text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Community Coordination And Resource 
  Empowerment Act'' or the ``Community CARE Act''.
  
  SEC. 2. EXTENSION FOR COMMUNITY HEALTH CENTERS.
  
      (a) Community Health Centers Funding.--Section 10503(b)(1)(E) of 
  the Patient Protection and Affordable Care Act (42 U.S.C. 254b-
  2(b)(1)(E)) is amended by striking ``2017'' and inserting ``2019''.
      (b) Other Community Health Centers Provisions.--Section 330 of the 
  Public Health Service Act (42 U.S.C. 254b) is amended--
              (1) in subsection (b)(1)(A)(ii), by striking ``abuse'' and 
          inserting ``use disorder'';
              (2) in subsection (b)(2)(A), by striking ``abuse'' and 
          inserting ``use disorder'';
              (3) in subsection (c)--
                      (A) by striking subparagraphs (B) through (D);
                      (B) by striking ``(1) In general'' and all that 
                  follows through ``The Secretary'' and inserting the 
                  following:
              ``(1) Centers.--The Secretary''; and
                      (C) in such paragraph (1), as amended, by 
                  redesignating clauses (i) through (v) as subparagraphs 
                  (A) through (E) and moving the margin of each of such 
                  redesignated subparagraph 2 ems to the left;
              (4) by striking subsection (d) and inserting the following:
      ``(d) Improving Quality of Care.--
              ``(1) Supplemental awards.--The Secretary may award 
          supplemental grant funds to health centers funded under this 
          section to implement evidence-based models for increasing 
          access to high-quality primary care services, which may include 
          models related to--
                      ``(A) improving the delivery of care for 
                  individuals with multiple chronic conditions;
                      ``(B) workforce configuration;
                      ``(C) reducing the cost of care;
                      ``(D) enhancing care coordination;
                      ``(E) expanding the use of telehealth and 
                  technology enabled collaborative learning and capacity 
                  building models;
                      ``(F) care integration, including integration of 
                  behavioral health, mental health, or substance use 
                  disorder services; and
                      ``(G) addressing emerging public health or 
                  substance use disorder issues to meet the health needs 
                  of the population served by the health center.
              ``(2) Sustainability.--In making supplemental awards under 
          this subsection, the Secretary may consider whether the health 
          center involved has submitted a plan for continuing the 
          activities funded under this subsection after supplemental 
          funding is expended.
              ``(3) Special consideration.--The Secretary may give 
          special consideration to applications for supplemental funding 
          under this subsection that seek to address significant barriers 
          to access to care in areas with a greater shortage of health 
          care providers and health services relative to the national 
          average.'';
              (5) in subsection (e)(1)--
                      (A) in subparagraph (B)--
                              (i) by striking ``2 years'' and inserting 
                          ``1 year''; and
                              (ii) by adding at the end the following: 
                          ``The Secretary shall not make a grant under 
                          this paragraph unless the applicant provides 
                          assurances to the Secretary that within 120 
                          days of receiving grant funding for the 
                          operation of the health center, the applicant 
                          will submit, for approval by the Secretary, an 
                          implementation plan to meet the requirements of 
                          subsection (l)(3). The Secretary may extend 
                          such 120-day period for achieving compliance 
                          upon a demonstration of good cause by the 
                          health center.''; and
                      (B) in subparagraph (C)--
                              (i) in the subparagraph heading, by 
                          striking ``and plans'';
                              (ii) by striking ``or plan (as described in 
                          subparagraphs (B) and (C) of subsection 
                          (c)(1))'';
                              (iii) by striking ``or plan, including the 
                          purchase'' and inserting the following: 
                          ``including--
                              ``(i) the purchase'';
                              (iv) by inserting ``, which may include 
                          data and information systems'' after ``of 
                          equipment'';
                              (v) by striking the period at the end and 
                          inserting a semicolon; and
                              (vi) by adding at the end the following:
                              ``(ii) the provision of training and 
                          technical assistance; and
                              ``(iii) other activities that--
                                      ``(I) reduce costs associated with 
                                  the provision of health services;
                                      ``(II) improve access to, and 
                                  availability of, health services 
                                  provided to individuals served by the 
                                  centers;
                                      ``(III) enhance the quality and 
                                  coordination of health services; or
                                      ``(IV) improve the health status of 
                                  communities.'';
              (6) in subsection (e)(5)(B), by striking ``and 
          subparagraphs (B) and (C) of subsection (c)(1) to a health 
          center or to a network or plan'' and inserting ``to a health 
          center'';
              (7) by striking subsection (s);
              (8) by redesignating subsections (g) through (r) as 
          subsections (h) through (s), respectively;
              (9) by inserting after subsection (f), the following:
      ``(g) New Access Points and Expanded Services.--
              ``(1) Approval of new access points.--
                      ``(A) In general.--The Secretary may approve 
                  applications for grants under subparagraph (A) or (B) 
                  of subsection (e)(1), subsection (h), subsection (i), 
                  and subsection (j) to establish new delivery sites.
