[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2491 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2491

   To amend the Public Health Service Act to promote and improve the 
                       allied health professions.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 2, 2004

Ms. Cantwell (for herself, Mr. Bingaman, and Mr. Lieberman) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to promote and improve the 
                       allied health professions.

    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 ``Allied Health Reinvestment Act''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) The United States Census Bureau and other reports 
        highlight the increased demand for acute and chronic healthcare 
        services among both the general population and a rapidly 
        growing aging portion of the population.
            (2) The calls for reduction in medical errors, increased 
        patient safety, and quality of care have resulted in an 
        amplified call for allied health professionals to provide 
        healthcare services.
            (3) Several allied health professions are characterized by 
        workforce shortages, declining enrollments in allied health 
        education programs, or a combination of both factors, and 
        hospital officials have reported vacancy rates in positions 
        occupied by allied health professionals.
            (4) Many allied health education programs are facing 
        significant economic pressure that could force their closure 
        due to an insufficient number of students.
    (b) Purpose.--It is the purpose of this Act to provide incentives 
for individuals to seek and complete high quality allied health 
education and training and provide additional funding to ensure that 
such education and training can be provided to allied health students 
so that the United States healthcare industry with have a supply of 
allied health professionals needed to support the health care system of 
the United States in this decade and beyond.

SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    Title VII of the Public Health Service Act (42 U.S.C. 292 et seq.) 
is amended by adding at the end the following:

                 ``PART G--ALLIED HEALTH PROFESSIONALS

``SEC. 799C. DEFINITIONS.

    ``In this part:
            ``(1) Allied health education program.--The term `allied 
        health education program' means any postsecondary educational 
        program offered by an institution accredited by an agency or 
        commission recognized by the Department of Education, or 
        leading to a State certificate or license or any other 
        educational program approved by the Secretary. Such term 
        includes colleges, universities, or schools of allied health 
        and equivalent entities that include programs leading to a 
        certificate, associate, baccalaureate, or graduate level degree 
        in an allied health profession.
            ``(2) Allied health professions.--The term `allied health 
        professions' includes professions in the following areas at the 
        certificate, associate, baccalaureate, or graduate level:
                    ``(A) Dental hygiene.
                    ``(B) Dietetics or nutrition.
                    ``(C) Emergency medical services.
                    ``(D) Health information management.
                    ``(E) Clinical laboratory sciences and medical 
                technology.
                    ``(F) Cytotechnology.
                    ``(G) Occupational therapy.
                    ``(H) Physical therapy.
                    ``(I) Radiologic technology.
                    ``(J) Nuclear medical technology.
                    ``(K) Rehabilitation counseling.
                    ``(L) Respiratory therapy.
                    ``(M) Speech-language pathology and audiology.
                    ``(N) Any other profession determined appropriate 
                by the Secretary.
            ``(3) Health care facility.--The term `health care 
        facility' means an outpatient health care facility, hospital, 
        nursing home, home health care agency, hospice, federally 
        qualified health center, nurse managed health center, rural 
        health clinic, public health clinic, or any similar healthcare 
        facility or practice that employs allied health professionals.

``SEC. 799C-1. PUBLIC SERVICE ANNOUNCEMENTS.

    ``The Secretary shall develop and issue public service 
announcements that shall--
            ``(1) advertise and promote the allied health professions;
            ``(2) highlight the advantages and rewards of the allied 
        health professions; and
            ``(3) encourage individuals from diverse communities and 
        backgrounds to enter the allied health professions.

``SEC. 799C-2. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS.

    ``(a) In General.--The Secretary shall award grants to designated 
eligible entities to support State and local advertising campaigns that 
are conducted through appropriate media outlets (as determined by the 
Secretary) to--
            ``(1) promote the allied health professions;
            ``(2) highlight the advantages and rewards of the allied 
        health professions; and
            ``(3) encourage individuals from disadvantaged communities 
        and backgrounds to enter the allied health professions.
    ``(b) Eligible Entity.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be a professional, national, or State allied health 
        association, State health care provider, or association of one 
        or more health care facilities, allied health education 
        programs, or other entities that provides similar services or 
        serves a like function; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.

``SEC. 799C-3. ALLIED HEALTH RECRUITMENT GRANT PROGRAM.

