[107th Congress Public Law 251]
[From the U.S. Government Printing Office]
<DOC>
[DOCID: f:publ251.107]
[[Page 116 STAT. 1621]]
Public Law 107-251
107th Congress
An Act
To amend the Public Health Service Act to reauthorize and strengthen the
health centers program and the National Health Service Corps, and to
establish the Healthy Communities Access Program, which will help
coordinate services for the uninsured and underinsured, and for other
purposes. <<NOTE: Oct. 26, 2002 - [S. 1533]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress <<NOTE: Health Care Safety Net
Amendments of 2002.>> assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This <<NOTE: 42 USC 201 note.>> Act may be cited
as the ``Health Care Safety Net Amendments of 2002''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS
Sec. 101. Health centers.
Sec. 102. Telemedicine; incentive grants regarding coordination among
States.
TITLE II--RURAL HEALTH
Subtitle A--Rural Health Care Services Outreach, Rural Health Network
Development, and Small Health Care Provider Quality Improvement Grant
Programs
Sec. 201. Grant programs.
Subtitle B--Telehealth Grant Consolidation
Sec. 211. Short title.
Sec. 212. Consolidation and reauthorization of provisions.
Subtitle C--Mental Health Services Telehealth Program and Rural
Emergency Medical Service Training and Equipment Assistance Program
Sec. 221. Programs.
TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM
Sec. 301. National Health Service Corps.
Sec. 302. Designation of health professional shortage areas.
Sec. 303. Assignment of Corps personnel.
Sec. 304. Priorities in assignment of Corps personnel.
Sec. 305. Cost-sharing.
Sec. 306. Eligibility for Federal funds.
Sec. 307. Facilitation of effective provision of Corps services.
Sec. 308. Authorization of appropriations.
Sec. 309. National Health Service Corps Scholarship Program.
Sec. 310. National Health Service Corps Loan Repayment Program.
Sec. 311. Obligated service.
Sec. 312. Private practice.
Sec. 313. Breach of scholarship contract or loan repayment contract.
Sec. 314. Authorization of appropriations.
Sec. 315. Grants to States for loan repayment programs.
Sec. 316. Demonstration grants to States for community scholarship
programs.
Sec. 317. Demonstration project.
[[Page 116 STAT. 1622]]
TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM
Sec. 401. Purpose.
Sec. 402. Creation of Healthy Communities Access Program.
Sec. 403. Expanding availability of dental services.
Sec. 404. Study regarding barriers to participation of farmworkers in
health programs.
TITLE V--STUDY AND MISCELLANEOUS PROVISIONS
Sec. 501. Guarantee study.
Sec. 502. Graduate medical education.
TITLE VI--CONFORMING AMENDMENTS
Sec. 601. Conforming amendments.
TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS
SEC. 101. HEALTH CENTERS.
Section 330 of the Public Health Service Act (42 U.S.C. 254b) is
amended--
(1) in subsection (b)(1)(A)--
(A) in clause (i)(III)(bb), by striking ``screening
for breast and cervical cancer'' and inserting
``appropriate cancer screening'';
(B) in clause (ii), by inserting ``(including
specialty referral when medically indicated)'' after
``medical services''; and
(C) in clause (iii), by inserting ``housing,'' after
``social,'';
(2) in subsection (b)(2)--
(A) in subparagraph (A)(i), by striking ``associated
with water supply;'' and inserting the following:
``associated with--
``(I) water supply;
``(II) chemical and pesticide
exposures;
``(III) air quality; or
``(IV) exposure to lead;'';
(B) by redesignating subparagraphs (A) and (B) as
subparagraphs (C) and (D), respectively; and
(C) by inserting before subparagraph (C) (as so
redesignated by subparagraph (B)) the following:
``(A) behavioral and mental health and substance
abuse services;
``(B) recuperative care services;'';
(3) in subsection (c)(1)--
(A) in subparagraph (B)--
(i) in the heading, by striking
``Comprehensive service delivery'' and inserting
``Managed care'';
(ii) in the matter preceding clause (i), by
striking ``network or plan'' and all that follows
to the period and inserting ``managed care network
or plan.''; and
(iii) in the matter following clause (ii), by
striking ``Any such grant may include'' and all
that follows through the period; and
(B) by adding at the end the following:
``(C) Practice management networks.--The Secretary
may make grants to health centers that receive
assistance under this section to enable the centers to
plan
[[Page 116 STAT. 1623]]
and develop practice management networks that will
enable the centers to--
``(i) reduce costs associated with the
provision of health care services;
``(ii) improve access to, and availability of,
health care services provided to individuals
served by the centers;
``(iii) enhance the quality and coordination
of health care services; or
``(iv) improve the health status of
communities.
``(D) Use of funds.--The activities for which a
grant may be made under subparagraph (B) or (C) may
include the purchase or lease of equipment, which may
include data and information systems (including paying
for the costs of amortizing the principal of, and paying
the interest on, loans for equipment), the provision of
training and technical assistance related to the
provision of health care services on a prepaid basis or
under another managed care arrangement, and other
activities that promote the development of practice
management or managed care networks and plans.'';
(4) in subsection (d)--
(A) by striking the subsection heading and inserting
``Loan Guarantee Program.--'';
(B) in paragraph (1)--
(i) in subparagraph (A), by striking ``the
principal and interest on loans'' and all that
follows through the period and inserting ``up to
90 percent of the principal and interest on loans
made by non-Federal lenders to health centers,
funded under this section, for the costs of
developing and operating managed care networks or
plans described in subsection (c)(1)(B), or
practice management networks described in
subsection (c)(1)(C).'';
(ii) in subparagraph (B)--
(I) in clause (i), by striking
``or'';
(II) in clause (ii), by striking the
period and inserting ``; or''; and
(III) by adding at the end the
following:
``(iii) to refinance an existing loan (as of
the date of refinancing) to the center or centers,
if the Secretary determines--
``(I) that such refinancing will be
beneficial to the health center and the
Federal Government;
``(II) that the center (or centers)
can demonstrate an ability to repay the
refinanced loan equal to or greater than
the ability of the center (or centers)
to repay the original loan on the date
the original loan was made.''; and
(iii) by adding at the end the following:
``(D) Provision directly to networks or plans.--At
the request of health centers receiving assistance under
this section, loan guarantees provided under this
paragraph may be made directly to networks or plans that
are at least majority controlled and, as applicable, at
least majority owned by those health centers.
[[Page 116 STAT. 1624]]
``(E) Federal credit reform.--The requirements of
the Federal Credit Reform Act of 1990 (2 U.S.C. 661 et
seq.) shall apply with respect to loans refinanced under
subparagraph (B)(iii).''; and
(C)(i) by striking paragraphs (6) and (7); and
(ii) by redesignating paragraph (8) as paragraph
(6);
(4) in subsection (e)--
(A) in paragraph (1)--
(i) in subparagraph (B), by striking
``subsection (j)(3)'' and inserting ``subsection
(k)(3)''; and
(ii) by adding at the end the following:
``(C) Operation of networks and plans.--The
Secretary may make grants to health centers that receive
assistance under this section, or at the request of the
health centers, directly to a network or plan (as
described in subparagraphs (B) and (C) of subsection
(c)(1)) that is at least majority controlled and, as
applicable, at least majority owned by such health
centers receiving assistance under this section, for the
costs associated with the operation of such network or
plan, including the purchase or lease of equipment
(including the costs of amortizing the principal of, and
paying the interest on, loans for equipment).'';
(B) in paragraph (5)--
(i) in subparagraph (A), by inserting
``subparagraphs (A) and (B) of'' after ``any
fiscal year under'';
(ii) by redesignating subparagraphs (B) and
(C) as subparagraphs (C) and (D), respectively;
and
(iii) by inserting after subparagraph (A) the
following:
``(B) Networks and plans.--The total amount of grant
funds made available for any fiscal year under paragraph
(1)(C) and subparagraphs (B) and (C) of subsection
(c)(1) to a health center or to a network or plan shall
be determined by the Secretary, but may not exceed 2
percent of the total amount appropriated under this
section for such fiscal year.''; and
(C) by redesignating paragraphs (4) and (5) as
paragraphs (3) and (4), respectively;
(5) in subsection (g)--
(A) in paragraph (2)--
(i) in subparagraph (A), by inserting ``and
seasonal agricultural worker'' after
``agricultural worker''; and
(ii) in subparagraph (B), by striking ``and
members of their families'' and inserting ``and
seasonal agricultural workers, and members of
their families,''; and
(B) in paragraph (3)(A), by striking ``on a seasonal
basis'';
(6) in subsection (h)--
(A) in paragraph (1), by striking ``homeless
children and children at risk of homelessness'' and
inserting ``homeless children and youth and children and
youth at risk of homelessness'';
(B)(i) by redesignating paragraph (4) as paragraph
(5); and
(ii) by inserting after paragraph (3) the following:
[[Page 116 STAT. 1625]]
``(4) Temporary continued provision of services to certain
former homeless individuals.--If any grantee under this
subsection has provided services described in this section under
the grant to a homeless individual, such grantee may,
notwithstanding that the individual is no longer homeless as a
result of becoming a resident in permanent housing, expend the
grant to continue to provide such services to the individual for
not more than 12 months.''; and
(C) in paragraph (5)(C) (as redesignated by
subparagraph (B)), by striking ``and residential
treatment'' and inserting ``, risk reduction, outpatient
treatment, residential treatment, and rehabilitation'';
(7) in subsection (j)(3)--
(A) in subparagraph (E)--
(i) in clause (i)--
(I) by striking ``(i)'' and
inserting ``(i)(I)'';
(II) by striking ``plan; or'' and
inserting ``plan; and''; and
(III) by adding at the end the
following:
``(II) has or will have a
contractual or other arrangement with
the State agency administering the
program under title XXI of such Act (42
U.S.C. 1397aa et seq.) with respect to
individuals who are State children's
health insurance program beneficiaries;
or''; and
(ii) by striking clause (ii) and inserting the
following:
``(ii) has made or will make every reasonable
effort to enter into arrangements described in
subclauses (I) and (II) of clause (i);'';
(B) in subparagraph (G)--
(i) in clause (ii)(II), by striking ``; and''
and inserting ``;'';
(ii) by redesignating clause (iii) as clause
(iv); and
(iii) by inserting after clause (ii) the
following:
``(iii)(I) will assure that no patient will be
denied health care services due to an individual's
inability to pay for such services; and
``(II) will assure that any fees or payments
required by the center for such services will be
reduced or waived to enable the center to fulfill
the assurance described in subclause (I); and'';
(C) in subparagraph (H), in the matter following
clause (iii), by striking ``or (p)'' and inserting ``or
(q)'';
(D) in subparagraph (K)(ii), by striking ``and'' at
the end;
(E) in subparagraph (L), by striking the period and
inserting ``; and''; and
(F) by inserting after subparagraph (L), the
following:
``(M) the center encourages persons receiving or
seeking health services from the center to participate
in any public or private (including employer-offered)
health programs or plans for which the persons are
eligible, so long as the center, in complying with this
subparagraph, does not violate the requirements of
subparagraph (G)(iii)(I).'';
(8)(A) by redesignating subsection (l) as subsection (s) and
moving that subsection (s) to the end of the section;
[[Page 116 STAT. 1626]]
(B) by redesignating subsections (j), (k), and (m) through
(q) as subsections (n), (o), and (p) through (s), respectively;
and
(C) by inserting after subsection (i) the following:
``(j) Access Grants.--
``(1) In general.--The Secretary may award grants to
eligible health centers with a substantial number of clients
with limited English speaking proficiency to provide
translation, interpretation, and other such services for such
clients with limited English speaking proficiency.
``(2) Eligible health center.--In this subsection, the term
`eligible health center' means an entity that--
``(A) is a health center as defined under subsection
(a);
``(B) provides health care services for clients for
whom English is a second language; and
``(C) has exceptional needs with respect to
linguistic access or faces exceptional challenges with
respect to linguistic access.
