[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 3708 Introduced in Senate (IS)]







110th CONGRESS
  2d Session
                                S. 3708

     To amend the Public Health Service Act with respect to health 
             professions education, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 19, 2008

 Mrs. Clinton 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 with respect to health 
             professions education, 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 ``Health Professions and Primary Care 
Reinvestment Act''.

SEC. 2. TABLE OF CONTENTS; REFERENCES IN ACT.

    (a) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.
Sec. 2. Table of contents; references in Act.
Sec. 3. Federally supported student loan funds.
Sec. 4. Centers of excellence.
Sec. 5. Health professions training for diversity.
Sec. 6. Training in family medicine, general internal medicine, general 
                            pediatrics, and physician assistantship; 
                            community health needs assessments; primary 
                            care training institutes.
Sec. 7. Training in general and pediatric dentistry; loan repayments.
Sec. 8. Interdisciplinary, community-based linkages.
Sec. 9. Geriatrics education and training.
Sec. 10. Training in graduate psychology education.
Sec. 11. Health professions workforce information and analysis.
Sec. 12. Health workforce information, evaluation, and assessment.
Sec. 13. Funding for dental public health and preventive medicine.
Sec. 14. Academic health departments grant program.
Sec. 15. Definitions.
    (b) References in Act.--Except as otherwise specified, amendments 
made by this Act to a section or other provision of law are amendments 
to such section or other provision of the Public Health Service Act (42 
U.S.C. 201 et seq.).

SEC. 3. FEDERALLY SUPPORTED STUDENT LOAN FUNDS.

    (a) Purpose.--Subpart II of title VII (42 U.S.C. 292q et seq.) is 
amended by inserting after the subpart heading the following:

``SEC. 720A. PURPOSE.

    ``The purpose of this subpart is to improve the supply, 
distribution, diversity, and quality of health professionals in the 
healthcare workforce by--
            ``(1) making health professionals more accessible to low-
        income, underserved, uninsured, minority, health disparity, and 
        rural populations;
            ``(2) improving the training of primary care physicians, 
        dentists, physician assistants, behavioral and mental health 
        professionals, public health professionals, and other health 
        professionals; and
            ``(3) training faculty educators in the health 
        professions.''.
    (b) Loan Provisions.--Section 722 (42 U.S.C. 292r) is amended by 
striking subsection (e) and inserting the following:
    ``(e) Rate of Interest.--Such loans shall bear interest, on the 
unpaid balance of the loan, computed only for periods for which the 
loan is repayable, at the rate of 2 percent less than the applicable 
rate of interest described in section 427A(l)(1) of the Higher 
Education Act of 1965 (20 U.S.C. 1077a(l)(1)) per year.''.
    (c) Medical Schools and Primary Health Care.--Section 723 (42 
U.S.C. 292s) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking subparagraph (B) 
                and inserting the following:
                    ``(B) to practice in such care for 10 years 
                (including residency training in primary health care) 
                or through the date on which the loan is repaid in 
                full, whichever occurs first.''; and
                    (B) by striking paragraph (3) and inserting the 
                following:
            ``(3) Noncompliance by student.--Each agreement entered 
        into with a student pursuant to paragraph (1) shall provide 
        that, if the student fails to comply with such agreement, the 
        loan involved will begin to accrue interest at a rate of 2 
        percent per year greater than the rate at which the student 
        would pay if compliant in such year.''; and
            (2) by adding at the end the following:
    ``(d) Sense of Congress.--It is the sense of Congress that funds 
repaid under the loan program under this section should not be 
transferred to the Treasury of the United States or otherwise used for 
any other purpose other than to carry out this section.''.
    (d) Student Loan Guidelines.--The Secretary of Health and Human 
Services shall not require parental financial information from a 
student to determine financial need under section 723 of the Public 
Health Service Act (42 U.S.C. 292s) and the determination of need for 
such information shall be at the discretion of applicable school loan 
officer. The Secretary shall amend guidelines issued by the Health 
Resources and Services Administration in accordance with the preceding 
sentence.

SEC. 4. CENTERS OF EXCELLENCE.

    Section 736 of the Public Health Service Act (42 U.S.C. 293) is 
amended--
            (1) by striking subsection (a) and inserting the following:
    ``(a) In General.--The Secretary shall make grants to, and enter 
into contracts with, public and nonprofit private health or educational 
entities, including designated health professions schools described in 
subsection (c), for the purpose of assisting the entities in supporting 
programs of excellence in health professions education for 
underrepresented minorities in health professions.'';
            (2) by striking subsection (b) and inserting the following:
    ``(b) Required Use of Funds.--The Secretary may not make a grant 
under subsection (a) unless the designated health professions school 
agrees, subject to subsection (c)(1)(C), to use the funds awarded under 
the grant to--
            ``(1) develop a large competitive applicant pool through 
        linkages with institutions of higher education, local school 
        districts, and other community-based entities and establish an 
        education pipeline for health professions careers;
            ``(2) establish, strengthen, or expand programs to enhance 
        the academic performance of underrepresented minority in health 
        professions students attending the school;
            ``(3) improve the capacity of such school to train, 
        recruit, and retain underrepresented minority faculty members 
        including the payment of such stipends and fellowships as the 
        Secretary may determine appropriate;
            ``(4) carry out activities to improve the information 
        resources, clinical education, curricula, and cultural and 
        linguistic competence of the graduates of the school, as it 
        relates to minority health issues;
            ``(5) facilitate faculty and student research on health 
        issues particularly affecting racial and ethnic minority 
        groups, including research on issues relating to the delivery 
        of culturally competent healthcare (as defined in section 270);
            ``(6) establish and implement a program to train students 
        of the school in providing health services to racial and ethnic 
        minority individuals through training provided to such students 
        at community-based health facilities that--
                    ``(A) provide such health services; and
                    ``(B) are located at a site remote from the main 
                site of the teaching facilities of the school;
            ``(7) provide stipends as the Secretary determines 
        appropriate, in amounts as the Secretary determines 
        appropriate; and
            ``(8) conduct accountability and other reporting 
        activities, as required by the Secretary in subsection (i).'';
            (3) in subsection (c)--
                    (A) by amending paragraph (1) to read as follows:
            ``(1) Designated schools.--
                    ``(A) In general.--The designated health 
                professions schools referred to in subsection (a) are 
                such schools that meet each of the conditions specified 
                in subparagraphs (B) and (C), and that--
                            ``(i) meet each of the conditions specified 
                        in paragraph (2)(A);
                            ``(ii) meet each of the conditions 
                        specified in paragraph (3);
                            ``(iii) meet each of the conditions 
                        specified in paragraph (4); or
                            ``(iv) meet each of the conditions 
                        specified in paragraph (5).
                    ``(B) General conditions.--The conditions specified 
                in this subparagraph are that a designated health 
                professions school--
                            ``(i) has a significant number of 
                        underrepresented minority in health professions 
                        students enrolled in the school, including 
                        individuals accepted for enrollment in the 
                        school;
                            ``(ii) has been effective in assisting such 
                        students of the school to complete the program 
                        of education and receive the degree involved;
                            ``(iii) has been effective in recruiting 
                        such students to enroll in and graduate from 
                        the school, including providing scholarships 
                        and other financial assistance to such students 
                        and encouraging such students from all levels 
                        of the educational pipeline to pursue health 
                        professions careers; and
                            ``(iv) has made significant recruitment 
                        efforts to increase the number of 
                        underrepresented minority in health professions 
                        individuals serving in faculty or 
                        administrative positions at the school.
                    ``(C) Consortium.--The condition specified in this 
                subparagraph is that, in accordance with subsection 
                (e)(1), the designated health profession school 
                involved has with other health profession schools 
                (designated or otherwise) formed a consortium to carry 
                out the purposes described in subsection (b) at the 
                schools of the consortium.
                    ``(D) Application of criteria to other programs.--
                In the case of any criteria established by the 
                Secretary for purposes of determining whether schools 
                meet the conditions described in subparagraph (B), this 
                section may not, with respect to racial and ethnic 
                minority groups, be construed to authorize, require, or 
                prohibit the use of such criteria in any program other 
                than the program established in this section.'';
                    (B) by amending paragraph (2) to read as follows:
            ``(2) Centers of excellence at certain historically black 
        colleges and universities.--
                    ``(A) Conditions.--The conditions specified in this 
                subparagraph are that a designated health professions 
                school is a school described in section 799B(1).
                    ``(B) Use of grant.--In addition to the purposes 
                described in subsection (b), a grant under subsection 
                (a) to a designated health professions school meeting 
                the conditions described in subparagraph (A) may be 
                expended--
                            ``(i) to develop a plan to achieve 
                        institutional improvements, including financial 
                        independence, to enable the school to support 
                        programs of excellence in health professions 
                        education for underrepresented minority 
                        individuals; and
                            ``(ii) to provide improved access to the 
                        library and informational resources of the 
                        school.
                    ``(C) Exception.--The requirements of paragraph 
                (1)(C) shall not apply to a historically black college 
                or university that receives funding under this 
                paragraph or paragraph (5).''; and
                    (C) by amending paragraphs (3) through (5) to read 
                as follows:
            ``(3) Hispanic centers of excellence.--The conditions 
        specified in this paragraph are that--
                    ``(A) with respect to Hispanic individuals, each of 
                clauses (i) through (iv) of paragraph (1)(B) applies to 
                the designated health professions school involved;
                    ``(B) the school agrees, as a condition of 
                receiving a grant under subsection (a) of this section, 
                that the school will, in carrying out the duties 
                described in subsection (b) of this section, give 
                priority to carrying out the duties with respect to 
                Hispanic individuals; and
                    ``(C) the school agrees, as a condition of 
                receiving a grant under subsection (a) of this section, 
                that--
                            ``(i) the school will establish an 
                        arrangement with 1 or more public or nonprofit 
                        community-based Hispanic serving organizations, 
                        or public or nonprofit private institutions of 
                        higher education, including schools of nursing, 
                        whose enrollment of students has traditionally 
                        included a significant number of Hispanic 
                        individuals, the purposes of which will be to 
                        carry out a program--
                                    ``(I) to identify Hispanic students 
                                who are interested in a career in the 
                                health profession involved; and
                                    ``(II) to facilitate the 
                                educational preparation of such 
                                students to enter the health 
                                professions school; and
                            ``(ii) the school will make efforts to 
                        recruit Hispanic students, including students 
                        who have participated in the undergraduate or 
                        other matriculation program carried out under 
                        arrangements established by the school pursuant 
                        to clause (i)(II) and will assist Hispanic 
                        students regarding the completion of the 
                        educational requirements for a degree from the 
                        school.
            ``(4) Native american centers of excellence.--Subject to 
        subsection (e), the conditions specified in this paragraph are 
        that--
                    ``(A) with respect to Native Americans, each of 
                clauses (i) through (iv) of paragraph (1)(B) applies to 
                the designated health professions school involved;
                    ``(B) the school agrees, as a condition of 
                receiving a grant under subsection (a) of this section, 
                that the school will, in carrying out the duties 
                described in subsection (b) of this section, give 
                priority to carrying out the duties with respect to 
                Native Americans; and
                    ``(C) the school agrees, as a condition of 
                receiving a grant under subsection (a) of this section, 
                that--
                            ``(i) the school will establish an 
                        arrangement with 1 or more public or nonprofit 
                        private institutions of higher education, 
                        including schools of nursing, whose enrollment 
                        of students has traditionally included a 
                        significant number of Native Americans, the 
                        purpose of which arrangement will be to carry 
                        out a program--
                                    ``(I) to identify Native American 
                                students, from the institutions of 
                                higher education referred to in clause 
                                (i), who are interested in health 
                                professions careers; and
                                    ``(II) to facilitate the 
                                educational preparation of such 
                                students to enter the designated health 
                                professions school; and
                            ``(ii) the designated health professions 
                        school will make efforts to recruit Native 
                        American students, including students who have 
                        participated in the undergraduate program 
                        carried out under arrangements established by 
                        the school pursuant to clause (i) and will 
                        assist Native American students regarding the 
                        completion of the educational requirements for 
                        a degree from the designated health professions 
                        school.
            ``(5) Other centers of excellence.--The conditions 
        specified in this paragraph are--
                    ``(A) with respect to other centers of excellence, 
                the conditions described in clauses (i) through (iv) of 
                paragraph (1)(B); and
                    ``(B) that the health professions school involved 
                has an enrollment of underrepresented minorities in 
                health professions significantly above the national 
                average for such enrollments of health professions 
                schools.''; and
            (4) by striking subsection (h) and inserting the following:
    ``(h) Formula for Allocations.--
            ``(1) Allocations.--Based on the amount appropriated under 
        subsection (i) for a fiscal year, the following subparagraphs 
        shall apply as appropriate:
                    ``(A) In general.--If the amounts appropriated 
                under subsection (i) for a fiscal year are $24,000,000 
                or less--
                            ``(i) the Secretary shall make available 
                        $12,000,000 for grants under subsection (a) to 
                        health professions schools that meet the 
                        conditions described in subsection (c)(2)(A); 
                        and
                            ``(ii) and available after grants are made 
                        with funds under clause (i), the Secretary 
                        shall make available--
                                    ``(I) 60 percent of such amount for 
                                grants under subsection (a) to health 
                                professions schools that meet the 
                                conditions described in paragraph (3) 
                                or (4) of subsection (c) (including 
                                meeting the conditions under subsection 
                                (e)); and
                                    ``(II) 40 percent of such amount 
                                for grants under subsection (a) to 
                                health professions schools that meet 
                                the conditions described in subsection 
                                (c)(5).
                    ``(B) Funding in excess of $24,000,000.--If amounts 
                appropriated under subsection (i) for a fiscal year 
                exceed $24,000,000 but are less than $30,000,000--
                            ``(i) 80 percent of such excess amounts 
                        shall be made available for grants under 
                        subsection (a) to health professions schools 
                        that meet the requirements described in 
                        paragraph (3) or (4) of subsection (c) 
                        (including meeting conditions pursuant to 
                        subsection (e)); and
                            ``(ii) 20 percent of such excess amount 
                        shall be made available for grants under 
                        subsection (a) to health professions schools 
                        that meet the conditions described in 
                        subsection (c)(5).
                    ``(C) Funding in excess of $30,000,000.--If amounts 
                appropriated under subsection (i) for a fiscal year 
                exceed $30,000,000 but are less than $40,000,000, the 
                Secretary shall make available--
                            ``(i) not less than $12,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        subsection (c)(2)(A);
                            ``(ii) not less than $12,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        paragraph (3) or (4) of subsection (c) 
                        (including meeting conditions pursuant to 
                        subsection (e));
                            ``(iii) not less than $6,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        subsection (c)(5); and
                            ``(iv) after grants are made with funds 
                        under clauses (i) through (iii), any remaining 
                        excess amount for grants under subsection (a) 
                        to health professions schools that meet the 
                        conditions described in paragraph (2)(A), (3), 
                        (4), or (5) of subsection (c).
                    ``(D) Funding in excess of $40,000,000.--If amounts 
                appropriated under subsection (i) for a fiscal year are 
                $40,000,000 or more, the Secretary shall make 
                available--
                            ``(i) not less than $16,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        subsection (c)(2)(A);
                            ``(ii) not less than $16,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        paragraph (3) or (4) of subsection (c) 
                        (including meeting conditions pursuant to 
                        subsection (e));
                            ``(iii) not less than $8,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        subsection (c)(5); and
                            ``(iv) after grants are made with funds 
                        under clauses (i) through (iii), any remaining 
                        funds for grants under subsection (a) to health 
                        professions schools that meet the conditions 
                        described in paragraph (2)(A), (3), (4), or (5) 
                        of subsection (c).
            ``(2) No limitation.--Nothing in this subsection shall be 
        construed as limiting the centers of excellence referred to in 
        this section to the designated amount, or to preclude such 
        entities from competing for grants under this section.
            ``(3) Maintenance of effort.--
                    ``(A) In general.--With respect to activities for 
                which a grant made under this part are authorized to be 
                expended, the Secretary may not make such a grant to a 
                center of excellence for any fiscal year unless the 
                center agrees to maintain expenditures of non-Federal 
                amounts for such activities at a level that is not less 
                than the level of such expenditures maintained by the 
                center for the fiscal year preceding the fiscal year 
                for which the school receives such a grant.
                    ``(B) Use of federal funds.--With respect to any 
                Federal amounts received by a center of excellence and 
                available for carrying out activities for which a grant 
                under this part is authorized to be expended, the 
                center shall, before expending the grant, expend the 
                Federal amounts obtained from sources other than the 
                grant, unless given prior approval from the Secretary.
    ``(i) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section--
            ``(1) $50,000,000 for each of the fiscal years 2009 through 
        2013; and
            ``(2) and such sums as are necessary for each subsequent 
        fiscal year.''.

