Minority Community Public Health Emergency Response Act of 2020
This bill establishes a grant program for COVID-19 (i.e., coronavirus disease 2019) preparedness and response in medically underserved communities where the disease disproportionally affects racial and ethnic minority groups. It also modifies the scope and administration of demonstration models carried out by the Center for Medicare and Medicaid Innovation (CMMI) to address health inequity.
With respect to the grant program, the Department of Health and Human Services (HHS) must award grants to government entities, giving priority to local governments and county health departments, for contact tracing, other public health activities, and the provision of nutrition assistance and quarantine housing. HHS may also support planning activities for entities that intend to apply for these grants.
As a condition for receiving funding, grantees must establish, or designate an existing body as, a COVID-19/infectious disease planning council. The council must reflect the demographics of the populations most impacted by COVID-19, and its responsibilities shall include developing a plan for the delivery of health care and support services to address COVID-19 and establishing priorities for allocating funding.
In addition, the CMMI must test a payment model that addresses social determinants of health and health disparities, particularly with respect to minorities, underserved areas, and high-risk individuals. The bill also generally incorporates consideration of such factors into the selection, implementation, and evaluation of other models, including the decision as to whether to expand a model's duration and scope.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7546 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 7546
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-19 pandemic, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 9, 2020
Mr. Lewis introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, 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-19 pandemic, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Minority Community
Public Health Emergency Response Act of 2020''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--RAPID RESPONSE GRANT PROGRAM
Sec. 101. Rapid response grant program.
TITLE II--EQUALITY IN MEDICARE AND MEDICAID TREATMENT
Sec. 201. Improving access to care for Medicare and Medicaid
beneficiaries.
TITLE I--RAPID RESPONSE GRANT PROGRAM
SEC. 101. RAPID RESPONSE GRANT PROGRAM.
Title XXVIII of the Public Health Service Act (42 U.S.C. 300hh et
seq.) is amended by adding at the end the following new subtitle:
``Subtitle D--Rapid Response
``SEC. 2831. RAPID RESPONSE GRANT PROGRAM.
``(a) Establishment of Program.--The Secretary of Health and Human
Services shall award grants to eligible entities described in
subsection (b) for COVID-19 preparedness and response efforts.
``(b) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall be a qualified government entity seeking
a grant for a qualified community within its jurisdiction that--
``(1) is, or contains, a medically underserved community;
and
``(2) has a percentage of COVID-19 cases, hospitalizations,
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 located.
``(c) Application.--To be eligible for a grant under this section,
an eligible entity shall submit to the Secretary an application at such
time, in such form, and containing such information as the Secretary
determines appropriate, including--
``(1) documentation that the entity is an eligible entity;
``(2) a plan for carrying out the activities described in
subsection (f) with amounts received under this section;
``(3) an oversight plan for tracking and security of
resources and supplies; and
``(4) a schedule for resource expenditure and response
readiness.
``(d) Certification.--Prior to awarding a grant under this section,
the Secretary shall obtain a certification from the Deputy Assistant
Secretary for Minority Health, the Deputy Assistant Secretary for
Women's Health, 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 grant.
``(e) Priority.--In making grants under this section, the Secretary
shall give priority to eligible entities that are local governments and
county health departments.
``(f) Grant Uses.--A recipient of a grant under this section may
use grant funds with respect to COVID-19 preparedness and rapid
response efforts for any of the following:
``(1) Purchasing medical supplies.
``(2) Providing nutrition assistance.
``(3) Warehousing stockpiled supplies, including rent and
security costs.
``(4) Constructing and operating testing sites.
``(5) Providing quarantine housing.
``(6) Providing public education related to the pandemic,
including misinformation response.
``(7) Contact tracing.
``(8) Providing vaccinations.
``(9) Distributing, dispensing, and administering antiviral
medications.
``(10) Providing community mitigation.
``(11) Performing laboratory epidemiology.
``(12) Performing surveillance.
