[Congressional Record Volume 165, Number 170 (Monday, October 28, 2019)]
[House]
[Pages H8509-H8513]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
EDUCATING MEDICAL PROFESSIONALS AND OPTIMIZING WORKFORCE EFFICIENCY AND
READINESS FOR HEALTH ACT OF 2019
Ms. SCHAKOWSKY. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 2781) 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. 2781
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 for Health Act of 2019'' or the ``EMPOWER for
Health Act of 2019''.
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 $24,897,000
for each of fiscal years 2020 through 2024.''.
(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 ``$51,419,000
for each of fiscal years 2020 through 2024'';
(2) in subsection (b), by striking ``$5,000,000 for each of
the fiscal years 2010 through 2014'' and inserting
``$1,250,000 for each of fiscal years 2020 through 2024'';
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 ``$20,000,000
for each of fiscal years 2020 through 2024''.
(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 ``$51,371,000
for each of fiscal years 2020 through 2024''.
(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
``$42,707,000 for each of fiscal years 2020 through 2024''.
(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 ``$42,075,000 for
each of fiscal years 2020 through 2024''.
(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 ``$5,947,000 for each of fiscal years 2020 through
2024''.
(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 ``$17,850,000 for each of fiscal years 2020
through 2024''.
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.
[[Page H8510]]
``(B) Developing providers from multiple disciplines and
specialties to work interprofessionally to assess and address
the needs and preferences of older adults and their families
and caregivers at the individual, community, and population
levels with cultural and linguistic competency.
``(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, including the specific measures
the applicant will use to demonstrate that the project is
improving the quality of care provided to older adults in the
applicant's region, which may include--
``(A) improvements in access to care provided by a health
professional with training in geriatrics or gerontology;
``(B) improvements in family caregiver capacity to care for
older adults;
``(C) patient outcome data demonstrating an improvement in
older adult health status or care quality; and
``(D) reports on how the applicant will implement specific
innovations with the target audience to improve older adults'
health status or the quality of care.
``(5) Equitable geographic distribution.--The Secretary may
award grants and contracts under paragraph (1) in a manner
which will equitably distribute such grants among the various
regions of the United States.
``(6) Qualifications.--In awarding grants and contracts
under paragraph (2), the Secretary shall consider programs
that--
``(A) have the goal of improving and providing
comprehensive coordinated care of older adults, including
medical, dental, and psychosocial needs;
``(B) demonstrate coordination with other programmatic
efforts funded under this program or other public or private
entities;
``(C) support the training and retraining of faculty,
preceptors, primary care providers, and providers in other
specialties to increase their knowledge of geriatrics and
gerontology;
``(D) 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;
``(E) emphasize education and engagement of family
caregivers on disease self-management, medication management,
and stress reduction strategies;
``(F) provide training to the health care workforce on
disease self-management, motivational interviewing,
medication management, and stress reduction strategies;
``(G) 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 with
cultural and linguistic competency;
``(H) integrate geriatrics competencies and
interprofessional collaborative practice into health care
education and training curricula for residents, fellows, and
students;
``(I) substantially benefit rural or underserved
populations of older adults or conduct outreach to
communities that have a shortage of geriatric workforce
professionals;
``(J) integrate behavioral health competencies into primary
care practice, especially with respect to elder abuse, pain
management, and advance care planning; or
``(K) 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.
``(7) Priority.--In awarding grants under paragraph (1),
particularly with respect to awarding, in fiscal year 2020,
any amount appropriated for such fiscal year for purposes of
carrying out this subsection that is in excess of the amount
appropriated for the most previous fiscal year for which
appropriations were made for such purposes, the Secretary may
give priority to entities that operate--
``(A) in communities that have a shortage of geriatric
workforce professionals; and
``(B) in States in which no entity has previously received
an award under such paragraph (including as in effect before
the date of enactment of the Educating Medical Professionals
and Optimizing Workforce Efficiency and Readiness for Health
Act of 2019).
