[Congressional Record Volume 147, Number 171 (Tuesday, December 11, 2001)]
[Senate]
[Pages S12863-S12864]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REED (for himself, Mr. Enzi, Mr. Johnson, Mr. Chafee, Mr. 
        Graham, Ms. Collins, Ms. Landrieu, Mr. Hutchinson, Mr. Inouye, 
        Mr. Cochran, and Mr. Wellstone):
  S. 1806. A bill to amend the Public Health Service Act with respect 
to health professions programs regarding the practice of pharmacy; to 
the Committee on Health, Education, Labor, and Pensions.
  Mr. REED. Madam President, I rise today, joined by my colleagues, 
Senator Johnson of South Dakota and Senator Enzi of Wyoming, to 
introduce legislation that will address the growing shortage of 
pharmacists.
  The Pharmacists Education Act takes a multi-faceted approach to the 
problem of workforce shortages in the pharmacy sector. In December 
2000, the Health Resources and Services Administration, HRSA, Bureau of 
Health Professions published a report entitled, ``The Pharmacist 
Workforce: A Study of the Supply and Demand for Pharmacists''. This 
study considered the factors influencing the demand for pharmacists in 
the health care sector and also looked at the ability of our academic 
institutions to supply the quantity of pharmacy students required to 
meet this growing demand. The report concluded that there was indeed 
evidence of a shortage in the field, due primarily to the rapid 
increase in demand for pharmacists and the array of services they 
provide, coupled with a constrained ability to expand the number of 
pharmacy education programs to accommodate the need for more practicing 
pharmacists. The study also indicated that the shortage was unlikely to 
abate in the future without significant changes to the current system.
  Pharmacists represent the third largest health professional group in 
the United States with about 190,000 active pharmacists last year. This 
figure is expected to grow to 224, 500 by 2010. Yet, despite this 
anticipated increase in the number of practicing pharmacists, the 
demand for the services is expected to continue to outpace supply. A 
recent employment survey conducted by the National Association of Chain 
Drug stores found that the number of vacancies among their member 
companies had increased by 1,000 positions in the last six months 
alone.
  Remarkable advancements in medical science have made treatments for 
diseases once thought impossible to treat a reality. And what is 
possible is quickly what is practiced in the medical profession. Many 
of these dynamic breakthroughs have been in the area of 
pharmaceuticals.
  These remarkable changes in health care have resulted in dramatic 
upswings in the number of retail prescriptions dispensed annually, from 
1.9 billion in 1992 to 2.8 billion in 1999. Moreover, as medications 
become more complex and diverse, and our population becomes older and 
sicker, the role of the pharmacist in the health care setting has 
become evermore important. For these reasons, my colleagues and I felt 
it was very important that steps be taken to avert a more serious 
shortage of these critical health professionals.
  The Pharmacy Education Act seeks to enhance not only the supply of 
pharmacists, by providing much needed support to Colleges of Pharmacy, 
it also aims to improve the distribution of pharmacists by building 
upon the National Health Service Corps. Specifically, the bill expands 
eligibility of certain existing Federal grant programs to Colleges of 
Pharmacy to upgrade and expand facilities and laboratory space and 
recruit and retain talented faculty to educate pharmacy students.
  The bill also provides a number of new sources of financial aid to 
students interested in pursuing a career in pharmacy. First, the bill 
allows students entering pharmacy school and students who have 
graduated with a PharmD degree to apply for National Health Service 
Corps, NHSC, Scholarship and Loan Repayment funds. Second, it allows 
students who demonstrate financial need to apply for scholarships to 
qualifying schools of pharmacy.
  This bill is endorsed by a number of organizations, including the 
American Association of Colleges of Pharmacy, the National Association 
of Chain Drug Stores, National Community Pharmacists Association, 
American College of Clinical Pharmacy and American Society of Health-
System Pharmacists.
  Increasing demand for pharmacists makes it imperative that a 
proactive response to current trends be undertaken before the situation 
becomes critical. I hope my colleagues will join me in seeking 
expeditious consideration and passage of this timely and important 
legislation.
  I ask unanimous consent that the text of the Pharmacy Education Act 
be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1806

