other action, may be initiated or taken by the 
Secretary, the Attorney General, or the head of another Federal agency, 
as the case may be, for the repayment of the amount due from an 
individual under this section.''.
    (b) Effective Date.--The amendment made by subsection (a)(4) shall 
apply to any obligation for which a discharge in bankruptcy has not 
been granted before the date that is 31 days after the date of 
enactment of this Act.

SEC. 314. AUTHORIZATION OF APPROPRIATIONS.

    Section 338H of the Public Health Service Act (42 U.S.C. 254q) is 
amended by striking subsections (a) and (b) and inserting the 
following:
    ``(a) Authorization of Appropriations.--For the purposes of 
carrying out this subpart, there are authorized to be appropriated 
$146,250,000 for fiscal year 2002, and such sums as may be necessary 
for each of the fiscal years 2003 through 2006.
    ``(b) Scholarships for New Participants.--Of the amounts 
appropriated under subsection (a) for a fiscal year, the Secretary 
shall obligate not less than 30 percent for the purpose of providing 
contracts for scholarships under this subpart to individuals who have 
not previously received such scholarships.
    ``(c) Scholarships and Loan Repayments.--With respect to 
certification as a nurse practitioner, nurse midwife, or physician 
assistant, the Secretary shall, from amounts appropriated under 
subsection (a) for a fiscal year, obligate not less than a total of 10 
percent for contracts for both scholarships under the Scholarship 
Program under section 338A and loan repayments under the Loan Repayment 
Program under section 338B to individuals who are entering the first 
year of study or programs described in section 338A(b)(1)(B) that lead 
to such a certification or individuals who are eligible for the loan 
repayment program as outlined in section 338B(b).''.

SEC. 315. GRANTS TO STATES FOR LOAN REPAYMENT PROGRAMS.

    Section 338I of the Public Health Service Act (42 U.S.C. 254q-1) is 
amended--
            (1) in subsection (a), by striking paragraph (1) and 
        inserting the following:
            ``(1) Authority for grants.--The Secretary, acting through 
        the Administrator of the Health Resources and Services 
        Administration may make grants to States for the purpose of 
        assisting the States in operating programs described in 
        paragraph (2) in order to provide for the increased 
        availability of primary health services in health professional 
        shortage areas. The National Advisory Council established under 
        section 337 shall advise the Administrator regarding the 
        program under this section.'';
            (2) in subsection (e), by striking paragraph (1) and 
        inserting the following:
            ``(1) to submit to the Secretary reports regarding their 
        loan repayment program, as determined appropriate by the 
        Secretary; and''; and
            (3) in subsection (i), by striking paragraph (1) and 
        inserting the following:
            ``(1) In general.--For the purpose of making grants under 
        subsection (a), there is authorized to be appropriated 
        $12,000,000 for fiscal year 2002 and such sums as may be 
        necessary for each of the fiscal years 2003 through 2006.''.

SEC. 316. DEMONSTRATION GRANTS TO STATES FOR COMMUNITY SCHOLARSHIP 
              PROGRAMS.

    Subpart III of part D of title III of the Public Health Service Act 
(42 U.S.C. 254l et seq.) is amended by striking section 338L.

SEC. 317. DEMONSTRATION PROJECT.

    (a) Findings.--Congress makes the following findings:
            (1) Chiropractic doctors are skilled at providing a wide 
        range of primary health care services.
            (2) Chiropractic doctors are often the only providers 
        available to provide health care in many rural communities.
    (b) Amendment to PHSA.--Subpart III of part D of title III of the 
Public Health Service Act (42 U.S.C. 254l et seq.) is amended by adding 
at the end the following:

``SEC. 338L. DEMONSTRATION PROJECT.

    ``(a) Program Authorized.--The Secretary shall establish a 
demonstration project to provide for the participation of individuals 
who are seeking a chiropractic degree in the Scholarship Program 
described in section 338A and for the participation of individuals who 
are chiropractic doctors in the Loan Repayment Program described in 
section 338B.
    ``(b) Procedure.--An individual that receives assistance under this 
section with regard to the programs described in sections 338A and 338B 
shall comply with all rules and requirements described in such sections 
in order to receive assistance under this section.
    ``(c) Limitations.--The demonstration project described in 
subsection (a) shall provide for the participation of individuals who 
shall provide services in both rural and urban areas, and shall also 
provide for the participation of enough individuals to allow the 
Secretary to properly analyze the effectiveness of such project.
    ``(d) Report.--The Secretary shall prepare and submit a report 
describing how the project described in subsection (a) has effected 
access to health care, patient satisfaction, and quality of care, 
especially how the project has effec
2000
ted health services in 
traditionally underserved populations, to--
            ``(1) the Committee on Health, Education, Labor, and 
        Pensions of the Senate;
            ``(2) the Subcommittee on Labor, Health and Human Services, 
        and Education of the Committee on Appropriations of the Senate;
            ``(3) the Committee on Energy and Commerce of the House of 
        Representatives; and
            ``(4) the Subcommittee on Labor, Health and Human Services, 
        and Education of the Committee on Appropriations of the House 
        of Representatives.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for the fiscal years 2002 through 2005.''.

            TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM ACT

SEC. 401. PURPOSE.

    The purpose of this title is to provide assistance to communities 
and consortia of health care providers and others, to develop or 
strengthen integrated community health care delivery systems that 
coordinate health services for individuals who are uninsured and 
underinsured and to develop or strengthen activities related to 
providing coordinated care for individuals who are uninsured and 
underinsured with chronic conditions, through the--
            (1) coordination of services to allow individuals to 
        receive efficient and higher quality care and to gain entry 
        into and receive services from a comprehensive system of care;
            (2) development of the infrastructure for a health care 
        delivery system characterized by effective collaboration, 
        information sharing, and clinical and financial coordination 
        among all providers of care in the community; and
            (3) provision of new Federal resources that do not supplant 
        funding for existing Federal categorical programs that support 
        entities providing services to low-income populations.

SEC. 402. CREATION OF HEALTHY COMMUNITIES ACCESS PROGRAM.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by inserting after subpart IV the following 
new subpart:

            ``Subpart V--Healthy Communities Access Program

``SEC. 340. GRANTS TO STRENGTHEN THE EFFECTIVENESS, EFFICIENCY, AND 
              COORDINATION OF SERVICES FOR THE UNINSURED AND 
              UNDERINSURED.

    ``(a) In General.--The Secretary may award grants to eligible 
entities to assist in the development of integrated health care 
delivery systems to serve communities of individuals who are uninsured 
and individuals who are underinsured--
            ``(1) to improve the efficiency and coordination among the 
        providers services through such systems;
            ``(2) to assist communities in developing programs targeted 
        toward preventing and managing chronic diseases; and
            ``(3) to expand and enhance the services provided.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity must be a public or nonprofit entity that--
            ``(1) represents a consortium--
                    ``(A) whose principal purpose is to provide a broad 
                range of coordinated health care services for a 
                community defined in the entity's grant application; 
                and
                    ``(B) that includes health care providers that 
                serve the community and that have traditionally 
                provided care to uninsured and underinsured individuals 
                without regard to the individuals' ability to pay 
                (including federally qualified health centers (as 
                defined in section 1861(aa) of the Social Security Act 
                (42 U.S.C. 1395x(aa))), public hospitals, public health 
                departments, and private health care providers and 
                organizations);
            ``(2) submits to the Secretary an application, in such form 
        and manner as the Secretary shall prescribe, that--
                    ``(A) defines a community of uninsured and 
                underinsured individuals that consists of all such 
                individuals--
                            ``(i) in a specified geographical area, 
                        such as a rural area; or
                            ``(ii) in a specified population within 
                        such an area, such as American Indians, Native 
                        Alaskans, Native Hawaiians, homeless 
                        individuals, migrant and seasonal farmworkers, 
                        individuals with disabilities, and public 
                        housing residents;
                    ``(B) identifies the providers who will participate 
                in the consortium's program under the grant, and 
                specifies each one's contribution to the care of 
                uninsured and underinsured individuals in the 
                community, including the volume of care it provides to 
                medicare, medicaid, and State child health insurance 
                program (SCHIP) beneficiaries and to privately paid 
                patients;
                    ``(C) describes the activities that the applicant 
                and the consortium propose to perform under the grant 
                to further the purposes of this section;
                    ``(D) demonstrates the consortium's ability to 
                build on the current system for serving uninsured and 
                underinsured individuals by involving providers who 
                have traditionally provided a significant volume of 
                care for that community;
                    ``(E) demonstrates the consortium's ability to 
                develop coordinated systems of care that either 
                directly provide or ensure the prompt provision of a 
                broad range of high-quality, accessible services, 
                including, as appropriate, primary, secondary, and 
                tertiary services, as well as substance abuse treatment 
                and mental health services in a manner which assures 
                continuity of care in the community;
                    ``(F) demonstrates the consortium's ability to 
                create comprehensive programs to address the prevention 
                and management of chronic diseases of high importance 
                within their communities where applicable;
                    ``(G) provides evidence of community involvement in 
                the development, implementation, and direction of the 
                program that it proposes to operate;
                    ``(H) demonstrates the consortium's ability to 
                ensure that individuals participating in the program 
                are enrolled in public insurance programs for which 
                they are eligible;
                    ``(I) presents a plan for leveraging other sources 
                of revenue, which may include State and local sources 
                and private grant funds, and integrating current and 
                proposed new funding sources in a way to assure long-
                term sustainability;
                    ``(J) describes a plan for evaluation of the 
                activities carried out under the grant, including 
                measurement of progress toward the goals and objectives 
of the program and the use of evaluation findings to improve program 
performance;
                    ``(K) demonstrates fiscal responsibility through 
                the use of appropriate accounting procedures and 
                appropriate management systems;
                    ``(L) demonstrates the consortium's commitment to 
                serve the community without regard to the ability of 
                the individual or family to pay by arranging for or 
                providing free or reduced charge care for the poor; and
                    ``(M) includes such other information as the 
             
