Health Services and Centers Amendments of 1978

(Conference report filed in House, H. Rept. 95-1799)

Health Services and Centers Amendments - =Title I: Health Centers and Primary Health Care= - Migrant and Community Health Centers Amendments - Amends the Public Health Service Act to make eligible to receive the services of migrant health centers and projects individuals who have previously been employed as migratory or seasonal agricultural workers but who no longer meet the requirements for eligibility because of age or disability. Removes preventive dental services from the category of primary health services provided by migrant health centers and designates such services as supplemental health services. Adds pharmaceutical services to the category of primary health services provided by such centers. Removes public health services from the supplemental health services provided by such centers and adds social services.

Redefines the term "high impact area" to reduce from 6,000 to 4,000 the number of migratory and seasonal agricultural workers who must reside within a health service area for more than two months in any calendar year.

Repeals the authority of the Secretary of Health, Education, and Welfare to make grants for the costs of operation of public and nonprofit private entities which intend to become migrant health centers and which provide services in high impact areas to migrant agricultural workers but which do not meet all the requirements which a migrant health center must meet in applying for a grant from the Secretary.

Authorizes the Secretary to make grants to migrant health centers to enable the centers to plan and develop the provision of health services on a prepaid basis to some or all of the individuals which the centers serve.

Sets forth guidelines to be used by the Secretary in making a grant for the cost of operation of migrant health centers in high impact areas.

Authorizes the Secretary to make a grant to a migrant health center for improvements to private property for which the written consent of the owner has been obtained and which are necessary to alleviate a hazard to the health of those residing on or using the property and other persons in the center's catchment area.

Extends the authorization of appropriations through fiscal year 1981 for grants and contracts for: (1) the planning and developing of migrant health centers in high impact areas; and (2) the costs of operating community health centers in such areas.

Defines "environmental health services" provided by community health centers to include the detection and alleviation of unhealthful conditions associated with water supply, sewage treatment, waste disposal, rodent and parasitic infestation, field sanitation, housing, and other environmental factors related to health.

Includes pharmaceutical services in the primary health services provided by community health centers.

Authorizes the Secretary to make grants to community health centers to enable the centers to plan and develop the provision of health services on a prepaid basis to some or all of the individuals which the centers serve.

Sets forth guidelines to be used by the Secretary in making grants to community health centers which serve medically underserved populations and to organizations which provide health services to medically underserved populations but as to which the Secretary is unable to determine if the organizations meet specified service, organizational, and financial standards.

Requires a community health center to develop an on-going referral relationship with at least one hospital in order to receive a grant.

Authorizes the Secretary to make a grant to a community health center for improvements to private property for which the written consent of the owner has been obtained and which are necessary to alleviate a hazard to the health of those residing on or otherwise using the property and of other persons in the center's catchment area.

Extends the authorization of appropriations through fiscal year 1981 for: (1) the planning and developing of community health centers which will serve medically underserved populations; and (2) the costs of operating community health centers which will serve such populations.

Authorizes the Secretary of Health, Education, and Welfare to make grants to public and nonprofit private entities to assist such entities in providing technical assistance for the planning, developing, or operation of migrant health centers, community health centers, or any other centers for the delivery of primary health care. Directs the Secretary to submit a report to Congress on the effectiveness of the entities assisted.

Directs the Secretary to conduct an assessment of the various types of continuing education programs available for health professions personnel serving medically underserved populations and the effect such types of programs have on the retention of such personnel by centers engaged in the delivery of primary health care to such populations.

Primary Health Care Act - Authorizes the Secretary to make grants to community hospitals (public general hospitals or private nonprofit hospitals primarily serving a medically underserved population) to support demonstration projects in the planning, development, and operation of hospital-affiliated primary care centers (distinct administrative units of community hospitals which provide primary and supplemental health services). Stipulates that to the extent feasible grants will not be made for such a center to serve a population whose need for primary health services is being met by a community health center, migrant health center, or other health care provider. Stipulates that such grants will not be made unless: (1) the primary health services of the center will be provided through a primary care group practice (any combination of physicians and other health care providers that includes at least three primary care physicians); (2) each patient of the center will have an identified primary care physician who is a member of the primary care group practice and who is responsible for the continuous management of the patient; (3) the grant application has been reviewed and approved by an advisory board composed of individuals being served by the center, unless the community hospital has a governing board; and (4) other specified requirements are met.

