Healing Communities through Health Care Act

II 116TH CONGRESS 1ST SESSION S. 2721 To reduce violence and health disparities by addressing social determinants of health, enhancing health care recruitment, and improving the delivery of quality, coordinated care services, and for other purposes. IN THE SENATE OF THE UNITED STATES OCTOBER 28, 2019 Mr. DURBIN introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To reduce violence and health disparities by addressing social determinants of health, enhancing health care recruit- ment, and improving the delivery of quality, coordinated care services, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Healing Communities 4 through Health Care Act’’. 5 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 2 •S 2721 IS SEC. 2. MEDICAID HOUSING AND HOSPITAL DEMONSTRA- 1 TION PROJECT. 2 (a) AUTHORITY.—Not later than 1 year after the 3 date of enactment of this Act, the Secretary shall select 4 States to conduct demonstration projects under title XIX 5 of the Social Security Act (42 U.S.C. 1396 et seq.) to test 6 innovative partnership programs between housing agencies 7 and programs, hospitals and health systems, and commu- 8 nity-based organizations, to establish screening, referral, 9 and supportive housing programs for individuals with be- 10 havioral health needs who are experiencing housing insecu- 11 rity, that account for disproportionately high rates of 12 emergency room visits and associated Medicaid spending. 13 (b) REQUIREMENTS.— 14 (1) NUMBER OF PROJECTS.—The Secretary 15 shall select not less than 6 States to conduct dem- 16 onstration projects under this section. 17 (2) ELIGIBILITY.—In order to be eligible to 18 conduct a demonstration project under this section, 19 a State shall demonstrate the following: 20 (A) The State has or will establish suffi- 21 cient processes for furnishing supportive hous- 22 ing services under the State Medicaid program, 23 working with managed care organizations as 24 applicable in the State, for Medicaid-eligible in- 25 dividuals described in subsection (a). 26 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 3 •S 2721 IS (B) The State Medicaid program has pro- 1 cedures in place to coordinate care and services 2 for Medicaid-eligible individuals described in 3 subsection (a), including those with behavioral 4 health needs, across settings, as appropriate, 5 which may include with law enforcement, hos- 6 pitals and health systems, housing authorities 7 or agencies, mental health and substance use 8 treatment facilities, and community-based orga- 9 nizations. 10 (3) PRIORITY.—In selecting States under this 11 section, the Secretary shall give priority to States 12 with large urban populations in which there are ex- 13 isting programs that deliver housing, case manage- 14 ment and service coordination, and establishment of 15 screening and referral processes in health care set- 16 tings, including programs that utilize public hos- 17 pitals and flexible housing pools to serve individuals 18 who are experiencing housing insecurity or have be- 19 havioral health needs. 20 (4) DURATION.—Each demonstration project 21 under this section shall be conducted for a period of 22 not less than 4 years. 23 (c) PAYMENT FOR SERVICES FURNISHED UNDER 24 DEMONSTRATION PROJECT.— 25 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 4 •S 2721 IS (1) IN GENERAL.—Subject to paragraph (2), 1 amounts expended by a State under a demonstration 2 project under this section on supportive housing 3 services for Medicaid-eligible individuals described in 4 subsection (a) shall be treated as medical assistance 5 for purposes of section 1903(a) of the Social Secu- 6 rity Act (42 U.S.C. 1396b(a)). 7 (2) LIMITATION ON FEDERAL FUNDING.— 8 (A) IN GENERAL.—The total amount cer- 9 tified by the Secretary under title XIX of the 10 Social Security Act (42 U.S.C. 1396 et seq.) for 11 payment to a State with respect to expenditures 12 described in paragraph (1) shall not exceed the 13 amount allocated to the State by the Secretary 14 under subparagraph (B). 15 (B) ALLOCATION.— 16 (i) IN GENERAL.—The Secretary shall 17 allocate to each State selected to conduct 18 a demonstration project under this section 19 an amount determined appropriate by the 20 Secretary for purposes of reimbursing the 21 State for services furnished under the dem- 22 onstration project in accordance with para- 23 graph (1). 24 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 5 •S 2721 IS (ii) LIMITATION.