PUBLIC LAW 109–18—JUNE 29, 2005

PATIENT NAVIGATOR OUTREACH AND

CHRONIC DISEASE PREVENTION ACT OF 2005

119 STAT. 340 PUBLIC LAW 109–18—JUNE 29, 2005

Public Law 109–18

109th Congress

An Act

To amend the Public Health Service Act to authorize a demonstration grant program

to provide patient navigator services to reduce barriers and improve health care

outcomes, and for other purposes.

Be it enacted by the Senate and House of Representatives of

the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘‘Patient Navigator Outreach

and Chronic Disease Prevention Act of 2005’’.

SEC. 2. PATIENT NAVIGATOR GRANTS.

Subpart V of part D of title III of the Public Health Service

Act (42 U.S.C. 256) is amended by adding at the end the following:

‘‘SEC. 340A. PATIENT NAVIGATOR GRANTS.

‘‘(a) GRANTS.—The Secretary, acting through the Administrator

of the Health Resources and Services Administration, may make

grants to eligible entities for the development and operation of

demonstration programs to provide patient navigator services to

improve health care outcomes. The Secretary shall coordinate with,

and ensure the participation of, the Indian Health Service, the

National Cancer Institute, the Office of Rural Health Policy, and

such other offices and agencies as deemed appropriate by the Secretary, regarding the design and evaluation of the demonstration

programs.

‘‘(b) USE OF FUNDS.—The Secretary shall require each recipient

of a grant under this section to use the grant to recruit, assign,

train, and employ patient navigators who have direct knowledge

of the communities they serve to facilitate the care of individuals,

including by performing each of the following duties:

‘‘(1) Acting as contacts, including by assisting in the

coordination of health care services and provider referrals, for

individuals who are seeking prevention or early detection services for, or who following a screening or early detection service

are found to have a symptom, abnormal finding, or diagnosis

of, cancer or other chronic disease.

‘‘(2) Facilitating the involvement of community organizations in assisting individuals who are at risk for or who have

cancer or other chronic diseases to receive better access to

high-quality health care services (such as by creating partnerships with patient advocacy groups, charities, health care centers, community hospice centers, other health care providers,

or other organizations in the targeted community).

42 USC 256a.

42 USC 201 note.

Patient

Navigator

Outreach and

Chronic Disease

Prevention Act of

2005.

June 29, 2005

[H.R. 1812]

PUBLIC LAW 109–18—JUNE 29, 2005 119 STAT. 341

‘‘(3) Notifying individuals of clinical trials and, on request,

facilitating enrollment of eligible individuals in these trials.

‘‘(4) Anticipating, identifying, and helping patients to overcome barriers within the health care system to ensure prompt

diagnostic and treatment resolution of an abnormal finding

of cancer or other chronic disease.

‘‘(5) Coordinating with the relevant health insurance

ombudsman programs to provide information to individuals

who are at risk for or who have cancer or other chronic diseases

about health coverage, including private insurance, health care

savings accounts, and other publicly funded programs (such

as Medicare, Medicaid, health programs operated by the

Department of Veterans Affairs or the Department of Defense,

the State children’s health insurance program, and any private

or governmental prescription assistance programs).

‘‘(6) Conducting ongoing outreach to health disparity populations, including the uninsured, rural populations, and other

medically underserved populations, in addition to assisting

other individuals who are at risk for or who have cancer or

other chronic diseases to seek preventative care.

‘‘(c) PROHIBITIONS.—

‘‘(1) REFERRAL FEES.—The Secretary shall require each

recipient of a grant under this section to prohibit any patient

navigator providing services under the grant from accepting

any referral fee, kickback, or other thing of value in return

for referring an individual to a particular health care provider.

‘‘(2) LEGAL FEES AND COSTS.—The Secretary shall prohibit

the use of any grant funds received under this section to pay

any fees or costs resulting from any litigation, arbitration,

mediation, or other proceeding to resolve a legal dispute.

‘‘(d) GRANT PERIOD.—

‘‘(1) IN GENERAL.—Subject to paragraphs (2) and (3), the

Secretary may award grants under this section for periods

of not more than 3 years.

‘‘(2) EXTENSIONS.—Subject to paragraph (3), the Secretary

may extend the period of a grant under this section. Each

such extension shall be for a period of not more than 1 year.

‘‘(3) LIMITATIONS ON GRANT PERIOD.—In carrying out this

section, the Secretary—

‘‘(A) shall ensure that the total period of a grant does

not exceed 4 years; and

‘‘(B) may not authorize any grant period ending after

September 30, 2010.