``(3) Grant amount.--The amount of a grant awarded to a
center under this subsection shall be determined by the
Administrator. Such determination of such amount shall be based
on the number of clients for whom English is a second language
that is served by such center, and larger grant amounts shall be
awarded to centers serving larger numbers of such clients.
``(4) Use of funds.--An eligible health center that receives
a grant under this subsection may use funds received through
such grant to--
``(A) provide translation, interpretation, and other
such services for clients for whom English is a second
language, including hiring professional translation and
interpretation services; and
``(B) compensate bilingual or multilingual staff for
language assistance services provided by the staff for
such clients.
``(5) Application.--An eligible health center desiring a
grant under this subsection shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may reasonably require, including--
``(A) an estimate of the number of clients that the
center serves for whom English is a second language;
``(B) the ratio of the number of clients for whom
English is a second language to the total number of
clients served by the center;
``(C) a description of any language assistance
services that the center proposes to provide to aid
clients for whom English is a second language; and
``(D) a description of the exceptional needs of such
center with respect to linguistic access or a
description of the exceptional challenges faced by such
center with respect to linguistic access.
``(6) Authorization of appropriations.--There are authorized
to be appropriated to carry out this subsection, in addition to
any funds authorized to be appropriated or appropriated for
health centers under any other subsection of this
[[Page 116 STAT. 1627]]
section, such sums as may be necessary for each of fiscal years
2002 through 2006.'';
(9) by striking subsection (m) (as redesignated by paragraph
(9)(B)) and inserting the following:
``(m) Technical Assistance.--The Secretary shall establish a program
through which the Secretary shall provide technical and other assistance
to eligible entities to assist such entities to meet the requirements of
subsection (l)(3). Services provided through the program may include
necessary technical and nonfinancial assistance, including fiscal and
program management assistance, training in fiscal and program
management, operational and administrative support, and the provision of
information to the entities of the variety of resources available under
this title and how those resources can be best used to meet the health
needs of the communities served by the entities.'';
(10) in subsection (q) (as redesignated by paragraph
(9)(B)), by striking ``(j)(3)(G)'' and inserting ``(l)(3)(G)'';
and
(11) in subsection (s) (as redesignated by paragraph
(9)(A))--
(A) in paragraph (1), by striking ``$802,124,000''
and all that follows through the period and inserting
``$1,340,000,000 for fiscal year 2002 and such sums as
may be necessary for each of the fiscal years 2003
through 2006.'';
(B) in paragraph (2)--
(i) in subparagraph (A)--
(I) by striking ``(j)(3))'' and
inserting ``(l)(3))''; and
(II) by striking ``(j)(3)(G)(ii)''
and inserting ``(l)(3)(H)''; and
(ii) by striking subparagraph (B) and
inserting the following:
``(B) Distribution of grants.--For fiscal year 2002
and each of the following fiscal years, the Secretary,
in awarding grants under this section, shall ensure that
the proportion of the amount made available under each
of subsections (g), (h), and (i), relative to the total
amount appropriated to carry out this section for that
fiscal year, is equal to the proportion of the amount
made available under that subsection for fiscal year
2001, relative to the total amount appropriated to carry
out this section for fiscal year 2001.''.
SEC. 102. <<NOTE: 42 USC 254c-17.>> TELEMEDICINE; INCENTIVE GRANTS
REGARDING COORDINATION AMONG STATES.
(a) In General.--The Secretary of Health and Human Services may make
grants to State professional licensing boards to carry out programs
under which such licensing boards of various States cooperate to develop
and implement State policies that will reduce statutory and regulatory
barriers to telemedicine.
(b) Authorization of Appropriations.--For the purpose of carrying
out subsection (a), there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2002 through 2006.
[[Page 116 STAT. 1628]]
TITLE II--RURAL HEALTH
Subtitle A--Rural Health Care Services Outreach, Rural Health Network
Development, and Small Health Care Provider Quality Improvement Grant
Programs
SEC. 201. GRANT PROGRAMS.
Section 330A of the Public Health Service Act (42 U.S.C. 254c) is
amended to read as follows:
``SEC. 330A. RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH
NETWORK DEVELOPMENT, AND SMALL HEALTH
CARE PROVIDER QUALITY IMPROVEMENT
GRANT PROGRAMS.
``(a) Purpose.--The purpose of this section is to provide 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.
``(b) Definitions.--
``(1) Director.--The term `Director' means the Director
specified in subsection (d).
``(2) Federally qualified health center; rural health
clinic.--The terms `Federally qualified health center' and
`rural health clinic' have the meanings given the terms in
section 1861(aa) of the Social Security Act (42 U.S.C.
1395x(aa)).
``(3) Health professional shortage area.--The term `health
professional shortage area' means a health professional shortage
area designated under section 332.
``(4) Medically underserved community.--The term `medically
underserved community' has the meaning given the term in section
799B.
``(5) Medically underserved population.--The term `medically
underserved population' has the meaning given the term in
section 330(b)(3).
``(c) Program.--The Secretary shall establish, under section 301, a
small health care provider quality improvement grant program.
``(d) Administration.--
``(1) Programs.--The rural health care services outreach,
rural health network development, and small health care provider
quality improvement grant programs established under section 301
shall be administered by the Director of the Office of Rural
Health Policy of the Health Resources and Services
Administration, in consultation with State offices of rural
health or other appropriate State government entities.
``(2) Grants.--
``(A) In general.--In carrying out the programs
described in paragraph (1), the Director may award
grants under subsections (e), (f), and (g) to expand
access to, coordinate, and improve the quality of
essential health care services, and enhance the delivery
of health care, in rural areas.
[[Page 116 STAT. 1629]]
``(B) Types of grants.--The Director may award the
grants--
``(i) to promote expanded delivery of health
care services in rural areas under subsection (e);
``(ii) to provide for the planning and
implementation of integrated health care networks
in rural areas under subsection (f); and
``(iii) to provide for the planning and
implementation of small health care provider
quality improvement activities under subsection
(g).
``(e) Rural Health Care Services Outreach Grants.--
``(1) Grants.--The Director may award grants to eligible
entities to promote rural health care services outreach by
expanding the delivery of health care services to include new
and enhanced services in rural areas. The Director may award the
grants for periods of not more than 3 years.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection for a project, an entity--
``(A) shall be a rural public or rural nonprofit
private entity;
``(B) shall represent a consortium composed of
members--
``(i) that include 3 or more health care
providers; and
``(ii) that may be nonprofit or for-profit
entities; and
``(C) shall not previously have received a grant
under this subsection for the same or a similar project,
unless the entity is proposing to expand the scope of
the project or the area that will be served through the
project.
``(3) Applications.--To be eligible to receive a grant under
this subsection, an eligible entity, in consultation with the
appropriate State office of rural health or another appropriate
State entity, shall prepare and submit to the Secretary an
application, at such time, in such manner, and containing such
information as the Secretary may require, including--
``(A) a description of the project that the eligible
entity will carry out using the funds provided under the
grant;
``(B) a description of the manner in which the
project funded under the grant will meet the health care
needs of rural underserved populations in the local
community or region to be served;
``(C) a description of how the local community or
region to be served will be involved in the development
and ongoing operations of the project;
``(D) a plan for sustaining the project after
Federal support for the project has ended;
``(E) a description of how the project will be
evaluated; and
``(F) other such information as the Secretary
determines to be appropriate.
``(f) Rural Health Network Development Grants.--
``(1) Grants.--
``(A) In general.--The Director may award rural
health network development grants to eligible entities
to promote, through planning and implementation, the
development of integrated health care networks that have
[[Page 116 STAT. 1630]]
combined the functions of the entities participating in
the networks in order to--
``(i) achieve efficiencies;
``(ii) expand access to, coordinate, and
improve the quality of essential health care
services; and
``(iii) strengthen the rural health care
system as a whole.
``(B) Grant periods.--The Director may award such a
rural health network development grant for
implementation activities for a period of 3 years. The
Director may also award such a rural health network
development grant for planning activities for a period
of 1 year, to assist in the development of an integrated
health care network, if the proposed participants in the
network do not have a history of collaborative efforts
and a 3-year grant would be inappropriate.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection, an entity--
``(A) shall be a rural public or rural nonprofit
private entity;
``(B) shall represent a network composed of
participants--
``(i) that include 3 or more health care
providers; and
``(ii) that may be nonprofit or for-profit
entities; and
``(C) shall not previously have received a grant
under this subsection (other than a grant for planning
activities) for the same or a similar project.
``(3) Applications.--To be eligible to receive a grant under
this subsection, an eligible entity, in consultation with the
appropriate State office of rural health or another appropriate
State entity, shall prepare and submit to the Secretary an
application, at such time, in such manner, and containing such
information as the Secretary may require, including--
``(A) a description of the project that the eligible
entity will carry out using the funds provided under the
grant;
``(B) an explanation of the reasons why Federal
assistance is required to carry out the project;
``(C) a description of--
``(i) the history of collaborative activities
carried out by the participants in the network;
``(ii) the degree to which the participants
are ready to integrate their functions; and
``(iii) how the local community or region to
be served will benefit from and be involved in the
activities carried out by the network;
``(D) a description of how the local community or
region to be served will experience increased access to
quality health care services across the continuum of
care as a result of the integration activities carried
out by the network;
``(E) a plan for sustaining the project after
Federal support for the project has ended;
``(F) a description of how the project will be
evaluated; and
[[Page 116 STAT. 1631]]
``(G) other such information as the Secretary
determines to be appropriate.
``(g) Small Health Care Provider Quality Improvement Grants.--
``(1) Grants.--The Director may award grants to provide for
the planning and implementation of small health care provider
quality improvement activities. The Director may award the
grants for periods of 1 to 3 years.
``(2) Eligibility.--To be eligible for a grant under this
subsection, an entity--
``(A)(i) shall be a rural public or rural nonprofit
private health care provider or provider of health care
services, such as a critical access hospital or a rural
health clinic; or
``(ii) shall be another rural provider or network of
small rural providers identified by the Secretary as a
key source of local care; and
``(B) shall not previously have received a grant
under this subsection for the same or a similar project.
``(3) Applications.--To be eligible to receive a grant under
this subsection, an eligible entity, in consultation with the
appropriate State office of rural health or another appropriate
State entity shall prepare and submit to the Secretary an
application, at such time, in such manner, and containing such
information as the Secretary may require, including--
``(A) a description of the project that the eligible
entity will carry out using the funds provided under the
grant;
``(B) an explanation of the reasons why Federal
assistance is required to carry out the project;
``(C) a description of the manner in which the
project funded under the grant will assure continuous
quality improvement in the provision of services by the
entity;
``(D) a description of how the local community or
region to be served will experience increased access to
quality health care services across the continuum of
care as a result of the activities carried out by the
entity;
``(E) a plan for sustaining the project after
Federal support for the project has ended;
``(F) a description of how the project will be
evaluated; and
``(G) other such information as the Secretary
determines to be appropriate.
``(4) Expenditures for small health care provider quality
improvement grants.--In awarding a grant under this subsection,
the Director shall ensure that the funds made available through
the grant will be used to provide services to residents of rural
areas. The Director shall award not less than 50 percent of the
funds made available under this subsection to providers located
in and serving rural areas.
``(h) General Requirements.--
``(1) Prohibited uses of funds.--An entity that receives a
grant under this section may not use funds provided through the
grant--
``(A) to build or acquire real property; or
``(B) for construction.
``(2) Coordination with other agencies.--The Secretary shall
coordinate activities carried out under grant programs
[[Page 116 STAT. 1632]]
described in this section, to the extent practicable, with
Federal and State agencies and nonprofit organizations that are
operating similar grant programs, to maximize the effect of
public dollars in funding meritorious proposals.
``(3) Preference.--In awarding grants under this section,
the Secretary shall give preference to entities that--
``(A) are located in health professional shortage
areas or medically underserved communities, or serve
medically underserved populations; or
``(B) propose to develop projects with a focus on
primary care, and wellness and prevention strategies.
