EMPOWER for Health Act of 2019

IIB 116TH CONGRESS 1ST SESSION H. R. 2781 IN THE SENATE OF THE UNITED STATES OCTOBER 29, 2019 Received; read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT To amend title VII of the Public Health Service Act to reauthorize certain programs relating to the health pro- fessions workforce, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 2 HR 2781 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Educating Medical 2 Professionals and Optimizing Workforce Efficiency and 3 Readiness for Health Act of 2019’’ or the ‘‘EMPOWER 4 for Health Act of 2019’’. 5 SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS 6 WORKFORCE PROGRAMS. 7 (a) CENTERS OF EXCELLENCE.—Subsection (i) of 8 section 736 of the Public Health Service Act (42 U.S.C. 9 293) is amended to read as follows: 10 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—To 11 carry out this section, there is authorized to be appro- 12 priated $24,897,000 for each of fiscal years 2020 through 13 2024.’’. 14 (b) HEALTH PROFESSIONS TRAINING FOR DIVER- 15 SITY.—Section 740 of the Public Health Service Act (42 16 U.S.C. 293d) is amended— 17 (1) in subsection (a), by striking ‘‘$51,000,000 18 for fiscal year 2010, and such sums as may be nec- 19 essary for each of the fiscal years 2011 through 20 2014’’ and inserting ‘‘$51,419,000 for each of fiscal 21 years 2020 through 2024’’; 22 (2) in subsection (b), by striking ‘‘$5,000,000 23 for each of the fiscal years 2010 through 2014’’ and 24 inserting ‘‘$1,250,000 for each of fiscal years 2020 25 through 2024’’; and 26 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 3 HR 2781 RFS (3) in subsection (c), by striking ‘‘$60,000,000 1 for fiscal year 2010 and such sums as may be nec- 2 essary for each of the fiscal years 2011 through 3 2014’’ and inserting ‘‘$20,000,000 for each of fiscal 4 years 2020 through 2024’’. 5 (c) PRIMARY CARE TRAINING AND ENHANCE- 6 MENT.—Section 747(c)(1) of the Public Health Service 7 Act (42 U.S.C. 293k(c)(1)) is amended by striking 8 ‘‘$125,000,000 for fiscal year 2010, and such sums as 9 may be necessary for each of fiscal years 2011 through 10 2014’’ and inserting ‘‘$51,371,000 for each of fiscal years 11 2020 through 2024’’. 12 (d) TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC 13 HEALTH DENTISTRY.—Section 748(f) of the Public 14 Health Service Act (42 U.S.C. 293k–2(f)) is amended by 15 striking ‘‘$30,000,000 for fiscal year 2010 and such sums 16 as may be necessary for each of fiscal years 2011 through 17 2015’’ and inserting ‘‘$42,707,000 for each of fiscal years 18 2020 through 2024’’. 19 (e) AREA HEALTH EDUCATION CENTERS.—Section 20 751(j)(1) of the Public Health Service Act (42 U.S.C. 21 294a(j)(1)) is amended by striking ‘‘$125,000,000 for 22 each of the fiscal years 2010 through 2014’’ and inserting 23 ‘‘$42,075,000 for each of fiscal years 2020 through 24 2024’’. 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 4 HR 2781 RFS (f) NATIONAL CENTER FOR HEALTHCARE WORK- 1 FORCE ANALYSIS.— 2 (1) IN GENERAL.—Section 761(e)(1)(A) of the 3 Public Health Service Act (42 U.S.C. 4 294n(e)(1)(A)) is amended by striking ‘‘$7,500,000 5 for each of fiscal years 2010 through 2014’’ and in- 6 serting ‘‘$5,947,000 for each of fiscal years 2020 7 through 2024’’. 8 (2) TECHNICAL CORRECTION.—Section 9 761(e)(2) of the Public Health Service Act (42 10 U.S.C. 294n(e)(2)) is amended by striking ‘‘sub- 11 section (a)’’ and inserting ‘‘paragraph (1)’’. 12 (g) PUBLIC HEALTH WORKFORCE.—Section 770(a) 13 of the Public Health Service Act (42 U.S.C. 295e(a)) is 14 amended by striking ‘‘$43,000,000 for fiscal year 2011, 15 and such sums as may be necessary for each of the fiscal 16 years 2012 through 2015’’ and inserting ‘‘$17,850,000 for 17 each of fiscal years 2020 through 2024’’. 18 SEC. 3. EDUCATION AND TRAINING RELATING TO GERI- 19 ATRICS. 20 Section 753 of the Public Health Service Act (42 21 U.S.C. 294c) is amended to read as follows: 22 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 5 HR 2781 RFS ‘‘SEC. 753. EDUCATION AND TRAINING RELATING TO GERI- 1 ATRICS. 2 ‘‘(a) GERIATRICS WORKFORCE ENHANCEMENT PRO- 3 GRAMS.— 4 ‘‘(1) IN GENERAL.—The Secretary shall award 5 grants or contracts under this subsection to entities 6 described in paragraph (1), (3), or (4) of section 7 799B, section 801(2), or section 865(d), or other 8 health professions schools or programs approved by 9 the Secretary, for the establishment or operation of 10 geriatrics workforce enhancement programs that 11 meet the requirements of paragraph (2). 