Source: https://www.law.cornell.edu/uscode/text/42/256?quicktabs_8=1
Timestamp: 2016-02-11 09:23:31
Document Index: 339660917

Matched Legal Cases: ['§ 256', '§ 256', '§ 256', '§\u202f340', '§\u202f402', '§\u202f340', '§\u202f601', '§\u202f801', '§\u202f601', '§\u202f5', '§\u202f501', '§\u202f309', '§\u202f4', '§\u202f340', '§\u202f115', '§\u202f301', '§\u202f903', '§\u202f8', '§\u202f903', '§\u202f340', '§\u202f332', '§\u202f340', '§\u202f407', '§\u202f105', '§\u202f10504', '§\u202f401', '§\u202f256', 'art 10']

42 U.S. Code § 256 - Grants to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured | US Law | LII / Legal Information Institute
U.S. Code › Title 42 › Chapter 6A › Subchapter II › Part D › Subpart v › § 256 42 U.S. Code § 256 - Grants to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured
Grants to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured
(a) In generalThe Secretary may award grants to eligible entities to assist in the development of integrated health care delivery systems to serve communities of individuals who are uninsured and individuals who are underinsured—
to improve the efficiency of, and coordination among, the providers providing services through such systems;
to assist communities in developing programs targeted toward preventing and managing chronic diseases; and
to expand and enhance the services provided through such systems.
(b) Eligible entitiesTo be eligible to receive a grant under this section, an entity shall be an entity that—
whose principal purpose is to provide a broad range of coordinated health care services for a community defined in the entity’s grant application as described in paragraph (2); and
a Federally qualified health center (as defined in section 1395x(aa) of this title);
a hospital with a low-income utilization rate (as defined in section 1396r–4(b)(3) of this title), that is greater than 25 percent;
a public health department; and
an interested public or private sector health care provider or an organization that has traditionally served the medically uninsured and underserved; and
defines a community or geographic area of uninsured and underinsured individuals;
identifies the providers who will participate in the consortium’s program under the grant, and specifies each provider’s contribution to the care of uninsured and underinsured individuals in the community, including the volume of care the provider provides to beneficiaries under the medicare, medicaid, and State child health insurance programs and to patients who pay privately for services;
describes the activities that the applicant and the consortium propose to perform under the grant to further the objectives of this section;
demonstrates the consortium’s ability to build on the current system (as of the date of submission of the application) for serving a community or geographic area of uninsured and underinsured individuals by involving providers who have traditionally provided a significant volume of care for that community;
demonstrates the consortium’s ability to develop coordinated systems of care that either directly provide or ensure the prompt provision of a broad range of high-quality, accessible services, including, as appropriate, primary, secondary, and tertiary services, as well as substance abuse treatment and mental health services in a manner that assures continuity of care in the community or geographic area;
provides evidence of community involvement in the development, implementation, and direction of the program that the entity proposes to operate;
demonstrates the consortium’s ability to ensure that individuals participating in the program are enrolled in public insurance programs for which the individuals are eligible or know of private insurance programs where available;
presents a plan for leveraging other sources of revenue, which may include State and local sources and private grant funds, and integrating current and proposed new funding sources in a way to assure long-term sustainability of the program;
describes a plan for evaluation of the activities carried out under the grant, including measurement of progress toward the goals and objectives of the program and the use of evaluation findings to improve program performance;
demonstrates fiscal responsibility through the use of appropriate accounting procedures and appropriate management systems;
demonstrates the consortium’s commitment to serve the community without regard to the ability of an individual or family to pay by arranging for or providing free or reduced charge care for the poor; and
includes such other information as the Secretary may prescribe.
For each of fiscal years 2003, 2004, 2005, and 2006, the Secretary may not make more than 35 new awards under subsection (a) of this section (excluding renewals of such awards).
(2) In generalAn eligible entity may not receive a grant under this section (including with respect to any such grant made before fiscal year 2003) for more than 3 consecutive fiscal years, except that such entity may receive such a grant award for not more than 1 additional fiscal year if—
the eligible entity submits to the Secretary a request for a grant for such an additional fiscal year;
the Secretary determines that extraordinary circumstances (as defined in paragraph (3)) justify the granting of such request; and
the Secretary determines that granting such request is necessary to further the objectives described in subsection (a) of this section.
