II 

110TH CONGRESS 

1ST SESSION S. 600 

To amend the Public Health Service Act to establish the School-Based Health 

Clinic program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 14, 2007 

Mr. SMITH (for himself, Mr. DODD, Ms. COLLINS, Ms. SNOWE, Mr. KENNEDY, Mr. VITTER, and Mr. BINGAMAN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to establish the 

School-Based Health Clinic program, 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘School-Based Health 

5 Clinic Establishment Act of 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

7 (a) FINDINGS.—Congress makes the following find8 ings: 


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1 (1) More than 8,000,000 children in the United 

2 States have no form of health insurance and are 

3 therefore unable to access preventive health care 

4 which may lead to untreated conditions, unnecessary 

5 diseases, and death. 

6 (2) The American Medical Association rates 

7 adolescents aged 13–18 as the group of Americans 

8 with the poorest health indicators. 

9 (3) More than 70 percent of the children who 

10 need psychiatric treatment do not receive services. 

11 (4) Children who are in poor health or are vic12 tims of child abuse, poverty, malnutrition, alcohol, 

13 and drug abuse are at risk for academic and social 

14 failure. 

15 (5) Without health and social intervention, at16 risk children are often unable to improve academic 

17 performance. 

18 (6) School-based health clinics are effective in 

19 bringing preventive and primary care to children and 

20 adolescents. 

21 (7) School-based health clinics are effective in 

22 decreasing academic failure resulting from poor 

23 health. 

24 (8) The goal of this Act is to provide children 

25 and adolescents with medical and mental health 


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1 services necessary to be healthy and succeed aca2 demically. 

3 (b) PURPOSE.—The purpose of this Act is to fund 

4 the development and operation of school-based health clin5 ics to— 

6 (1) provide comprehensive and accessible pri7 mary health care services to medically underserved 

8 children, youth, and families; 

9 (2) improve the physical health, emotional well10 being, and academic performance of medically un11 derserved children, youth, and families; and 

12 (3) work in collaboration with the school to in13 tegrate health into the overall school environment. 

14 SEC. 3. SCHOOL-BASED HEALTH CLINICS. 

15 Part Q of title III of the Public Health Service Act 

16 (42 U.S.C. 280h et seq.) is amended by adding at the end 

17 the following: 

18 ‘‘SEC. 399Z–1. SCHOOL-BASED HEALTH CLINICS. 

19 ‘‘(a) DEFINITIONS; ESTABLISHMENT OF CRITERIA.— 

20 In this section: 

21 ‘‘(1) COMMUNITY.—The term ‘community’ in22 cludes parents, consumers, local leaders, and organi23 zations. 

24 ‘‘(2) COMPREHENSIVE PRIMARY HEALTH SERV25 ICES.—The term ‘comprehensive primary health 


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1 services’ means the core services offered by school2 based health clinics, which shall include the fol3 lowing: 

4 ‘‘(A) PHYSICAL.—Comprehensive health 

5 assessments, diagnosis, and treatment of minor, 

6 acute, and chronic medical conditions and refer7 rals to, and follow-up for, specialty care. 

8 ‘‘(B) MENTAL HEALTH.—Mental health 

9 assessments, crisis intervention, counseling, 

10 treatment, and referral to a continuum of serv11 ices including emergency psychiatric care, com12 munity support programs, inpatient care, and 

13 outpatient programs. 

14 ‘‘(C) OPTIONAL SERVICES.—Additional 

15 services, which may include oral health, social, 

16 and health education services. 

17 ‘‘(3) MEDICALLY UNDERSERVED CHILDREN

18 AND ADOLESCENTS.— 

19 ‘‘(A) IN GENERAL.—The term ‘medically 

20 underserved children and adolescents’ means a 

21 population of children and adolescents who are 

22 residents of an area designated by the Sec23 retary as an area with a shortage of personal 

24 health services and health infrastructure for 

25 such children and adolescents. 


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1 ‘‘(B) CRITERIA.—The Secretary shall pre2 scribe criteria for determining the specific 

3 shortages of personal health services for medi4 cally underserved children and adolescents 

5 under subparagraph (A) that shall— 

6 ‘‘(i) take into account any comments 

7 received by the Secretary from the chief 

8 executive officer of a State and local offi9 cials in a State; and 

10 ‘‘(ii) include factors indicative of the 

11 health status of such children and adoles12 cents of an area, including the ability of 

13 the residents of such area to pay for health 

14 services, the accessibility of such services, 

15 the availability of health professionals to 

16 such children and adolescents, and other 

17 factors as determined appropriate by the 

18 Secretary. 

19 ‘‘(4) SCHOOL-BASED HEALTH CLINIC.—The 

20 term ‘school-based health clinic’ means a health clin21 ic that— 

22 ‘‘(A) is located in or near a school facility 

23 of a school district or board; 

24 ‘‘(B) is organized through school, commu25 nity, and health provider relationships; 


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1 ‘‘(C) is administered by a sponsoring facil2 ity; and 

3 ‘‘(D) provides, at a minimum, comprehen4 sive primary health services during school hours 

5 to children and adolescents by health profes6 sionals in accordance with State and local laws 

7 and regulations, established standards, and 

8 community practice. 

9 ‘‘(5) SPONSORING FACILITY.—The term ‘spon10 soring facility’ is a community-based organization, 

11 which may include— 

12 ‘‘(A) a hospital; 

13 ‘‘(B) a public health department; 

14 ‘‘(C) a community health center; 

15 ‘‘(D) a nonprofit health care agency; or 

16 ‘‘(E) a school or school system. 

