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<dc:title>117 HR 7177 IH: Sickle Cell Care Expansion Act of 2022</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2022-03-21</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">117th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 7177</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20220321">March 21, 2022</action-date><action-desc><sponsor name-id="C001111">Mr. Crist</sponsor> (for himself and <cosponsor name-id="L000551">Ms. Lee of California</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend the Public Health Service Act to authorize a scholarship and loan repayment program to incentivize physicians to enter into the field of sickle cell disease research and treatment, and for other purposes.</official-title></form><legis-body id="HB93959571E434D9E8BFE6ADEEA4AA223" style="OLC"><section id="H74597FDB3CC4485895BB94D384D38B0F" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Sickle Cell Care Expansion Act of 2022</short-title></quote>. </text></section><section id="H6EBE3DBC979D406CBA41FF9B8FF9D139"><enum>2.</enum><header>Advancing treatment and research pertaining to sickle cell disease</header><text display-inline="no-display-inline">Part D of title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b">42 U.S.C. 254b et seq.</external-xref>) is amended by adding at the end the following:</text><quoted-block style="OLC" id="H6DD4AAC0EAF64D7A8BCDC2FB62C2D005" display-inline="no-display-inline"><subpart id="H3374CC19344F4FC2B6C078EF44C8B18A"><enum>XIII</enum><header>Advancing treatment and research pertaining to sickle cell disease</header><section id="H5197AB5842F842A3943DECE808453689"><enum>340J.</enum><header>Scholarship and loan repayment program</header><subsection id="H320A90E471724F84BBC7063480889542"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">To advance learning regarding sickle cell disease and to enhance the supply of physicians to treat such disease, especially with respect to adult populations, the Secretary, acting through the Administrator of the Health Resources and Services Administration, shall carry out a program consisting of entering into contracts with individuals under which—</text><paragraph id="HF66C8C82431740A8A5C15660AC292536"><enum>(1)</enum><text>the Secretary awards a scholarship under subsection (b) or agrees to make loan repayments under subsection (c) with respect to each individual; and</text></paragraph><paragraph id="HE428385BED424D00A157944953CBA6A6"><enum>(2)</enum><text>the individual agrees to serve for a period (in this section referred to as the <quote>period of obligated service</quote>) as a physician engaged in—</text><subparagraph id="HF49EF1CC06254828A2200FF59ED8946A"><enum>(A)</enum><text>sickle cell disease research; or</text></subparagraph><subparagraph id="HF9401255681E433D837680CFC05DA106"><enum>(B)</enum><text display-inline="yes-display-inline">service in a public or private setting that is primarily focused on diagnosis, treatment, and education related to sickle cell disease in a health care facility, clinic, rural health clinic, mobile medical asset, or other facility as determined by the Secretary.</text></subparagraph></paragraph></subsection><subsection id="HF82FB720981748E6A9EB9A4B35F922F2"><enum>(b)</enum><header>Scholarships</header><paragraph id="H14C9A7345C664D75A840C7941D3F7669"><enum>(1)</enum><header>Eligibility</header><text>To be eligible to participate in the scholarship program under this section, an individual shall—</text><subparagraph id="H933905BB0E154BE88254514AAFC3FC18"><enum>(A)</enum><text>be accepted for enrollment, or be enrolled, as a full-time student in an accredited (as determined by the Secretary) educational institution in a State and in a course of study or program offered by such institution and approved by the Secretary, leading to a degree in medicine or osteopathic medicine;</text></subparagraph><subparagraph id="H0F17D1B1335C457382F4FA724E404424"><enum>(B)</enum><text>submit an application to participate in the scholarship program; and</text></subparagraph><subparagraph id="HE83CB449AE4047C6988FCEAA468E025C"><enum>(C)</enum><text>sign and submit to the Secretary, at the time of submittal of such application, a written contract (described in paragraph (2)) to accept payment of a scholarship and to serve (in accordance with this section) for the applicable period of obligated service.</text></subparagraph></paragraph><paragraph id="H2ED63555A927418096F570080445F3D7"><enum>(2)</enum><header>Written contract</header><text>The written contract under this subsection between the Secretary and an individual shall contain—</text><subparagraph id="HE24CBCE79BD8457BAB36DAE89E3C7526"><enum>(A)</enum><text>an agreement that—</text><clause id="H6AA8CBE7D2CF43E39E22CFA87FF0C27F"><enum>(i)</enum><text>subject to paragraph (1), the Secretary agrees to provide the individual with a scholarship in each such school year or years for a period of years (not to exceed four school years) determined by the individual, during which period the individual is pursuing a course of study described in paragraph (1)(A); and</text></clause><clause id="HCB4CA3B9BEDD462E8E66A8B5BF82B219"><enum>(ii)</enum><text>subject to paragraph (1), the individual agrees to—</text><subclause