S. 1990Senate110th Congress (2007-2009)In Committee

BUILD Act

Introduced August 3, 2007

Legislative Activity

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2 earlier actions
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S10905-10906)

August 3, 2007

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SenateIntro Referral

Introduced in Senate

August 3, 2007

SenateIntro Referral

Sponsor introductory remarks on measure. (CR S10905)

August 3, 2007

SenateIntro Referral

Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S10905-10906)

August 3, 2007

Floor Debate

10 members

What members said about S. 1990 on the floor

4 Republicans6 Democrats
Mary L. Landrieu
Sen. Mary L. LandrieuD-LA · Aug 3, 2007

Mr. President, today I rise to discuss the All Students Can Achieve Act that I am introducing today with Senators Lieberman and Coleman. I was proud to have been a part of developing the No Child…

Hillary Rodham Clinton
Sen. Hillary Rodham ClintonD-NY · Aug 3, 2007

Mr. President, today, I am introducing the Secondhand Smoke Education and Outreach Act of 2007 to provide information to the public about the health consequences of secondhand smoke and support…

Joseph I. Lieberman
Sen. Joseph I. LiebermanD-CT · Aug 3, 2007

Mr. President, I rise today to introduce, together with my colleagues Senator Mary Landrieu and Senator Norm Coleman, the All Students Can Achieve Act. This bill represents a comprehensive bipartisan…

Susan M. Collins
Sen. Susan M. CollinsR-ME · Aug 3, 2007

Mr. President, I rise to introduce Senate Bill 2003, a measure that will enhance the Federal Government's ability to perform its duties capably and economically as it faces a wave of retirement of…

Norm Coleman
Sen. Norm ColemanR-MN · Aug 3, 2007

Mr. President, today I rise with my colleagues Senators Joe Lieberman and Mary Landrieu to introduce the All Students Can Achieve Act of 2007, ASCA, legislation aimed at improving the current No…

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Ted Stevens
Sen. Ted StevensR-AK · Aug 3, 2007

Mr. President, I am pleased to introduce a Senate joint resolution directing the United States to initiate efforts with other Nations to negotiate international agreements for managing migratory and…

John D. Rockefeller IV
Sen. John D. Rockefeller IVD-WV · Aug 3, 2007

Mr. President, today I rise with Senators Inouye and Sanders to introduce a very important bill--the Build, Update, Improve, Lift, and Design Health Centers Act of 2007. Also known as the BUILD Act,…

John D. Rockefeller IV
Sen. John D. Rockefeller IVD-WV · Aug 3, 2007

Mr. President, today I rise with Senators Inouye and Sanders to introduce a very important bill--the Build, Update, Improve, Lift, and Design Health Centers Act of 2007. Also known as the BUILD Act,…

Sherrod Brown
Sen. Sherrod BrownD-OH · Aug 3, 2007

Mr. President, I am introducing legislation today that would delay for 18 months the requirement that doctors write Medicaid prescriptions on tamper-resistant paper. I am pleased that my colleague…

Jim Bunning
Sen. Jim BunningR-KY · Aug 3, 2007

Mr. President, I would like to introduce a bill to authorize the National Park Service to conduct a comprehensive study to examine the extension of the Lewis and Clark National Historic Trail to…

Richard J. Durbin
Sen. Richard J. DurbinD-IL · Aug 3, 2007

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

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Introduced in SenateIssued August 3, 2007

II

110th CONGRESS

1st Session

S. 1990

IN THE SENATE OF THE UNITED STATES

August 3, 2007

Mr. Rockefeller (for himself, Mr. Inouye, and Mr. Sanders) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend part D of title III of the Public Health Service Act to authorize grants and loan guarantees for health centers to enable the centers to fund capital needs projects, and for other purposes.

1.

Short title

This Act may be cited as the Build, Update, Improve, Lift, and Design Health Centers Act of 2007 or the BUILD Act.

2.

Findings

Congress makes the following findings:

(1)

Many health care experts believe that lack of access to basic health services is our Nation’s single most pressing health care problem. There are 56,000,000 Americans that do not have access to a primary care provider, whether they have health insurance or not. In addition, more than 45,000,000 Americans lack health insurance and have difficulty accessing care due to the inability to pay for such care.

(2)

Health centers, including community health centers, migrant health centers, health centers for the homeless, and public housing health centers, address the health care access problem by providing primary care services in thousands of rural and urban medically-underserved communities throughout the United States.

(3)

Health centers provide basic health care services to 16,000,000 Americans each year, including nearly 9,500,000 minorities, 850,000 farmworkers, and 750,000 homeless individuals. One in five children from low-income families receives care through health centers.

(4)

Studies show that health centers provide high-quality and cost-effective health care. The average yearly cost for a health center patient is approximately $1.25 per day.

(5)

One of the most effective ways to address America’s health care access problem is by dramatically expanding access to health centers, as both the Senate and the President have proposed.

(6)

Many existing health centers operate in facilities that desperately need renovation or modernization. Thirty percent of health centers are located in buildings that are more than 30 years old, with 12 percent of such centers operating out of facilities that are more than 50 years old. In a survey of health centers in 11 States, 2/3 of those centers identified a need to improve, expand, or replace their current facility. An extrapolation based on this survey indicates there may be as much as $2,200,000,000 in unmet capital needs in our Nation’s health centers.

(7)

Dramatically increasing access to health centers requires building new facilities in communities that have access problems and lack a health center.

