FOR IMMEDIATE RELEASE
Office of University Communications
Contact: Kim Betton, 202-238-2332
PRESIDENT BUSH PASSES PATIENT NAVIGATOR ACT
HOWARD BOARD OF TRUSTEE MEMBER IS PROJECT PIONEER AND DEVELOPER
(Washington, D.C., June 30, 2005) – At 5:00 p.m. on Wednesday, June 29, 2005, President George W. Bush signed into law the “Patient Navigator Outreach and Chronic Disease Prevention Act of 2005.” Pioneered and developed by Harold P. Freeman, M.D., at Harlem Hospital in 1990 in New York City, the bill will help increase access to breast cancer prevention, screening and treatment. It will also eliminate health disparities along racial, ethnic and socioeconomic lines. The legislation authorizes $25 million in grants over five years to establish patient navigator programs in low-income and rural communities nationwide. Under the system, navigators will help uninsured patients evaluate their treatment options, enroll in clinical trials, obtain referrals and apply for financial assistance.
The program is based on the research findings by Dr. Freeman who studied breast cancer in Harlem. An initial publication reported on a 22 year period ending in 1986 in which 606 patients (94 percent black) were treated at Harlem Hospital Center. Almost all patients were of low economic status and almost 50 percent had no medical coverage. Nearly half were incurable at diagnosis (stages 3 and 4) and only 6 percent had early breast cancer (stage 1 disease). The five-year survival rate of these patients was 39 percent compared to more than 60 percent in American white women at that time. In a second published study that analyzed the results of 325 breast cancer patients seen over a six year period ending in the year 2000, also at Harlem Hospital Center, the results were dramatically different. These improved results were due to screening and patient navigation. In this group of patients, 41 percent had early stage breast cancer and the five year survival rate was 70 percent. According to Dr. Freeman, breast cancer is the second leading cause of cancer death in women, claiming the lives of more than 40,000 women in this country each year. Late diagnosis and treatment at incurable stage of the disease is the principle cause of death.
Dr. Freeman is currently the associate director of the National Cancer Institute (NCI) and director of NCI’s Center to Reduce Cancer Health Disparities at the National Institutes of Health in Bethesda, Md. He has been a member of the Howard University Board of Trustees since 1993, and currently serves on the University’s Medical Affairs Committee.
“Poor and uninsured people have diminished access to healthcare. Diminished access is often manifested by low quality and inadequate continuity of health care as well as insufficient access to diagnosis and treatment. There is a critical window of opportunity to save lives from cancer between the point of an abnormal finding and resolution by further diagnosis and treatment. The principal responsibility of The Patient Navigator is to eliminate any barrier the patient may encounter to obtaining timely diagnosis and treatment after an abnormal finding,” said Dr. Freeman.
Dr. Freeman is also founder, president and medical director of the Ralph Lauren Center for Cancer Care and Prevention in New York, N.Y. He holds the academic rank of professor of Clinical Surgery at Columbia University College of Physicians and Surgeons. For 25 years (1974–1999), he was director of Surgery at Harlem Hospital in New York and for a two-year period ending in 2001 Dr. Freeman has served as the president and C.E.O. of North General Hospital in New York. He earned an A.B. degree from The Catholic University of America and a M.D. degree from the Howard University College of Medicine.
Howard University is one of 48 U.S. private, Doctoral/Research-Extensive universities and comprises 12 schools and colleges. Founded in 1867, students pursue studies in more than 120 areas leading to undergraduate, graduate and professional degrees. Since 1998, the University has produced two Rhodes Scholars, a Truman Scholar, seven Fulbright Scholars and nine Pickering Fellows. Howard also produces more on-campus African-American Ph.D.s than any other university in the world. For more information on Howard University, call 202-238-2330, or visit the University’s Web site at www.Howard.edu.
WHO: Harold P. Freeman, M.D., who has been on the Board of Trustees at Howard University since 1993, is the associate director of the National Cancer Institute (NCI) and director of NCI’s Center to Reduce Cancer Health Disparities at the National Institutes of Health, Bethesda, Md. Dr. Freeman is also founder, president and medical director of the Ralph Lauren Center for Cancer Care and Prevention in New York, N.Y. He holds the academic rank of professor of Clinical Surgery at Columbia University College of Physicians and Surgeons. For 25 years (1974–1999), Dr. Freeman was director of Surgery at Harlem Hospital in New York and for a two-year period ending in 2001, Dr. Freeman served as the president and C.E.O. of North General Hospital in New York. He earned an A.B. degree from The Catholic University of America and a M.D. degree from the Howard University College of Medicine.
WHAT: Dr. Freeman is available for media interviews regarding the “Patient Navigator Outreach and Chronic Disease Prevention Act of 2005” _____________________________________________________________________________
One Hundred Ninth Congress of the United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Tuesday, the fourth day of January, two thousand and five
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.
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 `Patient Navigator Outreach and Chronic Disease Prevention Act of 2005'.
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- The Secretary shall require each recipient of a grant under this section 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 in assisting 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, on request, facilitating enrollment of eligible individuals in these trials.
`(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, health programs operated by the Department of Veterans Affairs or the Department of Defense, the State children's health insurance program, and any private or governmental prescription assistance programs).
`(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.
`(1) REFERRAL FEES- The Secretary shall require each recipient of a grant under this section to prohibit any patient navigator providing services under the grant from accepting any referral fee, kickback, or other thing of value in return for referring an individual to a particular health care provider.
`(2) LEGAL FEES AND COSTS- The Secretary shall prohibit the use of any grant funds received under this section to pay any fees or costs resulting from any litigation, arbitration, mediation, or other proceeding to resolve a legal dispute.
`(d) 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. Each such extension shall be for a period of not more than 1 year.
`(3) LIMITATIONS ON GRANT PERIOD- In carrying out this section, the Secretary--
`(A) shall ensure that the total period of a grant does not exceed 4 years; and
`(B) may not authorize any grant period ending after September 30, 2010.
`(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.
`(f) Uniform Baseline Measures- The Secretary shall establish uniform baseline measures in order to properly evaluate the impact of the demonstration projects under this section.
`(g) 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.
`(h) Duplication of Services- An eligible entity that is receiving Federal funds for activities described in subsection (b) on the date on which the entity submits an application under subsection (e) may not receive a grant under this section unless the entity can demonstrate that amounts received under the grant will be utilized to expand services or provide new services to individuals who would not otherwise be served.
`(i) 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.
`(j) 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) REPORTS BY GRANTEES- The Secretary may require grant recipients under this section to submit interim and final reports on grant program outcomes.
`(k) 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)).
`(l) 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).
`(m) 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.'.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.