[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2739 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2739

  To improve the training and retention of health professionals under 
  titles VII and VIII of the Public Health Service Act, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 22, 2004

 Mr. Bingaman introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To improve the training and retention of health professionals under 
  titles VII and VIII of the Public Health Service Act, and for other 
                               purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Investing in 
America's Future Act of 2004''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
                         TITLE I--ALLIED HEALTH

Sec. 101. Findings.
Sec. 102. Purposes.
Sec. 103. Amendments to Public Health Service Act.
             TITLE II--HEALTH WORKFORCE ADVISORY COMMISSION

Sec. 201. Health Workforce Advisory Commission.
      TITLE III--PHYSICIAN DEMONSTRATION PROJECTS IN RURAL STATES

Sec. 301. Definitions.
Sec. 302. Rural States physician recruitment and retention 
                            demonstration program.
Sec. 303. Establishment of the health professions database.
Sec. 304. Evaluation and reports.
Sec. 305. Contracting flexibility.
              TITLE IV--HEALTH CAREERS OPPORTUNITY PROGRAM

Sec. 401. Purpose.
Sec. 402. Authorization of appropriations.
  TITLE V--PROGRAM OF EXCELLENCE IN HEALTH PROFESSIONS EDUCATION FOR 
                      UNDERREPRESENTED MINORITIES

Sec. 501. Purpose.
Sec. 502. Authorization of appropriation.
   TITLE VI--HEALTH PROFESSIONS STUDENT LOAN FUND; AUTHORIZATIONS OF 
    APPROPRIATIONS REGARDING STUDENTS FROM DISADVANTAGED BACKGROUNDS

Sec. 601. Student loans.
Sec. 602. National Health Service Corps; recruitment and fellowships 
                            for individuals from disadvantaged 
                            backgrounds.
                  TITLE VII--MISCELLANEOUS PROVISIONS

Sec. 703. Study by the Institute of Medicine.

                         TITLE I--ALLIED HEALTH

SEC. 101. FINDINGS.

    Congress makes the following findings:
            (1) The Bureau of the Census and other reports highlight 
        the increased demand for acute and chronic health care 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 increased quality of care have resulted in 
        an amplified call for allied health professionals to provide 
        health care 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.

SEC. 102. PURPOSES.

    The purpose of this title is to ensure that the United States 
health care industry will have a supply of allied health professionals 
needed to support the Nation's health care system in this decade and 
beyond by--
            (1) providing incentives for members of the United States 
        population to seek and complete high-quality allied health 
        education and training; and
            (2) providing additional funding to ensure that such 
        education and training can be provided to allied health 
        students.

SEC. 103. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

    (a) In General.--Part E of title VII of the Public Health Service 
Act (42 U.S.C. 294n et seq.) is amended by adding at the end the 
following:

                ``Subpart 3--Allied Health Professionals

``SEC. 775. DEFINITIONS.

    ``In this subpart:
            ``(1) Allied health education program.--The term `allied 
        health education program' means any education program at an 
        accredited institution of higher education leading to a 
        certificate, an associate's degree, a bachelor's degree, or a 
        post baccalaureate degree in an allied health profession.
            ``(2) Allied health profession.--The term `allied health 
        profession' means any profession practiced by an individual in 
        his or her capacity as an allied health professional.
            ``(3) Elementary school; secondary school.--The terms 
        `elementary school' and `secondary school' have the meanings 
        give to those terms in section 9101 of the Elementary and 
        Secondary Education Act of 1965 (20 U.S.C. 7801).
            ``(4) Institution of higher education.--The term 
        `institution of higher education' has the meaning given to that 
term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 
1001).

``SEC. 775A. PUBLIC SERVICE ANNOUNCEMENTS.

    ``The Secretary shall develop and issue public service 
announcements that advertise and promote the allied health professions, 
highlight the advantages and rewards of the allied health professions, 
and encourage individuals from disadvantaged communities and 
backgrounds to enter the allied health professions.

``SEC. 775B. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities to support State and local advertising campaigns through 
appropriate media outlets to promote the allied health professions, 
highlight the advantages and rewards of the allied health professions, 
and encourage individuals from disadvantaged communities and 
backgrounds to enter the allied health professions.
    ``(b) Eligible Entity.--In this section, the term `eligible entity' 
means an entity that is--
            ``(1) a professional, national, or State allied health 
        association;
            ``(2) a State health care provider; or
            ``(3) an association of entities that are each a health 
        care facility, an allied health education program, or an entity 
        that provides similar services or serves a like function.

``SEC. 775C. 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.--In this section, the term `eligible entity' 
means an entity that is--
            ``(1) a professional, national, or State allied health 
        association;
            ``(2) a State health care provider; or
            ``(3) an association of entities that are each a health 
        care facility, an allied health education program, or an entity 
        that provides similar services or serves a like function.
    ``(c) Use of Funds.--An eligible entity that receives a grant under 
this section shall use funds received under such grant to--
            ``(1) support outreach programs at elementary schools 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 
        professions education opportunities for individuals who are 
        from disadvantaged backgrounds (including racial and ethnic 
        minorities underrepresented in 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 professions 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; or
            ``(5) support community-based partnerships seeking to 
        recruit allied health professionals in rural communities, urban 
        medically underserved communities, and other communities 
        experiencing an allied health professions shortage.

