text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Health Care Safety Net Act of 
  2008''.
  
  SEC. 2. COMMUNITY HEALTH CENTERS PROGRAM OF THE PUBLIC HEALTH SERVICE 
                ACT.
  
      (a) Additional Authorizations of Appropriations for the Health 
  Centers Program of Public Health Service Act.--Section 330(r) of the 
  Public Health Service Act (42 U.S.C. 254b(r)) is amended by amending 
  paragraph (1) to read as follows:
              ``(1) In general.--For the purpose of carrying out this 
          section, in addition to the amounts authorized to be 
          appropriated under subsection (d), there are authorized to be 
          appropriated--
                      ``(A) $2,065,000,000 for fiscal year 2008;
                      ``(B) $2,313,000,000 for fiscal year 2009;
                      ``(C) $2,602,000,000 for fiscal year 2010;
                      ``(D) $2,940,000,000 for fiscal year 2011; and
                      ``(E) $3,337,000,000 for fiscal year 2012.''.
      (b) Studies Relating to Community Health Centers.--
              (1) Definitions.--For purposes of this subsection--
                      (A) the term ``community health center'' means a 
                  health center receiving assistance under section 330 of 
                  the Public Health Service Act (42 U.S.C. 254b); and
                      (B) the term ``medically underserved population'' 
                  has the meaning given that term in such section 330.
              (2) School-based health center study.--
                      (A) In general.--Not later than 2 years after the 
                  date of enactment of this Act, the Comptroller General 
                  of the United States shall issue a study of the 
                  economic costs and benefits of school-based health 
                  centers and the impact on the health of students of 
                  these centers.
                      (B) Content.--In conducting the study under 
                  subparagraph (A), the Comptroller General of the United 
                  States shall analyze--
                              (i) the impact that Federal funding could 
                          have on the operation of school-based health 
                          centers;
                              (ii) any cost savings to other Federal 
                          programs derived from providing health services 
                          in school-based health centers;
                              (iii) the effect on the Federal Budget and 
                          the health of students of providing Federal 
                          funds to school-based health centers and 
                          clinics, including the result of providing 
                          disease prevention and nutrition information;
                              (iv) the impact of access to health care 
                          from school-based health centers in rural or 
                          underserved areas; and
                              (v) other sources of Federal funding for 
                          school-based health centers.
              (3) Health care quality study.--
                      (A) In general.--Not later than 1 year after the 
                  date of enactment of this Act, the Secretary of Health 
                  and Human Services (referred to in this Act as the 
                  ``Secretary''), acting through the Administrator of the 
                  Health Resources and Services Administration, and in 
                  collaboration with the Agency for Healthcare Research 
                  and Quality, shall prepare and submit to the Committee 
                  on Health, Education, Labor, and Pensions of the Senate 
                  and the Committee on Energy and Commerce of the House 
                  of Representatives a report that describes agency 
                  efforts to expand and accelerate quality improvement 
                  activities in community health centers.
                      (B) Content.--The report under subparagraph (A) 
                  shall focus on--
                              (i) Federal efforts, as of the date of 
                          enactment of this Act, regarding health care 
                          quality in community health centers, including 
                          quality data collection, analysis, and 
                          reporting requirements;
                              (ii) identification of effective models for 
                          quality improvement in community health 
                          centers, which may include models that--
                                      (I) incorporate care coordination, 
                                  disease management, and other services 
                                  demonstrated to improve care;
                                      (II) are designed to address 
                                  multiple, co-occurring diseases and 
                                  conditions;
                                      (III) improve access to providers 
                                  through non-traditional means, such as 
                                  the use of remote monitoring equipment;
                                      (IV) target various medically 
                                  underserved populations, including 
                                  uninsured patient populations;
                                      (V) increase access to specialty 
                                  care, including referrals and 
                                  diagnostic testing; and
                                      (VI) enhance the use of electronic 
                                  health records to improve quality;
                              (iii) efforts to determine how effective 
                          quality improvement models may be adapted for 
                          implementation by community health centers that 
                          vary by size, budget, staffing, services 
                          offered, populations served, and other 
                          characteristics determined appropriate by the 
                          Secretary;
                              (iv) types of technical assistance and 
                          resources provided to community health centers 
                          that may facilitate the implementation of 
                          quality improvement interventions;
                              (v) proposed or adopted methodologies for 
                          community health center evaluations of quality 
                          improvement interventions, including any 
                          development of new measures that are tailored 
                          to safety-net, community-based providers;
                              (vi) successful strategies for sustaining 
                          quality improvement interventions in the long-
                          term; and
                              (vii) partnerships with other Federal 
                          agencies and private organizations or networks 
                          as appropriate, to enhance health care quality 
                          in community health centers.
                      (C) Dissemination.--The Administrator of the Health 
                  Resources and Services Administration shall establish a 
                  formal mechanism or mechanisms for the ongoing 
                  dissemination of agency initiatives, best practices, 
                  and other information that may assist health care 
                  quality improvement efforts in community health 
                  centers.
              (4) GAO study on integrated health systems model for the 
          delivery of health care services to medically underserved 
          populations.--
                      (A) Study.--The Comptroller General of the United 
                  States shall conduct a study on integrated health 
                  system models at not more than 10 sites for the 
                  delivery of health care services to medically 
                  underserved populations. The study shall include an 
                  examination of--
                              (i) health care delivery models sponsored 
                          by public or private non-profit entities that--
                                      (I) integrate primary, specialty, 
                                  and acute care; and
                                      (II) serve medically underserved 
                                  populations; and
                              (ii) such models in rural and urban areas.
                      (B) Report.--Not later than 1 year after the date 
                  of the enactment of this Act, the Comptroller General 
                  of the United States shall submit to Congress a report 
                  on the study conducted under subparagraph (A). The 
                  report shall include--
                              (i) an evaluation of the models, as 
                          described in subparagraph (A), in--
                                      (I) expanding access to primary and 
                                  preventive services for medically 
                                  underserved populations; and
                                      (II) improving care coordination 
                                  and health outcomes; and
                              (ii) an assessment of--
                                      (I) challenges encountered by such 
                                  entities in providing care to medically 
                                  underserved populations; and
                                      (II) advantages and disadvantages 
                                  of such models compared to other models 
                                  of care delivery for medically 
                                  underserved populations.
  
