[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1720 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1720

To amend title VII of the Public Health Service Act to provide improved 
                       training and primary care.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 25, 2009

  Mr. Reed (for himself and Mr. Leahy) 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 provide improved 
                       training and primary care.

    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. EDUCATION AND TRAINING FOR DELIVERY SYSTEM REFORM.

    (a) Medical Home Training.--Section 747(a) of the Public Health 
Service Act (42 U.S.C. 293k(a)) is amended--
            (1) in paragraph (5), by striking ``and'' at the end;
            (2) in paragraph (6), by striking the period and inserting 
        ``; and''; and
            (3) by inserting after paragraph (6) the following:
            ``(7) to plan, develop, and operate a demonstration program 
        that provides training in new competencies, as recommended by 
        the Advisory Committee on Training in Primary Care Medicine and 
        Dentistry, which may include--
                    ``(A) providing training to primary care providers 
                relevant to providing care through patient-centered 
                medical homes (as defined by the Secretary for purposes 
                of this paragraph, taking into account the criteria of 
                the National Committee for Quality Assurance and other 
                certifying entities);
                    ``(B) developing tools and curricula relevant to 
                patient-centered medical homes; and
                    ``(C) providing continuing education relevant to 
                patient-centered medical homes.''.
    (b) Priorities of Delivery System Reform.--Section 747 of the 
Public Health Service Act (42 U.S.C. 293k) is amended by striking 
subsection (c) and inserting the following:
    ``(c) Priorities in Making Awards.--In awarding grants or contracts 
under this section, the Secretary shall give priority to qualified 
applicants that--
            ``(1) have a record of training the greatest percentage of 
        providers, or that have demonstrated significant improvements 
        in the percentage of providers trained, who enter and remain in 
        primary care practice;
            ``(2) have a record of training individuals who are from 
        underrepresented minority groups or from a rural or 
        disadvantaged background;
            ``(3) provide training in the care of vulnerable 
        populations such as children, older adults, homeless 
        individuals, victims of abuse or trauma, individuals with 
        mental health or substance-related disorders, individuals with 
        HIV/AIDS, and individuals with disabilities;
            ``(4) establish formal relationships and submit joint 
        applications with federally qualified health centers, rural 
        health clinics, area health education centers, or clinics 
        located in underserved areas or that serve underserved 
        populations;
            ``(5) provide training in interdisciplinary, integrated 
        care through collaboration among health professionals, 
        including physician assistants, nurse practitioners, 
        pharmacists, dentists, geriatricians, and mental and behavioral 
        health professionals;
            ``(6) provide training in enhanced communication with 
        patients, evidence-based practice, chronic disease management, 
        preventive care, health information technology, or other 
        competencies as recommended by the Advisory Committee on 
        Training in Primary Care Medicine and Dentistry; or
            ``(7) provide training in cultural competency and health 
        literacy.''.
    (c) Other Amendments.--Section 747 of the Public Health Service Act 
(42 U.S.C. 293k) is amended--
            (1) in subsection (d)--
                    (A) by striking ``subsection (a) may not exceed'' 
                and inserting ``this section shall be''; and
                    (B) by striking the second sentence; and
            (2) by striking subsection (e) and inserting the following:
    ``(e) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated $125,000,000 
for each of fiscal years 2010 through 2014. Fifteen percent of the 
amount appropriated in each such fiscal year shall be allocated to the 
physician assistant training programs described in subsection (a)(5), 
which prepare students for practice in primary care.''.

SEC. 3. HEALTH WORKFORCE INFORMATION AND ANALYSIS.

