II 
Calendar No. 629
107TH CONGRESS 
2D SESSION 
H. R. 3450
IN THE SENATE OF THE UNITED STATES 
OCTOBER 2, 2002
Received; read twice and placed on the calendar 
AN ACT 
To amend the Public Health Service Act to reauthorize and 
strengthen the health centers program and the National 
Health Service Corps, 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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Health Care Safety Net Improvement Act’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows:
Sec. 1. Short title; table of contents. 
TITLE I—CONSOLIDATED HEALTH CENTER PROGRAM 
AMENDMENTS 
Sec. 101. Health centers. 
Sec. 102. Migratory and seasonal agricultural workers. 
TITLE II—RURAL HEALTH 
Subtitle A—Rural Health Care Services Outreach, Rural Health Network De-
velopment, and Small Health Care Provider Quality Improvement Grant 
Programs 
Sec. 201. Grant programs. 
Subtitle B—Telehealth Grant Consolidation 
Sec. 211. Short title. 
Sec. 212. Consolidation and reauthorization of provisions. 
Subtitle C—Mental Health Services Telehealth Program and Rural 
Emergency Medical Service Training and Equipment Assistance Program 
Sec. 221. Programs. 
TITLE III—NATIONAL HEALTH SERVICE CORPS PROGRAM 
Sec. 301. National Health Service Corps. 
Sec. 302. Designation of health professional shortage areas. 
Sec. 303. Assignment of Corps personnel. 
Sec. 304. Priorities in assignment of Corps personnel. 
Sec. 305. Cost-sharing. 
Sec. 306. Eligibility for Federal funds. 
Sec. 307. Facilitation of effective provision of Corps services. 
Sec. 308. Authorization of appropriations. 
Sec. 309. National Health Service Corps Scholarship Program. 
Sec. 310. National Health Service Corps Loan Repayment Program. 
Sec. 311. Obligated service. 
Sec. 312. Private practice. 
Sec. 313. Breach of scholarship contract or loan repayment contract. 
Sec. 314. Authorization of appropriations. 
Sec. 315. Grants to States for loan repayment programs. 
Sec. 316. Demonstration grants to States for community scholarship programs. 
TITLE IV—ADDITIONAL PROVISIONS 
Sec. 401. Community access demonstration program.
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Sec. 402. Expanding availability of dental services. 
Sec. 403. Study regarding barriers to participation of farmworkers in health 
programs. 
Sec. 404. Eligibility of certain entities for grants. 
Sec. 405. Conforming amendments.
TITLE 
I—CONSOLIDATED 
HEALTH CENTER PROGRAM 
AMENDMENTS 
SEC. 101. HEALTH CENTERS. 
(a) INCREASE OF AUTHORIZATION OF APPROPRIA-
TIONS FROM $802,124,000 FOR FISCAL YEAR 1997 TO 
$1,293,000,000 
FOR
FISCAL
YEAR
2002.—Section 
330(l)(1) of the Public Health Service Act (42 U.S.C. 
254b(l(1))) is amended by striking ‘‘$802,124,000’’ and 
all that follows and inserting ‘‘$1,293,000,000 for fiscal 
year 2002, and such sums as may be necessary for each 
of the fiscal years 2003 through 2006.’’. 
(b) ADDITIONAL AMENDMENTS.—Section 330 of the 
Public Health Service Act (42 U.S.C. 254b) is amended—
(1) in subsection (b)(1)(A)—
(A) in clause (i)(III)(bb), by striking 
‘‘screening for breast and cervical cancer’’ and 
inserting ‘‘appropriate cancer screening’’; 
(B) in clause (ii), by inserting ‘‘(including 
specialty referral when medically indicated)’’ 
after ‘‘medical services’’; and 
(C) in clause (iii), by inserting ‘‘housing,’’ 
after ‘‘social,’’;
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(2) in subsection (b)(2)—
(A) by redesignating subparagraphs (A) 
and (B) as subparagraphs (B) and (C), respec-
tively; and 
(B) by inserting before subparagraph (B) 
(as so redesignated) the following: 
‘‘(A) behavioral and mental health and 
substance abuse services;’’; 
(3) in subsection (c)(1)—
(A) in subparagraph (B)—
(i) in the heading, by striking ‘‘COM-
PREHENSIVE SERVICE DELIVERY’’ and in-
serting ‘‘MANAGED CARE’’; 
(ii) in the matter preceding clause (i), 
by striking ‘‘network or plan’’ and all that 
follows to the period and inserting ‘‘man-
aged care network or plan.’’; and 
(iii) in the matter following clause (ii), 
by striking ‘‘Any such grant may include’’ 
and all that follows through the period; 
and 
(B) by adding at the end the following: 
‘‘(C) 
PRACTICE
MANAGEMENT
NET-
WORKS.—The Secretary may make grants to 
health centers that receive assistance under this
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section to enable the centers to plan and de-
velop practice management networks that will 
enable the centers to—
‘‘(i) reduce costs associated with the 
provision of health care services; 
‘‘(ii) improve access to, and avail-
ability of, health care services provided to 
individuals served by the centers; 
‘‘(iii) enhance the quality and coordi-
nation of health care services; or 
‘‘(iv) improve the health status of 
communities. 
‘‘(D) USE OF FUNDS.—The activities for 
which a grant may be made under subpara-
graph (B) or (C) may include the purchase or 
lease of equipment, which may include data and 
information systems (including paying for the 
costs of amortizing the principal of, and paying 
the interest on, loans for equipment), the provi-
sion of training and technical assistance related 
to the provision of health care services on a pre-
paid basis or under another managed care ar-
rangement, and other activities that promote 
the development of practice management or 
managed care networks and plans.’’;
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(4) in subsection (d)—
(A) by striking the subsection heading and 
inserting ‘‘LOAN GUARANTEE PROGRAM.—’’; 
(B) in paragraph (1)—
(i) in subparagraph (A), by striking 
‘‘the principal and interest on loans’’ and 
all that follows through the period and in-
serting ‘‘the principal and interest on loans 
made by non-Federal lenders to health cen-
ters, funded under this section, for the 
costs of developing and operating managed 
care networks or plans described in sub-
section (c)(1)(B), or practice management 
networks described in subsection (c)(1)(C), 
and for the costs of acquiring or leasing 
buildings, or purchasing or leasing equip-
ment.’’; 
(ii) in subparagraph (B)—
(I) in clause (i), by striking ‘‘or’’; 
(II) in clause (ii), by striking the 
period and inserting ‘‘; or’’; and 
(III) by adding at the end the 
following:
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‘‘(iii) to refinance a loan to the center 
or centers, if the Secretary determines 
that—
‘‘(I) such refinancing will result 
in more favorable terms; 
‘‘(II) the savings resulting from 
the refinancing will be beneficial to 
both the center (or centers) and the 
Government; and 
‘‘(III) the center (or centers) can 
demonstrate an ability to repay the 
refinanced loan equal to or greater 
than the ability of the center (or cen-
ters) to repay the original loan on the 
date the original loan was made.’’; 
and 
(iii) by adding at the end the fol-
lowing: 
‘‘(D) PROVISION DIRECTLY TO NETWORKS 
OR PLANS.—At the request of health centers re-
ceiving assistance under this section, loan guar-
antees provided under this paragraph may be 
made directly to networks or plans that are at 
least majority controlled and, as applicable, at
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least majority owned by those health centers.’’; 
and 
(C)(i) by striking paragraphs (6) and (7); 
and 
(ii) by redesignating paragraph (8) as 
paragraph (6); 
(5) in subsection (e)—
(A) in paragraph (1), by adding at the end 
the following: 
‘‘(C) OPERATION
OF
NETWORKS
AND 
PLANS.—
‘‘(i) IN
GENERAL.—The Secretary 
may make grants to health centers that re-
ceive assistance under this section, or at 
the request of the health centers, directly 
to a network or plan (as described in sub-
paragraphs (B) and (C) of subsection 
(c)(1)) that is at least majority controlled 
and, as applicable, at least majority owned 
by such health centers receiving assistance 
under this section, for the costs associated 
with the operation of such network or plan, 
including the purchase or lease of equip-
ment (including the costs of amortizing the
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principal of, and paying the interest on, 
loans for equipment). 
‘‘(ii) CERTAIN REQUIREMENTS.—Sub-
section (j) applies with respect to grants 
under clause (i) to the same extent and in 
the same manner as such subsection ap-
plies with respect to grants under subpara-
graph (A) or (B), except to the extent that 
as applied to clause (i) the Secretary 
waives any requirement under subsection 
(j) on the basis that the requirement is not 
necessary with respect to the purposes for 
which grants under clause (i) are made.’’; 
and 
(B) in paragraph (5)—
(i) in subparagraph (A), by inserting 
‘‘subparagraphs (A) and (B) of’’ after 
‘‘any fiscal year under’’; 
(ii) by redesignating subparagraphs 
(B) and (C) as subparagraphs (C) and 
(D), respectively; and 
(iii) by inserting after subparagraph 
(A) the following: 
‘‘(B) NETWORKS AND PLANS.—The total 
amount of grant funds made available for any
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fiscal year under paragraph (1)(C) and sub-
paragraphs (B) and (C) of subsection (c)(1) to 
a health center shall be determined by the Sec-
retary, but may not exceed 2 percent of the 
total amount appropriated under this section 
for such fiscal year.’’; 
(6) in subsection (h)—
(A) in paragraph (1), by striking ‘‘home-
less children and children at risk of homeless-
ness’’ and inserting ‘‘homeless children and 
youth and children and youth at risk of home-
lessness’’; 
(B)(i) by redesignating paragraph (4) as 
paragraph (5); and 
(ii) by inserting after paragraph (3) the 
following: 
‘‘(4) TEMPORARY
CONTINUED
PROVISION
OF 
SERVICES TO CERTAIN FORMER HOMELESS INDIVID-
UALS.—If any grantee under this subsection has 
provided services described in this section under the 
grant to a homeless individual, such grantee may, 
notwithstanding that the individual is no longer 
homeless as a result of becoming a resident in per-
manent housing, expend the grant to continue to
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provide such services to the individual for not more 
than 12 months.’’; and 
(C) in paragraph (5)(C) (as redesignated 
by subparagraph (B)), by striking ‘‘and residen-
tial treatment’’ and inserting ‘‘, risk reduction, 
outpatient treatment, residential treatment, and 
rehabilitation’’; 
(7) in subsection (j)(3)—
(A) in subparagraph (E)—
(i) in clause (i)—
(I) by striking ‘‘(i)’’ and insert-
ing ‘‘(i)(I)’’; 
(II) by striking ‘‘plan; or’’ and 
inserting ‘‘plan; and’’; and 
(III) by adding at the end the 
following: 
‘‘(II) has or will have a contrac-
tual or other arrangement with the 
State agency administering the pro-
gram under title XXI of such Act (42 
U.S.C. 1397aa et seq.) with respect to 
individuals who are State children’s 
health 
insurance 
program 
bene-
ficiaries; or’’; and
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(ii) by striking clause (ii) and insert-
ing the following: 
‘‘(ii) has made or will make every rea-
sonable effort to enter into arrangements 
described in subclauses (I) and (II) of 
clause (i);’’; 
(B) in subparagraph (G)—
(i) in clause (ii)(II), by striking ‘‘; 
and’’ and inserting ‘‘;’’; 
(ii) by redesignating clause (iii) as 
clause (iv); and 
(iii) by inserting after clause (ii) the 
following: 
‘‘(iii)(I) will assure that no patient 
will be denied health care services due to 
an individual’s inability to pay for such 
services; and 
‘‘(II) will assure that any fees or pay-
ments required by the center for such serv-
ices will be reduced or waived to enable the 
center to fulfill the assurance described in 
subclause (I); and’’; 
(C) in subparagraph (K)(ii), by striking 
‘‘and’’ after the semicolon at the end;
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(D) in subparagraph (L), by striking the 
period at the end and inserting ‘‘; and’’; and 
(E) by adding at the end the following sub-
paragraph: 
‘‘(M) the center encourages persons receiv-
ing or seeking health services from the center to 
participate in any public or private (including 
employer-offered) health programs or plans for 
which the persons are eligible.’’; 
(8) by striking subsection (k) and inserting the 
following: 
‘‘(k) TECHNICAL ASSISTANCE.—The Secretary shall 
establish a program through which the Secretary shall 
provide technical and other assistance to eligible entities 
to assist such entities to meet the requirements of para-
graphs (2) and (3) of subsection (j) and in developing 
plans for, and operating health centers. Services provided 
through the program may include necessary technical and 
nonfinancial assistance, including fiscal and program man-
agement assistance, training in program management, 
operational and administrative support, and the provision 
of information to the entities of the variety of resources 
available under this title and how those resources can be 
best used to meet the health needs of the communities 
served by the entities.’’;
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(9)(A) in subsection (l) (as amended by sub-
section (a) of this section), by striking ‘‘(l) AUTHOR-
IZATION’’; 
(B) by transferring such undesignated sub-
section to the end of the section; 
(C) by redesignating subsections (m) through 
(q) as subsections (l) through (p), respectively; and 
(D) in the subsection transferred by subpara-
graph (B), by inserting ‘‘(q) AUTHORIZATION’’ be-
fore ‘‘OF APPROPRIATIONS.—’’; and 
(10) in subsection (q) (as transferred and re-
designated by paragraph (9)), in paragraph (2)—
(A) in subparagraph (A), by striking 
‘‘(j)(3)(G)(ii)’’ and inserting ‘‘(j)(3)(H)’’; and 
(B) by striking subparagraph (B) and in-
serting the following: 
‘‘(B) DISTRIBUTION OF GRANTS.—For fis-
cal year 2002 and each of the following fiscal 
years, the Secretary, in awarding grants under 
this section, shall ensure that the proportion of 
the amount made available under each of sub-
sections (g), (h), and (i), relative to the total 
amount appropriated to carry out this section 
for that fiscal year, is equal to the proportion 
of the amount made available under that sub-
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section for fiscal year 2001, relative to the total 
amount appropriated to carry out this section 
for fiscal year 2001.’’. 
