I 

110TH CONGRESS 

1ST SESSION H. R. 1244 

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

Clinic program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 28, 2007 

Ms. EDDIE BERNICE JOHNSON of Texas introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

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 ‘‘Student Medical Ac5 cess Raising Test Scores Health Act of 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

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

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

10 States have no form of health insurance and are 

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1 therefore unable to access preventive health care 

2 which may lead to untreated conditions, unnecessary 

3 diseases, and death. 

4 (2) The American Medical Association rates 

5 adolescents aged 13–18 as the group of Americans 

6 with the poorest health indicators. 

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

8 need psychiatric treatment do not receive services. 

9 (4) Children who are in poor health or are vic10 tims of child abuse, poverty, malnutrition, alcohol, 

11 and drug abuse are at risk for academic and social 

12 failure. 

13 (5) Without health and social intervention, at14 risk children are often unable to improve academic 

15 performance. 

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

17 bringing preventive and primary care to children and 

18 adolescents. 

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

20 decreasing academic failure resulting from poor 

21 health. 

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

23 and adolescents with medical and mental health 

24 services necessary to be healthy and succeed aca25 demically. 

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

2 the development and operation of school-based health clin3 ics to— 

4 (1) provide comprehensive and accessible pri5 mary health care services to medically underserved 

6 children, youth, and families; 

7 (2) improve the physical health, emotional well8 being, and academic performance of medically un9 derserved children, youth, and families; and 

10 (3) work in collaboration with the school to in11 tegrate health into the overall school environment. 

12 SEC. 3. SCHOOL-BASED HEALTH CLINICS. 

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

14 (42 U.S.C. 280h et seq.) is amended by adding at the end 

15 the following: 

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

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

18 In this section: 

19 ‘‘(1) COMMUNITY.—The term ‘community’ in20 cludes parents, consumers, local leaders, and organi21 zations. 

22 ‘‘(2) COMPREHENSIVE PRIMARY HEALTH SERV23 ICES.—The term ‘comprehensive primary health 

24 services’ means the core services offered by schoolmstockstill on PROD1PC66 with BILLS

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1 based health clinics, which shall include the fol2 lowing: 

3 ‘‘(A) PHYSICAL.—Comprehensive health 

4 assessments, diagnosis, and treatment of minor, 

5 acute, and chronic medical conditions and refer6 rals to, and follow-up for, specialty care. 

7 ‘‘(B) MENTAL HEALTH.—Mental health 

8 assessments, crisis intervention, counseling, 

9 treatment, and referral to a continuum of serv10 ices including emergency psychiatric care, com11 munity support programs, inpatient care, and 

12 outpatient programs. 

13 ‘‘(C) PRIMARY CARE EPSDT SERVICES.— 

14 Any other primary care services included within 

15 early and periodic screening, diagnostic, and 

16 treatment services (as defined in section 

17 1905(r) of the Social Security Act, as applied 

18 without regard to whether the individual receiv19 ing such services is eligible for medical assist20 ance with respect to such services under a State 

21 plan under title XIX of such Act). 

22 ‘‘(D) OPTIONAL SERVICES.—Additional 

23 services, which may include oral health, social, 

24 and health education services. 

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1 ‘‘(3) MEDICALLY UNDERSERVED CHILDREN

2 AND ADOLESCENTS.— 

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

4 underserved children and adolescents’ means a 

5 population of children and adolescents who are 

6 residents of an area designated by the Sec7 retary as an area with a shortage of personal 

8 health services and health infrastructure for 

9 such children and adolescents. 

10 ‘‘(B) CRITERIA.—The Secretary shall pre11 scribe criteria for determining the specific 

12 shortages of personal health services for medi13 cally underserved children and adolescents 

14 under subparagraph (A) that shall— 

15 ‘‘(i) take into account any comments 

16 received by the Secretary from the chief 

17 executive officer of a State and local offi18 cials in a State; and 

19 ‘‘(ii) include factors indicative of the 

20 health status of such children and adoles21 cents of an area, including the ability of 

22 the residents of such area to pay for health 

23 services, the accessibility of such services, 

24 the availability of health professionals to 

25 such children and adolescents, and other 

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1 factors as determined appropriate by the 

2 Secretary. 

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

4 term ‘school-based health clinic’ means a health clin5 ic that— 

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

7 of a school district or board; 

8 ‘‘(B) is organized through school, commu9 nity, and health provider relationships; 

10 ‘‘(C) is administered by a sponsoring facil11 ity; and 

12 ‘‘(D) provides, at a minimum, comprehen13 sive primary health services during school hours 

14 to children and adolescents by health profes15 sionals in accordance with State and local laws 

16 and regulations, established standards, and 

17 community practice. 

