health care for rural areas

health care for rural areas Sec. 714. Title VII of the Public Health Service Act is amended by adding at the end thereof the following: “Part I—Health Care for Rural Areas “health care for rural areas “Sec. 799A. (a) The Secretary is authorized to make grants to, or enter into contracts with, any eligible applicant to help such applicant fund authorized activities under an application and approved under subsection (d). (b)(1) Amounts provided under subsection (a) shall be used by the recipients to fund interdisciplinary projects designed to use new and innovative methods and models to— “(A) train health care practitioners to provide services in rural areas; “(B) provide access to cost-effective, comprehensive health care to individuals residing in rural areas; “(C) enhance the amount of research conducted concerning health care delivery in rural areas; and “(D) increase the recruitment and retention of health care practitioners in rural areas and make rural practice a more attractive career choice for health care practitioners. “(2) A recipient of funds under subsection (a) may use various methods in carrying out the projects described in paragraph (1), including— “(A) the distribution of stipends to students of eligible applicants; “(B) the establishment of a post-graduate fellowship program; “(C) the training of faculty in the economic and logistical problems confronting rural health care delivery systems; or 102 STAT. 4835 “(D) the purchase or rental of transportation and telecommunication equipment where the need for such equipment due to unique characteristics of the rural area is demonstrated by the recipient. “(3)(A) An applicant shall not use more than 10 percent of the funds made available to such applicant under subsection (a) for administrative expenses. “(B) Not more than 10 percent of the individuals receiving training with funds made available to an applicant under subsection (a) shall be trained as doctors of medicine or doctors of osteopathy. “(c) Applicants eligible to obtain funds under subsection (a) shall include nonprofit organizations and public or nonprofit colleges, universities, or schools of, or programs that specialize in, nursing, psychology, social work, optometry, public health, dentistry, osteopathy, physicians assistants, pharmacy, podiatry, medicine, chiropractic, and allied health professions if such applicants submit applications approved by the Secretary under subsection (d). Applicants eligible to obtain funds under subsection (a) shall not include for-profit entitles, either directly or through a subcontract or subgrant. “(d)(1) In order to receive a grant or contract under subsection (a) an entity shall submit an application to the Secretary. “(2) An application submitted under this subsection shall be in such form, be submitted by such date, and contain such information as the Secretary shall require. “(3) Applications submitted under this subsection shall— “(A) be jointly submitted by at least two eligible applicants with the express purpose of assisting individuals in academic institutions in establishing long-term collaborative relationships with health care providers in rural areas; (B) designate a rural health care agency or agencies for clinical treatment or training, including hospitals, community health centers, migrant health centers, rural health clinics, community mental health centers, long-term care facilities, facilities operated by the Indian Health Service or an Indian tribe or tribal organization or Indian organization under a contract with the Indian Health Service under the Indian Self-Determination Act, or Native Hawaiian health centers; and “(C) provide any additional information required by the Secretary. “(e)(1) The Secretary shall enter into a contract to conduct a study of manpower training needs in rural areas, with attention focused on the supply of health professionals and whether such supply is adequate to meet the demands for health care services in rural communities. “(2)(A) The study conducted under paragraph (1) shall include statistics and projections on— “(i) the supply of health care practitioners in rural areas; and “(ii) suggested methods of improving access to health care services in rural areas. The study shall pay particular attention to the needs of the elderly in rural areas. “(B) The study conducted under paragraph (1) shall evaluate existing models for health care training and service delivery and propose innovative alternative models to enhance the quality and availability of health care services in rural areas and to increase the retention of health professionals in rural areas. 102 STAT. 4836 “(3) The Secretary shall evaluate the effectiveness of the health care training and service delivery models developed with funds made available under this section and compare such models with programs designed to increase the availability of health care providers in rural areas, including the National Health Service Corps program authorized by subpart II of part D of the Public Health Service Act (42 U.S.C. 254d et seq.) and the area health education center program authorized under section 781 of such Act (42 U.S.C. 295g–1). “(4) Not later than 18 months after the date of the signing of the contract for the health care study under paragraph (1), the Secretary shall submit to the appropriate committees of the Congress a report that describes the results of the study conducted under paragraph (1). “(f)(1) Each application for a grant or contract under this section shall be submitted to a peer review group for an evaluation of the merits of the proposals made in the application. “(2) The Secretary shall establish such peer review groups as may be necessary to carry out paragraph (1). The Secretary shall make appointments to the peer review groups from among appropriately qualified persons who are not officers or employees of the United States. “(3) With respect to applications referred to in paragraph (1), a peer review group established pursuant to paragraph (2) shall report its findings and recommendations to the Secretary. The Secretary may not approve such an application unless a peer review group has recommended the application for approval. “(4) This paragraph shall be carried out by the Secretary, acting through Health Resources and Services Administration. “(g) For the purposes of this section, the term ‘rural area’ includes a frontier area, which is an area in which the population density is less than 7 individuals per square mile. “(h)(1) There are authorized to be appropriated to carry out the provisions of this section, other than subsection (e), $5,000,000 for fiscal year 1989. “(2) There are authorized to be appropriated $1,000,000 for fiscal year 1989 to carry out subsection (e). “(g) This section shall cease to be effective on October 1, 1989.”.