(c) TELEMEDICINE; INCENTIVE GRANTS REGARDING 
COORDINATION AMONG STATES.—
(1) IN GENERAL.—The Secretary of Health and 
Human Services may make grants to State profes-
sional licensing boards to carry out programs under 
which such licensing boards of various States co-
operate to develop and implement State policies that 
will reduce statutory and regulatory barriers to tele-
medicine. 
(2) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out paragraph (1), there are 
authorized to be appropriated $10,000,000 for fiscal 
year 2002, and such sums as may be necessary for 
each of the fiscal years 2002 through 2006. 
SEC. 102. MIGRATORY AND SEASONAL AGRICULTURAL 
WORKERS. 
Section 330(g) of the Public Health Service Act (42 
U.S.C. 254b(g)) is amended—
(1) in paragraph (2)—
(A) in subparagraph (A), by inserting 
‘‘and seasonal agricultural worker’’ after ‘‘agri-
cultural worker’’; and
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(B) in subparagraph (B), by striking ‘‘and 
members of their families’’ and inserting ‘‘and 
seasonal agricultural workers, and members of 
their families,’’; and 
(2) in paragraph (3)(A), by striking ‘‘on a sea-
sonal basis’’.
TITLE II—RURAL HEALTH 
Subtitle 
A—Rural 
Health 
Care 
Services Outreach, Rural Health 
Network 
Development, 
and 
Small 
Health 
Care 
Provider 
Quality 
Improvement 
Grant 
Programs 
SEC. 201. GRANT PROGRAMS. 
Section 330A of the Public Health Service Act (42 
U.S.C. 254c) is amended to read as follows: 
‘‘SEC. 330A. RURAL HEALTH CARE SERVICES OUTREACH, 
RURAL HEALTH NETWORK DEVELOPMENT, 
AND SMALL HEALTH CARE PROVIDER QUAL-
ITY IMPROVEMENT GRANT PROGRAMS. 
‘‘(a) PURPOSE.—The purpose of this section is to 
provide grants for expanded delivery of health care serv-
ices in rural areas, for the planning and implementation 
of integrated health care networks in rural areas, and for
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the planning and implementation of small health care pro-
vider quality improvement activities. 
‘‘(b) DEFINITIONS.—
‘‘(1) DIRECTOR.—The term ‘Director’ means 
the Director specified in subsection (d). 
‘‘(2) FEDERALLY QUALIFIED HEALTH CENTER; 
RURAL
HEALTH
CLINIC.—The terms ‘Federally 
qualified health center’ and ‘rural health clinic’ have 
the meanings given the terms in section 1861(aa) of 
the Social Security Act (42 U.S.C. 1395x(aa)). 
‘‘(3) 
HEALTH
PROFESSIONAL
SHORTAGE 
AREA.—The term ‘health professional shortage area’ 
means a health professional shortage area des-
ignated under section 332. 
‘‘(4) MEDICALLY UNDERSERVED COMMUNITY.—
The term ‘medically underserved community’ has the 
meaning given the term in section 799B. 
‘‘(5) 
MEDICALLY
UNDERSERVED
POPU-
LATION.—The term ‘medically underserved popu-
lation’ has the meaning given the term in section 
330(b)(3). 
‘‘(c) PROGRAM.—The Secretary shall establish, under 
section 301, a small health care provider quality improve-
ment grant program. 
‘‘(d) ADMINISTRATION.—
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‘‘(1) PROGRAMS.—The rural health care serv-
ices outreach, rural health network development, and 
small health care provider quality improvement 
grant programs established under section 301 shall 
be administered by the Director of the Office of 
Rural Health Policy of the Health Resources and 
Services Administration, in consultation with State 
offices of rural health or other appropriate State 
government entities. 
‘‘(2) GRANTS.—
‘‘(A) IN GENERAL.—In carrying out the 
programs described in paragraph (1), the Di-
rector may award grants under subsections (e), 
(f), and (g) to expand access to, coordinate, and 
improve the quality of essential health care 
services, and enhance the delivery of health 
care, in rural areas. 
‘‘(B) TYPES
OF
GRANTS.—The Director 
may award the grants—
‘‘(i) to promote expanded delivery of 
health care services in rural areas under 
subsection (e); 
‘‘(ii) to provide for the planning and 
implementation of integrated health care
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networks in rural areas under subsection 
(f); and 
‘‘(iii) to provide for the planning and 
implementation of small health care pro-
vider quality improvement activities under 
subsection (g). 
‘‘(e) RURAL HEALTH CARE SERVICES OUTREACH 
GRANTS.—
‘‘(1) GRANTS.—The Director may award grants 
to eligible entities to promote rural health care serv-
ices outreach by expanding the delivery of health 
care services to include new and enhanced services 
in rural areas. The Director may award the grants 
for periods of not more than 3 years. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under this subsection for a project, an enti-
ty—
‘‘(A) shall be a rural public or private enti-
ty; 
‘‘(B) shall represent a consortium com-
posed of members—
‘‘(i) that include 3 or more health 
care providers; and 
‘‘(ii) that may be nonprofit or for-
profit entities; and
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‘‘(C) shall not previously have received a 
grant under this subsection for the same or a 
similar project, unless the entity is proposing to 
expand the scope of the project or the area that 
will be served through the project. 
‘‘(3) APPLICATIONS.—To be eligible to receive a 
grant under this subsection, an eligible entity, in 
consultation with the appropriate State office of 
rural health or another appropriate State entity, 
shall prepare and submit to the Secretary an appli-
cation, at such time, in such manner, and containing 
such information as the Secretary may require, in-
cluding—
‘‘(A) a description of the project that the 
eligible entity will carry out using the funds 
provided under the grant; 
‘‘(B) a description of the manner in which 
the project funded under the grant will meet 
the health care needs of rural underserved pop-
ulations in the local community or region to be 
served; 
‘‘(C) a description of how the local commu-
nity or region to be served will be involved in 
the development and ongoing operations of the 
project;
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‘‘(D) a plan for sustaining the project after 
Federal support for the project has ended; and 
‘‘(E) a description of how the project will 
be evaluated. 
‘‘(f) RURAL
HEALTH
NETWORK
DEVELOPMENT 
GRANTS.—
‘‘(1) GRANTS.—
‘‘(A) IN
GENERAL.—The Director may 
award rural health network development grants 
to eligible entities to promote, through planning 
and implementation, the development of inte-
grated health care networks that have combined 
the functions of the entities participating in the 
networks in order to—
‘‘(i) achieve efficiencies; 
‘‘(ii) expand access to, coordinate, and 
improve the quality of essential health care 
services; and 
‘‘(iii) strengthen the rural health care 
system as a whole. 
‘‘(B) GRANT PERIODS.—The Director may 
award such a rural health network development 
grant for implementation activities for a period 
of 3 years. The Director may also award such 
a rural health network development grant for
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planning activities for a period of 1 year, to as-
sist in the development of an integrated health 
care network, if the proposed participants in 
the network do not have a history of collabo-
rative efforts and a 3-year grant would be inap-
propriate. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under this subsection, an entity—
‘‘(A) shall be a rural public or private enti-
ty; 
‘‘(B) shall represent a network composed 
of participants—
‘‘(i) that include 3 or more health 
care providers; and 
‘‘(ii) that may be nonprofit or for-
profit entities; and 
‘‘(C) shall not previously have received a 
grant under this subsection (other than a grant 
for planning activities) for the same or a simi-
lar project. 
‘‘(3) APPLICATIONS.—To be eligible to receive a 
grant under this subsection, an eligible entity, in 
consultation with the appropriate State office of 
rural health or another appropriate State entity, 
shall prepare and submit to the Secretary an appli-
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cation, at such time, in such manner, and containing 
such information as the Secretary may require, in-
cluding—
‘‘(A) a description of the project that the 
eligible entity will carry out using the funds 
provided under the grant; 
‘‘(B) an explanation of the reasons why 
Federal assistance is required to carry out the 
project; 
‘‘(C) a description of—
‘‘(i) the history of collaborative activi-
ties carried out by the participants in the 
network; 
‘‘(ii) the degree to which the partici-
pants are ready to integrate their func-
tions; and 
‘‘(iii) how the local community or re-
gion to be served will benefit from and be 
involved in the activities carried out by the 
network; 
‘‘(D) a description of how the local com-
munity or region to be served will experience in-
creased access to quality health care services 
across the continuum of care as a result of the
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integration activities carried out by the net-
work; 
‘‘(E) a plan for sustaining the project after 
Federal support for the project has ended; and 
‘‘(F) a description of how the project will 
be evaluated. 
‘‘(g) SMALL HEALTH CARE PROVIDER QUALITY IM-
PROVEMENT GRANTS.—
‘‘(1) GRANTS.—The Director may award grants 
to provide for the planning and implementation of 
small health care provider quality improvement ac-
tivities. The Director may award the grants for peri-
ods of 1 to 3 years. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
under this subsection, an entity—
‘‘(A)(i) shall be a rural public or rural non-
profit private health care provider or provider 
of health care services, such as a critical access 
hospital or a rural health clinic; or 
‘‘(ii) shall be another rural provider or net-
work of small rural providers identified by the 
Secretary as a key source of local care; and 
‘‘(B) shall not previously have received a 
grant under this subsection for the same or a 
similar project.
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‘‘(3) APPLICATIONS.—To be eligible to receive a 
grant under this subsection, an eligible entity, in 
consultation with the appropriate State office of 
rural health, another appropriate State entity, or a 
hospital association, shall prepare and submit to the 
Secretary an application, at such time, in such man-
ner, and containing such information as the Sec-
retary may require, including—
‘‘(A) a description of the project that the 
eligible entity will carry out using the funds 
provided under the grant; 
‘‘(B) an explanation of the reasons why 
Federal assistance is required to carry out the 
project; 
‘‘(C) a description of the manner in which 
the project funded under the grant will assure 
continuous quality improvement in the provision 
of services by the entity; 
‘‘(D) a description of how the local com-
munity or region to be served will experience in-
creased access to quality health care services 
across the continuum of care as a result of the 
activities carried out by the entity; 
‘‘(E) a plan for sustaining the project after 
Federal support for the project has ended; and
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‘‘(F) a description of how the project will 
be evaluated. 
‘‘(4) EXPENDITURES FOR SMALL HEALTH CARE 
PROVIDER
QUALITY
IMPROVEMENT
GRANTS.—In 
awarding a grant under this subsection, the Director 
shall ensure that the funds made available through 
the grant will be used to provide services to resi-
dents of rural areas. The Director shall award not 
less than 50 percent of the funds made available 
under this subsection to providers located in and 
serving rural areas. 
‘‘(h) GENERAL REQUIREMENTS.—
‘‘(1) PROHIBITED USES OF FUNDS.—An entity 
that receives a grant under this section may not use 
funds provided through the grant—
‘‘(A) to build or acquire real property; or 
‘‘(B) for construction, except that such 
funds may be expended for minor renovations 
relating to the installation of equipment. 
‘‘(2) COORDINATION WITH OTHER AGENCIES.—
The Secretary shall coordinate activities carried out 
under grant programs described in this section, to 
the extent practicable, with Federal and State agen-
cies and nonprofit organizations that are operating
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similar grant programs, to maximize the effect of 
public dollars in funding meritorious proposals. 
