II 

109TH CONGRESS 

1ST SESSION S. 898 

To amend the Public Health Service Act to authorize a demonstration grant 

program to provide patient navigator services to reduce barriers and 

improve health care outcomes, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 25, 2005 

Mrs. HUTCHISON (for herself, Mr. BINGAMAN, Mr. BROWNBACK, Mr. KENNEDY, and Mr. COCHRAN) 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 authorize a 

demonstration grant program to provide patient navigator services to reduce barriers and improve health care 

outcomes, 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 ‘‘Patient Navigator Out5 reach and Chronic Disease Prevention Act of 2005’’. 
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1 SEC. 2. PATIENT NAVIGATOR GRANTS. 

2 Subpart V of part D of title III of the Public Health 

3 Service Act (42 U.S.C. 256) is amended by adding at the 

4 end the following: 

5 ‘‘SEC. 340A. PATIENT NAVIGATOR GRANTS. 

6 ‘‘(a) GRANTS.—The Secretary, acting through the 

7 Administrator of the Health Resources and Services Ad8 ministration, may make grants to eligible entities for the 

9 development and operation of demonstration programs to 

10 provide patient navigator services to improve health care 

11 outcomes. The Secretary shall coordinate with, and ensure 

12 the participation of, the Indian Health Service, the Na13 tional Cancer Institute, the Office of Rural Health Policy, 

14 and such other offices and agencies as deemed appropriate 

15 by the Secretary, regarding the design and evaluation of 

16 the demonstration programs. 

17 ‘‘(b) USE OF FUNDS.—The Secretary shall require 

18 each recipient of a grant under this section to use the 

19 grant to recruit, assign, train, and employ patient naviga20 tors who have direct knowledge of the communities they 

21 serve to facilitate the care of individuals, including by per22 forming each of the following duties: 

23 ‘‘(1) Acting as contacts, including by assisting 

24 in the coordination of health care services and pro25 vider referrals, for individuals who are seeking pre26 vention or early detection services for, or who fol-
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1 lowing a screening or early detection service are 

2 found to have a symptom, abnormal finding, or diag3 nosis of, cancer or other chronic disease. 

4 ‘‘(2) Facilitating the involvement of community 

5 organizations in assisting individuals who are at risk 

6 for or who have cancer or other chronic diseases to 

7 receive better access to high-quality health care serv8 ices (such as by creating partnerships with patient 

9 advocacy groups, charities, health care centers, com10 munity hospice centers, other health care providers, 

11 or other organizations in the targeted community). 

12 ‘‘(3) Notifying individuals of clinical trials and, 

13 on request, facilitating enrollment of eligible individ14 uals in these trials. 

15 ‘‘(4) Anticipating, identifying, and helping pa16 tients to overcome barriers within the health care 

17 system to ensure prompt diagnostic and treatment 

18 resolution of an abnormal finding of cancer or other 

19 chronic disease. 

20 ‘‘(5) Coordinating with the relevant health in21 surance ombudsman programs to provide informa22 tion to individuals who are at risk for or who have 

23 cancer or other chronic diseases about health cov24 erage, including private insurance, health care sav25 ings accounts, and other publicly funded programs 
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1 (such as Medicare, Medicaid, health programs oper2 ated by the Department of Veterans Affairs or the 

3 Department of Defense, the State children’s health 

4 insurance program, and any private or governmental 

5 prescription assistance programs). 

6 ‘‘(6) Conducting ongoing outreach to health dis7 parity populations, including the uninsured, rural 

8 populations, and other medically underserved popu9 lations, in addition to assisting other individuals who 

10 are at risk for or who have cancer or other chronic 

11 diseases to seek preventative care. 

12 ‘‘(c) PROHIBITIONS.— 

13 ‘‘(1) REFERRAL FEES.—The Secretary shall re14 quire each recipient of a grant under this section to 

15 prohibit any patient navigator providing services 

16 under the grant from accepting any referral fee, 

17 kickback, or other thing of value in return for refer18 ring an individual to a particular health care pro19 vider. 

20 ‘‘(2) LEGAL FEES AND COSTS.—The Secretary 

21 shall prohibit the use of any grant funds received 

22 under this section to pay any fees or costs resulting 

23 from any litigation, arbitration, mediation, or other 

24 proceeding to resolve a legal dispute. 

25 ‘‘(d) GRANT PERIOD.— 
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1 ‘‘(1) IN GENERAL.—Subject to paragraphs (2) 

2 and (3), the Secretary may award grants under this 

3 section for periods of not more than 3 years. 

4 ‘‘(2) EXTENSIONS.—Subject to paragraph (3), 

5 the Secretary may extend the period of a grant 

6 under this section. Each such extension shall be for 

7 a period of not more than 1 year. 

