public center

(3) Requirements Except as provided in subsection (e)(1)(B) or subsection (e)(6), the Secretary may not approve an application for a grant under subparagraph (A) or (B) of subsection (e)(1) unless the Secretary determines that the entity for which the application is submitted is a health center (within the meaning of subsection (a)) and that— (A) the required primary health services of the center will be available and accessible in the catchment area of the center promptly, as appropriate, and in a manner which assures continuity; (B) the center has made and will continue to make every reasonable effort to establish and maintain collaborative relationships with other health care providers, including other health care providers that provide care within the catchment area, local hospitals, and specialty providers in the catchment area of the center, to provide access to services not available through the health center and to reduce the non-urgent use of hospital emergency departments; (C) the center will have an ongoing quality improvement system that includes clinical services and management, and that maintains the confidentiality of patient records; (D) the center will demonstrate its financial responsibility by the use of such accounting procedures and other requirements as may be prescribed by the Secretary; (E) the center— (i) (I) has or will have a contractual or other arrangement with the agency of the State, in which it provides services, which administers or supervises the administration of a State plan approved under title XIX of the Social Security Act [ 42 U.S.C. 1396 et seq.] for the payment of all or a part of the center’s costs in providing health services to persons who are eligible for medical assistance under such a State plan; and (II) has or will have a contractual or other arrangement with the State agency administering the program under title XXI of such Act ( 42 U.S.C. 1397aa et seq.) with respect to individuals who are State children’s health insurance program beneficiaries; or (ii) has made or will make every reasonable effort to enter into arrangements described in subclauses (I) and (II) of clause (i); (F) the center has made or will make and will continue to make every reasonable effort to collect appropriate reimbursement for its costs in providing health services to persons who are entitled to insurance benefits under title XVIII of the Social Security Act [ 42 U.S.C. 1395 et seq.], to medical assistance under a State plan approved under title XIX of such Act [ 42 U.S.C. 1396 et seq.], or to assistance for medical expenses under any other public assistance program or private health insurance program; (G) the center— (i) has prepared a schedule of fees or payments for the provision of its services consistent with locally prevailing rates or charges and designed to cover its reasonable costs of operation and has prepared a corresponding schedule of discounts to be applied to the payment of such fees or payments, which discounts are adjusted on the basis of the patient’s ability to pay; (ii) has made and will continue to make every reasonable effort— (I) to secure from patients payment for services in accordance with such schedules; and (II) to collect reimbursement for health services to persons described in subparagraph (F) on the basis of the full amount of fees and payments for such services without application of any discount; (iii) (I) will assure that no patient will be denied health care services due to an individual’s inability to pay for such services; and (II) will assure that any fees or payments required by the center for such services will be reduced or waived to enable the center to fulfill the assurance described in subclause (I); and (iv) has submitted to the Secretary such reports as the Secretary may require to determine compliance with this subparagraph; (H) the center has established a governing board which except in the case of an entity operated by an Indian tribe or tribal or Indian organization under the Indian Self-Determination Act [ 25 U.S.C. 5321 et seq.] or an urban Indian organization under the Indian Health Care Improvement Act ( 25 U.S.C. 1651 et seq.)— (i) is composed of individuals, a majority of whom are being served by the center and who, as a group, represent the individuals being served by the center; (ii) meets at least once a month, selects the services to be provided by the center, schedules the hours during which such services will be provided, approves the center’s annual budget, approves the selection of a director for the center who shall be directly employed by the center, and, except in the case of a governing board of a public center (as defined in the second sentence of this paragraph), establishes general policies for the center; and (iii) in the case of an application for a second or subsequent grant for a public center, has approved the application or if the governing body has not approved the application, the failure of the governing body to approve the application was unreasonable; except that, upon a showing of good cause the Secretary shall waive, for the length of the project period, all or part of the requirements of this subparagraph in the case of a health center that receives a grant pursuant to subsection (g), (h), (i), or (p); (I) the center has developed— (i) an overall plan and budget that meets the requirements of the Secretary; and (ii) an effective procedure for compiling and reporting to the Secretary such statistics and other information as the Secretary may require relating to— (I) the costs of its operations; (II) the patterns of use of its services; (III) the availability, accessibility, and acceptability of its services; and (IV) such other matters relating to operations of the applicant as the Secretary may require; (J) the center will review periodically its catchment area to— (i) ensure that the size of such area is such that the services to be provided through the center (including any satellite) are available and accessible to the residents of the area promptly and as appropriate; (ii) ensure that the boundaries of such area conform, to the extent practicable, to relevant boundaries of political subdivisions, school districts, and Federal and State health and social service programs; and (iii) ensure that the boundaries of such area eliminate, to the extent possible, barriers to access to the services of the center, including barriers resulting from the area’s physical characteristics, its residential patterns, its economic and social grouping, and available transportation; (K) in the case of a center which serves a population including a substantial proportion of individuals of limited English-speaking ability, the center has— (i) developed a plan and made arrangements responsive to the needs of such population for providing services to the extent practicable in the language and cultural context most appropriate to such individuals; and (ii) identified an individual on its staff who is fluent in both that language and in English and whose responsibilities shall include providing guidance to such individuals and to appropriate staff members with respect to cultural sensitivities and bridging linguistic and cultural differences; (L) the center, has developed an ongoing referral relationship with one or more hospitals; (M) the center encourages persons receiving or seeking health services from the center to participate in any public or private (including employer-offered) health programs or plans for which the persons are eligible, so long as the center, in complying with this subparagraph, does not violate the requirements of subparagraph (G)(iii)(I); and (N) the center has written policies and procedures in place to ensure the appropriate use of Federal funds in compliance with applicable Federal statutes, regulations, and the terms and conditions of the Federal award. For purposes of subparagraph (H), the term “public center” means a health center funded (or to be funded) through a grant under this section to a public agency.


42 USC § 254b(k)(3)

Scoping language

None identified, default scope is assumed to be the parent (subpart i) of this section.
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