‘‘(3) PREFERENCE.—In awarding grants under 
this section, the Secretary shall give preference to 
entities that—
‘‘(A) are located in health professional 
shortage areas or medically underserved com-
munities, or serve medically underserved popu-
lations; or 
‘‘(B) propose to develop projects with a 
focus on primary care, and wellness and preven-
tion strategies. 
‘‘(i) REPORT.—Not later than September 30, 2005, 
the Secretary shall prepare and submit to the appropriate 
committees of Congress a report on the progress and ac-
complishments of the grant programs described in sub-
sections (e), (f), and (g). 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$40,000,000 for fiscal year 2002, and such sums as may 
be necessary for each of fiscal years 2003 through 2006.’’.
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Subtitle B—Telehealth Grant 
Consolidation 
SEC. 211. SHORT TITLE. 
This subtitle may be cited as the ‘‘Telehealth Grant 
Consolidation Act of 2001’’. 
SEC. 212. CONSOLIDATION AND REAUTHORIZATION OF 
PROVISIONS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq) is amended by adding 
at the end the following: 
‘‘SEC. 330I. TELEHEALTH NETWORK AND TELEHEALTH RE-
SOURCE CENTERS GRANT PROGRAMS. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) DIRECTOR; OFFICE.—The terms ‘Director’ 
and ‘Office’ mean the Director and Office specified 
in subsection (c). 
‘‘(2) FEDERALLY QUALIFIED HEALTH CENTER 
AND RURAL HEALTH CLINIC.—The term ‘Federally 
qualified health center’ and ‘rural health clinic’ have 
the meanings given the terms in section 1861(aa) of 
the Social Security Act (42 U.S.C. 1395x(aa)). 
‘‘(3) FRONTIER COMMUNITY.—The term ‘fron-
tier community’ means an area with fewer than 6 
residents per square mile, based on the latest popu-
lation data published by the Bureau of the Census.
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‘‘(4) MEDICALLY
UNDERSERVED
AREA.—The 
term ‘medically underserved area’ has the meaning 
given the term ‘medically underserved community’ in 
section 799B. 
‘‘(5) 
MEDICALLY
UNDERSERVED
POPU-
LATION.—The term ‘medically underserved popu-
lation’ has the meaning given the term in section 
330(b)(3). 
‘‘(6) TELEHEALTH SERVICES.—The term ‘tele-
health services’ means services provided through 
telehealth technologies. 
‘‘(7) TELEHEALTH TECHNOLOGIES.—The term 
‘telehealth technologies’ means technologies relating 
to the use of electronic information, and tele-
communications technologies, to support and pro-
mote, at a distance, health care, patient and profes-
sional health-related education, health administra-
tion, and public health. 
‘‘(b) PROGRAMS.—The Secretary shall establish, 
under section 301, telehealth network and telehealth re-
source centers grant programs. 
‘‘(c) ADMINISTRATION.—
‘‘(1) ESTABLISHMENT.—There is established in 
the Health and Resources and Services Administra-
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tion an Office for the Advancement of Telehealth. 
The Office shall be headed by a Director. 
‘‘(2) DUTIES.—The telehealth network and tele-
health resource centers grant programs established 
under section 301 shall be administered by the Di-
rector, in consultation with the State offices of rural 
health, State offices concerning primary care, or 
other appropriate State government entities. 
‘‘(d) GRANTS.—
‘‘(1) TELEHEALTH
NETWORK
GRANTS.—The 
Director may, in carrying out the telehealth network 
grant program referred to in subsection (b), award 
grants to eligible entities for projects to demonstrate 
how telehealth technologies can be used through tele-
health networks in rural areas, frontier communities, 
and medically underserved areas, and for medically 
underserved populations, to— 
‘‘(A) expand access to, coordinate, and im-
prove the quality of health care services; 
‘‘(B) improve and expand the training of 
health care providers; and 
‘‘(C) expand and improve the quality of 
health information available to health care pro-
viders, and patients and their families, for deci-
sionmaking.
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‘‘(2) 
TELEHEALTH
RESOURCE
CENTERS 
GRANTS.—The Director may, in carrying out the 
telehealth resource centers grant program referred 
to in subsection (b), award grants to eligible entities 
for projects to demonstrate how telehealth tech-
nologies can be used in the areas and communities, 
and for the populations, described in paragraph (1), 
to establish telehealth resource centers. 
‘‘(e) GRANT PERIODS.—The Director may award 
grants under this section for periods of not more than 4 
years. 
‘‘(f) ELIGIBLE ENTITIES.—
‘‘(1) TELEHEALTH NETWORK GRANTS.—
‘‘(A) GRANT RECIPIENT.—To be eligible to 
receive a grant under subsection (d)(1), an enti-
ty shall be a nonprofit entity. 
‘‘(B) TELEHEALTH NETWORKS.—
‘‘(i) IN GENERAL.—To be eligible to 
receive a grant under subsection (d)(1), an 
entity shall demonstrate that the entity 
will provide services through a telehealth 
network. 
‘‘(ii) NATURE
OF
ENTITIES.—Each 
entity participating in the telehealth net-
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work may be a nonprofit or for-profit enti-
ty. 
‘‘(iii) COMPOSITION OF NETWORK.—
The telehealth network shall include at 
least 2 of the following entities (at least 1 
of which shall be a community-based 
health care provider): 
‘‘(I) 
Community 
or 
migrant 
health centers or other Federally 
qualified health centers. 
‘‘(II) Health care providers, in-
cluding pharmacists, in private prac-
tice. 
‘‘(III) Entities operating clinics, 
including rural health clinics. 
‘‘(IV) Local health departments. 
‘‘(V) Nonprofit hospitals, includ-
ing community access hospitals. 
‘‘(VI) 
Other 
publicly 
funded 
health or social service agencies. 
‘‘(VII) Long-term care providers. 
‘‘(VIII) Providers of health care 
services in the home. 
‘‘(IX) Providers of outpatient 
mental health services and entities op-
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erating outpatient mental health fa-
cilities. 
‘‘(X) Local or regional emergency 
health care providers. 
‘‘(XI) Institutions of higher edu-
cation. 
‘‘(XII) Entities operating dental 
clinics. 
‘‘(2) 
TELEHEALTH
RESOURCE
CENTERS 
GRANTS.—To be eligible to receive a grant under 
subsection (d)(2), an entity shall be a nonprofit enti-
ty. 
‘‘(g) APPLICATIONS.—To be eligible to receive a 
grant under subsection (d), an eligible entity, in consulta-
tion with the appropriate State office of rural health or 
another appropriate State entity, shall prepare and submit 
to the Secretary an application, at such time, in such man-
ner, and containing such information as the Secretary may 
require, including—
‘‘(1) a description of the project that the eligi-
ble entity will carry out using the funds provided 
under the grant; 
‘‘(2) a description of the manner in which the 
project funded under the grant will meet the health 
care needs of rural or other populations to be served
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through the project, or improve the access to serv-
ices of, and the quality of the services received by, 
those populations; 
‘‘(3) evidence of local support for the project, 
and a description of how the areas, communities, or 
populations to be served will be involved in the devel-
opment and ongoing operations of the project; 
‘‘(4) a plan for sustaining the project after Fed-
eral support for the project has ended; 
‘‘(5) information on the source and amount of 
non-Federal funds that the entity will provide for 
the project; 
‘‘(6) information demonstrating the long-term 
viability of the project, and other evidence of institu-
tional commitment of the entity to the project; and 
‘‘(7) in the case of an application for a project 
involving a telehealth network, information dem-
onstrating how the project will promote the integra-
tion of telehealth technologies into the operations of 
health care providers, to avoid redundancy, and im-
prove access to and the quality of care. 
‘‘(h) TERMS; CONDITIONS; MAXIMUM AMOUNT OF 
ASSISTANCE.—The Secretary shall establish the terms 
and conditions of each grant program described in sub-
section (b) and the maximum amount of a grant to be
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awarded to an individual recipient for each fiscal year 
under this section. The Secretary shall publish, in a publi-
cation of the Health Resources and Services Administra-
tion, notice of the application requirements for each grant 
program described in subsection (b) for each fiscal year. 
‘‘(i) PREFERENCES.—
‘‘(1) TELEHEALTH
NETWORKS.—In awarding 
grants under subsection (d)(1) for projects involving 
telehealth networks, the Secretary shall give pref-
erence to an eligible entity that meets at least 1 of 
the following requirements: 
‘‘(A) ORGANIZATION.—The eligible entity 
is a rural community-based organization or an-
other community-based organization. 
‘‘(B) SERVICES.—The eligible entity pro-
poses to use Federal funds made available 
through such a grant to develop plans for, or to 
establish, telehealth networks that provide men-
tal health, public health, long-term care, home 
care, preventive, or case management services. 
‘‘(C) COORDINATION.—The eligible entity 
demonstrates how the project to be carried out 
under the grant will be coordinated with other 
relevant federally funded projects in the areas,
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communities, and populations to be served 
through the grant. 
‘‘(D) NETWORK.—The eligible entity dem-
onstrates that the project involves a telehealth 
network that includes an entity that—
‘‘(i) provides clinical health care serv-
ices, or educational services for health care 
providers and for patients or their families; 
and 
‘‘(ii) is—
‘‘(I) a public school; 
‘‘(II) a public library; 
‘‘(III) an institution of higher 
education; or 
‘‘(IV) a local government entity. 
‘‘(E) CONNECTIVITY.—The eligible entity 
proposes 
a 
project 
that 
promotes 
local 
connectivity within areas, communities, or pop-
ulations to be served through the project. 
‘‘(F) INTEGRATION.—The eligible entity 
demonstrates that health care information has 
been integrated into the project. 
‘‘(2) TELEHEALTH
RESOURCE
CENTERS.—In 
awarding grants under subsection (d)(2) for projects 
involving telehealth resource centers, the Secretary
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shall give preference to an eligible entity that meets 
at least 1 of the following requirements: 
‘‘(A) PROVISION OF SERVICES.—The eligi-
ble entity has a record of success in the provi-
sion of telehealth services to medically under-
served areas or medically underserved popu-
lations. 
‘‘(B) COLLABORATION
AND
SHARING
OF 
EXPERTISE.—The eligible entity has a dem-
onstrated record of collaborating and sharing 
expertise with providers of telehealth services at 
the national, regional, State, and local levels. 
‘‘(C) BROAD
RANGE
OF
TELEHEALTH 
SERVICES.—The eligible entity has a record of 
providing a broad range of telehealth services, 
which may include—
‘‘(i) a variety of clinical specialty serv-
ices; 
‘‘(ii) patient or family education; 
‘‘(iii) health care professional edu-
cation; and 
‘‘(iv) rural residency support pro-
grams. 
‘‘(j) DISTRIBUTION OF FUNDS.—
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‘‘(1) IN GENERAL.—In awarding grants under 
this section, the Director shall ensure, to the great-
est extent possible, that such grants are equitably 
distributed among the geographical regions of the 
United States. 
‘‘(2) TELEHEALTH
NETWORKS.—In awarding 
grants under subsection (d)(1) for a fiscal year, the 
Director shall ensure that—
‘‘(A) not less than 50 percent of the funds 
awarded shall be awarded for projects in rural 
areas; and 
‘‘(B) the total amount of funds awarded 
for such projects for that fiscal year shall be 
not less than the total amount of funds award-
ed for such projects for fiscal year 2001 under 
section 330A (as in effect on the day before the 
date of enactment of the Health Care Safety 
Net Improvement Act). 
‘‘(k) USE OF FUNDS.— 
‘‘(1) TELEHEALTH NETWORK PROGRAM.—The 
recipient of a grant under subsection (d)(1) may use 
funds received through such grant for salaries, 
equipment, and operating or other costs, including 
the cost of—
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‘‘(A) developing and delivering clinical tele-
health services that enhance access to commu-
nity-based health care services in rural areas, 
frontier communities, or medically underserved 
areas, or for medically underserved populations; 
‘‘(B) developing and acquiring, through 
lease or purchase, computer hardware and soft-
ware, audio and video equipment, computer net-
work equipment, interactive equipment, data 
terminal equipment, and other equipment that 
furthers the objectives of the telehealth network 
grant program;
‘‘(C)(i) developing and providing distance 
education, in a manner that enhances access to 
care in rural areas, frontier communities, or 
medically underserved areas, or for medically 
underserved populations; or 
‘‘(ii) mentoring, precepting, or supervising 
health care providers and students seeking to 
become health care providers, in a manner that 
enhances access to care in the areas and com-
munities, or for the populations, described in 
clause (i); 
‘‘(D) developing and acquiring instruc-
tional programming;
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‘‘(E)(i) providing for transmission of med-
ical data, and maintenance of equipment; and 
‘‘(ii) providing for compensation (including 
travel expenses) of specialists, and referring 
health care providers, who are providing tele-
health services through the telehealth network, 
if no third party payment is available for the 
telehealth services delivered through the tele-
health network; 
‘‘(F) developing projects to use telehealth 
technology to facilitate collaboration between 
health care providers; 
‘‘(G) collecting and analyzing usage statis-
tics and data to document the cost-effectiveness 
of the telehealth services; and 
‘‘(H) carrying out such other activities as 
are consistent with achieving the objectives of 
this section, as determined by the Secretary. 
