PRINTER'S NO. 2263
No. 1655 Session of 1990
INTRODUCED BY PETERSON, CORMAN, BRIGHTBILL, MADIGAN, LOEPER,
PUNT, RHOADES, WILT, O'PAKE, HELFRICK, DAWIDA, STAPLETON,
WENGER, JUBELIRER, ROCKS, BAKER, LEMMOND, HOPPER AND
PORTERFIELD, JUNE 7, 1990
REFERRED TO PUBLIC HEALTH AND WELFARE, JUNE 7, 1990
AN ACT
1 Relating to rural health care; establishing the Bureau of Rural
2 Health Care Services within the Department of Health and
3 providing for its powers and duties; establishing the Rural
4 Health Care Services Advisory Committee and providing for its
5 powers and duties; and making appropriations.
6 The General Assembly finds that there exists a shortage of
7 health manpower, an unavailability of hospital care and barriers
8 to the access of health services that are unique to certain
9 rural areas of this Commonwealth. The General Assembly further
10 finds that the development of a systematic and uniform approach
11 to identifying the shortage areas and providing programs to
12 ensure the viability of hospitals and to increase access to
13 rural health care in those designated shortage areas is in the
14 best interests of all the citizens of this Commonwealth.
15 TABLE OF CONTENTS
16 Chapter 1. Preliminary Provisions
17 Section 101. Short title.
18 Section 102. Definitions.
1 Chapter 3. Bureau and Advisory Committee
2 Section 301. Bureau of Rural Health Care Services.
3 Section 302. Rural Health Care Services Advisory Committee.
4 Chapter 5. Medical Practice Loans
5 Section 501. Physician Practice Start-up and Expansion Loan
6 Repayment Program.
7 Section 502. Allocation of repayment amounts.
8 Section 503. Eligibility.
9 Section 504. Conditions for certain assistance.
10 Section 505. Terms and conditions of agreements.
11 Section 506. Assignment criteria.
12 Section 507. Other sources of funding.
13 Chapter 7. Residency Practice Program
14 Section 701. Residency practice incentives program in rural
15 clinics.
16 Section 702. Guidelines.
17 Section 703. Funding.
18 Section 704. Report to General Assembly.
19 Chapter 9. Family Practice
20 Section 901. Family Practice Incentive Grant Demonstration
21 Program.
22 Section 902. Grants.
23 Section 903. Report to General Assembly.
24 Section 904. Expiration of chapter.
25 Chapter 11. Health Care Grants
26 Section 1101. Health Care Transitional Grant Program.
27 Section 1102. Funding.
28 Chapter 13. School Health Programs
29 Section 1301. School Health Care Clinic Pilot Program.
30 Section 1302. Purpose.
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1 Section 1303. Pilot projects.
2 Section 1304. Conditions of projects.
3 Section 1305. Removal of impediments.
4 Section 1306. Further duties of bureau.
5 Section 1307. Funding.
6 Chapter 15. Rural Health Network
7 Section 1501. Rural Health and Human Services Network
8 Pilot Program.
9 Section 1502. Eligibility.
10 Section 1503. Technical advice.
11 Section 1504. Grant amounts.
12 Section 1505. Reports.
13 Section 1506. Further duties of bureau.
14 Chapter 17. Mobile Health Clinics
15 Section 1701. Mobile Health Clinic Demonstration Program.
16 Section 1702. Required clinics.
17 Section 1703. Conditions of grants.
18 Section 1704. Expiration of chapter.
19 Chapter 21. Miscellaneous Provisions
20 Section 2101. Appropriations.
21 Section 2102. Effective date.
22 The General Assembly of the Commonwealth of Pennsylvania
23 hereby enacts as follows:
24 CHAPTER 1
25 PRELIMINARY PROVISIONS
26 Section 101. Short title.
27 This act shall be known and may be cited as the Rural Health
28 Care Act.
29 Section 102. Definitions.
30 The following words and phrases when used in this act shall
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1 have the meanings given to them in this section unless the
2 context clearly indicates otherwise:
3 "Advisory committee" or "committee." The Rural Health Care
4 Services Advisory Committee.
5 "Bureau." The Bureau of Rural Health Care Services in the
6 Department of Health.
7 "Community-based practice." The noninstitutional private
8 practice of a physician.
