Community and Migrant Health Centers Amendments of 1988
PL 100-386 (S.2385), enacted 08/10/1988

PUBLIC LAW 100-386—AUG. 10, 1988 
102 STAT. 919 
Public Law 100-386 
100th Congress 
An Act 
To amend the Public Health Service Act to revise and extend the programs establish-
ing migrant health centers and community health centers. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, 
SECTION 1. SHORT TITLE, REFERENCE TO ACT. 
(a) SHORT TITLE.—This Act may be cited as the "Community and 
Migrant Health Centers Amendments of 1988". 
(b) REFERENCE.—Whenever in this Act an amendment or repeal is 
expressed in terms of an amendment to, or repeal of, a section or 
other provision, the reference shall be considered to be made to a 
section or other provision of the Public Health Service Act. 
SEC. 2. MIGRANT HEALTH CENTERS. 
(a) ADDITION OF PATIENT CASE MANAGEMENT SERVICES TO LIST OF 
PROVIDED SERVICES.—Section 329(a)(1) (42 U.S.C. 254b(a)(l)) is 
amended— 
(1) by striking "and " at the end of subparagraph (F) and 
inserting "and" at the end of subparagraph (G); and 
(2) by inserting after subparagraph (G) the following new 
sulDparagraph: 
"(H) patient case management services (including outreach, 
counseling, referral, and follow-up services),". 
(b) ADDITION OF APPROPRIATE HEALTH NEEDS TO LIST OF SUPPLE-
MENTAL HEALTH SERVICES.—Section 329(a)(7) (42 U.S.C. 254b(a)(7)) is 
amended— 
(1) by striking "and " at the end of subparagraph (K); 
(2) by striking the period at the end of subparagraph (L) and 
inserting "; and '; and 
(3) by adding at the end the following new subparagraph: 
"(M) other services appropriate to meet the health needs of 
the population served by the migrant health center involved.". 
(c) PROCEDURES FOR ALTERATION OF DETERMINATION OF HIGH 
IMPACT AREA.—Section 329(d)(1)(A) (42 U.S.C. 254b(d)(l)(A)) is 
amended— 
(1) by inserting "(i)" after "(A)"; and 
(2) by adding at the end the following new clause: 
"(ii) If the Secretary makes a determination that an area is a high 
impact area, the Secretary may alter the determination only after 
providing to the grantee under subclause (i) for the area, and to 
other interested entities in the area, reasonable notice with respect 
to such determination and a reasonable opportunity to offer 
information with respect to such determination.'. 
(d) REQUIREMENT OF FEES CONSISTENT WITH LOCALLY PREVAILING 
RATES.—Section 329(f)(3)(F)(i) (42 U.S.C. 254b(f)(3)(F)(i)) is amended— 
(1) by inserting after "provision of its services" the following: 
"consistent with locally prevailing rates or charges and"; and 
(2) by inserting "has prepared" after "operation and". 
Aug. 10, 1988 
[S. 2385] 
Community and 
Migrant Health 
Centers 
Amendments of 
1988 
42 u s e 201 note. 
102 STAT. 920 
PUBLIC LAW 100-386—AUG. 10, 1988 
Grants. 
Grants. 
Contracts. 
(e) AUTHORITY WITH RESPECT TO EXPANSION AND CONSTRUCTION OF 
(1) Section 329 (42 U.S.C. 254b) is amended— 
(A) in the second sentence of subsection (c)(1)(A), by strik-
ing "acquisition and modernization of existing buildings" 
and inserting "acquisition, expansion, and modernization of 
existing buildings and construction of new buildings"; 
(B) in the matter after and below subsection (c)(l)(B)(iv), 
by striking "acquisition and modernization of existing 
buildings" and inserting "acquisition, expansion, and mod-
ernization of existing buildings, construction of new 
buildings,"; 
(C) in the matter after and below subsection (d)(l)(B)(iv), 
by striking "acquisition and modernization of existing 
buildings" and inserting "acquisition, expansion, and mod-
ernization of existing buildings, construction of new 
buildings,"; 
(D) in the matter after and below subsection (d)(l)(C)(iii), 
by striking "acquisition and modernization of existing 
buildings" and inserting "acquisition, expansion, and mod-
ernization of existing buildings, construction of new 
buildings,"; 
(E) in subsection (d)(2), by striking "acquiring and mod-
ernizing existing buildings" and inserting "acquiring, 
expanding, and modernizing existing buildings and con-
structing new buildings"; and 
(F) in subsection (d)(4)(B)(ii)(III), by striking "construct 
and modernize" and inserting "construct, expand, and 
modernize". 
