I 
116TH CONGRESS 
1ST SESSION H. R. 5199 
To amend the Public Health Service Act to expand the capacity to improve 
health outcomes and increase access to specialized care. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 20, 2019 
Mr. LUJA´N (for himself, Mr. BURGESS, Ms. TORRES SMALL of New Mexico, 
Mr. KINZINGER, Ms. HAALAND, and Mr. GIANFORTE) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend the Public Health Service Act to expand the 
capacity to improve health outcomes and increase access 
to specialized care. 
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 ‘‘Expanding Capacity 
for Health Outcomes Act of 2019’’ or the ‘‘ECHO Act 
of 2019’’. 
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SEC. 2. EXPANDING CAPACITY FOR HEALTH OUTCOMES. 
Title III of the Public Health Service Act is amended 
by inserting after section 330M (42 U.S.C. 254c–19) the 
following: 
‘‘SEC. 330N. EXPANDING CAPACITY FOR HEALTH OUT-
COMES. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’— 
‘‘(A) means an entity that provides, or 
supports the provision of, health care services— 
‘‘(i) in rural areas, frontier areas, 
health professional shortage areas, or 
medically underserved areas; or 
‘‘(ii) to medically underserved popu-
lations or Native Americans, including In-
dian Tribes, Tribal organizations, or urban 
Indian organizations; and 
‘‘(B) may include entities leading, or capa-
ble of leading, a technology-enabled collabo-
rative learning and capacity building model or 
engaging in technology-enabled collaborative 
training of participants in such model. 
‘‘(2) 
HEALTH
PROFESSIONAL
SHORTAGE 
AREA.—The term ‘health professional shortage area’ 
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means a health professional shortage area des-
ignated under section 332. 
‘‘(3) INDIAN TRIBE.—The terms ‘Indian Tribe’ 
and ‘Tribal organization’ have the meanings given 
the terms ‘Indian tribe’ and ‘tribal organization’ in 
section 4 of the Indian Self-Determination and Edu-
cation Assistance Act. 
‘‘(4) 
MEDICALLY
UNDERSERVED
POPU-
LATION.—The term ‘medically underserved popu-
lation’ has the meaning given the term in section 
330(b)(3). 
‘‘(5) NATIVE
AMERICANS.—The term ‘Native 
Americans’ has the meaning given such term in sec-
tion 736 and includes Indian Tribes and Tribal or-
ganizations. 
‘‘(6) TECHNOLOGY-ENABLED
COLLABORATIVE 
LEARNING AND CAPACITY BUILDING MODEL.—The 
term ‘technology-enabled collaborative learning and 
capacity building model’ means a distance health 
education model that connects health care profes-
sionals, and particularly specialists, with multiple 
other health care professionals through simultaneous 
interactive videoconferencing for the purpose of fa-
cilitating case-based learning, disseminating best 
practices, and evaluating outcomes. 
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‘‘(7) 
URBAN
INDIAN
ORGANIZATION.—The 
‘urban Indian organization’ has the meaning given 
the term ‘Urban Indian organization’ in section 4 of 
the Indian Health Care Improvement Act. 
‘‘(b) PROGRAM ESTABLISHED.—The Secretary shall, 
as appropriate, award grants to evaluate, develop, and, as 
appropriate, expand the use of technology-enabled collabo-
rative learning and capacity building models, to improve 
retention of health care providers and increase access to 
health care services, such as those to address chronic dis-
eases and conditions, infectious diseases, mental health, 
substance use disorders, prenatal and maternal health, pe-
diatric care, pain management, palliative care, and other 
specialty care in rural areas, frontier areas, health profes-
sional shortage areas, or medically underserved areas and 
for medically underserved populations or Native Ameri-
cans, including Indian Tribes and Tribal organizations. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—Grants awarded under sub-
section (b) shall be used for— 
‘‘(A) the development and acquisition of 
instructional programming, and the training of 
health care providers and other professionals 
that provide or assist in the provision of serv-
ices through models described in subsection (b), 
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such as training on best practices for data col-
lection and leading or participating in such 
technology-enabled activities consistent with 
technology-enabled collaborative learning and 
capacity building models; 
‘‘(B) information collection and evaluation 
activities to study the impact of such models on 
patient outcomes and health care providers, and 
to identify best practices for the expansion and 
use of such models; or 
‘‘(C) other activities consistent with achiev-
ing the objectives of the grants awarded under 
this section, as determined by the Secretary. 
