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Union Calendar No. 58 

109TH CONGRESS 

1ST SESSION H. R. 1812 

[Report No. 109–104] 

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. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 25, 2005 

Mr. MENENDEZ (for himself and Ms. PRYCE of Ohio) introduced the following 

bill; which was referred to the Committee on Energy and Commerce 

JUNE 7, 2005 

Committed to the Committee of the Whole House on the State of the Union 

and ordered to be printed 

A BILL 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Patient Navigator Out3 reach and Chronic Disease Prevention Act of 2005’’. 

4 SEC. 2. PATIENT NAVIGATOR GRANTS. 

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

6 Service Act (42 U.S.C. 256) is amended by adding at the 

7 end the following: 

8 ‘‘SEC. 340A. PATIENT NAVIGATOR GRANTS. 

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

10 Administrator of the Health Resources and Services Ad11 ministration, may make grants to eligible entities for the 

12 development and operation of demonstration programs to 

13 provide patient navigator services to improve health care 

14 outcomes. The Secretary shall coordinate with, and ensure 

15 the participation of, the Indian Health Service, the Na16 tional Cancer Institute, the Office of Rural Health Policy, 

17 and such other offices and agencies as deemed appropriate 

18 by the Secretary, regarding the design and evaluation of 

19 the demonstration programs. 

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

21 each recipient of a grant under this section to use the 

22 grant to recruit, assign, train, and employ patient naviga23 tors who have direct knowledge of the communities they 

24 serve to facilitate the care of individuals, including by per25 forming each of the following duties: 
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1 ‘‘(1) Acting as contacts, including by assisting 

2 in the coordination of health care services and pro3 vider referrals, for individuals who are seeking pre4 vention or early detection services for, or who fol5 lowing a screening or early detection service are 

6 found to have a symptom, abnormal finding, or diag7 nosis of, cancer or other chronic disease. 

8 ‘‘(2) Facilitating the involvement of community 

9 organizations in assisting individuals who are at risk 

10 for or who have cancer or other chronic diseases to 

11 receive better access to high-quality health care serv12 ices (such as by creating partnerships with patient 

13 advocacy groups, charities, health care centers, com14 munity hospice centers, other health care providers, 

15 or other organizations in the targeted community). 

16 ‘‘(3) Notifying individuals of clinical trials and, 

17 on request, facilitating enrollment of eligible individ18 uals in these trials. 

19 ‘‘(4) Anticipating, identifying, and helping pa20 tients to overcome barriers within the health care 

21 system to ensure prompt diagnostic and treatment 

22 resolution of an abnormal finding of cancer or other 

23 chronic disease. 

24 ‘‘(5) Coordinating with the relevant health in25 surance ombudsman programs to provide informa-
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1 tion to individuals who are at risk for or who have 

2 cancer or other chronic diseases about health cov3 erage, including private insurance, health care sav4 ings accounts, and other publicly funded programs 

5 (such as Medicare, Medicaid, health programs oper6 ated by the Department of Veterans Affairs or the 

7 Department of Defense, the State children’s health 

8 insurance program, and any private or governmental 

9 prescription assistance programs). 

10 ‘‘(6) Conducting ongoing outreach to health dis11 parity populations, including the uninsured, rural 

12 populations, and other medically underserved popu13 lations, in addition to assisting other individuals who 

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

15 diseases to seek preventative care. 

16 ‘‘(c) PROHIBITIONS.— 

17 ‘‘(1) REFERRAL FEES.—The Secretary shall re18 quire each recipient of a grant under this section to 

19 prohibit any patient navigator providing services 

20 under the grant from accepting any referral fee, 

21 kickback, or other thing of value in return for refer22 ring an individual to a particular health care pro23 vider. 

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

25 shall prohibit the use of any grant funds received 
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1 under this section to pay any fees or costs resulting 

2 from any litigation, arbitration, mediation, or other 

3 proceeding to resolve a legal dispute. 

4 ‘‘(d) GRANT PERIOD.— 

5 ‘‘(1) IN GENERAL.—Subject to paragraphs (2) 

6 and (3), the Secretary may award grants under this 

7 section for periods of not more than 3 years. 

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

9 the Secretary may extend the period of a grant 

10 under this section. Each such extension shall be for 

11 a period of not more than 1 year. 

12 ‘‘(3) LIMITATIONS ON GRANT PERIOD.—In car13 rying out this section, the Secretary— 

14 ‘‘(A) shall ensure that the total period of 

15 a grant does not exceed 4 years; and 

16 ‘‘(B) may not authorize any grant period 

17 ending after September 30, 2010. 

