HR4796-118

1. Short title This Act may be cited as the Reproductive Health Patient Navigator Act of 2023.

2. Findings Congress finds as follows: As the legal hurdles to abortion services increase, so does the complexity of navigating access to these essential reproductive health services. Community-based organizations like abortion funds are connecting people to abortions, by working with individuals to navigate an ever-evolving landscape of reproductive health care. Abortion funds have been helping individuals navigate the complexity of abortion services for decades and are well placed to lead patient navigation programs.

3. Establishment of grant program for reproductive health patient navigators Subpart V of part D of title III of the Public Health Service Act (42 U.S.C. 256 et seq.) is amended by adding at the end the following: The Secretary shall establish a grant program to support eligible entities for purposes of serving as reproductive health patient navigators for individuals seeking to access abortion services in order to connect those individuals to abortion services. To be eligible to receive a grant under this section, an entity shall— be an abortion fund or other nonprofit organization, a community-based organization, a State, local governmental entity, or Tribal government that, through programs, services, or activities that are unbiased and medically- and factually-accurate, assists individuals seeking abortion services; and submit an application to the Secretary, at such time, in such manner, and containing such information as the Secretary may require, including a plan for— establishing and operating a program of patient navigator services to help individuals seeking abortion services access abortion services, as described in subsection (c); and ensuring that any personally identifiable patient data obtained through the operation of such program is kept confidential. An eligible entity receiving a grant under this section shall use such funds for one or more of the following activities related to abortion services: Offering individuals seeking abortion services medically-accurate, culturally- and linguistically-appropriate services and resources. Coordinating financing resources for travel-related costs, including transportation, childcare, and lodging. Coordinating abortion services, including identifying available abortion providers and scheduling appointments. Providing emotional wellness and doula support to individuals accessing abortion services. Providing individuals seeking abortion services with unbiased and medically and factually accurate reproductive health information to support individuals' informed decision-making. Developing partnerships with local community organizations providing services for which eligible entity provides assistance, abortion service providers, and other patient navigators, such as patient navigators receiving grants under section 340A. Assisting with understanding reimbursement and health insurance coverage options, including completing eligibility and enrollment forms. Assisting with understanding where abortion services are legal and the ways in which abortion services may be restricted. No individual, entity, or State may prevent, restrict, impede, or disadvantage an entity eligible to receive a grant under this section by nature of delivering services described in subsection (c), or any affiliate of such an entity or individual or other entity collaborating with such an entity, from— providing or assisting a health care provider, or any other person, with eligible services described in subsection (c) related to reproductive health care services— lawful in the State in which services are to be provided; or provided for an individual who does not reside in the State in which the services are to be provided; or carrying out the activities described in this section in any State, including any State in which abortion services are not lawful. The Attorney General may commence a civil action on behalf of the United States against any State, or against any government official, individual, or entity that enacts, implements, or enforces a limitation or requirement that violates paragraph (1). The court shall hold unlawful and set aside the limitation or requirement if it is in violation of paragraph (1). Any reproductive health patient navigator adversely affected by an alleged violation of paragraph (1) may commence a civil action against any State that violates this subsection, against any government official that enacts, implements, or enforces a limitation or requirement that violates paragraph (1), or against any individual who, pursuant to State law, prevents, restricts, impedes, or disadvantages the entity from carrying out activities in violation of paragraph (1). The court shall hold unlawful and enjoin the limitation or requirement if it is in violation of paragraph (1). In any action under this subsection, the court may award appropriate equitable relief, including temporary, preliminary, or permanent injunctive relief. In any action under this subsection, the court shall award costs of litigation, as well as reasonable attorney’s fees, to any prevailing plaintiff. A plaintiff shall not be liable to a defendant for costs or attorney’s fees in any nonfrivolous action under this subsection. The district courts of the United States shall have jurisdiction over proceedings under this subsection and shall exercise the same without regard to whether the party aggrieved shall have exhausted any administrative or other remedies that may be provided for by law. Neither a State that enforces or maintains, nor a government official who is permitted to implement or enforce, any limitation or requirement that violates paragraph (1) shall be immune under the Tenth Amendment to the Constitution of the United States, the Eleventh Amendment to the Constitution of the United States, or any other source of law, from an action in a Federal or State court of competent jurisdiction challenging that limitation or requirement. Any party shall have a right to remove an action brought under this subsection to the district court of the United States for the district and division embracing the place where such action is pending. An order remanding the case to the State court from which it was removed under this paragraph may be immediately reviewable by appeal or otherwise. There are appropriated, for fiscal years 2023 through 2027, out of amounts in the Treasury not otherwise appropriated, such sums as may be necessary for purposes of carrying out this section. 