I 

110TH CONGRESS 

1ST SESSION H. R. 1601 

To facilitate the provision of telehealth services, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 20, 2007 

Mr. JEFFERSON introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To facilitate the provision of telehealth services, 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 ‘‘Telehealth and Medi5 cally Underserved and Advancement Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 


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1 (1) Studies state that telehealth improves ac2 cess to medical care for geographically or socio-eco3 nomically isolated patients. 

4 (2) Research has consistently shown that the 

5 use of telehealth is a major factor in preventing un6 necessary patient travel to secondary or tertiary 

7 health care centers. 

8 (3) Literature states that the use of telehealth 

9 can augment the quality, continuity, and afford10 ability of medical care. 

11 (4) The practice of telehealth preserves the pa12 tient’s current provider-to-patient relationship while 

13 facilitating access to specialty care. 

14 (5) The use of telehealth will ensure educational 

15 and training support for rural-based providers and 

16 remove the obstacle of professional isolation. 

17 (6) Telehealth allows patients to obtain medical 

18 consultation in their own communities, and the ex19 panded use of telehealth technology will improve the 

20 quality of chronic disease care, increase wellness ini21 tiatives, and reduce health disparities for patients. 


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1 SEC. 3. INCREASING TYPES OF ORIGINATING TELEHEALTH 

2 SITES AND FACILITATING THE PROVISION OF 

3 TELEHEALTH SERVICES ACROSS STATE 

4 LINES. 

5 (a) INCREASING TYPES OF ORIGINATING SITES.— 

6 Section 1834(m)(4)(C)(ii) of the Social Security Act (42 

7 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the 

8 end the following: 

9 ‘‘(VI) A skilled nursing facility 

10 (as defined in section 1819(a)). 

11 ‘‘(VII) An assisted-living facility 

12 (as defined by the Secretary). 

13 ‘‘(VIII) A board-and-care home 

14 (as defined by the Secretary). 

15 ‘‘(IX) A county or community 

16 health clinic (as defined by the Sec17 retary). 

18 ‘‘(X) A community mental health 

19 center (as defined in section 

20 1861(ff)(3)(B)). 

21 ‘‘(XI) A facility operated by the 

22 Indian Health Service or by an Indian 

23 tribe, tribal organization, or an urban 

24 Indian organization (as such terms 

25 are defined in section 4 of the Indian 

26 Health Care Improvement Act (25 


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1 U.S.C. 1603)) directly, or under con2 tract or other arrangement. 

3 ‘‘(XII) A site in a State in which 

4 the respective State medical board has 

5 adopted a formal policy regarding li6 censing or certification requirements 

7 for providers at distant sites who do 

8 not have a license to practice medicine 

9 at the originating site.’’. 

10 (b) EXPANDING ELIGIBILITY FOR REIMBURSE11 MENT.—Section 1834(m)(4)(C)(i)(I) of the Social Secu12 rity Act (42 U.S.C. 1395m(m)(4)(C)(i)(I)) is amended by 

13 striking ‘‘rural’’. 

14 SEC. 4. STRENGTHENING TELEHEALTH SERVICES IN 

15 RURAL AND UNDERSERVED URBAN AMERICA. 

16 Subpart I of part D of title III of the Public Health 

17 Service Act (42 U.S.C. 254b et seq.) is amended— 

18 (1) in section 330L— 

19 (A) by redesignating subsection (b) as sub20 section (c); and 

21 (B) by inserting after subsection (a) the 

22 following: 

23 ‘‘(b) CONFERENCE.—Within 2 years of the date of 

24 enactment of the Telehealth Medically Underserved and 

25 Advancement Act of 2007, the Secretary shall convene a 


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1 conference of State licensing boards, local telehealth 

2 projects, health care practitioners, and patient advocates 

3 to promote interstate licensure for telehealth projects.’’; 

4 and 

5 (2) by inserting after section 330L the fol6 lowing: 

7 ‘‘SEC. 330M. INTEGRATIVE ELDERCARE TELEHEALTH DEM8 ONSTRATION PROJECT. 