``(i) Report.--Not <<NOTE: Deadline.>> later than September 30,
2005, the Secretary shall prepare and submit to the appropriate
committees of Congress a report on the progress and accomplishments of
the grant programs described in subsections (e), (f), and (g).
``(j) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $40,000,000 for fiscal year 2002,
and such sums as may be necessary for each of fiscal years 2003 through
2006.''.
Subtitle B--Telehealth <<NOTE: Telehealth Grant Consolidation Act of
2002.>> Grant Consolidation
SEC. 211. <<NOTE: 42 USC 201 note.>> SHORT TITLE.
This subtitle may be cited as the ``Telehealth Grant Consolidation
Act of 2002''.
SEC. 212. CONSOLIDATION AND REAUTHORIZATION OF PROVISIONS.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq) is amended by adding at the end the following:
``SEC. 330I. <<NOTE: 42 USC 254c-14.>> TELEHEALTH NETWORK AND
TELEHEALTH RESOURCE CENTERS GRANT
PROGRAMS.
``(a) Definitions.--In this section:
``(1) Director; office.--The terms `Director' and `Office'
mean the Director and Office specified in subsection (c).
``(2) Federally qualified health center and rural health
clinic.--The term `Federally qualified health center' and `rural
health clinic' have the meanings given the terms in section
1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)).
``(3) Frontier community.--The term `frontier community'
shall have the meaning given the term in regulations issued
under subsection (r).
``(4) Medically underserved area.--The term `medically
underserved area' has the meaning given the term `medically
underserved community' in section 799B.
``(5) Medically underserved population.--The term `medically
underserved population' has the meaning given the term in
section 330(b)(3).
``(6) Telehealth services.--The term `telehealth services'
means services provided through telehealth technologies.
``(7) Telehealth technologies.--The term `telehealth
technologies' means technologies relating to the use of
electronic information, and telecommunications technologies, to
support
[[Page 116 STAT. 1633]]
and promote, at a distance, health care, patient and
professional health-related education, health administration,
and public health.
``(b) Programs.--The Secretary shall establish, under section 301,
telehealth network and telehealth resource centers grant programs.
``(c) Administration.--
``(1) Establishment.--There is established in the Health and
Resources and Services Administration an Office for the
Advancement of Telehealth. The Office shall be headed by a
Director.
``(2) Duties.--The telehealth network and telehealth
resource centers grant programs established under section 301
shall be administered by the Director, in consultation with the
State offices of rural health, State offices concerning primary
care, or other appropriate State government entities.
``(d) Grants.--
``(1) Telehealth network grants.--The Director may, in
carrying out the telehealth network grant program referred to in
subsection (b), award grants to eligible entities for projects
to demonstrate how telehealth technologies can be used through
telehealth networks in rural areas, frontier communities, and
medically underserved areas, and for medically underserved
populations, to--
``(A) expand access to, coordinate, and improve the
quality of health care services;
``(B) improve and expand the training of health care
providers; and
``(C) expand and improve the quality of health
information available to health care providers, and
patients and their families, for decisionmaking.
``(2) Telehealth resource centers grants.--The Director may,
in carrying out the telehealth resource centers grant program
referred to in subsection (b), award grants to eligible entities
for projects to demonstrate how telehealth technologies can be
used in the areas and communities, and for the populations,
described in paragraph (1), to establish telehealth resource
centers.
``(e) Grant Periods.--The Director may award grants under this
section for periods of not more than 4 years.
``(f) Eligible Entities.--
``(1) Telehealth network grants.--
``(A) Grant recipient.--To be eligible to receive a
grant under subsection (d)(1), an entity shall be a
nonprofit entity.
``(B) Telehealth networks.--
``(i) In general.--To be eligible to receive a
grant under subsection (d)(1), an entity shall
demonstrate that the entity will provide services
through a telehealth network.
``(ii) Nature of entities.--Each entity
participating in the telehealth network may be a
nonprofit or for-profit entity.
``(iii) Composition of network.--The
telehealth network shall include at least 2 of the
following entities (at least 1 of which shall be a
community-based health care provider):
[[Page 116 STAT. 1634]]
``(I) Community or migrant health
centers or other Federally qualified
health centers.
``(II) Health care providers,
including pharmacists, in private
practice.
``(III) Entities operating clinics,
including rural health clinics.
``(IV) Local health departments.
``(V) Nonprofit hospitals, including
community access hospitals.
``(VI) Other publicly funded health
or social service agencies.
``(VII) Long-term care providers.
``(VIII) Providers of health care
services in the home.
``(IX) Providers of outpatient
mental health services and entities
operating outpatient mental health
facilities.
``(X) Local or regional emergency
health care providers.
``(XI) Institutions of higher
education.
``(XII) Entities operating dental
clinics.
``(2) Telehealth resource centers grants.--To be eligible to
receive a grant under subsection (d)(2), an entity shall be a
nonprofit entity.
``(g) Applications.--To be eligible to receive a grant under
subsection (d), an eligible entity, in consultation with the appropriate
State office of rural health or another appropriate State entity, shall
prepare and submit to the Secretary an application, at such time, in
such manner, and containing such information as the Secretary may
require, including--
``(1) a description of the project that the eligible entity
will carry out using the funds provided under the grant;
``(2) a description of the manner in which the project
funded under the grant will meet the health care needs of rural
or other populations to be served through the project, or
improve the access to services of, and the quality of the
services received by, those populations;
``(3) evidence of local support for the project, and a
description of how the areas, communities, or populations to be
served will be involved in the development and ongoing
operations of the project;
``(4) a plan for sustaining the project after Federal
support for the project has ended;
``(5) information on the source and amount of non-Federal
funds that the entity will provide for the project;
``(6) information demonstrating the long-term viability of
the project, and other evidence of institutional commitment of
the entity to the project;
``(7) in the case of an application for a project involving
a telehealth network, information demonstrating how the project
will promote the integration of telehealth technologies into the
operations of health care providers, to avoid redundancy, and
improve access to and the quality of care; and
``(8) other such information as the Secretary determines to
be appropriate.
``(h) Terms; Conditions; Maximum Amount of Assistance.--The
Secretary shall establish the terms and conditions of each
[[Page 116 STAT. 1635]]
grant program described in subsection (b) and the maximum amount of a
grant to be awarded to an individual recipient for each fiscal year
under this section. <<NOTE: Publication. Notice.>> The Secretary shall
publish, in a publication of the Health Resources and Services
Administration, notice of the application requirements for each grant
program described in subsection (b) for each fiscal year.
``(i) Preferences.--
``(1) Telehealth networks.--In awarding grants under
subsection (d)(1) for projects involving telehealth networks,
the Secretary shall give preference to an eligible entity that
meets at least 1 of the following requirements:
``(A) Organization.--The eligible entity is a rural
community-based organization or another community-based
organization.
``(B) Services.--The eligible entity proposes to use
Federal funds made available through such a grant to
develop plans for, or to establish, telehealth networks
that provide mental health, public health, long-term
care, home care, preventive, or case management
services.
``(C) Coordination.--The eligible entity
demonstrates how the project to be carried out under the
grant will be coordinated with other relevant federally
funded projects in the areas, communities, and
populations to be served through the grant.
``(D) Network.--The eligible entity demonstrates
that the project involves a telehealth network that
includes an entity that--
``(i) provides clinical health care services,
or educational services for health care providers
and for patients or their families; and
``(ii) is--
``(I) a public library;
``(II) an institution of higher
education; or
``(III) a local government entity.
``(E) Connectivity.--The eligible entity proposes a
project that promotes local connectivity within areas,
communities, or populations to be served through the
project.
``(F) Integration.--The eligible entity demonstrates
that health care information has been integrated into
the project.
``(2) Telehealth resource centers.--In awarding grants under
subsection (d)(2) for projects involving telehealth resource
centers, the Secretary shall give preference to an eligible
entity that meets at least 1 of the following requirements:
``(A) Provision of services.--The eligible entity
has a record of success in the provision of telehealth
services to medically underserved areas or medically
underserved populations.
``(B) Collaboration and sharing of expertise.--The
eligible entity has a demonstrated record of
collaborating and sharing expertise with providers of
telehealth services at the national, regional, State,
and local levels.
``(C) Broad range of telehealth services.--The
eligible entity has a record of providing a broad range
of telehealth services, which may include--
``(i) a variety of clinical specialty
services;
[[Page 116 STAT. 1636]]
``(ii) patient or family education;
``(iii) health care professional education;
and
``(iv) rural residency support programs.
``(j) Distribution of Funds.--
``(1) In general.--In awarding grants under this section,
the Director shall ensure, to the greatest extent possible, that
such grants are equitably distributed among the geographical
regions of the United States.
``(2) Telehealth networks.--In awarding grants under
subsection (d)(1) for a fiscal year, the Director shall ensure
that--
``(A) not less than 50 percent of the funds awarded
shall be awarded for projects in rural areas; and
``(B) the total amount of funds awarded for such
projects for that fiscal year shall be not less than the
total amount of funds awarded for such projects for
fiscal year 2001 under section 330A (as in effect on the
day before the date of enactment of the Health Care
Safety Net Amendments of 2002).
``(k) Use of Funds.--
``(1) Telehealth network program.--The recipient of a grant
under subsection (d)(1) may use funds received through such
grant for salaries, equipment, and operating or other costs,
including the cost of--
``(A) developing and delivering clinical telehealth
services that enhance access to community-based health
care services in rural areas, frontier communities, or
medically underserved areas, or for medically
underserved populations;
``(B) developing and acquiring, through lease or
purchase, computer hardware and software, audio and
video equipment, computer network equipment, interactive
equipment, data terminal equipment, and other equipment
that furthers the objectives of the telehealth network
grant program;
``(C)(i) developing and providing distance
education, in a manner that enhances access to care in
rural areas, frontier communities, or medically
underserved areas, or for medically underserved
populations; or
``(ii) mentoring, precepting, or supervising health
care providers and students seeking to become health
care providers, in a manner that enhances access to care
in the areas and communities, or for the populations,
described in clause (i);
``(D) developing and acquiring instructional
programming;
``(E)(i) providing for transmission of medical data,
and maintenance of equipment; and
``(ii) providing for compensation (including travel
expenses) of specialists, and referring health care
providers, who are providing telehealth services through
the telehealth network, if no third party payment is
available for the telehealth services delivered through
the telehealth network;
``(F) developing projects to use telehealth
technology to facilitate collaboration between health
care providers;
[[Page 116 STAT. 1637]]
``(G) collecting and analyzing usage statistics and
data to document the cost-effectiveness of the
telehealth services; and
``(H) carrying out such other activities as are
consistent with achieving the objectives of this
section, as determined by the Secretary.
``(2) Telehealth resource centers.--The recipient of a grant
under subsection (d)(2) may use funds received through such
grant for salaries, equipment, and operating or other costs
for--
``(A) providing technical assistance, training, and
support, and providing for travel expenses, for health
care providers and a range of health care entities that
provide or will provide telehealth services;
``(B) disseminating information and research
findings related to telehealth services;
``(C) promoting effective collaboration among
telehealth resource centers and the Office;
``(D) conducting evaluations to determine the best
utilization of telehealth technologies to meet health
care needs;
``(E) promoting the integration of the technologies
used in clinical information systems with other
telehealth technologies;
``(F) fostering the use of telehealth technologies
to provide health care information and education for
health care providers and consumers in a more effective
manner; and
``(G) implementing special projects or studies under
the direction of the Office.
``(l) Prohibited Uses of Funds.--An entity that receives a grant
under this section may not use funds made available through the grant--
``(1) to acquire real property;
``(2) for expenditures to purchase or lease equipment, to
the extent that the expenditures would exceed 40 percent of the
total grant funds;
``(3) in the case of a project involving a telehealth
network, to purchase or install transmission equipment (such as
laying cable or telephone lines, or purchasing or installing
microwave towers, satellite dishes, amplifiers, or digital
switching equipment);
``(4) to pay for any equipment or transmission costs not
directly related to the purposes for which the grant is awarded;
``(5) to purchase or install general purpose voice telephone
systems;
``(6) for construction; or
``(7) for expenditures for indirect costs (as determined by
the Secretary), to the extent that the expenditures would exceed
15 percent of the total grant funds.
