A bill to amend the Public Health Service Act to reauthorize the Community Health Centers program, the National Health Service Corps, and rural health care programs.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Safety Net Act of 
2008''.

SEC. 2. COMMUNITY HEALTH CENTERS PROGRAM OF THE PUBLIC HEALTH SERVICE 
              ACT.

    (a) Additional Authorizations of Appropriations for the Health 
Centers Program of Public Health Service Act.--Section 330(r) of the 
Public Health Service Act (42 U.S.C. 254b(r)) is amended by amending 
paragraph (1) to read as follows:
            ``(1) In general.--For the purpose of carrying out this 
        section, in addition to the amounts authorized to be 
        appropriated under subsection (d), there are authorized to be 
        appropriated--
                    ``(A) $2,065,000,000 for fiscal year 2008;
                    ``(B) $2,313,000,000 for fiscal year 2009;
                    ``(C) $2,602,000,000 for fiscal year 2010;
                    ``(D) $2,940,000,000 for fiscal year 2011; and
                    ``(E) $3,337,000,000 for fiscal year 2012.''.
    (b) Studies Relating to Community Health Centers.--
            (1) Definitions.--For purposes of this subsection--
                    (A) the term ``community health center'' means a 
                health center receiving assistance under section 330 of 
                the Public Health Service Act (42 U.S.C. 254b); and
                    (B) the term ``medically underserved population'' 
                has the meaning given that term in such section 330.
            (2) School-based health center study.--
                    (A) In general.--Not later than 2 years after the 
                date of enactment of this Act, the Comptroller General 
                of the United States shall issue a study of the 
                economic costs and benefits of school-based health 
                centers and the impact on the health of students of 
                these centers.
                    (B) Content.--In conducting the study under 
                subparagraph (A), the Comptroller General of the United 
                States shall analyze--
                            (i) the impact that Federal funding could 
                        have on the operation of school-based health 
                        centers;
                            (ii) any cost savings to other Federal 
                        programs derived from providing health services 
                        in school-based health centers;
                            (iii) the effect on the Federal Budget and 
                        the health of students of providing Federal 
                        funds to school-based health centers and 
                        clinics, including the result of providing 
                        disease prevention and nutrition information;
                            (iv) the impact of access to health care 
                        from school-based health centers in rural or 
                        underserved areas; and
                            (v) other sources of Federal funding for 
                        school-based health centers.
            (3) Health care quality study.--
                    (A) In general.--Not later than 1 year after the 
                date of enactment of this Act, the Secretary of Health 
                and Human Services (referred to in this Act as the 
                ``Secretary''), acting through the Administrator of the 
                Health Resources and Services Administration, and in 
                collaboration with the Agency for Healthcare Research 
                and Quality, shall prepare and submit to the Committee 
                on Health, Education, Labor, and Pensions of the Senate 
                and the Committee on Energy and Commerce of the House 
                of Representatives a report that describes agency 
                efforts to expand and accelerate quality improvement 
                activities in community health centers.
                    (B) Content.--The report under subparagraph (A) 
                shall focus on--
                            (i) Federal efforts, as of the date of 
                        enactment of this Act, regarding health care 
                        quality in community health centers, including 
                        quality data collection, analysis, and 
                        reporting requirements;
                            (ii) identification of effective models for 
                        quality improvement in community health 
                        centers, which may include models that--
                                    (I) incorporate care coordination, 
                                disease management, and other services 
                                demonstrated to improve care;
                                    (II) are designed to address 
                                multiple, co-occurring diseases and 
                                conditions;
                                    (III) improve access to providers 
                                through non-traditional means, such as 
                                the use of remote monitoring equipment;
                                    (IV) target various medically 
                                underserved populations, including 
                                uninsured patient populations;
                                    (V) increase access to specialty 
                                care, including referrals and 
                                diagnostic testing; and
                                    (VI) enhance the use of electronic 
                                health records to improve quality;
                            (iii) efforts to determine how effective 
                        quality improvement models may be adapted for 
                        implementation by community health centers that 
                        vary by size, budget, staffing, services 
                        offered, populations served, and other 
                        characteristics determined appropriate by the 
                        Secretary;
                            (iv) types of technical assistance and 
                        resources provided to community health centers 
                        that may facilitate the implementation of 
                        quality improvement interventions;
                            (v) proposed or adopted methodologies for 
                        community health center evaluations of quality 
                        improvement interventions, including any 
                        development of new measures that are tailored 
                        to safety-net, community-based providers;
                            (vi) successful strategies for sustaining 
                        quality improvement interventions in the long-
                        term; and
                            (vii) partnerships with other Federal 
                        agencies and private organizations or networks 
                        as appropriate, to enhance health care quality 
                        in community health centers.
                    (C) Dissemination.--The Administrator of the Health 
                Resources and Services Administration shall establish a 
                formal mechanism or mechanisms for the ongoing 
                dissemination of agency initiatives, best practices, 
                and other information that may assist health care 
                quality improvement efforts in community health 
                centers.
            (4) GAO study on integrated health systems model for the 
        delivery of health care services to medically underserved 
        populations.--
                    (A) Study.--The Comptroller General of the United 
                States shall conduct a study on integrated health 
                system models at not more than 10 sites for the 
                delivery of health care services to medically 
                underserved populations. The study shall include an 
                examination of--
                            (i) health care delivery models sponsored 
                        by public or private non-profit entities that--
                                    (I) integrate primary, specialty, 
                                and acute care; and
                                    (II) serve medically underserved 
                                populations; and
                            (ii) such models in rural and urban areas.
                    (B) Report.--Not later than 1 year after the date 
                of the enactment of this Act, the Comptroller General 
                of the United States shall submit to Congress a report 
                on the study conducted under subparagraph (A). The 
                report shall include--
                            (i) an evaluation of the models, as 
                        described in subparagraph (A), in--
                                    (I) expanding access to primary and 
                                preventive services for medically 
                                underserved populations; and
                                    (II) improving care coordination 
                                and health outcomes; and
                            (ii) an assessment of--
                                    (I) challenges encountered by such 
                                entities in providing care to medically 
                                underserved populations; and
                                    (II) advantages and disadvantages 
                                of such models compared to other models 
                                of care delivery for medically 
                                underserved populations.

