H. R. 1812 

One Hundred Ninth Congress 

of the 

United States of America 

AT THE FIRST SESSION 

Begun and held at the City of Washington on Tuesday, 

the fourth day of January, two thousand and five 

An Act 

To amend the Public Health Service Act to authorize a demonstration grant program 

to provide patient navigator services to reduce barriers and improve health care 

outcomes, and for other purposes. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Patient Navigator Outreach 

and Chronic Disease Prevention Act of 2005’’. 

SEC. 2. PATIENT NAVIGATOR GRANTS. 

Subpart V of part D of title III of the Public Health Service 

Act (42 U.S.C. 256) is amended by adding at the end the following: 

‘‘SEC. 340A. PATIENT NAVIGATOR GRANTS. 

‘‘(a) GRANTS.—The Secretary, acting through the Administrator 

of the Health Resources and Services Administration, may make 

grants to eligible entities for the development and operation of 

demonstration programs to provide patient navigator services to 

improve health care outcomes. The Secretary shall coordinate with, 

and ensure the participation of, the Indian Health Service, the 

National Cancer Institute, the Office of Rural Health Policy, and 

such other offices and agencies as deemed appropriate by the Secretary, regarding the design and evaluation of the demonstration 

programs. 

‘‘(b) USE OF FUNDS.—The Secretary shall require each recipient 

of a grant under this section to use the grant to recruit, assign, 

train, and employ patient navigators who have direct knowledge 

of the communities they serve to facilitate the care of individuals, 

including by performing each of the following duties: 

‘‘(1) Acting as contacts, including by assisting in the 

coordination of health care services and provider referrals, for 

individuals who are seeking prevention or early detection services for, or who following a screening or early detection service 

are found to have a symptom, abnormal finding, or diagnosis 

of, cancer or other chronic disease. 

‘‘(2) Facilitating the involvement of community organizations in assisting individuals who are at risk for or who have 

cancer or other chronic diseases to receive better access to 

high-quality health care services (such as by creating partnerships with patient advocacy groups, charities, health care centers, community hospice centers, other health care providers, 

or other organizations in the targeted community). 


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‘‘(3) Notifying individuals of clinical trials and, on request, 

facilitating enrollment of eligible individuals in these trials. 

‘‘(4) Anticipating, identifying, and helping patients to overcome barriers within the health care system to ensure prompt 

diagnostic and treatment resolution of an abnormal finding 

of cancer or other chronic disease. 

‘‘(5) Coordinating with the relevant health insurance 

ombudsman programs to provide information to individuals 

who are at risk for or who have cancer or other chronic diseases 

about health coverage, including private insurance, health care 

savings accounts, and other publicly funded programs (such 

as Medicare, Medicaid, health programs operated by the 

Department of Veterans Affairs or the Department of Defense, 

the State children’s health insurance program, and any private 

or governmental prescription assistance programs). 

‘‘(6) Conducting ongoing outreach to health disparity populations, including the uninsured, rural populations, and other 

medically underserved populations, in addition to assisting 

other individuals who are at risk for or who have cancer or 

other chronic diseases to seek preventative care. 

‘‘(c) PROHIBITIONS.— 

‘‘(1) REFERRAL FEES.—The Secretary shall require each 

recipient of a grant under this section to prohibit any patient 

navigator providing services under the grant from accepting 

any referral fee, kickback, or other thing of value in return 

for referring an individual to a particular health care provider. 

‘‘(2) LEGAL FEES AND COSTS.—The Secretary shall prohibit 

the use of any grant funds received under this section to pay 

any fees or costs resulting from any litigation, arbitration, 

mediation, or other proceeding to resolve a legal dispute. 

‘‘(d) GRANT PERIOD.— 

‘‘(1) IN GENERAL.—Subject to paragraphs (2) and (3), the 

Secretary may award grants under this section for periods 

of not more than 3 years. 

‘‘(2) EXTENSIONS.—Subject to paragraph (3), the Secretary 

may extend the period of a grant under this section. Each 

such extension shall be for a period of not more than 1 year. 

‘‘(3) LIMITATIONS ON GRANT PERIOD.—In carrying out this 

section, the Secretary— 

‘‘(A) shall ensure that the total period of a grant does 

not exceed 4 years; and 

‘‘(B) may not authorize any grant period ending after 

September 30, 2010. 

