161 
which is the primary variable of interest 
from a public health perspective; 
(C) is used to develop— 
(i) measures to address health and the 
connection of health to the built environ-
ment; and 
(ii) efforts to link the measures to 
travel and health databases; and 
(D) distinguishes carefully between per-
sonal attitudes and choices and external influ-
ences on observed behavior to determine how 
much an observed association between the built 
environment and the health of residents, versus 
the lifestyle preferences of the people that 
choose to live in the neighborhood, reflects the 
physical characteristics of the neighborhood; 
and 
(E)(i) identifies or develops effective inter-
vention strategies to promote better health 
among residents with a focus on behavioral 
interventions and enhancements of the built en-
vironment that promote increased use by resi-
dents; and 
(ii) in developing the intervention strate-
gies under clause (i), ensures that the interven-
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tion strategies will reach out to high-risk popu-
lations, including racial and ethnic minorities 
and low-income urban and rural communities. 
(4) PRIORITY.—In providing assistance under 
the grant program authorized under paragraph (2), 
the Secretary and the Administrator shall give pri-
ority to research that incorporates— 
(A) Minority-serving institutions as grant-
ees; 
(B) interdisciplinary approaches; or 
(C) the expertise of the public health, 
physical activity, urban planning, and transpor-
tation research communities in the United 
States and abroad. 
TITLE V—IMPROVEMENT OF 
HEALTH CARE SERVICES 
SEC. 501. HEALTH EMPOWERMENT ZONES. 
(a) HEALTH EMPOWERMENT ZONE PROGRAMS.— 
(1) GRANTS.—The Secretary, acting through 
the Administrator of the Health Resources and Serv-
ices Administration and the Deputy Assistant Sec-
retary for Minority Health, and in cooperation with 
the Director of the Office of Community Services 
and the Director of the National Center for Minority 
Health and Health Disparities, shall make grants to 
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partnerships of private and public entities to estab-
lish health empowerment zone programs in commu-
nities that disproportionately experience disparities 
in health status and health care for the purpose de-
scribed in paragraph (2). 
(2) USE OF FUNDS.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the purpose of a health empower-
ment zone program under this section shall be 
to assist individuals, businesses, schools, minor-
ity health associations, non-profit organizations, 
community-based 
organizations, 
hospitals, 
health care clinics, foundations, and other enti-
ties in communities that disproportionately ex-
perience disparities in health status and health 
care which are seeking— 
(i) to improve the health or environ-
ment of minority individuals in the com-
munity and to reduce disparities in health 
status and health care by assisting individ-
uals in accessing Federal programs; 
(ii) to coordinate the efforts of gov-
ernmental and private entities regarding 
the elimination of racial and ethnic dispari-
ties in health status and health care; and 
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(iii) to increase the adoption and use 
of health information technology by pro-
viders in racial and ethnic minority and 
rural communities to improve quality of 
care; enhance minority and rural consumer 
awareness; understand, adopt, and use 
health information technology to improve 
health literacy and health self-manage-
ment; and foster improved coordination of 
health services and care quality. 
(B) MEDICARE AND MEDICAID.—A health 
empowerment zone program under this section 
shall not provide any assistance (other than re-
ferral and follow-up services) that is duplicative 
of programs under title XVIII or XIX of the 
Social Security Act (42 U.S.C. 1395 and 1396 
et seq.). 
(3) DISTRIBUTION.—The Secretary shall make 
at least 1 grant per Health and Human Services re-
gion under this section to a partnership for a health 
empowerment zone program in communities that 
disproportionately experience disparities in health 
status and health care that is located in a territory 
or possession of the United States. 