‘‘(e) APPLICATION.—

‘‘(1) IN GENERAL.—To seek a grant under this section, an

eligible entity shall submit an application to the Secretary

in such form, in such manner, and containing such information

as the Secretary may require.

‘‘(2) CONTENTS.—At a minimum, the Secretary shall require

each such application to outline how the eligible entity will

establish baseline measures and benchmarks that meet the

Secretary’s requirements to evaluate program outcomes.

‘‘(f) UNIFORM BASELINE MEASURES.—The Secretary shall establish uniform baseline measures in order to properly evaluate the

impact of the demonstration projects under this section.

‘‘(g) PREFERENCE.—In making grants under this section, the

Secretary shall give preference to eligible entities that demonstrate

119 STAT. 342 PUBLIC LAW 109–18—JUNE 29, 2005

in their applications plans to utilize patient navigator services

to overcome significant barriers in order to improve health care

outcomes in their respective communities.

‘‘(h) DUPLICATION OF SERVICES.—An eligible entity that is

receiving Federal funds for activities described in subsection (b)

on the date on which the entity submits an application under

subsection (e) may not receive a grant under this section unless

the entity can demonstrate that amounts received under the grant

will be utilized to expand services or provide new services to individuals who would not otherwise be served.

‘‘(i) COORDINATION WITH OTHER PROGRAMS.—The Secretary

shall ensure coordination of the demonstration grant program under

this section with existing authorized programs in order to facilitate

access to high-quality health care services.

‘‘(j) STUDY; REPORTS.— ‘‘(1) FINAL REPORT BY SECRETARY.—Not later than 6 months

after the completion of the demonstration grant program under

this section, the Secretary shall conduct a study of the results

of the program and submit to the Congress a report on such

results that includes the following:

‘‘(A) An evaluation of the program outcomes,

including—

‘‘(i) quantitative analysis of baseline and benchmark measures; and

‘‘(ii) aggregate information about the patients

served and program activities.

‘‘(B) Recommendations on whether patient navigator

programs could be used to improve patient outcomes in

other public health areas.

‘‘(2) INTERIM REPORTS BY SECRETARY.—The Secretary may

provide interim reports to the Congress on the demonstration

grant program under this section at such intervals as the

Secretary determines to be appropriate.

‘‘(3) REPORTS BY GRANTEES.—The Secretary may require

grant recipients under this section to submit interim and final

reports on grant program outcomes.

‘‘(k) RULE OF CONSTRUCTION.—This section shall not be construed to authorize funding for the delivery of health care services

(other than the patient navigator duties listed in subsection (b)).

‘‘(l) DEFINITIONS.—In this section:

‘‘(1) The term ‘eligible entity’ means a public or nonprofit

private health center (including a Federally qualified health

center (as that term is defined in section 1861(aa)(4) of the

Social Security Act)), a health facility operated by or pursuant

to a contract with the Indian Health Service, a hospital, a

cancer center, a rural health clinic, an academic health center,

or a nonprofit entity that enters into a partnership or coordinates referrals with such a center, clinic, facility, or hospital

to provide patient navigator services.

‘‘(2) The term ‘health disparity population’ means a population that, as determined by the Secretary, has a significant

disparity in the overall rate of disease incidence, prevalence,

morbidity, mortality, or survival rates as compared to the

health status of the general population.

‘‘(3) The term ‘patient navigator’ means an individual who

has completed a training program approved by the Secretary

to perform the duties listed in subsection (b).

PUBLIC LAW 109–18—JUNE 29, 2005 119 STAT. 343

LEGISLATIVE HISTORY—H.R. 1812 (S. 898):

HOUSE REPORTS: No. 109–104 (Comm. on Energy and Commerce).

SENATE REPORTS: No. 109–73 accompanying S. 898 (Comm. on Health, Education, Labor, and Pensions).

CONGRESSIONAL RECORD, Vol. 151 (2005):

June 13, considered and passed House.

June 22, considered and passed Senate.

Æ

‘‘(m) AUTHORIZATION OF APPROPRIATIONS.— ‘‘(1) IN GENERAL.—To carry out this section, there are authorized to be appropriated $2,000,000 for fiscal year 2006,

$5,000,000 for fiscal year 2007, $8,000,000 for fiscal year 2008,

$6,500,000 for fiscal year 2009, and $3,500,000 for fiscal year

2010.

‘‘(2) AVAILABILITY.—The amounts appropriated pursuant to

paragraph (1) shall remain available for obligation through

the end of fiscal year 2010.’’.

Approved June 29, 2005.