RURAL HEALTH CLINIC SERVICES.

SEC. 6213. RURAL HEALTH CLINIC SERVICES. (a) Staffing Requirements; Inclusion of Nurse-Midwife Services.—Section 1861(aa)(2) of the Social Security Act (42 U.S.C. 1395x(aa)(2)) is amended— (1) by striking “; and” at the end of subparagraph (I) and inserting a semicolon; (2) by redesignating subparagraph (J) as subparagraph (K); and (3) by inserting after subparagraph (I) the following new subparagraph: “(J) has a nurse practitioner, a physician assistant or a certified nurse-midwife (as defined in subsection (gg)) available to furnish patient care services not less than 50 percent of the time the clinic operates; and”. (b) Coverage of Social Worker Services.—Section 1861(aa)(1)(B) of such Act (42 U.S.C. 1395x(aa)(1)(B)) is amended— 103 STAT. 2251 (1) by striking “or” before “by”; and (2) by inserting “or by a clinical social worker (as defined in subsection (hh)(1)),” after “Secretary)”. (c) Expansion of Eligible Areas.—The second sentence of section 1861(aa)(2) of such Act is amended— (1) by striking “designated by the Secretary” and inserting “designated by the chief executive officer of the State and certified by the Secretary as an area with a shortage of personal health services, or that is designated by the Secretary”; (2) by striking “section 1302(7) of the Public Health Service Act or” and inserting “section 330(b)(3) or 1302(7) of the Public Health Service Act,”; and (3) by striking “medical care manpower,” and inserting the following: “medical care manpower, (III) as a high impact area described in section 329(a)(5) of that Act, or (IV) as an area which includes a population group which the Secretary determines has a health manpower shortage under section 332(a)(1)(B) of that Act,”. (d) Effective Date.—The amendments made by subsections (a) through (c) of this section shall take effect October 1, 1989. (e) Dissemination of Rural Health Clinic Information.— (1) In general.—Not later than 60 days after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Director of the Office of Rural Health Policy, shall disseminate to health care facilities and to the chief executive officer, chief health officer, and chief human services officer of each State, applications and other necessary information to enable such a facility to apply for designation as a rural health clinic for the purposes of titles XVIII and XIX of the Social Security Act. (2) Definitions.— For purposes of this subsection: (A) The term “health care facility” means a community health center or a migrant health center, or a hospital, home health agency, or skilled nursing facility participating in a program established under title XVIII or title XIX of the Social Security Act. (B) The term “State” includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa. (f) Treatment of Certain Facilities as Rural Health Clinics.—The Secretary of Health and Human Services shall not deny certification of a facility as a rural health clinic under section 1861(aa)(2) of the Social Security Act if the facility is located on an island and would otherwise be qualified to be certified as such a facility but for the requirement that the services of a physician assistant or nurse practitioner be provided in the facility. (g) Expansion of Functions of Office of Rural Health Policy.—Section 711(b) of the Social Security Act (42 U.S.C. 912(b)) is amended— (1) in paragraph (2)(A), by striking “health care issues” and inserting “health care issues, including rural mental health, rural infant mortality prevention, and rural occupational safety and preventive health promotion”; (2) in paragraph (2)(C), by striking “rural areas” and inserting “rural areas, including programs providing community-based mental health services, prenatal and infant care services, and 103 STAT. 2252rural occupational safety and preventive health education and promotion”; and (3) in paragraph (4), by striking “rural health care” and inserting “rural health care, including activities relating to rural mental health, rural infant mortality, and rural occupational safety and preventive health promotion”.