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(4) APPLICATION.—To obtain a grant under 
this section, a partnership shall submit to the Sec-
retary an application in such form and in such man-
ner as the Secretary may require. An application 
under this paragraph shall— 
(A) demonstrate that the communities to 
be served by the health empowerment zone pro-
gram are those that disproportionately experi-
ence disparities in health status and health 
care; 
(B) set forth a strategic plan for accom-
plishing the purpose described in paragraph (2), 
by— 
(i) describing the coordinated health, 
economic, human, community, and physical 
development plan and related activities 
proposed for the community; 
(ii) describing the extent to which 
local institutions and organizations have 
contributed and will contribute to the plan-
ning process and implementation; 
(iii) identifying the projected amount 
of Federal, State, local, and private re-
sources that will be available in the area 
and the private and public partnerships to 
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be used (including any participation by or 
cooperation 
with 
universities, 
colleges, 
foundations, non-profit organizations, med-
ical centers, hospitals, health clinics, school 
districts, or other private and public enti-
ties); 
(iv) identifying the funding requested 
under any Federal program in support of 
the proposed activities; 
(v) identifying benchmarks for meas-
uring the success of carrying out the stra-
tegic plan; 
(vi) demonstrating the ability to reach 
and service the targeted underserved mi-
nority community populations in a cul-
turally appropriate and linguistically re-
sponsive manner; and 
(vii) demonstrating a capacity and in-
frastructure to provide long-term commu-
nity response that is culturally appropriate 
and linguistically responsive to commu-
nities that disproportionately experience 
disparities in health and health care; and 
(C) include such other information as the 
Secretary may require. 
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(5) PREFERENCE.—In awarding grants under 
this subsection, the Secretary shall give preference 
to proposals from indigenous community entities 
that have an expertise in providing culturally appro-
priate and linguistically responsive services to com-
munities that disproportionately experience dispari-
ties in health and health care. 
(b) FEDERAL ASSISTANCE FOR HEALTH EMPOWER-
MENT ZONE GRANT PROGRAMS.—The Secretary, the Ad-
ministrator of the Small Business Administration, the 
Secretary of Agriculture, the Secretary of Education, the 
Secretary of Labor, and the Secretary of Housing and 
Urban Development shall each— 
(1) where appropriate, provide entity-specific 
technical assistance and evidence-based strategies to 
communities that disproportionately experience dis-
parities in health status and health care to further 
the purposes served by a health empowerment zone 
program established with a grant under subsection 
(a); 
(2) identify all programs administered by the 
Department of Health and Human Services, Small 
Business Administration, Department of Agri-
culture, Department of Education, Department of 
Labor, and the Department of Housing and Urban 
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Development, respectively, that may be used to fur-
ther the purpose of a health empowerment zone pro-
gram established with a grant under subsection (a); 
and 
(3) in administering any program identified 
under paragraph (2), consider the appropriateness of 
giving priority to any individual or entity located in 
communities that disproportionately experience dis-
parities in health status and health care served by 
a health empowerment zone program established 
with a grant under subsection (a), if such priority 
would further the purpose of the health empower-
ment zone program. 
(c) HEALTH EMPOWERMENT ZONE COORDINATING 
COMMITTEE.— 
(1) ESTABLISHMENT.—For each health em-
powerment zone program established with a grant 
under subsection (a), the Secretary acting through 
the Director of Office of Minority Health and the 
Administrator of the Health Resources and Services 
Administration shall establish a health empowerment 
zone coordinating committee. 
(2) DUTIES.—Each coordinating committee es-
tablished, in coordination with the Deputy Assistant 
Secretary for Minority Health and the Administrator 
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of the Health Resources and Services Administra-
tion, shall provide technical assistance and evidence- 
based strategies to the grant recipient involved, in-
cluding providing guidance on research, strategies, 
health outcomes, program goals, management, im-
plementation, monitoring, assessment, and evalua-
tion processes. 
(3) MEMBERSHIP.— 
(A) APPOINTMENT.—The Deputy Assist-
ant Secretary for Minority Health and the Ad-
ministrator of the Health Resources and Serv-
ices Administration, in consultation with the re-
spective grant recipient shall appoint the mem-
bers of each coordinating committee. 
