[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 3190 Introduced in Senate (IS)]

<DOC>






114th CONGRESS
  2d Session
                                S. 3190

     To enhance the rural health workforce, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 13, 2016

  Mr. Franken (for himself and Ms. Heitkamp) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
     To enhance the rural health workforce, and for other purposes.

    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 ``Strengthening Our Rural Health 
Workforce Act of 2016''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
     TITLE I--COMPREHENSIVE STRATEGIC PLANNING FOR WORKFORCE NEEDS

Sec. 101. National Health Care Workforce Commission.
   TITLE II--INCREASING THE ADOPTION OF RURAL TRAINING TRACK PROGRAMS

Sec. 201. Clarifying description of rural training tracks.
Sec. 202. GAO study and report on Medicare payments for graduate 
                            medical education.
Sec. 203. Distribution of additional residency positions.
              TITLE III--SUPPORTING PRIMARY CARE WORKFORCE

Sec. 301. Reauthorization of primary care residency expansion program.
Sec. 302. Reauthorization of area health education centers.
               TITLE IV--SUPPORTING EMERGING PROFESSIONS

Sec. 401. Authorizing appropriations for Quentin N. Burdick program for 
                            rural interdisciplinary training.
Sec. 402. Dental therapists.
Sec. 403. Allied health professionals.
Sec. 404. Community health workers.
Sec. 405. GAO report.
                    TITLE V--MENTAL HEALTH WORKFORCE

Sec. 501. Establishing mental health and substance use disorder 
                            curriculum.
Sec. 502. Streamlining mental and behavioral health workforce programs.

     TITLE I--COMPREHENSIVE STRATEGIC PLANNING FOR WORKFORCE NEEDS

SEC. 101. NATIONAL HEALTH CARE WORKFORCE COMMISSION.

    Section 5101 of the Patient Protection and Affordable Care Act (42 
U.S.C. 294q) is amended--
     (a) in subsection (h)--
            (1) by striking paragraphs (1) and (2) and inserting the 
        following:
            ``(1) Appropriations.--There are authorized to be 
        appropriated, and there are appropriated, out of any monies in 
        the Treasury not otherwise appropriated, $10,000,000 for each 
        fiscal year to carry out this section.''; and
            (2) by redesignating paragraph (3) as paragraph (2); and
    (b) in subsection (d)--
            (1) in paragraph (7), by adding at the end ``Whenever 
        feasible, Congress and the Department of Health and Human 
        Services shall recognize and implement such recommendations.''; 
        and
            (2) by adding at the end the following:
            ``(9) Data tracking.--
                    ``(A) Data tracking mechanism.--The Commission 
                shall develop, or enter into a contract with another 
                entity to develop, a mechanism for tracking information 
                on the career paths of graduates of medical schools and 
                residency programs, as described in subparagraph (B), 
                and shall make such information publicly available.
                    ``(B) Recordkeeping.--The Commission shall collect 
                or ensure the collection of data, using the mechanism 
                developed under subparagraph (A), concerning--
                            ``(i) the specialty and subspecialty 
                        training of all graduates of medical schools 
                        receiving Federal funding; and
                            ``(ii) the professional trajectory of all 
                        graduates of medical schools receiving Federal 
                        funding for not less than 15 years after each 
                        individual graduates from medical school, 
                        including data concerning graduates who 
                        practice medicine--
                                    ``(I) in underserved areas such as 
                                health professional shortage areas (as 
                                designated by the Secretary under 
                                section 332 of the Public Health 
                                Service Act (42 U.S.C. 254e));
                                    ``(II) with medically underserved 
                                populations (as defined in section 
                                330(b)(3) of the Public Health Service 
                                Act (42 U.S.C. 254b(b)(3)));
                                    ``(III) in Federally-qualified 
                                health centers (as defined in section 
                                1905(l)(2)(B) of the Social Security 
                                Act (42 U.S.C. 1396d(l)(2)(B)));
                                    ``(IV) in rural health clinics (as 
                                defined in section 1861(aa)(2) of the 
                                Social Security Act (42 U.S.C. 
                                1395x(aa)(2)));
                                    ``(V) in the health care system of 
                                the Department of Veterans Affairs; and
                                    ``(VI) in clinics of the Indian 
                                Health Services.''.