``(8) Award amounts.--Awards under paragraph (1) shall be
in an amount determined by the Secretary. Entities that
submit applications under this subsection that describe a
plan for providing geriatric education and training for home
health workers and family caregivers are eligible to receive
$100,000 per year more than entities that do not include a
description of such a plan.
``(9) Reporting.--Each entity awarded a grant under
paragraph (1) shall submit an annual report to the Secretary
on financial and programmatic performance under such grant,
which may include factors such as the number of trainees, the
number of professions and disciplines, the number of
partnerships with health care delivery sites, the number of
faculty and practicing professionals who participated in
continuing education programs, and such other factors as the
Secretary may require.
``(b) Geriatric Academic Career Awards.--
``(1) Establishment of program.--The Secretary shall
establish a program to award grants, to be known as 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 accredited school of allopathic medicine,
osteopathic medicine, nursing, social work, psychology,
dentistry, pharmacy, or allied health; or
``(ii) another type of accredited health professions school
or graduate program deemed by the Secretary to be eligible
under this subsection.
``(B) Eligible individual.--
``(i) In general.--For purposes of this subsection, the
term `eligible individual' means an individual who--
``(I) has a junior, nontenured, faculty appointment at an
accredited school of allopathic medicine, osteopathic
medicine, nursing, social work, psychology, dentistry,
pharmacy, or allied health or at another type of accredited
health professions school or graduate program described in
subparagraph (A)(ii);
``(II)(aa) is board certified or board eligible in internal
medicine, family practice, psychiatry, or licensed dentistry,
or has completed the training required for the individual's
discipline; and
``(bb) is employed at an eligible entity; or
``(III) has completed an approved fellowship program in
geriatrics or gerontology, or has completed specialty
training in geriatrics or gerontology as required for the
individual's discipline and any additional geriatrics or
gerontology training as required by the Secretary.
``(ii) Special rule.--If during the period of an award
under this subsection respecting an eligible individual, the
individual is promoted to associate professor and thereby no
longer meets the criteria of clause (i)(I), the individual
may continue to be treated as an eligible individual through
the term of the award.
``(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 (8);
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
individual's time that is supported by the award 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, diverse
communities, and rural areas;
``(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; and
``(F) shall pay the full amount of the award to the
eligible entity.
``(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 2020, 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
[[Page H8511]]
appropriated $51,000,000 for each of fiscal years 2020
through 2024. 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.''.
SEC. 4. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE
WORKFORCE.
Section 775 of the Public Health Service Act (42 U.S.C.
295f) is amended to read as follows:
``SEC. 775. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE
WORKFORCE.
``(a) In General.--The Secretary shall establish and carry
out a program of entering into pediatric specialty loan
repayment agreements with qualified health professionals
under which--
``(1) the qualified health professional agrees to a period
of not less than 2 years of obligated service during which
the professional will--
``(A) participate in an accredited pediatric medical
subspecialty, pediatric surgical specialty, child and
adolescent psychiatry subspecialty, or child and adolescent
mental and behavioral health residency or fellowship; or
``(B) be employed full-time in providing pediatric medical
subspecialty care, pediatric surgical specialty care, child
and adolescent psychiatry subspecialty care, or child and
adolescent mental and behavioral health care, including
substance use disorder prevention and treatment services, in
an area with--
``(i) a shortage of health care professionals practicing in
the pediatric medical subspecialty, the pediatric surgical
specialty, the child and adolescent psychiatry subspecialty,
or child and adolescent mental and behavioral health, as
applicable; and
``(ii) a sufficient pediatric population, as determined by
the Secretary, to support the addition of a practitioner in
the pediatric medical subspecialty, the pediatric surgical
specialty, the child and adolescent psychiatry subspecialty,
or child and adolescent mental and behavioral health, as
applicable; and
``(2) the Secretary agrees to make payments on the
principal and interest of undergraduate, graduate, or
graduate medical education loans of the qualified health
professional of not more than $35,000 a year for each year of
agreed upon service under paragraph (1) for a period of not
more than 3 years.