SEC. 5. HEALTH PROFESSIONS TRAINING FOR DIVERSITY.

    (a) Loan Repayments and Fellowships Regarding Faculty Positions.--
Section 738(a)(1) (42 U.S.C. 293b(a)(1)) is amended by striking 
``$20,000 of the principal and interest of the educational loans of 
such individuals.'' and inserting ``$30,000 of the principal and 
interest of the educational loans of such individuals. With respect to 
such an individual who enters into a new contract under the preceding 
sentence with the Secretary after 2009, the amount paid by the Federal 
Government pursuant to such contract shall be increased by the 
percentage increase in the gross domestic product since the beginning 
of the previous year.''.
    (b) Scholarships for Disadvantaged Students.--Section 740(a) (42 
U.S.C. 293d(a)) is amended by striking ``$37,000,000'' and all that 
follows through ``2002'' and inserting ``$51,000,000 for fiscal year 
2008, and such sums as may be necessary for each of the fiscal years 
2009 through 2013''.
    (c) Reauthorization for Loan Repayments and Fellowships Regarding 
Faculty Positions.--Section 740(b) (42 U.S.C. 293d(b)) is amended by 
striking ``appropriated'' and all that follows through the period at 
the end and inserting ``appropriated, $5,000,000 for each of the fiscal 
years 2009 through 2013. For fiscal year 2014 and each subsequent 
fiscal year, there is authorized to be appropriated the amount 
authorized for the preceding fiscal year increased by the percentage 
increase in the gross domestic product during such preceding fiscal 
year.''.
    (d) Reauthorization for Educational Assistance in the Health 
Professions Regarding Individuals From a Disadvantaged Background.--
Section 740(c) of the Public Health Service Act (42 U.S.C. 293d(c)) is 
amended by striking the first sentence and inserting the following: 
``For the purpose of grants and contracts under section 739(a)(1), 
there is authorized to be appropriated $60,000,000 for fiscal year 2009 
and such sums as may be necessary for each of the fiscal years 2010 
through 2013.''

SEC. 6. TRAINING IN FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL 
              PEDIATRICS, AND PHYSICIAN ASSISTANTSHIP; COMMUNITY HEALTH 
              NEEDS ASSESSMENTS; PRIMARY CARE TRAINING INSTITUTES.

    Part C of title VII (42 U.S.C. 293k et seq.) is amended by striking 
section 747 and inserting the following:

``SEC. 747. PRIMARY CARE TRAINING AND ENHANCEMENT.