12 ‘‘(2) REQUIREMENTS.—A geriatrics workforce 13 enhancement program meets the requirements of 14 this paragraph if such program supports the devel- 15 opment of a health care workforce that maximizes 16 patient and family engagement and improves health 17 outcomes for older adults by integrating geriatrics 18 with primary care and other appropriate specialties. 19 Special emphasis should be placed on providing the 20 primary care workforce with the knowledge and 21 skills to care for older adults and collaborating with 22 community partners to address gaps in health care 23 for older adults through individual, system, commu- 24 nity, and population level changes. Areas of pro- 25 grammatic focus may include the following: 26 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 6 HR 2781 RFS ‘‘(A) Transforming clinical training envi- 1 ronments to integrated geriatrics and primary 2 care delivery systems to ensure trainees are well 3 prepared to practice in and lead in such sys- 4 tems. 5 ‘‘(B) Developing providers from multiple 6 disciplines and specialties to work interprofes- 7 sionally to assess and address the needs and 8 preferences of older adults and their families 9 and caregivers at the individual, community, 10 and population levels with cultural and lin- 11 guistic competency. 12 ‘‘(C) Creating and delivering community- 13 based programs that will provide older adults 14 and their families and caregivers with the 15 knowledge and skills to improve health out- 16 comes and the quality of care for such adults. 17 ‘‘(D) Providing Alzheimer’s disease and re- 18 lated dementias (ADRD) education to the fami- 19 lies and caregivers of older adults, direct care 20 workers, health professions students, faculty, 21 and providers. 22 ‘‘(3) DURATION.—The Secretary shall award 23 grants and contracts under paragraph (1) for a pe- 24 riod not to exceed five years. 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 7 HR 2781 RFS ‘‘(4) APPLICATION.—To be eligible to receive a 1 grant or contract under paragraph (1), an entity de- 2 scribed in such paragraph shall submit to the Sec- 3 retary an application at such time, in such manner, 4 and containing such information as the Secretary 5 may require, including the specific measures the ap- 6 plicant will use to demonstrate that the project is 7 improving the quality of care provided to older 8 adults in the applicant’s region, which may in- 9 clude— 10 ‘‘(A) improvements in access to care pro- 11 vided by a health professional with training in 12 geriatrics or gerontology; 13 ‘‘(B) improvements in family caregiver ca- 14 pacity to care for older adults; 15 ‘‘(C) patient outcome data demonstrating 16 an improvement in older adult health status or 17 care quality; and 18 ‘‘(D) reports on how the applicant will im- 19 plement specific innovations with the target au- 20 dience to improve older adults’ health status or 21 the quality of care. 22 ‘‘(5) EQUITABLE GEOGRAPHIC DISTRIBU- 23 TION.—The Secretary may award grants and con- 24 tracts under paragraph (1) in a manner which will 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 8 HR 2781 RFS equitably distribute such grants among the various 1 regions of the United States. 2 ‘‘(6) QUALIFICATIONS.—In awarding grants 3 and contracts under paragraph (2), the Secretary 4 shall consider programs that— 5 ‘‘(A) have the goal of improving and pro- 6 viding comprehensive coordinated care of older 7 adults, including medical, dental, and psycho- 8 social needs; 9 ‘‘(B) demonstrate coordination with other 10 programmatic efforts funded under this pro- 11 gram or other public or private entities; 12 ‘‘(C) support the training and retraining of 13 faculty, preceptors, primary care providers, and 14 providers in other specialties to increase their 15 knowledge of geriatrics and gerontology; 16 ‘‘(D) provide clinical experiences across 17 care settings, including ambulatory care, hos- 18 pitals, post-acute care, nursing homes, federally 19 qualified health centers, and home and commu- 20 nity-based services; 21 ‘‘(E) emphasize education and engagement 22 of family caregivers on disease self-manage- 23 ment, medication management, and stress re- 24 duction strategies; 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 9 HR 2781 RFS ‘‘(F) provide training to the health care 1 workforce on disease self-management, motiva- 2 tional interviewing, medication management, 3 and stress reduction strategies; 4 ‘‘(G) provide training to the health care 5 workforce on social determinants of health in 6 order to