``(b) Eligibility Requirements.--
``(1) Pediatric medical specialists and pediatric surgical
specialists.--For purposes of loan repayment agreements under
this section with respect to pediatric medical subspecialty
and pediatric surgical specialty practitioners, the term
`qualified health professional' means a licensed physician
who--
``(A) is entering or receiving training in an accredited
pediatric medical subspecialty or pediatric surgical
subspecialty residency or fellowship; or
``(B) has completed (but not prior to the end of the
calendar year in which the Educating Medical Professionals
and Optimizing Workforce Efficiency and Readiness for Health
Act of 2019 is enacted) the training described in
subparagraph (A).
``(2) Child and adolescent psychiatry and mental and
behavioral health.--For purposes of loan repayment agreements
under this section with respect to child and adolescent
mental and behavioral health care, the term `qualified health
professional' means a health care professional who--
``(A) has received specialized training or clinical
experience in child and adolescent mental health in
psychiatry, psychology, school psychology, or psychiatric
nursing;
``(B) has a license or certification in a State to practice
allopathic medicine, osteopathic medicine, psychology, school
psychology, or psychiatric nursing; or
``(C) is a mental health service professional who has
completed (but not before the end of the calendar year in
which the Educating Medical Professionals and Optimizing
Workforce Efficiency and Readiness for Health Act of 2019 is
enacted) specialized training or clinical experience in child
and adolescent mental health described in subparagraph (A).
``(3) Additional eligibility requirements.--The Secretary
may not enter into a loan repayment agreement under this
section with a qualified health professional unless--
``(A) the professional agrees to work in, or for a provider
serving, an area or community with a shortage of eligible
qualified health professionals (as defined in paragraphs (1)
and (2));
``(B) the professional is a United States citizen, a
permanent legal United States resident, or lawfully present
in the United States; and
``(C) if the professional is enrolled in a graduate
program, the program is accredited, and the professional has
an acceptable level of academic standing (as determined by
the Secretary).
``(c) Priority.--In entering into loan repayment agreements
under this section, the Secretary shall give priority to
applicants who--
``(1) have familiarity with evidence-based methods and
cultural and linguistic competence in health care services;
and
``(2) demonstrate financial need.
``(d) Authorization of Appropriations.--There are
authorized to be appropriated for each of fiscal years 2020
through 2024--
``(1) $30,000,000 to carry out this section with respect to
loan repayment agreements with qualified health professionals
described in subsection (b)(1); and
``(2) $20,000,000 to carry out this section with respect to
loan repayment agreements with respect to qualified health
professionals described in subsection (b)(2).''.
SEC. 5. INCREASING WORKFORCE DIVERSITY IN THE PROFESSIONS OF
PHYSICAL THERAPY, OCCUPATIONAL THERAPY,
AUDIOLOGY, AND SPEECH-LANGUAGE PATHOLOGY.
Title VII of the Public Health Service Act is amended--
(1) by redesignating part G (42 U.S.C. 295j et seq.) as
part H; and
(2) by inserting after part F (42 U.S.C. 294n et seq.) the
following new part:
``PART G--INCREASING WORKFORCE DIVERSITY IN THE PROFESSIONS OF PHYSICAL
THERAPY, OCCUPATIONAL THERAPY, AUDIOLOGY, AND SPEECH-LANGUAGE PATHOLOGY
``SEC. 783. SCHOLARSHIPS AND STIPENDS.
``(a) In General.--The Secretary may award grants and
contracts to eligible entities to increase educational
opportunities in the professions of physical therapy,
occupational therapy, audiology, and speech-language
pathology for eligible individuals by--
``(1) providing student scholarships or stipends, including
for--
``(A) completion of an accelerated degree program;
``(B) completion of an associate's, bachelor's, master's,
or doctoral degree program; and
``(C) entry by a diploma or associate's degree practitioner
into a bridge or degree completion program;
``(2) providing assistance for completion of prerequisite
courses or other preparation necessary for acceptance for
enrollment in the eligible entity; and
``(3) carrying out activities to increase the retention of
students in one or more programs in the professions of
physical therapy, occupational therapy, audiology, and
speech-language pathology.
