Health Heroes 2020 Act

I 116TH CONGRESS 2D SESSION H. R. 6650 To address health workforce shortages and disparities highlighted by the COVID–19 pandemic through additional funding for the National Health Service Corps and Nurse Corps. IN THE HOUSE OF REPRESENTATIVES MAY 1, 2020 Ms. SCHAKOWSKY introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on the Budget, for a period to be subsequently determined by the Speak- er, in each case for consideration of such provisions as fall within the ju- risdiction of the committee concerned 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 Nurse Corps. 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 ‘‘Health Heroes 2020 4 Act’’. 5 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 6650 IH SEC. 2. ADDITIONAL FUNDING FOR THE SCHOLARSHIP 1 PROGRAM OF THE NATIONAL HEALTH SERV- 2 ICE CORPS. 3 (a) ADDITIONAL FUNDING.—Section 10503(b) of the 4 Patient Protection and Affordable Care Act (42 U.S.C. 5 254b–2(b)) is amended— 6 (1) in paragraph (1)(F), by striking ‘‘and’’ at 7 the end; 8 (2) in paragraph (2)(H), by striking the period 9 and inserting ‘‘; and’’; and 10 (3) by adding at the end the following: 11 ‘‘(3) to be transferred to the Secretary of 12 Health and Human Services— 13 ‘‘(A) $25,000,000,000 for fiscal year 2020, 14 to provide additional funding to carry out sub- 15 section (i) of section 338A of the Public Health 16 Service Act and the National Health Service 17 Corps Loan Program under section 338B of 18 such Act, of which— 19 ‘‘(i) $15,000,000,000 shall be allo- 20 cated to the program under section 338A; 21 and 22 ‘‘(ii) $10,000,000,000 shall be allo- 23 cated to the program under such section 24 338B; and 25 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 6650 IH ‘‘(B) $690,000,000 for each of fiscal years 1 2021 through 2026, to provide additional 2 amounts to carry out the National Health Serv- 3 ice Corps Scholarship Program under section 4 338A of the Public Health Service Act, the Na- 5 tional Health Service Corps Loan Repayment 6 Program under section 338B of such Act, and 7 the reserve service program under section 338O 8 of such Act.’’. 9 (b) CRITERIA FOR USE OF ADDITIONAL FUNDING 10 FOR IN-DEMAND PROFESSIONALS.—Section 338A of the 11 Public Health Service Act (42 U.S.C. 254l) is amended 12 by adding at the end the following: 13 ‘‘(i) Not less than 40 percent of the amounts made 14 available to carry out this section under 10503(b)(3)(A)(i) 15 of the Patient Protection and Affordable Care Act shall 16 be allocated to scholarships under this section for eligible 17 applicants who are members of groups that are historically 18 underrepresented in health care professions, including ra- 19 cial and ethnic minorities and individuals from low-income 20 urban and rural communities. To carry out the require- 21 ments of this subsection, the Secretary may coordinate 22 with entities receiving funding under section 739 to iden- 23 tify, recruit, and select individuals to receive such scholar- 24 ships.’’. 25 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 6650 IH (c) NATIONAL HEALTH SERVICE CORPS RESERVE 1 DEMONSTRATION PROJECT.— 2 (1) IN GENERAL.—Subpart III of part D of 3 title III of the Public Health Service Act (42 U.S.C. 4 254l et seq.) is amended by adding at the end the 5 following: 6 ‘‘SEC. 338O. NATIONAL HEALTH SERVICE CORPS RESERVE 7 SERVICE DEMONSTRATION PROJECT. 8 ‘‘(a) IN GENERAL.—From the amounts made avail- 9 able under section 10503(b)(3)(B) of the Patient Protec- 10 tion and Affordable Care Act for each of fiscal years 2021 11 through 2024, the Secretary shall, to the extent permitted 12 by, and consistent with, the requirements of applicable 13 State law, use such sums as the Secretary determines nec- 14 essary to establish, as a demonstration project, a National 15 Health Service Corps Reserve Service (referred to in this 16 section as the ‘reserve service’) under which a qualified 17 individual agrees to engage in service for a period specified 18 in a contract under this section in such reserve service 19 under this section. 20 ‘‘(b) RESERVE SERVICE REQUIREMENTS.