SEC. 3. NATIONAL HEALTH SERVICE CORPS.

    (a) Funding.--
            (1) National health service corps program.--Section 338(a) 
        of the Public Health Service Act (42 U.S.C. 254k(a)) is amended 
        by striking ``2002 through 2006'' and inserting ``2008 through 
        2012''.
            (2) Scholarship and loan repayment programs.--Section 
        338H(a) of the Public Health Service Act (42 U.S.C. 254q(a)) is 
        amended by striking ``appropriated $146,250,000'' and all that 
        follows through the period and inserting the following: 
        ``appropriated--
            ``(1) for fiscal year 2008, $131,500,000;
            ``(2) for fiscal year 2009, $143,335,000;
            ``(3) for fiscal year 2010, $156,235,150;
            ``(4) for fiscal year 2011, $170,296,310; and
            ``(5) for fiscal year 2012, $185,622,980.''.
    (b) Elimination of 6-Year Demonstration Requirement.--Section 
332(a)(1) of the Public Health Service Act (42 U.S.C. 254e(a)(1)) is 
amended by striking ``Not earlier than 6 years'' and all that follows 
through ``purposes of this section.''.
    (c) Assignment to Shortage Area.--Section 333(a)(1)(D)(ii) of the 
Public Health Service Act (42 U.S.C. 254f(a)(1)(D)(ii)) is amended--
            (1) in subclause (IV), by striking ``and'';
            (2) in subclause (V), by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(VI) the entity demonstrates willingness to 
                support or facilitate mentorship, professional 
                development, and training opportunities for Corps 
                members.''.
    (d) Professional Development and Training.--Subsection (d) of 
section 336 of the Public Health Service Act (42 U.S.C. 254h-1) is 
amended to read as follows:
    ``(d) Professional Development and Training.--
            ``(1) In general.--The Secretary shall assist Corps members 
        in establishing and maintaining professional relationships and 
        development opportunities, including by--
                    ``(A) establishing appropriate professional 
                relationships between the Corps member involved and the 
                health professions community of the geographic area 
                with respect to which the member is assigned;
                    ``(B) establishing professional development, 
                training, and mentorship linkages between the Corps 
                member involved and the larger health professions 
                community, including through distance learning, direct 
                mentorship, and development and implementation of 
                training modules designed to meet the educational needs 
                of offsite Corps members;
                    ``(C) establishing professional networks among 
                Corps members; or
                    ``(D) engaging in other professional development, 
                mentorship, and training activities for Corps members, 
                at the discretion of the Secretary.
            ``(2) Assistance in establishing professional 
        relationships.--In providing such assistance under paragraph 
        (1), the Secretary shall focus on establishing relationships 
        with hospitals, with academic medical centers and health 
        professions schools, with area health education centers under 
        section 751, with health education and training centers under 
        section 752, and with border health education and training 
        centers under such section 752. Such assistance shall include 
        assistance in obtaining faculty appointments at health 
        professions schools.
            ``(3) Supplement not supplant.--Such efforts under this 
        subsection shall supplement, not supplant, non-government 
        efforts by professional health provider societies to establish 
        and maintain professional relationships and development 
        opportunities.''.

