I 
115TH CONGRESS 
1ST SESSION H. R. 3926 
To provide for an extension for community health centers, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 3, 2017 
Mr. BILIRAKIS (for himself and Ms. STEFANIK) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To provide for an extension for community health centers, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Community Coordina-
tion And Resource Empowerment Act’’ or the ‘‘Commu-
nity CARE Act’’. 
SEC. 2. EXTENSION FOR COMMUNITY HEALTH CENTERS. 
(a) COMMUNITY HEALTH CENTERS FUNDING.—Sec-
tion 10503(b)(1)(E) of the Patient Protection and Afford-
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able Care Act (42 U.S.C. 254b–2(b)(1)(E)) is amended 
by striking ‘‘2017’’ and inserting ‘‘2019’’. 
(b) OTHER COMMUNITY HEALTH CENTERS PROVI-
SIONS.—Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (b)(1)(A)(ii), by striking 
‘‘abuse’’ and inserting ‘‘use disorder’’; 
(2) in subsection (b)(2)(A), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(3) in subsection (c)— 
(A) by striking subparagraphs (B) through 
(D); 
(B) by striking ‘‘(1) IN GENERAL’’ and all 
that follows through ‘‘The Secretary’’ and in-
serting the following: 
‘‘(1) CENTERS.—The Secretary’’; and 
(C) in such paragraph (1), as amended, by 
redesignating clauses (i) through (v) as sub-
paragraphs (A) through (E) and moving the 
margin of each of such redesignated subpara-
graph 2 ems to the left; 
(4) by striking subsection (d) and inserting the 
following: 
‘‘(d) IMPROVING QUALITY OF CARE.— 
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‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary 
may award supplemental grant funds to health cen-
ters funded under this section to implement evi-
dence-based models for increasing access to high- 
quality primary care services, which may include 
models related to— 
‘‘(A) improving the delivery of care for in-
dividuals with multiple chronic conditions; 
‘‘(B) workforce configuration; 
‘‘(C) reducing the cost of care; 
‘‘(D) enhancing care coordination; 
‘‘(E) expanding the use of telehealth and 
technology enabled collaborative learning and 
capacity building models; 
‘‘(F) care integration, including integration 
of behavioral health, mental health, or sub-
stance use disorder services; and 
‘‘(G) addressing emerging public health or 
substance use disorder issues to meet the health 
needs of the population served by the health 
center. 
‘‘(2) 
SUSTAINABILITY.—In 
making 
supple-
mental awards under this subsection, the Secretary 
may consider whether the health center involved has 
submitted a plan for continuing the activities funded 
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under this subsection after supplemental funding is 
expended. 
‘‘(3) SPECIAL CONSIDERATION.—The Secretary 
may give special consideration to applications for 
supplemental funding under this subsection that 
seek to address significant barriers to access to care 
in areas with a greater shortage of health care pro-
viders and health services relative to the national av-
erage.’’; 
(5) in subsection (e)(1)— 
(A) in subparagraph (B)— 
(i) by striking ‘‘2 years’’ and inserting 
‘‘1 year’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall not make a 
grant under this paragraph unless the ap-
plicant provides assurances to the Sec-
retary that within 120 days of receiving 
grant funding for the operation of the 
health center, the applicant will submit, for 
approval by the Secretary, an implementa-
tion plan to meet the requirements of sub-
section (l)(3). The Secretary may extend 
such 120-day period for achieving compli-
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ance upon a demonstration of good cause 
by the health center.’’; and 
(B) in subparagraph (C)— 
(i) in the subparagraph heading, by 
striking ‘‘AND PLANS’’; 
(ii) by striking ‘‘or plan (as described 
in subparagraphs (B) and (C) of sub-
section (c)(1))’’; 
(iii) by striking ‘‘or plan, including 
the purchase’’ and inserting the following: 
‘‘including— 
‘‘(i) the purchase’’; 
(iv) by inserting ‘‘, which may include 
data and information systems’’ after ‘‘of 
equipment’’; 
(v) by striking the period at the end 
and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(ii) the provision of training and 
technical assistance; and 
‘‘(iii) other activities that— 
‘‘(I) reduce costs associated with 
the provision of health services; 
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‘‘(II) improve access to, and 
availability of, health services provided 
to individuals served by the centers; 
‘‘(III) enhance the quality and 
coordination of health services; or 
‘‘(IV) improve the health status 
of communities.’’; 
(6) in subsection (e)(5)(B), by striking ‘‘and 
subparagraphs (B) and (C) of subsection (c)(1) to a 
health center or to a network or plan’’ and inserting 
‘‘to a health center’’; 
(7) by striking subsection (s); 
(8) by redesignating subsections (g) through (r) 
as subsections (h) through (s), respectively; 
(9) by inserting after subsection (f), the fol-
lowing: 
‘‘(g) NEW ACCESS POINTS AND EXPANDED SERV-
ICES.— 
‘‘(1) APPROVAL OF NEW ACCESS POINTS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
approve applications for grants under subpara-
graph (A) or (B) of subsection (e)(1), sub-
section (h), subsection (i), and subsection (j) to 
establish new delivery sites. 
