1Establishing the Community-Based Health Care Program in the
2Department of Health; and providing for hospital health
3clinics, <-for mobile prenatal and natal care demonstration 
4project and for limitations.

5TABLE OF CONTENTS

6Chapter 1. Health Care Assistance

7Subchapter A. Preliminary Provisions

8Section 101. Short title.

9Section 102. Definitions.

10Subchapter B. Community-Based Health Care

11Section 111. Community-Based Health Care Program.

12Section 112. Powers and duties of department.

13Section 113. Hospital health clinics.

<-14Subchapter C. Mobile Prenatal and Natal Care Demonstration

15Project

16Section 121. Establishment.

1Section 122. Applications for planning grants.

2Section 123. Review and approval of grant applications.

3Section 124. Report.

4Chapter 51. Miscellaneous Provisions

5Section 5101. Limitation.

6Section 5102. Effective date.

7The General Assembly of the Commonwealth of Pennsylvania
8hereby enacts as follows:

9CHAPTER 1

10HEALTH CARE ASSISTANCE

11SUBCHAPTER A

12PRELIMINARY PROVISIONS

13Section 101. Short title.

14This act shall be known and may be cited as the Community-
15Based Health Care Act.

16Section 102. Definitions.

17The following words and phrases when used in this chapter
18shall have the meanings given to them in this section unless the
19context clearly indicates otherwise:

<-20"Advanced practice registered nurse." A registered nurse who
21has been certified in this Commonwealth to practice as:

22(1) a certified clinical nurse specialist;

23(2) a certified registered nurse anesthetist;

24(3) a certified registered nurse practitioner; or

25(4) a certified nurse midwife.

26"Chronic care and disease management." A model of care that 
27includes the following:

28(1) The provision of effective health management through
29support and information that also promotes patient self-care
30for patients with chronic conditions.

1(2) The use of evidence-based medicine to ensure
2appropriate treatment decisions by health care providers.

3(3) The coordination of care and use of reasonably
4accessible and updated patient information that encourages
5follow-up care as a standard procedure.

6(4) The tracking of clinical information for individual
7and general patient populations to guide treatment and
8effectively anticipate community health care problems.

9"Community-based health care clinic." A nonprofit health 
10care center located in this Commonwealth that provides 
11comprehensive health care services without regard for a 
12patient's ability to pay and that:

13(1) meets either of the following criteria:

14(i) serves a federally designated medically
15underserved area, a medically underserved population or a
16health professional shortage area; or

17(ii) serves a patient population with a majority of
18that population having an income less than 200% of the
19Federal poverty income guidelines; and

20(2) includes any of the following:

21(i) A federally qualified health center as defined
22in section 1905(l)(2)(B) of the Social Security Act (49 
23Stat. 620, 42 U.S.C. § 1396d(l)(2)(B)) or a federally
24qualified health center look-alike and is a participating
25provider with:

26(A) the Department of Public Welfare under the
27act of June 13, 1967 (P.L.31, No.21), known as the 
28Public Welfare Code; or

29(B) the Children's Health Insurance Program
30under:

1(I) Title XXI of the Social Security Act (49
2Stat. 620, 42 U.S.C. § 1397aa et seq.); and

3(II) Article XXIII of the act of May 17, 
41921 (P.L.682, No.284), known as The Insurance 
5Company Law of 1921, and the regulations
6promulgated thereunder.

7(ii) A rural health clinic as defined in section
81861(aa)(2) of the Social Security Act (49 Stat. 620, 42 
9U.S.C. § 1395x(aa)(2)), certified by Medicare and is a 
10participating provider with:

11(A) the Department of Public Welfare under the
12Public Welfare Code; or

13(B) the Children's Health Insurance Program
14under:

15(I) Title XXI of the Social Security Act;
16and

17(II) Article XXIII of The Insurance Company 
18Law of 1921 and the regulations promulgated
19thereunder.

20(iii) A hospital health clinic and is a 
21participating provider with:

22(A) the Department of Public Welfare under the
23Public Welfare Code; or

24(B) the Children's Health Insurance Program
25under:

26(I) Title XXI of the Social Security Act;
27and

28(II) Article XXIII of The Insurance Company 
29Law of 1921 and the regulations promulgated
30thereunder.

