# H.R. 3200/Division C/Title V/Subtitle B
## SUBTITLE B — SCHOOL-BASED HEALTH CLINICS
### SEC. 2511. SCHOOL-BASED HEALTH CLINICS.

    (a) In general.—
       Part Q of title III (42 U.S.C. 280h et seq.) is amended by adding at the end the following:
``SEC. 399Z–1. School-based health clinics.
    ``(a) Program.—The Secretary shall establish a school-based health clinic program consisting of awarding grants to eligible entities to support the operation of school-based health clinics (referred to in this section as ‘SBHCs’).
    ``(b) Eligibility.—To be eligible for a grant under this section, an entity shall—
       ``(1) be an SBHC (as defined in subsection (l)(4)); and
       ``(2) submit an application at such time, in such manner, and containing such information as the Secretary may require, including at a minimum—
          ``(A) evidence that the applicant meets all criteria necessary to be designated as an SBHC;
          ``(B) evidence of local need for the services to be provided by the SBHC;
          ``(C) an assurance that—
             ``(i) SBHC services will be provided in accordance with Federal, State, and local laws governing—
                ``(I) obtaining parental or guardian consent; and
                ``(II) patient privacy and student records, including section 264 of the Health Insurance Portability and Accountability Act of 1996 and section 444 of the General Education Provisions Act;
             ``(ii) the SBHC has established and maintains collaborative relationships with other health care providers in the catchment area of the SBHC;
             ``(iii) the SBHC will provide on-site access during the academic day when school is in session and has an established network of support and access to services with backup health providers when the school or SBHC is closed;
             ``(iv) the SBHC will be integrated into the school environment and will coordinate health services with appropriate school personnel and other community providers co-located at the school; and
             ``(v) the SBHC sponsoring facility assumes all responsibility for the SBHC administration, operations, and oversight; and
          ``(D) such other information as the Secretary may require.
    ``(c) Use of funds.—Funds awarded under a grant under this section may be used for—
       ``(1) providing training related to the provision of comprehensive primary health services and additional health services;
       ``(2) the management and operation of SBHC programs; and
       ``(3) the payment of salaries for health professionals and other appropriate SBHC personnel.
    ``(d) Consideration of need.—In determining the amount of a grant under this section, the Secretary shall take into consideration—
       ``(1) the financial need of the SBHC;
       ``(2) State, local, or other sources of funding provided to the SBHC; and
       ``(3) other factors as determined appropriate by the Secretary.
    ``(e) Preferences.—In awarding grants under this section, the Secretary shall give preference to SBHCs that have a demonstrated record of service to the following:
       ``(1) A high percentage of medically underserved children and adolescents.
       ``(2) Communities or populations in which children and adolescents have difficulty accessing health and mental health services.
       ``(3) Communities with high percentages of children and adolescents who are uninsured, underinsured, or eligible for medical assistance under Federal or State health benefits programs (including titles XIX and XXI of the Social Security Act).
    ``(f) Matching requirement.—The Secretary may award a grant to an SBHC only if the SBHC agrees to provide, from non-Federal sources, an amount equal to 20 percent of the amount of the grant (which may be provided in cash or in kind) to carry out the activities supported by the grant.
    ``(g) Supplement, not supplant.—The Secretary may award a grant to an SBHC under this section only if the SBHC demonstrates to the satisfaction of the Secretary that funds received through the grant will be expended only to supplement, and not supplant, non-Federal and Federal funds otherwise available to the SBHC for operation of the SBHC (including each activity described in paragraph (1) or (2) of subsection (c)).
    ``(h) Payor of last resort.—The Secretary may award a grant to an SBHC under this section only if the SBHC demonstrates to the satisfaction of the Secretary that funds received through the grant will not be expended for any activity to the extent that payment has been made, or can reasonably be expected to be made—
       ``(1) under any insurance policy;
       ``(2) under any Federal or State health benefits program (including titles XIX and XXI of the Social Security Act); or
       ``(3) by an entity which provides health services on a prepaid basis.
    ``(i) Regulations regarding reimbursement for health services.—The Secretary shall issue regulations regarding the reimbursement for health services provided by SBHCs to individuals eligible to receive such services through the program under this section, including reimbursement under any insurance policy or any Federal or State health benefits program (including titles XIX and XXI of the Social Security Act).
    ``(j) Technical Assistance.—The Secretary shall provide (either directly or by grant or contract) technical and other assistance to SBHCs to assist such SBHCs to meet the requirements of this section. Such assistance may include fiscal and program management assistance, training in fiscal and program management, operational and administrative support, and the provision of information to the SBHCs 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 SBHCs.
    ``(k) Evaluation; report.—The Secretary shall—
       ``(1) develop and implement a plan for evaluating SBHCs and monitoring quality performances under the awards made under this section; and
       ``(2) submit to the Congress on an annual basis a report on the program under this section.
    ``(l) Definitions.—In this section:
       ``(1) Comprehensive primary health services.—The term ‘comprehensive primary health services’ means the core services offered by SBHCs, which shall include the following:
          ``(A) Physical.—Comprehensive health assessments, diagnosis, and treatment of minor, acute, and chronic medical conditions and referrals to, and follow-up for, specialty care.
          ``(B) Mental health.—Mental health assessments, crisis intervention, counseling, treatment, and referral to a continuum of services including emergency psychiatric care, community support programs, inpatient care, and outpatient programs.
          ``(C) Optional services.—Additional services, which may include oral health, social, and age-appropriate health education services, including nutritional counseling.
       ``(2) Medically underserved children and adolescents.—The term ‘medically underserved children and adolescents’ means a population of children and adolescents who are residents of an area designated by the Secretary as an area with a shortage of personal health services and health infrastructure for such children and adolescents.
       ``(3) School-based health clinic.—The term ‘school-based health clinic’ means a health clinic that—
          ``(A) is located in, or is adjacent to, a school facility of a local educational agency;
          ``(B) is organized through school, community, and health provider relationships;
          ``(C) is administered by a sponsoring facility; and
          ``(D) provides, at a minimum, comprehensive primary health services during school hours to children and adolescents by health professionals in accordance with State and local laws and regulations, established standards, and community practice.
       ``(4) Sponsoring facility.—The term ‘sponsoring facility’ is—
          ``(A) a hospital;
          ``(B) a public health department;
          ``(C) a community health center;
          ``(D) a nonprofit health care agency;
          ``(E) a local educational agency; or
          ``(F) a program administered by the Indian Health Service or the Bureau of Indian Affairs or operated by an Indian tribe or a tribal organization under the Indian Self-Determination and Education Assistance Act, a Native Hawaiian entity, or an urban Indian program under title V of the Indian Health Care Improvement Act.
    ``(m) Authorization of Appropriations.—For purposes of carrying out this section, there are authorized to be appropriated $50,000,000 for fiscal year 2010 and such sums as may be necessary for each of the fiscal years 2011 through 2014.´´.
    (b) Effective date.—
       The Secretary of Health and Human Services shall begin awarding grants under section 399Z–1 of the Public Health Service Act, as added by subsection (b), not later than July 1, 2010, without regard to whether or not final regulations have been issued under section 399Z–1(h) of such Act.