I 

108TH CONGRESS 

1ST SESSION H. R. 3668

To amend the Public Health Service Act to provide greater access for residents of frontier areas to health care services provided by community 

health centers. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 8, 2003

Mr. CARSON of Oklahoma introduced the following bill; which was referred to 

the Committee on Energy and Commerce 

A BILL

To amend the Public Health Service Act to provide greater 

access for residents of frontier areas to health care services provided by community health centers.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Frontier Health Care 

5 Access Act of 2003’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

7 (a) FINDINGS.—The Congress finds as follows: 
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1 (1) People who live in frontier areas are medi2 cally underserved and face unique challenges in ac3 cessing affordable health care. 

4 (2) People who live in frontier areas are more 

5 likely to lack health insurance than other rural and 

6 urban citizens. 

7 (3) Frontier areas generally do not have popu8 lation centers that can support the full range of 

9 health care services available in most urban and 

10 some rural areas. 

11 (4) Community health centers play an impor12 tant role in providing health services to many medi13 cally underserved areas and populations. 

14 (5) Many frontier areas do not have community 

15 health centers. 

16 (6) Many frontier areas cannot currently qual17 ify for community health centers because the Fed18 eral definition of medically underserved areas or 

19 populations does not appropriately or effectively rec20 ognize the unique nature and needs of frontier areas 

21 and those who live in them. 

22 (7) Any definition of frontier areas for purposes 

23 of eligibility for Federal or State health care pro24 grams should look beyond simple measures of popu25 lation density to consider such factors as the dis-
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1 tance from and travel time to the nearest significant 

2 health care service center or market. 

3 (8) People who live in frontier areas should be 

4 included explicitly in this expansion of the commu5 nity health center program. 

6 (b) PURPOSE.—It is the purpose of this Act to pro7 vide greater access for residents of frontier areas to the 

8 health care services provided by community health centers. 

9 SEC. 3. FRONTIER COMMUNITY HEALTH CENTERS. 

10 Section 330 of the Public Health Service Act (42 

11 U.S.C. 254b) is amended—

12 (1) in subsection (a)(1), by striking ‘‘and resi13 dents of public housing’’ and inserting ‘‘residents of 

14 public housing, or residents of frontier areas’’; and 

15 (2) by inserting after subsection (r) the fol16 lowing: 

17 ‘‘(s) RESIDENTS OF FRONTIER AREAS.—

18 ‘‘(1) IN GENERAL.—The Secretary may award 

19 grants for the purposes described in subsections (c), 

20 (e), and (f) for the planning and delivery of services 

21 to a special medically underserved population com22 prised of residents of a frontier area. 

23 ‘‘(2) SUPPLEMENT NOT SUPPLANT.—A grant 

24 awarded under this subsection shall be expended to 

25 supplement, and not supplant, the expenditures of 
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1 the health center involved and the value of in-kind 

2 contributions for the delivery of services to the popu3 lation described in paragraph (1). 

4 ‘‘(3) DEFINITION.—

5 ‘‘(A) IN GENERAL.—In this subsection, the 

6 term ‘frontier area’ means a county or a ration7 al area identified by the Secretary, in consulta8 tion with appropriate State offices of rural 

9 health, as meeting the definition developed by 

10 the Secretary under subparagraph (B). 

11 ‘‘(B) REGULATIONS.—The Secretary shall 

12 through regulations develop a definition of a 

13 frontier area for purposes of this subsection. In 

14 developing such definition, the Secretary shall 

15 consider factors such as population density, dis16 tance in miles from the nearest significant 

17 health care service center or market, and travel 

18 time in minutes from the nearest significant 

19 health care service center or market.’’.

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