Senate Bill #1152-(the 2010/2011 Budget for the Department of Community Health), has passed the Full Senate by a vote of 21 to 16, without further amendments, and has gone to the House of Representatives where Gary McDowell is proceding to hold hearings on the Bill in his Appropriations Subcommittee on Community Health. The Subcommittee consists of the following members:

Representative Gary McDowell-D-Chair, Rep. S. Jackson, Rep. J. Espinoza, Rep. V. Gregory, Rep. F. Miller, Rep. K. Green, Rep. M. Lori, & Rep. H. Crawford.

Copies of the Bill, as it passed the Senate are available. We have facilitated three persons to speak before the Subcommittee, already, at a hearing at Sinai-Grace Hospital in Detroit. The next hearing is scheduled for April 14th, at 8:00 a.m. in Room 352 of the Capitol. The topic will be Medicaid. Please call us if you wish to come and observe or testify.

H.R.3590
Patient Protection and Affordable Care Act (Enrolled as Agreed to or Passed by Both House and Senate)

SEC. 10503. COMMUNITY HEALTH CENTERS AND THE NATIONAL HEALTH SERVICE CORPS FUND.
(a) Purpose- It is the purpose of this section to establish a Community Health Center Fund (referred to in this section as the `CHC Fund’), to be administered through the Office of the Secretary of the Department of Health and Human Services to provide for expanded and sustained national investment in community health centers under section 330 of the Public Health Service Act and the National Health Service Corps.
(b) Funding- There is authorized to be appropriated, and there is appropriated, out of any monies in the Treasury not otherwise appropriated, to the CHC Fund–
(1) to be transferred to the Secretary of Health and Human Services to provide enhanced funding for the community health center program under section 330 of the Public Health Service Act–
(A) $700,000,000 for fiscal year 2011;
(B) $800,000,000 for fiscal year 2012;
(C) $1,000,000,000 for fiscal year 2013;
(D) $1,600,000,000 for fiscal year 2014; and
(E) $2,900,000,000 for fiscal year 2015; and
(2) to be transferred to the Secretary of Health and Human Services to provide enhanced funding for the National Health Service Corps–
(A) $290,000,000 for fiscal year 2011;
(B) $295,000,000 for fiscal year 2012;
(C) $300,000,000 for fiscal year 2013;
(D) $305,000,000 for fiscal year 2014; and
(E) $310,000,000 for fiscal year 2015.
(c) Construction- There is authorized to be appropriated, and there is appropriated, out of any monies in the Treasury not otherwise appropriated, $1,500,000,000 to be available for fiscal years 2011 through 2015 to be used by the Secretary of Health and Human Services for the construction and renovation of community health centers.
(d) Use of Fund- The Secretary of Health and Human Services shall transfer amounts in the CHC Fund to accounts within the Department of Health and Human Services to increase funding, over the fiscal year 2008 level, for community health centers and the National Health Service Corps.
(e) Availability- Amounts appropriated under subsections (b) and (c) shall remain available until expended

H.R.3590
Patient Protection and Affordable Care Act (Enrolled as Agreed to or Passed by Both House and Senate)

