Strengthening America’s Health Care Readiness Act

II 117TH CONGRESS 1ST SESSION S. 54 To address health workforce shortages and disparities highlighted by the COVID–19 pandemic through additional funding for the National Health Service Corps and the Nurse Corps, and to establish a National Health Service Corps Emergency Service demonstration project. IN THE SENATE OF THE UNITED STATES JANUARY 26, 2021 Mr. DURBIN (for himself and Mr. RUBIO) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To address health workforce shortages and disparities high- lighted by the COVID–19 pandemic through additional funding for the National Health Service Corps and the Nurse Corps, and to establish a National Health Service Corps Emergency Service demonstration project. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Strengthening Amer- 4 ica’s Health Care Readiness Act’’. 5 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 2 •S 54 IS SEC. 2. ADDITIONAL FUNDING FOR THE NATIONAL HEALTH 1 SERVICE CORPS. 2 (a) ADDITIONAL FUNDING.—Section 10503(b) of the 3 Patient Protection and Affordable Care Act (42 U.S.C. 4 254b–2(b)) is amended— 5 (1) in paragraph (1)(F), by striking ‘‘and’’ at 6 the end; 7 (2) in paragraph (2)(H), by striking the period 8 and inserting ‘‘; and’’; and 9 (3) by adding at the end the following: 10 ‘‘(3) to be transferred to the Secretary of 11 Health and Human Services $5,000,000,000 for fis- 12 cal year 2021, to provide additional funding to carry 13 out the National Health Service Corps Scholarship 14 Program under section 338A of the Public Health 15 Service Act, the National Health Service Corps Loan 16 Program under section 338B of such Act, and the 17 National Health Service Corps Emergency Service 18 under section 2812A of such Act.’’. 19 (b) CRITERIA FOR USE OF ADDITIONAL FUNDING 20 FOR IN-DEMAND PROFESSIONALS.—Not less than 40 per- 21 cent of the amounts made available under paragraph (3) 22 of section 10503(b) of the Patient Protection and Afford- 23 able Care Act (42 U.S.C. 254b–2(b)) (as amended by sub- 24 section (a)) shall be allocated to awards to eligible appli- 25 cants to the National Health Service Corps Scholarship 26 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 3 •S 54 IS Program under section 338A of the Public Health Service 1 Act (42 U.S.C. 254l), the National Health Service Corps 2 Loan Repayment Program under section 338B of such 3 Act (42 U.S.C. 254l–1), or the National Health Service 4 Corps Emergency Service under section 2812A of such 5 Act (as added by subsection (c)) who are members of 6 groups that are historically underrepresented in health 7 care professions, including racial and ethnic minorities 8 and individuals from low-income urban and rural commu- 9 nities. To carry out the requirements of this subsection, 10 the Secretary may coordinate with entities receiving fund- 11 ing under section 739 or 821 of the Public Health Service 12 Act (42 U.S.C. 293c, 296m) to identify, provide 13 mentorship and support, and recruit such eligible appli- 14 cants. 15 (c) NATIONAL HEALTH SERVICE CORPS EMERGENCY 16 SERVICE DEMONSTRATION PROJECT.—Part B of title 17 XXVIII of the Public Health Service Act is amended by 18 inserting after section 2812 (42 U.S.C. 300hh–11) the fol- 19 lowing: 20 ‘‘SEC. 2812A. NATIONAL HEALTH SERVICE CORPS EMER- 21 GENCY SERVICE DEMONSTRATION PROJECT. 22 ‘‘(a) IN GENERAL.—For each of fiscal years 2022 23 through 2026, from the amounts made available under 24 section 10503(b)(3) of the Patient Protection and Afford- 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 4 •S 54 IS able Care Act, to the extent permitted by, and consistent 1 with, the requirements of applicable State law, the Sec- 2 retary shall allocate up to $50,000,000 to establishing, as 3 a demonstration project, a National Health Service Corps 4 Emergency Service (referred to in this section as the 5 ‘emergency service’) under which a qualified individual 6 currently or previously participating in the National 7 Health Service Corps agrees to engage in service through 8 the National Disaster Medical System established under 9 section 2812, as described in this section. 10 ‘‘(b) PARTICIPANTS.— 11 ‘‘(1) NHSC ALUMNI.— 12 ‘‘(A) QUALIFIED INDIVIDUALS.—An indi- 13 vidual may be eligible to participate in the 14 emergency service under this section if such in- 15 dividual participated in the Scholarship Pro- 16 gram under section 338A or the Loan Repay- 17 ment Program under section 338B, and who 18 satisfied the obligated service requirements 19 under such program, in accordance with the in- 20 dividual’s contract. 