[Congressional Record Volume 155, Number 137 (Friday, September 25, 2009)]
[Senate]
[Pages S9869-S9871]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REED (for himself and Mr. Leahy):
  S. 1720. A bill to amend title VII of the Public Health Service Act 
to provide improved training and primary

[[Page S9870]]

care; to the Committee on Health, Education, Labor, and Pensions.
  Mr. REED. Mr. President, today I, along with Senator Leahy, introduce 
the Health Professions and Primary Care Reinvestment Act, which seeks 
to enhance the training and education of primary care providers and 
establish a new system for evaluating and analyzing primary care 
workforce programs funded by Title VII Health Professions Education and 
Training grants.
  In 1963, in response to an impending physician shortage, Congress 
passed and President Johnson signed the Health Professions Educational 
Assistance Act into law. Qualified educational and medical institutions 
became eligible for grants to support primary care curriculum and 
faculty development, and scholarships and loans to train individuals in 
certain primary care health professions.
  The country is, once again, facing a physician shortage. However, 
this time, the shortage is one component of a larger system-wide 
crisis.
  The Health Professions and Primary Care Reinvestment Act takes an 
important step toward providing our primary care providers with the 
necessary resources for better coordinating care, integrating treatment 
options, and communicating with patients. It also would enhance the 
evaluation and analysis of programs funded by Title VII grants in an 
effort to ensure that funding is appropriately allocated.
  The Title VII program deserves a robust evaluation and restructuring 
and I believe that the provisions set forth in the Health Professions 
and Primary Care Reinvestment Act will accomplish that goal. My 
colleagues on the Health, Education, Labor, and Pensions Committee 
agreed and voted to include similar provisions in the Affordable Health 
Choices Act, which was reported out of the Committee on July 15, 2009.
  We must continue our efforts to reform our health care system. In 
doing so, we must not forget about the important need to ensure an 
adequate workforce to care for patients. I look forward to the full 
Senate considering these vitally important reforms.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1720

       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 Professions and 
     Primary Care Reinvestment Act''.

     SEC. 2. EDUCATION AND TRAINING FOR DELIVERY SYSTEM REFORM.

       (a) Medical Home Training.--Section 747(a) of the Public 
     Health Service Act (42 U.S.C. 293k(a)) is amended--
       (1) in paragraph (5), by striking ``and'' at the end;
       (2) in paragraph (6), by striking the period and inserting 
     ``; and''; and
       (3) by inserting after paragraph (6) the following:
       ``(7) to plan, develop, and operate a demonstration program 
     that provides training in new competencies, as recommended by 
     the Advisory Committee on Training in Primary Care Medicine 
     and Dentistry, which may include--
       ``(A) providing training to primary care providers relevant 
     to providing care through patient-centered medical homes (as 
     defined by the Secretary for purposes of this paragraph, 
     taking into account the criteria of the National Committee 
     for Quality Assurance and other certifying entities);
       ``(B) developing tools and curricula relevant to patient-
     centered medical homes; and
       ``(C) providing continuing education relevant to patient-
     centered medical homes.''.
       (b) Priorities of Delivery System Reform.--Section 747 of 
     the Public Health Service Act (42 U.S.C. 293k) is amended by 
     striking subsection (c) and inserting the following:
       ``(c) Priorities in Making Awards.--In awarding grants or 
     contracts under this section, the Secretary shall give 
     priority to qualified applicants that--
       ``(1) have a record of training the greatest percentage of 
     providers, or that have demonstrated significant improvements 
     in the percentage of providers trained, who enter and remain 
     in primary care practice;
       ``(2) have a record of training individuals who are from 
     underrepresented minority groups or from a rural or 
     disadvantaged background;
       ``(3) provide training in the care of vulnerable 
     populations such as children, older adults, homeless 
     individuals, victims of abuse or trauma, individuals with 
     mental health or substance-related disorders, individuals 
     with HIV/AIDS, and individuals with disabilities;
       ``(4) establish formal relationships and submit joint 
     applications with federally qualified health centers, rural 
     health clinics, area health education centers, or clinics 
     located in underserved areas or that serve underserved 
     populations;
       ``(5) provide training in interdisciplinary, integrated 
     care through collaboration among health professionals, 
     including physician assistants, nurse practitioners, 
     pharmacists, dentists, geriatricians, and mental and 
     behavioral health professionals;
       ``(6) provide training in enhanced communication with 
     patients, evidence-based practice, chronic disease 
     management, preventive care, health information technology, 
     or other competencies as recommended by the Advisory 
     Committee on Training in Primary Care Medicine and Dentistry; 
     or
       ``(7) provide training in cultural competency and health 
     literacy.''.
       (c) Other Amendments.--Section 747 of the Public Health 
     Service Act (42 U.S.C. 293k) is amended--
       (1) in subsection (d)--
       (A) by striking ``subsection (a) may not exceed'' and 
     inserting ``this section shall be''; and
       (B) by striking the second sentence; and
       (2) by striking subsection (e) and inserting the following:
       ``(e) Authorization of Appropriations.--For purposes of 
     carrying out this section, there are authorized to be 
     appropriated $125,000,000 for each of fiscal years 2010 
     through 2014. Fifteen percent of the amount appropriated in 
     each such fiscal year shall be allocated to the physician 
     assistant training programs described in subsection (a)(5), 
     which prepare students for practice in primary care.''.

