I 

111TH CONGRESS 

1ST SESSION H. R. 1883 

To require the Secretary of Health and Human Services to carry out a 

demonstration grants program to provide for certain patient coordination, 

outreach, and assistance services to reduce barriers to receiving health 

care and improve health care outcomes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 2, 2009 

Mr. SCOTT of Virginia (for himself, Ms. JACKSON-LEE of Texas, and Ms. LEE

of California) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To require the Secretary of Health and Human Services 

to carry out a demonstration grants program to provide 

for certain patient coordination, outreach, and assistance 

services to reduce barriers to receiving health care and 

improve health care outcomes. 

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 ‘‘Patient Advocate Act 

5 of 2009’’. 


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1 SEC. 2. PATIENT ASSISTANCE GRANTS DEMONSTRATION 

2 PROGRAM. 

3 (a) IN GENERAL.—The Secretary of Health and 

4 Human Services shall establish a demonstration program 

5 under which the Secretary may make grants to States, 

6 local and tribal entities, and public or private non-profit 

7 organizations for the development and operation of pro8 grams to provide services for patients to resolve health in9 surance, job retention, and debt crisis matters related to 

10 the patients’ diagnosis and illness, including services de11 scribed in subsection (b), to improve health care outcomes. 

12 (b) USE OF FUNDS.—A recipient of a grant under 

13 this section shall use the grant for the purposes of recruit14 ing, assigning, training, and employing patient health ad15 vocates (as defined in subsection (m)(2)) who have direct 

16 knowledge of the communities they serve to facilitate the 

17 care of individuals, including by performing each of the 

18 following services (and by ensuring that such services are 

19 available to such communities): 

20 (1) Acting as contacts, including by assisting in 

21 the coordination of health care services and provider 

22 referrals, for individuals who are seeking prevention 

23 or early detection services for, or who following a 

24 screening or early detection service are found to 

25 have a symptom, abnormal finding, or diagnosis of, 

26 an adverse health condition. 


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1 (2) Facilitating the involvement of community 

2 organizations in assisting individuals who are at risk 

3 for or who have an adverse health condition to re4 ceive better access to high-quality health care serv5 ices (such as by creating partnerships with patient 

6 advocacy groups, charities, health care centers, com7 munity hospice centers, other health care providers, 

8 or other organizations in the targeted community). 

9 (3) Notifying individuals of clinical trials and, 

10 upon request, facilitating enrollment of eligible indi11 viduals in these trials. 

12 (4) Anticipating, identifying, and helping indi13 viduals to overcome barriers within the health care 

14 system to ensure prompt diagnosis and treatment. 

15 (5) Coordinating with the relevant health insur16 ance ombudsman programs to provide information to 

17 individuals about health coverage, including private 

18 insurance, health care savings accounts, and other 

19 publicly funded programs (such as the Medicare, the 

20 Medicaid, and State children’s health insurance pro21 grams under titles XVIII, XIX, and XXI of the So22 cial Security Act, respectively, health programs oper23 ated by the Department of Veterans Affairs or the 

24 Department of Defense, and any private or govern25 mental prescription assistance programs). 


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1 (6) Conducting ongoing outreach to health dis2 parity populations, including the uninsured, rural 

3 populations, and other medically underserved popu4 lations, in addition to assisting other individuals to 

5 seek preventive care. 

6 A recipient of a grant under subsection (a) may use such 

7 grant for operational costs of any activity carried out by 

8 such entity for the purposes described in the previous sen9 tence. 

10 (c) PROHIBITIONS.— 

11 (1) REFERRAL FEES.—The Secretary of Health 

12 and Human Services shall require each recipient of 

13 a grant under this section to prohibit any patient 

14 health advocate providing services under the grant 

15 from accepting any referral fee, kickback, or other 

16 thing of value in return for referring an individual 

17 to a particular health care provider. 

18 (2) LEGAL FEES AND COSTS.—The Secretary of 

19 Health and Human Services shall prohibit the use of 

20 any grant funds received under this section to pay 

21 any fees or costs resulting from any litigation, arbi22 tration, mediation, or other proceeding to resolve a 

23 legal dispute. 

24 (d) GRANT PERIOD.— 


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1 (1) INITIAL GRANT PERIOD AND PERMISSIBLE

2 EXTENSIONS.—Subject to paragraph (2), the Sec3 retary of Health and Human Services— 

4 (A) may award grants under this section 

5 for initial periods of not more than 3 years; and 

6 (B) may extend the period of a grant 

7 under this section so long as each such exten8 sion is for a period of not more than 1 year. 

9 (2) LIMITATION.—In no case may the Secretary 

10 award an initial grant or extend the period of a 

11 grant under this section for a period ending after 

12 the date that is 5 years after the date of the enact13 ment of this Act. 

14 (e) APPLICATION.— 

15 (1) IN GENERAL.—To seek a grant under this 

16 section, an entity or organization described in sub17 section (a) shall submit an application to the Sec18 retary of Health and Human Services in such form, 

19 in such manner, and containing such information as 

20 the Secretary may require. 

21 (2) CONTENTS.—At a minimum, the Secretary 

22 shall require each such application to outline how 

23 the entity or organization involved will establish 

24 baseline measures and benchmarks that meet the 


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1 Secretary’s requirements to evaluate program out2 comes. 

3 (f) UNIFORM BASELINE MEASURES.—The Secretary 

4 of Health and Human Services shall establish uniform 

5 baseline measures in order to properly evaluate the impact 

6 of the programs funded under this section. 

