,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #gaeh  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #aa1 #bjbj,mr4  
,br[n ( ,m>yl& 7= himself1 ,mr4 ,hoy]1  
,ms4 ,sewell ( ,alabama1 ,ms4 ,ku/] (   
,new ,hamp%ire1 & ,ms4 ,blunt ,ro*e/]7  
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to provide = ! designation (  
areas z ,heal? ,ent]prise ,zones to     
r$uce heal? disp>ities & improve heal?  
outcomes 9 su* areas1 & = o!r purposes4 
#a4 ,%ort title2 table ( cont5ts  7a7   
,%ort title ,?is ,act may be cit$ z !   
,heal? ,ent]prise ,zones ,act ( #bjbj4  
7b7 ,table ( cont5ts ,?is table (       
cont5ts ( ?is ,act is z foll[s3 ,sec4   
#a4 ,%ort title2 table ( cont5ts4,sec4  
#b4 ,designation ( ,heal? ,ent]prise    
,zones4,sec4 #c4 ,consultation4,sec4 #d4

 ,tax inc5tives4,sec4 #e4 ,grants4,sec4 
#f4 ,/ud5t loan repaym5t program4,sec4  
#g4 ,t5 p]c5t increase ( paym5t = items 
& s]vices payable "u ,m$ic>e ,"p ,b     
furni%$ 9 ,heal? ,ent]prise ,zones4,sec4
 #h4 ,report+4,sec4 #i4                 
,def9itions4,sec4 #aj4 ,au?orization (  
appropriations4  #b4 ,designation (     
,heal? ,ent]prise ,zones  7a7           
,designation  7#a7 ,9 g5]al ,n lat] ?an 
#ah mon?s aft] ! date ( enactm5t ( ?is  
,act1 ! ,secret>y %all1 pursuant to     
applications submitt$ "u subsection 7c71
 designate areas z ,heal? ,ent]prise    
,zones to r$uce heal? disp>ities &      
improve heal? outcomes 9 su* areas4     
7#b7 ,eligibility ( area ,to be         
designat$ z a ,heal? ,ent]prise ,zone "u
 ?is section1 an area mu/-- 7,a7 be a   
contigu\s geographic area 9 "o c5sus    
tract or ,,zip code2  7,b7 h measurable 
& docum5t$ racial1 e?nic1 or geographic 
heal? disp>ities & poor heal? outcomes1 
demon/rat$ by-- 7i7 av]age income bel[  
#aej p]c5t ( ! ,f$]al pov]ty l9e2  7ii7 

a rate ( eligibility 9 ! special        
supplem5tal nutrition program "u section
 #ag ( ! ,*ild ,nutrition ,act ( #aiff  
7#db ,u4,s4,c4 #aghf7 t is high] ?an !  
national av]age rate ( eligibility 9 su*
 program2  7iii7 l[] life expectancy ?an
 ! national av]age2 or  7iv7 a high]    
p]c5tage ( in/ances ( l[ bir? weight ?an
 ! national av]age2 &  7,c7 are "p ( a  
,metropolitan ,/ati/ical ,area or       
,micropolitan ,/ati/ical ,area id5tifi$ 
by ! ,(fice ( ,managem5t & ,budget4  7b7
 ,solicitation ( applications ,!        
,secret>y %all-- 7#a7 n lat] ?an #ab    
mon?s aft] ! date ( enactm5t ( ?is ,act1
 solicit applications "u subsection 7c72
 &  7#b7 publi% on ! website ( !        
,dep>tm5t ( ,heal? & ,human ,s]vices--  
7,a7 ! names ( all applicants1 toge!r ) 
! names ( ea* applicant's coalition     
p>tn]s2 &  7,b7 a description ( all     
areas propos$ to be designat$ z ,heal?  
,ent]prise ,zones4  7c7 ,submission (   
applications ,to seek ! designation ( an
 area z a ,heal? ,ent]prise ,zone1 a    

