108TH CONGRESS REPORT " HOUSE OF REPRESENTATIVES ! 1st Session 108–275

HEALTH CARE SAFETY NET AMENDMENTS TECHNICAL 

CORRECTIONS ACT OF 2003

SEPTEMBER 17, 2003.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. TAUZIN, from the Committee on Energy and Commerce, 

submitted the following 

R E P O R T 

[To accompany H.R. 3038] 

[Including cost estimate of the Congressional Budget Office]

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 3038) to make certain technical and conforming 

amendments to correct the Health Care Safety Net Amendments of 

2002, having considered the same, report favorably thereon without 

amendment and recommend that the bill do pass.

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 1

Background and Need for Legislation .................................................................... 2

Hearings ................................................................................................................... 2

Committee Consideration ........................................................................................ 2

Committee Votes ...................................................................................................... 2

Committee Oversight Findings ............................................................................... 2

Statement of General Performance Goals and Objectives .................................... 2

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 2

Committee Cost Estimate ....................................................................................... 2

Congressional Budget Office Estimate ................................................................... 2

Federal Mandates Statement ................................................................................. 3

Advisory Committee Statement .............................................................................. 3

Constitutional Authority Statement ...................................................................... 3

Applicability to Legislative Branch ........................................................................ 4

Section-by-Section Analysis of the Legislation ...................................................... 4

Changes in Existing Law Made by the Bill, as Reported ..................................... 4

PURPOSE AND SUMMARY

H.R. 3038 makes technical and conforming changes to the Health 

Care Safety Net Amendments Act of 2002. 

2

BACKGROUND AND NEED FOR LEGISLATION

On October 22, 2002, President Bush signed into law the Health 

Care Safety Net Amendments Act of 2002 (P.L. 107–251), legislation to strengthen several public health programs for low-income 

individuals and the underserved, including Community Health 

Centers and the National Health Service Corps. This lengthy act 

amended several sections of the Public Health Service Act, albeit 

incorrectly. H.R. 3038 aligns the U.S. Code and makes minor corrections to clarify the original intent of Congress in order for the 

Department of Health and Human Services to fully implement the 

law as designed. 

HEARINGS

The Committee on Energy and Commerce has not held hearings 

on the legislation. 

COMMITTEE CONSIDERATION

On September 10, 2003, the Full Committee met in open markup 

session and favorably ordered H.R. 3038 reported to the House by 

a voice vote, a quorum being present. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the record votes on the motion 

to report legislation and amendments thereto. There were no 

record votes taken in connection with ordering H.R. 3038 reported. 

A motion by Mr. Tauzin to order H.R. 3038 reported to the House, 

without amendment, was agreed to by a voice vote. 

COMMITTEE OVERSIGHT FINDINGS

Pursuant to clause 3(c)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee has not held oversight or legislative hearings on this legislation. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

The goal of H.R. 3038 is to make technical and conforming 

changes to the Health Care Safety Net Amendments Act of 2002. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee finds that H.R. 3038, the 

Health Care Safety Net Amendments Technical Corrections Act of 

2003, would result in no new or increased budget authority, entitlement authority, or tax expenditures or revenues. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

3

CONGRESSIONAL BUDGET OFFICE ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate provided by 

the Congressional Budget Office pursuant to section 402 of the 

Congressional Budget Act of 1974:

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, September 16, 2003. 

Hon. W.J. ‘‘BILLY’’ TAUZIN, 

Chairman, Committee on Energy and Commerce, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 3038, the Health Care 

Safety Net Amendments Technical Corrections Act of 2003. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Margaret Nowak. 

Sincerely, 

DOUGLAS HOLTZ-EAKIN, 

Director. 

Enclosure. 

H.R. 3038—Health Care Safety Net Amendments Technical Corrections Act of 2003

H.R. 3038 would make technical and conforming amendments to 

the Health Care Safety Net Amendments of 2002 (Public Law 107–

251). That law reauthorized and expanded the Health Centers and 

National Health Service Corps programs, and established the Community Access Program in statute. CBO estimates that the bill’s 

changes would have no impact on the Federal budget. 

The bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would 

impose no costs on State, local, or tribal governments. 

The CBO staff contact is Margaret Nowak. This estimate was approved by Peter H. Fontaine, Deputy Assistant Director for Budget 

Analysis.

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates prepared by the Director of the Congressional Budget Office 

pursuant to section 423 of the Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act were created by this legislation. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the Constitutional authority for this legislation is provided in Article I, section 8, clause 

3, which grants Congress the power to regulate commerce with foreign nations, among the several States, and with the Indian tribes. 

4

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment or access to public services or 

accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 designates the short title as the ‘‘Health Care Safety 

Net Amendments Technical Corrections Act of 2003.’’ 

Section 2. Technical amendments 

Section 2 makes several technical changes to the Health Care 

Safety Net Amendments Act of 2002 (P.L. 107–251). It renumbers 

and aligns several sections of the Public Health Service Act, makes 

grammatical corrections, including period and comma placement, 

and corrects misnamed references to agencies within the Department of Health and Human Services. Section 2 makes stand-alone 

provisions in the Health Care Safety Net Amendments Act of 2002, 

including telemedicine incentive grants, part of the Public Health 

Service Act. 

Section 2 also clarifies the original intent of the Health Care 

Safety Net Amendments Act of 2002. Section 2 replaces language 

inadvertently deleted by the Act to permit the Department of 

Health and Human Services to provide technical assistance either 

through the Department or by grant or contract. Further, the technical assistance activities outlined under the law are not intended 

to be an exhaustive list; for example, the Department of Health 

and Human Services could provide technical assistance through the 

planning and development of networks. Section 2 amends section 

332 of the Public Health Service Act to clarify that Federally qualified community health centers may be designated as health professional shortage areas upon date of designation, not the date of the 

enactment of the law. It further clarifies section 333A(c)(4) to make 

priorities in assignment of National Health Service Corps personnel within 30 days ‘‘from such notification.’’ Section 2 clarifies 

section 338E of the Public Health Service Act with regard to loan 

repayments of National Health Service Corps personnel. Finally, 

section 2 clarifies that the Department of Health and Human Services is to conduct a study of the Department’s ability to provide for 

‘‘guarantees’’ of solvency for managed care networks or plans involving health centers receiving funding under section 330 of the 

Public Health Service Act. 

Section 3. Effective date 

Section 3 sets the effective date immediately after the enactment 

of Public Law 107–251.

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitVerDate jul 14 2003 06:50 Sep 18, 2003 Jkt 019006 PO 00000 Frm 00004 Fmt 6659 Sfmt 6602 E:\HR\OC\HR275.XXX HR275
5

ted is enclosed in black brackets, new matter is printed in italic, 

existing law in which no change is proposed is shown in roman): 

PUBLIC HEALTH SERVICE ACT 

* * * * * * *

TITLE II—ADMINISTRATION AND MISCELLANEOUS 

PROVISIONS 

PART A—ADMINISTRATION

* * * * * * *

DEFENSE OF CERTAIN MALPRACTICE AND NEGLIGENCE SUITS

SEC. 224. (a)***

* * * * * * *

(g)(1)(A)***

* * * * * * *

(G) In the case of an entity described in paragraph (4) that has 

not submitted an application under subparagraph (D): 

(i) * * *

(ii) This section does not affect any authority of the entity to 

purchase medical malpractice liability insurance coverage with 

Federal funds provided to the entity under section 329, ø330, 

330(h)¿ 330, or 340A. 

* * * * * * *

(k)(1)***

(2) Subject to appropriations, for each fiscal year, the Secretary 

shall establish a fund of an amount equal to the amount estimated 

under paragraph (1) that is attributable to entities receiving funds 

under each of the grant programs described in paragraph (4) of 

subsection (g), but not to exceed a total of $10,000,000 for each 

such fiscal year. Appropriations for purposes of this paragraph 

shall be made separate from appropriations made for purposes of 

sections 329, ø330, 330(h)¿ 330 and 340A. 

