113 S1152 IS: Building a Health Care Workforce for the Future Act
U.S. Senate
2013-06-12
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as
the Building a Health Care Workforce
for the Future Act
.
2.Grants to States
for scholarship programsSubpart III of part D of title III of the
Public Health Service Act (42 U.S.C. 254l et seq.) is amended by adding at the
end the following:
338N.Grants to
States for scholarship programs
(a)The Secretary shall award grants to eligible States to
enable such States to implement scholarship programs to ensure, with respect to
the provision of health services, an adequate supply of physicians, dentists,
behavioral and mental health professionals, certified nurse midwives, certified
nurse practitioners, physician assistants, and pharmacists or other health
profession as determined by the Secretary.
(b)To be eligible to receive a grant under this section, a
State shall submit to the Secretary an application containing such information
as the Secretary determines necessary to carry out this section.
(c)To be eligible to participate in a scholarship
program carried out with a grant received under this section, an individual
shall—
(1)be accepted for
enrollment, or be enrolled, as a full-time student—
(A)in an accredited
(as determined by the Secretary) educational institution in a State; and
(B)in a course of
study or program, offered by such institution and approved by the Secretary,
leading to a degree in medicine, dentistry, school of pharmacy, other health
profession designated by the Secretary, nursing college, or an appropriate
degree from a graduate program of behavioral and mental health;
(2)submit to the
State, an application to participate in the program; and
(3)sign and submit
to the State, at the time of the submission of the application under paragraph
(2), a written contract that requires the individual to—
(A)accept payments
under the scholarship;
(B)maintain a
minimum level of academic standing during the period of the scholarship, as
determined by the Secretary;
(C)if applicable,
complete an accredited residency training program;
(D)become licensed
in the applicant’s State of residence; and
(E)serve as a
provider for 1 year in—
(i)a
health professional shortage area (as defined by the National Health Service
Corps under section 332);
(ii)a medically
underserved area (as defined for purposes of section 330); or
(iii)any other
shortage area defined by the State and approved by the Secretary;
in the
applicant's State of residence for every year in which the applicant received a
scholarship.(d)To be eligible to receive a grant under this section, a
State shall adequately demonstrate to the Secretary that the State has
designated appropriate health professions or specialty shortage areas.
(e)In disseminating application and contract forms to
individuals desiring to participate in a scholarship program funded under this
section, the State shall include with such forms a summary of the rights and
liabilities of an individual whose application is approved (and whose contract
is accepted), including a clear explanation of the damages to which the State
is entitled in the case of the individual’s breach of the contract.
(f)
(1)A State that enters into a contract with an individual
under subsection (c)(3) shall, with respect to the program in which the
individual is enrolled, agree to pay—
(A)all tuition and
costs associated with the program;
(B)any other
reasonable educational expenses, including fees, books, and laboratory
expenses, related to the program; and
(C)a cost-of-living
stipend in an amount to be determined the Secretary.
(2)In entering into contracts with individuals that meet
the requirements of subsection (c), the State shall consider the extent of the
applicant's demonstrated interest in the provision of care services in a
particular provider shortage area.
(g)A State receiving a grant under this section shall, with
respect to the costs of making payments on behalf of individuals under the
scholarship program implemented by the State under the grant, make available
(directly or through donations from public or private entities) non-Federal
contributions in cash toward such costs in an amount equal to not less than $1
for each $1 of Federal funds provided under the grant.
(h)Direct
administration by State agencyThe scholarship program of any
State receiving a grant under this section shall be administered directly by a
State agency.
(i)Not later than 4 years after the date of enactment of
this section, and every 5 years thereafter, the Secretary shall submit to
Congress a report concerning—
(1)the number of
scholarships awarded under the State scholarship program;
(2)the number of
scholarship recipients, broken down by practice area, serving in the profession
originally awarded a scholarship for 1 year after the completion of the service
period required under subsection (c)(3)(E);
(3)the number of
scholarship recipients, broken down by provider type, practicing in an
underserved area 1 year after the completion of the service period required
under subsection (c)(3)(E);
(4)data on any
changes in health professional shortage areas or medically underserved areas
within the State;
(5)remaining gaps in
such health professional shortage areas or medically underserved areas;
(6)the number of
additional full-time physicians that would be required to eliminate such health
professional shortage areas or medically underserved areas in the State;
(7)the number of
individuals who received a scholarship but failed to comply with its
requirements;
(8)the action taken
by the State to recoup scholarship funds in the case of any non-compliance;
and
(9)recommendations
to improve the program under this section.
(j)Authorization
of appropriationsThere are authorized to be appropriated to
carry out this section, $20,000,000 for each of fiscal years 2014 through 2018.
Not less than 50 percent of the amount appropriated for a fiscal year under
this subsection shall be used to provide scholarships to providers who intend
on pursuing careers in primary
care.
.