   TITLE II--INCREASING THE ADOPTION OF RURAL TRAINING TRACK PROGRAMS

SEC. 201. CLARIFYING DESCRIPTION OF RURAL TRAINING TRACKS.

    Section 1886(h)(4)(H)(iv) of the Social Security Act (42 U.S.C. 
1395ww(h)(4)(H)(iv)) is amended by adding at the end the following new 
sentence: ``The Secretary, in coordination with representatives of the 
Centers for Medicare & Medicaid Services, the Health Resources Services 
Administration, and the Federal Office of Rural Health Policy, shall 
develop a consistent definition of approved medical residency training 
programs (or rural tracks) in a rural area for purposes of this section 
and any other residency training program administered by the 
Secretary.''.

SEC. 202. GAO STUDY AND REPORT ON MEDICARE PAYMENTS FOR GRADUATE 
              MEDICAL EDUCATION.

    (a) Study.--The Comptroller General of the United States shall 
conduct a study on the effectiveness of payments for graduate medical 
education costs and indirect costs for medical education under 
subsections (h) and (d)(5)(B) of section 1886 of the Social Security 
Act (42 U.S.C. 1395ww), including efforts to distribute unused 
residency positions under subsection (h)(8) of such section, to meet 
the primary care and mental health needs of individuals living in rural 
areas. Such study shall include--
            (1) an analysis of the number of additional residency 
        positions available as a result of such distribution that are 
        being used to train residents who practice in rural areas after 
        completing their residency; and
            (2) identification of approved medical residency training 
        programs with proven track records in training primary care 
        physicians and psychiatrists who practice in rural areas.
    (b) Report.--Not later than 1 year after the date of enactment of 
this Act, the Comptroller General of the United States shall submit to 
Congress a report containing the results of the study conducted under 
subsection (a), together with recommendations for such legislation and 
administrative action as the Comptroller General determines 
appropriate.

SEC. 203. DISTRIBUTION OF ADDITIONAL RESIDENCY POSITIONS.

