[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.

                          ____________________