II 116TH CONGRESS 1ST SESSION S. 2080 To amend the Public Health Service Act to increase the number of permanent faculty in palliative care at accredited allopathic and osteopathic medical schools, nursing schools, social work schools, and other programs, includ- ing physician assistant education programs, to promote education and research in palliative care and hospice, and to support the development of faculty careers in academic palliative medicine. IN THE SENATE OF THE UNITED STATES JULY 10, 2019 Ms. BALDWIN (for herself, Mrs. CAPITO, Mr. KING, Mrs. HYDE-SMITH, Ms. SINEMA, Mr. CRAMER, Mrs. SHAHEEN, and Mr. HOEVEN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to increase the number of permanent faculty in palliative care at accred- ited allopathic and osteopathic medical schools, nursing schools, social work schools, and other programs, includ- ing physician assistant education programs, to promote education and research in palliative care and hospice, and to support the development of faculty careers in academic palliative medicine. 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 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 2 •S 2080 IS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Palliative Care and 2 Hospice Education and Training Act’’. 3 SEC. 2. PALLIATIVE CARE AND HOSPICE EDUCATION AND 4 TRAINING. 5 (a) IN GENERAL.—Part D of title VII of the Public 6 Health Service Act (42 U.S.C. 294 et seq.) is amended 7 by inserting after section 759 the following: 8 ‘‘SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION 9 AND TRAINING. 10 ‘‘(a) PALLIATIVE CARE AND HOSPICE EDUCATION 11 CENTERS.— 12 ‘‘(1) IN GENERAL.—The Secretary shall award 13 grants or contracts under this section to entities de- 14 scribed in paragraph (1), (3), or (4) of section 15 799B, and section 801(2), for the establishment or 16 operation of Palliative Care and Hospice Education 17 Centers that meet the requirements of paragraph 18 (2). 19 ‘‘(2) REQUIREMENTS.—A Palliative Care and 20 Hospice Education Center meets the requirements of 21 this paragraph if such Center— 22 ‘‘(A) improves the interprofessional team- 23 based training of health professionals in pallia- 24 tive care, including residencies, traineeships, or 25 fellowships; 26 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 3 •S 2080 IS ‘‘(B) develops and disseminates inter- 1 professional team-based curricula relating to 2 the palliative treatment of the complex health 3 problems of individuals with serious or life- 4 threatening illnesses; 5 ‘‘(C) supports the training and retraining 6 of faculty to provide instruction in interprofes- 7 sional team-based palliative care; 8 ‘‘(D) supports interprofessional team-based 9 continuing education of health professionals 10 who provide palliative care to patients with seri- 11 ous or life-threatening illness; 12 ‘‘(E) provides students (including resi- 13 dents, trainees, and fellows) with clinical train- 14 ing in interprofessional team-based palliative 15 care in appropriate health settings, including 16 hospitals, hospices, home care, long-term care 17 facilities, and ambulatory care centers; 18 ‘‘(F) establishes traineeships for individ- 19 uals who are preparing for advanced education 20 nursing degrees, social work degrees, or ad- 21 vanced degrees in physician assistant studies, 22 with a focus in interprofessional team-based 23 palliative care in appropriate health settings, in- 24 cluding hospitals, hospices, home care, long- 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 4 •S 2080 IS term care facilities, and ambulatory care cen- 1 ters; 2 ‘‘(G) supports collaboration between mul- 3 tiple specialty training programs (such as medi- 4 cine, nursing, social work, physician assistant, 5 chaplaincy, and pharmacy) and clinical training 6 sites to provide training in interprofessional 7 team-based palliative care; and 8 ‘‘(H) does not duplicate the activities of 9 existing education centers funded under this 10 section or under section 753 or 865. 11 ‘‘(3) EXPANSION OF EXISTING CENTERS.— 12 Nothing in this section shall be construed to— 13 ‘‘(A) prevent the Secretary from providing 14 grants to expand existing education centers, in- 15 cluding geriatric education centers established 16 under section 753 or 865, to provide for edu- 17 cation and training focused specifically on pal- 18 liative care, including for non-geriatric popu- 19 lations; or 20 ‘‘(B) limit the number of education centers 21 that may be funded in a community. 22 ‘‘(b) PALLIATIVE MEDICINE PHYSICIAN TRAINING.