—The total amount 1 allocated to States under this subpara- 2 graph shall not exceed $75,000,000. 3 (d) WAIVER AUTHORITY.—The Secretary may waive 4 the following requirements as may be necessary to conduct 5 demonstration projects in accordance with the require- 6 ments of this section: 7 (1) The requirements of section 1902(a)(1) of 8 the Social Security Act (42 U.S.C. 1396a(a)(1)) (re- 9 lating to statewideness). 10 (2) The requirements of section 1902(a)(10)(B) 11 of such Act (42 U.S.C. 1396a(a)(10)(B)) (relating 12 to comparability). 13 (3) The requirements of section 14 1902(a)(10)(C)(i)(III) of such (42 U.S.C. 15 1396a(a)(10)(C)(i)(III)) (relating to income and re- 16 source rules applicable in the community). 17 (e) DEFINITIONS.—In this section: 18 (1) MEDICAID.—The term ‘‘Medicaid’’ means 19 the medical assistance program established under 20 title XIX of the Social Security Act (42 U.S.C. 1396 21 et seq.) and includes any waivers of such program. 22 (2) SECRETARY.—The term ‘‘Secretary’’ means 23 the Secretary of Health and Human Services. 24 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 6 •S 2721 IS (3) STATE.—The term ‘‘State’’ has the mean- 1 ing given that term for purposes of title XIX of the 2 Social Security Act (42 U.S.C. 1396 et seq.). 3 (4) SUPPORTIVE HOUSING SERVICES.—The 4 term ‘‘supportive housing services’’ means— 5 (A) financial assistance with rental pay- 6 ments, room and board, or other housing costs, 7 as appropriate; 8 (B) case management and service coordi- 9 nation services; and 10 (C) housing support screening and referral 11 services provided in a healthcare setting. 12 SEC. 3. ESTABLISHING NIH CLINICAL TRIALS RESEARCH 13 NETWORK ON VIOLENCE RECOVERY. 14 Part B of title IV of the Public Health Service Act 15 (42 U.S.C. 284 et seq.) is amended by adding at the end 16 the following: 17 ‘‘SEC. 409K. CLINICAL TRIALS RESEARCH NETWORK ON VI- 18 OLENCE RECOVERY. 19 ‘‘(a) NETWORK.—The Director of NIH shall develop 20 and support a regional clinical research center network, 21 by awarding funding to participants in accordance with 22 subsection (b) through grants, contracts, or other mecha- 23 nisms, to study and evaluate hospital- and community- 24 based interventions for victims of violent or penetrating 25 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 7 •S 2721 IS injuries to prevent, mitigate, and furnish treatments to ad- 1 dress the trauma and mental health impacts of those inju- 2 ries on such victims and prevent re-injury. 3 ‘‘(b) PARTICIPANTS.— 4 ‘‘(1) IN GENERAL.—An entity seeking funding 5 under this section shall— 6 ‘‘(A) be a university or hospital; and 7 ‘‘(B) submit an application to the Director 8 of NIH at such time, in such manner, and con- 9 taining such information as the Director may 10 require, including the information described in 11 paragraph (2). 12 ‘‘(2) DEMONSTRATED EXPERTISE.—An applica- 13 tion submitted under paragraph (1)(B) shall include 14 information demonstrating that the applicant has 15 multidisciplinary expertise in— 16 ‘‘(A) furnishing hospital- or community- 17 based interventions to improve outcomes for pa- 18 tients suffering a violent or penetrating injury; 19 ‘‘(B) quality improvement research; 20 ‘‘(C) linking clinical research with practice 21 and community outcomes and activities; and 22 ‘‘(D) providing, linking to, or otherwise fa- 23 cilitating community-based care, case manage- 24 ment, and treatment. 25 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 8 •S 2721 IS ‘‘(3) SELECTION.—The Director of NIH shall, 1 subject to available funding, select not less than 15 2 entities meeting the requirements of this subsection 3 to receive funding under this section (provided that 4 fifteen or more entities meeting such requirements 5 apply for such funding). 6 ‘‘(c) ACTIVITIES AND USE OF FUNDS.—An entity 7 that receives funding under this section shall use the funds 8 to provide support for a trauma-informed and violence re- 9 injury prevention research center, including funding for— 10 ‘‘(1) clinical, behavioral, or translational re- 11 search to test and evaluate trauma-informed inter- 12 ventions for trauma recovery in an effort to prevent 13 and reduce violence-related re-injury, readmission, 14 and mortality; 15 ‘‘(2) the provision of screening, delivery of post- 16 injury mental health counseling, trauma-informed 17 care, education, discharge planning, skills building, 18 and long-term case management; and 19 ‘‘(3) training researchers, clinicians, case work- 20 ers, mental health professionals, community health 21 workers, and other appropriate providers to provide 22 appropriate interventions described in paragraph 23 (2). 