IB 

Union Calendar No. 425 

110TH CONGRESS 

2D SESSION H. R. 1343 

[Report No. 110–680] 

To amend the Public Health Service Act to provide additional authorizations 

of appropriations for the health centers program under section 330 

of such Act. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 6, 2007 

Mr. GENE GREEN of Texas (for himself and Mr. PICKERING) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

JUNE 4, 2008 

Additional sponsors: Mrs. CAPPS, Mr. ENGEL, Mr. ELLISON, Mr. HIGGINS, 

Mr. UDALL of New Mexico, Mr. CLEAVER, Mr. CAPUANO, Mr. BERMAN, 

Mr. SHAYS, Mr. TERRY, Ms. LINDA T. SA ́NCHEZ of California, Mrs. 

MALONEY of New York, Mr. GRIJALVA, Mr. MCCOTTER, Ms. HIRONO, 

Mr. KENNEDY, Mr. SALAZAR, Mr. PRICE of North Carolina, Mr. RENZI, 

Mr. FARR, Mr. DELAHUNT, Mr. FORBES, Mr. WEXLER, Mr. NADLER, 

Mr. WAXMAN, Mr. DAVID DAVIS of Tennessee, Mr. KAGEN, Mr. NUNES, 

Mr. COOPER, Mr. MCNERNEY, Mr. OLVER, Mr. COHEN, Mr. MATHESON, 

Mr. SIRES, Mr. MARKEY, Mr. EMANUEL, Ms. SCHAKOWSKY, Ms. MCCOLLUM of Minnesota, Mr. BUTTERFIELD, Mr. ABERCROMBIE, Mr. 

HINOJOSA, Mr. SMITH of New Jersey, Ms. BORDALLO, Ms. NORTON, Mr. 

LARSEN of Washington, Mr. MICHAUD, Mr. EHLERS, Mr. LANGEVIN, Mr. 

MCNULTY, Mr. MCDERMOTT, Mr. GOODE, Mr. STARK, Mr. FILNER, Mr. 

CLAY, Mr. HINCHEY, Mr. JOHNSON of Georgia, Mr. SARBANES, Mr. 

BARROW, Mr. INSLEE, Mr. BOSWELL, Mr. UPTON, Ms. BALDWIN, Ms. 

EDDIE BERNICE JOHNSON of Texas, Ms. WOOLSEY, Mrs. GILLIBRAND, 

Mr. MELANCON, Mr. LATHAM, Ms. GRANGER, Mr. CANNON, Mr. MITCHELL, Mr. LINCOLN DAVIS of Tennessee, Mr. WICKER, Mr. ROSS, Mr. 

ALLEN, Mr. ORTIZ, Mr. SCOTT of Virginia, Ms. SOLIS, Mr. DOOLITTLE, 

Mr. BAIRD, Mr. WHITFIELD of Kentucky, Mr. SMITH of Texas, Mr. 

MCINTYRE, Mr. RANGEL, Mr. PLATTS, Mr. BLUMENAUER, Mr. THOMPSON of California, Mr. GONZALEZ, Mr. LANTOS, Mrs. JO ANN DAVIS of 

Virginia, Mr. DICKS, Mr. BOUSTANY, Mr. BISHOP of New York, Mrs. 


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DRAKE, Mr. BOREN, Mr. DOYLE, Mrs. CAPITO, Mr. DAVIS of Illinois, 

Mr. THORNBERRY, Ms. VELA ́ZQUEZ, Mr. GEORGE MILLER of California, 

Mr. REHBERG, Mr. MURPHY of Connecticut, Mr. SMITH of Washington, 

Mr. CARTER, Mr. MEEK of Florida, Mrs. DAVIS of California, Mr. 

BISHOP of Utah, Mr. REYES, Ms. HERSETH SANDLIN, Ms. CLARKE, Mr. 

STUPAK, Mr. CUELLAR, Mr. TOWNS, Ms. ROS-LEHTINEN, Mr. GUTIERREZ, Mr. COSTELLO, Mrs. CUBIN, Mr. ISSA, Mr. RODRIGUEZ, Mr. HALL

of Texas, Mr. BRADY of Texas, Mr. AL GREEN of Texas, Mr. MCCAUL

of Texas, Mr. EDWARDS, Ms. JACKSON-LEE of Texas, Mr. DOGGETT, Mr. 