(2) Section 329(f) (42 U.S.C. 254b(f)) is amended by adding at 
the end the following: 
"(7) The Secretary may make a grant under subsection (c) or (d) 
for the construction of new buildings for a migrant health center or 
a migrant health program only if the Secretary determines that 
appropriate facilities are not available through acquiring, moderniz-
ing, or expanding existing buildings and that the entity to which the 
grant will be made has made reasonable efforts to secure from other 
sources funds, in lieu of the grant, to construct such facilities.". 
(f) AMOUNT OF GRANTS FOR COSTS OF OPERATION.— 
(1) Section 329(d)(4)(A)(i) (42 U.S.C. 254b(d)(4)(A)(i)) is amended 
to read as follows: 
"(i) State, local, and other operational funding, and". 
(2) Section 329(d)(4)(B) (42 U.S.C. 254b(d)(4)(B)) is amended by 
striking out "may retain such an amount (equal to not less than 
one-half of the amount by which such sum exceeded such costs) 
as the center can demonstrate to the satisfaction of the Sec-
retary will be used to enable the center" in the matter imme-
diately following clause (ii) and inserting in lieu thereof "shall 
be entitled to retain the additional amount of fees, premiums, 
and other third party reimbursements as the center will use". 
(g) ADMINISTRATION OF PROGRAMS.—Section 329 (42 U.S.C. 254b) is 
amended by adding at the end the following: 
"(i) The Secretary may delegate the authority to administer the 
programs authorized by this section to any office within the Service, 
except that the authority to enter into, modify, or issue approvals 
with respect to grants or contracts may be delegated only within the 
PUBLIC LAW 100-386—AUG. 10, 1988 
102 STAT. 921 
central office of the Health Resources and Services Administra-
tion.". 
(h) AUTHORIZATION OF APPROPRIATIONS.—Section 329(h) (42 U.S.C. Grants. 
254b(h)) is amended— 
(1) by amending paragraph (1) to read as follows: 
"(1)(A) For the purposes of subsections (c) through (e), there are 
authorized to be appropriated $48,500,000 for fiscal year 1989 and 
such sums as may be necessary for fiscal years 1990 and 1991. 
"(B) Of the amounts appropriated pursuant to subparagraph (A) Contracts. 
for a fiscal year, the Secretary may obligate for grants and contracts 
under subsection (c)(1) not more than 2 percent, for grants under 
subsection (d)(1)(C) not more than 5 percent, and for contracts under 
subsection (e) not more than 10 percent."; and 
(2) by redesignating paragraph (2) as paragraph (3) and insert-
ing after paragraph (1) the following new paragraph: 
"(2)(A) For the purpose of carrying out subparagraph (B), there 
are authorized to be appropriated $1,500,000 for fiscal year 1989, 
$2,000,000 for fiscal year 1990, and $2,500,000 for fiscal year 1991. 
"(B) The Secretary may make grants to migrant health centers to Children and 
assist such centers in— 
youth, 
"(i) providing services for the reduction of the incidence of 
infant mortality; and 
"(ii) developing and coordinating referral arrangements be- Women, 
tween migrant health centers and other entities for the health 
management of infants and pregnant women. 
"(C) In making grants under subparagraph (B), the Secretary shall Children and 
give priority to migrant health centers providing services in any youth. 
catchment area in which there is a substantial incidence of infant 
mortality or in which there is a significant increase in the incidence 
of infant mortality.". 