    ``(a) Support and Development of Primary Care Training Programs.--
            ``(1) In general.--The Secretary may make grants to, or 
        enter into contracts with, an accredited public or nonprofit 
        private hospital, school of medicine or osteopathic medicine, 
        academically affiliated physician assistant training program, 
        or a public or private nonprofit entity which the Secretary has 
        determined is capable of carrying out such grant or contract--
                    ``(A) to plan, develop, operate, or participate in 
                an accredited professional training program, including 
                an accredited residency or internship program in the 
                field of family medicine, general internal medicine, or 
                general pediatrics for medical students, interns, 
                residents, or practicing physicians as defined by the 
                Secretary;
                    ``(B) to provide need-based financial assistance in 
                the form of traineeships and fellowships to medical 
                students, interns, residents, practicing physicians, or 
                other medical personnel, who are participants in any 
                such program, and who plan to specialize or work in the 
                practice of family medicine, general internal medicine, 
                or general pediatrics;
                    ``(C) to plan, develop, and operate a program for 
                the training of physicians who plan to teach in family 
                medicine, general internal medicine, or general 
                pediatrics training programs;
                    ``(D) to plan, develop, and operate a program for 
                the training of physicians teaching in community-based 
                settings;
                    ``(E) to provide financial assistance in the form 
                of traineeships and fellowships to physicians who are 
                participants in any such programs and who plan to teach 
                or conduct research in a family medicine, general 
                internal medicine, or general pediatrics training 
                program;
                    ``(F) to plan, develop, and operate a physician 
                assistant education program, and for the training of 
                individuals who will teach in programs to provide such 
                training;
                    ``(G) to plan, develop, and operate an 
                interdisciplinary training program that includes at 
                least 1 of the following which demonstrates a team 
                approach to care and may demonstrate a patient-centered 
                medical home model:
                            ``(i) A program designed to teach trainees 
                        the skills to provide interdisciplinary patient 
                        care through collaboration among various 
                        professionals, including those trained in 
                        geriatrics, physician assistants, nurse 
                        practitioners, pharmacists, or social workers.
                            ``(ii) A program developed in collaboration 
                        with dental students or residency training 
                        programs to improve integration and access to 
                        dental care.
                            ``(iii) A program developed in 
                        collaboration with psychologists and other 
                        behavioral and mental health professionals to 
                        integrate mental and behavioral health and 
                        primary health care; and
                    ``(H) to plan, develop and operate joint degree 
                programs to provide interdisciplinary graduate training 
                in public health and other health professions to 
                provide training in environmental health, infectious 
                disease control, disease prevention and health 
                promotion, epidemiological studies and injury control.
            ``(2) Duration of awards.--The period during which payments 
        are made to an entity from an award of a grant or contract 
        under this subsection shall be 5 years.
    ``(b) Capacity Building in Primary Care.--
            ``(1) In general.--The Secretary may make grants to or 
        enter into contracts with accredited schools of medicine or 
        osteopathic medicine to establish, maintain, or improve 
        academic units (which may be departments, divisions, or other 
        units) or programs that improve clinical teaching and research 
        in family medicine, general internal medicine, or general 
        pediatrics.
            ``(2) Preference in making awards under this subsection.--
        In making awards of grants and contracts under paragraph (1), 
        the Secretary shall give preference to any qualified applicant 
        for such an award that agrees to expend the award for the 
        purpose of--
                    ``(A) establishing academic units or programs in 
                family medicine; or
                    ``(B) substantially expanding such units or 
                programs.
            ``(3) Priority in making awards.--In making awards of 
        grants and contracts under paragraph (1), the Secretary shall 
        give priority to any qualified applicant for such an award that 
        proposes--
                    ``(A) a collaborative project between academic 
                administrative units of primary care; and
                    ``(B) innovative approaches to clinical teaching 
                using models of primary care, such as the patient 
                centered medical home, team management of chronic 
                disease, and interdisciplinary integrated models of 
                health care that incorporate transitions in health care 
                settings and integration physical and mental health 
                provision.
            ``(4) Duration of awards.--The period during which payments 
        are made to an entity from an award of a grant or contract 
        under this subsection shall be 5 years.
    ``(c) Community Health Needs Assessment.--
            ``(1) In general.--The Secretary may award grants or enter 
        into contracts with eligible entities to conduct community 
        health needs assessments as described by this subsection.
            ``(2) Eligible entity.--For purposes of this subsection, 
        the term `eligible entity' means an entity described in section 
        799(b).
            ``(3) Application.--To receive a grant under this section, 
        an eligible entity shall submit to the Secretary an application 
        at such time, in such manner, and containing such information 
        as the Secretary may require.
            ``(4) Content.--A community health needs assessment shall--
                    ``(A) identify community needs for a health care 
                workforce and collaborative programs and partnerships 
                to address the needs;
                    ``(B) identify barriers to health care in 
                underserved areas, health disparity populations, or 
                regions experiencing significant changes in the 
                cultural and linguistic demographics of their 
                populations, including border communities; and
                    ``(C) provide assurance that the entity or entities 
                conducting such assessment will assess how to--
                            ``(i) link community organizations and 
                        academic health centers to address community 
                        health workforce training needs;
                            ``(ii) support development of a workforce 
                        reflective of the cultural, linguistic, racial, 
                        and ethnic makeup of the population involved;
                            ``(iii) address the barriers identified in 
                        subparagraph (B), with an emphasis on community 
                        based participatory research which includes 
                        local communities and prepares members of the 
                        identified populations to participate in 
                        improving health care in these communities;
                            ``(iv) enhance the development of the 
                        workforce practicing in primary care;
                            ``(v) enhance the development of the 
                        workforce serving underserved areas and health 
                        disparity populations;
                            ``(vi) build capacity and develop 
                        competency within the health care delivery and 
                        public health systems; and
                            ``(vii) be responsive to national and local 
                        health issues impacting the workforce, such as 
                        problems specific to children, emerging chronic 
                        diseases, an aging population, infectious 
                        diseases, mental health or substance related 
                        disorders, or bioterrorism by employing such 
                        approaches as health promotion, health 
                        literacy, pharmaceutical case management, 
                        interdisciplinary integrated models of health 
                        care that include both physical and mental 
                        health, cultural and linguistic competency, or 
                        approaches that reduce health disparities.
            ``(5) Term and amount of award.--A grant awarded under this 
        subsection shall be--
                    ``(A) for a term of 2 years; and
                    ``(B) in an amount of $150,000 for each year of the 
                2-year term.
    ``(d) Primary Care Training Institutes.--
            ``(1) Purpose.--The purpose of the Primary Care Training 
        Institute program established under this subsection is to--
                    ``(A) prepare and train primary care providers by 
                enhancing and coordinating multiple aims within 
                academic health centers in order to lead to improving 
                patient care delivered to health disparity populations 
                and reduce health disparities;
                    ``(B) enhance the status of primary care within 
                undergraduate and graduate medical education through 
                influencing priorities in practice, education, and 
                research;
                    ``(C) develop innovative approaches to primary care 
                education and scholarship by transforming and 
                integrating health care systems through 
                interdisciplinary, team-based, and collaborative models 
                that may demonstrate improved quality or lower costs; 
                and
                    ``(D) create economies of scale through academic 
                and community collaborations by enabling academic 
                infrastructure support for multiple community programs.
            ``(2) Establishment.--Grants or contracts awarded under 
        this subsection shall establish new centers for primary care 
        education and research within academic units of family 
        medicine, general internal medicine, or general pediatrics 
        within academic health centers. Such new centers shall be known 
        as Primary Care Training Institutes (referred to in this 
        section as `PCTIs').
            ``(3) Authority to award grants.--The Secretary may make 
        grants to or enter into contracts with eligible entities to 
        develop and implement PCTIs in accordance with this subsection.
            ``(4) Eligible entity.--For purposes of this subsection, 
        the term `eligible entity' means a primary care (including 
        family medicine, general internal medicine, and general 
        pediatrics) academic administrative unit.
            ``(5) Application; requirement for needs assessment.--An 
        eligible entity desiring a grant under this subsection shall 
        submit to the Secretary an application at such time, in such 
        manner, and containing--
                    ``(A)(i) a community health needs assessment 
                conducted by such eligible entity through a grant 
                awarded under subsection (c); or
                    ``(ii) a community health needs assessment 
                conducted by such entity through other means and that 
                meets the requirements of subsection (c); and
                    ``(B) such information as the Secretary may 
                require.
            ``(6) Functions.--An eligible entity shall use amounts 
        awarded under a grant under this subsection to carry out the 
        purpose described in paragraph (1), through--
                    ``(A) establishment of a PCTI to improve primary 
                care training and practice, to improve recruitment of 
                underrepresented minority students into primary care 
                careers, and to improve the number and percentage of 
                trained professionals serving in underserved areas and 
                health disparity populations; and
                    ``(B) the establishment of infrastructure to 
                support the PCTI including development of, and training 
                in--
                            ``(i) curriculum designs;
                            ``(ii) education evaluation tools;
                            ``(iii) online interactive educational 
                        curricula;
                            ``(iv) community-based and population 
                        research study designs;
                            ``(v) applied behavioral science and 
                        psychology educational programs;
                            ``(vi) clinical epidemiology;
                            ``(vii) models for teaching caring for 
                        older adults;
                            ``(viii) models for health services 
                        delivery;
                            ``(ix) public health and preventive 
                        medicine; and
                            ``(x) models for teaching cultural 
                        competency and health literacy.
            ``(7) Requirements.--
                    ``(A) Required activities.--Each eligible entity 
                that establishes a PCTI under this subsection shall, 
                through such PCTI--
                            ``(i) collaborate across disciplines 
                        including family medicine, general internal 
                        medicine, general pediatrics, or with 
                        disciplines such as physician assistants and 
                        those certified in geriatrics or gerontology, 
                        general dentistry, behavioral and mental 
                        health, or public health;
                            ``(ii) establish and maintain formal 
                        partnerships with area health education 
                        centers, Federally qualified health centers, 
                        rural health clinics, hospital and nonhospital-
                        based teaching clinics, Geriatric Education 
                        Centers, Geriatric Research Education and 
                        Clinical Centers, or other facilities focused 
                        on social and health needs of older adults or 
                        other underserved areas, health disparity 
                        populations, and other vulnerable populations, 
                        such as older adults, homeless individuals, 
                        victims of abuse or trauma, individuals with 
                        mental health or substance-related disorders, 
                        and individuals with HIV/AIDS;
                            ``(iii) create new models of teaching and 
                        evaluating patient care based on the patient 
                        centered medical home model, interdisciplinary 
                        integrated models of health care that 
                        incorporate both physical and mental health, 
                        drug therapy management, or other new models of 
                        effective patient care utilizing a team or 
                        collaborative approach;
                            ``(iv) conduct research and education that 
                        improves or is relevant to community practice 
                        and that is carried out in community or primary 
                        care settings, and that may address such issues 
                        as environmental health, infectious disease 
                        control, disease prevention, health promotion, 
                        and injury control;
                            ``(v) increase the number of trainees and 
                        faculty from underrepresented minority groups, 
                        and from rural disadvantaged backgrounds; and
                            ``(vi) address the changing national, 
                        regional, and local health care needs and 
                        priorities as identified in the community 
                        health needs assessment submitted by such 
                        eligible entity in the application under this 
                        subsection.
                    ``(B) Voluntary activities.--Each eligible entity 
                that establishes a PCTI under this subsection may, 
                through such PCTI, integrate programs along the 
                educational continuum, including high school and 
                college pipeline programs, predoctoral education in 
                primary care, primary care residency training, faculty 
                development, fellowship programs, and primary care 
                research infrastructure programs and interdisciplinary 
                joint degree programs in graduate public health 
                training and other health professions.
            ``(8) Term and amount of award.--A grant awarded under this 
        subsection shall be--
                    ``(A) for a term of 5 years; and
                    ``(B) in an amount of $750,000 for each year of the 
                5-year term.
    ``(e) Priorities in Making Awards.--With respect to the training 
provided for under this section, the Secretary shall give priority in 
awarding grants or contracts to the following:
            ``(1) Qualified applicants that have a record of training 
        individuals who are from underrepresented minority groups or 
        from a rural or disadvantaged background.
            ``(2) Qualified applicants that establish formal 
        relationships with Federally qualified health centers, rural 
        health centers, or accredited teaching facilities located in 
        underserved areas or serve health disparity populations, and 
        that conduct training of students, residents, fellows, or 
        faculty at the center or facility.
            ``(3) Qualified applicants that conduct teaching programs 
        targeting vulnerable populations such as older adults, homeless 
        individuals, victims of abuse or trauma, individuals with 
        mental health or substance-related disorders, and individuals 
        with HIV/AIDS.
            ``(4) Qualified applicants that include educational 
        activities in care of older adults.
            ``(5) Qualified applicants that conduct teaching programs 
        in an interdiscliplinary setting demonstrating a team or 
        collaborative approach to care.
            ``(6) Qualified applicants that include educational 
        activities in cultural competency and health literacy.
    ``(f) Preference in Making Awards Under This Section.--In making 
awards of grants or contracts under this section, the Secretary shall 
give preference to any qualified applicant that--
            ``(1) has a high rate for placing graduates in practice 
        settings having the principle focus of serving underserved 
        areas or health disparity populations;
            ``(2) during the 2-year period preceding the fiscal year 
        for which such an award is sought, has achieved a significant 
        increase in the rate of placing graduates in such settings; or
            ``(3) have a record of training the greatest percentage of 
        providers, or that have demonstrated significant improvements 
        in the percentage of providers, who enter and remain in primary 
        care practice.
    ``(g) Application.--An eligible entity desiring a grant under this 
section shall submit to the Secretary an application at such time, in 
such manner, and containing such information as the Secretary may 
require.
    ``(h) Duties of Secretary.--The Secretary shall, in carrying out 
this section and section 748--
            ``(1) require collaboration--
                    ``(A) among the pertinent workforce programs within 
                this title and the Department of Health and Human 
                Services; and
                    ``(B) among such pertinent programs administered by 
                the Department of Labor and the Department of 
                Education;
            ``(2) use and adequately support existing programs to 
        address new Departmental initiatives, as appropriate;
            ``(3) take into consideration capabilities of existing 
        programs before creating separate or parallel programs; and
            ``(4) evaluate and publicly report on the effectiveness of 
        such programs on an annual basis.
    ``(i) Rural Background Defined.--For purposes of this section, the 
term `rural background' means, with respect to an individual, having 
grown up, lived a substantial portion of such individual's life, or 
attended high school in a federally designated rural or nonmetropolitan 
area.
    ``(j) Authorization of Appropriations.--
            ``(1) Training programs.--There is authorized to be 
        appropriated to carry out subsections (a) and (b), $125,000,000 
        for each of the fiscal years 2009 through 2014, of which 15 
        percent of the amount appropriated in each such fiscal year 
        shall be allocated to physician assistant training programs as 
        described under subsection (a)(1)(F), which prepare students 
        for practice in primary care settings.
            ``(2) Community health needs assessments.--There is 
        authorized to be appropriated to carry out subsection (c)--
                    ``(A) $1,800,000 for fiscal year 2009; and
                    ``(B) $3,600,000 for each of the fiscal years 2010 
                through 2013.
            ``(3) Primary care training institutes.--There is 
        authorized to be appropriated to carry out subsection (d)--
                    ``(A) $6,000,000 for fiscal year 2009;
                    ``(B) $12,000,000 for fiscal year 2010;
                    ``(C) $18,000,000 for fiscal year 2011;
                    ``(D) $24,000,000 for fiscal year 2012; and
                    ``(E) $30,000,000 for fiscal year 2013.
            ``(4) Carryover funds.--An entity that receives an award 
        under this section may carry over funds from 1 fiscal year to 
        another without obtaining approval from the Secretary. In no 
        case may any funds be carried over pursuant to the preceding 
        sentence for more than 3 years, and in the case of a community 
        health needs assessment under subsection (c), for more than 1 
        year.''.