‘‘(2) TELEHEALTH RESOURCE CENTERS.—The 
recipient of a grant under subsection (d)(2) may use 
funds received through such grant for salaries, 
equipment, and operating or other costs for—
‘‘(A) providing technical assistance, train-
ing, and support, and providing for travel ex-
penses, for health care providers and a range of
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health care entities that provide or will provide 
telehealth services; 
‘‘(B) disseminating information and re-
search findings related to telehealth services; 
‘‘(C) 
promoting 
effective 
collaboration 
among telehealth resource centers and the Of-
fice; 
‘‘(D) conducting evaluations to determine 
the best utilization of telehealth technologies to 
meet health care needs; 
‘‘(E) promoting the integration of the tech-
nologies used in clinical information systems 
with other telehealth technologies; 
‘‘(F) fostering the use of telehealth tech-
nologies to provide health care information and 
education for health care providers and con-
sumers in a more effective manner; and 
‘‘(G) implementing special projects or 
studies under the direction of the Office.
‘‘(l) PROHIBITED USES OF FUNDS.—An entity that 
receives a grant under this section may not use funds 
made available through the grant—
‘‘(1) to acquire real property;
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‘‘(2) for expenditures to purchase or lease 
equipment, to the extent that the expenditures would 
exceed 40 percent of the total grant funds; 
‘‘(3) in the case of a project involving a tele-
health network, to purchase or install transmission 
equipment (such as laying cable or telephone lines, 
or purchasing or installing microwave towers, sat-
ellite dishes, amplifiers, or digital switching equip-
ment); 
‘‘(4) to pay for any equipment or transmission 
costs not directly related to the purposes for which 
the grant is awarded; 
‘‘(5) to purchase or install general purpose 
voice telephone systems; 
‘‘(6) for construction, except that such funds 
may be expended for minor renovations relating to 
the installation of equipment; or 
‘‘(7) for expenditures for indirect costs (as de-
termined by the Secretary), to the extent that the 
expenditures would exceed 10 percent of the total 
grant funds. 
‘‘(m) COLLABORATION.—In providing services under 
this section, an eligible entity shall collaborate, if feasible, 
with entities that—
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‘‘(1)(A) are private or public organizations, that 
receive Federal or State assistance; or 
‘‘(B) are public or private entities that operate 
centers, or carry out programs, that receive Federal 
or State assistance; and 
‘‘(2) provide telehealth services or related activi-
ties. 
‘‘(n) COORDINATION WITH OTHER AGENCIES.—The 
Secretary shall coordinate activities carried out under 
grant programs described in subsection (b), to the extent 
practicable, with Federal and State agencies and nonprofit 
organizations that are operating similar programs, to 
maximize the effect of public dollars in funding meri-
torious proposals. 
‘‘(o) OUTREACH ACTIVITIES.—The Secretary shall 
establish and implement procedures to carry out outreach 
activities to advise potential end users of telehealth serv-
ices in rural areas, frontier communities, medically under-
served areas, and medically underserved populations in 
each State about the grant programs described in sub-
section (b). 
‘‘(p) TELEHEALTH.—It is the sense of Congress that, 
for purposes of this section, States should develop reci-
procity agreements so that a provider of services under 
this section who is a licensed or otherwise authorized
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health care provider under the law of 1 or more States, 
and who, through telehealth technology, consults with a 
licensed or otherwise authorized health care provider in 
another State, is exempt, with respect to such consulta-
tion, from any State law of the other State that prohibits 
such consultation on the basis that the first health care 
provider is not a licensed or authorized health care pro-
vider under the law of that State. 
‘‘(q) REPORT.—Not later than September 30, 2005, 
the Secretary shall prepare and submit to the appropriate 
committees of Congress a report on the progress and ac-
complishments of the grant programs described in sub-
section (b). 
‘‘(r) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this sec-
tion—
‘‘(1) for grants under subsection (d)(1), 
$40,000,000 for fiscal year 2002, and such sums as 
may be necessary for each of fiscal years 2003 
through 2006; and 
‘‘(2) for grants under subsection (d)(2), 
$20,000,000 for fiscal year 2002, and such sums as 
may be necessary for each of fiscal years 2003 
through 2006.’’.
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Subtitle C—Mental Health Services 
Telehealth Program and Rural 
Emergency 
Medical 
Service 
Training and Equipment Assist-
ance Program 
SEC. 221. PROGRAMS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) (as amended by sec-
tion 212) is further amended by adding at the end the 
following: 
‘‘SEC. 330J. RURAL EMERGENCY MEDICAL SERVICE TRAIN-
ING AND EQUIPMENT ASSISTANCE PROGRAM. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration (referred to in this section as the ‘Secretary’) 
shall award grants to eligible entities to enable such enti-
ties to provide for improved emergency medical services 
in rural areas. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an entity shall—
‘‘(1) be—
‘‘(A) a State emergency medical services 
office; 
‘‘(B) a State emergency medical services 
association;
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‘‘(C) a State office of rural health; 
‘‘(D) a local government entity; 
‘‘(E) a State or local ambulance provider; 
or 
‘‘(F) any other entity determined appro-
priate by the Secretary; and 
‘‘(2) prepare and submit to the Secretary an 
application at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, that includes—
‘‘(A) a description of the activities to be 
carried out under the grant; and 
‘‘(B) an assurance that the eligible entity 
will comply with the matching requirement of 
subsection (e). 
‘‘(c) USE OF FUNDS.—An entity shall use amounts 
received under a grant made under subsection (a), either 
directly or through grants to emergency medical service 
squads that are located in, or that serve residents of, a 
nonmetropolitan statistical area, an area designated as a 
rural area by any law or regulation of a State, or a rural 
census tract of a metropolitan statistical area (as deter-
mined under the most recent Goldsmith Modification, 
originally published in a notice of availability of funds in
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the Federal Register on February 27, 1992, 57 Fed. Reg. 
6725), to—
‘‘(1) recruit emergency medical service per-
sonnel; 
‘‘(2) recruit volunteer emergency medical serv-
ice personnel; 
‘‘(3) train emergency medical service personnel 
in emergency response, injury prevention, safety 
awareness, and other topics relevant to the delivery 
of emergency medical services; 
‘‘(4) fund specific training to meet Federal or 
State certification requirements; 
‘‘(5) develop new ways to educate emergency 
health care providers through the use of technology-
enhanced educational methods (such as distance 
learning); 
‘‘(6) acquire emergency medical services equip-
ment, including cardiac defibrillators; 
‘‘(7) acquire personal protective equipment for 
emergency medical services personnel as required by 
the Occupational Safety and Health Administration; 
and 
‘‘(8) 
educate 
the 
public 
concerning 
cardiopulmonary resuscitation, first aid, injury pre-
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vention, safety awareness, illness prevention, and 
other related emergency preparedness topics. 
‘‘(d) PREFERENCE.—In awarding grants under this 
section the Secretary shall give preference to—
‘‘(1) applications that reflect a collaborative ef-
fort by 2 or more of the entities described in sub-
paragraphs (A) through (F) of subsection (b)(1); 
and 
‘‘(2) applications submitted by entities that in-
tend to use amounts provided under the grant to 
fund activities described in any of paragraphs (1) 
through (5) of subsection (c). 
‘‘(e) MATCHING REQUIREMENT.—The Secretary may 
not award a grant under this section to an entity unless 
the entity agrees that the entity will make available (di-
rectly or through contributions from other public or pri-
vate entities) non-Federal contributions toward the activi-
ties to be carried out under the grant in an amount equal 
to 25 percent of the amount received under the grant. 
‘‘(f) EMERGENCY MEDICAL SERVICES.—In this sec-
tion, the term ‘emergency medical services’—
‘‘(1) means resources used by a qualified public 
or private nonprofit entity, or by any other entity 
recognized as qualified by the State involved, to de-
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liver medical care outside of a medical facility under 
emergency conditions that occur—
‘‘(A) as a result of the condition of the pa-
tient; or 
‘‘(B) as a result of a natural disaster or 
similar situation; and 
‘‘(2) includes services delivered by an emer-
gency medical services provider (either compensated 
or volunteer) or other provider recognized by the 
State involved that is licensed or certified by the 
State as an emergency medical technician or its 
equivalent (as determined by the State), a registered 
nurse, a physician assistant, or a physician that pro-
vides services similar to services provided by such an 
emergency medical services provider. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—There are authorized to be 
appropriated to carry out this section such sums as 
may be necessary for each of fiscal years 2002 
through 2006. 
‘‘(2) ADMINISTRATIVE COSTS.—The Secretary 
may use not more than 10 percent of the amount 
appropriated under paragraph (1) for a fiscal year 
for the administrative expenses of carrying out this 
section.
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‘‘SEC. 330K. MENTAL HEALTH SERVICES DELIVERED VIA 
TELEHEALTH. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means a public or nonprofit private telehealth 
provider network that offers services that include 
mental health services provided by qualified mental 
health providers. 
‘‘(2) QUALIFIED
MENTAL
HEALTH
PROFES-
SIONALS.—The term ‘qualified mental health profes-
sionals’ refers to providers of mental health services 
reimbursed under the medicare program carried out 
under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.) who have additional training in 
the treatment of mental illness in children and ado-
lescents or who have additional training in the treat-
ment of mental illness in the elderly. 
‘‘(3) SPECIAL POPULATIONS.—The term ‘spe-
cial populations’ refers to the following 2 distinct 
groups: 
‘‘(A) Children and adolescents in mental 
health underserved rural areas or in mental 
health underserved urban areas. 
‘‘(B) Elderly individuals located in long-
term care facilities in mental health under-
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served rural areas or in mental health under-
served urban areas. 
‘‘(4) 
TELEHEALTH.—The 
term 
‘telehealth’ 
means the use of electronic information and tele-
communications technologies to support long dis-
tance clinical health care, patient and professional 
health-related education, public health, and health 
administration. 
‘‘(b) PROGRAM AUTHORIZED.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Office for the Advance-
ment of Telehealth of the Health Resources and 
Services Administration, shall award grants to eligi-
ble entities to establish demonstration projects for 
the provision of mental health services to special 
populations as delivered remotely by qualified mental 
health professionals using telehealth and for the pro-
vision of education regarding mental illness as deliv-
ered remotely by qualified mental health profes-
sionals and qualified mental health education profes-
sionals using telehealth. 
‘‘(2) POPULATIONS
SERVED.—The Secretary 
shall award the grants under paragraph (1) in a 
manner that distributes the grants so as to serve eq-
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uitably the populations described in subparagraphs 
(A) and (B) of subsection (a)(4). 
‘‘(c) USE OF FUNDS.—
‘‘(1) IN GENERAL.—An eligible entity that re-
ceives a grant under this section shall use the grant 
funds—
‘‘(A) for the populations described in sub-
section (a)(3)(A)—
‘‘(i) to provide mental health services, 
including diagnosis and treatment of men-
tal illness, in public elementary and public 
secondary schools as delivered remotely by 
qualified mental health professionals using 
telehealth; and 
‘‘(ii) to collaborate with local public 
health entities to provide the mental health 
services; and 
‘‘(B) for the populations described in sub-
section (a)(3)(B)—
‘‘(i) to provide mental health services, 
including diagnosis and treatment of men-
tal illness, in long-term care facilities as 
delivered remotely by qualified mental 
health professionals using telehealth; and
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‘‘(ii) to collaborate with local public 
health entities to provide the mental health 
services. 
‘‘(2) OTHER USES.—An eligible entity that re-
ceives a grant under this section may also use the 
grant funds to—
‘‘(A) pay telecommunications costs; and 
‘‘(B) pay qualified mental health profes-
sionals on a reasonable basis as determined by 
the Secretary for services rendered. 
‘‘(3) PROHIBITED
USES.—An eligible entity 
that receives a grant under this section shall not use 
the grant funds to—
‘‘(A) purchase or install transmission 
equipment (other than such equipment used by 
qualified mental health professionals to deliver 
mental health services using telehealth under 
the project involved); or 
‘‘(B) build upon or acquire real property. 
‘‘(d) 
EQUITABLE
DISTRIBUTION.—In 
awarding 
grants under this section, the Secretary shall ensure, to 
the greatest extent possible, that such grants are equitably 
distributed among geographical regions of the United 
States.
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‘‘(e) APPLICATION.—An entity that desires a grant 
under this section shall submit an application to the Sec-
retary at such time, in such manner, and containing such 
information as the Secretary determines to be reasonable. 