(B) COMPOSITION.—The Deputy Assistant 
Secretary for Minority Health, and the Admin-
istrator of the Health Resources and Services 
Administration shall ensure that each coordi-
nating committee established— 
(i) has not more than 20 members; 
(ii) includes individuals from commu-
nities that disproportionately experience 
disparities in health status and health 
care; 
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(iii) includes community leaders and 
leaders of community-based organizations; 
(iv) includes representatives of aca-
demia and lay and professional organiza-
tions and associations including those hav-
ing expertise in medicine (including dental 
and oral medicine), technical, social, and 
behavioral science, health policy, health in-
formation technology, advocacy, cultural 
and linguistic competency, research man-
agement, and organization; and 
(v) represents a reasonable cross-sec-
tion of knowledge, views, and application 
of expertise on societal, ethical, behavioral, 
educational, policy, legal, cultural, lin-
guistic, and technological workforce issues 
related to eliminating disparities in health 
and health care. 
(C) INDIVIDUAL
QUALIFICATIONS.—The 
Deputy Assistant Secretary for Minority Health 
and the Administrator of the Health Resources 
and Services Administration may not appoint 
an individual to serve on a coordinating com-
mittee unless the individual meets the following 
qualifications: 
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(i) The individual is not employed by 
the Federal Government. 
(ii) The individual has appropriate ex-
perience, including experience in the areas 
of community development, cultural and 
linguistic competency, reducing and elimi-
nating racial and ethnic disparities in 
health and health care, or minority health. 
(D) SELECTION.—In selecting individuals 
to serve on a coordinating committee, the Dep-
uty Assistant Secretary for Minority Health 
and the Administrator Health Resources and 
Services Administration shall give due consider-
ation to the recommendations of the Congress, 
industry leaders, the scientific community (in-
cluding the Institute of Medicine), academia, 
community based non-profit organizations, mi-
nority health and related organizations, the 
education community, State and local govern-
ments, and other appropriate organizations. 
(E) CHAIRPERSON.—The Deputy Assistant 
Secretary for Minority Health and the Adminis-
trator of the Health Resources and Services Ad-
ministration, in consultation with the members 
of the coordinating committee involved, shall 
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designate a chairperson of the coordinating 
committee, who shall serve for a term of 3 
years and who may be reappointed at the expi-
ration of each such term. 
(F) TERMS.—Each member of a coordi-
nating committee shall be appointed for a term 
of 1 to 3 years in overlapping staggered terms, 
as determined by the Deputy Assistant Sec-
retary for Minority Health and the Adminis-
trator of the Health Resources and Services Ad-
ministration at the time of appointment, and 
may be reappointed at the expiration of each 
such term. 
(G) VACANCIES.—A vacancy on a coordi-
nating committee shall be filled in the same 
manner in which the original appointment was 
made. 
(4) MEETINGS.—A coordinating committee 
shall meet at least twice each year, at the call of the 
coordinating committee’s chairperson and in con-
sultation with the Deputy Assistant Secretary for 
Minority Health and the Administrator Health Re-
sources and Services Administration. 
(5) REPORT.—Each coordinating committee 
shall transmit to the Congress an annual report 
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that, with respect to the health empowerment zone 
program involved, includes the following: 
(A) A review of the program’s effectiveness 
in achieving stated goals and outcomes. 
(B) A review of the program’s manage-
ment and the coordination of the entities in-
volved, including the representation and involve-
ment of communities experiencing health dis-
parities. 
(C) A review of the activities in the pro-
gram’s portfolio and components. 
(D) An identification of policy issues raised 
by the program. 
(E) An assessment of the program’s capac-
ity, infrastructure, and number of underserved 
minority communities engaged. 
(F) Recommendations for new program 
goals, research areas, enhanced approaches, 
partnerships, coordination and management 
mechanisms, and projects to be established to 
achieve the program’s stated goals, to improve 
outcomes, monitoring, and evaluation. 
(G) A review of the degree of minority en-
tity participation in the program, and an identi-
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fication of a strategy to increase such participa-
tion. 