SEC. 7. TRAINING IN GENERAL AND PEDIATRIC DENTISTRY; LOAN REPAYMENTS.

    (a) Training in General and Pediatric Dentistry.--Part C of Title 
VII (42 U.S.C. 293k et seq.) is amended by--
            (1) redesignating section 748 as section 749; and
            (2) inserting after section 747 the following:

``SEC. 748. TRAINING IN GENERAL AND PEDIATRIC DENTISTRY.

    ``(a) Support and Development of Dental Training Programs.--
            ``(1) In general.--The Secretary may make grants to, or 
        enter into contracts with, a school of dentistry, public or 
        nonprofit private hospital, or a public or private nonprofit 
        entity which the Secretary has determined is capable of 
        carrying out such grant or contract--
                    ``(A) to plan, develop, and operate, or participate 
                in, an approved professional training program in the 
                field of general dentistry, or pediatric dentistry for 
                dental students, residents, or practicing dentists, 
                that emphasizes training for general dentistry or 
                pediatric dentistry;
                    ``(B) to provide financial assistance to dental 
                students, residents, and practicing dentists who are in 
                need thereof, who are participants in any such program, 
                and who plan to work in the practice of general or 
                pediatric dentistry;
                    ``(C) to plan, develop, and operate a program for 
                the training of dentists who plan to teach in general 
                or pediatric dentistry; and
                    ``(D) to provide financial assistance in the form 
                of traineeships and fellowships to dentists who plan to 
                teach or are teaching in general or pediatric 
                dentistry.
            ``(2) Eligible entity.--For purposes of this subsection, 
        entities eligible for such grants or contracts in general or 
        pediatric dentistry shall include entities that have programs 
        in dental schools, or approved residency or advanced education 
        programs in the practice of general or pediatric dentistry.
    ``(b) Academic Administrative Units.--
            ``(1) In general.--The Secretary may make grants to or 
        enter into contracts with schools of dentistry to meet the 
        costs of projects to establish, maintain, or improve academic 
        administrative units (which may be departments, divisions, or 
        other units) to provide clinical instruction in general or 
        pediatric dentistry.
            ``(2) Priority in making awards.--In making awards of 
        grants and contracts under paragraph (1), the Secretary shall 
        give priority to any qualified applicant for such an award that 
        proposes a collaborative project between departments of primary 
        care medicine and departments of general and pediatric 
        dentistry.
            ``(3) Preference in making awards.--In making awards of 
        grants and contracts under paragraph (1), the Secretary shall 
        give preference to any qualified applicant for such an award 
        that agrees to expend the award for the purpose of--
                    ``(A) establishing an academic administrative unit 
                for programs in general or pediatric dentistry; and
                    ``(B) substantially expanding the programs of such 
                a unit.
    ``(c) Priorities in Making Awards Under This Section.--With respect 
to training provided for under this section, the Secretary shall give 
priority in awarding grants or contracts to the following:
            ``(1) Qualified applicants that have a record of training 
        the greatest percentage of providers, or that have demonstrated 
        significant improvements in the percentage of providers, who 
        enter and remain in general or pediatric dentistry.
            ``(2) Qualified applicants that have a record of training 
        individuals who are from a rural or disadvantaged background, 
        or from underrepresented minorities.
            ``(3) Qualified applicants that establish formal 
        relationships with Federally qualified health centers, rural 
        health centers, or accredited teaching facilities and that 
        conduct training of students, residents, fellows, or faculty at 
        the center or facility.
            ``(4) Qualified applicants that conduct teaching programs 
        targeting vulnerable populations such as older adults, homeless 
        individuals, victims of abuse or trauma, individuals with 
        mental health or substance-related disorders, and individuals 
        with HIV/AIDS.
            ``(5) Qualified applicants that include educational 
        activities in cultural competency and health literacy.
    ``(d) Preference in Making Awards.--In making awards of grants or 
contracts under this section, the Secretary shall give preference to 
any qualified applicant that--
            ``(1) has a high rate for placing graduates in practice 
        settings having the principal focus of serving in underserved 
        areas or health disparity populations; or
            ``(2) during the 2-year period before the fiscal year for 
        which such an award is sought, has achieved a significant 
        increase in the rate of placing graduates in such settings.
    ``(e) Application.--An eligible entity desiring a grant under this 
section shall submit to the Secretary an application at such time, in 
such manner, and containing such information as the Secretary may 
require.
    ``(f) Duration of Award.--The period during which payments are made 
to an entity from an award of a grant or contract under subsection (a) 
shall be 5 years. The provision of such payments shall be subject to 
annual approval by the Secretary of the payments and subject to the 
availability of appropriations for the fiscal year involved to make the 
payments.
    ``(g) Funding.--For the purpose of carrying out subsections (a) and 
(b), there is authorized to be appropriated $20,000,000 for each of the 
fiscal years 2009 through 2013.
    ``(h) Carryover Funds.--An entity that receives an award under this 
section may carry over funds from 1 fiscal year to another without 
obtaining approval from the Secretary. In no case may any funds be 
carried over pursuant to the preceding sentence for more than 3 
years.''.
    (b) Loan Repayments for Dental Professionals.--
            (1) In general.--Section 738(a) (42 U.S.C. 293b(a)) is 
        amended by inserting at the end the following:
            ``(7) Priority for dental professionals.--In entering into 
        contracts under this subsection, the Secretary shall give 
        priority to individuals who--
                    ``(A) are teaching or doing research in an academic 
                dental setting in general or pediatric dentistry;
                    ``(B) have a degree in dentistry;
                    ``(C) are enrolled in an approved graduate training 
                program in dentistry; or
                    ``(D) are enrolled as full-time students--
                            ``(i) in an accredited (as determined by 
                        the Secretary) school of dentistry; and
                            ``(ii) in the final year of a course of a 
                        study or program, offered by such institution 
                        and approved by the Secretary, leading to a 
                        degree from such a school.''.
            (2) Authorization of appropriations.--Section 740(b) (42 
        U.S.C. 293d(b)) is amended by adding at the end the following: 
        ``In addition to any amounts authorized under this subsection, 
        there is authorized to be appropriated to enter into contracts 
        under section 738(a) with individuals described in section 
        738(a)(7), $500,000 for fiscal year 2009, $1,000,000 for fiscal 
        year 2010, $1,500,000 for fiscal year 2011, and $2,000,000 for 
        each of the fiscal years 2012 and 2013.''.

SEC. 8. INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES.

    (a) Area Health Education Centers.--Section 751 (42 U.S.C. 294a) is 
amended to read as follows:

``SEC. 751. AREA HEALTH EDUCATION CENTERS.