                      ``(B) Special consideration.--In carrying out 
                  subparagraph (A), the Secretary may give special 
                  consideration to applicants that have demonstrated the 
                  new delivery site will be located within a sparsely 
                  populated area, or an area which has a level of unmet 
                  need that is higher relative to other applicants.
                      ``(C) Consideration of applications.--In carrying 
                  subparagraph (A), the Secretary shall approve 
                  applications for grants under subparagraphs (A) and (B) 
                  of subsection (e)(1) in such a manner that the ratio of 
                  the medically underserved populations in rural areas 
                  which may be expected to use the services provided by 
                  the applicants involved to the medically underserved 
                  populations in urban areas which may be expected to use 
                  the services provided by the applicants is not less 
                  than two to three or greater than three to two.
                      ``(D) Service area overlap.--If in carrying out 
                  subparagraph (A) the applicant proposes to serve an 
                  area that is currently served by another health center 
                  funded under this section, the Secretary may consider 
                  whether the award of funding to an additional health 
                  center in the area can be justified based on the unmet 
                  need for additional services within the catchment area.
              ``(2) Approval of expanded service applications.--
                      ``(A) In general.--The Secretary may approve 
                  applications for grants under subparagraph (A) or (B) 
                  of subsection (e)(1) to expand the capacity of the 
                  applicant to provide required primary health services 
                  described in subsection (b)(1) or additional health 
                  services described in subsection (b)(2).
                      ``(B) Priority expansion projects.--In carrying out 
                  subparagraph (A), the Secretary may give special 
                  consideration to expanded service applications that 
                  seek to address emerging public health or behavioral 
                  health, mental health, or substance abuse issues 
                  through increasing the availability of additional 
                  health services described in subsection (b)(2) in an 
                  area in which there are significant barriers to 
                  accessing care.
                      ``(C) Consideration of applications.--In carrying 
                  out subparagraph (A), the Secretary shall approve 
                  applications for applicants in such a manner that the 
                  ratio of the medically underserved populations in rural 
                  areas which may be expected to use the services 
                  provided by the applicants involved to the medically 
                  underserved populations in urban areas which may be 
                  expected to use the services provided by such 
                  applicants is not less than two to three or greater 
                  than three to two.'';
              (10) in subsection (i) (as so redesignated)--
                      (A) in paragraph (1), by striking ``and children 
                  and youth at risk of homelessness'' and inserting ``, 
                  children and youth at risk of homelessness, homeless 
                  veterans, and veterans at risk of homelessness''; and
                      (B) in paragraph (5)--
                              (i) by striking subparagraph (B);
                              (ii) by redesignating subparagraph (C) as 
                          subparagraph (B); and
                              (iii) in subparagraph (B) (as so 
                          redesignated)--
                                      (I) in the subparagraph heading, by 
                                  striking ``abuse'' and inserting ``use 
                                  disorder''; and
                                      (II) by striking ``abuse'' and 
                                  inserting ``use disorder'';
              (11) in subsection (l) (as so redesignated)--
                      (A) in paragraph (2)--
                              (i) in the paragraph heading, by inserting 
                          ``unmet'' before ``need'';
                              (ii) in the matter preceding subparagraph 
                          (A), by inserting ``and an application for a 
                          grant under subsection (g)'' after ``subsection 
                          (e)(1)'';
                              (iii) in subparagraph (A), by inserting 
                          ``unmet'' before ``need for health services'';
                              (iv) in subparagraph (B), by striking 
                          ``and'' at the end;
                              (v) in subparagraph (C), by striking the 
                          period at the end and inserting ``; and''; and
                              (vi) by adding after subparagraph (C) the 
                          following:
                      ``(D) in the case of an application for a grant 
                  pursuant to subsection (g)(1), a demonstration that the 
                  applicant has consulted with appropriate State and 
                  local government agencies, and health care providers 
                  regarding the need for the heath services to be 
                  provided at the proposed delivery site.'';
                      (B) in paragraph (3)--
                              (i) in the matter preceding subparagraph 
                          (A), by inserting ``or subsection (g)'' after 
                          ``subsection (e)(1)(B)'';