    (a) In General.--Section 761 of the Public Health Service Act (42 
U.S.C. 294m) 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 (referred to in 
        this section as the ``National Center'') within the Department 
        of Health and Human Services.
            ``(2) Purposes.--The purposes of the National Center are 
        to--
                    ``(A) carry out the activities under section 
                792(a); and
                    ``(B) collect, analyze, and report data related to 
                health workforce issues in coordination with the State 
                and Regional Centers for Health Workforce Analysis 
                described in subsection (c) (referred to in this 
                section as the ``State and Regional Centers'').
            ``(3) Functions.--The National Center shall--
                    ``(A) annually evaluate the effectiveness of 
                programs under this title, based on data reported by 
                recipients of contracts or grants under this title, 
                data collected from the State and Regional Centers 
                described in subsection (c), and analyses conducted 
                under paragraph (4);
                    ``(B) develop and publish benchmarks for 
                performance for programs under this title;
                    ``(C) regularly produce and report to the relevant 
                committees of Congress estimates of the supply, demand, 
                and distribution of health professionals, such as 
                physicians, dentists, nurses, physician assistants, 
                pharmacists, mental and behavioral health 
                professionals, public health workers, and long-term 
                care workers, as appropriate;
                    ``(D) establish, maintain, and make publicly 
                available through the Internet a national health 
                workforce database to collect data from--
                            ``(i) longitudinal tracking systems (as 
                        defined in section 761(d)(2)) on performance 
                        measures (as developed under sections 
                        748(d)(3), 756(d)(3), and 762(a)(3)); and
                            ``(ii) the State and Regional Centers 
                        described in subsection (c);
                    ``(E) establish and maintain a registry of each 
                grant awarded under this title, including data on the 
                project director, the institution, the type and year of 
                the award, and the residency, fellowship, or internship 
                program, as appropriate; and
                    ``(F) biennially submit to the relevant committees 
                of Congress a report on the activities of the National 
                Center during the previous 2-year period.
            ``(4) Collaboration and data sharing.--
                    ``(A) In general.--The National Center shall 
                collaborate with Federal agencies, health professions 
                education organizations, health professions 
                organizations, and professional medical societies for 
                the purpose of linking data regarding grants awarded 
                under this title with 1 or more of the following:
                            ``(i) Data maintained by the Centers for 
                        Medicare & Medicaid Services.
                            ``(ii) Data on participation in the 
                        National Health Service Corps.
                            ``(iii) Data sets maintained by health 
                        professions education organizations, health 
                        professions organizations, or professional 
                        medical societies.
                            ``(iv) Other data sets, as the Secretary 
                        determines appropriate.
                    ``(B) Contracts for health workforce analysis.--For 
                the purpose of carrying out the activities described in 
                subparagraph (A), the National Center may enter into 
                contracts with health professions education 
                organizations, health professions organizations, or 
                professional medical societies.
    ``(c) State and Regional Centers for Health Workforce Analysis.--
            ``(1) In general.--The Secretary shall award grants to, or 
        enter into contracts with, eligible entities for purposes of--
                    ``(A) collecting, analyzing, and reporting to the 
                National Center data regarding programs under this 
                title and data related to health workforce issues;
                    ``(B) conducting, broadly disseminating, and making 
                publicly available through the Internet research and 
                reports on State, regional, and national health 
                workforce issues, including research on the supply, 
                demand, and distribution of health professionals;
                    ``(C) evaluating the effectiveness of programs 
                under this title and other policies related to health 
                workforce issues; and
                    ``(D) providing technical assistance to local and 
                regional entities on the collection, analysis, and 
                reporting of data related to health workforce issues.
            ``(2) Eligible entities.--To be eligible for a grant or 
        contract under this subsection, an entity shall--
                    ``(A) be a State, a State workforce commission, a 
                public health or health professions school, an academic 
                health center, or an appropriate public or private 
                nonprofit entity or a partnership of such entities; and
                    ``(B) submit to the Secretary an application at 
                such time, in such manner, and containing such 
                information as the Secretary may require.
    ``(d) Increase in Grants for Longitudinal Tracking Systems.--
            ``(1) In general.--The Secretary shall increase the amount 
        of a grant or contract awarded to an eligible entity under this 
        title for the establishment and maintenance of a longitudinal 
        tracking system.''.
            ``(2) Definition.--
                    ``(A) In general.--For purposes of paragraph (1), 
                the term `longitudinal tracking system' means a system 
                that tracks students, residents, fellows, interns, or 
                faculty who have received education, training, or 
