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108th Congress                                            Rept. 108-727
                        HOUSE OF REPRESENTATIVES
 2d Session                                                      Part 1
======================================================================

 
 PATIENT NAVIGATOR OUTREACH AND CHRONIC DISEASE PREVENTION ACT OF 2004

                                _______
                                

                October 5, 2004.--Ordered to be printed

                                _______
                                

    Mr. Barton of Texas, from the Committee on Energy and Commerce, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 918]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 918) to authorize the Health Resources and 
Services Administration, the National Cancer Institute, and the 
Indian Health Service to make grants for model programs to 
provide to individuals of health disparity populations 
prevention, early detection, treatment, and appropriate follow-
up care services for cancer and chronic diseases, and to make 
grants regarding patient navigators to assist individuals of 
health disparity populations in receiving such services, having 
considered the same, report favorably thereon with amendments 
and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     4
Hearings.........................................................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings.....................................     4
Statement of General Performance Goals and Objectives............     4
New Budget Authority, Entitlement Authority, and Tax Expenditures     4
Committee Cost Estimate..........................................     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     6
Advisory Committee Statement.....................................     6
Constitutional Authority Statement...............................     6
Applicability to Legislative Branch..............................     6
Section-by-Section Analysis of the Legislation...................     6
Changes in Existing Law Made by the Bill, as Reported............     8

                               Amendment

  The amendments are as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Patient Navigator Outreach and Chronic 
Disease Prevention Act of 2004''.

SEC. 2. PATIENT NAVIGATOR GRANTS.

  Subpart V of part D of title III of the Public Health Service Act (42 
U.S.C. 256) is amended by adding at the end the following:

``SEC. 340A. PATIENT NAVIGATOR GRANTS.

