I 
111TH CONGRESS 
1ST SESSION H. R. 1883 
To require the Secretary of Health and Human Services to carry out a 
demonstration grants program to provide for certain patient coordination, 
outreach, and assistance services to reduce barriers to receiving health 
care and improve health care outcomes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 2, 2009 
Mr. SCOTT of Virginia (for himself, Ms. JACKSON-LEE of Texas, and Ms. LEE 
of California) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To require the Secretary of Health and Human Services 
to carry out a demonstration grants program to provide 
for certain patient coordination, outreach, and assistance 
services to reduce barriers to receiving health care and 
improve health care outcomes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Patient Advocate Act 
of 2009’’. 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
SEC. 2. PATIENT ASSISTANCE GRANTS DEMONSTRATION 
PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a demonstration program 
under which the Secretary may make grants to States, 
local and tribal entities, and public or private non-profit 
organizations for the development and operation of pro-
grams to provide services for patients to resolve health in-
surance, job retention, and debt crisis matters related to 
the patients’ diagnosis and illness, including services de-
scribed in subsection (b), to improve health care outcomes. 
(b) USE OF FUNDS.—A recipient of a grant under 
this section shall use the grant for the purposes of recruit-
ing, assigning, training, and employing patient health ad-
vocates (as defined in subsection (m)(2)) who have direct 
knowledge of the communities they serve to facilitate the 
care of individuals, including by performing each of the 
following services (and by ensuring that such services are 
available to such communities): 
(1) Acting as contacts, including by assisting in 
the coordination of health care services and provider 
referrals, for individuals who are seeking prevention 
or early detection services for, or who following a 
screening or early detection service are found to 
have a symptom, abnormal finding, or diagnosis of, 
an adverse health condition. 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
(2) Facilitating the involvement of community 
organizations in assisting individuals who are at risk 
for or who have an adverse health condition to re-
ceive better access to high-quality health care serv-
ices (such as by creating partnerships with patient 
advocacy groups, charities, health care centers, com-
munity hospice centers, other health care providers, 
or other organizations in the targeted community). 
(3) Notifying individuals of clinical trials and, 
upon request, facilitating enrollment of eligible indi-
viduals in these trials. 
(4) Anticipating, identifying, and helping indi-
viduals to overcome barriers within the health care 
system to ensure prompt diagnosis and treatment. 
(5) Coordinating with the relevant health insur-
ance ombudsman programs to provide information to 
individuals about health coverage, including private 
insurance, health care savings accounts, and other 
publicly funded programs (such as the Medicare, the 
Medicaid, and State children’s health insurance pro-
grams under titles XVIII, XIX, and XXI of the So-
cial Security Act, respectively, health programs oper-
ated by the Department of Veterans Affairs or the 
Department of Defense, and any private or govern-
mental prescription assistance programs). 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
(6) Conducting ongoing outreach to health dis-
parity populations, including the uninsured, rural 
populations, and other medically underserved popu-
lations, in addition to assisting other individuals to 
seek preventive care. 
A recipient of a grant under subsection (a) may use such 
grant for operational costs of any activity carried out by 
such entity for the purposes described in the previous sen-
tence. 
(c) PROHIBITIONS.— 
(1) REFERRAL FEES.—The Secretary of Health 
and Human Services shall require each recipient of 
a grant under this section to prohibit any patient 
health advocate providing services under the grant 
from accepting any referral fee, kickback, or other 
thing of value in return for referring an individual 
to a particular health care provider. 
(2) LEGAL FEES AND COSTS.—The Secretary of 
Health and Human Services shall prohibit the use of 
any grant funds received under this section to pay 
any fees or costs resulting from any litigation, arbi-
tration, mediation, or other proceeding to resolve a 
legal dispute. 
(d) GRANT PERIOD.— 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
(1) INITIAL GRANT PERIOD AND PERMISSIBLE 
EXTENSIONS.—Subject to paragraph (2), the Sec-
retary of Health and Human Services— 
(A) may award grants under this section 
for initial periods of not more than 3 years; and 
(B) may extend the period of a grant 
under this section so long as each such exten-
sion is for a period of not more than 1 year. 
(2) LIMITATION.—In no case may the Secretary 
award an initial grant or extend the period of a 
grant under this section for a period ending after 
the date that is 5 years after the date of the enact-
ment of this Act. 
(e) APPLICATION.— 
(1) IN GENERAL.—To seek a grant under this 
section, an entity or organization described in sub-
section (a) shall submit an application to the Sec-
retary of Health and Human Services in such form, 
in such manner, and containing such information as 
the Secretary may require. 
(2) CONTENTS.—At a minimum, the Secretary 
shall require each such application to outline how 
the entity or organization involved will establish 
baseline measures and benchmarks that meet the 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
Secretary’s requirements to evaluate program out-
comes. 
(f) UNIFORM BASELINE MEASURES.—The Secretary 
of Health and Human Services shall establish uniform 
baseline measures in order to properly evaluate the impact 
of the programs funded under this section. 
