I 
111TH CONGRESS 
1ST SESSION H. R. 3124 
To provide for the use of improved health information technology with respect 
to certain safety net health care providers. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 8, 2009 
Ms. FUDGE (for herself, Mr. MASSA, Ms. LEE of California, Mr. LOEBSACK, 
Mr. HARE, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. CARSON of In-
diana, Mr. ELLISON, Mr. CLEAVER, Mr. PAYNE, Mr. JOHNSON of Geor-
gia, Ms. WATSON, Ms. KILPATRICK of Michigan, Ms. CLARKE, Mr. 
MEEKS of New York, Mr. WATT, Ms. CORRINE BROWN of Florida, Mr. 
TOWNS, and Mr. GRAYSON) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committees on Veterans’ Affairs and Natural Resources, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To provide for the use of improved health information tech-
nology with respect to certain safety net health care 
providers. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Health Information 
Technology (IT) Public Utility Act of 2009’’. 
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SEC. 2. DEFINITIONS. 
In this Act: 
(1) BOARD.—The term ‘‘Board’’ means the 
Federal Consolidated Health Information Tech-
nology Board established under section 3. 
(2) RPMS.—The term ‘‘RPMS’’ means the Re-
source and Patient Management System of the In-
dian Health Service. 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Veterans Affairs. 
(4) VISTA.—The term ‘‘VistA’’ means the 
VistA software program utilized by the Department 
of Veterans Affairs. 
SEC. 3. FEDERAL CONSOLIDATED HEALTH INFORMATION 
TECHNOLOGY BOARD. 
(a) ESTABLISHMENT.—To facilitate the implementa-
tion of electronic health record systems among safety-net 
health care providers (particularly small, rural providers) 
there shall be established within the Office of the National 
Coordinator for Health Information Technology of the De-
partment of Health and Human Services, a Federal Con-
solidated Health Information Technology Board. 
(b) BOARD OF DIRECTORS.—The Board shall be ad-
ministered by a board of directors that shall be composed 
of the following individuals or their designees: 
(1) The Secretary. 
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(A) determining specific health information 
technology grant needs based on health care 
provider settings; 
(B) developing benchmarks for levels of 
implementation in each year that 21st Century 
grant funding is provided; and 
(C) providing ongoing VistA and RPMS 
technical assistance to grantees under such pro-
gram (either through the provision of direct 
technical support or through the awarding of 
competitive contracts to other qualified enti-
ties); 
(D) develop mechanisms to integrate VistA 
and RPMS with records and billing systems uti-
lized under the Medicaid and State children’s 
health insurance programs under titles XIX 
and XXI of the Social Security Act (42 U.S.C. 
1396 and 1397aa et seq.); 
(4) establish a child-specific electronic health 
record, consistent with the parameters to be set for 
child electronic health records as provided for in the 
American Recovery and Reinvestment Act of 2009, 
to be used in the Medicaid and State children’s 
health insurance programs under titles XIX and 
XXI of the Social Security Act, and under other 
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Federal children’s health programs determined ap-
propriate by the board of directors; 
(5) develop and integrate quality and perform-
ance measurement into the VistA and RPMS mod-
ules; 
(6) integrate the 21st Century HIT Grant Pro-
gram under section 4 with the Federal Communica-
tions Commission’s Rural Health Care Pilot Pro-
gram, with Department of Veterans Affairs hospital 
systems, and with other Federal health information 
technology health initiatives; and 
(7) carry out other activities determined appro-
priate by the board of directors. 
(d) ANNUAL AUDITS.—The Comptroller General of 
the United States shall annually conduct an audit of the 
activities of the Board during the year and submit the re-
sults of such audits to the appropriate committees of Con-
gress. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary to carry out this section. 
SEC. 4. 21ST CENTURY HEALTH INFORMATION TECH-
NOLOGY (HIT) GRANTS. 
(a) ESTABLISHMENT.—The Board shall establish a 
grant program, to be known as the 21st Century Health 
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Information Technology (HIT) Grant program, to award 
competitive grants to eligible safety-net health care pro-
viders to enable such providers to fully implement VistA 
or RPMS with respect to the patients served by such pro-
viders. 
