I 
109TH CONGRESS 
2D SESSION 
H. R. 4858 
To provide for the restoration of health care-related services in Hurricane 
Katrina-affected areas, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 2, 2006 
Mr. JEFFERSON (for himself, Mrs. CHRISTENSEN, Mr. CLAY, Mr. CLYBURN, 
Mr. RANGEL, Mr. DAVIS of Illinois, Mr. MEEKS of New York, Mrs. 
JONES of Ohio, Ms. LEE, Mr. BISHOP of Georgia, Ms. EDDIE BERNICE 
JOHNSON of Texas, Mr. LEWIS of Georgia, Mr. AL GREEN of Texas, Ms. 
CORRINE BROWN of Florida, Mr. HASTINGS of Florida, Mr. SCOTT of 
Virginia, Ms. WATERS, Ms. MOORE of Wisconsin, Ms. MILLENDER- 
MCDONALD, Mr. WYNN, Mr. SCOTT of Georgia, Mr. MEEK of Florida, 
Ms. NORTON, Ms. JACKSON-LEE
of Texas, Mr. CLEAVER, Mr. 
CUMMINGS, Ms. KILPATRICK of Michigan, and Mr. OWENS) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce, and in addition to the Committee on Ways and Means, for 
a period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To provide for the restoration of health care-related services 
in Hurricane Katrina-affected areas, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Katrina Health Access, 
Recovery, and Empowerment Act of 2006’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
Sec. 3. Findings. 
Sec. 4. Hurricane Katrina-affected area defined. 
TITLE I—REBUILDING HEALTH CARE INFRASTRUCTURE 
Sec. 101. Small business concerns. 
Sec. 102. Credit for expenditures by health professionals in Hurricane Katrina- 
affected area for medical professional malpractice insurance. 
Sec. 103. Deduction for premiums of physicians in Hurricane Katrina-affected 
area for medical liability insurance for high risk specialties. 
Sec. 104. Deduction for premiums for medical liability insurance for practices 
in Hurricane Katrina-affected area serving medically under-
served communities. 
Sec. 105. Grants and contracts regarding health provider shortages. 
TITLE II—REBUILDING PIPELINES OF PROVIDERS IN MEDI-
CALLY NEEDY AND UNDERSERVED AREAS AND COMMUNITIES 
Sec. 201. Amendment to the Public Health Service Act. 
TITLE III—PROVIDING RELIEF TO ACADEMIC INSTITUTIONS 
Sec. 301. Grants to institutions of higher education. 
TITLE IV—RESTORING KEY COMPONENTS OF THE HEALTH CARE 
INFRASTRUCTURE IN MEDICALLY-NEEDY AND MEDICALLY UN-
DERSERVED AREAS 
Sec. 401. Medically-needy Katrina recovery zones. 
Sec. 402. Repair and disparities grants. 
Sec. 403. Disaster relief Medicaid. 
SEC. 3. FINDINGS. 
The Congress finds the following: 
(1) Many of the communities that were most 
affected by Hurricane Katrina had poor health care 
infrastructures and some of the highest poverty 
rates before the storm reached the coast. For exam-
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ple, Louisiana had the fourth highest uninsurance 
rate in the Nation and nearly one in four residents 
was living in poverty. Today, the number of people 
from the Gulf Coast who are uninsured and lack ac-
cess to adequate health care has significantly in-
creased. 
(2) Numerous studies show that poverty has a 
direct impact on the health, health care, and well- 
being of all people. 
(3) Studies confirm that numerous factors exac-
erbate 
health 
disparities, 
including: 
poverty; 
uninsurance; unemployment; low educational attain-
ment; the absence of culturally and linguistically 
competent care; and a lack of access to housing, 
needed health care services and treatments, and 
health care information. 
(4) In New Orleans, more than 2 in 3 displaced 
providers (4,486) were in three central New Orleans 
parishes—Plaquemines, St. Bernard, and Jefferson 
parishes—all of which were evacuated (Ricketts 
2005). Additionally, it is estimated that more than 
one in three (35 percent) of the displaced physicians 
in these three central New Orleans parishes were 
primary care physicians (Ricketts 2005). 