2000
   Secretary may prescribe;
            ``(3) agrees along with each of the participating providers 
        that each one will commit to use grant monies awarded under 
        this section to supplement, not supplant, any other sources of 
        funding available to cover the expenditures (including the 
        value of any in-kind contributions) of the consortium and of 
        its participating providers in carrying out the activities for 
        which the grant would be awarded; and
            ``(4) has established or will establish before the receipt 
        of any grant under this section, a decision-making body that 
        has full and complete authority to determine and oversee all 
        the activities undertaken by the consortium with finds made 
        available through such grant and that includes at least 1 
        representative of each participating provider identified under 
        paragraph (2)(B).
    ``(c) Priorities.--In awarding grants under this section, the 
Secretary--
            ``(1) shall accord priority to applicants that demonstrate 
        the extent of unmet need in the community involved for a more 
        coordinated system of care; and
            ``(2) may accord priority to applicants that best promote 
        the purposes of this section, taking into consideration the 
        extent to which the application involved--
                    ``(A) identifies a community whose geographical 
                area has a high or increasing percentage of individuals 
                who are uninsured;
                    ``(B) includes in its consortium providers, support 
                systems, and programs that have a tradition of serving 
                uninsured individuals and underinsured individuals in 
                the community;
                    ``(C) shows evidence that the program would expand 
                utilization of preventive and primary care services for 
                uninsured and underinsured individuals and families in 
                the community, including mental and behavioral health 
                services, oral health services, or substance abuse 
                services;
                    ``(D) proposes a program that would improve 
                coordination between health care providers and 
                appropriate social service providers, including local 
                and regional human services agencies, school systems, 
                and agencies on aging;
                    ``(E) demonstrates collaboration with State and 
                local governments;
                    ``(F) makes use of non-Federal contributions to the 
                greatest extent possible; or
                    ``(G) demonstrates a likelihood that the proposed 
                program will continue after support under this section 
                ceases.
    ``(d) Use of Funds.--
            ``(1) Use by grantees.--
                    ``(A) In general.--Except as provided in paragraphs 
                (2) and (3), a grantee may use amounts provided under 
                this section only for--
                            ``(i) direct expenses associated with 
                        planning, developing, and operating the greater 
                        integration of a health care delivery system so 
                        that it either directly provides or ensures the 
                        provision of a broad range of services, as 
                        appropriate, including primary, secondary, and 
                        tertiary services, as well as substance abuse 
                        treatment and mental health services; and
                            ``(ii) direct patient care and service 
                        expansions to fill identified or documented 
                        gaps within an integrated delivery system.
                    ``(B) Specific uses.--The following are examples of 
                purposes for which a grantee may use grant funds, when 
                such use meets the conditions stated in subparagraph 
                (A):
                            ``(i) Increase in outreach activities.
                            ``(ii) Improvements to case management.
                            ``(iii) Improvements to coordination of 
                        transportation to health care facilities.
                            ``(iv) Development of provider networks and 
                        other innovative models to engage physicians in 
                        voluntary efforts to serve the medically 
                        underserved within a community.
                            ``(v) Recruitment, training, and 
                        compensation of necessary personnel.
                            ``(vi) Acquisition of technology, such as 
                        telehealth technologies to increase access to 
                        tertiary care.
                            ``(vii) Identifying and closing gaps in 
                        services being provided.
                            ``(viii) Improvements to provider 
                        communication, including implementation of 
                        shared information systems or shared clinical 
                        systems.
                            ``(ix) Development of common processes for 
                        determining eligibility for the programs, 
                        including creating common identification cards 
                        and single `sliding fee' discounts.
                            ``(x) Creation of a triage system to 
                        coordinate referrals and to screen and route 
                        individuals to appropriate locations of 
                        primary, specialty, and inpatient care.
                            ``(xi) Development of specific prevention 
                        and disease management tools and processes, 
                        including--
                                    ``(I) carrying out a protocol or 
                                plan for each individual patient about 
                                what needs to be done, at what 
                                intervals, and by whom;
                                    ``(II) redesigning practice to 
                                incorporate regular patient contact, 
                                collection of critical data on health 
                                and disease status, and strategies to 
meet the educational and psychosocial needs of patients who may need to 
make lifestyle and other changes to manage their disease;
                                    ``(III) the promotion of the 
                                availability of specialized expertise 
                                through the use of--
                                            ``(aa) teams of providers 
                                        with specialized knowledge;
                                            ``(bb) collaborative care 
                                        arrangements;
                                            ``(cc) computer decision 
                                        support services; or
                                            ``(dd) telehealth 
                                        technologies.
                                    ``(IV) providing patient 
                                educational and support tools that are 
                                culturally competent and demonstrate 
                                appropriate health literacy and 
                                literacy requirements; and
                                    ``(V) the collection of data 
                                related to patient care and outcomes.
                            ``(xii) Carrying out other activities that 
                        may be appropriate to a community that would 
                        increase access to the uninsured such as access 
                        initiatives for which private entities provide 
       
