,,ii  #aag? ,,congress  #b;d ,session   
,s4 #ebic  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #ai1 #bjbb,mr4
 ,padilla introduc$ ! foll[+ bill2 :i* 0
 read twice & ref]r$ to ! ,committee on 
,f9ance  ,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 ( #bjbb4  7b7 ,table ( cont5ts ,!  
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  
,inc5tive paym5ts = ,m$ic>e "p ,b items 
& s]vices furni%$ 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 %all-- 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 ( p>ticipation 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 ( p>ticipation 9   
su* program2  7iii7 l[] life expectancy 
?an ! national av]age2  7iv7 a high]    
p]c5tage ( in/ances ( l[ bir? weight ?an

 ! national av]age2 or  7v7 designation 
"u section #ccb ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bed;e7 z a 
heal? pr(essional %ortage area2 &  7,c7 
be "p ( a metropolitan /ati/ical area or
 micropolitan /ati/ical area id5tifi$ by
 ! ,director ( ! ,(fice ( ,managem5t &  
,budget4  7b7 ,solicitation (           
applications ,! ,secret>y %all-- 7#a7 n 
lat] ?an #a ye> 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 applicants
 "u subsection 7c71 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$ organizations1 %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 section #d1 #e1 or
 #f ( ?is ,act1 or section #ahcc7;a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciel7a771 z am5d$ by section #g ( ?is 
,act1 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 7,a7 ,c>diovascul> disease4 
7,b7 ,a/hma4  7,c7 ,diabetes4  7,d7     
,d5tal heal?4  7,e7 ,behavioral heal?4  

7,f7 ,mat]nal & bir? heal?4  7,g7       
,sexually transmitt$ infections4  7,h7  
,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* an area demon/rates ! 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 ( an area z a
 ,heal? ,ent]prise ,zone %all be 9      
effect until ! date t is #aj ye>s aft] !
 date on :i* ! fir/ su* area is s       
designat$4  #c4 ,consultation ,!        
,secret>y %all c>ry out ?is ,act 9      
consultation )-- 7#a7 ! ,secret>y (     
,h\s+ & ,urban ,developm5t2 &  7#b7 !   
,deputy ,assi/ant ,secret>y = ,m9ority  
,heal?4  #d4 ,tax inc5tives  7a7 ,"w    
opportunity cr$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>agraph3   
7#af7 ,heal? ,ent]prise ,zones  7,a7    
,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 ,zone4 
7,b7 ,qualifi$ ,heal? ,ent]prise ,zone  
"w ,! t]m qualifi$ ,heal? ,ent]prise    
,zone "w means employm5t by a ,heal?    
,ent]prise ,zone practition]1 ! prim>y  
(ficial duties ( :i* promote access to  
heal?c>e 9 a ,heal? ,ent]prise ,zone4   
7,c7 ,relat$ t]ms ,= purposes ( ?is     
p>agraph1 ! t]ms ,heal? ,ent]prise ,zone

 & ,heal? ,ent]prise ,zone practition] h
 ! same mean+ giv5 su* t]ms "u section  
#i ( ! ,heal? ,ent]prise ,zones ,act (  
#bjbb4  4  7#c7 ,effective date ,!      
am5dm5ts made by ?is subsection %all    
apply to am\nts paid or incurr$ aft] !  
date ( ! enactm5t ( ?is ,act to         
individuals :o beg9 "w = ! employ] aft] 
su* date4  7b7 ,cr$it = ,heal?          
,ent]prise ,zone work]s  7#a7 ,9 g5]al  
,subp>t ,a ( "p ,,iv ( sub*apt] ,a (    
*apt] #a ( ! ,int]nal ,rev5ue ,code (   
#aihf1 z am5d$ by section #acdjb (      
,public ,law #aag-afi1 is am5d$ by      
ins]t+ aft] section #be;,e ! foll[+ new 
section3  #be;,f4 ,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 "w dur+
 su* taxable ye>4  7b7 ,def9itions ,=   
purposes ( ?is section-- 7#a7 ,qualifi$ 

