I
104TH CONGRESS
2D SESSION
H. R. 3081
To amend title III of the Public Health Service Act to consolidate and
reauthorize provisions relating to health centers, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 13, 1996
Mr. RICHARDSON introduced the following bill; which was referred to the
Committee on Commerce
A BILL
To amend title III of the Public Health Service Act to
consolidate and reauthorize provisions relating to 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 ‘‘Health Centers Con-
solidation Act of 1996’’.
SEC. 2. CONSOLIDATION AND REAUTHORIZATION OF PRO-
VISIONS.
Subpart I of part D of title III of the Public Health
Service Act (42 U.S.C. 254b et seq.) is amended to read
as follows:
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‘‘Subpart I—Health Centers
‘‘SEC. 330. HEALTH CENTERS.
‘‘(a) DEFINITION OF HEALTH CENTER.—
‘‘(1) IN GENERAL.—For purposes of this sec-
tion, the term ‘health center’ means an entity that
serves a population that is medically underserved, or
a special medically underserved population com-
prised of migratory and seasonal agricultural work-
ers, the homeless, and residents of public housing,
by providing, either through the staff and supporting
resources of the center or through contracts or coop-
erative arrangements—
‘‘(A) required primary health services (as
defined in subsection (b)(1)); and
‘‘(B) as may be appropriate for particular
centers, additional health services (as defined in
subsection (b)(2)) necessary for the adequate
support of the primary health services required
under subparagraph (A);
for all residents of the area served by the center
(hereafter referred to in this section as the
‘catchment area’).
‘‘(2) LIMITATION.—The requirement in para-
graph (1) to provide services for all residents within
a catchment area shall not apply in the case of a
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health center receiving a grant only under subsection
(f), (g), or (h).
‘‘(b) DEFINITIONS.—For purposes of this section:
‘‘(1) REQUIRED PRIMARY HEALTH SERVICES.—
‘‘(A) IN
GENERAL.—The term ‘required
primary health services’ means—
‘‘(i) basic health services which, for
purposes of this section, shall consist of—
‘‘(I) health services related to
family medicine, internal medicine, pe-
diatrics, obstetrics, or gynecology that
are furnished by physicians and where
appropriate, 
physician 
assistants,
nurse practitioners, and nurse mid-
wives;
‘‘(II) diagnostic laboratory and
radiologic services;
‘‘(III) preventive health services,
including—
‘‘(aa) prenatal and perinatal
services;
‘‘(bb) screening for breast
and cervical cancer;
‘‘(cc) well-child services;
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signed to assist health center patients in
establishing eligibility for and gaining ac-
cess to Federal, State, and local programs
that provide or financially support the pro-
vision of medical, social, educational, or
other related services;
‘‘(iv) services that enable individuals
to use the services of the health center (in-
cluding outreach and transportation serv-
ices and, if a substantial number of the in-
dividuals in the population served by a cen-
ter are of limited English-speaking ability,
the services of appropriate personnel fluent
in the language spoken by a predominant
number of such individuals); and
‘‘(v) education of patients and the
general population served by the health
center regarding the availability and prop-
er use of health services.
‘‘(B) EXCEPTION.—With respect to a
health center that receives a grant only under
subsection (f), the Secretary, upon a showing of
good cause, shall—
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‘‘(i) waive the requirement that the
center provide all required primary health
services under this paragraph; and
‘‘(ii) approve, as appropriate, the pro-
vision of certain required primary health
services only during certain periods of the
year.
‘‘(2) ADDITIONAL
HEALTH
SERVICES.—The
term ‘additional health services’ means services that
are not included as required primary health services
and that are appropriate to meet the health needs
of the population served by the health center in-
volved. Such term may include—
‘‘(A) environmental health services, includ-
ing—
‘‘(i) the detection and alleviation of
unhealthful 
conditions 
associated 
with
water supply;
‘‘(ii) sewage treatment;
‘‘(iii) solid waste disposal;
‘‘(iv) rodent and parasitic infestation;
‘‘(v) field sanitation;
‘‘(vi) housing; and
‘‘(vii) other environmental factors re-
lated to health; and
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‘‘(B) in the case of health centers receiving
grants under subsection (f), special occupation-
related health services for migratory and sea-
sonal agricultural workers, including—
‘‘(i) screening for and control of infec-
tious diseases, including parasitic diseases;
and
‘‘(ii) injury prevention programs, in-
cluding prevention of exposure to unsafe
levels of agricultural chemicals including
pesticides.
‘‘(3) 
MEDICALLY
UNDERSERVED
POPU-
LATIONS.—
‘‘(A) IN GENERAL.—The term ‘medically
underserved population’ means the population
of an urban or rural area designated by the
Secretary as an area with a shortage of per-
sonal health services or a population group des-
ignated by the Secretary as having a shortage
of such services.
‘‘(B) CRITERIA.—In carrying out subpara-
graph (A), the Secretary shall prescribe criteria
for determining the specific shortages of per-
sonal health services of an area or population
group. Such criteria shall—
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‘‘(i) take into account comments re-
ceived by the Secretary from the chief ex-
ecutive officer of a State and local officials
in a State; and
‘‘(ii) include factors indicative of the
health status of a population group or resi-
dents of an area, the ability of the resi-
dents of an area or of a population group
to pay for health services and their acces-
sibility to them, and the availability of
health professionals to residents of an area
or to a population group.
‘‘(C) LIMITATION.—The Secretary may not
designate a medically underserved population in
a State or terminate the designation of such a
population unless, prior to such designation or
termination, the Secretary provides reasonable
notice and opportunity for comment and
consults with—
‘‘(i) the chief executive officer of such
State;
‘‘(ii) local officials in such State; and
‘‘(iii) the organization, if any, which
represents a majority of health centers in
such State.
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‘‘(D) PERMISSIBLE
DESIGNATION.—The
Secretary may designate a medically under-
served population that does not meet the cri-
teria established under subparagraph (B) if the
chief executive officer of the State in which
such population is located and local officials of
such State recommend the designation of such
population based on unusual local conditions
which are a barrier to access to or the availabil-
ity of personal health services.
‘‘(c) PLANNING GRANTS.—
‘‘(1) IN GENERAL.—
‘‘(A) CENTERS.—The Secretary may make
grants to public and nonprofit private entities
for projects to plan and develop health centers
which will serve medically underserved popu-
lations. A project for which a grant may be
made under this subsection may include the
cost of the acquisition, expansion, and mod-
ernization of existing buildings and construction
of new buildings (including the costs of amortiz-
ing the principal of, and paying the interest on,
loans) and shall include—
‘‘(i) an assessment of the need that
the population proposed to be served by