     SEC. 3. HEALTH WORKFORCE INFORMATION AND ANALYSIS.

       (a) In General.--Section 761 of the Public Health Service 
     Act (42 U.S.C. 294m) is amended--
       (1) by redesignating subsection (c) as subsection (e);
       (2) by striking subsection (b) and inserting the following:
       ``(b) National Center for Health Workforce Analysis.--
       ``(1) Establishment.--The Secretary shall establish the 
     National Center for Health Workforce Analysis (referred to in 
     this section as the ``National Center'') within the 
     Department of Health and Human Services.
       ``(2) Purposes.--The purposes of the National Center are 
     to--
       ``(A) carry out the activities under section 792(a); and
       ``(B) collect, analyze, and report data related to health 
     workforce issues in coordination with the State and Regional 
     Centers for Health Workforce Analysis described in subsection 
     (c) (referred to in this section as the ``State and Regional 
     Centers'').
       ``(3) Functions.--The National Center shall--
       ``(A) annually evaluate the effectiveness of programs under 
     this title, based on data reported by recipients of contracts 
     or grants under this title, data collected from the State and 
     Regional Centers described in subsection (c), and analyses 
     conducted under paragraph (4);
       ``(B) develop and publish benchmarks for performance for 
     programs under this title;
       ``(C) regularly produce and report to the relevant 
     committees of Congress estimates of the supply, demand, and 
     distribution of health professionals, such as physicians, 
     dentists, nurses, physician assistants, pharmacists, mental 
     and behavioral health professionals, public health workers, 
     and long-term care workers, as appropriate;
       ``(D) establish, maintain, and make publicly available 
     through the Internet a national health workforce database to 
     collect data from--
       ``(i) longitudinal tracking systems (as defined in section 
     761(d)(2)) on performance measures (as developed under 
     sections 748(d)(3), 756(d)(3), and 762(a)(3)); and
       ``(ii) the State and Regional Centers described in 
     subsection (c);
       ``(E) establish and maintain a registry of each grant 
     awarded under this title, including data on the project 
     director, the institution, the type and year of the award, 
     and the residency, fellowship, or internship program, as 
     appropriate; and
       ``(F) biennially submit to the relevant committees of 
     Congress a report on the activities of the National Center 
     during the previous 2-year period.
       ``(4) Collaboration and data sharing.--
       ``(A) In general.--The National Center shall collaborate 
     with Federal agencies, health professions education 
     organizations, health professions organizations, and 
     professional medical societies for the purpose of linking 
     data regarding grants awarded under this title with 1 or more 
     of the following:
       ``(i) Data maintained by the Centers for Medicare & 
     Medicaid Services.
       ``(ii) Data on participation in the National Health Service 
     Corps.
       ``(iii) Data sets maintained by health professions 
     education organizations, health professions organizations, or 
     professional medical societies.
       ``(iv) Other data sets, as the Secretary determines 
     appropriate.
       ``(B) Contracts for health workforce analysis.--For the 
     purpose of carrying out the activities described in 
     subparagraph (A),

[[Page S9871]]

     the National Center may enter into contracts with health 
     professions education organizations, health professions 
     organizations, or professional medical societies.
       ``(c) State and Regional Centers for Health Workforce 
     Analysis.--
       ``(1) In general.--The Secretary shall award grants to, or 
     enter into contracts with, eligible entities for purposes 
     of--
       ``(A) collecting, analyzing, and reporting to the National 
     Center data regarding programs under this title and data 
     related to health workforce issues;
       ``(B) conducting, broadly disseminating, and making 
     publicly available through the Internet research and reports 
     on State, regional, and national health workforce issues, 
     including research on the supply, demand, and distribution of 
     health professionals;
       ``(C) evaluating the effectiveness of programs under this 
     title and other policies related to health workforce issues; 
     and
       ``(D) providing technical assistance to local and regional 
     entities on the collection, analysis, and reporting of data 
     related to health workforce issues.
       ``(2) Eligible entities.--To be eligible for a grant or 
     contract under this subsection, an entity shall--
       ``(A) be a State, a State workforce commission, a public 
     health or health professions school, an academic health 
     center, or an appropriate public or private nonprofit entity 
     or a partnership of such entities; and
       ``(B) submit to the Secretary an application at such time, 
     in such manner, and containing such information as the 
     Secretary may require.
       ``(d) Increase in Grants for Longitudinal Tracking 
     Systems.--
       ``(1) In general.--The Secretary shall increase the amount 
     of a grant or contract awarded to an eligible entity under 
     this title for the establishment and maintenance of a 
     longitudinal tracking system.''.
       ``(2) Definition.--
       ``(A) In general.--For purposes of paragraph (1), the term 
     `longitudinal tracking system' means a system that tracks 
     students, residents, fellows, interns, or faculty who have 
     received education, training, or financial assistance from 
     programs under this title over a period of not less than 5 
     years, as specified by the Secretary.
       ``(B) Capability.--A longitudinal tracking system shall be 
     capable of--
       ``(i) tracking participation in the National Health Service 
     Corps, practice in federally qualified health centers, 
     practice in health professional shortage areas and medically 
     underserved areas, and practice in primary care; and
       ``(ii) collecting and reporting data on performance 
     measures developed under sections 748(d)(3), 756(d)(3), and 
     762(a)(3).
       ``(C) Guidelines.--A longitudinal tracking system shall 
     comply with guidelines issued under sections 748(d)(4), 
     756(d)(4), and 762(a)(4).
       ``(3) Eligible entities.--To be eligible to obtain an 
     increase under this section, an entity shall be a recipient 
     of a grant or contract under this title and have not 
     previously received an increase under this section.''; and
       (3) in subsection (e), as so redesignated--
       (A) by striking paragraph (1) and inserting the following:
       ``(1) In general.--
       ``(A) National center for health workforce analysis.--To 
     carry out subsection (b), there are authorized to be 
     appropriated $1,000,000 for each of fiscal years 2010 through 
     2014, and such sums as may be necessary for each subsequent 
     fiscal year.
       ``(B) State and regional centers.--To carry out subsection 
     (c), there are authorized to be appropriated $4,500,000 for 
     each of fiscal years 2010 through 2014, and such sums as may 
     be necessary for each subsequent fiscal year.
       ``(C) Grants for longitudinal tracking systems.--To carry 
     out subsection (d), there are authorized to be appropriated 
     such sums as may be necessary for fiscal years 2010 through 
     2014.
       ``(D) Carryover funds.--An entity that receives an award 
     under this section may carry over funds from 1 fiscal year to 
