110TH CONGRESS 

2D SESSION S. 901 

AN ACT 

To amend the Public Health Service Act to reauthorize the 

Community Health Centers program, the National 

Health Service Corps, and rural health care programs. 

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

2 This Act may be cited as the ‘‘Health Care Safety 

3 Net Act of 2008’’. 

4 SEC. 2. COMMUNITY HEALTH CENTERS PROGRAM OF THE 

5 PUBLIC HEALTH SERVICE ACT. 

6 (a) ADDITIONAL AUTHORIZATIONS OF APPROPRIA7 TIONS FOR THE HEALTH CENTERS PROGRAM OF PUBLIC

8 HEALTH SERVICE ACT.—Section 330(r) of the Public 

9 Health Service Act (42 U.S.C. 254b(r)) is amended by 

10 amending paragraph (1) to read as follows: 

11 ‘‘(1) IN GENERAL.—For the purpose of car12 rying out this section, in addition to the amounts 

13 authorized to be appropriated under subsection (d), 

14 there are authorized to be appropriated— 

15 ‘‘(A) $2,065,000,000 for fiscal year 2008; 

16 ‘‘(B) $2,313,000,000 for fiscal year 2009; 

17 ‘‘(C) $2,602,000,000 for fiscal year 2010; 

18 ‘‘(D) $2,940,000,000 for fiscal year 2011; 

19 and 

20 ‘‘(E) $3,337,000,000 for fiscal year 

21 2012.’’. 

22 (b) STUDIES RELATING TO COMMUNITY HEALTH

23 CENTERS.— 

24 (1) DEFINITIONS.—For purposes of this sub25 section— 
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1 (A) the term ‘‘community health center’’ 

2 means a health center receiving assistance 

3 under section 330 of the Public Health Service 

4 Act (42 U.S.C. 254b); and 

5 (B) the term ‘‘medically underserved popu6 lation’’ has the meaning given that term in such 

7 section 330. 

8 (2) SCHOOL-BASED HEALTH CENTER STUDY.— 

9 (A) IN GENERAL.—Not later than 2 years 

10 after the date of enactment of this Act, the 

11 Comptroller General of the United States shall 

12 issue a study of the economic costs and benefits 

13 of school-based health centers and the impact 

14 on the health of students of these centers. 

15 (B) CONTENT.—In conducting the study 

16 under subparagraph (A), the Comptroller Gen17 eral of the United States shall analyze— 

18 (i) the impact that Federal funding 

19 could have on the operation of school-based 

20 health centers; 

21 (ii) any cost savings to other Federal 

22 programs derived from providing health 

23 services in school-based health centers; 

24 (iii) the effect on the Federal Budget 

25 and the health of students of providing 
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1 Federal funds to school-based health cen2 ters and clinics, including the result of pro3 viding disease prevention and nutrition in4 formation; 

5 (iv) the impact of access to health 

6 care from school-based health centers in 

7 rural or underserved areas; and 

8 (v) other sources of Federal funding 

9 for school-based health centers. 

10 (3) HEALTH CARE QUALITY STUDY.— 

11 (A) IN GENERAL.—Not later than 1 year 

12 after the date of enactment of this Act, the Sec13 retary of Health and Human Services (referred 

14 to in this Act as the ‘‘Secretary’’), acting 

15 through the Administrator of the Health Re16 sources and Services Administration, and in col17 laboration with the Agency for Healthcare Re18 search and Quality, shall prepare and submit to 

19 the Committee on Health, Education, Labor, 

20 and Pensions of the Senate and the Committee 

21 on Energy and Commerce of the House of Rep22 resentatives a report that describes agency ef23 forts to expand and accelerate quality improve24 ment activities in community health centers. 
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1 (B) CONTENT.—The report under sub2 paragraph (A) shall focus on— 

3 (i) Federal efforts, as of the date of 

4 enactment of this Act, regarding health 

5 care quality in community health centers, 

6 including quality data collection, analysis, 

7 and reporting requirements; 