MARCHANT, Mr. RUSH, Mr. WYNN, Ms. DEGETTE, Mr. SHIMKUS, Mr. 

LOBIONDO, Mr. ETHERIDGE, Mr. UDALL of Colorado, Mr. WELCH of 

Vermont, Mr. RAHALL, Mr. MANZULLO, Mr. TIM MURPHY of Pennsylvania, Mr. ALEXANDER, Mr. MCHUGH, Mr. LARSON of Connecticut, Mr. 

PAYNE, Mr. WAMP, Mr. HARE, Mr. HERGER, Mr. MARSHALL, Mr. WU, 

Mr. KANJORSKI, Mr. SPRATT, Mr. WALSH of New York, Mr. HALL of 

New York, Mr. GORDON of Tennessee, Ms. ESHOO, Mr. PERLMUTTER, 

Mrs. EMERSON, Mr. SHERMAN, Ms. ROYBAL-ALLARD, Mr. LOEBSACK, 

Mr. HODES, Mr. CONAWAY, Mr. SIMPSON, Mr. FRANK of Massachusetts, 

Mr. BILIRAKIS, Mr. DAVIS of Kentucky, Mr. JACKSON of Illinois, Mr. 

GILLMOR, Mr. ISRAEL, Mrs. WILSON of New Mexico, Mr. WELLER of Illinois, Mr. CASTLE, Ms. SHEA-PORTER, Mr. LAMPSON, Mrs. BOYDA of 

Kansas, Mr. SAXTON, Mr. LYNCH, Mr. WALDEN of Oregon, Mr. BRADY

of Pennsylvania, Mr. COURTNEY, Mr. BOUCHER, Ms. HOOLEY, Mr. 

NEUGEBAUER, Mr. MORAN of Virginia, Mr. SERRANO, Mr. MCGOVERN, 

Mr. ROGERS of Alabama, Mr. TIERNEY, Mr. REICHERT, Mr. PASTOR, 

Mr. PASCRELL, Mr. MEEHAN, Mrs. NAPOLITANO, Mr. ENGLISH of Pennsylvania, Mr. WOLF, Mr. BECERRA, Mr. YARMUTH, Mrs. BLACKBURN, 

Ms. SLAUGHTER, Mr. REYNOLDS, Mr. WEINER, Ms. GIFFORDS, Mr. 

ARCURI, Mr. PUTNAM, Mr. ROGERS of Kentucky, Ms. HARMAN, Mr. 

SMITH of Nebraska, Mr. CARNEY, Mr. BISHOP of Georgia, Mr. 

BOOZMAN, Mr. BRALEY of Iowa, Mr. ALTMIRE, Mr. LAHOOD, Mr. KUHL

of New York, Mr. LEWIS of Georgia, Mr. SCOTT of Georgia, Ms. LEE, 

Mr. GERLACH, Mr. CUMMINGS, Mr. FATTAH, Mr. HOLDEN, Mr. MOORE

of Kansas, Mr. MEEKS of New York, Mr. YOUNG of Alaska, Mr. LUCAS, 

Ms. SCHWARTZ, Mr. ROTHMAN, Mr. JOHNSON of Illinois, Mr. MILLER of 

North Carolina, Mr. PETRI, Ms. MATSUI, Mr. MURTHA, Mr. HOLT, Mr. 

FORTUN ̃O, Mr. WILSON of Ohio, Mr. THOMPSON of Mississippi, Mr. 

DONNELLY, Ms. MOORE of Wisconsin, Mr. CULBERSON, Ms. GINNY

BROWN-WAITE of Florida, Mr. FOSSELLA, Mr. SPACE, Mr. COSTA, Mr. 

SALI, Mr. POE, Mr. DEFAZIO, Mr. CARSON, Mr. JEFFERSON, Mr. 

HULSHOF, and Mr. FORTENBERRY

JUNE 4, 2008 

Reported with amendments, committed to the Committee of the Whole House 

on the State of the Union, and ordered to be printed 


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[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on March 6, 2007] 

A BILL 

To amend the Public Health Service Act to provide additional 

authorizations of appropriations for the health centers 

program under section 330 of such Act. 