(g) PREFERENCE.—In making grants under this sec-
tion, the Secretary of Health and Human Services shall 
give preference to eligible entities that demonstrate in 
their applications plans to utilize services described in sub-
section (b) to overcome significant barriers in order to im-
prove health care outcomes in their respective commu-
nities. 
(h) DUPLICATION OF SERVICES.—An entity or orga-
nization that is receiving Federal funds for services de-
scribed in subsection (b) on the date on which the entity 
or organization, respectively, submits an application under 
subsection (e) may not receive a grant under this section 
unless the entity or organization, respectively, can dem-
onstrate that amounts received under the grant will be uti-
lized to expand services or provide new services to individ-
uals who would not otherwise be served. 
(i) COORDINATION WITH OTHER PROGRAMS.—The 
Secretary of Health and Human Services shall ensure co-
ordination of the demonstration program under this sec-
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
tion with existing authorized programs in order to facili-
tate access to high-quality health care services. 
(j) STUDY; REPORTS.— 
(1) FINAL REPORT BY SECRETARY.—Not later 
than 6 months after the completion of the dem-
onstration program under this section, the Secretary 
of Health and Human Services shall conduct a study 
of the results of the program and submit to the Con-
gress a report on such results that includes the fol-
lowing: 
(A) An evaluation of the program out-
comes, including— 
(i) quantitative analysis of baseline 
and benchmark measures; and 
(ii) aggregate information about the 
individuals served and program activities. 
(B) Recommendations on whether the pro-
grams funded under this section could be used 
to improve patient outcomes in other public 
health areas. 
(2) INTERIM
REPORTS
BY
SECRETARY.—The 
Secretary of Health and Human Services may pro-
vide interim reports to the Congress on the dem-
onstration program under this section at such inter-
vals as the Secretary determines to be appropriate. 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
(3) REPORTS BY GRANTEES.—The Secretary of 
Health and Human Services may require each re-
cipient of a grant under this section to submit in-
terim and final reports on the programs carried out 
by such recipient with such grant. 
(k) RULE OF CONSTRUCTION.—This section shall not 
be construed to authorize funding for the delivery of 
health care services (other than the services listed in sub-
section (b)). 
(l) NONDISCRIMINATION.— 
(1) TREATMENT AS FEDERAL FINANCIAL AS-
SISTANCE.—For the purpose of applying the prohibi-
tions against discrimination on the basis of age 
under the Age Discrimination Act of 1975 (42 
U.S.C. 6101 et seq.), on the basis of disability under 
section 504 of the Rehabilitation Act of 1973 (29 
U.S.C. 794), on the basis of sex under title IX of 
the Education Amendments of 1972 (20 U.S.C. 
1681 et seq.), or on the basis of race, color, or na-
tional origin under title VI of the Civil Rights Act 
of 1964 (42 U.S.C. 2000d et seq.), programs and 
activities funded or otherwise financially assisted in 
whole or in part under this Act (whether through 
grant, contract, or otherwise) are considered to be 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
programs and activities receiving Federal financial 
assistance. 
(2) PROHIBITION OF DISCRIMINATION REGARD-
ING
PARTICIPATION, 
BENEFITS, 
AND
EMPLOY-
MENT.— 
(A) IN GENERAL.—No individual shall be 
excluded from participation in, denied the bene-
fits of, subjected to discrimination under, or de-
nied employment in the administration of or in 
connection with, any program or activity funded 
or otherwise financially assisted in whole or in 
part under this Act because of race, color, reli-
gion, sex, national origin, age, disability, or po-
litical affiliation or belief. 
(B) ENFORCEMENT.—The powers, rem-
edies, and procedures set forth in title VI of the 
Civil Rights Act of 1964 (42 U.S.C. 2000d et 
seq.) shall be the powers, remedies, and proce-
dures this paragraph provides to the Secretary 
concerning a violation of subparagraph (A). 
(m) DEFINITIONS.—In this section: 
(1) HEALTH
DISPARITY
POPULATION.—The 
term ‘‘health disparity population’’ means a popu-
lation that, as determined by the Secretary of 
Health and Human Services, has a significant dis-
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS
parity in the overall rate of disease incidence, preva-
lence, morbidity, mortality, or survival rates as com-
pared to the health status of the general population. 
(2) PATIENT
HEALTH
ADVOCATE.—The term 
‘‘patient health advocate’’ means, with respect to a 
program developed by a recipient of a grant under 
this section, an individual who has completed a cer-
tified social work program (or program in a related 
field) approved by such recipient, or has attained an 
equivalent level of proficiency through organization- 
sponsored training or work experience in areas of so-
cial work, case work, or nursing. 
(n) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—To carry out this section, 
there are authorized to be appropriated $10,000,000 
for each of the fiscal years 2010 through 2014. 
(2) AVAILABILITY.—The amounts appropriated 
pursuant to paragraph (1) shall remain available for 
obligation through the end of fiscal year 2014. 
Æ 
VerDate Nov 24 2008 
02:24 Apr 07, 2009
Jkt 079200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6301
E:\BILLS\H1883.IH
H1883
wwoods2 on PRODPC68 with BILLS