II 

108TH CONGRESS 

1ST SESSION S. 1883

To amend the Public Health Service Act to provide greater access for residents of frontier areas to the healthcare services provided by community 

health centers. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 18, 2003

Mr. ENZI (for himself, Mr. BINGAMAN, Mr. THOMAS, and Mr. CRAIG) 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 provide greater 

access for residents of frontier areas to the healthcare 

services provided by community health centers.

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 ‘‘Frontier Healthcare 

5 Access Act of 2003’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

7 (a) Congress makes the following findings: 
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1 (1) People who live in frontier areas are medi2 cally underserved and face unique challenges in ac3 cessing affordable healthcare. 

4 (2) People who live in frontier areas are more 

5 likely to lack health insurance than other rural and 

6 urban citizens. 

7 (3) Frontier areas generally do not have popu8 lation centers that can support the full range of 

9 healthcare services available in most urban and some 

10 rural areas. 

11 (4) Community health centers play an impor12 tant role in providing health services to many medi13 cally underserved areas and populations. 

14 (5) Many frontier areas do not have community 

15 health centers. 

16 (6) Many frontier areas cannot currently qual17 ify for community health centers because the Fed18 eral definition of medically underserved areas or 

19 populations does not appropriately or effectively rec20 ognize the unique nature and needs of frontier areas 

21 and those who live in them. 

22 (7) Any definition of frontier areas for purposes 

23 of eligibility for Federal or State healthcare pro24 grams should look beyond simple measures of popu25 lation density to consider such factors as the dis-
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1 tance from and travel time to the nearest significant 

2 healthcare service center or market. 

3 (8) President George W. Bush has made the 

4 development of new community health centers a pri5 ority of his administration. 

6 (9) People who live in frontier areas should be 

7 included explicitly in this expansion of the commu8 nity health center program. 

9 (b) PURPOSE.—It is the purpose of this Act to pro10 vide greater access for residents of frontier areas to the 

11 healthcare services provided by community health centers. 

12 SEC. 3. FRONTIER COMMUNITY HEALTH CENTERS. 

13 Section 330 of the Public Health Service Act (42 

14 U.S.C. 254b) is amended—

15 (1) in subsection (a)(1), by striking ‘‘and resi16 dents of public housing’’ and inserting ‘‘residents of 

17 public housing, and residents of frontier areas’’; 

18 (2) by redesignating subsections (j), (n), (o), 

19 (p), (q), (r), (s), (q), and (s) as subsections (k), (l), 

20 (m), (n), (o), (p), (q), (r), and (s), respectively; and 

21 (3) by inserting after subsection (i), the fol22 lowing: 

23 ‘‘(j) RESIDENTS OF FRONTIER AREAS.—

24 ‘‘(1) IN GENERAL.—The Secretary may award 

25 grants for the purposes described in subsections (c), 
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1 (e), and (f) for the planning and delivery of services 

2 to areas identified under paragraph (3)(B). 

3 ‘‘(2) SUPPLEMENT NOT SUPPLANT.—A grant 

4 awarded under this subsection shall be expended to 

5 supplement, and not supplant, the expenditures of 

6 the health center and the value of in-kind contribu7 tions for the delivery of services to the population 

8 described in paragraph (1). 

9 ‘‘(3) DEFINITION.—

10 ‘‘(A) IN GENERAL.—In this subsection, the 

11 term ‘frontier area’ means a county or a ration12 al area identified by the Secretary in consulta13 tion with appropriate State offices of rural 

14 health. 

15 ‘‘(B) REGULATIONS.—The Secretary shall 

16 through regulations develop a definition to iden17 tify frontier areas and shall designate residents 

18 of such areas as medically underserved for pur19 poses of this section. In developing such defini20 tion the Secretary shall consider factors such as 

21 population density, distance in miles from the 

22 nearest significant healthcare service center or 

23 market, and travel time in minutes from the 
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1 nearest significant healthcare service center or 

2 market.’’.

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