Restoring America’s Health Care Workforce and Readiness Act

II 118TH CONGRESS 1ST SESSION S. 862 To address health workforce shortages through additional funding for the National Health Service Corps, and to establish a National Health Serv- ice Corps Emergency Service demonstration project. IN THE SENATE OF THE UNITED STATES MARCH 16, 2023 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 through additional funding for the National Health Service 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 ‘‘Restoring America’s 4 Health Care Workforce and Readiness Act’’. 5 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 862 IS SEC. 2. ADDITIONAL FUNDING FOR THE NATIONAL HEALTH 1 SERVICE CORPS. 2 (a) ADDITIONAL FUNDING.—Section 10503(b)(2) of 3 the Patient Protection and Affordable Care Act (42 4 U.S.C. 254b–2(b)(2)) is amended— 5 (1) in subparagraph (G), by striking ‘‘; and’’ 6 and inserting a semicolon; 7 (2) in subparagraph (H), by striking the period 8 and inserting a semicolon; and 9 (3) by adding at the end the following: 10 ‘‘(I) $625,000,000 for fiscal year 2024; 11 ‘‘(J) $675,000,000 for fiscal year 2025; 12 and 13 ‘‘(K) $825,000,000 for fiscal year 2026.’’. 14 (b) NATIONAL HEALTH SERVICE CORPS EMERGENCY 15 SERVICE DEMONSTRATION PROJECT.—Part B of title 16 XXVIII of the Public Health Service Act is amended by 17 inserting after section 2812 (42 U.S.C. 300hh–11) the fol- 18 lowing: 19 ‘‘SEC. 2812A. NATIONAL HEALTH SERVICE CORPS EMER- 20 GENCY SERVICE DEMONSTRATION PROJECT. 21 ‘‘(a) IN GENERAL.—For each of fiscal years 2024 22 through 2026, from the amounts made available under 23 section 10503(b)(2) of the Patient Protection and Afford- 24 able Care Act, to the extent permitted by, and consistent 25 with, the requirements of applicable State law, the Sec- 26 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 862 IS retary shall allocate up to $50,000,000 to establishing, as 1 a demonstration project, a National Health Service Corps 2 Emergency Service (referred to in this section as the 3 ‘emergency service’) under which a qualified individual 4 currently or previously participating in the National 5 Health Service Corps agrees to engage in service through 6 the National Disaster Medical System established under 7 section 2812, as described in this section. 8 ‘‘(b) PARTICIPANTS.— 9 ‘‘(1) NHSC ALUMNI.— 10 ‘‘(A) QUALIFIED INDIVIDUALS.—An indi- 11 vidual may be eligible to participate in the 12 emergency service under this section if such in- 13 dividual participated in the Scholarship Pro- 14 gram under section 338A or the Loan Repay- 15 ment Program under section 338B, and satis- 16 fied the obligated service requirements under 17 such program, in accordance with the individ- 18 ual’s contract. 19 ‘‘(B) PRIORITY AND INCREASED FUNDING 20 AMOUNTS.— 21 ‘‘(i) PRIORITY.—In selecting eligible 22 individuals to participate in the program 23 under this paragraph, the Secretary shall 24 give priority— 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 862 IS ‘‘(I) first, to qualified individuals 1 who continue to practice at the site 2 where the individual fulfilled his or 3 her obligated service under the Schol- 4 arship Program or Loan Repayment 5 Program through the time of the ap- 6 plication to the program under this 7 section; and 8 ‘‘(II) secondly, to qualified indi- 9 viduals who continue to practice in 10 any site approved for obligated service 11 under the Scholarship Program or 12 Loan Repayment Program other than 13 the site at which the individual served. 14 ‘‘(ii) INCREASED FUNDING 15 AMOUNTS.—The Secretary may grant in- 16 creased award amounts to certain partici- 17 pants in the program under this section 18 based on the site where a participant ful- 19 filled his or her obligated service under the 20 Scholarship Program or Loan Repayment 21 Program. 22 ‘‘(C) PRIVATE PRACTICE.—An individual 23 participating in the emergency service under 24 this section may practice a health profession in 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 862 IS any private capacity when not obligated to ful- 1 fill the requirements described in subsection (c). 2 ‘‘(2) CURRENT NHSC MEMBERS.— 3 ‘‘(A) IN GENERAL.