,i #aafth ,,congress #ast ,session ,h4 ,r4 #decg ,,in ,,the ,,house ,,of ,,representatives ,september #bf1 #bjai,ms4 ,velzquez introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to improve the provision of mobile medical health care services to certain underserved areas and populations1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,mobile ,health ,clinics ,act of #bjai4 #b4 ,findings ,congress finds the following3 7#a7 ,according to the ,mobile ,health ,map report1 approximately #a1ejj mobile health clinics 7,m,h,cs7 operate nationwide4 7#b7 ,m,h,cs can effectively provide care in areas where health care infrastructure is limited because of distance1 financial capabilities1 or inadequate supporting infrastructure1 including lack of public transportation resources4 7#c7 ,m,h,cs can offer services such as primary care1 screenings1 dental care1 medications1 behavioral health care1 immunizations1 laboratory tests1 case management1 triage1 and assistance for public benefit programs4 7#d7 ,m,h,cs help improve community health and access to medical services in underserved communities across the ,united ,states1 including urban1 rural1 and suburban areas4 7#e7 ,such clinics are cost-effective and help reduce the burden on hospitals1 insurers1 and government entities managing health programs by providing prevention services1 which also reduces unnecessary emergency department visits4 7#f7 ,the average cost of a visit to a provider of mobile medical health care services is significantly lower than the average cost of an emergency department visit4 ,visiting an ,,mhc instead of the emergency department can result in a cost savings of more than #hjj per visit4 7#g7 ,several studies have shown that the return on investment generated by ,m,h,cs ranges from #bj to #cf for every #a spent4 7#h7 ,m,h,cs are successful when they engage with other local stakeholders who can provide insight1 knowledge1 and strategies to help meet public health challenges that are immediately relevant to the communities receiving services from ,,mhc providers4 7#i7 ,funding has been the largest barrier to the development and maintenance of ,m,h,cs and their resources4 7#aj7 ,with additional ,federal support1 health systems would be able to better invest in purchasing1 maintaining1 and upgrading mobile units1 increasing the number of staff1 dispensing more medication1 and advancing the use of efficient information technology for health purposes4 #c4 ,improving access to mobile medical health care services 7a7 ,in general ,subpart ,i of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq47 is amended by adding at the end the following new section3 #ccj,n4 ,partnerships to improve access to mobile medical health care services 7a7 ,authority established 7#a7 ,in general ,the ,secretary may award grants1 contracts1 or cooperative agreements to eligible entities to provide mobile medical health care services in accordance with subsection 7e74 7#b7 ,limitation ,a hospital or health care facility may not be eligible for a grant1 contract1 or cooperative agreement under this section with respect to more than one partnership described in subsection 7b77#a74 7b7 ,eligible entities ,to be eligible for a grant1 contract1 or cooperative agreement under this section1 an entity shall-- 7#a7 be a partnership consisting of-- 7,a7 one or more hospitals2 or 7,b7 one or more other local health care facilities1 including clinics1 rural health clinics1 federally qualified health centers1 health centers1 primary care facilities1 mental health centers1 pharmacies1 or other mobile medical assets1 without regard to whether or not such a local health care facility is owned 7either in whole or in part7 by a hospital in a partnership described in subparagraph 7,a7 or another local health care facility as described in this subparagraph2 and 7#b7 provide services for any one of the following3 7,a7 ,a medically underserved community 7as defined in section #gii;,b7#f774 7,b7 ,a medically underserved population 7as defined in section #ccj7;b77#c774 7c7 ,application ,an eligible entity seeking funding under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including1 at a minimum1 the following3 7#a7 ,a long-term strategy and detailed implementation plan developed in consultation with community groups and appropriate stakeholders4 7#b7 ,a demonstration of a specific public health need that is relevant to a community or population described in subsection 7b77#b74 7#c7 ,a description of the services that the entity will provide directly with funds under this section1 and1 if applicable1 a description of the services that the eligible entity will provide indirectly with such funds through contracts or cooperative agreements4 7#d7 ,an explanation of the entity's inability to address the need in paragraph 7#b7 without ,federal assistance4 7#e7 ,an identification of any related governmental or community initiative that compliments or will be coordinated with the long-term strategy and detailed implementation plan required under paragraph 7#a74 7#f7 ,a plan detailing the methodologies that will be used to evaluate the access and quality of mobile medical health care services provided by the entity to a community or population described in subsection 7b77#b74 7#g7 ,a description of community outreach mechanisms that the entity will employ to ensure the participation of a community or population described in subsection 7b77#b74 7#h7 ,an identification of best practices for treatment1 outreach1 and data collection that the entity will employ to track program participation and program effectiveness4 7#i7 ,a plan for