[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3648 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 3648

  To amend title VII of the Public Health Service Act to increase the 
  number of physicians who practice in underserved rural communities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 24, 2009

  Mr. Salazar (for himself and Ms. Markey of Colorado) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title VII of the Public Health Service Act to increase the 
  number of physicians who practice in underserved rural communities.

    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 ``Rural Physician Pipeline Act of 
2009''.

SEC. 2. RURAL PHYSICIAN TRAINING GRANTS.

    Part C of title VII of the Public Health Service Act (42 U.S.C. 
293k et seq.) is amended--
            (1) after the part heading, by inserting the following:

               ``Subpart I--Medical Training Generally'';

        and
            (2) by inserting at the end the following:

           ``Subpart II--Training in Underserved Communities

``SEC. 749. RURAL PHYSICIAN TRAINING GRANTS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall establish a 
program to make grants to eligible entities for the purposes of--
            ``(1) assisting eligible entities in recruiting students 
        most likely to practice medicine in underserved rural 
        communities;
            ``(2) providing rural-focused training and experience; and
            ``(3) increasing the number of recent allopathic and 
        osteopathic medical school graduates who practice in 
        underserved rural communities.
    ``(b) Eligible Entities.--In order to be eligible to receive a 
grant under this section, an entity shall--
            ``(1) be a school of allopathic or osteopathic medicine 
        accredited by a nationally recognized accrediting agency or 
        association approved by the Secretary for this purpose, or any 
        combination or consortium of such schools; and
            ``(2) submit an application to the Secretary at such time, 
        in such form, and containing such information as the Secretary 
        may require, including a certification that such entity--
                    ``(A) will use amounts provided to the institution 
                to--
                            ``(i) establish and carry out a Rural 
                        Physician Training Program described in 
                        subsection (d);
                            ``(ii) improve an existing rural-focused 
                        training program to meet the requirements 
                        described in subsection (d) and carry out such 
                        program; or
                            ``(iii) expand and carry out an existing 
                        rural-focused training program that meets the 
                        requirements described in subsection (d); and
                    ``(B) employs, or will employ within a timeframe 
                sufficient to implement the Program (as described by a 
                timetable and supporting documentation in the 
                application of the eligible entity), faculty with 
                experience or training in rural medicine or with 
                experience in training rural physicians.
    ``(c) Priority.--In awarding grant funds under this section, the 
Secretary shall give priority to eligible entities that--
            ``(1) demonstrate a record of successfully training 
        students, as determined by the Secretary, who practice medicine 
        in underserved rural communities;
            ``(2) demonstrate that an existing academic program of the 
        eligible entity produces a high percentage, as determined by 
        the Secretary, of graduates from such program who practice 
        medicine in underserved rural communities;
            ``(3) demonstrate rural community institutional 
        partnerships, though such mechanisms as matching or 
        contributory funding, documented in-kind services for 
        implementation, or existence of training partners with 
        interprofessional expertise (such as dental, vision, or mental 
        health services) in community health center training locations 
        or other similar facilities; or
            ``(4) submit, as part of the application of the entity 
        under subsection (b), a plan for the long-term tracking of 
        where the graduates of such entity are practicing medicine.
    ``(d) Use of Funds.--
            ``(1) Establishment.--An eligible entity receiving a grant 
        under this section shall use the funds made available under 
        such grant to--
                    ``(A) establish and carry out a `Rural Physician 
                Training Program' (referred to in this section as the 
                `Program');
                    ``(B) improve an existing rural-focused training 
                program to meet the Program requirements described in 
                this subsection and carry out such program; or
                    ``(C) expand and carry out an existing rural-
                focused training program that meets the Program 
                requirements described in this subsection.
            ``(2) Structure of program.--An eligible entity shall--
                    ``(A) enroll no fewer than 10 students per class 
                year into the Program; and
                    ``(B) develop criteria for admission to the Program 
                that gives priority to students--
                            ``(i) who have originated from or lived for 
                        a period of 2 or more years in an underserved 
                        rural community; and
                            ``(ii) who express a commitment to practice 
                        medicine in an underserved rural community.