    (a) In General.--Section 1886(h) of the Social Security Act (42 
U.S.C. 1395ww(h)) is amended--
            (1) in paragraph (4)(F)(i), by striking ``and (8)'' and 
        inserting ``, (8), and (9)'';
            (2) in paragraph (4)(H)(i), by striking ``and (8)'' and 
        inserting ``, (8), and (9)'';
            (3) in paragraph (7)(E), by inserting ``paragraph (9),'' 
        after ``paragraph (8),''; and
            (4) by adding at the end the following new paragraph:
            ``(9) Distribution of additional residency positions.--
                    ``(A) Reductions in limit based on unused 
                positions.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), if a hospital's reference resident 
                        level (as defined in subparagraph (H)) is less 
                        than the otherwise applicable resident limit 
                        (as defined in such subparagraph), effective 
                        for portions of cost reporting periods 
                        occurring on or after July 1, 2020, the 
                        otherwise applicable resident limit shall be 
                        reduced by 65 percent of the difference between 
                        such otherwise applicable resident limit and 
                        such reference resident level.
                            ``(ii) Exceptions.--This subparagraph shall 
                        not apply to--
                                    ``(I) a hospital with fewer than 
                                250 acute care inpatient beds that is 
                                located in a rural area (as defined in 
                                subsection (d)(2)(D)(ii)), including a 
                                hospital treated as being located in a 
                                rural area under subsection (d)(8)(E);
                                    ``(II) a hospital that was part of 
                                a qualifying entity which had a 
                                voluntary residency reduction plan 
                                approved under paragraph (6)(B) or 
                                under the authority of section 402 of 
                                Public Law 90-248, if the hospital 
                                demonstrates to the Secretary that it 
                                has a specified plan in place for 
                                filling the unused positions by not 
                                later than 2 years after the date of 
                                enactment of this paragraph; or
                                    ``(III) a hospital described in 
                                paragraph (4)(H)(v).
                    ``(B) Distribution.--
                            ``(i) In general.--The Secretary shall 
                        increase the otherwise applicable resident 
                        limit for each qualifying hospital that submits 
                        an application under this subparagraph by such 
                        number as the Secretary may approve for 
                        portions of cost reporting periods occurring on 
                        or after July 1, 2020. The aggregate number of 
                        increases in the otherwise applicable resident 
                        limit under this subparagraph shall be equal to 
                        the aggregate reduction in such limits 
                        attributable to subparagraph (A) (as estimated 
                        by the Secretary).
                            ``(ii) Requirements.--Subject to clause 
                        (iii), a hospital that receives an increase in 
                        the otherwise applicable resident limit under 
                        this subparagraph shall ensure, during the 5-
                        year period beginning on the date of such 
                        increase, that--
                                    ``(I) the number of full-time 
                                equivalent primary care residents, as 
                                defined in paragraph (5)(H) (as 
                                determined by the Secretary), excluding 
                                any additional positions under 
                                subclause (II), is not less than the 
                                average number of full-time equivalent 
                                primary care residents (as so 
                                determined) during the 3 most recent 
                                cost reporting periods ending prior to 
                                the date of enactment of this 
                                paragraph; and
                                    ``(II) not less than 75 percent of 
                                the positions attributable to such 
                                increase are in a primary care, 
                                psychiatry, or general surgery 
                                residency (as determined by the 
                                Secretary).
                        The Secretary may determine whether a hospital 
                        has met the requirements under this clause 
                        during such 5-year period in such manner and at 
                        such time as the Secretary determines 
                        appropriate, including at the end of such 5-
                        year period.
                            ``(iii) Redistribution of positions if 
                        hospital no longer meets certain 
                        requirements.--In the case where the Secretary 
                        determines that a hospital described in clause 
                        (ii) does not meet either of the requirements 
                        under subclause (I) or (II) of such clause, the 
                        Secretary shall--
                                    ``(I) reduce the otherwise 
                                applicable resident limit of the 
                                hospital by the amount by which such 
                                limit was increased under this 
                                paragraph; and
                                    ``(II) provide for the distribution 
                                of positions attributable to such 
                                reduction in accordance with the 
                                requirements of this paragraph.
                    ``(C) Considerations in redistribution.--In 