``(m) Collaboration.--In providing services under this section, an
eligible entity shall collaborate, if feasible, with entities that--
``(1)(A) are private or public organizations, that receive
Federal or State assistance; or
``(B) are public or private entities that operate centers,
or carry out programs, that receive Federal or State assistance;
and
``(2) provide telehealth services or related activities.
[[Page 116 STAT. 1638]]
``(n) Coordination With Other Agencies.--The Secretary shall
coordinate activities carried out under grant programs described in
subsection (b), to the extent practicable, with Federal and State
agencies and nonprofit organizations that are operating similar
programs, to maximize the effect of public dollars in funding
meritorious proposals.
``(o) Outreach Activities.--The Secretary shall establish and
implement procedures to carry out outreach activities to advise
potential end users of telehealth services in rural areas, frontier
communities, medically underserved areas, and medically underserved
populations in each State about the grant programs described in
subsection (b).
``(p) Telehealth.--It is the sense of Congress that, for purposes of
this section, States should develop reciprocity agreements so that a
provider of services under this section who is a licensed or otherwise
authorized health care provider under the law of 1 or more States, and
who, through telehealth technology, consults with a licensed or
otherwise authorized health care provider in another State, is exempt,
with respect to such consultation, from any State law of the other State
that prohibits such consultation on the basis that the first health care
provider is not a licensed or authorized health care provider under the
law of that State.
``(q) Report.--Not <<NOTE: Deadline.>> later than September 30,
2005, the Secretary shall prepare and submit to the appropriate
committees of Congress a report on the progress and accomplishments of
the grant programs described in subsection (b).
``(r) Regulations.--The Secretary shall issue regulations
specifying, for purposes of this section, a definition of the term
`frontier area'. The definition shall be based on factors that include
population density, travel distance in miles to the nearest medical
facility, travel time in minutes to the nearest medical facility, and
such other factors as the Secretary determines to be appropriate. The
Secretary shall develop the definition in consultation with the Director
of the Bureau of the Census and the Administrator of the Economic
Research Service of the Department of Agriculture.
``(s) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
``(1) for grants under subsection (d)(1), $40,000,000 for
fiscal year 2002, and such sums as may be necessary for each of
fiscal years 2003 through 2006; and
``(2) for grants under subsection (d)(2), $20,000,000 for
fiscal year 2002, and such sums as may be necessary for each of
fiscal years 2003 through 2006.''.
Subtitle C--Mental Health Services Telehealth Program and Rural
Emergency Medical Service Training and Equipment Assistance Program
SEC. 221. PROGRAMS.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) (as amended by section 212) is further amended
by adding at the end the following:
[[Page 116 STAT. 1639]]
``SEC. 330J. <<NOTE: 42 USC 254c-15.>> RURAL EMERGENCY MEDICAL
SERVICE TRAINING AND EQUIPMENT
ASSISTANCE PROGRAM.
``(a) Grants.--The Secretary, acting through the Administrator of
the Health Resources and Services Administration (referred to in this
section as the `Secretary') shall award grants to eligible entities to
enable such entities to provide for improved emergency medical services
in rural areas.
``(b) Eligibility.--To be eligible to receive a grant under this
section, an entity shall--
``(1) be--
``(A) a State emergency medical services office;
``(B) a State emergency medical services
association;
``(C) a State office of rural health;
``(D) a local government entity;
``(E) a State or local ambulance provider; or
``(F) any other entity determined appropriate by the
Secretary; and
``(2) prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require, that includes--
``(A) a description of the activities to be carried
out under the grant; and
``(B) an assurance that the eligible entity will
comply with the matching requirement of subsection (e).
``(c) Use of Funds.--An entity shall use amounts received under a
grant made under subsection (a), either directly or through grants to
emergency medical service squads that are located in, or that serve
residents of, a nonmetropolitan statistical area, an area designated as
a rural area by any law or regulation of a State, or a rural census
tract of a metropolitan statistical area (as determined under the most
recent Goldsmith Modification, originally published in a notice of
availability of funds in the Federal Register on February 27, 1992, 57
Fed. Reg. 6725), to--
``(1) recruit emergency medical service personnel;
``(2) recruit volunteer emergency medical service personnel;
``(3) train emergency medical service personnel in emergency
response, injury prevention, safety awareness, and other topics
relevant to the delivery of emergency medical services;
``(4) fund specific training to meet Federal or State
certification requirements;
``(5) develop new ways to educate emergency health care
providers through the use of technology-enhanced educational
methods (such as distance learning);
``(6) acquire emergency medical services equipment,
including cardiac defibrillators;
``(7) acquire personal protective equipment for emergency
medical services personnel as required by the Occupational
Safety and Health Administration; and
``(8) educate the public concerning cardiopulmonary
resuscitation, first aid, injury prevention, safety awareness,
illness prevention, and other related emergency preparedness
topics.
``(d) Preference.--In awarding grants under this section the
Secretary shall give preference to--
``(1) applications that reflect a collaborative effort by 2
or more of the entities described in subparagraphs (A) through
(F) of subsection (b)(1); and
[[Page 116 STAT. 1640]]
``(2) applications submitted by entities that intend to use
amounts provided under the grant to fund activities described in
any of paragraphs (1) through (5) of subsection (c).
``(e) Matching Requirement.--The Secretary may not award a grant
under this section to an entity unless the entity agrees that the entity
will make available (directly or through contributions from other public
or private entities) non-Federal contributions toward the activities to
be carried out under the grant in an amount equal to 25 percent of the
amount received under the grant.
``(f) Emergency Medical Services.--In this section, the term
`emergency medical services'--
``(1) means resources used by a qualified public or private
nonprofit entity, or by any other entity recognized as qualified
by the State involved, to deliver medical care outside of a
medical facility under emergency conditions that occur--
``(A) as a result of the condition of the patient;
or
``(B) as a result of a natural disaster or similar
situation; and
``(2) includes services delivered by an emergency medical
services provider (either compensated or volunteer) or other
provider recognized by the State involved that is licensed or
certified by the State as an emergency medical technician or its
equivalent (as determined by the State), a registered nurse, a
physician assistant, or a physician that provides services
similar to services provided by such an emergency medical
services provider.
``(g) Authorization of Appropriations.--
``(1) In general.--There are authorized to be appropriated
to carry out this section such sums as may be necessary for each
of fiscal years 2002 through 2006.
``(2) Administrative costs.--The Secretary may use not more
than 10 percent of the amount appropriated under paragraph (1)
for a fiscal year for the administrative expenses of carrying
out this section.
``SEC. 330K. <<NOTE: 42 USC 254c-16.>> MENTAL HEALTH SERVICES DELIVERED
VIA TELEHEALTH.
``(a) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means a
public or nonprofit private telehealth provider network that
offers services that include mental health services provided by
qualified mental health providers.
``(2) Qualified mental health professionals.--The term
`qualified mental health professionals' refers to providers of
mental health services reimbursed under the medicare program
carried out under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.) who have additional training in the
treatment of mental illness in children and adolescents or who
have additional training in the treatment of mental illness in
the elderly.
``(3) Special populations.--The term `special populations'
refers to the following 2 distinct groups:
``(A) Children and adolescents in mental health
underserved rural areas or in mental health underserved
urban areas.
``(B) Elderly individuals located in long-term care
facilities in mental health underserved rural or urban
areas.
[[Page 116 STAT. 1641]]
``(4) Telehealth.--The term `telehealth' means the use of
electronic information and telecommunications technologies to
support long distance clinical health care, patient and
professional health-related education, public health, and health
administration.
``(b) Program Authorized.--
``(1) In general.--The Secretary, acting through the
Director of the Office for the Advancement of Telehealth of the
Health Resources and Services Administration, shall award grants
to eligible entities to establish demonstration projects for the
provision of mental health services to special populations as
delivered remotely by qualified mental health professionals
using telehealth and for the provision of education regarding
mental illness as delivered remotely by qualified mental health
professionals using telehealth.
``(2) Populations served.--The Secretary shall award the
grants under paragraph (1) in a manner that distributes the
grants so as to serve equitably the populations described in
subparagraphs (A) and (B) of subsection (a)(4).
``(c) Use of Funds.--
``(1) In general.--An eligible entity that receives a grant
under this section shall use the grant funds--
``(A) for the populations described in subsection
(a)(4)(A)--
``(i) to provide mental health services,
including diagnosis and treatment of mental
illness, as delivered remotely by qualified mental
health professionals using telehealth; and
``(ii) to collaborate with local public health
entities to provide the mental health services;
and
``(B) for the populations described in subsection
(a)(4)(B)--
``(i) to provide mental health services,
including diagnosis and treatment of mental
illness, in long-term care facilities as delivered
remotely by qualified mental health professionals
using telehealth; and
``(ii) to collaborate with local public health
entities to provide the mental health services.
``(2) Other uses.--An eligible entity that receives a grant
under this section may also use the grant funds to--
``(A) pay telecommunications costs; and
``(B) pay qualified mental health professionals on a
reasonable cost basis as determined by the Secretary for
services rendered.
``(3) Prohibited uses.--An eligible entity that receives a
grant under this section shall not use the grant funds to--
``(A) purchase or install transmission equipment
(other than such equipment used by qualified mental
health professionals to deliver mental health services
using telehealth under the project involved); or
``(B) build upon or acquire real property.
``(d) Equitable Distribution.--In awarding grants under this
section, the Secretary shall ensure, to the greatest extent possible,
that such grants are equitably distributed among geographical regions of
the United States.
``(e) Application.--An entity that desires a grant under this
section shall submit an application to the Secretary at such time,
[[Page 116 STAT. 1642]]
in such manner, and containing such information as the Secretary
determines to be reasonable.
``(f) Report.--Not <<NOTE: Deadline.>> later than 4 years after the
date of enactment of the Health Care Safety Net Amendments of 2002, the
Secretary shall prepare and submit to the appropriate committees of
Congress a report that shall evaluate activities funded with grants
under this section.
``(g) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $20,000,000 for fiscal year 2002
and such sums as may be necessary for fiscal years 2003 through 2006.''.
TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM
SEC. 301. NATIONAL HEALTH SERVICE CORPS.
(a) In General.--Section 331 of the Public Health Service Act (42
U.S.C. 254d) is amended--
(1) by adding at the end of subsection (a)(3) the following:
``(E)(i) The term `behavioral and mental health
professionals' means health service psychologists, licensed
clinical social workers, licensed professional counselors,
marriage and family therapists, psychiatric nurse specialists,
and psychiatrists.
``(ii) The term `graduate program of behavioral and mental
health' means a program that trains behavioral and mental health
professionals.'';
(2) in subsection (b)--
(A) in paragraph (1), by striking ``health
professions'' and inserting ``health professions,
including schools at which graduate programs of
behavioral and mental health are offered,''; and
(B) in paragraph (2), by inserting ``behavioral and
mental health professionals,'' after ``dentists,''; and
(3) by striking subsection (c) and inserting the following:
``(c)(1) The Secretary may reimburse an applicant for a position in
the Corps (including an individual considering entering into a written
agreement pursuant to section 338D) for the actual and reasonable
expenses incurred in traveling to and from the applicant's place of
residence to an eligible site to which the applicant may be assigned
under section 333 for the purpose of evaluating such site with regard to
being assigned at such site. The Secretary may establish a maximum total
amount that may be paid to an individual as reimbursement for such
expenses.
``(2) The Secretary may also reimburse the applicant for the actual
and reasonable expenses incurred for the travel of 1 family member to
accompany the applicant to such site. The Secretary may establish a
maximum total amount that may be paid to an individual as reimbursement
for such expenses.