                              (ii) in subparagraph (B), by striking ``in 
                          the catchment area of the center'' and 
                          inserting ``, including other health care 
                          providers that provide care within the 
                          catchment area, local hospitals, and specialty 
                          providers in the catchment area of the center, 
                          to provide access to services not available 
                          through the health center and to reduce the 
                          non-urgent use of hospital emergency 
                          departments'';
                              (iii) in subparagraph (H)(ii), by inserting 
                          ``who shall be directly employed by the 
                          center'' after ``approves the selection of a 
                          director for the center'';
                              (iv) in subparagraph (L), by striking 
                          ``and'' at the end;
                              (v) in subparagraph (M), by striking the 
                          period and inserting ``; and''; and
                              (vi) by inserting after subparagraph (M), 
                          the following:
                      ``(N) the center has written policies and 
                  procedures in place to ensure the appropriate use of 
                  Federal funds in compliance with applicable Federal 
                  statutes, regulations, and the terms and conditions of 
                  the Federal award.''; and
                      (C) by striking paragraph (4);
              (12) in subsection (m) (as so redesignated), by adding at 
          the end the following: ``Funds expended to carry out activities 
          under this subsection and operational support activities under 
          subsection (n) shall not exceed three percent of the amount 
          appropriated for this section for the fiscal year involved.'';
              (13) in subsection (q) (as so redesignated), by striking 
          ``grants for new health centers under subsections (c) and (e)'' 
          and inserting ``operating grants under subsection (e), 
          applications for new access points and expanded service 
          pursuant to subsection (g)'';
              (14) in subsection (r)(4) (as so redesignated), by adding 
          at the end the following: ``A waiver provided by the Secretary 
          under this paragraph may not remain in effect for more than 1 
          year and may not be extended after such period. An entity may 
          not receive more than one waiver under this paragraph in 
          consecutive years.''; and
              (15) in subsection (s)(3) (as so redesignated)--
                      (A) by striking ``appropriate committees of 
                  Congress a report concerning the distribution of funds 
                  under this section'' and inserting the following: 
                  ``Committee on Health, Education, Labor, and Pensions 
                  of the Senate, and the Committee on Energy and Commerce 
                  of the House of Representatives, a report including, at 
                  a minimum--
                      ``(A) the distribution of funds for carrying out 
                  this section'';
                      (B) by striking ``populations. Such report shall 
                  include an assessment'' and inserting the following: 
                  ``populations;
                      ``(B) an assessment'';
                      (C) by striking ``and the rationale for any 
                  substantial changes in the distribution of funds.'' and 
                  inserting a semicolon; and
                      (D) by adding at the end the following:
                      ``(C) the distribution of awards and funding for 
                  new or expanded services in each of rural areas and 
                  urban areas;
                      ``(D) the distribution of awards and funding for 
                  establishing new access points, and the number of new 
                  access points created;
                      ``(E) the amount of unexpended funding for loan 
                  guarantees and loan guarantee authority under title 
                  XVI;
                      ``(F) the rationale for any substantial changes in 
                  the distribution of funds;
                      ``(G) the rate of closures for health centers and 
                  access points;
                      ``(H) the number and reason for any grants awarded 
                  pursuant to subsection (e)(1)(B); and
                      ``(I) the number and reason for any waivers 
                  provided pursuant to subsection (r)(4).''.
      (c) Application.--Amounts appropriated pursuant to this section for 
  fiscal year 2018 or 2019 are subject to the requirements contained in 
  Public Law 115-31 for funds for programs authorized under sections 330 
  through 340 of the Public Health Service Act (42 U.S.C. 254b-256).
      (d) Conforming Amendments.--Section 3014(h) of title 18, United 
  States Code, is amended--
              (1) in paragraph (1), by striking ``, as amended by section 
          221 of the Medicare Access and CHIP Reauthorization Act of 
          2015,''; and
              (2) in paragraph (4), by inserting ``and section 101(d) of 
          the CARE Act'' after ``section 221(c) of the Medicare Access 
          and CHIP Reauthorization Act of 2015''.
target: Community Coordination And Resource Empowerment Act or the Community CARE Act This bill amends the Patient Protection and Affordable Care Act to extend funding through FY2019 for community health centers. Health centers that serve medically underserved populations may receive supplemental grant funds to increase access to primary care services.
feat_title: Community Coordination And Resource Empowerment Act