1(iv) A free or partial-pay health clinic that
2provides services by volunteer and nonvolunteer health
3care providers.

4(v) A nurse-managed health care clinic that is
5managed by <-advanced practice registered nurses and a 
6certified clinical nurse specialist, a certified 
7registered nurse anesthetist, a certified registered 
8nurse practitioner or a certified nurse midwife, is
9associated with a nursing education program, a federally
10qualified health center or an independent nonprofit
11health or social services agency and is a participating 
12provider with:

13(A) the Department of Public Welfare under the
14Public Welfare Code; or

15(B) the Children's Health Insurance Program
16under:

17(I) Title XXI of the Social Security Act;
18and

19(II) Article XXIII of The Insurance Company 
20Law of 1921 and the regulations promulgated
21thereunder.

22"Department." <-Except as provided under section 113, the The
23Department of Health of the Commonwealth.

24"Health care provider." A health care provider licensed to 
25practice a component of the healing arts by a licensing board 
26within the Department of State who provides health care services 
27at a community-based health care clinic.

28"Hospital." An entity located in this Commonwealth that is 
29licensed as a hospital under the act of July 19, 1979 (P.L.130, 
30No.48), known as the Health Care Facilities Act.

1"Low-income patient." A patient whose household income is
2below 200% of the Federal poverty income guidelines.

3"Medical assistance." A State program of medical assistance 
4established under Article IV(f) of the act of June 13, 1967 
5(P.L.31, No.21), known as the Public Welfare Code.

6"Patient." A natural person receiving health care from a 
7health care provider at a community-based health care clinic.

8"Program." The Community-Based Health Care Program.

9SUBCHAPTER B

10COMMUNITY-BASED HEALTH CARE

11Section 111. Community-Based Health Care Program.

12(a) Establishment.--The Community-Based Health Care Program
13is established within the department to provide grants to
14community-based health care clinics to:

15(1) Expand and improve health care access and services,
16such as preventive care, chronic care and disease management,
17prenatal, obstetric, postpartum and newborn care, dental
18treatment, behavioral health and pharmacy services.

19(2) Reduce unnecessary utilization of hospital emergency
20services by providing an effective alternative health care
21delivery system.

22(3) Encourage collaborative relationships among
23community-based health care clinics, hospitals and other
24health care providers.

25(b) Grant award methodology.--A methodology for the
26allocation of grant awards shall be developed by the department
27based on the following distribution:

28(1) Not more than 50% for the expansion of an existing
29or the development of a new community-based health care
30clinic using criteria that include:

1(i) The actual and projected number of total
2patients, new patients and patient visits for all
3patients served or to be served, specifically delineating
4the number of low-income and uninsured patients, who fall
5below 200% of the Federal poverty income guidelines.

6(ii) The addition or expansion of ancillary health
7care services, such as dental, behavioral health and
8pharmacy.

9(iii) The development or enhancement of preventive
10and chronic care and disease management techniques.

11(2) Not more than 25% for improvements in prenatal,
12obstetric, postpartum and newborn care.

13(3) Not more than 20% for improved access and services, 
14including patient transportation, intended to reduce
15unnecessary emergency room utilization.

16(4) Not more than 5% for the establishment of
17collaborative relationships among community-based health care
18clinics, hospitals and other health care providers.

19(5) Not more than 15% of the funds made available for
20the program authorized by this section may be awarded to
21applicants within any one city, town, borough or township of
22this Commonwealth.

23(b.1) Limitation.--No more than 25% of the grants awarded
24under subsection (b) may go to federally qualified health
25centers as defined in section 1905(l)(2)(B) of the Social
26Security Act (49 Stat. 620, 42 U.S.C. § 1396d(l)(2)(B)) or
27federally qualified health center look-alikes.

28(c) Distribution.--Funds shall be distributed in a manner
29that improves access and expands services in all geographic
30areas of this Commonwealth.

1(d) Reallocation.--The department shall reallocate funds
2among the categories described in <-subsection (b) subsections (b) 
3and (b.1) if sufficient qualified grant requests are not
4received to use all the funds available in a specific category.