— 23 ‘‘(1) IN GENERAL.—The Secretary may make 24 grants to, and enter into contracts with, schools of 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 5 •S 2080 IS medicine, schools of osteopathic medicine, teaching 1 hospitals, and graduate medical education programs 2 for the purpose of providing support for projects 3 that fund the training of physicians (including resi- 4 dents, trainees, and fellows) who plan to teach pal- 5 liative medicine. 6 ‘‘(2) REQUIREMENTS.—Each project for which 7 a grant or contract is made under this subsection 8 shall— 9 ‘‘(A) be staffed by full-time teaching physi- 10 cians who have experience or training in inter- 11 professional team-based palliative medicine; 12 ‘‘(B) be based in a hospice and palliative 13 medicine fellowship program accredited by the 14 Accreditation Council for Graduate Medical 15 Education; 16 ‘‘(C) provide training in interprofessional 17 team-based palliative medicine through a vari- 18 ety of service rotations, such as consultation 19 services, acute care services, extended care fa- 20 cilities, ambulatory care and comprehensive 21 evaluation units, hospices, home care, and com- 22 munity care programs; 23 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 6 •S 2080 IS ‘‘(D) develop specific performance-based 1 measures to evaluate the competency of train- 2 ees; and 3 ‘‘(E) provide training in interprofessional 4 team-based palliative medicine through one or 5 both of the training options described in para- 6 graph (3). 7 ‘‘(3) TRAINING OPTIONS.—The training options 8 referred to in subparagraph (E) of paragraph (2) 9 are as follows: 10 ‘‘(A) 1-year retraining programs in hospice 11 and palliative medicine for physicians who are 12 faculty at schools of medicine and osteopathic 13 medicine, or others determined appropriate by 14 the Secretary. 15 ‘‘(B) 1- or 2-year training programs that 16 are designed to provide training in interprofes- 17 sional team-based hospice and palliative medi- 18 cine for physicians who have completed grad- 19 uate medical education programs in any med- 20 ical specialty leading to board eligibility in hos- 21 pice and palliative medicine pursuant to the 22 American Board of Medical Specialties. 23 ‘‘(4) DEFINITIONS.—For purposes of this sub- 24 section, the term ‘graduate medical education’ 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 7 •S 2080 IS means a program sponsored by a school of medicine, 1 a school of osteopathic medicine, a hospital, or a 2 public or private institution that— 3 ‘‘(A) offers postgraduate medical training 4 in the specialties and subspecialties of medicine; 5 and 6 ‘‘(B) has been accredited by the Accredita- 7 tion Council for Graduate Medical Education or 8 the American Osteopathic Association through 9 its Committee on Postdoctoral Training. 10 ‘‘(c) PALLIATIVE MEDICINE AND HOSPICE ACA- 11 DEMIC CAREER AWARDS.— 12 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec- 13 retary shall establish a program to provide awards, 14 to be known as the ‘Palliative Medicine and Hospice 15 Academic Career Awards’, to eligible individuals to 16 promote the career development of such individuals 17 as academic hospice and palliative care physicians. 18 ‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 19 receive an award under paragraph (1), an individual 20 shall— 21 ‘‘(A) be board certified or board eligible in 22 hospice and palliative medicine; and 23 ‘‘(B) have a junior (non-tenured) faculty 24 appointment at an accredited (as determined by 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 8 •S 2080 IS the Secretary) school of medicine or osteopathic 1 medicine. 2 ‘‘(3) LIMITATIONS.—No award under para- 3 graph (1) may be made to an eligible individual un- 4 less the individual— 5 ‘‘(A) has submitted to the Secretary an ap- 6 plication, at such time, in such manner, and 7 containing such information as the Secretary 8 may require, and the Secretary has approved 9 such application; 10 ‘‘(B) provides, in such form and manner as 11 the Secretary may require, assurances that the 12 individual will meet the service requirement de- 13 scribed in paragraph (6); and 14 ‘‘(C) provides, in such form and manner as 15 the Secretary may require, assurances that the 16 individual has a full-time faculty appointment 17 in a health professions institution and docu- 18 mented commitment from such institution to 19 spend a majority of the total funded time of 20 such individual on teaching and developing 21 skills in education in interprofessional team- 22 based palliative care. 23 ‘‘(4) MAINTENANCE OF EFFORT.