ECHO Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 5199 To amend the Public Health Service Act to expand the capacity to improve health outcomes and increase access to specialized care. IN THE HOUSE OF REPRESENTATIVES NOVEMBER 20, 2019 Mr. LUJA´N (for himself, Mr. BURGESS, Ms. TORRES SMALL of New Mexico, Mr. KINZINGER, Ms. HAALAND, and Mr. GIANFORTE) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce A BILL To amend the Public Health Service Act to expand the capacity to improve health outcomes and increase access to specialized care. 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 ‘‘Expanding Capacity 4 for Health Outcomes Act of 2019’’ or the ‘‘ECHO Act 5 of 2019’’. 6 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 2 •HR 5199 IH SEC. 2. EXPANDING CAPACITY FOR HEALTH OUTCOMES. 1 Title III of the Public Health Service Act is amended 2 by inserting after section 330M (42 U.S.C. 254c–19) the 3 following: 4 ‘‘SEC. 330N. EXPANDING CAPACITY FOR HEALTH OUT- 5 COMES. 6 ‘‘(a) DEFINITIONS.—In this section: 7 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en- 8 tity’— 9 ‘‘(A) means an entity that provides, or 10 supports the provision of, health care services— 11 ‘‘(i) in rural areas, frontier areas, 12 health professional shortage areas, or 13 medically underserved areas; or 14 ‘‘(ii) to medically underserved popu- 15 lations or Native Americans, including In- 16 dian Tribes, Tribal organizations, or urban 17 Indian organizations; and 18 ‘‘(B) may include entities leading, or capa- 19 ble of leading, a technology-enabled collabo- 20 rative learning and capacity building model or 21 engaging in technology-enabled collaborative 22 training of participants in such model. 23 ‘‘(2) HEALTH PROFESSIONAL SHORTAGE 24 AREA.—The term ‘health professional shortage area’ 25 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 3 •HR 5199 IH means a health professional shortage area des- 1 ignated under section 332. 2 ‘‘(3) INDIAN TRIBE.—The terms ‘Indian Tribe’ 3 and ‘Tribal organization’ have the meanings given 4 the terms ‘Indian tribe’ and ‘tribal organization’ in 5 section 4 of the Indian Self-Determination and Edu- 6 cation Assistance Act. 7 ‘‘(4) MEDICALLY UNDERSERVED POPU- 8 LATION.—The term ‘medically underserved popu- 9 lation’ has the meaning given the term in section 10 330(b)(3). 11 ‘‘(5) NATIVE AMERICANS.—The term ‘Native 12 Americans’ has the meaning given such term in sec- 13 tion 736 and includes Indian Tribes and Tribal or- 14 ganizations. 15 ‘‘(6) TECHNOLOGY-ENABLED COLLABORATIVE 16 LEARNING AND CAPACITY BUILDING MODEL.—The 17 term ‘technology-enabled collaborative learning and 18 capacity building model’ means a distance health 19 education model that connects health care profes- 20 sionals, and particularly specialists, with multiple 21 other health care professionals through simultaneous 22 interactive videoconferencing for the purpose of fa- 23 cilitating case-based learning, disseminating best 24 practices, and evaluating outcomes. 25 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 4 •HR 5199 IH ‘‘(7) URBAN INDIAN ORGANIZATION.—The 1 ‘urban Indian organization’ has the meaning given 2 the term ‘Urban Indian organization’ in section 4 of 3 the Indian Health Care Improvement Act. 4 ‘‘(b) PROGRAM ESTABLISHED.—The Secretary shall, 5 as appropriate, award grants to evaluate, develop, and, as 6 appropriate, expand the use of technology-enabled collabo- 7 rative learning and capacity building models, to improve 8 retention of health care providers and increase access to 9 health care services, such as those to address chronic dis- 10 eases and conditions, infectious diseases, mental health, 11 substance use disorders, prenatal and maternal health, pe- 12 diatric care, pain management, palliative care, and other 13 specialty care in rural areas, frontier areas, health profes- 14 sional shortage areas, or medically underserved areas and 15 for medically underserved populations or Native Ameri- 16 cans, including Indian Tribes and Tribal organizations. 17 ‘‘(c) USE OF FUNDS.— 18 ‘‘(1) IN GENERAL.—Grants awarded under sub- 19 section (b) shall be used for— 20 ‘‘(A) the development and acquisition of 21 instructional programming, and the training of 22 health care providers and other professionals 23 that provide or assist in the provision of serv- 24 ices through models described in subsection (b), 25 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 5 •HR 5199 IH such as training on best practices for data col- 1 lection and leading or participating in such 2 technology-enabled activities consistent with 3 technology-enabled collaborative learning and 4 capacity building models; 5 ‘‘(B) information collection and evaluation 6 activities to study the impact of such models on 7 patient outcomes and health care providers, and 8 to identify best practices for the expansion and 9 use of such models; or 10 ‘‘(C) other activities consistent with achiev- 11 ing the objectives of the grants awarded under 12 this section, as determined by the Secretary. 