[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 1088 Introduced in Senate (IS)]
103d CONGRESS
1st Session
S. 1088
To amend the Public Health Service Act to provide grants for the
development of rural telemedicine, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 10, 1993
Mr. Harkin introduced the following bill; which was read twice and
referred to the Committee on Agriculture, Nutrition, and Forestry
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to provide grants for the
development of rural telemedicine, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rural Telemedicine Development Act
of 1993''.
SEC. 2. PURPOSE.
It is the purpose of this Act to support the development of
telemedicine projects that are designed to improve the delivery,
accessability and affordability of health care services to Americans
living in rural areas. This Act is intended to--
(1) assist rural hospitals and other rural health care
providers in dealing with personnel shortages and shared
staffing arrangements by providing such providers with the
telecommunications technology necessary to maintain contact
with itinerant staff and remote specialists;
(2) reduce the cost of care for rural patients and
strengthen rural health care providers by using
telecommunications technologies to permit such patients to stay
in their local hospitals and to receive other health services
locally whenever possible and appropriate, by reducing
paperwork costs and by improving coordination and efficiency in
the delivery of health care;
(3) provide rural health care providers with access, via
telecommunications systems, to equipment, specialists, and
continuing education programs that are otherwise generally not
available in rural areas; and
(4) demonstrate the effectiveness of fiber optics
telecommunication systems in improving the quality and access
of health care services in rural areas.
SEC. 3. ESTABLISHMENT OF GRANT PROGRAMS.
Title XVII of the Public Health Service Act (42 U.S.C. 300u et
seq.) is amended--
(1) in the title heading by striking out ``AND HEALTH
PROMOTION'' and inserting in lieu thereof ``, HEALTH PROMOTION
AND TELEMEDICINE DEVELOPMENT'';
(2) by inserting after the title heading the following:
``Part A--Health Information and Health Promotion'';
and
(3) by adding at the end thereof the following new part:
``Part B--Telemedicine Development
``SEC. 1711. GRANT PROGRAM FOR PROMOTING THE INITIAL DEVELOPMENT OF
RURAL TELEMEDICINE NETWORKS.
``(a) Establishment.--The Secretary shall award grants to eligible
entities described in section 1714(a) for the purpose of encouraging
the initial development of rural telemedicine networks. Grants shall be
awarded under this section to encourage the formation of rural health
care networks that could benefit from the use of telecommunications
technology in providing health services to rural areas.
``(b) Application.--To be eligible to receive a grant under this
section an entity shall prepare and submit to the Secretary an
application at such time, in such manner and containing such
information as the Secretary may require, including a description of
the use to which the entity will apply any amounts received under such
grant.
``(c) Preference in Awarding Grants.--The Secretary shall, in
awarding grant under subsection (a), give preference to applicants
that--
``(1) are participants in rural health care networks or
that propose to form such networks;
``(2) can demonstrate broad geographic coverage in the
rural areas of the State, or States in which the applicant is
located; and
``(3) propose to use Federal funds to develop plans for, or
to establish, pilot telecommunications systems that will link
rural hospitals and other rural health care providers to other
hospitals, and health care providers.
``SEC. 1712. GRANT PROGRAM FOR THE ESTABLISHMENT OF ADVANCED RURAL
TELEMEDICINE NETWORKS.
``(a) Establishment.--The Secretary shall award grants to rural
health networks for the purpose of linking such networks together using
advanced telemedicine systems. Grants shall be awarded under this
section to further develop telemedicine projects initiated by these
rural health care networks.
``(b) Application.--To be eligible to receive a grant under this
section an entity shall prepare and submit to the Secretary an
application at such time, in such manner and containing such
information as the Secretary may require, including a description of
the use to which the entity will apply any amounts received under such
grant.
``(c) Minimum Qualifications.--The Secretary may not award a grant
to an applicant under subsection (a) unless--
``(1) the applicant is determined by the Secretary to
include one or more rural health network; and
``(2) the applicant can demonstrate broad geographical
coverage in the rural areas of the State or States in which it
is located.
``(d) Preferences in Awarding Grants.--The Secretary shall, in
awarding grants under subsection (a), give preference to qualified
applicants that--
``(1) can demonstrate that a majority of the hospitals and
other providers participating in the applicant group have
functioned as networks for at least 1 year prior to applying
for funding under this section; and
``(2) will use amounts provided under the grant to provide
a range of telecommunications applications such as
teleradiology, telepathology, interactive video consultation
and remote educational services and to promote areawide health
planning and greater efficiency in administrative activities.
``SEC. 1713. GRANT PROGRAM FOR THE ESTABLISHMENT OF ADVANCED FIBER
OPTIC BASED RURAL TELEMEDICINE NETWORKS.
``(a) Establishment.--The Secretary shall award grants to rural
health networks for the purpose of linking these networks to existing
fiber optic telecommunications systems.
``(b) Application.--To be eligible to receive a grant under this
section an entity shall prepare and submit to the Secretary an
application at such time, in such manner and containing such
information as the Secretary may require, including a description of
the use to which the entity will apply any amounts received under such
grant.
``(c) Minimum Qualifications.--The Secretary may not award a grant
to an applicant under subsection (a) unless--
``(1) the applicant is determined by the Secretary to
include one or more rural health network;
``(2) the applicant group can demonstrate broad
geographical coverage in the rural areas of the State or States
in which it is located; and
``(3) the applicant group will participate in an existing
fiber optic telecommunications system.