* * * * * * *

(n)(1) Not later than one year after the date of the enactment of 

the Federally Supported Health Centers Assistance Act of 1995, 

the Comptroller General of the United States shall submit to the 

Congress a report on the following: 

(A) * * *

* * * * * * *

(C) The value of private sector risk-management services, 

and the value of risk-management services and procedures required as a condition of receiving a grant under section 329, 

ø330, 330(h)¿ 330, or 340A. 

* * * * * * *

TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC 

HEALTH SERVICE 

* * * * * * *

6

PART B—FEDERAL-STATE COOPERATION

* * * * * * *

SCREENINGS, REFERRALS, AND EDUCATION REGARDING LEAD

POISONING

SEC. 317A. (a) AUTHORITY FOR GRANTS.— (1) * * *

(2) AUTHORITY REGARDING CERTAIN ENTITIES.—With respect 

to a geographic area with a need for activities authorized in 

paragraph (1), in any case in which neither the State nor the 

political subdivision in which such area is located has applied 

for a grant under paragraph (1), the Secretary may make a 

grant under such paragraph to any grantee under section 329, 

ø330, 330(h)¿ 330, or 340A for carrying out such activities in 

the area. 

* * * * * * *

PREVENTIVE HEALTH SERVICES REGARDING TUBERCULOSIS

SEC. 317E. (a)***

* * * * * * *

(c) COOPERATION WITH PROVIDERS OF PRIMARY HEALTH SERV- ICES.—The Secretary may make a grant under subsection (a) or (b) 

only if the applicant for the grant agrees that, in carrying out activities under the grant, the applicant will cooperate with public 

and nonprofit private providers of primary health services or substance abuse services, including entities receiving assistance under 

section 329, ø330, 330(h)¿ 330, or 340A or under title V or XIX. 

* * * * * * *

INFERTILITY AND SEXUALLY TRANSMITTED DISEASES

SEC. 318A. (a)***

* * * * * * *

(e) REQUIRED PROVIDERS REGARDING CERTAIN SERVICES.—The 

Secretary may make a grant under subsection (a) only if the applicant involved agrees that, in expending the grant to carry out activities authorized in subsection (c), the services described in paragraphs (1) through (7) of such subsection will be provided only 

through entities that are State or local health departments, grantees under section 329, ø330, 330(h)¿ 330, 340A, or 1001, or are 

other public or nonprofit private entities that provide health services to a significant number of low-income women. 

* * * * * * *

PART D—PRIMARY HEALTH CARE

Subpart I—Health Centers 

SEC. 330. HEALTH CENTERS. 

(a) * * *

* * * * * * *

(c) PLANNING GRANTS.—

7

(1) IN GENERAL.— (A) * * *

(B) COMPREHENSIVE SERVICE DELIVERY NETWORKS AND

PLANS.—The Secretary may make grants to health centers 

that receive assistance under this section to enable the 

centers to plan and develop a managed care network or 

øplan..¿ plan. Such a grant may only be made for such a 

center if—

(i) * * *

* * * * * * *

(d) MANAGED CARE LOAN GUARANTEE PROGRAM.—

(1) ESTABLISHMENT.— (A) * * *

(B) USE OF FUNDS.—Loan funds guaranteed under this 

subsection may be used—

(i) * * *

* * * * * * *

(iii) to refinance an existing loan (as of the date of 

refinancing) to the center or centers, if the Secretary 

determines—

(I) that such refinancing will be beneficial to the 

health center and the Federal Government; or

* * * * * * *

(e) OPERATING GRANTS.—

(1) * * *

* * * * * * *

ø(3)¿ (4) LIMITATION.—Not more than two grants may be 

made under subparagraph (B) of paragraph (1) for the same 

entity. 