8 ‘‘(3) LIMITATIONS ON GRANT PERIOD.—In car9 rying out this section, the Secretary— 

10 ‘‘(A) shall ensure that the total period of 

11 a grant does not exceed 4 years; and 

12 ‘‘(B) may not authorize any grant period 

13 ending after September 30, 2010. 

14 ‘‘(e) APPLICATION.— 

15 ‘‘(1) IN GENERAL.—To seek a grant under this 

16 section, an eligible entity shall submit an application 

17 to the Secretary in such form, in such manner, and 

18 containing such information as the Secretary may 

19 require. 

20 ‘‘(2) CONTENTS.—At a minimum, the Secretary 

21 shall require each such application to outline how 

22 the eligible entity will establish baseline measures 

23 and benchmarks that meet the Secretary’s require24 ments to evaluate program outcomes. 
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1 ‘‘(f) UNIFORM BASELINE MEASURES.—The Sec2 retary shall establish uniform baseline measures in order 

3 to properly evaluate the impact of the demonstration 

4 projects under this section. 

5 ‘‘(g) PREFERENCE.—In making grants under this 

6 section, the Secretary shall give preference to eligible enti7 ties that demonstrate in their applications plans to utilize 

8 patient navigator services to overcome significant barriers 

9 in order to improve health care outcomes in their respec10 tive communities. 

11 ‘‘(h) DUPLICATION OF SERVICES.—An eligible entity 

12 that is receiving Federal funds for activities described in 

13 subsection (b) on the date on which the entity submits 

14 an application under subsection (e), may not receive a 

15 grant under this section unless the entity can demonstrate 

16 that amounts received under the grant will be utilized to 

17 expand services or provide new services to individuals who 

18 would not otherwise be served. 

19 ‘‘(i) COORDINATION WITH OTHER PROGRAMS.—The 

20 Secretary shall ensure coordination of the demonstration 

21 grant program under this section with existing authorized 

22 programs in order to facilitate access to high-quality 

23 health care services. 

24 ‘‘(j) STUDY; REPORTS.— 
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1 ‘‘(1) FINAL REPORT BY SECRETARY.—Not later 

2 than 6 months after the completion of the dem3 onstration grant program under this section, the 

4 Secretary shall conduct a study of the results of the 

5 program and submit to the Congress a report on 

6 such results that includes the following: 

7 ‘‘(A) An evaluation of the program out8 comes, including— 

9 ‘‘(i) quantitative analysis of baseline 

10 and benchmark measures; and 

11 ‘‘(ii) aggregate information about the 

12 patients served and program activities. 

13 ‘‘(B) Recommendations on whether patient 

14 navigator programs could be used to improve 

15 patient outcomes in other public health areas. 

16 ‘‘(2) REPORTS BY SECRETARY.—The Secretary 

17 may provide interim reports to the Congress on the 

18 demonstration grant program under this section at 

19 such intervals as the Secretary determines to be ap20 propriate. 

21 ‘‘(3) INTERIM REPORTS BY GRANTEES.—The 

22 Secretary may require grant recipients under this 

23 section to submit interim and final reports on grant 

24 program outcomes. 
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1 ‘‘(k) RULE OF CONSTRUCTION.—This section shall 

2 not be construed to authorize funding for the delivery of 

3 health care services (other than the patient navigator du4 ties listed in subsection (b)). 

5 ‘‘(l) DEFINITIONS.—In this section: 

6 ‘‘(1) The term ‘eligible entity’ means a public 

7 or nonprofit private health center (including a Fed8 erally qualified health center (as that term is defined 

9 in section 1861(aa)(4) of the Social Security Act)), 

10 a health facility operated by or pursuant to a con11 tract with the Indian Health Service, a hospital, a 

12 cancer center, a rural health clinic, an academic 

13 health center, or a nonprofit entity that enters into 

14 a partnership or coordinates referrals with such a 

15 center, clinic, facility, or hospital to provide patient 

16 navigator services. 

17 ‘‘(2) The term ‘health disparity population’ 

18 means a population that, as determined by the Sec19 retary, has a significant disparity in the overall rate 

20 of disease incidence, prevalence, morbidity, mor21 tality, or survival rates as compared to the health 

22 status of the general population. 

23 ‘‘(3) The term ‘patient navigator’ means an in24 dividual who has completed a training program ap-
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1 proved by the Secretary to perform the duties listed 

2 in subsection (b). 

3 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.— 

4 ‘‘(1) IN GENERAL.—To carry out this section, 

5 there are authorized to be appropriated $2,000,000 

6 for fiscal year 2006, $5,000,000 for fiscal year 

7 2007, $8,000,000 for fiscal year 2008, $6,500,000 

8 for fiscal year 2009, and $3,500,000 for fiscal year 

9 2010. 

10 ‘‘(2) AVAILABILITY.—The amounts appro11 priated pursuant to paragraph (1) shall remain 

12 available for obligation through the end of fiscal year 

13 2010.’’.

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