—An individual who is 4 participating in the Scholarship Program under 5 section 338A or the Loan Repayment Program 6 under section 338B may apply to participate in 7 the program under this section while fulfilling 8 the individual’s obligated services under such 9 program. 10 ‘‘(B) CLARIFICATIONS.—Notwithstanding 11 any other provision of law or any contract with 12 respect to service requirements under the Schol- 13 arship Program or Loan Repayment Program, 14 an individual fulfilling service requirements de- 15 scribed in subsection (c) shall not be considered 16 in breach of such contract under such Scholar- 17 ship Program or Loan Repayment Program, 18 provided that the individual give advance and 19 reasonable notification to the site at which the 20 individual is fulfilling his or her obligated serv- 21 ice requirements under such contract, and the 22 site approves the individual’s deployment 23 through the National Disaster Medical System. 24 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •S 862 IS ‘‘(C) NO CREDIT TOWARD OBLIGATED 1 SERVICE.—No period of service under the Na- 2 tional Disaster Medical System described in 3 subsection (c)(1) shall be counted toward satis- 4 fying a period of obligated service under the 5 Scholarship Program or Loan Repayment Pro- 6 gram. 7 ‘‘(c) PARTICIPANTS AS MEMBERS OF THE NATIONAL 8 DISASTER MEDICAL SYSTEM.— 9 ‘‘(1) SERVICE REQUIREMENTS.—An individual 10 participating in the program under this section shall 11 participate in the activities of the National Disaster 12 Medical System under section 2812 in the same 13 manner and to the same extent as other participants 14 in such system. 15 ‘‘(2) RIGHTS AND REQUIREMENTS.—An indi- 16 vidual participating in the program under this sec- 17 tion shall be considered participants in the National 18 Disaster Medical System and shall be subject to the 19 rights and requirements of subsections (c) and (d) of 20 section 2812. 21 ‘‘(d) EMERGENCY SERVICE PLAN.—In carrying out 22 this section, the Secretary, in consultation with the Ad- 23 ministrator of the Health Resources and Services Admin- 24 istration and the Assistant Secretary for Preparedness 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •S 862 IS and Response, shall establish an action plan for the service 1 commitments, deployment protocols, coordination efforts, 2 training requirements, liability, workforce development, 3 and such other considerations as the Secretary determines 4 appropriate. Such action plan shall— 5 ‘‘(1) ensure adherence to the missions of both 6 the National Health Service Corps and National 7 Disaster Medical Service; 8 ‘‘(2) outline the type of providers determined by 9 the Assistant Secretary to be priorities for participa- 10 tion in the program established under this section; 11 ‘‘(3) describe how such deployments will be de- 12 termined and prioritized in a manner consistent 13 with— 14 ‘‘(A) the National Health Service Corps 15 contracts; and 16 ‘‘(B) the National Disaster Medical Sys- 17 tem’s deployment policy of not hindering civil- 18 ian responders already engaged in an emer- 19 gency response; 20 ‘‘(4) ensure an adequate health care workforce 21 during a public health emergency declared by the 22 Secretary under section 319 of this Act, a major dis- 23 aster declared by the President under section 401 of 24 the Robert T. Stafford Disaster Relief and Emer- 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •S 862 IS gency Assistance Act, an emergency declared by the 1 President under section 501 of the Robert T. Staf- 2 ford Disaster Relief and Emergency Assistance Act, 3 or a national emergency declared by the President 4 under the National Emergencies Act; and 5 ‘‘(5) describe how the program established 6 under this section will be implemented in a manner 7 consistent with, and in furtherance of, the assess- 8 ments and goals for workforce and training de- 9 scribed in the review conducted by the Secretary 10 under section 2812(b)(2). 11 ‘‘(e) CONTRACTS FOR CERTAIN PARTICIPATING INDI- 12 VIDUALS.