(H) Any other reviews or recommendations 
determined to be appropriate by the coordi-
nating committee. 
(d) REPORT.—The Deputy Assistant Secretary for 
Minority Health and the Administrator of the Health Re-
sources and Services Administration shall submit a joint 
annual report to the appropriate committees of Congress 
on the results of the implementation of programs under 
this section. 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2013. 
SEC. 502. AMENDMENT TO THE PUBLIC HEALTH SERVICE 
ACT. 
Title XXX of the Public Health Service Act, as 
amended by titles II, III, and IV of this Act, is further 
amended by adding at the end the following: 
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‘‘Subtitle 
D—Reconstruction 
and 
Improvement Grants for Public 
Health Care Facilities Serving 
Pacific Islanders and the Insu-
lar Areas 
‘‘SEC. 3051. GRANT SUPPORT FOR QUALITY IMPROVEMENT 
INITIATIVES. 
‘‘(a) IN GENERAL.—The Secretary, in collaboration 
with the Administrator of the Health Resources and Serv-
ices Administration, the Director of the Agency for 
Healthcare Research and Quality, and the Administrator 
of the Centers for Medicare & Medicaid Services, shall 
award grants to eligible entities for the conduct of dem-
onstration projects to improve the quality of and access 
to health care. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
‘‘(1) be a health center, hospital, health plan, 
health system, community clinic. or other health en-
tity determined appropriate by the Secretary— 
‘‘(A) that, by legal mandate or explicitly 
adopted mission, provides patients with access 
to services regardless of their ability to pay; 
‘‘(B) that provides care or treatment for a 
substantial number of patients who are unin-
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sured, are receiving assistance under a State 
program under title XIX of the Social Security 
Act, or are members of vulnerable populations, 
as determined by the Secretary; and 
‘‘(C)(i) with respect to which, not less than 
50 percent of the entity’s patient population is 
made up of racial and ethnic minorities; or 
‘‘(ii) that— 
‘‘(I) serves a disproportionate percent-
age of local, minority racial and ethnic pa-
tients, or that has a patient population, at 
least 50 percent of which is limited English 
proficient; and 
‘‘(II) provides an assurance that 
amounts received under the grant will be 
used only to support quality improvement 
activities in the racial and ethnic popu-
lation served; and 
‘‘(2) prepare and submit to the Secretary an 
application at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
‘‘(c) PRIORITY.—In awarding grants under sub-
section (a), the Secretary shall give priority to applicants 
under subsection (b)(2) that— 
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‘‘(1) demonstrate an intent to operate as part 
of a health care partnership, network, collaborative, 
coalition, or alliance where each member entity con-
tributes to the design, implementation, and evalua-
tion of the proposed intervention; or 
‘‘(2) intend to use funds to carry out system-
wide changes with respect to health care quality im-
provement, including— 
‘‘(A) improved systems for data collection 
and reporting; 
‘‘(B) innovative collaborative or similar 
processes; 
‘‘(C) group programs with behavioral or 
self-management interventions; 
‘‘(D) case management services; 
‘‘(E) physician or patient reminder sys-
tems; 
‘‘(F) educational interventions; or 
‘‘(G) other activities determined appro-
priate by the Secretary. 
‘‘(d) USE OF FUNDS.—An entity shall use amounts 
received under a grant under subsection (a) to support 
the implementation and evaluation of health care quality 
improvement activities or minority health and health care 
disparity reduction activities that include— 
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‘‘(1) with respect to health care systems, activi-
ties relating to improving— 
‘‘(A) patient safety; 
‘‘(B) timeliness of care; 
‘‘(C) effectiveness of care; 
‘‘(D) efficiency of care; 
‘‘(E) patient centeredness; and 
‘‘(F) health information technology; and 
‘‘(2) with respect to patients, activities relating 
to— 
‘‘(A) staying healthy; 
‘‘(B) getting well; 
‘‘(C) living with illness or disability; and 
‘‘(D) coping with end of life issues. 
