Building a Health Care Workforce for the Future Act

I 116TH CONGRESS 2D SESSION H. R. 7470 To amend the Public Health Service Act to help build a stronger health care workforce. IN THE HOUSE OF REPRESENTATIVES JULY 1, 2020 Mr. RUIZ introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the juris- diction of the committee concerned A BILL To amend the Public Health Service Act to help build a stronger health care workforce. 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 ‘‘Building a Health Care 4 Workforce for the Future Act’’. 5 SEC. 2. GRANTS TO STATES FOR SCHOLARSHIP PROGRAMS. 6 Subpart III of part D of title III of the Public Health 7 Service Act (42 U.S.C. 254l et seq.) is amended by adding 8 at the end the following: 9 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 7470 IH ‘‘SEC. 338O. GRANTS TO STATES FOR SCHOLARSHIP PRO- 1 GRAMS. 2 ‘‘(a) IN GENERAL.—The Secretary shall award 3 grants to eligible States to enable such States to imple- 4 ment scholarship programs to ensure, with respect to the 5 provision of health services, an adequate supply of physi- 6 cians, dentists, behavioral and mental health professionals, 7 certified nurse midwives, certified nurse practitioners, 8 physician assistants, pharmacists, and other health profes- 9 sionals as determined by the Secretary. 10 ‘‘(b) ELIGIBLE STATES.—To be eligible to receive a 11 grant under this section, a State shall submit to the Sec- 12 retary an application containing such information as the 13 Secretary determines necessary to carry out this section. 14 ‘‘(c) ELIGIBLE PARTICIPANTS.—To be eligible to par- 15 ticipate in a scholarship program carried out with a grant 16 received under this section, an individual shall— 17 ‘‘(1) be accepted for enrollment, or be enrolled, 18 as a full-time student— 19 ‘‘(A) in an accredited (as determined by 20 the Secretary) educational institution in a 21 State; and 22 ‘‘(B) in a course of study or program, of- 23 fered by such institution and approved by the 24 Secretary, leading to a degree in medicine, den- 25 tistry, nursing, pharmacy, or other health pro- 26 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 7470 IH fession, or an appropriate degree from a grad- 1 uate program of behavioral and mental health; 2 ‘‘(2) submit to the State an application to par- 3 ticipate in the program; and 4 ‘‘(3) sign and submit to the State, at the time 5 of the submission of the application under paragraph 6 (2), a written contract that requires the individual 7 to— 8 ‘‘(A) accept payments under the scholar- 9 ship; 10 ‘‘(B) maintain a minimum level of aca- 11 demic standing during the period of the schol- 12 arship, as determined by the Secretary; 13 ‘‘(C) if applicable, complete an accredited 14 residency training program; 15 ‘‘(D) become licensed in the applicant’s 16 State of residence; and 17 ‘‘(E) serve as a provider for one year in— 18 ‘‘(i) a health professional shortage 19 area (as defined under section 332); 20 ‘‘(ii) a medically underserved commu- 21 nity (as defined under section 799B); or 22 ‘‘(iii) any other shortage area defined 23 by the State and approved by the Sec- 24 retary; 25 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 7470 IH in the applicant’s State of residence for every 1 year in which the applicant received a scholar- 2 ship. 3 ‘‘(d) DESIGNATION OF AREAS.—To be eligible to re- 4 ceive a grant under this section, a State shall adequately 5 demonstrate to the Secretary that the State has des- 6 ignated appropriate health professional or specialty short- 7 age areas. 8 ‘‘(e) REQUIRED DISCLOSURES.—In disseminating 9 application and contract forms to individuals desiring to 10 participate in a scholarship program funded under this 11 section, the State shall include with such forms a sum- 12 mary of the rights and liabilities of an individual whose 13 application is approved (and whose contract is accepted), 14 including a clear explanation of the damages to which the 15 State is entitled in the case of the individual’s breach of 16 the contract. 17 ‘‘(f) AWARDING OF CONTRACTS.— 18 ‘‘(1) IN GENERAL.—A State that enters into a 19 contract with an individual under subsection (c)(3) 20 shall, with respect to the program in which the indi- 21 vidual is enrolled, agree to pay— 22 ‘‘(A) all tuition and costs associated with 23 the program; 24 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 7470 IH ‘‘(B) any other reasonable educational ex- 1 penses, including fees, books, and laboratory ex- 2 penses, related to the program; and 3 ‘‘(C) a cost-of-living stipend in an amount 4 to be determined the Secretary. 