(8)

Health centers often do not have the means to pay for capital improvements or new facilities. While most health centers raise some funds through private donations, it is difficult to raise sufficient amounts for capital needs without a middle-upper-class donor base similar to other nonprofit organizations like universities and hospitals.

(9)

Health centers have a limited ability to support loan payments. Due to an increasing number of uninsured patients and the fact that many health care reimbursements are less than the cost of care, health centers rarely have more than minimal positive operating margins. Yet lenders are rarely willing to take risks on nonprofit organizations without these positive margins.

(10)

While the Federal Government currently provides grants to health centers to assist with operational expenses used to provide care to a medically underserved population, there is no authority to provide grants to assist health centers to meet capital needs, such as construction of new facilities or modernization, expansion, or replacement of existing buildings.

(11)

To assist health centers with their mission of providing health care to the medically underserved, the Federal Government should supplement local efforts to meet the capital needs of health centers.

3.

Amendments to the Public Health Service Act

(a)

Health care facility grants and loan guarantees

Subpart I of part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended by adding at the end the following:

330R.

Health care facility grants and loan guarantees

(a)

Eligible health center defined

In this section, the term eligible health center means a health center that receives—

(1)

a grant, on or after the date of enactment of this section, under subsection (c)(1)(A), (e)(1)(A), (e)(1)(B), (f), (g), (h), or (i) of section 330; or

(2)

a subgrant, on or after the date of enactment of this section, from a grant awarded under such provision of law.

(b)

Grant program authorized

(1)

In general

The Secretary may award grants to eligible health centers to pay for the costs described in paragraph (2).

(2)

Use of funds

An eligible health center that receives a grant under paragraph (1) may use the grant funds to—

(A)

modernize, expand, and replace existing facilities at such center; and

(B)

construct new facilities at such center.

(3)

Limitation

(A)

In general

Subject to subparagraph (B), the Federal share of a grant awarded under paragraph (1) to expand an existing, or construct a new, facility shall not exceed 90 percent of the total cost of the project (including interest payments) proposed by the eligible health center.

(B)

Exception

The Federal share maximum under subparagraph (A) shall not apply if—

(i)

the total cost of the project proposed by the eligible health center is less than $750,000; or

(ii)

the Secretary waives such maximum upon a showing of good cause.

(c)

Facility loan guarantees

(1)

In general

(A)

In general

The Secretary shall establish a program under which the Secretary may guarantee not less than 90 percent of the principal and interest on the total amount of loans made to an eligible health center by non-Federal lenders in order to pay for the costs associated with a capital needs project described in subparagraph (B).

(B)

Projects

Capital needs projects under this subsection include—

(i)
(I)

acquiring, leasing, modernizing, expanding, or replacing existing facilities;

(II)

constructing new facilities; or

(III)

purchasing or leasing equipment; or

(ii)

the costs of refinancing loans made for any of the projects described in clause (i).

(C)

Not a Federal subsidy

Any loan guarantee issued pursuant to this subsection shall not be deemed a Federal subsidy for any other purpose.

(2)

Authority for loan guarantee program

With respect to the program established under paragraph (1), the Secretary shall assume such authority—

(A)

as the Secretary has under paragraphs (2) and (4) of section 330; and

(B)

under section 1620 as the Secretary determines is necessary and appropriate.

(3)

Health center project applications

The Secretary shall require that all applicants for grants and loans under this section—

(A)

comply with the conditions set forth in section 1621, as in effect on the date of enactment of this section, with respect to activities authorized for assistance under subsections (b)(2) and (c)(1)(B) in the same manner that applicants for loans, loan guarantees, or grants for medical facilities projects under such section are required to comply with such conditions, unless such conditions are, by their terms, otherwise inapplicable; and

(B)
(i)

give priority to contractors that employ substantial numbers of workers who reside in the area to be served by the health center; and

(ii)

include in the construction contract involved a requirement that the contractor will give priority in hiring new employees to residents of such area.

(4)

Definitions

In this subsection:

(A)

Facilities

The term facilities means a building or buildings used by a health center, in whole or in part, to provide services permitted under section 330 and for such other purposes as are not specifically prohibited under such section as long as such use furthers the objectives of the health center.

(B)

Non-federal lender

The term non-Federal lender means any entity other than an agency or instrumentality of the Federal Government authorized by law to make loans, including a federally-insured bank, a lending institution authorized or licensed to make loans by the State in which it is located, a community development finance institution or community development entity (as designated by the Secretary of the Treasury), any such lender as the Secretary may designate, and a State or municipal bonding authority or such authority’s designee.

(d)

Evaluation

Not later than 3 years after the date of enactment of this section, the Secretary shall prepare a report containing an evaluation of the programs authorized under this section. Such report shall include recommendations on how this section can be improved to better help health centers meet such centers’ capital needs in order to expand access to health care in the United States.

(e)

Authorization

For the purpose of carrying out this section, the Secretary shall use not more than 5 percent of any funds appropriated pursuant to section 330(s) (relating to authorization of appropriations). In addition, funds appropriated for fiscal years 1997 and 1998 under the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Acts of 1997 and 1998, which were made available for loan guarantees for loans made by non-Federal lenders for construction, renovation, and modernization of medical facilities that are owned and operated by health centers and which have not been expended, shall be made available for loan guarantees under this section.

.

(b)

Authorization of appropriations

Section 330(r)(1) of the Public Health Service Act (42 U.S.C. 254b(r)(1)) (relating to authorization of appropriations) is amended by striking this section and inserting this section and section 330R.