Index for HR3962: Affordable Health Care for America Act

To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

Mr. Dingell (for himself, Mr. Rangel, Mr. Waxman, Mr. George Miller of California, Mr. Stark, Mr. Pallone, and Mr. Andrews) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

Title III (42 U.S.C. 241 et seq.) is amended by adding at the end the following:

“(a) Program.—The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a nurse-managed health center program consisting of awarding grants to entities under subsection (b).

“(b) Grant.—The Secretary shall award grants to entities—

“(1) to plan and develop a nurse-managed health center; or

“(2) to operate a nurse-managed health center.

“(c) Use of funds.—Amounts received as a grant under subsection (b) may be used for activities including the following:

“(1) Purchasing or leasing equipment.

“(2) Training and technical assistance related to the provision of comprehensive primary care services and wellness services.

“(3) Other activities for planning, developing, or operating, as applicable, a nurse-managed health center.

“(d) Assurances applicable to both planning and operation grants.—

“(1) IN GENERAL.—The Secretary may award a grant under this section to an entity only if the entity demonstrates to the Secretary’s satisfaction that—

“(A) nurses, in addition to managing the center, will be adequately represented as providers at the center; and

“(B) not later than 90 days after receiving the grant, the entity will establish a community advisory committee composed of individuals, a majority of whom are being served by the center, to provide input into the nurse-managed health center’s operations.

“(2) MATCHING REQUIREMENT.—The Secretary may award a grant under this section to an entity only if the entity agrees to provide, from non-Federal sources, an amount equal to 20 percent of the amount of the grant (which may be provided in cash or in kind) to carry out the activities supported by the grant.

“(3) PAYOR OF LAST RESORT.—The Secretary may award a grant under this section to an entity only if the entity demonstrates to the satisfaction of the Secretary that funds received through the grant will not be expended for any activity to the extent that payment has been made, or can reasonably be expected to be made—

“(A) under any insurance policy;

“(B) under any Federal or State health benefits program (including titles XIX and XXI of the Social Security Act); or

“(C) by an entity which provides health services on a prepaid basis.

“(4) MAINTENANCE OF EFFORT.—The Secretary may award a grant under this section to an entity only if the entity demonstrates to the satisfaction of the Secretary that—

“(A) funds received through the grant will be expended only to supplement, and not supplant, non-Federal and Federal funds otherwise available to the entity for the activities to be funded through the grant; and

“(B) with respect to such activities, the entity will maintain expenditures of non-Federal amounts for such activities at a level not less than the lesser of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the grant.

“(e) Additional assurance for planning grants.—The Secretary may award a grant under subsection (b)(1) to an entity only if the entity agrees—

“(1) to assess the needs of the medically underserved populations proposed to be served by the nurse-managed health center; and

“(2) to design services and operations of the nurse-managed health center for such populations based on such assessment.

“(f) Additional assurance for operation grants.—The Secretary may award a grant under subsection (b)(2) to an entity only if the entity assures that the nurse-managed health center will provide—

“(1) comprehensive primary care services, wellness services, and other health care services deemed appropriate by the Secretary;

“(2) care without respect to insurance status or income of the patient; and

“(3) direct access to client-centered services offered by advanced practice nurses, other nurses, physicians, physician assistants, or other qualified health professionals.

“(g) Technical assistance.—The Secretary shall provide (either directly or by grant or contract) technical and other assistance to nurse-managed health centers to assist such centers in meeting the requirements of this section. Such assistance may include fiscal and program management assistance, training in fiscal and program management, operational and administrative support, and the provision of information to nurse-managed health centers regarding the various resources available under this section and how those resources can best be used to meet the health needs of the communities served by nurse-managed health centers.

“(h) Report.—The Secretary shall submit to the Congress an annual report on the program under this section.

“(i) Definitions.—In this section:

“(1) COMPREHENSIVE PRIMARY CARE SERVICES.—The term ‘comprehensive primary care services’ has the meaning given to the term ‘required primary health services’ in section 330(b)(1).

“(2) MEDICALLY UNDERSERVED POPULATION.—The term ‘medically underserved population’ has the meaning given to such term in section 330(b)(3).

“(3) NURSE-MANAGED HEALTH CENTER.—The term ‘nurse-managed health center’ has the meaning given to such term in section 801.

“(4) WELLNESS SERVICES.—The term ‘wellness services’ means any health-related service or intervention, not including primary care, which is designed to reduce identifiable health risks and increase healthy behaviors intended to prevent the onset of disease or lessen the impact of existing chronic conditions by teaching more effective management techniques that focus on individual self-care and patient-driven decisionmaking.

“(j) Authorization of appropriations.—To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2011 through 2015.”.