``(b) Consideration of Recommendations.--In carrying out
subsection (a), the Secretary shall take into consideration
the recommendations of national organizations representing
the professions of physical therapy, occupational therapy,
audiology, and speech-language pathology, including the
American Physical Therapy Association, the American
Occupational Therapy Association, the American Speech-
Language-Hearing Association, the American Academy of
Audiology, and the Academy of Doctors of Audiology.
``(c) Required Information and Conditions for Award
Recipients.--
``(1) In general.--The Secretary may require recipients of
awards under this section to report to the Secretary
concerning the annual admission, retention, and graduation
rates for eligible individuals in programs of the recipient
leading to a degree in any of the professions of physical
therapy, occupational therapy, audiology, and speech-language
pathology.
``(2) Falling rates.--If any of the rates reported by a
recipient under paragraph (1) fall below the average for such
recipient over the two years preceding the year covered by
the report, the recipient shall provide the Secretary with
plans for immediately improving such rates.
``(3) Ineligibility.--A recipient described in paragraph
(2) shall be ineligible for continued funding under this
section if the plan of the recipient fails to improve the
rates within the 1-year period beginning on the date such
plan is implemented.
``(d) Definitions.--In this section:
``(1) Eligible entities.--The term `eligible entity' means
an education program that--
``(A) is accredited by--
``(i) the Council on Academic Accreditation in Audiology
and Speech-Language Pathology or the Accreditation Commission
for Audiology Education;
``(ii) the Commission on Accreditation in Physical Therapy
Education; or
``(iii) the Accreditation Council for Occupational Therapy
Education; and
``(B) is carrying out a program for recruiting and
retaining students underrepresented in the professions of
physical therapy, occupational therapy, audiology, and
speech-language pathology (including racial or ethnic
minorities, or students from disadvantaged backgrounds).
``(2) Eligible individual.--The term `eligible individual'
means an individual who--
``(A) is a member of a class of persons who are
underrepresented in the professions of physical therapy,
occupational therapy, audiology, and speech-language
pathology (including individuals who are racial or ethnic
minorities, or are from disadvantaged backgrounds);
``(B) has a financial need for a scholarship or stipend;
and
``(C) is enrolled (or accepted for enrollment) at an
audiology, speech-language pathology, physical therapy, or
occupational therapy program as a full-time student at an
eligible entity.
``(e) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$5,000,000 for each of fiscal years 2020 through 2024.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
Illinois (Ms. Schakowsky) and the gentleman from Texas (Mr. Burgess)
each will control 20 minutes.
The Chair recognizes the gentlewoman from Illinois.
General Leave
Ms. SCHAKOWSKY. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
include extraneous materials on H.R. 2781.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Illinois?
There was no objection.
[[Page H8512]]
Ms. SCHAKOWSKY. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in strong support of H.R. 2781, the EMPOWER
for Health Act of 2019, or Educating Medical Professionals and
Optimizing Workforce Efficiency and Readiness for Health Act, which I
introduced with my colleague, Congressman Burgess, in May. This
legislation advanced out of the Committee on Energy and Commerce by
unanimous vote.
By 2032, the United States may see a shortage of up to 122,000
physicians, but we already have a significant physician shortage. If
healthcare access were equitable across all races, socioeconomic
statuses, and geographic locations, the United States would need almost
100,000 more doctors immediately.
This legislation is one solution to this real problem. The EMPOWER
for Health Act will spur growth in our healthcare workforce and ensure
increased funding for several title VII health, education, and training
programs over the next 5 years.
Madam Speaker, I reserve the balance of my time.
Mr. BURGESS. Madam Speaker, I yield myself such time as I may
consume.
