II

107TH CONGRESS

1ST SESSION S. 1012

To ensure that children at highest risk for asthma, vision, hearing, and

other health problems are identified and treated.

IN THE SENATE OF THE UNITED STATES

JUNE 11, 2001

Mr. DURBIN (for himself and Ms. COLLINS) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To ensure that children at highest risk for asthma, vision,

hearing, and other health problems are identified and treated.

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 ‘‘Healthy Children

5 Learn Act’’.
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1 SEC. 2. ASTHMA, VISION, AND HEARING SCREENING FOR

2 EARLY HEAD START AND HEAD START PRO3 GRAMS.

4 (a) EARLY HEAD START PROGRAMS.—Section 645A

5 of the Head Start Act (42 U.S.C. 9840a) is amended by

6 adding at the end the following:

7 ‘‘(h) ASTHMA, VISION, AND HEARING SCREENING.—

8 ‘‘(1) IN GENERAL.—An entity that receives as9 sistance under this section may carry out a program

10 under which the entity—

11 ‘‘(A) determines whether a child eligible to

12 participate in the program described in sub13 section (a)(1) has received each of an asthma,

14 vision, and hearing screening test using a test

15 that is appropriate for age and risk factors on

16 the enrollment of the child in the program; and

17 ‘‘(B) in the case of a child who has not re18 ceived each of an asthma, and vision, and hear19 ing screening test, ensures that the enrolled

20 child receives such a test either by referral or

21 by performing the test (under contract or other22 wise).

23 ‘‘(2) REIMBURSEMENT.—

24 ‘‘(A) IN GENERAL.—On the request of an

25 entity that performs or arranges for the per26 formance of an asthma, vision, or hearing
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1 screening test under paragraph (1) on a child

2 who is eligible for or receiving medical assist3 ance under a State plan under title XIX of the

4 Social Security Act (42 U.S.C. 1396 et seq.),

5 the Secretary of Health and Human Services,

6 notwithstanding any other provision of, or limi7 tation under, title XIX of the Social Security

8 Act, shall reimburse the entity, from funds that

9 are made available under that title, for 100 per10 cent of the cost of the test and data reporting.

11 ‘‘(B) COSTS.—The costs of a test con12 ducted under this subsection—

13 ‘‘(i) shall include reimbursement for

14 testing devices and associated supplies ap15 proved for sale by the Food and Drug Ad16 ministration and used in compliance with

17 section 353 of the Public Health Service

18 Act (42 U.S.C. 263a); and

19 ‘‘(ii) shall include reimbursement for

20 administering the tests and related serv21 ices, as determined appropriate by the

22 State agency.

23 ‘‘(3) HEAD START.—This subsection shall apply

24 to Head Start programs that include coverage, di-
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1 rectly or indirectly, for infants and toddlers under

2 the age of 3 years.’’.

3 (b) HEAD START PROGRAMS.—Section 642(b) of the

4 Head Start Act (42 U.S.C. 9837(b)) is amended—

5 (1) in paragraph (10), by striking ‘‘and’’ at the

6 end;

7 (2) in paragraph (11), by striking the period at

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

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

10 ‘‘(12) with respect to an agency that elects to

11 carry out a program under section 645(h), comply

12 with the requirements of such section 645A(h) in the

13 case of each child eligible to participate in the Head

14 Start program to be carried out by the agency.’’.

15 SEC. 3. ASTHMA, VISION, AND HEARING SCREENING AND

16 TREATMENT FOR CHILDREN ENROLLED IN

17 PUBLIC SCHOOLS.

18 Part B of title III of the Public Health Service Act

19 (42 U.S.C. 243 et seq.) is amended by adding at the end

20 the following:

21 ‘‘SEC. 320B. ASTHMA, VISION, AND HEARING SCREENING

22 AND TREATMENT FOR CHILDREN ENROLLED

23 IN PUBLIC SCHOOLS.

24 ‘‘(a) GRANTS.—The Secretary shall award grants to

25 eligible local educational agencies to enable such agencies
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1 to carry out asthma, vision, hearing, or other health

2 screening and case management programs determined ap3 propriate by the Secretary in accordance with the program

4 elements described in subsection (d).