‘‘(e) COMMON DATA SYSTEMS.—The Secretary shall 
provide financial and other technical assistance to grant-
ees under this section for the development of common data 
systems. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2013. 
‘‘SEC. 3052. CENTERS OF EXCELLENCE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
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Administration, shall designate centers of excellence at 
public hospitals, and other health systems serving large 
numbers of minority patients, that— 
‘‘(1) 
meet 
the 
requirements 
of 
section 
3051(b)(1); 
‘‘(2) demonstrate excellence in providing care to 
minority populations; and 
‘‘(3) demonstrate excellence in reducing dispari-
ties in health and health care. 
‘‘(b) REQUIREMENTS.—A hospital or health system 
that serves as a Center of Excellence under subsection (a) 
shall— 
‘‘(1) design, implement, and evaluate programs 
and policies relating to the delivery of care in ra-
cially, ethnically, and linguistically diverse popu-
lations; 
‘‘(2) provide training and technical assistance 
to other hospitals and health systems relating to the 
provision of quality health care to minority popu-
lations; and 
‘‘(3) develop activities for graduate or con-
tinuing medical education that institutionalize a 
focus on cultural competence training for health care 
providers. 
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‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2013. 
‘‘SEC. 3053. RECONSTRUCTION AND IMPROVEMENT GRANTS 
FOR PUBLIC HEALTH CARE FACILITIES SERV-
ING PACIFIC ISLANDERS AND THE INSULAR 
AREAS. 
‘‘(a) IN GENERAL.—The Secretary shall provide di-
rect financial assistance to designated health care pro-
viders and community health centers in American Samoa, 
Guam, the Commonwealth of the Northern Mariana Is-
lands, the United States Virgin Islands, Puerto Rico, and 
Hawaii for the purposes of reconstructing and improving 
health care facilities and services. 
‘‘(b) ELIGIBILITY.—To be eligible to receive direct fi-
nancial assistance under subsection (a), an entity shall be 
a public health facility or community health center located 
in American Samoa, Guam, or the Commonwealth of the 
Northern Mariana Islands, the United States Virgin Is-
lands, Puerto Rico, and Hawaii that— 
‘‘(1) is owned or operated by— 
‘‘(A) the government of American Samoa, 
Guam, or the Commonwealth of the Northern 
Mariana Islands, the United States Virgin Is-
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lands, Puerto Rico, and Hawaii or a unit of 
local government; or 
‘‘(B) a nonprofit organization; and 
‘‘(2)(A) provides care or treatment for a sub-
stantial number of patients who are uninsured, re-
ceiving assistance under a State program under a 
title XVIII of the Social Security Act, or a State 
program under title XIX of such Act, or who are 
members of a vulnerable population, as determined 
by the Secretary; or 
‘‘(B) serves a disproportionate percentage of 
local, minority racial and ethnic patients. 
‘‘(c) REPORT.—Not later than 180 days after the 
date of enactment of this title and annually thereafter, the 
Secretary shall submit to the Congress and the President 
a report that includes an assessment of health resources 
and facilities serving populations in American Samoa, 
Guam, and the Commonwealth of the Northern Mariana 
Islands, the United States Virgin Islands, Puerto Rico, 
and Hawaii. In preparing such report, the Secretary 
shall— 
‘‘(1) consult with and obtain information on all 
health care facilities needs from the entities de-
scribed in subsection (b); and 
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‘‘(2) include all amounts of Federal assistance 
received by each entity in the preceding fiscal year; 
‘‘(3) review the total unmet needs of each juris-
diction for health care facilities, including needs for 
renovation and expansion of existing facilities; and 
‘‘(4) include a strategic plan for addressing the 
needs of each jurisdiction identified in the report. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated such sums as necessary 
to carry out this section.’’. 
SEC. 503. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS 
UNDER THE MEDICAID PROGRAM AND SCHIP. 