``(g) Reporting.--
``(1) Grant recipients.--Not later than 1 month after the
date of enactment of this subtitle, 6 months after such date of
enactment, and 1 year after such date of enactment, and
annually thereafter, the recipient of a grant under this
section shall report to the Secretary on the program funded
through the grant, with respect to--
``(A) program oversight as described in subsection
(c)(3);
``(B) delays in funding expenditures; and
``(C) resource distribution.
``(2) Secretary.--Not later than 6 months after the date of
enactment of this subtitle and 1 year after such date of
enactment, and annually thereafter, the Secretary shall report
to the Congress on the programs funded by grants under this
section, with respect to--
``(A) program oversight as described in subsection
(c)(3); and
``(B) unmet needs in grant recipient pandemic
response infrastructure.
``SEC. 2832. PLANNING GRANT PROGRAM.
``(a) In General.--The Secretary may award a planning grant to any
entity that certifies that--
``(1) it is an eligible entity under section 2831(b); and
``(2) it intends to submit to the Secretary an application
for a grant under section 2831.
``(b) Use of Funds.--Any grant awarded under this section, for
purposes of developing an application for a grant under section 2831,
shall be used to--
``(1) identify community needs to rapidly and effectively
respond to the COVID-19 pandemic;
``(2) estimate the cost of such a response and maintaining
a state of readiness; and
``(3) hire staff to carry out paragraphs (1) and (2).
``(c) Timing.--Not later than 30 days after receipt of an
application for an award under this section, the Secretary shall
determine whether to award the grant.
``(d) Funding Condition.--As a condition on receipt of a planning
grant under this section, an applicant shall agree to submit to the
Secretary an application for a grant under section 2831 no later than
90 days after receiving the planning grant.
``SEC. 2833. COMMUNITY INFECTIOUS DISEASE HEALTH SERVICES PLANNING
COUNCIL.
``(a) Establishment.--To be eligible for assistance under this
subtitle, the chief elected official of the qualified government entity
applying for such assistance shall establish or designate a COVID-19/
infectious disease health services planning council (in this section
referred to as a `COVID-19/infectious disease health services planning
council') that shall reflect in its composition the demographics of the
populations of individuals with COVID-19 and other infectious diseases
in the qualified community involved, with particular consideration
given to disproportionately affected and historically underserved
groups and subpopulations.
``(b) Selection Criteria.--Nominations for membership on a COVID-
19/infectious disease health services planning council shall be
identified through an open process and candidates shall be selected
based on locally delineated and publicized criteria. Such criteria
shall include a conflict-of-interest standard that is in accordance
with subsection (f).
``(c) Representation.--A COVID-19/infectious disease health
services planning council--
``(1) shall include representatives of--
``(A) health care providers, including federally
qualified health centers;
``(B) community-based organizations serving
affected populations and AIDS service organizations;
``(C) social service providers, including providers
of housing and homeless services;
``(D) mental health and substance abuse providers;
``(E) local public health agencies;
``(F) hospital planning agencies or health care
planning agencies;
``(G) affected communities, including--
``(i) individuals with COVID-19 or another
infectious disease designated by the council as
having a disproportionate effect on a racial
and ethnic minority group;
``(ii) members of a federally recognized
Indian Tribe as represented in the affected
communities; and
``(iii) historically underserved groups and
subpopulations;
``(H) nonelected community leaders;
``(I) State government (including the State
Medicaid agency);
``(J) grantees under this subtitle, or, if none are
operating in the area, representatives of organizations
with a history of serving children, youth, women, and
families living with COVID-19 or other infectious
diseases and operating in the area;
``(K) grantees who receive funding from other
Federal COVID-19 or other infectious disease programs;
and
``(L) representatives of individuals who formerly
were Federal, State, or local prisoners, were released
from the custody of the penal system during the
preceding 3 years, and had COVID-19 or another
infectious disease as of the date on which the
individuals were so released; and
``(2) to the extent possible, shall include individuals who
have had COVID-19.
