[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3728 Referred in Senate (RFS)]

<DOC>
115th CONGRESS
  2d Session
                                H. R. 3728


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 24, 2018

     Received; read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 AN ACT


 
  To amend title VII of the Public Health Service Act to reauthorize 
certain programs relating to the health professions 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 ``Educating Medical Professionals and 
Optimizing Workforce Efficiency and Readiness Act of 2018'' or the 
``EMPOWER Act of 2018''.

SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS WORKFORCE PROGRAMS.

    (a) Centers of Excellence.--Subsection (i) of section 736 of the 
Public Health Service Act (42 U.S.C. 293) is amended to read as 
follows:
    ``(i) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $23,711,000 for each of fiscal 
years 2019 through 2023.''.
    (b) Health Professions Training for Diversity.--Section 740 of the 
Public Health Service Act (42 U.S.C. 293d) is amended--
            (1) in subsection (a), by striking ``$51,000,000 for fiscal 
        year 2010, and such sums as may be necessary for each of the 
        fiscal years 2011 through 2014'' and inserting ``$48,970,000 
        for each of fiscal years 2019 through 2023'';
            (2) in subsection (b), by striking ``$5,000,000 for each of 
        the fiscal years 2010 through 2014'' and inserting ``$1,190,000 
        for each of fiscal years 2019 through 2023''; and
            (3) in subsection (c), by striking ``$60,000,000 for fiscal 
        year 2010 and such sums as may be necessary for each of the 
        fiscal years 2011 through 2014'' and inserting ``$14,189,000 
        for each of fiscal years 2019 through 2023''.
    (c) Primary Care Training and Enhancement.--Section 747(c)(1) of 
the Public Health Service Act (42 U.S.C. 293k(c)(1)) is amended by 
striking ``$125,000,000 for fiscal year 2010, and such sums as may be 
necessary for each of fiscal years 2011 through 2014'' and inserting 
``$48,924,000 for each of fiscal years 2019 through 2023''.
    (d) Training in General, Pediatric, and Public Health Dentistry.--
Section 748(f) of the Public Health Service Act (42 U.S.C. 293k-2(f)) 
is amended by striking ``$30,000,000 for fiscal year 2010 and such sums 
as may be necessary for each of fiscal years 2011 through 2015'' and 
inserting ``$40,673,000 for each of fiscal years 2019 through 2023''.
    (e) 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 ``$38,250,000 for each of fiscal years 2019 through 2023''.
    (f) National Center for Healthcare Workforce Analysis.--
            (1) In general.--Section 761(e)(1)(A) of the Public Health 
        Service Act (42 U.S.C. 294n(e)(1)(A)) is amended by striking 
        ``$7,500,000 for each of fiscal years 2010 through 2014'' and 
        inserting ``$5,663,000 for each of fiscal years 2019 through 
        2023''.
            (2) Technical correction.--Section 761(e)(2) of the Public 
        Health Service Act (42 U.S.C. 294n(e)(2)) is amended by 
        striking ``subsection (a)'' and inserting ``paragraph (1)''.
    (g) Public Health Workforce.--Section 770(a) of the Public Health 
Service Act (42 U.S.C. 295e(a)) is amended by striking ``$43,000,000 
for fiscal year 2011, and such sums as may be necessary for each of the 
fiscal years 2012 through 2015'' and inserting ``$17,000,000 for each 
of fiscal years 2019 through 2023''.

SEC. 3. EDUCATION AND TRAINING RELATING TO GERIATRICS.

    Section 753 of the Public Health Service Act (42 U.S.C. 294c) is 
amended to read as follows:

``SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.