Directs the Comptroller General to submit a report to Congress evaluating the operation of hospital-affiliated primary care centers.

Authorizes the Secretary to make grants to, and enter into contracts with, public and private nonprofit entities which provide health services to medically underserved populations: (1) to demonstrate new and innovative methods for the provison of primary health services and dental services; or (2) to conduct research on such methods or on existing methods for the provision of primary health services and dental health services. Directs the Secretary to report to Congress concerning such methods.

Directs the Secretary to submit to Congress special reports on the primary health care needs of immigrants, American-Indians, Alaskan Natives, and on the future of National Health Service Corps.

Authorizes the Secretary to make grants to assist educational institutions in meeting the costs of special projects in: (1) biostatistics or epidemiology; (2) health administration or health planning or health policy analysis and planning; (3) environmental or occupational health; or (4) dietetics and nutrition.

Increases the authorization of appropriations for fiscal year 1979 for the National Health Service Corps Program.

=Title II: Health Services Extension= - Health Services Extension Act - Amends the Public Health Service Act to extend authorization of appropriations through fiscal year 1979 for grants to States for comprehensive State health planning.

Directs the Secretary of Health, Education, and Welfare to make grants to State health authorities to assist in meeting the costs of providing comprehensive public health services. Directs that funds received should be used to supplement non-Federal funds for comprehensive public health services and not to supplant such funds.

Provides guidelines by which each State and local public health entity shall compute the amount of such funds it shall receive.

Requires the Secretary to review annually the activities undertaken by each State public health authority to determine if such authority complied with the assurances provided with the application for funds. Authorizes the Secretary to withhold payment from authorities which have failed to meet such assurances.

Provides guidelines for determining the total amount of grants received by a public health authority for comprehensive public health services.

Authorizes the Secretary to make project grants to State health authorities, States, political subdivisions of States, and other public entities to assist them in meeting the costs of establishing and maintaining preventive health services programs. States that an application for such a grant shall provide a complete description of the type and extent of the program for which the applicant is seeking a grant. Sets forth other specified information to be included in such applications. Requires the Secretary to review annually the activities undertaken by each State pursuant to an approved application.

Provides that the amount of a grant for preventive health services shall be determined by the Secretary.

Authorizes the Secretary to provide technical assistance to States, State health authorities, and other public entities in connection with the operation of their preventive health service programs.

Authorizes appropriations for specified preventive immunization programs for children and influenza immunization programs for individuals through fiscal year 1981. Stipulates that no funds may be obligated for such immunization programs until reports concerning previous programs are submitted to Congress by the Secretary. Requires information from such reports concerning personal injuries and deaths in connection with the previous immunization programs be distributed to individuals before the individuals receive any immunization under a program funded through this Act.

Authorizes appropriations through fiscal year 1981 for: (1) rodent control programs; (2) hypertension programs; and (3) other preventive health service programs.

Requires the Secretary to make formula grants to States to assist them in planning, developing, and providing preventive health service programs designed to reduce the mortality rate for one or more of the five leading causes of death in the State.

Stipulates that no such grant shall be made unless an application containing a detailed plan of the program has been submitted to the Secretary. Sets forth specified information and assurances to be included in such application. Requires the Secretary to review annually the activities undertaken by each State pursuant to an approved application.

States that the total amount of such formula grants shall be determined by the Secretary except that it may neither be less than nor exceed specified guidelines.

Authorizes appropriations for such formula grants through fiscal year 1982.

Extends the authorization of appropriations through fiscal year 1981 for: (1) projects and programs for the prevention and control of venereal disease; (2) genetic disease programs; (3) hemophilia programs; (4) home health agencies and services as defined in the Social Security Act; and (5) lead-based paint poisoning prevention programs.

Amends the National Sickle Cell Anemia, Cooley's Anemia, Tay-Sachs, and Genetic Diseases Act to include genetic conditions, as well as genetic diseases, within the program of research, counseling, and education established by such Act.