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 ‘‘Health Centers Renewal 

5 Act of 2008’’. 

6 SEC. 2. ADDITIONAL AUTHORIZATIONS OF APPROPRIA7 TIONS FOR HEALTH CENTERS PROGRAM. 

8 Section 330(r)(1) of the Public Health Service Act (42 

9 U.S.C. 254b(r)(1)) is amended to read as follows: 

10 ‘‘(1) IN GENERAL.—For the purpose of carrying 

11 out this section, in addition to the amounts author12 ized to be appropriated under subsection (d), there 

13 are authorized to be appropriated— 

14 ‘‘(A) for fiscal year 2008, $2,213,020,000; 

15 ‘‘(B) for fiscal year 2009, $2,451,394,400; 

16 ‘‘(C) for fiscal year 2010, $2,757,818,700; 

17 ‘‘(D) for fiscal year 2011, $3,116,335,131; 

18 and 


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1 ‘‘(E) for fiscal year 2012, $3,537,040,374.’’. 

2 SEC. 3. RECOGNITION OF HIGH POVERTY AREAS. 

3 (a) IN GENERAL.—Section 330(c) of the Public Health 

4 Service Act (42 U.S.C. 254b(c)) is amended by adding at 

5 the end the following new paragraph: 

6 ‘‘(3) RECOGNITION OF HIGH POVERTY AREAS.— 

7 ‘‘(A) IN GENERAL.—In making grants 

8 under this subsection, the Secretary may recog9 nize the unique needs of high poverty areas. 

10 ‘‘(B) HIGH POVERTY AREA DEFINED.—For 

11 purposes of subparagraph (A), the term ‘high 

12 poverty area’ means a catchment area which is 

13 established in a manner that is consistent with 

14 the factors in subsection (k)(3)(J), and the pov15 erty rate of which is greater than the national 

16 average poverty rate as determined by the Bu17 reau of the Census.’’. 

18 (b) EFFECTIVE DATE.—The amendment made by sub19 section (a) shall apply to grants made on or after January 

20 1, 2009. 

21 SEC. 4. LIABILITY PROTECTIONS FOR HEALTH CENTER 

22 VOLUNTEER PRACTITIONERS. 

23 (a) IN GENERAL.—Section 224 of the Public Health 

24 Service Act (42 U.S.C. 233) is amended— 

25 (1) in subsection (g)(1)(A)— 


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1 (A) in the first sentence, by striking ‘‘or em2 ployee’’ and inserting ‘‘employee, or (subject to 

3 subsection (k)(4)) volunteer practitioner’’; and 

4 (B) in the second sentence, by inserting 

5 ‘‘and subsection (k)(4)’’ after ‘‘subject to para6 graph (5)’’; and 

7 (2) in each of subsections (g), (i), (j), (k), (l), 

8 and (m)— 

9 (A) by striking the term ‘‘employee, or con10 tractor’’ each place such term appears and in11 serting ‘‘employee, volunteer practitioner, or con12 tractor’’; 

13 (B) by striking the term ‘‘employee, and 

14 contractor’’ each place such term appears and 

15 inserting ‘‘employee, volunteer practitioner, and 

16 contractor’’; 

17 (C) by striking the term ‘‘employee, or any 

18 contractor’’ each place such term appears and 

19 inserting ‘‘employee, volunteer practitioner, or 

20 contractor’’; and 

21 (D) by striking the term ‘‘employees, or con22 tractors’’ each place such term appears and in23 serting ‘‘employees, volunteer practitioners, or 

24 contractors’’. 


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1 (b) APPLICABILITY; DEFINITION.—Section 224(k) of 

2 the Public Health Service Act (42 U.S.C. 233(k)) is amend3 ed by adding at the end the following paragraph: 

4 ‘‘(4)(A) Subsections (g) through (m) apply with respect 

5 to volunteer practitioners beginning with the first fiscal 

6 year for which an appropriations Act provides that 

7 amounts in the fund under paragraph (2) are available 

8 with respect to such practitioners. 

9 ‘‘(B) For purposes of subsections (g) through (m), the 

10 term ‘volunteer practitioner’ means a practitioner who, 

11 with respect to an entity described in subsection (g)(4), 

12 meets the following conditions: 

13 ‘‘(i) In the State involved, the practitioner is a 

14 licensed physician, a licensed clinical psychologist, or 

15 other licensed or certified health care practitioner. 

