[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 892 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 892

   To amend title VII of the Public Health Service Act to revise and 
            extend the area health education center program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 12, 1997

 Mr. Graham (for himself, Mr. McCain, Mr. Smith of Oregon, Mr. Wyden, 
Mr. Bumpers, Mr. Thomas, Mr. Hutchinson, Mr. Bond, Mr. Gregg, Mr. Reid, 
Mr. Ford, Mr. Robb, Mr. Inouye, Mr. Santorum, Mr. Breaux, Mr. Hollings, 
  Mr. Glenn, and Mr. Durbin) introduced the following bill; which was 
 read twice and referred to the Committee on Labor and Human Resources

_______________________________________________________________________

                                 A BILL


 
   To amend title VII of the Public Health Service Act to revise and 
            extend the area health education center program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Area Health Education Center Program 
Extension Act''.

SEC. 2. AREA HEALTH EDUCATION CENTER PROGRAM.

    Section 746 of the Public Health Service Act (42 U.S.C. 293j et 
seq.) is amended to read as follows:

``SEC. 746. AREA HEALTH EDUCATION CENTER PROGRAMS.

    ``(a) Authority for Provision of Financial Assistance.--
            ``(1) Assistance for planning, development, and operation 
        of programs.--
                    ``(A) In general.--The Secretary shall award grants 
                to and enter into contracts with schools of medicine 
                and osteopathic medicine and incorporated consortia 
                made up of such schools, or the parent institutions of 
                such schools, for projects for the planning, 
                development and operation of area health education 
                center programs that--
                            ``(i) improve the recruitment, 
                        distribution, supply, quality and efficiency of 
                        personnel providing health services in 
                        underserved rural and urban areas and personnel 
                        providing health services to populations having 
                        demonstrated serious unmet health care needs;
                            ``(ii) increase the number of primary care 
                        physicians and other primary care providers who 
                        provide services in underserved areas through 
                        the offering of an educational continuum of 
                        health career recruitment through clinical 
                        education concerning underserved areas in a 
                        comprehensive health workforce strategy;
                            ``(iii) carry out recruitment and health 
                        career awareness programs to recruit 
                        individuals from underserved areas and under-
                        represented populations into the health 
                        professions;
                            ``(iv) prepare individuals to more 
                        effectively provide health services to 
                        underserved areas or underserved populations 
                        through field placements, preceptorships, the 
                        conduct of or support of community-based 
                        primary care residency programs, and agreements 
                        with community-based organizations such as 
                        community health centers, migrant health 
                        centers, Indian health centers, public health 
                        departments and others;
                            ``(v) conduct health professions education 
                        and training activities for students and 
                        medical residents;
                            ``(vi) conduct at least 10 percent of 
                        medical student required clinical education at 
                        sites remote to the primary teaching facility 
                        of the contracting institution; and
                            ``(vii) provide information dissemination 
                        and educational support to reduce professional 
                        isolation, increase retention, enhance the 
                        practice environment, and improve health care 
                        through the timely dissemination of research 
                        findings using relevant resources.
                    ``(B) Project terms.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), the period during which payments 
                        may be made under an award under subparagraph 
                        (A) may not exceed--
                                    ``(I) in the case of a project, 12 
                                years or
                                    ``(II) in the case of a center 
                                within a project, 6 years.
                            ``(ii) Exception.--The periods described in 
                        clause (i) shall not apply to--
                                    ``(I) projects that have completed 
                                the initial period of Federal funding 
                                under this section and that desire to 
                                compete for model awards under 
                                paragraph (2)(A); and
                                    ``(II) projects that apply for 
                                awards under subsection (d) regardless 
                                of whether such projects have completed 
                                their initial period of Federal funding 
                                under this section.
            ``(2) Assistance for operation of model programs.--
                    ``(A) In general.--In the case of any entity 
                described in paragraph (1)(A) that--
                            ``(i) has previously received funds under 
                        this section;
                            ``(ii) is operating an area health 
                        education center program; and
                            ``(iii) is no longer receiving financial 
                        assistance under paragraph (1);
                the Secretary may provide financial assistance to such 
                entity to pay the costs of operating and carrying out 
                the requirements of the program as described in 
                746(a)(1).
                    ``(B) Matching requirement.--With respect to the 
                costs of operating a model program under subparagraph 
                (A), an entity, to be eligible for financial assistance 
                under subparagraph (A), shall make available (directly 
                or through contributions from State, county or 
                municipal governments, or the private sector) recurring 
                non-Federal contributions in cash toward such costs in 
                an amount that is equal to not less than 50 percent of 
                such costs.
                    ``(C) Limitation.--The aggregate amount of awards 
                provided under subparagraph (A) to entities in a State 
                for a fiscal year may not exceed the lesser of--