`SEC. 340H. COMMUNITY-BASED COLLABORATIVE CARE NETWORK PROGRAM.
`(a) In General- The Secretary may award grants to eligible entities to support community-based collaborative care networks that meet the requirements of subsection (b).
`(b) Community-based Collaborative Care Networks-
`(1) DESCRIPTION- A community-based collaborative care network (referred to in this section as a `network’) shall be a consortium of health care providers with a joint governance structure (including providers within a single entity) that provides comprehensive coordinated and integrated health care services (as defined by the Secretary) for low-income populations.
`(2) REQUIRED INCLUSION- A network shall include the following providers (unless such provider does not exist within the community, declines or refuses to participate, or places unreasonable conditions on their participation):
`(A) A hospital that meets the criteria in section 1923(b)(1) of the Social Security Act; and
`(B) All Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act located in the community.
`(3) PRIORITY- In awarding grants, the Secretary shall give priority to networks that include–
`(A) the capability to provide the broadest range of services to low-income individuals;
`(B) the broadest range of providers that currently serve a high volume of low-income individuals; and
`(C) a county or municipal department of health.
`(c) Application-
`(1) APPLICATION- A network described in subsection (b) shall submit an application to the Secretary.
`(2) RENEWAL- In subsequent years, based on the performance of grantees, the Secretary may provide renewal grants to prior year grant recipients.
`(d) Use of Funds-
`(1) USE BY GRANTEES- Grant funds may be used for the following activities:
`(A) Assist low-income individuals to–
`(i) access and appropriately use health services;
`(ii) enroll in health coverage programs; and
`(iii) obtain a regular primary care provider or a medical home.
`(B) Provide case management and care management.
`(C) Perform health outreach using neighborhood health workers or through other means.
`(D) Provide transportation.
`(E) Expand capacity, including through telehealth, after-hours services or urgent care.
`(F) Provide direct patient care services.
`(2) GRANT FUNDS TO HRSA GRANTEES- The Secretary may limit the percent of grant funding that may be spent on direct care services provided by grantees of programs administered by the Health Resources and Services Administration or impose other requirements on such grantees deemed necessary.
`(e) Authorization of Appropriations- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2011 through 2015.’.
SEC. 10334. MINORITY HEALTH.
(a) Office of Minority Health-
(1) IN GENERAL- Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is amended–
(A) in subsection (a), by striking `within the Office of Public Health and Science’ and all that follows through the end and inserting `. The Office of Minority Health as existing on the date of enactment of the Patient Protection and Affordable Care Act shall be transferred to the Office of the Secretary in such manner that there is established in the Office of the Secretary, the Office of Minority Health, which shall be headed by the Deputy Assistant Secretary for Minority Health who shall report directly to the Secretary, and shall retain and strengthen authorities (as in existence on such date of enactment) for the purpose of improving minority health and the quality of health care minorities receive, and eliminating racial and ethnic disparities. In carrying out this subsection, the Secretary, acting through the Deputy Assistant Secretary, shall award grants, contracts, enter into memoranda of understanding, cooperative, interagency, intra-agency and other agreements with public and nonprofit private entities, agencies, as well as Departmental and Cabinet agencies and organizations, and with organizations that are indigenous human resource providers in communities of color to assure improved health status of racial and ethnic minorities, and shall develop measures to evaluate the effectiveness of activities aimed at reducing health disparities and supporting the local community. Such measures shall evaluate community outreach activities, language services, workforce cultural competence, and other areas as determined by the Secretary.’; and
(B) by striking subsection (h) and inserting the following:
`(h) Authorization of Appropriations- For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2011 through 2016.’.
(2) TRANSFER OF FUNCTIONS- There are transferred to the Office of Minority Health in the office of the Secretary of Health and Human Services, all duties, responsibilities, authorities, accountabilities, functions, staff, funds, award mechanisms, and other entities under the authority of the Office of Minority Health of the Public Health Service as in effect on the date before the date of enactment of this Act, which shall continue in effect according to the terms in effect on the date before such date of enactment, until modified, terminated, superseded, set aside, or revoked in accordance with law by the President, the Secretary, a court of competent jurisdiction, or by operation of law.
