```

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1812 Enrolled Bill (ENR)]

        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).
        ``(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 
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).
    ``(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.
```