9 ‘‘(a) PURPOSES.—The purposes of this section are to 

10 encourage the creation of programs to— 

11 ‘‘(1) evaluate the use of telehealth services in 

12 an integrative eldercare setting; 

13 ‘‘(2) eliminate fragmented service delivery while 

14 promoting enhanced continuity of care, elimination 

15 of health disparities, and more simplified access to 

16 services; 

17 ‘‘(3) develop community-based options that pro18 mote patient independence and leverage telehealth 

19 services and equipment to enable the use of the most 

20 cost-effective, least restrictive care settings; and 

21 ‘‘(4) promote access for elderly patients in rural 

22 and underserved urban areas to improvements in 

23 medical technology and training across an integrated 

24 spectrum of care; and 


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1 ‘‘(5) make health care services more flexible 

2 and responsive to the diverse and changing needs of 

3 elderly patients in rural areas. 

4 ‘‘(b) GRANTS AUTHORIZED.— 

5 ‘‘(1) IN GENERAL.—The Director may award 

6 grants to eligible providers for projects to dem7 onstrate how telehealth technologies can be used 

8 through telehealth networks in rural areas, frontier 

9 communities, and medically underserved areas, and 

10 for medically underserved populations, to— 

11 ‘‘(A) expand access to, coordinate, and im12 prove the quality of health care services; 

13 ‘‘(B) improve and expand the training of 

14 health care providers; 

15 ‘‘(C) expand and improve the quality of 

16 health information available to health care pro17 viders, and patients and their families, for deci18 sion making; and 

19 ‘‘(D) expand and improve efforts to elimi20 nate health care disparities. 

21 ‘‘(2) GRANT PERIOD.—The Director shall 

22 award grants under this subsection for a period of 

23 up to 5 years. 

24 ‘‘(3) NUMBER OF GRANTS.—Not to exceed 50 

25 grants shall be awarded under this subsection, of 


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which at least 1 1 ⁄2 shall be dedicated to providing 

2 services in rural communities. 

3 ‘‘(c) USE OF FUNDS.—Grants awarded pursuant to 

4 subsection (b) may be used for activities including— 

5 ‘‘(1) improving access to coordinated health 

6 care services and resource levels of care consistent 

7 with quality health care services and optimal patient 

8 outcomes, improving the quality of such care, in9 creasing patient satisfaction with such care, and re10 ducing the cost of such care through advanced tele11 communication technologies; 

12 ‘‘(2) developing effective care management 

13 practices and educational curricula to train health 

14 care professionals, paraprofessionals, and caregivers, 

15 including family members, and to increase the gen16 eral level of competency of such individuals through 

17 such training; and 

18 ‘‘(3) developing culturally competent curricula 

19 to train health care professionals, paraprofessionals, 

20 and caregivers, including family members, serving 

21 integrative eldercare patients in the use of tele22 communications. 

23 ‘‘(d) APPLICATIONS.—To be eligible to receive a 

24 grant under subsection (b), an eligible provider, in con25 sultation with the appropriate State office of rural health 


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1 or another appropriate State entity, shall prepare and sub2 mit to the Director an application, at such time, in such 

3 manner, and containing such information as the Director 

4 may require, including— 

5 ‘‘(1) a description of the project that the eligi6 ble entity will carry out using the funds provided 

7 under the grant; 

8 ‘‘(2) a description of the manner in which the 

9 project funded under the grant will meet the health 

10 care needs of rural or other populations to be served 

11 through the project, or improve the access to serv12 ices of, and the quality of the services received by, 

13 those populations; 

14 ‘‘(3) evidence of local support for the project, 

15 and a description of how the areas, communities, or 

16 populations to be served will be involved in the devel17 opment and ongoing operations of the project; 

18 ‘‘(4) a plan for sustaining the project after Fed19 eral support for the project has ended; 