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(5) The Medical Center of Louisiana and New 
Orleans (MCLNO) was the only Level 1 trauma cen-
ter in the region and included Charity and Univer-
sity Hospitals. More than 50 percent of inpatient 
care provided by MCLNO was provided to uninsured 
patients and more than 8 in 10 (85 percent) pa-
tients had annual incomes that were $20,000 or less. 
SEC. 4. HURRICANE KATRINA-AFFECTED AREA DEFINED. 
In this Act, the term ‘‘Hurricane Katrina-affected 
area’’ means an area in a county or parish in Alabama, 
Louisiana, or Mississippi, for which a major disaster has 
been declared in accordance with section 401 of the Robert 
T. Stafford Disaster Relief and Emergency Assistance Act 
(42 U.S.C. 5170) as a result of Hurricane Katrina. 
TITLE I—REBUILDING HEALTH 
CARE INFRASTRUCTURE 
SEC. 101. SMALL BUSINESS CONCERNS. 
(a) LOANS.—During fiscal years 2006 and 2007, the 
Secretary of Health and Human Services shall provide 
low-interest loans to eligible small business concerns for 
the restoration of health care and other services connected 
to health care. 
(b) CANCELLATION OF LOANS.—At the end of the 
5-year period beginning on the date of the provision of 
a loan under this section, the Secretary shall cancel the 
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unpaid balance and any accrued interest on the loan if 
the eligible small business concern meets each of the fol-
lowing: 
(1) The eligible small business concern is oper-
ating at 70 percent or greater of the level of oper-
ation of the concern before Hurricane Katrina. 
(2) The eligible small business concern has not, 
because of a change in ownership, control, or affili-
ation, ceased to be a small business concern. 
(3) If the eligible small business concern pro-
vides direct health care, the concern gives an assur-
ance satisfactory to the Secretary that the concern 
will not, because of a change in ownership, control, 
or affiliation, cease to be a small business concern 
during the 5 years following such 5-year period. 
(4) If the eligible business concern does not 
provide direct health care, the concern gives an as-
surance satisfactory to the Secretary that the owner-
ship of the concern will not, because of a change in 
ownership, control, or affiliation, cease to be a small 
business concern during the 2 years following such 
5-year period. 
(c) CONSULTATION.—The Secretary shall carry out 
this section in consultation with— 
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(1) the Office of Minority Health in the Depart-
ment of Health and Human Services; and 
(2) the Director of the Office of Small and Dis-
advantaged Business Utilization (OFSDBU) in each 
of the Department of Health and Human Services 
and the Department of Homeland Security. 
(d) ELIGIBLE SMALL BUSINESS CONCERN.—In this 
section, the term ‘‘eligible small business concern’’ means 
a small business concern that— 
(1) was located in a Hurricane Katrina-affected 
area as of August 28, 2005; and 
(2) provides health care or health care-related 
services to individuals in such area. 
(e) USE OF LOANS.—A loan under this section shall 
be used for the restoration of health care for individuals 
in a Hurricane Katrina-affected area or for the restoration 
of other services connected to such health care. Such res-
toration may include rebuilding physical structures. 
(f) APPLICATION.— 
(1) IN GENERAL.—To seek a loan under this 
section, an eligible small business concern shall sub-
mit an application to the Secretary at such time, in 
such manner, and containing such information as 
the Secretary may require. 
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(2) APPROVAL.—Not later than 30 days after 
the receipt of an application for a loan under this 
section, the Secretary shall approve or disapprove 
the application. If the Secretary disapproves the ap-
plication, the Secretary shall provide the applicant 
with a written explanation of the reasons for the dis-
approval. 
(g) PRIORITY.—In making loans under this section, 
the Secretary shall give— 
(1) highest priority to eligible small business 
concerns providing direct health care primarily to 
medically-needy individuals; and 
(2) second highest priority to eligible small 
business concerns providing health-care related serv-
ices primarily to medically-needy individuals. 
(h) OTHER DEFINITIONS.—In this section: 
(1) The term ‘‘small business concern’’ has the 
meaning given to that term in section 3 of the Small 
Business Act (15 U.S.C. 632) and the regulations 
promulgated thereunder. 
(2) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(i) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
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such sums as may be necessary for fiscal years 2006 
through 2012. 
SEC. 102. CREDIT FOR EXPENDITURES BY HEALTH PROFES-
SIONALS IN HURRICANE KATRINA-AFFECTED 
AREA FOR MEDICAL PROFESSIONAL MAL-
PRACTICE INSURANCE. 