(a) MEDICAID PROGRAM.—Section 1903(v) of the 
Social Security Act (42 U.S.C. 1396b(v)) is amended— 
(1) in paragraph (1), by striking ‘‘paragraph 
(2)’’ and inserting ‘‘paragraphs (2) and (4)’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(4)(A) A State may elect (in a plan amendment 
under this title) to provide medical assistance under this 
title, notwithstanding sections 401(a), 402(b), 403, and 
421 of the Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996, for undocumented residents 
who are lawfully residing in the United States (including 
battered undocumented residents described in section 
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431(c) of such Act) and who are otherwise eligible for such 
assistance, within either or both of the following eligibility 
categories: 
‘‘(i) PREGNANT WOMEN.—Women during preg-
nancy (and during the 60-day period beginning on 
the last day of the pregnancy). 
‘‘(ii) CHILDREN.—Individuals under 21 years of 
age, including optional targeted low-income children 
described in section 1905(u)(2)(B). 
‘‘(B) In the case of a State that has elected to provide 
medical assistance to a category of undocumented resi-
dents under subparagraph (A), no debt shall accrue under 
an affidavit of support against any sponsor of such an un-
documented resident on the basis of provision of assistance 
to such category and the cost of such assistance shall not 
be considered as an unreimbursed cost.’’. 
(b) SCHIP.—Section 2107(e)(1) of such Act (42 
U.S.C. 1397gg(e)(1)) is amended by redesignating sub-
paragraphs (C) and (D) as subparagraph (D) and (E), 
respectively, and by inserting after subparagraph (B) the 
following new subparagraph: 
‘‘(C) Section 1903(v)(4) (relating to op-
tional coverage of categories of lawfully residing 
immigrant children), but only if the State has 
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elected to apply such section to the category of 
children under title XIX.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section take effect on October 1, 2007, and apply to 
medical assistance and child health assistance furnished 
on or after such date. 
SEC. 504. BORDER HEALTH GRANTS. 
(a) ELIGIBLE ENTITY DEFINED.—In this section, 
the term ‘‘eligible entity’’ means a State, public institution 
of higher education, local government, tribal government, 
nonprofit health organization, community health center, or 
community clinic receiving assistance under section 330 
of the Public Health Service Act (42 U.S.C. 254b), that 
is located in the border area. 
(b) AUTHORIZATION.—From funds appropriated 
under subsection (f), the Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’), 
acting through the United States members of the United 
States-Mexico Border Health Commission, shall award 
grants to eligible entities to address priorities and rec-
ommendations to improve the health of border area resi-
dents that are established by— 
(1) the United States members of the United 
States-Mexico Border Health Commission; 
(2) the State border health offices; and 
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(3) the Secretary. 
(c) APPLICATION.—An eligible entity that desires a 
grant under subsection (b) shall submit an application to 
the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require. 
(d) USE OF FUNDS.—An eligible entity that receives 
a grant under subsection (b) shall use the grant funds 
for— 
(1) programs relating to— 
(A) maternal and child health; 
(B) primary care and preventative health; 
(C) public health and public health infra-
structure; 
(D) health education and promotion; 
(E) oral health; 
(F) mental and behavioral health; 
(G) substance abuse; 
(H) health conditions that have a high 
prevalence in the border area; 
(I) medical and health services research; 
(J) workforce training and development; 
(K) 
community 
health 
workers 
or 
promotoras; 
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(L) health care infrastructure problems in 
the border area (including planning and con-
struction grants); 
(M) health disparities in the border area; 
(N) environmental health; and 
(O) outreach and enrollment services with 
respect to Federal programs (including pro-
grams authorized under titles XIX and XXI of 
the Social Security Act (42 U.S.C. 1396 and 
1397aa)); and 
(2) other programs determined appropriate by 
the Secretary. 