``(d) Method of Providing for Council.--
``(1) In general.--In providing for a council for purposes
of subsection (a), 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 council, subject to paragraph (2).
``(2) Consideration regarding designation of council.--In
making a determination of whether to establish or designate a
council under paragraph (1), 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-19 and other infectious diseases health care service
needs within the qualified community and in the implementation
of such plans in addressing those needs. 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 served.
``(e) Duties.--A COVID-19/infectious disease health services
planning council shall--
``(1) determine the size and demographics of the population
of individuals who have or had COVID-19 or other infectious
disease, as well as the size and demographics of the estimated
population of individuals with COVID-19 or other infectious
disease who are unaware of their COVID-19 or other infectious
disease status;
``(2) determine the needs of such population, with
particular attention to--
``(A) individuals who have or had COVID-19 or other
infectious disease and are not receiving health care
with respect to COVID-19 or such disease;
``(B) disparities in access and services among
affected subpopulations and historically underserved
communities; and
``(C) individuals who are unaware that such
individual has or had COVID-19 or other infectious
disease;
``(3) establish priorities for the allocation of funds
within the qualified community, 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--
``(A) size and demographics of the population of
individuals who have or had COVID-19 (as determined
under paragraph (1)) or other infectious disease and
the needs of such population (as determined under
paragraph (2));
``(B) demonstrated (or probable) cost effectiveness
and outcome effectiveness of proposed strategies and
interventions, to the extent that data are reasonably
available;
``(C) priorities of the communities of individuals
who have or had COVID-19 or other infectious disease
for whom the services are intended;
``(D) availability of other governmental and
nongovernmental resources, 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-19 or
other infectious disease; and
``(E) capacity development needs resulting from
disparities in the availability of COVID-19 or other
infectious disease-related services in historically
underserved communities;
``(4) develop a comprehensive plan for the organization and
delivery of health and support services described in section
2831 that--
``(A) includes a strategy for identifying
individuals who have or had COVID-19 or other
infectious disease and for informing the individuals of
and enabling the individuals to utilize the services,
giving particular attention to eliminating disparities
in access and services among affected subpopulations
and historically underserved communities, and including
discrete goals, a timetable, and an appropriate
allocation of funds;
``(B) includes a strategy to coordinate the
provision of such services with programs to prevent the
spread of COVID-19 or other infectious disease;
``(C) is compatible with any State or local plan
for the provision of services to individuals who have
COVID-19 or other infectious disease; and
``(D) includes a strategy, coordinated as
appropriate with other community strategies and
efforts, including discrete goals, a timetable, and
appropriate funding, for identifying individuals who
have COVID-19 or other infectious disease or who are
unaware that such individuals have COVID-19 or other
infectious disease, making such individuals aware of
such status, and enabling such individuals to use the
health and support services described in section 2831,
with particular attention to reducing barriers to
routine testing and disparities in access and services
among affected subpopulations and historically
underserved communities;
``(5) assess the efficiency of the administrative mechanism
in rapidly allocating funds to the areas of greatest need
within the qualified community, and at the discretion of a
COVID-19/infectious disease health services planning council,
assess the effectiveness, either directly or through
contractual arrangements, of the services offered in meeting
the identified needs;
``(6) establish methods for obtaining input on community
needs and priorities which may include public meetings (in
accordance with subsection (h)), conducting focus groups, and
convening ad-hoc panels; and
``(7) coordinate with Federal grantees that provide COVID-
19 or other infectious disease-related services in the
qualified community.
``(f) Conflicts of Interest.--
``(1) In general.--A COVID-19/infectious disease health
services planning council may not be directly involved in the
administration of a grant under this subtitle. With respect to
compliance with the preceding sentence, a COVID-19/infectious
disease health services planning council may not designate (or
otherwise be involved in the selection of) particular entities
as recipients of any of the amounts provided in the grant.