    ``(a) Program Authorized.--The Secretary shall award grants to 
eligible entities to increase allied health professions education 
opportunities.
    ``(b) Eligible Entity.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be a professional, national, or State allied health 
        association, State health care provider, or association of one 
        or more health care facilities, allied health education 
        programs, or other eligible entities that provides similar 
        services or serves a like function; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Use of Funds.--An entity shall use amounts received under a 
grant under subsection (a) to--
            ``(1) support outreach programs at elementary and secondary 
        schools that inform guidance counselors and students of 
        education opportunities regarding the allied health 
        professions;
            ``(2) carry out special projects to increase allied health 
        education opportunities for individuals who are from 
        disadvantaged backgrounds (including racial and ethnic 
        minorities that are underrepresented among the allied health 
        professions) by providing student scholarships or stipends, 
        pre-entry preparation, and retention activities;
            ``(3) provide assistance to public and nonprofit private 
        educational institutions to support remedial education programs 
        for allied health students who require assistance with math, 
        science, English, and medical terminology;
            ``(4) meet the costs of child care and transportation for 
        individuals who are taking part in an allied health education 
        program at any level; and
            ``(5) support community-based partnerships seeking to 
        recruit allied health professionals in rural communities and 
        medically underserved urban communities, and other communities 
        experiencing an allied health professions shortage.

``SEC. 799C-4. GRANTS FOR HEALTH CAREER ACADEMIES.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities to assist such entities in collaborating to carry out programs 
that form education pipelines to facilitate the entry of students of 
secondary educational institutions, especially underrepresented racial 
and ethnic minorities, into careers in the allied health professions.
    ``(b) Eligible Entity.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be an institution that offers allied health education 
        programs, a health care facility, or a secondary educational 
        institution; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.

``SEC. 799C-5. ALLIED HEALTH EDUCATION, PRACTICE, AND RETENTION GRANTS.

    ``(a) Education Priority Areas.--The Secretary may award grants to 
or enter into contracts with eligible entities to--
            ``(1) expand the enrollment of individuals in allied health 
        education programs, especially the enrollment of 
        underrepresented racial and ethnic minority students; and
            ``(2) provide education through new technologies and 
        methods, including distance-learning methodologies.
    ``(b) Practice Priority Areas.--The Secretary may award grants to 
or enter into contracts with eligible entities to--
            ``(1) establish or expand allied health practice 
        arrangements in noninstitutional settings to demonstrate 
        methods to improve access to primary health care in rural areas 
        and other medically underserved communities;
            ``(2) provide care for underserved populations and other 
        high-risk groups such as the elderly, individuals with HIV/
        AIDS, substance abusers, the homeless, and victims of domestic 
        violence;
            ``(3) provide managed care, information management, quality 
        improvement, and other skills needed to practice in existing 
        and emerging organized health care systems; or
            ``(4) develop generational and cultural competencies among 
        allied health professionals.
    ``(c) Retention Priority Areas.--
            ``(1) In general.--The Secretary may award grants to and 
        enter into contracts with eligible entities to enhance the 
        allied health professions workforce by initiating and 
        maintaining allied health retention programs described in 
        paragraph (2) or (3).
            ``(2) Grants for career ladder programs.--The Secretary may 
        award grants to and enter into contracts with eligible entities 
        for programs--
                    ``(A) to promote career advancement for allied 
                health personnel in a variety of training settings, 
                cross training or specialty training among diverse 
                population groups, and the advancement of individuals; 
                and
                    ``(B) to assist individuals in obtaining the 
                education and training required to enter the allied 
                health professions and advance within such professions, 
                such as by providing career counseling and mentoring.
            ``(3) Enhancing patient care delivery systems.--
                    ``(A) Grants.--The Secretary may award grants to 
                eligible entities to improve the retention of allied 
                health professionals and to enhance patient care that 
                is directly related to allied health activities by 
                enhancing collaboration and communication among allied 
                health professionals and other health care 
                professionals, and by promoting allied health 
                involvement in the organizational and clinical 
                decision-making processes of a health care facility.
                    ``(B) Preference.--In making awards of grants under 
                this paragraph, the Secretary shall give preferences to 
                applicants that have not previously received an award 
                under this paragraph and to applicants from rural, 
                underserved areas.
                    ``(C) Continuation of an award.--The Secretary 
                shall make continuation of any award under this 
                paragraph beyond the second year of such award 
                contingent on the recipient of such award having 
                demonstrated to the Secretary measurable and 
                substantive improvement in allied health personnel 
                retention or patient care.
    ``(d) Eligible Entity.--To be eligible to receive a grant under 
this section, an entity shall--
            ``(1) be a health care facility, or any partnership or 
        coalition containing a health care facility or allied health 
        education program; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.

