[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1423 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 1423

 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, treatment, and patient care, and 
                          for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 3, 2023

Mr. Van Hollen (for himself, Mr. Booker, and Ms. Klobuchar) 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 authorize a scholarship and 
  loan repayment program to incentivize physicians to enter into the 
field of sickle cell disease research, treatment, and patient care, 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 ``Sickle Cell Care Expansion Act of 
2023''.

SEC. 2. ADVANCING TREATMENT AND RESEARCH PERTAINING TO SICKLE CELL 
              DISEASE.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by adding at the end the following:

 ``Subpart XIII--Advancing Treatment and Research Pertaining to Sickle 
                              Cell Disease

``SEC. 340J. SCHOLARSHIP AND LOAN REPAYMENT PROGRAM.

    ``(a) In General.--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--
            ``(1) the Secretary awards a scholarship under subsection 
        (b) or agrees to make loan repayments under subsection (c) with 
        respect to each individual; and
            ``(2) the individual agrees to serve for a period (in this 
        section referred to as the `period of obligated service') as a 
        physician engaged in--
                    ``(A) sickle cell disease research; or
                    ``(B) service in a public or private setting that 
                is primarily focused on 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.
    ``(b) Scholarships.--
            ``(1) Eligibility.--To be eligible to participate in the 
        scholarship program under this section, an individual shall--
                    ``(A) 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;
                    ``(B) submit an application to participate in the 
                scholarship program; and
                    ``(C) 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.
            ``(2) Written contract.--The written contract under this 
        subsection between the Secretary and an individual shall 
        contain--
                    ``(A) an agreement that--
                            ``(i) 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
                            ``(ii) subject to paragraph (1), the 
                        individual agrees to--
                                    ``(I) accept provision of such a 
                                scholarship to the individual;
                                    ``(II) maintain enrollment in a 
                                course of study described in paragraph 
                                (1)(A) until the individual completes 
                                the course of study;
                                    ``(III) maintain an acceptable 
                                level of academic standing;
                                    ``(IV) complete a residency in a 
                                specialty that the Secretary determines 
                                is consistent with pursuit of a 
                                fellowship in hematology;
                                    ``(V) complete a fellowship in the 
                                specialty of hematology; and
                                    ``(VI) serve for a time period 
                                equal to one year for each school year 
                                for which the individual was provided a 
                                scholarship under this section;
                    ``(B) 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;
                    ``(C) a statement of the damages to which the 
                United States is entitled if the individual should 
                breach the contract; and
                    ``(D) 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.
    ``(c) Loan Repayments.--
            ``(1) Eligibility.--To be eligible to participate in the 
        loan repayment program under this section, an individual 
        shall--
                    ``(A) 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;
                    ``(B) submit an application to participate in the 
                loan repayment program; and
                    ``(C) 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.
            ``(2) Written contract.--The written contract under this 
        subsection between the Secretary and an individual shall 
        contain--
                    ``(A) an agreement that--
                            ``(i) 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--
                                    ``(I) tuition expenses;
                                    ``(II) all other reasonable 
                                educational expenses, including fees, 
                                books, and laboratory expenses, 
                                incurred by the individual; or
                                    ``(III) reasonable living expenses 
                                as determined by the Secretary; and
                            ``(ii) subject to paragraph (1), the 
                        individual agrees to--
                                    ``(I) accept loan payments on 
                                behalf of the individual;
                                    ``(II) maintain enrollment in a 
                                course of study described in paragraph 
                                (1)(A) (if applicable) until the 
                                individual completes the course of 
                                study;
                                    ``(III) maintain an acceptable 
                                level of academic standing;
                                    ``(IV) complete a residency in a 
                                specialty that the Secretary determines 
                                is consistent with pursuit of a 
                                fellowship in hematology; and
                                    ``(V) complete a fellowship in 
                                hematology;
                    ``(B) 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;
                    ``(C) a statement of the damages to which the 
                United States is entitled if the individual should 
                breach the contract; and
                    ``(D) 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.
    ``(d) Priority.--In awarding contracts under this section for 
scholarships and loan repayments, the Secretary may prioritize making 
awards to individuals from disadvantaged backgrounds.
    ``(e) Definition.--In this section, the term `sickle cell disease 
research' means research into the detection, diagnosis, treatment, or 
control of sickle cell disease.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $150,000,000 for each of fiscal 
years 2024 through 2029.