8 (ii) identification of effective models 

9 for quality improvement in community 

10 health centers, which may include models 

11 that— 

12 (I) incorporate care coordination, 

13 disease management, and other serv14 ices demonstrated to improve care; 

15 (II) are designed to address mul16 tiple, co-occurring diseases and condi17 tions; 

18 (III) improve access to providers 

19 through non-traditional means, such 

20 as the use of remote monitoring 

21 equipment; 

22 (IV) target various medically un23 derserved populations, including unin24 sured patient populations; 
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1 (V) increase access to specialty 

2 care, including referrals and diag3 nostic testing; and 

4 (VI) enhance the use of electronic 

5 health records to improve quality; 

6 (iii) efforts to determine how effective 

7 quality improvement models may be adapt8 ed for implementation by community 

9 health centers that vary by size, budget, 

10 staffing, services offered, populations 

11 served, and other characteristics deter12 mined appropriate by the Secretary; 

13 (iv) types of technical assistance and 

14 resources provided to community health 

15 centers that may facilitate the implementa16 tion of quality improvement interventions; 

17 (v) proposed or adopted methodologies 

18 for community health center evaluations of 

19 quality improvement interventions, includ20 ing any development of new measures that 

21 are tailored to safety-net, community-based 

22 providers; 

23 (vi) successful strategies for sus24 taining quality improvement interventions 

25 in the long-term; and 
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1 (vii) partnerships with other Federal 

2 agencies and private organizations or net3 works as appropriate, to enhance health 

4 care quality in community health centers. 

5 (C) DISSEMINATION.—The Administrator 

6 of the Health Resources and Services Adminis7 tration shall establish a formal mechanism or 

8 mechanisms for the ongoing dissemination of 

9 agency initiatives, best practices, and other in10 formation that may assist health care quality 

11 improvement efforts in community health cen12 ters. 

13 (4) GAO STUDY ON INTEGRATED HEALTH SYS14 TEMS MODEL FOR THE DELIVERY OF HEALTH CARE

15 SERVICES TO MEDICALLY UNDERSERVED POPU16 LATIONS.— 

17 (A) STUDY.—The Comptroller General of 

18 the United States shall conduct a study on inte19 grated health system models at not more than 

20 10 sites for the delivery of health care services 

21 to medically underserved populations. The study 

22 shall include an examination of— 

23 (i) health care delivery models spon24 sored by public or private non-profit enti25 ties that— 
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1 (I) integrate primary, specialty, 

2 and acute care; and 

3 (II) serve medically underserved 

4 populations; and 

5 (ii) such models in rural and urban 

6 areas. 

7 (B) REPORT.—Not later than 1 year after 

8 the date of the enactment of this Act, the 

9 Comptroller General of the United States shall 

10 submit to Congress a report on the study con11 ducted under subparagraph (A). The report 

12 shall include— 

13 (i) an evaluation of the models, as de14 scribed in subparagraph (A), in— 

15 (I) expanding access to primary 

16 and preventive services for medically 

17 underserved populations; and 

18 (II) improving care coordination 

19 and health outcomes; and 

20 (ii) an assessment of— 

21 (I) challenges encountered by 

22 such entities in providing care to 

23 medically underserved populations; 

24 and 
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1 (II) advantages and disadvan2 tages of such models compared to 

3 other models of care delivery for medi4 cally underserved populations. 

5 SEC. 3. NATIONAL HEALTH SERVICE CORPS. 

6 (a) FUNDING.— 

7 (1) NATIONAL HEALTH SERVICE CORPS PRO8 GRAM.—Section 338(a) of the Public Health Service 

9 Act (42 U.S.C. 254k(a)) is amended by striking 

10 ‘‘2002 through 2006’’ and inserting ‘‘2008 through 

11 2012’’. 