                determining for which hospitals the increase in the 
                otherwise applicable resident limit is provided under 
                subparagraph (B), the Secretary shall take into 
                account--
                            ``(i) the demonstration likelihood of the 
                        hospital filling the positions made available 
                        under this paragraph within the first 3 cost 
                        reporting periods beginning on or after July 1, 
                        2020, as determined by the Secretary; and
                            ``(ii) whether the hospital has an 
                        accredited rural training track (as described 
                        in paragraph (4)(H)(iv)).
                    ``(D) Priority for certain areas.--In determining 
                for which hospitals the increase in the otherwise 
                applicable resident limit is provided under 
                subparagraph (B), subject to subparagraph (E), the 
                Secretary shall distribute the increase to hospitals 
                based on the following factors:
                            ``(i) Whether the hospital and the approved 
                        medical residency training program of the 
                        hospital have a proven track record of primary 
                        care and rural support (as determined by the 
                        Secretary).
                            ``(ii) Whether the hospital is located in a 
                        State, a territory of the United States, or the 
                        District of Columbia that is among the top 20 
                        States, territories, or Districts in terms of 
                        the ratio of the geographic area of the State, 
                        territory, or District in square miles that is 
                        rural compared to the geographic area in each 
                        other State, territory, or District in square 
                        miles that is rural (as determined by the 
                        Secretary based solely on the most recent 
                        available population data published by the 
                        Bureau of the Census).
                            ``(iii) Whether the hospital is located in 
                        a rural area (as defined in subsection 
                        (d)(2)(D)(ii)), including a hospital treated as 
                        being located in a rural area under subsection 
                        (d)(8)(E).
                    ``(E) Reservation of positions for certain 
                hospitals.--
                            ``(i) In general.--Subject to clause (ii), 
                        the Secretary shall reserve the positions 
                        available for distribution under this paragraph 
                        as follows:
                                    ``(I) 70 percent of such positions 
                                for distribution to hospitals described 
                                in clause (i) of subparagraph (D).
                                    ``(II) 30 percent of such positions 
                                for distribution to hospitals described 
                                in clauses (ii) and (iii) of such 
                                subparagraph.
                            ``(ii) Exception if positions not 
                        redistributed by july 1, 2020.--In the case 
                        where the Secretary does not distribute 
                        positions to hospitals in accordance with 
                        clause (i) by July 1, 2020, the Secretary shall 
                        distribute such positions to other hospitals in 
                        accordance with the considerations described in 
                        subparagraph (C) and the priority described in 
                        subparagraph (D).
                    ``(F) Limitation.--A hospital may not receive more 
                than 75 full-time equivalent additional residency 
                positions under this paragraph.
                    ``(G) Application of per resident amounts for 
                primary care and nonprimary care.--With respect to 
                additional residency positions in a hospital 
                attributable to the increase provided under this 
                paragraph, the approved FTE per resident amounts are 
                deemed to be equal to the hospital per resident amounts 
                for primary care and nonprimary care computed under 
                paragraph (2)(D) for that hospital.
                    ``(H) Definitions.--In this paragraph, the terms 
                `reference resident level', `resident level', and 
                `otherwise applicable resident limit' have the meaning 
                given such terms in paragraph (8)(H).
                    ``(I) Affiliation.--The provisions of this 
                paragraph shall be applied to hospitals which are 
                members of the same affiliated group (as defined by the 
                Secretary under paragraph (4)(H)(ii)) and the reference 
                resident level for each such hospital shall be the 
                reference resident level with respect to the cost 
                reporting period that results in the smallest 
                difference between the reference resident level and the 
                otherwise applicable resident limit.''.
    (b) IME.--
            (1) In general.--Section 1886(d)(5)(B)(v) of the Social 
        Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)), in the second 
        sentence, is amended by striking ``and (h)(8)'' and inserting 
        ``, (h)(8), and (h)(9)''.
            (2) Conforming amendment.--Section 1886(d)(5)(B) of the 
        Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by 
        adding at the end the following new clause:
            ``(xi) For discharges occurring on or after July 1, 2020, 
        insofar as an additional payment amount under this subparagraph 
        is attributable to resident positions distributed to a hospital 
        under subsection (h)(9)(B), the indirect teaching adjustment 
        factor shall be computed in the same manner as provided under 
        clause (ii) with respect to such resident positions.''.
    (c) Conforming Amendment.--Section 422(b)(2) of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (Public 
Law 108-173) is amended by striking ``and (8)'' and inserting ``, (8), 
and (9)''.