5 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant

6 under subsection (a), a local educational agency shall pre7 pare and submit to the Secretary an application at such

8 time, in such manner, and containing such information as

9 the Secretary may require.

10 ‘‘(c) PREFERENCE.—In awarding grants under this

11 section, the Secretary shall give preference to local edu12 cational agencies serving schools that are located in areas

13 with a high incidence of childhood asthma or a high death

14 rate associated with childhood asthma.

15 ‘‘(d) PROGRAM ELEMENTS.—

16 ‘‘(1) ASTHMA.—Under an asthma program op17 erated under a grant under this section, a local edu18 cational agency shall—

19 ‘‘(A) determine whether a child enrolled in

20 a school in which the program is in effect has

21 received an asthma screening test using a test

22 that is appropriate for age and risk factors on

23 the enrollment of the child in the school;

24 ‘‘(B) in the case of a child who has not re25 ceived an asthma screening test, ensure that
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1 the child receives such a test either by referral

2 or by performing the test (under contract or

3 otherwise); and

4 ‘‘(C) in the case of a child determined to

5 have asthma, provide treatment or refer the

6 child for treatment (including case manage7 ment) and education in the management of

8 asthma.

9 ‘‘(2) VISION AND HEARING.—Under a vision

10 and hearing program operated under a grant under

11 this section, a local educational agency shall—

12 ‘‘(A) elect to provide vision and hearing

13 screening tests—

14 ‘‘(i) to all children enrolled in a school

15 who are most likely to suffer from vision or

16 hearing loss; or

17 ‘‘(ii) to all children enrolled in a

18 school;

19 ‘‘(B) ensure that the category of children

20 elected under subparagraph (A) receive such

21 tests, either by referral or by performing the

22 test (under contract or otherwise), that are ap23 propriate for the age and risk factors of the

24 children, based on the enrollment of the chil25 dren in the school; and
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1 ‘‘(C) in the case of any child determined to

2 have a vision or hearing impairment, provide

3 the child with such eyewear and hearing aids as

4 are appropriate to correct the child’s vision or

5 hearing, to the extent that such correction is

6 feasible.

7 ‘‘(3) OTHER HEALTH SCREENING PROGRAMS.—

8 The Secretary shall determine the program elements

9 that shall be applicable to other health screening

10 programs operated under a grant under this section.

11 ‘‘(e) REIMBURSEMENT.—

12 ‘‘(1) CHILDREN ENROLLED IN OR ELIGIBLE

13 FOR MEDICAID.—

14 ‘‘(A) IN GENERAL.—With respect to a

15 child who is eligible for or receiving medical as16 sistance under a State plan under title XIX of

17 the Social Security Act (42 U.S.C. 1396 et

18 seq.) and who receives, or is provided, a test,

19 treatment, education, corrective eyewear, or

20 hearing aid under a program established under

21 subsection (a), the Secretary, notwithstanding

22 any other provision of, or limitation under, such

23 title XIX, including the payment limitation

24 commonly known as the ‘free care rule’, shall

25 reimburse the local educational agency admin-
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1 istering such program from funds that are

2 made available under such title XIX for 100

3 percent of the cost of the performance, arrange4 ment, or provision and data reporting.

5 ‘‘(B) COSTS.—The costs of a test con6 ducted under this section shall include reim7 bursement for—

8 ‘‘(i) testing devices and associated

9 supplies approved for sale by the Food and

10 Drug Administration and used in compli11 ance with section 353; and

12 ‘‘(ii) administering the tests and re13 lated services, as determined appropriate

14 by the State agency responsible for the ad15 ministration of title XIX of the Social Se16 curity Act (42 U.S.C. 1396 et seq.).

17 ‘‘(2) CHILDREN ENROLLED IN OR ELIGIBLE

18 FOR SCHIP.—

19 ‘‘(A) IN GENERAL.—With respect to a

20 child who is eligible for or receiving child health

21 assistance under a State plan under title XXI

22 of the Social Security Act (42 U.S.C. 1397aa et

23 seq.) and who receives, or is provided, a test,

24 treatment, education, corrective eyewear, or

25 hearing aid under a program established under
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1 subsection (a), the Secretary, notwithstanding

2 any other provision of, or limitation under, such

3 title XXI, or any other provision of law (includ4 ing the payment limitation under title XIX

5 commonly known as the ‘free care rule’ to the

6 extent, if any, such limitation applies to the

7 State children’s health insurance program es8 tablished under title XXI of that Act), shall re9 imburse the local educational agency admin10 istering such program from funds that are

11 made available under such title XXI for 100

12 percent of the cost of the performance, arrange13 ment, or provision and data reporting.

