I 
109TH CONGRESS 
1ST SESSION H. R. 1812
To amend the Public Health Service Act to authorize a demonstration grant 
program to provide patient navigator services to reduce barriers and 
improve health care outcomes, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2005
Mr. MENENDEZ (for himself and Ms. PRYCE of Ohio) introduced the following 
bill; which was referred to the Committee on Energy and Commerce 
A BILL 
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 2005’’.
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.—The Secretary shall require 
each recipient of a grant under this section to use the 
grant to recruit, assign, train, and employ patient naviga-
tors who have direct knowledge of the communities they 
serve to facilitate the care of individuals, including by per-
forming 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 in assisting individuals who are at risk 
for or who have cancer or other chronic diseases to 
receive better access to high-quality health care serv-
ices (such as by creating partnerships with patient 
advocacy groups, charities, health care centers, com-
munity hospice centers, other health care providers, 
or other organizations in the targeted community). 
‘‘(3) Notifying individuals of clinical trials and, 
on request, facilitating enrollment of eligible individ-
uals in these trials. 
‘‘(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, health programs oper-
ated by the Department of Veterans Affairs or the 
Department of Defense, the State children’s health 
insurance program, and any private or governmental 
prescription assistance programs). 
‘‘(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) PROHIBITIONS.—
‘‘(1) REFERRAL FEES.—The Secretary shall re-
quire each recipient of a grant under this section to 
prohibit any patient navigator providing services 
under the grant from accepting any referral fee, 
kickback, or other thing of value in return for refer-
ring an individual to a particular health care pro-
vider. 
‘‘(2) LEGAL FEES AND COSTS.—The Secretary 
shall prohibit the use of any grant funds received 
under this section to pay any fees or costs resulting 
from any litigation, arbitration, mediation, or other 
proceeding to resolve a legal dispute. 
‘‘(d) 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. Each such extension shall be for 
a period of not more than 1 year. 
‘‘(3) LIMITATIONS ON GRANT PERIOD.—In car-
rying out this section, the Secretary—
‘‘(A) shall ensure that the total period of 
a grant does not exceed 4 years; and 
‘‘(B) may not authorize any grant period 
ending after September 30, 2010. 
‘‘(e) 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.
‘‘(f) 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. 
‘‘(g) 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. 
‘‘(h) DUPLICATION OF SERVICES.—An eligible entity 
that is receiving Federal funds (including funds through 
a grant under section 340, which is commonly referred 
to as the ‘Healthy Communities Access Program’) for ac-
tivities described in subsection (b) on the date on which 
the entity submits an application under subsection (e), 
may not receive a grant under this section unless the enti-
ty can demonstrate that amounts received under the grant 
will be utilized to expand services or provide new services 
to individuals who would not otherwise be served. 
‘‘(i) 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.
‘‘(j) 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-
gress on the demonstration grant program under 
this section at such intervals as the Secretary deter-
mines to be appropriate. 
‘‘(3) REPORTS BY GRANTEES.—The Secretary 
may require grant recipients under this section to 
submit interim and final reports on grant program 
outcomes.
‘‘(k) 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)). 
‘‘(l) 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-
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-