Health Enterprise Zones Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 7158 To provide for the designation of areas as Health Enterprise Zones to reduce health disparities and improve health outcomes in such areas, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JUNE 11, 2020 Mr. BROWN of Maryland (for himself, Mr. HOYER, Ms. SEWELL of Alabama, Ms. KUSTER of New Hampshire, and Ms. BLUNT ROCHESTER) intro- duced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To provide for the designation of areas as Health Enterprise Zones to reduce health disparities and improve health outcomes in such areas, 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; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Health Enterprise Zones Act of 2020’’. 5 (b) TABLE OF CONTENTS.—This table of contents of 6 this Act is as follows: 7 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 7158 IH Sec. 1. Short title; table of contents. Sec. 2. Designation of Health Enterprise Zones. Sec. 3. Consultation. Sec. 4. Tax incentives. Sec. 5. Grants. Sec. 6. Student loan repayment program. Sec. 7. Ten percent increase of payment for items and services payable under Medicare Part B furnished in Health Enterprise Zones. Sec. 8. Reporting. Sec. 9. Definitions. Sec. 10. Authorization of appropriations. SEC. 2. DESIGNATION OF HEALTH ENTERPRISE ZONES. 1 (a) DESIGNATION.— 2 (1) IN GENERAL.—Not later than 18 months 3 after the date of enactment of this Act, the Sec- 4 retary shall, pursuant to applications submitted 5 under subsection (c), designate areas as Health En- 6 terprise Zones to reduce health disparities and im- 7 prove health outcomes in such areas. 8 (2) ELIGIBILITY OF AREA.—To be designated 9 as a Health Enterprise Zone under this section, an 10 area must— 11 (A) be a contiguous geographic area in one 12 census tract or ZIP code; 13 (B) have measurable and documented ra- 14 cial, ethnic, or geographic health disparities and 15 poor health outcomes, demonstrated by— 16 (i) average income below 150 percent 17 of the Federal poverty line; 18 (ii) a rate of eligibility in the special 19 supplemental nutrition program under sec- 20 VerDate Sep 11 2014 20:21 Jul 02, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 7158 IH tion 17 of the Child Nutrition Act of 1966 1 (42 U.S.C. 1786) that is higher than the 2 national average rate of eligibility in such 3 program; 4 (iii) lower life expectancy than the na- 5 tional average; or 6 (iv) a higher percentage of instances 7 of low birth weight than the national aver- 8 age; and 9 (C) are part of a Metropolitan Statistical 10 Area or Micropolitan Statistical Area identified 11 by the Office of Management and Budget. 12 (b) SOLICITATION OF APPLICATIONS.—The Sec- 13 retary shall— 14 (1) not later than 12 months after the date of 15 enactment of this Act, solicit applications under sub- 16 section (c); and 17 (2) publish on the website of the Department of 18 Health and Human Services— 19 (A) the names of all applicants, together 20 with the names of each applicant’s coalition 21 partners; and 22 (B) a description of all areas proposed to 23 be designated as Health Enterprise Zones. 24 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 7158 IH (c) SUBMISSION OF APPLICATIONS.—To seek the 1 designation of an area as a Health Enterprise Zone, a 2 community-based nonprofit organization or local govern- 3 mental agency, in coalition with an array of health care 4 providers, hospitals, nonprofit community health clinics, 5 health centers, social service organizations, and other re- 6 lated organizations shall submit an application to the Sec- 7 retary. 8 (d) CONTENTS.—An application under subsection (c) 9 shall— 10 (1) include an effective and sustainable plan 11 with respect to the area proposed for designation— 12 (A) to reduce health disparities; 13 (B) to reduce the costs of, or to produce 14 savings to, the health care system; 15 (C) to improve health outcomes; and 16 (D) to utilize one or more of the incentives 17 established pursuant to sections 4, 5, 6, and 7 18 to address health care provider capacity, im- 19 prove health services delivery, effectuate com- 20 munity improvements, or conduct outreach and 21 education efforts; and 22 (2) identify specific diseases or indicators of 23 health for improvement of health outcomes in such 24 area, including at least one of the following: cardio- 25 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 7158 IH vascular disease, asthma, diabetes, dental health, be- 1 havioral health, maternal and birth health, sexually 2 transmitted infections, and obesity. 