21 ‘‘(B) PRIORITY AND INCREASED FUNDING 22 AMOUNTS.— 23 ‘‘(i) PRIORITY.—In selecting eligible 24 individuals to participate in the program 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 5 •S 54 IS under this paragraph, the Secretary shall 1 give priority— 2 ‘‘(I) first, to qualified individuals 3 who continue to practice at the site 4 where the individual fulfilled his or 5 her obligated service under the Schol- 6 arship Program or Loan Repayment 7 Program through the time of the ap- 8 plication to the program under this 9 section; and 10 ‘‘(II) secondly, to qualified indi- 11 viduals who continue to practice in 12 any site approved for obligated service 13 under the Scholarship Program or 14 Loan Repayment Program other than 15 the site at which the individual served. 16 ‘‘(ii) INCREASED FUNDING 17 AMOUNTS.—The Secretary may grant in- 18 creased award amounts to certain partici- 19 pants in the program under this section 20 based on the site where a participant ful- 21 filled his or her obligated service under the 22 Scholarship Program or Loan Repayment 23 Program. 24 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 6 •S 54 IS ‘‘(C) PRIVATE PRACTICE.—An individual 1 participating in the emergency service under 2 this section may practice a health profession in 3 any private capacity when not obligated to ful- 4 fill the requirements described in subsection (c). 5 ‘‘(2) CURRENT NHSC MEMBERS.— 6 ‘‘(A) IN GENERAL.—An individual who is 7 participating in the Scholarship Program under 8 section 338A or the Loan Repayment Program 9 under section 338B may apply to participate in 10 the program under this section while fulfilling 11 the individual’s obligated services under such 12 program. 13 ‘‘(B) CLARIFICATIONS.—Notwithstanding 14 any other provision of law or any contract with 15 respect to service requirements under the Schol- 16 arship Program or Loan Repayment Program, 17 an individual fulfilling service requirements de- 18 scribed in subsection (c) shall not be considered 19 in breach of such contract under such Scholar- 20 ship Program or Loan Repayment Program, 21 provided that the individual give advance and 22 reasonable notification to the site at which the 23 individual is fulfilling his or her obligated serv- 24 ice requirements under such contract, and the 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 7 •S 54 IS site approves the individual’s deployment 1 through the National Disaster Medical System. 2 ‘‘(C) NO CREDIT TOWARD OBLIGATED 3 SERVICE.—No period of service under the Na- 4 tional Disaster Medical System described in 5 subsection (c)(1) shall be counted toward satis- 6 fying a period of obligated service under the 7 Scholarship Program or Loan Repayment Pro- 8 gram. 9 ‘‘(c) PARTICIPANTS AS MEMBERS OF THE NATIONAL 10 DISASTER MEDICAL SYSTEM.— 11 ‘‘(1) SERVICE REQUIREMENTS.—An individual 12 participating in the program under this section shall 13 participate in the activities of the National Disaster 14 Medical System under section 2812 in the same 15 manner and to the same extent as other participants 16 in such system. 17 ‘‘(2) RIGHTS AND REQUIREMENTS.—An indi- 18 vidual participating in the program under this sec- 19 tion shall be considered participants in the National 20 Disaster Medical System and shall be subject to the 21 rights and requirements of subsections (c) and (d) of 22 section 2812. 23 ‘‘(d) EMERGENCY SERVICE PLAN.—In carrying out 24 this section, the Secretary, in consultation with the Ad- 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 8 •S 54 IS ministrator of the Health Resources and Services Admin- 1 istration and the Assistant Secretary for Preparedness 2 and Response, shall establish an action plan for the service 3 commitments, deployment protocols, coordination efforts, 4 training requirements, liability, workforce development, 5 and such other considerations as the Secretary determines 6 appropriate. Such action plan shall— 7 ‘‘(1) ensure adherence to the missions of both 8 the National Health Service Corps and National 9 Disaster Medical Service; 10 ‘‘(2) outline the type of providers determined by 11 the Assistant Secretary to be priorities for participa- 12 tion in the program established under this section; 13 ‘‘(3) describe how such deployments will be de- 14 termined and prioritized in a manner consistent 15 with— 16 ‘‘(A) the National Health Service Corps 17 contracts; and 18 ‘‘(B) the National Disaster Medical Sys- 19 tem’s deployment policy of not hindering civil- 