24 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 9 •S 2721 IS ‘‘(d) OUTCOMES MEASUREMENTS.—Any activity sup- 1 ported under this section shall be furnished with the aim 2 of preventing and mitigating the impact of trauma and 3 mental health consequences associated with a violent or 4 penetrative injury, improve the overall health and well- 5 being of individuals with a violent or penetrative injury, 6 and prevent re-injury, readmission, and mortality. 7 ‘‘(e) COORDINATION OF CONSORTIA ACTIVITIES.— 8 The Director of NIH shall, as appropriate— 9 ‘‘(1) provide for the coordination of activities 10 (including the exchange of information and regular 11 communication) among the entities receiving funding 12 under this section; and 13 ‘‘(2) require each entity receiving funding under 14 this section to prepare and submit to the Director 15 periodic reports on the activities of the entity that 16 are supported by this section.’’. 17 SEC. 4. HEALTH PROFESSIONS OPPORTUNITY GRANTS. 18 (a) FUNDING.—Section 2008(c)(1) of the Social Se- 19 curity Act (42 U.S.C. 1397g(c)(1)) is amended by insert- 20 ing ‘‘, and $170,000,000 for each of fiscal years 2021 21 through 2025’’ after ‘‘2019’’. 22 (b) MAKING HOSPITALS ELIGIBLE.—Section 23 2008(a)(4)(A) of such Act (42 U.S.C. 1397g(a)(4)(A)) is 24 amended by striking ‘‘or a community-based organization’’ 25 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 10 •S 2721 IS and inserting ‘‘, a community-based organization, or a 1 hospital (as defined in section 1861(e))’’. 2 (c) AID AND SUPPORTIVE SERVICES.—Section 3 2008(a)(2)(A)(i) of such Act (42 U.S.C. 4 1397g(a)(2)(A)(i)) is amended— 5 (1) by inserting ‘‘affordable’’ before ‘‘child 6 care’’; and 7 (2) by inserting ‘‘transportation, basic skills 8 and English language proficiency training,’’ after 9 ‘‘case management,’’. 10 SEC. 5. HEALTH PROFESSIONS TRAINING FOR DIVERSITY 11 PROGRAMS. 12 (a) CENTERS OF EXCELLENCE.—Section 736(c) of 13 the Public Health Service Act (42 U.S.C. 293(c)) is 14 amended by adding at the end the following: 15 ‘‘(4) PREFERENCE.— 16 ‘‘(A) IN GENERAL.—In making grants 17 under subsection (a), the Secretary shall give 18 preference to designated health professions 19 schools, or other public or nonprofit health or 20 educational entities, meeting the requirements 21 of this section that propose to— 22 ‘‘(i) carry out the activities supported 23 by this section in communities with a high 24 rate of community trauma; or 25 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 11 •S 2721 IS ‘‘(ii) recruit participants for activities 1 supported by this section from commu- 2 nities with a high rate of community trau- 3 ma. 4 ‘‘(B) COMMUNITY WITH A HIGH RATE OF 5 COMMUNITY TRAUMA.—For purposes of sub- 6 paragraph (A), the term ‘community with a 7 high rate of community trauma’ means a com- 8 munity with a high rate of intergenerational 9 poverty, civil unrest, or discrimination, and may 10 include— 11 ‘‘(i) a community with an age-ad- 12 justed rate of drug overdose deaths that is 13 above the national average for age-adjusted 14 rates of drug overdose deaths, as deter- 15 mined by the Director of the Centers for 16 Disease Control and Prevention; and 17 ‘‘(ii) a community with an age-ad- 18 justed rate of violence-related (or inten- 19 tional) injury deaths that is above the na- 20 tional average for age-adjusted rates of vi- 21 olence-related (or intentional) injury 22 deaths, as determined by the Director of 23 the Centers for Disease Control and Pre- 24 vention.’’. 25 VerDate Sep 11 2014 04:22 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2721.IS S2721 dlhill on DSKBBY8HB2PROD with BILLS 12 •S 2721 IS (b) SCHOLARSHIPS FOR DISADVANTAGED STU- 1 DENTS.—Section 737(b) of the Public Health Service Act 2 (42 U.S.C. 293a(b)) is amended— 3 (1) in the subsection heading by striking ‘‘IN 4 PROVIDING SCHOLARSHIPS’’; 5 (2) by striking ‘‘The Secretary’’ and inserting 6 the following: 7 ‘‘(1) PREFERENCE IN PROVIDING SCHOLAR- 8 SHIPS.—The Secretary’’; and 9 (3) by adding at the end the following: 10 ‘‘(2) PREFERENCE TO ELIGIBLE ENTITIES PRO- 11 POSING TO SERVE COMMUNITIES WITH HIGH RATES 12 OF COMMUNITY TRAUMA.— 13 ‘‘(A) IN GENERAL.—In making grants 14 under this subsection (a), the Secretary shall 15 give preference to eligible entities that propose 16 to— 17 ‘‘(i) carry out the activities s [Text truncated for display. 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