II 111th CONGRESS 1st Session S. 1628 IN THE SENATE OF THE UNITED STATES August 6, 2009 Mr. Udall of Colorado (for himself and Mrs. Hagan) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend title VII of the Public Health Service Act to increase the number of physicians who practice in underserved rural communities.

1.

Short title

This Act may be cited as the Rural Physician Pipeline Act of 2009.

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: I

Medical training generally

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

Training in underserved communities

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, through 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; (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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