``SEC. 799C-6. DEVELOPING MODELS AND BEST PRACTICES PROGRAM.

    ``(a) Authorized.--The Secretary shall award grants to eligible 
entities to enable such entities to carry out demonstration programs 
using models and best practices in allied health for the purpose of 
developing innovative strategies or approaches for the retention of 
allied health professionals.
    ``(b) Eligible Entity.--To be eligible to receive a grant under 
this section, an entity shall--
            ``(1) be a health care facility, or any partnership or 
        coalition containing a health care facility or allied health 
        education program; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Distribution of Grants.--In awarding grants under this 
section, the Secretary shall ensure that grantee represent a variety of 
geographic regions and a range of different types and sizes of 
facilities, including facilities located in rural, urban, and suburban 
areas.
    ``(d) Use of Funds.--An entity shall use amounts received under a 
grant under this section to carry out demonstration programs of models 
and best practices in allied health for the purpose of--
            ``(1) promoting retention and satisfaction of allied health 
        professionals;
            ``(2) promoting opportunities for allied health 
        professionals to pursue education, career advancement, and 
        organizational recognition; and
            ``(3) developing continuing education programs that 
        instruct allied health professionals in how to use emerging 
        medical technologies and how to address current and future 
        health care needs.
    ``(e) Area Health Education Centers.--The Secretary shall award 
grants to area health education centers to enable such centers to enter 
into contracts with allied health education programs to expand the 
operation of area health education centers to work in communities to 
develop models of excellence for allied health professionals or to 
expand any junior and senior high school mentoring programs to include 
an allied health professions mentoring program.

``SEC. 799C-7. ALLIED HEALTH FACULTY LOAN PROGRAM.

    ``(a) Establishment.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, may 
enter into an agreement with any institution offering an eligible 
allied health education program for the establishment and operation of 
a faculty loan fund in accordance with this section (referred to in 
this section as the `loan fund'), to increase the number of qualified 
allied health faculty.
    ``(b) Agreements.--Each agreement entered into under this section 
shall--
            ``(1) provide for the establishment of a loan fund by the 
        institution offering the allied health education program 
        involved;
            ``(2) provide for deposit in the loan fund of--
                    ``(A) the Federal capital contributions to the 
                fund;
                    ``(B) an amount provided by the institution 
                involved which shall be equal to not less than one-
                ninth of the amount of the Federal capital contribution 
                under subparagraph (A);
                    ``(C) any collections of principal and interest on 
                loans made from the fund; and
                    ``(D) any other earnings of the fund;
            ``(3) provide that the loan fund will be used only for the 
        provision of loans to faculty of the allied health education 
        program in accordance with subsection (c) and for the costs of 
        the collection of such loans and the interest thereon;
            ``(4) provide that loans may be made from such fund only to 
        faculty who are pursuing a full-time course of study or, at the 
        discretion of the Secretary, a part-time course of study in an 
        advanced degree program; and
            ``(5) contain such other provisions determined appropriate 
        by the Secretary to protect the financial interests of the 
        United States.
    ``(c) Loan Provisions.--Loans from any faculty loan fund 
established pursuant to an agreement under this section shall be made 
to an individual on such terms and conditions as the allied health 
education program may determine, except that--
            ``(1) such terms and conditions are subject to any 
        conditions, limitations, and requirements prescribed by the 
        Secretary;
            ``(2) in the case of any individual, the total of the loans 
        for any academic year made by an allied health education 
        program from loan funds established pursuant to agreements 
        under this section may not exceed $30,000, plus any amount 
        determined by the Secretary on an annual basis to reflect 
        inflation;
            ``(3) upon completion by the individual of each of the 
        first, second, and third year of full-time employment, as 
        required under the loan agreement, as a faculty member in an 
        allied health education program, the program shall cancel 20 
        percent of the principal and interest due on the amount of the 
        unpaid portion of the loan on the first day of such employment;
            ``(4) upon completion by the individual of the fourth year 
        of full-time employment, as required under the loan agreement, 
        as a faculty member in an allied health education program, the 
        program shall cancel 25 percent of the principal and interest 
        due on the amount of the unpaid portion of the loan on the 
        first day of such employment;
            ``(5) the loan may be used to pay the cost of tuition, 
        fees, books, laboratory expenses, and other reasonable 
        education expenses;
            ``(6) the loan shall be repayable in equal or graduated 
        periodic installments (with the right of the borrower to 
        accelerate repayment) over the 10-year period that begins 9 
        months after the individual ceases to pursue a course of study 
        in an allied health education program; and
            ``(7) such loan shall--
                    ``(A) beginning on the date that is 3 months after 
                the individual ceases to pursue a course of study in an 
                allied health education program, bear interest on the 
                unpaid balance of the loan at the rate of 3 percent per 
                year; or
                    ``(B) subject to subsection (e), if the allied 
                health education program determines that the individual 
                will not complete such course of study or serve as a 
                faculty member as required under the loan agreement 
                under this subsection, bear interest on the unpaid 
                balance of the loan at the prevailing market rate.
    ``(d) Payment of Proportionate Share.--Where all or any part of a 
loan (including interest thereon) is canceled under this section, the 
Secretary shall pay to the allied health education program involved an 
amount equal to the program's proportionate share of the canceled 
portion, as determined by the Secretary.
    ``(e) Review by Secretary.--At the request of the individual 
involved, the Secretary may review any determination by an allied 
health education program under this section.

