[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3244 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
                                S. 3244

To amend the Public Health Service Act to establish a Bio-Preparedness 
       and Infectious Diseases Workforce Loan Repayment Program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 18, 2021

 Ms. Baldwin (for herself, Ms. Collins, Ms. Rosen, Ms. Murkowski, Mrs. 
 Gillibrand, and Mr. Cardin) introduced the following bill; which was 
 read twice and referred to the Committee on Health, Education, Labor, 
                              and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to establish a Bio-Preparedness 
       and Infectious Diseases Workforce Loan Repayment Program.

    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 ``Bolstering Infectious Outbreaks 
Preparedness Workforce Act of 2021'' or the ``BIO Preparedness 
Workforce Act of 2021''.

SEC. 2. ESTABLISHMENT OF A BIO-PREPAREDNESS AND INFECTIOUS DISEASES 
              WORKFORCE LOAN REPAYMENT PROGRAM.

    Subpart 3 of part E of title VII of the Public Health Service Act 
(42 U.S.C. 295f et seq.) is amended by inserting after section 776 (42 
U.S.C. 295f-1) the following:

``SEC. 776A BIO-PREPAREDNESS AND INFECTIOUS DISEASES WORKFORCE LOAN 
              REPAYMENT PROGRAM.

    ``(a) Establishment.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, 
shall establish the Bio-Preparedness and Infectious Diseases Workforce 
Loan Repayment Program (referred to in this section as the `Program') 
to ensure an adequate supply of health care professionals engaged in 
bio-preparedness and response activities described in subsection 
(c)(2)(A)(1) and health care professionals engaged in infectious 
disease care described in subsection (c)(2)(A)(ii).
    ``(b) Eligibility.--
            ``(1) In general.--To be eligible to participate in the 
        Program, an individual shall--
                    ``(A)(i) be accepted for enrollment, or be 
                enrolled, as a student in an accredited academic 
                educational institution in a State or territory in the 
                final year of a course of study or program leading to a 
                health professions degree or certificate described in 
                paragraph (2); or
                    ``(ii) have graduated, during the preceding 10-year 
                period, from an accredited educational institution in a 
                State or territory and received a health professions 
                degree or certificate described in paragraph (2);
                    ``(B) be a United States citizen;
                    ``(C)(i) submit an application to the Secretary to 
                participate in the Program; and
                    ``(ii) execute a written contract as required in 
                subsection (c); and
                    ``(D) not have received, for the same service, a 
                reduction of loan obligations under--
                            ``(i) section 338B, 338I, 776, or 846; or
                            ``(ii) section 428K or 428L of the Higher 
                        Education Act of 1965.
            ``(2) Health professions degree or certificate.--A health 
        professions degree or certificate described in this paragraph 
        is a degree or certificate for--
                    ``(A) a doctor of medicine;
                    ``(B) a doctor of osteopathic medicine;
                    ``(C) a doctor of philosophy;
                    ``(D) a doctor of pharmacy;
                    ``(E) certification as a registered nurse;
                    ``(F) a bachelor of science in nursing;
                    ``(G) a master of science in nursing;
                    ``(H) certification as a nurse practitioner;
                    ``(I) certification as a physician assistant;
                    ``(J) a doctor of public health;
                    ``(K) a master of public health;
                    ``(L) a master of science in epidemiology;
                    ``(M) a bachelor of science in medical technology;
                    ``(N) certification in medical technology or as a 
                medical lab scientist;
                    ``(O) a doctor of dental surgery, doctor of 
                medicine in dentistry, or doctor of dental medicine; 
                and
                    ``(P) completion of any other program determined 
                appropriate by the Secretary.
    ``(c) Contract.--
            ``(1) In general.--The written contract (referred to in 
        this section as the `written contract') between the Secretary 
        and an individual shall contain--
                    ``(A) an agreement on the part of the Secretary 
                that the Secretary will repay on behalf of the 
                individual loans incurred by the individual in the 
                pursuit of the relevant degree or certificate in 
                accordance with the terms of the contract;
                    ``(B) an agreement on the part of the individual 
                that the individual will serve as a health care 
                professional engaged in a qualified role for a period 
                of time (referred to in this section as the `period of 
                obligated service') equal to the greater of--
                            ``(i) 3 years; or
                            ``(ii) such longer period of time as 
                        determined appropriate by the Secretary and the 
                        individual;
                    ``(C) a provision that any financial obligation of 
                the United States arising out of a contract entered 
                into under this section and any obligation of the 
                individual that is conditioned thereon, is contingent 
                on funds being appropriated for loan repayments under 
                this section;
                    ``(D) a statement of the damages to which the 
