[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 693 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 693

   To amend the Public Health Service Act to provide grants for the 
   training of graduate medical residents in preventive medicine and 
                             public health.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 25, 2009

Mr. Harkin (for himself, Mr. Isakson, Mr. Bingaman, and Mr. Lieberman) 
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 to provide grants for the 
   training of graduate medical residents in preventive medicine and 
                             public health.

    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 ``Preventive Medicine and Public 
Health Training Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The American Board of Preventive medicine defines 
        preventive medicine as ``that specialty of medical practice 
        which focuses on the health of individuals and defined 
        populations in order to protect, promote and maintain health 
        and well-being and prevent disease, disability and premature 
        death''.
            (2) Specialists in preventive medicines are uniquely 
        trained in both clinical medicine and public health. They have 
        the skills needed to understand and reduce the risks of 
        disease, disability, and death in individuals and in population 
        groups.
            (3) Preventive medicine includes both clinical and non-
        clinical aspects. Clinicians see patients on a daily basis and 
        provide services in screening, health counseling, and 
        immunization to diabetics, cardiac patients, and others who can 
        benefit from prevention and lifestyle modification. Non-
        clinical preventive medicine includes health policy, social and 
        behavioral aspects of health and disease, epidemiology, or 
        other areas in which populations, not individual patients are 
        not the primary focus. Many preventive medicine physicians 
        practice both clinical and non-clinical medicine.
            (4) Of the 24 medical specialities recognized by the 
        American Board of Medical Specialties, preventive medicine is 
        the only specialty that requires training in both clinical 
        medicine and public health.
            (5) While preventive medicine doctors are employed in all 
        health sectors, they often serve in lead roles within the 
        public health force, working in State and local health 
        departments, as well as Federal Government agencies, such as 
        the Centers for Disease Control and Prevention and the National 
        Institutes of Health.
            (6) In the workplace, preventive medicine doctors in 
        occupational medicine parallel the general public health system 
        in dealing with illnesses and injuries in workplace populations 
        through worker protection, personal health promotion, hazard 
        control, business continuity and effective medical management.
            (7) There is an extreme shortage of doctors in the public 
        health field. For example, only 23 percent of local health 
        agencies are directed by physicians and 8 percent are directed 
        by physicians who have masters of public health degrees or are 
        fellows in the American College of Preventive Medicine.
            (8) Many of these physicians are nearing retirement, and 
        the average age of a public health doctor today is 58 years.
            (9) The Health Resources and Services Administration 
        reports that the demand for public health professionals will 
        grow at twice the rate of all occupations between 2000 and 
        2010.
            (10) In addition, as the body of evidence supporting the 
        effectiveness of clinical and population-based interventions to 
        prevent and control diseases continues to expand, so does the 
        need for specialists trained in preventive medicine.
            (11) The Health Resources and Services Administration 
        reported that in 2000, there were 7,011 preventive medicine 
        specialists. This was a decrease from 7,734 in 1970.
            (12) The number of preventive medicine residency programs 
        has decreased from 90 in 1998-1999 to 76 programs today. Over 
        this same period, the number of preventive medicine residents 
        declined from 420 to 364.
            (13) In 2000, less than 3 percent of all medical school 
        faculty also held masters degrees in public health. An even 
        smaller number had completed preventive medicine training or 
        were board certified in preventive medicine.
            (14) Preventive medicine trained physicians are an 
        essential part of the public health workforce and are critical 
        to the Nation's ability to protect its citizens from biological 
        threats, including avian influenza and emerging threats from 
        bioterrorism.

SEC. 3. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT PROGRAM.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by adding at the end the following:

               ``Subpart XI--Preventive Medicine Training

``SEC. 340H. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT 
              PROGRAM.

    ``(a) Grants.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, may award grants to, or 
enter into contracts with, eligible entities to provide training to 
graduate medical residents in preventive medicine specialties.
    ``(b) Eligibility.--To be eligible to receive a grant or contract 
under subsection (a), an entity shall--
            ``(1) be a school of public health, public health 
        department, school of medicine or osteopathic medicine, public 
        or private hospital, or public or private non-profit entity;
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require; and
            ``(3) maintain and adhere to a Letter of Agreement with a 
        local community health center (if available in the local area 
        involved) that supports practicum training of preventive 
        medicine residents, if practicable.
    ``(c) Use of Funds.--Amounts received under a grant or contract 
under this section shall be used to--
            ``(1) plan, develop, and operate residency programs for 
        preventive medicine or public health;
            ``(2) provide financial assistance, including tuition and 
        stipends, to resident physicians (MD or DO) who plan to 
        specialize in preventive medicine or public health;
            ``(3) defray the costs associated with the planning, 
        development, and operation of preventive medicine or public 
        health programs, including the development of curriculum to be 
        used in such programs, and the costs of practicum experiences; 
        and
            ``(4) provide for the improvement of academic 
        administrative units.
    ``(d) Duration of Award.--A grant or contract under this section 
shall be for a term not to exceed 5 years.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $43,000,000 for fiscal year 
2010, and such sums as may be necessary for each succeeding fiscal 
year.''.
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