As an author of the Educating Medical Professionals and Optimizing
Workforce Efficiency and Readiness for Health Act of 2019, also known
as the EMPOWER for Health Act, I rise in support of this bill, H.R.
2781. This moved with strong bipartisan support through regular order
in the Energy and Commerce Committee and its Health Subcommittee.
As the chairman of the Energy and Commerce Health Subcommittee in the
last Congress, I made it a priority to get this bill to the House
floor. While I succeeded in doing so, the Senate did not take up the
legislation; so I hope, this year, with plenty of time and plenty of
runway, the Senate will reauthorize these critically important
programs.
This legislation reauthorizes the title VII health professions
workforce programs for fiscal years 2020 through 2024.
Title VII programs have expired, but they continue to receive
appropriations. In fact, in fiscal year 2018, the appropriations levels
for these programs actually increased. Reauthorizing these physician
workforce programs will provide the needed stability to those who
depend upon this funding.
{time} 1800
Title VII of the Public Health Services Act includes programs that
are vital to building and maintaining a well-educated, well-trained
physician workforce. The EMPOWER Act reauthorizes the funding for Area
Health Education Centers at more than $40 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 $24 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 school's capacity or to improve curriculum.
Primary care is an important aspect of our Nation's healthcare
system, and now many Americans receive the majority of their healthcare
services through primary care centers. H.R. 2781 reauthorizes funding
for our Primary Care Training and Enhancement Program at more than $50
million a year. This program provides grants to hospitals and other
professional schools to develop and operate supplemental primary
training programs.
Lastly, this bill aims to strengthen our workforce that cares for our
geriatric population. This bill makes strides towards modernizing the
Geriatric Workforce Enhancement program and the Geriatric Academic
Career Awards. 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 be able to
achieve that training.
I want to thank Representative Schakowsky and the staff of the Energy
and Commerce Committee for their work on this legislation.
Reauthorizing title VII is long overdue, especially in a time when our
existing physician workforce is struggling to keep up with the demand
for healthcare services.
Madam Speaker, I urge support of this legislation, and I reserve the
balance of my time.
Ms. SCHAKOWSKY. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, for decades title VII programs have assisted students
from minority and economically disadvantaged backgrounds to enter the
health professions by focusing on development, retention,
matriculation, and graduation, but we still have a lot of work to do.
In 1998 about 7 percent of the medical school matriculants were
Black, and 5 percent were Hispanic and Latino. In 2016 those numbers
only increased to 8.2 percent for African Americans and 6.2 percent for
Hispanics and Latinos. I believe the extreme racial health disparities
in this country are directly linked to the lack of underrepresented
minorities in medicine. This legislation reflects our commitment to a
diverse workforce by authorizing higher funding levels for these
diversity programs.
We also have a rapidly growing population of older Americans, as Mr.
Burgess mentioned. This legislation will address the extreme shortage
of health professionals expertly trained for care of the rapidly
growing and diverse population of older Americans.
As well, the pediatric workforce is at a crisis point right now. In
my home State of Illinois, for example, we face severe shortages of
child and adolescent psychiatrists. Children with special or complex
health issues often have to wait months before a specialist can see
them, and this is unacceptable. So this legislation will encourage
physicians to specialize in pediatric care by authorizing funding for
this critical program for the first time since 2010.
Finally, this bill also creates a new program to increase diversity
in the professions of physical therapists, occupational therapists,
audiologists, and speech-language pathologists. This was a section that
was added by my colleague from Illinois, Bobby Rush, and we appreciate
that.
This bill assures almost $2 billion in funding over the next 5 years
for these essential programs.
Madam Speaker, I reserve the balance of my time.
Mr. BURGESS. Madam Speaker, I yield myself the balance of my time.
Madam Speaker, I have no additional speakers and am prepared to
close.
This is a good bill. It was a good bill last Congress when we passed
it then and sent it over to the Senate. The authorization on these
programs has expired. They are continuing to receive funding. The
people who depend upon these programs deserve the certainty that
reauthorization would allow.
Madam Speaker, I urge passage of the bill, and I yield back the
balance of my time.