                financial assistance from programs under this title 
                over a period of not less than 5 years, as specified by 
                the Secretary.
                    ``(B) Capability.--A longitudinal tracking system 
                shall be capable of--
                            ``(i) tracking participation in the 
                        National Health Service Corps, practice in 
                        federally qualified health centers, practice in 
                        health professional shortage areas and 
                        medically underserved areas, and practice in 
                        primary care; and
                            ``(ii) collecting and reporting data on 
                        performance measures developed under sections 
                        748(d)(3), 756(d)(3), and 762(a)(3).
                    ``(C) Guidelines.--A longitudinal tracking system 
                shall comply with guidelines issued under sections 
                748(d)(4), 756(d)(4), and 762(a)(4).
            ``(3) Eligible entities.--To be eligible to obtain an 
        increase under this section, an entity shall be a recipient of 
        a grant or contract under this title and have not previously 
        received an increase under this section.''; and
            (3) in subsection (e), as so redesignated--
                    (A) by striking paragraph (1) and inserting the 
                following:
            ``(1) In general.--
                    ``(A) National center for health workforce 
                analysis.--To carry out subsection (b), there are 
                authorized to be appropriated $1,000,000 for each of 
                fiscal years 2010 through 2014, and such sums as may be 
                necessary for each subsequent fiscal year.
                    ``(B) State and regional centers.--To carry out 
                subsection (c), there are authorized to be appropriated 
                $4,500,000 for each of fiscal years 2010 through 2014, 
                and such sums as may be necessary for each subsequent 
                fiscal year.
                    ``(C) Grants for longitudinal tracking systems.--To 
                carry out subsection (d), there are authorized to be 
                appropriated such sums as may be necessary for fiscal 
                years 2010 through 2014.
                    ``(D) 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, authorities, and 
resources of the National Center for Health Workforce Analysis of the 
Health Resources and Services Administration, as in effect on the date 
before the date of enactment of this Act, shall be transferred to the 
National Center for Health Workforce Analysis established under section 
761 of the Public Health Service Act, as amended by subsection (a).
    (c) Preference for Use of Longitudinal Tracking Systems.--Section 
791(a)(1) of the Public Health Service Act (42 U.S.C. 295j(a)(1)) is 
amended--
            (1) in subparagraph (A), by striking ``or'' at the end;
            (2) in subparagraph (B), by striking the period and 
        inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(C) utilizes a longitudinal tracking system (as 
                defined in section 761(d)(2)) and reports data from 
                such system to the national workforce database (as 
                established under section 761(b)(3)(D)).''.
    (d) Performance Measures; Guidelines for Longitudinal Tracking 
Systems.--
            (1) Advisory committee on training in primary care medicine 
        and dentistry.--Section 748(d) of the Public Health Service Act 
        (42 U.S.C. 293l(d)) is amended--
                    (A) in paragraph (1), by striking ``and'' at the 
                end;
                    (B) in paragraph (2), by striking the period and 
                inserting a semicolon; and
                    (C) by adding at the end the following:
            ``(3) not later than 3 years after the date of enactment of 
        the Health Professions and Primary Care Reinvestment Act, 
        develop, publish, and implement performance measures, which 
        shall be quantitative to the extent possible, for programs 
        under this part;
            ``(4) develop and publish guidelines for longitudinal 
        tracking systems (as defined in section 761(d)(2)) for programs 
        under this part; and
            ``(5) recommend appropriation levels for programs under 
        this part.''.
            (2) Advisory committee on interdisciplinary, community-
        based linkages.--Section 756(d) of the Public Health Service 
        Act (42 U.S.C. 294f(d)) is amended--
                    (A) in paragraph (1), by striking ``and'' at the 
                end;
                    (B) in paragraph (2), by striking the period and 
                inserting a semicolon; and
                    (C) by adding at the end the following:
            ``(3) not later than 3 years after the date of enactment of 
        the Health Professions and Primary Care Reinvestment Act, 
        develop, publish, and implement performance measures, which 
        shall be quantitative to the extent possible, for programs 
        under this part;
            ``(4) develop and publish guidelines for longitudinal 
        tracking systems (as defined in section 761(d)(2)) for programs 
        under this part; and
            ``(5) recommend appropriation levels for programs under 
        this part.''.
            (3) Advisory council on graduate medical education.--
        Section 762(a) of the Public Health Service Act (42 U.S.C. 
        294o(a)) is amended--
                    (A) in paragraph (1), by striking ``and'' at the 
                end;
                    (B) in paragraph (2), by striking the period and 
                inserting a semicolon; and
                    (C) by adding at the end the following:
            ``(3) not later than 3 years after the date of enactment of 
        the Health Professions and Primary Care Reinvestment Act, 
        develop, publish, and implement performance measures, which 
        shall be quantitative to the extent possible, for programs 
        under this title, except for programs under part C or D;
            ``(4) develop and publish guidelines for longitudinal 
        tracking systems (as defined in section 761(d)(2)) for programs 
        under this title, except for programs under part C or D; and
            ``(5) recommend appropriation levels for programs under 
        this title, except for programs under part C or D.''.
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