(e) SUPPLEMENT, NOT SUPPLANT.—Amounts pro-
vided to an eligible entity awarded a grant under sub-
section (b) shall be used to supplement and not supplant 
other funds available to the eligible entity to carry out the 
activities described in subsection (d). 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$200,000,000 for fiscal year 2008, and such sums as may 
be necessary for each succeeding fiscal year. 
SEC. 505. CANCER PREVENTION AND TREATMENT DEM-
ONSTRATION FOR ETHNIC AND RACIAL MI-
NORITIES. 
(a) DEMONSTRATION.— 
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187 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the 
‘‘Secretary’’) shall conduct demonstration projects 
(in this section referred to as ‘‘demonstration 
projects’’) for the purpose of developing models and 
evaluating methods that— 
(A) improve the quality of items and serv-
ices provided to target individuals in order to 
facilitate reduced disparities in early detection 
and treatment of cancer; 
(B) improve clinical outcomes, satisfaction, 
quality of life, and appropriate use of Medicare- 
covered services and referral patterns among 
those target individuals with cancer; 
(C) eliminate disparities in the rate of pre-
ventive cancer screening measures, such as pap 
smears, prostate cancer screenings, and CT 
scans for lung cancer among target individuals; 
and 
(D) promote collaboration with community- 
based organizations to ensure cultural com-
petency of health care professionals and lin-
guistic access for persons with limited English 
proficiency. 
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188 
(2) TARGET
INDIVIDUAL
DEFINED.—In this 
section, the term ‘‘target individual’’ means an indi-
vidual of a racial and ethnic minority group, as de-
fined by section 1707 of the Public Health Service 
Act (42 U.S.C. 300u–6) who is entitled to benefits 
under part A, and enrolled under part B, of title 
XVIII of the Social Security Act. 
(b) PROGRAM DESIGN.— 
(1) INITIAL DESIGN.—Not later than 1 year 
after the date of the enactment of this Act, the Sec-
retary shall evaluate best practices in the private 
sector, community programs, and academic research 
of methods that reduce disparities among individuals 
of racial and ethnic minority groups in the preven-
tion and treatment of cancer and shall design the 
demonstration projects based on such evaluation. 
(2) NUMBER AND PROJECT AREAS.—Not later 
than 2 years after the date of the enactment of this 
Act, the Secretary shall implement at least nine 
demonstration projects, including the following: 
(A) Two projects for each of the four fol-
lowing major racial and ethnic minority groups: 
(i) American Indians and Alaska Na-
tives, Eskimos and Aleuts. 
(ii) Asian Americans. 
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189 
(iii) Blacks/African Americans. 
(iv) Hispanic/Latino Americans. 
(v) Native Hawaiians and other Pa-
cific Islanders. 
The two projects must target different ethnic 
subpopulations. 
(B) One project within the Pacific Islands 
or United States insular areas. 
(C) At least one project each in a rural 
area and inner-city area. 
(3) EXPANSION
OF
PROJECTS; IMPLEMENTA-
TION
OF
DEMONSTRATION
PROJECT
RESULTS.—If 
the initial report under subsection (c) contains an 
evaluation that demonstration projects— 
(A) reduce expenditures under the Medi-
care program under title XVIII of the Social 
Security Act; or 
(B) do not increase expenditures under the 
Medicare program and reduce racial and ethnic 
health disparities in the quality of health care 
services provided to target individuals and in-
crease satisfaction of beneficiaries and health 
care providers; 
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190 
the Secretary shall continue the existing demonstra-
tion projects and may expand the number of dem-
onstration projects. 
(c) REPORT TO CONGRESS.— 
(1) IN GENERAL.—Not later than 2 years after 
the date the Secretary implements the initial dem-
onstration projects, and biannually thereafter, the 
Secretary shall submit to Congress a report regard-
ing the demonstration projects. 
(2) CONTENTS OF REPORT.—Each report under 
paragraph (1) shall include the following: 
(A) A description of the demonstration 
projects. 