16 ‘‘(ii) At the request of such entity, the practi17 tioner provides services to patients of the entity, at a 

18 site at which the entity operates or at a site des19 ignated by the entity. The weekly number of hours of 

20 services provided to the patients by the practitioner is 

21 not a factor with respect to meeting conditions under 

22 this subparagraph. 

23 ‘‘(iii) The practitioner does not for the provision 

24 of such services receive any compensation from such 

25 patients, from the entity, or from third-party payors 


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1 (including reimbursement under any insurance policy 

2 or health plan, or under any Federal or State health 

3 benefits program).’’. 

4 SEC. 5. LIABILITY PROTECTIONS FOR HEALTH CENTER 

5 PRACTITIONERS PROVIDING SERVICES IN 

6 EMERGENCY AREAS. 

7 Section 224(g) of the Public Health Service Act (42 

8 U.S.C. 233(g)) is amended— 

9 (1) in paragraph (1)(B)(ii), by striking ‘‘sub10 paragraph (C)’’ and inserting ‘‘subparagraph (C) 

11 and paragraph (6)’’; and 

12 (2) by adding at the end the following para13 graph: 

14 ‘‘(6)(A) Subject to subparagraph (C), paragraph 

15 (1)(B)(ii) applies to health services provided to individuals 

16 who are not patients of the entity involved if, as determined 

17 under criteria issued by the Secretary, the following condi18 tions are met: 

19 ‘‘(i) The services are provided by a contractor, 

20 volunteer practitioner (as defined in subsection 

21 (k)(4)(B)), or employee of the entity who is a physi22 cian or other licensed or certified health care practi23 tioner and who is otherwise deemed to be an employee 

24 for purposes of paragraph (1)(A) when providing 

25 services with respect to the entity. 


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1 ‘‘(ii) The services are provided in an emergency 

2 area (as defined in subparagraph (D)), with respect 

3 to a public health emergency or major disaster de4 scribed in subparagraph (D), and during the period 

5 for which such emergency or disaster is determined or 

6 declared, respectively. 

7 ‘‘(iii) The services of the contractor, volunteer 

8 practitioner, or employee (referred to in this para9 graph as the ‘out-of-area practitioner’) are provided 

10 under an arrangement with— 

11 ‘‘(I) an entity that is deemed to be an em12 ployee for purposes of paragraph (1)(A) and that 

13 serves the emergency area involved (referred to in 

14 this paragraph as an ‘emergency-area entity’); 

15 or 

16 ‘‘(II) a Federal agency that has responsibil17 ities regarding the provision of health services in 

18 such area during the emergency. 

19 ‘‘(iv) The purposes of the arrangement are— 

20 ‘‘(I) to coordinate, to the extent practicable, 

21 the provision of health services in the emergency 

22 area by the out-of-area practitioner with the pro23 vision of services by the emergency-area entity, 

24 or by the Federal agency, as the case may be; 


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1 ‘‘(II) to identify a location in the emergency 

2 area to which such practitioner should report for 

3 purposes of providing health services, and to 

4 identify an individual or individuals in the area 

5 to whom the practitioner should report for such 

6 purposes; and 

7 ‘‘(III) to verify the identity of the practi8 tioner and that the practitioner is licensed or 

9 certified by one or more of the States. 

10 ‘‘(v) With respect to the licensure or certification 

11 of health care practitioners, the provision of services 

12 by the out-of-area practitioner in the emergency area 

13 is not a violation of the law of the State in which the 

14 area is located. 

15 ‘‘(B) In issuing criteria under subparagraph (A), the 

16 Secretary shall take into account the need to rapidly enter 

17 into arrangements under such subparagraph in order to 

18 provide health services in emergency areas promptly after 

19 the emergency begins. 

20 ‘‘(C) Subparagraph (A) applies with respect to an act 

21 or omission of an out-of-area practitioner only to the extent 

22 that the practitioner is not immune from liability for such 

23 act or omission under the Volunteer Protection Act of 1997. 

24 ‘‘(D) For purposes of this paragraph, the term ‘emer25 gency area’ means a geographic area for which— 


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1 ‘‘(i) the Secretary has made a determination 

2 under section 319 that a public health emergency ex3 ists; or 

4 ‘‘(ii) a presidential declaration of major disaster 

5 has been issued under section 401 of the Robert T. 