9 "Community health center." An entity which through its staff
10 and supporting resources or through contracts or cooperative
11 arrangements with other public or private entities provides
12 health services or information thereon to residents of a
13 particular area of this Commonwealth.
14 "Department." The Department of Health of the Commonwealth.
15 "Designated shortage area." An area:
16 (1) designated by the Secretary of Health as a physician
17 shortage area using criteria which take into account the
18 special barriers to the provision of health care services in
19 a rural area;
20 (2) a medically underserved area as designated by the
21 United States Department of Health and Human Services; or
22 (3) a critical manpower shortage area as defined by the
23 United States Department of Health and Human Services, or as
24 further defined by the Bureau of Rural Health Care Services
25 in consultation with the Rural Health Care Services Advisory
26 Committee.
27 "Family Practice" or "General Practice." A medical specialty
28 as defined by the American Board of Medical Specialties or the
29 American Osteopathic Board of General Practice.
30 "Health care facility." A general or special hospital,
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1 including tuberculosis and psychiatric hospitals, rehabilitation
2 facilities, skilled nursing facilities, kidney disease treatment
3 centers, including freestanding hemodialysis units, intermediate
4 care facilities and ambulatory surgical facilities, both profit
5 and nonprofit and, including those operated by an agency of
6 State or local government, but shall not include an office used
7 exclusively for their private or group practice by physicians or
8 dentists, nor a program which renders treatment or care for drug
9 or alcohol dependence, unless located within, by or through a
10 health care facility, a facility providing treatment solely on
11 the basis of prayer or spiritual means in accordance with the
12 tents of any church or religious denomination, nor a facility
13 conducted by a religious organization for the purpose of
14 providing health care services exclusively to clergymen or other
15 persons in a religious profession who are members of the
16 religious denominations conducting the facility.
17 "Health and Human Services Network Program." The
18 coordination of rural health services provided by health care
19 providers as established under this act.
20 "Internal Medicine." A medical specialty as defined by the
21 American Board of Medical Specialties or the American
22 Osteopathic Board of Internal Medicine.
23 "Pediatrics." A medical specialty as defined by the American
24 Board of Medical Specialties and the American Osteopathic Board
25 of Pediatrics.
26 "Primary Care Services." Medical services provided by family
27 or general practitioners, general internists, general
28 pediatricians or obstetrician-gynecologists.
29 "Secretary." The Secretary of Health of the Commonwealth.
30 CHAPTER 3
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1 BUREAU AND ADVISORY COMMITTEE
2 Section 301. Bureau of Rural Health Care Services.
3 (a) Establishment.--There is hereby established within the
4 Department of Health the Bureau of Rural Health Care Services.
5 (b) Powers and duties.--Upon the advice and recommendations
6 of the advisory committee, the bureau shall:
7 (1) Coordinate the health services provided by the
8 department to rural residents.
9 (2) Coordinate the services provided for rural residents
10 by various local, county and regional agencies or groups.
11 (3) Administer the programs established under this act
12 to increase the numbers of physicians practicing in rural
13 designated shortage areas.
14 (4) Administer the programs established under this act
15 to increase the viability and enhance the quality of health
16 services provided by rural hospitals.
17 (5) Administer the programs established under this act
18 to increase access to health care for rural residents.
19 (6) Annually review and update the designation of
20 physician, medically underserved and critical manpower
21 shortage areas and report to the General Assembly the then
22 current status of the need for health care services and
23 providers in the areas so designated.
24 (7) Consult with and receive recommendations from the
25 advisory committee in determining and fulfilling rural health
26 care needs.
27 (8) Administer sums appropriated to carry out this act
28 to increase the numbers of rural physicians, to increase the
29 viability and enhance the quality of health services provided
30 by rural hospitals, and to increase access to health care for
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1 rural residents.