—An indi- 21 vidual whose obligated service under a contract under sec- 22 tion 338A is provided, pursuant to a contract under sub- 23 section (a), as reserve service, and any other participating 24 individual described in subparagraph (B) of subsection 25 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 6650 IH (c)(2) may practice a health profession in any private ca- 1 pacity, subject to the following requirements: 2 ‘‘(1) In the event of a public health emergency 3 declared under section 319, a major disaster de- 4 clared by the President under section 401 of the 5 Robert T. Stafford Disaster Relief and Emergency 6 Assistance Act, or an emergency declared by the 7 President under section 501 of the Robert T. Staf- 8 ford Disaster Relief and Emergency Assistance Act 9 or a national emergency declared by the President 10 under the National Emergencies Act, for the dura- 11 tion of such emergency or disaster, such individual 12 shall be subject to serve in such capacity as the Sec- 13 retary shall determine appropriate to carry out the 14 purposes of this section, and in accordance with the 15 Secretary’s plan to increase surge capacity in re- 16 sponse to public health emergencies or disasters. 17 Such service may be furnished in coordination with 18 the Corps described in section 204, a State, terri- 19 torial, or local public health department, or through 20 the process described in section 319(e). 21 ‘‘(2) Not less frequently than 2 days each 22 month, and for a total of not fewer than 30 days 23 each year, as directed by the Secretary, such indi- 24 vidual shall— 25 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 6650 IH ‘‘(A) conduct trainings on public health 1 preparedness and response activities, which may 2 be in coordination with the State, territorial, or 3 local health department; or 4 ‘‘(B) furnish health care services to low-in- 5 come individuals in a health professional short- 6 age area (as defined under section 332(a)), a 7 medically underserved population (as defined 8 under section 330(b)(3)), or a medically under- 9 served area or area at high risk of a public 10 health emergency as designated by the Sec- 11 retary. 12 ‘‘(c) QUALIFIED INDIVIDUALS.—An individual may 13 be eligible to participate in the reserve service under this 14 section if such individual meets one of the following cri- 15 teria: 16 ‘‘(1) An individual participating in the Scholar- 17 ship Program under section 338A may satisfy the 18 obligated service requirement under such program if 19 the individual’s contract provides for such service. 20 ‘‘(2) An individual who participated in the Loan 21 Repayment Program under section 338B and who 22 satisfied the obligated service requirements under 23 such program, in accordance with the individual’s 24 contract. 25 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 6650 IH ‘‘(3) An individual who— 1 ‘‘(A) did not participate in the Scholarship 2 Program under section 338A or the Loan Re- 3 payment Program under section 338B; 4 ‘‘(B) has a graduate degree in medicine, 5 osteopathic medicine, dentistry, or another 6 health profession, or an appropriate graduate 7 degree from a program of behavioral or mental 8 health, or is certified as a nurse midwife, nurse 9 practitioner, or physician assistant; 10 ‘‘(C) holds a license issued by a State, the 11 District of Columbia, or a territory to practice 12 the applicable profession; 13 ‘‘(D) is otherwise qualified to practice, and 14 has experience practicing, in a profession— 15 ‘‘(i) described in section 338B(a)(1); 16 or 17 ‘‘(ii) another high-demand health care 18 field or specialty that the Secretary identi- 19 fies, through a process conducted every 3 20 years, as a field or specialty of national 21 priority, based on relative workforce short- 22 ages, expected workforce changes, or pro- 23 jected changes in patient needs; and 24 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 6650 IH ‘‘(E) satisfies any other eligibility or appli- 1 cation requirements specified by the Secretary 2 in order to demonstrate the individual’s quali- 3 fications. 4 ‘‘(d) RESERVE SERVICE PLAN.—In carrying out this 5 section, the Secretary shall establish, in coordination with 6 the Surgeon General and State, tribal, and local health 7 departments, an action plan for the service commitments, 8 priority areas, coordination efforts, training requirements, 9 and such other considerations as the Secretary determines 10 appropriate, to ensure the complementary, additive capac- 11 ity of such individuals providing reserve service. 12 ‘‘(e) CONTRACTS FOR CERTAIN PARTICIPATING INDI- 13 VIDUALS.