6 Stafford Disaster Relief and Emergency Assistance 

7 Act.’’. 

8 SEC. 6. DEMONSTRATION PROJECT FOR INTEGRATED 

9 HEALTH SYSTEMS TO EXPAND ACCESS TO 

10 PRIMARY AND PREVENTIVE SERVICES FOR 

11 THE MEDICALLY UNDERSERVED. 

12 Part D of title III of the Public Health Service Act 

13 (42 U.S.C. 259b et seq.) is amended by adding at the end 

14 the following new subpart: 

15 ‘‘Subpart XI—Demonstration Project for Integrated 

16 Health Systems to Expand Access to Primary and 

17 Preventive Services for the Medically Under18 served 

19 ‘‘SEC. 340H. DEMONSTRATION PROJECT FOR INTEGRATED 

20 HEALTH SYSTEMS TO EXPAND ACCESS TO 

21 PRIMARY AND PREVENTIVE CARE FOR THE 

22 MEDICALLY UNDERSERVED. 

23 ‘‘(a) ESTABLISHMENT OF DEMONSTRATION.— 

24 ‘‘(1) IN GENERAL.—Not later than January 1, 

25 2009, the Secretary shall establish a demonstration 


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1 project (hereafter in this section referred to as the 

2 ‘demonstration’) under which up to 30 qualifying in3 tegrated health systems receive grants for the costs of 

4 their operations to expand access to primary and pre5 ventive services for the medically underserved. 

6 ‘‘(2) RULE OF CONSTRUCTION.—Nothing in this 

7 section shall be construed as authorizing grants to be 

8 made or used for the costs of specialty care or hospital 

9 care furnished by an integrated health system. 

10 ‘‘(b) APPLICATION.—Any integrated health system de11 siring to participate in the demonstration shall submit an 

12 application in such manner, at such time, and containing 

13 such information as the Secretary may require. 

14 ‘‘(c) CRITERIA FOR SELECTION.—In selecting inte15 grated health systems to participate in the demonstration 

16 (hereafter in this section referred to as ‘participating inte17 grated health systems’), the Secretary shall ensure represen18 tation of integrated health systems that are located in a 

19 variety of States (including the District of Columbia and 

20 the territories and possessions of the United States) and lo21 cations within States, including rural areas, inner-city 

22 areas, and frontier areas. 

23 ‘‘(d) DURATION.—Subject to the availability of appro24 priations, the demonstration shall be conducted (and operVerDate Aug 31 2005 22:42 Jun 04, 2008 Jkt 069200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6203 E:\BILLS\H1343.RH H1343

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1 ating grants be made to each participating integrated 

2 health system) for a period of 3 years. 

3 ‘‘(e) REPORTS.— 

4 ‘‘(1) IN GENERAL.—The Secretary shall submit 

5 to the appropriate committees of the Congress interim 

6 and final reports with respect to the demonstration, 

7 with an interim report being submitted not later than 

8 3 months after the demonstration has been in oper9 ation for 24 months and a final report being sub10 mitted not later than 3 months after the close of the 

11 demonstration. 

12 ‘‘(2) CONTENT.—Such reports shall evaluate the 

13 effectiveness of the demonstration in providing greater 

14 access to primary and preventive care for medically 

15 underserved populations, and how the coordinated ap16 proach offered by integrated health systems contrib17 utes to improved patient outcomes. 

18 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.— 

19 ‘‘(1) IN GENERAL.—There is authorized to be ap20 propriated $25,000,000 for each of the fiscal years 

21 2009, 2010, and 2011 to carry out this section. 

22 ‘‘(2) CONSTRUCTION.—Nothing in this section 

23 shall be construed as requiring or authorizing a re24 duction in the amounts appropriated for grants to 


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1 health centers under section 330 for the fiscal years 

2 referred to in paragraph (1). 

3 ‘‘(g) DEFINITIONS.—For purposes of this section: 

4 ‘‘(1) FRONTIER AREA.—The term ‘frontier area’ 

5 has the meaning given to such term in regulations 

6 promulgated pursuant to section 330I(r). 