‘‘(f) REPORT.—Not later than 4 years after the date 
of enactment of the Health Care Safety Net Improvement 
Act, the Secretary shall prepare and submit to the appro-
priate committees of Congress a report that shall evaluate 
activities funded with grants under this section. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$20,000,000 for fiscal year 2002 and such sums as may 
be necessary for fiscal years 2003 through 2006.’’. 
TITLE III—NATIONAL HEALTH 
SERVICE CORPS PROGRAM 
SEC. 301. NATIONAL HEALTH SERVICE CORPS. 
(a) IN GENERAL.—Section 331 of the Public Health 
Service Act (42 U.S.C. 254d) is amended—
(1) by adding at the end of subsection (a)(3) 
the following: 
‘‘(E)(i) The term ‘behaviorial and mental health 
professionals’ means health service psychologists, li-
censed clinical social workers, licensed professional 
counselors, marriage and family therapists, psy-
chiatric nurse specialists, and psychiatrists.
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‘‘(ii) The term ‘graduate program of behavioral 
and mental health’ means a program that trains 
behavorial and mental health professionals.’’; 
(2) in subsection (b)—
(A) in paragraph (1), by striking ‘‘health 
professions’’ and inserting ‘‘health professions, 
including schools at which graduate programs 
of behavioral and mental health are offered,’’; 
and 
(B) in paragraph (2), by inserting ‘‘behav-
ioral and mental health professionals,’’ after 
‘‘dentists,’’; and 
(3) by striking subsection (c) and inserting the 
following: 
‘‘(c)(1) The Secretary may reimburse an applicant 
for a position in the Corps (including an individual consid-
ering entering into a written agreement pursuant to sec-
tion 338D) for the actual and reasonable expenses in-
curred in traveling to and from the applicant’s place of 
residence to an eligible site to which the applicant may 
be assigned under section 333 for the purpose of evalu-
ating such site with regard to being assigned at such site. 
The Secretary may establish a maximum total amount 
that may be paid to an individual as reimbursement for 
such expenses.
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‘‘(2) The Secretary may also reimburse the applicant 
for the actual and reasonable expenses incurred for the 
travel of 1 family member to accompany the applicant to 
such site. The Secretary may establish a maximum total 
amount that may be paid to an individual as reimburse-
ment for such expenses. 
‘‘(3) In the case of an individual who has entered into 
a contract for obligated service under the Scholarship Pro-
gram or under the Loan Repayment Program, the Sec-
retary may reimburse such individual for all or part of 
the actual and reasonable expenses incurred in trans-
porting the individual to the site of the individual’s assign-
ment under section 333. The Secretary may establish a 
maximum total amount that may be paid to an individual 
as reimbursement for such expenses.’’. 
(b) DEMONSTRATION PROJECTS.—Section 331 of the 
Public Health Service Act (42 U.S.C. 254d) is amended— 
(1) by redesignating subsection (i) as subsection 
(j); and 
(2) by inserting after subsection (h) the fol-
lowing: 
‘‘(i)(1) In carrying out subpart III, the Secretary 
may, in accordance with this subsection, carry out dem-
onstration projects in which individuals who have entered 
into a contract for obligated service under the Loan Re-
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payment Program receive waivers under which the individ-
uals are authorized to satisfy the requirement of obligated 
service through providing clinical service that is not full-
time. 
‘‘(2) A waiver described in paragraph (1) may be pro-
vided by the Secretary only if—
‘‘(A) the entity for which the service is to be 
performed—
‘‘(i) has been approved under section 333A 
for assignment of a Corps member; and 
‘‘(ii) has requested in writing assignment 
of a health professional who would serve less 
than full time; 
‘‘(B) the Secretary has determined that assign-
ment of a health professional who would serve less 
than full time would be appropriate for the area 
where the entity is located; 
‘‘(C) a Corps member who is required to per-
form obligated service has agreed in writing to be 
assigned for less than full-time service to an entity 
described in subparagraph (A); 
‘‘(D) the entity and the Corps member agree in 
writing that the less than full-time service provided 
by the Corps member will not be less than 16 hours 
of clinical service per week;
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‘‘(E) the Corps member agrees in writing that 
the period of obligated service pursuant to section 
338B will be extended so that the aggregate amount 
of less than full-time service performed will equal the 
amount of service that would be performed through 
full-time service under section 338C; and 
‘‘(F) the Corps member agrees in writing that 
if the Corps member begins providing less than full-
time service but fails to begin or complete the period 
of obligated service, the method stated in 338E(c) 
for determining the damages for breach of the indi-
vidual’s written contract will be used after con-
verting periods of obligated service or of service per-
formed into their full-time equivalents.’’. 
SEC. 
302. 
DESIGNATION 
OF 
HEALTH 
PROFESSIONAL 
SHORTAGE AREAS. 
(a) IN GENERAL.—Section 332 of the Public Health 
Service Act (42 U.S.C. 254e) is amended—
(1) in subsection (a)—
(A) in paragraph (1), by inserting after 
the first sentence the following: ‘‘All Federally 
qualified health centers and rural health clinics, 
as defined in section 1861(aa) of the Social Se-
curity Act (42 U.S.C. 1395x(aa)), that meet the 
requirements of section 334 shall be automati-
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cally designated as having such a shortage. Not 
earlier than 6 years after such date of enact-
ment, and every 6 years thereafter, each such 
center or clinic shall demonstrate that the cen-
ter or clinic meets the applicable requirements 
of the Federal regulations, issued after the date 
of enactment of this Act, that revise the defini-
tion of a health professional shortage area for 
purposes of this section.’’; and 
(B) in paragraph (3), by striking ‘‘340(r)) 
may be a population group’’ and inserting 
‘‘330(h)(4)), seasonal agricultural workers (as 
defined in section 330(g)(3)) and migratory ag-
ricultural workers (as so defined)), and resi-
dents of public housing (as defined in section 
3(b)(1) of the United States Housing Act of 
1937 (42 U.S.C. 1437a(b)(1))) may be popu-
lation groups’’; 
(2) in subsection (b)(2), by striking ‘‘with spe-
cial consideration to the indicators of’’ and all that 
follows through ‘‘services.’’ and inserting a period; 
and 
(3) in subsection (c)(2)(B), by striking ‘‘XVIII 
or XIX’’ and inserting ‘‘XVIII, XIX, or XXI’’. 
(b) REGULATIONS.—
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(1) REPORT.—
(A) IN
GENERAL.—The Secretary shall 
submit the report described in subparagraph 
(B) if the Secretary, acting through the Admin-
istrator of the Health Resources and Services 
Administration, issues—
(i) a regulation that revises the defini-
tion of a health professional shortage area 
for purposes of section 332 of the Public 
Health Service Act (42 U.S.C. 254e); or 
(ii) a regulation that revises the 
standards concerning priority of such an 
area under section 333A of that Act (42 
U.S.C. 254f–1). 
(B) REPORT.—On issuing a regulation de-
scribed in subparagraph (A), the Secretary shall 
prepare and submit to the Committee on En-
ergy and Commerce of the House of Represent-
atives and the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate a re-
port that describes the regulation. 
(2) EFFECTIVE
DATE.—Each regulation de-
scribed in paragraph (1)(A) shall take effect 180 
days after the committees described in paragraph
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(1)(B) receive a report referred to in paragraph 
(1)(B) describing the regulation. 
(c) SCHOLARSHIP
AND LOAN REPAYMENT PRO-
GRAMS.—The Secretary of Health and Human Services, 
in consultation with organizations representing individuals 
in the dental field and organizations representing publicly 
funded health care providers, shall develop and implement 
a plan for increasing the participation of dentists and den-
tal hygienists in the National Health Service Corps Schol-
arship Program under section 338A of the Public Health 
Service Act (42 U.S.C. 254l) and the Loan Repayment 
Program under section 338B of such Act (42 U.S.C. 
254l–1). 
(d) SITE DESIGNATION PROCESS.—
(1) IMPROVEMENT
OF
DESIGNATION
PROC-
ESS.—The Administrator of the Health Resources 
and Services Administration, in consultation with 
appropriate State and territorial dental directors, 
dental societies, and other interested parties, shall 
revise the criteria on which the designations of den-
tal health professional shortage areas are based so 
that such criteria provide a more accurate reflection 
of oral health care need, particularly in rural areas. 
(2) PUBLIC
HEALTH
SERVICE
ACT.—Section 
332 of the Public Health Service Act (42 U.S.C.
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254e) is amended by adding at the end the fol-
lowing: 
‘‘(i) DISSEMINATION.—The Administrator of the 
Health Resources and Services Administration shall dis-
seminate information concerning the designation criteria 
described in subsection (b) to— 
‘‘(1) the Governor of each State; 
‘‘(2) the representative of any area, population 
group, or facility selected by any such Governor to 
receive such information; 
‘‘(3) the representative of any area, population 
group, or facility that requests such information; 
and 
‘‘(4) the representative of any area, population 
group, or facility determined by the Administrator to 
be likely to meet the criteria described in subsection 
(b).’’. 
(e) GAO STUDY.—Not later than February 1, 2005, 
the Comptroller General of the United States shall submit 
to the Congress a report on the appropriateness of the 
criteria, including but not limited to infant mortality rates, 
access to health services taking into account the distance 
to primary health services, the rate of poverty and ability 
to pay for health services, and low birth rates, established 
by the Secretary of Health and Human Services for the
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designation of health professional shortage areas and 
whether the deeming of Federally qualified health centers 
and rural health clinics as such areas is appropriate and 
necessary. 
SEC. 303. ASSIGNMENT OF CORPS PERSONNEL. 
Section 333 of the Public Health Service Act (42 
U.S.C. 254f) is amended—
(1) in subsection (a)—
(A) in paragraph (1)—
(i) in the matter before subparagraph 
(A), by striking ‘‘(specified in the agree-
ment described in section 334)’’; 
(ii) in subparagraph (A), by striking 
‘‘nonprofit’’; and 
(iii) by striking subparagraph (C) and 
inserting the following: 
‘‘(C) the entity agrees to comply with the 
requirements of section 334; and’’; and 
(B) in paragraph (3), by adding at the end 
‘‘In approving such applications, the Secretary 
shall give preference to applications in which a 
nonprofit entity or public entity shall provide a 
site to which Corps members may be as-
signed.’’; and 
(2) in subsection (d)—
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(A) in paragraphs (1), (2), and (4), by 
striking ‘‘nonprofit’’ each place it appears; and 
(B) in paragraph (1)—
(i) in the second sentence—
(I) in subparagraph (C), by strik-
ing ‘‘and’’ at the end; and 
(II) by striking the period and 
inserting ‘‘, and (E) developing long-
term plans for addressing health pro-
fessional shortages and improving ac-
cess to health care.’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall encourage en-
tities that receive technical assistance 
under this paragraph to communicate with 
other communities, State Offices of Rural 
Health, State Primary Care Associations 
and Offices, and other entities concerned 
with site development and community 
needs assessment.’’. 
SEC. 304. PRIORITIES IN ASSIGNMENT OF CORPS PER-
SONNEL. 
Section 333A of the Public Health Service Act (42 
U.S.C. 254f–1) is amended—
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(1) in subsection (a)(1)(A), by striking ‘‘, as de-
termined in accordance with subsection (b)’’; 
(2) by striking subsection (b); 
(3) in subsection (c), by striking the second 
sentence; 
(4) in subsection (d)—
(A) 
by 
redesignating 
paragraphs 
(1) 
through (3) as paragraphs (2) through (4), re-
spectively; 
(B) by inserting before paragraph (2) (as 
redesignated by subparagraph (A)) the fol-
lowing: 
‘‘(1) PROPOSED LIST.—The Secretary shall pre-
pare and publish a proposed list of health profes-
sional shortage areas and entities that would receive 
priority under subsection (a)(1) in the assignment of 
Corps members. The list shall contain the informa-
tion described in paragraph (2), and the relative 
scores and relative priorities of the entities submit-
ting applications under section 333, in a proposed 
format. All such entities shall have 30 days after the 
date of publication of the list to provide additional 
data and information in support of inclusion on the 
list or in support of a higher priority determination 
and the Secretary shall reasonably consider such
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data and information in preparing the final list 
under paragraph (2).’’; 
(C) in paragraph (2) (as redesignated by 
subparagraph (A)), in the matter before sub-
paragraph (A)—
(i) by striking ‘‘paragraph (2)’’ and 
inserting ‘‘paragraph (3)’’; 
(ii) by striking ‘‘prepare a list of 
health professional shortage areas’’ and in-
serting ‘‘prepare and, as appropriate, up-
date a list of health professional shortage 
areas and entities’’; and 
(iii) by striking ‘‘for the period appli-
cable under subsection (f)’’; 
(D) by striking paragraph (3) (as redesig-
nated by subparagraph (A)) and inserting the 
following: 
‘‘(3) NOTIFICATION OF AFFECTED PARTIES.—
‘‘(A) ENTITIES.—Not later than 30 days 
after the Secretary has added to a list under 
paragraph (2) an entity specified as described 
in subparagraph (A) of such paragraph, the 
Secretary shall notify such entity that the entity 
has been provided an authorization to receive 
assignments of Corps members in the event
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that Corps members are available for the as-
signments. 
