[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8790 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 8790
To amend the Public Health Service Act to help build a stronger health
care workforce.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 9, 2022
Mr. Ruiz introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to help build a stronger health
care workforce.
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 ``Building a Health Care Workforce for
the Future Act''.
SEC. 2. GRANTS TO STATES FOR SCHOLARSHIP 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. 338O. GRANTS TO STATES FOR SCHOLARSHIP PROGRAMS.
``(a) In General.--The Secretary shall award grants to eligible
States to enable such States to implement scholarship programs to
ensure, with respect to the provision of health services, an adequate
supply of physicians, dentists, behavioral and mental health
professionals, certified nurse midwives, certified nurse practitioners,
physician assistants, pharmacists, and other health professionals as
determined by the Secretary.
``(b) Eligible States.--To be eligible to receive a grant under
this section, a State shall submit to the Secretary an application
containing such information as the Secretary determines necessary to
carry out this section.
``(c) Eligible Participants.--To be eligible to participate in a
scholarship program carried out with a grant received under this
section, an individual shall--
``(1) be accepted for enrollment, or be enrolled, as a
full-time student--
``(A) in an accredited (as determined by the
Secretary) educational institution in a State; and
``(B) in a course of study or program, offered by
such institution and approved by the Secretary, leading
to a degree in medicine, dentistry, nursing, pharmacy,
or other health profession, or an appropriate degree
from a graduate program of behavioral and mental
health;
``(2) submit to the State an application to participate in
the program; and
``(3) sign and submit to the State, at the time of the
submission of the application under paragraph (2), a written
contract that requires the individual to--
``(A) accept payments under the scholarship;
``(B) maintain a minimum level of academic standing
during the period of the scholarship, as determined by
the Secretary;
``(C) if applicable, complete an accredited
residency training program;
``(D) become licensed in the applicant's State of
residence; and
``(E) serve as a provider for one year in--
``(i) a health professional shortage area
(as defined under section 332);
``(ii) a medically underserved community
(as defined under section 799B); or
``(iii) any other shortage area defined by
the State and approved by the Secretary;
in the applicant's State of residence for every year in
which the applicant received a scholarship.
``(d) Designation of Areas.--To be eligible to receive a grant
under this section, a State shall adequately demonstrate to the
Secretary that the State has designated appropriate health professional
or specialty shortage areas.
``(e) Required Disclosures.--In disseminating application and
contract forms to individuals desiring to participate in a scholarship
program funded under this section, the State shall include with such
forms a summary of the rights and liabilities of an individual whose
application is approved (and whose contract is accepted), including a
clear explanation of the damages to which the State is entitled in the
case of the individual's breach of the contract.
``(f) Awarding of Contracts.--
``(1) In general.--A State that enters into a contract with
an individual under subsection (c)(3) shall, with respect to
the program in which the individual is enrolled, agree to pay--
``(A) all tuition and costs associated with the
program;
``(B) any other reasonable educational expenses,
including fees, books, and laboratory expenses, related
to the program; and
``(C) a cost-of-living stipend in an amount to be
determined by the Secretary.
``(2) Consideration by state.--In entering into contracts
with individuals that meet the requirements of subsection (c),
the State shall consider the extent of the applicant's
demonstrated interest in the provision of care services in a
particular provider shortage area.
``(g) Matching Funds.--A State receiving a grant under this section
shall, with respect to the costs of making payments on behalf of
individuals under the scholarship program implemented by the State
under the grant, 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 $1 of
Federal funds provided under the grant.
``(h) Direct Administration by State Agency.--The scholarship
program of any State receiving a grant under this section shall be
administered directly by a State agency.
``(i) Report by Secretary.--Not later than four years after the
date of enactment of this section, and every five years thereafter, the
Secretary shall submit to Congress a report concerning--
``(1) the number of scholarships awarded under the State
scholarship program;
``(2) the number of scholarship recipients, broken down by
practice area, serving in the profession originally awarded a
scholarship for one year after the completion of the service
period required under subsection (c)(3)(E);
``(3) the number of scholarship recipients, broken down by
provider type, practicing in a medically underserved community
one year after the completion of the service period required
under subsection (c)(3)(E);
``(4) data on any changes in health professional shortage
areas or medically underserved communities within the State;
``(5) remaining gaps in such health professional shortage
areas or medically underserved communities;
``(6) the number of additional full-time physicians that
would be required to eliminate such health professional
shortage areas or medically underserved communities in the
State;
``(7) the number of individuals who received a scholarship
but failed to comply with the requirements of the scholarship;
``(8) the action taken by the State to recoup scholarship
funds in the case of any non-compliance; and
``(9) recommendations to improve the program under this
section.
``(j) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $20,000,000 for each of fiscal
years 2023 through 2027. Not less than 50 percent of the amount
appropriated for a fiscal year under this subsection shall be used to
provide scholarships to providers who intend on pursuing careers in
primary care.''.
SEC. 3. INCREASING MENTORING AND TRANSFORMING COMPETENCIES IN PRIMARY
CARE.