(3) REPORTS- Not later than 1 year after the date of enactment of this section, and biennially thereafter, the Secretary of Health and Human Services shall prepare and submit to the appropriate committees of Congress a report describing the activities carried out under section 1707 of the Public Health Service Act (as amended by this subsection) during the period for which the report is being prepared. Not later than 1 year after the date of enactment of this section, and biennially thereafter, the heads of each of the agencies of the Department of Health and Human Services shall submit to the Deputy Assistant Secretary for Minority Health a report summarizing the minority health activities of each of the respective agencies.
(b) Establishment of Individual Offices of Minority Health Within the Department of Health and Human Services-
(1) IN GENERAL- Title XVII of the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting after section 1707 the following section:
`SEC. 1707A. INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN THE DEPARTMENT.
`(a) In General- The head of each agency specified in subsection (b)(1) shall establish within the agency an office to be known as the Office of Minority Health. The head of each such Office shall be appointed by the head of the agency within which the Office is established, and shall report directly to the head of the agency. The head of such agency shall carry out this section (as this section relates to the agency) acting through such Director.
`(b) Specified Agencies- The agencies referred to in subsection (a) are the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Healthcare Research and Quality, the Food and Drug Administration, and the Centers for Medicare & Medicaid Services.
`(c) Director; Appointment- Each Office of Minority Health established in an agency listed in subsection (a) shall be headed by a director, with documented experience and expertise in minority health services research and health disparities elimination.
`(d) References- Except as otherwise specified, any reference in Federal law to an Office of Minority Health (in the Department of Health and Human Services) is deemed to be a reference to the Office of Minority Health in the Office of the Secretary.
`(e) Funding-
`(1) ALLOCATIONS- Of the amounts appropriated for a specified agency for a fiscal year, the Secretary must designate an appropriate amount of funds for the purpose of carrying out activities under this section through the minority health office of the agency. In reserving an amount under the preceding sentence for a minority health office for a fiscal year, the Secretary shall reduce, by substantially the same percentage, the amount that otherwise would be available for each of the programs of the designated agency involved.
`(2) AVAILABILITY OF FUNDS FOR STAFFING- The purposes for which amounts made available under paragraph may be expended by a minority health office include the costs of employing staff for such office.’.
(2) NO NEW REGULATORY AUTHORITY- Nothing in this subsection and the amendments made by this subsection may be construed as establishing regulatory authority or modifying any existing regulatory authority.
(3) LIMITATION ON TERMINATION- Notwithstanding any other provision of law, a Federal office of minority health or Federal appointive position with primary responsibility over minority health issues that is in existence in an office of agency of the Department of Health and Human Services on the date of enactment of this section shall not be terminated, reorganized, or have any of its power or duties transferred unless such termination, reorganization, or transfer is approved by an Act of Congress.
(c) Redesignation of National Center on Minority Health and Health Disparities-
(1) REDESIGNATION- Title IV of the Public Health Service Act (42 U.S.C. 281 et seq.) is amended–
(A) by redesignating subpart 6 of part E as subpart 20;
(B) by transferring subpart 20, as so redesignated, to part C of such title IV;
(C) by inserting subpart 20, as so redesignated, after subpart 19 of such part C; and
(D) in subpart 20, as so redesignated–
(i) by redesignating sections 485E through 485H as sections 464z-3 through 464z-6, respectively;
(ii) by striking `National Center on Minority Health and Health Disparities’ each place such term appears and inserting `National Institute on Minority Health and Health Disparities’; and
(iii) by striking `Center’ each place such term appears and inserting `Institute’.
(2) PURPOSE OF INSTITUTE; DUTIES- Section 464z-3 of the Public Health Service Act, as so redesignated, is amended–
(A) in subsection (h)(1), by striking `research endowments at centers of excellence under section 736.’ and inserting the following: `research endowments–
`(1) at centers of excellence under section 736; and
`(2) at centers of excellence under section 464z-4.’;
(B) in subsection (h)(2)(A), by striking `average’ and inserting `median’; and
(C) by adding at the end the following:
`(h) Interagency Coordination- The Director of the Institute, as the primary Federal officials with responsibility for coordinating all research and activities conducted or supported by the National Institutes of Health on minority health and health disparities, shall plan, coordinate, review and evaluate research and other activities conducted or supported by the Institutes and Centers of the National Institutes of Health.’.
(3) TECHNICAL AND CONFORMING AMENDMENTS-
(A) Section 401(b)(24) of the Public Health Service Act (42 U.S.C. 281(b)(24)) is amended by striking `Center’ and inserting `Institute’.
(B) Subsection (d)(1) of section 903 of the Public Health Service Act (42 U.S.C. 299a-1(d)(1)) is amended by striking `section 485E’ and inserting `section 464z-3′.