‘‘(B) INDIVIDUALS.—In the case of an in-
dividual obligated to provide service under the 
Scholarship Program, not later than 3 months 
before the date described in section 338C(b)(5), 
the Secretary shall provide to such individual 
the names of each of the entities specified as 
described in paragraph (2)(B)(i) that is appro-
priate for the individual’s medical specialty and 
discipline.’’; and 
(E) by striking paragraph (4) (as redesig-
nated by subparagraph (A)) and inserting the 
following: 
‘‘(4) REVISIONS.—If the Secretary proposes to 
make a revision in the list under paragraph (2), and 
the revision would adversely alter the status of an 
entity with respect to the list, the Secretary shall no-
tify the entity of the revision. Any entity adversely 
affected by such a revision shall be notified in writ-
ing by the Secretary of the reasons for the revision 
and shall have 30 days to file a written appeal of the 
determination involved which shall be reasonably 
considered by the Secretary before the revision to 
the list becomes final. The revision to the list shall
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be effective with respect to assignment of Corps 
members beginning on the date that the revision be-
comes final.’’; 
(5) by striking subsection (e) and inserting the 
following: 
‘‘(e) LIMITATION
ON NUMBER
OF ENTITIES OF-
FERED AS ASSIGNMENT CHOICES IN SCHOLARSHIP PRO-
GRAM.—
‘‘(1) DETERMINATION
OF
AVAILABLE
CORPS 
MEMBERS.—By April 1 of each calendar year, the 
Secretary shall determine the number of participants 
in the Scholarship Program who will be available for 
assignments under section 333 during the program 
year beginning on July 1 of that calendar year. 
‘‘(2) DETERMINATION
OF
NUMBER
OF
ENTI-
TIES.—At all times during a program year, the 
number of entities specified under subsection 
(c)(2)(B)(i) shall be—
‘‘(A) not less than the number of partici-
pants determined with respect to that program 
year under paragraph (1); and 
‘‘(B) not greater than twice the number of 
participants determined with respect to that 
program year under paragraph (1).’’; 
(6) by striking subsection (f); and
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(7) by redesignating subsections (c), (d), and 
(e) as subsections (b), (c), and (d) respectively. 
SEC. 305. COST-SHARING. 
Subpart II of part D of title III of the Public Health 
Service Act (42 U.S.C. 254d et seq.) is amended by strik-
ing section 334 and inserting the following: 
‘‘SEC. 334. CHARGES FOR SERVICES BY ENTITIES USING 
CORPS MEMBERS. 
‘‘(a) AVAILABILITY OF SERVICES REGARDLESS OF 
ABILITY TO PAY OR PAYMENT SOURCE.—An entity to 
which a Corps member is assigned shall not deny re-
quested health care services, and shall not discriminate in 
the provision of services to an individual—
‘‘(1) because the individual is unable to pay for 
the services; or 
‘‘(2) because payment for the services would be 
made under—
‘‘(A) the medicare program under title 
XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.); 
‘‘(B) the medicaid program under title 
XIX of such Act (42 U.S.C. 1396 et seq.); or 
‘‘(C) the State children’s health insurance 
program under title XXI of such Act (42 
U.S.C. 1397aa et seq.).
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‘‘(b) CHARGES FOR SERVICES.—The following rules 
shall apply to charges for health care services provided by 
an entity to which a Corps member is assigned: 
‘‘(1) IN GENERAL.—
‘‘(A) 
SCHEDULE
OF
FEES
OR
PAY-
MENTS.—Except as provided in paragraph (2), 
the entity shall prepare a schedule of fees or 
payments for the entity’s services, consistent 
with locally prevailing rates or charges and de-
signed to cover the entity’s reasonable cost of 
operation. 
‘‘(B) SCHEDULE OF DISCOUNTS.—Except 
as provided in paragraph (2), the entity shall 
prepare a corresponding schedule of discounts 
(including, in appropriate cases, waivers) to be 
applied to such fees or payments. In preparing 
the schedule, the entity shall adjust the dis-
counts on the basis of a patient’s ability to pay. 
‘‘(C) USE
OF
SCHEDULES.—The entity 
shall make every reasonable effort to secure 
from patients fees and payments for services in 
accordance with such schedules, and fees or 
payments shall be sufficiently discounted in ac-
cordance with the schedule described in sub-
paragraph (B).
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‘‘(2) SERVICES TO BENEFICIARIES OF FEDERAL 
AND FEDERALLY ASSISTED PROGRAMS.—In the case 
of health care services furnished to an individual 
who is a beneficiary of a program listed in sub-
section (a)(2), the entity—
‘‘(A) shall accept an assignment pursuant 
to section 1842(b)(3)(B)(ii) of the Social Secu-
rity Act (42 U.S.C. 1395u(b)(3)(B)(ii)) with re-
spect to an individual who is a beneficiary 
under the medicare program; and 
‘‘(B) shall enter into an appropriate agree-
ment with—
‘‘(i) the State agency administering 
the program under title XIX of such Act 
with respect to an individual who is a ben-
eficiary under the medicaid program; and 
‘‘(ii) the State agency administering 
the program under title XXI of such Act 
with respect to an individual who is a ben-
eficiary under the State children’s health 
insurance program. 
‘‘(3) COLLECTION OF PAYMENTS.—The entity 
shall take reasonable and appropriate steps to collect 
all payments due for health care services provided by 
the entity, including payments from any third party
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(including a Federal, State, or local government 
agency and any other third party) that is responsible 
for part or all of the charge for such services.’’. 
SEC. 306. ELIGIBILITY FOR FEDERAL FUNDS. 
Section 335(e)(1)(B) of the Public Health Service 
Act (42 U.S.C. 254h(e)(1)(B)) is amended by striking 
‘‘XVIII or XIX’’ and inserting ‘‘XVIII, XIX, or XXI’’. 
SEC. 307. FACILITATION OF EFFECTIVE PROVISION OF 
CORPS SERVICES. 
(a) HEALTH PROFESSIONAL SHORTAGE AREAS.—
Section 336 of the Public Health Service Act (42 U.S.C. 
254h–1) is amended—
(1) in subsection (c), by striking ‘‘health man-
power’’ and inserting ‘‘health professional’’; and 
(2) in subsection (f)(1), by striking ‘‘health 
manpower’’ and inserting ‘‘health professional’’. 
(b) TECHNICAL AMENDMENT.—Section 336A(8) of 
the Public Health Service Act (42 U.S.C. 254i(8)) is 
amended by striking ‘‘agreements under’’. 
SEC. 308. AUTHORIZATION OF APPROPRIATIONS. 
Section 338(a) of the Public Health Service Act (42 
U.S.C. 254k(a)) is amended—
(1) by striking ‘‘(1) For’’ and inserting ‘‘For’’; 
(2) by striking ‘‘1991 through 2000’’ and in-
serting ‘‘2002 through 2006’’; and
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(3) by striking paragraph (2). 
SEC. 309. NATIONAL HEALTH SERVICE CORPS SCHOLAR-
SHIP PROGRAM. 
Section 338A of the Public Health Service Act (42 
U.S.C. 254l) is amended—
(1) in subsection (a)(1), by inserting ‘‘behav-
ioral and mental health professionals,’’ after ‘‘den-
tists,’’; 
(2) in subsection (b)(1)(B), by inserting ‘‘, or 
an appropriate degree from a graduate program of 
behavioral and mental health’’ after ‘‘other health 
profession’’; 
(3) in subsection (c)(1)—
(A) in subparagraph (A), by striking 
‘‘338D’’ and inserting ‘‘338E’’; and 
(B) in subparagraph (B), by striking 
‘‘338C’’ and inserting ‘‘338D’’; 
(4) in subsection (d)(1)—
(A) in subparagraph (A), by striking 
‘‘and’’ at the end; 
(B) by redesignating subparagraph (B) as 
subparagraph (C); and 
(C) by inserting after subparagraph (A) 
the following:
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‘‘(B) the Secretary, in considering applica-
tions from individuals accepted for enrollment 
or enrolled in dental school, shall consider ap-
plications from all individuals accepted for en-
rollment or enrolled in any accredited dental 
school in a State; and’’; 
(5) in subsection (f)—
(A) in paragraph (1)(B)—
(i) in clause (iii), by striking ‘‘and’’ 
after the semicolon; 
(ii) by redesignating clause (iv) as 
clause (v); and 
(iii) by inserting after clause (iii) the 
following new clause: 
‘‘(iv) if pursuing a degree from a 
school of medicine or osteopathic medicine, 
to complete a residency in a specialty that 
the Secretary determines is consistent with 
the needs of the Corps; and’’; and 
(B) in paragraph (3), by striking ‘‘338D’’ 
and inserting ‘‘338E’’; and 
(6) by striking subsection (i).
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SEC. 310. NATIONAL HEALTH SERVICE CORPS LOAN REPAY-
MENT PROGRAM. 
Section 338B of the Public Health Service Act (42 
U.S.C. 254l–1) is amended— 
(1) in subsection (a)—
(A) in paragraph (1), by inserting ‘‘behav-
ioral and mental health professionals,’’ after 
‘‘dentists,’’; and 
(B) in paragraph (2), by striking ‘‘(includ-
ing mental health professionals)’’; 
(2) in subsection (b)(1), by striking subpara-
graph (A) and inserting the following: 
‘‘(A) have a degree in medicine, osteopathic 
medicine, dentistry, or another health profession, or 
an appropriate degree from a graduate program of 
behavioral and mental health, or be certified as a 
nurse midwife, nurse practitioner, or physician as-
sistant;’’; 
(3) in subsection (e), by striking ‘‘(1) IN GEN-
ERAL.—’’; and 
(4) by striking subsection (i). 
SEC. 311. OBLIGATED SERVICE. 
Section 338C of the Public Health Service Act (42 
U.S.C. 254m) is amended—
(1) in subsection (b)—
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(A) in paragraph (1), in the matter pre-
ceding subparagraph (A), by striking ‘‘section 
338A(f)(1)(B)(iv)’’ 
and 
inserting 
‘‘section 
338A(f)(1)(B)(v)’’; and 
(B) in paragraph (5)—
(i) by striking all that precedes sub-
paragraph (C) and inserting the following: 
‘‘(5)(A) In the case of the Scholarship Program, the 
date referred to in paragraphs (1) through (4) shall be 
the date on which the individual completes the training 
required for the degree for which the individual receives 
the scholarship, except that—
‘‘(i) for an individual receiving such a degree 
after September 30, 2000, from a school of medicine 
or osteopathic medicine, such date shall be the date 
the individual completes a residency in a specialty 
that the Secretary determines is consistent with the 
needs of the Corps; and 
‘‘(ii) at the request of an individual, the Sec-
retary may, consistent with the needs of the Corps, 
defer such date until the end of a period of time re-
quired for the individual to complete advanced train-
ing (including an internship or residency).’’; 
(ii) by striking subparagraph (D);
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(iii) by redesignating subparagraphs 
(C) and (E) as subparagraphs (B) and 
(C), respectively; and 
(iv) in clause (i) of subparagraph (C) 
(as redesignated by clause (iii)) by striking 
‘‘subparagraph (A), (B), or (D)’’ and in-
serting ‘‘subparagraph (A)’’; and 
(2) by striking subsection (e). 
SEC. 312. PRIVATE PRACTICE. 
Section 338D of the Public Health Service Act (42 
U.S.C. 254n) is amended by striking subsection (b) and 
inserting the following: 
‘‘(b)(1) The written agreement described in sub-
section (a) shall—
‘‘(A) provide that, during the period of private 
practice by an individual pursuant to the agreement, 
the individual shall comply with the requirements of 
section 334 that apply to entities; and 
‘‘(B) contain such additional provisions as the 
Secretary may require to carry out the objectives of 
this section. 
‘‘(2) The Secretary shall take such action as may be 
appropriate to ensure that the conditions of the written 
agreement prescribed by this subsection are adhered to.’’.
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SEC. 313. BREACH OF SCHOLARSHIP CONTRACT OR LOAN 
REPAYMENT CONTRACT. 
