[Congressional Record Volume 151, Number 46 (Monday, April 18, 2005)]
[Senate]
[Pages S3823-S3825]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN:
  S. 831. A bill to provide for the establishment of a Health Workforce 
Advisory Commission to review Federal health workforce policies and 
make recommendations on improving those policies; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. BINGAMAN. Mr. President, I rise today to introduce legislation 
that will help address the devastating health workforce shortages we 
will be facing in this country. Health care expenditures represent 15.3 
percent of U.S. gross domestic product. These expenditures are expected 
to rise to l8.7 percent by 2014. As health care needs grow, society 
faces increasing challenges related to the health care workforce. By 
2020, 29 percent nursing positions are projected to be vacant. From 
2000-2010, an additional 1.2 million aides will be needed to cover 
projected growth in long-term care positions and replacement of 
departing workers. An aging health care workforce means that by 2008, 
almost half of the workforce will be 45 years of age and older. 
Currently, U.S. providers rely on international medical graduate and 
foreign trained nurses to fill some critical roles, while continuing to 
face a shortage of providers in health professional shortage areas. 
Health workforce challenges need to analyzed, understood, and 
alleviated, to ensure better access and better quality of care.
  The Health Workforce Advisory Commission Act of 2005 will help to 
create a national vision to serve as a roadmap for investing in the 
health workforce. Through analysis and recommendation, an 18 member 
commission of national workforce and health experts will provide 
insight regarding the solutions necessary to enhance our health 
workforce. Key areas for commission focus will include forecasting of 
supply and distribution of physicians, nurses and other health 
professionals, studying the national and global impact of workforce 
policies related to the utilization of internationally trained 
practitioners, and developing appropriate measures to ensure diversity 
of the U.S. health workforce. The commission will make recommendations 
to Congress on health workforce policy.

[[Page S3824]]

  It is vital that the U.S. take new measures to ensure that workforce 
challenges are met and overcome for current and future generations. By 
undertaking and overcoming the challenges before us, we will enhance 
both the quality of healthcare and the quality of life, provide access 
nationwide, and build a health care system that is consistent with our 
current and future health and economic needs. The Health Workforce 
Advisory Commission can serve a new and integral role for our health 
care system and our society, now and in the future.
  I ask unanimous consent that the text of this bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 831

       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 ``Health Workforce Advisory 
     Commission Act of 2005''.

     SEC. 2. HEALTH WORKFORCE ADVISORY COMMISSION.