,heal? ,ent]prise ,zone work] ,! 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 (      
#bjbb74  7#b7 ,qualifi$ ,heal?          
,ent]prise ,zone "w ,! t]m qualifi$     
,heal? ,ent]prise ,zone "w has ! same   
mean+ giv5 su* t]m 9 section            
#ea7;d77#af77;,b74  4  7#b7 ,cl]ical    
am5dm5t ,! table ( sections = subp>t ,a 
( "p ,,iv ( sub*apt] ,a ( *apt] #a ( su*
 ,code1 z am5d$ by section #acdjb7;d7 ( 
,public ,law #aag-afi1 is am5d$ by      
ins]t+ aft] ! item relat+ to section    
#be;,e ! foll[+ new item3  ,sec4 #be;,f4
 ,cr$it = qualifi$ ,heal? ,ent]prise    
,zone work]s4  4  7#c7 ,effective date  
,! am5dm5ts made by ?is subsection %all 
apply to wages receiv$ 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 improvem5ts4  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 ,ineligibility = d\ble b5efits ,no  
borr[] may1 = ! same s]vice1 receive a  
r$uction ( loan obligations or a loan   
repaym5t "u bo?-- 7#a7 ?is section2 &   
7#b7 any f$]ally support$ loan =giv5ess 
program1 includ+ "u section #cch;,b1    
#cch;,i1 or #hdf ( ! ,public ,heal?     

,s]vice ,act 7#db ,u4,s4,c4 #bedl-#a1   
#bedq-#a1 #bign71 or section #dbh;,j1   
#dbh,l1 #dee7m71 or #dfj ( ! ,high]     
,education ,act ( #aife 7#bj ,u4,s4,c4  
#ajgh-aj1 #ajgh-ab1 #ajhg;e7m71         
#ajhg;j74  7d7 ,def9itions ,9 ?is       
section3 7#a7 ,! t]m eligible           
educational loan means any f$]ally fund$
 or gu>ante$ /ud5t loan1 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-- 7,a7 agrees 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        
,inc5tive paym5ts = ,m$ic>e "p ,b items 
& s]vices furni%$ 9 ,heal? ,ent]prise   
,zones ,section #ahcc7;a7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4 #aciel7a77
 is am5d$ by add+ at ! end ! foll[+ new 
subsection3  7ee7 ,inc5tive paym5ts =   
items & s]vices furni%$ 9 ,heal?        

,ent]prise ,zones  7#a7 ,9 g5]al ,9 !   
case ( items & s]vices furni%$ "u ?is "p
 9 an area t is designat$ z a ,heal?    
,ent]prise ,zone section #b7;a77#a7 ( ! 
,heal? ,ent]prise ,zones ,act ( #bjbb1 9
 addition to ! am\nt ( paym5t t w\ld    
o!rwise be made = su* items & s]vices "u
 ?is "p1 !re also %all be paid 7on a    
mon?ly or qu>t]ly basis7 an am\nt equal 
to #aj p]c5t ( ! paym5t am\nt = ! item  
or s]vice "u ?is "p4  7#b7 ,coord9ation 
) o!r paym5ts ,! am\nt ( ! additional   
paym5t = an item or a s]vice "u ?is     
subsection & subsection 7m7 %all be     
det]m9$ )\t reg>d to any additional     
paym5t = ! item or s]vice "u subsection 
7m7 & ?is subsection1 respectively4 ,!  
am\nt ( ! additional paym5t = an item or
 a s]vice "u ?is subsection & subsection
 7z7 %all be det]m9$ )\t reg>d to any   
additional paym5t = ! item or s]vice "u 
subsection 7z7 & ?is subsection1        
respectively4  4  #h4 ,report+  7a7 ,9  
g5]al ,n lat] ?an ! day t is #aj ye>s   
aft] ! fir/ ,heal? ,ent]prise ,zone is  

designat$ "u section #b7;a77#a71 !      
,secret>y %all submit to ,congress a    
report on ! implem5tation ( ?is ,act 7& 
! am5dm5ts made by ?is ,act7 & ! 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 beg9n+ 
on ! date ( enactm5t ( ?is ,act & end+  
on ! la/ day ( ! #aj-ye> p]iod t beg9s  
on ! date on :i* ! fir/ ,heal?          
,ent]prise ,zone is designat$ "u section

 #b7;a77#a74