Makes certain unexpended funds appropriated for FY's 1997 and 1998 under the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Acts of 1997 and 1998, which were made available for loan guarantees for loans made by non-Federal lenders for building costs associated with medical facilities owned and operated by health centers, available for loan guarantees under this Act.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1386 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 1386
To amend part D of title III of the Public Health Service Act to
authorize grants and loan guarantees for health centers to enable the
centers to fund capital needs projects, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 20, 2003
Mr. Bonilla introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend part D of title III of the Public Health Service Act to
authorize grants and loan guarantees for health centers to enable the
centers to fund capital needs projects, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Building Better Health Centers Act
of 2003''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Many health care experts believe that lack of access to
basic health services is our Nation's single most pressing
health care problem. Nearly 50,000,000 Americans do not have
access to a primary care provider, whether they are insured or
not. In addition, 43,000,000 Americans lack health insurance
and have difficulty accessing care due to the inability to pay
for such care.
(2) Health centers, including community health centers,
migrant health centers, health centers for the homeless, and
public housing health centers, address the health care access
problem by providing primary care services in thousands of
rural and urban medically-underserved communities throughout
the United States.
(3) Health centers provide basic health care services to
nearly 14,000,000 Americans each year, including nearly
9,000,000 minorities, 850,000 farmworkers, and 750,000 homeless
individuals.
(4) Studies show that health centers provide high-quality
and cost-effective health care. The average yearly cost for a
health center patient is approximately $1.25 per day.
(5) One of the most effective ways to address America's
health care access problem is by dramatically expanding access
to health centers, as both the Senate and the President have
proposed.
(6) Many existing health centers operate in facilities that
desperately need renovation or modernization. Thirty percent of
health centers are located in buildings that are more than 30
years old, with 12 percent of such centers operating out of
facilities that are more than 50 years old. In a recent survey
of health centers in 11 States, 2/3 of those centers identified
a need to improve, expand, or replace their current facility.
An extrapolation based on this survey indicates there may be as
much as $1,200,000,000 in unmet capital needs in our Nation's
health centers.
(7) Dramatically increasing access to health centers
requires building new facilities in communities that have
access problems and lack a health center.
(8) Health centers often do not have the means to pay for
capital improvements or new facilities. While most health
centers raise some funds through private donations, it is
difficult to raise sufficient amounts for capital needs without
a middle- and upper-class donor base similar to other nonprofit
organizations like universities and hospitals.
(9) Health centers have a limited ability to support loan
payments. Due to an increasing number of uninsured patients and
the fact that many health care reimbursements are less than the
cost of care, health centers rarely have more than minimal
positive operating margins. Yet lenders are rarely willing to
take risks on nonprofit organizations without these positive
margins.
(10) While the Federal Government currently provides grants
to health centers to assist with operational expenses used to
provide care to a medically-underserved population, there is no
authority to provide grants to assist health centers to meet
capital needs, such as construction of new facilities or
modernization, expansion, or replacement of existing buildings.
(11) To assist health centers with their mission of
providing health care to the medically underserved, the Federal
Government should supplement local efforts to meet the capital
needs of health centers.
SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
(a) Health Care Facility Grants and Loan Guarantees.--Subpart I of
part D of title III of the Public Health Service Act (42 U.S.C. 254b et
seq.) is amended by adding at the end the following:
``SEC. 330L. HEALTH CARE FACILITY GRANTS AND LOAN GUARANTEES.
``(a) Eligible Health Center Defined.--In this section, the term
`eligible health center' means a health center that receives--
``(1) a grant, on or after the date of enactment of this
section, under subsection (c)(1)(A), (e)(1)(A), (f), (g), (h),
or (i) of section 330; or
``(2) a subgrant, on or after the date of enactment of this
section, from a grant awarded under such provision of law.
``(b) Grant Program Authorized.--
``(1) In general.--The Secretary may award grants to
eligible health centers to pay for the costs described in
paragraph (2).
``(2) Use of funds.--An eligible health center that
receives a grant under paragraph (1) may use the grant funds
to--
``(A) modernize, expand, and replace existing
facilities at such center;
``(B) construct new facilities at such center; and
``(C) acquire and lease facilities and equipment
(including paying the costs of amortizing the principal
of, and paying the interest on, loans for such
facilities and equipment) to support or further the
operation of such center.
``(3) Limitation.--
``(A) In general.--Subject to subparagraph (B), the
Federal share of a grant awarded under paragraph (1) to
expand an existing, or construct a new, facility shall
not exceed 90 percent of the total cost of the project
(including interest payments) proposed by the eligible
health center.
``(B) Exception.--The Federal share maximum under
subparagraph (A) shall not apply if--
``(i) the total cost of the project
proposed by the eligible health center is less
than $750,000; or
``(ii) the Secretary waives such maximum
upon a showing of good cause.
``(b) Facility Loan Guarantees.--
``(1) In general.--
``(A) In general.--The Secretary shall establish a
program under which the Secretary may guarantee not
less than 90 percent of the principal and interest on
the total amount of loans made to an eligible health
center by non-Federal lenders in order to pay for the
costs associated with a capital needs project described
in subparagraph (B).
``(B) Projects.--Capital needs projects under this
subsection include--
``(i)(I) acquiring, leasing, modernizing,
expanding, or replacing existing facilities;
``(II) constructing new facilities; or
``(III) purchasing or leasing equipment; or
``(ii) the costs of refinancing loans made
for any of the projects described in clause
(i).
``(C) Not a federal subsidy.--Any loan guarantee
issued pursuant to this subsection shall not be deemed
a Federal subsidy for any other purpose.
``(2) Authority for loan guarantee program.--With respect
to the program established under paragraph (1), the Secretary
shall assume such authority--
``(A) as the Secretary has under paragraphs (2) and
(4) of section 330; and
``(B) under section 1620 as the Secretary
determines is necessary and appropriate.
``(3) Definitions.--In this subsection:
``(A) Facilities.--The term `facilities' means a
building or buildings used by a health center, in whole
or in part, to provide services permitted under section
330 and for such other purposes as are not specifically
prohibited under such section as long as such use
furthers the objectives of the health center.
``(B) Non-federal lender.--The term `non-Federal
lender' means any entity other than an agency or
instrumentality of the Federal Government authorized by
law to make loans, including a federally-insured bank,
a lending institution authorized or licensed to make
loans by the State in which it is located, and a State
or municipal bonding authority or such authority's
designee.
``(c) Evaluation.--Not later than 3 years after the date of
enactment of this section, the Secretary shall prepare a report
containing an evaluation of the programs authorized under this section.
Such report shall include recommendations on how this section can be
improved to better help health centers meet such centers' capital needs
in order to expand access to health care in the United States.
``(d) Authorization.--For the purpose of carrying out this section,
the Secretary shall use no more than 5 percent of any funds
appropriated pursuant to section 330(s) (the subsection relating to
authorization of appropriations). In addition, funds appropriated for
fiscal years 1997 and 1998 under the Departments of Labor, Health and
Human Services, and Education, and Related Agencies Appropriations Acts
of 1997 and 1998, which were made available for loan guarantees for
loans made by non-Federal lenders for construction, renovation, and
modernization of medical facilities that are owned and operated by
health centers and which have not been expended, shall be made
available for loan guarantees under this section.''.
(b) Authorization of Appropriations.--Section 330(s) of the Public
Health Service Act (the subsection relating to authorization of
appropriations) is amended by striking ``this section'' and inserting
``this section and section 330L''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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