``SEC. 340J-1. COMMUNITY-BASED GRANTS TO ENGAGE THE SICKLE CELL DISEASE 
              POPULATION BY DESIGNING EDUCATION AND ADVOCACY PROGRAMS 
              AND POLICIES FOR HEALTH AND COMMUNITY SERVICES.

    ``(a) In General.--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 
engage the sickle cell disease population, their families, or State and 
local governments in order to--
            ``(1) improve sickle cell disease health literacy, 
        including mental health awareness and educational attainment;
            ``(2) disseminate information on health and community 
        services related to sickle cell disease; or
            ``(3) improve access to care and treatment decision-making 
        processes related to sickle cell disease.
    ``(b) Applications.--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.
    ``(c) Consideration.--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.
    ``(d) Definition.--In this section, the term `eligible entity' 
means--
            ``(1) a community-based organization or faith-based 
        organization or clinic that provides services to, or engages 
        in, advocacy for individuals with sickle cell disease;
            ``(2) 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; or
            ``(3) 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.
    ``(e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $50,000,000 for each of fiscal 
years 2024 through 2029.

``SEC. 340J-2. GRANTS FOR SICKLE CELL DISEASE PEDIATRIC TO ADULT 
              TRANSITIONS OF CARE.

    ``(a) In General.--The Secretary shall carry out a program of 
awarding grants to eligible entities for the establishment and support 
of programs--
            ``(1) that--
                    ``(A) provide transition support through a 
                dedicated transition coordinator and management of care 
                for sickle cell disease patients between the ages of 18 
                and 29 who are aging out of pediatric care and 
                receiving adult care for sickle cell disease;
                    ``(B) assist sickle cell patients in identifying 
                and maintaining adult primary care providers and adult 
                specialists for sickle cell disease compatible with the 
                patient's health insurance; and
                    ``(C) provide support services, including mental 
                health services, for the management of the patient's 
                treatments and medical appointments throughout the 
                transition to adult care; and
            ``(2) which, in the case of an eligible entity that is a 
        hospital or an institute of higher education, may include 
        providing training to adult sickle cell disease care 
        specialists on the medical needs of young sickle cell disease 
        patients, through--
                    ``(A) 1- to 2-year long fellowships for any 
                individual that has completed a residency in medicine, 
                combined internal medicine and pediatrics, or family 
                medicine; or
                    ``(B) short-term programs and workshops.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall--
            ``(1) be a nonprofit organization providing comprehensive 
        care to populations with sickle cell disease, including a 
        hospital or an institute of higher education, and including any 
        such nonprofit organization that is a faith-based organization 
        or community-based organization; and
            ``(2) submit an application to the Secretary at such time, 
        in such manner, and containing such information and assurances 
        as the Secretary may require.
    ``(c) Consideration.--In determining whether to award a grant under 
this section to an eligible entity, and the amount of a grant under 
this section, the Secretary shall consider the size of the population 
the eligible entity intends to serve.
    ``(d) Reports.--
            ``(1) Reporting by eligible entities.--Eligible entities 
        receiving a grant under this section shall submit, during the 
        grant period, an annual report to the Secretary. Each such 
        report shall--
                    ``(A) use an established and recognized registry on 
                measuring quality metrics specified by the Secretary; 
                and
                    ``(B) include--
                            ``(i) a description of the activities 
                        carried out using the grant funds;
                            ``(ii) a summary of the health outcomes for 
                        sickle cell patients benefitting from the 
                        transition coordination and management program 
                        supported by the grant; and
                            ``(iii) the number of specialists trained 
                        and fellowships funded under the grant, as 
                        described in subsection (a)(2), as applicable.
            ``(2) Reporting by the secretary.--Not later than 2 years 
        after the date of enactment of the Sickle Cell Care Expansion 
        Act of 2023, and annually thereafter, the Secretary shall 
        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 activities carried 
        out by eligible entities under this section, based on the 
        reports submitted to the Secretary under paragraph (1).
    ``(e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $70,000,000 for each of fiscal 
years 2024 through 2029.''.
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