7 (g) PREFERENCE.—In making grants under this sec8 tion, the Secretary of Health and Human Services shall 

9 give preference to eligible entities that demonstrate in 

10 their applications plans to utilize services described in sub11 section (b) to overcome significant barriers in order to im12 prove health care outcomes in their respective commu13 nities. 

14 (h) DUPLICATION OF SERVICES.—An entity or orga15 nization that is receiving Federal funds for services de16 scribed in subsection (b) on the date on which the entity 

17 or organization, respectively, submits an application under 

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

19 unless the entity or organization, respectively, can dem20 onstrate that amounts received under the grant will be uti21 lized to expand services or provide new services to individ22 uals who would not otherwise be served. 

23 (i) COORDINATION WITH OTHER PROGRAMS.—The 

24 Secretary of Health and Human Services shall ensure co25 ordination of the demonstration program under this secVerDate Nov 24 2008 02:24 Apr 07, 2009 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1883.IH H1883

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1 tion with existing authorized programs in order to facili2 tate access to high-quality health care services. 

3 (j) STUDY; REPORTS.— 

4 (1) FINAL REPORT BY SECRETARY.—Not later 

5 than 6 months after the completion of the dem6 onstration program under this section, the Secretary 

7 of Health and Human Services shall conduct a study 

8 of the results of the program and submit to the Con9 gress a report on such results that includes the fol10 lowing: 

11 (A) An evaluation of the program out12 comes, including— 

13 (i) quantitative analysis of baseline 

14 and benchmark measures; and 

15 (ii) aggregate information about the 

16 individuals served and program activities. 

17 (B) Recommendations on whether the pro18 grams funded under this section could be used 

19 to improve patient outcomes in other public 

20 health areas. 

21 (2) INTERIM REPORTS BY SECRETARY.—The 

22 Secretary of Health and Human Services may pro23 vide interim reports to the Congress on the dem24 onstration program under this section at such inter25 vals as the Secretary determines to be appropriate. 


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1 (3) REPORTS BY GRANTEES.—The Secretary of 

2 Health and Human Services may require each re3 cipient of a grant under this section to submit in4 terim and final reports on the programs carried out 

5 by such recipient with such grant. 

6 (k) RULE OF CONSTRUCTION.—This section shall not 

7 be construed to authorize funding for the delivery of 

8 health care services (other than the services listed in sub9 section (b)). 

10 (l) NONDISCRIMINATION.— 

11 (1) TREATMENT AS FEDERAL FINANCIAL AS12 SISTANCE.—For the purpose of applying the prohibi13 tions against discrimination on the basis of age 

14 under the Age Discrimination Act of 1975 (42 

15 U.S.C. 6101 et seq.), on the basis of disability under 

16 section 504 of the Rehabilitation Act of 1973 (29 

17 U.S.C. 794), on the basis of sex under title IX of 

18 the Education Amendments of 1972 (20 U.S.C. 

19 1681 et seq.), or on the basis of race, color, or na20 tional origin under title VI of the Civil Rights Act 

21 of 1964 (42 U.S.C. 2000d et seq.), programs and 

22 activities funded or otherwise financially assisted in 

23 whole or in part under this Act (whether through 

24 grant, contract, or otherwise) are considered to be 


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1 programs and activities receiving Federal financial 

2 assistance. 

3 (2) PROHIBITION OF DISCRIMINATION REGARD4 ING PARTICIPATION, BENEFITS, AND EMPLOY5 MENT.— 

6 (A) IN GENERAL.—No individual shall be 

7 excluded from participation in, denied the bene8 fits of, subjected to discrimination under, or de9 nied employment in the administration of or in 

10 connection with, any program or activity funded 

11 or otherwise financially assisted in whole or in 

12 part under this Act because of race, color, reli13 gion, sex, national origin, age, disability, or po14 litical affiliation or belief. 

15 (B) ENFORCEMENT.—The powers, rem16 edies, and procedures set forth in title VI of the 

17 Civil Rights Act of 1964 (42 U.S.C. 2000d et 

18 seq.) shall be the powers, remedies, and proce19 dures this paragraph provides to the Secretary 

20 concerning a violation of subparagraph (A). 

21 (m) DEFINITIONS.—In this section: 

22 (1) HEALTH DISPARITY POPULATION.—The 

23 term ‘‘health disparity population’’ means a popu24 lation that, as determined by the Secretary of 

25 Health and Human Services, has a significant disVerDate Nov 24 2008 02:24 Apr 07, 2009 Jkt 079200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1883.IH H1883

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1 parity in the overall rate of disease incidence, preva2 lence, morbidity, mortality, or survival rates as com3 pared to the health status of the general population. 

4 (2) PATIENT HEALTH ADVOCATE.—The term 

5 ‘‘patient health advocate’’ means, with respect to a 

6 program developed by a recipient of a grant under 

7 this section, an individual who has completed a cer8 tified social work program (or program in a related 

9 field) approved by such recipient, or has attained an 

10 equivalent level of proficiency through organization11 sponsored training or work experience in areas of so12 cial work, case work, or nursing. 

13 (n) AUTHORIZATION OF APPROPRIATIONS.— 

14 (1) IN GENERAL.—To carry out this section, 

15 there are authorized to be appropriated $10,000,000 

16 for each of the fiscal years 2010 through 2014. 

17 (2) AVAILABILITY.—The amounts appropriated 

18 pursuant to paragraph (1) shall remain available for 

19 obligation through the end of fiscal year 2014. 

Æ 


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