‘‘(e) APPLICATION.— 

‘‘(1) IN GENERAL.—To seek a grant under this section, an 

eligible entity shall submit an application to the Secretary 

in such form, in such manner, and containing such information 

as the Secretary may require. 

‘‘(2) CONTENTS.—At a minimum, the Secretary shall require 

each such application to outline how the eligible entity will 

establish baseline measures and benchmarks that meet the 

Secretary’s requirements to evaluate program outcomes. 

‘‘(f) UNIFORM BASELINE MEASURES.—The Secretary shall establish uniform baseline measures in order to properly evaluate the 

impact of the demonstration projects under this section. 

‘‘(g) PREFERENCE.—In making grants under this section, the 

Secretary shall give preference to eligible entities that demonstrate 


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in their applications plans to utilize patient navigator services 

to overcome significant barriers in order to improve health care 

outcomes in their respective communities. 

‘‘(h) DUPLICATION OF SERVICES.—An eligible entity that is 

receiving Federal funds for activities described in subsection (b) 

on the date on which the entity submits an application under 

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

the entity can demonstrate that amounts received under the grant 

will be utilized to expand services or provide new services to individuals who would not otherwise be served. 

‘‘(i) COORDINATION WITH OTHER PROGRAMS.—The Secretary 

shall ensure coordination of the demonstration grant program under 

this section with existing authorized programs in order to facilitate 

access to high-quality health care services. 

‘‘(j) STUDY; REPORTS.— 

‘‘(1) FINAL REPORT BY SECRETARY.—Not later than 6 months 

after the completion of the demonstration grant program under 

this section, the Secretary shall conduct a study of the results 

of the program and submit to the Congress a report on such 

results that includes the following: 

‘‘(A) An evaluation of the program outcomes, 

including— 

‘‘(i) quantitative analysis of baseline and benchmark measures; and 

‘‘(ii) aggregate information about the patients 

served and program activities. 

‘‘(B) Recommendations on whether patient navigator 

programs could be used to improve patient outcomes in 

other public health areas. 

‘‘(2) INTERIM REPORTS BY SECRETARY.—The Secretary may 

provide interim reports to the Congress on the demonstration 

grant program under this section at such intervals as the 

Secretary determines to be appropriate. 

‘‘(3) REPORTS BY GRANTEES.—The Secretary may require 

grant recipients under this section to submit interim and final 

reports on grant program outcomes. 

‘‘(k) RULE OF CONSTRUCTION.—This section shall not be construed to authorize funding for the delivery of health care services 

(other than the patient navigator duties listed in subsection (b)). 

‘‘(l) DEFINITIONS.—In this section: 

‘‘(1) The term ‘eligible entity’ means a public or nonprofit 

private health center (including a Federally qualified health 

center (as that term is defined in section 1861(aa)(4) of the 

Social Security Act)), a health facility operated by or pursuant 

to a contract with the Indian Health Service, a hospital, a 

cancer center, a rural health clinic, an academic health center, 

or a nonprofit entity that enters into a partnership or coordinates referrals with such a center, clinic, facility, or hospital 

to provide patient navigator services. 

‘‘(2) The term ‘health disparity population’ means a population that, as determined by the Secretary, has a significant 

disparity in the overall rate of disease incidence, prevalence, 

morbidity, mortality, or survival rates as compared to the 

health status of the general population. 

‘‘(3) The term ‘patient navigator’ means an individual who 

has completed a training program approved by the Secretary 

to perform the duties listed in subsection (b). 


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‘‘(m) AUTHORIZATION OF APPROPRIATIONS.— 

‘‘(1) IN GENERAL.—To carry out this section, there are 

authorized to be appropriated $2,000,000 for fiscal year 2006, 

$5,000,000 for fiscal year 2007, $8,000,000 for fiscal year 2008, 

$6,500,000 for fiscal year 2009, and $3,500,000 for fiscal year 

2010. 

‘‘(2) AVAILABILITY.—The amounts appropriated pursuant to 

paragraph (1) shall remain available for obligation through 

the end of fiscal year 2010.’’. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate. 


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