18 ‘‘(e) APPLICATION.— 

19 ‘‘(1) IN GENERAL.—To seek a grant under this 

20 section, an eligible entity shall submit an application 

21 to the Secretary in such form, in such manner, and 

22 containing such information as the Secretary may 

23 require. 

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

25 shall require each such application to outline how 
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1 the eligible entity will establish baseline measures 

2 and benchmarks that meet the Secretary’s require3 ments to evaluate program outcomes. 

4 ‘‘(f) UNIFORM BASELINE MEASURES.—The Sec5 retary shall establish uniform baseline measures in order 

6 to properly evaluate the impact of the demonstration 

7 projects under this section. 

8 ‘‘(g) PREFERENCE.—In making grants under this 

9 section, the Secretary shall give preference to eligible enti10 ties that demonstrate in their applications plans to utilize 

11 patient navigator services to overcome significant barriers 

12 in order to improve health care outcomes in their respec13 tive communities. 

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

15 that is receiving Federal funds (including funds through 

16 a grant under section 340, which is commonly referred 

17 to as the ‘Healthy Communities Access Program’) for ac18 tivities described in subsection (b) on the date on which 

19 the entity submits an application under subsection (e), 

20 may not receive a grant under this section unless the enti21 ty can demonstrate that amounts received under the grant 

22 will be utilized to expand services or provide new services 

23 to individuals who would not otherwise be served. 

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

25 Secretary shall ensure coordination of the demonstration 
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1 grant program under this section with existing authorized 

2 programs in order to facilitate access to high-quality 

3 health care services. 

4 ‘‘(j) STUDY; REPORTS.— 

5 ‘‘(1) FINAL REPORT BY SECRETARY.—Not later 

6 than 6 months after the completion of the dem7 onstration grant program under this section, the 

8 Secretary shall conduct a study of the results of the 

9 program and submit to the Congress a report on 

10 such results that includes the following: 

11 ‘‘(A) An evaluation of the program out12 comes, including— 

13 ‘‘(i) quantitative analysis of baseline 

14 and benchmark measures; and 

15 ‘‘(ii) aggregate information about the 

16 patients served and program activities. 

17 ‘‘(B) Recommendations on whether patient 

18 navigator programs could be used to improve 

19 patient outcomes in other public health areas. 

20 ‘‘(2) INTERIM REPORTS BY SECRETARY.—The 

21 Secretary may provide interim reports to the Con22 gress on the demonstration grant program under 

23 this section at such intervals as the Secretary deter24 mines to be appropriate. 
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1 ‘‘(3) REPORTS BY GRANTEES.—The Secretary 

2 may require grant recipients under this section to 

3 submit interim and final reports on grant program 

4 outcomes. 

5 ‘‘(k) RULE OF CONSTRUCTION.—This section shall 

6 not be construed to authorize funding for the delivery of 

7 health care services (other than the patient navigator du8 ties listed in subsection (b)). 

9 ‘‘(l) DEFINITIONS.—In this section: 

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

11 or nonprofit private health center (including a Fed12 erally qualified health center (as that term is defined 

13 in section 1861(aa)(4) of the Social Security Act)), 

14 a health facility operated by or pursuant to a con15 tract with the Indian Health Service, a hospital, a 

16 cancer center, a rural health clinic, an academic 

17 health center, or a nonprofit entity that enters into 

18 a partnership or coordinates referrals with such a 

19 center, clinic, facility, or hospital to provide patient 

20 navigator services. 

21 ‘‘(2) The term ‘health disparity population’ 

22 means a population that, as determined by the Sec23 retary, has a significant disparity in the overall rate 

24 of disease incidence, prevalence, morbidity, mor-
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1 tality, or survival rates as compared to the health 

2 status of the general population. 

3 ‘‘(3) The term ‘patient navigator’ means an in4 dividual who has completed a training program ap5 proved by the Secretary to perform the duties listed 

6 in subsection (b). 

7 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.— 

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

9 there are authorized to be appropriated $2,000,000 

10 for fiscal year 2006, $5,000,000 for fiscal year 

11 2007, $8,000,000 for fiscal year 2008, $6,500,000 

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

13 2010. 

14 ‘‘(2) AVAILABILITY.—The amounts appro15 priated pursuant to paragraph (1) shall remain 

16 available for obligation through the end of fiscal year 

17 2010.’’. 
Union Calendar No. 58 

109TH CONGRESS 

1ST SESSION H. R. 1812 

[Report No. 109–104] 

A BILL 

To amend the Public Health Service Act to authorposes. improve health care outcomes, and for other pur- tient navigator services to reduce barriers and ize a demonstration grant program to provide paJUNE 7, 2005 

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed