I
104TH CONGRESS
1ST SESSION
H. R. 2206
To provide for the consolidation and simplification of health center programs,
and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 4, 1995
Mr. DINGELL (for himself and Mr. WAXMAN) introduced the following bill;
which was referred to the Committee on Commerce
A BILL
To provide for the consolidation and simplification of health
center programs, 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 AND REFERENCES IN ACT.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Health Centers Consolidation Act of 1995’’.
(b) REFERENCES IN ACT.—The amendments in this
Act apply to the Public Health Service Act unless other-
wise specifically stated.
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SEC. 2. CONSOLIDATION OF AUTHORITY FOR COMMUNITY
HEALTH CENTERS, MIGRANT HEALTH CEN-
TERS, HEALTH SERVICES FOR THE HOME-
LESS, AND HEALTH SERVICES FOR RESI-
DENTS OF PUBLIC HOUSING.
(a) NEW AND REVISED TERMS.—
(1) HEALTH CENTER.—
(A) 
DEFINITION.—Section 
330(a) 
is
amended to read as follows:
‘‘(a) For purposes of this section, the term ‘health
center’ means an entity that serves a population that is
medically underserved, or that serves a special medically
underserved population comprised of migratory agricul-
tural workers, seasonal agricultural workers, the homeless,
or residents of public housing by providing, either through
its staff and supporting resources or through contracts or
cooperative arrangements—
‘‘(1) required primary health services (as de-
fined in subsection (b)(1)); and
‘‘(2) as may be appropriate for particular cen-
ters, additional health services (as defined in sub-
section (b)(2)) necessary for the adequate support of
the required primary health services;
for all residents of the area it serves (referred to in this
section as a ‘catchment area’).’’.
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(B) CONFORMING AMENDMENTS.—Section
330 is amended—
(i) by striking the term ‘‘community
health center’’ each place such term ap-
pears and inserting ‘‘health center’’; and
(ii) by striking the term ‘‘community
health centers’’ each place such term ap-
pears and inserting ‘‘health centers’’.
(2) REQUIRED PRIMARY HEALTH SERVICES.—
Section 330(b)(1) is amended to read as follows:
‘‘(1) The term ‘required primary health serv-
ices’ means—
‘‘(A) basic health services which, for pur-
poses of this section, consist of—
‘‘(i) health services related to family
medicine, internal medicine, pediatrics, ob-
stetrics, gynecology, or dentistry that are
furnished by physicians, dentists, and,
where appropriate, physician assistants,
nurse practitioners, and nurse midwives;
‘‘(ii) 
diagnostic 
laboratory 
and
radiologic services;
‘‘(iii) preventive health services, in-
cluding—
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‘‘(I) prenatal and perinatal serv-
ices;
‘‘(II) screening for breast and
cervical cancer;
‘‘(III) well-child services;
‘‘(IV) immunizations against vac-
cine-preventable diseases;
‘‘(V) 
screenings 
for 
elevated
blood lead levels, communicable dis-
eases, and cholesterol;
‘‘(VI) pediatric eye and ear ex-
aminations to determine the need for
vision and hearing correction;
‘‘(VII) voluntary family planning
services; and
‘‘(VIII) preventive dental serv-
ices;
‘‘(iv) emergency medical services;
‘‘(v) pharmaceutical services as may
be appropriate for particular centers;
‘‘(B) referrals to providers of medical serv-
ices and other health-related services (including
substance abuse and mental health services);
‘‘(C) patient case management services (in-
cluding counseling, referral, and follow-up serv-
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ices) designed to assist health center patients in
establishing eligibility for, and gaining access
to, Federal, State, and local programs that pro-
vide or financially support the provision of med-
ical, social, educational, or other related serv-
ices;
‘‘(D) services that enable individuals to use
the services of the center (including outreach
and transportation services and, if a substantial
number of the individuals in the population
served by a center are of limited English-speak-
ing ability, the services of appropriate personnel
fluent in the language spoken by a predominant
number of such individuals); and
‘‘(E) education of patients and the general
population served by the health center regard-
ing the availability and proper use of health
services.’’.
(3) ADDITIONAL
HEALTH
SERVICES.—Section
330(b)(2) is amended to read as follows:
‘‘(2) The term ‘additional health services’
means services which are not included as required
primary health services and which are appropriate to
meet the health needs of the population serviced by
the health center involved. Such term may include—
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‘‘(A) environmental health services, includ-
ing—
‘‘(i) the detection and alleviation of
unhealthful 
conditions 
associated 
with
water supply;
‘‘(ii) sewage treatment;
‘‘(iii) solid waste disposal;
‘‘(iv) rodent and parasitic infestation;
‘‘(v) field sanitation;
‘‘(vi) housing; and
‘‘(vii) other environmental factors re-
lated to health; and
‘‘(B) in the case of health centers receiving
grants pursuant to subsection (f), special occu-
pation-related health services for migratory ag-
ricultural workers and seasonal agricultural
workers, including—
‘‘(i) screening for and control of infec-
tions and parasitic diseases; and
‘‘(ii) accident prevention programs, in-
cluding prevention of excessive pesticide
exposure.’’.
(b) RELOCATION AND CONSOLIDATION WITHIN SEC-
TION 330 OF AUTHORITIES RESPECTING GRANTS FOR IN-
FANT MORTALITY
AND CHILDHOOD MORBIDITY, AND
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GRANTS FOR HEALTH CENTERS SERVING MIGRATORY
AND SEASONAL WORKERS, HOMELESS, AND PUBLIC
HOUSING POPULATIONS.—
(1) REDESIGNATION
OF
SUBSECTIONS.—Sub-
sections (e) through (k) of section 330 are redesig-
nated as subsections (i) through (o), respectively.
(2) GRANTS
FOR
INFANT
MORTALITY
AND
CHILDHOOD MORBIDITY.—
(A) Paragraph (2) of section 330(k) (as so
redesignated) is amended by redesignating such
paragraph as subsection (e);
(B) in the material redesignated (by sub-
paragraph (A) of this paragraph) as subsection
(e), by striking subparagraphs (A), (D), and
(E);
(C) in the material redesignated (by sub-
paragraph (A) of this paragraph) as subsection
(e), by redesignating subparagraphs (B), (C),
and (F) as paragraphs (1) through (3), respec-
tively;
(D) in the material redesignated (by sub-
paragraph (A) of this paragraph) as subsection
(e), by redesignating each clause designated as
(i), (ii), (iii), or (iv), as subparagraph (A), (B),
(C), or (D), respectively;
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(E) by redesignating clauses (I) and (II) of
paragraph (1)(A) (as redesignated by subpara-
graphs (C) and (D) of this paragraph) as
clauses (i) and (ii), respectively;
(F) by striking ‘‘subparagraph (B)’’ each
place such term appears in subsection (e) (as
redesignated by subparagraph (A) of this para-
graph) and inserting ‘‘this subsection’’;
(G) in subsection (e)(1)(B) (as redesig-
nated by subparagraphs (A), (C), and (D) of
this paragraph, by striking ‘‘clause (i)’’ and in-
serting ‘‘subparagraph (A)’’; and
(H) in subsection (e)(3) (as redesignated
by subparagraphs (A), (C), and (D) of this
paragraph)—
(i) in the matter preceding subpara-
graph (A), by striking ‘‘subparagraph (B)’’
and inserting ‘‘paragraph (1)’’;
(ii) by adding ‘‘and’’ at the end of
subparagraph (B);
(iii) by striking subparagraph (C);
and
(iv) by redesignating subparagraph
(D) as subparagraph (C).