    ``(a) Geriatrics Workforce Enhancement Programs.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this subsection to entities described in 
        paragraph (1), (3), or (4) of section 799B, section 801(2), or 
        section 865(d), or other health professions schools or programs 
        approved by the Secretary, for the establishment or operation 
        of geriatrics workforce enhancement programs that meet the 
        requirements of paragraph (2).
            ``(2) Requirements.--A geriatrics workforce enhancement 
        program meets the requirements of this paragraph if such 
        program supports the development of a health care workforce 
        that maximizes patient and family engagement and improves 
        health outcomes for older adults by integrating geriatrics with 
        primary care and other appropriate specialties. Special 
        emphasis should be placed on providing the primary care 
        workforce with the knowledge and skills to care for older 
        adults and collaborating with community partners to address 
        gaps in health care for older adults through individual, 
        system, community, and population level changes. Areas of 
        programmatic focus may include the following:
                    ``(A) Transforming clinical training environments 
                to integrated geriatrics and primary care delivery 
                systems to ensure trainees are well prepared to 
                practice in and lead in such systems.
                    ``(B) Developing providers who can assess and 
                address the needs and preferences of older adults and 
                their families and caregivers at the individual, 
                community, and population levels.
                    ``(C) Creating and delivering community-based 
                programs that will provide older adults and their 
                families and caregivers with the knowledge and skills 
                to improve health outcomes and the quality of care for 
                such adults.
                    ``(D) Providing Alzheimer's disease and related 
                dementias (ADRD) education to the families and 
                caregivers of older adults, direct care workers, health 
                professions students, faculty, and providers.
            ``(3) Duration.--The Secretary shall award grants and 
        contracts under paragraph (1) for a period not to exceed 5 
        years.
            ``(4) Application.--To be eligible to receive a grant or 
        contract under paragraph (1), an entity described in such 
        paragraph shall submit to the Secretary an application at such 
        time, in such manner, and containing such information as the 
        Secretary may require.
            ``(5) Equitable geographic distribution.--The Secretary may 
        award grants and contracts under paragraph (1) in a manner 
        which will equitably distribute such grants and contracts among 
        the various regions of the United States.
            ``(6) Priority.--In awarding grants and contracts under 
        paragraph (1), the Secretary may give priority to programs 
        that--
                    ``(A) have the goal of improving and providing 
                comprehensive coordinated care of older adults, 
                including medical, dental, and psychosocial needs;
                    ``(B) support the training and retraining of 
                faculty, preceptors, primary care providers, and 
                providers in other specialties to increase their 
                knowledge of geriatrics and gerontology;
                    ``(C) provide clinical experiences across care 
                settings, including ambulatory care, hospitals, post-
                acute care, nursing homes, federally qualified health 
                centers, and home and community-based services;
                    ``(D) emphasize education and engagement of family 
                caregivers on disease self-management, medication 
                management, and stress reduction strategies;
                    ``(E) provide training to the health care workforce 
                on disease self-management, motivational interviewing, 
                medication management, and stress reduction strategies;
                    ``(F) provide training to the health care workforce 
                on social determinants of health in order to better 
                address the geriatric health care needs of diverse 
                populations;
                    ``(G) integrate geriatrics competencies and 
                interprofessional collaborative practice into health 
                care education and training curricula for residents, 
                fellows, and students;
                    ``(H) substantially benefit rural or underserved 
                populations of older adults;
                    ``(I) integrate behavioral health competencies into 
                primary care practice, especially with respect to elder 
                abuse, pain management, and advance care planning; or
                    ``(J) offer short-term intensive courses that--
                            ``(i) focus on geriatrics, gerontology, 
                        chronic care management, and long-term care 
                        that provide supplemental training for faculty 
                        members in medical schools and other health 
                        professions schools or graduate programs in 
                        psychology, pharmacy, nursing, social work, 
                        dentistry, public health, allied health, or 
                        other health disciplines, as approved by the 
                        Secretary; and
                            ``(ii) are open to current faculty, and 
                        appropriately credentialed volunteer faculty 
                        and practitioners, to upgrade their knowledge 
                        and clinical skills for the care of older 
                        adults and adults with functional and cognitive 
                        limitations and to enhance their 
                        interdisciplinary teaching skills.
    ``(b) Geriatric Academic Career Awards.--
            ``(1) Establishment of program.--The Secretary shall 
        establish a program to provide Geriatric Academic Career Awards 
        to eligible entities applying on behalf of eligible individuals 
        to promote the career development of such individuals as 
