II 
108TH CONGRESS 
2D SESSION 
H. R. 918 
IN THE SENATE OF THE UNITED STATES 
OCTOBER 6, 2004 
Received 
AN ACT 
To amend the Public Health Service Act to authorize a 
demonstration grant program to provide patient navi-
gator services to reduce barriers and improve health care 
outcomes, 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 ‘‘Patient Navigator Out-
reach and Chronic Disease Prevention Act of 2004’’. 
SEC. 2. PATIENT NAVIGATOR GRANTS. 
Subpart V of part D of title III of the Public Health 
Service Act (42 U.S.C. 256) is amended by adding at the 
end the following: 
‘‘SEC. 340A. PATIENT NAVIGATOR GRANTS. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, may make grants to eligible entities for the 
development and operation of demonstration programs to 
provide patient navigator services to improve health care 
outcomes. The Secretary shall coordinate with, and ensure 
the participation of, the Indian Health Service, the Na-
tional Cancer Institute, the Office of Rural Health Policy, 
and such other offices and agencies as deemed appropriate 
by the Secretary, regarding the design and evaluation of 
the demonstration programs. 
‘‘(b) USE OF FUNDS.—A condition on the receipt of 
a grant under this section is that the grantee agree to 
use the grant to recruit, assign, train, and employ patient 
navigators who have direct knowledge of the communities 
they serve to facilitate the care of individuals, including 
by performing each of the following duties:
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‘‘(1) Acting as contacts, including by assisting 
in the coordination of health care services and pro-
vider referrals, for individuals who are seeking pre-
vention or early detection services for, or who fol-
lowing a screening or early detection service are 
found to have a symptom, abnormal finding, or diag-
nosis of, cancer or other chronic disease. 
‘‘(2) Facilitating the involvement of community 
organizations providing assistance to individuals who 
are at risk for or who have cancer or other chronic 
diseases to receive better access to high-quality 
health care services (such as by creating partner-
ships with patient advocacy groups, charities, health 
care centers, community hospice centers, other 
health care providers, or other organizations in the 
targeted community). 
‘‘(3) Notifying individuals of clinical trials and 
facilitating enrollment in these trials if requested 
and eligible. 
‘‘(4) Anticipating, identifying, and helping pa-
tients to overcome barriers within the health care 
system to ensure prompt diagnostic and treatment 
resolution of an abnormal finding of cancer or other 
chronic disease.
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‘‘(5) Coordinating with the relevant health in-
surance ombudsman programs to provide informa-
tion to individuals who are at risk for or who have 
cancer or other chronic diseases about health cov-
erage, including private insurance, health care sav-
ings accounts, and other publicly funded programs 
(such as Medicare, Medicaid, and the State chil-
dren’s health insurance program). 
‘‘(6) Conducting ongoing outreach to health dis-
parity populations, including the uninsured, rural 
populations, and other medically underserved popu-
lations, in addition to assisting other individuals who 
are at risk for or who have cancer or other chronic 
diseases to seek preventative care. 
‘‘(c) GRANT PERIOD.— 
‘‘(1) IN GENERAL.—Subject to paragraphs (2) 
and (3), the Secretary may award grants under this 
section for periods of not more than 3 years. 
‘‘(2) EXTENSIONS.—Subject to paragraph (3), 
the Secretary may extend the period of a grant 
under this section, except that— 
‘‘(A) each such extension shall be for a pe-
riod of not more than 1 year; and
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‘‘(B) the Secretary may make not more 
than 4 such extensions with respect to any 
grant. 
‘‘(3) END OF GRANT PERIOD.—In carrying out 
this section, the Secretary may not authorize any 
grant period ending after September 30, 2010. 
‘‘(d) APPLICATION.— 
‘‘(1) IN GENERAL.—To seek a grant under this 
section, an eligible entity shall submit an application 
to the Secretary in such form, in such manner, and 
containing such information as the Secretary may 
require. 
‘‘(2) CONTENTS.—At a minimum, the Secretary 
shall require each such application to outline how 
the eligible entity will establish baseline measures 
and benchmarks that meet the Secretary’s require-
ments to evaluate program outcomes. 
‘‘(e) UNIFORM BASELINE MEASURES.—The Sec-
retary shall establish uniform baseline measures in order 
to properly evaluate the impact of the demonstration 
projects under this section. 
‘‘(f) PREFERENCE.—In making grants under this 
section, the Secretary shall give preference to eligible enti-
ties that demonstrate in their applications plans to utilize 
patient navigator services to overcome significant barriers
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in order to improve health care outcomes in their respec-
tive communities. 
‘‘(g) COORDINATION WITH OTHER PROGRAMS.—The 
Secretary shall ensure coordination of the demonstration 
grant program under this section with existing authorized 
programs in order to facilitate access to high-quality 
health care services. 
‘‘(h) STUDY; REPORTS.— 
‘‘(1) FINAL REPORT BY SECRETARY.—Not later 
than 6 months after the completion of the dem-
onstration grant program under this section, the 
Secretary shall conduct a study of the results of the 
program and submit to the Congress a report on 
such results that includes the following: 
‘‘(A) An evaluation of the program out-
comes, including— 
‘‘(i) quantitative analysis of baseline 
and benchmark measures; and 
‘‘(ii) aggregate information about the 
patients served and program activities. 
‘‘(B) Recommendations on whether patient 
navigator programs could be used to improve 
patient outcomes in other public health areas. 
‘‘(2) INTERIM REPORTS BY SECRETARY.—The 
Secretary may provide interim reports to the Con-
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gress on the demonstration grant program under 
this section at such intervals as the Secretary deter-
mines to be appropriate. 
‘‘(3) INTERIM
REPORTS
BY
GRANTEES.—The 
Secretary may require grant recipients under this 
section to submit interim reports on grant program 
outcomes. 
‘‘(i) RULE OF CONSTRUCTION.—This section shall 
not be construed to authorize funding for the delivery of 
health care services (other than the patient navigator du-
ties listed in subsection (b)). 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) The term ‘eligible entity’ means a public 
or nonprofit private health center (including a Fed-
erally qualified health center (as that term is defined 
in section 1861(aa)(4) of the Social Security Act)), 
a health facility operated by or pursuant to a con-
tract with the Indian Health Service, a hospital, a 
cancer center, a rural health clinic, an academic 
health center, or a nonprofit entity that enters into 
a partnership or coordinates referrals with such a 
center, clinic, facility, or hospital to provide patient 
navigator services. 
‘‘(2) The term ‘health disparity population’ 
means a population that, as determined by the Sec-
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retary, has a significant disparity in the overall rate 
of disease incidence, prevalence, morbidity, mor-
tality, or survival rates as compared to the health 
status of the general population. 
‘‘(3) The term ‘patient navigator’ means an in-
dividual who has completed a training program ap-
proved by the Secretary to perform the duties listed 
in subsection (b). 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there are authorized to be appropriated $2,000,000 
for fiscal year 2006, $5,000,000 for fiscal year 
2007, $8,000,000 for fiscal year 2008, $6,500,000 
for fiscal year 2009, and $3,500,000 for fiscal year 
2010. 
‘‘(2) 
AVAILABILITY.—The 
amounts 
appro-
priated pursuant to paragraph (1) shall remain 
available for obligation through the end of fiscal year 
2010.’’. 
Passed the House of Representatives October 5, 
2004. 
Attest: 
JEFF TRANDAHL, 
Clerk.