5 ‘‘(2) CONSIDERATION BY STATE.—In entering 6 into contracts with individuals that meet the require- 7 ments of subsection (c), the State shall consider the 8 extent of the applicant’s demonstrated interest in 9 the provision of care services in a particular provider 10 shortage area. 11 ‘‘(g) MATCHING FUNDS.—A State receiving a grant 12 under this section shall, with respect to the costs of mak- 13 ing payments on behalf of individuals under the scholar- 14 ship program implemented by the State under the grant, 15 make available (directly or through donations from public 16 or private entities) non-Federal contributions in cash to- 17 ward such costs in an amount equal to not less than $1 18 for each $1 of Federal funds provided under the grant. 19 ‘‘(h) DIRECT ADMINISTRATION BY STATE AGENCY.— 20 The scholarship program of any State receiving a grant 21 under this section shall be administered directly by a State 22 agency. 23 ‘‘(i) REPORT BY SECRETARY.—Not later than four 24 years after the date of enactment of this section, and every 25 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 7470 IH five years thereafter, the Secretary shall submit to Con- 1 gress a report concerning— 2 ‘‘(1) the number of scholarships awarded under 3 the State scholarship program; 4 ‘‘(2) the number of scholarship recipients, bro- 5 ken down by practice area, serving in the profession 6 originally awarded a scholarship for one year after 7 the completion of the service period required under 8 subsection (c)(3)(E); 9 ‘‘(3) the number of scholarship recipients, bro- 10 ken down by provider type, practicing in a medically 11 underserved community one year after the comple- 12 tion of the service period required under subsection 13 (c)(3)(E); 14 ‘‘(4) data on any changes in health professional 15 shortage areas or medically underserved commu- 16 nities within the State; 17 ‘‘(5) remaining gaps in such health professional 18 shortage areas or medically underserved commu- 19 nities; 20 ‘‘(6) the number of additional full-time physi- 21 cians that would be required to eliminate such 22 health professional shortage areas or medically un- 23 derserved communities in the State; 24 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 7470 IH ‘‘(7) the number of individuals who received a 1 scholarship but failed to comply with the require- 2 ments of the scholarship; 3 ‘‘(8) the action taken by the State to recoup 4 scholarship funds in the case of any non-compliance; 5 and 6 ‘‘(9) recommendations to improve the program 7 under this section. 8 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 9 is authorized to be appropriated to carry out this section 10 $20,000,000 for each of fiscal years 2021 through 2025. 11 Not less than 50 percent of the amount appropriated for 12 a fiscal year under this subsection shall be used to provide 13 scholarships to providers who intend on pursuing careers 14 in primary care.’’. 15 SEC. 3. INCREASING MENTORING AND TRANSFORMING 16 COMPETENCIES IN PRIMARY CARE. 17 Title VII of the Public Health Service Act is amended 18 by inserting after section 747A (42 U.S.C. 293k–1) the 19 following: 20 ‘‘SEC. 747B. DEVELOPING EFFECTIVE PRIMARY CARE MEN- 21 TORS AND IMPROVING MENTORSHIP OPPOR- 22 TUNITIES FOR MEDICAL STUDENTS. 23 ‘‘(a) GRANTS TO CULTIVATE PRIMARY CARE MEN- 24 TORS AND IMPROVE PRIMARY CARE MENTORSHIP OPPOR- 25 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 7470 IH TUNITIES FOR MEDICAL STUDENTS.—The Secretary may 1 award grants to eligible medical schools to assist such 2 schools in developing and strengthening primary care 3 mentorship programs and cultivating leaders in primary 4 care among students. 5 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 6 under this section, an entity shall— 7 ‘‘(1) be an accredited medical school or college 8 of osteopathic medicine; and 9 ‘‘(2) submit to the Secretary an application at 10 such time, in such manner, and containing such in- 11 formation as the Secretary may require, including an 12 assurance that the applicant will use amounts re- 13 ceived under the grant to— 14 ‘‘(A) establish or enhance existing 15 mentorship programs, including— 16 ‘‘(i) incentivizing medical school fac- 17 ulty (through financial or other reward 18 systems) to participate as a mentor of 19 other primary care physician faculty mem- 20 bers and students; 21 ‘‘(ii) providing resources for aspiring 