H.R.3590
Patient Protection and Affordable Care Act (Enrolled as Agreed to or Passed by Both House and Senate)

`Subpart XI–Community-Based Collaborative Care Network Program
`SEC. 340H. COMMUNITY-BASED COLLABORATIVE CARE NETWORK PROGRAM.
`(a) In General- The Secretary may award grants to eligible entities to support community-based collaborative care networks that meet the requirements of subsection (b).
`(b) Community-based Collaborative Care Networks-
`(1) DESCRIPTION- A community-based collaborative care network (referred to in this section as a `network’) shall be a consortium of health care providers with a joint governance structure (including providers within a single entity) that provides comprehensive coordinated and integrated health care services (as defined by the Secretary) for low-income populations.
`(2) REQUIRED INCLUSION- A network shall include the following providers (unless such provider does not exist within the community, declines or refuses to participate, or places unreasonable conditions on their participation):
`(A) A hospital that meets the criteria in section 1923(b)(1) of the Social Security Act; and
`(B) All Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act located in the community.
`(3) PRIORITY- In awarding grants, the Secretary shall give priority to networks that include–
`(A) the capability to provide the broadest range of services to low-income individuals;
`(B) the broadest range of providers that currently serve a high volume of low-income individuals; and
`(C) a county or municipal department of health.
`(c) Application-
`(1) APPLICATION- A network described in subsection (b) shall submit an application to the Secretary.
`(2) RENEWAL- In subsequent years, based on the performance of grantees, the Secretary may provide renewal grants to prior year grant recipients.
`(d) Use of Funds-

`(1) USE BY GRANTEES- Grant funds may be used for the following activities:
`(A) Assist low-income individuals to–
`(i) access and appropriately use health services;
`(ii) enroll in health coverage programs; and
`(iii) obtain a regular primary care provider or a medical home.
`(B) Provide case management and care management.
`(C) Perform health outreach using neighborhood health workers or through other means.
`(D) Provide transportation.
`(E) Expand capacity, including through telehealth, after-hours services or urgent care.
`(F) Provide direct patient care services.
`(2) GRANT FUNDS TO HRSA GRANTEES- The Secretary may limit the percent of grant funding that may be spent on direct care services provided by grantees of programs administered by the Health Resources and Services Administration or impose other requirements on such grantees deemed necessary.
`(e) Authorization of Appropriations- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2011 through 2015.’.
SEC. 10334. MINORITY HEALTH.
(a) Office of Minority Health-
(1) IN GENERAL- Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is amended–
(A) in subsection (a), by striking `within the Office of Public Health and Science’ and all that follows through the end and inserting `. The Office of Minority Health as existing on the date of enactment of the Patient Protection and Affordable Care Act shall be transferred to the Office of the Secretary in such manner that there is established in the Office of the Secretary, the Office of Minority Health, which shall be headed by the Deputy Assistant Secretary for Minority Health who shall report directly to the Secretary, and shall retain and strengthen authorities (as in existence on such date of enactment) for the purpose of improving minority health and the quality of health care minorities receive, and eliminating racial and ethnic disparities. In carrying out this subsection, the Secretary, acting through the Deputy Assistant Secretary, shall award grants, contracts, enter into memoranda of understanding, cooperative, interagency, intra-agency and other agreements with public and nonprofit private entities, agencies, as well as Departmental and Cabinet agencies and organizations, and with organizations that are indigenous human resource providers in communities of color to assure improved health status of racial and ethnic minorities, and shall develop measures to evaluate the effectiveness of activities aimed at reducing health disparities and supporting the local community. Such measures shall evaluate community outreach activities, language services, workforce cultural competence, and other areas as determined by the Secretary.’; and
(B) by striking subsection (h) and inserting the following:
`(h) Authorization of Appropriations- For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2011 through 2016.’.
(2) TRANSFER OF FUNCTIONS- There are transferred to the Office of Minority Health in the office of the Secretary of Health and Human Services, all duties, responsibilities, authorities, accountabilities, functions, staff, funds, award mechanisms, and other entities under the authority of the Office of Minority Health of the Public Health Service as in effect on the date before the date of enactment of this Act, which shall continue in effect according to the terms in effect on the date before such date of enactment, until modified, terminated, superseded, set aside, or revoked in accordance with law by the President, the Secretary, a court of competent jurisdiction, or by operation of law.
(3) REPORTS- Not later than 1 year after the date of enactment of this section, and biennially thereafter, the Secretary of Health and Human Services shall prepare and submit to the appropriate committees of Congress a report describing the activities carried out under section 1707 of the Public Health Service Act (as amended by this subsection) during the period for which the report is being prepared. Not later than 1 year after the date of enactment of this section, and biennially thereafter, the heads of each of the agencies of the Department of Health and Human Services shall submit to the Deputy Assistant Secretary for Minority Health a report summarizing the minority health activities of each of the respective agencies.
(b) Establishment of Individual Offices of Minority Health Within the Department of Health and Human Services-
(1) IN GENERAL- Title XVII of the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting after section 1707 the following section:

