Page:United States Statutes at Large Volume 92 Part 3.djvu/932

 92 STAT. 3564

PUBLIC LAW 95-626—NOV. 10, 1978

"(ii) which combination is located in or adjacent to the community hospital; " (iii) the physicians of which have admitting privileges to the community hospital; • • ' \; • -•^'? ^-'.' " (iv)(I) the primary care physicians of which are salaried H"..nj,.;; and full time in the hospital and a majority of whom practice full time in the primary care center, or (II) which combination is organized into a partnership, corporation, or professional association which has an agreement with the hospital to fulfill the obligations described in subparagraphs (A) and ', „t.'//«,.'• (C) of subsection (b)(3); and "(v) the primary care physicians of which are not all personnel serving with the National Health Service Corps; except that in the case of such a combination serving a health man42 USC 254e. power shortage area (designated under section 332), in lieu of one of the primary care physicians required in such a combination ''^, there may be a nurse practitioner or physician assistant. "Primary care ' "(4) The term 'primary care resident' means a graduate phyresident." sician in a training program which (A) is in primary care (as 42 USC 295f-2. defined in section 772(b)(2)(F) (ii)), (B) is approved by an appropriate certifying body, and (C) requires that at least onethird of the time in the last two years of residency training (or in the case of the osteopathic general practice resident, the last year '" of residency training) be spent in an ambulatory care setting. "(5) The terms 'primary health services' and 'supplemental health services' have the meanings given such terms in paragraphs 42 USC 254c. (1) and (2) of section 330(b), respectively. "(b)(1) The Secretary may make grants to community hospitals to support demonstration projects in the planning, development, and operation of hospital-affiliated primary care centers. To the extent feasible, the Secretary shall not make a grant for such a center to serve a population whose need for primary health services is being met by a community health center, migrant health center, or other health care provider. "(2) No grant may be made under paragraph (1) unless an application therefor is submitted to, and approved by, the Secretary. Such an application shall be submitted in such form and manner and shall contain such information as the Secretary shall prescribe. Insofar as practicable, the Secretary shall approve applications under this subsection in a manner which results in an equitable distribution of primary care centers among urban and rural areas. "(3) The Secretary may not approve an application for a grant under paragraph (1) with respect to a primary care center affiliated with a community hospital unless the Secretary has made the following determinations: "(A) The primary health services of the center will be provided through a primary care group practice, and may be provided by a primary care resident if (i) such services are provided under the direction of a member of the practice who is a • primary care physician, and (ii) provision of such services by the .1 t2i>2 i«:U £ » 4 resident are credited toward the resident's fulfilling the require^•^ ment of the residency training program described in subsection (a)(4)(C). "(B) Except under unusual circumstances (as established by the Secretary by regulation), primary health services provided by the community hospital will be provided only through the cen^> ter, and qualified personnel trained in triage will be placed in the i

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