In paragraph (2), the term “extraordinary circumstances” means an event (or events) that is outside of the control of the eligible entity that has prevented the eligible entity from fulfilling the objectives described by such entity in the application submitted under subsection (b)(2) of this section.
(B) ExamplesExtraordinary circumstances include—
natural disasters or other major disruptions to the security or health of the community or geographic area served by the eligible entity; or
a significant economic deterioration in the community or geographic area served by such eligible entity, that directly and adversely affects the entity receiving an award under subsection (a) of this section.
(d) PrioritiesIn awarding grants under this section, the Secretary—
shall accord priority to applicants that demonstrate the extent of unmet need in the community involved for a more coordinated system of care; and
identifies a community whose geographical area has a high or increasing percentage of individuals who are uninsured;
demonstrates that the applicant has included in its consortium providers, support systems, and programs that have a tradition of serving uninsured individuals and underinsured individuals in the community;
shows evidence that the program would expand utilization of preventive and primary care services for uninsured and underinsured individuals and families in the community, including behavioral and mental health services, oral health services, or substance abuse services;
proposes a program that would improve coordination between health care providers and appropriate social service providers;
demonstrates collaboration with State and local governments;
demonstrates that the applicant makes use of non-Federal contributions to the greatest extent possible; or
demonstrates a likelihood that the proposed program will continue after support under this section ceases.
(A) In generalExcept as provided in paragraphs (2) and (3), a grantee may use amounts provided under this section only for—
direct expenses associated with achieving the greater integration of a health care delivery system so that the system either directly provides or ensures the provision of a broad range of culturally competent services, as appropriate, including primary, secondary, and tertiary services, as well as substance abuse treatment and mental health services; and
direct patient care and service expansions to fill identified or documented gaps within an integrated delivery system.
(B) Specific usesThe following are examples of purposes for which a grantee may use grant funds under this section, when such use meets the conditions stated in subparagraph (A):
Increases in outreach activities and closing gaps in health care service.
Improvements to case management.
Improvements to coordination of transportation to health care facilities.
Development of provider networks and other innovative models to engage physicians in voluntary efforts to serve the medically underserved within a community.
Recruitment, training, and compensation of necessary personnel.
Acquisition of technology for the purpose of coordinating care.
Improvements to provider communication, including implementation of shared information systems or shared clinical systems.
Development of common processes for determining eligibility for the programs provided through the system, including creating common identification cards and single sliding scale discounts.
Development of specific prevention and disease management tools and processes.
Carrying out other activities that may be appropriate to a community and that would increase access by the uninsured to health care, such as access initiatives for which private entities provide non-Federal contributions to supplement the Federal funds provided through the grants for the initiatives.
(1) Evaluation of effectivenessA grantee under this section shall—
progress in meeting the goals and measurable objectives set forth in the grant application submitted by the grantee under subsection (b) of this section; and
improved the effectiveness, efficiency, and coordination of services for uninsured and underinsured individuals in the communities or geographic areas served by such grantee;
resulted in the provision of better quality health care for such individuals; and
resulted in the provision of health care to such individuals at lower cost than would have been possible in the absence of the activities conducted by such grantee; and
provide for an independent annual financial audit of all records that relate to the disposition of funds received through the grant.
The Secretary may not renew an annual grant under this section for an entity for a fiscal year unless the Secretary is satisfied that the consortium represented by the entity has made reasonable and demonstrable progress in meeting the goals and measurable objectives set forth in the entity’s grant application for the preceding fiscal year.
(j) Demonstration authorityThe Secretary may make demonstration awards under this section to historically black health professions schools for the purposes of—
developing patient-based research infrastructure at historically black health professions schools, which have an affiliation, or affiliations, with any of the providers identified in subsection (b)(1)(B) of this section;
establishment of joint and collaborative programs of medical research and data collection between historically black health professions schools and such providers, whose goal is to improve the health status of medically underserved populations; or
supporting the research-related costs of patient care, data collection, and academic training resulting from such affiliations.
(July 1, 1944, ch. 373, title III, § 340, as added Pub. L. 107–251, title IV, § 402, Oct. 26, 2002, 116 Stat. 1655.)
