1.This Act may be cited as the
Restoring the Doctors of Our Country
through Scholarships Act of 2012
or the
RDOCS Act of 2012
.
2.The Congress finds the following:
(1)Due to an aging
population, the retirement of a generation of physicians, and 30,000,000 newly
insured under the Patient Protection and Affordable Care Act (Public Law
110–148), the United States is expected to experience an acute physician
workforce shortage in the coming decades, particularly in primary care. If
unaddressed, this shortage will compromise the health of the population as well
as the ability of the United States to remain competitive in the world.
(2)By 2020, the
shortage of primary care doctors is expected to reach 45,000.
(3)The shortage will
disproportionately impact rural communities and underserved urban
communities.
(4)The Reserve
Officers’ Training Corps (ROTC) model of education and training is a respected
and effective way of meeting the Nation’s need for educated and trained
officers in the United States Armed Forces, and can be applied to solving the
Nation’s primary care shortage.
(5)There are 10
applicants for each National Health Service Corps scholarship awarded,
indicating the unmet demand for medical scholarships.
3.Grants to States
for Restoring the Doctors of Our Country through Scholarships (RDOCS)
programsSubpart III of part D
of title III of the Public Health Service Act (42 U.S.C. 254l et seq.) is
amended by adding at the end the following:
338N.Grants to
States for scholarship programs
(a)
(1)The Secretary, acting through the Administrator of the
Health Resources and Services Administration, shall make grants to States for
the purpose of assisting the States in operating a program described in
paragraph (2) (referred to in this section as an RDOCS program) in
order to provide for the increased availability of primary health care services
in health professional shortage areas.
(2)To
seek a grant under this section, a State shall submit an application in such
form, in such manner, and containing such agreements, assurances, and
information as the Secretary determines to be necessary to carry out this
section.
(b)Scholarship
program describedAn RDOCS program is a program of entering into
contracts between the State involved and an RDOCS scholar under which—
(1)the State involved
agrees—
(A)to pay all tuition
and costs for the RDOCS scholar’s undergraduate medical education, to the
participating undergraduate medical program, for a period of study not
exceeding 48 consecutive months; and
(B)to pay, during
such period, a cost-of-living stipend, in an amount to be determined by the
Secretary, to the RDOCS scholar; and
(2)the RDOCS scholar
agrees—
(A)to be admitted
into and maintain enrollment in a participating undergraduate medical program
in the RDOCS scholar’s State of residence (or if such State of residence
operates no such program, in a participating undergraduate medical program in a
State within an associated region);
(B)when enrolled in
such program, to maintain a minimum level (to be determined by the Secretary)
of academic standing;
(C)to complete an
accredited residency training program in a primary care specialty;
(D)to become licensed
to practice medicine in the applicant’s State of residence;
(E)to receive and
maintain board certification in a primary care speciality; and
(F)to complete a
5-year post-graduate period of service in a health professional shortage
area.
(c)Priority in
awarding scholarshipsIn selecting RDOCS scholars and awarding
scholarship contracts described in subsection (b), the State involved shall
give preference to applicants who are enrolled in—
(1)an accelerated
track family-medicine program; or
(2)a program that
includes clinical training in rural or underserved urban communities.
(d)Direct
administration by State agencyThe RDOCS program of any State
receiving a grant under this section shall be administered directly by a State
agency.
(e)Requirement of
matching funds
(1)Any State receiving a grant under this section shall,
with respect to the costs of making payments on behalf of individuals under
scholarship contracts described in subsection (b), make available (directly or
through donations from public or private entities) non-Federal contributions in
cash toward such costs in an amount equal to not less than $1 for each $9 of
Federal funds provided through the grant.
(2)Determination of
amount of non-federal contributionIn determining the amount of
non-Federal contributions in cash that a State has provided pursuant to
paragraph (1)—
(A)any amounts
provided to the State by the Federal Government shall not be included;
and
(B)any amounts
expended by the State as administrative funds to operate its RDOCS program may,
at the State’s discretion, be included.
(f)Coordination
with Federal program
(1)Assignments for
health professional shortage areas under federal programAny
State receiving a grant under this section shall, in carrying out its RDOCS
program, assign RDOCS officers participating in the program only to public and
nonprofit private entities located in and providing health services in health
professional shortage areas.
(2)Remedies for
breach of contractsThe
Secretary may not make a grant under subsection (a) unless the State involved
agrees that the scholarship contracts provided by the State pursuant to
subsection (b) will provide remedies for any breach of the contracts by the
RDOCS scholars and RDOCS officers involved.