(a) IN GENERAL.—Subpart D of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to business tax credits) is amended by add-
ing at the end the following: 
‘‘SEC. 45N. CREDIT FOR EXPENDITURES BY HEALTH PRO-
FESSIONALS 
IN 
HURRICANE 
KATRINA-AF-
FECTED AREA FOR MEDICAL PROFESSIONAL 
MALPRACTICE INSURANCE. 
‘‘(a) GENERAL RULE.—For purposes of section 38, 
in the case of a taxpayer who is an eligible health profes-
sional, the medical malpractice insurance expenditure tax 
credit determined under this section for a covered year 
shall equal 15 percent of the qualified medical malpractice 
insurance expenditures incurred by the professional during 
the covered year. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) COVERED YEAR.—The term ‘covered year’ 
means taxable years beginning in 2005 and 2006. 
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‘‘(2) ELIGIBLE HEALTH PROFESSIONAL.—The 
term ‘eligible health professional’ means a physician, 
nurse, mental health provider, pharmacist, para-
medic, dentist, allied health professional, hospice 
care provider, or other individual health care pro-
vider whose primary place of employment is located 
in the Hurricane Katrina-affected area. 
‘‘(3) HURRICANE KATRINA-AFFECTED AREA.— 
The term ‘Hurricane Katrina-affected area’ means 
an area in a county or parish in Alabama, Lou-
isiana, or Mississippi, for which a major disaster has 
been declared in accordance with section 401 of the 
Robert T. Stafford Disaster Relief and Emergency 
Assistance Act as a result of Hurricane Katrina. 
‘‘(4) QUALIFIED MEDICAL MALPRACTICE INSUR-
ANCE EXPENDITURE.—The term ‘qualified medical 
malpractice insurance expenditure’ means so much 
of any professional insurance premium, surcharge, 
payment, or other cost or expense required as a con-
dition of State licensure which is incurred by an eli-
gible health professional in a covered year for the 
sole purpose of providing or furnishing general med-
ical malpractice liability insurance for such eligible 
health professional as does not exceed twice the 
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Statewide average of such costs for similarly situ-
ated eligible health professionals. 
‘‘(c) SPECIAL RULES.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the credit determined under this section 
shall be claimed by the eligible health professional 
incurring the qualified medical malpractice insurance 
expenditure. 
‘‘(2) CERTIFICATION.—Each State, through its 
board of medical licensure and State board (or agen-
cy) regulating insurance, annually shall provide such 
information to the Secretary of Health and Human 
Services as is necessary to permit the Secretary to 
calculate average costs for purposes of subsection 
(b)(4) and to certify such average costs (rounded to 
the nearest whole dollar) to the Secretary of the 
Treasury on or before the 15th day of November of 
each year.’’. 
(b) CREDIT MADE PART OF GENERAL BUSINESS 
CREDIT.—Section 38(b) of such Code (relating to current 
year business credit) is amended by striking ‘‘and’’ at the 
end of paragraph (25), by striking the period at the end 
of paragraph (26) and inserting ‘‘, and’’, and by adding 
at the end the following new paragraph: 
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‘‘(27) the medical malpractice insurance ex-
penditure tax credit determined under section 
45N(a).’’. 
(c) DENIAL OF DOUBLE BENEFIT.—Section 280C of 
the Internal Revenue Code of 1986 (relating to certain 
expenses for which credits are allowable) is amended by 
adding at the end the following new subsection: 
‘‘(d) CREDIT FOR MEDICAL MALPRACTICE LIABILITY 
INSURANCE PREMIUMS.— 
‘‘(1) IN GENERAL.—No deduction shall be al-
lowed for that portion of the qualified medical mal-
practice insurance expenditures (as defined in sec-
tion 45N(b)) otherwise allowable as a deduction for 
the taxable year which is equal to the amount of the 
credit allowable for the taxable year under section 
45 (determined without regard to section 38(c)). 
‘‘(2) CONTROLLED GROUPS.—In the case of a 
corporation which is a member of a controlled group 
of corporations (within the meaning of section 
41(f)(5)) or a trade or business which is being treat-
ed as being under common control with other trades 
or 
business 
(within 
the 
meaning 
of 
section 
41(f)(1)(B)), this subsection shall be applied under 
rules prescribed by the Secretary similar to the rules 
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