108TH CONGRESS
2D SESSION
H. R. 918
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,
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:
‘‘(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.
‘‘(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
‘‘(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
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-