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(3) GRANTS FOR HEALTH CENTERS SERVING
MIGRATORY AND AGRICULTURAL WORKERS.—
(A) Section 330 is amended by inserting
after subsection (e) a new subsection as follows:
‘‘(f) MIGRATORY
AND SEASONAL AGRICULTURAL
WORKER POPULATIONS.—(1) The Secretary is authorized
to award grants for the purposes described in subsections
(c), (d), and (e) for the planning and delivery of services
to a special medically underserved population comprised
of migratory agricultural workers, seasonal agricultural
workers, and members of the families of such migratory
and seasonal workers who are within a designated
catchment area, and individuals who have previously been
migratory agricultural workers but can no longer meet the
requirements of subparagraph (A) of paragraph (4) be-
cause of age or disability and members of their families
who are within such catchment area.
‘‘(2) The Secretary may make grants to or enter into
contracts with public and nonprofit private entities for
projects to plan and develop, and to operate, programs in
areas in which no health center serving the special medi-
cally underserved population described in paragraph (1)
exists and in which not more than 4000 migratory agricul-
tural workers and their families reside for more than two
months—
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‘‘(A) for the provision of emergency care to mi-
gratory agricultural workers, seasonal agricultural
workers, and the members of families of such migra-
tory and seasonal workers; and
‘‘(B) for the provision of required primary
health services and additional health services for
such workers and the members of their families.
Any such program may include the acquisition, expansion,
and modernization of existing buildings, construction of
new buildings, and the provision of training related to the
management of programs assisted under this paragraph.’’.
(B) Section 329(e) is amended—
(i) by redesignating paragraphs (1)
and (2) as subparagraphs (A) and (B), re-
spectively; and
(ii) by redesignating subsection (e) as
paragraph (3) of subsection 330(f).
(C) Section 329(a) is amended—
(i) in paragraph (4)—
(I) in subparagraph (C), by strik-
ing ‘‘subparagraphs (B)’’ and insert-
ing ‘‘clause (ii)’’; and
(II) by redesignating subpara-
graphs (A) through (C) as clauses (i)
through (iii), respectively;
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(ii) by redesignating paragraphs (2),
(3), and (4) as subparagraphs (A), (B),
and (C), respectively, of new paragraph (4)
of section 330(f), and by adjusting their
margins so as to align with paragraphs (1)
through (3) of such section 330(f).
(4) GRANTS FOR HEALTH CENTERS SERVING
HOMELESS POPULATIONS.—
(A) Section 330 is amended by inserting
after subsection (f) a new subsection as follows:
‘‘(g) HOMELESS POPULATIONS.—
‘‘(1) IN GENERAL.—The Secretary is authorized
to award grants for the purposes described in sub-
sections (c), (d), and (e) for the planning and deliv-
ery of services to a special medically underserved
population comprised of homeless individuals, includ-
ing homeless children and children at risk of home-
lessness.
‘‘(2) REQUIRED SERVICES.—In addition to re-
quired primary health services (as defined in sub-
section (b)(1)), any entity that receives a grant
under this subsection shall be required to provide
substance abuse services as a condition of such
grant.
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‘‘(3) SUPPLEMENT
NOT
SUPPLANT
REQUIRE-
MENT.—Any grant awarded under this subsection
must be expended to supplement, and not supplant,
the health center’s expenditures for the delivery of
services to the population described in paragraph
(1).’’.
(B) Paragraphs (2), (7), and (8) of section
340(r) are redesignated as subparagraphs (A),
(B), and (C) of paragraph (4), respectively, of
section 330(g).
(C) Section 330(k)(2)(B) (as redesignated
by paragraph (1) of this subsection) is amended
by adding at the end the following sentence:
‘‘For purposes of applying the preceding sen-
tence, the term ‘public centers’ shall not include
health centers that receive grants pursuant to
subsection (g).’’.
(5) GRANTS FOR HEALTH CENTERS SERVING
PUBLIC HOUSING POPULATIONS.—
(A) Section 330 is amended by inserting
after subsection (g) a new subsection as follows:
‘‘(h) RESIDENTS OF PUBLIC HOUSING.—
‘‘(1) IN GENERAL.—The Secretary is authorized
to award grants for the purposes described in sub-
sections (c), and (d), and (e) for the planning and