ø(4)¿ (5) AMOUNT.— (A) IN GENERAL.—The amount of any grant made in any 

fiscal year under paragraph (1) to a health center shall be 

determined by the Secretary, but may not exceed the 

amount by which the costs of operation of the center in 

such fiscal year exceed the total of—

(i) * * *

* * * * * * *

ø(n)¿ (k) APPLICATIONS.—

(1) * * *

* * * * * * *

(3) REQUIREMENTS.—Except as provided in subsection 

(e)(1)(B), the Secretary may not approve an application for a 

grant under subparagraph (A) or (B) of subsection (e)(1) unless 

the Secretary determines that the entity for which the application is submitted is a health center (within the meaning of subsection (a)) and that—

(A) * * *

* * * * * * *

(H) the center has established a governing board which 

except in the case of an entity operated by an Indian tribe 

or tribal or Indian organization under the Indian Self-DeVerDate jul 14 2003 06:50 Sep 18, 2003 Jkt 019006 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\HR275.XXX HR275
8

termination Act or an urban Indian organization under the 

Indian Health Care Improvement Act (25 U.S.C. 1651 et 

seq.)—

(i) * * *

* * * * * * *

except that, upon a showing of good cause the Secretary 

shall waive, for the length of the project period, all or part 

of the requirements of this subparagraph in the case of a 

health center that receives a grant pursuant to subsection 

(g), (h), (i), øor (q)¿ or (p); 

* * * * * * *

ø(m) TECHNICAL ASSISTANCE.—The Secretary shall establish a 

program through which the Secretary shall provide technical and 

other assistance to eligible entities to assist such entities to meet 

the requirements of subsection (l)(3). Services provided through the 

program may include necessary technical and nonfinancial assistance, including fiscal and program management assistance, training in fiscal and program management, operational and administrative support, and the provision of information to the entities of 

the variety of resources available under this title and how those resources can be best used to meet the health needs of the communities served by the entities.¿

(l) TECHNICAL ASSISTANCE.—The Secretary shall establish a program through which the Secretary shall provide (either through the 

Department of Health and Human Services or by grant or contract) 

technical and other assistance to eligible entities to assist such entities to meet the requirements of subsection (k)(3). Services provided 

through the program may include necessary technical and nonfinancial assistance, including fiscal and program management assistance, training in fiscal and program management, operational 

and administrative support, and the provision of information to the 

entities of the variety of resources available under this title and how 

those resources can be best used to meet the health needs of the communities served by the entities.

ø(p)¿ (m) MEMORANDUM OF AGREEMENT.—In carrying out this 

section, the Secretary may enter into a memorandum of agreement 

with a State. Such memorandum may include, where appropriate, 

provisions permitting such State to—

(1) * * *

* * * * * * *

ø(q)¿ (n) RECORDS.—

(1) * * *

* * * * * * *

ø(r)¿ (o) DELEGATION OF AUTHORITY.—The Secretary may delegate the authority to administer the programs authorized by this 

section to any office, except that the authority to enter into, modify, 

or issue approvals with respect to grants or contracts may be delegated only within the central office of the Health Resources and 

Services Administration. 

ø(s)¿ (p) SPECIAL CONSIDERATION.—In making grants under this 

section, the Secretary shall give special consideration to the unique 

needs of sparsely populated rural areas, including giving priority in 

the awarding of grants for new health centers under subsections (c) 

9

and (e), and the granting of waivers as appropriate and permitted 

under subsections (b)(1)(B)(i) and ø(j)(3)(G)¿ (k)(3)(G). 

* * * * * * *

ø(s)¿ (r) AUTHORIZATION OF APPROPRIATIONS.—

(1) IN GENERAL.—For the purpose of carrying out this section, in addition to the amounts authorized to be appropriated 

under subsection (d), there are authorized to be appropriated 

ø$802,124,000 for fiscal year 1997, and such sums as may be 

necessary for each of the fiscal years 1998 through 2001.¿

$1,340,000,000 for fiscal year 2002 and such sums as may be 

necessary for each of the fiscal years 2003 through 2006.

(2) SPECIAL PROVISIONS.— (A) PUBLIC CENTERS.—The Secretary may not expend in 

any fiscal year, for grants under this section to public centers (as defined in the second sentence of subsection 

ø(j)(3))¿ (k)(3)) the governing boards of which (as described 

in subsection ø(j)(3)(G)(ii)¿ (k)(3)(H)) do not establish general policies for such centers, an amount which exceeds 5 

percent of the amounts appropriated under this section for 

that fiscal year. For purposes of applying the preceding 

sentence, the term ‘‘public centers’’ shall not include health 

centers that receive grants pursuant to subsection (h) or 

(i). 

