[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 410 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 410

   To amend the Public Health Service Act to increase the number of 
primary care physicians serving health professional shortage areas, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 11, 2007

Mr. Conyers (for himself, Mrs. Christensen, Mr. Davis of Illinois, Mr. 
    Bishop of Georgia, Ms. Jackson-Lee of Texas, and Mr. Jackson of 
  Illinois) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to increase the number of 
primary care physicians serving health professional shortage areas, 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.

    This Act may be cited as the ``United States Physician Shortage 
Elimination Act of 2007''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The average life expectancy in the United States has 
        increased to 80 years of age, causing an ever-increasing demand 
        for medical care.
            (2) In 1975, United States medical schools graduated 
        approximately 12,716 physicians. Half of these physicians 
        entered programs of medical studies as graduates of United 
        States colleges and universities. The other half consisted of 
        graduates of foreign institutions admitted to United States 
        medical schools under the J-1 Visa Program.
            (3) Presently, the number of applicants, foreign and 
        domestic, seeking admission to United States medical schools 
        has decreased to approximately 39,109.
            (4) During the last 20 years, median tuition and fees at 
        medical schools have increased by 229 percent (122 percent 
        adjusted for inflation) in private schools and by 479 percent 
        (256 percent adjusted for inflation) in public schools.
            (5) The Association of American Medical Colleges, in its 
        Statement on the Physician Workforce, dated June, 2006, called 
        for an increase of 1,500 National Health Service Corps program 
        awards per year to help meet the need for physicians caring for 
        underserved populations and to help address rising medical 
        student indebtedness.
            (6) The National Health Service Corps program has a proven 
        record of supplying physicians to underserved areas, and has 
        played an important role in expanding access for underserved 
        populations in rural and inner city communities.
            (7) Continued expansion of the National Health Service 
        Corps program is strongly recommended.
            (8) The growing debt incurred by graduating medical 
        students is likely to increase the interest and willingness of 
        graduates of United States medical schools to apply for 
        National Health Service Corps program funding and awards.
            (9) One third (250,000) of active physicians are over the 
        age of 55 and are likely to retire in the next ten years, while 
        the population will have increased by 24 percent. These 
        demographic changes will cause the population-to-physician 
        ratio to peak by the year 2020.
            (10) The Indiana State Medical Licensing Board has 
        estimated that in 20 years there will be 200,000 fewer 
        physicians available to deliver medical services.
            (11) In 2005, the Council on Graduate Medical Education 
        stated in a report to Congress that there will be a shortage of 
        not fewer than 90,000 full-time physicians by 2020.
            (12) A decrease in Federal spending to carry out programs 
        authorized by title VII of the Public Health Service Act 
        threatens the viability of programs used to solve the problem 
        of inadequate access to health care.
            (13) A continuing decline in the number of family 
        physicians may lead to renewed shortages of safety net and 
        rural physicians.
            (14) There is a declining ability to recruit qualified 
        medical students from rural and underserved areas, coupled with 
        greater difficulty on the part of community health centers and 
        other clinics to attract adequate personnel.

SEC. 3. REAUTHORIZATION OF NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP 
              PROGRAM AND LOAN REPAYMENT PROGRAM.

    (a) Reauthorization of Appropriations.--Section 338H(a) of the 
Public Health Service Act (42 U.S.C. 254q(a)) is amended by striking 
``$146,250,000'' and all that follows through the period and inserting 
``$300,000,000 for each of fiscal years 2007 through 2011.''.
    (b) Scholarships for Medical Students.--Section 338H of such Act is 
further amended by adding at the end the following:
    ``(d) Scholarships for Medical Students.--Of the amounts 
appropriated under subsection (a) for a fiscal year, the Secretary 
shall obligate $30,000,000 for contracts for scholarships under this 
subpart to individuals who are accepted for enrollment, or enrolled, in 
a course of study or program described in section 338A(b)(1)(B) that 
leads to a degree in medicine or osteopathic medicine.''.

SEC. 4. REAUTHORIZATION OF CERTAIN PROGRAMS PROVIDING GRANTS FOR HEALTH 
              PROFESSIONS TRAINING FOR DIVERSITY.

    (a) Grants for Centers of Excellence.--Section 736(h)(1) of the 
Public Health Service Act (42 U.S.C. 293(h)(1)) is amended by striking 
``$26,000,000'' and all that follows through ``2002'' and inserting 
``$33,610,000 for each of fiscal years 2007 through 2011''.
    (b) Educational Assistance for Individuals From Disadvantaged 
Backgrounds.--Section 740(c) of such Act (42 U.S.C. 293d(c)) is amended 
by striking ``$29,400,000'' and all that follows through the period and 
inserting ``$35,650,000 for each of fiscal years 2007 through 2011.'' .

