text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Access for All America Act''.
  
  SEC. 2. FINDINGS.
  
      Congress makes the following findings:
              (1) Providing universal coverage for health care for all 
          Americans will be incomplete if access to medical and other 
          health services is not improved.
              (2) Currently, 56,000,000 Americans, both insured and 
          uninsured, have inadequate access to primary care due to a 
          shortage of physicians and other like providers in their 
          community.
              (3) Several demonstrations are underway at the Federal and 
          State level to link patients to a primary care ``medical home'' 
          as a means of assuring access, controlling costs, and improving 
          quality.
              (4) Yet, there already exists a proven medical home model 
          that accomplishes these goals and has done so over the past 40 
          years while serving over 18,000,000 Americans.
              (5) Community health centers, also known as Federally 
          Qualified Health Centers (FQHCs), have been found to more than 
          pay for themselves by providing coordinated, comprehensive 
          medical, dental, behavioral health, and prescription drug 
          services that reduce unnecessary emergency room visits, 
          ambulatory-sensitive hospitalizations, and avoidable specialty 
          care.
              (6) The result is that the American Academy of Family 
          Physicians' Robert Graham Center found that medical expenses 
          for health center patients are 41 percent lower compared to 
          patients seen elsewhere, an average savings of $1,810 per 
          person per year.
              (7) The Lewin Group found that providing access to a 
          medical home for every American would produce health care 
          savings of $67,000,000,000 per year, more than 8 times the 
          subsidy needed to sustain the 1,100 current health centers and 
          to create 3,900 new or expanded health center sites to 
          accomplish full access.
              (8) Hand in hand with the expansion of the community health 
          center program, a renewed investment in the National Health 
          Service Corps is essential to reverse the decline in the supply 
          of primary care physicians and dentists.
              (9) Both the expansion of the community health center 
          program and the investment in the National Health Service Corps 
          can be accomplished for less than 1 percent of total health 
          care spending today.
              (10) Finally, to encourage broader adoption of the cost-
          effective community health center model of care beyond 
          underserved areas and populations and to encourage the pursuit 
          and practice of primary care as a career, all willing primary 
          care practitioners should be encouraged to collaborate with 
          community health centers.
  
  SEC. 3. SPENDING FOR FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS).
  
      Section 330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) 
  is amended by striking paragraph (1) and inserting the following:
              ``(1) General amounts for grants.--For the purpose of 
          carrying out this section, in addition to the amounts 
          authorized to be appropriated under subsection (d), there is 
          authorized to be appropriated the following:
                      ``(A) For fiscal year 2010, $2,988,821,592.
                      ``(B) For fiscal year 2011, $3,862,107,440.
                      ``(C) For fiscal year 2012, $4,990,553,440.
                      ``(D) For fiscal year 2013, $6,448,713,307.
                      ``(E) For fiscal year 2014, $7,332,924,155.
                      ``(F) For fiscal year 2015, $8,332,924,155.
                      ``(G) For fiscal year 2016, and each subsequent 
                  fiscal year, the amount appropriated for the preceding 
                  fiscal year adjusted by the product of--
                              ``(i) one plus the average percentage 
                          increase in costs incurred per patient served; 
                          and
                              ``(ii) one plus the average percentage 
                          increase in the total number of patients 
                          served.''.
  
  SEC. 4. OTHER PROVISIONS.
  