providing mobile medical health care services to individuals of limited ,english-speaking ability4 ,such plan shall-- 7,a7 take into account data from the ,bureau of the ,census and previously documented qualitative or quantitative observations from community service providers offering health care services in the areas in which the entity will provide mobile medical health care services2 and 7,b7 outline which languages are most prevalent and commonly requested for translation services in such areas4 7#aj7 7,a7 ,subject to subparagraph 7,b71 an assurance that1 if the entity receives a grant1 contract1 or cooperative agreement or a renewal of such grant1 contract1 or cooperative agreement under this section1 the entity will develop a plan to secure other public or private funding resources to ensure the continued operation and maintenance of mobile medical health care services provided under this section after funds under such grant1 contract1 or cooperative agreement1 or renewal1 are no longer available4 7,b7 ,the ,secretary shall waive the requirement under subparagraph 7,a7 for the entity if the entity demonstrates that complying with such requirement would create an undue burden and result in significant disruption of the provision of mobile medical health care services4 7#aa7 ,any additional information required by the ,secretary4 7d7 ,requirements 7#a7 ,amount ,a grant contract1 or cooperative agreement awarded under this section may not exceed #gej1jjj4 7#b7 ,duration ,a grant1 contract1 or cooperative agreement awarded under this section shall be for a period of #c years4 7#c7 ,renewals 7,a7 ,in general ,the ,secretary may renew a grant1 contract1 or cooperative agreement awarded under this section with respect to an eligible entity if the entity-- 7i7 submits to the ,secretary an application for renewal at such time1 in such manner1 and containing such information as the ,secretary may require2 and 7ii7 demonstrates in such application that-- 7,i7 grant1 contract1 or cooperative agreement funds made available to the entity were used in a manner required under the most recently approved application of the entity under this section2 and 7,,ii7 the entity has made significant progress in achieving the objectives of the initial application approved for the entity under this section4 7,b7 ,duration ,an initial renewal for an eligible entity under subparagraph 7,a7 shall1 at a minimum1 be for a period of #b years4 ,any subsequent renewal for such an entity shall be for a period of #a year4 7e7 ,use of funds ,a grant1 contract1 or cooperative agreement awarded under this section may be expended for-- 7#a7 purchases of mobile medical health care service vehicles2 7#b7 maintenance or upgrade of mobile medical health care service vehicles2 7#c7 hiring of casework staff1 physicians1 practitioners1 pharmacists1 nursing personnel1 or similar medical professionals2 7#d7 hiring and professional development of administrative1 oversight1 clerical1 or other support staff managing the operations or care provided by mobile medical health care service vehicles2 7#e7 professional development1 including appropriate training for medical professionals specified in paragraph 7#c72 7#f7 distributing or dispensing prescriptions2 7#g7 advancing the use of information technology for treatment purposes1 including the employment of appropriate staff required for maintenance to ensure the secure and stable operations of computers1 servers1 and other appropriate information technology infrastructure2 and 7#h7 increasing access of medically underserved communities 7as defined in section #gii;,b7#f77 or medically underserved populations 7as defined in section #ccj7;b77#c77 to mobile medical health care services1 including required primary health services 7as defined in section #ccj7;b77#a771 substance use disorder services 7as defined in section #ccj7;h77#e77;,c771 and mental health counseling4 7f7 ,supplement1 not supplant1 requirement ,a grant1 contract1 or cooperative agreement awarded under this section shall be expended to supplement1 and not supplant1 the expenditures of the eligible entity involved and the value of in-kind contributions for the delivery of services to medically underserved communities or medically underserved populations4 7g7 ,annual report ,an eligible entity that receives funds under this section during a fiscal year shall submit to the ,secretary1 on a date specified by the ,secretary1 an annual report detailing the progress in addressing the public health need specified in subsection 7c77#b74 7h7 ,mobile medical health care service defined ,in this section1 the term mobile medical health care service means any health care-related service provided in a moveable vehicle or a non-permanent clinic4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #ae1jjj1jjj for fiscal year #bjbj and each succeeding fiscal year4 4 7b7 ,rulemaking ,not later than the date that is one year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall1 through notice and comment rulemaking1 establish-- 7#a7 a process for awarding grants1 contract1 and cooperative agreement including renewing and terminating grants1 contract1 and cooperative agreement under section #ccj,n of the ,public ,health ,service ,act1 as added by subsection 7a72 7#b7 benchmarks for measuring significant progress as described in subsection 7d77#c77;,a77ii77,,ii7 of such section2 and 7#c7 a process for providing entities described in such section a fair hearing and appellate review regarding any decision by the ,secretary to renew or terminate a grant1 contract1 or cooperative agreement under such section4