2 Section 302. Rural Health Care Services Advisory Committee.
3 (a) Establishment and purpose.--There is hereby established
4 the Rural Health Care Services Advisory Committee which shall
5 provide advice and recommendations to the bureau on the programs
6 created under this act and on all other health care matters
7 impacting on rural areas.
8 (b) Composition.--The committee shall include the following:
9 (1) One member appointed by the President pro tempore of
10 the Senate; one by the Minority Leader of the Senate; one by
11 the Speaker of the House of Representatives; and one by the
12 Minority Leader of the House of Representatives.
13 (2) Ten members appointed by the Governor as follows:
14 (i) Two members who are licensed family or general
15 practitioners, general internists, general pediatricians
16 or obstetrician-gynecologists actively engaged in
17 practice in a rural area.
18 (ii) One member who is a director of a rural
19 community health center.
20 (iii) Two rural county commissioners chosen by the
21 Pennsylvania Association of County Commissioners.
22 (iv) Two representatives of rural hospitals.
23 (v) One licensed osteopathic physician actively
24 practicing in a rural designated shortage area.
25 (vi) One registered nurse practicing in a rural
26 designated area.
27 (vii) One dentist practicing in a rural designated
28 area.
29 (c) Terms of office.--Legislative members shall serve terms
30 coterminous with that of their legislative office. All other
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1 members shall serve four years or the term of the office by
2 which he holds membership on the committee, and until his
3 successor has been appointed and qualified, but not longer than
4 six months beyond the applicable period.
5 CHAPTER 5
6 MEDICAL PRACTICE LOANS
7 Section 501. Physician Practice Start-up and Expansion Loan
8 Repayment Program.
9 (a) Fund.--There is hereby established a separate account in
10 the State Treasury, to be known as the Physician Practice Start-
11 up and Expansion Loan Repayment Fund. This fund shall be
12 administered by the bureau. All moneys in the fund are hereby
13 appropriated to the bureau on a continuing basis to carry out
14 this chapter.
15 (b) Purpose.--The fund shall be used to repay physician
16 start-up and expansion loans for physicians providing primary
17 care services full time in rural designated shortage areas.
18 Section 502. Allocation of repayment amounts.
19 In allocating funds for repayment, the director of the bureau
20 shall, if possible, apportion the repayment funds so that 25% of
21 the loans repaid will be for the loans of family or general
22 practitioners, 25% for general internists, 25% for general
23 pediatricians and 25% for obstetrician-gynecologists.
24 Section 503. Eligibility.
25 To be considered for loan repayment assistance, an applicant
26 shall:
27 (1) Have a medical degree from an accredited
28 Pennsylvania medical school or osteopathic medical college,
29 have completed an approved Pennsylvania graduate training
30 program in primary medicine and be licensed to practice
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1 medicine in Pennsylvania.
2 (2) Agree to serve in a designated shortage area as a
3 primary care physician, as defined in this act, one year for
4 each $50,000 in loans repaid by the department.
5 (3) For practice start-up loan repayment, have completed
6 one full year of community-based solo primary care practice
7 in a rural designated shortage area and have obtained a
8 start-up loan from a local lending institution in the rural
9 designated area; or, in the case of expansion of a practice
10 to add one or two physicians, have completed one or more
11 years of community-based solo primary care practice in the
12 rural designated shortage area where expansion is sought.
13 Section 504. Conditions for certain assistance.
14 (a) Certain loans prior to act.--The bureau may provide
15 assistance for the repayment of any start-up or expansion loan
16 received by a physician through a local lending institution in
17 the rural designated shortage area of Pennsylvania where the
18 physician agrees, under the terms of this section, to practice,
19 except that loans with any lender that have been executed prior
20 to the effective date of this act may be considered for
21 repayment.
22 (b) Loans in default.--The bureau may not provide repayment
23 assistance for a loan that is in default at the time of the
24 physician's application.
25 (c) Community-based practice.--The bureau may not provide
26 practice start-up loan repayment assistance unless the primary
27 care physician has completed one year of community-based solo
28 practice. The bureau may not provide practice expansion loans
29 unless the applicant has completed one or more years of such
30 practice in the rural designated shortage area in which he seeks
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1 to expand practice.