  ``(a) Grants.--The Secretary, acting through the Administrator of the 
Health Resources and Services Administration, may make grants to 
eligible entities for the development and operation of demonstration 
programs to provide patient navigator services to improve health care 
outcomes. The Secretary shall coordinate with, and ensure the 
participation of, the Indian Health Service, the National Cancer 
Institute, the Office of Rural Health Policy, and such other offices 
and agencies as deemed appropriate by the Secretary, regarding the 
design and evaluation of the demonstration programs.
  ``(b) Use of Funds.--A condition on the receipt of a grant under this 
section is that the grantee agree to use the grant to recruit, assign, 
train, and employ patient navigators who have direct knowledge of the 
communities they serve to facilitate the care of individuals, including 
by performing each of the following duties:
          ``(1) Acting as contacts, including by assisting in the 
        coordination of health care services and provider referrals, 
        for individuals who are seeking prevention or early detection 
        services for, or who following a screening or early detection 
        service are found to have a symptom, abnormal finding, or 
        diagnosis of, cancer or other chronic disease.
          ``(2) Facilitating the involvement of community organizations 
        providing assistance to individuals who are at risk for or who 
        have cancer or other chronic diseases to receive better access 
        to high-quality health care services (such as by creating 
        partnerships with patient advocacy groups, charities, health 
        care centers, community hospice centers, other health care 
        providers, or other organizations in the targeted community).
          ``(3) Notifying individuals of clinical trials and 
        facilitating enrollment in these trials if requested and 
        eligible.
          ``(4) Anticipating, identifying, and helping patients to 
        overcome barriers within the health care system to ensure 
        prompt diagnostic and treatment resolution of an abnormal 
        finding of cancer or other chronic disease.
          ``(5) Coordinating with the relevant health insurance 
        ombudsman programs to provide information to individuals who 
        are at risk for or who have cancer or other chronic diseases 
        about health coverage, including private insurance, health care 
        savings accounts, and other publicly funded programs (such as 
        Medicare, Medicaid, and the State children's health insurance 
        program).
          ``(6) Conducting ongoing outreach to health disparity 
        populations, including the uninsured, rural populations, and 
        other medically underserved populations, in addition to 
        assisting other individuals who are at risk for or who have 
        cancer or other chronic diseases to seek preventative care.
  ``(c) Grant Period.--
          ``(1) In general.--Subject to paragraphs (2) and (3), the 
        Secretary may award grants under this section for periods of 
        not more than 3 years.
          ``(2) Extensions.--Subject to paragraph (3), the Secretary 
        may extend the period of a grant under this section, except 
        that--
                  ``(A) each such extension shall be for a period of 
                not more than 1 year; and
                  ``(B) the Secretary may make not more than 4 such 
                extensions with respect to any grant.
          ``(3) End of grant period.--In carrying out this section, the 
        Secretary may not authorize any grant period ending after 
        September 30, 2010.
  ``(d) Application.--
          ``(1) In general.--To seek a grant under this section, an 
        eligible entity shall submit an application to the Secretary in 
        such form, in such manner, and containing such information as 
        the Secretary may require.
          ``(2) Contents.--At a minimum, the Secretary shall require 
        each such application to outline how the eligible entity will 
        establish baseline measures and benchmarks that meet the 
        Secretary's requirements to evaluate program outcomes.
  ``(e) Uniform Baseline Measures.--The Secretary shall establish 
uniform baseline measures in order to properly evaluate the impact of 
the demonstration projects under this section.
  ``(f) Preference.--In making grants under this section, the Secretary 
shall give preference to eligible entities that demonstrate in their 
applications plans to utilize patient navigator services to overcome 
significant barriers in order to improve health care outcomes in their 
respective communities.
  ``(g) Coordination With Other Programs.--The Secretary shall ensure 
coordination of the demonstration grant program under this section with 
existing authorized programs in order to facilitate access to high-
quality health care services.
  ``(h) Study; Reports.--
          ``(1) Final report by secretary.--Not later than 6 months 
        after the completion of the demonstration grant program under 
        this section, the Secretary shall conduct a study of the 
        results of the program and submit to the Congress a report on 
        such results that includes the following:
                  ``(A) An evaluation of the program outcomes, 
                including--
                          ``(i) quantitative analysis of baseline and 
                        benchmark measures; and
                          ``(ii) aggregate information about the 
                        patients served and program activities.
                  ``(B) Recommendations on whether patient navigator 
                programs could be used to improve patient outcomes in 
                other public health areas.
          ``(2) Interim reports by secretary.--The Secretary may 
        provide interim reports to the Congress on the demonstration 
        grant program under this section at such intervals as the 
        Secretary determines to be appropriate.
          ``(3) Interim reports by grantees.--The Secretary may require 
        grant recipients under this section to submit interim reports 
        on grant program outcomes.
  ``(i) Rule of Construction.--This section shall not be construed to 
authorize funding for the delivery of health care services (other than 
the patient navigator duties listed in subsection (b)).
  ``(j) Definitions.--In this section:
          ``(1) The term `eligible entity' means a public or nonprofit 
        private health center (including a Federally qualified health 
        center (as that term is defined in section 1861(aa)(4) of the 
        Social Security Act)), a health facility operated by or 
        pursuant to a contract with the Indian Health Service, a 
        hospital, a cancer center, a rural health clinic, an academic 
        health center, or a nonprofit entity that enters into a 
        partnership or coordinates referrals with such a center, 
        clinic, facility, or hospital to provide patient navigator 
        services.
          ``(2) The term `health disparity population' means a 
        population that, as determined by the Secretary, has a 
        significant disparity in the overall rate of disease incidence, 
        prevalence, morbidity, mortality, or survival rates as compared 
        to the health status of the general population.
          ``(3) The term `patient navigator' means an individual who 
        has completed a training program approved by the Secretary to 
        perform the duties listed in subsection (b).
  ``(k) Authorization of Appropriations.--
          ``(1) In general.--To carry out this section, there are 
        authorized to be appropriated $2,000,000 for fiscal year 2006, 
        $5,000,000 for fiscal year 2007, $8,000,000 for fiscal year 
        2008, $6,500,000 for fiscal year 2009, and $3,500,000 for 
        fiscal year 2010.
          ``(2) Availability.--The amounts appropriated pursuant to 
        paragraph (1) shall remain available for obligation through the 
        end of fiscal year 2010.''.