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‘‘(B) SPECIAL
CONSIDERATION.—In car-
rying out subparagraph (A), the Secretary may 
give special consideration to applicants that 
have demonstrated the new delivery site will be 
located within a sparsely populated area, or an 
area which has a level of unmet need that is 
higher relative to other applicants. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying subparagraph (A), the Secretary 
shall approve applications for grants under sub-
paragraphs (A) and (B) of subsection (e)(1) in 
such a manner that the ratio of the medically 
underserved populations in rural areas which 
may be expected to use the services provided by 
the applicants involved to the medically under-
served populations in urban areas which may be 
expected to use the services provided by the ap-
plicants is not less than two to three or greater 
than three to two. 
‘‘(D) SERVICE AREA OVERLAP.—If in car-
rying out subparagraph (A) the applicant pro-
poses to serve an area that is currently served 
by another health center funded under this sec-
tion, the Secretary may consider whether the 
award of funding to an additional health center 
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in the area can be justified based on the unmet 
need for additional services within the catch-
ment area. 
‘‘(2) APPROVAL OF EXPANDED SERVICE APPLI-
CATIONS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
approve applications for grants under subpara-
graph (A) or (B) of subsection (e)(1) to expand 
the capacity of the applicant to provide required 
primary health services described in subsection 
(b)(1) or additional health services described in 
subsection (b)(2). 
‘‘(B) PRIORITY EXPANSION PROJECTS.—In 
carrying out subparagraph (A), the Secretary 
may give special consideration to expanded 
service applications that seek to address emerg-
ing public health or behavioral health, mental 
health, or substance abuse issues through in-
creasing the availability of additional health 
services described in subsection (b)(2) in an 
area in which there are significant barriers to 
accessing care. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
In carrying out subparagraph (A), the Sec-
retary shall approve applications for applicants 
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‘‘(E) the amount of unexpended funding 
for loan guarantees and loan guarantee author-
ity under title XVI; 
‘‘(F) the rationale for any substantial 
changes in the distribution of funds; 
‘‘(G) the rate of closures for health centers 
and access points; 
‘‘(H) the number and reason for any 
grants 
awarded 
pursuant 
to 
subsection 
(e)(1)(B); and 
‘‘(I) the number and reason for any waiv-
ers provided pursuant to subsection (r)(4).’’. 
(c) APPLICATION.—Amounts appropriated pursuant 
to this section for fiscal year 2018 or 2019 are subject 
to the requirements contained in Public Law 115–31 for 
funds for programs authorized under sections 330 through 
340 of the Public Health Service Act (42 U.S.C. 254b– 
256). 
(d) CONFORMING AMENDMENTS.—Section 3014(h) 
of title 18, United States Code, is amended— 
(1) in paragraph (1), by striking ‘‘, as amended 
by section 221 of the Medicare Access and CHIP 
Reauthorization Act of 2015,’’; and 
(2) in paragraph (4), by inserting ‘‘and section 
101(d) of the CARE Act’’ after ‘‘section 221(c) of 
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the Medicare Access and CHIP Reauthorization Act 
of 2015’’. 
Æ 
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