better address the geriatric health care 7 needs of diverse populations with cultural and 8 linguistic competency; 9 ‘‘(H) integrate geriatrics competencies and 10 interprofessional collaborative practice into 11 health care education and training curricula for 12 residents, fellows, and students; 13 ‘‘(I) substantially benefit rural or under- 14 served populations of older adults or conduct 15 outreach to communities that have a shortage 16 of geriatric workforce professionals; 17 ‘‘(J) integrate behavioral health com- 18 petencies into primary care practice, especially 19 with respect to elder abuse, pain management, 20 and advance care planning; or 21 ‘‘(K) offer short-term intensive courses 22 that— 23 ‘‘(i) focus on geriatrics, gerontology, 24 chronic care management, and long-term 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 10 HR 2781 RFS care that provide supplemental training for 1 faculty members in medical schools and 2 other health professions schools or grad- 3 uate programs in psychology, pharmacy, 4 nursing, social work, dentistry, public 5 health, allied health, or other health dis- 6 ciplines, as approved by the Secretary; and 7 ‘‘(ii) are open to current faculty, and 8 appropriately credentialed volunteer faculty 9 and practitioners, to upgrade their knowl- 10 edge and clinical skills for the care of older 11 adults and adults with functional and cog- 12 nitive limitations and to enhance their 13 interdisciplinary teaching skills. 14 ‘‘(7) PRIORITY.—In awarding grants under 15 paragraph (1), particularly with respect to awarding, 16 in fiscal year 2020, any amount appropriated for 17 such fiscal year for purposes of carrying out this 18 subsection that is in excess of the amount appro- 19 priated for the most previous fiscal year for which 20 appropriations were made for such purposes, the 21 Secretary may give priority to entities that oper- 22 ate— 23 ‘‘(A) in communities that have a shortage 24 of geriatric workforce professionals; and 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 11 HR 2781 RFS ‘‘(B) in States in which no entity has pre- 1 viously received an award under such paragraph 2 (including as in effect before the date of enact- 3 ment of the Educating Medical Professionals 4 and Optimizing Workforce Efficiency and Read- 5 iness for Health Act of 2019). 6 ‘‘(8) AWARD AMOUNTS.—Awards under para- 7 graph (1) shall be in an amount determined by the 8 Secretary. Entities that submit applications under 9 this subsection that describe a plan for providing 10 geriatric education and training for home health 11 workers and family caregivers are eligible to receive 12 $100,000 per year more than entities that do not in- 13 clude a description of such a plan. 14 ‘‘(9) REPORTING.—Each entity awarded a 15 grant under paragraph (1) shall submit an annual 16 report to the Secretary on financial and pro- 17 grammatic performance under such grant, which 18 may include factors such as the number of trainees, 19 the number of professions and disciplines, the num- 20 ber of partnerships with health care delivery sites, 21 the number of faculty and practicing professionals 22 who participated in continuing education programs, 23 and such other factors as the Secretary may require. 24 ‘‘(b) GERIATRIC ACADEMIC CAREER AWARDS.— 25 VerDate Sep 11 2014 00:44 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2781.RFS H2781 pamtmann on DSKBC07HB2PROD with BILLS 12 HR 2781 RFS ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec- 1 retary shall establish a program to award grants, to 2 be known as Geriatric Academic Career Awards, to 3 eligible entities applying on behalf of eligible individ- 4 uals to promote the career development of such indi- 5 viduals as academic geriatricians or other academic 6 geriatrics health professionals. 7 ‘‘(2) ELIGIBILITY.— 8 ‘‘(A) ELIGIBLE ENTITY.—For purposes of 9 this subsection, the term ‘eligible entity’ 10 means— 11 ‘‘(i) an accredited school of allopathic 12 medicine, osteopathic medicine, nursing, 13 social work, psychology, dentistry, phar- 14 macy, or allied health; or 15 ‘‘(ii) another type of accredited health 16 professions school or graduate program 17 deemed by the Secretary to be eligible 18 under this subsection. 19 ‘‘(B) ELIGIBLE INDIVIDUAL.— 20 ‘‘(i) IN GENERAL.—For purposes of 21 this subsection, the term ‘eligible indi- 22 vidual’ means an individual who— 23 ‘‘(I) has a junior, nontenured, 24 faculty appointment at an accredited 25 Ver [Text truncated for display. 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