``SEC. 799C-8. SCHOLARSHIP PROGRAM FOR SERVICE IN RURAL AND OTHER 
              MEDICALLY UNDERSERVED AREAS.

    ``(a) Program Authorized.--The Secretary shall establish a 
scholarship program (referred to in this section as the `program') to 
provide scholarships to individuals seeking allied health education who 
agree to provide service in rural and other medically underserved areas 
with allied health personnel shortages.
    ``(b) Preference.--In awarding scholarships under this section, the 
Secretary shall give preference to--
            ``(1) applicants who demonstrate the greatest financial 
        need;
            ``(2) applicants who agree to serve in health care 
        facilities experiencing allied health shortages in rural and 
        other medically underserved areas;
            ``(3) applicants who are currently working in a health care 
        facility who agree to serve the period of obligated service at 
        such facility;
            ``(4) minority applicants; and
            ``(5) applicants with an interest in a practice area of 
        allied health that has unmet needs.
    ``(c) Program Requirements.--
            ``(1) Contracts.--Under the program, the Secretary shall 
        enter into contracts with eligible individuals under which such 
        individuals agree to serve as allied health professionals for a 
        period of not less than 2 years at a health care facility with 
        a critical shortage of allied health professionals in 
        consideration of the Federal Government agreeing to provide to 
        the individuals scholarships for attendance in an allied health 
        education program.
            ``(2) Eligible individuals.--In this subsection, the term 
        `eligible individual' means an individual who is enrolled or 
        accepted for enrollment as a full-time or part-time student in 
        an allied health education program.
            ``(3) Service requirement.--
                    ``(A) In general.--The Secretary may not enter into 
                a contract with an eligible individual under this 
                section unless the individual agrees to serve as an 
                allied health professional at a health care facility 
                with a critical shortage of allied health professionals 
                for a period of full-time service of not less than 2 
                years, or for a period of part-time service in 
                accordance with subparagraph (B).
                    ``(B) Part-time service.--An individual may 
                complete the period of service described in 
                subparagraph (A) on a part-time basis if the individual 
                has a written agreement that--
                            ``(i) is entered into by the facility and 
                        the individual and is approved by the 
                        Secretary; and
                            ``(ii) provides that the period of 
                        obligated service will be extended so that the 
                        aggregate amount of service performed will 
                        equal the amount of service that would be 
                        performed through a period of full-time service 
                        of not less than 2 years.
    ``(d) Reports.--Not later than 18 months after the date of 
enactment of this part, and annually thereafter, the Secretary shall 
prepare and submit to the appropriate committees of Congress a report 
describing the program carried out under this section, including 
statements regarding--
            ``(1) the number of enrollees by specialty or discipline, 
        scholarships, and grant recipients;
            ``(2) the number of graduates;
            ``(3) the amount of scholarship payments made;
            ``(4) which educational institution the recipients 
        attended;
            ``(5) the number and placement location of the scholarship 
        recipients at health care facilities with a critical shortage 
        of allied health professionals;
            ``(6) the default rate and actions required;
            ``(7) the amount of outstanding default funds of the 
        scholarship program;
            ``(8) to the extent that it can be determined, the reason 
        for the default;
            ``(9) the demographics of the individuals participating in 
        the scholarship program; and
            ``(10) an evaluation of the overall costs and benefits of 
        the program.

