I 
108TH CONGRESS 
1ST SESSION H. R. 3668
To amend the Public Health Service Act to provide greater access for resi-
dents of frontier areas to health care services provided by community 
health centers. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 8, 2003
Mr. CARSON of Oklahoma introduced the following bill; which was referred to 
the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to provide greater 
access for residents of frontier areas to health care serv-
ices provided by community health centers.
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 ‘‘Frontier Health Care 
Access Act of 2003’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—The Congress finds as follows:
(1) People who live in frontier areas are medi-
cally underserved and face unique challenges in ac-
cessing affordable health care. 
(2) People who live in frontier areas are more 
likely to lack health insurance than other rural and 
urban citizens. 
(3) Frontier areas generally do not have popu-
lation centers that can support the full range of 
health care services available in most urban and 
some rural areas. 
(4) Community health centers play an impor-
tant role in providing health services to many medi-
cally underserved areas and populations. 
(5) Many frontier areas do not have community 
health centers. 
(6) Many frontier areas cannot currently qual-
ify for community health centers because the Fed-
eral definition of medically underserved areas or 
populations does not appropriately or effectively rec-
ognize the unique nature and needs of frontier areas 
and those who live in them. 
(7) Any definition of frontier areas for purposes 
of eligibility for Federal or State health care pro-
grams should look beyond simple measures of popu-
lation density to consider such factors as the dis-
tance from and travel time to the nearest significant 
health care service center or market. 
(8) People who live in frontier areas should be 
included explicitly in this expansion of the commu-
nity health center program. 
(b) PURPOSE.—It is the purpose of this Act to pro-
vide greater access for residents of frontier areas to the 
health care services provided by community health centers. 
SEC. 3. FRONTIER COMMUNITY HEALTH CENTERS. 
Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended—
(1) in subsection (a)(1), by striking ‘‘and resi-
dents of public housing’’ and inserting ‘‘residents of 
public housing, or residents of frontier areas’’; and 
(2) by inserting after subsection (r) the fol-
lowing: 
‘‘(s) RESIDENTS OF FRONTIER AREAS.—
‘‘(1) IN GENERAL.—The Secretary may award 
grants for the purposes described in subsections (c), 
(e), and (f) for the planning and delivery of services 
to a special medically underserved population com-
prised of residents of a frontier area. 
‘‘(2) SUPPLEMENT
NOT
SUPPLANT.—A grant 
awarded under this subsection shall be expended to 
supplement, and not supplant, the expenditures of
the health center involved and the value of in-kind 
contributions for the delivery of services to the popu-
lation described in paragraph (1). 
‘‘(3) DEFINITION.—
‘‘(A) IN GENERAL.—In this subsection, the 
term ‘frontier area’ means a county or a ration-
al area identified by the Secretary, in consulta-
tion with appropriate State offices of rural 
health, as meeting the definition developed by 
the Secretary under subparagraph (B). 
‘‘(B) REGULATIONS.—The Secretary shall 
through regulations develop a definition of a 
frontier area for purposes of this subsection. In 
developing such definition, the Secretary shall 
consider factors such as population density, dis-
tance in miles from the nearest significant 
health care service center or market, and travel 
time in minutes from the nearest significant 
health care service center or market.’’.
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