3 (e) CONSIDERATIONS.—The Secretary— 4 (1) shall consider geographic diversity, among 5 other factors, in selecting areas for designation as 6 Health Enterprise Zones; and 7 (2) may conduct outreach efforts to encourage 8 a geographically diverse pool of applicants, including 9 for designating Health Enterprise Zones in rural 10 areas. 11 (f) PRIORITY.—In selecting areas for designation as 12 Health Enterprise Zones, the Secretary shall give higher 13 priority to applications based on the extent to which they 14 demonstrate the following: 15 (1) Support from, and participation of, key 16 stakeholders in the public and private sectors in the 17 area proposed for designation, including residents 18 and local governments of such area. 19 (2) A plan for long-term funding and sustain- 20 ability. 21 (3) Supporting funds from the private sector. 22 (4) Integration with any applicable State health 23 improvement process or plan. 24 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 7158 IH (5) A plan for evaluation of the impact of des- 1 ignation of such area as a Health Enterprise Zone. 2 (6) A plan to utilize existing State tax credits, 3 grants, or other incentives to reduce health dispari- 4 ties and improve health outcomes in the proposed 5 Health Enterprise Zone. 6 (7) Such other factors as the Secretary deter- 7 mines are appropriate to demonstrate a commitment 8 to reduce health disparities and improve health out- 9 comes in such area. 10 (g) PERIOD OF DESIGNATION.—The designation 11 under this section of any area as a Health Enterprise Zone 12 shall expire at the end of the period of 10 fiscal years 13 following the enactment of this Act. 14 SEC. 3. CONSULTATION. 15 The Secretary shall carry out this Act in consultation 16 with— 17 (1) the Secretary of Housing and Urban Devel- 18 opment; and 19 (2) the Deputy Assistant Secretary for Minority 20 Health. 21 SEC. 4. TAX INCENTIVES. 22 (a) WORK OPPORTUNITY CREDIT FOR HIRING 23 HEALTH ENTERPRISE ZONE WORKERS.— 24 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 7158 IH (1) IN GENERAL.—Section 51(d)(1) of the In- 1 ternal Revenue Code of 1986 is amended by striking 2 ‘‘or’’ at the end of subparagraph (I), by striking the 3 period at the end of subparagraph (J) and inserting 4 ‘‘, or’’, and by adding at the end the following new 5 subparagraph: 6 ‘‘(K) a qualified Health Enterprise Zone 7 worker, to the extent that the qualified first- 8 year wages with respect to such worker are paid 9 for qualified Health Enterprise Zone work.’’. 10 (2) QUALIFIED HEALTH ENTERPRISE ZONE 11 WORKER.—Section 51(d) of such Code is amended 12 by adding at the end the following new paragraphs: 13 ‘‘(16) QUALIFIED HEALTH ENTERPRISE ZONE 14 WORKER.—The term ‘qualified Health Enterprise 15 Zone worker’ means any individual who is certified 16 by the designated local agency as having (as of the 17 hiring date) a principal place of employment within 18 a Health Enterprise Zone (as such term is defined 19 in section 9 of the Health Enterprise Zones Act of 20 2020). 21 ‘‘(17) QUALIFIED HEALTH ENTERPRISE ZONE 22 WORK.—The term ‘qualified Health Enterprise Zone 23 work’ means employment by a Health Enterprise 24 Zone practitioner (as such term is defined in section 25 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 7158 IH 9 of the Health Enterprise Zones Act of 2020), the 1 primary official duties of which promote access to 2 healthcare in a Health Enterprise Zone (as such 3 term is defined in section 9 of the Health Enterprise 4 Zones Act of 2020).’’. 5 (3) EFFECTIVE DATE.—The amendments made 6 by this section shall apply to amounts paid or in- 7 curred after the date of the enactment of this Act 8 to individuals who begin work for the employer after 9 such date. 10 (b) CREDIT FOR HEALTH ENTERPRISE ZONE WORK- 11 ERS.— 12 (1) IN GENERAL.—Subpart A of part IV of sub- 13 chapter A of chapter 1 of the Internal Revenue Code 14 of 1986 is amended by inserting after section 25D 15 the following new section: 16 ‘‘SEC. 25E. CREDIT FOR QUALIFIED HEALTH ENTERPRISE 17 ZONE WORKERS. 18 ‘‘(a) ALLOWANCE OF CREDIT.—In the case of a 19 qualified Health Enterprise Zone worker, there shall be 20 allowed as a credit against the tax imposed by this chapter 21 for a taxable year an amount equal to 40 percent of wages 22 received for qualified Health Enterprise Zone work. 23 ‘‘(b) DEFINITIONS.