13 ‘‘(2) OTHER USES.—In addition to any of the 14 uses under paragraph (1), grants awarded under 15 subsection (b) may be used for— 16 ‘‘(A) equipment to support the use and ex- 17 pansion of technology-enabled collaborative 18 learning and capacity building models, including 19 for hardware and software that enables distance 20 learning, health care provider support, and the 21 secure exchange of electronic health informa- 22 tion; or 23 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 6 •HR 5199 IH ‘‘(B) support for health care providers and 1 other professionals that provide or assist in the 2 provision of services through such models. 3 ‘‘(d) LENGTH OF GRANTS.—Grants awarded under 4 subsection (b) shall be for a period of up to 5 years. 5 ‘‘(e) GRANT REQUIREMENTS.—The Secretary may 6 require entities awarded a grant under this section to col- 7 lect information on the effect of the use of technology- 8 enabled collaborative learning and capacity building mod- 9 els, such as on health outcomes, access to health care serv- 10 ices, quality of care, and provider retention in areas and 11 populations described in subsection (b). The Secretary 12 may award a grant or contract to assist in the coordina- 13 tion of such models, including to assess outcomes associ- 14 ated with the use of such models in grants awarded under 15 subsection (b), including for the purpose described in sub- 16 section (c)(1)(B). 17 ‘‘(f) APPLICATION.—An eligible entity that seeks to 18 receive a grant under subsection (b) shall submit to the 19 Secretary an application, at such time, in such manner, 20 and containing such information as the Secretary may re- 21 quire. Such application shall include plans to assess the 22 effect of technology-enabled collaborative learning and ca- 23 pacity building models on patient outcomes and health 24 care providers. 25 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 7 •HR 5199 IH ‘‘(g) ACCESS TO BROADBAND.—In administering 1 grants under this section, the Secretary may coordinate 2 with other agencies to ensure that funding opportunities 3 are available to support access to reliable, high-speed 4 internet for grantees. 5 ‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall 6 provide (either directly through the Department of Health 7 and Human Services or by contract) technical assistance 8 to eligible entities, including recipients of grants under 9 subsection (b), on the development, use, and evaluation 10 of technology-enabled collaborative learning and capacity 11 building models in order to expand access to health care 12 services provided by such entities, including for medically 13 underserved areas and to medically underserved popu- 14 lations or Native Americans, including Indian Tribes and 15 Tribal organizations. 16 ‘‘(i) RESEARCH AND EVALUATION.—The Secretary, 17 in consultation with stakeholders with appropriate exper- 18 tise in such models, shall develop a strategic plan to re- 19 search and evaluate the evidence for such models. The 20 Secretary shall use such plan to inform the activities car- 21 ried out under this section. 22 ‘‘(j) REPORT BY SECRETARY.—Not later than 4 23 years after the date of enactment of this section, the Sec- 24 retary shall prepare and submit to the Committee on 25 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 8 •HR 5199 IH Health, Education, Labor, and Pensions of the Senate and 1 the Committee on Energy and Commerce of the House 2 of Representatives, and post on the internet website of the 3 Department of Health and Human Services, a report in- 4 cluding, at minimum— 5 ‘‘(1) a description of any new and continuing 6 grants awarded to entities under subsection (b) and 7 the specific purpose and amounts of such grants; 8 ‘‘(2) an overview of— 9 ‘‘(A) the evaluations conducted under sub- 10 section (b); 11 ‘‘(B) technical assistance provided under 12 subsection (h); and 13 ‘‘(C) activities conducted by entities award- 14 ed grants under subsection (b); and 15 ‘‘(3) a description of any significant findings or 16 developments related to patient outcomes or health 17 care providers and best practices for eligible entities 18 expanding, using, or evaluating technology-enabled 19 collaborative learning and capacity building models, 20 including through the activities described in sub- 21 section (h). 22 VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS 9 •HR 5199 IH ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 1 is authorized to be appropriated to carry out this section, 2 $20,000,000 for each of fiscal years 2020 through 2024.’’. 3 Æ VerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H5199.IH H5199 kjohnson on DSK79L0C42 with BILLS