(b) ELIGIBILITY.— 
(1) IN GENERAL.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
(A) be— 
(i) a public or nonprofit health care 
provider 
(as 
defined 
in 
section 
254(h)(7)(B) of the Communications Act 
of 1934 (47 U.S.C. 254(h)(7)(B)), includ-
ing— 
(I) post-secondary educational in-
stitutions offering health care instruc-
tion, teaching hospitals, and medical 
schools; 
(II) a community health center 
receiving a grant under section 330 of 
the Public Health Service Act (42 
U.S.C. 254) or a health center that 
provides health care to migrants; 
(III) a local health department or 
agency, including a dedicated emer-
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gency department of rural for-profit 
hospitals; 
(IV) a community mental health 
center; 
(V) a nonprofit hospital; 
(VI) a rural health clinic, includ-
ing a mobile clinic; 
(VII) a consortia of health care 
providers, that consists of 1 or more 
of the entities described in clauses (i) 
through (vi); and 
(VIII) a part-time eligible entity 
that is located in an otherwise ineli-
gible facility (as described in section 
5(b); or 
(ii) a free clinic (as defined in para-
graph (4); and 
(B) submit to the Board as application at 
such time, in such manner, and containing such 
information as the Board may require. 
(2) NON-ELIGIBLE ENTITIES.— 
(A) IN GENERAL.—An entity shall not be 
eligible to receive a grant under this section if 
such entity is a for-profit health care entity (ex-
cept as provided for in paragraph (1)(A)), or 
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any other type of entity that is not described in 
such paragraph, including— 
(i) an entity described in paragraph 
(1)(A) that is implementing an existing 
electronic health records system; 
(ii) an entity that is receiving grant 
funding under the Federal Communication 
Commission Rural Health Pilot Program; 
(iii) an entity receiving funding for 
health information technology through a 
Medicaid transformation grant under title 
XIX of the Social Security Act (42 U.S.C. 
1936 et seq.); 
(iv) a private physician office or clinic; 
(v) a nursing home or other long-term 
care facility (such as an assisted living fa-
cility); 
(vi) an emergency medical service fa-
cility; 
(vii) a residential substance abuse 
treatment facility; 
(viii) a hospice; 
(ix) a for-profit hospital; 
(x) a home health agency; 
(xi) a blood bank; 
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(xii) a social service agency; and 
(xiii) a community center, vocational 
rehabilitation center, or youth center. 
(B) OTHER ENTITIES.—An entity shall not 
be eligible to receive a grant under this section 
if such entity is receiving Medicare or Medicaid 
incentive funding under any of the amendments 
made by title IV of division B of the American 
Recovery and Reinvestment Act of 2009. 
(3) PREFERENCE.—In awarding grant under 
this section the Board shall give preference to appli-
cants that— 
(A) are located in geographical areas that 
have a greater likelihood of serving the same 
patients and utilizing interoperability to pro-
mote coordinated care management; or 
(B) demonstrate the greatest need for such 
award (as determined by the Secretary). 
(4) DEFINITION.—In this subsection, the term 
‘‘free clinic’’ means a safety-net health care organi-
zation that— 
(A) utilizes volunteers to provide a range 
of medical, dental, pharmacy, or behavioral 
health services to economically disadvantaged 
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individuals the majority of whom are uninsured 
or underinsured; and 
(B) is a community-based tax-exempt orga-
nization under section 501(c)(3) of the Internal 
Revenue Code of 1986, or that operates as a 
program component or affiliate of such a 
501(c)(3) organization. 
An entity that is otherwise a free clinic under this 
paragraph, but that charge a nominal fee to pa-
tients, shall still be considered to be a free clinic if 
the entity delivers essential services regardless of the 
patient’s ability to pay. 
(c) USE OF FUNDS.—An entity shall use amounts re-
ceived under a grant under this section to fully implement 
the VistA or RPMS with respect to the patients served 
by such entity. Such implementation shall include at least 
the meaningful use (as defined by the Secretary of Health 
and Human Services) of such systems, including any on-
going updates and changes to such definition. 