id="H6A397AACF535426EA824F369DC5AA9A1"><enum>(I)</enum><text>accept provision of such a scholarship to the individual;</text></subclause><subclause id="HED1B44F5EF09468E98D2C48ED427C509"><enum>(II)</enum><text>maintain enrollment in a course of study described in paragraph (1)(A) until the individual completes the course of study;</text></subclause><subclause id="H0C009C1AD10344D9B98DC6811E63BE5E"><enum>(III)</enum><text>maintain an acceptable level of academic standing;</text></subclause><subclause id="H78130DC3EE46498091C60A2595909DCA"><enum>(IV)</enum><text>complete a residency in a specialty that the Secretary determines is consistent with pursuit of a fellowship in hematology;</text></subclause><subclause id="H62F2CB71134549949EA5AD3DB606A823"><enum>(V)</enum><text>complete a fellowship in the specialty of hematology; and</text></subclause><subclause id="HD474B7B4FCE34BA9854A2C82A60DC142"><enum>(VI)</enum><text>serve for a time period equal to one year for each school year for which the individual was provided a scholarship under this section;</text></subclause></clause></subparagraph><subparagraph id="H349B9AF9CC984DC3884B2CA5169552B2"><enum>(B)</enum><text display-inline="yes-display-inline">a provision that any financial obligation of the United States arising out of the contract and any obligation of the individual which is conditioned thereon, is contingent upon funds being appropriated for scholarships under this section;</text></subparagraph><subparagraph id="H7E5D13E892BC4F67BA5025861DBF4E6A"><enum>(C)</enum><text>a statement of the damages to which the United States is entitled if the individual should breach the contract; and</text></subparagraph><subparagraph id="H8291756F16BD4705BF5D967E8D5B86B2"><enum>(D)</enum><text>such other statements of the rights and liabilities of the Secretary and of the individual as the Secretary determines appropriate, not inconsistent with the provisions of this section.</text></subparagraph></paragraph></subsection><subsection id="H664E83C179B3484A8C7996AEA0DF07B8"><enum>(c)</enum><header>Loan repayments</header><paragraph id="HFF21D7CC928A42F8861DA2215789F5E3"><enum>(1)</enum><header>Eligibility</header><text>To be eligible to participate in the loan repayment program under this section, an individual shall—</text><subparagraph id="H18E6F726B53C431BB2A7047A6FBF7018"><enum>(A)</enum><text display-inline="yes-display-inline">have a degree in medicine or osteopathic medicine; be enrolled in an approved graduate training program in medicine or osteopathic medicine; or be enrolled as a full-time student in an accredited (as determined by the Secretary) educational institution in a State, and in the final year of a course of study offered by such institution and approved by the Secretary, leading to a degree in medicine or osteopathic medicine;</text></subparagraph><subparagraph id="HA285F3A6989646C48CCFB30B6065C7A7"><enum>(B)</enum><text display-inline="yes-display-inline">submit an application to participate in the loan repayment program; and</text></subparagraph><subparagraph id="HE6F3922216AB49D0BA0D8F9B701B25C4"><enum>(C)</enum><text>sign and submit to the Secretary, at the time of submittal of such application, a written contract (described in paragraph (2)) to accept payment by the Secretary of the educational loans of the individual in consideration of the individual serving for a period of obligated service.</text></subparagraph></paragraph><paragraph id="H353CE0B281154D3086D3F66A185280CD"><enum>(2)</enum><header>Written contract</header><text>The written contract under this subsection between the Secretary and an individual shall contain—</text><subparagraph id="HB3B71A5084A247AA8CC89FE4E479806C"><enum>(A)</enum><text>an agreement that—</text><clause id="H6F2B673B11084776B282FB8BA4E58E0A"><enum>(i)</enum><text display-inline="yes-display-inline">subject to paragraph (1), the Secretary agrees to pay on behalf of the individual the principal, interest, and related expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for—</text><subclause id="H0D16054396F84ECBAB59285238DD389B"><enum>(I)</enum><text>tuition expenses;</text></subclause><subclause id="H59FC7A3923C6474DB116BBFB092F1154"><enum>(II)</enum><text>all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the individual; or</text></subclause><subclause id="H94A7523435704E6F8D4E54D66CBA351C"><enum>(III)</enum><text>reasonable living expenses as determined by the Secretary; and</text></subclause></clause><clause id="H0622E0D8500E4C2482A8426153F260ED"><enum>(ii)</enum><text>subject to paragraph (1), the individual agrees to—</text><subclause id="HA47B0F85CE6143D89E2DBB071C823989"><enum>(I)</enum><text>accept loan payments on behalf of the individual;</text></subclause><subclause id="H45CAC58CF27546FE99E0E5F363CFF7D0"><enum>(II)</enum><text>maintain enrollment in a course of study described in paragraph (1)(C) (if applicable) until the individual completes the course of study;</text></subclause><subclause id="H1C8525E0E9554837972564259A5A1A15"><enum>(III)</enum><text>maintain an acceptable level of academic standing;</text></subclause><subclause id="H4833071A7D7547F7952F8F92F3CEF1B6"><enum>(IV)</enum><text>complete a residency in a specialty that the Secretary determines is consistent with pursuit of a fellowship in hematology; and</text></subclause><subclause