II 

Calendar No. 548 

110TH CONGRESS 

1ST SESSION S. 901 

To amend the Public Health Service Act to provide additional authorizations 

of appropriations for the health centers program under section 330 

of such Act. 

IN THE SENATE OF THE UNITED STATES 

MARCH 15, 2007 

Mr. KENNEDY (for himself, Mr. HATCH, Mr. DODD, Mr. ROBERTS, Mr. HARKIN, Mr. BOND, Ms. MIKULSKI, Ms. SNOWE, Mr. BINGAMAN, Mr. 

DOMENICI, Mr. REED, Ms. MURKOWSKI, Mrs. CLINTON, Mr. BENNETT, 

Mr. OBAMA, Mr. GRASSLEY, Mr. BROWN, Mr. BURR, Mr. MENENDEZ, 

Mr. SCHUMER, Mr. LIEBERMAN, Mrs. MURRAY, Mr. COLEMAN, Mr. 

SMITH, Mr. CONRAD, Mr. TESTER, Mr. WHITEHOUSE, Mr. BAUCUS, Mr. 

AKAKA, Mr. INOUYE, Mr. KERRY, Mr. DURBIN, Ms. CANTWELL, Mr. 

LAUTENBERG, Ms. COLLINS, Mr. ISAKSON, Mr. SUNUNU, Mr. SANDERS, 

Mr. KOHL, Mr. JOHNSON, Ms. LANDRIEU, Mr. LEVIN, Mr. THUNE, Mrs. 

FEINSTEIN, Mr. PRYOR, Mr. CRAIG, Mr. SALAZAR, Mr. LEAHY, Mrs. 

LINCOLN, Mr. BIDEN, Mr. COCHRAN, Mr. WARNER, Mr. CHAMBLISS, Ms. 

STABENOW, Mr. DORGAN, Mr. LUGAR, Mr. VOINOVICH, Mr. NELSON of 

Florida, Mrs. BOXER, Mr. CASEY, Mrs. DOLE, Ms. KLOBUCHAR, Mr. 

CARPER, Mr. CARDIN, Mrs. MCCASKILL, Mr. BAYH, Mr. WEBB, Mrs. 

HUTCHISON, and Mr. SPECTER) introduced the following bill; which was 

read twice and referred to the Committee on Health, Education, Labor, 

and Pensions 

DECEMBER 18, 2007 

Reported by Mr. KENNEDY, with an amendment and an amendment to the 

title 


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[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To amend the Public Health Service Act to provide additional 

authorizations of appropriations for the health centers 

program under section 330 of such Act. 

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 ‘‘Health Centers Re5 newal Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Community, migrant, public housing, and 

9 homeless health centers are vital to thousands of 

10 communities across the United States. 

11 (2) There are more than 1,000 such health cen12 ters serving more than 16,000,000 people at more 

13 than 5,000 health delivery sites, located in all 50 

14 States of the United States, the District of Colum15 bia, and Puerto Rico, Guam, the Virgin Islands, and 

16 other territories of the United States. 

17 (3) Health centers provide cost-effective, quality 

18 health care to poor and medically underserved people 

19 in the States, the District of Columbia, and the terVerDate Aug 31 2005 04:44 Dec 19, 2007 Jkt 069200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6401 E:\BILLS\S901.RS S901

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1 ritories, including the working poor, the uninsured, 

2 and many high-risk and vulnerable populations, and 

3 have done so for over 40 years. 

4 (4) Health centers provide care to 1 of every 8 

5 uninsured Americans, 1 of every 4 Americans in 

6 poverty, and 1 of every 9 rural Americans. 

7 (5) Health centers provide primary and preven8 tive care services to more than 700,000 homeless 

9 persons and more than 725,000 farm workers in the 

10 United States. 

11 (6) Health centers are community-oriented and 

12 patient-focused and tailor their services to fit the 

13 special needs and priorities of local communities, 

14 working together with schools, businesses, churches, 

15 community organizations, foundations, and State 

16 and local governments. 

17 (7) Health centers are built through community 

18 initiative. 

19 (8) Health centers encourage citizen participa20 tion and provide jobs for 50,000 community resi21 dents. 

22 (9) Congress established the program as a 

23 unique public-private partnership, and has continued 

24 to provide direct funding to community organiza25 tions for the development and operation of health 


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1 centers systems that address pressing local health 

2 needs and meet national performance standards. 

