community health centers

community health centers Sec. 501. (a) Part C of title III of the Public Health Service Act is amended by adding after section 329 the following new section: “community health centers Sec. 330. (a) For purposes of this section, the term ‘community health center’ means an entity which either through its staff and sup-porting resources or through contracts or cooperative arrangements with other public or private entities provides— “(1) primarily health services, “(2) as may be appropriate for particular centers, supple-mental health services necessary for the adequate support of primary health services, “(3) referral to providers of supplemental health services and payment, as appropriate and feasible, for their provision of such services, “(4) as may be appropriate for particular centers, environmental health services, and “(5) information on the availability and proper use of health services, for all residents of the area it serves (referred to in this section as a ‘catchment area’). “(b) For purposes of this section: “(1) The term ‘primary health services’ means— “(A) services of physicians and, where feasible, services of physicians’ assistants and nurse clinicians; “(B) diagnostic laboratory and radiologic services; “(C) preventive health services (including children’s eye and ear examinations to determine the need for vision and bearing correction, perinatal services, well cl did services, and family planning services); “(D) emergency medical services; “(E) transportation services as required for adequate patient care; and “(F) preventive dental services. 89 STAT. 343 “(2) The term ‘supplemental health services’ means services which are not included as primary health services and which are— “(A) hospital services; “(B) home health services; “(C) extended care facility services; “(D) rehabilitative services (including physical therapy) and long-term physical medicine; “(E) mental health services; “(E) dental services; “(G) vision services; “(H) allied health services; “(I) pharmaceutical services; “(J) therapeutic radiologic services; “(K) public health services (including nutrition education and social services); “(L) health education services; and “(M) services which promote and facilitate optimal use of primary health services and the services referred to in the preceding subparagraphs of this paragraph, including, if a substantial number of the individuals in the population served by a community health center are of limited English-speaking ability, the services of outreach workers fluent in the language spoken by a predominant number of such individuals. “(3) The term ‘medically underserved population’ means the population of an urban or rural area designated by the Secretary as an area with a shortage of personal health services or a population group designated by the Secretary as having a shortage of such services. “(c) (1) The Secretary may make grants to public and nonprofit private entities for projects to plan and develop community health centers which will serve medically underserved populations. A project for which a grant may be made under this subsection may include the cost of the acquisition and modernization of existing buildings (including the costs of amortizing the principal of, and paying the interest on, loans) and shall include— “(A) an assessment of the need that the population proposed to be served by the community health center for which the project is undertaken has for primary health services, supplemental health services, and environmental health services; “(B) the design of a community health center program for such population based on such assessment; “(C) efforts to secure, within the proposed catchment area of such center, financial and professional assistance and support for the project; and “(D) initiation and encouragement of continuing community involvement in the development and operation of the project. “(2) Not more than two grants may lie made under this subsection for the same project. “(3) the amount of any grant made under this subsection for any project shall be determined by the Secretary. “(d) (1) (A) The Secretary may make grants for the costs of operation of public and nonprofit private community health centers which serve medically underserved populations. “(B) The Secretary may make grants for the costs of the operation of public and nonprofit private entities which provide health services to medically underserved populations but with respect to which he is unable to make each of the determinations required by subsection (e) (2). 89 STAT. 344 “(2) The costs for which a grant may be made under paragraph (1) may include the costs of acquiring and modernizing existing buildings (including the costs of amortizing the principal of, and paying interest on, loans) and the costs of providing training related to the provision of primary health services, supplemental health services and environmental health services, and to the management of community health center programs. “(3) Not more than two grants may be made under paragraph (11(B) for the same entity. “(4) The amount of any grant made under paragraph (1) shall be determined by the Secretary. “(e) (1) No grant may be made under subsection (e) or (d) unless an application therefor is submitted to, and approved by, the Secretary. Such an application shall be submitted in such form and manner and shall contain such information as the Secretary shall prescribe. An application for a grant which will cover the costs of modernizing a building shall include, in addition to other information required by the Secretary— “(A) a description of the site of the building, “(B) plans and specifications for its modernization, and “(C) reasonable assurance that all laborers and mechanics employed by contractors or subcontractors in the performance of work on the modernization of the building will be paid wages at rates not less than those prevailing on similar work in the locality as determined by the Secretary of Labor in accordance with the Act of March 3, 1931 (40 U.S.C. 276a–276a–5, known as the Davis-Bacon Act). The Secretary of Labor shall have with respect to the labor standards referred to in subparagraph (C) the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 