—An individual who is participating in the emer- 13 gency service program under this section shall receive loan 14 repayments in an amount up to 50 percent (as determined 15 by the Secretary) of the highest new award made for the 16 year under the National Health Service Corps Loan Re- 17 payment Program pursuant to a contract entered into at 18 the same time under section 338B(g), in a manner similar 19 to the manner in which payments are made under such 20 section, pursuant to the terms of a contract between the 21 Secretary and such individual. The Secretary shall estab- 22 lish a system of contracting for purposes of this subsection 23 which shall be similar to the contract requirements and 24 terms under subsections (c), (d), and (f) of section 338B. 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •S 862 IS Amounts received by an individual under this subsection 1 shall be in addition to any amounts received by an indi- 2 vidual described in subsection (b)(2) pursuant to the 3 Scholarship Program under section 338A or the Loan Re- 4 payment Program under section 338B, as applicable. 5 ‘‘(f) BREACH OF CONTRACT, TERMINATION, WAIVER, 6 AND SUSPENSION.— 7 ‘‘(1) RECOVERY OF AMOUNTS IN THE EVENT 8 OF A BREACH.—If an individual breaches the written 9 contract of the individual under subsection (e) by 10 failing either to begin such individual’s service obli- 11 gation in accordance with such contract or to com- 12 plete such service obligation, the United States shall 13 be entitled to recover from the individual an amount 14 equal to the sum of— 15 ‘‘(A) the total of the amounts paid by the 16 United States under such contract on behalf of 17 the individual for any period of such service not 18 served; 19 ‘‘(B) an amount equal to the product of 20 the number of months of service that were not 21 completed by the individual, multiplied by 22 $3,750; and 23 ‘‘(C) the interest on the amounts described 24 in subparagraphs (A) and (B), at the maximum 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •S 862 IS legal prevailing rate, as determined by the 1 Treasurer of the United States, from the date 2 of the breach. 3 ‘‘(2) TERMINATION OF CONTRACT.—The Sec- 4 retary may terminate a contract under subsection 5 (e) in accordance with the termination standards 6 that are— 7 ‘‘(A) applicable to contracts entered into 8 under section 338B; and 9 ‘‘(B) in effect in the fiscal year in which 10 such contract was entered. 11 ‘‘(3) WAIVER OR SUSPENSION OF OBLIGA- 12 TION.—If an individual participating in the program 13 under this section submits a written request to the 14 Secretary, the Secretary may waive or suspend a 15 service or payment obligation arising under this sub- 16 section or a contract under subsection (e), in whole 17 or in part, in accordance with the standards set 18 forth in section 62.12 of title 42, Code of Federal 19 Regulations (or any successor regulations). 20 ‘‘(g) REPORT.—Not later than 4 years after the date 21 of enactment of this section, the Secretary shall submit 22 to the Committee on Health, Education, Labor, and Pen- 23 sions of the Senate and the Committee on Energy and 24 Commerce of the House of Representatives a report that 25 VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •S 862 IS evaluates the demonstration project established under this 1 section, including— 2 ‘‘(1) the effects of such program on health care 3 access in underserved areas and health professional 4 shortage areas and on public health emergency re- 5 sponse capacity; 6 ‘‘(2) the effects of such program on the health 7 care provider workforce pipeline, including any im- 8 pact on the fields or specialties pursued by students 9 in approved graduate training programs in medicine, 10 osteopathic medicine, dentistry, behavioral and men- 11 tal health, or other health profession; 12 ‘‘(3) the impact of such program on the enroll- 13 ment, participation, and completion of requirements 14 in the underlying scholarship and loan repayment 15 programs of the National Health Service Corps; 16 ‘‘(4) the effects of such program on the Na- 17 tional Disaster Medical System’s response capability, 18 readiness, and workforce strength; and 19 ‘‘(5) recommendations for improving the dem- 20 onstration project described in this section, and any 21 other considerations as the Secretary determines ap- 22 propriate.’’. 23 Æ VerDate Sep 11 2014 00:09 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\S862.IS S862 pbinns on DSKJLVW7X2PROD with $$_JOB