                United States is entitled, under this section for the 
                individual's breach of the contract; and
                    ``(E) such other statements of the rights and 
                liabilities of the Secretary and of the individual, not 
                inconsistent with this section.
            ``(2) Qualified role.--
                    ``(A) In general.--In this subsection, the term 
                `qualified role' means either of the following:
                            ``(i) Bio-preparedness health care 
                        professional.--A role in which the health care 
                        professional spends not less than 50 percent of 
                        their time engaged in bio-preparedness and 
                        response activities, including--
                                    ``(I) developing and updating 
                                response, surge, and isolation capacity 
                                plans and protocols;
                                    ``(II) collaborating with State, 
                                local, and Tribal health departments on 
                                preparedness and response efforts;
                                    ``(III) training health care 
                                facility personnel in matters related 
                                to bio-preparedness;
                                    ``(IV) purchasing and managing 
                                equipment (such as personal protective 
                                equipment) for public health 
                                emergencies, including those declared 
                                under section 319;
                                    ``(V) executing readiness 
                                assessments for public health 
                                emergencies, including those declared 
                                under section 319;
                                    ``(VI) repurposing areas of a 
                                health care facility to manage patient 
                                influx;
                                    ``(VII) communicating with the 
                                public regarding preventing or 
                                responding to public health 
                                emergencies, including those declared 
                                under section 319;
                                    ``(VIII) performing infection 
                                prevention and control and 
                                environmental disinfection;
                                    ``(IX) conducting epidemiologic 
                                surveillance and investigations; and
                                    ``(X) conducting antimicrobial 
                                stewardship.
                            ``(ii) Infectious diseases health care 
                        professional.--A role (including through a 
                        fellowship) in which the health care 
                        professional spends not less than 50 percent of 
                        their time engaging in infectious disease 
                        care--
                                    ``(I) in a medically underserved 
                                community;
                                    ``(II) for a medically underserved 
                                population as defined in section 
                                330(b)(3);
                                    ``(III) at a Federally qualified 
                                health center or rural health clinic 
                                (as those terms are defined in section 
                                1861(aa) of the Social Security Act);
                                    ``(IV) at a health center receiving 
                                assistance under section 330;
                                    ``(V) at a Federal medical 
                                facility;
                                    ``(VI) in a health program, or at a 
                                facility operated, by an Indian Tribe 
                                or Tribal organization (as those terms 
                                are defined in section 4 of the Indian 
                                Self-Determination and Education 
                                Assistance Act) or by an urban Indian 
                                organization as defined in section 4 of 
                                the Indian Health Care Improvement Act;
                                    ``(VII) in a health professional 
                                shortage area as designated under 
                                section 332;
                                    ``(VIII) at an entity receiving 
                                assistance under title XXVI for the 
                                provision of clinical services;
                                    ``(IX) at a critical access 
                                hospital (as defined in section 
                                1861(mm)(1) of the Social Security 
                                Act);
                                    ``(X) in a frontier health 
                                professional shortage area; or
                                    ``(XI) at an accredited public 
                                academic educational institution in a 
                                State or territory or health care 
                                setting affiliated with such an 
                                institution.
                    ``(B) Employment by public health agency.--The term 
                `qualified role' does not include a role in which the 
                health care professional is employed by a Federal, 
                State, local, or Tribal public health agency or is in a 