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                 non-Federal contributions to supplement the 
                        Federal funds provided through the grants for 
                        the initiatives.
            ``(2) Direct patient care limitation.--No more than 15 
        percent of the funds provided under a grant may be used for 
        providing direct patient care and services.
            ``(3) Reservation of funds for national program purposes.--
        The Secretary may use not more than 3 percent of funds 
        appropriated to carry out this section for technical assistance 
        to grantees, obtaining assistance of experts and consultants, 
        meetings, development of tools, dissemination of information, 
        evaluation, and activities that will extend the benefits of 
        funded programs to communities other than the one funded.
    ``(e) Grantee Requirements.--The recipient of a grant under this 
section shall--
            ``(1) report to the Secretary annually regarding--
                    ``(A) progress in meeting the goals and measurable 
                objectives stated in its grant application; and
                    ``(B) such additional information as the Secretary 
                may require, and the Secretary may not renew an annual 
                grant under this section unless the Secretary is 
                satisfied that the consortium has made reasonable and 
                demonstrable progress in meeting the goals and 
                measurable objectives set forth in its grant 
                application for the preceding year; and
            ``(2) provide for an independent annual financial audit of 
        all records that relate to the disposition of funds received 
        through this grant.
    ``(f) Technical Assistance.--The Secretary may, either directly or 
by grant or contract, provide any funded entity with technical and 
other nonfinancial assistance necessary to meet the requirements of 
this section.
    ``(g) Report.--Not later than September 30, 2005, 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 this section.
    ``(h) 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 fiscal years 2002 through 2006.''.

                     TITLE V--RURAL HEALTH CLINICS

SEC. 501. EXEMPTIONS FOR RURAL HEALTH CLINICS.

    (a) Exemptions From Copayment Requirements.--Section 1128B(b)(3)(D) 
of the Social Security Act (42 U.S.C.1320a-7b(b)(3)(D)) is amended by 
striking ``a Federally qualified health care center'' and inserting ``a 
Federally qualified health center or rural health clinic, as defined in 
section 1861(aa) of the Social Security Act,''.
    (b) Exemptions From Deductible Requirements.--Section 1833(b)(4) of 
the Social Security Act (42 U.S.C. 1395l(b)(4)) is amended by striking 
``such deductible shall not apply to Federally qualified health center 
services,'' and inserting ``such deductible shall not apply to 
Federally qualified health center services or rural health clinic 
services, as defined in section 1861(aa) of the Social Security Act, 
provided to an individual who qualifies for subsidized services under 
the Public Health Service Act,''.

                    TITLE VI--CONFORMING AMENDMENTS

SEC. 601. CONFORMING AMENDMENTS.

    (a) Homeless Programs.--Subsections (g)(1)(G)(ii), (k)(2), and 
(n)(1)(C) of section 224, and sections 317A(a)(2), 317E(c), 318A(e), 
332(a)(2)(C), 340D(c)(5), 799B(6)(B), 1313, and 2652(2) of the Public 
Health Service Act (42 U.S.C. 233, 247b-1(a)(2), 247b-6(c), 247c-1(e), 
254e(a)(2)(C), 256d(c)(5), 295p(6)(B), 300e-12, and 300ff-52(2)) are 
amended by striking ``340'' and inserting ``330(h)''.
    (b) Homeless Individual.--Section 534(2) of the Public Health 
Service Act (42 U.S.C. 290cc-34(2)) is amended by striking ``340(r)'' 
and inserting ``330(h)(5)''.
                                 &lt;all&gt;

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