  Amend the title so as to read:

      A bill to amend the Public Health Service Act to 
authorize a demonstration grant program to provide patient 
navigator services to reduce barriers and improve health care 
outcomes, and for other purposes.

                          Purpose and Summary

    The purpose of H.R. 918 is to authorize the Secretary of 
the Department of Health and Human Services to conduct a 
demonstration program to promote model ``patient navigator'' 
programs to improve health care outcomes for individuals with 
cancer or other chronic diseases, with a specific emphasis on 
health disparity populations.

                  Background and Need for Legislation

    Improving health care outcomes for all Americans requires 
substantial improvement in health disparity populations, 
populations--not defined solely by race and ethinicity--that 
have a significant disparity in the overall rate of disease 
incidence, prevalence, morbidity, mortality, or survival rates 
as compared to the health status of the general population. 
Patient navigator programs provide outreach to communities to 
seek preventative care and coordinate health care services for 
individuals who are at risk for or who have a chronic disease. 
For example, the Ralph Lauren Center for Cancer Care and 
Prevention, a partnership between Memorial Sloan-Kettering and 
North General Hospital in Harlem, New York, operates a patient 
navigator program to help patients and family members deal with 
the complexities of the health care system. By coordinating 
health care services through a patient navigator, the patient 
navigator programs strive to shorten the period of time when a 
patient is screened for cancer or other chronic diseases and 
further diagnosis and treatment, if needed.
    H.R. 918 authorizes the Secretary of Health and Human 
Services to conduct a demonstration program to evaluate the 
impact of patient navigator programs on improving health care 
outcomes.

                                Hearings

    The Committee on Energy and Commerce has not held hearings 
on the legislation.

                        Committee Consideration

    On Thursday, September 30, 2004 the Full Committee met in 
open markup session and ordered H.R. 918 favorably reported to 
the House, as amended, by a voice vote, a quorum being present.

                            Committee Votes

    There were no record votes taken in connection with 
ordering H.R. 918 reported. A motion by Mr. Barton to order 
H.R. 918 reported to the House, as amended, was agreed to by a 
voice vote.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held oversight 
or legislative hearings on this legislation.

         Statement of General Performance Goals and Objectives

    The goal of H.R. 918 is to establish a demonstration 
program to evaluate the impact of ``patient navigator'' 
programs on improving health care outcomes for individuals with 
cancer or other chronic diseases.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
918, the Patient Navigator Outreach and Chronic Disease 
Prevention Act of 2004, would result in no new or increased 
budget authority, entitlement authority, or tax expenditures or 
revenues.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                   Washington, DC, October 4, 2003.
Hon. Joe Barton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 918, the Patient 
Navigator Outreach and Chronic Disease Prevention Act of 2004.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Margaret 
Nowak.
            Sincerely,
                                       Douglas Holtz-Eakin,
                                                          Director.
    Enclosure.

H.R. 918--Patient Navigator Outreach and Chronic Disease Prevention Act 
        of 2004

    H.R. 918 would amend the Public Health Service Act to 
authorize the Secretary of Health and Human Services to make 
grants for the development and operation of programs that 
provide ``patient navigator'' services. Patient navigators 
assist patients in overcoming obstacles to the prompt diagnosis 
and treatment of health problems, in part by identifying 
sources of care and insurance, coordinating referrals, and 
facilitating enrollment in clinical trials. The bill also would 
require the Secretary to conduct a study and report to the 
Congress within six months of completion of the grant program.
    The bill would authorize the appropriation of $2 million in 
2006, $5 million in 2007, $8 million in 2008, $6.5 million in 
2009, and $3.5 million in 2010. Based on spending patterns for 
similar programs, and assuming appropriation of the authorized 
amounts, CBO estimates that implementing H.R. 918 would cost 
$18 million from 2005 through 2009. The legislation would not 
affect direct spending or receipts.
    H.R. 918 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act; state, 
local, and tribal governments would be eligible to apply for 
grants authorized by the bill.
    The CBO staff contact for this estimate is Margaret Nowak. 
This estimate was approved by Peter H. Fontaine, Deputy 
Assistant Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
Constitutional authority for this legislation is provided in 
Article I, section 8, clause 3, which grants Congress the power 
to regulate commerce with foreign nations, among the several 
States, and with the Indian tribes.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    This section provides the short title of the bill, the 
``Patient Navigator Outreach and Chronic Disease Prevention Act 
of 2004.''