(a) IN GENERAL.—Section 338E of the Public 
Health Service Act (42 U.S.C. 254o) is amended—
(1) in subsection (a)(1)—
(A) in subparagraph (A), by striking the 
comma and inserting a semicolon; 
(B) in subparagraph (B), by striking the 
comma and inserting ‘‘; or’’; 
(C) in subparagraph (C), by striking ‘‘or’’ 
at the end; and 
(D) by striking subparagraph (D); 
(2) in subsection (b)—
(A) in paragraph (1)(A)—
(i) by striking ‘‘338F(d)’’ and insert-
ing ‘‘338G(d)’’; 
(ii) by striking ‘‘either’’; 
(iii) by striking ‘‘338D or’’ and insert-
ing ‘‘338D,’’; and 
(iv) by inserting ‘‘or to complete a re-
quired residency as specified in section 
338A(f)(1)(B)(iv),’’ before ‘‘the United 
States’’; and 
(B) by adding at the end the following new 
paragraph:
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‘‘(3) The Secretary may terminate a contract with an 
individual under section 338A if, not later than 30 days 
before the end of the school year to which the contract 
pertains, the individual—
‘‘(A) submits a written request for such termi-
nation; and 
‘‘(B) repays all amounts paid to, or on behalf 
of, the individual under section 338A(g).’’; 
(3) in subsection (c)—
(A) in paragraph (1)—
(i) in the matter preceding subpara-
graph (A), by striking ‘‘338F(d)’’ and in-
serting ‘‘338G(d)’’; and 
(ii) by striking subparagraphs (A) 
through (C) and inserting the following: 
‘‘(A) the total of the amounts paid by the 
United States under section 338B(g) on behalf of 
the individual for any period of obligated service not 
served; 
‘‘(B) an amount equal to the product of the 
number of months of obligated service that were not 
completed by the individual, multiplied by $7,500; 
and 
‘‘(C) the interest on the amounts described in 
subparagraphs (A) and (B), at the maximum legal
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prevailing rate, as determined by the Treasurer of 
the United States, from the date of the breach; 
except that the amount the United States is entitled to 
recover under this paragraph shall not be less than 
$31,000.’’; 
(B) by striking paragraphs (2) and (3) and 
inserting the following: 
‘‘(2) The Secretary may terminate a contract with an 
individual under section 338B if, not later than 45 days 
before the end of the fiscal year in which the contract was 
entered into, the individual—
‘‘(A) submits a written request for such termi-
nation; and 
‘‘(B) repays all amounts paid on behalf of the 
individual under section 338B(g).’’; and 
(C) by redesignating paragraph (4) as 
paragraph (3); 
(4) in subsection (d)(3)(A), by striking ‘‘only if 
such discharge is granted after the expiration of the 
five-year period’’ and inserting ‘‘only if such dis-
charge is granted after the expiration of the 7-year 
period’’; and 
(5) by adding at the end the following new sub-
section:
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‘‘(e) Notwithstanding any other provision of Federal 
or State law, there shall be no limitation on the period 
within which suit may be filed, a judgment may be en-
forced, or an action relating to an offset or garnishment, 
or other action, may be initiated or taken by the Secretary, 
the Attorney General, or the head of another Federal 
agency, as the case may be, for the repayment of the 
amount due from an individual under this section.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a)(4) shall apply to any obligation for which 
a discharge in bankruptcy has not been granted before the 
date that is 31 days after the date of enactment of this 
Act. 
SEC. 314. AUTHORIZATION OF APPROPRIATIONS. 
Section 338H of the Public Health Service Act (42 
U.S.C. 254q) is amended to read as follows: 
‘‘SEC. 338H. AUTHORIZATION OF APPROPRIATIONS. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purposes of carrying out this subpart, there are authorized 
to be appropriated $146,250,000 for fiscal year 2002, and 
such sums as may be necessary for each of fiscal years 
2003 through 2006. 
‘‘(b) SCHOLARSHIPS
AND LOAN REPAYMENTS.—
With respect to certification as a nurse practitioner, nurse 
midwife, or physician assistant, the Secretary shall, from
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amounts appropriated under subsection (a) for a fiscal 
year, obligate not less than a total of 10 percent for con-
tracts for both scholarships under the Scholarship Pro-
gram under section 338A and loan repayments under the 
Loan Repayment Program under section 338B to individ-
uals who are entering the first year of a course of study 
or program described in section 338A(b)(1)(B) that leads 
to such a certification or individuals who are eligible for 
the loan repayment program as specified in section 
338B(b) for a loan related to such certification.’’. 
SEC. 315. GRANTS TO STATES FOR LOAN REPAYMENT PRO-
GRAMS. 
Section 338I of the Public Health Service Act (42 
U.S.C. 254q–1) is amended—
(1) in subsection (a), by striking paragraph (1) 
and inserting the following: 
‘‘(1) AUTHORITY FOR GRANTS.—The Secretary, 
acting through the Administrator of the Health Re-
sources and Services Administration, may make 
grants to States for the purpose of assisting the 
States in operating programs described in paragraph 
(2) in order to provide for the increased availability 
of primary health care services in health professional 
shortage areas. The National Advisory Council es-
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tablished under section 337 shall advise the Admin-
istrator regarding the program under this section.’’; 
(2) in subsection (e), by striking paragraph (1) 
and inserting the following: 
‘‘(1) to submit to the Secretary such reports re-
garding the States loan repayment program, as are 
determined to be appropriate by the Secretary; and’’; 
and 
(3) in subsection (i), by striking paragraph (1) 
and inserting the following: 
‘‘(1) IN GENERAL.—For the purpose of making 
grants under subsection (a), there are authorized to 
be appropriated $12,000,000 for fiscal year 2002 
and such sums as may be necessary for each of fis-
cal years 2003 through 2006.’’. 
SEC. 316. DEMONSTRATION GRANTS TO STATES FOR COM-
MUNITY SCHOLARSHIP PROGRAMS. 
Section 338L of the Public Health Service Act (42 
U.S.C. 254t) is repealed.
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TITLE IV—ADDITIONAL 
PROVISIONS 
SEC. 401. COMMUNITY ACCESS DEMONSTRATION PRO-
GRAM. 
Part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by inserting after 
subpart IV the following new subpart: 
‘‘Subpart V—Community Access Demonstration Program 
‘‘SEC. 340. GRANTS TO STRENGTHEN EFFECTIVENESS, EFFI-
CIENCY, AND COORDINATION OF SERVICES 
FOR THE UNINSURED AND UNDERINSURED. 
‘‘(a) IN GENERAL.—
‘‘(1) GRANTS.—The Secretary may make not 
more than 35 grants for the purpose of carrying out 
demonstration projects to improve the effectiveness, 
efficiency, and coordination of services for uninsured 
and underinsured individuals. 
‘‘(2) 
PROJECT
PERIOD.—A 
demonstration 
project under this section may not receive funding 
under this section for more than three fiscal years. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity must—
‘‘(1) be an entity that is a public or private en-
tity such as—
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‘‘(A) a Federally qualified health center 
(as defined under section 1861(aa)(4) of the 
Social Security Act); 
‘‘(B) a hospital that meets the require-
ments of section 340B(a)(4)(L) (or, if none are 
available in the area, a hospital that is a pro-
vider of a substantial volume of non-emergency 
health services to uninsured individuals and 
families without regard to their ability to pay) 
without regard to 340B (a)(4)(L)(iii); or 
‘‘(C) a public health department; or 
‘‘(2) represent a consortium of providers and, 
as appropriate, related agencies or entities—
‘‘(A) whose principal purpose is to provide 
a broad range of coordinated health care serv-
ices in a geographic area defined in the entity’s 
grant application; 
‘‘(B) that includes health care providers 
that serve such geographic area and that have 
traditionally provided care (beyond emergency 
services) to uninsured and underinsured individ-
uals without regard to the individuals’ ability to 
pay; and
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‘‘(C) that may include other health care 
providers and related agencies and organiza-
tions; 
except that preference may be given to applicants that are 
health care providers identified in paragraph (1). 
‘‘(c) APPLICATIONS.—To be eligible to receive a grant 
under this section, an eligible entity shall submit to the 
Secretary an application, in such form and manner as the 
Secretary shall prescribe, that shall—
‘‘(1) define a geographic area of uninsured and 
underinsured individuals; 
‘‘(2) identify the providers who will participate 
in the consortium’s program under the grant, and 
specify each one’s contribution to the care of unin-
sured and underinsured individuals in such geo-
graphic area, including the volume of care it pro-
vides to medicare and medicaid beneficiaries, to indi-
viduals served by the program under title XXI of the 
Social Security Act (relating to SCHIP), and to pri-
vately paid patients; 
‘‘(3) describe the activities that the applicant 
and the consortium propose to perform under the 
grant to further the purposes of this section; 
‘‘(4) demonstrate the consortium’s ability to 
build on the current system for serving uninsured
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and underinsured individuals by involving providers 
who have traditionally provided a significant volume 
of care for that community; 
‘‘(5) demonstrate the consortium’s ability to de-
velop coordinated systems of care that either directly 
provide or ensure the prompt provision of a broad 
range of high-quality, accessible services, including, 
as appropriate, primary, secondary, and tertiary 
services, as well as substance abuse treatment and 
mental health services in a manner which assures 
continuity of care in the community; 
‘‘(6) provide evidence of community involvement 
in the development, implementation, and direction of 
the program that it proposes to operate; 
‘‘(7) demonstrate the consortium’s ability to en-
sure that individuals participating in the program 
are enrolled in public insurance programs for which 
they are eligible (or know of private insurance op-
tions available to them, if any); 
‘‘(8) present a plan for leveraging other sources 
of revenue, which may include State and local 
sources and private grant funds, and integrating 
current and proposed new funding sources in a way 
to assure long-term sustainability;
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‘‘(9) describe a plan for evaluation of the activi-
ties carried out under the grant, including measure-
ment of progress toward the goals and objectives of 
the program; 
‘‘(10) demonstrate fiscal responsibility through 
the use of appropriate accounting procedures and 
appropriate management systems; 
‘‘(11) include such other information as the 
Secretary may prescribe; and 
‘‘(12) demonstrate the commitment to serve in-
dividuals in the geographic area without regard to 
the ability of the individual or family to pay by ar-
ranging for or providing free or reduced charge care 
for the poor. 
‘‘(d) PRIORITIES.—In awarding grants under this 
section, the Secretary may accord priority to applicants—
‘‘(1) whose consortium includes public hospitals, 
Federally qualified health centers (as defined in sec-
tion 1905(l)(2)(B) of the Social Security Act), and 
other providers that are covered entities as defined 
by section 340B(a)(4) of this Act (or that would be 
covered entities as so defined but for subparagraph 
(L)(iii) of such section);
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‘‘(2) that identify a geographic area has a high 
or increasing percentage of individuals who are unin-
sured; 
‘‘(3) whose consortium includes other health 
care providers that have a tradition of serving unin-
sured individuals and underinsured individuals in 
the community; 
‘‘(4) who show evidence that the program would 
expand utilization of preventive and primary care 
services for uninsured and underinsured individuals 
and families in the community, including mental 
health services or substance abuse services; 
‘‘(5) whose proposed program would improve 
coordination between health care providers and ap-
propriate social service providers, including local and 
regional human services agencies, school systems, 
and agencies on aging; 
‘‘(6) that demonstrate collaboration with State 
and local governments; 
‘‘(7) that make use of non-Federal contribu-
tions to the greatest extent possible; or 
‘‘(8) that demonstrate a significant likelihood 
that the proposed program will continue after sup-
port under this section ceases. 
‘‘(e) USE OF FUNDS.—
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‘‘(1) USE BY GRANTEES.—
‘‘(A) IN GENERAL.—Except as provided in 
paragraphs (2) and (3), a grantee may use 
amounts provided under this section only for—
‘‘(i) direct expenses associated with 
operating the greater integration of a 
health care delivery system so that it either 
directly provides or ensures the provision 
of a broad range of services, as appro-
priate, including primary, secondary, and 
tertiary services, as well as substance 
abuse treatment and mental health serv-
ices; and 
‘‘(ii) direct patient care and service 
expansions to fill identified or documented 
gaps within an integrated delivery system. 
‘‘(B) SPECIFIC USES.—The following are 
examples of purposes for which a grantee may 
use grant funds, when such use meets the con-
ditions stated in subparagraph (A): 
‘‘(i) Increase in outreach activities. 
‘‘(ii) Improvements to case manage-
ment. 
‘‘(iii) Development of provider net-
works.
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‘‘(iv) Recruitment, training, and com-
pensation of necessary personnel. 
‘‘(v) Acquisition of technology for the 
purpose of coordinating health care. 
‘‘(vi) Identifying and closing gaps in 
health care services being provided. 
‘‘(vii) Improvements to provider com-
munication, including implementation of 
shared information systems or shared clin-
ical systems. 
‘‘(viii) Other activities that may be 
appropriate to a community that would in-
crease access to the uninsured. 