ø(B) DISTRIBUTION OF GRANTS.—

ø(i) FISCAL YEAR 1997.—For fiscal year 1997, the 

Secretary, in awarding grants under this section shall 

ensure that the amounts made available under each of 

subsections (g), (h), and (i) in such fiscal year bears 

the same relationship to the total amount appropriated for such fiscal year under paragraph (1) as the 

amounts appropriated for fiscal year 1996 under each 

of sections 329, 340, and 340A (as such sections existed one day prior to the date of enactment of this 

section) bears to the total amount appropriated under 

sections 329, 330, 340, and 340A (as such sections existed one day prior to the date of enactment of this 

section) for such fiscal year. 

ø(ii) FISCAL YEARS 1998 AND 1999.—For each of the 

fiscal years 1998 and 1999, the Secretary, in awarding 

grants under this section shall ensure that the proportion of the amounts made available under each of subsections (g), (h), and (i) is equal to the proportion of 

amounts made available under each such subsection 

for the previous fiscal year, as such amounts relate to 

the total amounts appropriated for the previous fiscal 

year involved, increased or decreased by not more 

than 10 percent.¿

(B) DISTRIBUTION OF GRANTS.—For fiscal year 2002 and 

each of the following fiscal years, the Secretary, in awarding grants under this section, shall ensure that the proportion of the amount made available under each of subsections (g), (h), and (i), relative to the total amount appropriated to carry out this section for that fiscal year, is equal 

to the proportion of the amount made available under that 

10

subsection for fiscal year 2001, relative to the total amount 

appropriated to carry out this section for fiscal year 2001.

* * * * * * *

SEC. 330A. RURAL HEALTH CARE SERVICES OUTREACH, RURAL 

HEALTH NETWORK DEVELOPMENT, AND SMALL HEALTH 

CARE PROVIDER QUALITY IMPROVEMENT GRANT PROGRAMS. 

(a) * * *

(b) DEFINITIONS.— (1) * * *

* * * * * * *

(4) MEDICALLY UNDERSERVED COMMUNITY.—The term ‘‘medically underserved community’’ has the meaning given the term 

in section ø799B¿ 799B(6). 

* * * * * * *

SEC. 330I. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE 

CENTERS GRANT PROGRAMS. 

(a) DEFINITIONS.—In this section: 

(1) * * *

* * * * * * *

(4) MEDICALLY UNDERSERVED AREA.—The term ‘‘medically 

underserved area’’ has the meaning given the term ‘‘medically 

underserved community’’ in section ø799B¿ 799B(6). 

* * * * * * *

(c) ADMINISTRATION.— (1) ESTABLISHMENT.—There is established in the øHealth 

and Resources and Services Administration¿ Health Resources 

and Services Administration an Office for the Advancement of 

Telehealth. The Office shall be headed by a Director. 

* * * * * * *

SEC. 330K. MENTAL HEALTH SERVICES DELIVERED VIA TELEHEALTH. 

(a) * * *

(b) PROGRAM AUTHORIZED.—

(1) * * *

(2) POPULATIONS SERVED.—The Secretary shall award the 

grants under paragraph (1) in a manner that distributes the 

grants so as to serve equitably the populations described in 

subparagraphs (A) and (B) of subsection ø(a)(4)¿ (a)(3). 

(c) USE OF FUNDS.—

(1) IN GENERAL.—An eligible entity that receives a grant 

under this section shall use the grant funds—

(A) for the populations described in subsection 

ø(a)(4)(A)¿ (a)(3)(A)—

(i) * * *

* * * * * * *

(B) for the populations described in subsection 

ø(a)(4)(B)¿ (a)(3)(B)—

(i) * * *

* * * * * * *

11

SEC. 330L. TELEMEDICINE; INCENTIVE GRANTS REGARDING COORDINATION AMONG STATES. 