       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 ``Pharmacy Education Aid Act 
     of 2001''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Pharmacists are an important link in our Nation's 
     health care system. A critical shortage of pharmacists is 
     threatening the ability of pharmacies to continue to provide 
     important prescription related services.
       (2) In the landmark report entitled ``To Err is Human: 
     Building a Safer Health System'', the Institute of Medicine 
     reported that medication errors can be partially attributed 
     to factors that are indicative of a shortage of pharmacists 
     (such as too many customers, numerous distractions, and staff 
     shortages).
       (3) Congress acknowledged in the Healthcare Research and 
     Quality Act of 1999 (Public Law 106-129) a growing demand for 
     pharmacists by requiring the Secretary of Health and Human 
     Services to conduct a study to determine whether there is a 
     shortage of pharmacists in the United States and, if so, to 
     what extent.
       (4) As a result of Congress' concern about how a shortage 
     of pharmacists would impact the public health, the Secretary 
     of Health and Human Services published a report entitled 
     ``The Pharmacist Workforce: A Study in Supply and Demand for 
     Pharmacists'' in December of 2000.
       (5) The Pharmacist Workforce: A Study in Supply and Demand 
     for Pharmacists'' found that ``While the overall supply of 
     pharmacists has increased in the past decade, there has been 
     an unprecedented demand for pharmacists and for 
     pharmaceutical care services, which has not been met by the 
     currently available supply'' and that the ``evidence clearly 
     indicates the emergence of a shortage of pharmacists over the 
     past two years''.
       (6) The same study also found that ``The factors causing 
     the current shortage are of a nature not likely to abate in 
     the near future without fundamental changes in pharmacy 
     practice and education.'' The study projects that the number 
     of prescriptions filled by community pharmacists will 
     increase by 20 percent by 2004. In contrast, the number of 
     community pharmacists is expected to increase by only 6 
     percent by 2005.
       (7) The demand for pharmacists will increase as 
     prescription drug use continues to grow.

     SEC. 3. INCLUSION OF PRACTICE OF PHARMACY IN PROGRAM FOR 
                   NATIONAL HEALTH SERVICE CORPS.

       (a) Inclusion in Corps Mission.--Section 331(a)(3) of the 
     Public Health Service Act (42 U.S.C. 254d(a)(3)) is amended--
       (1) in subparagraph (D), by adding at the end the 
     following: ``Such term includes pharmacist services.''; and
       (2) by adding at the end the following:
       ``(E)(i) The term `pharmacist services' includes drug 
     therapy management services furnished by a pharmacist, 
     individually or on behalf of a pharmacy provider, and such 
     services and supplies furnished incident to

[[Page S12864]]

     the pharmacist's drug therapy management services, that the 
     pharmacist is legally authorized to perform (in the State in 
     which the individual performs such services) in accordance 
     with State law (or the State regulatory mechanism provided 
     for by State law).''.
       (b) Scholarship Program.--Section 338A of the Public Health 
     Service Act (42 U.S.C. 254l) is amended--
       (1) in subsection (a)(1), by inserting ``pharmacists,'' 
     after ``physicians,''; and
       (2) in subsection (b)(1), by inserting ``pharmacy'' after 
     ``dentistry,''.
       (c) Loan Repayment Program.--Section 338B of the Public 
     Health Service Act (42 U.S.C. 254l-1) is amended--
       (1) in subsection (a)(1), by inserting ``pharmacists,'' 
     after ``physicians,''; and
       (2) in subsection (b)(1), by inserting ``pharmacy,'' after 
     ``dentistry,''.
       (d) Funding.--Section 338H(b)(2) of the Public Health 
     Service Act (42 U.S.C. 254q(b)(2)) is amended in subparagraph 
     (A), by inserting before the period the following: ``, which 
     may include such contracts for individuals who are in a 
     course of study or program leading to a pharmacy degree''.

     SEC. 4. CERTAIN HEALTH PROFESSIONS PROGRAMS REGARDING 
                   PRACTICE OF PHARMACY.