``(2) Required agreements.--An individual may serve on a
COVID-19/infectious disease health services planning council
only if the individual agrees that if the individual has a
financial interest in an entity, if the individual is an
employee of a public or private entity, or if the individual is
a member of a public or private organization, and such entity
or organization is seeking amounts from a grant under this
subtitle, the individual will not, with respect to the purpose
for which the entity seeks such amounts, participate (directly
or in an advisory capacity) in the process of selecting
entities to receive such amounts for such purpose.
``(3) Composition of council.--The following applies
regarding the membership of a COVID-19/infectious disease
health services planning council:
``(A) Not less than 33 percent of the council shall
be individuals who--
``(i) are not officers, employees, or
consultants to any entity that receives amounts
from such a grant, and do not represent any
such entity; and
``(ii) reflect the demographics of the
population of individuals who have COVID-19 or
other infectious diseases as determined under
subsection (e)(1).
``(B) With respect to membership on a COVID-19/
infectious disease health services planning council,
subparagraph (A) may not be construed as having any
effect on entities that receive any Federal funds with
respect to COVID-19 or other infectious disease but do
not receive funds from grants under section 2831, on
officers or employees of such entities, or on
individuals who represent such entities.
``(g) Grievance Procedures.--A COVID-19/infectious disease health
services planning council shall develop procedures for addressing
grievances with respect to funding under this subtitle, including
procedures for submitting grievances that cannot be resolved to binding
arbitration. Such procedures shall be described in the by-laws of a
COVID-19/infectious disease health services planning council and be
consistent with the requirements of subsection (c).
``(h) Public Deliberations.--With respect to a planning council
under subsection (a), the following applies:
``(1) The council may not be chaired solely by an employee
of the grantee under this subtitle.
``(2) In accordance with criteria established by the
Secretary:
``(A) The meetings of the council shall be open to
the public and shall be held only after adequate notice
to the public.
``(B) The records, reports, transcripts, minutes,
agenda, 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 location.
``(C) Detailed minutes of each meeting of the
council shall be kept. The accuracy of all minutes
shall be certified to by the chair of the council.
``(D) This paragraph does not apply to any
disclosure of information of a personal nature that
would constitute a clearly unwarranted invasion of
personal privacy, including any disclosure of medical
information or personnel matters.
``SEC. 2834. DEFINITIONS.
``In this subtitle:
``(1) Medically underserved community.--The term `medically
underserved community' has the meaning given the term in
section 799B(6).
``(2) Qualified community.--The term `qualified community'
means either of the following:
``(A) A political subdivision of a State.
``(B) A group of political subdivisions of one or
more States.
``(3) Qualified government entity.--The term `qualified
government entity' means any of the following:
``(A) A State.
``(B) A political subdivision of a State.
``(C) A group of political subdivisions of one or
more States.
``(D) A county health department.
``(4) Racial and ethnic minority group.--The term `racial
and ethnic minority group' has the meaning given the term in
section 1707(g).
``(5) Secretary.--The term `Secretary' means the Secretary
of Health and Human Services.
``(6) State.--The term `State' means each of the several
States, the District of Columbia, and the territories and
possessions of the United States.
``SEC. 2835. AUTHORIZATION OF APPROPRIATION.
``There is authorized to be appropriated to carry out this subtitle
$1,000,000,000, to remain available until expended.''.
TITLE II--EQUALITY IN MEDICARE AND MEDICAID TREATMENT
SEC. 201. IMPROVING ACCESS TO CARE FOR MEDICARE AND MEDICAID
BENEFICIARIES.