``SEC. 775D. GRANTS FOR HEALTH CAREER ACADEMIES.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities for the purpose of assisting such entities in collaborating to 
carry out programs that form education pipelines to facilitate the 
entry of students of secondary schools, especially underrepresented 
racial and ethnic minorities, into careers in the allied health 
professions.
    ``(b) Eligible Entity.--In this section, the term `eligible entity' 
means an institution that offers an allied health education program, a 
health care facility, or a secondary school.

``SEC. 775E. ALLIED HEALTH PROFESSION, PRACTICE, AND RETENTION GRANTS.

    ``(a) Education Priority Areas.--The Secretary may award grants to 
or enter into contracts with eligible entities for--
            ``(1) expanding the enrollment in allied health profession 
        education programs, especially by underrepresented racial and 
        ethnic minority students; and
            ``(2) providing allied health 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 for--
            ``(1) establishing or expanding allied health professions 
        practice arrangements in noninstitutional settings to 
        demonstrate methods to improve access to primary health care in 
        rural areas and other medically underserved communities;
            ``(2) providing 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) providing managed care, information management, 
        quality improvement, and other skills needed to practice in 
        existing and emerging organized health care systems; or
            ``(4) developing 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 pursuant to 
        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 professionals 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 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 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 the involvement of 
                allied health professionals in the organizational and 
                clinical decisionmaking processes of a health care 
                facility.
                    ``(B) Preference.--In making awards of grants under 
                this paragraph, the Secretary shall give preference 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 professional 
                retention or patient care.
    ``(d) Eligible Entity.--In this section, the term `eligible entity' 
means a health care facility, or any partnership or coalition including 
a health care facility or an allied health education program.

``SEC. 775F. DEVELOPING MODELS AND BEST PRACTICES PROGRAM.

    ``(a) Models and Best Practices.--
            ``(1) Grants.--The Secretary shall award grants to eligible 
        entities to enable such entities to carry out demonstrations of 
        models and best practices in allied health for the purpose of 
        developing innovative strategies or approaches for the 
        retention of allied health professionals.
            ``(2) Distribution of grants.--The Secretary shall ensure 
        the distribution of grants under this subsection to a range of 
        types and sizes of facilities, including facilities located in 
        rural, urban, and suburban areas and a variety of geographic 
        regions.
            ``(3) Use of fund.--The Secretary may not make a grant to 
        an eligible entity under this subsection unless the entity 
        agrees to use funds received under the grant to carry out 
        demonstrations of models and best practices in allied health 
        for the purpose of--
                    ``(A) promoting retention and satisfaction of 
                allied health professionals;
                    ``(B) promoting opportunities for allied health 
                professionals to pursue education, career advancement, 
                and organizational recognition; and
                    ``(C) developing continuing education programs that 
                instruct allied health professionals on how to use 
                emerging medical technologies and how to address 
                current and future health care needs.
    ``(b) Models of Excellence.--The Secretary shall award grants to 
area health education centers to enable such centers to enter into 
contracts with allied health education programs--
            ``(1) to expand the operation of area health education 
        centers to work in communities to develop models of excellence 
        for allied health professionals; or
            ``(2) to expand any junior or senior secondary school 
        mentoring programs to include an allied health professions 
        mentoring program.
    ``(c) Definition.--In this section the term `eligible entity' means 
a health care facility, or any partnership or coalition containing a 
health care facility and an allied health education program.

``SEC. 775G. 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 of higher education 
offering an allied health education program for the establishment and 
operation of a faculty loan fund in accordance with this section, 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 involved;
            ``(2) provide for deposit in the fund of--
                    ``(A) the Federal capital contributions to the 
                fund;
                    ``(B) an amount equal to not less than one-ninth of 
                such Federal capital contributions, contributed by such 
                institution;
                    ``(C) collections of principal and interest on 
                loans made from the fund; and
                    ``(D) any other earnings of the fund;
            ``(3) provide that the fund will be used only for loans to 
        faculty of allied health education programs in accordance with 
        subsection (c) and for the costs of collection of such loans 
        and interest thereon;
            ``(4) provide that loans may be made from such fund only to 
        faculty 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 as are necessary to 
        protect the financial interests of the United States.
    ``(c) Loan Provisions.--Loans from any faculty loan fund 
established by an institution pursuant to an agreement under this 
section shall be made to an individual on such terms and conditions as 
the institution 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 institution 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) an amount up to 85 percent of any such loan (plus 
        interest thereon) shall be canceled by the institution as 
        follows--
                    ``(A) upon completion by the individual of each of 
                the first, second, and third year of full-time 
                employment required by the loan agreement entered into 
                under this section, as a faculty member in an allied 
                health education program, the institution shall cancel 
                __ percent of the principal of, and the interest on, 
                the amount of such loan unpaid on the first day of such 
                employment; and
                    ``(B) upon completion by the individual of the 
                fourth year of full-time employment, required by the 
                loan agreement entered into under this section, as a 
                faculty member in an allied health education program, 
                the school shall cancel 25 percent of the principal of, 
                and the interest on, the amount of such loan unpaid on 
                the first day of such employment;
            ``(4) such a loan may be used to pay the cost of tuition, 
        fees, books, laboratory expenses, and other reasonable 
        education expenses;
            ``(5) such a 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
            ``(6) such a 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 
                annum; or
                    ``(B) subject to subsection (e), if the institution 
                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, or interest, is canceled under this section, the Secretary shall 
pay to the institution and amount equal to the school'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 institution 
under this section.