  SEC. 3. NATIONAL HEALTH SERVICE CORPS.
  
      (a) Funding.--
              (1) National health service corps program.--Section 338(a) 
          of the Public Health Service Act (42 U.S.C. 254k(a)) is amended 
          by striking ``2002 through 2006'' and inserting ``2008 through 
          2012''.
              (2) Scholarship and loan repayment programs.--Section 
          338H(a) of the Public Health Service Act (42 U.S.C. 254q(a)) is 
          amended by striking ``appropriated $146,250,000'' and all that 
          follows through the period and inserting the following: 
          ``appropriated--
              ``(1) for fiscal year 2008, $131,500,000;
              ``(2) for fiscal year 2009, $143,335,000;
              ``(3) for fiscal year 2010, $156,235,150;
              ``(4) for fiscal year 2011, $170,296,310; and
              ``(5) for fiscal year 2012, $185,622,980.''.
      (b) Elimination of 6-Year Demonstration Requirement.--Section 
  332(a)(1) of the Public Health Service Act (42 U.S.C. 254e(a)(1)) is 
  amended by striking ``Not earlier than 6 years'' and all that follows 
  through ``purposes of this section.''.
      (c) Assignment to Shortage Area.--Section 333(a)(1)(D)(ii) of the 
  Public Health Service Act (42 U.S.C. 254f(a)(1)(D)(ii)) is amended--
              (1) in subclause (IV), by striking ``and'';
              (2) in subclause (V), by striking the period at the end and 
          inserting ``; and''; and
              (3) by adding at the end the following:
                      ``(VI) the entity demonstrates willingness to 
                  support or facilitate mentorship, professional 
                  development, and training opportunities for Corps 
                  members.''.
      (d) Professional Development and Training.--Subsection (d) of 
  section 336 of the Public Health Service Act (42 U.S.C. 254h-1) is 
  amended to read as follows:
      ``(d) Professional Development and Training.--
              ``(1) In general.--The Secretary shall assist Corps members 
          in establishing and maintaining professional relationships and 
          development opportunities, including by--
                      ``(A) establishing appropriate professional 
                  relationships between the Corps member involved and the 
                  health professions community of the geographic area 
                  with respect to which the member is assigned;
                      ``(B) establishing professional development, 
                  training, and mentorship linkages between the Corps 
                  member involved and the larger health professions 
                  community, including through distance learning, direct 
                  mentorship, and development and implementation of 
                  training modules designed to meet the educational needs 
                  of offsite Corps members;
                      ``(C) establishing professional networks among 
                  Corps members; or
                      ``(D) engaging in other professional development, 
                  mentorship, and training activities for Corps members, 
                  at the discretion of the Secretary.
              ``(2) Assistance in establishing professional 
          relationships.--In providing such assistance under paragraph 
          (1), the Secretary shall focus on establishing relationships 
          with hospitals, with academic medical centers and health 
          professions schools, with area health education centers under 
          section 751, with health education and training centers under 
          section 752, and with border health education and training 
          centers under such section 752. Such assistance shall include 
          assistance in obtaining faculty appointments at health 
          professions schools.
              ``(3) Supplement not supplant.--Such efforts under this 
          subsection shall supplement, not supplant, non-government 
          efforts by professional health provider societies to establish 
          and maintain professional relationships and development 
          opportunities.''.
  