community-bas$ nonpr(it organization or 
local gov]nm5tal ag5cy1 9 coalition ) an
 array ( heal? c>e provid]s1 hospitals1 
nonpr(it community heal? cl9ics1 heal?  
c5t]s1 social s]vice organizations1 &   
o!r relat$ organizations %all submit an 
application to ! ,secret>y4  7d7        
,cont5ts ,an application "u subsection  
7c7 %all-- 7#a7 include an effective &  
su/a9able plan ) respect to ! area      
propos$ = designation-- 7,a7 to r$uce   
heal? disp>ities2  7,b7 to r$uce ! co/s 
(1 or to produce sav+s to1 ! heal? c>e  
sy/em2  7,c7 to improve heal? outcomes2 
&  7,d7 to utilize "o or m ( ! inc5tives
 e/abli%$ pursuant to sections #d1 #e1  
#f1 & #g to address heal? c>e provid]   
capacity1 improve heal? s]vices deliv]y1
 effectuate community improvem5ts1 or   
conduct outrea* & education ef=ts2 &    
7#b7 id5tify specific diseases or       
indicators ( heal? = improvem5t ( heal? 
outcomes 9 su* area1 includ+ at lea/ "o 
( ! foll[+3 c>diovascul> disease1 a/hma1
 diabetes1 d5tal heal?1 behavioral      

heal?1 mat]nal & bir? heal?1 sexually   
transmitt$ infections1 & obesity4  7e7  
,consid]ations ,! ,secret>y-- 7#a7 %all 
consid] geographic div]sity1 among o!r  
factors1 9 select+ areas = designation z
 ,heal? ,ent]prise ,zones2 &  7#b7 may  
conduct outrea* ef=ts to enc\rage a     
geographically div]se pool ( applicants1
 includ+ = designat+ ,heal? ,ent]prise  
,zones 9 rural areas4  7f7 ,priority ,9 
select+ areas = designation z ,heal?    
,ent]prise ,zones1 ! ,secret>y %all give
 high] priority to applications bas$ on 
! ext5t to :i* !y demon/rate ! foll[+3  
7#a7 ,support f1 & p>ticipation (1 key  
/akehold]s 9 ! public & private sectors 
9 ! area propos$ = designation1 includ+ 
resid5ts & local gov]nm5ts ( su* area4  
7#b7 ,a plan = long-t]m fund+ &         
su/a9ability4  7#c7 ,support+ funds f ! 
private sector4  7#d7 ,integration ) any
 applicable ,/ate heal? improvem5t      
process or plan4  7#e7 ,a plan =        
evaluation ( ! impact ( designation (   
su* area z a ,heal? ,ent]prise ,zone4   

7#f7 ,a plan to utilize exi/+ ,/ate tax 
cr$its1 grants1 or o!r inc5tives to     
r$uce heal? disp>ities & improve heal?  
outcomes 9 ! propos$ ,heal? ,ent]prise  
,zone4  7#g7 ,su* o!r factors z !       
,secret>y det]m9es are appropriate to   
demon/rate a commitm5t to r$uce heal?   
disp>ities & improve heal? outcomes 9   
su* area4  7g7 ,p]iod ( designation ,!  
designation "u ?is section ( any area z 
a ,heal? ,ent]prise ,zone %all expire at
 ! end ( ! p]iod ( #aj fiscal ye>s      
foll[+ ! enactm5t ( ?is ,act4  #c4      
,consultation ,! ,secret>y %all c>ry out
 ?is ,act 9 consultation )-- 7#a7 !     
,secret>y ( ,h\s+ & ,urban ,developm5t2 
&  7#b7 ! ,deputy ,assi/ant ,secret>y = 
,m9ority ,heal?4  #d4 ,tax inc5tives    
7a7 ,"w opportunity cr$it = hir+ ,heal? 
,ent]prise ,zone work]s  7#a7 ,9 g5]al  
,section #ea7;d77#a7 ( ! ,int]nal       
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
or at ! end ( subp>agraph 7,i71 by /rik+
 ! p]iod at ! end ( subp>agraph 7,j7 &  
ins]t+ 1 or1 & by add+ at ! end ! foll[+