7 ‘‘(2) INTEGRATED HEALTH SYSTEM.—The term 

8 ‘integrated health system’ means a health system 

9 that— 

10 ‘‘(A) has a demonstrated capacity and com11 mitment to provide a full range of primary care, 

12 specialty care, and hospital care in both inpa13 tient and outpatient settings; and 

14 ‘‘(B) is organized to provide such care in a 

15 coordinated fashion. 

16 ‘‘(3) QUALIFYING INTEGRATED HEALTH SYS17 TEM.— 

18 ‘‘(A) IN GENERAL.—The term ‘qualifying 

19 integrated health system’ means a public or pri20 vate nonprofit entity that is an integrated health 

21 system that meets the requirements of subpara22 graph (B) and serves a medically underserved 

23 population (either through the staff and sup24 porting resources of the integrated health system 


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1 or through contracts or cooperative arrange2 ments) by providing— 

3 ‘‘(i) required primary and preventive 

4 health and related services (as defined in 

5 paragraph (4)); and 

6 ‘‘(ii) as may be appropriate for a pop7 ulation served by a particular integrated 

8 health system, integrative health services (as 

9 defined in paragraph (5)) that are nec10 essary for the adequate support of the re11 quired primary and preventive health and 

12 related services and that improve care co13 ordination. 

14 ‘‘(B) OTHER REQUIREMENTS.—The require15 ments of this subparagraph are that the inte16 grated health system— 

17 ‘‘(i) will make the required primary 

18 and preventive health and related services of 

19 the integrated health system available and 

20 accessible in the service area of the inte21 grated health system promptly, as appro22 priate, and in a manner which assures con23 tinuity; 

24 ‘‘(ii) will demonstrate financial re25 sponsibility by the use of such accounting 


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1 procedures and other requirements as may 

2 be prescribed by the Secretary; 

3 ‘‘(iii) provides or will provide services 

4 to individuals who are eligible for medical 

5 assistance under title XIX of the Social Se6 curity Act or for assistance under title XXI 

7 of such Act; 

8 ‘‘(iv) has prepared a schedule of fees or 

9 payments for the provision of its services 

10 consistent with locally prevailing rates or 

11 charges and designed to cover its reasonable 

12 costs of operation and has prepared a cor13 responding schedule of discounts to be ap14 plied to the payment of such fees or pay15 ments, which discounts are adjusted on the 

16 basis of the patient’s ability to pay; 

17 ‘‘(v) will assure that no patient will be 

18 denied health care services due to an indi19 vidual’s inability to pay for such services; 

20 ‘‘(vi) will assure that any fees or pay21 ments required by the system for such serv22 ices will be reduced or waived to enable the 

23 system to fulfill the assurance described in 

24 clause (v); 


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1 ‘‘(vii) provides assurances that any 

2 grant funds will be expended to supplement, 

3 and not supplant, the expenditures of the 

4 integrated health system for primary and 

5 preventive health services for the medically 

6 underserved; and 

7 ‘‘(viii) submits to the Secretary such 

8 reports as the Secretary may require to de9 termine compliance with this subparagraph. 

10 ‘‘(C) TREATMENT OF CERTAIN ENTITIES.— 

11 The term ‘qualifying integrated health system’ 

12 may include a nurse-managed health clinic if 

13 such clinic meets the requirements of subpara14 graphs (A) and (B) (except those requirements 

15 that have been waived under paragraph (4)(B)). 

16 ‘‘(4) REQUIRED PRIMARY AND PREVENTIVE

17 HEALTH AND RELATED SERVICES.— 

18 ‘‘(A) IN GENERAL.—Except as provided in 

19 subparagraph (B), the term ‘required primary 

20 and preventive health and related services’ means 

21 basic health services consisting of— 

22 ‘‘(i) health services related to family 

23 medicine, internal medicine, pediatrics, ob24 stetrics, or gynecology that are furnished by 

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1 sistants, nurse practitioners, and nurse 

2 midwives; 

3 ‘‘(ii) diagnostic laboratory services and 

4 radiologic services; 

5 ‘‘(iii) preventive health services, in6 cluding prenatal and perinatal care; appro7 priate cancer screening; well-child services; 

8 immunizations against vaccine-preventable 

9 diseases; screenings for elevated blood lead 

10 levels, communicable diseases, and choles11 terol; pediatric eye, ear, and dental 

12 screenings to determine the need for vision 

13 and hearing correction and dental care; and 

14 voluntary family planning services; 

15 ‘‘(iv) emergency medical services; and 

16 ‘‘(v) pharmaceutical services, behav17 ioral, mental health, and substance abuse 

18 services, preventive dental services, and re19 cuperative care, as may be appropriate. 