Section 2. Patient navigator grants

    Section 2 authorizes the Secretary of the Department of 
Health and Human Services, acting through the Administrator of 
the Health Resources and Services Administration (``HRSA''), to 
make grants to eligible entities for the development and 
operation of demonstration programs to provide patient 
navigator services to improve health care outcomes. Eligible 
entities include a public or nonprofit private health center, a 
community health center, a health facility operated with the 
Indian Health Services, a hospital, a cancer center, a rural 
health clinic, an academic health center, or a nonprofit entity 
that enters into a partnership or coordinates referrals with 
such health care facilities. With respect to a nonprofit 
entity, the Committee does not intend the term ``coordinates 
referrals with'' to imply that a nonprofit entity must jointly 
file a grant application with a health care facility. Instead, 
the Committee fully expects the Administrator of HRSA to 
evaluate nonprofit entity applications by the strength of the 
nonprofit entity's ability to provide all of the requirements 
of patient navigator services, including referrals to specific 
facilities, as well as the ability of the nonprofit 
organization to conduct outreach activities for prevention 
services and treatment programs.
    The Committee recognizes the challenges of some communities 
in overcoming significant barriers to high quality health care 
services, including geographic isolation, cultural and 
linguistic barriers, limited transportation services, lack of 
health insurance and information about health options, and 
socioeconomic status. Therefore, section 2 requires the 
Administrator of HRSA to give preference to grant applicants 
who target populations in greatest need and utilize patient 
navigators to help overcome these and other barriers in order 
to reduce health care disparities and improve health care 
outcomes.
    Eligible entities may use the grant to recruit, assign, 
train, and employ patient navigators who have a direct 
knowledge of the communities they serve. The term ``patient 
navigator'' is defined to mean an individual who has completed 
a training program approved by the Secretary to perform the 
duties outlined in the legislation. The Committee recognizes 
that there will be grant applicants with varying levels of 
experience in patient navigation. Some may have existing, 
trained patient navigators who want to expand their services; 
others may have no trained navigators but are well positioned 
to begin providing patient navigator services with appropriate 
training. An allowable use of part of the funds under this 
grant would be to provide navigator training, a plan for which 
should be included in the grant application.
    Patient navigators must coordinate health care services and 
provider referrals, facilitate the involvement of community 
organizations to provide assistance to patients, facilitate 
enrollment in clinical trials, anticipate barriers within the 
health care system and help ensure prompt diagnostic care and 
treatment, coordinate with appropriate health insurance 
ombudsman programs, and conduct ongoing outreach to health 
disparity populations and other individuals to seek 
preventative care. Section 2 includes a rule of construction to 
clarify that the bill does not authorize funding for the 
delivery of health care services other than the patient 
navigator duties outlined in the legislation. The Committee 
fully expects that patient navigators will assist the uninsured 
individuals in enrolling in appropriate health coverage 
programs, including private insurance, publicly funded programs 
like Medicaid, as well as health care savings accounts.
    The Administrator of HRSA must coordinate and ensure the 
participation of the Indian Health Service, the National Cancer 
Institute, the Office of Rural Health Policy, and other such 
office and agencies deemed appropriate by the Secretary, 
regarding the deign and evaluation of the demonstration 
program. To facilitate the operation of the program, the 
Committee has assigned primary responsibility to the 
Administrator of HRSA. However, the Committee recognizes the 
distinct role of each of these offices and agencies within the 
Department of Health and Human Services, and therefore requires 
close coordination to maximize the impact of the patient 
navigator demonstration program. Section 2 also requires the 
Secretary to ensure coordination of the demonstration program 
with existing authorized programs in order to facilitate access 
tohigh-quality health care services, for example, the Community 
Access Program administered by HRSA and the breast and cervical cancer 
screening programs administered by the Centers for Disease Control and 
Prevention.
    An eligible entity may receive a grant for a period of not 
more than 3 years. The Secretary may, based on extenuating 
circumstances, approve an extension of the grant period for up 
to one-year. The demonstration program expires on September 30, 
2010.
    Grant recipients must establish baseline measures and 
benchmarks to evaluate program outcomes. The Secretary may 
require grant recipients to submit interim reports on grant 
program outcomes, as well as provide Congress with interim 
reports on the progress of the demonstration program. The 
Secretary is required to conduct an evaluation of the results 
of the program no later than 6 months after the completion of 
the demonstration grant program. To effectively measure program 
outcomes, the Committee recommends that the Secretary collect 
and include the following data in the final report to Congress: 
the patient's insurance status, income, education level, 
gender, age, race and ethnicity, the number of patients 
navigated, demographic coverage area, screening location and 
date, type and stage of diagnosis, point at which the navigator 
was brought into the process, type of navigator (lay or 
professional), barriers the patient encountered and how they 
were resolved, compliance rate for appointments and follow-up 
exams, number of patients referred (e.g., to treatment, 
pharmaceutical assistance programs, ombudsman programs/other 
health insurance programs, community organizations) and follow-
up outcomes (e.g., number of uninsured who get health coverage, 
etc.), time interval between diagnosis or referral and 
resolution date, and the final outcome or result. For 
applicants who are providing training for patient navigators, 
the report should also include the plan for such training and 
the outcomes.
    Finally, section 2 authorizes to be appropriated $2 million 
in fiscal year 2006, $5 million in fiscal year 2007, $8 million 
in fiscal year 2008, $6.5 million in fiscal year 2009, and $3.5 
million in fiscal year 2010 to carry out the patient navigator 
demonstration program. Amounts appropriated will be available 
through the end of fiscal year 2010.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part D--Primary Health Care