``(3) In the case of an individual who has entered into a contract
for obligated service under the Scholarship Program or under the Loan
Repayment Program, the Secretary may reimburse such individual for all
or part of the actual and reasonable expenses incurred in transporting
the individual, the individual's family, and the family's possessions to
the site of the individual's assignment under section 333. The Secretary
may establish a maximum total amount
[[Page 116 STAT. 1643]]
that may be paid to an individual as reimbursement for such expenses.''.
(b) Demonstration Projects.--Section 331 of the Public Health
Service Act (42 U.S.C. 254d) is amended--
(1) by redesignating subsection (i) as subsection (j); and
(2) by inserting after subsection (h) the following:
``(i)(1) In carrying out subpart III, the Secretary may, in
accordance with this subsection, carry out demonstration projects in
which individuals who have entered into a contract for obligated service
under the Loan Repayment Program receive waivers under which the
individuals are authorized to satisfy the requirement of obligated
service through providing clinical service that is not full-time.
``(2) A waiver described in paragraph (1) may be provided by the
Secretary only if--
``(A) the entity for which the service is to be performed--
``(i) has been approved under section 333A for
assignment of a Corps member; and
``(ii) has requested in writing assignment of a
health professional who would serve less than full time;
``(B) the Secretary has determined that assignment of a
health professional who would serve less than full time would be
appropriate for the area where the entity is located;
``(C) a Corps member who is required to perform obligated
service has agreed in writing to be assigned for less than full-
time service to an entity described in subparagraph (A);
``(D) the entity and the Corps member agree in writing that
the less than full-time service provided by the Corps member
will not be less than 16 hours of clinical service per week;
``(E) the Corps member agrees in writing that the period of
obligated service pursuant to section 338B will be extended so
that the aggregate amount of less than full-time service
performed will equal the amount of service that would be
performed through full-time service under section 338C; and
``(F) the Corps member agrees in writing that if the Corps
member begins providing less than full-time service but fails to
begin or complete the period of obligated service, the method
stated in 338E(c) for determining the damages for breach of the
individual's written contract will be used after converting
periods of obligated service or of service performed into their
full-time equivalents.
``(3) In evaluating a demonstration project described in paragraph
(1), the Secretary shall examine the effect of multidisciplinary
teams.''.
SEC. 302. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS.
(a) In General.--Section 332 of the Public Health Service Act (42
U.S.C. 254e) is amended--
(1) in subsection (a)--
(A) in paragraph (1), by inserting after the first
sentence the following: ``All Federally qualified health
centers and rural health clinics, as defined in section
1861(aa) of the Social Security Act (42 U.S.C.
1395x(aa)), that meet the requirements of section 334
shall be automatically designated as having such a
shortage. Not earlier than 6 years after such date of
enactment, and every 6 years
[[Page 116 STAT. 1644]]
thereafter, each such center or clinic shall demonstrate
that the center or clinic meets the applicable
requirements of the Federal regulations, issued after
the date of enactment of this Act, that revise the
definition of a health professional shortage area for
purposes of this section.''; and
(B) in paragraph (3), by striking ``340(r)) may be a
population group'' and inserting ``330(h)(4)), seasonal
agricultural workers (as defined in section 330(g)(3))
and migratory agricultural workers (as so defined)), and
residents of public housing (as defined in section
3(b)(1) of the United States Housing Act of 1937 (42
U.S.C. 1437a(b)(1))) may be population groups'';
(2) in subsection (b)(2), by striking ``with special
consideration to the indicators of'' and all that follows
through ``services.'' and inserting a period; and
(3) in subsection (c)(2)(B), by striking ``XVIII or XIX''
and inserting ``XVIII, XIX, or XXI''.
(b) <<NOTE: 42 USC 254e note.>> Regulations.--
(1) Report.--
(A) In general.--The Secretary shall submit the
report described in subparagraph (B) if the Secretary,
acting through the Administrator of the Health Resources
and Services Administration, issues--
(i) a regulation that revises the definition
of a health professional shortage area for
purposes of section 332 of the Public Health
Service Act (42 U.S.C. 254e); or
(ii) a regulation that revises the standards
concerning priority of such an area under section
333A of that Act (42 U.S.C. 254f-1).
(B) Report.--On issuing a regulation described in
subparagraph (A), the Secretary shall prepare and submit
to the Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education,
Labor, and Pensions of the Senate a report that
describes the regulation.
(2) Effective date.--Each regulation described in paragraph
(1)(A) shall take effect 180 days after the committees described
in paragraph (1)(B) receive a report referred to in paragraph
(1)(B) describing the regulation.
(c) Scholarship <<NOTE: 42 USC 254l note.>> and Loan Repayment
Programs.--The Secretary of Health and Human Services, in consultation
with organizations representing individuals in the dental field and
organizations representing publicly funded health care providers, shall
develop and implement a plan for increasing the participation of
dentists and dental hygienists in the National Health Service Corps
Scholarship Program under section 338A of the Public Health Service Act
(42 U.S.C. 254l) and the Loan Repayment Program under section 338B of
such Act (42 U.S.C. 254l-1).
(d) Site Designation Process.--
(1) Improvement <<NOTE: 42 USC 254e note.>> of designation
process.--The Administrator of the Health Resources and Services
Administration, in consultation with the Association of State
and Territorial Dental Directors, dental societies, and other
interested parties, shall revise the criteria on which the
designations of dental
[[Page 116 STAT. 1645]]
health professional shortage areas are based so that such
criteria provide a more accurate reflection of oral health care
need, particularly in rural areas.
(2) Public health service act.--Section 332 of the Public
Health Service Act (42 U.S.C. 254e) is amended by adding at the
end the following:
``(i) Dissemination.--The Administrator of the Health Resources and
Services Administration shall disseminate information concerning the
designation criteria described in subsection (b) to--
``(1) the Governor of each State;
``(2) the representative of any area, population group, or
facility selected by any such Governor to receive such
information;
``(3) the representative of any area, population group, or
facility that requests such information; and
``(4) the representative of any area, population group, or
facility determined by the Administrator to be likely to meet
the criteria described in subsection (b).''.
(e) GAO Study.--Not <<NOTE: Deadline. 42 USC 254e note.>> later than
February 1, 2005, the Comptroller General of the United States shall
submit to the Congress a report on the appropriateness of the criteria,
including but not limited to infant mortality rates, access to health
services taking into account the distance to primary health services,
the rate of poverty and ability to pay for health services, and low
birth rates, established by the Secretary of Health and Human Services
for the designation of health professional shortage areas and whether
the deeming of federally qualified health centers and rural health
clinics as such areas is appropriate and necessary.
SEC. 303. ASSIGNMENT OF CORPS PERSONNEL.
Section 333 of the Public Health Service Act (42 U.S.C. 254f) is
amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) in the matter before subparagraph (A), by
striking ``(specified in the agreement described
in section 334)'';
(ii) in subparagraph (A), by striking
``nonprofit''; and
(iii) by striking subparagraph (C) and
inserting the following:
``(C) the entity agrees to comply with the
requirements of section 334; and''; and
(B) in paragraph (3), by adding at the end ``In
approving such applications, the Secretary shall give
preference to applications in which a nonprofit entity
or public entity shall provide a site to which Corps
members may be assigned.''; and
(2) in subsection (d)--
(A) in paragraphs (1), (2), and (4), by striking
``nonprofit'' each place it appears; and
(B) in paragraph (1)--
(i) in the second sentence--
(I) in subparagraph (C), by striking
``and'' at the end; and
[[Page 116 STAT. 1646]]
(II) by striking the period and
inserting
``, and (E) developing long-term plans
for addressing health professional
shortages and improving access to health
care.''; and
(ii) by adding at the end the following: ``The
Secretary shall encourage entities that receive
technical assistance under this paragraph to
communicate with other communities, State Offices
of Rural Health, State Primary Care Associations
and Offices, and other entities concerned with
site development and community needs
assessment.''.
SEC. 304. PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL.
Section 333A of the Public Health Service Act (42 U.S.C. 254f-1) is
amended--
(1) in subsection (a)(1)(A), by striking ``, as determined
in accordance with subsection (b)'';
(2) by striking subsection (b);
(3) in subsection (c), by striking the second sentence;
(4) in subsection (d)--
(A) by redesignating paragraphs (1) through (3) as
paragraphs (2) through (4), respectively;
(B) by inserting before paragraph (2) (as
redesignated by subparagraph (A)) the following:
``(1) Proposed list.--The <<NOTE: Publication.>> Secretary
shall prepare and publish a proposed list of health professional
shortage areas and entities that would receive priority under
subsection (a)(1) in the assignment of Corps members. The list
shall contain the information described in paragraph (2), and
the relative scores and relative priorities of the entities
submitting applications under section 333, in a proposed format.
All such entities shall have 30 days after the date of
publication of the list to provide additional data and
information in support of inclusion on the list or in support of
a higher priority determination and the Secretary shall
reasonably consider such data and information in preparing the
final list under paragraph (2).'';
(C) in paragraph (2) (as redesignated by
subparagraph (A)), in the matter before subparagraph
(A)--
(i) by striking ``paragraph (2)'' and
inserting ``paragraph (3)'';
(ii) by striking ``prepare a list of health
professional shortage areas'' and inserting
``prepare and, as appropriate, update a list of
health professional shortage areas and entities'';
and
(iii) by striking ``for the period applicable
under subsection (f)'';
(D) by striking paragraph (3) (as redesignated by
subparagraph (A)) and inserting the following:
``(3) Notification of affected parties.--
``(A) Entities.--Not <<NOTE: Deadline.>> later than
30 days after the Secretary has added to a list under
paragraph (2) an entity specified as described in
subparagraph (A) of such paragraph, the Secretary shall
notify such entity that the entity has been provided an
authorization to receive assignments of Corps members in
the event that Corps members are available for the
assignments.
[[Page 116 STAT. 1647]]
``(B) Individuals.--In the case of an individual
obligated to provide service under the Scholarship
Program, not later than 3 months before the date
described in section 338C(b)(5), the Secretary shall
provide to such individual the names of each of the
entities specified as described in paragraph (2)(B)(i)
that is appropriate for the individual's medical
specialty and discipline.''; and
(E) by striking paragraph (4) (as redesignated by
subparagraph (A)) and inserting the following:
``(4) Revisions.--If <<NOTE: Notification.>> the Secretary
proposes to make a revision in the list under paragraph (2), and
the revision would adversely alter the status of an entity with
respect to the list, the Secretary shall notify the entity of
the revision. Any entity adversely affected by such a revision
shall be notified in writing by the Secretary of the reasons for
the revision and shall have 30 days to file a written appeal of
the determination involved which shall be reasonably considered
by the Secretary before the revision to the list becomes final.
The revision to the list shall be effective with respect to
assignment of Corps members beginning on the date that the
revision becomes final.'';
(5) by striking subsection (e) and inserting the following:
``(e) Limitation on Number of Entities Offered as Assignment Choices
in Scholarship Program.--
``(1) Determination <<NOTE: Deadline.>> of available corps
members.--By April 1 of each calendar year, the Secretary shall
determine the number of participants in the Scholarship Program
who will be available for assignments under section 333 during
the program year beginning on July 1 of that calendar year.
``(2) Determination of number of entities.--At all times
during a program year, the number of entities specified under
subsection (c)(2)(B)(i) shall be--
``(A) not less than the number of participants
determined with respect to that program year under
paragraph (1); and
``(B) not greater than twice the number of
participants determined with respect to that program
year under paragraph (1).'';
(6) by striking subsection (f); and
(7) by redesignating subsections (c), (d), and (e) as
subsections (b), (c), and (d) respectively.
SEC. 305. COST-SHARING.
Subpart II of part D of title III of the Public Health Service Act
(42 U.S.C. 254d et seq.) is amended by striking section 334 and
inserting the following:
``SEC. 334. <<NOTE: 42 USC 254g.>> CHARGES FOR SERVICES BY
ENTITIES USING CORPS MEMBERS.
