II 

112TH CONGRESS 

1ST SESSION S. 1609 

To require the Secretary of Health and Human Services to establish a 

demonstration program to award grants to, and enter into contracts 

with, medical-legal partnerships to assist patients and their families to 

navigate health-related programs and activities. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 22, 2011 

Mr. HARKIN (for himself, Mr. LEAHY, and Mr. INOUYE) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To require the Secretary of Health and Human Services 

to establish a demonstration program to award grants 

to, and enter into contracts with, medical-legal partnerships to assist patients and their families to navigate 

health-related programs and activities. 

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 ‘‘Medical-Legal Partner5 ship for Health Act’’. 

6 SEC. 2. FINDINGS; PURPOSE. 

7 (a) FINDINGS.—Congress finds the following: 


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1 (1) Numerous studies and reports, including 

2 the annual National Healthcare Disparities Report 

3 and Unequal Treatment, the 2002 Institute of Medi4 cine Report, document the extensiveness to which 

5 vulnerable populations suffer from health disparities 

6 across the country. 

7 (2) These studies have found that, on average, 

8 racial and ethnic minorities and low-income popu9 lations are disproportionately afflicted with chronic 

10 and acute conditions such as asthma, cancer, diabe11 tes, and hypertension and suffer worse health out12 comes, worse health status, and higher mortality 

13 rates. 

14 (3) Several recent studies also show that health 

15 and healthcare quality are a function of not only ac16 cess to healthcare, but also the social determinants 

17 of health, including the environment, the physical 

18 structure of communities, socio-economic status, nu19 trition, educational attainment, employment, race, 

20 ethnicity, geography, and language preference, that 

21 directly and indirectly affect the health, healthcare, 

22 and wellness of individuals and communities. 

23 (4) Formally integrating medical and legal pro24 fessionals in the health setting can more effectively 


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1 address the health needs of vulnerable populations 

2 and ultimately reduce health disparities. 

3 (5) All over the United States, healthcare pro4 viders who take care of low-income individuals and 

5 families are partnering with legal professionals to 

6 assist them in providing better quality of healthcare. 

7 (6) Medical-legal partnerships integrate lawyers 

8 in a health setting to help patients navigate the com9 plex government, legal, and service systems in ad10 dressing social determinants of health, such as in11 come supports for food insecure families and mold 

12 removal from the home of asthmatics. 

13 (b) PURPOSES.—The purposes of this Act are to— 

14 (1) support and advance opportunity for med15 ical-legal partnerships to be more fully integrated in 

16 healthcare settings nationwide; 

17 (2) to improve the quality of care for vulnerable 

18 populations by reducing health disparities among 

19 health disparities populations and addressing the so20 cial determinants of health; and 

21 (3) identify and develop cost-effective strategies 

22 that will improve patient outcomes and realize sav23 ings for healthcare systems. 


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1 SEC. 3. MEDICAL-LEGAL PARTNERSHIPS. 

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

3 Human Services shall establish a nationwide demonstra4 tion project consisting of— 

5 (1) awarding grants to, and entering into con6 tracts with, medical-legal partnerships to assist pa7 tients and their families to navigate programs and 

8 activities; and 

9 (2) evaluating the effectiveness of such partner10 ships. 

11 (b) TECHNICAL ASSISTANCE.—The Secretary may, 

12 directly or through grants or contracts, provide technical 

13 assistance to grantees under subsection (a)(1) to support 

14 the establishment and sustainability of medical-legal part15 nerships. Not to exceed 5 percent of the amount appro16 priated to carry out this section in a fiscal year may be 

17 used for purposes of this subsection. 

18 (c) FUNDING.— 

19 (1) USE OF FUNDS.—Amounts received as a 

20 grant or pursuant to a contract under this section 

21 shall be used to assist patients and their families to 

22 navigate health-related programs and activities for 

23 purposes of achieving one or more of the following 

24 goals: 

25 (A) Enhancing access to healthcare serv26 ices. 


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1 (B) Improving health outcomes for low-in2 come individuals, as defined in subsection (g). 

3 (C) Reducing health disparities among 

4 health disparities populations. 

5 (D) Enhancing wellness and prevention of 

6 chronic conditions and other health problems. 

7 (E) Reducing cost of care to the healthcare 

8 system. 

9 (F) Addressing the social determinants of 

10 health. 

11 (G) Addressing situational contributing 

12 factors. 