            ``(3) Curricula.--The Program shall require students to 
        enroll in didactic coursework and clinical experience 
        particularly applicable to medical practice in underserved 
        rural communities, including--
                    ``(A) clinical rotations in underserved rural 
                communities, and in specialties including family 
                medicine, internal medicine, pediatrics, surgery, 
                psychiatry, and emergency medicine;
                    ``(B) in addition to core school curricula, 
                additional coursework or training experiences focused 
                on medical issues prevalent in underserved rural 
                communities, including in areas such as trauma, 
                obstetrics, ultrasound, oral health, and behavioral 
                health; and
                    ``(C) any coursework or clinical experience that--
                            ``(i) may be developed as a result of the 
                        Symposium described in subsection (f); or
                            ``(ii) the Secretary finds appropriate.
            ``(4) Residency placement assistance.--Where available, the 
        Program shall assist all students of the Program in obtaining 
        clinical training experiences in locations with postgraduate 
        programs offering residency training opportunities in 
        underserved rural communities, or in local residency training 
        programs that support and train physicians to practice in 
        underserved rural communities, as well as assist all students 
        of the Program in obtaining postgraduate residency training in 
        such programs.
            ``(5) Program student cohort support.--The Program shall 
        provide and require all students of the Program to participate 
        in social, educational, and other group activities designed to 
        further develop, maintain, and reinforce the original 
        commitment of such students to practice in an underserved rural 
        community.
    ``(e) Annual Reporting Requirement.--On an annual basis, an 
eligible entity receiving a grant under this section shall submit a 
report to the Secretary on--
            ``(1) the overall success of the Program established by the 
        entity, based on criteria the Secretary determines appropriate;
            ``(2) the number of students participating in the Program;
            ``(3) the number of graduating students who participated in 
        the Program;
            ``(4) the residency program selection of graduating 
        students who participated in the Program;
            ``(5) the number of graduates who participated in the 
        Program who are practicing in underserved rural communities not 
        less than one year after completing residency training; and
            ``(6) the number of graduates who participated in the 
        Program who are not practicing in underserved rural communities 
        not less than one year after completing residency training.
    ``(f) Rural Training Program Symposium.--
            ``(1) Purposes of symposium.--To assist the Secretary in 
        carrying out the Program and making grant determinations under 
        this section, the Secretary shall convene a Rural Training 
        Program Symposium (referred to in this section as the 
        `Symposium') to--
                    ``(A) develop best practices that may be 
                incorporated into consideration of applications under 
                subsection (b); and
                    ``(B) establish a network of allopathic and 
                osteopathic medical schools that have developed or will 
                develop rural training programs in accordance with 
                subsection (d).
            ``(2) Composition.--The Symposium shall include--
                    ``(A) representatives from eligible entities with 
                existing rural training programs;
                    ``(B) representatives from all eligible entities 
                interested in developing the Program;
                    ``(C) representatives from area health education 
                centers;
                    ``(D) representatives from the Health Resources and 
                Services Administration; and
                    ``(E) any other experts or individuals with 
                experience in practicing medicine in underserved rural 
                communities the Secretary determines appropriate.
    ``(g) Regulations.--Not later than 60 days after the date of 
enactment of this section, the Secretary shall by regulation define 
`underserved rural community' for purposes of this section.
    ``(h) Supplement Not Supplant.--Any eligible entity receiving funds 
under this section shall use such funds to supplement, not supplant, 
any other Federal, State, and local funds that would otherwise be 
expended by such entity to carry out the activities described in this 
section.
    ``(i) Maintenance of Effort.--With respect to activities for which 
funds awarded under this section are to be expended, the entity shall 
agree 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 entity for the fiscal year preceding the 
fiscal year for which the entity receives a grant under this section.
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated--
            ``(1) to carry out this section (other than subsection 
        (f))--
                    ``(A) $4,000,000 for fiscal year 2010;
                    ``(B) $8,000,000 for fiscal year 2011;
                    ``(C) $12,000,000 for fiscal year 2012; and
                    ``(D) $16,000,000 for fiscal year 2013; and
            ``(2) to carry out subsection (f), such sums as may be 
        necessary.''.
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