    ``(a) Definitions; Establishment of Awards.--
            ``(1) Definitions.--In this section:
                    ``(A) Area health education center.--The terms 
                `area health education center' or `center' mean a 
                public or nonprofit private organization that has a 
                cooperative agreement or contract in effect with an 
                entity that has received an award under subsection (b) 
                or (c), satisfies the requirements in subsection 
                (d)(1), and has as one of its principal functions the 
                operation of an area health education center. 
                Appropriate organizations may include hospitals, health 
                organizations with accredited primary care training 
                programs, accredited physician assistant educational 
                programs associated with a college or university, and 
                universities or colleges not operating a school of 
                medicine or osteopathic medicine.
                    ``(B) Area health education center program.--The 
                terms `area health education center program' or 
                `program' mean cooperative program consisting of an 
                entity that has received an award under subsection (b) 
                or (c) for the purpose of planning, developing, 
                operating, and evaluating an area health education 
                center program and one or more area health education 
                centers, which carries out the required activities 
                described in subsection (b)(4) or (c)(4), satisfies the 
                program requirements in this section, and has as one of 
                its principal functions identifying and implementing 
                strategies and activities that address health care 
                workforce needs in its service area.
                    ``(C) Rural background.--For purposes of this 
                section, the term `rural background' means, with 
                respect to an individual, having grown up, lived a 
                substantial portion of such individual's life, or 
                attended high school in a federally designated rural or 
                nonmetropolitan area.
            ``(2) Establishment.--The Secretary shall make awards in 
        accordance with this section.
    ``(b) Infrastructure Development Award.--
            ``(1) In general.--The Secretary shall make awards to 
        eligible entities to enable such entities to initiate health 
        care workforce educational programs or to continue to carry out 
        comparable programs that are operating at the time the award is 
        made by planning, developing, operating, and evaluating of an 
        area health education center program.
            ``(2) Eligible entity.--For purposes of this subsection, an 
        `eligible entity' means a school of medicine or osteopathic 
        medicine, an incorporated consortium of such schools, or the 
        parent institutions of such a school. With respect to a State 
        in which no area health education center program is in 
        operation, the Secretary may award a grant or contract under 
        paragraph (1) to a school of nursing.
            ``(3) Application.--An eligible entity desiring to receive 
        an award under this subsection shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(4) Use of funds.--
                    ``(A) Required activities.--An eligible entity 
                shall use amounts awarded under a grant under paragraph 
                (1) to carry out the following activities:
                            ``(i) Develop and implement strategies to 
                        recruit individuals from underrepresented 
                        minority populations or from disadvantaged or 
                        rural backgrounds into health professions, and 
                        support such individuals in attaining such 
                        careers.
                            ``(ii) Develop and implement strategies to 
                        foster and provide community-based training and 
                        education to individuals seeking careers in 
                        health professions within underserved areas for 
                        the purpose of developing and maintaining a 
                        diverse health care workforce that is prepared 
                        to deliver high-quality care, with an emphasis 
                        on primary care, in underserved areas or for 
                        health disparity populations, in collaboration 
                        with other Federal and State health care 
                        workforce development programs, and in health 
                        care safety net sites.
                            ``(iii) Prepare individuals to more 
                        effectively provide health services to 
                        underserved areas and health disparity 
                        populations through field placements or 
                        preceptorships in conjunction with community-
                        based organizations, accredited primary care 
                        residency training programs, Federally 
                        qualified health centers, rural health clinics, 
                        public health departments, or other appropriate 
                        facilities.
                            ``(iv) Conduct and participate in 
                        interdisciplinary training that involves 
                        physicians, physician assistants, nurse 
                        practitioners, nurse midwives, dentists, 
                        psychologists, pharmacists, public health, or 
                        other health professionals, as practicable.
                            ``(v) Deliver or facilitate continuing 
                        education and information dissemination 
                        programs for health care professionals, with an 
                        emphasis on individuals providing care in 
                        underserved areas and for health disparity 
                        populations.
                            ``(vi) Propose and implement effective 
                        program and outcomes measurement and evaluation 
                        strategies.
                    ``(B) Innovative opportunities.--An eligible entity 
                may use amounts awarded under a grant under paragraph 
                (1) to carry out any of the following activities:
                            ``(i) Develop and implement innovative 
                        curricula in collaboration with community-based 
                        accredited primary care residency training 
                        programs, Federally qualified health centers, 
                        rural health clinics, behavioral and mental 
                        health facilities, public health departments, 
                        or other appropriate facilities, with the goal 
                        of increasing the number of primary care 
                        physicians and other primary care providers 
                        prepared to serve in underserved areas and 
                        health disparity populations.
                            ``(ii) Coordinate community-based 
                        participatory research with academic health 
                        centers, and facilitate rapid flow and 
                        dissemination of evidence-based health care 
                        information, research results, and best 
                        practices to improve quality, efficiency, and 
                        effectiveness of health care and health care 
                        systems within community settings.
                            ``(iii) Develop and implement other 
                        strategies to address identified workforce 
                        needs and increase and enhance the health care 
                        workforce in the area served by the area health 
                        education center program.
    ``(c) Point of Service Maintenance and Enhancement Award.--
            ``(1) In general.--The Secretary shall make awards to 
        eligible entities to maintain and improve the effectiveness and 
        capabilities of an existing area health education center 
        program, and make other modifications to the program that are 
        appropriate due to changes in demographics, needs of the 
        populations served, or other similar issues affecting the 
        program.
            ``(2) Eligible entity.--For purposes of this subsection, 
        the term `eligible entity' means an entity that has received 
        funds under this section (as this section was in effect on the 
        day before the date of enactment of the Health Professions and 
        Primary Care Reinvestment Act), is operating an area health 
        education center program, including area health education 
        centers, and has a center or centers that are no longer 
        eligible to receive financial assistance under subsection (b).
            ``(3) Application.--An eligible entity desiring to receive 
        an award under this subsection shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(4) Use of funds.--
                    ``(A) Required activities.--An eligible entity 
                shall use amounts awarded under a grant under paragraph 
                (1) to carry out the following activities:
                            ``(i) Develop and implement strategies to 
                        recruit individuals from underrepresented 
                        minority groups, underserved areas, or with 
                        rural backgrounds into health care careers, and 
                        support such individuals in attaining such 
                        careers.
                            ``(ii) Develop and implement strategies to 
                        foster and provide community-based training and 
                        education to individuals seeking careers in 
                        health professions within underserved areas for 
                        the purpose of developing and maintaining a 
                        diverse health care workforce that is prepared 
                        to deliver high-quality care, with an emphasis 
                        on primary care, in underserved areas and to 
                        health disparity populations, in collaboration 
                        with other Federal and State health care 
                        workforce development programs, and in health 
                        care safety net sites.
                            ``(iii) Prepare individuals to more 
                        effectively provide health services to 
                        underserved areas or health disparity 
                        populations through field placements or 
                        preceptorships in conjunction with community-
                        based organizations, accredited primary care 
                        residency training programs, Federally 
                        qualified health centers, rural health clinics, 
                        behavioral and mental health facilities, public 
                        health departments, or other appropriate 
                        facilities.
                            ``(iv) Conduct and participate in 
                        interdisciplinary training that involves 
                        physicians, physician assistants, nurse 
                        practitioners, nurse midwives, dentists, 
                        psychologists, pharmacists, public health, or 
                        other health professionals, as practicable.
                            ``(v) Deliver or facilitate continuing 
                        education and information dissemination 
                        programs for health care professionals, with an 
                        emphasis on individuals providing care in 
                        underserved areas and for health disparity 
                        populations.
                            ``(vi) Propose and implement effective 
                        program and outcomes measurement and evaluation 
                        strategies.
                    ``(B) Innovative opportunities.--An eligible entity 
                shall use amounts awarded under a grant under paragraph 
                (1) to carry out at least 1 of the following 
                activities:
                            ``(i) Develop innovative curricula in 
                        collaboration with community-based accredited 
                        primary care residency training programs, 
                        Federally qualified health centers, rural 
                        health clinics, behavioral and mental health 
                        facilities, public health departments, or other 
                        appropriate facilities, with the goal of 
                        increasing the number of primary care 
                        physicians and other primary care providers 
                        prepared to serve in underserved areas and 
                        health disparity populations.
                            ``(ii) Coordinate community-based 
                        participatory research with academic health 
                        centers, and facilitate rapid flow and 
                        dissemination of evidence-based health care 
                        information, research results, and best 
                        practices to improve quality, efficiency, and 
                        effectiveness of health care and health care 
                        systems within community settings.
                            ``(iii) Develop and implement other 
                        strategies to address identified workforce 
                        needs and increase and enhance the health care 
                        workforce in the area served by the area health 
                        education center program.
    ``(d) Requirements.--
            ``(1) Area health education center program.--In carrying 
        out this section, the Secretary shall ensure the following:
                    ``(A) An entity that receives an award under this 
                section shall conduct at least 10 percent of clinical 
                education required for medical students in community 
                settings that are removed from the primary teaching 
                facility of the contracting institution for grantees 
                that operate a school of medicine or osteopathic 
                medicine. In States in which an entity that receives an 
                award under this section is a nursing school or its 
                parent institution, the Secretary shall alternatively 
                ensure that--
                            ``(i) the nursing school places at least 10 
                        percent of its students in training sites 
                        affiliated with an area health education center 
                        that is remote from the primary teaching 
                        facility of the school; and
                            ``(ii) the entity receiving the award 
                        maintains a written agreement with a school of 
                        medicine or osteopathic medicine to place 
                        students from that school in training sites in 
                        the area health education center program area.
                    ``(B) An entity receiving funds under subsection 
                (c) does not distribute such funding to a center that 
                is eligible to receive funding under subsection (b).
            ``(2) Area health education center.--The Secretary shall 
        ensure that each area health education center program includes 
        at least 1 area health education center, and that each such 
        center--
                    ``(A) is a public or private organization whose 
                structure, governance, and operation is independent 
                from the awardee and the parent institution of the 
                awardee;
                    ``(B) is not a school of medicine or osteopathic 
                medicine, the parent institution of such a school, or a 
                branch campus or other subunit of a school of medicine 
                or osteopathic medicine or its parent institution, or a 
                consortium of such entities;
                    ``(C) designates an underserved area or population 
                to be served by the center which is in a location 
                removed from the main location of the teaching 
                facilities of the schools participating in the program 
                with such center and does not duplicate, in whole or in 
                part, the geographic area or population served by any 
                other center;
                    ``(D) fosters networking and collaboration among 
                communities and between academic health centers and 
                community-based centers;
                    ``(E) serves communities with a demonstrated need 
                of health professionals in partnership with academic 
                medical centers;
                    ``(F) addresses the health care workforce needs of 
                the communities served;
                    ``(G) has a community-based governing or advisory 
                board that reflects the diversity of the communities 
                involved;
                    ``(H) addresses changes in local community health 
                and demographics identified in--
                            ``(i) a community health needs assessment 
                        that was conducted by the area health education 
                        center through a grant awarded under section 
                        748(a); or
                            ``(ii) a community health needs assessment 
                        that was conducted by such center through other 
                        means and that meets the requirements of 
                        section 748(a); and
                    ``(I) evaluates and reports to the Secretary, in 
                collaboration with the area health education center 
                program of which the center is a part, concerning the 
                effectiveness of the center on an annual basis.
    ``(e) Duties of the Secretary.--In carrying out this section, the 
Secretary shall--
            ``(1) require collaboration--
                    ``(A) among the pertinent workforce programs under 
                this title and the Department of Health and Human 
                Services; and
                    ``(B) among such pertinent programs administered by 
                the Department of Labor and the Department of 
                Education;
            ``(2) use and adequately support existing programs to 
        address new initiatives of the Department of Health and Human 
        Services, as appropriate;
            ``(3) take into consideration capabilities of existing 
        programs prior to establishing separate or parallel programs; 
        and
            ``(4) evaluate and publicly report on the effectiveness of 
        such programs on an annual basis.
    ``(f) Matching Funds.--With respect to the costs of operating a 
program through a grant under this section, to be eligible for 
financial assistance under this section, an entity shall make available 
(directly or through contributions from State, county or municipal 
governments, or the private sector) recurring non-Federal contributions 
in cash or in kind, toward such costs in an amount that is equal to not 
less than 50 percent of such costs. At least 25 percent of the total 
required non-Federal contributions shall be in cash. An entity may 
apply to the Secretary for a waiver of not more than 75 percent of the 
matching fund amount required by the entity for each of the first 3 
years the entity is funded through a grant under subsection (b).
    ``(g) Limitation.--Not less than 75 percent of the total amount 
provided to an area health education center program under subsection 
(b) or (c) shall be allocated to the area health education centers 
participating in the program under this section. To provide needed 
flexibility to newly funded area health education center programs, the 
Secretary may waive the requirement in the sentence for the first 2 
years of a new area health education center program funded under 
subsection (b).
    ``(h) Award.--An award to an entity under this section shall be not 
less than $250,000 annually per area health education center included 
in the program involved. If amounts appropriated to carry out this 
section are not sufficient to comply with the preceding sentence, the 
Secretary may reduce the per center amount provided for in such 
sentence as necessary, provided the distribution established in 
subsection (l)(2) is maintained.
    ``(i) Project Terms.--
            ``(1) In general.--Except as provided in paragraph (2), the 
        period during which payments may be made under an award under 
        subsection (b) may not exceed--
                    ``(A) in the case of a program, 12 years; or
                    ``(B) in the case of a center within a program, 6 
                years.
            ``(2) Exception.--The periods described in paragraph (1) 
        shall not apply to programs receiving point of service 
        maintenance and enhancement awards under subsection (c) to 
        maintain existing centers and activities.
    ``(j) Inapplicability of Provision.--Notwithstanding any other 
provision of this title, section 791(a) shall not apply to an area 
health education center funded under this section.
    ``(k) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section $125,000,000 for each of the fiscal 
        years 2009 through 2013.
            ``(2) Requirements.--Of the amounts appropriated for a 
        fiscal year under subparagraph (A)--
                    ``(A) not more than 35 percent shall be used for 
                awards under subsection (b);
                    ``(B) not less than 60 percent shall be used for 
                awards under subsection (c);
                    ``(C) not more than 1 percent shall be used for 
                grants and contracts to implement outcomes evaluation 
                for the area health education centers; and
                    ``(D) not more than 4 percent shall be used for 
                grants and contracts to provide technical assistance to 
                entities receiving awards under this section.
            ``(3) Carryover funds.--An entity that receives an award 
        under this section may carry over funds from 1 fiscal year to 
        another without obtaining approval from the Secretary. In no 
        case may any funds be carried over pursuant to the preceding 
        sentence for more than 3 years.
    ``(l) Sense of Congress.--It is the sense of the Congress that 
every State have an area health education center program in effect 
under this section.''.
    (b) Continuing Educational Support for Health Professionals Serving 
in Underserved Communities.--Part D of title VII (42 U.S.C. 294 et 
seq.) is amended by striking section 752 and inserting the following:

``SEC. 752. CONTINUING EDUCATIONAL SUPPORT FOR HEALTH PROFESSIONALS 
              SERVING IN UNDERSERVED COMMUNITIES.