13 (2) AUTHORIZATION OF APPROPRIATIONS.— 

14 There are authorized to be appropriated to carry out 

15 this section such sums as may be necessary, but not 

16 to exceed $10,000,000, for each of the fiscal years 

17 2012 through 2016. 

18 (3) MATCHING REQUIREMENT.—For each fiscal 

19 year, the Secretary may not award a grant or con20 tract under this section to an entity unless the entity 

21 agrees to make available non-Federal contributions 

22 (which may include in-kind contributions) toward 

23 the costs of a grant or contract awarded under this 

24 section in an amount that is not less than $1 for 


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1 each $10 of Federal funds provided under the grant 

2 or contract. 

3 (4) ALLOCATION.—Of the amounts appro4 priated pursuant to paragraph (2) for a fiscal year, 

5 the Secretary may obligate not more than 5 percent 

6 for the administrative expenses of the Secretary in 

7 carrying out this section. 

8 (d) ELIGIBLE ENTITIES.—To be eligible to receive a 

9 grant or contract under this section, an entity shall— 

10 (1) be an organization experienced in bridging 

11 the medical and legal professions on behalf of vul12 nerable populations nationally; and 

13 (2) submit to the Secretary an application at 

14 such time, in such manner, and containing such in15 formation as the Secretary may require, including 

16 information demonstrating that the applicant has ex17 perience in bridging the medical and legal profes18 sions or a strategy or plan for cultivating and build19 ing medical-legal partnerships. 

20 (e) PROHIBITIONS.—No funds under this section may 

21 be used— 

22 (1) for any medical malpractice action or pro23 ceeding; 

24 (2) to provide any support to an alien who is 

25 not— 


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1 (A) a qualified alien (as defined in section 

2 431 of the Immigration and Nationality Act); 

3 (B) a nonimmigrant under the Immigra4 tion and Nationality Act; or 

5 (C) an alien who is paroled into the United 

6 States under section 212(d)(5) of such Act for 

7 less than one year; 

8 (3) to provide legal assistance with respect to 

9 any proceeding or litigation which seeks to procure 

10 an abortion or to compel any individual or institu11 tion to perform an abortion, or assist in the per12 formance of an abortion; or 

13 (4) to initiate or participate in a class action 

14 lawsuit. 

15 (f) REPORTS.— 

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

17 than 6 months after the date of the completion of 

18 the demonstration program under this section, the 

19 Secretary shall conduct a study of the results of the 

20 program and submit to the Congress a report on 

21 such results that includes the following: 

22 (A) An evaluation of the program out23 comes, including— 

24 (i) a description of the extent to which 

25 medical-legal partnerships funded through 


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1 this section achieved the goals described in 

2 subsection (b); 

3 (ii) quantitative and qualitative anal4 ysis of baseline and benchmark measures; 

5 and 

6 (iii) aggregate information about the 

7 individuals served and program activities. 

8 (B) Recommendations on whether the pro9 grams funded under this section could be used 

10 to improve patient outcomes in other public 

11 health areas. 

12 (2) INTERIM REPORTS BY SECRETARY.—The 

13 Secretary may provide interim reports to the Con14 gress on the demonstration program under this sec15 tion at such intervals as the Secretary determines to 

16 be appropriate. 

17 (3) REPORTS BY GRANTEES.—The Secretary 

18 may require each recipient of a grant under this sec19 tion to submit interim and final reports on the pro20 grams carried out by such recipient with such grant. 

21 (g) DEFINITIONS.—In this section: 

22 (1) The term ‘‘health disparities populations’’ 

23 has the meaning given such term in section 485E(d) 

24 of the Public Health Service Act. 


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1 (2) The term ‘‘low-income individuals’’ refers to 

2 the population of individuals and families who earn 

3 up to 200 percent of the Federal poverty level. 

4 (3) The term ‘‘medical-legal partnership’’ 

5 means an entity— 

6 (A) that is a partnership between— 

7 (i) a community health center, public 

8 hospital, children’s hospital, or other pro9 vider of healthcare services to a significant 

10 number of low-income beneficiaries; and 

11 (ii) one or more legal professionals; 

12 and 

13 (B) whose primary mission is to assist pa14 tients and their families navigate health-related 

15 programs, activities, and services through the 

16 provision of relevant civil legal assistance on17 site in the healthcare setting involved, in con18 junction with regular training for healthcare 

19 staff and providers regarding the connections 

20 between legal interventions, social determinants, 

21 and health of low-income individuals. 

22 (4) The term ‘‘Secretary’’ means the Secretary 

23 of Health and Human Services. 

Æ 


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