A prior section 256, act July 1, 1944, ch. 373, title III, § 340, as added July 22, 1987, Pub. L. 100–77, title VI, § 601, 101 Stat. 511; amended Nov. 4, 1988, Pub. L. 100–607, title VIII, §§ 801(a), (c), 802(a), (b)(1), 803, 804, 102 Stat. 3168, 3169; Nov. 7, 1988, Pub. L. 100–628, title VI, §§ 601(a), (c), 602(a), (b)(1), 603, 604, 102 Stat. 3241, 3242; Aug. 16, 1989, Pub. L. 101–93, § 5(t)(1), (3), 103 Stat. 615; Nov. 29, 1990, Pub. L. 101–645, title V, §§ 501–503, 104 Stat. 4724; Oct. 27, 1992, Pub. L. 102–531, title III, § 309(c), 106 Stat. 3501, related to grant program for certain health services for the homeless, prior to repeal by Pub. L. 104–299, § 4(a)(3), Oct. 11, 1996, 110 Stat. 3645, eff. Oct. 1, 1996.
Another prior section 256, act July 1, 1944, ch. 373, title III, § 340, as added Nov. 10, 1978, Pub. L. 95–626, title I, § 115(2), 92 Stat. 3567; amended Dec. 12, 1979, Pub. L. 96–142, title III, § 301(a), 93 Stat. 1073; Aug. 13, 1981, Pub. L. 97–35, title IX, § 903(b)(1), 95 Stat. 561; Jan. 4, 1983, Pub. L. 97–414, § 8(h), 96 Stat. 2061, related to primary care research and demonstration projects to serve medically underserved population, prior to repeal by Pub. L. 97–35, title IX, § 903(c), Aug. 13, 1981, 95 Stat. 561, eff. Oct. 1, 1982.
Another prior section 256, act July 1, 1944, ch. 373, title III, § 340, formerly § 332, 58 Stat. 698; renumbered § 340, Oct. 12, 1976, Pub. L. 94–484, title IV, § 407(b)(2), 90 Stat. 2268, related to apprehension, detention, treatment, and release of persons being treated for leprosy, prior to repeal by Pub. L. 95–626, title I, § 105(b), Nov. 10, 1978, 92 Stat. 3560.
Pub. L. 111–148, title X, § 10504, Mar. 23, 2010, 124 Stat. 1004, provided that:
Not later than 6 months after the date of enactment of this Act [Mar. 23, 2010], the Secretary of Health and Human Services (referred to in this section as the ‘Secretary’), acting through the Health Resources and Services Administration, shall establish a 3 year demonstration project in up to 10 States to provide access to comprehensive health care services to the uninsured at reduced fees. The Secretary shall evaluate the feasibility of expanding the project to additional States.
To be eligible to participate in the demonstration project, an entity shall be a State-based, nonprofit, public-private partnership that provides access to comprehensive health care services to the uninsured at reduced fees. Each State in which a participant selected by the Secretary is located shall receive not more than $2,000,000 to establish and carry out the project for the 3-year demonstration period.
“(c)Authorization.—
There is authorized to be appropriated such sums as may be necessary to carry out this section.”
Pub. L. 107–251, title IV, § 401, Oct. 26, 2002, 116 Stat. 1655, provided that: “The purpose of this title [enacting this subpart and subpart X (§ 256f et seq.) of this part and provisions set out as a note under section 1396a of this title] is to provide assistance to communities and consortia of health care providers and others, to develop or strengthen integrated community health care delivery systems that coordinate health care services for individuals who are uninsured or underinsured and to develop or strengthen activities related to providing coordinated care for individuals with chronic conditions who are uninsured or underinsured, through the—
coordination of services to allow individuals to receive efficient and higher quality care and to gain entry into and receive services from a comprehensive system of care;
development of the infrastructure for a health care delivery system characterized by effective collaboration, information sharing, and clinical and financial coordination among all providers of care in the community; and
provision of new Federal resources that do not supplant funding for existing Federal categorical programs that support entities providing services to low-income populations.”
This is a list of parts within the Code of Federal Regulations for which this US Code section provides rulemaking authority.This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.42 CFR - Public Health42 CFR Part 10 - 340B DRUG PRICING PROGRAM