              TITLE III--SUPPORTING PRIMARY CARE WORKFORCE

SEC. 301. REAUTHORIZATION OF PRIMARY CARE RESIDENCY EXPANSION PROGRAM.

    Section 747 of the Public Health Service Act (42 U.S.C. 293k) is 
amended--
            (1) in subsection (b)(3)(E), by striking ``vulnerable 
        populations'' and inserting ``individuals with a mental illness 
        or substance use disorder or other vulnerable populations,''; 
        and
            (2) in subsection (c)--
                    (A) in paragraph (1), by striking ``$125,000,000'' 
                and all that follows through the period at the end and 
                inserting ``$168,000,000 for the period of fiscal years 
                2017 through 2021.''; and
                    (B) in paragraph (3), by striking ``2010 through 
                2014'' and inserting ``2017 through 2021''.

SEC. 302. REAUTHORIZATION OF AREA HEALTH EDUCATION CENTERS.

    Section 751(j)(1) of the Public Health Service Act (42 U.S.C. 
294a(j)(1)) is amended by striking ``$125,000,000 for each of the 
fiscal years 2010 through 2014'' and inserting ``$40,000,000 for each 
of fiscal years 2017 through 2021''.

               TITLE IV--SUPPORTING EMERGING PROFESSIONS

SEC. 401. AUTHORIZING APPROPRIATIONS FOR QUENTIN N. BURDICK PROGRAM FOR 
              RURAL INTERDISCIPLINARY TRAINING.

    Section 754 of the Public Health Service Act (42 U.S.C. 794d) is 
amended by adding at the end the following:
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated $10,000,000 for each of fiscal years 2017 through 2021 to 
carry out this section.''.

SEC. 402. DENTAL THERAPISTS.

    (a) Training in General, Pediatric, and Public Health Dentistry.--
Section 748 of the Public Health Service Act (42 U.S.C. 293k-2) is 
amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (A), by inserting ``dental 
                therapists,'' after ``practicing dentists,''; and
                    (B) in subparagraph (B), by inserting ``dental 
                therapists,'' after ``practicing dentists,''; and
            (2) in subsection (b)--
                    (A) by striking ``programs in dental or dental 
                hygiene'' and inserting ``programs in dental, dental 
                therapy, or dental hygiene''; and
                    (B) by striking ``dental students, residents, and 
                dental hygiene students'' and inserting ``dental 
                students, residents, dental therapy students, and 
                dental hygiene students''.
    (b) Funding for Primary Dental Demonstration Program.--
            (1) Timeframe.--Section 340G-1(b) of the Public Health 
        Service Act (42 U.S.C. 256g-1(b)) is amended--
                    (A) by striking ``2 years'' and inserting ``10 
                years''; and
                    (B) by striking ``7 years'' and inserting ``14 
                years''.
            (2) Sense of senate.--It is the sense of the Senate that--
                    (A) section 340G-1 of the Public Health Service Act 
                (42 U.S.C. 256g-1) should be fully funded for each of 
                fiscal years 2017 through 2021; and
                    (B) any appropriations Act appropriating amounts 
                for fiscal year 2017, or any subsequent fiscal year 
                through fiscal year 2021, should not contain any 
                language prohibiting the availability of funds for such 
                section.

SEC. 403. ALLIED HEALTH PROFESSIONALS.

    (a) Definition of Allied Health Professionals.--Section 799B(5) of 
the Public Health Service Act (42 U.S.C. 295p(5)) is amended--
            (1) in subparagraph (B)(v), by striking ``; and'' and 
        inserting ``, including services related to managing the 
        implementation and operation of health information 
        technology;'';
            (2) in subparagraph (C), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(D) who may be licensed or certified to practice 
                in an emerging health care profession as defined by the 
                Secretary, which may include community paramedics, 
                dental therapists, doulas, and other community health 
                workers.''.
    (b) Loan Forgiveness for Allied Health Professionals.--Section 
428K(h) of the Higher Education Act of 1965 (20 U.S.C. 1078-11(h)) is 
amended--
            (1) by striking ``this section such sums'' and inserting 
        ``this section--
            ``(1) such sums'';
            (2) by striking the period and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(2) such sums as may be necessary for each of fiscal 
        years 2017 through 2021 to provide loan forgiveness in 
        accordance with this section for individuals meeting the 
        requirements of subsection (b)(18).''.
    (c) Training for Mid-Career Public and Allied Health 
Professionals.--Section 777 of the Public Health Service Act (42 U.S.C. 
295f-2) is amended--
            (1) in subsection (b)(2), by inserting ``, including 
        individuals who are foreign-trained health professionals'' 
        before the period;
            (2) by redesignating subsection (c) as subsection (d);
            (3) by inserting after subsection (b) the following:
    ``(c) Preference.--
            ``(1) Eligible institutions.--In making grants under this 
        section, the Secretary shall prioritize awarding grants to 
        eligible entities located in rural or underserved areas.
            ``(2) Eligible individuals.--In awarding scholarships to 
        eligible individuals under this section, an eligible entity 
        shall prioritize individuals from rural or underserved 
        communities.''; and
            (4) in subsection (d), as so redesignated, by striking 
        ``2015'' and inserting ``2021''.