    ``(a) In General.--The Secretary shall make grants to, and enter 
into contracts with, eligible entities to improve health care, increase 
retention, increase representation of minority faculty members, enhance 
the practice environment, and provide information dissemination and 
educational support to reduce professional isolation through the timely 
dissemination of research findings using relevant resources.
    ``(b) Eligible Entities.--For purposes of this section, the term 
`eligible entity' means an entity described in section 799(b).
    ``(c) Application.--An eligible entity desiring to receive an award 
under this section shall submit to the Secretary an application at such 
time, in such manner, and containing such information as the Secretary 
may require.
    ``(d) Use of Funds.--An eligible entity shall use amounts awarded 
under a grant or contract under this section to provide innovative 
supportive activities to enhance education through distance learning, 
continuing educational activities, collaborative conferences, and 
electronic and telelearning activities, with preference for primary 
care, including physician assistants, general and pediatric dental 
providers, psychologists, and other mental health providers, and 
physicians teaching in federally designated underserved areas.
    ``(e) Authorization.--There is authorized to be appropriated to 
carry out this section $5,000,000 for each of the fiscal years 2009 
through 2014, and such sums as may be necessary for each subsequent 
fiscal year.''.

SEC. 9. GERIATRICS EDUCATION AND TRAINING.

    (a) Geriatric Education Centers.--Section 753(a) (42 U.S.C. 
294c(a)) is amended--
            (1) in paragraph (1), by striking ``in paragraphs (1), (3), 
        or (4) of section 799B, and section 801(2),'' and inserting 
        ``in paragraph (1), (3), or (4) of section 799B and section 
        801(2), health paraprofessional programs, community health 
        worker programs, and programs for informal caregivers,'';
            (2) in paragraph (2)--
                    (A) in subparagraph (A), by inserting ``allied 
                health professionals, community health workers, and 
                informal caregivers'' after ``health professionals'';
                    (B) in subparagraph (D), by inserting ``allied 
                health professionals, community health workers, and 
                informal caregivers'' after ``health professionals''; 
                and
                    (C) in subparagraph (E), by striking ``and senior 
                centers'' and inserting ``or senior centers''; and
            (3) by adding at the end the following:
            ``(3) Term of grant.--The term of any award made under this 
        subsection shall not exceed 5 years.
            ``(4) Data collections and reporting.--
                    ``(A) Submission to center.--Each entity that 
                receives an award under this subsection shall submit to 
                the National Health Workforce Analysis Center 
                established under section 761, standardized and 
                specific workforce data, as determined by the Secretary 
                and in a form and manner specified by the Secretary.
                    ``(B) Annual report to congress.--Such National 
                Health Workforce Analysis Center shall, on an annual 
                basis, submit to Congress and the Secretary a report 
                the describes the information received by such Center 
                under subparagraph (A) during the previous year.''.
    (b) Geriatric Training Regarding Physicians, Dentists, and the 
Health Professions.--Section 753(b) (42 U.S.C. 294c(b)) is amended--
            (1) in the subsection heading, by striking ``Physicians and 
        Dentists'' and inserting ``Physicians, Dentists, and the Health 
        Professions''; and
            (2) by striking paragraph (1) and inserting the following:
            ``(1) In general.--The Secretary may make grants to, and 
        enter into contracts with, schools of medicine, schools of 
        osteopathic medicine, academic dental institutions, teaching 
        hospitals, physician assistant education programs, graduate 
        medical or dental education programs, and graduate programs in 
        behavioral or mental health, for the purpose of providing 
        support (including internships, residencies, traineeships, and 
        fellowships) for geriatric training projects to train 
        physicians, physician assistants, dentists, and behavioral and 
        mental health professionals who plan to teach geriatric 
        medicine, geriatric behavioral or mental health, or geriatric 
        dentistry.''.
    (c) Geriatric Academic Career Awards.--Section 753(c) (42 U.S.C. 
294c(c)) is amended by striking paragraph (1) through paragraph (3) and 
inserting the following:
            ``(1) Establishment of program.--The Secretary shall 
        establish a program to provide Geriatric Academic Career Awards 
        to eligible entities to promote the career development of 
        individuals as academic geriatricians or gerontologists.
            ``(2) Eligible entity.--
                    ``(A) In general.--For purposes of this section, 
                the term `eligible entity' means an entity described in 
                section 799(b).
                    ``(B) Awards to individuals from eligible 
                entities.--An eligible entity shall provide funding to 
                an individual through a grant received under this 
                section only if such individual--
                            ``(i) is board certified or board eligible 
                        in internal medicine, family medicine, or 
                        psychiatry, or is a certified and licensed 
                        nurse, pharmacist, psychologist, social worker, 
                        or physician assistant, employed by an approved 
                        school;
                            ``(ii) has completed an approved internship 
                        or fellowship program in geriatrics; and
                            ``(iii) has a junior or midlevel faculty 
                        appointment at an accredited (as determined by 
                        the Secretary) school of medicine or 
                        osteopathic medicine, physician assistant 
                        education program, or graduate program in 
                        behavioral or mental health.
            ``(3) Limitations.--No Award under paragraph (1) may be 
        made to an eligible entity unless the entity--
                    ``(A) has submitted to the Secretary an 
                application, at such time, in such manner, and 
                containing such information as the Secretary may 
                require, and the Secretary has approved such 
                application; and
                    ``(B) provides, in such form and manner as the 
                Secretary may require, assurances that the entity will 
                provide funding only to individuals associated with 
                such entity that will meet the service requirement 
                described in paragraph (5).''.
    (d) Authorization of Appropriations.--Section 753 is (42 U.S.C. 
294c) is amended by adding at the end the following:
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $50,000,000 for each of the 
fiscal years 2009 through 2013.''.
    (e) Other Provisions.--
            (1) Rural interdisciplinary training.--Title VII (42 U.S.C. 
        292 et seq.) is amended by striking section 754.
            (2) Allied health and other disciplines.--Section 755 (42 
        U.S.C. 294e) is amended--
                    (A) in subsection (a) by striking ``may make'' and 
                inserting ``shall make'';
                    (B) in subsection (b)(1)--
                            (i) in subparagraph (H), by striking the 
                        semicolon at the end and inserting ``; and'';
                            (ii) in subparagraph (I) by striking 
                        ``necessary; and'' and inserting a period; and
                            (iii) striking subparagraph (J); and
                    (C) by adding at the end the following:
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $12,000,000 for each of the 
fiscal years 2009 through 2013.''.

SEC. 10. TRAINING IN GRADUATE PSYCHOLOGY EDUCATION.

    (a) In General.--Part D of title VII (42 U.S.C. 294 et seq.) is 
amended by--
            (1) striking section 757;
            (2) redesignating section 756 as section 757; and
            (3) inserting after section 755 the following:

``SEC. 756. TRAINING IN GRADUATE PSYCHOLOGY EDUCATION.

    ``(a) In General.--The Secretary may award grants, cooperative 
agreements and contracts to accredited graduate programs of psychology 
including public or nonprofit private hospitals for the development and 
implementation of interdisciplinary training of psychology graduate 
students for providing behavioral and mental health services. Such 
training shall focus on the needs of vulnerable groups such as older 
adults and children, individuals with mental health or substance-
related disorders, victims of abuse or trauma and of combat stress 
disorders such as posttraumatic stress disorder and traumatic brain 
injuries, homeless individuals, chronically ill persons, and their 
families.
    ``(b) Program Sites.--Training under subsection (a) may be provided 
through accredited graduate programs of psychology including public or 
nonprofit private hospitals and such other sites as the Secretary 
determines to be appropriate.
    ``(c) Evaluation of Programs.--The Secretary shall directly or 
through grants or contracts provide for the evaluation of programs 
implemented under subsection (a) in order to determine the effect of 
such programs on increasing the number of psychologists who provide 
behavioral and mental health services to identified underserved areas 
or health disparity populations.
    ``(d) Authorization of Appropriation.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of the 
fiscal years 2009 through 2013.''.
    (b) Conforming Amendments.--Section 757(b)(2), as redesignated by 
subsection (a), is amended by striking ``sections 751(a)(1)(A), 
751(a)(1)(B), 753(b), 754(3)(A), and 755(b)'' and inserting ``sections 
751(b), 753(b), and 755(b)''.

SEC. 11. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.