``SEC. 775H. SCHOLARSHIP PROGRAM FOR SERVICE IN RURAL AND OTHER 
              MEDICALLY UNDER-SERVED AREAS.

    ``(a) Scholarship Program.--
            ``(1) In general.--The Secretary shall carry out a program 
        of entering 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 health care 
                        facility involved 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.
            ``(4) Preference.--In awarding scholarships under this 
        section, the Secretary shall give a preference to applicants 
        with the greatest financial need, applicants currently working 
        in a health care facility who agree to serve the period of 
        obligated service at such facility, minority allied health 
        applicants, and applicants with an interest in a practice area 
        of allied health that has unmet needs.
    ``(b) Reports.--Not later than 18 months after the date of 
enactment of this subpart and annually thereafter, the Secretary shall 
prepare and submit to Congress a report describing the programs 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 institutions 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. 775I. GRANTS FOR CLINICAL EDUCATION, INTERNSHIP, RESIDENCY 
              PROGRAMS, AND CONTINUING EDUCATION.

    ``(a) Program Authorized.--The Secretary shall award grants to 
eligible entities to develop allied health clinical education, 
internship, residency, and continuing education programs described in 
subsection (b).
    ``(b) Use of Funds.--The Secretary may not award a grant to an 
eligible entity under this section unless the entity agrees to use the 
grant to develop clinical education, internship, residency, and 
continuing education programs for graduates of allied health education 
programs. Each such clinical education, internship, residency, or 
continuing education program shall--
            ``(1) provide support for allied health education program 
        faculty and mentors;
            ``(2) provide support for allied health professionals 
        participating on a full-time or a part-time basis; and
            ``(3) encourage the development of specialties.
    ``(c) Eligible Entity.--In this section, the term `eligible entity' 
means a partnership of an allied health education program and a health 
care facility.

``SEC. 775J. 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) Use of Funds.--An eligible entity that receives a grant under 
this section shall use amounts received under the grant to--
            ``(1) provide employees of the health care facility 
        involved advanced training and education in an allied health 
        education program;
            ``(2) establish or expand allied health practice 
        arrangements in noninstitutional 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.
    ``(c) Eligible Entity.--In this section, the term `eligible entity' 
means a partnership of an allied health education program and a health 
care facility formed to carry out the activities described in this 
section.

``SEC. 775K. ALLIED HEALTH WORKFORCE DATA COLLECTION AND ANALYSIS.

    ``The Secretary, 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, 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 for the purpose of--
            ``(1) determining educational pipeline and practitioner 
        shortages; and
            ``(2) projecting future needs for such a workforce.

``SEC. 775L. REPORTS BY GOVERNMENT ACCOUNTABILITY OFFICE.

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

``SEC. 775M. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this 
subpart, such sums as may be necessary for fiscal years 2005 through 
2009.''.
    (b) Centers of Excellence.--Subparagraph (A) of section 736(g)(1) 
of the Public Health Service Act (42 U.S.C. 293(g)(1)) is amended by 
inserting ``a school of allied health,'' after ``a school of 
pharmacy,''.

             TITLE II--HEALTH WORKFORCE ADVISORY COMMISSION

SEC. 201. HEALTH WORKFORCE ADVISORY COMMISSION.