2 Section 505. Terms and conditions of agreements.
3 Each recipient of a repayment loan shall enter into a written
4 contract with the bureau, which shall be considered a contract
5 with the Commonwealth. In executing contracts, the bureau shall
6 give priority to those applicants who agree to practice a
7 minimum of three years in a rural designated shortage area. The
8 contract shall include the following terms and conditions:
9 (1) The physician shall serve one year in the designated
10 shortage area for each repayment up to $50,000 made on his
11 behalf to the lender.
12 (2) In no event shall service for less than one full
13 year entitle the participant to any benefits under the loan
14 repayment program.
15 (3) The participant shall treat patients in the area
16 eligible for Medicaid and Medicare and develop a sliding fee
17 scale for low-income patients.
18 (4) The participant shall practice full time in the
19 rural designated shortage area.
20 (5) The participant shall permit the bureau to monitor
21 the practice to determine compliance with the program.
22 (6) The bureau shall certify compliance with the terms
23 of the program for purposes of receipt by the participant of
24 loans for years subsequent to the initial year of the loan.
25 (7) The contract shall be renewable on a yearly basis
26 upon certification by the bureau that the participant has
27 complied with the terms of the contract.
28 (8) In the event of the participant's death or total or
29 permanent disability, the bureau shall nullify the service
30 obligation of the recipient and the bureau shall repay the
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1 loan in full.
2 (9) In the event that the participant is convicted of a
3 felony or misdemeanor or the participant commits an act of
4 gross negligence in the performance of service obligations,
5 or where the license to practice has been revoked or
6 suspended, the bureau shall have the authority to terminate
7 the participant's service in the program and demand repayment
8 of the outstanding loan.
9 (10) No participant may receive repayment assistance for
10 more than five years.
11 (11) Loan recipients who fail to fulfill the obligations
12 contracted for shall pay to the bureau a sum equal to three
13 times the amount received plus interest from the date of the
14 breach at a rate of 2% above the prime rate at the time of
15 the breach.
16 Section 506. Assignment criteria.
17 The bureau shall establish criteria for assigning
18 participants to the rural designated shortage area. In making
19 the assignments, the bureau shall match the characteristics and
20 preferences of the participant with those of the area,
21 population group or health care facility to the extent possible
22 to maximize the probability of the participant's remaining in
23 the area upon completion of the assignment period.
24 Section 507. Other sources of funding.
25 The bureau shall seek Federal funds to carry out the purposes
26 of this chapter and may accept gifts, grants and donations from
27 other sources. All sums appropriated by the General Assembly to
28 carry out the purposes of this chapter in a fiscal year shall be
29 used for providing repayment assistance for practice start-up or
30 expansion loans.
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1 CHAPTER 7
2 RESIDENCY PRACTICE PROGRAM
3 Section 701. Residency practice incentives program in rural
4 clinics.
5 The bureau shall encourage and coordinate the creation or
6 expansion of a rural primary care residency program between the
7 Commonwealth's teaching hospitals and health care facilities and
8 community groups which provide at least one-month rotations in
9 clinics established in rural designated shortage areas.
10 Section 702. Guidelines.
11 In determining the distribution of grants to teaching
12 hospitals, health care facilities and community groups which
13 establish primary care residency programs in rural clinics, the
14 bureau shall establish criteria in accordance with the following
15 guidelines:
16 (1) Preference shall be given to programs which are to
17 be established at locations which exhibit potential for
18 extending primary care practice physician availability to
19 rural designated shortage areas.
20 (2) Preference shall be given to programs located away
21 from areas in which medical schools and osteopathic medical
22 colleges are located.
23 (3) Preference shall be given to programs developed by
24 health care facilities having affiliation agreements with
25 teaching hospitals located within this Commonwealth.
26 (4) The degree of local support for the program in the
27 form of the establishment of clinics, matching funding,
28 services or other in-kind resources.
29 (5) The opportunity for the provision of education and
30 cultural resources.
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1 Section 703. Funding.
2 The bureau shall provide for this program through Medical
3 Assistance direct medical education payments.
4 Section 704. Report to General Assembly.
5 The bureau shall annually, on or before March 15, report to
6 the Senate and the House of Representatives the results and
7 progress of the program established under this chapter.
8 CHAPTER 9
9 FAMILY PRACTICE
10 Section 901. Family Practice Incentive Grant Demonstration
11 Program.
12 The bureau shall administer a grant program to be known as
13 the Family Practice Incentive Demonstration Program.
14 Section 902. Grants.
15 The bureau shall administer this program by allocating sums
16 appropriated for this purpose by the General Assembly to the
17 medical schools and osteopathic medical colleges of the
18 Commonwealth as follows:
19 (1) One primary grant of $100,000 per year shall be
20 awarded to the medical school or osteopathic medical college
21 with the most innovative project to increase the total number
22 of family practitioners in this Commonwealth and the numbers
23 of family practitioners choosing to serve in rural designated
24 shortage areas.
25 (2) A one-time $50,000 follow-up grant may be awarded to
26 a prior year's grantee.
27 Section 903. Report to General Assembly.
28 The bureau shall report annually on or before March 15 to the
29 Senate and the House of Representatives on the progress of the
30 program established under this act.
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1 Section 904. Expiration of chapter.
2 This chapter shall expire on June 30, 1995, unless reenacted
3 by the General Assembly.
4 CHAPTER 11
5 HEALTH CARE GRANTS
6 Section 1101. Health Care Transitional Grant Program.
7 The bureau shall:
8 (1) Provide technical assistance to rural hospitals to
9 complete the forms necessary for the development of projects
10 eligible for Federal rural health care transitional grants.
11 (2) Notify eligible rural hospitals and rural hospitals
12 under 150 beds of the existence of Federal programs impacting
13 upon the provision of services in rural areas and shall
14 provide technical assistance necessary to apply for projects
15 which advance health care services to enhance the quality of
16 care provided in rural areas.
17 (3) Consider rural hospitals which would qualify for
18 consideration under the Federal program, except for size, for
19 participation in a State-funded program.
20 (4) Screen applicant hospitals to determine which shall
21 receive consideration for the Federal Rural Health Transition
22 Grant Program and submit the names of eligible applicants to
23 the Office of the Governor for transmission to the United
24 States Department of Health and Human Services.
25 (5) Upon the awarding of grants, determine which of the
26 projects forwarded by the Governor's Office to the United
27 States Department of Health and Human Services failed to
28 receive funding. The bureau shall then consider those
29 projects and the projects of other rural hospitals which meet
30 all the Federal criteria, except size, in the awarding of
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1 State grants.
2 Section 1102. Funding.
3 All sums appropriated to the bureau for the purpose of this
4 chapter shall be allocated solely for the funding of State
5 projects. No moneys allocated hereunder shall be used for the
6 administration of this section by the department.
7 CHAPTER 13
8 SCHOOL HEALTH PROGRAMS
9 Section 1301. School Health Care Clinic Pilot Program.
10 There is hereby established the Rural School Health Care
11 Clinic Pilot Program, to provide pediatric, dental,
12 immunization, health and nutrition education and physical
13 therapy services to children in rural areas. This program shall
14 be administered by the bureau.
15 Section 1302. Purpose.
16 (a) School clinics.--Grants provided under this chapter
17 shall be used to create school health care clinics in rural
18 designated shortage areas on a pilot program basis to serve as a
19 model for future Statewide implementation.
20 (b) Assistance to health care providers, etc.--The bureau
21 shall award grants to assist local and regional health care
22 providers, consumers and organizations in rural designated
23 shortage areas in providing services as enumerated in subsection
24 (a) to preschool, elementary and junior high school-aged
25 children at a school site.
26 (c) Certain uses prohibited.--Funds provided under this
27 grant program shall not be used for distributing birth control
28 devices or providing pregnancy counseling.
29 Section 1303. Pilot projects.
30 Pilot projects selected by the bureau shall include proposals
19900S1655B2263 - 15 -
1 that address the health care needs of children in rural
2 designated shortage areas and which would result in the
3 following:
4 (1) The coordination of services of health care
5 providers at a school site.
