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H.R.4561 / 103rd Congress

To amend the Public Health Service Act and the Social Security Act to provide improved and expanded access to comprehensive primary health care and related services for medically underserved and vulnerable populations through the establishment of financial support for the development of community-based health networks and plans, to allow federally-assisted health centers to expand their capacity and develop and operate new sites to serve underserved and vulnerable populations, to provide certain financial and other protections for such networks, plans, and health centers, and to facilitate the involvement of, and payment to, entities serving underserved and vulnerable populations in the training and education of primary care health professionals.

Referred to the Subcommittee on Health and the Environment.

Official summary

Version 00 · Introduced in House · Jun 9, 1994

Access to Community Health Care Act of 1994 - Amends the Public Health Service Act to require community health centers (CHC's) to provide: (1) outreach workers to help determine eligibility for Federal, State, and local health programs; and (2) enabling services that promote access to necessary health and other human and social services. (Sec. 2) Permits CHC's to provide their services at schools and other appropriate places. Authorizes the Secretary of Health and Human Services to make grants to CHC's, or to Federally qualified health centers, to support the development and operation of a community health service network (a consortium of health care providers) or plan. Allows the Secretary to waive certain grant requirements for good cause. Prohibits approval of a grant application unless the network or plan will at a minimum assure significant community involvement, including a board of directors at least one-third of whom are registered patients or representatives of all entities providing health services. Requires a network or plan, also, to establish a patient advisory council. Authorizes appropriations. Specifies funding preferences. (Sec. 3) Authorizes the Secretary to make loans and guarantee payment of principal and interest to Federal and non-Federal lenders for loans to grantees for facility acquisition or modernization, major equipment purchases, and other specified purposes. Establishes a loan and loan guarantee fund. Authorizes appropriations. (Sec. 4) Requires migrant health centers (MHC's) to provide: (1) outreach workers to help determine eligibility for Federal, State, and local health programs; and (2) enabling services that promote access to necessary health and other human and social services. Declares that any grant to an MHC may include building acquisition or modernization and new building construction. Declares that health services include supplemental health services and enabling services. Authorizes appropriations. (Sec. 5) Authorizes additional appropriations for the National Health Service Corps. (Sec. 6) Requires preference in the award of grants or contracts to CHC's, MHC's, certified Federally qualified health centers, and certain nurse training program applicants. Provides for Federal payment of direct and indirect costs of graduate medical education (GME) to hospitals incurring any of the costs for training programs at a Federally qualified health center if the hospitals reimburse the center for any costs it incurs. (Sec. 7) Amends title XI of the Social Security Act (SSA) with respect to demonstration projects to deny the Secretary authority to waive compliance of State plans with certain Medicaid requirements for provision of, payment for, and allowance of freedom of choice to select the provider of care and services at rural health clinics and Federally qualified health centers. Amends SSA title XIX (Medicaid) to provide for payments to rural health clinics and Federally qualified health centers operating in the same geographic area as certain health maintenance organizations (HMO's). (Sec. 8) Amends SSA title XI to exempt from criminal penalties for acts involving Medicare or State health care programs certain patient referral activities conducted as specified collaborative efforts that benefit medically underserved persons.

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Who introduced it

Rep. Rangel, Charles B. [D-NY-15] · D–NY

Committees

  • Energy and Commerce Committee
  • Ways and Means Committee
14 cosponsorship records, including any withdrawals

Actions

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  1. Referred to the Subcommittee on Health and the Environment.

  2. Referred to the Subcommittee on Health.

  3. Referred to the House Committee on Ways and Means.

  4. Referred to the House Committee on Energy and Commerce.

  5. Sponsor introductory remarks on measure. (CR E1156-1157)

  6. Introduced in House

  7. Introduced in House

Bill text & related measures

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Related bills identified by Congress.gov

No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.

Source last updated: Jun 3, 2026. Consult Congress.gov for the current record.

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Neutral evidence review

Objective

Analyze H.R.4561 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.

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Fairness and public impact

Progressive lens

Examine H.R.4561 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.

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Institutions and government scope

Conservative lens

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Individual rights and government power

Liberty lens

Examine H.R.4561 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.

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