20 ‘‘(5) information on the source and amount of 

21 non-Federal funds that the entity will provide for 

22 the project; 

23 ‘‘(6) information demonstrating the long-term 

24 viability of the project, and other evidence of institu25 tional commitment of the entity to the project; 


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1 ‘‘(7) information on how services will be used to 

2 eliminate health care disparities; 

3 ‘‘(8) in the case of an application for a project 

4 involving a telehealth network, information dem5 onstrating how the project will promote the integra6 tion of telehealth technologies into the operations of 

7 health care providers, to avoid redundancy, and im8 prove access to and the quality of care; and 

9 ‘‘(9) other such information as the Director de10 termines to be appropriate. 

11 ‘‘(e) REPORT.— 

12 ‘‘(1) FINAL REPORT.—Not later than 1 year 

13 after the date of termination of the last grant to be 

14 awarded under this section, the Director shall sub15 mit to Congress a final report— 

16 ‘‘(A) describing the results of the programs 

17 funded by grants awarded pursuant to this sec18 tion; and 

19 ‘‘(B) evaluating the impact of the use of 

20 telehealth services in an integrative eldercare 

21 setting on— 

22 ‘‘(i) access to care for patients served 

23 by integrative eldercare programs; and 

24 ‘‘(ii) the quality of, patient satisfac25 tion with, and the cost of, such care. 


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1 ‘‘(2) ENSURING ACCESS TO QUALITY CARE.—In 

2 conducting the evaluation under paragraph (1)(B), 

3 the Director shall— 

4 ‘‘(A) give special consideration to the im5 pact of programs funded under this section on 

6 face-to-face access to medical providers; and 

7 ‘‘(B) develop specific measures to evaluate 

8 the quality of care provided to those partici9 pating in such programs to ensure that tele10 health augments the plan of care. 

11 ‘‘(f) ELIGIBLE PROVIDER.—The term ‘eligible pro12 vider’ means a consortia of home and facility-based care 

13 providers that includes providers from no less than 2 of 

14 the following: 

15 ‘‘(1) An adult congregate care facility. 

16 ‘‘(2) A continuing care retirement community. 

17 ‘‘(3) An assisted living facility. 

18 ‘‘(4) An Alzheimer’s facility. 

19 ‘‘(5) An institutional hospice facility. 

20 ‘‘(6) A residential care facility. 

21 ‘‘(7) An adult foster home. 

22 ‘‘(8) A State-licensed nursing home, including a 

23 skilled nursing facility, an intermediate care facility, 

24 licensed home health provider or other health care 


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1 provider that the Director deems appropriate and 

2 consistent with the purposes of this section. 

3 ‘‘(g) DEFINITIONS.—In this section: 

4 ‘‘(1) DIRECTOR; OFFICE.—The terms ‘Director’ 

5 and ‘Office’ mean the Director of the Office for the 

6 Advancement of Telehealth and the Office for the 

7 Advancement of Telehealth, respectively. 

8 ‘‘(2) INTEGRATIVE ELDERCARE.—The term ‘in9 tegrative eldercare’ includes case management and 

10 coordination of care for elderly patients recovering 

11 from acute illness or coping with chronic disease at 

12 the lowest intensity and resource level of care con13 sistent with quality health care services and optimal 

14 patient outcomes. 

15 ‘‘(3) TELEHEALTH SERVICES.—The term ‘tele16 health services’ means services provided through 

17 telehealth technologies. 

18 ‘‘(4) TELEHEALTH TECHNOLOGIES.—The term 

19 ‘telehealth technologies’ means technologies relating 

20 to the use of electronic information, and tele21 communications technologies, to support and pro22 mote, at a distance, health care, patient and profes23 sional health-related education, health administra24 tion, and public health. 


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

2 are authorized to be appropriated to the Office for the Ad3 vancement of Telehealth to carry out this section 

4 $45,000,000 for fiscal year 2008 and such sums as may 

5 be necessary for each of fiscal years 2009 through 2013. 