    (a) Establishment.--The Comptroller General of the United States 
(referred to in this title as the ``Comptroller General'') shall 
establish a commission to be known as the Health Workforce Advisory 
Commission (referred to in this title as the ``Commission'').
    (b) Membership.--
            (1) In general.--The Commission shall be composed of 18 
        members to be appointed by the Comptroller General not later 
        than 90 days after the date of enactment of this Act, and an 
        ex-officio member who shall serve as the Director of the 
        Commission.
            (2) Qualifications.--In appointing members to the 
        Commission under paragraph (1), the Comptroller General shall 
        ensure that--
                    (A) the Commission includes individuals with 
                national recognition for their expertise in health care 
                workforce issues, including workforce forecasting, 
                undergraduate and graduate training, economics, health 
                care and health care systems financing, public health 
                policy, and other fields;
                    (B) the members are geographically representative 
                of the United States and maintain a balance between 
                urban and rural representatives;
                    (C) the members include a representative from the 
                commissioned corps of the Public Health Service;
                    (D) the members represent the spectrum of 
                professions in the current and future healthcare 
workforce, including physicians, nurses, and other health professionals 
and personnel, and are skilled in the conduct and interpretation of 
health workforce measurement, monitoring and analysis, health services, 
economics, and other workforce related research and technology 
assessment;
                    (E) at least 25 percent of the members who are 
                health care providers are from rural areas; and
                    (F) a majority of the members are individuals who 
                are not currently primarily involved in the provision 
                or management of health professions education and 
                training programs.
            (3) Terms and vacancies.--
                    (A) Terms.--The term of service of the members of 
                the Commission shall be for 3 years, except that the 
                Comptroller General shall designate staggered terms for 
                members initially appointed under paragraph (1).
                    (B) Vacancies.--Any member of the Commission who is 
                appointed to fill a vacancy on the Commission that 
                occurs before the expiration of the term for which the 
                member's predecessor was appointed shall be appointed 
                only for the remainder of that term.
            (4) Chairperson.--
                    (A) Designation.--The Comptroller General shall 
                designate a member of the Commission, at the time of 
                the appointment of such member--
                            (i) to serve as the Chairperson of the 
                        Commission; and
                            (ii) to serve as the Vice Chairperson of 
                        the Commission.
                    (B) Term.--A member of the Commission shall serve 
                as the Chairperson or Vice Chairperson of the 
                Commission under subparagraph (A) for the term of such 
                member.
                    (C) Vacancy.--In the case of a vacancy in the 
                Chairpersonship or Vice Chairpersonship, the 
                Comptroller General shall designate another member to 
                serve for the remainder of the vacant member's term.
    (c) Duties.--The Commission shall--
            (1) review the health workforce policies implemented--
                    (A) under titles XVIII and XIX of the Social 
                Security Act (42 U.S.C. 1395, 1396 et seq.);
                    (B) under titles VII and VIII of the Public Health 
                Service Act (42 U.S.C. 292, 296 et seq.);
                    (C) by the National Institutes of Health;
                    (D) by the Department of Health and Human Services;
                    (E) by the Department of Veterans Affairs; and
                    (F) by other departments and agencies as 
                appropriate;
            (2) analyze and make recommendations to improve the methods 
        used to measure and monitor the health workforce and the 
        relationship between the number and make up of such personnel 
        and the access of individuals to appropriate health care;
            (3) review the impact of health workforce policies and 
        other factors on the ability of the health care system to 
        provide optimal medical and health care services;
            (4) analyze and make recommendations pertaining to Federal 
        incentives (financial, regulatory, and otherwise) and Federal 
        programs that are in place to promote the education of an 
        appropriate number and mix of health professionals to provide 
        access to appropriate health care in the United States;
            (5) analyze and make recommendations about the appropriate 
        supply and distribution of physicians, nurses, and other health 
        professionals and personnel to achieve a health care system 
        that is safe, effective, patient centered, timely, equitable, 
        and efficient;
            (6) analyze the role and global implications of 
        internationally trained physicians, nurses, and other health 
        professionals and personnel in the United States health 
        workforce;
            (7) analyze and make recommendations about achieving 
        appropriate diversity in the United States health workforce;
            (8) conduct public meetings to discuss health workforce 
        policy issues and help formulate recommendations for Congress 
        and the Secretary of Health and Human Services;
            (9) in the course of meetings conducted under paragraph 
        (8), consider the results of staff research, presentations by 
        policy experts, and comments from interested parties;
            (10) make recommendations to Congress concerning health 
        workforce policy issues;
            (11) not later than April 15, 2005, and each April 15 
        thereafter, submit a report to Congress containing the results 
        of the reviews conducted under this subsection and the 
        recommendations developed under this subsection;
            (12) periodically, as determined appropriate by the 
        Commission, submit reports to Congress concerning specific 
        issues that the Commission determines are of high importance; 
        and
            (13) carry out any other activities determined appropriate 
        by the Secretary of Health and Human Services.
    (d) Ongoing Duties Concerning Reports and Reviews.--
            (1) Commenting on reports.--
                    (A) Submission to commission.--The Secretary of 
                Health and Human Services shall transmit to the 
                Commission a copy of each report that is submitted by 
                the Secretary to Congress if such report is required by 
                law and relates to health workforce policy.
                    (B) Review.--The Commission shall review a report 
                transmitted under subparagraph (A) and, not later than 
6 months after the date on which the report is transmitted, submit to 
the appropriate committees of Congress written comments concerning such 
report. Such comments may include such recommendations as the 
Commission determines appropriate.
            (2) Agenda and additional reviews.--
                    (A) In general.--The Commission shall consult 
                periodically with the chairman and ranking members of 
                the appropriate committees of Congress concerning the 
                agenda and progress of the Commission.
                    (B) Additional reviews.--The Commission may from 
                time to time conduct additional reviews and submit 
                additional reports to the appropriate committees of 
                Congress on topics relating to Federal health 
                workforce-related programs and as may be requested by 
                the chairman and ranking members of such committees.
            (3) Availability of reports.--The Commission shall transmit 
        to the Secretary of Health and Human Services a copy of each 
        report submitted by the Commission under this section and shall 
        make such reports available to the public.
    (e) Powers of the Commission.--
            (1) General powers.--Subject to such review as the 
        Comptroller General determines to be necessary to ensure the 
        efficient administration of the Commission, the Commission 
        may--
                    (A) employ and fix the compensation of the 
                Executive Director and such other personnel as may be 
                necessary to carry out its duties;
                    (B) seek such assistance and support as may be 
                required in the performance of its duties from 
                appropriate Federal departments and agencies;
                    (C) enter into contracts or make other arrangements 
                as may be necessary for the conduct of the work of the 
                Commission;
                    (D) make advance, progress, and other payments that 
                relate to the work of the Commission;
                    (E) provide transportation and subsistence for 
                personnel who are serving without compensation; and
                    (F) prescribe such rules and regulations as the 
                Commission determines necessary with respect to the 
                internal organization and operation of the Commission.
            (2) Information.--To carry out its duties under this 
        section, the Commission--
                    (A) shall have unrestricted access to all 
                deliberations, records, and nonproprietary data 
                maintained by the Government Accountability Office;
                    (B) may secure directly from any department or 
                agency of the United States information necessary to 
                enable the Commission to carry out its duties under 
                this section, on a schedule that is agreed upon between 
                the Chairperson and the head of the department or 
                agency involved;
                    (C) shall utilize existing information (published 
                and unpublished) collected and assessed either by the 
                staff of the Commission or under other arrangements;
                    (D) may conduct, or award grants or contracts for 
                the conduct of, original research and experimentation 
                where information available under subparagraphs (A) and 
                (B) is inadequate;
                    (E) may adopt procedures to permit any interested 
                party to submit information to be used by the 
                Commission in making reports and recommendations under 
                this section; and
                    (F) may carry out other activities determined 
                appropriate by the Commission.
    (f) Administrative Provisions.--
            (1) Compensation.--While serving on the business of the 
        Commission a member of the Commission shall be entitled to 
        compensation at the per diem equivalent of the rate provided 
        for under level IV of the Executive Schedule under title 5, 
        United States Code.
            (2) Meetings.--The Commission shall meet at the call of the 
        Chairperson.
            (3) Executive director and staff.--The Comptroller General 
        shall appoint an individual to serve as the interim Executive 
        Director of the Commission until the members of the Commission 
        are able to select a permanent Executive Director under 
        subsection (e)(1)(A).
            (4) Ethical disclosure.--The Comptroller General shall 
        establish a system for public disclosure by members of the 
        Commission of financial and other potential conflicts of 
        interest relating to such members.
            (5) Audits.--The Commission shall be subject to periodic 
        audit by the Comptroller General.
    (g) Funding.--
            (1) Requests.--The Commission shall submit requests for 
        appropriations in the same manner as the Comptroller General 
        submits such requests. Amounts appropriated for the Commission 
        shall be separate from amounts appropriated for the Comptroller 
        General.
            (2) Authorization of appropriations.--There are authorized 
        to be appropriated to carry out this section, $6,000,000 for 
        fiscal year 2005, and such sums as may be necessary for each 
        subsequent fiscal year, of which--
                    (A) 80 percent of such appropriated amount shall be 
                made available from the Federal Hospital Insurance 
                Trust Fund under section 1817 of the Social Security 
                Act (42 U.S.C. 1395i); and
                    (B) 20 percent of such appropriated amount shall be 
                made available from amounts appropriated to carry out 
                title XIX of such Act (42 U.S.C. 1396 et seq.).
    (h) Definition.--In this title, the term ``appropriate committees 
of Congress'' means the Committee on Finance of the Senate and the 
Committee on Ways and Means of the House of Representatives.