3.Increasing
mentoring and transforming competencies in primary careTitle VII of the Public Health Service Act
is amended by inserting after section 747A (42 U.S.C. 293k–1), the
following:
747B.Developing
effective primary care mentors and improving mentorship opportunities for
medical students
(a)Grants To
cultivate primary care mentors and improve primary care mentorship
opportunities for medical studentsThe Secretary may award grants
to eligible medical schools to assist such schools in developing and
strengthening primary care mentorship programs and cultivating leaders in
primary care among students.
(b)To
be eligible to receive a grant under this section, an entity shall—
(1)be an accredited
medical school or college of osteopathic medicine; and
(2)submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require, including an assurance that the
applicant will use amounts received under the grant to—
(A)establish or
enhance existing mentorship programs, including—
(i)incentivizing
medical school faculty (through financial or other reward systems) to
participate as a mentor of other primary care physician faculty members and
students;
(ii)providing
resources for aspiring mentors to participate in workshops or other learning
experiences in which primary care physicians can learn about effective
strategies in primary care mentoring;
(iii)enabling
successful primary care mentors on medical school faculty to spend time at
another institution where they can promote best practices in mentoring primary
care leaders and students; and
(iv)developing
web-based resources for mentors to interact regularly and share successful
strategies; or
(B)cultivate
interest and leaders in primary care among students, including—
(i)offering students
that identify interest in primary care upon matriculation, longitudinal
experiences in primary care to care for and track the health and wellness of
patients throughout medical school;
(ii)arranging
partnerships with private practices, insurers, schools of public health, public
health departments, and community-based service projects with the goal of
providing students with the opportunity to interact with primary care mentors
from a variety of health care settings;
(iii)providing
stipends or other forms of financial resources to students who work with
designated mentors in the field of primary care in underserved urban and rural
communities; and
(iv)supporting
opportunities for students to engage in practice redesign or other efforts in
which primary care physicians are taking a leadership role in delivery system
reform.
(c)Authorization
of appropriationsThere are authorized to be appropriated to
carry out this section, $20,000,000 for each of fiscal years 2014 through
2020.
747C.Developing
and promoting new competencies
(a)Grants To
develop and promote new competenciesIn order to foster
curricular innovations to improve the education and training of health care
providers, the Secretary shall award grants to medical and other health
professions schools to promote priority competencies (as described in
subsection (b)).
(b)In awarding grants under subsection (a), the
Secretary, acting through the Advisory Committee on Training in Primary Care
and Dentistry, shall select an annual competency to direct the awarding of such
grants. Such annual competencies may include—
(1)patient-centered
medical homes;
(2)chronic disease
management;
(3)integration of
primary care and mental health care;
(4)integration of
primary care, public and population health, and health promotion;
(5)cultural
competency;
(6)domestic
violence;
(7)improving care in
medically undeserved areas; and
(8)team-based
care.
(c)The Secretary may award grants under subsection (a) to
programs that provide education or training for—
(1)physicians;
(2)dentists and
dental hygienists;
(3)physician
assistants;
(4)mental and
behavioral health providers;
(5)public and
populations health professionals; or
(6)pharmacists.
(d)Consideration
in evaluating grant applicationsThe Secretary shall give
consideration to applicants that are proposing to partner with other medical
programs, health professions programs, or nursing programs.
(e)The recipient of a grant under this section shall, not
later than 180 days after the end of the grant period involved, submit to the
Advisory Committee, a report on the following (where appropriate):
(1)A description of
how the funding under the grant was used by the grantee.
(2)A description of
the intended goal of such funding.
(3)A description of
the challenges faced by the grantee in reaching the goal described in paragraph
(2).
(4)A description of
the lessons learned by the grantee related to the grant activities.
(f)Recommendations
of the Advisory CommitteeThe Advisory Committee, based on the
information submitted under subsection (d), shall annually report to the
Secretary on outcomes of the activities carried out under grants under this
section, including specific recommendations for scaling up innovations to
promote education and training of health care providers in the priority
competencies described in subsection (b).
(g)Authorization
of appropriationsThere are authorized to be appropriated,
$10,000,000 for each of fiscal years 2014 through 2018 to carry out this
section.
.
4.Study on
documentation requirements for cognitive serviceNot later than 3 years after the date of
enactment of this Act, the Institute of Medicine shall conduct a study, and
submit a report to Congress, concerning the documentation requirements for
cognitive services (evaluation and management services) required under the
Medicare and Medicaid programs under titles XVIII and XIX of the Social
Security Act, and through private health insurers. Such study shall include an
evaluation of—
(1)how documentation
requirements designed for paper-based records should be modified for electronic
records;
(2)whether or not
the documentation requirements are overly burdensome on physicians and detract
from patient care;
(3)the
administrative costs to physician practices of the current documentation
requirements;
(4)the average
amount of time required by physicians to document cognitive services;
(5)options to more
appropriately compensate physicians for evaluation and management of patient
care without requiring excessive documentation of cognitive services;
and
(6)recommendations
for less burdensome alternatives or changes to existing documentation
requirements of cognitive services.