—For purposes of this section— 24 VerDate Sep 11 2014 20:21 Jul 02, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 7158 IH ‘‘(1) The term ‘qualified Health Enterprise 1 Zone worker’ means, with respect to wages, an indi- 2 vidual whose principal place of employment while 3 earning such wages is within a Health Enterprise 4 Zone (as such term is defined in section 9 of the 5 Health Enterprise Zones Act of 2020). 6 ‘‘(2) The term ‘qualified Health Enterprise 7 Zone work’ has the meaning given such term in sec- 8 tion 51.’’. 9 (2) CLERICAL AMENDMENT.—The table of sec- 10 tions for subpart A of part IV of subchapter A of 11 chapter 1 of such Code is amended by inserting 12 after the item relating to section 25D the following 13 new item: 14 ‘‘Sec. 25E. Credit for qualified Health Enterprise Zone workers.’’. (3) EFFECTIVE DATE.—The amendments made 15 by this section shall apply to amounts paid or in- 16 curred after the date of the enactment of this Act. 17 SEC. 5. GRANTS. 18 (a) AUTHORIZATION.—For each area designated 19 under section 2 as a Health Enterprise Zone, the Sec- 20 retary may award a grant to the community-based non- 21 profit organization or local governmental agency that ap- 22 plied for such designation to support such applicant and 23 its coalition partners in reducing health disparities and 24 improving health outcomes in such area. 25 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 7158 IH (b) USE OF FUNDS.—Programs and activities funded 1 through a grant under this section shall be consistent with 2 the grantee’s plan submitted pursuant to section 2(d)(1) 3 and may include the following: 4 (1) SUBGRANTS TO HEALTH CARE PRACTI- 5 TIONERS.— 6 (A) IN GENERAL.—For the purpose of im- 7 proving or expanding the delivery of health care 8 in the respective Health Enterprise Zone, the 9 grantee may award subgrants to Health Enter- 10 prise Zone practitioners to defray costs related 11 to innovative strategies listed in paragraph (2). 12 (B) ELIGIBILITY.—To be eligible to receive 13 a subgrant pursuant to subparagraph (A), a 14 Health Enterprise Zone practitioner shall— 15 (i) own or lease a health care facility 16 in the Health Enterprise Zone; or 17 (ii) provide health care in such a facil- 18 ity. 19 (C) AMOUNT.—The amount of a subgrant 20 under subparagraph (A) may not exceed the 21 lesser of— 22 (i) $5,000,000; or 23 (ii) 50 percent of the costs of the 24 equipment, or capital or leasehold improve- 25 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 7158 IH ments, to be defrayed using the subgrant 1 to implement innovative strategies listed in 2 paragraph (2). 3 (2) INNOVATIVE STRATEGIES.—A grantee (or 4 subgrantee) may use a grant received under this sec- 5 tion (or a subgrant received under paragraph (1)) to 6 implement innovative public health strategies in the 7 respective Health Enterprise Zone, which strategies 8 may include— 9 (A) internships and volunteer opportunities 10 for students who reside in the Health Enter- 11 prise Zone; 12 (B) funding resources to improve health 13 care provider capacity to serve non-English 14 speakers; 15 (C) operation of medical, mental and be- 16 havioral health, and dental mobile clinics; 17 (D) provision of transportation to and 18 from medical appointments for patients; 19 (E) funding resources to improve access to 20 healthy food, recreation, and high-quality hous- 21 ing; 22 (F) capital or leasehold improvements to a 23 health care facility in the respective Health En- 24 terprise Zone; and 25 VerDate Sep 11 2014 20:56 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H7158.IH H7158 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 7158 IH (G) medical or dental equipment to be 1 used in such a facility. 2 SEC. 6. STUDENT LOAN REPAYMENT PROGRAM. 3 (a) IN GENERAL.—The Secretary shall carry out a 4 loan repayment program under which the Secretary enters 5 into agreements with eligible Health Enterprise Zone 6 practitioners to make payments on the principal and inter- 7 est of the eligible educational loans of such practitioners 8 for each year such practitioners agree to provide health 9 care services in a Health Enterprise Zone. 10 (b) LIMITATIONS.—In entering into loan repayment 11 agreements under this section, the Secretary may not 12 agree to— 13 (1) make payments for more than 10 years with 14 respect to a practitioner; or 15 (2) pay more than $10,000 per y [Text truncated for display. Full text available on Congress.gov.]