      TITLE III--PHYSICIAN DEMONSTRATION PROJECTS IN RURAL STATES

SEC. 301. DEFINITIONS.

    In this title:
            (1) COGME.--The term ``COGME'' means the Council on 
        Graduate Medical Education established under section 762 of the 
        Public Health Service Act (42 U.S.C. 294o).
            (2) Demonstration program.--The term ``demonstration 
        program'' means the Rural States Physician Recruitment and 
        Retention Demonstration Program established by the Secretary 
        under section 302(a).
            (3) Demonstration states.--The term ``demonstration 
        States'' means each State identified by the Secretary, based 
        upon data from the most recent year for which data are 
        available--
                    (A) that has an uninsured population above 16 
                percent (as determined by the Bureau of the Census);
                    (B) for which the sum of the number of individuals 
                who are entitled to benefits under the medicare program 
                under title XVIII of the Social Security Act (42 U.S.C. 
                1395 et seq.) and the number of individuals who are 
                eligible for medical assistance under the medicaid 
                program under title XIX of such Act (42 U.S.C. 1396 et 
                seq.) equals or exceeds 20 percent of the total 
                population of the State (as determined by the Centers 
                for Medicare & Medicaid Services); and
                    (C) that has an estimated number of individuals in 
                the State without access to a primary care provider of 
                at least 17 percent (as published in ``HRSA's Bureau of 
                Primary Health Care: BPHC State Profiles'').
            (4) Eligible residency or fellowship graduate.--The term 
        ``eligible residency or fellowship graduate'' means a graduate 
        of an approved medical residency training program (as defined 
        in section 1886(h)(5)(A) of the Social Security Act (42 U.S.C. 
        1395ww(h)(5)(A))) in a shortage physician specialty.
            (5) Health professions database.--The term ``Health 
        Professions Database'' means the database established under 
        section 303(a).
            (6) Medicare program.--The term ``medicare program'' means 
        the health benefits program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).
            (7) MedPAC.--The term ``MedPAC'' means the Medicare Payment 
        Advisory Commission established under section 1805 of the 
        Social Security Act (42 U.S.C. 1395b-6).
            (8) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (9) Shortage physician specialty.--The term ``shortage 
        physician specialty'' means a medical or surgical specialty 
        identified in a demonstration State by the Secretary based on--
                    (A) an analysis and comparison of national data and 
                demonstration State data; and
                    (B) recommendations from appropriate Federal, 
                State, and private commissions, centers, councils, 
                medical and surgical physician specialty boards, and 
                medical societies or associations involved in physician 
                workforce, education and training, and payment issues.

SEC. 302. RURAL STATES PHYSICIAN RECRUITMENT AND RETENTION 
              DEMONSTRATION PROGRAM.