SEC. 404. COMMUNITY HEALTH WORKERS.

    Section 399V of the Public Health Service Act (42 U.S.C. 280g-11) 
is amended--
            (1) in subsection (b)--
                    (A) in paragraph (4), by striking ``; or'';
                    (B) in paragraph (5), by striking the period and 
                inserting ``; or''; and
                    (C) by adding at the end the following:
            ``(6) to educate, guide, and provide assistance with 
        patients enrolled in patient-centered medical homes, 
        accountable care organizations (as such term is used in section 
        1899 of the Social Security Act), other State certified medical 
        or health care homes, or other coordinated care models.''; and
            (2) in subsection (d)(1)--
                    (A) in subparagraph (B), by striking ``or'' after 
                the semicolon;
                    (B) in subparagraph (C), by inserting ``or'' after 
                the semicolon; and
                    (C) by adding at the end the following:
                    ``(D) that meet the requirements of subparagraph 
                (A), (B), or (C) and are designated as a health 
                professional shortage area under section 332(a);''.

SEC. 405. GAO REPORT.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Comptroller General of the United States shall prepare 
and submit to Congress a report on emerging health care professions as 
defined by the Secretary of Health and Human Services.
    (b) Contents.--The report prepared under subsection (a) shall 
include recommendations on--
            (1) improving data collection with respect to emerging 
        health care professions, such as community health workers, 
        community paramedics, and dental therapists;
            (2) establishing a systematic way for Federal officials to 
        track State financing and use of community health workers, 
        community paramedics, and dental therapists;
            (3) improving methodologies to calculate the return on 
        investment associated with supporting emerging health care 
        professions and the impact of such professions on health care 
        quality;
            (4) standards for certification and training of individuals 
        in emerging health care professions;
            (5) establishing a process to ensure that the Secretary of 
        Health and Human Services continually--
                    (A) assesses emerging health care professions for 
                quality and consistency; and
                    (B) recognizes and incorporates these professions 
                in health care delivery; and
            (6) establishing a centralized source for evidence on 
        emerging health care professions to facilitate the 
        establishment of best practices for expanded use of emerging 
        health care professions.

                    TITLE V--MENTAL HEALTH WORKFORCE

SEC. 501. ESTABLISHING MENTAL HEALTH AND SUBSTANCE USE DISORDER 
              CURRICULUM.

    (a) In General.--Subpart I of part C of title VII of the Public 
Health Service Act (42 U.S.C. 293K et seq.) is amended by inserting 
after section 747A the following:

``SEC. 747B. ESTABLISHING MENTAL HEALTH AND SUBSTANCE USE DISORDER 
              CURRICULUM.