Ms. SCHAKOWSKY. Madam Speaker, I yield myself such time as I may
consume.
I will close with this: I thank all the Members who worked together
to produce this great legislation, especially my colleague, Congressman
Michael Burgess, who has been a champion of these issues and
introduced the bill along with me and the chairman of our Energy and
Commerce Committee, Mr. Pallone.
I also would like to give a quick thank you to the Energy and
Commerce Health Subcommittee staff on both sides of the aisle and my
health policy advisor, Osaremen Okolo.
Madam Speaker, I would also like to include in the Record a few
letters and statements from the Association of American Medical
Colleges, the American Academy of Pediatrics, the Eldercare Workforce
Alliance, the American Geriatrics Society, the National Association for
Geriatric Education and the National Hispanic Medical Association all
urging strong support for this legislation.
association of american medical colleges
``The HRSA Title VII programs improve access to care for
rural and underserved communities and create a diverse and
culturally competent health workforce, which can enhance
patients' health outcomes,'' said the AAMC (Association of
American Medical Colleges). ``We applaud the House of
Representatives for passing bipartisan Title VII
reauthorization and recognizing the need to increase federal
funding in our nation's health workforce infrastructure.''
[[Page H8513]]
american geriatrics society
``The future we're working for at the AGS--a future when
all older Americans have access to high-quality, person-
centered care--begins by building the workforce to make that
possible, and by ensuring that workforce can connect us to
the tools and supports we need as we grow older together,''
observed Nancy E. Lundebjerg, MPA. CEO of the AGS. ``The
EMPOWER for Health Act will make that possible by supporting
two training programs that are as critical to our future as
they are widely supported, thanks in large part to the
bipartisan efforts that will make this bill law.''
Eldercare workforce alliance
``Our nation faces a severe and growing shortage of
eldercare professionals with the skills and training to meet
the unique healthcare needs of older adults,'' said Amy York,
Executive Director of the Eldercare Workforce Alliance. ``EWA
supports the EMPOWER for Health Act of 2019 because it
expands the only federal geriatrics training program. That's
an investment in an eldercare workforce that can support
well-coordinated, high-quality care for all older
Americans.''
national association for geriatric education
``NAGE is please to support the EMPOWER Act which will
enable the GWEP and GACA programs to continue to train health
care professionals and caregivers across the nation to care
for older adults with the most effective and efficient
practices. We are particularly indebted to Representative
Schakowsky who is a true leader in aging and health care
policy.''
american academy of pediatrics
``Across the country, there are significant shortages of
pediatric subspecialists, which lead to long commutes for
parents seeking care for their children and appointment wait
times that can last more than three months. For a child with
a complex, serious health condition, three months can seem
like a lifetime. Children with complex medical conditions are
among the most vulnerable; their ability to see the right
doctor in a reasonable amount of time should not be
determined by where they live. The EMPOWER for Health Act
reauthorizes the Pediatric Subspecialty Loan Repayment
Program, which is an important step toward addressing the
shortage and geographic disparities that impact a child's
ability to access subspecialty care. The American Academy of
Pediatrics thanks Rep. Schakowsky (D-Ill.) and Rep. Mike
Burgess (R-Texas) for their leadership advancing this
important legislation.''--American Academy of Pediatrics
President Kyle Yasuda, MD, FAAP
____
National Association for Geriatric Education, National
Association of Geriatric Education Centers,
October 28, 2019.
Hon. Jan Schakowsky,
House of Representatives,
Washington, DC.
Dear Representative Schakowsky: On behalf of the HRSA Title
VII and Title VIII funded Geriatrics Workforce Enhancement
Programs (GWEPs) across the country, thank you for your past
support of geriatric education and for introducing the
EMPOWER for Health Act of 2019, which is scheduled to come to
the floor of the House for consideration today. The National
Association for Geriatric Education (NAGE) is pleased to
offer our full support for the EMPOWER Act, which will
reauthorize the GWEP and once again make the Geriatrics
Academic Career Award program (GACA) a part of the effort to
prepare the geriatrics workforce for the aging of our
population. We and the growing numbers of older adults,
caregivers, and clinicians caring for elders are pleased that
you have been able to move this bill forward and will urge
the Senate to follow this lead and provide the resources to
address our nation's growing demand for geriatric care.