    (a) Establishment.--
            (1) In general.--The Secretary shall establish a Rural 
        States Physician Recruitment and Retention Demonstration 
        Program for the purpose of ameliorating physician shortage, 
        recruitment, and retention problems in rural States in 
        accordance with the requirements of this section.
            (2) Consultation.--For purposes of establishing the 
        demonstration program, the Secretary shall consult with--
                    (A) COGME;
                    (B) MedPAC;
                    (C) a representative of each demonstration State 
                medical society or association;
                    (D) the health workforce planning and physician 
                training authority of each demonstration State; and
                    (E) any other entity described in section 
                301(9)(B).
    (b) Duration.--The Secretary shall conduct the demonstration 
program for a period of 10 years.
    (c) Conduct of Program.--
            (1) Funding of additional residency and fellowship 
        positions.--
                    (A) In general.--As part of the demonstration 
                program, the Secretary (acting through the 
                Administrator of the Centers for Medicare & Medicaid 
                Services) shall--
                            (i) notwithstanding section 1886(h)(4)(F) 
                        of the Social Security Act (42 U.S.C. 
                        1395ww(h)(4)(F)) increase, by up to 50 percent 
                        of the total number of residency and fellowship 
                        positions approved at each medical residency 
                        training program in each demonstration State, 
                        the number of residency and fellowship 
                        positions in each shortage physician specialty; 
                        and
                            (ii) subject to subparagraph (C), provide 
                        funding under subsections (d)(5)(B) and (h) of 
                        section 1886 of the Social Security Act (42 
                        U.S.C. 1395ww) for each position added under 
                        clause (i).
                    (B) Establishment of additional positions.--
                            (i) Identification.--The Secretary shall 
                        identify each additional residency and 
                        fellowship position created as a result of the 
                        application of subparagraph (A).
                            (ii) Negotiation and consultation.--The 
                        Secretary shall negotiate and consult with 
                        representatives of each approved medical 
                        residency training program in a demonstration 
                        State at which a position identified under 
                        clause (i) is created for purposes of 
                        supporting such position.
                    (C) Contracts with sponsoring institutions.--
                            (i) In general.--The Secretary shall 
                        condition the availability of funding for each 
                        residency and fellowship position identified 
                        under subparagraph (B)(i) on the execution of a 
                        contract containing such provisions as the 
                        Secretary determines are appropriate, including 
                        the provision described in clause (ii) by each 
                        sponsoring institution.
                            (ii) Provision described.--
                                    (I) In general.--Except as provided 
                                in subclause (II), the provision 
                                described in this clause is a provision 
                                that provides that, during the 
                                residency or fellowship, the resident 
                                or fellow shall spend not less than 10 
                                percent of the training time providing 
                                specialty services to underserved and 
                                rural community populations other than 
                                an underserved population of the 
                                sponsoring institution.
                                    (II) Exceptions.--The Secretary, in 
                                consultation with COGME, shall identify 
                                shortage physician specialties and 
                                subspecialties for which the 
                                application of the provision described 
                                in subclause (I) would be inappropriate 
                                and the Secretary may waive the 
                                requirement under clause (i) that such 
                                provision be included in the contract 
                                of a resident or fellow with such a 
                                specialty or subspecialty.
                    (D) Limitations.--
                            (i) Period of payment.--The Secretary may 
                        not fund any residency or fellowship position 
                        identified under subparagraph (B)(i) for a 
                        period of more than 5 years.
                            (ii) Reassessment of need.--The Secretary 
                        shall reassess the status of the shortage 
                        physician specialty in the demonstration State 
                        prior to entering into any contract under 
                        subparagraph (C) after the date that is 5 years 
                        after the date on which the Secretary 
                        establishes the demonstration program.
            (2) Loan repayment and forgiveness program.--
                    (A) In general.--As part of the demonstration 
                program, the Secretary (acting through the 
                Administrator of the Health Resources and Services 
                Administration) shall establish a loan repayment and 
                forgiveness program, through the holder of the loan, 
                under which the Secretary assumes the obligation to 
                repay a qualified loan amount for an educational loan 
                of an eligible residency or fellowship graduate--
                            (i) for whom the Secretary has approved an 
                        application submitted under subparagraph (D); 
                        and
                            (ii) with whom the Secretary has entered 
                        into a contract under subparagraph (C).
                    (B) Qualified loan amount.--
                            (i) In general.--Subject to clause (ii), 
                        the Secretary shall repay the lesser of--
                                    (I) 25 percent of the loan 
                                obligation of a graduate on a loan that 
                                is outstanding during the period that 
                                the eligible residency or fellowship 
                                graduate practices in the area 
                                designated by the contract entered into 
                                under subparagraph (C); or
                                    (II) $25,000 per graduate per year 
                                of such obligation during such period.
                            (ii) Limitation.--The aggregate amount 
                        under this subparagraph may not exceed $125,000 
                        for any graduate and the Secretary may not 
                        repay or forgive more than 30 loans per year in 
                        each demonstration State under this paragraph.
                    (C) Contracts with residents and fellows.--
                            (i) In general.--Each eligible residency or 
                        fellowship graduate desiring repayment of a 
                        loan under this paragraph shall execute a 
                        contract containing the provisions described in 
                        clause (ii).
                            (ii) Provisions.--The provisions described 
                        in this clause are provisions that require the 
                        eligible residency or fellowship graduate--
                                    (I) to practice in a health 
                                professional shortage area of a 
                                demonstration State during the period 
                                in which a loan is being repaid or 
                                forgiven under this section; and
                                    (II) to provide health services 
                                relating to the shortage physician 
                                specialty of the graduate that was 
                                funded with the loan being repaid or 
                                forgiven under this section during such 
                                period.
                    (D) Application.--
                            (i) In general.--Each eligible residency or 
                        fellowship graduate desiring repayment of a 
                        loan under this paragraph shall submit an 
                        application to the Secretary at such time, in 
                        such manner, and accompanied by such 
                        information as the Secretary may reasonably 
                        require.
                            (ii) Reassessment of need.--The Secretary 
                        shall reassess the shortage physician specialty 
                        in the demonstration State prior to accepting 
                        an application for repayment of any loan under 
                        this paragraph after the date that is 5 years 
                        after the date on which the demonstration 
                        program is established.
                    (E) Construction.--Nothing in the section shall be 
                construed to authorize any refunding of any repayment 
                of a loan.
                    (F) Prevention of double benefits.--No borrower 
                may, for the same service, receive a benefit under both 
                this paragraph and any loan repayment or forgiveness 
                program under title VII of the Public Health Service 
                Act (42 U.S.C. 292 et seq.).
    (d) Waiver of Medicare Requirements.--The Secretary is authorized 
to waive any requirement of the medicare program, or approve equivalent 
or alternative ways of meeting such a requirement, if such waiver is 
necessary to carry out the demonstration program, including the waiver 
of any limitation on the amount of payment or number of residents under 
section 1886 of the Social Security Act (42 U.S.C. 1395ww).
    (e) Appropriations.--
            (1) Funding of additional residency and fellowship 
        positions.--Any expenditures resulting from the establishment 
        of the funding of additional residency and fellowship positions 
        under subsection (c)(1) shall be made from the Federal Hospital 
        Insurance Trust Fund under section 1817 of the Social Security 
        Act (42 U.S.C. 1395i).
            (2) Loan repayment and forgiveness program.--There are 
        authorized to be appropriated such sums as may be necessary to 
        carry out the loan repayment and forgiveness program 
        established under subsection (c)(2).

