,i #aafth ,,congress #b;d ,session ,h4 ,r4 #gedf ,,in ,,the ,,house ,,of ,,representatives ,july #i1 #bjbj ,mr4 ,lewis introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to direct the ,secretary of ,health and ,human ,services to ensure that minority and medically underserved communities have meaningful and immediate access to public health interventions and medically necessary health care services during the ,,covid-#ai pandemic1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,minority ,community ,public ,health ,emergency ,response ,act of #bjbj4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,title ,i--,rapid ,response ,grant ,program ,sec4 #aja4 ,rapid response grant program4 ,title ,,ii--,equality in ,medicare and ,medicaid ,treatment ,sec4 #bja4 ,improving access to care for ,medicare and ,medicaid beneficiaries4 ,i ,rapid ,response ,grant ,program #aja4 ,rapid response grant program ,title ,,xxviii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh et seq47 is amended by adding at the end the following new subtitle3 ,d ,rapid ,response #bhca4 ,rapid response grant program 7a7 ,establishment of program ,the ,secretary of ,health and ,human ,services shall award grants to eligible entities described in subsection 7b7 for ,,covid-#ai preparedness and response efforts4 7b7 ,eligible ,entities ,to be eligible to receive a grant under this section1 an entity shall be a qualified government entity seeking a grant for a qualified community within its jurisdiction that-- 7#a7 is1 or contains1 a medically underserved community2 and 7#b7 has a percentage of ,,covid-#ai cases1 hospitalizations1 or deaths for any racial and ethnic minority group that is greater than the percentage of such cases in the ,state or county in which the community is located4 7c7 ,application ,to be eligible for a grant under this section1 an eligible entity shall submit to the ,secretary an application at such time1 in such form1 and containing such information as the ,secretary determines appropriate1 including-- 7#a7 documentation that the entity is an eligible entity2 7#b7 a plan for carrying out the activities described in subsection 7f7 with amounts received under this section2 7#c7 an oversight plan for tracking and security of resources and supplies2 and 7#d7 a schedule for resource expenditure and response readiness4 7d7 ,certification ,prior to awarding a grant under this section1 the ,secretary shall obtain a certification from the ,deputy ,assistant ,secretary for ,minority ,health1 the ,deputy ,assistant ,secretary for ,women's ,health1 and the ,director of the ,office of ,rural ,health ,policy that the application involved addresses health disparities and social determinants of health as appropriate for populations to be cared for through the grant4 7e7 ,priority ,in making grants under this section1 the ,secretary shall give priority to eligible entities that are local governments and county health departments4 7f7 ,grant uses ,a recipient of a grant under this section may use grant funds with respect to ,,covid-#ai preparedness and rapid response efforts for any of the following3 7#a7 ,purchasing medical supplies4 7#b7 ,providing nutrition assistance4 7#c7 ,warehousing stockpiled supplies1 including rent and security costs4 7#d7 ,constructing and operating testing sites4 7#e7 ,providing quarantine housing4 7#f7 ,providing public education related to the pandemic1 including misinformation response4 7#g7 ,contact tracing4 7#h7 ,providing vaccinations4 7#i7 ,distributing1 dispensing1 and administering antiviral medications4 7#aj7 ,providing community mitigation4 7#aa7 ,performing laboratory epidemiology4 7#ab7 ,performing surveillance4 7g7 ,reporting 7#a7 ,grant recipients ,not later than #a month after the date of enactment of this subtitle1 #f months after such date of enactment1 and #a year after such date of enactment1 and annually thereafter1 the recipient of a grant under this section shall report to the ,secretary on the program funded through the grant1 with respect to-- 7,a7 program oversight as described in subsection 7c77#c72 7,b7 delays in funding expenditures2 and 7,c7 resource distribution4 7#b7 ,secretary ,not later than #f months after the date of enactment of this subtitle and #a year after such date of enactment1 and annually thereafter1 the ,secretary shall report to the ,congress on the programs funded by grants under this section1 with respect to-- 7,a7 program oversight as described in subsection 7c77#c72 and 7,b7 unmet needs in grant recipient pandemic response infrastructure4 #bhcb4 ,planning grant program 7a7 ,in general ,the ,secretary may award a planning grant to any entity that certifies that-- 7#a7 it is an eligible entity under section #bhca7;b72 and 7#b7 it intends to submit to the ,secretary an application for a grant under section #bhca4 7b7 ,use of funds ,any grant awarded under this section1 