       (a) Establishment.--The Comptroller General shall establish 
     a commission to be known as the Health Workforce Advisory 
     Commission (referred to in this Act as the ``Commission'').
       (b) Membership.--
       (1) In general.--The Commission shall be composed of 18 
     members to be appointed by the Comptroller General not later 
     than 90 days after the date of enactment of this Act, and an 
     ex-officio member who shall serve as the Director of the 
     Commission.
       (2) Qualifications.--In appointing members to the 
     Commission under paragraph (1), the Comptroller General shall 
     ensure that--
       (A) the Commission includes individuals with national 
     recognition for their expertise in health care workforce 
     issues, including workforce forecasting, undergraduate and 
     graduate training, economics, health care and health care 
     systems financing, public health policy, and other fields;
       (B) the members are geographically representative of the 
     United States and maintain a balance between urban and rural 
     representatives;
       (C) the members includes a representative from the 
     commissioned corps of the Public Health Service;
       (D) the members represent the spectrum of professions in 
     the current and future healthcare workforce, including 
     physicians, nurses, and other health professionals and 
     personnel, and are skilled in the conduct and interpretation 
     of health workforce measurement, monitoring and analysis, 
     health services, economic, and other workforce related 
     research and technology assessment;
       (E) at least 25 percent of the members who are health care 
     providers are from rural areas; and
       (F) a majority of the members are individuals who are not 
     currently primarily involved in the provision or management 
     of health professions education and training programs.
       (3) Terms and vacancies.--
       (A) Terms.--The term of service of the members of the 
     Commission shall be for 3 years except that the Comptroller 
     General shall designate staggered terms for members initially 
     appointed under paragraph (1).
       (B) Vacancies.--Any member who is appointed to fill a 
     vacancy on the Commission that occurs before the expiration 
     of the term for which the member's predecessor was appointed 
     shall be appointed only for the remainder of that term.
       (4) Chairperson.--
       (A) Designation.--The Comptroller General shall designate a 
     member of the Commission, at the time of the appointment of 
     such member--
       (i) to serve as the Chairperson of the Commission; and
       (ii) to serve as the Vice Chairperson of the Commission.
       (B) Term.--A member shall serve as the Chairperson or Vice 
     Chairperson of the Commission under subparagraph (A) for the 
     term of such member.
       (C) Vacancy.--In the case of a vacancy in the 
     Chairpersonship or Vice Chairpersonship, the Comptroller 
     General shall designate another member to serve for the 
     remainder of the vacant member's term.
       (c) Duties.--The Commission shall--
       (1) review the health workforce policies implemented--
       (A) under titles XVIII and XIX of the Social Security Act 
     (42 U.S.C. 1395, 1396 et seq.);
       (B) under titles VII and VIII of the Public Health Service 
     Act (42 U.S.C. 292, 296 et seq.);
       (C) by the National Institutes of Health;
       (D) by the Department of Health and Human Services;
       (E) by the Department of Veterans Affairs; and
       (F) by other departments and agencies as appropriate;
       (2) analyze and make recommendations to improve the methods 
     used to measure and monitor the health workforce and the 
     relationship between the number and make up of such personnel 
     and the access of individuals to appropriate health care;
       (3) review the impact of health workforce policies and 
     other factors on the ability of the health care system to 
     provide optimal medical and health care services;
       (4) analyze and make recommendations pertaining to Federal 
     incentives (financial, regulatory, and otherwise) and Federal 
     programs that are in place to promote the education of an 
     appropriate number and mix of health professionals to provide 
     access to appropriate health care in the United States;
       (5) analyze and make recommendations about the appropriate 
     supply and distribution of physicians, nurses, and other 
     health professionals and personnel to achieve a health care 
     system that is safe, effective, patient centered, timely, 
     equitable, and efficient;
       (6) analyze the role and global implications of 
     internationally trained physicians, nurses, and other health 
     professionals and personnel in the United States health 
     workforce;
       (7) analyze and make recommendations about achieving 
     appropriate diversity in the United States health workforce;
       (8) conduct public meetings to discuss health workforce 
     policy issues and help formulate recommendations for Congress 
     and the Secretary of Health and Human Services;
       (9) in the course of meetings conducted under paragraph 
     (8), consider the results of staff research, presentations by 
     policy experts, and comments from interested parties;
       (10) make recommendations to Congress concerning health 
     workforce policy issues;
       (11) not later than April 15, 2006, and each April 15 
     thereafter, submit a report to Congress containing the 
     results of the reviews conducted under this subsection and 
     the recommendations developed under this subsection;
       (12) periodically, as determined appropriate by the 
     Commission, submit reports to Congress concerning specific 
     issues that the Commission determines are of high importance; 
     and
       (13) carry out any other activities determined appropriate 
     by the Secretary of Health and Human Services.
       (d) Ongoing Duties Concerning Reports and Reviews.--
       (1) Commenting on reports.--
       (A) Submission to commission.--The Secretary of Health and 
     Human Services shall transmit to the Commission a copy of 
     each report that is submitted by the Secretary to Congress if 
     such report is required by law and relates to health 
     workforce policy.
       (B) Review.--The Commission shall review a report 
     transmitted under subparagraph (A) and, not later than 6 
     months after the date on which the report is transmitted, 
     submit to the appropriate committees of Congress written 
     comments concerning such report. Such comments may include 
     such recommendations as the Commission determines 
     appropriate.
       (2) Agenda and additional reviews.--
       (A) In general.--The Commission shall consult periodically 
     with the chairman and ranking members of the appropriate 
     committees of Congress concerning the agenda and progress of 
     the Commission.
       (B) Additional reviews.--The Commission may from time to 
     time conduct additional reviews and submit additional reports 
     to the appropriate committees of Congress on topics relating 
     to Federal health workforce-related programs and as may be 
     requested by the chairman and ranking members of such 
     committees.
       (3) Availability of reports.--The Commission shall transmit 
     to the Secretary of Health and Human Services a copy of each 
     report submitted by the Commission under this section and 
     shall make such reports available to the public.
       (e) Powers of the Commission.--
       (1) General powers.--Subject to such review as the 
     Comptroller General determines to be necessary to ensure the 
     efficient administration of the Commission, the Commission 
     may--
       (A) employ and fix the compensation of the Executive 
     Director and such other personnel as may be necessary to 
     carry out its duties;
       (B) seek such assistance and support as may be required in 
     the performance of its duties from appropriate Federal 
     departments *and agencies;
       (C) enter into contracts or make other arrangements as may 
     be necessary for the conduct of the work of the Commission;
       (D) make advance, progress, and other payments that relate 
     to the work of the Commission;
       (E) provide transportation and subsistence for personnel 
     who are serving without compensation; and
       (F) prescribe such rules and regulations at the Commission 
     determined necessary with respect to the internal 
     organization and operation of the Commission.
       (2) Information.--To carry out its duties under this 
     section, the Commission--
       (A) shall have unrestricted access to all deliberations, 
     records, and nonproprietary data maintained by the General 
     Accounting Office;
       (B) may secure directly from any department or agency of 
     the United States information necessary to enable the 
     Commission to carry out its duties under this section, on a 
     schedule that is agreed upon between the Chairperson and the 
     head of the department or agency involved;
       (C) shall utilize existing information (published and 
     unpublished) collected and assessed either by the staff of 
     the Commission or under other arrangements;
       (D) may conduct, or award grants or contracts for the 
     conduct of, original research and experimentation where 
     information