(d) TERM AND RENEWAL.—A grant under this sec-
tion shall be for a period of not to exceed 5 years and 
may be renewed, as determined appropriate by the Board, 
based on the achievement of benchmarks required by the 
Board. 
(e) ANNUAL REPORTING.— 
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(1) BY GRANTEES.—Not later than 1 year after 
the date on which an entity receives a grant under 
this section, and annually during each year in which 
such entity has received funds under such grant, 
such entity shall submit to the Board a report con-
cerning the activities carried out under the grant. 
(2) BY BOARD.—Not later than 2 years after 
the date of enactment of this Act, and annually 
thereafter, the Board shall submit to the appropriate 
committees of Congress a report concerning the ac-
tivities carried out under this section, including— 
(A) a description of the grants that have 
been awarded under this section and the pur-
poses of such grants; 
(B) specific implementation information 
with respect to activities carried out by grant-
ees; 
(C) the costs and savings achieved under 
the program under this section; 
(D) a description of any innovations devel-
oped by health care providers as a result of the 
implementation of activities under this grant; 
(E) a description of the results of grant 
activities on patient care quality measurement 
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(including reductions in medication errors and 
the provision of care management); 
(F) a description of the extent of electronic 
health record use across health care provider 
settings; 
(G) a description of the extent to which in-
tegration of VistA and RPMS with Medicaid 
and State children’s health insurance program 
billing has been achieved; and 
(H) any other information determined nec-
essary by the Board. 
(f) ANNUAL AUDITS.—The Comptroller General of 
the United States shall annually conduct an audit of the 
grant program carried out under this section and submit 
the results of such audits to the Board and the appro-
priate committees of Congress. 
(g) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section— 
(1) $2,000,000,000 for each of fiscal years 
2010 and 2011; and 
(2) $1,000,000,000 for each of fiscal years 
2012 through 2014. 
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SEC. 5. 21ST CENTURY HEALTH INFORMATION TECH-
NOLOGY DEMONSTRATION PROGRAM FOR IN-
ELIGIBLE ENTITIES. 
(a) IN GENERAL.—The Board may use not to exceed 
10 percent of the amount appropriate for each fiscal year 
under section 4(g) to award competitive grants to eligible 
long-term care providers for the conduct of demonstration 
projects to implement VistA or RPMS with respect to the 
individuals served by such providers. 
(b) ELIGIBILITY.— 
(1) IN GENERAL.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
(A) be a— 
(i) nursing home or other long-term 
care facility (such as an assisted living fa-
cility); 
(ii) a hospice; or 
(iii) a home health agency; and 
(B) submit to the Board as application at 
such time, in such manner, and containing such 
information as the Board may require, includ-
ing a description of the manner in which the 
applicant will use grant funds to implement 
VistA or RPMS with respect to the individuals 
served by such applicant to achieve one or more 
of the following: 
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(i) Improve care coordination and 
chronic disease management. 
(ii) Reduce hospitalizations. 
(iii) Reduce patient churning between 
the hospital, nursing home, hospice, and 
home health entity. 
(iv) Increase the ability of long-term 
care patients to remain in their homes and 
communities. 
(v) Improve patient completion, and 
provider execution, of advance directives. 
(2) NONELIGIBILITY.—An entity shall not be 
eligible to receive a grant under this section if such 
entity is receiving Medicare or Medicaid incentive 
funding under any of the amendments made by title 
IV of division B of the American Recovery and Rein-
vestment Act of 2009. 
(c) USE OF FUNDS.—An entity shall use amounts re-
ceived under a grant under this section to implement the 
VistA or RPMS with respect to the individuals served by 
such entity. Such implementation shall include at least the 
meaningful use (as defined by the Secretary of Health and 
Human Services) of such systems, including any ongoing 
updates and changes to such definition. 
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(d) DURATION.—A grant under this section shall be 
for a period of not to exceed 3 years, as determined appro-
priate by the Board. 
(e) REPORTING.—The Board, as part of the report 
submitted under section 4(e)(2), shall provide comprehen-
sive information on the activities conducted under grants 
awarded under this section. 
Æ 
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