II 

110TH CONGRESS 

1ST SESSION S. 1451 

To encourage the development of coordinated quality reforms to improve 

health care delivery and reduce the cost of care in the health care system. 

IN THE SENATE OF THE UNITED STATES 

MAY 22, 2007 

Mr. WHITEHOUSE introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To encourage the development of coordinated quality reforms 

to improve health care delivery and reduce the cost of 

care in the health care system. 

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 ‘‘Quality Reform Expan5 sion and Savings Act of 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

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

9 (1) The United States health care system ur10 gently needs reform and improvement in the quality 


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1 of care delivered, the optimization of investments, 

2 and prevention and detection of illness. 

3 (2) The present system for payment of pro4 viders for health care services often acts to deter or 

5 discourage optimal investment in prevention or qual6 ity of care improvement. 

7 (3) Properly tailored health care reforms can 

8 lower medical cost and improve quality of care. 

9 (4) The urgent need for reform of the American 

10 health care system, to improve quality of care and 

11 health outcomes, to lower cost, and to reduce waste 

12 and frustration, is not presently met with a commen13 surate national effort to design and implement those 

14 reforms. 

15 (5) Many initiatives underway at the State and 

16 local level merit encouragement and support as they 

17 depend upon and inspire mutual trust and com18 promise within a community. 

19 (b) PURPOSE.—It is the purpose of this Act to estab20 lish a program to award grants to local, regional, or state21 wide organizations to— 

22 (1) encourage the coordinated development of 

23 local health care quality reforms; 

24 (2) fund the development of practices beneficial 

25 to the health care system; 


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1 (3) expand information technology, electronic 

2 health records, and interoperable data systems in 

3 the health care system; 

4 (4) develop reimbursement practices that align 

5 financial incentives with health and prevention re6 forms to identify and encourage best practices; 

7 (5) lower the costs of health care delivery; 

8 (6) encourage experimentation in different re9 gions of the United States; and 

10 (7) reward cooperation among local entities en11 gaged in reforming the health care system. 

12 SEC. 3. QUALITY REFORM GRANT INITIATIVE. 

13 (a) GRANTS.—The Secretary of Health and Human 

14 Services (referred to in this section as the ‘‘Secretary’’) 

15 shall award quality reform grants to eligible entities to en16 hance, encourage, and expedite implementation of quality 

17 reform plans to carry out the purposes of this Act. 

18 (b) ELIGIBILITY OF STATE, LOCAL, AND REGIONAL

19 ENTITIES.—To be eligible to receive a grant under sub20 section (a), a qualifying entity shall be a State, local, or 

21 regional organization dedicated to improving the quality 

22 of health care through broad participation of the local 

23 health care community, with a focus on quality improve24 ment and reporting, expansion of health information techVerDate Aug 31 2005 21:08 May 23, 2007 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451

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1 nology, cost-effective prevention, and restructuring of the 

2 reimbursement system to enhance these goals. 

3 (c) QUALITY REFORM COMMITTEE.— 

4 (1) ESTABLISHMENT.—Not later than 180 days 

5 after the date of the enactment of this Act, the Sec6 retary shall establish a Quality Reform Committee 

7 (referred to in this Act as the ‘‘Committee’’) in ac8 cordance with this subsection. 

9 (2) MEMBERSHIP.—The Committee shall be 

10 composed of not less than 7 members, of which— 

11 (A) one member shall be appointed by the 

12 Administrator of the Centers for Medicare & 

13 Medicaid Services; 

14 (B) one member shall be appointed by the 

15 Director of the National Institutes of Health; 

16 (C) one member shall be appointed by the 

17 Administrator of the Agency for Healthcare Re18 search and Quality; 

19 (D) one member shall be appointed by the 

20 National Coordinator for Health Information 

21 Technology; 

22 (E) one member shall be appointed by the 

23 President of the Institute of Medicine; 


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1 (F) one member shall be appointed by the 

2 Secretary from among candidates recommended 

3 by the National Governor’s Association; and 

4 (G) one member shall be appointed by the 

5 Secretary from among candidates recommended 

6 by the United States Conference of Mayors. 