``SEC. 799C-9. GRANTS FOR CLINICAL EDUCATION, INTERNSHIP, AND RESIDENCY 
              PROGRAMS.

    ``(a) Program Authorized.--The Secretary shall award grants to 
eligible entities to develop clinical education, internship, and 
residency programs that encourage mentoring and the development of 
specialties.
    ``(b) Eligible Entities.--To be eligible for a grant under this 
section an entity shall--
            ``(1) be a partnership of an allied health education 
        program and a health care facility; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Use of Funds.--An eligible entity shall use amounts received 
under a grant under this section to--
            ``(1) develop clinical education, internship, and residency 
        programs and curriculum and training programs for graduates of 
        an allied health education program;
            ``(2) provide support for faculty and mentors; and
            ``(3) provide support for allied health professionals 
        participating in clinical education, internship, and residency 
        programs on both a full-time and part-time basis.

``SEC. 799C-10. GRANTS FOR PARTNERSHIPS.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities to enable such entities to form partnerships to carry out the 
activities described in this section.
    ``(b) Eligible Entity.--To be eligible to receive a grant under 
this section, and entity shall--
            ``(1) be a partnership between an allied health education 
        program and a health care facility; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Use of Funds.--An eligible entity shall use amounts received 
under a grant under this section to--
            ``(1) provide employees of the health care facility that is 
        a member of the partnership involved advanced training and 
        education in a allied health education program;
            ``(2) establish or expand allied health practice 
        arrangements in non-institutional settings to demonstrate 
        methods to improve access to health care in rural and other 
        medically underserved communities;
            ``(3) purchase distance learning technology to extend 
        general education and training programs to rural areas, and to 
        extend specialty education and training programs to all areas; 
        and
            ``(4) establish or expand mentoring, clinical education, 
        and internship programs for training in specialty care areas.

``SEC. 799C-11. ALLIED HEALTH PROFESSIONS TRAINING FOR DIVERSITY.

    ``The Secretary, acting in conjunction with allied health 
professional associations, shall develop a system for collecting and 
analyzing allied health workforce data gathered by the Bureau of Labor 
Statistics, the Health Resources and Services Administration, other 
entities within the Department of Health and Human Services, the 
Department of Veterans Affairs, the Center for Medicare & Medicaid 
Services, the Department of Defense, allied health professional 
associations, and regional centers for health workforce studies to 
determine educational pipeline and practitioner shortages, and project 
future needs for such a workforce.

``SEC. 799C-12. ALLIED HEALTH PROFESSIONS TRAINING FOR DIVERSITY.

    ``The Secretary shall include schools of allied health among the 
health professions schools that are eligible to receive grants under 
this part for the purpose of assisting such schools in supporting 
Centers of Excellence in health professions education for under-
represented minority individuals.

``SEC. 799C-13. REPORTS BY GENERAL ACCOUNTING OFFICE.

    ``Not later than 4 years after the date of enactment of this part, 
the Comptroller General of the United States shall conduct an 
evaluation of whether the programs carried out under this part have 
demonstrably increased the number of applicants to allied health 
education programs and prepare and submit to the appropriate committees 
of Congress a report concerning the results of such evaluation.

``SEC. 799C-14. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated to carry out this part, 
such sums as may be necessary for each of fiscal years 2005 through 
2010.''.
                                 <all>