for purposes of developing an application for a grant under section #bhca1 shall be used to-- 7#a7 identify community needs to rapidly and effectively respond to the ,,covid-#ai pandemic2 7#b7 estimate the cost of such a response and maintaining a state of readiness2 and 7#c7 hire staff to carry out paragraphs 7#a7 and 7#b74 7c7 ,timing ,not later than #cj days after receipt of an application for an award under this section1 the ,secretary shall determine whether to award the grant4 7d7 ,funding condition ,as a condition on receipt of a planning grant under this section1 an applicant shall agree to submit to the ,secretary an application for a grant under section #bhca no later than #ij days after receiving the planning grant4 #bhcc4 ,community ,infectious ,disease ,health ,services ,planning ,council 7a7 ,establishment ,to be eligible for assistance under this subtitle1 the chief elected official of the qualified government entity applying for such assistance shall establish or designate a ,,covid-#ai_/;infectious disease health services planning council 7in this section referred to as a ,,covid-#ai_/;infectious disease health services planning council7 that shall reflect in its composition the demographics of the populations of individuals with ,,covid-#ai and other infectious diseases in the qualified community involved1 with particular consideration given to disproportionately affected and historically underserved groups and subpopulations4 7b7 ,selection criteria ,nominations for membership on a ,,covid-#ai_/;infectious disease health services planning council shall be identified through an open process and candidates shall be selected based on locally delineated and publicized criteria4 ,such criteria shall include a conflict-of-interest standard that is in accordance with subsection 7f74 7c7 ,representation ,a ,,covid-#ai_/;infectious disease health services planning council-- 7#a7 shall include representatives of-- 7,a7 health care providers1 including federally qualified health centers2 7,b7 community-based organizations serving affected populations and ,,aids service organizations2 7,c7 social service providers1 including providers of housing and homeless services2 7,d7 mental health and substance abuse providers2 7,e7 local public health agencies2 7,f7 hospital planning agencies or health care planning agencies2 7,g7 affected communities1 including-- 7i7 individuals with ,,covid-#ai or another infectious disease designated by the council as having a disproportionate effect on a racial and ethnic minority group2 7ii7 members of a federally recognized ,indian ,tribe as represented in the affected communities2 and 7iii7 historically underserved groups and subpopulations2 7,h7 nonelected community leaders2 7,i7 ,state government 7including the ,state ,medicaid agency72 7,j7 grantees under this subtitle1 or1 if none are operating in the area1 representatives of organizations with a history of serving children1 youth1 women1 and families living with ,,covid-#ai or other infectious diseases and operating in the area2 7,k7 grantees who receive funding from other ,federal ,,covid-#ai or other infectious disease programs2 and 7,l7 representatives of individuals who formerly were ,federal1 ,state1 or local prisoners1 were released from the custody of the penal system during the preceding #c years1 and had ,,covid-#ai or another infectious disease as of the date on which the individuals were so released2 and 7#b7 to the extent possible1 shall include individuals who have had ,,covid-#ai4 7d7 ,method of providing for council 7#a7 ,in general ,in providing for a council for purposes of subsection 7a71 a chief elected official of a qualified government entity receiving a grant under this subtitle may establish the council directly or designate an existing entity to serve as the council1 subject to paragraph 7#b74 7#b7 ,consideration regarding designation of council ,in making a determination of whether to establish or designate a council under paragraph 7#a71 a chief elected official of a qualified government entity receiving a grant under this subtitle shall give priority to the designation of an existing entity that has demonstrated experience in planning for the ,,covid-#ai and other infectious diseases health care service needs within the qualified community and in the implementation of such plans in addressing those needs4 ,any existing entity so designated shall be expanded to include a broad representation of the full range of entities that provide such services within the geographic area to be served4 7e7 ,duties ,a ,,covid-#ai_/;infectious disease health services planning council shall-- 7#a7 determine the size and demographics of the population of individuals who have or had ,,covid-#ai or other infectious disease1 as well as the size and demographics of the estimated population of individuals with ,,covid-#ai or other