(B) An evaluation of— 
(i) the cost-effectiveness of the dem-
onstration projects; 
(ii) the quality of the health care serv-
ices provided to target individuals under 
the demonstration projects; and 
(iii) beneficiary and health care pro-
vider satisfaction under the demonstration 
projects. 
(C) Any other information regarding the 
demonstration projects that the Secretary de-
termines to be appropriate. 
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191 
(d) WAIVER AUTHORITY.—The Secretary shall waive 
compliance with the requirements of title XVIII of the So-
cial Security Act to such extent and for such period as 
the Secretary determines is necessary to conduct dem-
onstration projects. 
SEC. 506. GRANTS TO PROMOTE POSITIVE HEALTH BEHAV-
IORS IN WOMEN AND CHILDREN. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399R. GRANTS TO PROMOTE POSITIVE HEALTH BE-
HAVIORS IN WOMEN AND CHILDREN. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, in col-
laboration with the Director of the Centers for Disease 
Control and Prevention and other Federal officials deter-
mined appropriate by the Secretary, is authorized to 
award grants to eligible entities to promote positive health 
behaviors for women and children in target populations, 
especially racial and ethnic minority women and children 
in medically underserved communities. 
‘‘(b) USE OF FUNDS.—Grants awarded pursuant to 
subsection (a) may be used to support community health 
workers— 
‘‘(1) to educate and provide outreach regarding 
enrollment in health insurance including the State 
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Children’s Health Insurance Program under title 
XXI of the Social Security Act, Medicare under title 
XVIII of such Act, and Medicaid under title XIX of 
such Act; 
‘‘(2) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
alent among women and children and especially 
among racial and ethnic minority women and chil-
dren; 
‘‘(3) to educate, guide, and provide experiential 
learning opportunities that target behavioral risk 
factors including— 
‘‘(A) poor nutrition; 
‘‘(B) physical inactivity; 
‘‘(C) being overweight or obese; 
‘‘(D) tobacco use; 
‘‘(E) alcohol and substance use; 
‘‘(F) injury and violence; 
‘‘(G) risky sexual behavior; 
‘‘(H) mental health problems; 
‘‘(I) dental and oral health problems; and 
‘‘(J) understanding informed consent; 
‘‘(4) to educate and guide regarding effective 
strategies to promote positive health behaviors with-
in the family; 
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‘‘(5) to promote community wellness and aware-
ness; and 
‘‘(6) to educate and refer target populations to 
appropriate health care agencies and community- 
based programs and organizations in order to in-
crease access to quality health care services, includ-
ing preventive health services. 
‘‘(c) APPLICATION.— 
‘‘(1) IN
GENERAL.—Each eligible entity that 
desires to receive a grant under subsection (a) shall 
submit an application to the Secretary, at such time, 
in such manner, and accompanied by such additional 
information as the Secretary may require. 
‘‘(2) CONTENTS.—Each application submitted 
pursuant to paragraph (1) shall— 
‘‘(A) describe the activities for which as-
sistance under this section is sought; 
‘‘(B) contain an assurance that with re-
spect to each community health worker pro-
gram receiving funds under the grant awarded, 
such program provides training and supervision 
to community health workers to enable such 
workers to provide authorized program services; 
‘‘(C) contain an assurance that the appli-
cant will evaluate the effectiveness of commu-
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nity health worker programs receiving funds 
under the grant; 
‘‘(D) contain an assurance that each com-
munity health worker program receiving funds 
under the grant will provide services in the cul-
tural context most appropriate for the individ-
uals served by the program; 
‘‘(E) contain a plan to document and dis-
seminate project description and results to 
other States and organizations as identified by 
the Secretary; and 
‘‘(F) describe plans to enhance the capac-
ity of individuals to utilize health services and 
health-related social services under Federal, 
State, and local programs by— 
‘‘(i) assisting individuals in estab-
lishing eligibility under the programs and 
in receiving the services or other benefits 
of the programs; and 
‘‘(ii) providing other services as the 
Secretary determines to be appropriate, 
that may include transportation and trans-
lation services. 
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