[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5223 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 5223

 To amend the Public Health Service Act to authorize grants to States 
 for the purpose of assisting the States in operating an RDOCS program 
 in order to provide for the increased availability of primary health 
          care services in health professional shortage areas.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 28, 2014

Mr. McDermott introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to authorize grants to States 
 for the purpose of assisting the States in operating an RDOCS program 
 in order to provide for the increased availability of primary health 
          care services in health professional shortage areas.

    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 ``Restoring the Doctors of Our Country 
through Scholarships Act of 2014'' or the ``RDOCS Act of 2014''.

SEC. 2. FINDINGS.

    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.

SEC. 3. GRANTS TO STATES FOR RESTORING THE DOCTORS OF OUR COUNTRY 
              THROUGH SCHOLARSHIPS (RDOCS) PROGRAMS.

    Subpart 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:

``SEC. 338N. GRANTS TO STATES FOR SCHOLARSHIP PROGRAMS.

    ``(a) Grants to States.--
            ``(1) In general.--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) Applications.--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.
            ``(3) Total number of new rdocs scholars each year.--
        Subject to the availability of appropriations, the Secretary 
        shall ensure that a total of at least 4,000 new RDOCS scholars 
        are awarded scholarships under this section each academic year.
    ``(b) Scholarship Program Described.--An 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 Scholarships.--In 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 Agency.--The 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) In general.--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 
        contribution.--In 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 program.--Any 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 contracts.--The 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 inducements.--Any 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 Funds.--Any 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) Reports by States.--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) Reports by Secretary.--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) Noncompliance.--
            ``(1) In general.--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 
                contracts.--Before 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) Reduction of grants.--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 grant.--The 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) Definitions.--For the purposes of this section:
            ``(1) Accelerated track family-medicine program.--The 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) Associated region.--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) Board certification.--The term `board certification' 
        means a certification to practice medicine in a specialty, by 
        an appropriate medical specialty board.
            ``(4) Health professional shortage area.--The term `health 
        professional shortage area' means a health professional 
        shortage area designated under section 332.
            ``(5) Participating undergraduate medical program.--The 
        term `participating undergraduate medical program' means an 
        allopathic or osteopathic undergraduate medical program 
        operated by a State.
            ``(6) Primary care specialty.--The term `primary care 
        specialty' means pediatrics, geriatric, gerontology, family 
        medicine, or general internal medicine.
            ``(7) RDOCS officer.--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) RDOCS scholar.--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) Relevant committees.--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) State.--The term `State' means each of the 50 States 
        and the District of Columbia.''.
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