      (a) Settings for Service Delivery.--Section 330(a)(1) of the Public 
  Health Service Act (42 U.S.C. 254b(a)(1)) is amended by adding at the 
  end the following: ``Required primary health services and additional 
  health services may be provided either at facilities directly operated 
  by the center or at any other inpatient or outpatient settings 
  determined appropriate by the center to meet the needs of its 
  patents.''.
      (b) Location of Service Delivery Sites.--Section 330(a) of the 
  Public Health Service Act (42 U.S.C. 254b(a)) is amended by adding at 
  the end the following:
              ``(3) Considerations.--
                      ``(A) Location of sites.--Subject to subparagraph 
                  (B), a center shall not be required to locate its 
                  service facility or facilities within a designated 
                  medically underserved area in order to serve either the 
                  residents of its catchment area or a special medically 
                  underserved population comprised of migratory and 
                  seasonal agricultural workers, the homeless, or 
                  residents of public housing, if that location is 
                  determined by the center to be reasonably accessible to 
                  and appropriate to meet the needs of the medically 
                  underserved residents of the center's catchment area or 
                  the special medically underserved population, in 
                  accordance with subparagraphs (A) and (J) of subsection 
                  (k)(3).
                      ``(B) Location within another center's area.--The 
                  Secretary may permit applicants for grants under this 
                  section to propose the location of a service delivery 
                  site within another center's catchment area if the 
                  applicant demonstrates sufficient unmet need in such 
                  area and can otherwise justify the need for additional 
                  Federal resources in the catchment area. In determining 
                  whether to approve such a proposal, the Secretary shall 
                  take into consideration whether collaboration between 
                  the two centers exists, or whether the applicant has 
                  made reasonable attempts to establish such 
                  collaboration, and shall consider any comments timely 
                  submitted by the affected center concerning the 
                  potential impact of the proposal on the availability or 
                  accessibility of services the affected center currently 
                  provides or the financial viability of the affected 
                  center.''.
      (c) Affiliation Agreements.--Section 330(k)(3)(B) of the Public 
  Health Service Act (42 U.S.C. 254b(k)(3)(B)) is amended by inserting 
  before the semicolon the following: ``, including contractual 
  arrangements as appropriate, while maintaining full compliance with the 
  requirements of this section, including the requirements of 
  subparagraph (H) concerning the composition and authorities of the 
  center's governing board, and, except as otherwise provided in clause 
  (ii) of such subparagraph, ensuring full autonomy of the center over 
  policies, direction, and operations related to health care delivery, 
  personnel, finances, and quality assurance''.
      (d) Governance Requirements.--Section 330(k)(3) of the Public 
  Health Service Act (42 U.S.C. 254b(k)(3)) is amended--
              (1) in subparagraph (H)--
                      (A) in clause (ii), by striking ``; and'' and 
                  inserting ``, except that in the case of a public 
                  center (as defined in the second sentence of this 
                  paragraph), the public entity may retain authority to 
                  establish financial and personnel policies for the 
                  center; and'';
                      (B) in clause (iii), by adding ``and'' at the end; 
                  and
                      (C) by inserting after clause (iii) the following:
                              ``(iv) in the case of a co-applicant with a 
                          public entity, meets the requirements of 
                          clauses (i) and (ii);''; and
              (2) in the second sentence, by inserting before the period 
          the following: ``that is governed by a board that satisfies the 
          requirements of subparagraph (H) or that jointly applies (or 
          has applied) for funding with a co-applicant board that meets 
          such requirements''.
      (e) Adjustment in Center's Operating Plan and Budget.--Section 
  330(k)(3)(I)(i) of the Public Health Service Act (42 U.S.C. 
  254b(k)(3)(I)(i)) is amended by inserting before the semicolon the 
  following: ``, which may be modified by the center at any time during 
  the fiscal year involved if such modifications do not require 
  additional grant funds, do not compromise the availability or 
  accessibility of services currently provided by the center, and 
  otherwise meet the conditions of subsection (a)(3)(B), except that any 
  such modifications that do not comply with this clause, as determined 
  by the health center, shall be submitted to the Secretary for 
  approval''.
      (f) Joint Purchasing Arrangements for Reduced Cost.--Section 330(l) 
  of the Public Health Service Act (42 U.S.C. 254b(l)) is amended--
              (1) by striking ``The Secretary'' and inserting the 
          following:
              ``(1) In general.--The Secretary''; and
              (2) by adding at the end the following:
              ``(2) Assistance with supplies and services costs.--The 
          Secretary, directly or through grants or contracts, may carry 
          out projects to establish and administer arrangements under 
          which the costs of providing the supplies and services needed 
          for the operation of federally qualified health centers are 
          reduced through collaborative efforts of the centers, through 
          making purchases that apply to multiple centers, or through 
          such other methods as the Secretary determines to be 
          appropriate.''.
      (g) Opportunity To Correct Material Failure Regarding Grant 
  Conditions.--Section 330(e) of the Public Health Service Act (42 U.S.C. 
  254b(e)) is amended by adding at the end the following:
              ``(6) Opportunity to correct material failure regarding 
          grant conditions.--If the Secretary finds that a center 
          materially fails to meet any requirement (except for any 
          requirements waived by the Secretary) necessary to qualify for 
          its grant under this subsection, the Secretary shall provide 
          the center with an opportunity to achieve compliance (over a 
          period of up to 1 year from making such finding) before 
          terminating the center's grant. A center may appeal and obtain 
          an impartial review of any Secretarial determination made with 
          respect to a grant under this subsection, or may appeal and 
          receive a fair hearing on any Secretarial determination 
          involving termination of the center's grant entitlement, 
          modification of the center's service area, termination of a 
          medically underserved population designation within the 
          center's service area, disallowance of any grant expenditures, 
          or a significant reduction in a center's grant amount.''.
  
  SEC. 5. FUNDING FOR NATIONAL HEALTH SERVICE CORPS.
  
      Section 338H(a) of the Public Health Service Act (42 U.S.C. 
  254q(a)) is amended to read as follows:
      ``(a) Authorization of Appropriations.--For the purpose of carrying 
  out this section, there is authorized to be appropriated, out of any 
  funds in the Treasury not otherwise appropriated, the following:
              ``(1) For fiscal year 2010, $320,461,632.
              ``(2) For fiscal year 2011, $414,095,394.
              ``(3) For fiscal year 2012, $535,087,442.
              ``(4) For fiscal year 2013, $691,431,432.
              ``(5) For fiscal year 2014, $893,456,433.
              ``(6) For fiscal year 2015, $1,154,510,336.
              ``(7) For fiscal year 2016, and each subsequent fiscal 
          year, the amount appropriated for the preceding fiscal year 
          adjusted by the product of--
                      ``(A) one plus the average percentage increase in 
                  the costs of health professions education during the 
                  prior fiscal year; and
                      ``(B) one plus the average percentage change in the 
                  number of individuals residing in health professions 
                  shortage areas designated under section 333 during the 
                  prior fiscal year, relative to the number of 
                  individuals residing in such areas during the previous 
                  fiscal year.''.
target: Access for All America Act - Amends the Public Health Service Act to: (1) increase and extend the authorization of appropriations for community health centers and for the National Health Service Corps scholarship and loan repayment program for FY2010-FY2015, and provide for increased funding for such programs in FY2016 and each subsequent fiscal year; and (2) revise and expand provisions allowing a community health center to provide services at different locations, adjust its operating plan and budget, enter into arrangements with other centers to purchase supplies and services at reduced cost, and correct material failures in grant compliance.
feat_title: To achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs.