Grants to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured

The Secretary may award grants to eligible entities to assist in the development of integrated health care delivery systems to serve communities of individuals who are uninsured and individuals who are underinsured— To be eligible to receive a grant under this section, an entity shall be an entity that— represents a consortium— that includes at least one of each of the following providers that serve the community (unless such provider does not exist within the community, declines or refuses to participate, or places unreasonable conditions on their participation)— submits to the Secretary an application, in such form and manner as the Secretary shall prescribe, that— For each of fiscal years 2003, 2004, 2005, and 2006, the Secretary may not make more than 35 new awards under subsection (a) (excluding renewals of such awards). This paragraph shall not be construed to affect awards made before fiscal year 2003. An eligible entity may not receive a grant under this section (including with respect to any such grant made before fiscal year 2003) for more than 3 consecutive fiscal years, except that such entity may receive such a grant award for not more than 1 additional fiscal year if— In paragraph (2), the term “extraordinary circumstances” means an event (or events) that is outside of the control of the eligible entity that has prevented the eligible entity from fulfilling the objectives described by such entity in the application submitted under subsection (b)(2). Extraordinary circumstances include— In awarding grants under this section, the Secretary— may accord priority to applicants that best promote the objectives of this section, taking into consideration the extent to which the application involved— Except as provided in paragraphs (2) and (3), a grantee may use amounts provided under this section only for— The following are examples of purposes for which a grantee may use grant funds under this section, when such use meets the conditions stated in subparagraph (A): Not more than 15 percent of the funds provided under a grant awarded under this section may be used for providing direct patient care and services. The Secretary may use not more than 3 percent of funds appropriated to carry out this section for providing technical assistance to grantees, obtaining assistance of experts and consultants, holding meetings, developing of tools, disseminating of information, evaluation, and carrying out activities that will extend the benefits of programs funded under this section to communities other than the community served by the program funded. A grantee under this section shall— report to the Secretary annually regarding— the extent to which activities conducted by such grantee have— The Secretary may not renew an annual grant under this section for an entity for a fiscal year unless the Secretary is satisfied that the consortium represented by the entity has made reasonable and demonstrable progress in meeting the goals and measurable objectives set forth in the entity’s grant application for the preceding fiscal year. With respect to activities for which a grant under this section is authorized, the Secretary may award such a grant only if the applicant for the grant, and each of the participating providers, agree that the grantee and each such provider will maintain its expenditures of non-Federal funds for such activities at a level that is not less than the level of such expenditures during the fiscal year immediately preceding the fiscal year for which the applicant is applying to receive such grant. The Secretary may, either directly or by grant or contract, provide any entity that receives a grant under this section with technical and other nonfinancial assistance necessary to meet the requirements of this section. Not later than September 30, 2005, the Secretary shall prepare and submit to the appropriate committees of Congress a report that describes the extent to which projects funded under this section have been successful in improving the effectiveness, efficiency, and coordination of services for uninsured and underinsured individuals in the communities or geographic areas served by such projects, including whether the projects resulted in the provision of better quality health care for such individuals, and whether such care was provided at lower costs, than would have been provided in the absence of such projects. The Secretary may make demonstration awards under this section to historically black health professions schools for the purposes of— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2002 through 2006. Funds may not be appropriated to carry out this section after September 30, 2006.