SEC. 303. ESTABLISHMENT OF THE HEALTH PROFESSIONS DATABASE.

    (a) Establishment of the Health Professions Database.--
            (1) In general.--Not later than 7 months after the date of 
        enactment of this Act, the Secretary (acting through the 
        Administrator of the Health Resources and Services 
        Administration) shall establish a State-specific health 
        professions database to track health professionals in each 
        demonstration State with respect to specialty certifications, 
        practice characteristics, professional licensure, practice 
        types, locations, education, and training, as well as 
        obligations under the demonstration program as a result of the 
        execution of a contract under paragraph (1)(C) or (2)(C) of 
        section 302(c).
            (2) Data sources.--In establishing the Health Professions 
        Database, the Secretary shall use the latest available data 
        from existing health workforce files, including the American 
        Medical Association Master File, State databases, specialty 
        medical society data sources and information, and such other 
        data points as may be recommended by COGME, MedPAC, the 
        National Center for Workforce Information and Analysis, or the 
        medical society of the respective demonstration State.
    (b) Availability.--
            (1) During the program.--During the demonstration program, 
        data from the Health Professions Database shall be made 
        available to the Secretary, each demonstration State, and the 
        public for the purposes of--
                    (A) developing a baseline with respect to a State's 
                health professions workforce and to track changes in a 
                demonstration State's health professions workforce;
                    (B) tracking direct and indirect graduate medical 
                education payments to hospitals;
                    (C) tracking the forgiveness and repayment of loans 
                for educating physicians; and
                    (D) tracking commitments by physicians under the 
                demonstration program.
            (2) Following the program.--Following the termination of 
        the demonstration program, a demonstration State may elect to 
        maintain the Health Professions Database for such State at its 
        expense.
    (c) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary for the purpose of carrying 
out this section.

SEC. 304. EVALUATION AND REPORTS.

    (a) Evaluation.--
            (1) In general.--COGME and MedPAC shall jointly conduct a 
        comprehensive evaluation of the demonstration program.
            (2) Matters evaluated.--The evaluation conducted under 
        paragraph (1) shall include an analysis of the effectiveness of 
        the funding of additional residency and fellowship positions 
        and the loan repayment and forgiveness program on physician 
        recruitment, retention, and specialty mix in each demonstration 
        State.
    (b) Progress Reports.--
            (1) COGME.--Not later than 1 year after the date on which 
        the Secretary establishes the demonstration program, 5 years 
        after such date, and 10 years after such date, COGME shall 
        submit a report on the progress of the demonstration program to 
the Secretary and Congress.
            (2) MedPAC.--MedPAC shall submit biennial reports on the 
        progress of the demonstration program to the Secretary and 
        Congress.
    (c) Final Report.--Not later than 1 year after the date on which 
the demonstration program terminates, COGME and MedPAC shall submit a 
final report to the President, Congress, and the Secretary which shall 
contain a detailed statement of the findings and conclusions of COGME 
and MedPAC, together with such recommendations for legislation and 
administrative actions as COGME and MedPAC consider appropriate.
    (d) Authorization of Appropriations.--There are authorized to be 
appropriated to COGME such sums as may be necessary for the purpose of 
carrying out this section.