—An individual described in subparagraph (B) 14 of subsection (c)(2) who is participating in the reserve 15 service program under this section shall receive loan re- 16 payments in an amount equal to 50 percent of the amount 17 of payments that would be required with respect to a par- 18 ticipant of the same clinical profession in the Loan Repay- 19 ment Program pursuant to a contract entered into at the 20 same time under section 338B(g), in a manner similar to 21 the manner in which payments are made under such sec- 22 tion, pursuant to the terms of a contract between the Sec- 23 retary and such individual. The Secretary shall establish 24 a system of contracting for purposes of this subsection 25 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 6650 IH which shall be similar to the contract requirements and 1 terms under subsections (c), (d), and (f) of section 338B. 2 ‘‘(f) REPORT.—Not later than 5 years after the date 3 of enactment of this section, the Secretary shall submit 4 to the Committee on Health, Education, Labor, and Pen- 5 sions of the Senate and the Committee on Energy and 6 Commerce of the House of Representatives a report that 7 evaluates the demonstration project established under this 8 section, including— 9 ‘‘(1) the effects of such program on health care 10 access, public health emergency response capacity, 11 and the provider workforce pipeline; and 12 ‘‘(2) any other considerations as the Secretary 13 determines appropriate.’’. 14 (2) CONFORMING AMENDMENTS.— 15 (A) SCHOLARSHIP PROGRAM.—Section 16 338A of the Public Health Service Act (42 17 U.S.C. 254l) is amended— 18 (i) in subsection (b)(2), by inserting 19 ‘‘, or be eligible for, or hold, an appoint- 20 ment in the reserve service under section 21 338O’’ before the semicolon; 22 (ii) in subsection (c)(2)(B), by insert- 23 ing ‘‘or through reserve service under an 24 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 6650 IH agreement under section 338O’’ after ‘‘sec- 1 tion 338D’’; and 2 (iii) in the flush text of subsection 3 (f)(1)(B)(v), by inserting ‘‘, including serv- 4 ice under the reserve service in accordance 5 with section 338O, as applicable’’ before 6 the semicolon at the end. 7 (B) OBLIGATED SERVICE.—Section 338C 8 of the Public Health Service Act (42 U.S.C. 9 254m) is amended— 10 (i) in subsection (a), by inserting ‘‘or 11 338O’’ after ‘‘section 338D’’; and 12 (ii) in subsection (c)— 13 (I) in paragraph (1), by striking 14 ‘‘, or’’ and inserting a semicolon; 15 (II) in paragraph (2), by striking 16 ‘‘agreement,’’ and inserting ‘‘agree- 17 ment; or’’; and 18 (III) by inserting after paragraph 19 (2) the following: 20 ‘‘(3) in the case of an individual who enters into 21 an agreement with the Secretary under section 22 338O, on the date specified in such agreement,’’. 23 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 6650 IH SEC. 3. FUNDING FOR THE NURSE CORPS SCHOLARSHIP 1 AND LOAN REPAYMENT PROGRAM. 2 (a) FUNDING.—There are hereby appropriated, out 3 of amounts in the Treasury not otherwise appropriated, 4 $5,000,000,000 for fiscal year 2020, for purposes of car- 5 rying out section 846 of the Public Health Service Act 6 (42 U.S.C. 297n), to remain available until expended, ex- 7 cept that— 8 (1) of the amount appropriated under this 9 heading and made available for scholarships, not less 10 than 40 percent shall be allocated to scholarships for 11 eligible applicants who are members of groups that 12 are historically underrepresented in health care pro- 13 fessions, including racial and ethnic minorities and 14 individuals from low-income urban and rural com- 15 munities; and 16 (2) to carry out the requirements of paragraph 17 (1), the Secretary may coordinate with entities re- 18 ceiving funding under section 821 to identify, re- 19 cruit, and select individuals to receive such scholar- 20 ships. 21 (b) EMERGENCY DESIGNATION.— 22 (1) IN GENERAL.—The amounts provided by 23 this section are designated as an emergency require- 24 ment pursuant to section 4(g) of the Statutory Pay- 25 As-You-Go Act of 2010 (2 U.S.C. 933(g)). 26 VerDate Sep 11 2014 17:32 May 05, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6650.IH H6650 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 6650 IH (2) DESIGNATION IN SENATE.—In the Senate, 1 this section is designated as an emergency require- 2 ment pursuant to section 4112(a) of H. Con. Res. 3 71 (115th Congress), the concurrent resolution on 4 the budget for fiscal year 2018. 5 SEC. 4. FLEXIBILITY FOR MEMBERS OF NATIONAL HEALTH 6 SERVICE CORPS DURING EMERGENCY PERI- 7 ODS. 8 Section 333 of the Public Health Service Act (42 9 U.S.C. 254f) is [Text truncated for display. Full text available on Congress.gov.]