(A) a schedule of fees or payments for the 
provision of its health care services related to 
the prevention and treatment of disease that is 
consistent with locally prevailing rates or 
charges and is designed to cover its reasonable 
costs of operation; and 
(B) a corresponding schedule of discounts 
to be applied to the payment of such fees or
payments, which discounts are adjusted on the 
basis of the ability of the patient to pay. 
(2) RULE OF CONSTRUCTION.—Nothing in this 
section shall be construed to require payment for 
navigation services or to require payment for health 
care services in cases, such as with the Indian 
Health Service, where care is provided free of 
charge. 
(d) MODEL.—Not later than five years after the date 
of the enactment of this section, the Secretary shall de-
velop a peer-reviewed model of systems for the services 
provided by this section. The Secretary shall update such 
model as may be necessary to ensure that the best prac-
tices are being utilized. 
(e) DURATION OF GRANT.—The period during which 
payments are made to an entity from a grant under sub-
section (a)(1) or (b)(1) may not exceed five years. The
provision of such payments are subject to annual approval 
by the Secretary of the payments and subject to the avail-
ability of appropriations for the fiscal year involved to 
make the payments. This subsection may not be construed 
as establishing a limitation on the number of grants under 
such subsection that may be made to an entity. 
(f) DEFINITIONS.—For purposes of this section: 
(1) The term ‘‘culturally competent’’, with re-
spect to providing health-related services, means 
services that, in accordance with standards and 
measures of the Secretary, are designed to effec-
tively and efficiently respond to the cultural and lin-
guistic needs of patients. 
(2) The term ‘‘appropriate follow-up care’’ in-
cludes palliative and end-of-life care. 
(3) The term ‘‘health disparity population’’ 
means a population where there exists a significant 
disparity in the overall rate of disease incidence, 
morbidity, mortality, or survival rates in the popu-
lation as compared to the health status of the gen-
eral population. Such term includes—
(A) racial and ethnic minority groups as 
defined in section 1707; and
(B) medically underserved groups, such as 
rural and low-income individuals and individ-
uals with low levels of literacy. 
(4)(A) The term ‘‘patient navigator’’ means an 
individual whose functions include—
(i) assisting and guiding patients with a 
symptom or an abnormal finding or diagnosis of 
cancer or other chronic disease within the 
health care system to accomplish the follow-up 
and diagnosis of an abnormal finding as well as 
the treatment and appropriate follow-up care of 
cancer or other chronic disease, including pro-
viding information about clinical trials; and 
(ii) identifying, anticipating, and helping 
patients overcome barriers within the health 
care system to ensure prompt diagnostic and 
treatment resolution of an abnormal finding of 
cancer or other chronic disease. 
(B) Such term includes representatives of the 
target health disparity population, such as nurses, 
social workers, cancer survivors, and patient advo-
cates. 
(g) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—
(A) MODEL PROGRAMS.—For the purpose 
of carrying out subsection (a) (other than the 
purpose described in paragraph (2)(A)), there 
are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 
2004 through 2008. 
(B) PATIENT NAVIGATORS.—For the pur-
pose of carrying out subsection (b) (other than 
the purpose described in paragraph (2)(B)), 
there are authorized to be appropriated such 
sums as may be necessary for each of the fiscal 
years 2004 through 2008. 
(C) BUREAU
OF
PRIMARY
HEALTH
CARE.—Amounts appropriated under subpara-
graph (A) or (B) shall be administered through 
the Bureau of Primary Health Care. 
(2) PROGRAMS IN RURAL AREAS.—
(A) MODEL PROGRAMS.—For the purpose 
of carrying out subsection (a) by making grants 
under such subsection for model programs in 
rural areas, there are authorized to be appro-
priated such sums as may be necessary for each 
of the fiscal years 2004 through 2008. 
(B) PATIENT NAVIGATORS.—For the pur-
pose of carrying out subsection (b) by making
grants under such subsection for programs in 
rural areas, there are authorized to be appro-
priated such sums as may be necessary for each 
of the fiscal years 2004 through 2008. 
(C) OFFICE OF RURAL HEALTH POLICY.—
Amounts appropriated under subparagraph (A) 
or (B) shall be administered through the Office 
of Rural Health Policy. 
(3) RELATION TO OTHER AUTHORIZATIONS.—
Authorizations of appropriations under paragraphs 
(1) and (2) are in addition to other authorizations 
of appropriations that are available for the purposes 
described in such paragraphs.
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