22 mentors to participate in workshops or 23 other learning experiences in which pri- 24 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 7470 IH mary care physicians can learn about effec- 1 tive strategies in primary care mentoring; 2 ‘‘(iii) enabling successful primary care 3 mentors on medical school faculty to spend 4 time at another institution where they can 5 promote best practices in mentoring pri- 6 mary care leaders and students; and 7 ‘‘(iv) developing web-based resources 8 for mentors to interact regularly and share 9 successful strategies; or 10 ‘‘(B) cultivate interest and leaders in pri- 11 mary care among students, including— 12 ‘‘(i) offering students that identify in- 13 terest in primary care upon matriculation 14 longitudinal experiences in primary care to 15 care for and track the health and wellness 16 of patients throughout medical school; 17 ‘‘(ii) arranging partnerships with pri- 18 vate practices, insurers, schools of public 19 health, public health departments, and 20 community-based service projects with the 21 goal of providing students with the oppor- 22 tunity to interact with primary care men- 23 tors from a variety of health care settings; 24 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 7470 IH ‘‘(iii) providing stipends or other 1 forms of financial resources to students 2 who work with designated mentors in the 3 field of primary care in underserved urban 4 and rural communities; and 5 ‘‘(iv) supporting opportunities for stu- 6 dents to engage in practice redesign or 7 other efforts in which primary care physi- 8 cians are taking a leadership role in deliv- 9 ery system reform. 10 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 11 is authorized to be appropriated to carry out this section 12 $20,000,000 for each of fiscal years 2021 through 2027. 13 ‘‘SEC. 747C. DEVELOPING AND PROMOTING NEW COM- 14 PETENCIES. 15 ‘‘(a) GRANTS TO DEVELOP AND PROMOTE NEW 16 COMPETENCIES.—In order to foster curricular innova- 17 tions to improve the education and training of health care 18 providers, the Secretary shall award grants to medical and 19 other health professions schools to promote priority com- 20 petencies (as described in subsection (b)). 21 ‘‘(b) PRIORITY COMPETENCIES.—In awarding grants 22 under subsection (a), the Secretary, acting through the 23 Advisory Committee on Training in Primary Care and 24 Dentistry, shall select an annual competency to direct the 25 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 7470 IH awarding of such grants. Such annual competencies may 1 include— 2 ‘‘(1) patient-centered medical homes; 3 ‘‘(2) chronic disease management; 4 ‘‘(3) integration of primary care and mental 5 health care; 6 ‘‘(4) integration of primary care, public and 7 population health, and health promotion; 8 ‘‘(5) cultural competency; 9 ‘‘(6) domestic violence; 10 ‘‘(7) improving care in medically undeserved 11 areas; and 12 ‘‘(8) team-based care. 13 ‘‘(c) GRANT RECIPIENTS.—The Secretary may award 14 grants under subsection (a) to programs that provide edu- 15 cation or training for— 16 ‘‘(1) physicians; 17 ‘‘(2) dentists and dental hygienists; 18 ‘‘(3) physician assistants; 19 ‘‘(4) mental and behavioral health providers; 20 ‘‘(5) public and populations health profes- 21 sionals; or 22 ‘‘(6) pharmacists. 23 ‘‘(d) CONSIDERATION IN EVALUATING GRANT APPLI- 24 CATIONS.—The Secretary shall give consideration to appli- 25 VerDate Sep 11 2014 05:41 Jul 24, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H7470.IH H7470 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 7470 IH cants that are proposing to partner with other medical 1 programs, health professions programs, or nursing pro- 2 grams. 3 ‘‘(e) GRANTEE REPORTS.—Each recipient of a grant 4 under this section shall, not later than 180 days after the 5 end of the grant period involved, submit to the Advisory 6 Committee, a report on the following (where appropriate): 7 ‘‘(1) A description of how the funding under 8 the grant was used by the grantee. 9 ‘‘(2) A description of the intended goal of such 10 funding. 11 ‘‘(3) A description of the challenges faced by 12 the grantee in reaching the goal described in para- 13 graph (2). 14 ‘‘(4) A description of the lessons learned by the 15 grantee related to the grant activities. 16 ‘‘(f) RECOMMENDATIONS OF THE ADVISORY COM- 17 MITTEE.—The Advisory Committee, based on the informa- 18 tion submitted under su [Text truncated for display. 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