18 ‘‘(5) SPONSORING FACILITY.—The term ‘spon19 soring facility’ is a community-based organization, 

20 which may include— 

21 ‘‘(A) a hospital; 

22 ‘‘(B) a public health department; 

23 ‘‘(C) a community health center; 

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

25 ‘‘(E) a school or school system. 

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1 ‘‘(b) AUTHORITY TO AWARD GRANTS.—The Sec2 retary shall award grants for the costs of the operation 

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

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

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

6 under this section, an entity shall— 

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

8 (a)(4)); and 

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

10 such time, in such manner, and containing— 

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

12 criteria necessary to be designated an SBHC; 

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

14 to be provided by the SBHC; 

15 ‘‘(C) an assurance that— 

16 ‘‘(i) school-based health clinic services 

17 will be provided to those children and ado18 lescents for whom parental or guardian 

19 consent has been obtained in cooperation 

20 with Federal, State, and local laws gov21 erning health care service provision to chil22 dren and adolescents; 

23 ‘‘(ii) the SBHC has made and will 

24 continue to make every reasonable effort to 

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1 tionships with other health care providers 

2 in the catchment area of the SBHC; 

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

4 access during the academic day when 

5 school is in session and 24-hour coverage 

6 through an on-call system and through its 

7 backup health providers to ensure access to 

8 services on a year-round basis when the 

9 school or the SBHC is closed; 

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

11 the school environment and will coordinate 

12 health services with school personnel, such 

13 as administrators, teachers, nurses, coun14 selors, and support personnel, as well as 

15 with other community providers co-located 

16 at the school; and 

17 ‘‘(v) the SBHC sponsoring facility as18 sumes all responsibility for the SBHC ad19 ministration, operations, and oversight; 

20 and 

21 ‘‘(D) such other information as the Sec22 retary may require. 

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

24 Secretary may give preference to applicants who dem25 onstrate an ability to serve the following: 

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1 ‘‘(1) Communities that have evidenced barriers 

2 to primary health care and mental health services 

3 for children and adolescents. 

4 ‘‘(2) Communities that have consistently scored 

5 poorly on child and adolescent standardized health 

6 indicator reports. 

7 ‘‘(3) Communities with high percentages of chil8 dren and adolescents who are uninsured, under9 insured, or enrolled in public health insurance pro10 grams. 

11 ‘‘(4) Populations of children and adolescents 

12 that have historically demonstrated difficulty in ac13 cessing health and mental health services. 

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

15 may— 

16 ‘‘(1) under appropriate circumstances, waive 

17 the application of all or part of the requirements of 

18 this subsection with respect to an SBHC for a des19 ignated period of time to be determined by the Sec20 retary; and 

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

22 requirement that the SBHC provide all required 

23 comprehensive primary health services for a des24 ignated period of time to be determined by the Sec25 retary. 

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1 ‘‘(f) USE OF FUNDS.— 

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

3 under this section may be used for acquiring and 

4 leasing buildings and equipment (including the costs 

5 of amortizing the principle of, and paying interest 

6 on, loans for such buildings and equipment), for pro7 viding training related to the provision of required 

8 comprehensive primary health services and addi9 tional health services, for the management of health 

10 center programs, and for the payment of salaries for 

11 physicians and other personnel. 

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

13 award grants which may be used to pay the costs as14 sociated with expanding and modernizing existing 

15 buildings for use as an SBHC. 

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

17 in any fiscal year to an SBHC shall be determined 

18 by the Secretary, taking into account— 

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

20 ‘‘(B) State, local, or other operation fund21 ing provided to the SBHC; and 

22 ‘‘(C) other factors as determined appro23 priate by the Secretary. 

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

25 establish a program through which the Secretary shall 

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1 provide (either through the Department of Health and 

2 Human Services or by grant or contract) technical and 

3 other assistance to SBHCs to assist such SBHCs to meet 

4 the requirements of subsection (c)(2)(C). Services pro5 vided through the program may include necessary tech6 nical and nonfinancial assistance, including fiscal and pro7 gram management assistance, training in fiscal and pro8 gram management, operational and administrative sup9 port, and the provision of information to the entities of 

10 the variety of resources available under this title and how 

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

12 of the communities served by the entities. 

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

14 implement a plan for evaluating SBHCs and monitoring 

15 quality performances under the awards made under this 

16 section. 

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

18 purposes of carrying out this section, there are authorized 

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

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

21 2009 through 2012.’’. 

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