infectious disease who are unaware of their ,,covid-#ai or other infectious disease status2 7#b7 determine the needs of such population1 with particular attention to-- 7,a7 individuals who have or had ,,covid-#ai or other infectious disease and are not receiving health care with respect to ,,covid-#ai or such disease2 7,b7 disparities in access and services among affected subpopulations and historically underserved communities2 and 7,c7 individuals who are unaware that such individual has or had ,,covid-#ai or other infectious disease2 7#c7 establish priorities for the allocation of funds within the qualified community1 including how best to meet each such priority and additional factors that a grantee should consider in allocating funds under a grant based on the-- 7,a7 size and demographics of the population of individuals who have or had ,,covid-#ai 7as determined under paragraph 7#a77 or other infectious disease and the needs of such population 7as determined under paragraph 7#b772 7,b7 demonstrated 7or probable7 cost effectiveness and outcome effectiveness of proposed strategies and interventions1 to the extent that data are reasonably available2 7,c7 priorities of the communities of individuals who have or had ,,covid-#ai or other infectious disease for whom the services are intended2 7,d7 availability of other governmental and nongovernmental resources1 including the ,state ,medicaid plan under title ,,xix of the ,social ,security ,act and the ,state ,children's ,health ,insurance ,program under title ,,xxi of such ,act to cover health care costs of eligible individuals and families with respect to ,,covid-#ai or other infectious disease2 and 7,e7 capacity development needs resulting from disparities in the availability of ,,covid-#ai or other infectious disease-related services in historically underserved communities2 7#d7 develop a comprehensive plan for the organization and delivery of health and support services described in section #bhca that-- 7,a7 includes a strategy for identifying individuals who have or had ,,covid-#ai or other infectious disease and for informing the individuals of and enabling the individuals to utilize the services1 giving particular attention to eliminating disparities in access and services among affected subpopulations and historically underserved communities1 and including discrete goals1 a timetable1 and an appropriate allocation of funds2 7,b7 includes a strategy to coordinate the provision of such services with programs to prevent the spread of ,,covid-#ai or other infectious disease2 7,c7 is compatible with any ,state or local plan for the provision of services to individuals who have ,,covid-#ai or other infectious disease2 and 7,d7 includes a strategy1 coordinated as appropriate with other community strategies and efforts1 including discrete goals1 a timetable1 and appropriate funding1 for identifying individuals who have ,,covid-#ai or other infectious disease or who are unaware that such individuals have ,,covid-#ai or other infectious disease1 making such individuals aware of such status1 and enabling such individuals to use the health and support services described in section #bhca1 with particular attention to reducing barriers to routine testing and disparities in access and services among affected subpopulations and historically underserved communities2 7#e7 assess the efficiency of the administrative mechanism in rapidly allocating funds to the areas of greatest need within the qualified community1 and at the discretion of a ,,covid-#ai_/;infectious disease health services planning council1 assess the effectiveness1 either directly or through contractual arrangements1 of the services offered in meeting the identified needs2 7#f7 establish methods for obtaining input on community needs and priorities which may include public meetings 7in accordance with subsection 7h771 conducting focus groups1 and convening ad-hoc panels2 and 7#g7 coordinate with ,federal grantees that provide ,,covid-#ai or other infectious disease-related services in the qualified community4 7f7 ,conflicts of interest 7#a7 ,in general ,a ,,covid-#ai_/;infectious disease health services planning council may not be directly involved in the administration of a grant under this subtitle4 ,with respect to compliance with the preceding sentence1 a ,,covid-#ai_/;infectious disease health services planning council may not designate 7or otherwise be involved in the selection of7 particular entities as recipients of any of the amounts provided in the grant4 7#b7 ,required agreements ,an individual may serve on a ,,covid-#ai_/;infectious disease health services planning council only if the individual agrees that if the individual has a financial interest in an entity1 if the individual is an employee of a public or private entity1 or if the individual is a member of a public or private organization1 and such entity or