SEC. 305. CONTRACTING FLEXIBILITY.

    For purposes of conducting the demonstration program and 
establishing and administering the Health Professions Database, the 
Secretary may procure temporary and intermittent services under section 
3109(b) of title 5, United States Code.

              TITLE IV--HEALTH CAREERS OPPORTUNITY PROGRAM

SEC. 401. PURPOSE.

    It is the purpose of this title to diversify the healthcare 
workforce by increasing the number of individuals from disadvantaged 
backgrounds in the health and allied health professions by enhancing 
the academic skills of students from disadvantaged backgrounds and 
supporting them in successfully completing, entering, and graduating 
from health professions training programs.

SEC. 402. AUTHORIZATION OF APPROPRIATIONS.

    Section 740(c) of the Public Health Service Act (42 U.S.C. 293d(c)) 
is amended by striking ``$29,400,000'' and all that follows through 
``2002'' and inserting ``$50,000,000 for fiscal year 2005, and such 
sums as may be necessary for each of fiscal years 2006 through 2010''.

  TITLE V--PROGRAM OF EXCELLENCE IN HEALTH PROFESSIONS EDUCATION FOR 
                      UNDERREPRESENTED MINORITIES

SEC. 501. PURPOSE.

    It is the purpose of this title to diversify the healthcare 
workforce by supporting programs of excellence in designated health 
professions schools that demonstrate a commitment to underrepresented 
minority populations with a focus on minority health issues, cultural 
and linguistic competence, and eliminating health disparities.

SEC. 502. AUTHORIZATION OF APPROPRIATION.

    Section 736(h)(1) of the Public Health Service Act (42 U.S.C. 
293(h)(1)) is amended to read as follows:
            ``(1) Authorization of appropriations.--For the purpose of 
        making grants under subsection (a), there are authorized to be 
        appropriated $50,000,000 for fiscal year 2005, and such sums as 
        may be necessary for each of the fiscal years 2006 through 
        2010.''.

   TITLE VI--HEALTH PROFESSIONS STUDENT LOAN FUND; AUTHORIZATIONS OF 
    APPROPRIATIONS REGARDING STUDENTS FROM DISADVANTAGED BACKGROUNDS

SEC. 601. STUDENT LOANS.

    Section 724(f) of the Public Health Service Act (42 U.S.C. 292t(f)) 
is amended by inserting before paragraph (2), the following:
            ``(1) In general.--With respect to making Federal capital 
        contributions to student loan funds for purposes of subsection 
        (a), there are authorized to be appropriated $35,000,000 for 
        fiscal year 2005, and such sums as may be necessary for each of 
        the fiscal years 2006 through 2010.''.

SEC. 602. NATIONAL HEALTH SERVICE CORPS; RECRUITMENT AND FELLOWSHIPS 
              FOR INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.

    (a) In General.--Section 331(b) of the Public Health Service Act 
(42 U.S.C. 254d(b)) is amended by adding at the end the following:
    ``(3) The Secretary shall ensure that the individuals with respect 
to whom activities under paragraphs (1) and (2) are carried out include 
individuals from disadvantaged backgrounds, including activities 
carried out to provide health professions students with information on 
the Scholarship and Repayment Programs.''.
    (b) Assignment of Corps Personnel.--Section 333(a) of the Public 
Health Service Act (42 U.S.C. 254f(a)) is amended by adding at the end 
the following:
    ``(4) In assigning Corps personnel under this section, the 
Secretary shall give preference to applicants who request assignment to 
a federally qualified health center (as defined in section 
1905(1)(2)(B) of the Social Security Act) or to a provider organization 
that has a majority of patients who are minorities or individuals from 
low-income families (families with a family income that is less than 
200 percent of the Official Poverty Line).''.

                  TITLE VII--MISCELLANEOUS PROVISIONS

SEC. 703. STUDY BY THE INSTITUTE OF MEDICINE.

    (a) Contract.--Not later than 90 days after the date of enactment 
of this Act, the Secretary of Health and Human Services shall enter 
into a contract with the Institute of Medicine for the conduct of a 
study and the preparation of a report on the role of United States 
medical schools in meeting the physician needs of the United States.
    (b) Requirements.--In conducting the study under the contract under 
subsection (a), the Institute of Medicine shall--
            (1) examine the supply structure of United States 
        undergraduate medical education and make recommendations 
        concerning the advisability of expanding, enhancing, or 
        modifying such structure to achieve a higher degree of self-
        sufficiency and equity in such medical education and to 
        position medical schools for the future demands generated by 
        the growing population of the United States; and
            (2) examine the role of United States medical schools in 
        reducing racial and ethnic disparities in medical education 
        opportunities and in population health outcomes as well as in 
        reducing the drain on the medical education systems of other 
        countries.
    (c) Report.--The contract under subsection (a) shall require the 
Institute of Medicine to submit a report to the Secretary of Health and 
Human Services on the results of the study not later than 12 months 
after the date on which the contract is entered into. The Secretary 
shall submit such report to the Committee on Health, Education, Labor, 
and Pensions of the Senate and the Committee on Commerce of the House 
of Representatives.
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