(6) Community health advisors can be a critical
part of our national challenge to meet the Healthy
People 2000 vision for the new century.
SEC. 3. DEFINITIONS.
For purposes of this Act:
(1) The term ‘‘authorized program services’’,
with respect to a community health advisor program,
means the services authorized in section 5(a) to be
included in a plan under such section.
(2) The term ‘‘community health advisor’’
means an individual—
(A) who has demonstrated the capacity to
carry out one or more of the authorized pro-
gram services;
(B) who, for not less than 1 year, has been
a resident of the community in which the com-
munity health advisor program involved is to be
operated; and
(C) is a member of the target population
to be served by the program.
(3) The term ‘‘community health advisor pro-
gram’’ means a program carried out in accordance
with a plan under section 5(a).
(4) The term ‘‘financial assistance’’, with re-
spect to an award under section 4, means a grant,
cooperative agreement, or a contract.
(5) The term ‘‘Healthy People 2000 Objectives’’
means the objectives established by the Secretary to-
ward the goals of increasing the span of healthy life,
reducing health disparities among various popu-
lations, and providing access to preventive services,
which objectives apply to the health status of the
population of the United States for the year 2000.
(6) The term ‘‘medically underserved commu-
nity’’ means—
(A) a community that has a substantial
number of individuals who are members of a
medically underserved population, as defined in
section 330 of the Public Health Service Act; or
(B) a community a significant portion of
which is a health professional shortage area
designated under section 332 of such Act.
(7) The term ‘‘official poverty line’’ means the
official poverty line established by the Director of
the Office of Management and Budget and revised
by the Secretary in accordance with section 673(2)
of the Omnibus Budget Reconciliation Act of 1981,
which poverty line is applicable the size of the family
involved.
(8) The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
(9) The term ‘‘State’’ means each of the several
States, the District of Columbia, and each of the
Commonwealth of Puerto Rico, American Samoa,
Guam, the Commonwealth of the Northern Mariana
Islands, the Virgin Islands, and the Trust Territory
of the Pacific Islands.
(10) The term ‘‘State involved’’, with respect to
an applicant for an award under section 4, means
the State in which the applicant is to carry out a
community health advisor program.
SEC. 
4. 
FORMULA 
GRANTS 
REGARDING 
COMMUNITY
HEALTH ADVISOR PROGRAMS.
(a) FORMULA GRANTS.—In the case of each State
(or entity designated by a State under subsection (c)) that
submits to the Secretary a plan in accordance with section
5(a) for a fiscal year, the Secretary of Health and Human
Services, acting through the Director of the Centers for
Disease Control and Prevention and in coordination with
the heads of the agencies specified in subsection (b), shall
make an award of financial assistance to the State or en-
tity for the development and operation of community
health advisor programs under the plan. The award shall
consist of the allotment determined under section 7 with
respect to the State, subject to section 11(b).
(b) COORDINATION WITH OTHER AGENCIES.—The
agencies referred to in subsection (a) regarding coordina-
tion are the Health Resources and Services Administra-
tion, the National Institutes of Health, and the Substance
Abuse and Mental Health Services Administration.
(c) DESIGNATED ENTITIES.—With respect to the
State involved, an entity other than the State may receive
an award under subsection (a) only if the entity—
(1) is a public or nonprofit private academic or-
ganization (or other public or nonprofit private en-
tity); and
(2) has been designated by the State to carry
out the purpose described in such subsection in the
State and to receive amounts under such subsection
in lieu of the State.
SEC. 5. STATE PLAN.
(a) IN GENERAL.—An applicant for an award under
section 4 for a fiscal year may receive such an award only
if the applicant submits to the Secretary a plan for such
year that is in such form, is made in such manner, and
is submitted at such time as the Secretary may require,
and that meets the following requirements:
(1) The plan contains a description of how—
(A) if the applicant is a State, the award
will be administered by the State agency with
the principal responsibility for carrying out
public health programs; and
(B) if the applicant is an entity designated
under section 4, the award will be administered
in consultation with such State agency.
(2)(A) The plan contains a description of how
the applicant will—
(i) operate a clearinghouse to maintain and
disseminate information on community health
advisor programs (and similar programs) in the
State;
(ii) provide to community health advisor
programs in the State technical assistance in
training community health advisors; and
(iii) provide to community health advisor
programs in the State evaluation assistance in
evaluating their community health advisor pro-
grams and preparing the reports required in
paragraph (22); and
(B) The plan contains assurances that—
(i) not more than 15 percent of the award
will be expended in the aggregate for carrying
award, a program of evaluation will be carried
out.
(E) A description of how the applicant will
identify and consider the needs of the commu-
nity involved for the authorized program serv-
ices.
(F) Assurances that each community
health advisor program operated with the award
will be provided in the cultural context most ap-
propriate for the individuals served by the pro-
gram.
(G) A description of how the applicant will
provide public education on health promotion
and disease prevention and facilitate the use of
available health services and health-related so-
cial services.
(H) A description of how the applicant will
provide health-related counseling.
(I) A description of how the applicant will
collaborate with and provide referrals for avail-
able health services and health-related social
services.