6 ‘‘SEC. 330N. ORAL HEALTH TELEHEALTH DEMONSTRATION 

7 PROJECT. 

8 ‘‘(a) PURPOSE.—The purpose of this section is to 

9 evaluate the use of telehealth services to expand access 

10 to oral health services and improve oral health outcomes 

11 among rural and underserved urban patients. 

12 ‘‘(b) GRANTS AUTHORIZED.— 

13 ‘‘(1) IN GENERAL.—The Director is authorized 

14 to award competitive grants to eligible providers, in15 dividually or as part of a network of eligible pro16 viders, for the provision of oral health services to im17 prove patient care, prevent health care complica18 tions, improve patient outcomes, and achieve effi19 ciencies in the delivery of oral health care to patients 

20 who reside in rural areas. 

21 ‘‘(2) GRANT PERIOD.—The Director shall 

22 award grants under this section for a period of up 

23 to 5 years. 


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1 ‘‘(3) NUMBER OF GRANTS.—The number of 

2 grants awarded under this section shall not exceed 

3 30 grants. 

4 ‘‘(c) USE OF FUNDS.—Grants awarded pursuant to 

5 subsection (b) may be used for activities including— 

6 ‘‘(1) improving access to care for rural and un7 derserved urban patients served by eligible providers, 

8 improving the quality of that care, increasing patient 

9 satisfaction with that care, and reducing the cost of 

10 that care through advanced telecommunication tech11 nologies; 

12 ‘‘(2) developing effective oral telehealth care 

13 management practices and culturally competent edu14 cational curricula to train oral health professionals 

15 and paraprofessionals and increase their general 

16 level of competency through that training; and 

17 ‘‘(3) developing culturally competent curricula 

18 to train health care professionals and paraprofes19 sionals, serving rural and underserved urban pa20 tients in the use of telecommunications. 

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

22 grant under subsection (b), an eligible entity, in consulta23 tion with the appropriate State office of rural health or 

24 another appropriate State entity, shall prepare and submit 

25 to the Director an application, at such time, in such manVerDate Aug 31 2005 06:11 Mar 23, 2007 Jkt 059200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H1601.IH H1601

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1 ner, and containing such information as the Director may 

2 require, including— 

3 ‘‘(1) a description of the project that the eligi4 ble entity will carry out using the funds provided 

5 under the grant; 

6 ‘‘(2) a description of the manner in which the 

7 project funded under the grant will meet the health 

8 care needs of rural or other populations to be served 

9 through the project, or improve the access to serv10 ices of, and the quality of the services received by, 

11 those populations; 

12 ‘‘(3) evidence of local support for the project, 

13 and a description of how the areas, communities, or 

14 populations to be served will be involved in the devel15 opment and ongoing operations of the project; 

16 ‘‘(4) a plan for sustaining the project after Fed17 eral support for the project has ended; 

18 ‘‘(5) information on the source and amount of 

19 non-Federal funds that the entity will provide for 

20 the project; 

21 ‘‘(6) information demonstrating the long-term 

22 viability of the project, and other evidence of institu23 tional commitment of the entity to the project; 

24 ‘‘(7) information on how services will be used to 

25 eliminate health care disparities; 


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1 ‘‘(8) in the case of an application for a project 

2 involving a telehealth network, information dem3 onstrating how the project will promote the integra4 tion of telehealth technologies into the operations of 

5 health care providers, to avoid redundancy, and im6 prove access to and the quality of care; and 

7 ‘‘(9) other such information as the Director de8 termines to be appropriate. 

9 ‘‘(e) REPORT.— 

10 ‘‘(1) FINAL REPORT.—Not later than 1 year 

11 after the date of termination of the last grant to be 

12 awarded under this section, the Director shall sub13 mit to Congress a final report— 

14 ‘‘(A) describing the results of the programs 

15 funded by grants awarded pursuant to this sec16 tion; and 

17 ‘‘(B) including an evaluation of the impact 

18 of the use of oral telehealth services on— 

19 ‘‘(i) access to oral health care for 

20 rural patients; and 

21 ‘‘(ii) the quality of, patient satisfac22 tion with, and the cost of, that care. 