6 (2) The delivery of health care services to 10,000
7 children.
8 (3) The provision of free health care service to
9 children who have no health insurance coverage through a
10 nominal waivable fee.
11 (4) The involvement of parents through the creation of a
12 parental advisory board.
13 (5) The sharing of resources among the coordination of
14 service delivery by providers.
15 (6) In-kind contributions of equipment, space or
16 services of a school nurse by the host school.
17 (7) Increased accessibility to the full continuum of
18 health care services, including illness prevention, for
19 preschool, elementary and junior high school children in the
20 rural designated shortage area.
21 (8) Identification of regulatory and other impediments
22 to the coordination of service delivery and sharing of
23 resources by health care providers.
24 Section 1304. Conditions of projects.
25 Pilot projects shall not be approved for a time period
26 exceeding three years. The bureau shall approve pilot project
27 grant awards of $60 per student to be served in any one 12-month
28 period. Grants shall be renewed annually for up to three
29 consecutive years. If it is determined that a grantee is using
30 funds for purposes inconsistent with this section, the bureau
19900S1655B2263 - 16 -
1 may withdraw approval of the project and require repayment of
2 all or part of such grant to the Commonwealth. Any funds thus
3 repaid shall be used only for other pilot projects approved
4 under this section. The bureau shall require reports to be
5 prepared and submitted for each project by the grantees at such
6 times and in such manner as are consistent with the purposes of
7 this section.
8 Section 1305. Removal of impediments.
9 Upon the request of the applicant, the bureau shall provide
10 expertise in the removal of impediments or barriers to the
11 coordination of health care services at a school site.
12 Section 1306. Further duties of bureau.
13 For the purpose of promoting maximum effectiveness of this
14 program, the bureau shall:
15 (1) Arrange for the waiver of impediments to the
16 successful implementation and testing of the pilot project,
17 provided there is a finding by the bureau that the health,
18 safety and general welfare of the children receiving health
19 care services will not be impaired.
20 (2) Consult with Federal, State and local officials to
21 secure their cooperation in coordinating related programs and
22 regulatory waivers.
23 (3) In consultation with the advisory committee, provide
24 the General Assembly with legislative recommendations to
25 facilitate the provisions of this section.
26 Section 1307. Funding.
27 The bureau shall administer the program with sums
28 appropriated by the General Assembly.
29 CHAPTER 15
30 RURAL HEALTH NETWORK
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1 Section 1501. Rural Health and Human Services Network Pilot
2 Program.
3 (a) Establishment.--There is hereby created a Rural Health
4 and Human Services Network Pilot Program which shall be
5 administered by the bureau.
6 (b) Grants.--The bureau shall provide grants from the sums
7 appropriated by the General Assembly to establish networks of
8 health care and human service providers in rural areas.
9 Section 1502. Eligibility.
10 The bureau shall consider grant proposals addressing the
11 special needs of rural designated shortage areas offered by
12 applicants who can demonstrate the capability of planning with
13 providers and consumers for the creation of a viable network of
14 rural health care and human service providers, whether
15 proprietary, nonprofit or public. To be considered for grants,
16 proposals shall:
17 (1) Result in the merger, integration, reorganization or
18 coordination of health care and human services.
19 (2) Promote cost reduction.
20 (3) Improve rural access to a continuum of health care
21 and human services.
22 (4) Result in illness prevention.
23 (5) Capitalize on the strengths of existing providers.
24 (6) Identify methods of addressing regulatory and other
25 barriers to the merger, integration, reorganization or
26 coordination of services.
27 Section 1503. Technical advice.
28 The bureau shall provide technical expertise on the
29 identification of barriers to the merger, integration,
30 reorganization or coordination of services.
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1 Section 1504. Grant amounts.
2 Grants shall be awarded in amounts ranging from $10,000 to
3 $50,000 per annum and may be awarded for a period not to exceed
4 three years. In determining the amount of an award, the bureau
5 shall consider the nature of the pilot project, the number of
6 provider and consumer entities involved and the likely increase
7 in access to and availability of health care and human services
8 to rural residents.
