[Congressional Record Volume 164, Number 123 (Monday, July 23, 2018)]
[House]
[Pages H6598-H6600]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




EDUCATING MEDICAL PROFESSIONALS AND OPTIMIZING WORKFORCE EFFICIENCY AND 
                         READINESS ACT OF 2018

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3728) to amend title VII of the Public Health Service Act to 
reauthorize certain programs relating to the health professions 
workforce, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3728

       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 ``Educating Medical 
     Professionals and Optimizing Workforce Efficiency and 
     Readiness Act of 2018'' or the ``EMPOWER Act of 2018''.

     SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS WORKFORCE 
                   PROGRAMS.

       (a) Centers of Excellence.--Subsection (i) of section 736 
     of the Public Health Service Act (42 U.S.C. 293) is amended 
     to read as follows:
       ``(i) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $23,711,000 
     for each of fiscal years 2019 through 2023.''.
       (b) Health Professions Training for Diversity.--Section 740 
     of the Public Health Service Act (42 U.S.C. 293d) is 
     amended--
       (1) in subsection (a), by striking ``$51,000,000 for fiscal 
     year 2010, and such sums as may be necessary for each of the 
     fiscal years 2011 through 2014'' and inserting ``$48,970,000 
     for each of fiscal years 2019 through 2023'';
       (2) in subsection (b), by striking ``$5,000,000 for each of 
     the fiscal years 2010 through 2014'' and inserting 
     ``$1,190,000 for each of fiscal years 2019 through 2023''; 
     and
       (3) in subsection (c), by striking ``$60,000,000 for fiscal 
     year 2010 and such sums as may be necessary for each of the 
     fiscal years 2011 through 2014'' and inserting ``$14,189,000 
     for each of fiscal years 2019 through 2023''.
       (c) Primary Care Training and Enhancement.--Section 
     747(c)(1) of the Public Health Service Act (42 U.S.C. 
     293k(c)(1)) is amended by striking ``$125,000,000 for fiscal 
     year 2010, and such sums as may be necessary for each of 
     fiscal years 2011 through 2014'' and inserting ``$48,924,000 
     for each of fiscal years 2019 through 2023''.
       (d) Training in General, Pediatric, and Public Health 
     Dentistry.--Section 748(f) of the Public Health Service Act 
     (42 U.S.C. 293k-2(f)) is amended by striking ``$30,000,000 
     for fiscal year 2010 and such sums as may be necessary for 
     each of fiscal years 2011 through 2015'' and inserting 
     ``$40,673,000 for each of fiscal years 2019 through 2023''.
       (e) Area Health Education Centers.--Section 751(j)(1) of 
     the Public Health Service Act (42 U.S.C. 294a(j)(1)) is 
     amended by striking ``$125,000,000 for each of the fiscal 
     years 2010 through 2014'' and inserting ``$38,250,000 for 
     each of fiscal years 2019 through 2023''.
       (f) National Center for Healthcare Workforce Analysis.--
       (1) In general.--Section 761(e)(1)(A) of the Public Health 
     Service Act (42 U.S.C. 294n(e)(1)(A)) is amended by striking 
     ``$7,500,000 for each of fiscal years 2010 through 2014'' and 
     inserting ``$5,663,000 for each of fiscal years 2019 through 
     2023''.
       (2) Technical correction.--Section 761(e)(2) of the Public 
     Health Service Act (42 U.S.C. 294n(e)(2)) is amended by 
     striking ``subsection (a)'' and inserting ``paragraph (1)''.
       (g) Public Health Workforce.--Section 770(a) of the Public 
     Health Service Act (42 U.S.C. 295e(a)) is amended by striking 
     ``$43,000,000 for fiscal year 2011, and such sums as may be 
     necessary for each of the fiscal years 2012 through 2015'' 
     and inserting

[[Page H6599]]

     ``$17,000,000 for each of fiscal years 2019 through 2023''.

     SEC. 3. EDUCATION AND TRAINING RELATING TO GERIATRICS.

       Section 753 of the Public Health Service Act (42 U.S.C. 
     294c) is amended to read as follows:

     ``SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.