12 (2) SCHOLARSHIP AND LOAN REPAYMENT PRO13 GRAMS.—Section 338H(a) of the Public Health 

14 Service Act (42 U.S.C. 254q(a)) is amended by 

15 striking ‘‘appropriated $146,250,000’’ and all that 

16 follows through the period and inserting the fol17 lowing: ‘‘appropriated— 

18 ‘‘(1) for fiscal year 2008, $131,500,000; 

19 ‘‘(2) for fiscal year 2009, $143,335,000; 

20 ‘‘(3) for fiscal year 2010, $156,235,150; 

21 ‘‘(4) for fiscal year 2011, $170,296,310; and 

22 ‘‘(5) for fiscal year 2012, $185,622,980.’’. 

23 (b) ELIMINATION OF 6-YEAR DEMONSTRATION RE24 QUIREMENT.—Section 332(a)(1) of the Public Health 

25 Service Act (42 U.S.C. 254e(a)(1)) is amended by striking 
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1 ‘‘Not earlier than 6 years’’ and all that follows through 

2 ‘‘purposes of this section.’’. 

3 (c) ASSIGNMENT TO SHORTAGE AREA.—Section 

4 333(a)(1)(D)(ii) of the Public Health Service Act (42 

5 U.S.C. 254f(a)(1)(D)(ii)) is amended— 

6 (1) in subclause (IV), by striking ‘‘and’’; 

7 (2) in subclause (V), by striking the period at 

8 the end and inserting ‘‘; and’’; and 

9 (3) by adding at the end the following: 

10 ‘‘(VI) the entity demonstrates willingness 

11 to support or facilitate mentorship, professional 

12 development, and training opportunities for 

13 Corps members.’’. 

14 (d) PROFESSIONAL DEVELOPMENT AND TRAIN15 ING.—Subsection (d) of section 336 of the Public Health 

16 Service Act (42 U.S.C. 254h–1) is amended to read as 

17 follows: 

18 ‘‘(d) PROFESSIONAL DEVELOPMENT AND TRAIN19 ING.— 

20 ‘‘(1) IN GENERAL.—The Secretary shall assist 

21 Corps members in establishing and maintaining pro22 fessional relationships and development opportuni23 ties, including by— 

24 ‘‘(A) establishing appropriate professional 

25 relationships between the Corps member in-
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1 volved and the health professions community of 

2 the geographic area with respect to which the 

3 member is assigned; 

4 ‘‘(B) establishing professional development, 

5 training, and mentorship linkages between the 

6 Corps member involved and the larger health 

7 professions community, including through dis8 tance learning, direct mentorship, and develop9 ment and implementation of training modules 

10 designed to meet the educational needs of off11 site Corps members; 

12 ‘‘(C) establishing professional networks 

13 among Corps members; or 

14 ‘‘(D) engaging in other professional devel15 opment, mentorship, and training activities for 

16 Corps members, at the discretion of the Sec17 retary. 

18 ‘‘(2) ASSISTANCE IN ESTABLISHING PROFES19 SIONAL RELATIONSHIPS.—In providing such assist20 ance under paragraph (1), the Secretary shall focus 

21 on establishing relationships with hospitals, with 

22 academic medical centers and health professions 

23 schools, with area health education centers under 

24 section 751, with health education and training cen25 ters under section 752, and with border health edu-
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1 cation and training centers under such section 752. 

2 Such assistance shall include assistance in obtaining 

3 faculty appointments at health professions schools. 

4 ‘‘(3) SUPPLEMENT NOT SUPPLANT.—Such ef5 forts under this subsection shall supplement, not 

6 supplant, non-government efforts by professional 

7 health provider societies to establish and maintain 

8 professional relationships and development opportu9 nities.’’. 

10 SEC. 4. REAUTHORIZATION OF RURAL HEALTH CARE PRO11 GRAMS. 

12 Section 330A(j) of the Public Health Service Act (42 

13 U.S.C. 254c(j)) is amended by striking ‘‘$40,000,000’’ 

14 and all that follows and inserting ‘‘$45,000,000 for each 

15 of fiscal years 2008 through 2012.’’. 

Passed the Senate July 21 (legislative day, July 17), 

2008. 

Attest: 

Secretary. 

110TH CONGRESS 

2D SESSION S. 901 

AN ACT 

To amend the Public Health Service Act to reauhealth care programs. the National Health Service Corps, and rural thorize the Community Health Centers program,