340A–1.Establishment of grant program for reproductive health patient navigators(a)In generalThe Secretary shall establish a grant program to support eligible entities for purposes of serving as reproductive health patient navigators for individuals seeking to access abortion services in order to connect those individuals to abortion services. (b)Eligible entitiesTo be eligible to receive a grant under this section, an entity shall—(1)be an abortion fund or other nonprofit organization, a community-based organization, a State, local governmental entity, or Tribal government that, through programs, services, or activities that are unbiased and medically- and factually-accurate, assists individuals seeking abortion services; and(2)submit an application to the Secretary, at such time, in such manner, and containing such information as the Secretary may require, including a plan for—(A)establishing and operating a program of patient navigator services to help individuals seeking abortion services access abortion services, as described in subsection (c); and(B)ensuring that any personally identifiable patient data obtained through the operation of such program is kept confidential.(c)ActivitiesAn eligible entity receiving a grant under this section shall use such funds for one or more of the following activities related to abortion services:(1)Offering individuals seeking abortion services medically-accurate, culturally- and linguistically-appropriate services and resources.(2)Coordinating financing resources for travel-related costs, including transportation, childcare, and lodging.(3)Coordinating abortion services, including identifying available abortion providers and scheduling appointments.(4)Providing emotional wellness and doula support to individuals accessing abortion services.(5)Providing individuals seeking abortion services with unbiased and medically and factually accurate reproductive health information to support individuals' informed decision-making.(6)Developing partnerships with local community organizations providing services for which eligible entity provides assistance, abortion service providers, and other patient navigators, such as patient navigators receiving grants under section 340A.(7)Assisting with understanding reimbursement and health insurance coverage options, including completing eligibility and enrollment forms.(8)Assisting with understanding where abortion services are legal and the ways in which abortion services may be restricted.(d)Patient navigator protections(1)In generalNo individual, entity, or State may prevent, restrict, impede, or disadvantage an entity eligible to receive a grant under this section by nature of delivering services described in subsection (c), or any affiliate of such an entity or individual or other entity collaborating with such an entity, from—(A)providing or assisting a health care provider, or any other person, with eligible services described in subsection (c) related to reproductive health care services—(i)lawful in the State in which services are to be provided; or(ii)provided for an individual who does not reside in the State in which the services are to be provided; or(B)carrying out the activities described in this section in any State, including any State in which abortion services are not lawful. (2)Enforcement(A)Attorney GeneralThe Attorney General may commence a civil action on behalf of the United States against any State, or against any government official, individual, or entity that enacts, implements, or enforces a limitation or requirement that violates paragraph (1). The court shall hold unlawful and set aside the limitation or requirement if it is in violation of paragraph (1).(B)Private right of actionAny reproductive health patient navigator adversely affected by an alleged violation of paragraph (1) may commence a civil action against any State that violates this subsection, against any government official that enacts, implements, or enforces a limitation or requirement that violates paragraph (1), or against any individual who, pursuant to State law, prevents, restricts, impedes, or disadvantages the entity from carrying out activities in violation of paragraph (1). The court shall hold unlawful and enjoin the limitation or requirement if it is in violation of paragraph (1).(C)Equitable reliefIn any action under this subsection, the court may award appropriate equitable relief, including temporary, preliminary, or permanent injunctive relief.(D)CostsIn any action under this subsection, the court shall award costs of litigation, as well as reasonable attorney’s fees, to any prevailing plaintiff. A plaintiff shall not be liable to a defendant for costs or attorney’s fees in any nonfrivolous action under this subsection.(E)JurisdictionThe district courts of the United States shall have jurisdiction over proceedings under this subsection and shall exercise the same without regard to whether the party aggrieved shall have exhausted any administrative or other remedies that may be provided for by law.(F)Abrogation of State immunityNeither a State that enforces or maintains, nor a government official who is permitted to implement or enforce, any limitation or requirement that violates paragraph (1) shall be immune under the Tenth Amendment to the Constitution of the United States, the Eleventh Amendment to the Constitution of the United States, or any other source of law, from an action in a Federal or State court of competent jurisdiction challenging that limitation or requirement.(G)Right to removeAny party shall have a right to remove an action brought under this subsection to the district court of the United States for the district and division embracing the place where such action is pending. An order remanding the case to the State court from which it was removed under this paragraph may be immediately reviewable by appeal or otherwise. (e)FundingThere are appropriated, for fiscal years 2023 through 2027, out of amounts in the Treasury not otherwise appropriated, such sums as may be necessary for purposes of carrying out this section..