       ``(a) Geriatrics Workforce Enhancement Programs.--
       ``(1) In general.--The Secretary shall award grants or 
     contracts under this subsection to entities described in 
     paragraph (1), (3), or (4) of section 799B, section 801(2), 
     or section 865(d), or other health professions schools or 
     programs approved by the Secretary, for the establishment or 
     operation of geriatrics workforce enhancement programs that 
     meet the requirements of paragraph (2).
       ``(2) Requirements.--A geriatrics workforce enhancement 
     program meets the requirements of this paragraph if such 
     program supports the development of a health care workforce 
     that maximizes patient and family engagement and improves 
     health outcomes for older adults by integrating geriatrics 
     with primary care and other appropriate specialties. Special 
     emphasis should be placed on providing the primary care 
     workforce with the knowledge and skills to care for older 
     adults and collaborating with community partners to address 
     gaps in health care for older adults through individual, 
     system, community, and population level changes. Areas of 
     programmatic focus may include the following:
       ``(A) Transforming clinical training environments to 
     integrated geriatrics and primary care delivery systems to 
     ensure trainees are well prepared to practice in and lead in 
     such systems.
       ``(B) Developing providers who can assess and address the 
     needs and preferences of older adults and their families and 
     caregivers at the individual, community, and population 
     levels.
       ``(C) Creating and delivering community-based programs that 
     will provide older adults and their families and caregivers 
     with the knowledge and skills to improve health outcomes and 
     the quality of care for such adults.
       ``(D) Providing Alzheimer's disease and related dementias 
     (ADRD) education to the families and caregivers of older 
     adults, direct care workers, health professions students, 
     faculty, and providers.
       ``(3) Duration.--The Secretary shall award grants and 
     contracts under paragraph (1) for a period not to exceed five 
     years.
       ``(4) Application.--To be eligible to receive a grant or 
     contract under paragraph (1), an entity described in such 
     paragraph shall submit to the Secretary an application at 
     such time, in such manner, and containing such information as 
     the Secretary may require.
       ``(5) Equitable geographic distribution.--The Secretary may 
     award grants and contracts under paragraph (1) in a manner 
     which will equitably distribute such grants and contracts 
     among the various regions of the United States.
       ``(6) Priority.--In awarding grants and contracts under 
     paragraph (1), the Secretary may give priority to programs 
     that--
       ``(A) have the goal of improving and providing 
     comprehensive coordinated care of older adults, including 
     medical, dental, and psychosocial needs;
       ``(B) support the training and retraining of faculty, 
     preceptors, primary care providers, and providers in other 
     specialties to increase their knowledge of geriatrics and 
     gerontology;
       ``(C) provide clinical experiences across care settings, 
     including ambulatory care, hospitals, post-acute care, 
     nursing homes, federally qualified health centers, and home 
     and community-based services;
       ``(D) emphasize education and engagement of family 
     caregivers on disease self-management, medication management, 
     and stress reduction strategies;
       ``(E) provide training to the health care workforce on 
     disease self-management, motivational interviewing, 
     medication management, and stress reduction strategies;
       ``(F) provide training to the health care workforce on 
     social determinants of health in order to better address the 
     geriatric health care needs of diverse populations;
       ``(G) integrate geriatrics competencies and 
     interprofessional collaborative practice into health care 
     education and training curricula for residents, fellows, and 
     students;
       ``(H) substantially benefit rural or underserved 
     populations of older adults;
       ``(I) integrate behavioral health competencies into primary 
     care practice, especially with respect to elder abuse, pain 
     management, and advance care planning; or
       ``(J) offer short-term intensive courses that--
       ``(i) focus on geriatrics, gerontology, chronic care 
     management, and long-term care that provide supplemental 
     training for faculty members in medical schools and other 
     health professions schools or graduate programs in 
     psychology, pharmacy, nursing, social work, dentistry, public 
     health, allied health, or other health disciplines, as 
     approved by the Secretary; and
       ``(ii) are open to current faculty, and appropriately 
     credentialed volunteer faculty and practitioners, to upgrade 
     their knowledge and clinical skills for the care of older 
     adults and adults with functional and cognitive limitations 
     and to enhance their interdisciplinary teaching skills.
       ``(b) Geriatric Academic Career Awards.--
       ``(1) Establishment of program.--The Secretary shall 