20 ian responders already engaged in an emer- 21 gency response; 22 ‘‘(4) ensure an adequate health care workforce 23 during a public health emergency declared by the 24 Secretary under section 319 of this Act, a major dis- 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 9 •S 54 IS aster declared by the President under section 401 of 1 the Robert T. Stafford Disaster Relief and Emer- 2 gency Assistance Act, an emergency declared by the 3 President under section 501 of the Robert T. Staf- 4 ford Disaster Relief and Emergency Assistance Act, 5 or a national emergency declared by the President 6 under the National Emergencies Act; and 7 ‘‘(5) describe how the program established 8 under this section will be implemented in a manner 9 consistent with, and in furtherance of, the assess- 10 ments and goals for workforce and training de- 11 scribed in the review conducted by the Secretary 12 under section 2812(b)(2). 13 ‘‘(e) CONTRACTS FOR CERTAIN PARTICIPATING INDI- 14 VIDUALS.—An individual who is participating in the emer- 15 gency service program under this section shall receive loan 16 repayments in an amount up to 50 percent (as determined 17 by the Secretary) of the highest new award made for the 18 year under the National Health Service Corps Loan Re- 19 payment Program pursuant to a contract entered into at 20 the same time under section 338B(g), in a manner similar 21 to the manner in which payments are made under such 22 section, pursuant to the terms of a contract between the 23 Secretary and such individual. The Secretary shall estab- 24 lish a system of contracting for purposes of this subsection 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 10 •S 54 IS which shall be similar to the contract requirements and 1 terms under subsections (c), (d), and (f) of section 338B. 2 Amounts received by an individual under this subsection 3 shall be in addition to any amounts received by an indi- 4 vidual described in subsection (b)(2) pursuant to the 5 Scholarship Program under section 338A or the Loan Re- 6 payment Program under section 338B, as applicable. 7 ‘‘(f) BREACH OF CONTRACT, TERMINATION, WAIVER, 8 AND SUSPENSION.— 9 ‘‘(1) RECOVERY OF AMOUNTS IN THE EVENT 10 OF A BREACH.—If an individual breaches the written 11 contract of the individual under subsection (e) by 12 failing either to begin such individual’s service obli- 13 gation in accordance with such contract or to com- 14 plete such service obligation, the United States shall 15 be entitled to recover from the individual an amount 16 equal to the sum of— 17 ‘‘(A) the total of the amounts paid by the 18 United States under such contract on behalf of 19 the individual for any period of such service not 20 served; 21 ‘‘(B) an amount equal to the product of 22 the number of months of service that were not 23 completed by the individual, multiplied by 24 $3,750; and 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 11 •S 54 IS ‘‘(C) the interest on the amounts described 1 in subparagraphs (A) and (B), at the maximum 2 legal prevailing rate, as determined by the 3 Treasurer of the United States, from the date 4 of the breach. 5 ‘‘(2) TERMINATION OF CONTRACT.—The Sec- 6 retary may terminate a contract under subsection 7 (e) in accordance with the termination standards 8 that are— 9 ‘‘(A) applicable to contracts entered into 10 under section 338B; and 11 ‘‘(B) in effect in the fiscal year in which 12 such contract was entered. 13 ‘‘(3) WAIVER OR SUSPENSION OF OBLIGA- 14 TION.—If an individual participating in the program 15 under this section submits a written request to the 16 Secretary, the Secretary may waive or suspend a 17 service or payment obligation arising under this sub- 18 section or a contract under subsection (e), in whole 19 or in part, in accordance with the standards set 20 forth in section 62.12 of title 42, Code of Federal 21 Regulations (or any successor regulations). 22 ‘‘(g) REPORT.—Not later than 4 years after the date 23 of enactment of this section, the Secretary shall submit 24 to the Committee on Health, Education, Labor, and Pen- 25 VerDate Sep 11 2014 21:50 Feb 06, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S54.IS S54 kjohnson on DSK79L0C42PROD with BILLS 12 •S 54 IS sions of the Senate and the Committee on Energy and 1 Commerce of the House of Representatives a report that 2 evaluates the demonstration project established under this 3 section, including— 4 ‘‘(1) the effects of such program on health care 5 ac [Text truncated for display. 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