       (a) In General.--Part E of title VII of the Public Health 
     Service Act (42 U.S.C. 294n et seq) is amended--
       (1) by redesignating section 770 as section 771; and
       (2) by adding at the end the following subpart:

                ``Subpart 3--Certain Workforce Programs

     ``SEC. 771. PRACTICING PHARMACIST WORKFORCE.

       ``(a) Recruiting and Retaining Students and Faculty.--
       ``(1) In general.--The Secretary may make awards of grants 
     or contracts to qualifying schools of pharmacy (as defined in 
     subsection (f)) for the purpose of carrying out programs for 
     recruiting and retaining students and faculty for such 
     schools, including programs to provide scholarships for 
     attendance at such schools to full-time students who have 
     financial need for the scholarships and who demonstrate a 
     commitment to becoming practicing pharmacists or faculty.
       ``(2) Preference in providing scholarships.--An award may 
     not be made under paragraph (1) unless the qualifying school 
     of pharmacy involved agrees that, in providing scholarships 
     pursuant to the award, the school will give preference to 
     students for whom the costs of attending the school would 
     constitute a severe financial hardship.
       ``(b) Loan Repayment Program Regarding Faculty Positions.--
       ``(1) In general.--The Secretary may establish a program of 
     entering into contracts with individuals described in 
     paragraph (2) under which the individuals agree to serve as 
     members of the faculties of qualifying schools of pharmacy in 
     consideration of the Federal Government agreeing to pay, for 
     each year of such service, not more than $20,000 of the 
     principal and interest of the educational loans of such 
     individuals.
       ``(2) Eligible individuals.--The individuals referred to in 
     paragraph (1) are individuals who--
       ``(A) have a doctoral degree in pharmacy or the 
     pharmaceutical sciences; or
       ``(B) are enrolled in a school of pharmacy and are in the 
     final academic year of such school in a program leading to 
     such a doctoral degree.
       ``(3) Requirements regarding faculty positions.--The 
     Secretary may not enter into a contract under paragraph (1) 
     unless--
       ``(A) the individual involved has entered into a contract 
     with a qualifying school of pharmacy to serve as a member of 
     the faculty of the school for not less than 2 years;
       ``(B) the contract referred to in subparagraph (A) provides 
     that, in serving as a member of the faculty pursuant to such 
     subparagraph, the individual will--
       ``(i) serve full time; or
       ``(ii) serve as a member of the adjunct clinical faculty 
     and in so serving will actively supervise pharmacy students 
     for 25 academic weeks per year (or such greater number of 
     academic weeks as may be specified in the contract); and
       ``(C) such contract provides that--
       ``(i) the school will, for each year for which the 
     individual will serve as a member of the faculty under the 
     contract with the school, make payments of the principal and 
     interest due on the educational loans of the individual for 
     such year in an amount equal to the amount of such payments 
     made by the Secretary for the year;
       ``(ii) the payments made by the school pursuant to clause 
     (i) on behalf of the individual will be in addition to the 
     pay that the individual would otherwise receive for serving 
     as a member of such faculty; and
       ``(iii) the school, in making a determination of the amount 
     of compensation to be provided by the school to the 
     individual for serving as a member of the faculty, will make 
     the determination without regard to the amount of payments 
     made (or to be made) to the individual by the Federal 
     Government under paragraph (1).
       ``(4) Applicability of certain provisions.--The provisions 
     of sections 338C, 338G, and 338I shall apply to the program 
     established in paragraph (1) to the same extent and in the 
     same manner as such provisions apply to the National Health 
     Service Corps Loan Repayment Program established in subpart 
     III of part D of title III, including the applicability of 
     provisions regarding reimbursements for increased tax 
     liability and provisions regarding bankruptcy.
       ``(5) Waiver regarding school contributions.--The Secretary 
     may waive the requirement established in paragraph (3)(C) if 
     the Secretary determines that the requirement will impose an 
     undue financial hardship on the school involved.
       ``(c) Information Technology.--The Secretary may make 