20 ‘‘(B) EXCEPTION.—In the case of an inte21 grated health system serving a targeted popu22 lation, the Secretary shall, upon a showing of 

23 good cause, waive the requirement that the inte24 grated health system provide each required pri25 mary and preventive health and related service 


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1 under this paragraph if the Secretary determines 

2 one or more such services are inappropriate or 

3 unnecessary for such population. 

4 ‘‘(5) INTEGRATIVE HEALTH SERVICES.—The 

5 term ‘integrative health services’ means services that 

6 are not included as required primary and preventive 

7 health and related services and are associated with 

8 achieving the greater integration of a health care de9 livery system to improve patient care coordination so 

10 that the system either directly provides or ensures the 

11 provision of a broad range of culturally competent 

12 services. Integrative health services include but are 

13 not limited to the following: 

14 ‘‘(A) Outreach activities. 

15 ‘‘(B) Case management and patient naviga16 tion services. 

17 ‘‘(C) Chronic care management. 

18 ‘‘(D) Transportation to health care facili19 ties. 

20 ‘‘(E) Development of provider networks and 

21 other innovative models to engage local physi22 cians and other providers to serve the medically 

23 underserved within a community. 

24 ‘‘(F) Recruitment, training, and compensa25 tion of necessary personnel. 


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1 ‘‘(G) Acquisition of technology for the pur2 pose of coordinating care. 

3 ‘‘(H) Improvements to provider communica4 tion, including implementation of shared infor5 mation systems or shared clinical systems. 

6 ‘‘(I) Determination of eligibility for Fed7 eral, State, and local programs that provide, or 

8 financially support the provision of, medical, so9 cial, housing, educational, or other related serv10 ices. 

11 ‘‘(J) Development of prevention and disease 

12 management tools and processes. 

13 ‘‘(K) Translation services. 

14 ‘‘(L) Development and implementation of 

15 evaluation measures and processes to assess pa16 tient outcomes. 

17 ‘‘(M) Integration of primary care and men18 tal health services. 

19 ‘‘(N) Carrying out other activities that may 

20 be appropriate to a community and that would 

21 increase access by the uninsured to health care, 

22 such as access initiatives for which private enti23 ties provide non-Federal contributions to supple24 ment the Federal funds provided through the 

25 grants for the initiatives. 


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1 ‘‘(6) SPECIALTY CARE.—The term ‘specialty 

2 care’ means care that is provided through a referral 

3 and by a physician or nonphysician practitioner, 

4 such as surgical consultative services, radiology serv5 ices requiring the immediate presence of a physician, 

6 audiology, optometric services, cardiology services, 

7 magnetic resonance imagery (MRI) services, comput8 erized axial tomography (CAT) scans, nuclear medi9 cine studies, and ambulatory surgical services. 

10 ‘‘(7) NURSE-MANAGED HEALTH CLINIC.—The 

11 term ‘nurse-managed health clinic’ means a nurse12 practice arrangement, managed by advanced practice 

13 nurses, that provides care for underserved and vulner14 able populations and is associated with a school, col15 lege, or department of nursing or an independent 

16 nonprofit health or social services agency.’’. 

Amend the title so as to read: ‘‘A bill to amend the 

Public Health Service Act to provide additional authorizations of appropriations for the health centers program 

under section 330 of such Act, and for other purposes.’’. 


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Union Calendar No. 425 

110TH CONGRESS 

2D SESSION H. R. 1343 

[Report No. 110

–680] 

A BILL 

To amend the Public Health Service Act to provide 

such Act. the health centers program under section 330 of additional authorizations of appropriations for 

JUNE 4, 2008 

Reported with amendments, committed to the Committee 

dered to be printed of the Whole House on the State of the Union, and orVerDate Aug 31 2005 22:42 Jun 04, 2008 Jkt 069200 PO 00000 Frm 00022 Fmt 6651 Sfmt 6651 E:\BILLS\H1343.RH H1343

wwoods2 on PRODPC68 with BILLS