‘‘(2) RESERVATION OF FUNDS FOR NATIONAL 
PROGRAM PURPOSES.—The Secretary may use not 
more than 3 percent of funds appropriated to carry 
out this section for technical assistance to grantees, 
obtaining assistance of experts and consultants, 
meetings, dissemination of information, evaluation, 
and activities that will extend the benefits of funded 
programs to communities other than the one funded. 
‘‘(f) MAINTENANCE OF EFFORT.—With respect to 
activities for which a grant under this section is author-
ized, the Secretary may award such a grant only if the 
recipient of the grant and each of the participating pro-
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viders agree that each one will maintain its expenditures 
of non-Federal funds for such activities at a level that is 
not less than the level of such expenditures during the year 
immediately preceding the fiscal year for which the appli-
cant is applying to receive such grant. 
‘‘(g) REPORTS TO THE SECRETARY.—The recipient 
of a grant under this section shall report to the Secretary 
annually regarding—
‘‘(1) progress in meeting the goals stated in its 
grant application; and 
‘‘(2) such additional information as the Sec-
retary may require. 
The Secretary may not renew an annual grant under this 
section unless the Secretary is satisfied that the consor-
tium has made reasonable and demonstrable progress in 
meeting the goals set forth in its grant application for the 
preceding year. 
‘‘(h) AUDITS.—Each entity which receives a grant 
under this section shall provide for an independent annual 
financial audit of all records that relate to the disposition 
of funds received through this grant. 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may, 
either directly or by grant or contract, provide any funded 
entity with technical and other non-financial assistance 
necessary to meet the requirements of this section.
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‘‘(j) REPORT.—Not later than September 30, 2005, 
the Secretary shall submit to the Congress a report de-
scribing the extent to which demonstration projects under 
this section have been successful in improving the effec-
tiveness, efficiency, and coordination of services for unin-
sured and underinsured individuals in the geographic 
areas served by such projects, including providing better 
quality health care for such individuals, and at lower costs, 
than would have been the case in the absence of such 
projects. 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $40,000,000 for fiscal year 2002, and 
such sums as may be necessary for each of fiscal years 
2003 through 2006.’’. 
SEC. 402. EXPANDING AVAILABILITY OF DENTAL SERVICES. 
Part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end 
the following: 
‘‘Subpart X—Primary Dental Programs 
‘‘SEC. 340F. DESIGNATED DENTAL HEALTH PROFESSIONAL 
SHORTAGE AREA. 
‘‘In this subpart, the term ‘designated dental health 
professional shortage area’ means an area, population 
group, or facility that is designated by the Secretary as
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a dental health professional shortage area under section 
332 or designated by the applicable State as having a den-
tal health professional shortage. 
‘‘SEC. 340G. GRANTS FOR INNOVATIVE PROGRAMS. 
‘‘(a) GRANT
PROGRAM
AUTHORIZED.—The Sec-
retary, acting through the Administrator of the Health 
Resources and Services Administration, is authorized to 
award grants to States for the purpose of helping States 
develop and implement innovative programs to address the 
dental workforce needs of designated dental health profes-
sional shortage areas in a manner that is appropriate to 
the States’ individual needs. 
‘‘(b) STATE ACTIVITIES.—A State receiving a grant 
under subsection (a) may use funds received under the 
grant for—
‘‘(1) loan forgiveness and repayment programs 
for dentists who—
‘‘(A) agree to practice in designated dental 
health professional shortage areas; 
‘‘(B) are dental school graduates who 
agree to serve as public health dentists for the 
Federal, State, or local government; and 
‘‘(C) agree to—
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‘‘(i) provide services to patients re-
gardless of such patients’ ability to pay; 
and 
‘‘(ii) use a sliding payment scale for 
patients who are unable to pay the total 
cost of services; 
‘‘(2) dental recruitment and retention efforts; 
‘‘(3) grants and low-interest or no-interest loans 
to help dentists who participate in the medicaid pro-
gram under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) to establish or expand practices 
in designated dental health professional shortage 
areas by equipping dental offices or sharing in the 
overhead costs of such practices; 
‘‘(4) the establishment or expansion of dental 
residency programs in coordination with accredited 
dental training institutions in States without dental 
schools; 
‘‘(5) programs developed in consultation with 
State and local dental societies to expand or estab-
lish oral health services and facilities in designated 
dental health professional shortage areas, including 
services and facilities for children with special needs, 
such as—
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‘‘(A) the expansion or establishment of a 
community-based dental facility, free-standing 
dental clinic, consolidated health center dental 
facility, school-linked dental facility, or United 
States dental school-based facility; 
‘‘(B) the establishment of a mobile or port-
able dental clinic; and 
‘‘(C) the establishment or expansion of pri-
vate dental services to enhance capacity through 
additional equipment or additional hours of op-
eration; 
‘‘(6) placement and support of dental students, 
dental residents, and advanced dentistry trainees; 
‘‘(7) continuing dental education, including dis-
tance-based education; 
‘‘(8) practice support through teledentistry con-
ducted in accordance with State laws; 
‘‘(9) community-based prevention services such 
as water fluoridation and dental sealant programs; 
‘‘(10) coordination with local educational agen-
cies within the State to foster programs that pro-
mote children going into oral health or science pro-
fessions; 
‘‘(11) the establishment of faculty recruitment 
programs at accredited dental training institutions
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whose mission includes community outreach and 
service and that have a demonstrated record of serv-
ing underserved States; 
‘‘(12) the development of a State dental officer 
position or the augmentation of a State dental office 
to coordinate oral health and access issues in the 
State; and 
‘‘(13) any other activities determined to be ap-
propriate by the Secretary. 
‘‘(c) APPLICATION.—
‘‘(1) IN
GENERAL.—Each State desiring a 
grant under this section shall submit an application 
to the Secretary at such time, in such manner, and 
containing such information as the Secretary may 
reasonably require. 
‘‘(2) ASSURANCES.—The application shall in-
clude assurances that the State will meet the re-
quirements of subsection (d) and that the State pos-
sesses sufficient infrastructure to manage the activi-
ties to be funded through the grant and to evaluate 
and report on the outcomes resulting from such ac-
tivities. 
‘‘(d) MATCHING REQUIREMENT.—The Secretary may 
not make a grant to a State under this section unless that 
State agrees that, with respect to the costs to be incurred
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by the State in carrying out the activities for which the 
grant was awarded, the State will provide non-Federal 
contributions in an amount equal to not less than 40 per-
cent of Federal funds provided under the grant. The State 
may provide the contributions in cash or in kind, fairly 
evaluated, including plant, equipment, and services and 
may provide the contributions from State, local, or private 
sources. 
‘‘(e) REPORT.—Not later than 5 years after the date 
of enactment of the Health Care Safety Net Improvement 
Act, the Secretary shall prepare and submit to the appro-
priate committees of Congress a report containing data 
relating to whether grants provided under this section 
have increased access to dental services in designated den-
tal health professional shortage areas. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$50,000,000 for the 5-fiscal year period beginning with 
fiscal year 2002.’’. 
SEC. 403. STUDY REGARDING BARRIERS TO PARTICIPA-
TION OF FARMWORKERS IN HEALTH PRO-
GRAMS. 
(a) IN GENERAL.—The Secretary shall conduct a 
study of the problems experienced by farmworkers (includ-
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ing their families) under Medicaid and SCHIP. Specifi-
cally, the Secretary shall examine the following: 
(1) BARRIERS TO ENROLLMENT.—Barriers to 
their enrollment, including a lack of outreach and 
outstationed eligibility workers, complicated applica-
tions and eligibility determination procedures, and 
linguistic and cultural barriers. 
(2) LACK OF PORTABILITY.—The lack of port-
ability of Medicaid and SCHIP coverage for farm-
workers who are determined eligible in one State but 
who move to other States on a seasonal or other 
periodic basis. 
(3) POSSIBLE SOLUTIONS.—The development of 
possible solutions to increase enrollment and access 
to benefits for farmworkers, because, in part, of the 
problems identified in paragraphs (1) and (2), and 
the associated costs of each of the possible solution 
described in subsection (b). 
(b) POSSIBLE SOLUTIONS.—Possible solutions to be 
examined shall include each of the following: 
(1) INTERSTATE COMPACTS.—The use of inter-
state compacts among States that establish port-
ability and reciprocity for eligibility for farmworkers 
under the Medicaid and SCHIP and potential finan-
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cial incentives for States to enter into such com-
pacts. 
(2) DEMONSTRATION PROJECTS.—The use of 
multi-state demonstration waiver projects under sec-
tion 1115 of the Social Security Act (42 U.S.C. 
1315) to develop comprehensive migrant coverage 
demonstration projects. 
(3) USE OF CURRENT LAW FLEXIBILITY.—Use 
of current law Medicaid and SCHIP State plan pro-
visions relating to coverage of residents and out-of-
State coverage. 
(4) NATIONAL MIGRANT FAMILY COVERAGE.—
The development of programs of national migrant 
family coverage in which States could participate. 
(5) PUBLIC-PRIVATE PARTNERSHIPS.—The pro-
vision of incentives for development of public-private 
partnerships to develop private coverage alternatives 
for farmworkers. 
(6) OTHER POSSIBLE SOLUTIONS.—Such other 
solutions as the Secretary deems appropriate. 
(c) CONSULTATIONS.—In conducting the study, the 
Secretary shall consult with the following: 
(1) Farmworkers affected by the lack of port-
ability of coverage under the Medicaid program or 
the State children’s health insurance program
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(under titles XIX and XXI of the Social Security 
Act). 
(2) Individuals with expertise in providing 
health care to farmworkers, including designees of 
national and local organizations representing mi-
grant health centers and other providers. 
(3) Resources with expertise in health care fi-
nancing. 
(4) Representatives of foundations and other 
nonprofit entities that have conducted or supported 
research on farmworker health care financial issues. 
(5) Representatives of Federal agencies which 
are involved in the provision or financing of health 
care to farmworkers, including the Health Care Fi-
nancing Administration and the Health Research 
and Services Administration. 
(6) Representatives of State governments. 
(7) Representatives from the farm and agricul-
tural industries. 
(8) Designees of labor organizations rep-
resenting farmworkers. 
(d) DEFINITIONS.—For purposes of this section: 
(1) FARMWORKER.—The term ‘‘farmworker’’ 
means a migratory agricultural worker or seasonal 
agricultural worker, as such terms are defined in
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section 330(g)(3) of the Public Health Service Act 
(42 U.S.C. 254c(g)(3)), and includes a family mem-
ber of such a worker. 
(2) MEDICAID.—The term ‘‘Medicaid’’ means 
the program under title XIX of the Social Security 
Act. 
(3) SCHIP.—The term ‘‘SCHIP’’ means the 
State children’s health insurance program under 
title XXI of the Social Security Act. 
(e) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary shall transmit 
a report to the President and the Congress on the study 
conducted under this section. The report shall contain a 
detailed statement of findings and conclusions of the 
study, together with its recommendations for such legisla-
tion and administrative actions as the Secretary considers 
appropriate. 
SEC. 404. ELIGIBILITY OF CERTAIN ENTITIES FOR GRANTS. 
If under a program established in this Act (other 
than section 401), or if pursuant to an amendment made 
by this Act, a private entity that is not a nonprofit entity 
is eligible for an award of a grant, contract, or cooperative 
agreement, such an award may not be made to such pri-
vate entity unless the entity is the only available provider 
of quality health services in the geographic area involved.
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SEC. 405. CONFORMING AMENDMENTS. 
(a) 
HOMELESS
PROGRAMS.—Subsections 
(g)(1)(G)(ii), (k)(2), and (n)(1)(C) of section 224, and 
sections 317A(a)(2), 317E(c), 318A(e), 332(a)(2)(C), 
340D(c)(5), 799B(6)(B), 1313, and 2652(2) of the Public 
Health Service Act (42 U.S.C. 233, 247b–1(a)(2), 247b–
6(c), 247c–1(e), 254e(a)(2)(C), 256d(c)(5), 295p(6)(B), 
300e–12, and 300ff–52(2)) are amended by striking 
‘‘340’’ and inserting ‘‘330(h)’’. 
(b) HOMELESS INDIVIDUAL.—Section 534(2) of the 
Public Health Service Act (42 U.S.C. 290cc–34(2)) is 
amended by striking ‘‘340(r)’’ and inserting ‘‘330(h)(5)’’.
Passed the House of Representatives October 1, 
2002. 
Attest: 
JEFF TRANDAHL, 
Clerk.
Calendar No. 629
107TH CONGRESS 
2D SESSION 
H. R. 3450
AN ACT 
To amend the Public Health Service Act to reau-
thorize and strengthen the health centers pro-
gram and the National Health Service Corps, 
and for other purposes. 
OCTOBER 2, 2002
Received; read twice and placed on the calendar