    (a) In General.--Section 761 (42 U.S.C. 294n) is amended--
            (1) by redesignating subsection (c) as subsection (e);
            (2) by striking subsection (b) and inserting the following:
    ``(b) National Center for Health Workforce Analysis.--
            ``(1) Establishment.--The Secretary shall establish the 
        National Center for Health Workforce Analysis within the 
        Department of Health and Human Services. The Secretary shall 
        appoint a Director in consultation with the Advisory Committee 
        on Health Workforce Information, Evaluation, and Assessment 
        established under section 764 (in this section referred to as 
        the `Committee').
            ``(2) In general.--The National Center for Health Workforce 
        Analysis shall--
                    ``(A) carry out the duties of the Secretary under 
                section 792(a); and
                    ``(B) collect, analyze, and report data regarding 
                workforce issues, as determined appropriate by the 
                Committee in coordination with the Regional Centers 
                designated under subsection (c).
            ``(3) Functions.--The National Center for Health Workforce 
        Analysis shall--
                    ``(A) describe and evaluate the effectiveness of 
                the programs under this part, and under other sections 
                of this title determined relevant by the Committee, 
                including evaluating and reporting on workforce 
                diversity, distribution in underserved areas and for 
                health disparity populations, primary care capacity and 
                other needs, including the establishment of benchmarks 
                for such programs;
                    ``(B) use grantee data and data collected from 
                regional workforce analysis centers designated under 
                subsection (c) in conjunction with National DataNet to 
                regularly evaluate program performance through--
                            ``(i) comparing benchmarks;
                            ``(ii) assessing the effectiveness of 
                        programs in meeting the specified goals of this 
                        title; and
                            ``(iii) tracking recognized subspecialties 
                        of the physician and dentistry workforce and 
                        nonphysician providers including physician 
                        assistants, advance practice nurses, 
                        psychologists, pharmacists, public health 
                        workers, and other professionals as appropriate 
                        by measuring and reporting on changes in 
                        workforce production and distribution, and 
                        population health;
                    ``(C) produce and report to the relevant committees 
                of Congress an estimate of the supply and need for 
                physicians, nurses, dentists, psychologists, 
                pharmacists, and other health professionals, as 
                directed by the Committee, that--
                            ``(i) uses the best available methods for 
                        estimating supply and needs;
                            ``(ii) provides that any models or 
                        statistical software be subject to review and 
                        made available to the public; and
                            ``(iii) is routinely (such as biennially) 
                        compiled and reported for physicians 
                        alternating with other professions;
                    ``(D) maintain uniform data sets in coordination 
                with, and responsive to, the regional centers 
                designated under subsection (c) that--
                            ``(i) can be used to estimate State and 
                        county supply and needs of physicians, nurses, 
                        dentists, and other health professionals;
                            ``(ii) can be used to develop in the 
                        identification of health professional shortage 
                        areas and medically underserved areas; and
                            ``(iii) shall be updated and made available 
                        to the public via the Internet or other 
                        electronic means; and
                    ``(E) collaborate with agencies in the Department 
                of Health and Human Services, the Department of Labor, 
                and the Department of Education in data collection and 
                maintenance of uniform data sets as determined 
                appropriate by the Secretary and the Committee.
            ``(4) Report.--On biennial basis, the Director shall submit 
        to the relevant Congressional committees a report on the 
        activities, information gathered, and findings of the Center 
        during the previous 2-year period.
    ``(c) Regional Centers for Workforce Analysis.--
            ``(1) Establishment.--The Secretary shall designate 6 to 10 
        entities described in paragraph (2) as regional workforce 
        analysis centers.
            ``(2) Entities.--An entity described in this paragraph 
        shall be a public health or health professions school, an 
        academic health center, or other appropriate public or private 
        nonprofit entity or partnerships of such entities determined by 
        the Secretary to be capable of carrying out the functions 
        described in paragraph (3).
            ``(3) Functions.--An entity designated under this 
        subsection shall--
                    ``(A) function cooperatively with the national and 
                other regional centers to--
                            ``(i) collect data on programs carried out 
                        under this part, and under other sections of 
                        this title determined relevant by the 
                        Committee, in a consistent manner;
                            ``(ii) develop and maintain standardized 
                        approaches toward reporting conformity across 
                        regional centers;
                            ``(iii) collaborate with the National 
                        Center for Health Workforce Analysis, the 
                        Committee, and other regional centers, on the 
                        development and distribution of regional and 
                        national studies and reports to a wide 
                        audience, including policymakers;
                            ``(iv) coordinate with identified local and 
                        regional sources of health professionals 
                        workforce data, such as State workforce 
                        commissions, for reporting to national level; 
                        and
                            ``(v) develop program evaluations and 
                        assessments, as described in subsection (b);
                    ``(B) serve as a regional resource for monitoring 
                the impact of policies and programs on the healthcare 
                workforce, including--
                            ``(i) developing and maintaining a 
                        nongovernment analytic and research 
                        infrastructure related to the purposes 
                        described in subsection (b); and
                            ``(ii) working with States and State 
                        agencies, including State primary care offices 
                        and State workforce commissions, to identify 
                        areas that qualify as shortage designations and 
                        supporting the development of such shortage 
                        designation requests; and
                    ``(C) provide technical assistance to local and 
                regional entities on data collection and analysis 
                related to healthcare workforce issues, including--
                            ``(i) supporting studies that lead to 
                        understanding the impact of a diverse workforce 
                        on health outcomes, both descriptive and 
                        analytic;
                            ``(ii) supporting studies that lead to 
                        understanding the impact of the primary care 
                        workforce on health outcomes, both descriptive 
                        and analytic; and
                            ``(iii) supporting studies that lead to 
                        understanding the impact of geographic 
                        distribution on health outcomes, both 
                        descriptive and analytic; and
                    ``(D) initiate and conduct research on high-
                priority health workforce questions, in accordance with 
                subparagraph (A).
            ``(4) Grants or contracts to conduct research.--
                    ``(A) In general.--The Secretary shall award grants 
                or contracts to regional centers for workforce analysis 
                for the conduct of research on high-priority workforce 
                questions described in paragraph (3)(D), including--
                            ``(i) national studies on emerging issues;
                            ``(ii) State health workforce profiles; and
                            ``(iii) future health workforce issues and 
                        trends.
                    ``(B) Duration of award.--The period during which 
                payments are made to an entity from an award of a grant 
                or contract under this paragraph shall not exceed 3 
                years.
                    ``(C) Dissemination of information.--Amounts 
                awarded under this paragraph shall include amounts 
                necessary for the dissemination of reports produced 
                pursuant to the award.
    ``(d) Grants To Assess and Monitor the Supply and Need of Health 
Professionals.--
            ``(1) In general.--The Secretary shall award grants to, and 
        enter into contracts with, eligible entities for the purpose of 
        monitoring the supply, need for, and diversity and distribution 
        of, physicians, psychologists, dentists, physician assistants, 
        and other health professionals as determined by, and based on 
        health workforce needs assessments provided by the National 
        Center for Health Workforce Analysis under subsection (b).
            ``(2) Eligible entity.--For purposes of this subsection, 
        the term `eligible entity' means an entity described in section 
        799(b) and regional centers for health workforce analysis under 
        subsection (c).
            ``(3) Application.--To be eligible for a grant or contract 
        under paragraph (1), an entity shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(4) Use of funds.--An entity shall use amounts awarded 
        under a grant or contract under this subsection to collaborate 
        with the National and regional centers under subsections (b) 
        and (c) to conduct research on workforce issues, as determined 
        by the Director of the National Center for Health Workforce 
        Analysis in consultation with the Committee. Such research 
        shall include--
                    ``(A) collecting, analyzing, and reporting data 
                pertinent to State and regional workforce issues that 
                may contribute to the national understanding of 
                workforce supply and need;
                    ``(B) setting up and monitoring data sets 
                appropriate to specific workforce supply and need; and
                    ``(C) other projects as deemed appropriate by such 
                Director and Committee.''; and
            (3) in subsection (e) (as so redesignated)--
                    (A) by striking paragraph (1) and inserting the 
                following:
            ``(1) In general.--
                    ``(A) National center for workforce analysis.--
                There are authorized to be appropriated to carry out 
                subsection (b) (to fund the National Center for 
                Workforce Analysis), $1,000,000 for each of the fiscal 
                years 2009 through 2013, and such sums as may be 
                necessary for each fiscal year thereafter.
                    ``(B) Regional centers.--There are authorized to be 
                appropriated $4,500,000 to carry out subsection (c) (to 
                fund each of the regional centers), an amount not to 
                exceed $750,000 for each of the centers for each of the 
                fiscal years 2009 through 2013, and such sums as may be 
                necessary for each fiscal year thereafter.
                    ``(C) Awards to conduct research.--There are 
                authorized to be appropriated to carry out subsection 
                (c)(4), $2,000,000 for each of the fiscal years 2009 
                through 2013. Any amount appropriated pursuant to the 
                preceding sentence shall be in addition to any amount 
                appropriated pursuant to subparagraph (B).
                    ``(D) Awards to assess and monitor the supply and 
                need of health professionals.--There are authorized to 
                be appropriated to carry out subsection (d), $1,000,000 
                for each of the fiscal years 2009 through 2013, and 
                such sums as may be necessary for each fiscal year 
                thereafter.
                    ``(E) Carryover funds.--An entity that receives an 
                award under this section may carry over funds from 1 
                fiscal year to another without obtaining approval from 
                the Secretary. In no case may any funds be carried over 
                pursuant to the preceding sentence for more than 3 
                years.''; and
                    (B) in paragraph (2), by striking ``subsection 
                (a)'' and inserting ``paragraph (1)''.
    (b) Transfer of Functions.--Not later than 180 days after the date 
of enactment of this Act, all of the functions and authorities carried 
out by the National Center for Health Workforce Analysis of the Health 
Resources and Services Administration as in effect on the day before 
the date of enactment of this Act shall be transferred to the National 
Center for Health Workforce Analysis established under section 761(b) 
of the Public Health Service Act (as amended by subsection (a)).

SEC. 12. HEALTH WORKFORCE INFORMATION, EVALUATION, AND ASSESSMENT.

    (a) Health Professional Workforce Information and Analysis.--
Subpart 1 of part E of title VII (42 U.S.C. 294n et seq.) is amended by 
adding at the end the following:

``SEC. 764. HEALTH WORKFORCE INFORMATION, EVALUATION, AND ASSESSMENT.