    ``(a) Support and Development of Mental Health and Substance Use 
Disorder Training Programs.--
            ``(1) In general.--The Secretary may make grants to, or 
        enter into contracts with, a school of medicine or osteopathic 
        medicine, a nursing school, a physician assistant training 
        program, a school of pharmacy, a school of social work, an 
        accredited public or nonprofit private hospital, or a public or 
        private nonprofit entity which the Secretary has determined is 
        capable of carrying out such grant or contract to establish, 
        maintain, or improve--
                    ``(A) academic units or programs that include 
                content and clinical experiences related to mental 
                health and substance use disorder fields, with a 
                special focus on addiction;
                    ``(B) programs that enhance interdisciplinary 
                recruitment, training, and faculty development for the 
                purposes of improving clinical teaching and research in 
                mental health and substance use disorder fields, 
                including addiction;
                    ``(C) programs that develop, assess, and 
                disseminate evidence-based practices for the design of 
                academic units, training programs, and faculty 
                development initiatives in mental health and substance 
                use disorder fields, including addiction; and
                    ``(D) recommendations for medical education 
                curriculum content standards regarding mental health 
                and substance use disorders, including addiction, to 
                ensure that students are able to recognize, diagnose, 
                and treat mental health and substance use disorders.
            ``(2) Partnership required.--To be eligible to receive a 
        grant or contract under paragraph (1), an entity shall enter 
        into a partnership with a medical education accrediting 
        organization (such as the Liaison Committee on Medical 
        Education, the Accreditation Council for Graduate Medical 
        Education, the Commission on Osteopathic College Accreditation, 
        the Accreditation Commission for Education in Nursing, the 
        Commission on Collegiate Nursing Education, the Accreditation 
        Council for Pharmacy Education, the Council on Social Work 
        Education, or the Accreditation Review Commission on Education 
        for the Physician Assistant).
    ``(b) Preference in Making Awards Under This Section.--In making 
awards of grants and contracts under subsection (a), the Secretary 
shall give preference to any qualified applicant for such an award that 
agrees to expend the award for the purpose of--
            ``(1) establishing academic units or programs in mental 
        health and substance use disorder fields, including addiction 
        medicine; or
            ``(2) substantially expanding such units or programs.
    ``(c) Priorities in Making Awards.--In awarding grants or contracts 
under subsection (a), the Secretary shall give priority to qualified 
applicants that--
            ``(1) have a record of training the greatest percentage of 
        mental health and substance use disorder providers, including 
        addiction providers, who enter and remain in mental health and 
        substance use disorder fields;
            ``(2) 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 
        settings with integrated primary and mental health and 
        substance use disorder health care service, or have a record of 
        establishing multidisciplinary addiction medicine fellowship 
        training programs;
            ``(3) have a record of training individuals who are from 
        underrepresented minority groups, including native populations, 
        or from a rural or disadvantaged background;
            ``(4) provide training in the care of rural and vulnerable 
        populations, such as children, pregnant and post-partum women, 
        older adults, homeless individuals, victims of trafficking, 
        victims of abuse or trauma, and other groups as defined by the 
        Secretary;
            ``(5) teach trainees the skills to provide 
        interprofessional, integrated care through collaboration among 
        health professionals; or
            ``(6) provide training in cultural competency and health 
        literacy.
    ``(d) Duration of Awards.--The period during which payments are 
made to an entity from an award of a grant or contract under this 
section shall be 5 years.
    ``(e) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of fiscal years 2017 through 2021.''.
    (b) Increasing Transparency Regarding Graduate Medical Education on 
Mental Health and Substance Use Disorders.--Not later than 5 years 
after the date of the enactment of this Act, and annually thereafter, 
the Secretary of Health and Human Services shall submit to Congress a 
report that describes the activities that hospitals receiving funding 
under the Medicare program under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) have underway to promote interdisciplinary 
care teams and provide training for all medical residents, medical 
students, and faculty in mental health and substance use disorders, 
including addiction medicine.

SEC. 502. STREAMLINING MENTAL AND BEHAVIORAL HEALTH WORKFORCE PROGRAMS.

    (a) In General.--Part D of title VII of the Public Health Service 
Act (42 U.S.C. 294 et seq.) is amended--
            (1) by striking sections 755 (42 U.S.C. 294e) and 756 (42 
        U.S.C. 294e-1);
            (2) by redesignating sections 757 (42 U.S.C. 294f) and 759 
        (42 U.S.C. 294i) as sections 756 and 757, respectively; and
            (3) by inserting after section 754 the following:

``SEC. 755. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS.