F.R. 3176, 5 U.S.C. Appendix) and section 2 of the Act of June 13, 1934 (40 U.S.C. 276c). “(2) Except as provided in subsection (d) (1) (B), the Secretary may not approve an application for a grant under subsection (d) unless the Secretary determines that the entity for which the application is submitted is a community health center (within the meaning of subsection (a)) and that— “(A) the primary health services of the center will be available and accessible in the center’s catchment area promptly, as appropriate, and in a manner which assures continuity; “(B) the center will have organizational arrangements, established in accordance with regulations prescribed by the Secretary, or (i) an ongoing quality assurance program (including utilization and peer review systems) respecting the center’s services, and (ii) maintaining the confidentiality of patient records; “(C) the center will demonstrate its financial responsibility by the use of such accounting procedures and other requirements as may be prescribed by the Secretary; “(D) the center (i) has or will have a contractual or other arrangement with the agency of the State, in which it provides services, which administers or supervises the administration of a State plan approved under title XIX of the Social Security Act for the payment of all or a part of the center’s costs in providing health services to persons who are eligible for medical assistance under such a State plan, or (ii) has made or will make every reasonable effort to enter into such an arrangement; 89 STAT. 345 “(E) the center has made or will make and will continue to make every reasonable effort to collect appropriate reimbursement for its costs in providing health services to persons who are entitled to insurance benefits under title XVIII of the Social Security Act, to medical assistance under a State plan approved under title XIX of such Act, or to assistance for medical expenses under any other public assistance program or private health insurance program; “(F) the center (i) has prepared a schedule of fees or payments for the provision of its services designed to cover its reasonable costs of operation and a corresponding schedule of discounts to be applied to the payment of such fees or payments, which discounts are adjusted on the basis of the patient’s ability to pay, (ii) has made and will continue to make every reasonable effort (I) to secure from patients payment for services in accordance with such schedules, and (II) to collect reimbursement for health services to persons described in subparagraph (E) on the basis of the full amount of fees and payments for such services without application of any discount, and (iii) has submitted to the Secretary such reports as he may require to determine compliance with this subparagraph; “(G) the center has established a governing board which (i) is composed of individuals a majority of whom are being served by the center and who, as a group, represent the individuals being served by the center, and (ii) meets at least once a month, establishes general policies for the center (including the selection of services to be provided by the center and a schedule of hours during which services will be provided), approves the center’s annual budget, and approves the selection of a director for the center; “(H) the center has developed, in accordance with regulations of the Secretary, (i) an overall plan and budget that meets the requirements of section 1861 (z) of the Social Security Act, and (ii) an effective procedure for compiling and reporting to the Secretary such statistics and other information as the Secretary may require relating to (I) the costs of its operations, (H) the patterns of use of its services, (III) the availability, accessibility, and acceptability of its services, and (IV) such other matters relating to operations of the applicant ns the Secretary may, by regulation, require; “(I) the center will review periodically its catchment area to (i) insure that the size of such area is such that the services to be provided through the center (including any satellite) ere available and accessible to the residents of the area promptly and as appropriate, (ii) insure that the boundaries of such area conform, to the extent practicable, to relevant boundaries of political subdivisions, school districts, and Federal and State health and social service programs, and (iii) insure that the boundaries of such area eliminate, to the extent possible, barriers to access to the services of the center, including barriers resulting from the area’s physical characteristics, its residential patterns, its economic and social groupings, and available transportation; and “(J) in the case of a center which serves a population including a substantial proportion of individuals of limited English-speaking ability, the center has (i) developed a plan and made arrangements responsive to the needs of such population for 89 STAT. 346providing services to the extent practicable in the language and cultural context most appropriate to such individuals, and (ii) identified an individual on its staff who is fluent in both that language and in English and whose responsibilities shall include providing guidance to such individuals and to appropriate staff members with respect to cultural sensitivities and bridging linguistic and cultural differences. “(f) The Secretary may provide (either through the Department of Health, Education, and Welfare or by grant or contract) all necessary technical and other nonfinancial assistance (including fiscal and program management assistance and training in such management) to any public or private nonprofit entity to assist it in developing plans for, and in operating as, a community health center, and in meeting requirements of subsection (e) (3). “(g) (1) There are authorized to be appropriated for payments pursuant to grants under subsection (e) $5,000,000 for fiscal year 1976, and $5,000,000 for fiscal year 1977, “(2) There are authorized to be appropriated for payments pursuant to grants under subsection (d) $215,000,000 for fiscal year 1976, and $235,000,000 for fiscal year 1977.”. (b) Section 314(e) of the Public Health Service Act is repealed.