Strengthening America’s Health Care Readiness Act

II 116TH CONGRESS 2D SESSION S. 4055 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 JUNE 24, 2020 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 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 4055 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 2020, 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 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 4055 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.—From the amounts made avail- 23 able under section 10503(b)(3) of the Patient Protection 24 and Affordable Care Act for each of fiscal years 2021 25 VerDate Sep 11 2014 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 4055 IS through 2025, 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 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 4055 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 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 4055 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 notifies the site at 22 which the individual is fulfilling his or her obli- 23 gated service requirements under such contract. 24 VerDate Sep 11 2014 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 4055 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 coordination 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 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 4055 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) ensure an adequate health care workforce 9 during a public health emergency declared by the 10 Secretary under section 319 of this Act, a major dis- 11 aster declared by the President under section 401 of 12 the Robert T. Stafford Disaster Relief and Emer- 13 gency Assistance Act, an emergency declared by the 14 President under section 501 of the Robert T. Staf- 15 ford Disaster Relief and Emergency Assistance Act, 16 or a national emergency declared by the President 17 under the National Emergencies Act; and 18 ‘‘(3) describe how the program established 19 under this section will be implemented in a manner 20 consistent with, and in furtherance of, the assess- 21 ments and goals for workforce and training de- 22 scribed in the review conducted by the Secretary 23 under section 2812(b)(2). 24 VerDate Sep 11 2014 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 4055 IS ‘‘(e) CONTRACTS FOR CERTAIN PARTICIPATING INDI- 1 VIDUALS.—An individual who is participating in the emer- 2 gency service program under this section shall receive loan 3 repayments in an amount equal to 50 percent of the high- 4 est new award made for the year under the National 5 Health Service Corps Loan Repayment Program pursuant 6 to a contract entered into at the same time under section 7 338B(g), in a manner similar to the manner in which pay- 8 ments are made under such section, pursuant to the terms 9 of a contract between the Secretary and such individual. 10 The Secretary shall establish a system of contracting for 11 purposes of this subsection which shall be similar to the 12 contract requirements and terms under subsections (c), 13 (d), and (f) of section 338B. Amounts received by an indi- 14 vidual under this subsection shall be in addition to any 15 amounts received by an individual described in subsection 16 (b)(2) pursuant to the Scholarship Program under section 17 338A or the Loan Repayment Program under section 18 338B, as applicable. 19 ‘‘(f) BREACH OF CONTRACT.—If an individual 20 breaches the written contract of the individual under sub- 21 section (e) by failing either to begin such individual’s serv- 22 ice obligation in accordance with such contract or to com- 23 plete such service obligation, the United States shall be 24 VerDate Sep 11 2014 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 4055 IS entitled to recover from the individual an amount equal 1 to the sum of— 2 ‘‘(1) the total of the amounts paid by the 3 United States under such contract on behalf of the 4 individual for any period of such service not served; 5 ‘‘(2) an amount equal to the product of the 6 number of months of service that were not com- 7 pleted by the individual, multiplied by $3,750; and 8 ‘‘(3) the interest on the amounts described in 9 paragraphs (1) and (2), at the maximum legal pre- 10 vailing rate, as determined by the Treasurer of the 11 United States, from the date of the breach. 12 ‘‘(g) REPORT.—Not later than 4 years after the date 13 of enactment of this section, the Secretary shall submit 14 to the Committee on Health, Education, Labor, and Pen- 15 sions of the Senate and the Committee on Energy and 16 Commerce of the House of Representatives a report that 17 evaluates the demonstration project established under this 18 section, including— 19 ‘‘(1) the effects of such program on health care 20 access in underserved areas and health professional 21 shortage areas and on public health emergency re- 22 sponse capacity; 23 ‘‘(2) the effects of such program on the health 24 care provider workforce pipeline, including any im- 25 VerDate Sep 11 2014 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 4055 IS pact on the demographic representation among, and 1 the fields or specialties pursued by, students in ap- 2 proved graduate training programs in medicine, os- 3 teopathic medicine, dentistry, behavioral and mental 4 health, or other health profession; 5 ‘‘(3) the impact of such program on the enroll- 6 ment, participation, and completion of requirements 7 in the underlying scholarship and loan repayment 8 programs of the National Health Service Corps; 9 ‘‘(4) the effects of such program on the Na- 10 tional Disaster Medical System’s response capability, 11 readiness, and workforce strength; and 12 ‘‘(5) recommendations for improving the dem- 13 onstration project described in this section, and any 14 other considerations as the Secretary determines ap- 15 propriate.’’. 16 SEC. 3. FUNDING FOR THE NURSE CORPS SCHOLARSHIP 17 AND LOAN REPAYMENT PROGRAM. 18 (a) FUNDING.—There are hereby appropriated, out 19 of amounts in the Treasury not otherwise appropriated, 20 $1,000,000,000 for fiscal year 2020, for purposes of car- 21 rying out section 846 of the Public Health Service Act 22 (42 U.S.C. 297n), to remain available until expended, ex- 23 cept that— 24 VerDate Sep 11 2014 22:28 Jul 03, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S4055.IS S4055 pbinns on DSKJLVW7X2PROD with BILLS 12 •S 4055 IS (1) of the amount appropriated under this 1 heading and made available for scholarships and 2 loan repayment, not l [Text truncated for display. Full text available on Congress.gov.]