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42 U.S. Code § 254b. Health centers
(a) “Health center” defined
(1) In generalFor purposes of this section, the term “health center” means an entity that serves a population that is medically underserved, or a special medically underserved population comprised of migratory and seasonal agricultural workers, the homeless, and residents of public housing, by providing, either through the staff and supporting resources of the center or through contracts or cooperative arrangements—
(A)
required primary health services (as defined in subsection (b)(1)); and
(B)
as may be appropriate for particular centers, additional health services (as defined in subsection (b)(2)) necessary for the adequate support of the primary health services required under subparagraph (A);
for all residents of the area served by the center (hereafter referred to in this section as the “catchment area”).
(2) Limitation
The requirement in paragraph (1) to provide services for all residents within a catchment area shall not apply in the case of a health center receiving a grant only under subsection (g), (h), or (i).
(b) DefinitionsFor purposes of this section:
(1) Required primary health services
(A) In generalThe term “required primary health services” means—
(i) basic health services which, for purposes of this section, shall consist of—
(I)
health services related to family medicine, internal medicine, pediatrics, obstetrics, or gynecology that are furnished by physicians and where appropriate, physician assistants, nurse practitioners, and nurse midwives;
(II)
diagnostic laboratory and radiologic services;
(III) preventive health services, including—
(aa)
prenatal and perinatal services;
(bb)
appropriate cancer screening;
(cc)
well-child services;
(dd)
immunizations against vaccine-preventable diseases;
(ee)
screenings for elevated blood lead levels, communicable diseases, and cholesterol;
(ff)
pediatric eye, ear, and dental screenings to determine the need for vision and hearing correction and dental care;
(gg)
voluntary family planning services; and
(hh)
preventive dental services;
(IV)
emergency medical services; and
(V)
pharmaceutical services as may be appropriate for particular centers;
(ii)
referrals to providers of medical services (including specialty referral when medically indicated) and other health-related services (including substance use disorder and mental health services);
(iii)
patient case management services (including counseling, referral, and follow-up services) and other services designed to assist health center patients in establishing eligibility for and gaining access to Federal, State, and local programs that provide or financially support the provision of medical, social, housing, educational, or other related services;
(iv)
services that enable individuals to use the services of the health center (including outreach and transportation services and, if a substantial number of the individuals in the population served by a center are of limited English-speaking ability, the services of appropriate personnel fluent in the language spoken by a predominant number of such individuals); and
(v)
education of patients and the general population served by the health center regarding the availability and proper use of health services.
(B) ExceptionWith respect to a health center that receives a grant only under subsection (g), the Secretary, upon a showing of good cause, shall—
(i)
waive the requirement that the center provide all required primary health services under this paragraph; and
(ii)
approve, as appropriate, the provision of certain required primary health services only during certain periods of the year.
(2) Additional health servicesThe term “additional health services” means services that are not included as required primary health services and that are appropriate to meet the health needs of the population served by the health center involved. Such term may include—
(A)
behavioral and mental health and substance use disorder services;
(B)
recuperative care services;
(C) environmental health services, including—
(i) the detection and alleviation of unhealthful conditions associated with—
(I)
water supply;
(II)
chemical and pesticide exposures;
(III)
air quality; or
(IV)
exposure to lead;
(ii)
sewage treatment;
(iii)
solid waste disposal;
(iv)
rodent and parasitic infestation;
(v)
field sanitation;
(vi)
housing; and
(vii)
other environmental factors related to health; and
(D) in the case of health centers receiving grants under subsection (g), special occupation-related health services for migratory and seasonal agricultural workers, including—
(i)
screening for and control of infectious diseases, including parasitic diseases; and
(ii)
injury prevention programs, including prevention of exposure to unsafe levels of agricultural chemicals including pesticides.
(3) Medically underserved populations
(A) In general
The term “medically underserved population” means the population of an urban or rural area designated by the Secretary as an area with a shortage of personal health services or a population group designated by the Secretary as having a shortage of such services.
(B) CriteriaIn carrying out subparagraph (A), the Secretary shall prescribe criteria for determining the specific shortages of personal health services of an area or population group. Such criteria shall—
(i)
take into account comments received by the Secretary from the chief executive officer of a State and local officials in a State; and
(ii)
include factors indicative of the health status of a population group or residents of an area, the ability of the residents of an area or of a population group to pay for health services and their accessibility to them, and the availability of health professionals to residents of an area or to a population group.
(C) LimitationThe Secretary may not designate a medically underserved population in a State or terminate the designation of such a population unless, prior to such designation or termination, the Secretary provides reasonable notice and opportunity for comment and consults with—
(i)
the chief executive officer of such State;
(ii)
local officials in such State; and
(iii)
the organization, if any, which represents a majority of health centers in such State.
(D) Permissible designation
The Secretary may designate a medically underserved population that does not meet the criteria established under subparagraph (B) if the chief executive officer of the State in which such population is located and local officials of such State recommend the designation of such population based on unusual local conditions which are a barrier to access to or the availability of personal health services.