5(e) Amount of grants.--A grant under this subsection shall
6require a matching commitment of 25% of the grant, which can be
7in the form of cash or equivalent in-kind services.

8(f) Federal funds.--The department shall seek any available
9Federal funds, as well as any available grants and funding from
10other sources, to supplement amounts made available under this
11subchapter to the extent permitted by law.

12Section 112. Powers and duties of department.

13The department shall have the following powers and duties:

14(1) To administer the program.

15(2) To develop an allocation methodology pursuant to
16section 111(b).

17(3) Within 90 days of the effective date of this
18section, to develop and provide a grant application form
19consistent with this act. The department shall provide
20applications for grants under this section to all known
21community-based health care clinics. A grant under this
22section may be extended over two State fiscal years at the
23request of the community-based health care clinic.

24(4) To calculate and make grants to qualified community-
25based health care clinics.

26(5) To provide an annual report no later than November
2730 to the chair and minority chair of the Public Health and
28Welfare Committee of the Senate and the chair and minority
29chair of the Health Committee of the House of
30Representatives. The report shall include all of the

1following:

2(i) The total dollar amount for each grant awarded,
3listing the type of community-based health care clinic
4and the name of the grantee.

5(ii) The use of the grant by each grantee.

6(iii) How each grant expanded access and services
7in accordance with the criteria set forth in section
8111(a) and (b), including specific documentation of low-
9income and uninsured patients served, and the total
10amount of funds allocated in each distribution category
11under section 111(b).

12(iv) The impact of the grant on improving the
13delivery and quality of health care in the community.

14(v) The benefits of the assistance provided under
15this subchapter and any recommendations for changes to
16the program.

17The report shall be made available for public inspection and
18posted on the department's publicly accessible Internet
19website.

20(6) To audit grants awarded under this subchapter to
21ensure that funds have been used in accordance with this
22subchapter and the terms and standards adopted by the
23department.

24(7) To establish and maintain an online database of
25community-based health care clinics.

26(8) To establish a toll-free telephone number for
27individuals to obtain information about community-based
28health care clinics.

29Section 113. Hospital health clinics.

30(a) Program.--The Department of Public Welfare shall, in 

1cooperation with the department, be responsible for
2administering the program as it relates to hospital health
3clinics in accordance with the requirements of this act and
4shall have the following additional duties:

5(1) To develop an application and collect such data and
6information as may be necessary to determine the eligibility
7of hospital health clinics for payments under this section
8using the criteria set forth in section 111(a) and (b).

9(2) To review an application and make a final
10determination regarding a hospital health clinic's
11eligibility for funding within 90 days of receipt.

12(3) To make payments to hospital health clinics in
13accordance with the payment calculation set forth in
14subsection (e).

15(b) Submission of application.--In order to qualify for
16funding under this section, a hospital health clinic shall
17submit the required application to the Department of Public
18Welfare no later than 90 days after the effective date of this
19act.

20(c) Funding.--

21(1) For each fiscal year, upon Federal approval of an
22amendment to the Medicaid State plan, the Department of
23Public Welfare shall annually distribute any available funds
24obtained under this act for hospital health clinics through
25disproportionate share payments to hospitals to provide
26financial assistance that will assure readily available and
27coordinated comprehensive health care to the citizens of this
28Commonwealth.

29(2) The Secretary of Public Welfare shall determine the
30funds available and make appropriate adjustments based on the

1number of qualifying hospitals with hospital health clinics.

2(d) Maximization.--The Department of Public Welfare shall
3seek to maximize any Federal funds, including funds obtained
4under Title XIX of the Social Security Act (49 Stat. 620, 42 
5U.S.C. § 1396 et seq.).

6(e) Payment calculation.--

7(1) Thirty percent of the total amount available shall
8be allocated to eligible hospital health clinics of hospitals
9located in counties of the first and second class. The total
10amount available for each hospital health clinic at a
11hospital in these counties shall be allocated on the basis of
12each hospital's percentage of medical assistance and low-
13income hospital health clinic visits compared to the total
14number of medical assistance and low-income hospital health
15clinic visits for all hospitals in the first and second class
16counties.