 new subp>agraph3  7,k7 a qualifi$      
,heal? ,ent]prise ,zone work]1 to !     
ext5t t ! qualifi$ fir/-ye> wages )     
respect to su* work] are paid = qualifi$
 ,heal? ,ent]prise ,zone "w4  4  7#b7   
,qualifi$ ,heal? ,ent]prise ,zone work] 
,section #ea7;d7 ( su* ,code is am5d$ by
 add+ at ! end ! foll[+ new p>agraphs3  
7#af7 ,qualifi$ ,heal? ,ent]prise ,zone 
work] ,! t]m qualifi$ ,heal? ,ent]prise 
,zone work] means any individual :o is  
c]tifi$ by ! designat$ local ag5cy z    
hav+ 7z ( ! hir+ date7 a pr9cipal place 
( employm5t )9 a ,heal? ,ent]prise ,zone
 7z su* t]m is def9$ 9 section #i ( !   
,heal? ,ent]prise ,zones ,act ( #bjbj74 
7#ag7 ,qualifi$ ,heal? ,ent]prise ,zone 
"w ,! t]m qualifi$ ,heal? ,ent]prise    
,zone "w means employm5t by a ,heal?    
,ent]prise ,zone practition] 7z su* t]m 
is def9$ 9 section #i ( ! ,heal?        
,ent]prise ,zones ,act ( #bjbj71 !      
prim>y (ficial duties ( :i* promote     
access to heal?c>e 9 a ,heal? ,ent]prise
 ,zone 7z su* t]m is def9$ 9 section #i 

( ! ,heal? ,ent]prise ,zones ,act (     
#bjbj74  4  7#c7 ,effective date ,!     
am5dm5ts made by ?is section %all apply 
to am\nts paid or incurr$ aft] ! date ( 
! enactm5t ( ?is ,act to individuals :o 
beg9 "w = ! employ] aft] su* date4  7b7 
,cr$it = ,heal? ,ent]prise ,zone work]s 
7#a7 ,9 g5]al ,subp>t ,a ( "p ,,iv (    
sub*apt] ,a ( *apt] #a ( ! ,int]nal     
,rev5ue ,code ( #aihf is am5d$ by ins]t+
 aft] section #be;,d ! foll[+ new       
section3  #be;,e4 ,cr$it = qualifi$     
,heal? ,ent]prise ,zone work]s  7a7     
,all[ance ( cr$it ,9 ! case ( a qualifi$
 ,heal? ,ent]prise ,zone work]1 !re %all
 be all[$ z a cr$it aga9/ ! tax impos$  
by ?is *apt] = a taxable ye> an am\nt   
equal to #dj p]c5t ( wages receiv$ =    
qualifi$ ,heal? ,ent]prise ,zone "w4    
7b7 ,def9itions ,= purposes ( ?is       
section-- 7#a7 ,! t]m qualifi$ ,heal?   
,ent]prise ,zone work] means1 ) respect 
to wages1 an individual ^: pr9cipal     
place ( employm5t :ile e>n+ su* wages is
 )9 a ,heal? ,ent]prise ,zone 7z su* t]m

 is def9$ 9 section #i ( ! ,heal?       
,ent]prise ,zones ,act ( #bjbj74  7#b7  
,! t]m qualifi$ ,heal? ,ent]prise ,zone 
"w has ! mean+ giv5 su* t]m 9 section   
#ea4  4  7#b7 ,cl]ical am5dm5t ,! table 
( sections = subp>t ,a ( "p ,,iv (      
sub*apt] ,a ( *apt] #a ( su* ,code is   
am5d$ by ins]t+ aft] ! item relat+ to   
section #be;,d ! foll[+ new item3  ,sec4
 #be;,e4 ,cr$it = qualifi$ ,heal?       
,ent]prise ,zone work]s4  4  7#c7       
,effective date ,! am5dm5ts made by ?is 
section %all apply to am\nts paid or    
incurr$ aft] ! date ( ! enactm5t ( ?is  
,act4  #e4 ,grants  7a7 ,au?orization ,=
 ea* area designat$ "u section #b z a   
,heal? ,ent]prise ,zone1 ! ,secret>y may
 aw>d a grant to ! community-bas$       
nonpr(it organization or local          
gov]nm5tal ag5cy t appli$ = su*         
designation to support su* applicant &  
its coalition p>tn]s 9 r$uc+ heal?      
disp>ities & improv+ heal? outcomes 9   
su* area4  7b7 ,use ( funds ,programs & 
activities fund$ ?r\gh a grant "u ?is   