        academic geriatricians or other academic geriatrics health 
        professionals.
            ``(2) Eligibility.--
                    ``(A) Eligible entity.--For purposes of this 
                subsection, the term `eligible entity' means--
                            ``(i) an entity described in paragraph (1), 
                        (3), or (4) of section 799B or section 801(2); 
                        or
                            ``(ii) an accredited health professions 
                        school or graduate program approved by the 
                        Secretary.
                    ``(B) Eligible individual.--For purposes of this 
                subsection, the term `eligible individual' means an 
                individual who--
                            ``(i) is board certified in internal 
                        medicine, family practice, psychiatry, or 
                        licensed dentistry, or has completed any 
                        required training in a discipline and is 
                        employed in an accredited health professions 
                        school or graduate program that is approved by 
                        the Secretary;
                            ``(ii) has completed an approved fellowship 
                        program in geriatrics or gerontology, or has 
                        completed specialty training in geriatrics or 
                        gerontology as required by the discipline and 
                        any additional geriatrics or gerontology 
                        training as required by the Secretary; and
                            ``(iii) has a junior (non-tenured) faculty 
                        appointment at an accredited school of 
                        allopathic medicine, osteopathic medicine, 
                        nursing, social work, psychology, dentistry, 
                        pharmacy, or other allied health disciplines in 
                        an accredited health professions school or 
                        graduate program that is approved by the 
                        Secretary.
            ``(3) Limitations.--An eligible entity may not receive an 
        award under paragraph (1) on behalf of an eligible individual 
        unless the eligible entity--
                    ``(A) submits to the Secretary an application, at 
                such time, in such manner, and containing such 
                information as the Secretary may require, and the 
                Secretary approves such application;
                    ``(B) provides, in such form and manner as the 
                Secretary may require, assurances that the eligible 
                individual on whose behalf an application was submitted 
                under subparagraph (A) will meet the service 
                requirement described in paragraph (7); and
                    ``(C) provides, in such form and manner as the 
                Secretary may require, assurances that such individual 
                has a full-time faculty appointment in an accredited 
                health professions school or graduate program and 
                documented commitment from such school or program to 
                spend 75 percent of the total time of such individual 
                on teaching and developing skills in interprofessional 
                education in geriatrics.
            ``(4) Requirements.--In awarding grants under this 
        subsection, the Secretary--
                    ``(A) shall give priority to eligible entities that 
                apply on behalf of eligible individuals who are on the 
                faculty of institutions that integrate geriatrics 
                education, training, and best practices into academic 
                program criteria;
                    ``(B) may give priority to eligible entities that 
                operate a geriatrics workforce enhancement program 
                under subsection (a);
                    ``(C) shall ensure that grants are equitably 
                distributed across the various geographical regions of 
                the United States, including rural and underserved 
                areas;
                    ``(D) shall pay particular attention to geriatrics 
                health care workforce needs among underserved 
                populations and rural areas; and
                    ``(E) may not require an eligible individual, or an 
                eligible entity applying on behalf of an eligible 
                individual, to be a recipient of a grant or contract 
                under this part.
            ``(5) Maintenance of effort.--An eligible entity receiving 
        an award under paragraph (1) on behalf of an eligible 
        individual shall provide assurances to the Secretary that funds 
        provided to such individual under this subsection will be used 
        only to supplement, not to supplant, the amount of Federal, 
        State, and local funds otherwise expended by such individual.
            ``(6) Amount and term.--
                    ``(A) Amount.--The amount of an award under this 
                subsection for eligible individuals who are physicians 
                shall equal $100,000 for fiscal year 2017, adjusted for 
                subsequent fiscal years to reflect the increase in the 
                Consumer Price Index. The Secretary shall determine the 
                amount of an award under this subsection for 
                individuals who are not physicians.
                    ``(B) Term.--The term of any award made under this 
                subsection shall not exceed 5 years.
            ``(7) Service requirement.--An eligible individual on whose 
        behalf an application was submitted and approved under 
        paragraph (3)(A) shall provide training in clinical geriatrics 
        or gerontology, including the training of interprofessional 
        teams of health care professionals.
    ``(c) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $40,737,000 for each of fiscal 
years 2019 through 2023. Notwithstanding the preceding sentence, no 
funds shall be made available to carry out subsection (b) for a fiscal 
year unless the amount made available to carry out this section for 
such fiscal year is more than the amount made available to carry out 
this section for fiscal year 2017.''.

            Passed the House of Representatives July 23, 2018.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.