     establish a program to provide Geriatric Academic Career 
     Awards to eligible entities applying on behalf of eligible 
     individuals to promote the career development of such 
     individuals as academic geriatricians or other academic 
     geriatrics health professionals.
       ``(2) Eligibility.--
       ``(A) Eligible entity.--For purposes of this subsection, 
     the term `eligible entity' means--
       ``(i) an entity described in paragraph (1), (3), or (4) of 
     section 799B or section 801(2); or
       ``(ii) an accredited health professions school or graduate 
     program approved by the Secretary.
       ``(B) Eligible individual.--For purposes of this 
     subsection, the term `eligible individual' means an 
     individual who--
       ``(i) is board certified in internal medicine, family 
     practice, psychiatry, or licensed dentistry, or has completed 
     any required training in a discipline and is employed in an 
     accredited health professions school or graduate program that 
     is approved by the Secretary;
       ``(ii) has completed an approved fellowship program in 
     geriatrics or gerontology, or has completed specialty 
     training in geriatrics or gerontology as required by the 
     discipline and any additional geriatrics or gerontology 
     training as required by the Secretary; and
       ``(iii) has a junior (non-tenured) faculty appointment at 
     an accredited school of allopathic medicine, osteopathic 
     medicine, nursing, social work, psychology, dentistry, 
     pharmacy, or other allied health disciplines in an accredited 
     health professions school or graduate program that is 
     approved by the Secretary.
       ``(3) Limitations.--An eligible entity may not receive an 
     award under paragraph (1) on behalf of an eligible individual 
     unless the eligible entity--
       ``(A) submits to the Secretary an application, at such 
     time, in such manner, and containing such information as the 
     Secretary may require, and the Secretary approves such 
     application;
       ``(B) provides, in such form and manner as the Secretary 
     may require, assurances that the eligible individual on whose 
     behalf an application was submitted under subparagraph (A) 
     will meet the service requirement described in paragraph (7); 
     and
       ``(C) provides, in such form and manner as the Secretary 
     may require, assurances that such individual has a full-time 
     faculty appointment in an accredited health professions 
     school or graduate program and documented commitment from 
     such school or program to spend 75 percent of the total time 
     of such individual on teaching and developing skills in 
     interprofessional education in geriatrics.
       ``(4) Requirements.--In awarding grants under this 
     subsection, the Secretary--
       ``(A) shall give priority to eligible entities that apply 
     on behalf of eligible individuals who are on the faculty of 
     institutions that integrate geriatrics education, training, 
     and best practices into academic program criteria;
       ``(B) may give priority to eligible entities that operate a 
     geriatrics workforce enhancement program under subsection 
     (a);
       ``(C) shall ensure that grants are equitably distributed 
     across the various geographical regions of the United States, 
     including rural and underserved areas;
       ``(D) shall pay particular attention to geriatrics health 
     care workforce needs among underserved populations and rural 
     areas; and
       ``(E) may not require an eligible individual, or an 
     eligible entity applying on behalf of an eligible individual, 
     to be a recipient of a grant or contract under this part.
       ``(5) Maintenance of effort.--An eligible entity receiving 
     an award under paragraph (1) on behalf of an eligible 
     individual shall provide assurances to the Secretary that 
     funds provided to such individual under this subsection will 
     be used only to supplement, not to supplant, the amount of 
     Federal, State, and local funds otherwise expended by such 
     individual.
       ``(6) Amount and term.--
       ``(A) Amount.--The amount of an award under this subsection 
     for eligible individuals who are physicians shall equal 
     $100,000 for fiscal year 2017, adjusted for subsequent fiscal 
     years to reflect the increase in the Consumer Price Index. 
     The Secretary shall determine the amount of an award under 
     this subsection for individuals who are not physicians.
       ``(B) Term.--The term of any award made under this 
     subsection shall not exceed 5 years.
       ``(7) Service requirement.--An eligible individual on whose 
     behalf an application was submitted and approved under 
     paragraph (3)(A) shall provide training in clinical 
     geriatrics or gerontology, including the training of 
     interprofessional teams of health care professionals.
       ``(c) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $40,737,000 
     for each of fiscal years 2019 through 2023. Notwithstanding 
     the preceding sentence, no funds shall be made available to 
     carry out subsection (b) for a fiscal year unless the amount 
     made available to carry out this section for such fiscal year 
     is more than the amount made available to carry out this 
     section for fiscal year 2017.''.