section %all be consi/5t ) ! grantee's  
plan submitt$ pursuant to section       
#b7;d77#a7 & may include ! foll[+3 7#a7 
,subgrants to heal? c>e practition]s    
7,a7 ,9 g5]al ,= ! purpose ( improv+ or 
exp&+ ! deliv]y ( heal? c>e 9 !         
respective ,heal? ,ent]prise ,zone1 !   
grantee may aw>d subgrants to ,heal?    
,ent]prise ,zone practition]s to defray 
co/s relat$ to innovative /rategies li/$
 9 p>agraph 7#b74  7,b7 ,eligibility ,to
 be eligible to receive a subgrant      
pursuant to subp>agraph 7,a71 a ,heal?  
,ent]prise ,zone practition] %all-- 7i7 
own or lease a heal? c>e facility 9 !   
,heal? ,ent]prise ,zone2 or  7ii7       
provide heal? c>e 9 su* a facility4     
7,c7 ,am\nt ,! am\nt ( a subgrant "u    
subp>agraph 7,a7 may n exce$ ! less] (--
 7i7 #e1jjj1jjj2 or  7ii7 #ej p]c5t ( ! 
co/s ( ! equipm5t1 or capital or        
leasehold improvem5ts1 to be defray$ us+
 ! subgrant to implem5t innovative      
/rategies li/$ 9 p>agraph 7#b74  7#b7   
,innovative /rategies ,a grantee 7or    

subgrantee7 may use a grant receiv$ "u  
?is section 7or a subgrant receiv$ "u   
p>agraph 7#a77 to implem5t innovative   
public heal? /rategies 9 ! respective   
,heal? ,ent]prise ,zone1 :i* /rategies  
may include-- 7,a7 int]n%ips & volunte] 
opportunities = /ud5ts :o reside 9 !    
,heal? ,ent]prise ,zone2  7,b7 fund+    
res\rces to improve heal? c>e provid]   
capacity to s]ve non-,engli% speak]s2   
7,c7 op]ation ( m$ical1 m5tal &         
behavioral heal?1 & d5tal mobile cl9ics2
  7,d7 provision ( transportation to & f
 m$ical appo9tm5ts = pati5ts2  7,e7     
fund+ res\rces to improve access to     
heal?y food1 recreation1 & high-quality 
h\s+2  7,f7 capital or leasehold        
improvem5ts to a heal? c>e facility 9 ! 
respective ,heal? ,ent]prise ,zone2 &   
7,g7 m$ical or d5tal equipm5t to be us$ 
9 su* a facility4  #f4 ,/ud5t loan      
repaym5t program  7a7 ,9 g5]al ,!       
,secret>y %all c>ry out a loan repaym5t 
program "u :i* ! ,secret>y ent]s into   
agreem5ts ) eligible ,heal? ,ent]prise  

,zone practition]s to make paym5ts on ! 
pr9cipal & int]e/ ( ! eligible          
educational loans ( su* practition]s =  
ea* ye> su* practition]s agree to       
provide heal? c>e s]vices 9 a ,heal?    
,ent]prise ,zone4  7b7 ,limitations ,9  
ent]+ into loan repaym5t agreem5ts "u   
?is section1 ! ,secret>y may n agree    
to-- 7#a7 make paym5ts = m ?an #aj ye>s 
) respect to a practition]2 or  7#b7 pay
 m ?an #aj1jjj p] ye>1 or m ?an a total 
( #ajj1jjj1 ) respect to a practition]4 
7c7 ,def9itions ,9 ?is section3 7#a7 ,! 
t]m eligible educational loan means any 
f$]ally fund$ or gu>ante$ /ud5t loan z  
det]m9$ appropriate by ! ,secret>y 9    
coord9ation ) ! ,secret>y ( ,education4 
7#b7 ,! t]m eligible ,heal? ,ent]prise  
,zone practition] means a ,heal?        
,ent]prise ,zone practition] :o agrees--
 7,a7 to provide heal? c>e s]vices 9 a  
,heal? ,ent]prise ,zone = a specifi$    
p]iod t is n less ?an "o ye>2 &  7,b7   
has "o or m eligible educational loans4 
#g4 ,t5 p]c5t increase ( paym5t = items 