(a) IN GENERAL.—The Secretary may make grants to State professional licensing boards to carry out programs under which such licensing boards of various States cooperate to develop and implement State policies that will reduce statutory and regulatory barriers to telemedicine. 

(b) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of carrying out subsection (a), there are authorized to be appropriated 

such sums as may be necessary for each of the fiscal years 2002 

through 2006.

Subpart II—National Health Service Corps Program 

* * * * * * *

DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS

SEC. 332. (a)(1) For purposes of this subpart the term ‘‘health 

professional shortage area’’ means (A) an area in an urban or rural 

area (which need not conform to the geographic boundaries of a political subdivision and which is a rational area for the delivery of 

health services) which the Secretary determines has a health manpower shortage, (B) a population group which the Secretary determines has such a shortage, or (C) a public or nonprofit private 

medical facility or other public facility which the Secretary determines has such a shortage. All Federally qualified health centers 

and rural health clinics, as defined in section 1861(aa) of the Social 

Security Act (42 U.S.C. 1395x(aa)), that meet the requirements of 

section 334 shall be automatically designated as having such a 

shortage. Not earlier than 6 years after øsuch date of enactment¿

such date of designation, and every 6 years thereafter, each such 

center or clinic shall demonstrate that the center or clinic meets 

the applicable requirements of the Federal regulationsø, issued 

after the date of enactment of this Act, that revise¿ regarding the 

definition of a health professional shortage area for purposes of this 

section. The Secretary shall not remove an area from the areas determined to be health professional shortage areas under subparagraph (A) of the preceding sentence until the Secretary has afforded interested persons and groups in such area an opportunity 

to provide data and information in support of the designation as a 

health professional shortage area or a population group described 

in subparagraph (B) of such sentence or a facility described in subparagraph (C) of such sentence, and has made a determination on 

the basis of the data and information submitted by such persons 

and groups and other data and information available to the Secretary. 

* * * * * * *

(3) Homeless individuals (as defined in section ø330(h)(4)¿

330(h)(5)), seasonal agricultural workers (as defined in section 

330(g)(3)) and migratory agricultural workers (as so defined)), and 

residents of public housing (as defined in section 3(b)(1) of the 

United States Housing Act of 1937 (42 U.S.C. 1437a(b)(1))) may be 

population groups under paragraph (1). 

(b) The Secretary shall establish by regulation criteria for the 

designation of areas, population groups, medical facilities, and 

12

other public facilities, in the States, as health professional shortage 

areas. In establishing such criteria, the Secretary shall take into 

consideration the following: 

(1) * * *

(2) Indicators of a need, notwithstanding the supply of health 

manpower, for health services for the individuals in an area or 

population group or served by a medical facility or other public 

facility under consideration for ødesignation,.¿ designation.

* * * * * * *

(j)(1) The Secretary shall submit the report described in paragraph (2) if the Secretary, acting through the Administrator of the 

Health Resources and Services Administration, issues—

(A) a regulation that revises the definition of a health professional shortage area for purposes of this section; or 

(B) a regulation that revises the standards concerning priority of such an area under section 333A. 

(2) On issuing a regulation described in paragraph (1), the Secretary shall prepare and submit to the Committee on Energy and 

Commerce of the House of Representatives and the Committee on 

Health, Education, Labor, and Pensions of the Senate a report that 

describes the regulation. 

(3) Each regulation described in paragraph (1) shall take effect 

180 days after the committees described in paragraph (2) receive a 

report referred to in such paragraph describing the regulation.

ASSIGNMENT OF CORPS PERSONNEL

SEC. 333. (a)(1) The Secretary may assign members of the Corps 

to provide, under regulations promulgated by the Secretary, health 

services in or to a health professional shortage area during the assignment period only if—

(A) * * *

* * * * * * *

(C) the entity agrees to comply with the requirements of section 334; and 

* * * * * * *

SEC. 333A. PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL. 