Requires the Secretary to conduct epidemiological assessments and surveillance of genetic diseases to define the scope and extent of such diseases and the need for programs to control such diseases.

Authorizes the Secretary to make grants for lead-based paint poisoning prevention programs. Defines "lead-based paint poisoning prevention program.

Requires the Secretary to study the long-term effect on child development of various levels of lead in blood.

Repeals provisions of the Act which require that grants for the establishment and operation or improvement of an emergency medical services systems facility be made for project costs in the year in which the grant is made.

Requires the Secretary to establish, within the Office of the Secretary, a Select Panel for the Promotion of Child Health.

Requires the Panel to: (1) formulate specific goals with respect to the promotion of the health status of children and expectant mothers; and (2) develop a comprehensive national plan for achieving such goals.

=Title III: Review= - Provides that a grant or contract made under this Act shall be considered, for purposes of the health systems agencies and the Statewide Health Coordinating Councils of the Public Health Service Act, to be a grant or contract made under such Act.

=Title IV: Resources for Disease Prevention and Health Promotion= - Directs the Secretary to undertake or support five intensive and comprehensive community based programs in both rural and urban areas for the purpose of demonstrating and evaluating optimal methods for organizing and delivering comprehensive preventive health services to defined populations. Requires the Secretary to submit reports to Congress on such programs.

Directs the Secretary to establish a comprehensive program designed to deter smoking and the use of alcoholic beverages among children and adolescents.

Directs the Secretary to conduct, or arrange for the conduct of, a study or studies of: (1) the relative health risks associated with smoking cigarettes of varying levels of tar, nicotine, and carbon monoxide; and (2) the health risks associated with smoking cigarettes containing any substances commonly added to commercially manufactured cigarettes. Requires the Secretary to report to Congress concerning such study or studies.

Directs the Secretary, acting through the National Center for Health Statistics, to submit to Congress a national disease prevention data profile in order to provide a data base for the effective implementation of this Act and to increase public awareness of the prevalence, incidence, and any trends in the preventable causes of death and disability in the United States.

=Title V: Office of Physical Fitness and Sports Medicine= - Directs the Secretary to establish within the Office of the Assistant Secretary for Health an Office of Health Information, Health Promotion and Physical Fitness and Sports Medicine which shall: (1) coordinate activities within the Department of Health, Education, and Welfare and the private sector relating to health information and health promotion; (2) establish a national clearinghouse to facilitate the exchange of information concerning matters relating to health information and health promotion; (3) support projects, conduct research, and disseminate information in the areas of physical fitness and sports medicine; (4) foster research into the proper role of nutrition in physical fitness programs; and (5) communicate the results of such research to the American people.

Authorizes the Office to make grants to each State for the establishment by the Governor of a State Council on Physical Fitness to promote the development of physical fitness. Provides that each State shall be eligible for a grant to the State Council.

Authorizes grants to conduct research and establish model projects with regard to improvement of physical fitness.

Directs the Office to establish a program of project grants to conduct research into the problem of athletic injuries with specific concentration on frequency of injuries, seriousness of injuries, the development of athletic protective equipment, and problems associated with full recovery from athletic injuries. Directs the Office to disseminate the results of the research to practitioners in relevant fields of health care.

Directs the Office and the Office of Education in the Department to conduct a joint conference during 1979 on the teaching and support of educational programs in lifetime sports by secondary and postsecondary educational institutions.

=Title VI: Grant Program= - Sets forth findings concerning the high risks and problems associated with adolescent pregnancies. Establishes a grant program to provide better coordination among existing programs in order to expand and improve community services which assist in preventing unwanted and repeat pregnancies among adolescents, enable pregnant adolescents to obtain proper care, and assist pregnant adolescents and adolescent parents to become productive independent contributors to family and community life. Enumerates services to be provided by grant recipients.

=Title VII: Improving Coordination of Federal and State Programs= - Directs the Secretary to coordinate Federal policies and programs providing services related to prevention of initial and repeat adolescent pregnancies.

=Title VIII: Study of Adolescent Pregnancy= - Directs the Secretary to arrange for a study of the problem of adolescent pregnancies which shall evaluate the effectiveness of existing programs and include suggestions for reducing unwanted pregnancies.