Title VII of the Public Health Service Act is amended by inserting
after section 747A (42 U.S.C. 293k-1) the following:
``SEC. 747B. DEVELOPING EFFECTIVE PRIMARY CARE MENTORS AND IMPROVING
MENTORSHIP OPPORTUNITIES FOR MEDICAL STUDENTS.
``(a) Grants To Cultivate Primary Care Mentors and Improve Primary
Care Mentorship Opportunities for Medical Students.--The Secretary may
award grants to eligible medical schools to assist such schools in
developing and strengthening primary care mentorship programs and
cultivating leaders in primary care among students.
``(b) Eligibility.--To be eligible to receive a grant under this
section, an entity shall--
``(1) be an accredited medical school or college of
osteopathic medicine; and
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require, including an assurance that the
applicant will use amounts received under the grant to--
``(A) establish or enhance existing mentorship
programs, including--
``(i) incentivizing medical school faculty
(through financial or other reward systems) to
participate as a mentor of other primary care
physician faculty members and students;
``(ii) providing resources for aspiring
mentors to participate in workshops or other
learning experiences in which primary care
physicians can learn about effective strategies
in primary care mentoring;
``(iii) enabling successful primary care
mentors on medical school faculty to spend time
at another institution where they can promote
best practices in mentoring primary care
leaders and students; and
``(iv) developing web-based resources for
mentors to interact regularly and share
successful strategies; or
``(B) cultivate interest and leaders in primary
care among students, including--
``(i) offering students that identify
interest in primary care upon matriculation
longitudinal experiences in primary care to
care for and track the health and wellness of
patients throughout medical school;
``(ii) arranging partnerships with private
practices, insurers, schools of public health,
public health departments, and community-based
service projects with the goal of providing
students with the opportunity to interact with
primary care mentors from a variety of health
care settings;
``(iii) providing stipends or other forms
of financial resources to students who work
with designated mentors in the field of primary
care in underserved urban and rural
communities; and
``(iv) supporting opportunities for
students to engage in practice redesign or
other efforts in which primary care physicians
are taking a leadership role in delivery system
reform.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $20,000,000 for each of fiscal
years 2023 through 2029.
``SEC. 747C. DEVELOPING AND PROMOTING NEW COMPETENCIES.
``(a) Grants To Develop and Promote New Competencies.--In order to
foster curricular innovations to improve the education and training of
health care providers, the Secretary shall award grants to medical and
other health professions schools to promote priority competencies (as
described in subsection (b)).
``(b) Priority Competencies.--In awarding grants under subsection
(a), the Secretary, acting through the Advisory Committee on Training
in Primary Care and Dentistry, shall select an annual competency to
direct the awarding of such grants. Such annual competencies may
include--
``(1) patient-centered medical homes;
``(2) chronic disease management;
``(3) integration of primary care and mental health care;
``(4) integration of primary care, public and population
health, and health promotion;
``(5) cultural competency;
``(6) domestic violence;
``(7) improving care in medically undeserved areas; and
``(8) team-based care.
``(c) Grant Recipients.--The Secretary may award grants under
subsection (a) to programs that provide education or training for--
``(1) physicians;
``(2) dentists and dental hygienists;
``(3) physician assistants;
``(4) mental and behavioral health providers;
``(5) public and populations health professionals; or
``(6) pharmacists.
``(d) Consideration in Evaluating Grant Applications.--The
Secretary shall give consideration to applicants that are proposing to
partner with other medical programs, health professions programs, or
nursing programs.
``(e) Grantee Reports.--Each recipient of a grant under this
section shall, not later than 180 days after the end of the grant
period involved, submit to the Advisory Committee, a report on the
following (where appropriate):
``(1) A description of how the funding under the grant was
used by the grantee.
``(2) A description of the intended goal of such funding.
``(3) A description of the challenges faced by the grantee
in reaching the goal described in paragraph (2).
``(4) A description of the lessons learned by the grantee
related to the grant activities.
``(f) Recommendations of the Advisory Committee.--The Advisory
Committee, based on the information submitted under subsection (e),
shall annually report to the Secretary on outcomes of the activities
carried out under grants under this section, including specific
recommendations for scaling up innovations to promote education and
training of health care providers in the priority competencies
described in subsection (b).
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2023 through 2027.''.
SEC. 4. STUDY ON DOCUMENTATION REQUIREMENTS FOR COGNITIVE SERVICES.
Not later than three years after the date of enactment of this Act,
the Institute of Medicine shall conduct a study and submit a report to
Congress concerning the documentation requirements for cognitive
services (evaluation and management services) required under the
Medicare and Medicaid programs under titles XVIII and XIX of the Social
Security Act, respectively, and through private health insurers. Such
study shall include an evaluation of--
(1) how documentation requirements designed for paper-based
records should be modified for electronic records;
(2) whether or not the documentation requirements are
overly burdensome on physicians and detract from patient care;
(3) the administrative costs to physician practices of the
current documentation requirements;
(4) the average amount of time required by physicians to
document cognitive services;
(5) options to more appropriately compensate physicians for
evaluation and management of patient care without requiring
excessive documentation of cognitive services; and
(6) recommendations for less burdensome alternatives or
changes to existing documentation requirements of cognitive
services.
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