SEC. 3. COMMUNITY HEALTH CENTERS. 
(a) ADDITION OF PATIENT CASE MANAGEMENT SERVICES TO LIST OF 
PROVIDED SERVICES.—Section 330(a)(1) (42 U.S.C. 254c(a)(l)) is 
amended— 
(1) by striking "and" at the end of paragraph (4) and inserting 
"and" at the end of paragraph (5); and 
(2) by inserting after paragraph (5) the following new para-
graph: 
"(6) patient case management services (including outreach, 
counseling, referral, and follow-up services),". 
(b) ADDITION OF APPROPRIATE HEALTH NEEDS TO LIST OF SUPPLE-
MENTAL HEALTH SERVICES.—Section 330(b)(2) (42 U.S.C. 254c(b)(2)) is 
amended— 
(1) by striking "and" at the end of subparagraph (L); 
(2) by striking the period at the end of subparagraph (M) and 
inserting "; and"; and 
(3) by adding at the end the following new subparagraph: 
Disadvantaged 
"(N) other services appropriate to meet the health needs of persons. 
the medically underserved population served by the community 
health center involved.". 
(c) REQUIREMENT OP NOTICE AND COMMENT WITH RESPECT TO 
REGULATIONS ON MEDICALLY UNDERSERVED POPULATIONS.—Section 
330(b)(4) (42 U.S.C. 254c(b)(4)) is amended by inserting after and 
below subparagraph (B) the following: 
102 STAT. 922 
PUBLIC L A W 100-386—AUG. 10, 1988 
Grants. 
Grants. 
Contracts. 
"The Secretary may modify the criteria established in regulations 
issued under this paragraph only after affording public notice and 
an opportunity for comment on any such proposed modifications.". 
(d) REQUIREMENT OF FEES CONSISTENT W I T H LOCALLY PREVAILING 
RATES.—Section 330(e)(3)(F)(i) (42 U.S.C. 254c(e)(3)(F)(i)) is amended— 
(1) by inserting after "provision of its services" the following: 
"consistent with locally prevailing rates or charges and"; and 
(2) by inserting "has prepared" after "operation and". 
(e) AUTHORITY W I T H RESPECT TO EXPANSION AND CONSTRUCTION OF 
(1) Section 330 (42 U.S.C. 254c) is amended— 
(A) in the second sentence of subsection (c)(1), by striking 
"acquisition and modernization of existing buildings" and 
inserting "acquisition, expansion, and modernization of 
existing buildings and construction of new buildings"; 
(B) in the matter after and below subsection (d)(l)(C)(iii), 
by striking "acquisition and modernization of existing 
buildings" and inserting "acquisition, expansion, and mod-
ernization of existing buildings, construction of new build-
ings,"; 
(C) in subsection (d)(2), by striking "acquiring and mod-
ernizing 
existing 
buildings" and inserting 
"acquiring, 
expanding, and modernizing existing buildings and con-
structing new buildings"; and 
(D) in subsection (d)(4)(B)(ii)(III), by striking "construct 
and modernize" and inserting "construct, expand, and mod-
ernize". 
(2) Section 330(e) (42 U.S.C. 254c(e)) is amended by adding at 
the end the following: 
"(6) The Secretary may make a grant under subsection (c) or (d) 
for the construction of new buildings for a community health center 
only if the Secretary determines that appropriate facilities are not 
available through acquiring, modernizing, or expanding existing 
buildings and that the entity to which the grant will be made has 
made reasonable efforts to secure from other sources funds, in lieu 
of the grant, to construct such facilities.". 
(f) AMOUNT OF GRANTS FOR COSTS OF OPERATION.— 
(1) Section 330(d)(4)(A)(i) (42 U.S.C. 254c(d)(4)(A)(i)) is amended 
to read as follows: 
"(i) State, local, and other operational funding, and". 