14 ‘‘(B) COSTS.—The costs shall include the

15 costs described in paragraph (1)(B).

16 ‘‘(f) DEFINITIONS.—In this section, the terms ‘local

17 educational agency’ and ‘elementary and secondary school’

18 shall have the meanings given such terms in section 14101

19 of the Elementary and Secondary Education Act of 1965

20 (20 U.S.C. 8801).

21 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There

22 is authorized to be appropriated to carry out this section

23 with respect to a child, and any data reporting with re24 spect to the child, who is not eligible for coverage under
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1 title XIX or XXI of the Social Security Act, or is not oth2 erwise covered under a health insurance plan—

3 ‘‘(1) $10,000,000 for each of fiscal years 2002

4 through 2007 to carry out asthma programs;

5 ‘‘(2) $10,000,000 for each of fiscal years 2002

6 through 2007 to carry out vision and hearing pro7 grams; and

8 ‘‘(3) such sums as may be necessary for each

9 of fiscal years 2002 through 2007 to carry out other

10 health screening programs.

11 ‘‘(h) EVALUATIONS.—Not later than 4 years after the

12 date of enactment of this section, the Secretary shall pre13 pare and submit to the appropriate committees of Con14 gress a report containing data related to whether grants

15 provided under this section have ensured that children at

16 the highest risk for asthma, vision, hearing, and other

17 health problems are identified and treated.’’.

18 SEC. 4. PAYMENTS FOR SCREENING AND TREATMENT PRO19 VIDED TO CHILDREN ELIGIBLE UNDER MED20 ICAID OR SCHIP.

21 (a) MEDICAID.—Section 1903(c) of the Social Secu22 rity Act (42 U.S.C. 1396b(c)) is amended—

23 (1) by inserting ‘‘(1)’’ after ‘‘(c)’’; and

24 (2) by adding at the end the following:
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1 ‘‘(2) Nothing in this title or any other provision of

2 law, including the payment limitation commonly known as

3 the ‘free care rule’, shall be construed as prohibiting or

4 restricting, or authorizing the Secretary to prohibit or re5 strict, payment under subsection (a) for medical assist6 ance for covered services furnished to a child who is eligi7 ble for or receiving medical assistance under the State

8 plan and who receives an asthma, vision, hearing, or other

9 health screening test, or is provided treatment, education

10 in disease management, corrective eyewear, or hearing

11 aids, through a public elementary or secondary school,

12 whether directly or indirectly, and regardless of whether

13 the school participates in a program established under

14 subsection (a) or (b) of section 1120C of the Elementary

15 and Secondary Education Act of 1965.’’.

16 (b) SCHIP.—Section 2105 of the Social Security Act

17 (42 U.S.C.1397ee) is amended by adding at the end the

18 following:

19 ‘‘(g) REQUIRED PAYMENT FOR CERTAIN SCHOOL20 BASED SERVICES.—Nothing in this title or any other pro21 vision of law (including the payment limitation under title

22 XIX commonly known as the ‘free care rule’ to the extent,

23 if any, such limitation applies to the program established

24 under this title), shall be construed as prohibiting or re25 stricting, or authorizing the Secretary to prohibit or re-
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1 strict, payment under subsection (a) for child health as2 sistance for covered services furnished to a child who is

3 eligible for or receiving such assistance under the State

4 plan and who receives an asthma, vision, or hearing

5 screening test, or other health screening test that is avail6 able to children receiving assistance under the State plan,

7 or is provided treatment, education in disease manage8 ment, corrective eyewear, or hearing aids through a public

9 elementary or secondary school, whether directly or indi10 rectly, and regardless of whether the school participates

11 in a program established under subsection (a) or (b) of

12 section 1120C of the Elementary and Secondary Edu13 cation Act of 1965.’’.

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