II 

116TH CONGRESS 

1ST SESSION S. 1618 

To amend the Public Health Service Act to expand the capacity to improve 

health outcomes and increase access to specialized care. 

IN THE SENATE OF THE UNITED STATES 

MAY 22, 2019 

Mr. SCHATZ (for himself, Mr. KAINE, and Ms. MURKOWSKI) 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 expand the 

capacity to improve health outcomes and increase access 

to specialized care. 

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 ‘‘Expanding Capacity 

5 for Health Outcomes Act of 2019’’ or the ‘‘ECHO 2019 

6 Act’’. 


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1 SEC. 2. EXPANDING CAPACITY FOR HEALTH OUTCOMES. 

2 Title III of the Public Health Service Act is amended 

3 by inserting after section 399I (42 U.S.C. 280f–1) the fol4 lowing: 

5 ‘‘SEC. 399I-1. EXPANDING CAPACITY FOR HEALTH OUT6 COMES. 

7 ‘‘(a) DEFINITIONS.—In this section: 

8 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en9 tity’ means an entity providing health care services 

10 in rural areas, frontier areas, health professional 

11 shortage areas, or medically underserved areas, or to 

12 medically underserved populations or Native Ameri13 cans, including Indian tribes or tribal organizations. 

14 ‘‘(2) HEALTH PROFESSIONAL SHORTAGE

15 AREA.—The term ‘health professional shortage area’ 

16 means a health professional shortage area des17 ignated under section 332. 

18 ‘‘(3) INDIAN TRIBES AND TRIBAL ORGANIZA19 TIONS.—The terms ‘Indian tribes’ and ‘tribal orga20 nizations’ have the meaning given such terms in sec21 tion 4 of the Indian Self-Determination and Edu22 cation Assistance Act. 

23 ‘‘(4) MEDICALLY UNDERSERVED POPU24 LATION.—The term ‘medically underserved popu25 lation’ has the meaning given the term in section 

26 330(b)(3). 


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1 ‘‘(5) NATIVE AMERICANS.—The term ‘Native 

2 Americans’ has the meaning given the term in sec3 tion 736 and includes Indian tribes and tribal orga4 nizations. 

5 ‘‘(6) TECHNOLOGY-ENABLED COLLABORATIVE

6 LEARNING AND CAPACITY BUILDING MODEL.—The 

7 term ‘technology-enabled collaborative learning and 

8 capacity building model’ means a distance health 

9 education model that connects specialists with mul10 tiple other health care professionals through simulta11 neous interactive videoconferencing for the purpose 

12 of facilitating case-based learning, disseminating 

13 best practices, and evaluating outcomes. 

14 ‘‘(b) PROGRAM ESTABLISHED.—The Secretary shall, 

15 as appropriate, award grants to evaluate, develop, and, as 

16 appropriate, expand the use of technology-enabled collabo17 rative learning and capacity building models, to increase 

18 access to health care services, such as those to address 

19 chronic diseases and conditions, mental health, substance 

20 use disorders, prenatal and maternal health, pediatric 

21 care, pain management, palliative care, and other specialty 

22 care in medically underserved areas and for medically un23 derserved populations. 

24 ‘‘(c) USE OF FUNDS.—Grants awarded under sub25 section (b) shall, as appropriate, be used for— 


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1 ‘‘(1) equipment to support the use and expan2 sion of technology-enabled collaborative learning and 

3 capacity building models, including for hardware and 

4 software that enables distance learning, health care 

5 provider support, and the secure exchange of elec6 tronic health information; 

7 ‘‘(2) support for health care providers and other 

8 professionals that provide or assist in the provision 

9 of services through such models; 

10 ‘‘(3) the development and acquisition of instruc11 tional programming, and the training of health care 

12 providers and other professionals that provide or as13 sist in the provision of services through such models; 

14 ‘‘(4) information collection and evaluation ac15 tivities to study the impact of such models on pa16 tient outcomes and health care providers, and to 

17 identify best practices for the expansion and use of 

18 such models; and 

19 ‘‘(5) other activities consistent with achieving 

20 the objectives of the grants awarded under this sec21 tion, as determined by the Secretary. 

22 ‘‘(d) LENGTH OF GRANTS.—Grants awarded under 

23 subsection (b) shall be for a period of up to 5 years. 

24 ‘‘(e) APPLICATION.—An eligible entity that seeks to 

25 receive a grant under subsection (b) shall submit to the 


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1 Secretary an application, at such time, in such manner, 

2 and containing such information as the Secretary may re3 quire. Such application criteria shall include an evaluation 

4 of patient outcomes and health care providers resulting 

5 from technology-enabled collaborative learning and capac6 ity building models. 

7 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary shall 

8 provide (either directly through the Department of Health 

9 and Human Services or by contract) technical assistance 

10 to eligible entities, including recipients of grants under 

11 subsection (b), on the development, use, and evaluation 

12 of technology-enabled collaborative learning and capacity 

13 building models in order to expand access to health care 

14 services provided by such entities, including for medically 

15 underserved areas and to medically underserved popu16 lations. 

17 ‘‘(g) REPORT BY SECRETARY.—Not later than 4 

18 years after the date of enactment of this section, the Sec19 retary shall prepare and submit to the Committee on 

20 Health, Education, Labor, and Pensions of the Senate, 

21 and the Committee on Energy and Commerce of the 

22 House of Representatives, and post on the internet website 

23 of the Department of Health and Human Services, a re24 port including, at minimum— 


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1 ‘‘(1) a description of any new and continuing 

2 grants awarded to entities under subsection (b) and 

3 the specific purpose and amounts of such grants; 

4 ‘‘(2) an overview of— 

5 ‘‘(A) the evaluations conducted under sub6 sections (b) or (f); and 

7 ‘‘(B) technical assistance provided under 

8 subsection (f); and 

9 ‘‘(3) a description of any significant findings or 

10 developments in patient outcomes and health care 

11 providers and best practices for eligible entities ex12 panding, using, or evaluating technology-enabled col13 laborative learning and capacity building models. 

14 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

15 is authorized to be appropriated to carry out this section, 

16 $20,000,000 for each of fiscal years 2020 through 2024.’’. 

Æ 


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