(2) Section 330(d)(4)(B) (42 U.S.C. 254c(d)(4)(B)) is amended by 
striking out "may retain such an amount (equal to not less than 
one-half of the amount by which such sum exceeded such costs) 
as the center can demonstrate to the satisfaction of the Sec-
retary will be used to enable the center" in the matter imme-
diately following clause (ii) and inserting in lieu thereof "shall 
be entitled to retain the additional amount of fees, premiums, 
and other third party reimbursements as the center will use". 
(g) ADMINISTRATION OF PROGRAMS.—Section 330 (42 U.S.C. 254c) is 
amended by adding at the end the following: 
"(j) The Secretary may delegate the authority to administer the 
programs authorized by this section to any office within the Service, 
except that the authority to enter into, modify, or issue approvals 
with respect to grants or contracts may be delegated only within the 
central office of the Health Resources and Services Administra-
tion.". 
PUBLIC LAW 100-386—AUG. 10, 1988 
102 STAT. 923 
(h) AUTHORIZATION OF APPROPRIATIONS.—Section 330(g) (42 U.S.C. Grants. 
254c(g)) is amended— 
(1) by amending paragraph (1) to read as follows: 
"(1)(A) For the purpose of payments under grants under this 
section, there are authorized to be appropriated $440,000,000 for 
fiscal year 1989 and such sums as may be necessary for fiscal years 
1990 and 1991."; 
(2)(A) by redesignating subparagraphs (A) and (B) of para-
graph (2) as clauses (i) and (ii), respectively; 
(B) by redesignating paragraph (2) as subparagraph (B); 
(C) in paragraph (IXBXi) (as so redesignated), by striking "this 
section" and inserting "paragraph (1)"; and 
(D) in paragraph (lXB)(ii) (as so redesignated), by striking 
"this section" and inserting "paragraph (1)"; and 
(3) by inserting after paragraph (1) the following new 
paragraph: 
"(2)(A) For the purpose of carrying out subparagraph (B), there 
are authorized to be appropriated $25,000,000 for fiscal year 1989, 
$30,000,000 for fiscal year 1990, and $35,000,000 for fiscal year 1991. 
"(B) The Secretary may make grants to community health centers 
to assist such centers in— 
"(i) providing services for the reduction of the incidence of 
infant mortality; and 
"(ii) developing and coordinating referral arrangements be-
tween community health centers and other entities for the 
health management of infants and pregnant women. 
"(C) In making grants under subparagraph (B), the Secretary shall 
give priority to community health centers providing services to any 
medically underserved population among which there is a substan-
tial incidence of infant mortality or among which there is a signifi-
cant increase in the incidence of infant mortality.", 
SEC. 4. REQUIREMENT WITH RESPECT TO FRONTIER AREAS. 
Section 330 (42 U.S.C. 254c) is amended by adding at the end the 
following new subsection: 
"(j) In making grants under this section, the Secretary shall give 
special consideration to the unique needs of frontier areas.". 
SEC. 5. EFFECTIVE DATE. 
The amendments made by this Act shall take effect October 1, 
1988, or upon the date of the enactment of this Act, whichever 
occurs later. 
Children and 
youth. 
Women. 
Disadvantaged 
persons. 
Children and 
youth. 
Grants. 
42 u s e 254b 
note. 
Approved August 10, 1988. 
LEGISLATIVE HISTORY—S. 2385 (H.R. 4503): 
HOUSE REPORTS: No. 100-719 accompanying H.R. 4503 (Comm. on Energy and 
Commerce). 
SENATE REPORTS: No. 100-343 (Comm. on Labor and Human Resources). 
CONGRESSIONAL RECORD, Vol. 134 (1988): 
June 13, considered and p£issed Senate. 
June 27, 28, H.R. 4503 considered and passed House. 
July 12, S. 2385 considered and passed House, amended, in lieu of H.R. 4503. 
July 29, Senate concurred in House amendment with an amendment. 
Aug. 1, House concurred in Senate amendment. 
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