‘‘(2) OTHER USES.—In addition to any of the 
uses under paragraph (1), grants awarded under 
subsection (b) may be used for— 
‘‘(A) equipment to support the use and ex-
pansion 
of 
technology-enabled 
collaborative 
learning and capacity building models, including 
for hardware and software that enables distance 
learning, health care provider support, and the 
secure exchange of electronic health informa-
tion; or 
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‘‘(B) support for health care providers and 
other professionals that provide or assist in the 
provision of services through such models. 
‘‘(d) LENGTH OF GRANTS.—Grants awarded under 
subsection (b) shall be for a period of up to 5 years. 
‘‘(e) GRANT REQUIREMENTS.—The Secretary may 
require entities awarded a grant under this section to col-
lect information on the effect of the use of technology- 
enabled collaborative learning and capacity building mod-
els, such as on health outcomes, access to health care serv-
ices, quality of care, and provider retention in areas and 
populations described in subsection (b). The Secretary 
may award a grant or contract to assist in the coordina-
tion of such models, including to assess outcomes associ-
ated with the use of such models in grants awarded under 
subsection (b), including for the purpose described in sub-
section (c)(1)(B). 
‘‘(f) APPLICATION.—An eligible entity that seeks to 
receive a grant under subsection (b) shall submit to the 
Secretary an application, at such time, in such manner, 
and containing such information as the Secretary may re-
quire. Such application shall include plans to assess the 
effect of technology-enabled collaborative learning and ca-
pacity building models on patient outcomes and health 
care providers. 
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‘‘(g) ACCESS
TO BROADBAND.—In administering 
grants under this section, the Secretary may coordinate 
with other agencies to ensure that funding opportunities 
are available to support access to reliable, high-speed 
internet for grantees. 
‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly through the Department of Health 
and Human Services or by contract) technical assistance 
to eligible entities, including recipients of grants under 
subsection (b), on the development, use, and evaluation 
of technology-enabled collaborative learning and capacity 
building models in order to expand access to health care 
services provided by such entities, including for medically 
underserved areas and to medically underserved popu-
lations or Native Americans, including Indian Tribes and 
Tribal organizations. 
‘‘(i) RESEARCH AND EVALUATION.—The Secretary, 
in consultation with stakeholders with appropriate exper-
tise in such models, shall develop a strategic plan to re-
search and evaluate the evidence for such models. The 
Secretary shall use such plan to inform the activities car-
ried out under this section. 
‘‘(j) REPORT
BY SECRETARY.—Not later than 4 
years after the date of enactment of this section, the Sec-
retary shall prepare and submit to the Committee on 
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Health, Education, Labor, and Pensions of the Senate and 
the Committee on Energy and Commerce of the House 
of Representatives, and post on the internet website of the 
Department of Health and Human Services, a report in-
cluding, at minimum— 
‘‘(1) a description of any new and continuing 
grants awarded to entities under subsection (b) and 
the specific purpose and amounts of such grants; 
‘‘(2) an overview of— 
‘‘(A) the evaluations conducted under sub-
section (b); 
‘‘(B) technical assistance provided under 
subsection (h); and 
‘‘(C) activities conducted by entities award-
ed grants under subsection (b); and 
‘‘(3) a description of any significant findings or 
developments related to patient outcomes or health 
care providers and best practices for eligible entities 
expanding, using, or evaluating technology-enabled 
collaborative learning and capacity building models, 
including through the activities described in sub-
section (h). 
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‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$20,000,000 for each of fiscal years 2020 through 2024.’’. 
Æ 
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