``(a) Availability of Services Regardless of Ability To Pay or
Payment Source.--An entity to which a Corps member is assigned shall not
deny requested health care services, and shall not discriminate in the
provision of services to an individual--
``(1) because the individual is unable to pay for the
services; or
``(2) because payment for the services would be made under--
[[Page 116 STAT. 1648]]
``(A) the medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.);
``(B) the medicaid program under title XIX of such
Act (42 U.S.C. 1396 et seq.); or
``(C) the State children's health insurance program
under title XXI of such Act (42 U.S.C. 1397aa et seq.).
``(b) Charges for Services.--The following rules shall apply to
charges for health care services provided by an entity to which a Corps
member is assigned:
``(1) In general.--
``(A) Schedule of fees or payments.--Except as
provided in paragraph (2), the entity shall prepare a
schedule of fees or payments for the entity's services,
consistent with locally prevailing rates or charges and
designed to cover the entity's reasonable cost of
operation.
``(B) Schedule of discounts.--Except as provided in
paragraph (2), the entity shall prepare a corresponding
schedule of discounts (including, in appropriate cases,
waivers) to be applied to such fees or payments. In
preparing the schedule, the entity shall adjust the
discounts on the basis of a patient's ability to pay.
``(C) Use of schedules.--The entity shall make every
reasonable effort to secure from patients fees and
payments for services in accordance with such schedules,
and fees or payments shall be sufficiently discounted in
accordance with the schedule described in subparagraph
(B).
``(2) Services to beneficiaries of federal and federally
assisted programs.--In the case of health care services
furnished to an individual who is a beneficiary of a program
listed in subsection (a)(2), the entity--
``(A) shall accept an assignment pursuant to section
1842(b)(3)(B)(ii) of the Social Security Act (42 U.S.C.
1395u(b)(3)(B)(ii)) with respect to an individual who is
a beneficiary under the medicare program; and
``(B) shall enter into an appropriate agreement
with--
``(i) the State agency administering the
program under title XIX of such Act with respect
to an individual who is a beneficiary under the
medicaid program; and
``(ii) the State agency administering the
program under title XXI of such Act with respect
to an individual who is a beneficiary under the
State children's health insurance program.
``(3) Collection of payments.--The entity shall take
reasonable and appropriate steps to collect all payments due for
health care services provided by the entity, including payments
from any third party (including a Federal, State, or local
government agency and any other third party) that is responsible
for part or all of the charge for such services.''.
SEC. 306. ELIGIBILITY FOR FEDERAL FUNDS.
Section 335(e)(1)(B) of the Public Health Service Act (42 U.S.C.
254h(e)(1)(B)) is amended by striking ``XVIII or XIX'' and inserting
``XVIII, XIX, or XXI''.
[[Page 116 STAT. 1649]]
SEC. 307. FACILITATION OF EFFECTIVE PROVISION OF CORPS SERVICES.
(a) Health Professional Shortage Areas.--Section 336 of the Public
Health Service Act (42 U.S.C. 254h-1) is amended--
(1) in subsection (c), by striking ``health manpower'' and
inserting ``health professional''; and
(2) in subsection (f)(1), by striking ``health manpower''
and inserting ``health professional''.
(b) Technical Amendment.--Section 336A(8) of the Public Health
Service Act (42 U.S.C. 254i(8)) is amended by striking ``agreements
under''.
SEC. 308. AUTHORIZATION OF APPROPRIATIONS.
Section 338(a) of the Public Health Service Act (42 U.S.C. 254k(a))
is amended--
(1) by striking ``(1) For'' and inserting ``For'';
(2) by striking ``1991 through 2000'' and inserting ``2002
through 2006''; and
(3) by striking paragraph (2).
SEC. 309. NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM.
Section 338A of the Public Health Service Act (42 U.S.C. 254l) is
amended--
(1) in subsection (a)(1), by inserting ``behavioral and
mental health professionals,'' after ``dentists,'';
(2) in subsection (b)(1)(B), by inserting ``, or an
appropriate degree from a graduate program of behavioral and
mental health'' after ``other health profession'';
(3) in subsection (c)(1)--
(A) in subparagraph (A), by striking ``338D'' and
inserting ``338E''; and
(B) in subparagraph (B), by striking ``338C'' and
inserting ``338D'';
(4) in subsection (d)(1)--
(A) in subparagraph (A), by striking ``and'' at the
end;
(B) by redesignating subparagraph (B) as
subparagraph (C); and
(C) by inserting after subparagraph (A) the
following:
``(B) the Secretary, in considering applications
from individuals accepted for enrollment or enrolled in
dental school, shall consider applications from all
individuals accepted for enrollment or enrolled in any
accredited dental school in a State; and'';
(5) in subsection (f)--
(A) in paragraph (1)(B)--
(i) in clause (iii), by striking ``and'' after
the semicolon;
(ii) by redesignating clause (iv) as clause
(v); and
(iii) by inserting after clause (iii) the
following new clause:
``(iv) if pursuing a degree from a school of
medicine or osteopathic medicine, to complete a
residency in a specialty that the Secretary
determines is consistent with the needs of the
Corps; and''; and
(B) in paragraph (3), by striking ``338D'' and
inserting ``338E''; and
[[Page 116 STAT. 1650]]
(6) by striking subsection (i).
SEC. 310. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM.
Section 338B of the Public Health Service Act (42 U.S.C. 254l-1) is
amended--
(1) in subsection (a)--
(A) in paragraph (1), by inserting ``behavioral and
mental health professionals,'' after ``dentists,''; and
(B) in paragraph (2), by striking ``(including
mental health professionals)'';
(2) in subsection (b)(1), by striking subparagraph (A) and
inserting the following:
``(A) have a degree in medicine, osteopathic medicine,
dentistry, or another health profession, or an appropriate
degree from a graduate program of behavioral and mental health,
or be certified as a nurse midwife, nurse practitioner, or
physician assistant;'';
(3) in subsection (e), by striking ``(1) In general.--'';
and
(4) by striking subsection (i).
SEC. 311. OBLIGATED SERVICE.
Section 338C of the Public Health Service Act (42 U.S.C. 254m) is
amended--
(1) in subsection (b)--
(A) in paragraph (1), in the matter preceding
subparagraph (A), by striking ``section
338A(f)(1)(B)(iv)'' and inserting ``section
338A(f)(1)(B)(v)''; and
(B) in paragraph (5)--
(i) by striking all that precedes subparagraph
(C) and inserting the following:
``(5)(A) In the case of the Scholarship Program, the date referred
to in paragraphs (1) through (4) shall be the date on which the
individual completes the training required for the degree for which the
individual receives the scholarship, except that--
``(i) for an individual receiving such a degree after
September 30, 2000, from a school of medicine or osteopathic
medicine, such date shall be the date the individual completes a
residency in a specialty that the Secretary determines is
consistent with the needs of the Corps; and
``(ii) at the request of an individual, the Secretary may,
consistent with the needs of the Corps, defer such date until
the end of a period of time required for the individual to
complete advanced training (including an internship or
residency).'';
(ii) by striking subparagraph (D);
(iii) by redesignating subparagraphs (C) and
(E) as subparagraphs (B) and (C), respectively;
and
(iv) in clause (i) of subparagraph (C) (as
redesignated by clause (iii)) by striking
``subparagraph (A), (B), or (D)'' and inserting
``subparagraph (A)''; and
(2) by striking subsection (e).
SEC. 312. PRIVATE PRACTICE.
Section 338D of the Public Health Service Act (42 U.S.C. 254n) is
amended by striking subsection (b) and inserting the following:
``(b)(1) The written agreement described in subsection (a) shall--
[[Page 116 STAT. 1651]]
``(A) provide that, during the period of private practice by
an individual pursuant to the agreement, the individual shall
comply with the requirements of section 334 that apply to
entities; and
``(B) contain such additional provisions as the Secretary
may require to carry out the objectives of this section.
``(2) The Secretary shall take such action as may be appropriate to
ensure that the conditions of the written agreement prescribed by this
subsection are adhered to.''.
SEC. 313. BREACH OF SCHOLARSHIP CONTRACT OR LOAN REPAYMENT
CONTRACT.
(a) In General.--Section 338E of the Public Health Service Act (42
U.S.C. 254o) is amended--
(1) in subsection (a)(1)--
(A) in subparagraph (A), by striking the comma and
inserting a semicolon;
(B) in subparagraph (B), by striking the comma and
inserting ``; or'';
(C) in subparagraph (C), by striking ``or'' at the
end; and
(D) by striking subparagraph (D);
(2) in subsection (b)--
(A) in paragraph (1)(A)--
(i) by striking ``338F(d)'' and inserting
``338G(d)'';
(ii) by striking ``either'';
(iii) by striking ``338D or'' and inserting
``338D,''; and
(iv) by inserting ``or to complete a required
residency as specified in section
338A(f)(1)(B)(iv),'' before ``the United States'';
and
(B) by adding at the end the following new
paragraph:
``(3) <<NOTE: Deadline.>> The Secretary may terminate a contract
with an individual under section 338A if, not later than 30 days before
the end of the school year to which the contract pertains, the
individual--
``(A) submits a written request for such termination; and
``(B) repays all amounts paid to, or on behalf of, the
individual under section 338A(g).'';
(3) in subsection (c)--
(A) in paragraph (1)--
(i) in the matter preceding subparagraph (A),
by striking ``338F(d)'' and inserting ``338G(d)'';
and
(ii) by striking subparagraphs (A) through (C)
and inserting the following:
``(A) the total of the amounts paid by the United
States under section 338B(g) on behalf of the individual
for any period of obligated service not served;
``(B) an amount equal to the product of the number
of months of obligated service that were not completed
by the individual, multiplied by $7,500; and
``(C) the interest on the amounts described in
subparagraphs (A) and (B), at the maximum legal
prevailing rate, as determined by the Treasurer of the
United States, from the date of the breach;
except that the amount the United States is entitled to recover
under this paragraph shall not be less than $31,000.'';
[[Page 116 STAT. 1652]]
(B) by striking paragraphs (2) and (3) and inserting
the following:
``(2) <<NOTE: Deadline.>> The Secretary may terminate a contract
with an individual under section 338B if, not later than 45 days before
the end of the fiscal year in which the contract was entered into, the
individual--
``(A) submits a written request for such termination; and
``(B) repays all amounts paid on behalf of the individual
under section 338B(g).''; and
(C) by redesignating paragraph (4) as paragraph (3);
(4) in subsection (d)(3)(A), by striking ``only if such
discharge is granted after the expiration of the five-year
period'' and inserting ``only if such discharge is granted after
the expiration of the 7-year period''; and
(5) by adding at the end the following new subsection:
``(e) Notwithstanding any other provision of Federal or State law,
there shall be no limitation on the period within which suit may be
filed, a judgment may be enforced, or an action relating to an offset or
garnishment, or other action, may be initiated or taken by the
Secretary, the Attorney General, or the head of another Federal agency,
as the case may be, for the repayment of the amount due from an
individual under this section.''.
(b) Effective Date.--The <<NOTE: 42 USC 254o note.>> amendment made
by subsection (a)(4) shall apply to any obligation for which a discharge
in bankruptcy has not been granted before the date that is 31 days after
the date of enactment of this Act.
SEC. 314. AUTHORIZATION OF APPROPRIATIONS.
Section 338H of the Public Health Service Act (42 U.S.C. 254q) is
amended to read as follows:
``SEC. 338H. AUTHORIZATION OF APPROPRIATIONS.
``(a) Authorization of Appropriations.--For the purposes of carrying
out this subpart, there are authorized to be appropriated $146,250,000
for fiscal year 2002, and such sums as may be necessary for each of
fiscal years 2003 through 2006.
``(b) Scholarships for New Participants.--Of the amounts
appropriated under subsection (a) for a fiscal year, the Secretary shall
obligate not less than 10 percent for the purpose of providing contracts
for--
``(1) scholarships under this subpart to individuals who
have not previously received such scholarships; or
``(2) scholarships or loan repayments under the Loan
Repayment Program under section 338B to individuals from
disadvantaged backgrounds.