17 ‘‘(b) AUTHORITY TO AWARD GRANTS.—The Sec18 retary shall award grants for the costs of the operation 

19 of school-based health clinics (referred to in this section 

20 as ‘SBHCs’) that meet the requirements of this section. 

21 ‘‘(c) APPLICATIONS.—To be eligible to receive a grant 

22 under this section, an entity shall— 

23 ‘‘(1) be an SBHC (as defined in subsection 

24 (a)(4)); and 


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1 ‘‘(2) submit to the Secretary an application at 

2 such time, in such manner, and containing— 

3 ‘‘(A) evidence that the applicant meets all 

4 criteria necessary to be designated an SBHC; 

5 ‘‘(B) evidence of local need for the services 

6 to be provided by the SBHC; 

7 ‘‘(C) an assurance that— 

8 ‘‘(i) SBHC services will be provided to 

9 those children and adolescents for whom 

10 parental or guardian consent has been ob11 tained in cooperation with Federal, State, 

12 and local laws governing health care serv13 ice provision to children and adolescents; 

14 ‘‘(ii) the SBHC has made and will 

15 continue to make every reasonable effort to 

16 establish and maintain collaborative rela17 tionships with other health care providers 

18 in the catchment area of the SBHC; 

19 ‘‘(iii) the SBHC will provide on-site 

20 access during the academic day when 

21 school is in session and 24-hour coverage 

22 through an on-call system and through its 

23 backup health providers to ensure access to 

24 services on a year-round basis when the 

25 school or the SBHC is closed; 


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1 ‘‘(iv) the SBHC will be integrated into 

2 the school environment and will coordinate 

3 health services with school personnel, such 

4 as administrators, teachers, nurses, coun5 selors, and support personnel, as well as 

6 with other community providers co-located 

7 at the school; and 

8 ‘‘(v) the SBHC sponsoring facility as9 sumes all responsibility for the SBHC ad10 ministration, operations, and oversight; 

11 and 

12 ‘‘(D) such other information as the Sec13 retary may require. 

14 ‘‘(d) PREFERENCES.—In reviewing applications, the 

15 Secretary may give preference to applicants who dem16 onstrate an ability to serve the following: 

17 ‘‘(1) Communities that have evidenced barriers 

18 to primary health care and mental health services 

19 for children and adolescents. 

20 ‘‘(2) Communities that have consistently scored 

21 poorly on child and adolescent standardized health 

22 indicator reports. 

23 ‘‘(3) Communities with high percentages of chil24 dren and adolescents who are uninsured, underVerDate Aug 31 2005 23:22 Feb 17, 2007 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S600.IS S600

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1 insured, or enrolled in public health insurance pro2 grams. 

3 ‘‘(4) Populations of children and adolescents 

4 that have historically demonstrated difficulty in ac5 cessing health and mental health services. 

6 ‘‘(e) WAIVER OF REQUIREMENTS.—The Secretary 

7 may— 

8 ‘‘(1) under appropriate circumstances, waive 

9 the application of all or part of the requirements of 

10 this subsection with respect to an SBHC for a des11 ignated period of time to be determined by the Sec12 retary; and 

13 ‘‘(2) upon a showing of good cause, waive the 

14 requirement that the SBHC provide all required 

15 comprehensive primary health services for a des16 ignated period of time to be determined by the Sec17 retary. 

18 ‘‘(f) USE OF FUNDS.— 

19 ‘‘(1) FUNDS.—Funds awarded under a grant 

20 under this section may be used for acquiring and 

21 leasing buildings and equipment (including the costs 

22 of amortizing the principle of, and paying interest 

23 on, loans for such buildings and equipment), for pro24 viding training related to the provision of required 

25 comprehensive primary health services and addiVerDate Aug 31 2005 23:22 Feb 17, 2007 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S600.IS S600

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1 tional health services, for the management of health 

2 center programs, and for the payment of salaries for 

3 physicians and other personnel. 

4 ‘‘(2) CONSTRUCTION.—The Secretary may 

5 award grants which may be used to pay the costs as6 sociated with expanding and modernizing existing 

7 buildings for use as an SBHC. 

8 ‘‘(3) AMOUNT.—The amount of any grant made 

9 in any fiscal year to an SBHC shall be determined 

10 by the Secretary, taking into account— 

11 ‘‘(A) the financial need of the SBHC; 

12 ‘‘(B) State, local, or other operation fund13 ing provided to the SBHC; and 

14 ‘‘(C) other factors as determined appro15 priate by the Secretary. 

16 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 

17 establish a program through which the Secretary shall 

18 provide (either through the Department of Health and 

19 Human Services or by grant or contract) technical and 

20 other assistance to SBHCs to assist such SBHCs to meet 

21 the requirements of subsection (c)(2)(C). Services pro22 vided through the program may include necessary tech23 nical and nonfinancial assistance, including fiscal and pro24 gram management assistance, training in fiscal and pro25 gram management, operational and administrative supVerDate Aug 31 2005 23:22 Feb 17, 2007 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S600.IS S600

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1 port, and the provision of information to the entities of 

2 the variety of resources available under this title and how 

3 those resources can be best used to meet the health needs 

4 of the communities served by the entities. 

5 ‘‘(h) EVALUATION.—The Secretary shall develop and 

6 implement a plan for evaluating SBHCs and monitoring 

7 quality performances under the awards made under this 

8 section. 

9 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For 

10 purposes of carrying out this section, there are authorized 

11 to be appropriated $50,000,000 for fiscal year 2008 and 

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

13 2009 through 2012.’’. 

Æ 


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