3 (10) Federal grants assist participating commu4 nities in finding partners and recruiting doctors and 

5 other health professionals. 

6 (11) Federal grants constitute, on average, 24 

7 percent of the annual budget of such health centers, 

8 with the remainder provided by State and local gov9 ernments, Medicare, Medicaid, private contributions, 

10 private insurance, and patient fees. 

11 (12) Health centers make health care respon12 sive and cost-effective through aggressive outreach, 

13 patient education, translation, and other enabling 

14 support services. 

15 (13) Health centers help reduce health dispari16 ties, meet escalating health care needs, and provide 

17 a vital safety net in the health care delivery system 

18 of the United States. 

19 (14) Health centers increase the use of preven20 tive health services, including immunizations, pap 

21 smears, mammograms, and HBa1c tests for diabetes 

22 screenings. 

23 (15) Expert studies have demonstrated the im24 pact that these community-owned and patient-con25 trolled primary care delivery systems have achieved 


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1 both in the reduction of traditional access barriers 

2 and the elimination of health disparities among their 

3 patients. 

4 SEC. 3. ADDITIONAL AUTHORIZATIONS OF APPROPRIA5 TIONS FOR HEALTH CENTERS PROGRAM OF 

6 PUBLIC HEALTH SERVICE ACT. 

7 Section 330(r) of the Public Health Service Act (42 

8 U.S.C. 254b(r)) is amended by amending paragraph (1) 

9 to read as follows: 

10 ‘‘(1) IN GENERAL.—For the purpose of car11 rying out this section, in addition to the amounts 

12 authorized to be appropriated under subsection (d), 

13 there are authorized to be appropriated— 

14 ‘‘(A) $2,188,745,000 for fiscal year 2008; 

15 ‘‘(B) $2,451,394,400 for fiscal year 2009; 

16 ‘‘(C) $2,757,818,700 for fiscal year 2010; 

17 ‘‘(D) $3,116,335,131 for fiscal year 2011; 

18 and 

19 ‘‘(E) $3,537,040,374 for fiscal year 

20 2012.’’. 

21 SECTION 1. SHORT TITLE. 

22 This Act may be cited as the ‘‘Health Care Safety Net 

23 Act of 2007’’. 


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1 SEC. 2. COMMUNITY HEALTH CENTERS PROGRAM OF THE 

2 PUBLIC HEALTH SERVICE ACT. 

3 (a) ADDITIONAL AUTHORIZATIONS OF APPROPRIA4 TIONS FOR THE HEALTH CENTERS PROGRAM OF PUBLIC

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

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

7 amending paragraph (1) to read as follows: 

8 ‘‘(1) IN GENERAL.—For the purpose of carrying 

9 out this section, in addition to the amounts author10 ized to be appropriated under subsection (d), there 

11 are authorized to be appropriated— 

12 ‘‘(A) $2,213,020,000 for fiscal year 2008; 

13 ‘‘(B) $2,451,394,400 for fiscal year 2009; 

14 ‘‘(C) $2,757,818,700 for fiscal year 2010; 

15 ‘‘(D) $3,116,335,131 for fiscal year 2011; 

16 and 

17 ‘‘(E) $3,537,040,374 for fiscal year 2012.’’. 

18 (b) STUDIES RELATING TO COMMUNITY HEALTH CEN19 TERS.— 

20 (1) DEFINITIONS.—For purposes of this sub21 section— 

22 (A) the term ‘‘community health center’’ 

23 means a health center receiving assistance under 

24 section 330 of the Public Health Service Act (42 

25 U.S.C. 254b); and 


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1 (B) the term ‘‘medically underserved popu2 lation’’ has the meaning given that term in such 

3 section 330. 

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

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

6 after the date of enactment of this Act, the 

7 Comptroller General of the United States shall 

8 issue a study of the economic costs and benefits 

9 of school-based health centers and the impact on 

10 the health of students of these centers. 