    ``(a) Advisory Committee.--The Secretary shall establish an 
advisory committee to be known as the Advisory Committee on Health 
Workforce Information, Evaluation, and Assessment (referred to in this 
section as the `Advisory Committee').
    ``(b) Membership.--
            ``(1) In general.--The Secretary shall determine the 
        appropriate number of individuals to serve on the Advisory 
        Committee, which shall include--
                    ``(A) the Director of Health Resources and Services 
                Administration (or his or her designee);
                    ``(B) the Director of the National Health Service 
                Corps (or his or her designee);
                    ``(C) a director of an area health education center 
                program or area health education center under section 
                751;
                    ``(D) the chairperson of the Accreditation Council 
                on Graduate Medical Education;
                    ``(E) the Director of the National Center for 
                Healthcare Workforce Analysis;
                    ``(F) the Chair of the National Advisory Council on 
                Nurse Education and Practice;
                    ``(G) at least 1 representative of--
                            ``(i) the Department of Labor;
                            ``(ii) the Department of Education;
                            ``(iii) the Advisory Committee on Training 
                        in Primary Care Medicine and Dentistry;
                            ``(iv) a regional workforce analysis center 
                        designated under section 761(c); and
                            ``(v) a State-level primary care 
                        organization; and
                    ``(H) one representative from each of the 
                practicing clinical professions described in paragraph 
                (2).
            ``(2) Practicing clinical professions.--The practicing 
        clinical professions described in this paragraph include--
                    ``(A) one of each of the physician specialties 
                representing primary care including family medicine, 
                pediatrics, general internal medicine, and general 
                geriatrics;
                    ``(B) physician assistants;
                    ``(C) general or pediatric dental professionals;
                    ``(D) psychology professionals;
                    ``(E) nursing professionals;
                    ``(F) pharmacy professionals;
                    ``(G) public health professionals; and
                    ``(H) preventive medicine physicians.
            ``(3) Requirements.--In providing for the membership of the 
        Advisory Committee, the Secretary shall ensure that--
                    ``(A) the members adequately represent urban and 
                federally designated rural and nonmetropolitan areas 
                from throughout the Nation and that there is at least 1 
                clinical professional representing a rural and an urban 
                Federally qualified health center;
                    ``(B) the members adequately represent 
                underrepresented populations in the health professions; 
                and
                    ``(C) the members are selected based on competence, 
                interest, and knowledge of the mission and professions 
                involved.
            ``(4) Initial appointment.--The Secretary shall make the 
        initial appointment under this section of members to the 
        Advisory Committee in consultation with the Comptroller General 
        of the United States.
            ``(5) Chairperson.--The chairperson of the Advisory 
        Committee shall be selected by a vote of the members of the 
        Committee.
            ``(6) Terms.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), each member of the Advisory Committee 
                shall be appointed for a period of 3 years.
                    ``(B) Staggered terms.--Of the members first 
                appointed to the Advisory Committee under paragraph 
                (4)--
                            ``(i) \1/3\ shall be appointed for a period 
                        of 1 year;
                            ``(ii) \1/3\ shall be appointed for a 
                        period of 2 years; and
                            ``(iii) \1/3\ shall be appointed for a 
                        period of 3 years.
    ``(c) Duties.--The Advisory Committee shall carry out the following 
activities:
            ``(1) Make recommendations regarding the classifications of 
        the health care workforce in collaboration with the Department 
        of Labor to ensure the consistency of data collection, and 
        update these recommendations at least every 5 years.
            ``(2) Make recommendations regarding standardized 
        methodology and procedures to enumerate the health care 
        workforce, and update these recommendations at least every 5 
        years.
            ``(3) Direct that adequate data be collected to evaluate 
        the impact on the distribution and deployment of the health 
        care workforce in settings such as Federally qualified health 
        centers, the National Health Service Corps, and to underserved 
        areas or populations.
            ``(4)(A) Make recommendations regarding standardized 
        measures and procedures for reporting, including reporting with 
        respect to--
                    ``(i) student entry and retention in the health 
                professions, with focus on primary care fields and 
                general dentistry;
                    ``(ii) increasing the diversity of the health 
                professional population;
                    ``(iii) improving the distribution of health 
                professionals in the United States;
                    ``(iv) strengthening the public health and health 
                care delivery infrastructure;
                    ``(v) providing access to care relative to 
                workforce distribution;
                    ``(vi) improving the quality of health care through 
                education, training, and collaboration with appropriate 
                entities to identify and define excellence in health 
                services delivery which is efficient, effective, 
                evidence-based, and timely and may include--
                            ``(I) community-based quality improvement 
                        and best practices networks;
                            ``(II) community-based participatory 
                        research networks;
                            ``(III) continuing professional education 
                        programs; and
                            ``(IV) distance learning technologies and 
                        methodologies;
                    ``(vii) practice improvement through the 
                implementation of new systems of care, such as health 
                information technology, chronic care models, 
                interdisciplinary and collaborative care, cultural 
                competency, and health literacy and other models; and
                    ``(viii) assessing the link between the pipeline 
                programs and staffing of health professional shortage 
                areas, medically underserved areas, and the National 
                Health Service Corps as well as other Federal safety 
                net programs.
            ``(B) Update the recommendations under subparagraph (A) at 
        least every 5 years.
            ``(5) Define successful performance outcome measures within 
        programs under this title.
            ``(6) Define processes by which funding recipients will 
        collaborate with regional workforce analysis centers under 
        section 761(c) to collect and share data with other such 
        centers for further analysis.
            ``(7) Other duties as deemed appropriate by the Secretary 
        in consultation with the Committee.
    ``(d) Working Groups and Subcommittees.--The Advisory Committee may 
establish working groups or other subcommittees to carry out functions 
determined to be appropriate by the Advisory Committee and the Chairman 
and meet separately for these purposes.
    ``(e) Meetings.--The full Advisory Committee shall meet at least 3 
times annually.
    ``(f) Termination.--The Advisory Committee shall not be terminated 
prior to the later of--
            ``(1) the date that is 5 years after the date of enactment 
        of this section; or
            ``(2) the date on which funding is not made available for 
        the Advisory Committee.
    ``(g) FACA.--The Federal Advisory Committee Act (5 U.S.C. App.) 
shall apply to the Advisory Committee under this section only to the 
extent that the provisions of such Act do not conflict with the 
requirements of this section.''.
    (b) Public Health Workforce General Provisions.--Section 765 (42 
U.S.C. 295) is amended--
            (1) in subsection (b)(1)(A), by striking ``or dental public 
        health'' and inserting ``dental public health, or behavioral 
        and mental health''; and
            (2) in subsection (d)--
                    (A) in paragraph (5)(A)--
                            (i) by inserting ``internship and'' after 
                        ``new'';
                            (ii) by inserting ``internship and'' after 
                        ``existing'';
                            (iii) by striking ``and dental public 
                        health, that'' and inserting ``, dental public 
                        health, and behavioral and mental health, 
                        that''; and
                            (iv) by striking ``and dental public 
                        health; and'' and inserting ``, dental public 
                        health, and behavioral and mental health; 
                        and'';
                    (B) in paragraph (5)(B), by inserting ``internship 
                and'' after ``assistance to''; and
                    (C) in paragraph (6), by inserting ``behavioral and 
                mental health,'' after ``public health dentistry,''

SEC. 13. FUNDING FOR DENTAL PUBLIC HEALTH AND PREVENTIVE MEDICINE.

    Section 768 (42 U.S.C. 295c) is amended by adding at the end the 
following:
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated--
            ``(1) for dental public health programs carried out under 
        this section--
                    ``(A) $1,000,000 for each of the fiscal years 2009 
                through 2013; and
                    ``(B) such sums as may be necessary for each fiscal 
                year thereafter; and
            ``(2) for public health (other than dental public health) 
        and preventive medicine programs carried out under this 
        section--
                    ``(A) $16,000,000 for each of the fiscal years 2009 
                through 2013; and
                    ``(B) such sums as may be necessary for each fiscal 
                year thereafter.''.

SEC. 14. ACADEMIC HEALTH DEPARTMENTS GRANT PROGRAM.

    Subpart 2 of part E (42 U.S.C. 295 et seq.) is amended by adding at 
the end the following:

``SEC. 771. ACADEMIC HEALTH DEPARTMENTS GRANT PROGRAM.

    ``(a) Establishment.--
            ``(1) In general.--In order to improve the training of 
        public health students, the Secretary, acting in conjunction 
        with the Director of the Centers for Disease Control and 
        Prevention and in consultation with the Association of Schools 
        of Public Health, shall carry out the Academic Health 
        Departments grant program (referred to in this section as the 
        `Program') under which the Secretary shall award competitive 
        grants, of not more than $250,000 each, to eligible 
        partnerships to establish Academic Health Departments.
            ``(2) Academic health department.--For purposes of this 
        section, the term `Academic Health Department' means a program 
        administered by an eligible partnership that provides for 
        collaboration between the academic and practice aspects of 
        public health. The purpose of such a department is to increase 
        the number of graduates in public health who work in State and 
        local health departments, increase the relevance of the 
        curriculum in schools and programs of public health to health 
        department practice, and to increase the use of academic 
        theories, knowledge, and methodologies in the work of health 
        departments.
    ``(b) Eligibility.--For purposes of this section, an eligible 
partnership is a partnership, with respect to establishing an Academic 
Health Department, consisting of--
            ``(1) a State or local public health department; and
            ``(2) an accredited school of public health or an 
        accredited public health degree program.
    ``(c) Use of Funds.--An eligible partnership described in 
subsection (b) may use funds provided under a grant made under 
subsection (a) for the following purposes, with respect to an Academic 
Health Department:
            ``(1) To conduct training needs assessment surveys.
            ``(2) To provide for curriculum development.
            ``(3) To provide for training and academic instruction.
            ``(4) To conduct leadership seminars.
            ``(5) To facilitate appropriate staff of the State or local 
        health department participating in the eligible partnership to 
        teach with the school of public health or public health degree 
        program participating in such partnership.
            ``(6) To facilitate faculty and students of the school of 
        public health or public health degree program participating in 
        the eligible partnership to work in the health department 
        participating in such partnership.
            ``(7) To provide for a project coordinator.
            ``(8) To provide for subgrants to organizations to conduct 
        activities consistent with the goals of the Program.
            ``(9) Other appropriate activities specified by the 
        Secretary to recruit public health students to full time 
        employment in a health department after graduation.
    ``(d) Reports.--
            ``(1) Grant recipient reports to the secretary.--Each 
        recipient of a grant awarded under subsection (a) shall submit 
        to the Secretary a report for each year for which the recipient 
        received such a grant on the results and outcomes of the 
        activities funded by such grant during such year.
            ``(2) Reports to congress.--For the 3-year period beginning 
        on the date of the establishment of the Program, and for each 
        subsequent 3-year period in which the Program is in existence, 
        the Secretary shall submit to Congress a report on the results 
        and outcomes of the Program during such 3-year period, 
        including the number of Academic Health Departments funded by 
        grants under the Program, the number of students trained 
        through grants under the Program, and the number of trainees 
        participating in such Academic Health Departments who remain in 
        public health professions.
            ``(3) Evaluation of program.--Not later than the date that 
        is 5 years after the date of the establishment of the Program, 
        the Secretary shall submit to Congress a report that examines 
        the results and outcomes of the Program and recommends the 
        extent to which the Program should be continued.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $4,000,000 for each of the 
fiscal years 2009 through 2013.''.

SEC. 15. DEFINITIONS.

    Section 799B (42 U.S.C. 295p) is amended--
            (1) by striking paragraph (3) and inserting the following:
            ``(3) Physician assistant education program.--The term 
        `physician assistant education program' means an educational 
        program in a public or private institution in a State that--
                    ``(A) has as its objective the education of 
                individuals who, upon completion of their studies in 
                the program, be qualified to provide primary care 
                medical services with the supervision of a physician; 
                and
                    ``(B) is accredited by the Accreditation Review 
                Commission on Education for the Physician Assistant.''; 
                and
            (2) by adding at the end the following:
            ``(12) Federally qualified health center.--The term 
        `Federally qualified health center' has the meaning given that 
        term in section 1861(aa) of the Social Security Act.
            ``(13) Rural health clinic.--The term `rural health clinic' 
        has the meaning given that term in section 1861(aa) of the 
        Social Security Act.
            ``(14) Cultural competency.--The term `culturally 
        competency'--
                    ``(A) with respect to health-related services, 
                means the ability to provide healthcare tailored to 
                meet the social, cultural, and linguistic needs of 
                patients from diverse backgrounds; and
                    ``(B) when used to describe education or training, 
                means education or training designed to prepare those 
                receiving the education or training to provide health-
                related services tailored to meet the social, cultural, 
                and linguistic needs of patients from diverse 
                backgrounds.
            ``(15) Health disparity population.--The term `health 
        disparity population' has the meaning given such term in 
        section 903(d)(1).
            ``(16) Health literacy.--The term `health literacy' means 
        the degree to which an individual has the capacity to obtain, 
        communicate, process, and understand health information 
        (including the register and language in which the information 
        is provided) and services in order to make appropriate health 
        decisions.
            ``(17) Indian.--The term `Indian' has the meaning given 
        such term in section 4 of the Indian Health Care Improvement 
        Act (25 U.S.C. 1603).
            ``(18) Minority group.--The term `minority group' has the 
        meaning given the term `racial and ethnic minority group' in 
        section 1707.''.
                                 <all>