organization is seeking amounts from a grant under this subtitle1 the individual will not1 with respect to the purpose for which the entity seeks such amounts1 participate 7directly or in an advisory capacity7 in the process of selecting entities to receive such amounts for such purpose4 7#c7 ,composition of council ,the following applies regarding the membership of a ,,covid-#ai_/;infectious disease health services planning council3 7,a7 ,not less than #cc percent of the council shall be individuals who-- 7i7 are not officers1 employees1 or consultants to any entity that receives amounts from such a grant1 and do not represent any such entity2 and 7ii7 reflect the demographics of the population of individuals who have ,,covid-#ai or other infectious diseases as determined under subsection 7e77#a74 7,b7 ,with respect to membership on a ,,covid-#ai_/;infectious disease health services planning council1 subparagraph 7,a7 may not be construed as having any effect on entities that receive any ,federal funds with respect to ,,covid-#ai or other infectious disease but do not receive funds from grants under section #bhca1 on officers or employees of such entities1 or on individuals who represent such entities4 7g7 ,grievance procedures ,a ,,covid-#ai_/;infectious disease health services planning council shall develop procedures for addressing grievances with respect to funding under this subtitle1 including procedures for submitting grievances that cannot be resolved to binding arbitration4 ,such procedures shall be described in the by-laws of a ,,covid-#ai_/;infectious disease health services planning council and be consistent with the requirements of subsection 7c74 7h7 ,public deliberations ,with respect to a planning council under subsection 7a71 the following applies3 7#a7 ,the council may not be chaired solely by an employee of the grantee under this subtitle4 7#b7 ,in accordance with criteria established by the ,secretary3 7,a7 ,the meetings of the council shall be open to the public and shall be held only after adequate notice to the public4 7,b7 ,the records1 reports1 transcripts1 minutes1 agenda1 or other documents which were made available to or prepared for or by the council shall be available for public inspection and copying at a single location4 7,c7 ,detailed minutes of each meeting of the council shall be kept4 ,the accuracy of all minutes shall be certified to by the chair of the council4 7,d7 ,this paragraph does not apply to any disclosure of information of a personal nature that would constitute a clearly unwarranted invasion of personal privacy1 including any disclosure of medical information or personnel matters4 #bhcd4 ,definitions ,in this subtitle3 7#a7 ,medically underserved community ,the term medically underserved community has the meaning given the term in section #gii;,b7#f74 7#b7 ,qualified community ,the term qualified community means either of the following3 7,a7 ,a political subdivision of a ,state4 7,b7 ,a group of political subdivisions of one or more ,states4 7#c7 ,qualified government entity ,the term qualified government entity means any of the following3 7,a7 ,a ,state4 7,b7 ,a political subdivision of a ,state4 7,c7 ,a group of political subdivisions of one or more ,states4 7,d7 ,a county health department4 7#d7 ,racial and ethnic minority group ,the term racial and ethnic minority group has the meaning given the term in section #agjg7;g74 7#e7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#f7 ,state ,the term ,state means each of the several ,states1 the ,district of ,columbia1 and the territories and possessions of the ,united ,states4 #bhce4 ,authorization of appropriation ,there is authorized to be appropriated to carry out this subtitle #a1jjj1jjj1jjj1 to remain available until expended4 4 ,,ii ,equality in ,medicare and ,medicaid ,treatment #bja4 ,improving access to care for ,medicare and ,medicaid beneficiaries ,section #aaae;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 is amended-- 7#a7 in subsection 7a77#c7-- 7,a7 by inserting after relevant ,federal agencies1 the following3 including the ,office of ,minority ,health of the ,centers for ,medicare ,medicaid ,services1 the ,office of ,rural ,health ,policy of the ,health ,resources and ,services ,administration1 and the ,office on ,women's ,health in the ,office of the ,secretary12 and 7,b7 by inserting after medicine the following3 1 the causes of health disparities and social determinants of health12 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#b7-- 7i7 in subparagraph 7,a7-- 7,i7 by inserting after the first sentence1 the following new sentence3 ,prior to model selection1 the ,secretary shall consult with the ,office of ,minority ,health of the ,centers for ,medicare ,medicaid ,services1 the ,federal ,office of ,rural ,health ,policy1 and the ,office on ,women's ,health to ensure that models under consideration