  The SPEAKER pro tempore (Mr. Bacon). Pursuant to the rule, the 
gentleman from Texas (Mr. Burgess) and

[[Page H6600]]

the gentleman from Texas (Mr. Gene Green) each will control 20 minutes.
  The Chair recognizes the gentleman from Texas (Mr. Burgess).

                              {time}  1445


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous material into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, as the author of the Educating Medical Professionals and 
Optimizing Workforce Efficiency and Readiness Act of 2018, I rise in 
strong support of this bill. H.R. 3728 moved with strong bipartisan 
support through regular order in the full Energy and Commerce Committee 
and the subcommittee, which I chair. This legislation reauthorizes the 
title VII health professions workforce program for fiscal years 2019 
through 2023.
  Title VII programs have expired but have continued to receive 
appropriations. In fact, in fiscal year 2018, the appropriations levels 
for the program actually increased. Reauthorizing these physician 
workforce programs will provide much-needed stability for those who 
depend upon this funding.
  Title VII of the Public Health Service Act includes various programs 
that are vital to building and maintaining a well-educated, well-
trained physician workforce.
  The EMPOWER Act reauthorizes funding for the Area Health Education 
Centers at more than $38 million a year. These centers are critical in 
providing both medical education and healthcare services to medically 
underserved areas.
  The bill also reauthorizes programs that incentivize diversity in the 
physician workforce, including the Centers of Excellence Program, which 
this bill authorizes at a level of $23 million per year. This 
particular program provides grants to medical schools that have a 
disproportionate number of minority students for the purpose of 
expanding the schools' capacity or to improve curriculum.
  Primary care is an important aspect of our Nation's healthcare system 
and how many Americans receive the majority of their healthcare 
services. H.R. 3728 reauthorizes funding for our Primary Care Training 
and Enhancement Program at more than $48 million per year. This program 
provides grants to hospitals and health professional schools to develop 
and operate supplemental primary care training programs.
  Lastly, this bill aims to strengthen our workforce that cares for the 
geriatric population. The bill makes strides toward modernizing the 
Geriatrics Workforce Enhancement Program and the Geriatric Academic 
Career Award. With an aging population, our workforce needs to be 
adequately trained in handling the unique needs of our seniors. These 
two programs enable physicians and other providers to achieve that 
training.
  Lastly, I want to thank Representatives Schakowsky and Bucshon and 
their staffs and the majority and minority staffs on the Energy and 
Commerce Committee for their work on this legislation.
  Reauthorizing title VII programs is long overdue, especially in a 
time where our existing physician workforce is struggling to keep up 
with the demands for healthcare services. I urge strong support of the 
legislation, and I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise in support of H.R. 3728, the Educating Medical 
Professionals and Optimizing Workforce Efficiency and Readiness Act, 
the EMPOWER Act.
  I thank the main sponsors of the bill--Representative and Chair  
Michael Burgess, Representative Jan Schakowsky, and Representative 
Larry Bucshon--for their work on this important bill.
  This legislation will reauthorize title VII health professional 
workforce programs under the Public Health Service Act that support 
loan repayment and provider training experiences in primary care, 
dentistry, rural, and underserved areas.
  These programs include the Centers of Excellence, the Health 
Professions Training for Diversity Program, Primary Care Training and 
Enhancement grants, and Training in General, Pediatric, and Public 
Health Dentistry grants.
  Investing in these programs helps ensure the availability of 
providers who are increasingly in demand across the country. These 
grants help support the health professional workforce by improving the 
diversity and distribution and supply of health professionals with an 
emphasis on primary care and interdisciplinary education and training.
  This legislation will also boost training for geriatric providers who 
are needed to respond to our aging workforce.
  I ask my colleagues to join me in voting for this important piece of 
legislation that will continue support for our Nation's health 
professions workforce programs.
  I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, I would just point out that reauthorizing these title 
VII programs is long overdue. The House of Representatives in the last 
Congress, the 114th Congress, did provide the reauthorization. It never 
made it through the other body, unfortunately. It is time to do that 
work now, and that is what this bill, today, purports to do.
  Mr. Speaker, this is an important bill. It is long overdue. I urge 
all Members to support the bill, and I yield back the balance of my 
time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
pass the bill, H.R. 3728, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________