                            ``(i) $2,000,000; or
                            ``(ii) an amount equal to the product of 
                        $250,000 and the aggregate number of area 
                        health education centers operated in the State 
                        by such entities.
    ``(b) Requirements for Centers.--
            ``(1) General requirement.--Each area health education 
        center that receives funds under this section shall encourage 
        the regionalization of health professions schools through the 
        establishment of partnerships with community-based area health 
        education centers.
            ``(2) Service area.--Each area health education center that 
        receives funds under this section shall specifically designate 
        a geographic area or medically underserved population to be 
        served by the center. Such area or population shall be in a 
        location removed from the main location of the teaching 
        facilities of the schools participating in the program with 
        such center.
            ``(3) Other requirements.--Each area health education 
        center that receives funds under this section shall--
                    ``(A) assess the health personnel needs of the area 
                to be served by the center and assist in the planning 
                and development of training programs to meet such 
                needs;
                    ``(B) arrange and support rotations for students 
                and residents in family medicine, general internal 
                medicine or general pediatrics, with at least one 
                center in each program being affiliated with or 
                conducting a rotating osteopathic internship or medical 
                residency training program in family medicine, general 
                internal medicine, or general pediatrics in which no 
                fewer than 4 individuals are enrolled in first-year 
                positions;
                    ``(C) conduct interdisciplinary training that 
                involves physicians and other health personnel 
                including, where practicable, public health 
                professionals, physician assistants, nurse 
                practitioners, and nurse midwives; and
                    ``(D) have an advisory board, at least 75 percent 
                of the members of which shall be individuals, including 
                both health service providers and consumers, from the 
                area served by the center.
    ``(c) Certain Provisions Regarding Funding.--
            ``(1) Allocation to centers.--Not less than 75 percent of 
        the total amount of Federal funds provided to an entity under 
        this section shall be allocated by an area health education 
        center program to the area health education centers. Such 
        entity shall enter into an agreement with each center for 
        purposes of specifying the allocation of such 75 percent of 
        funds.
            ``(2) Operating costs.--With respect to the operating costs 
        of the area health education program of an entity receiving 
        funds under this section, the entity shall make available 
        (directly or through contributions from State, county or 
        municipal governments, or the private sector) non-Federal 
        contributions in cash toward such costs in an amount that is 
        equal to not less than 50 percent of such costs, except that 
        the Secretary may grant a waiver for up to 75 percent of the 
        amount of the required non-Federal match in the first three 
        years in which an entity receives funds under this section.
    ``(d) Health Education and Training Centers.--
            ``(1) Requirements.--A health education training center 
        shall be an entity eligible for funds under this section that--
                    ``(A) addresses the persistent and severe unmet 
                health care needs in States along the border between 
                the United States and Mexico and in the State of 
                Florida, and in other urban and rural areas with 
                populations with serious unmet health care needs;
                    ``(B) establishes an advisory board comprised of 
                health service providers, educators and consumers from 
                the service area;
                    ``(C) conducts training and education programs for 
                health professions students in these areas;
                    ``(D) conducts training in health education 
                services, including training to prepare community 
                health workers; and
                    ``(E) supports health professionals practicing in 
                the area through educational and other services.
            ``(2) Allocation of funds.--The Secretary shall make 
        available 50 percent of the amounts appropriated for each 
        fiscal year under subsection (e) for the establishment or 
        operation of health education training centers through projects 
        in States along the border between the United States and Mexico 
        and in the State of Florida.
    ``(e) Authorization of Appropriations.--
            ``(1) Area health education center programs.--
                    ``(A) In general.--There is authorized to be 
                appropriated to carry out this section, other than 
                subsection (d), $40,000,000 for each of the fiscal 
                years 1998 through 2002.
                    ``(B) Required obligation.--Of the amounts 
                appropriated under subparagraph (A) for each fiscal 
                year, the Secretary may obligate for awards under 
                subsection (a)(2)--
                            ``(i) not less than 20 percent of such 
                        amounts in fiscal year 1998;
                            ``(ii) not less than 25 percent of such 
                        amounts in fiscal year 1999;
                            ``(iii) not less than 30 percent of such 
                        amounts in fiscal year 2000;
                            ``(iv) not less than 35 percent of such 
                        amounts in fiscal year 2001; and
                            ``(v) not less than 40 percent of such 
                        amounts in fiscal year 2002.
                    ``(C) Health education and training centers.--There 
                is authorized to be appropriated to carry out 
                subsection (d), $10,000,000 for each of the fiscal 
                years 1998 through 2002.
            ``(2) Sense of congress.--It is the sense of the Congress 
        that--
                    ``(A) every State have an active area health 
                education center program in effect under this section; 
                and
                    ``(B) the ratio of Federal funding for the model 
                program under section 746(a)(2) should increase over 
                time and that Federal funding for other awards under 
                this section shall decrease so that the national 
                program will become entirely comprised of programs that 
                are funded at least 50 percent by State and local 
                partners.''.
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