                related training fellowship, as recognized by the 
                Secretary, excluding--
                            ``(i) a role under clause (i) of 
                        subparagraph (A) in which the health care 
                        professional is employed at a medical facility 
                        described in subclause (XI) of subparagraph 
                        (A)(ii);
                            ``(ii) a role under clause (ii) of 
                        subparagraph (A) in which the health care 
                        professional is employed at a medical facility 
                        described in subclause (V), (VI), or (XI) of 
                        subparagraph (A)(ii); or
                            ``(iii) a role under clause (i) or (ii) of 
                        subparagraph (A) in which the health care 
                        professional is employed in any other setting 
                        specified by the Secretary.
            ``(3) Health care professional.--In this section, the term 
        `health care professional' includes--
                    ``(A) with respect to an individual in a role 
                described in paragraph (2)(A)(i), an individual who 
                is--
                            ``(i) a physician;
                            ``(ii) a clinical pharmacist;
                            ``(iii) a physician assistant;
                            ``(iv) an advanced practice registered 
                        nurse;
                            ``(v) an infection preventionist; or
                            ``(vi) a laboratory professional; or
                    ``(B) with respect to an individual in a role 
                described in paragraph (2)(A)(ii), an individual who 
                is--
                            ``(i) a physician;
                            ``(ii) a clinical pharmacist;
                            ``(iii) a physician assistant;
                            ``(iv) a dentist; or
                            ``(v) an advanced practice registered 
                        nurse.
    ``(d) Payments.--
            ``(1) In general.--A loan repayment provided for an 
        individual under a written contract under the Program shall 
        consist of payment, in accordance with paragraph (2), on behalf 
        of the individual of 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 tuition 
        expenses incurred by the individual.
            ``(2) Payments for years served.--For each year of 
        obligated service that an individual contracts to serve under 
        subsection (c), the Secretary may pay up to $50,000 on behalf 
        of the individual for loans described in paragraph (1). With 
        respect to participants under the Program whose total eligible 
        loans are less than $150,000, the Secretary shall pay an amount 
        that does not exceed \1/3\ of the eligible loan balance for 
        each year of obligated service of the individual.
            ``(3) Tax liability.--For the purpose of providing 
        reimbursements for tax liability resulting from payments under 
        paragraph (2) on behalf of an individual, the Secretary shall, 
        in addition to such payments, make payments to the individual 
        in an amount not to exceed 39 percent of the total amount of 
        loan repayments made for the taxable year involved.
    ``(e) Postponing Obligated Service.--With respect to any individual 
participating in the Program, the date of the initiation of the period 
of obligated service may be postponed as approved by the Secretary.
    ``(f) Breach of Contract.--An individual who fails to comply with 
the contract entered into under subsection (c) shall be subject to the 
same financial penalties as provided for under section 338E for 
breaches of loan repayment contracts under section 338B.
    ``(g) Considerations.--In awarding contracts under this section, 
the Secretary may--
            ``(1) distribute contracts under this section equitably 
        among geographic areas of the United States; and
            ``(2) ensure that contracts under this section help to 
        increase the number of underrepresented minority individuals 
        (as defined in section 738(b)(5)) serving as heath care 
        professionals in roles described in clauses (i) and (ii) of 
        subsection (c)(2)(A).
    ``(h) Additional Criteria.--The Secretary--
            ``(1) may establish, in addition to the criteria and rules 
        specified in this section, such criteria and rules to carry out 
        this section as the Secretary determines are needed; and
            ``(2) shall give notice to the committees specified in 
        subsection (i) of any criteria and rules so established.
    ``(i) Report to Congress.--Not later than 3 years after the date of 
enactment of this section, and every other year thereafter, the 
Secretary shall prepare and submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report on--
            ``(1) the number and location of borrowers who have 
        qualified for loan repayments under this section; and
            ``(2) the impact of this section on the availability of--
                    ``(A) health care professionals engaged in bio-
                preparedness and response activities described in 
                subsection (c)(2)(A)(i), and health care professionals 
                engaged in infectious disease care described in 
                subsection (c)(2)(A)(ii), nationally; and
                    ``(B) health care professionals engaged in 
                infectious disease care described in subsection 
                (c)(2)(A)(ii) in the areas and settings listed in such 
                subsection.
    ``(j) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $50,000,000 for each of fiscal 
years 2023 through 2027.''.
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