11 (B) CONTENT.—In conducting the study 

12 under subparagraph (A), the Comptroller Gen13 eral of the United States shall analyze— 

14 (i) the impact that Federal funding 

15 could have on the operation of school-based 

16 health centers; 

17 (ii) any cost savings to other Federal 

18 programs derived from providing health 

19 services in school-based health centers; 

20 (iii) the effect on the Federal Budget 

21 and the health of students of providing Fed22 eral funds to school-based health centers and 

23 clinics, including the result of providing 

24 disease prevention and nutrition informa25 tion; 


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1 (iv) the impact of access to health care 

2 from school-based health centers in rural or 

3 underserved areas; and 

4 (v) other sources of Federal funding for 

5 school-based health centers. 

6 (3) HEALTH CARE QUALITY STUDY.— 

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

8 after the date of enactment of this Act, the Sec9 retary of Health and Human Services (referred 

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

11 the Administrator of the Health Resources and 

12 Services Administration, and in collaboration 

13 with the Agency for Healthcare Research and 

14 Quality, shall prepare and submit to the Com15 mittee on Health, Education, Labor, and Pen16 sions of the Senate and the Committee on En17 ergy and Commerce of the House of Representa18 tives a report that describes agency efforts to ex19 pand and accelerate quality improvement activi20 ties in community health centers. 

21 (B) CONTENT.—The report under subpara22 graph (A) shall focus on— 

23 (i) Federal efforts, as of the date of en24 actment of this Act, regarding health care 

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1 cluding quality data collection, analysis, 

2 and reporting requirements; 

3 (ii) identification of effective models 

4 for quality improvement in community 

5 health centers, which may include models 

6 that— 

7 (I) incorporate care coordination, 

8 disease management, and other services 

9 demonstrated to improve care; 

10 (II) are designed to address mul11 tiple, co-occurring diseases and condi12 tions; 

13 (III) improve access to providers 

14 through non-traditional means, such as 

15 the use of remote monitoring equip16 ment; 

17 (IV) target various medically un18 derserved populations, including unin19 sured patient populations; 

20 (V) increase access to specialty 

21 care, including referrals and diagnostic 

22 testing; and 

23 (VI) enhance the use of electronic 

24 health records to improve quality; 


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1 (iii) efforts to determine how effective 

2 quality improvement models may be adapt3 ed for implementation by community health 

4 centers that vary by size, budget, staffing, 

5 services offered, populations served, and 

6 other characteristics determined appropriate 

7 by the Secretary; 

8 (iv) types of technical assistance and 

9 resources provided to community health cen10 ters that may facilitate the implementation 

11 of quality improvement interventions; 

12 (v) proposed or adopted methodologies 

13 for community health center evaluations of 

14 quality improvement interventions, includ15 ing any development of new measures that 

16 are tailored to safety-net, community-based 

17 providers; 

18 (vi) successful strategies for sustaining 

19 quality improvement interventions in the 

20 long-term; and 

21 (vii) partnerships with other Federal 

22 agencies and private organizations or net23 works as appropriate, to enhance health 

24 care quality in community health centers. 


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1 (C) DISSEMINATION.—The Administrator of 

2 the Health Resources and Services Administra3 tion shall establish a formal mechanism or mech4 anisms for the ongoing dissemination of agency 

5 initiatives, best practices, and other information 

6 that may assist health care quality improvement 

7 efforts in community health centers. 

8 (4) GAO STUDY ON INTEGRATED HEALTH SYS9 TEMS MODEL FOR THE DELIVERY OF HEALTH CARE

10 SERVICES TO MEDICALLY UNDERSERVED POPU11 LATIONS.— 

12 (A) STUDY.—The Comptroller General of 

13 the United States shall conduct a study on inte14 grated health system models at not more than 10 

15 sites for the delivery of health care services to 

16 medically underserved populations. The study 

17 shall include an examination of— 

18 (i) health care delivery models spon19 sored by public or private non-profit enti20 ties that— 

21 (I) integrate primary, specialty, 

22 and acute care; and 

23 (II) serve medically underserved 

24 populations; and 


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1 (ii) such models in rural and urban 

2 areas. 

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

4 the date of the enactment of this Act, the Comp5 troller General of the United States shall submit 

6 to Congress a report on the study conducted 

7 under subparagraph (A). The report shall in8 clude— 

9 (i) an evaluation of the models, as de10 scribed in subparagraph (A), in— 

11 (I) expanding access to primary 

12 and preventive services for medically 

13 underserved populations; and 

14 (II) improving care coordination 

15 and health outcomes; and 

16 (ii) an assessment of— 

17 (I) challenges encountered by such 

18 entities in providing care to medically 

19 underserved populations; and 

20 (II) advantages and disadvan21 tages of such models compared to other 

22 models of care delivery for medically 

23 underserved populations. 