(3)Limitation
regarding contract inducementsAny State receiving a grant under
this section shall ensure that contracts between the State and RDOCS scholars
under this section do not include any terms more favorable to the RDOCS
scholars than the most favorable terms which the Secretary is authorized to
provide in contracts under the National Health Service Corps Scholarship
Program under section 338A, including terms regarding the availability of
remedies for any breach of the contracts by the health professionals
involved.
(g)Restrictions on
use of fundsAny State receiving a grant under this section shall
not expend the grant funds for any purpose other than making payments on behalf
of or to RDOCS scholars under contracts entered into pursuant to this
section.
(h)Any State receiving a grant under this section shall
submit to the Secretary—
(1)a report on the
State’s RDOCS program not later than January 10 of each fiscal year immediately
following any fiscal year for which the State has received such a grant;
and
(2)such other reports
regarding the State’s RDOCS program, as are determined to be appropriate by the
Secretary.
(i)The Secretary shall report annually to the relevant
committees on the physician workforce in the United States, and shall include
in each such report—
(1)data on the
physician shortage, if any, disaggregated by State and region; and
(2)a gap analysis of
the primary care practitioners needed in each State and region, and 5- and
10-year estimates of the funding needed to close the gap through the RDOCS
program.
(j)
(1)The Secretary may not make payments under this section to
a State for any fiscal year subsequent to the first fiscal year of such
payments unless the Secretary determines that, for the immediately preceding
fiscal year, the State has complied with each of the agreements made by the
State under this section.
(2)Reduction in
grant relative to number of breached contracts
(A)Determination of
number of breached contractsBefore making a grant under this
section to a State for a fiscal year, the Secretary shall determine the number
of contracts provided pursuant to the State’s RDOCS program with respect to
which there has been an initial breach by the RDOCS scholars or officers
involved during the fiscal year preceding the fiscal year for which the State
is applying to receive the grant.
(B)Subject to paragraph (3), in the case of a State with 1 or
more initial breaches for purposes of subparagraph (A), the Secretary shall
reduce the amount of a grant under this section to the State for the fiscal
year involved by an amount equal to the sum of—
(i)the expenditures
of Federal funds made regarding the contracts involved; and
(ii)an amount
representing interest on the amount of such expenditures, determined with
respect to each contract on the basis of the maximum legal rate prevailing for
loans made during the time amounts were paid under the contract, as determined
by the Treasurer of the United States.
(3)Waiver regarding
reduction in grantThe Secretary may waive the requirement of
paragraph (2)(B) with respect to the initial breach of a contract if the
Secretary determines that such breach by the RDOCS scholar or officer involved
was attributable solely to the professional having a serious illness.
(k)For the purposes of this section:
(1)Accelerated
track family-medicine programThe term accelerated track
family-medicine program refers to an appropriately accredited,
integrated course of study in which a candidate can complete undergraduate
medical education and graduate medical education in 6 years.
(2)The term associated region refers to—
(A)the area
encompassing the boundaries of Washington, Wyoming, Alaska, Montana, and
Idaho;
(B)the area
encompassing the boundaries of Maine, New Hampshire, Massachusetts, Rhode
Island, Connecticut, and Vermont;
(C)the area
encompassing the boundaries of Delaware and Pennsylvania; or
(D)the area
encompassing the boundaries of Maryland, the District of Columbia, and
Virginia.
(3)The term
board certification means a certification to practice medicine in
a specialty, by an appropriate medical specialty board.
(4)Health
professional shortage areaThe term health professional
shortage area means a health professional shortage area designated under
section 332.
(5)Participating
undergraduate medical programThe term participating
undergraduate medical program means an allopathic or osteopathic
undergraduate medical program operated by a State.
(6)The term primary care specialty means
pediatrics, family medicine, or general internal medicine.
(7)The term RDOCS officer means an RDOCS
program participant who has completed undergraduate medical training, but has
not yet fulfilled the remaining requirements of his or her scholarship contract
under subsection (b).
(8)The term RDOCS scholar means an individual
participating in an RDOCS program pursuant to a scholarship contract under
subsection (b), who has not yet completed undergraduate medical
education.
(9)The term relevant committees means the
Committee on Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of Representatives.
(10)The
term State means each of the 50 States and the District of
Columbia.
(l)Authorization of
appropriations
(1)For carrying out this section, there is authorized to be
appropriated $200,000,000 for each of fiscal year 2013 through 2016.
(2)Amounts
appropriated under paragraph (1) shall remain available until
expended.
.