id="H30E8E8825D884F27B8866AAC9A23C9A9"><enum>(V)</enum><text>complete a fellowship in hematology;</text></subclause></clause></subparagraph><subparagraph id="H0D352FD6B0664FD6BBFBF5FBD2F6B416"><enum>(B)</enum><text display-inline="yes-display-inline">a provision that any financial obligation of the United States arising out of the contract and any obligation of the individual which is conditioned thereon, is contingent upon funds being appropriated for loan repayments under this section;</text></subparagraph><subparagraph id="H061DCD9B0703432C9084A9814705E623"><enum>(C)</enum><text display-inline="yes-display-inline">a statement of the damages to which the United States is entitled if the individual should breach the contract; and</text></subparagraph><subparagraph id="H3F3C11D684EF442CB4AF581B32E6D8B7"><enum>(D)</enum><text display-inline="yes-display-inline">such other statements of the rights and liabilities of the Secretary and of the individual as the Secretary determines appropriate, not inconsistent with the provisions of this section.</text></subparagraph></paragraph></subsection><subsection id="H73661F59BD244DCC8506D42EBC688F81"><enum>(d)</enum><header>Priority</header><text display-inline="yes-display-inline">In awarding contracts under this section for scholarships and loan repayments, the Secretary may prioritize making awards to individuals from disadvantaged backgrounds.</text></subsection><subsection id="H0ECB4C96DE5347D6BD3C24335C0FE5AA"><enum>(e)</enum><header>Definition</header><text>In this section, the term <term>sickle cell disease research</term> means research into the detection, diagnosis, treatment, or control of sickle cell disease.</text></subsection><subsection id="HD532BDEBD5064D73B64B1E999CEB1097"><enum>(f)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there is authorized to be appropriated $150,000,000 for each of fiscal years 2023 through 2028.</text></subsection></section><section id="HC6185C4EC8D0407CB8F2F56630ED01C1"><enum>340K.</enum><header>Community-based grants to engage the sickle cell disease population by designing education and advocacy programs and policies for health and community services</header><subsection id="HD2441185B5434131B3E813F6702683E7"><enum>(a)</enum><header>In general</header><text>The Secretary shall carry out a program consisting of awarding grants to eligible entities for the establishment and support of education and advocacy programs that—</text><paragraph id="H8457CE23FE3741E1830D7E868D649FD2"><enum>(1)</enum><text>engage the sickle cell disease population, their families, or State and local governments in order to—</text><subparagraph id="H59826021EEEC40718B854BA7D78391FE"><enum>(A)</enum><text>improve sickle cell disease health literacy;</text></subparagraph><subparagraph id="H1B9328B0D72F421592027A038727FA47"><enum>(B)</enum><text>disseminate information on health and community services related to sickle cell disease; or</text></subparagraph><subparagraph id="H1B87173483174A82B40A579E06E0F76A"><enum>(C)</enum><text>improve the care and treatment decisionmaking process related to sickle cell disease; and</text></subparagraph></paragraph><paragraph id="H00C679338E4F4BE48ED8BB4E36D011C9"><enum>(2)</enum><text>may include education and advocacy regarding fertility preservation and surrogacy options for individuals with sickle cell disease.</text></paragraph></subsection><subsection id="H39AA69763A4044B389AF8B9307E9B5A0"><enum>(b)</enum><header>Applications</header><text>To seek a grant under subsection (a), an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information and assurances as the Secretary may require.</text></subsection><subsection id="H2D2318233537446A94AAA15B39CD4548"><enum>(c)</enum><header>Consideration</header><text>In determining whether to award a grant under this section to an applicant, and the amount of a grant under this section, the Secretary shall consider the need for sickle cell education or services in the area to be served using the grant.</text></subsection><subsection id="H88E8A973B38B44B0BA95FB8E735E90B5"><enum>(d)</enum><header>Definition</header><text>In this section, the term <term>eligible entity</term> means—</text><paragraph id="H8CD892FC6F5B4E57A5D12E86EBC48BE9"><enum>(1)</enum><text>a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act) or nonprofit organization engaged in providing sickle cell disease education, information, or treatment services;</text></paragraph><paragraph id="HF4872B92DA584F06BA261027090AF3DA"><enum>(2)</enum><text>a community-based organization or faith-based organization or clinic that provides services to, or engages in, advocacy for individuals with sickle cell disease; or</text></paragraph><paragraph id="H32A95F62C0C742689A0E9493EC52FA75"><enum>(3)</enum><text>a nonprofit organization providing comprehensive care to populations with sickle cell disease, including any such nonprofit organization that is a faith-based organization or community-based organization.</text></paragraph></subsection><subsection id="H830BFE83AA1046219580FFE2A4456851"><enum>(e)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">To carry out this section, there is authorized to be appropriated $50,000,000 for each of fiscal years 2023 through 2028.</text></subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block></section></legis-body></bill> 