17(2) Fifty percent of the total amount available shall be
18allocated to eligible hospital health clinics of hospitals
19located in counties of the third, fourth and fifth class. The
20total amount available for each hospital health clinic at a
21hospital in these counties shall be allocated on the basis of
22each hospital's percentage of medical assistance and low-
23income hospital health clinic visits compared to the total
24number of medical assistance and low-income hospital health
25clinic visits for all hospitals in the third, fourth and
26fifth class counties.

27(3) Twenty percent of the total amount available shall
28be allocated to eligible hospital health clinics of hospitals
29located in counties of the sixth, seventh and eighth class.
30The total amount available for each hospital health clinic at

1a hospital in these counties shall be allocated on the basis
2of each hospital's percentage of medical assistance and low-
3income hospital health clinic visits compared to the total
4number of medical assistance and low-income hospital health
5clinic visits for all hospitals in the sixth, seventh and
6eighth class counties.

7(4) Any hospital that has reached its disproportionate
8share limit under Title XIX of the Social Security Act shall
9receive its share of the State funds available under this
10act.

<-11SUBCHAPTER C

12MOBILE PRENATAL AND

13NATAL CARE DEMONSTRATION PROJECT

14Section 121. Establishment.

15There is established within the department a program to be
16known as the Mobile Prenatal and Natal Care Demonstration
17Project. The program shall provide prenatal, obstetric,
18postpartum and newborn care to individuals on a mobile basis.

19Section 122. Applications for planning grants.

20A hospital or health care provider may submit an application
21to the department requesting a grant for costs associated with
22establishing a mobile unit to provide prenatal, obstetric,
23postpartum and newborn care. The application shall be on the
24form required by the department and shall include all of the
25following:

26(1) The applicant's name and address.

27(2) The geographic region where the unit will operate.

28(3) A statement of the services to be provided.

29(4) An estimate of the cost of the mobile unit.

30(5) Proof of participation in the medical assistance

1program.

2(6) Any other information required by the department.

3Section 123. Review and approval of grant applications.

4(a) Review.--The department shall review the applications.
5Preference shall be given to applicants in communities where
6prenatal, obstetric, postpartum and newborn care is limited.
7Upon being satisfied that all requirements have been met, the
8department may approve four applications and award grants. The
9following grants shall be awarded:

10(1) One to an applicant which seeks to provide services
11in an urban setting.

12(2) One to an applicant which seeks to provide services
13in a suburban setting.

14(3) One to an applicant which seeks to provide services
15in a rural setting.

16(4) One to an underserved area which is most likely to
17benefit from a mobile clinic.

18(b) Limit.--Grants awarded may not be more than $100,000.

19Section 124. Report.

20By May 1, 2016, the department shall file a report with the
21chairman and minority chairman of the Public Health and Welfare
22Committee of the Senate, the chairman and minority chairman of
23the Health Committee of the House of Representatives and the
24chairman and minority chairman of the Human Services Committee
25of the House of Representatives. The report shall additionally
26be posted on the department's publicly accessible Internet
27website and shall include all of the following for each grant
28made in the prior calendar year:

29(1) The name of each grantee.

30(2) The amount of each grant awarded.

1(3) The use of each grant by each grantee.

2(4) A summary of how each grant expanded access and
3services and improved the delivery and quality of health care
4in the community, including a comparison of the rate of
5infant mortality and low birth weight in the community for
6the year immediately prior to the award of the grant with
7those rates in the community for the year of the grant.

8(5) The types of services and the amount spent on each
9type of service provided by each grantee.

10(6) Any recommendations for changes to the program.

11CHAPTER 51

12MISCELLANEOUS PROVISIONS

13Section 5101. Limitations.

14The payments made under the program shall not exceed the 
15amount of funds appropriated for the program<-, and the payments 
16made for the Mobile Prenatal and Natal Care Demonstration 
17Project shall not exceed the amount of funds appropriated for 
18the Mobile Prenatal and Natal Care Demonstration Project. A
19payment under this act shall not constitute an entitlement from
20the Commonwealth or a claim on any other funds of the
21Commonwealth.

22Section 5102. Effective date.

23This act shall take effect in 90 days.