(a) * * *

* * * * * * *

(c) NOTIFICATIONS REGARDING PRIORITIES.—

(1) * * *

* * * * * * *

(4) REVISIONS.—If the Secretary proposes to make a revision 

in the list under paragraph (2), and the revision would adversely alter the status of an entity with respect to the list, the 

Secretary shall notify the entity of the revision. Any entity adversely affected by such a revision shall be notified in writing 

by the Secretary of the reasons for the revision and shall have 

ø30 days¿ 30 days from such notification to file a written appeal of the determination involved which shall be reasonably 

considered by the Secretary before the revision to the list becomes final. The revision to the list shall be effective with reVerDate jul 14 2003 06:50 Sep 18, 2003 Jkt 019006 PO 00000 Frm 00012 Fmt 6659 Sfmt 6601 E:\HR\OC\HR275.XXX HR275
13

spect to assignment of Corps members beginning on the date 

that the revision becomes final. 

* * * * * * *

SEC. 334. CHARGES FOR SERVICES BY ENTITIES USING CORPS MEMBERS. 

(a) * * *

(b) CHARGES FOR SERVICES.—The following rules shall apply to 

charges for health care services provided by an entity to which a 

Corps member is assigned: 

(1) IN GENERAL.—

(A) * * *

(B) SCHEDULE OF DISCOUNTS.—Except as provided in 

paragraph (2), the entity shall prepare a corresponding 

schedule of discounts (including, in appropriate cases, 

waivers) to be applied to the payment of such fees or payments. In preparing the schedule, the entity shall adjust 

the discounts on the basis of a patient’s ability to pay. 

* * * * * * *

Subpart III—Scholarship Program and Loan 

Repayment Program 

* * * * * * *

NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM

SEC. 338A. (a)***

* * * * * * *

(d)(1) Subject to section 333A, in providing contracts under the 

Scholarship Program—

(A) * * *

(B) the Secretary, in considering applications from individuals accepted for enrollment or enrolled in dental school, shall 

consider applications from all individuals accepted for enrollment or enrolled in any accredited dental school in a State; 

and 

* * * * * * *

SEC. 338B. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT 

PROGRAM. 

(a) * * *

* * * * * * *

(e) APPROVAL REQUIRED FOR øPARTICIPATION.— øAn individual¿

PARTICIPATION.—An individual becomes a participant in the Loan 

Repayment Program only upon the Secretary and the individual 

entering into a written contract described in subsection (f). 

* * * * * * *

BREACH OF SCHOLARSHIP CONTRACT OR LOAN REPAYMENT CONTRACT

SEC. 338E. (a)***

* * * * * * *

14

(c)(1) If (for any reason not specified in subsection (a) or section 

338G(d)) an individual breaches the written contract of the individual under section 338B by failing either to begin such individual’s service obligation in accordance with section 338C or 338D or 

to complete such service obligation, the United States shall be entitled to recover from the individual an amount equal to the sum 

of—

(A) the total of the amounts paid by the United States under 

section 338B(g) on behalf of the individual for any period of obligated service not served; 

(B) an amount equal to the product of the number of months 

of obligated service that were not completed by the individual, 

multiplied by $7,500; and 

(C) the interest on the amounts described in subparagraphs 

(A) and (B), at the maximum legal prevailing rate, as determined by the Treasurer of the United States, from the date of 

the breach; 

except that the amount the United States is entitled to recover 

under this paragraph shall not be less than $31,000. 

* * * * * * *

(f) The amendment made by section 313(a)(4) of the Health Care 

Safety Net Amendments of 2002 (Public Law 107-251) shall apply 

to any obligation for which a discharge in bankruptcy has not been 

granted before the date that is 31 days after the date of enactment 

of such Act.

* * * * * * *

TITLE XIII—HEALTH MAINTENANCE ORGANIZATIONS 

* * * * * * *

LIMITATION ON SOURCE OF FUNDING FOR HEALTH MAINTENANCE

ORGANIZATIONS

SEC. 1313. No funds appropriated under any provision of this Act 

(except as provided in sections ø329, 330, and 330(h)¿ 329 and 330) 

other than this title may be used—

(1) * * *

* * * * * * *

TITLE XXVI—HIV HEALTH CARE 

SERVICES PROGRAM 

* * * * * * *

PART C—EARLY INTERVENTION SERVICES

Subpart I—Categorical Grants 

* * * * * * *

SEC. 2652. MINIMUM QUALIFICATIONS OF GRANTEES. 