SEC. 5. EXPANSION OF RESIDENCY TRAINING PROGRAMS AND PRIMARY CARE 
              SERVICES OFFERED BY COMMUNITY HEALTH CENTERS.

    Part C of title VII of the Public Health Service Act (42 U.S.C. 
293k et seq.) is amended--
            (1) by adding before section 747 the following:

                     ``Subpart I--In General''; and

            (2) by adding after section 748 the following:

                   ``Subpart II--Additional Programs

``SEC. 749. GRANTS TO EXPAND MEDICAL RESIDENCY TRAINING PROGRAMS AT 
              COMMUNITY HEALTH CENTERS.

    ``(a) Program Authorized.--The Secretary may make grants to 
community health centers--
            ``(1) to establish, at the centers, new or alternative-
        campus accredited medical residency training programs 
        affiliated with a hospital or other health care facility; or
            ``(2) to fund new residency positions within existing 
        accredited medical residency training programs at the centers 
        and their affiliated partners.
    ``(b) Use of Funds.--Amounts from a grant under this section shall 
be used to cover the costs of establishing or expanding a medical 
residency training program described in subsection (a), including costs 
associated with--
            ``(1) curriculum development;
            ``(2) equipment acquisition;
            ``(3) recruitment, training, and retention of residents and 
        faculty; and
            ``(4) residency stipends.
    ``(c) Applications.--A community health center seeking a grant 
under this section shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may require.
    ``(d) Preference.--In selecting recipients for a grant under this 
section, the Secretary shall give preference to funding medical 
residency training programs focusing on primary health care.
    ``(e) Definition.--In this section:
            ``(1) The term `accredited', as applied to a new or 
        alternative-campus medical residency training program, means a 
        program that is accredited by a recognized body or bodies 
        approved for such purpose by the Accreditation Council for 
        Graduate Medical Education, except that a new medical residency 
        training program that, by reason of an insufficient period of 
        operation, is not eligible for accreditation on or before the 
        date of submission of an application under subsection (c) shall 
        be deemed accredited if the Accreditation Council for Graduate 
        Medical Education finds, after consultation with the 
        appropriate accreditation body or bodies, that there is 
        reasonable assurance that the program will meet the 
        accreditation standards of such body or bodies prior to the 
        date of graduation of the first entering class in that program.
            ``(2) The term `community health center' means a health 
        center as defined in section 330.

``SEC. 749A. GRANTS TO IMPROVE DELIVERY OF PRIMARY CARE SERVICES IN 
              COMMUNITY HEALTH CENTERS.

    ``(a) Primary Care Access Grants.--
            ``(1) Program authorized.--The Secretary, acting through 
        the Administrator of the Health Resources and Services 
        Administration, may make grants to community health centers for 
        the purpose of increasing the number of medical service 
        providers associated with such centers.
            ``(2) Grants.--A recipient of a grant under this subsection 
        shall be eligible to receive such grants for a total of 5 
        fiscal years.
            ``(3) Use of funds.--A recipient of a grant under this 
        subsection shall use amounts from the grant for one or more of 
        the following activities:
                    ``(A) To recruit residents for medical residency 
                training programs at the community health center.
                    ``(B) To establish a multi-community physician 
                mentoring program to encourage upper level residents to 
                remain in the State in which the community health 
                center and medical residency training program are 
                located.
                    ``(C) To enter into contracts for technical 
                assistance for the purpose of recruiting or retaining 
                primary health care staff.
                    ``(D) To enter into contracts for technical 
                assistance in preparing contracts with local providers 
                of primary health care to provide services for 
                medically underserved communities.
            ``(4) Application.--A community health center seeking a 
        grant under this subsection shall submit an application to the 
        Secretary at such time, in such manner, and containing such 
        information as the Secretary may require.
    ``(b) Grants for Primary Care Facility Capital Expenditures.--
            ``(1) Program authorized.--The Secretary, acting through 
        the Administrator of the Health Resources and Services 
        Administration, may make grants to community health centers for 
        the purpose of increasing primary health care capabilities 
        through the construction, expansion, or renovation of 
        facilities.
            ``(2) Grants.--A recipient of a grant under this subsection 
        shall be eligible to receive such grants for a total of 5 
        fiscal years.
            ``(3) Use of funds.--A recipient of a grant under this 
        subsection shall use amounts from the grant for one or more of 
        the following activities:
                    ``(A) To acquire or lease facilities.
                    ``(B) To construct new facilities.
                    ``(C) To repair or modernize existing facilities.
                    ``(D) To purchase or lease medical equipment.
    ``(c) Definition.--The term `community health center' means a 
health center as defined in section 330.

``SEC. 749B. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated $200,000,000 for fiscal 
year 2007 and such sums as may be necessary for each fiscal year 
thereafter to carry out this subpart.''.
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