[[Page S3825]]

     available under subparagraphs (A) and (B) is inadequate;
       (E) may adopt procedures to permit any interested party to 
     submit information to be used by the Commission in making 
     reports and recommendations under this section; and
       (F) may carry out other activities determined appropriate 
     by the Commission.
       (f) Administrative Provisions.--
       (1) Compensation.--While serving on the business of the 
     Commission a member of the Commission shall be entitled to 
     compensation at the per diem equivalent of the rate provided 
     for under level IV of the Executive Schedule under title 5, 
     United States Code.
       (2) Meetings.--The Commission shall meet at the call of the 
     Chairperson.
       (3) Executive director and staff.--The Comptroller General 
     shall appoint an individual to serve as the interim Executive 
     Director of the Commission until the members of the 
     Commission are able to select a permanent Executive Director 
     under subsection (e)(1)(A).
       (4) Ethical disclosure.--The Comptroller General shall 
     establish a system for public disclosure by members of the 
     Commission of financial and other potential conflicts of 
     interest relating to such members.
       (5) Audits.--The Commission shall be subject to periodic 
     audit by the Comptroller General.
       (g) Funding.--
       (1) Requests.--The Commission shall submit requests for 
     appropriations in the same manner as the Comptroller General 
     submits such requests. Amounts appropriated for the 
     Commission shall be separate from amounts appropriated for 
     the Comptroller General.
       (2) Authorization of appropriations.--There are authorized 
     to be appropriated to carry out this section, $6,000,000 for 
     fiscal year 2006, and such sums as may be necessary for each 
     subsequent fiscal year, of which--
       (A) 80 percent of such appropriated amount shall be made 
     available from the Federal Hospital Insurance Trust Fund 
     under section 1817 of the Social Security Act (42 U.S.C. 
     1395i); and
       (B) 20 percent of such appropriation shall be made 
     available for amounts appropriated to carry out title XIX of 
     such Act (42 U.S.C. 1396 et seq.).
       (h) Definition.--In this Act, the term ``appropriate 
     committees of Congress'' means the Committee on Finance of 
     the Senate and the Committee on Ways and Means of the House 
     of Representatives.
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