    ``(a) Grants Authorized.--The Secretary may award grants to 
eligible institutions of higher education to support the recruitment of 
students for, and education and clinical experience of the students 
in--
            ``(1) accredited institutions of higher education or 
        accredited professional training programs that are establishing 
        or expanding internships or other field placement programs in 
        mental health in psychiatry, psychology, school psychology, 
        behavioral pediatrics, psychiatric nursing, social work, school 
        social work, substance use disorder prevention and treatment, 
        marriage and family therapy, occupational therapy, school 
        counseling, or professional counseling, including such 
        internships or programs with a focus on child and adolescent 
        mental health and transitional-age youth;
            ``(2) accredited doctoral, internship, and post-doctoral 
        residency programs of health service psychology, including 
        clinical psychology, counseling, and school psychology, for the 
        development and implementation of interdisciplinary training of 
        psychology graduate students for providing behavioral and 
        mental health services, including substance use disorder 
        prevention and treatment services, and the development of 
        faculty in health service psychology;
            ``(3) accredited master's and doctoral degree programs of 
        social work for the development and implementation of 
        interdisciplinary training of social work graduate students for 
        providing behavioral and mental health services, including 
        substance use disorder prevention and treatment services, and 
        the development of faculty in social work; or
            ``(4) State-licensed mental health nonprofit and for-profit 
        organizations to enable such organizations to pay for programs 
        for preservice or in-service training in a behavioral health-
        related paraprofessional field with preference for preservice 
        or in-service training of paraprofessional child and adolescent 
        mental health workers.
    ``(b) Eligibility Requirements.--To be eligible for a grant under 
this section, an institution of higher education shall demonstrate--
            ``(1) an ability to recruit and place the students 
        described in subsection (a) in areas with a high need and high 
        demand population or rural or underserved areas;
            ``(2) that individuals and groups from different racial, 
        ethnic, cultural, geographic, religious, linguistic, and class 
        backgrounds, and different genders and sexual orientations, 
        participate in the programs of the institution;
            ``(3) knowledge and understanding of the concerns of the 
        individuals and groups described in paragraph (2), especially 
        individuals with mental health symptoms or diagnoses, 
        particularly children and adolescents, and transitional-age 
        youth;
            ``(4) that any internship or other field placement program 
        assisted through the grant will prioritize cultural and 
        linguistic competency; and
            ``(5) that the institution of higher education will provide 
        to the Secretary such data, assurances, and information as the 
        Secretary may require.
    ``(c) Institutional Requirement.--For grants awarded under 
paragraphs (2) and (3) of subsection (a), at least 4 of the grant 
recipients shall be historically black colleges or universities or 
other minority-serving institutions.
    ``(d) Priority.--In selecting grant recipients, the Secretary shall 
give priority to--
            ``(1) for grants awarded under paragraphs (1), (2), and (3) 
        of subsection (a), programs that have demonstrated the ability 
        to train psychology and social work professionals to work in 
        integrated care settings;
            ``(2) for a grant under subsection (a)(4), programs for 
        paraprofessionals that emphasize the role of the family and the 
        lived experience of the consumer and family-paraprofessional 
        partnerships; and
            ``(3) programs with a record of training individuals from 
        rural and underserved communities and placing graduates in 
        these communities.
    ``(e) Report to Congress.--Not later than 2 years after the date of 
enactment of the Strengthening Our Rural Health Workforce Act of 2016, 
and annually thereafter, the Secretary shall submit to Congress a 
report on the effectiveness of the grants under this section in--
            ``(1) providing graduate students support for experiential 
        training (internship or field placement);
            ``(2) recruiting of students interested in behavioral 
        health practice;
            ``(3) developing and implementing interprofessional 
        training and integration within primary care;
            ``(4) developing and implementing accredited field 
        placements and internships; and
            ``(5) collecting data on the number of students trained in 
        mental health and the number of available accredited 
        internships and field placements.
    ``(f) Authorization of Appropriation.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2017 through 2021.''.
    (b) Conforming Amendments.--The Public Health Service Act (42 
U.S.C. 201 et seq.), as amended by subsection (a), is further amended--
            (1) in section 338A(d)(2)(A) (42 U.S.C. 254l(d)(2)(A)), by 
        striking ``or under section 758'';
            (2) in section 756(b)(2) (42 U.S.C. 294f(b)(2)), as so 
        redesignated, by striking ``, 753(b), and 755(b)'' and 
        inserting ``and 753(b)''; and
            (3) in section 761 (42 U.S.C. 294n)--
                    (A) in subsection (b)(2)(E), by striking 
                ``757(d)(3)'' and inserting ``756(d)(3)'';
                    (B) in subsection (d)(2)(B), by striking 
                ``757(d)(3)'' and inserting ``756(d)(3)''; and
                    (C) in subsection (d)(3), by striking ``757(d)(4)'' 
                and inserting ``756(d)(4)''.
                                 <all>