``(c) Scholarships and Loan Repayments.--With respect to
certification as a nurse practitioner, nurse midwife, or physician
assistant, the Secretary shall, from amounts appropriated under
subsection (a) for a fiscal year, obligate not less than a total of 10
percent for contracts for both scholarships under the Scholarship
Program under section 338A and loan repayments under the Loan Repayment
Program under section 338B to individuals who are entering the first
year of a course of study or program described in section 338A(b)(1)(B)
that leads to such a certification or individuals who are eligible for
the loan repayment program as specified in section 338B(b) for a loan
related to such certification.''.
[[Page 116 STAT. 1653]]
SEC. 315. GRANTS TO STATES FOR LOAN REPAYMENT PROGRAMS.
Section 338I of the Public Health Service Act (42 U.S.C. 254q-1) is
amended--
(1) in subsection (a), by striking paragraph (1) and
inserting the following:
``(1) Authority for grants.--The Secretary, acting through
the Administrator of the Health Resources and Services
Administration, may make grants to States for the purpose of
assisting the States in operating programs described in
paragraph (2) in order to provide for the increased availability
of primary health care services in health professional shortage
areas. The National Advisory Council established under section
337 shall advise the Administrator regarding the program under
this section.'';
(2) in subsection (e), by striking paragraph (1) and
inserting the following:
``(1) to submit to the Secretary such reports regarding the
States loan repayment program, as are determined to be
appropriate by the Secretary; and''; and
(3) in subsection (i), by striking paragraph (1) and
inserting the following:
``(1) In general.--For the purpose of making grants under
subsection (a), there are authorized to be appropriated
$12,000,000 for fiscal year 2002 and such sums as may be
necessary for each of fiscal years 2003 through 2006.''.
SEC. 316. DEMONSTRATION GRANTS TO STATES FOR COMMUNITY SCHOLARSHIP
PROGRAMS.
Section 338L of the Public Health Service Act (42 U.S.C. 254t) is
repealed.
SEC. 317. DEMONSTRATION PROJECT.
Subpart III of part D of title III of the Public Health Service Act
(42 U.S.C. 254l et seq.) is amended by adding at the end the following:
``SEC. 338L. <<NOTE: 42 USC 254t.>> DEMONSTRATION PROJECT.
``(a) Program Authorized.--The Secretary shall establish a
demonstration project to provide for the participation of individuals
who are chiropractic doctors or pharmacists in the Loan Repayment
Program described in section 338B.
``(b) Procedure.--An individual that receives assistance under this
section with regard to the program described in section 338B shall
comply with all rules and requirements described in such section (other
than subparagraphs (A) and (B) of section 338B(b)(1)) in order to
receive assistance under this section.
``(c) Limitations.--
``(1) In general.--The demonstration project described in
this section shall provide for the participation of individuals
who shall provide services in rural and urban areas.
``(2) Availability of other health professionals.--The
Secretary may not assign an individual receiving assistance
under this section to provide obligated service at a site
unless--
``(A) the Secretary has assigned a physician (as
defined in section 1861(r) of the Social Security Act)
or other health professional licensed to prescribe drugs
to provide obligated service at such site under section
338C or 338D; and
[[Page 116 STAT. 1654]]
``(B) such physician or other health professional
will provide obligated service at such site concurrently
with the individual receiving assistance under this
section.
``(3) Rules of construction.--
``(A) Supervision of individuals.--Nothing in this
section shall be construed to require or imply that a
physician or other health professional licensed to
prescribe drugs must supervise an individual receiving
assistance under the demonstration project under this
section, with respect to such project.
``(B) Licensure of health professionals.--Nothing in
this section shall be construed to supersede State law
regarding licensure of health professionals.
``(d) Designations.--The demonstration project described in this
section, and any providers who are selected to participate in such
project, shall not be considered by the Secretary in the designation of
a health professional shortage area under section 332 during fiscal
years 2002 through 2004.
``(e) Rule of Construction.--This section shall not be construed to
require any State to participate in the project described in this
section.
``(f) Report.--
``(1) In general.--The Secretary shall evaluate the
participation of individuals in the demonstration projects under
this section and prepare and submit a report containing the
information described in paragraph (2) to--
``(A) the Committee on Health, Education, Labor, and
Pensions of the Senate;
``(B) the Subcommittee on Labor, Health and Human
Services, and Education of the Committee on
Appropriations of the Senate;
``(C) the Committee on Energy and Commerce of the
House of Representatives; and
``(D) the Subcommittee on Labor, Health and Human
Services, and Education of the Committee on
Appropriations of the House of Representatives.
``(2) Content.--The report described in paragraph (1) shall
detail--
``(A) the manner in which the demonstration project
described in this section has affected access to primary
care services, patient satisfaction, quality of care,
and health care services provided for traditionally
underserved populations;
``(B) how the participation of chiropractic doctors
and pharmacists in the Loan Repayment Program might
affect the designation of health professional shortage
areas; and
``(C) whether adding chiropractic doctors and
pharmacists as permanent members of the National Health
Service Corps would be feasible and would enhance the
effectiveness of the National Health Service Corps.
``(g) Authorization of Appropriations.--
``(1) in general.--There are authorized to be appropriated
to carry out this section, such sums as may be necessary for
fiscal years 2002 through 2004.
``(2) Fiscal year 2005.--If <<NOTE: Deadline.>> the
Secretary determines and certifies to Congress by not later than
September 30, 2004,
[[Page 116 STAT. 1655]]
that the number of individuals participating in the
demonstration project established under this section is
insufficient for purposes of performing the evaluation described
in subsection (f)(1), the authorization of appropriations under
paragraph (1) shall be extended to include fiscal year 2005.''.
TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM
SEC. 401. <<NOTE: 42 USC 256 note.>> PURPOSE.
The purpose 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--
(1) 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;
(2) 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
(3) provision of new Federal resources that do not supplant
funding for existing Federal categorical programs that support
entities providing services to low-income populations.
SEC. 402. CREATION OF HEALTHY COMMUNITIES ACCESS PROGRAM.
Part D of title III of the Public Health Service Act (42 U.S.C. 254b
et seq.) is amended by inserting after subpart IV the following new
subpart:
``Subpart V--Healthy Communities Access Program
``SEC. 340. <<NOTE: 42 USC 256.>> GRANTS TO STRENGTHEN THE
EFFECTIVENESS, EFFICIENCY, AND
COORDINATION OF SERVICES FOR THE
UNINSURED AND UNDERINSURED.
``(a) In General.--The 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--
``(1) to improve the efficiency of, and coordination among,
the providers providing services through such systems;
``(2) to assist communities in developing programs targeted
toward preventing and managing chronic diseases; and
``(3) to expand and enhance the services provided through
such systems.
``(b) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall be an entity that--
``(1) represents a consortium--
``(A) whose principal purpose is to provide a broad
range of coordinated health care services for a
community
[[Page 116 STAT. 1656]]
defined in the entity's grant application as described
in paragraph (2); and
``(B) that includes at least one of each of the
following providers that serve the community (unless
such provider does not exist within the community,
declines or refuses to participate, or places
unreasonable conditions on their participation)--
``(i) a Federally qualified health center (as
defined in section 1861(aa) of the Social Security
Act (42 U.S.C. 1395x(aa)));
``(ii) a hospital with a low-income
utilization rate (as defined in section 1923(b)(3)
of the Social Security Act (42 U.S.C. 1396r-
4(b)(3)), that is greater than 25 percent;
``(iii) a public health department; and
``(iv) an interested public or private sector
health care provider or an organization that has
traditionally served the medically uninsured and
underserved; and
``(2) submits to the Secretary an application, in such form
and manner as the Secretary shall prescribe, that--
``(A) defines a community or geographic area of
uninsured and underinsured individuals;
``(B) 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;
``(C) describes the activities that the applicant
and the consortium propose to perform under the grant to
further the objectives of this section;
``(D) 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;
``(E) 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;
``(F) provides evidence of community involvement in
the development, implementation, and direction of the
program that the entity proposes to operate;
``(G) 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;
``(H) 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
[[Page 116 STAT. 1657]]
new funding sources in a way to assure long-term
sustainability of the program;
``(I) 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;
``(J) demonstrates fiscal responsibility through the
use of appropriate accounting procedures and appropriate
management systems;
``(K) 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
``(L) includes such other information as the
Secretary may prescribe.
``(c) Limitations.--
``(1) Number of awards.--
``(A) In general.--For each of fiscal years 2003,
2004, 2005, and 2006, the Secretary may not make more
than 35 new awards under subsection (a) (excluding
renewals of such awards).
``(B) Rule of construction.--This paragraph shall
not be construed to affect awards made before fiscal
year 2003.
``(2) In general.--An 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--
``(A) the eligible entity submits to the Secretary a
request for a grant for such an additional fiscal year;
``(B) the Secretary determines that extraordinary
circumstances (as defined in paragraph (3)) justify the
granting of such request; and
``(C) the Secretary determines that granting such
request is necessary to further the objectives described
in subsection (a).
``(3) Extraordinary circumstances.--
``(A) In general.--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).
``(B) Examples.--Extraordinary circumstances
include--
``(i) natural disasters or other major
disruptions to the security or health of the
community or geographic area served by the
eligible entity; or
``(ii) 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).
``(d) Priorities.--In awarding grants under this section, the
Secretary--
[[Page 116 STAT. 1658]]
``(1) shall accord priority to applicants that demonstrate
the extent of unmet need in the community involved for a more
coordinated system of care; and
``(2) may accord priority to applicants that best promote
the objectives of this section, taking into consideration the
extent to which the application involved--
``(A) identifies a community whose geographical area
has a high or increasing percentage of individuals who
are uninsured;
``(B) 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;
``(C) 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;
``(D) proposes a program that would improve
coordination between health care providers and
appropriate social service providers;
``(E) demonstrates collaboration with State and
local governments;
``(F) demonstrates that the applicant makes use of
non-Federal contributions to the greatest extent
possible; or
``(G) demonstrates a likelihood that the proposed
program will continue after support under this section
ceases.
``(e) Use of Funds.--
``(1) Use by grantees.--
``(A) In general.--Except as provided in paragraphs
(2) and (3), a grantee may use amounts provided under
this section only for--
``(i) 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
``(ii) direct patient care and service
expansions to fill identified or documented gaps
within an integrated delivery system.
``(B) Specific uses.--The 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):
``(i) Increases in outreach activities and
closing gaps in health care service.
``(ii) Improvements to case management.
``(iii) Improvements to coordination of
transportation to health care facilities.
``(iv) Development of provider networks and
other innovative models to engage physicians in
voluntary efforts to serve the medically
underserved within a community.
[[Page 116 STAT. 1659]]
``(v) Recruitment, training, and compensation
of necessary personnel.
``(vi) Acquisition of technology for the
purpose of coordinating care.
``(vii) Improvements to provider
communication, including implementation of shared
information systems or shared clinical systems.
``(viii) Development of common processes for
determining eligibility for the programs provided
through the system, including creating common
identification cards and single sliding scale
discounts.
``(ix) Development of specific prevention and
disease management tools and processes.
``(x) Translation services.
``(xi) 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.
``(2) Direct patient care limitation.--Not more than 15
percent of the funds provided under a grant awarded under this
section may be used for providing direct patient care and
services.
``(3) Reservation of funds for national program purposes.--
The Secretary may use not more than 3 percent of funds
appropriated to carry out this section for providing technical
assistance to grantees, obtaining assistance of experts and
consultants, holding meetings, developing of tools,
disseminating of information, evaluation, and carrying out
activities that will extend the benefits of programs funded
under this section to communities other than the community
served by the program funded.
``(f) Grantee Requirements.--
``(1) Evaluation of effectiveness.--A grantee under this
section shall--
``(A) report to the Secretary annually regarding--
``(i) progress in meeting the goals and
measurable objectives set forth in the grant
application submitted by the grantee under
subsection (b); and
``(ii) the extent to which activities
conducted by such grantee have--
``(I) improved the effectiveness,
efficiency, and coordination of services
for uninsured and underinsured
individuals in the communities or
geographic areas served by such grantee;
``(II) resulted in the provision of
better quality health care for such
individuals; and
``(III) 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
``(B) provide for an independent annual financial
audit of all records that relate to the disposition of
funds received through the grant.