9 Section 1505. Reports.
10 The grantees shall be monitored by the bureau and required to
11 prepare reports at such times and in such manner as the bureau
12 shall require. If it is determined that a grantee is using grant
13 funds for purposes inconsistent with this chapter, the bureau
14 shall require repayment of all or part of the grant to the
15 Commonwealth.
16 Section 1506. Further duties of bureau.
17 To promote maximum effectiveness of any network created under
18 this chapter, the bureau shall:
19 (1) Arrange for the waiver of impediments to the
20 implementation and testing of the project, so long as the
21 waiver is consistent with the health, safety and general
22 welfare of the rural residents who are to receive the
23 services.
24 (2) Consult with Federal, State and local officials to
25 secure the coordination of related programs and obtain
26 waivers.
27 (3) Provide the General Assembly with legislative
28 recommendations to facilitate the provisions of this chapter.
29 CHAPTER 17
30 MOBILE HEALTH CLINICS
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1 Section 1701. Mobile Health Clinic Demonstration Program.
2 There is hereby established the Mobile Health Clinic
3 Demonstration Program which shall be administered by the bureau.
4 Section 1702. Required clinics.
5 The bureau shall:
6 (1) Purchase two vehicles and medical equipment to
7 furnish the vehicles to establish two Mobile Health Clinic
8 Demonstration Programs in rural designated shortage areas of
9 this Commonwealth.
10 (2) Provide two grants from sums appropriated by the
11 General Assembly to health care providers, health care
12 networks, teaching hospitals or dental schools to assist in
13 the purchase of vehicles, medical or dental equipment or the
14 coordination of activities leading to the establishment of
15 one mobile health clinic and one mobile dental clinic in
16 rural designated shortage areas.
17 (3) In awarding grants, give preference to programs
18 which evidence coordination of existing services and the
19 pooling of resources by applicants.
20 (4) Award grants in an amount which is the lesser of
21 $600,000 or 50% of the cost of the vehicle, equipment or
22 coordination of activities leading to the establishment of a
23 rural mobile health clinic.
24 (5) Award grants to prior year's grantees in an amount
25 which is the lesser of $600,000 or 50% of the program project
26 cost to enter a follow-up phase for the prior year's program.
27 Section 1703. Conditions of grants.
28 (a) Eligibility.--All health care providers, health care
29 networks, teaching hospitals and dental schools located in this
30 Commonwealth may apply for grants to provide mobile health
19900S1655B2263 - 20 -
1 clinic services to rural designated shortage areas in this
2 Commonwealth.
3 (b) Expenses.--Bureau expenses may be no greater than 10% of
4 the sums appropriated by the General Assembly for the purposes
5 of this chapter.
6 (c) Annual report.--The department shall annually report, on
7 or before March 15, to the General Assembly on the program
8 established under this chapter.
9 Section 1704. Expiration of chapter.
10 This chapter shall expire June 30, 1995, unless reenacted by
11 the General Assembly.
12 CHAPTER 21
13 MISCELLANEOUS PROVISIONS
14 Section 2101. Appropriations.
15 (a) Department.--The sum of $500,000, or as much thereof as
16 may be necessary, is hereby appropriated to the Department of
17 Health for the fiscal period July 1, 1990, to June 30, 1991, for
18 start-up costs and expenses of the Bureau of Rural Health Care
19 Services.
20 (b) Bureau.--The following sums, or as much thereof as may
21 be necessary, are hereby appropriated to the Bureau of Rural
22 Health Care Services for the fiscal period July 1, 1990, to June
23 30, 1991, and shall be allocated as follows:
24 (1) The sum of $700,000 to carry out Chapter 9.
25 (2) The sum of $500,000 to carry out Chapter 11.
26 (3) The sum of $600,000 to carry out Chapter 13.
27 (4) The sum of $250,000 to carry out Chapter 15.
28 (5) The sum of $2,400,000 to carry out Chapter 17.
29 Section 2102. Effective date.
30 This act shall take effect July 1, 1990, or immediately,
19900S1655B2263 - 21 -
1 whichever is later.
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