     awards of grants or contracts to qualifying schools of 
     pharmacy for the purpose of assisting such schools in 
     acquiring and installing computer-based systems to provide 
     pharmaceutical education. Education provided through such 
     systems may be graduate education, professional education, or 
     continuing education. The computer-based systems may be 
     designed to provide on-site education, or education at remote 
     sites (commonly referred to as distance learning), or both.
       ``(d) Facilities.--The Secretary may award grants under 
     section 1610 for construction projects to expand, remodel, 
     renovate, or alter existing facilities for qualifying schools 
     of pharmacy or to provide new facilities for the schools.
       ``(e) Requirement Regarding Education in Practice of 
     Pharmacy.--With respect to the qualifying school of pharmacy 
     involved, the Secretary shall ensure that programs and 
     activities carried out with Federal funds provided under this 
     section have the goal of educating students to become 
     licensed pharmacists, or the goal of providing for faculty to 
     recruit, retain, and educate students to become licensed 
     pharmacists.
       ``(f) Qualifying School of Pharmacy.--For purposes of this 
     section, the term `qualifying school of pharmacy' means a 
     college or school of pharmacy (as defined in section 799B) 
     that, in providing clinical experience for students, requires 
     that the students serve in a clinical rotation in which 
     pharmacist services (as defined in section 331(a)(3)(E)) are 
     provided at or for--
       ``(1) a medical facility that serves a substantial number 
     of individuals who reside in or are members of a medically 
     underserved community (as so defined);
       ``(2) an entity described in any of subparagraphs (A) 
     through (L) of section 340B(a)(4) (relating to the definition 
     of covered entity);
       ``(3) a health care facility of the Department of Veterans 
     Affairs or of any of the Armed Forces of the United States;
       ``(4) a health care facility of the Bureau of Prisons;
       ``(5) a health care facility operated by, or with funds 
     received from, the Indian Health Service; or
       ``(6) a disproportionate share hospital under section 1923 
     of the Social Security Act.
       ``(g) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 2002 through 2006.''.
       (b) Technical and Conform Amendments.--Section 1610(a) of 
     the Public Health Service Act (42 U.S.C. 300r(a)) is 
     amended--
       (1) in paragraph (1)--
       (A) in subparagraph (A)--
       (i) in clause (i), by striking ``or'' at the end thereof;
       (ii) in clause (ii), by striking the period and inserting 
     ``; or''; and
       (iii) by adding at the end the following:
       ``(iii) expand, remodel, renovate, or alter existing 
     facilities for qualifying schools of pharmacy or to provide 
     new facilities for the schools in accordance with section 
     771(d).'';
       (B) in subparagraph (B)--
       (i) in clause (i), by striking ``and'' at the end thereof;
       (ii) in clause (ii)(II), by striking the period and 
     inserting ``; or''; and
       (iii) by adding at the end the following:
       ``(iii) a qualifying school of pharmacy (as defined in 
     section 771(f)).'';
       (2) by striking the first sentence of paragraph (3) and 
     inserting the following: ``There are authorized to be 
     appropriated for grants under paragraph (1)(A)(iii), such 
     sums as may be necessary.''; and
       (3) by adding at the end the following:
       ``(4) Recapture of payments.--If, during the 20-year period 
     beginning on the date of the completion of construction 
     pursuant to a grant under paragraph (1)(A)(iii)--
       ``(A) the school of pharmacy involved, or other owner of 
     the facility, ceases to be a public or nonprofit private 
     entity; or
       ``(B) the facility involved ceases to be used for the 
     purposes for which it was constructed (unless the Secretary 
     determines, in accordance with regulations, that there is 
     good cause for releasing the school or other owner from such 
     obligation);

     the United States is entitled to recover from the school or 
     other owner of the facility the amount bearing the same ratio 
     to the current value (as determined by an agreement between 
     the parties or by action brought in the United States 
     District Court for the district in which such facility is 
     situated) of the facility as the amount of the Federal 
     participation bore to the cost of the construction of such 
     facility.''.
                                 ______