``(2) Progress.--The Secretary may not renew an annual grant
under this section for an entity for a fiscal year unless
[[Page 116 STAT. 1660]]
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.
``(g) Maintenance of Effort.--With respect to activities for which a
grant under this section is authorized, the Secretary may award such a
grant only if the applicant for the grant, and each of the participating
providers, agree that the grantee and each such provider will maintain
its expenditures of non-Federal funds for such activities at a level
that is not less than the level of such expenditures during the fiscal
year immediately preceding the fiscal year for which the applicant is
applying to receive such grant.
``(h) Technical Assistance.--The Secretary may, either directly or
by grant or contract, provide any entity that receives a grant under
this section with technical and other nonfinancial assistance necessary
to meet the requirements of this section.
``(i) <<NOTE: Deadline.>> Evaluation of Program.--Not later than
September 30, 2005, the Secretary shall prepare and submit to the
appropriate committees of Congress a report that describes the extent to
which projects funded under this section have been successful in
improving the effectiveness, efficiency, and coordination of services
for uninsured and underinsured individuals in the communities or
geographic areas served by such projects, including whether the projects
resulted in the provision of better quality health care for such
individuals, and whether such care was provided at lower costs, than
would have been provided in the absence of such projects.
``(j) Demonstration Authority.--The Secretary may make demonstration
awards under this section to historically black health professions
schools for the purposes of--
``(1) 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);
``(2) 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
``(3) supporting the research-related costs of patient care,
data collection, and academic training resulting from such
affiliations.
``(k) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary for
each of fiscal years 2002 through 2006.
``(l) Date Certain for Termination of Program.--Funds may not be
appropriated to carry out this section after September 30, 2006.''.
SEC. 403. EXPANDING AVAILABILITY OF DENTAL SERVICES.
Part D of title III of the Public Health Service Act (42 U.S.C. 254b
et seq.) is amended by adding at the end the following:
[[Page 116 STAT. 1661]]
``Subpart X--Primary Dental Programs
``SEC. 340F. <<NOTE: 42 USC 256f.>> DESIGNATED DENTAL HEALTH
PROFESSIONAL SHORT-
AGE AREA.
``In this subpart, the term `designated dental health professional
shortage area' means an area, population group, or facility that is
designated by the Secretary as a dental health professional shortage
area under section 332 or designated by the applicable State as having a
dental health professional shortage.
``SEC. 340G. <<NOTE: 42 USC 256g.>> GRANTS FOR INNOVATIVE PROGRAMS.
``(a) Grant Program Authorized.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration, is
authorized to award grants to States for the purpose of helping States
develop and implement innovative programs to address the dental
workforce needs of designated dental health professional shortage areas
in a manner that is appropriate to the States' individual needs.
``(b) State Activities.--A State receiving a grant under subsection
(a) may use funds received under the grant for--
``(1) loan forgiveness and repayment programs for dentists
who--
``(A) agree to practice in designated dental health
professional shortage areas;
``(B) are dental school graduates who agree to serve
as public health dentists for the Federal, State, or
local government; and
``(C) agree to--
``(i) provide services to patients regardless
of such patients' ability to pay; and
``(ii) use a sliding payment scale for
patients who are unable to pay the total cost of
services;
``(2) dental recruitment and retention efforts;
``(3) grants and low-interest or no-interest loans to help
dentists who participate in the medicaid program under title XIX
of the Social Security Act (42 U.S.C. 1396 et seq.) to establish
or expand practices in designated dental health professional
shortage areas by equipping dental offices or sharing in the
overhead costs of such practices;
``(4) the establishment or expansion of dental residency
programs in coordination with accredited dental training
institutions in States without dental schools;
``(5) programs developed in consultation with State and
local dental societies to expand or establish oral health
services and facilities in designated dental health professional
shortage areas, including services and facilities for children
with special needs, such as--
``(A) the expansion or establishment of a community-
based dental facility, free-standing dental clinic,
consolidated health center dental facility, school-
linked dental facility, or United States dental school-
based facility;
``(B) the establishment of a mobile or portable
dental clinic; and
``(C) the establishment or expansion of private
dental services to enhance capacity through additional
equipment or additional hours of operation;
[[Page 116 STAT. 1662]]
``(6) placement and support of dental students, dental
residents, and advanced dentistry trainees;
``(7) continuing dental education, including distance-based
education;
``(8) practice support through teledentistry conducted in
accordance with State laws;
``(9) community-based prevention services such as water
fluoridation and dental sealant programs;
``(10) coordination with local educational agencies within
the State to foster programs that promote children going into
oral health or science professions;
``(11) the establishment of faculty recruitment programs at
accredited dental training institutions whose mission includes
community outreach and service and that have a demonstrated
record of serving underserved States;
``(12) the development of a State dental officer position or
the augmentation of a State dental office to coordinate oral
health and access issues in the State; and
``(13) any other activities determined to be appropriate by
the Secretary.
``(c) Application.--
``(1) In general.--Each State desiring a grant under this
section shall submit an application to the Secretary at such
time, in such manner, and containing such information as the
Secretary may reasonably require.
``(2) Assurances.--The application shall include assurances
that the State will meet the requirements of subsection (d) and
that the State possesses sufficient infrastructure to manage the
activities to be funded through the grant and to evaluate and
report on the outcomes resulting from such activities.
``(d) Matching Requirement.--The Secretary may not make a grant to a
State under this section unless that State agrees that, with respect to
the costs to be incurred by the State in carrying out the activities for
which the grant was awarded, the State will provide non-Federal
contributions in an amount equal to not less than 40 percent of Federal
funds provided under the grant. The State may provide the contributions
in cash or in kind, fairly evaluated, including plant, equipment, and
services and may provide the contributions from State, local, or private
sources.
``(e) Report.--Not <<NOTE: Deadline.>> later than 5 years after the
date of enactment of the Health Care Safety Net Amendments of 2002, the
Secretary shall prepare and submit to the appropriate committees of
Congress a report containing data relating to whether grants provided
under this section have increased access to dental services in
designated dental health professional shortage areas.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $50,000,000 for the 5-fiscal
year period beginning with fiscal year 2002.''.
SEC. 404. <<NOTE: 42 USC 1396a note.>> STUDY REGARDING BARRIERS TO
PARTICIPATION OF FARMWORKERS IN HEALTH
PROGRAMS.
(a) In General.--The Secretary shall conduct a study of the problems
experienced by farmworkers (including their families) under Medicaid and
SCHIP. Specifically, the Secretary shall examine the following:
(1) Barriers to enrollment.--Barriers to their enrollment,
including a lack of outreach and outstationed eligibility
[[Page 116 STAT. 1663]]
workers, complicated applications and eligibility determination
procedures, and linguistic and cultural barriers.
(2) Lack of portability.--The lack of portability of
Medicaid and SCHIP coverage for farmworkers who are determined
eligible in one State but who move to other States on a seasonal
or other periodic basis.
(3) Possible solutions.--The development of possible
solutions to increase enrollment and access to benefits for
farmworkers, because, in part, of the problems identified in
paragraphs (1) and (2), and the associated costs of each of the
possible solutions described in subsection (b).
(b) Possible Solutions.--Possible solutions to be examined shall
include each of the following:
(1) Interstate compacts.--The use of interstate compacts
among States that establish portability and reciprocity for
eligibility for farmworkers under the Medicaid and SCHIP and
potential financial incentives for States to enter into such
compacts.
(2) Demonstration projects.--The use of multi-state
demonstration waiver projects under section 1115 of the Social
Security Act (42 U.S.C. 1315) to develop comprehensive migrant
coverage demonstration projects.
(3) Use of current law flexibility.--Use of current law
Medicaid and SCHIP State plan provisions relating to coverage of
residents and out-of-State coverage.
(4) National migrant family coverage.--The development of
programs of national migrant family coverage in which States
could participate.
(5) Public-private partnerships.--The provision of
incentives for development of public-private partnerships to
develop private coverage alternatives for farmworkers.
(6) Other possible solutions.--Such other solutions as the
Secretary deems appropriate.
(c) Consultations.--In conducting the study, the Secretary shall
consult with the following:
(1) Farmworkers affected by the lack of portability of
coverage under the Medicaid program or the State children's
health insurance program (under titles XIX and XXI of the Social
Security Act).
(2) Individuals with expertise in providing health care to
farmworkers, including designees of national and local
organizations representing migrant health centers and other
providers.
(3) Resources with expertise in health care financing.
(4) Representatives of foundations and other nonprofit
entities that have conducted or supported research on farmworker
health care financial issues.
(5) Representatives of Federal agencies which are involved
in the provision or financing of health care to farmworkers,
including the Health Care Financing Administration and the
Health Research and Services Administration.
(6) Representatives of State governments.
(7) Representatives from the farm and agricultural
industries.
(8) Designees of labor organizations representing
farmworkers.
(d) Definitions.--For purposes of this section:
[[Page 116 STAT. 1664]]
(1) Farmworker.--The term ``farmworker'' means a migratory
agricultural worker or seasonal agricultural worker, as such
terms are defined in section 330(g)(3) of the Public Health
Service Act (42 U.S.C. 254c(g)(3)), and includes a family member
of such a worker.
(2) Medicaid.--The term ``Medicaid'' means the program under
title XIX of the Social Security Act.
(3) SCHIP.--The term ``SCHIP'' means the State children's
health insurance program under title XXI of the Social Security
Act.
(e) Report.--Not <<NOTE: Deadline.>> later than one year after the
date of the enactment of this Act, the Secretary shall transmit a report
to the President and the Congress on the study conducted under this
section. The report shall contain a detailed statement of findings and
conclusions of the study, together with its recommendations for such
legislation and administrative actions as the Secretary considers
appropriate.
TITLE V--STUDY AND MISCELLANEOUS PROVISIONS
SEC. 501. <<NOTE: 42 USC 254b note.>> GUARANTEE STUDY.
The Secretary of Health and Human Services shall conduct a study
regarding the ability of the Department of Health and Human Services to
provide for solvency for managed care networks involving health centers
receiving funding under section 330 of the Public Health Service Act.
The Secretary shall prepare and submit a report to the appropriate
Committees of Congress regarding such ability not later than 2 years
after the date of enactment of the Health Care Safety Net Amendments of
2002.
SEC. 502. GRADUATE MEDICAL EDUCATION.
Section 762(k) of the Public Health Service Act (42 U.S.C. 294o(k))
is amended by striking ``2002'' and inserting ``2003''.
TITLE VI--CONFORMING AMENDMENTS
SEC. 601. CONFORMING AMENDMENTS.
(a) Homeless Programs.--Subsections (g)(1)(G)(ii), (k)(2), and
(n)(1)(C) of section 224, and sections 317A(a)(2), 317E(c), 318A(e),
332(a)(2)(C), 340D(c)(5), 799B(6)(B), 1313, and 2652(2) of the Public
Health Service Act (42 U.S.C. 233, 247b-1(a)(2), 247b-6(c), 247c-1(e),
254e(a)(2)(C), 256d(c)(5), 295p(6)(B), 300e-12, and 300ff-52(2)) are
amended by striking ``340'' and inserting ``330(h)''.
[[Page 116 STAT. 1665]]
(b) Homeless Individual.--Section 534(2) of the Public Health
Service Act (42 U.S.C. 290cc-34(2)) is amended by striking ``340(r)''
and inserting ``330(h)(5)''.
Approved October 26, 2002.
LEGISLATIVE HISTORY--S. 1533 (H.R. 3450):
---------------------------------------------------------------------------
SENATE REPORTS: No. 107-83 (Comm. on Health, Education, Labor, and
Pensions).
CONGRESSIONAL RECORD, Vol. 148 (2002):
Apr. 16, considered and passed Senate.
Oct. 16, considered and passed House, amended.
Oct. 17, Senate concurred in House amendment.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 38 (2002):
Oct. 26, Presidential remarks.
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