  SEC. 4. REAUTHORIZATION OF RURAL HEALTH CARE PROGRAMS.
  
      Section 330A(j) of the Public Health Service Act (42 U.S.C. 
  254c(j)) is amended by striking ``$40,000,000'' and all that follows 
  and inserting ``$45,000,000 for each of fiscal years 2008 through 
  2012.''.
  
              Passed the Senate July 21 (legislative day, July 17), 2008.
  
              Attest:
  
                                                               Secretary.
  110th CONGRESS
  
    2d Session
  
                                   S. 901
  
  _______________________________________________________________________
  
                                   AN ACT
  
    To amend the Public Health Service Act to reauthorize the Community 
   Health Centers program, the National Health Service Corps, and rural 
                           health care programs.
target: Health Care Safety Net Act of 2008 - (Sec. 2) Amends the Public Health Service Act to reauthorize appropriations for FY2008-FY2012 for health centers to meet the health care needs of medically underserved populations.
  
  Requires the Comptroller General to study the economic costs and benefits of school-based health centers and their impact on the health of students, including an analysis of: (1) the impact that federal funding could have on the operation of such centers; (2) any cost savings to other federal programs derived from providing health services in such centers; and (3) the impact of such centers in rural or underserved areas.
  
  Requires the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration (HRSA), to submit a report to the relevant congressional committees that describes efforts to expand and accelerate quality improvement activities in community health centers.
  
  Requires the Administrator to establish a mechanism for the dissemination of initiatives, best practices, and other information that may assist health care quality improvement efforts in community health centers.
  
  Directs the Comptroller General to study integrated health system models for the delivery of health care services to medically underserved populations.
  
  (Sec. 3) Reauthorizes appropriations for FY2008-FY2012 for: (1) the National Health Service Corps program; and (2) the National Health Service Corps Scholarship Program and National Health Service Corps Loan Repayment Program.
  
  Repeals provisions requiring each center or clinic designated as having a health manpower shortage to demonstrate every six years that it meets the applicable requirements of the definition of a health professional shortage area.
  
  Revises requirements for assigning members of the Corps to a health professional shortage area to require that the Secretary determine that an entity demonstrates willingness to support or facilitate mentorship, professional development, and training opportunities for Corps members.
  
  Requires the Secretary to assist Corps members in establishing and maintaining professional relationships and developmental opportunities.
  
  (Sec. 4) Reauthorizes appropriations for FY2008-FY2012 for grants for expanded delivery of health care services in rural areas, for the planning and implementation of integrated health care networks in rural areas, and for the planning and implementation of small health care provider quality improvement activities.
feat_title: A bill to amend the Public Health Service Act to reauthorize the Community Health Centers program, the National Health Service Corps, and rural health care programs.