& s]vices payable "u ,m$ic>e ,"p ,b     
furni%$ 9 ,heal? ,ent]prise ,zones      
,section #ahcc7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciel7a77 is am5d$
 by ins]t+ be=e ! p]iod at ! end !      
foll[+3 4 ,) respect to items & s]vices 
payable "u ?is "p t are furni%$ 9 a     
,heal? ,ent]prise ,zone 7z def9$ 9      
section #i ( ! ,heal? ,ent]prise ,zones 
,act ( #bjbj7 dur+ ! p]iod beg9n+ on !  
fir/ day an area is designat$ a ,heal?  
,ent]prise ,zone "u section #b7;a77#a7 (
 su* ,act & end+ on ! la/ day ( ! fiscal
 ye> t is #aj fiscal ye>s foll[+ !      
enactm5t ( ?is ,act1 ! paym5t rates     
o!rwise e/abli%$ = su* items & s]vices  
%all be increas$ by #aj p]c5t4  #h4     
,report+  7a7 ,9 g5]al ,n lat] ?an ! end
 ( ea* fiscal ye> 9 ! p]iod ( #aj fiscal
 ye>s foll[+ ! date ( enactm5t ( ?is    
,act1 ! ,secret>y %all submit to !      
,congress a report on ! implem5tation ( 
?is ,act & ! results !re(4  7b7 ,cont5ts
 ,ea* report "u subsection 7a7 %all--   
7#a7 specify ! numb] & types ( inc5tives

 provid$ pursuant to ?is ,act 9 ea*     
,heal? ,ent]prise ,zone designat$ "u    
section #b2  7#b7 include evid5ce ( !   
ext5t to :i* ! inc5tives utiliz$ by ea* 
,heal? ,ent]prise ,zone h succe$$-- 7,a7
 9 attract+ heal? c>e practition]s to   
practice 9 ,heal? ,ent]prise ,zones2    
7,b7 9 r$uc+ heal? disp>ities & improv+ 
heal? outcomes 9 ,heal? ,ent]prise      
,zones2 &  7,c7 9 r$uc+ heal? co/s &    
hospital admissions & readmissions 9    
,heal? ,ent]prise ,zones4  #i4          
,def9itions ,9 ?is ,act3 7#a7 ,! t]m    
,heal? ,ent]prise ,zone means an area   
designat$ "u section #b z a ,heal?      
,ent]prise ,zone4  7#b7 ,! t]m ,heal?   
,ent]prise ,zone practition] means a    
heal? c>e practition] :o-- 7,a7 is      
lic5s$ or c]tifi$ 9 accordance )        
applicable ,/ate law to treat pati5ts 9 
! respective ,heal? ,ent]prise ,zone2   
7,b7 provides-- 7i7 prim>y c>e1 :i* may 
include ob/etrics1 gynecological        
s]vices1 p$iatric s]vices1 or g]iatric  
s]vices2  7ii7 behavioral heal? s]vices1

 :i* may include m5tal heal? or sub/ance
 use disord] s]vices2 or  7iii7 d5tal   
s]vices2 &  7,c7 is a p>ticipat+ provid]
 ( s]vices or suppli] "u ! ,m$ic>e      
program "u title ,,xviii ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acie et  
seq47 or a p>ticipat+ provid] "u a ,/ate
 plan "u title ,,xix ( su* ,act 7#db    
,u4,s4,c4 #acif et seq474  7#c7 ,! t]m  
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  #aj4 ,au?orization (  
appropriations ,to c>ry out ?is ,act1   
!re is au?oriz$ to be appropriat$ su*   
sums z may be necess>y = ! p]iod ( #aj  
fiscal ye>s foll[+ ! date ( enactm5t (  
?is ,act4