23 ‘‘(2) ENSURING ACCESS TO QUALITY CARE.—In 

24 conducting the evaluation under paragraph (1)(B), 

25 the Director shall— 


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1 ‘‘(A) give special consideration to the im2 pact of programs funded under this section on 

3 face-to-face access to medical providers; and 

4 ‘‘(B) develop specific measures to evaluate 

5 the quality of care provided to those partici6 pating in such programs to ensure that tele7 medicine augments the plan of care. 

8 ‘‘(f) DEFINITION OF ELIGIBLE PROVIDER.—In this 

9 section, the term ‘eligible provider’ includes dentists, 

10 periodontists, orthodontists, dental and oral health clinics, 

11 and schools of dentistry and oral health, where a majority 

12 of the patient population resides in a rural area, and may 

13 include other rural oral health providers that the Director 

14 deems appropriate. 

15 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

16 are authorized to be appropriated to carry out this section 

17 $30,000,000 for fiscal year 2008 and such sums as may 

18 be necessary for each of fiscal years 2009 through 2011.’’. 

19 SEC. 5. JOINT WORKING GROUP ON TELEHEALTH. 

20 (a) IN GENERAL.— 

21 (1) REPRESENTATION OF RURAL AND URBAN

22 AREAS.—The Secretary of Health and Human Serv23 ices shall establish, within the Office for the Ad24 vancement of Telehealth in the Health Resources 

25 and Services Administration, and under the leaderVerDate Aug 31 2005 06:11 Mar 23, 2007 Jkt 059200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H1601.IH H1601

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1 ship of the Director of such Office, a Joint Working 

2 Group on Telehealth. In establishing such Group, 

3 the Secretary shall ensure that all relevant Federal 

4 agencies are represented and that input from rel5 evant industry groups, including representatives of 

6 rural areas and medically underserved areas, is fully 

7 considered. 

8 (2) MISSION.—The mission of the Joint Work9 ing Group on Telehealth is— 

10 (A) to identify, monitor, and coordinate 

11 Federal telehealth projects, data sets, and pro12 grams in rural and urban areas; 

13 (B) to analyze— 

14 (i) how telehealth systems are expand15 ing access to health care services, edu16 cation, and information; 

17 (ii) the clinical, educational, or admin18 istrative efficacy and cost-effectiveness of 

19 telehealth applications; and 

20 (iii) the quality of the telehealth serv21 ices delivered; 

22 (iv) how telehealth systems can ad23 vance the improvement of health care qual24 ity and the elimination of health care dis25 parities; and 


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1 (v) the level of Federal resources 

2 needed to accomplish the stated objectives 

3 of telehealth programs as established 

4 under this Act; and 

5 (C) to make further recommendations for 

6 coordinating Federal and State efforts to in7 crease access to health services, education, and 

8 information in rural and urban medically un9 derserved areas. 

10 (3) ANNUAL REPORTS.—Not later than 2 years 

11 after the date of enactment of this Act, and each 

12 January 1 thereafter, the Joint Working Group on 

13 Telehealth shall submit to Congress a report on the 

14 status of the Group’s mission and the state of the 

15 telehealth field generally. 

16 (b) REPORT SPECIFICS.—The annual report required 

17 under subsection (a)(3) shall provide— 

18 (1) an analysis of— 

19 (A) the matters described in subsection 

20 (a)(2)(B); 

21 (B) Federal activities with respect to tele22 health; and 

23 (C) the process of the Joint Working 

24 Group on Telehealth’s efforts to coordinate 

25 Federal telehealth programs; and 


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1 (2) recommendations for a coordinated Federal 

2 strategy to increase health care access through tele3 health. 

4 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

5 are authorized to be appropriated such sums as may be 

6 necessary to enable the Joint Working Group on Tele7 health to carry out this section. 

Æ 


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