I
106TH CONGRESS
2D SESSION
H. R. 4973
To amend the Public Health Service Act to establish a grant program regard-
ing the unreimbursed costs of border hospitals in providing emergency
medical services to undocumented aliens.
IN THE HOUSE OF REPRESENTATIVES
JULY 26, 2000
Mr. KOLBE introduced the following bill; which was referred to the Committee
on Commerce
A BILL
To amend the Public Health Service Act to establish a grant
program regarding the unreimbursed costs of border hos-
pitals in providing emergency medical services to undocu-
mented aliens.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Border Hospital Relief
Act’’.
SEC. 2. ESTABLISHMENT OF GRANT PROGRAM REGARDING
EMERGENCY HEALTH SERVICES PROVIDED
BY ELIGIBLE BORDER HOSPITALS TO CER-
TAIN UNDOCUMENTED ALIENS.
Subpart I of part D of title III of the Public Health
Service Act (42 U.S.C. 254b et seq.) is amended by adding
at the end the following section:
‘‘SEC. 330E. EMERGENCY HEALTH SERVICES PROVIDED BY
ELIGIBLE BORDER HOSPITALS TO CERTAIN
UNDOCUMENTED ALIENS.
‘‘(a) IN GENERAL.—The Secretary may make grants
to eligible border hospitals to assist the hospitals with the
costs of providing emergency medical services to qualifying
undocumented aliens.
‘‘(b) 
ELIGIBLE
BORDER
HOSPITAL; 
OTHER
TERMS.—For purposes of this section:
‘‘(1) A hospital is a border hospital if the hos-
pital is located in the United States in a county or
other political subdivision that is contiguous with the
border between the United States and Mexico.
‘‘(2) A border hospital is an eligible border hos-
pital if the number of cases in which the border hos-
pital provides emergency medical care to qualifying
undocumented aliens is significantly above the num-
ber of cases in which other border hospitals provide
emergency medical care to such aliens.
‘‘(3) A qualifying undocumented alien is an un-
documented alien—
‘‘(A) who is not eligible for medical assist-
ance under the State plan under title XIX of
the Social Security Act (for the State in which
the border hospital involved is located); or
‘‘(B) for whom eligibility to receive medical
assistance under such State plan is difficult to
determine.
‘‘(4) An undocumented alien is an individual
who is not in possession of any of the following:
‘‘(A) A driver’s license issued by a State,
or other document indicating that the individual
is a citizen or national of the United States.
‘‘(B) An unexpired immigrant visa, non-
immigrant visa, reentry permit, border crossing
identification card, or other entry document
under the Immigration and Nationality Act.
‘‘(c) RELATIONSHIP TO PAYMENTS UNDER OTHER
PROGRAMS.—A grant may be made under subsection (a)
only if the applicant involved agrees that the grant will
not be expended to pay the costs of providing emergency
medical services to qualifying undocumented aliens to the
extent that payment has been made, or can reasonably be
expected to be made, with respect to such costs—
‘‘(1) under any State compensation program,
under an insurance policy, or under any Federal or
State health benefits program; or
‘‘(2) by an entity that provides health services
on a prepaid basis.
‘‘(d) APPLICATION FOR GRANT.—A grant may be
made under subsection (a) only if an application for the
grant is submitted to the Secretary and the application
is in such form, is made in such manner, and contains
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this section.
‘‘(e) AMOUNT OF GRANT.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
the amount of a grant under subsection (a) to an el-
igible border hospital shall be based on the amount
of the unreimbursed costs incurred by the hospital
in providing emergency medical services to qualifying
undocumented aliens.
‘‘(2) PRIORITY.—In determining the amount of
a grant under subsection (a), the Secretary shall
give priority to eligible border hospitals that have
100 or fewer inpatient beds.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated $25,000,000 for fiscal year 2001, and