address health disparities and social determinants of health as appropriate for populations to be cared for under the model42 7,,ii7 by inserting 1 as well as improving access to care received by individuals receiving benefits under such title1 after title2 and 7,,iii7 by adding at the end the following new sentence3 ,the models selected under this subparagraph shall include the social determinants of health payment model described in subparagraph 7,d71 the testing of which shall begin not later than ,december #ca1 #bjbj42 7ii7 in subparagraph 7,c71 by adding at the end the following new clauses3 7ix7 ,whether the model will affect access to care from providers and suppliers caring for high-risk patients or operating in underserved areas4 7x7 ,whether the model has the potential to produce reductions in minority and rural health disparities4 2 and 7iii7 by adding at the end the following new subparagraph3 7,d7 ,social determinants of health payment model 7i7 ,in general ,the social determinants of health payment model described in this subparagraph is a payment model that tests each of the payment and service delivery innovations described in clause 7ii7 in a region determined appropriate by the ,secretary4 7ii7 ,payment and service delivery innovations described ,for purposes of clause 7i71 the payment and service delivery innovations described in this clause are the following3 7,i7 ,payment and service delivery innovations for behavioral health services1 focusing on gathering actionable data to address the higher costs associated with beneficiaries with diagnosed behavioral conditions4 7,,ii7 ,payment and service delivery innovations targeting conditions or comorbidities of individuals entitled or enrolled under the ,medicare program under title ,,xviii and enrolled under a ,state plan under the ,medicaid program under title ,,xix to increase capacity in underserved areas4 7,,iii7 ,payment and service delivery innovations targeted on ,medicaid-eligible pregnant and postpartum women1 up to one year after delivery4 7,,iv7 ,payment and service delivery innovations targeted on communities where a percentage of ,,covid-#ai cases1 hospitalizations1 or deaths for any racial or ethnic minority group that is greater than the percentage of such cases in the ,state or county in which the community is located4 2 and 7,b7 in paragraph 7#d77;,a7-- 7i7 in clause 7i7 at the end1 by striking and2 7ii7 in clause 7ii71 at the end1 by striking the period and inserting 2 and2 and 7iii7 by adding at the end the following new clause3 7iii7 the extent to which the model improves access to care or the extent to which the model improves care for high-risk patients1 patients from racial or ethnic minorities1 or patients in underserved areas4 2 7#c7 in subsection 7c7-- 7,a7 in paragraph 7#b71 by striking at the end and2 7,b7 by redesignating paragraph 7#c7 as paragraph 7#d72 7,c7 by inserting after paragraph 7#b7 the following new paragraph3 7#c7 the ,office of ,minority ,health of the ,centers for ,medicare ,medicaid ,services certifies that such expansion will not reduce access to care for low-income1 minority1 or rural beneficiaries2 and 2 7,d7 in paragraph 7#d71 as redesignated by subparagraph 7,b71 by inserting before the period at the end the following3 nor increase health disparities experienced by low-income1 minority1 or rural beneficiaries2 and 7,e7 in the matter following paragraph 7#d71 as redesignated by subparagraph 7,b71 by inserting 1 improve access to care1 after care2 and 7#d7 in subsection 7g7-- 7,a7 by inserting 7or1 beginning with #bjba1 once every year thereafter7 after thereafter2 and 7,b7 by adding at the end the following new sentence3 ,for reports for #bjba and each subsequent year1 each such report shall include information on the following3 7#a7 ,the extent and severity of minority and rural health disparities in ,medicare and ,medicaid beneficiaries4 7#b7 ,the interventions that address social determinants of health in payment models selected by the ,center for ,medicare and ,medicaid ,innovation for testing4 7#c7 ,the interventions that address social determinants of health in payment models not selected by the ,center for ,medicare and ,medicaid ,innovation for testing4 7#d7 ,the effectiveness of interventions in mitigating negative health outcomes and higher costs associated with social determinants of health within models selected by the ,center for ,medicare and ,medicaid ,innovation for testing4 7#e7 ,changes in disparities among minorities and ,medicare and ,medicaid beneficiaries in underserved areas that are attributable to provider and supplier participation in a ,phase ,,ii model4 7#f7 ,in consultation with the ,comptroller ,general of the ,united ,states1 estimated ,federal savings achieved through the reduction of rural and minority health disparities4 7#g7 ,other areas determined appropriate by the ,secretary4 4