SEC. 4. REAUTHORIZATION OF RURAL HEALTH CARE PROGRAMS.

    Section 330A(j) of the Public Health Service Act (42 U.S.C. 
254c(j)) is amended by striking ``$40,000,000'' and all that follows 
and inserting ``$45,000,000 for each of fiscal years 2008 through 
2012.''.

            Passed the Senate July 21 (legislative day, July 17), 2008.

            Attest:

                                                             Secretary.
110th CONGRESS

  2d Session

                                 S. 901

_______________________________________________________________________

                                 AN ACT

  To amend the Public Health Service Act to reauthorize the Community 
 Health Centers program, the National Health Service Corps, and rural 
                         health care programs.

Summary: Health Care Safety Net Act of 2008 - (Sec. 2) Amends the Public Health Service Act to reauthorize appropriations for FY2008-FY2012 for health centers to meet the health care needs of medically underserved populations.

Requires the Comptroller General to study the economic costs and benefits of school-based health centers and their impact on the health of students, including an analysis of: (1) the impact that federal funding could have on the operation of such centers; (2) any cost savings to other federal programs derived from providing health services in such centers; and (3) the impact of such centers in rural or underserved areas.

Requires the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration (HRSA), to submit a report to the relevant congressional committees that describes efforts to expand and accelerate quality improvement activities in community health centers.

Requires the Administrator to establish a mechanism for the dissemination of initiatives, best practices, and other information that may assist health care quality improvement efforts in community health centers.

Directs the Comptroller General to study integrated health system models for the delivery of health care services to medically underserved populations.

(Sec. 3) Reauthorizes appropriations for FY2008-FY2012 for: (1) the National Health Service Corps program; and (2) the National Health Service Corps Scholarship Program and National Health Service Corps Loan Repayment Program.

Repeals provisions requiring each center or clinic designated as having a health manpower shortage to demonstrate every six years that it meets the applicable requirements of the definition of a health professional shortage area.

Revises requirements for assigning members of the Corps to a health professional shortage area to require that the Secretary determine that an entity demonstrates willingness to support or facilitate mentorship, professional development, and training opportunities for Corps members.

Requires the Secretary to assist Corps members in establishing and maintaining professional relationships and developmental opportunities.

(Sec. 4) Reauthorizes appropriations for FY2008-FY2012 for grants for expanded delivery of health care services in rural areas, for the planning and implementation of integrated health care networks in rural areas, and for the planning and implementation of small health care provider quality improvement activities.