Hallways to Health Act

To amend title XXI of the Social Security Act to improve access to, and the delivery of, children’s health services through school-based health centers, and for other purposes. 1. Short title This Act may be cited as the Hallways to Health Act 2. School-based health centers Title XXI of the Social Security Act ( 42 U.S.C. 1397aa et seq. 2114. Grants and programs to improve access to, and the delivery of, children's health services through school-based health centers (a) Grants to school-Based health centers To encourage children To adopt healthy behaviors (1) Establishment Not later than 18 months after the date of enactment of this subsection, the Secretary shall publish criteria to enable school-based health centers to apply for grants for the purpose of assisting eligible children under this title and title XIX and other children by providing funding for community health workers to facilitate children's access to services that encourage children to adopt healthy behaviors and to improve the quality and cultural competence of the delivery of such services. Not later than 2 years after such date, the Secretary shall award grants to school-based health centers for such purposes. (2) Requirements A school-based health center that employs individuals who meet the Bureau of Labor Statistics standard occupational definition of health educator community health worker (3) Reporting (A) By grantees A grantee under this subsection shall annually submit to the Secretary a report containing a description of the services provided under the grant, the data collected with respect to such services, a description of the efficacy of such services, any other information determined appropriate by the Secretary. (B) By secretary The Secretary biennially shall submit to Congress a report on the efficacy of the grant program established under this subsection. (4) Authorization of appropriations There are authorized to be appropriated such sums as may be necessary to carry out this subsection. Funds appropriated under the preceding sentence shall remain available until expended. . 3. Establishment and expansion of demonstration programs to provide tele-health services at school-based health centers Section 2114 of the Social Security Act (as added by section 2), is amended by adding at the end the following new subsection: (b) Establishment and expansion of tele-Health services demonstration programs (1) Establishment Not later than 18 months after the date of enactment of this subsection, the Secretary shall publish criteria for the establishment of a demonstration program to provide new tele-health services, or to expand existing tele-health service programs, located at school-based health centers. A school-based health center's receipt of funds under the demonstration program under this subsection shall not preclude the school-based health center from being reimbursed by public or private health insurance programs according to State law and regulation for items and services furnished by or through the center. (2) Authorization of appropriations There are authorized to be appropriated such sums as may be necessary to carry out this subsection. Funds appropriated under the preceding sentence shall remain available until expended. . 4. Assurance of payment under Medicaid and CHIP for covered items and services furnished by certain school-based health centers (a) State plan requirement Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) (78) provide that the State shall certify to the Secretary that the State has implemented procedures to pay for medical assistance (including care and services described in subsections (a)(4)(B) and (r) of section 1905 and provided in accordance with section 1902(a)(43)) furnished in a school-based health center (as defined in section 2110(c)(9)), if payment would be made under the State plan for the same items and services if furnished in a physician's office or other outpatient clinic (including if such payment would be included in the determination of a prepaid capitation or other risk-based rate of payment to an entity under a contract pursuant to section 1903(m)); . (b) Application to CHIP Section 2107(e)(1) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1) (1) by redesignating subparagraphs (E) through (O) as subparagraphs (F) through (P), respectively; and (2) by inserting after subparagraph (D), the following new subparagraph: (E) Section 1902(a)(78) (relating to procedures to ensure payment for covered services furnished in a school-based health center). . (c) Effective date The amendments made by this section take effect on October 1, 2016. 5. Other improvements (a) In general Section 399Z–1 of the Public Health Service Act ( 42 U.S.C. 280h–5 (1) in subsection (a)(1), in the matter preceding subparagraph (A), by inserting either in person or via telehealth, health centers, (2) in subsection (a)(3)(A), by inserting before the semicolon the following: , and include universities, accountable care organizations, and behavioral health organizations (3) in subsection (c)(2)(C)(4), by inserting and health education health services (4) in subsection (e), by striking may— may, upon a showing of good cause, waive the requirement that the SBHC provide all required comprehensive primary health services for a period of not to exceed 2 years. (5) in subsection (i), by inserting before the period the following: , including using existing quality performance measures funded by the Federal Government for such entities (6) in subsection (l)— (A) by striking 2014 2021 (B) by redesignating such subsection as subsection (n); and (7) by inserting after subsection (k), the following: (l) Technical assistance The Secretary, acting directly or through the awarding of grants or contracts to private, nonprofit entities shall establish or support existing State school-based health center resource centers that— (1) provide advocacy, training, and technical assistance to school-based health centers, including maximizing Federal and State resources; (2) support the development of school-based health centers; and (3) enhance the operations and performance of school-based health centers. (m) Authorization of appropriations For purposes of carrying out this section, there are authorized to be appropriated such sums as may be necessary. . (b) Covered entity Section 340B(a)(4) of the Public Health Service Act ( 42 U.S.C. 256b(a)(4) (P) A school-based health center. . (c) Qualified health plans Section 1311(c)(1)(C) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(c)(1)(C) , providers defined in section 2110(c)(9) of the Social Security Act, Public Health Service Act

Summary: Hallways to Health Act This bill amends titles XIX (Medicaid) and XXI (Children's Health Insurance Program [CHIP]) of the Social Security Act to: establish a grant program for school-based health centers to, with respect to children who are eligible for Medicaid and CHIP, facilitate access to services and encourage the adoption of healthy behaviors; establish a demonstration program for the provision or expansion of telehealth services in school-based health centers; and require state Medicaid and CHIP programs to cover services furnished by school-based health centers. In addition, the bill amends the Public Health Service Act to reauthorize through FY2021 and revise school-based health center programs.  The bill also amends the Patient Protection and Affordable Care Act to specify that school-based health centers are essential community providers for purposes of inclusion in a qualified health plan.