24 SEC. 3. NATIONAL HEALTH SERVICE CORPS. 

25 (a) FUNDING.— 


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1 (1) NATIONAL HEALTH SERVICE CORPS PRO2 GRAM.—Section 338(a) of the Public Health Service 

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

4 ‘‘2002 through 2006’’ and inserting ‘‘2008 through 

5 2012’’. 

6 (2) SCHOLARSHIP AND LOAN REPAYMENT PRO7 GRAMS.—Section 338H(a) of the Public Health Serv8 ice Act (42 U.S.C. 254q(a)) is amended by striking 

9 ‘‘appropriated $146,250,000’’ and all that follows 

10 through the period and inserting the following: ‘‘ap11 propriated— 

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

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

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

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

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

17 (b) ELIMINATION OF 6-YEAR DEMONSTRATION RE18 QUIREMENT.—Section 332(a)(1) of the Public Health Serv19 ice Act (42 U.S.C. 254e(a)(1)) is amended by striking ‘‘Not 

20 earlier than 6 years’’ and all that follows through ‘‘purposes 

21 of this section.’’. 

22 (c) ASSIGNMENT TO SHORTAGE AREA.—Section 

23 333(a)(1)(D)(ii) of the Public Health Service Act (42 

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

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


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

2 end and inserting ‘‘; and’’; and 

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

4 ‘‘(VI) the entity demonstrates willingness to 

5 support or facilitate mentorship, professional de6 velopment, and training opportunities for Corps 

7 members.’’. 

8 (d) PROFESSIONAL DEVELOPMENT AND TRAINING.— 

9 Subsection (d) of section 336 of the Public Health Service 

10 Act (42 U.S.C. 254h–1) is amended to read as follows: 

11 ‘‘(d) PROFESSIONAL DEVELOPMENT AND TRAINING.— 

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

13 Corps members in establishing and maintaining pro14 fessional relationships and development opportunities, 

15 including by— 

16 ‘‘(A) establishing appropriate professional 

17 relationships between the Corps member involved 

18 and the health professions community of the geo19 graphic area with respect to which the member 

20 is assigned; 

21 ‘‘(B) establishing professional development, 

22 training, and mentorship linkages between the 

23 Corps member involved and the larger health 

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1 ment and implementation of training modules 

2 designed to meet the educational needs of offsite 

3 Corps members; 

4 ‘‘(C) establishing professional networks 

5 among Corps members; or 

6 ‘‘(D) engaging in other professional develop7 ment, mentorship, and training activities for 

8 Corps members, at the discretion of the Sec9 retary. 

10 ‘‘(2) ASSISTANCE IN ESTABLISHING PROFES11 SIONAL RELATIONSHIPS.—In providing such assist12 ance under paragraph (1), the Secretary shall focus 

13 on establishing relationships with hospitals, with aca14 demic medical centers and health professions schools, 

15 with area health education centers under section 751, 

16 with health education and training centers under sec17 tion 752, and with border health education and train18 ing centers under such section 752. Such assistance 

19 shall include assistance in obtaining faculty appoint20 ments at health professions schools. 

21 ‘‘(3) SUPPLEMENT NOT SUPPLANT.—Such efforts 

22 under this subsection shall supplement, not supplant, 

23 non-government efforts by professional health provider 

24 societies to establish and maintain professional rela25 tionships and development opportunities.’’. 


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1 SEC. 4. REAUTHORIZATION OF RURAL HEALTH CARE PRO2 GRAMS. 

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

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

5 all that follows and inserting ‘‘$45,000,000 for each of fiscal 

6 years 2008 through 2012.’’. 

Amend the title so as to read: ‘‘A bill to amend the 

Public Health Service Act to reauthorize the Community 

Health Centers program, the National Health Service 

Corps, and rural health care programs.’’. 


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Calendar No. 548 

110TH CONGRESS 

1ST SESSION S. 901 

A BILL 

To amend the Public Health Service Act to provide 

such Act. the health centers program under section 330 of additional authorizations of appropriations for 

DECEMBER 18, 2007 

Reported with an amendment and an amendment to the 

title 


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