SEC. 2602. PROVIDING FEDERAL COVERAGE AND PAYMENT COORDINATION FOR DUAL ELIGIBLE BENEFICIARIES.
(a) Establishment of Federal Coordinated Health Care Office-
(1) IN GENERAL- Not later than March 1, 2010, the Secretary of Health and Human Services (in this section referred to as the `Secretary’) shall establish a Federal Coordinated Health Care Office.
(2) ESTABLISHMENT AND REPORTING TO CMS ADMINISTRATOR- The Federal Coordinated Health Care Office–
(A) shall be established within the Centers for Medicare & Medicaid Services; and
(B) have as the Office a Director who shall be appointed by, and be in direct line of authority to, the Administrator of the Centers for Medicare & Medicaid Services.
(b) Purpose- The purpose of the Federal Coordinated Health Care Office is to bring together officers and employees of the Medicare and Medicaid programs at the Centers for Medicare & Medicaid Services in order to–
(1) more effectively integrate benefits under the Medicare program under title XVIII of the Social Security Act and the Medicaid program under title XIX of such Act; and
(2) improve the coordination between the Federal Government and States for individuals eligible for benefits under both such programs in order to ensure that such individuals get full access to the items and services to which they are entitled under titles XVIII and XIX of the Social Security Act.
(c) Goals- The goals of the Federal Coordinated Health Care Office are as follows:
(1) Providing dual eligible individuals full access to the benefits to which such individuals are entitled under the Medicare and Medicaid programs.
(2) Simplifying the processes for dual eligible individuals to access the items and services they are entitled to under the Medicare and Medicaid programs.
(3) Improving the quality of health care and long-term services for dual eligible individuals.
(4) Increasing dual eligible individuals’ understanding of and satisfaction with coverage under the Medicare and Medicaid programs.
(5) Eliminating regulatory conflicts between rules under the Medicare and Medicaid programs.
(6) Improving care continuity and ensuring safe and effective care transitions for dual eligible individuals.
(7) Eliminating cost-shifting between the Medicare and Medicaid program and among related health care providers.
(8) Improving the quality of performance of providers of services and suppliers under the Medicare and Medicaid programs.
(d) Specific Responsibilities- The specific responsibilities of the Federal Coordinated Health Care Office are as follows:
(1) Providing States, specialized MA plans for special needs individuals (as defined in section 1859(b)(6) of the Social Security Act (42 U.S.C. 1395w-28(b)(6))), physicians and other relevant entities or individuals with the education and tools necessary for developing programs that align benefits under the Medicare and Medicaid programs for dual eligible individuals.
(2) Supporting State efforts to coordinate and align acute care and long-term care services for dual eligible individuals with other items and services furnished under the Medicare program.
(3) Providing support for coordination of contracting and oversight by States and the Centers for Medicare & Medicaid Services with respect to the integration of the Medicare and Medicaid programs in a manner that is supportive of the goals described in paragraph (3).
(4) To consult and coordinate with the Medicare Payment Advisory Commission established under section 1805 of the Social Security Act (42 U.S.C. 1395b-6) and the Medicaid and CHIP Payment and Access Commission established under section 1900 of such Act (42 U.S.C. 1396) with respect to policies relating to the enrollment in, and provision of, benefits to dual eligible individuals under the Medicare program under title XVIII of the Social Security Act and the Medicaid program under title XIX of such Act.
(5) To study the provision of drug coverage for new full-benefit dual eligible individuals (as defined in section 1935(c)(6) of the Social Security Act (42 U.S.C. 1396u-5(c)(6)), as well as to monitor and report annual total expenditures, health outcomes, and access to benefits for all dual eligible individuals.
(e) Report- The Secretary shall, as part of the budget transmitted under section 1105(a) of title 31, United States Code, submit to Congress an annual report containing recommendations for legislation that would improve care coordination and benefits for dual eligible individuals.
(f) Dual Eligible Defined- In this section, the term `dual eligible individual’ means an individual who is entitled to, or enrolled for, benefits under part A of title XVIII of the Social Security Act, or enrolled for benefits under part B of title XVIII of such Act, and is eligible for medical assistance under a State plan under title XIX of such Act or under a waiver of such plan.