We appreciate the many discussions that your staff
facilitated with NAGE, as well as with the Eldercare
Workforce Alliance, the American Geriatrics Society, and The
Gerontological Society of America during the process of
developing this legislation. This authorization and related
funding are needed for the development of a health care
workforce specifically trained to care for older adults and
to support their family caregivers. The modest increase in
the authorization in your bill will have an important impact
on training in geriatric care. Likewise, the funds you have
authorized for the GACA program complement the GWEP, and
support faculty that will teach and lead geriatrics programs.
The bill will also assist in ensuring that rural and
underserved areas will have geriatrics education programs.
NAGE is a non-profit membership organization representing
GWEP sites, Centers on Aging, and Geriatric Education Centers
that provide education and training to health professionals
in the areas of geriatrics and gerontology. Our mission is to
help America's healthcare workforce be better prepared to
render age-appropriate care to today's older Americans and
those of tomorrow.
Thank you for your continued support for geriatric
education programs.
Sincerely,
Catherine Carrico, PhD,
President NAGE/NAGEC; Associate Director, Wyoming Geriatric
Workforce Enhancement Program, Wyoming Center on Aging;
Clinical Assistant Professor, College of Health Sciences,
University of Wyoming.
____
National Hispanic
Medical Association,
Washington, DC, July 21, 2019.
Hon. Jan Schakowsky,
Committee on Energy & Commerce, House of Representatives,
Washington, DC.
Dear Congresswoman Schakowsky: On behalf of the National
Hispanic Medical Association (NHMA) Board of Directors, we
strongly support H.R. 2781 ``Educating Medical Professionals
and Optimizing Workforce Efficiency and Readiness for Health
(EMPOWER for Health) Act of 2019''.
We support the amendment of Title VII of the Public Health
Service Act to reauthorize certain programs relating to the
health professions workforce from FY 2020 through FY 2024.
Critical health professional development programs revolving
around the underserved, Hispanic communities of this country
have been a staple of our organization. The programs listed
in this document are essential to furthering patient
population, physician parity.
The Centers of Excellence program award recipients, who
recruit, train, and retain underrepresented minority students
and faculty at health professional schools, achieve the
ultimate goal of producing a quality healthcare workforce
whose racial and ethnic diversity is representative of the
U.S. populations.
Health Professionals Training for Diversity has provided
scholarships for disadvantaged students, loan repayments, and
fellowships regarding faculty positions. These programs have
assisted students from minority and economically
disadvantaged backgrounds to enter the health professions for
decades by focusing on student development, retention,
matriculation, and graduation.
Past health professional school, graduate medical education
enjoys funds and accreditation authorized by this
legislation. The Primary Care Training and Enhancement
program accredits and funds residency and internship programs
in the fields of family medicine, general internal medicine,
and general pediatrics, and provides a need-based financial
assistance.
The National Hispanic Medical Association strongly supports
H.R. 2781 ``Educating Medical Professionals and Optimizing
Workforce Efficiency and Readiness for Health (EMPOWER for
Health) Act of 2019''. We are especially supportive since
this bill reauthorizes the aforementioned programs and
generally furthers a healthcare workforce that represents the
U.S. patient population.
Sincerely,
Elena Rios, MD, MSPH, FACP,
President & CEO.
Ms. SCHAKOWSKY. Madam Speaker, I certainly urge all my colleagues to
support the bill, and I yield back the balance of my time.
The SPEAKER pro tempore (Ms. Titus). The question is on the motion
offered by the gentlewoman from Illinois (Ms. Schakowsky) that the
House suspend the rules and pass the bill, H.R. 2781, 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.
____________________