340A–1. Establishment of grant program for reproductive health patient navigators The Secretary shall establish a grant program to support eligible entities for purposes of serving as reproductive health patient navigators for individuals seeking to access abortion services in order to connect those individuals to abortion services. To be eligible to receive a grant under this section, an entity shall— be an abortion fund or other nonprofit organization, a community-based organization, a State, local governmental entity, or Tribal government that, through programs, services, or activities that are unbiased and medically- and factually-accurate, assists individuals seeking abortion services; and submit an application to the Secretary, at such time, in such manner, and containing such information as the Secretary may require, including a plan for— establishing and operating a program of patient navigator services to help individuals seeking abortion services access abortion services, as described in subsection (c); and ensuring that any personally identifiable patient data obtained through the operation of such program is kept confidential. An eligible entity receiving a grant under this section shall use such funds for one or more of the following activities related to abortion services: Offering individuals seeking abortion services medically-accurate, culturally- and linguistically-appropriate services and resources. Coordinating financing resources for travel-related costs, including transportation, childcare, and lodging. Coordinating abortion services, including identifying available abortion providers and scheduling appointments. Providing emotional wellness and doula support to individuals accessing abortion services. Providing individuals seeking abortion services with unbiased and medically and factually accurate reproductive health information to support individuals' informed decision-making. Developing partnerships with local community organizations providing services for which eligible entity provides assistance, abortion service providers, and other patient navigators, such as patient navigators receiving grants under section 340A. Assisting with understanding reimbursement and health insurance coverage options, including completing eligibility and enrollment forms. Assisting with understanding where abortion services are legal and the ways in which abortion services may be restricted. No individual, entity, or State may prevent, restrict, impede, or disadvantage an entity eligible to receive a grant under this section by nature of delivering services described in subsection (c), or any affiliate of such an entity or individual or other entity collaborating with such an entity, from— providing or assisting a health care provider, or any other person, with eligible services described in subsection (c) related to reproductive health care services— lawful in the State in which services are to be provided; or provided for an individual who does not reside in the State in which the services are to be provided; or carrying out the activities described in this section in any State, including any State in which abortion services are not lawful. The Attorney General may commence a civil action on behalf of the United States against any State, or against any government official, individual, or entity that enacts, implements, or enforces a limitation or requirement that violates paragraph (1). The court shall hold unlawful and set aside the limitation or requirement if it is in violation of paragraph (1). Any reproductive health patient navigator adversely affected by an alleged violation of paragraph (1) may commence a civil action against any State that violates this subsection, against any government official that enacts, implements, or enforces a limitation or requirement that violates paragraph (1), or against any individual who, pursuant to State law, prevents, restricts, impedes, or disadvantages the entity from carrying out activities in violation of paragraph (1). The court shall hold unlawful and enjoin the limitation or requirement if it is in violation of paragraph (1). In any action under this subsection, the court may award appropriate equitable relief, including temporary, preliminary, or permanent injunctive relief. In any action under this subsection, the court shall award costs of litigation, as well as reasonable attorney’s fees, to any prevailing plaintiff. A plaintiff shall not be liable to a defendant for costs or attorney’s fees in any nonfrivolous action under this subsection. The district courts of the United States shall have jurisdiction over proceedings under this subsection and shall exercise the same without regard to whether the party aggrieved shall have exhausted any administrative or other remedies that may be provided for by law. Neither a State that enforces or maintains, nor a government official who is permitted to implement or enforce, any limitation or requirement that violates paragraph (1) shall be immune under the Tenth Amendment to the Constitution of the United States, the Eleventh Amendment to the Constitution of the United States, or any other source of law, from an action in a Federal or State court of competent jurisdiction challenging that limitation or requirement. Any party shall have a right to remove an action brought under this subsection to the district court of the United States for the district and division embracing the place where such action is pending. An order remanding the case to the State court from which it was removed under this paragraph may be immediately reviewable by appeal or otherwise. There are appropriated, for fiscal years 2023 through 2027, out of amounts in the Treasury not otherwise appropriated, such sums as may be necessary for purposes of carrying out this section.