7 (3) GENERAL DUTIES.—The Committee shall— 

8 (A) formally approve the application of an 

9 eligible entity for a grant under this section and 

10 recommend to the Secretary that such a grant 

11 be awarded to such entity; 

12 (B) facilitate communication among eligi13 ble entities and other organizations; 

14 (C) evaluate and exchange best practices 

15 relating to activities carried out under the 

16 grants; 

17 (D) share research and expertise relating 

18 to activities under the grants; 

19 (E) encourage collaboration and coopera20 tion with and among grantees under this sec21 tion; 

22 (F) recognize the achievements of grantees 

23 under this section in a public manner; 

24 (G) assist grantees under this section by 

25 serving as an advocate and ombudsman to overVerDate Aug 31 2005 21:08 May 23, 2007 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451

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1 come bureaucratic and other obstacles within 

2 the Federal Government that hinder the 

3 achievement of this effort; 

4 (H) encourage integration of activities 

5 under this section with the private sector; 

6 (I) study, identify, and report on market 

7 failures and anomalies that create economic in8 centives adverse to achievement of the goals of 

9 quality reform, cost reduction, health informa10 tion technology expansion, and illness preven11 tion; 

12 (J) assist with coordinating information 

13 technology infrastructure; and 

14 (K) assign personnel to serve as 

15 facilitators for local programs and as primary 

16 Federal points of contact with grantees under 

17 this section. 

18 (4) PERIOD OF APPOINTMENT.—Members shall 

19 be appointed to serve for a term as determined ap20 propriate by the appointing authority, as the case 

21 may be, and shall serve until their successor is ap22 pointed. 

23 (5) CHAIRPERSON; MEETINGS.— 

24 (A) CHAIRPERSON.—The Committee shall 

25 select a Chairperson from among its members. 


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1 (B) QUORUM.—A majority of the members 

2 of the Committee shall constitute a quorum, but 

3 a lesser number of members may hold hearings. 

4 (C) MEETINGS.—Not later than 30 days 

5 after the date on which all members of the 

6 Committee have been appointed under para7 graph (2), the Committee shall hold its first 

8 meeting. The Committee shall meet at the call 

9 of the Chairperson. 

10 (6) POWERS.— 

11 (A) HEARINGS.—The Committee may hold 

12 hearings, if determined necessary by the Com13 mittee to carry out the purposes of this Act, sit 

14 and act at such times and places, take such tes15 timony, and receive such evidence as the Com16 mittee determines appropriate to carry out the 

17 purposes of this Act. 

18 (B) ANNUAL PUBLIC MEETINGS.—In addi19 tion to other meetings the Committee may hold, 

20 the Committee shall hold an annual public 

21 meeting for grantees under this section in order 

22 that grantees may report progress toward 

23 achieving the purposes in section 2(b) and in 

24 the exchange of information with one another 

25 and with the Committee. 


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1 (C) INFORMATION.—The Committee may 

2 obtain information directly from any Federal 

3 department or agency as the Committee deter4 mines is necessary to carry out this section. 

5 Upon the request of the Chairperson of the 

6 Committee, the head of such department or 

7 agency shall furnish such information to the 

8 Committee. 

9 (D) CONTRACTING.—The Committee may 

10 enter into contracts with qualified independent 

11 organizations to obtain necessary information to 

12 assist grantees with the development of best 

13 evidence-based practices and outcomes measure14 ments or any other matters determined by the 

15 Committee to be appropriate and reasonable to 

16 carry out this section. 

17 (E) POSTAL SERVICES.—The Committee 

18 may use the United States mails in the same 

19 manner and under the same conditions as other 

20 departments and agencies of the Federal Gov21 ernment. 

22 (7) PERSONNEL MATTERS.— 

23 (A) COMPENSATION.—Each member of the 

24 Committee who is not an officer or employee of 

25 the Federal Government shall be compensated 


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1 at a rate equal to the daily equivalent of the an2 nual rate of basic pay prescribed for level IV of 

3 the Executive Schedule under section 5315 of 

4 title 5, United States Code, for each day (in5 cluding travel time) during which such member 

6 is engaged in the performance of the duties of 

7 the Committee. All members of the Committee 

8 who are officers or employees of the United 

9 States shall serve without compensation in addi10 tion to that received for their services as offi11 cers or employees of the United States. 

12 (B) TRAVEL EXPENSES.—The members of 

13 the Committee shall be allowed travel expenses, 

14 including per diem in lieu of subsistence, at 

15 rates authorized for employees of agencies 

16 under subchapter I of chapter 57 of title 5, 

17 United States Code, while away from their 

18 homes or regular places of business in the per19 formance of services for the Committee. 