(J) Assurances that, with respect to the
purposes for the award is authorized to be ex-
pended, the State involved will maintain ex-
penditures of non-Federal amounts for such
purposes at a level that is not less than the
level of such expenditures maintained by the
State for the fiscal year preceding the first fis-
cal year for which such an award is made with
respect to the State.
(K) Assurances that not more than 15 per-
cent of the award will be expended for the pro-
gram of training under subparagraph (C).
(L) Assurances that the applicant will not
provide amounts from the award to a commu-
nity-based public and private nonprofit entity to
operate a community health advisor program
unless the entity complies with section 6.
(M) Assurances that the applicant will
carry out community health advisor programs
in accordance with the guidelines established
under section 8.
(N) Such other information as the Sec-
retary may require.
(b) CERTAIN EXPENDITURES.—An award under sec-
tion 4 may be expended to provide compensation for the
services of community health advisors.
SEC. 6. LOCAL PLAN.
A community-based public or private nonprofit entity
may receive funds from an award under section 4 for a
fiscal year to operate a community health advisor program
only if the entity submits to the recipient of such award
a plan for such year that is in such form, is made in such
manner, and is submitted at such time as the recipient
may require.
SEC. 7. DETERMINATION OF AMOUNT OF ALLOTMENT.
(a) IN GENERAL.—For purposes of section 4(a), the
allotment under this section with respect to a State for
a fiscal year is the greater of—
(1) the sum of the respective amounts deter-
mined for the State under subsection (b) and sub-
section (c); and
(2) $500,000.
(b) AMOUNT RELATING TO POPULATION.—For pur-
poses of subsection (a), the amount determined under this
subsection is the product of—
(1) an amount equal to 50 percent of the
amount appropriated under section 11 for the fiscal
year and available for awards under section 4; and
(2) the percentage constituted by the ratio of—
(A) the number of individuals residing in
the State involved; to
(B) the sum of the respective amounts de-
termined for each State under subparagraph
(A).
(c) AMOUNT RELATING TO POVERTY LEVEL.—For
purposes of subsection (a), the amount determined under
this subsection is the product of—
(1) the amount determined under subsection
(b)(1); and
(2) the percentage constituted by the ratio of—
(A) the number of individuals residing in
the State whose income is at or below an
amount equal to 200 percent of the official pov-
erty line; to
(B) the sum of the respective amounts de-
termined for each State under subparagraph
(A).
SEC. 8. QUALITY ASSURANCE; COST-EFFECTIVENESS.
The Secretary shall establish guidelines for assuring
the quality of community health advisor programs (includ-
ing quality in the training of community health advisors)
and for assuring the cost-effectiveness of the programs.
SEC. 9. EVALUATIONS; TECHNICAL ASSISTANCE.
(a) EVALUATIONS.—The Secretary shall conduct
evaluations of community health advisor programs, and
disseminate information developed as a result of the eval-
uations. In conducting such evaluations, the Secretary
shall determine whether the programs are in compliance
with the guidelines established under section 8.
(b) TECHNICAL ASSISTANCE.—The Secretary may
provide technical assistance to recipients of awards under
section 4 with respect to the planning, development, and
operation of community health advisor programs.
(c) GRANTS AND CONTRACTS.—The Secretary may
carry out this section directly or through grants, coopera-
tive agreements, or contracts.
(d) 
LIMITATION
ON
EXPENDITURES.—Of 
the
amounts appropriated under section 11 for a fiscal year,
the Secretary may reserve not more than 5 percent for
carrying out this section.
SEC. 10. RULE OF CONSTRUCTION REGARDING PROGRAMS
OF INDIAN HEALTH SERVICE.
This Act may not be construed as requiring the Sec-
retary to modify or terminate the program carried out by
the Director of the Indian Health Service and designated
by such Director as the Community Health Representative
Program. The Secretary shall ensure that support for such
Program is not supplanted by awards under section 4. In
communities in which both such Program and a commu-
nity health advisor program are being carried out, the Sec-
retary shall ensure that the community health advisor pro-
gram works in cooperation with, and as a complement to,
the Community Health Representative Program.
SEC. 11. FUNDING.
(a) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this Act, there are authorized to
be appropriated such sums as may be necessary for each
of the fiscal years 1996 through 2001.
(b) EFFECT OF INSUFFICIENT APPROPRIATIONS FOR
MINIMUM ALLOTMENTS.—
(1) IN GENERAL.—If the amounts made avail-
able under subsection (a) for a fiscal year are insuf-
ficient for providing each State (or entity designated
by the State pursuant to section 4, as the case may
be) with an award under section 4 in an amount
equal to or greater than the amount specified in sec-
tion 7(a)(2), the Secretary shall, from such amounts
as are made available under subsection (a), make
such awards on a discretionary basis.
(2) RULE OF CONSTRUCTION.—For purposes of
paragraph (1), awards under section 4 are made on
a discretionary basis if the Secretary determines
which States (or entities designated by States pursu-
ant to such section, as the case may be) are to re-
ceive such awards, subject to meeting the require-
ments of this subtitle for such an award, and the
Secretary determines the amount of such awards.
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