2 "SEC. 1106. (a) The Secretary may make loans, sub3 ject to the general provisions of this title, to any public or 4 private nonprofit health maintenance organization, or any 5 public or private nonprofit agency, organization, or institu6 tion intending to become a health maintenance organization, 7 to assist it in meeting the cost of construction of facilities for 8 ambulatory care and transportation services for the provi9 sion of health services to its enrollees. The Secretary shall 10 give special consideration to applications for loans for the 11 acquisition or renovation of existing facilities. No loan under 12 this section for any project may exceed 90 per centum of 13 the cost of construction (as determined by the Secretary) 14 of such project. 15 "(b) There are authorized to be appropriated to carry 16 out the provisions of this section such sums as may be nec 17 essary. Sums so appropriated, together with repayments of 18 loans made under this section and any other receipts in 19 connection with the program under this section, shall be 20 placed in and constitute a revolving fund which shall be 21 available to the Secretary without fiscal year limitation for 22 use in making loans and other, expenditures in the exercise 23 of his functions under this section. 1 14 "(c) There are authorized to be appropriated to carry 2 out the provisions of this section such sums as may be 3 necessary. 4 5 "GRANTS FOR INITIAL COSTS OF OPERATION "SEC. 1105. (a) Where the Secretary determines that 6 the applicant has made all reasonable attempts to meet his 7 operating expenses (including loans and loan guarantees), 8 he may make grants to public and private nonprofit health 9 maintenance organizations to assist them in meeting operat10 ing deficits during the initial three-year period of their 11 operation. 12 "(b) Grants under this section shall be made only for 13 the period beginning with the first day of the first month 14 for which such grant is made and ending with the close of 15 three years after such first day; and such grant with respect 16 to any such organization may not exceed 100 per centum of 17 such operating deficit for the first year after such first day; 18 67 per centum of such first year operating deficit for the 19 second year after such first day; and 33 per centum of such 20 first year operating deficit for the third year after such first 21 day. 22 "(c) There are authorized to be appropriated to carry 23 out the provisions of this section such sums as may be 1 2 15 "CONSTRUCTION LOANS "SEC. 1106. (a) The Secretary may make loans, sub3 ject to the general provisions of this title, to any public or 4 private nonprofit health maintenance organization, or any 5 public or private nonprofit agency, organization, or institu6 tion intending to become a health maintenance organization, 7 to assist it in meeting the cost of construction of facilities for 8 ambulatory care and transportation services for the provi9 sion of health services to its enrollees. The Secretary shall 10 give special consideration to applications for loans for the 11 acquisition or renovation of existing facilities. No loan under 12 this section for any project may exceed 90 per centum of 13 the cost of construction (as determined by the Secretary) 14 of such project. 15 "(b) There are authorized to be appropriated to carry 16 out the provisions of this section such sums as may be nec 17 essary. Sums so appropriated, together with repayments of 18 loans made under this section and any other receipts in 19 connection with the program under this section, shall be 20 placed in and constitute a revolving fund which shall be 21 available to the Secretary without fiscal year limitation for 22 use in making loans and other. expenditures in the exercise 23 of his functions under this section. 1 2 16 "LOANS FOR INITIAL COSTS OF OPERATION "SEC. 1107. (a) The Secretary may make loans, subject to the general provisions of this title, to any public or private 4 nonprofit health maintenance organization to assist it in 5 meeting, for the period prescribed in subsection (b), a por6 tion of its initial operating costs in excess of gross revenues de7 termined under regulations of the Secretary. 8 "(b) Loans under this section for initial costs of opera9 tion may be made only for the period beginning with the 10 first day of the first month for which such a loan is made 11 and ending with the close of three years after such first day; 12 and such loans with respect to any project may not exceed 13 60 per centum of such costs of operation, for the first year 14 after such first day; 40 per centum, of such costs for the 15 second year after such first day; and 20 per centum, of such 16 costs for the third year after such first day. 18 17 "(c) There are authorized to be appropriated to carry out the provisions of this section such sums as may be nec19 essary. Sums so appropriated, together with repayments of 20 loans made under this section and any other receipts in 21 connection with the program under this section, shall be 22 placed in and constitute a revolving fund which shall be 23 available to the Secretary without fiscal year limitation for 24 use in making loans and other expenditures in the exercise 25 of his functions under this section." 1 2 3 4 17 TITLE II-SUPPORT OF HEALTH SERVICE ORGANIZATIONS STATEMENT OF PURPOSE SEC. 201. It is the purpose of this title to assist in the 5 establishment of health service organizations and area health 6 education centers primarily directed at defined rural popu7 lation groups which are characterized by a lack of medical 8 9 10 care services. AMENDMENT TO PUBLIC HEALTH SERVICE ACT SEC. 202. The Public Health Service Act, as amended this Act, is further amended by inserting after part A of 12 title XI the following new part: "PART B-HEALTH SERVICE ORGANIZATIONS 13 14 "DEFINITIONS "SEC. 1120. For the purpose of this part the term "(1) health service organization' means an entity operating in a rural or non-metropolitan area which"(A) provides as a minimum for all its enrollees indirectly or directly through its own staff, and supporting resources or through a medical group or groups, comprehensive health services, to the extent the Secretary determines such organization is able, which are uniformly available to all its enrollees and such additional services as may be S. 3327-3 |