     another without obtaining approval from the Secretary. In no 
     case may any funds be carried over pursuant to the preceding 
     sentence for more than 3 years.''; and
       (B) in paragraph (2), by striking ``subsection (a)'' and 
     inserting ``paragraph (1)''.
       (b) Transfer of Functions.--Not later than 180 days after 
     the date of enactment of this Act, all of the functions, 
     authorities, and resources of the National Center for Health 
     Workforce Analysis of the Health Resources and Services 
     Administration, as in effect on the date before the date of 
     enactment of this Act, shall be transferred to the National 
     Center for Health Workforce Analysis established under 
     section 761 of the Public Health Service Act, as amended by 
     subsection (a).
       (c) Preference for Use of Longitudinal Tracking Systems.--
     Section 791(a)(1) of the Public Health Service Act (42 U.S.C. 
     295j(a)(1)) is amended--
       (1) in subparagraph (A), by striking ``or'' at the end;
       (2) in subparagraph (B), by striking the period and 
     inserting ``; or''; and
       (3) by adding at the end the following:
       ``(C) utilizes a longitudinal tracking system (as defined 
     in section 761(d)(2)) and reports data from such system to 
     the national workforce database (as established under section 
     761(b)(3)(D)).''.
       (d) Performance Measures; Guidelines for Longitudinal 
     Tracking Systems.--
       (1) Advisory committee on training in primary care medicine 
     and dentistry.--Section 748(d) of the Public Health Service 
     Act (42 U.S.C. 293l(d)) is amended--
       (A) in paragraph (1), by striking ``and'' at the end;
       (B) in paragraph (2), by striking the period and inserting 
     a semicolon; and
       (C) by adding at the end the following:
       ``(3) not later than 3 years after the date of enactment of 
     the Health Professions and Primary Care Reinvestment Act, 
     develop, publish, and implement performance measures, which 
     shall be quantitative to the extent possible, for programs 
     under this part;
       ``(4) develop and publish guidelines for longitudinal 
     tracking systems (as defined in section 761(d)(2)) for 
     programs under this part; and
       ``(5) recommend appropriation levels for programs under 
     this part.''.
       (2) Advisory committee on interdisciplinary, community-
     based linkages.--Section 756(d) of the Public Health Service 
     Act (42 U.S.C. 294f(d)) is amended--
       (A) in paragraph (1), by striking ``and'' at the end;
       (B) in paragraph (2), by striking the period and inserting 
     a semicolon; and
       (C) by adding at the end the following:
       ``(3) not later than 3 years after the date of enactment of 
     the Health Professions and Primary Care Reinvestment Act, 
     develop, publish, and implement performance measures, which 
     shall be quantitative to the extent possible, for programs 
     under this part;
       ``(4) develop and publish guidelines for longitudinal 
     tracking systems (as defined in section 761(d)(2)) for 
     programs under this part; and
       ``(5) recommend appropriation levels for programs under 
     this part.''.
       (3) Advisory council on graduate medical education.--
     Section 762(a) of the Public Health Service Act (42 U.S.C. 
     294o(a)) is amended--
       (A) in paragraph (1), by striking ``and'' at the end;
       (B) in paragraph (2), by striking the period and inserting 
     a semicolon; and
       (C) by adding at the end the following:
       ``(3) not later than 3 years after the date of enactment of 
     the Health Professions and Primary Care Reinvestment Act, 
     develop, publish, and implement performance measures, which 
     shall be quantitative to the extent possible, for programs 
     under this title, except for programs under part C or D;
       ``(4) develop and publish guidelines for longitudinal 
     tracking systems (as defined in section 761(d)(2)) for 
     programs under this title, except for programs under part C 
     or D; and
       ``(5) recommend appropriation levels for programs under 
     this title, except for programs under part C or D.''.

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