           *       *       *       *       *       *       *



Subpart V--Healthy Communities Access Program

           *       *       *       *       *       *       *


SEC. 340A. PATIENT NAVIGATOR GRANTS.

  (a) Grants.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, may make 
grants to eligible entities for the development and operation 
of demonstration programs to provide patient navigator services 
to improve health care outcomes. The Secretary shall coordinate 
with, and ensure the participation of, the Indian Health 
Service, the National Cancer Institute, the Office of Rural 
Health Policy, and such other offices and agencies as deemed 
appropriate by the Secretary, regarding the design and 
evaluation of the demonstration programs.
  (b) Use of Funds.--A condition on the receipt of a grant 
under this section is that the grantee agree to use the grant 
to recruit, assign, train, and employ patient navigators who 
have direct knowledge of the communities they serve to 
facilitate the care of individuals, including by performing 
each of the following duties:
          (1) Acting as contacts, including by assisting in the 
        coordination of health care services and provider 
        referrals, for individuals who are seeking prevention 
        or early detection services for, or who following a 
        screening or early detection service are found to have 
        a symptom, abnormal finding, or diagnosis of, cancer or 
        other chronic disease.
          (2) Facilitating the involvement of community 
        organizations providing assistance to individuals who 
        are at risk for or who have cancer or other chronic 
        diseases to receive better access to high-quality 
        health care services (such as by creating partnerships 
        with patient advocacy groups, charities, health care 
        centers, community hospice centers, other health care 
        providers, or other organizations in the targeted 
        community).
          (3) Notifying individuals of clinical trials and 
        facilitating enrollment in these trials if requested 
        and eligible.
          (4) Anticipating, identifying, and helping patients 
        to overcome barriers within the health care system to 
        ensure prompt diagnostic and treatment resolution of an 
        abnormal finding of cancer or other chronic disease.
          (5) Coordinating with the relevant health insurance 
        ombudsman programs to provide information to 
        individuals who are at risk for or who have cancer or 
        other chronic diseases about health coverage, including 
        private insurance, health care savings accounts, and 
        other publicly funded programs (such as Medicare, 
        Medicaid, and the State children's health insurance 
        program).
          (6) Conducting ongoing outreach to health disparity 
        populations, including the uninsured, rural 
        populations, and other medically underserved 
        populations, in addition to assisting other individuals 
        who are at risk for or who have cancer or other chronic 
        diseases to seek preventative care.
  (c) Grant Period.--
          (1) In general.--Subject to paragraphs (2) and (3), 
        the Secretary may award grants under this section for 
        periods of not more than 3 years.
          (2) Extensions.--Subject to paragraph (3), the 
        Secretary may extend the period of a grant under this 
        section, except that--
                  (A) each such extension shall be for a period 
                of not more than 1 year; and
                  (B) the Secretary may make not more than 4 
                such extensions with respect to any grant.
          (3) End of grant period.--In carrying out this 
        section, the Secretary may not authorize any grant 
        period ending after September 30, 2010.
  (d) Application.--
          (1) In general.--To seek a grant under this section, 
        an eligible entity shall submit an application to the 
        Secretary in such form, in such manner, and containing 
        such information as the Secretary may require.
          (2) Contents.--At a minimum, the Secretary shall 