(a) IN GENERAL.—The entities referred to in section 2651(a) are 

public entities and nonprofit private entities that are—

(1) * * *

15

(2) grantees under section ø340¿ 330(h) (regarding health 

services for the homeless); 

* * * * * * *

HEALTH CARE SAFETY NET AMENDMENTS ACT OF 2002

* * * * * * *

TITLE I—CONSOLIDATED HEALTH 

CENTER PROGRAM AMENDMENTS 

* * * * * * *

øSEC. 102. TELEMEDICINE; INCENTIVE GRANTS REGARDING COORDINATION AMONG STATES. 

ø(a) IN GENERAL.—The Secretary of Health and Human Services 

may make grants to State professional licensing boards to carry out 

programs under which such licensing boards of various States cooperate to develop and implement State policies that will reduce 

statutory and regulatory barriers to telemedicine. 

ø(b) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of 

carrying out subsection (a), there are authorized to be appropriated 

such sums as may be necessary for each of the fiscal years 2002 

through 2006.¿

* * * * * * *

TITLE III—NATIONAL HEALTH SERVICE 

CORPS PROGRAM 

* * * * * * *

SEC. 302. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE 

AREAS. 

(a) * * *

ø(b) REGULATIONS.—

ø(1) REPORT.—

ø(A) IN GENERAL.—The Secretary shall submit the report 

described in subparagraph (B) if the Secretary, acting 

through the Administrator of the Health Resources and 

Services Administration, issues—

ø(i) a regulation that revises the definition of a 

health professional shortage area for purposes of section 332 of the Public Health Service Act (42 U.S.C. 

254e); or 

ø(ii) a regulation that revises the standards concerning priority of such an area under section 333A of 

that Act (42 U.S.C. 254f–1). 

ø(B) REPORT.—On issuing a regulation described in subparagraph (A), the Secretary shall prepare and submit to 

the Committee on Energy and Commerce of the House of 

Representatives and the Committee on Health, Education, 

Labor, and Pensions of the Senate a report that describes 

the regulation. 

16

ø(2) EFFECTIVE DATE.—Each regulation described in paragraph (1)(A) shall take effect 180 days after the committees described in paragraph (1)(B) receive a report referred to in paragraph (1)(B) describing the regulation.¿

* * * * * * *

SEC. 313. BREACH OF SCHOLARSHIP CONTRACT OR LOAN REPAYMENT CONTRACT. 

(a) * * *

ø(b) EFFECTIVE DATE.—The amendment made by subsection 

(a)(4) shall apply to any obligation for which a discharge in bankruptcy has not been granted before the date that is 31 days after 

the date of enactment of this Act.¿

* * * * * * *

TITLE IV—HEALTHY COMMUNITIES 

ACCESS PROGRAM 

* * * * * * *

SEC. 404. STUDY REGARDING BARRIERS TO PARTICIPATION OF 

FARMWORKERS IN HEALTH PROGRAMS. 

(a) * * *

* * * * * * *

(c) CONSULTATIONS.—In conducting the study, the Secretary shall 

consult with the following: 

(1) * * *

* * * * * * *

(5) Representatives of Federal agencies which are involved in 

the provision or financing of health care to farmworkers, including the øHealth Care Financing Administration and the 

Health Research¿ Centers for Medicare & Medicaid Services 

and the Health Resources and Services Administration. 

* * * * * * *

TITLE V—STUDY AND MISCELLANEOUS 

PROVISIONS 

SEC. 501. GUARANTEE STUDY. 

The Secretary of Health and Human Services shall conduct a 

study regarding the ability of the Department of Health and 

Human Services to provide for øsolvency for managed care networks¿ guarantees of solvency for managed care networks or plans

involving health centers receiving funding under section 330 of the 

Public Health Service Act. The Secretary shall prepare and submit 

a report to the appropriate Committees of Congress regarding such 

ability not later than 2 years after the date of enactment of the 

Health Care Safety Net Amendments of 2002. 

* * * * * * *

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