—An eligible 24 individual who receives an award under paragraph 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 9 •S 2080 IS (1) shall provide assurances to the Secretary that 1 funds provided to the eligible individual under this 2 subsection will be used only to supplement, not to 3 supplant, the amount of Federal, State, and local 4 funds otherwise expended by the eligible individual. 5 ‘‘(5) AMOUNT AND TERM.— 6 ‘‘(A) AMOUNT.—The amount of an award 7 under this subsection shall be equal to the 8 award amount provided for under section 9 753(c)(5)(A) for the fiscal year involved. 10 ‘‘(B) TERM.—The term of an award made 11 under this subsection shall not exceed 5 years. 12 ‘‘(C) PAYMENT TO INSTITUTION.—The 13 Secretary shall make payments for awards 14 under this subsection to institutions, including 15 schools of medicine and osteopathic medicine. 16 ‘‘(6) SERVICE REQUIREMENT.—An individual 17 who receives an award under this subsection shall 18 provide training in palliative care and hospice, in- 19 cluding the training of interprofessional teams of 20 health care professionals. The provision of such 21 training shall constitute a majority of the total fund- 22 ed obligations of such individual under the award. 23 ‘‘(d) PALLIATIVE CARE WORKFORCE DEVELOP- 24 MENT.— 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 10 •S 2080 IS ‘‘(1) IN GENERAL.—The Secretary shall award 1 grants or contracts under this subsection to entities 2 that operate a Palliative Care and Hospice Edu- 3 cation Center pursuant to subsection (a)(1). 4 ‘‘(2) APPLICATION.—To be eligible for an 5 award under paragraph (1), an entity described in 6 such paragraph shall submit to the Secretary an ap- 7 plication at such time, in such manner, and con- 8 taining such information as the Secretary may re- 9 quire. 10 ‘‘(3) USE OF FUNDS.—Amounts awarded under 11 a grant or contract under paragraph (1) shall be 12 used to carry out the fellowship program described 13 in paragraph (4). 14 ‘‘(4) FELLOWSHIP PROGRAM.— 15 ‘‘(A) IN GENERAL.—Pursuant to para- 16 graph (3), a Palliative Care and Hospice Edu- 17 cation Center that receives an award under this 18 subsection shall use such funds to offer short- 19 term intensive courses (referred to in this sub- 20 section as a ‘fellowship’) that focus on inter- 21 professional team-based palliative care that pro- 22 vide supplemental training for faculty members 23 in medical schools and other health professions 24 schools with programs in psychology, pharmacy, 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 11 •S 2080 IS nursing, social work, physician assistant edu- 1 cation, chaplaincy, or other health disciplines, 2 as approved by the Secretary. Such a fellowship 3 shall be open to current faculty, and appro- 4 priately credentialed volunteer faculty and prac- 5 titioners, who do not have formal training in 6 palliative care, to upgrade their knowledge and 7 clinical skills for the care of individuals with se- 8 rious or life-threatening illness and to enhance 9 their interdisciplinary and interprofessional 10 teaching skills. 11 ‘‘(B) LOCATION.—A fellowship under this 12 paragraph shall be offered either at the Pallia- 13 tive Care and Hospice Education Center that is 14 sponsoring the course, in collaboration with 15 other Palliative Care and Hospice Education 16 Centers, or at medical schools, schools of nurs- 17 ing, schools of pharmacy, schools of social work, 18 schools of chaplaincy or pastoral care education, 19 graduate programs in psychology, physician as- 20 sistant education programs, or other health pro- 21 fessions schools approved by the Secretary with 22 which the Centers are affiliated. 23 ‘‘(C) CONTINUING EDUCATION CREDIT.— 24 Participation in a fellowship under this para- 25 VerDate Sep 11 2014 22:29 Jul 16, 2019 Jkt 034408 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2080.IS S2080 pbinns on DSK79D2C42PROD with BILLS 12 •S 2080 IS graph shall be accepted with respect to com- 1 plying with continuing health profession edu- 2 cation requirements. As a condition of such ac- 3 ceptance, the recipient shall subsequently pro- 4 vide a minimum of 18 hours of voluntary in- 5 struction in palliative care content (that has 6 been approved by a palliative care and hospice 7 education center) to students or trainees in 8 health-related educational, home, hospice, or 9 long-term care settings. 10 ‘‘(5) TARGETS.—A Palliative Care and H [Text truncated for display. Full text available on Congress.gov.]