``(d) Preferences in Awarding Grants.--The Secretary shall, in
awarding grants under subsection (a), give preference to qualified
applicants that--
``(1) will use grant funds to provide a range of
telecommunications applications including teleradiology,
telepathology, interactive video consultation and remote
educational services and to promote areawide health planning
and greater efficiency in administrative activities;
``(2) demonstrate that the majority of the hospitals and
other providers participating in the applicant group have
functioned as networks for at least 1 year prior to applying
for funding under this section; and
``(3) will participate in an existing Statewide fiber
optics cable system.
``SEC. 1714. USE OF FUNDS FOR INITIAL DEVELOPMENT GRANT PROGRAMS.
``(a) Eligible Entities.--Entities eligible to receive a grant
under section 1711 shall include hospitals, hospital networks, and
other health care providers.
``(b) Use of Amounts.--Amounts received under a grant awarded under
section 1711 shall be utilized for the initial development of rural
telemedicine networks, including the establishment of pilot
telemedicine projects involving two or more providers. Such amounts may
be used to cover the costs associated with the development of
telemedicine networks and the acquisition or construction of
telecommunications facilities and equipment including--
``(1) the development and acquisition through lease or
purchase of computer hardware and software, audio and visual
equipment, computer network equipment, telecommunications
transmission facilities, telecommunications terminal equipment,
interactive video equipment, data terminal equipment, and other
facilities and equipment that would further the purposes
authorized by this part;
``(2) the provision of technical assistance and instruction
for the development and use of such programming, equipment, or
facilities;
``(3) the development and acquisition of instructional
programming; or
``(4) such other uses that are consistent with achieving
the purposes of this part as approved by the Secretary.
``SEC. 1715. USE OF FUNDS FOR ADVANCED TELEMEDICINE GRANT PROGRAMS.
``Grants under sections 1712 and 1713 shall be available to health
care networks for the development of telemedicine networks and the
acquisition or construction of telecommunications facilities and
equipment including--
``(1) the development and acquisition through lease or
purchase of computer hardware and software, audio and visual
equipment, computer network equipment, telecommunications
transmission facilities, telecommunications terminal equipment,
interactive video equipment, data terminal equipment, and other
facilities and equipment that would further the purposes
authorized by this part;
``(2) the provision of technical assistance and instruction
for the development and use of such programming, equipment, or
facilities;
``(3) the development and acquisition of instructional
programming; or
``(4) such other uses that are consistent with achieving
the purposes of this part as approved by the Secretary.
``SEC. 1716. DEFINITIONS.
``For the purposes of this part:
``(1) Computer networks.--The term `computer networks'
means computer hardware and software, terminals, signal
conversion equipment including both modulators and
demodulators, or related devices, used to communicate with
other computers to process and exchange data through a
telecommunication network in which signals are generated,
modified, or prepared for transmission, or received, via
telecommunications terminal equipment and telecommunications
transmission facilities.
``(2) Data terminal equipment.--The term `data terminal
equipment' means equipment that converts user information into
data signals for transmission, or reconverts the received data
signals into user information, and is normally found on the
terminal of a circuit and on the premises of the end user.
``(3) Fiber optic cable.--The term `fiber optic cable'
means a bundle of optical transmission elements or waveguides
usually consisting of a fiber core and fiber cladding that can
guide a lightwave and that are incorporated into an assembly of
materials that provide tensile strength and external
protection.
``(4) Interactive video equipment.--The term `interactive
video equipment' means equipment used to produce and prepare
for transmission audio and visual signals from at least two
distant locations in order that individuals at such locations
can verbally and visually communicate with each other, and such
equipment includes monitors, other display devices, cameras or
other recording devices, audio pickup devices, and other
related equipment.
``(5) Health care network.--The term `rural health care
network' means a group of rural hospitals or other rural health
care providers (including clinics, physicians and non-physician
primary care providers) that have entered into a formal
relationship with each other or with nonrural hospitals and
health care providers for the purpose of strengthening the
delivery of health care services in rural areas or specifically
to improve their patients' access to telemedicine services. At
least 75 percent of hospitals and other health care providers
participating in the network shall be located in rural areas.
``(6) Statewide fiber optic cable system.--The term
`Statewide fiber optic cable system' means a telecommunications
system that will carry voice, data, and full motion video
traffic through fiber optic cable to a point of presence in
every county in the State in which it is located.
``(7) Telecommunications terminal equipment.--The term
`telecommunications terminal equipment' means the assembly of
telecommunications equipment at the end of a circuit, normally
located on the premises of the end user, that interfaces with
telecommunications transmission facilities, and that is used to
modify, convert, encode, or otherwise prepare signals to be
transmitted via such telecommunications facilities, or that is
used to modify, reconvert or carry signals received from such
facilities, the purpose of which is to accomplish the goal for
which the circuit was established.
``(8) Telecommunications transmission facilities.--The term
`telecommunications transmission facilities' means those
facilities that transmit, receive, or carry data between the
telecommunications terminal equipment at each end of a
telecommunications circuit or path. Such facilities include
microwave antennae, relay stations and towers, other
telecommunications antennae, fiber-optic cables and repeaters,
coaxial cables, communication satellite ground station
complexes, copper cable electronic equipment associated with
telecommunications transmissions, and similar items as defined
by the Secretary.
``SEC. 1717. AUTHORIZATION OF APPROPRIATIONS.
``For the purposes of carrying out this part, there are authorized
to be appropriated such sums as may be necessary for each of the fiscal
years 1994 through 1997.''.
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