20 (C) STAFF.—The Chairperson of the Com21 mittee may, without regard to the civil service 

22 laws and regulations, appoint and terminate 

23 personnel as may be necessary to enable the 

24 Committee to perform its duties. 


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1 (D) DETAIL OF GOVERNMENTAL EMPLOY2 EES.—Any Federal Government employee may 

3 be detailed to the Committee without reim4 bursement upon the request of the Committee, 

5 and such detail shall be without interruption or 

6 loss of civil service status or privilege. 

7 (E) TEMPORARY AND INTERMITTENT

8 SERVICES.—The Chairperson of the Committee 

9 may procure temporary and intermittent serv10 ices under section 3109(b) of title 5, United 

11 States Code, at rates for individuals which do 

12 not exceed the daily equivalent of the annual 

13 rate of basic pay prescribed for level V of the 

14 Executive Schedule under section 5316 of such 

15 title. 

16 (8) FUNDING.—For the purpose of carrying out 

17 this subsection, there are authorized to be appro18 priated $2,000,000 for fiscal year 2008 and each 

19 subsequent fiscal year. 

20 (d) QUALITY REFORM PLAN.— 

21 (1) IN GENERAL.—To be eligible to receive a 

22 grant under this section, an entity shall prepare and 

23 submit to the Committee, as part of the application 

24 under subsection (b), a plan to seek to improve qualVerDate Aug 31 2005 21:08 May 23, 2007 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451

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1 ity of care, which is encouraged to include the fol2 lowing elements: 

3 (A) Involvement and leadership of the local 

4 health care community in the area to be served 

5 under the grant. 

6 (B) Strategies to achieve cost-saving qual7 ity improvements in service delivery as a result 

8 of activities carried out under the grant. 

9 (C) Development and implementation of 

10 electronic health record keeping, health infor11 mation systems, interoperability, evidence-based 

12 clinical decision support, or electronic prescrip13 tion of pharmaceuticals. 

14 (D) Methods to optimize evidence-based in15 vestment in early prevention and detection of 

16 illness. 

17 (E) Restructuring of provider reimburse18 ment provisions to assist in accomplishing the 

19 objectives of the plan. 

20 (F) Efforts to use savings to expand health 

21 care coverage to the uninsured. 

22 (2) GRANT PERIOD.—The period of a grant 

23 awarded under this section shall not exceed 2 years 

24 and may be renewed for subsequent 2-year periods 

25 upon reapplication to the Committee. Nothing in 


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1 this paragraph shall be construed to prohibit a 

2 grantee from requesting an extension for a period of 

3 less than 2 years. 

4 (e) WAIVERS.—A State in which a grantee under this 

5 section is located shall receive expedited and priority con6 sideration of waiver requests from the Centers for Medi7 care & Medicaid Services when necessary or appropriate 

8 to achieve the purposes for which the grant was awarded. 

9 (f) AMOUNT OF GRANT.—The amount of a grant 

10 awarded to an entity under this section shall be deter11 mined based upon the recommendations of the Committee, 

12 subject to appropriations, but is intended to be an unre13 stricted grant to eligible entities with qualifying plans. 

14 (g) REPORT.— 

15 (1) BY ENTITIES.—An entity that is awarded a 

16 grant under this section shall submit to the Com17 mittee an annual report for the period representing 

18 the entity’s fiscal year, that shall contain a descrip19 tion of the results of activities carried out under the 

20 project. 

21 (2) BY COMMITTEE.—Not later than the end of 

22 the 5-year period beginning on the date on which the 

23 first grant is awarded under this section, the Com24 mittee shall prepare and submit to the appropriate 

25 committees of Congress, a report on the progress 


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1 made by grantees in achieving the purposes of this 

2 Act. 

3 (h) SENSE OF THE SENATE.—It is the sense of the 

4 Senate that, not later than 45 days after receiving the re5 port submitted under subsection (g)(2), each Committee 

6 to which such report is submitted should hold at least 1 

7 hearing concerning such report and the recommendations 

8 contained in such report. 

9 (i) AUTHORIZATION OF APPROPRIATIONS.—There 

10 are authorized to be appropriated to carry out this Act, 

11 $100,000,000 for the 10-fiscal year period beginning in 

12 fiscal year 2008. 

Æ 


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