        require each such application to outline how the 
        eligible entity will establish baseline measures and 
        benchmarks that meet the Secretary's requirements to 
        evaluate program outcomes.
  (e) Uniform Baseline Measures.--The Secretary shall establish 
uniform baseline measures in order to properly evaluate the 
impact of the demonstration projects under this section.
  (f) Preference.--In making grants under this section, the 
Secretary shall give preference to eligible entities that 
demonstrate in their applications plans to utilize patient 
navigator services to overcome significant barriers in order to 
improve health care outcomes in their respective communities.
  (g) Coordination With Other Programs.--The Secretary shall 
ensure coordination of the demonstration grant program under 
this section with existing authorized programs in order to 
facilitate access to high-quality health care services.
  (h) Study; Reports.--
          (1) Final report by secretary.--Not later than 6 
        months after the completion of the demonstration grant 
        program under this section, the Secretary shall conduct 
        a study of the results of the program and submit to the 
        Congress a report on such results that includes the 
        following:
                  (A) An evaluation of the program outcomes, 
                including--
                          (i) quantitative analysis of baseline 
                        and benchmark measures; and
                          (ii) aggregate information about the 
                        patients served and program activities.
                  (B) Recommendations on whether patient 
                navigator programs could be used to improve 
                patient outcomes in other public health areas.
          (2) Interim reports by secretary.--The Secretary may 
        provide interim reports to the Congress on the 
        demonstration grant program under this section at such 
        intervals as the Secretary determines to be 
        appropriate.
          (3) Interim reports by grantees.--The Secretary may 
        require grant recipients under this section to submit 
        interim reports on grant program outcomes.
  (i) Rule of Construction.--This section shall not be 
construed to authorize funding for the delivery of health care 
services (other than the patient navigator duties listed in 
subsection (b)).
  (j) Definitions.--In this section:
          (1) The term ``eligible entity'' means a public or 
        nonprofit private health center (including a Federally 
        qualified health center (as that term is defined in 
        section 1861(aa)(4) of the Social Security Act)), a 
        health facility operated by or pursuant to a contract 
        with the Indian Health Service, a hospital, a cancer 
        center, a rural health clinic, an academic health 
        center, or a nonprofit entity that enters into a 
        partnership or coordinates referrals with such a 
        center, clinic, facility, or hospital to provide 
        patient navigator services.
          (2) The term ``health disparity population'' means a 
        population that, as determined by the Secretary, has a 
        significant disparity in the overall rate of disease 
        incidence, prevalence, morbidity, mortality, or 
        survival rates as compared to the health status of the 
        general population.
          (3) The term ``patient navigator'' means an 
        individual who has completed a training program 
        approved by the Secretary to perform the duties listed 
        in subsection (b).
  (k) Authorization of Appropriations.--
          (1) In general.--To carry out this section, there are 
        authorized to be appropriated $2,000,000 for fiscal 
        year 2006, $5,000,000 for fiscal year 2007, $8,000,000 
        for fiscal year 2008, $6,500,000 for fiscal year 2009, 
        and $3,500,000 for fiscal year 2010.
          (2) Availability.--The amounts appropriated pursuant 
        to paragraph (1) shall remain available for obligation 
        through the end of fiscal year 2010.

           *       *       *       *       *       *       *