Section 1115A of the Social Security Act (42 U.S.C. 1315a) is
amended--
(1) in subsection (a)(3)--
(A) by inserting after ``relevant Federal
agencies,'' the following: ``including the Office of
Minority Health of the Centers for Medicare & Medicaid
Services, the Office of Rural Health Policy of the
Health Resources and Services Administration, and the
Office on Women's Health in the Office of the
Secretary,''; and
(B) by inserting after ``medicine'' the following:
``, the causes of health disparities and social
determinants of health,'';
(2) in subsection (b)--
(A) in paragraph (2)--
(i) in subparagraph (A)--
(I) by inserting after the first
sentence, the following new sentence:
``Prior to model selection, the
Secretary shall consult with the Office
of Minority Health of the Centers for
Medicare & Medicaid Services, the
Federal Office of Rural Health Policy,
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 model.'';
(II) by inserting ``, as well as
improving access to care received by
individuals receiving benefits under
such title,'' after ``title''; and
(III) by adding at the end the
following new sentence: ``The models
selected under this subparagraph shall
include the social determinants of
health payment model described in
subparagraph (D), the testing of which
shall begin not later than December 31,
2020.'';
(ii) in subparagraph (C), by adding at the
end the following new clauses:
``(ix) Whether the model will affect access
to care from providers and suppliers caring for
high-risk patients or operating in underserved
areas.
``(x) Whether the model has the potential
to produce reductions in minority and rural
health disparities.''; and
(iii) by adding at the end the following
new subparagraph:
``(D) Social determinants of health payment
model.--
``(i) 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 (ii) in a region determined
appropriate by the Secretary.
``(ii) Payment and service delivery
innovations described.--For purposes of clause
(i), the payment and service delivery
innovations described in this clause are the
following:
``(I) Payment and service delivery
innovations for behavioral health
services, focusing on gathering
actionable data to address the higher
costs associated with beneficiaries
with diagnosed behavioral conditions.
``(II) 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 areas.
``(III) Payment and service
delivery innovations targeted on
Medicaid-eligible pregnant and
postpartum women, up to one year after
delivery.
``(IV) Payment and service delivery
innovations targeted on communities
where a percentage of COVID-19 cases,
hospitalizations, 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 located.''; and
(B) in paragraph (4)(A)--
(i) in clause (i) at the end, by striking
``and'';
(ii) in clause (ii), at the end, by
striking the period and inserting ``; and'';
and
(iii) by adding at the end the following
new clause:
``(iii) the extent to which the model
improves access to care or the extent to which
the model improves care for high-risk patients,
patients from racial or ethnic minorities, or
patients in underserved areas.'';
(3) in subsection (c)--
(A) in paragraph (2), by striking at the end
``and'';
(B) by redesignating paragraph (3) as paragraph
(4);
(C) by inserting after paragraph (2) the following
new paragraph:
``(3) the Office of Minority Health of the Centers for
Medicare & Medicaid Services certifies that such expansion will
not reduce access to care for low-income, minority, or rural
beneficiaries; and'';
(D) in paragraph (4), as redesignated by
subparagraph (B), by inserting before the period at the
end the following: ``nor increase health disparities
experienced by low-income, minority, or rural
beneficiaries''; and
(E) in the matter following paragraph (4), as
redesignated by subparagraph (B), by inserting ``,
improve access to care,'' after ``care''; and
(4) in subsection (g)--
(A) by inserting ``(or, beginning with 2021, once
every year thereafter)'' after ``thereafter''; and
(B) by adding at the end the following new
sentence: ``For reports for 2021 and each subsequent
year, each such report shall include information on the
following:
``(1) The extent and severity of minority and rural health
disparities in Medicare and Medicaid beneficiaries.
``(2) The interventions that address social determinants of
health in payment models selected by the Center for Medicare
and Medicaid Innovation for testing.
``(3) The interventions that address social determinants of
health in payment models not selected by the Center for
Medicare and Medicaid Innovation for testing.
``(4) 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 testing.
``(5) 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 model.
``(6) In consultation with the Comptroller General of the
United States, estimated Federal savings achieved through the
reduction of rural and minority health disparities.
``(7) Other areas determined appropriate by the
Secretary.''.
<all>
Introduced in House
Introduced in House
Referred to the Subcommittee on Health.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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