graph (A) or (B) of subsection (e)(1) to estab-
lish new delivery sites. 
‘‘(B) SPECIAL
CONSIDERATION.—In car-
rying out subparagraph (A), the Secretary may 
give special consideration to applicants that 
have demonstrated the new delivery site will be 
located within a sparsely populated area, or an 
area which has a level of unmet need that is 
higher relative to other applicants. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Sec-
retary shall approve applications for grants 
under subparagraphs (A) and (B) of subsection 
(e)(1) in such a manner that the ratio of the 
medically underserved populations in rural 
areas which may be expected to use the services 
provided by the applicants involved to the medi-
cally underserved populations in urban areas 
which may be expected to use the services pro-
vided by the applicants is not less than two to 
three or greater than three to two. 
‘‘(D) SERVICE AREA OVERLAP.—If in car-
rying out subparagraph (A) the applicant pro-
poses to serve an area that is currently served 
by another health center funded under this sec-
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tion, the Secretary may consider whether the 
award of funding to an additional health center 
in the area can be justified based on the unmet 
need 
for 
additional 
services 
within 
the 
catchment area. 
‘‘(2) APPROVAL OF EXPANDED SERVICE APPLI-
CATIONS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
approve applications for grants under subpara-
graph (A) or (B) of subsection (e)(1) to expand 
the capacity of the applicant to provide required 
primary health services described in subsection 
(b)(1) or additional health services described in 
subsection (b)(2). 
‘‘(B) PRIORITY EXPANSION PROJECTS.—In 
carrying out subparagraph (A), the Secretary 
may give special consideration to expanded 
service applications that seek to address emerg-
ing public health or behavioral health, mental 
health, or substance abuse issues through in-
creasing the availability of additional health 
services described in subsection (b)(2) in an 
area in which there are significant barriers to 
accessing care. 
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‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Sec-
retary shall approve applications for applicants 
in such a manner that the ratio of the medically 
underserved populations in rural areas which 
may be expected to use the services provided by 
the applicants involved to the medically under-
served populations in urban areas which may be 
expected to use the services provided by such 
applicants is not less than two to three or 
greater than three to two.’’; 
(10) in subsection (i) (as so redesignated)— 
(A) in paragraph (1), by striking ‘‘and 
children and youth at risk of homelessness’’ and 
inserting ‘‘, children and youth at risk of home-
lessness, homeless veterans, and veterans at 
risk of homelessness’’; and 
(B) in paragraph (5)— 
(i) by striking subparagraph (B); 
(ii) by redesignating subparagraph 
(C) as subparagraph (B); and 
(iii) in subparagraph (B) (as so redes-
ignated)— 
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(I) in the subparagraph heading, 
by striking ‘‘ABUSE’’ and inserting 
‘‘USE DISORDER’’; and 
(II) by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; 
(11) in subsection (l) (as so redesignated)— 
(A) in paragraph (2)— 
(i) in the paragraph heading, by in-
serting ‘‘UNMET’’ before ‘‘NEED’’; 
(ii) in the matter preceding subpara-
graph (A), by inserting ‘‘and an applica-
tion for a grant under subsection (g)’’ 
after ‘‘subsection (e)(1)’’; 
(iii) in subparagraph (A), by inserting 
‘‘unmet’’ before ‘‘need for health services’’; 
(iv) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(v) in subparagraph (C), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(vi) by adding after subparagraph (C) 
the following: 
‘‘(D) in the case of an application for a 
grant pursuant to subsection (g)(1), a dem-
onstration that the applicant has consulted with 
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appropriate State and local government agen-
cies, and health care providers regarding the 
need for the health services to be provided at 
the proposed delivery site.’’; 
(B) in paragraph (3)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘or subsection (g)’’ 
after ‘‘subsection (e)(1)(B)’’; 
(ii) in subparagraph (B), by striking 
‘‘in the catchment area of the center’’ and 
inserting ‘‘, including other health care 
providers that provide care within the 
catchment area, local hospitals, and spe-
cialty providers in the catchment area of 
the center, to provide access to services not 
available through the health center and to 
reduce the non-urgent use of hospital 
emergency departments’’; 
(iii) in subparagraph (H)(ii), by in-
serting ‘‘who shall be directly employed by 
the center’’ after ‘‘approves the selection of 
a director for the center’’; 
(iv) in subparagraph (L), by striking 
‘‘and’’ at the end; 
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(v) in subparagraph (M), by striking 
the period and inserting ‘‘; and’’; and 
(vi) by inserting after subparagraph 
(M), the following: 
‘‘(N) the center has written policies and 
procedures in place to ensure the appropriate 
use of Federal funds in compliance with appli-
cable Federal statutes, regulations, and the 
terms and conditions of the Federal award.’’; 
and 
(C) by striking paragraph (4); 
(12) in subsection (m) (as so redesignated), by 
adding at the end the following: ‘‘Funds expended to 
carry out activities under this subsection and oper-
ational support activities under subsection (n) shall 
not exceed 3 percent of the amount appropriated for 
this section for the fiscal year involved.’’; 
(13) in subsection (q) (as so redesignated), by 
striking ‘‘grants for new health centers under sub-
sections (c) and (e)’’ and inserting ‘‘operating grants 
under subsection (e), applications for new access 
points and expanded service pursuant to subsection 
(g)’’; 
(14) in subsection (r)(4) (as so redesignated), 
by adding at the end the following: ‘‘A waiver pro-
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vided by the Secretary under this paragraph may 
not remain in effect for more than 1 year and may 
not be extended after such period. An entity may not 
receive more than one waiver under this paragraph 
in consecutive years.’’; 
(15) in subsection (s)(3) (as so redesignated)— 
(A) by striking ‘‘appropriate committees of 
Congress a report concerning the distribution of 
funds under this section’’ and inserting the fol-
lowing: ‘‘Committee on Health, Education, 
Labor, and Pensions of the Senate, and the 
Committee on Energy and Commerce of the 
House of Representatives, a report including, at 
a minimum— 
‘‘(A) the distribution of funds for carrying 
out this section’’; 
(B) by striking ‘‘populations. Such report 
shall include an assessment’’ and inserting the 
following: ‘‘populations; 
‘‘(B) an assessment’’; 
(C) by striking ‘‘and the rationale for any 
substantial changes in the distribution of 
funds.’’ and inserting a semicolon; and 
(D) by adding at the end the following: 
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