[Congressional Record Volume 167, Number 15 (Tuesday, January 26, 2021)]
[Senate]
[Pages S154-S155]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTION
By Mr. DURBIN (for himself and Mr. Rubio):
S. 54. A bill to address health workforce shortages and disparities
highlighted by the COVID-19 pandemic through additional funding for the
National Health Service Corps and the Nurse Corps, and to establish a
National Health Service Corps Emergency Service demonstration project;
to the Committee on Health, Education, Labor, and Pensions.
Mr. DURBIN. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 54
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 ``Strengthening America's
Health Care Readiness Act''.
SEC. 2. ADDITIONAL FUNDING FOR THE NATIONAL HEALTH SERVICE
CORPS.
(a) Additional Funding.--Section 10503(b) of the Patient
Protection and Affordable Care Act (42 U.S.C. 254b-2(b)) is
amended--
(1) in paragraph (1)(F), by striking ``and'' at the end;
(2) in paragraph (2)(H), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following:
``(3) to be transferred to the Secretary of Health and
Human Services $5,000,000,000 for fiscal year 2021, to
provide additional funding to carry out the National Health
Service Corps Scholarship Program under section 338A of the
Public Health Service Act, the National Health Service Corps
Loan Program under section 338B of such Act, and the National
Health Service Corps Emergency Service under section 2812A of
such Act.''.
(b) Criteria for Use of Additional Funding for In-demand
Professionals.--Not less than 40 percent of the amounts made
available under paragraph (3) of section 10503(b) of the
Patient Protection and Affordable Care Act (42 U.S.C. 254b-
2(b)) (as amended by subsection (a)) shall be allocated to
awards to eligible applicants to the National Health Service
Corps Scholarship Program under section 338A of the Public
Health Service Act (42 U.S.C. 254l), the National Health
Service Corps Loan Repayment Program under section 338B of
such Act (42 U.S.C. 254l-1), or the National Health Service
Corps Emergency Service under section 2812A of such Act (as
added by subsection (c)) who are members of groups that are
historically underrepresented in health care professions,
including racial and ethnic minorities and individuals from
low-income urban and rural communities. To carry out the
requirements of this subsection, the Secretary may coordinate
with entities receiving funding under section 739 or 821 of
the Public Health Service Act (42 U.S.C. 293c, 296m) to
identify, provide mentorship and support, and recruit such
eligible applicants.
(c) National Health Service Corps Emergency Service
Demonstration Project.--Part B of title XXVIII of the Public
Health Service Act is amended by inserting after section 2812
(42 U.S.C. 300hh-11) the following:
``SEC. 2812A. NATIONAL HEALTH SERVICE CORPS EMERGENCY SERVICE
DEMONSTRATION PROJECT.
``(a) In General.--For each of fiscal years 2022 through
2026, from the amounts made available under section
10503(b)(3) of the Patient Protection and Affordable Care
Act, to the extent permitted by, and consistent with, the
requirements of applicable State law, the Secretary shall
allocate up to $50,000,000 to establishing, as a
demonstration project, a National Health Service Corps
Emergency Service (referred to in this section as the
`emergency service') under which a qualified individual
currently or previously participating in the National Health
Service Corps agrees to engage in service through the
National Disaster Medical System established under section
2812, as described in this section.
``(b) Participants.--
``(1) NHSC alumni.--
``(A) Qualified individuals.--An individual may be eligible
to participate in the emergency service under this section if
such individual participated in the Scholarship Program under
section 338A or the Loan Repayment Program under section
338B, and who satisfied the obligated service requirements
under such program, in accordance with the individual's
contract.
``(B) Priority and increased funding amounts.--
``(i) Priority.--In selecting eligible individuals to
participate in the program under this paragraph, the
Secretary shall give priority--
``(I) first, to qualified individuals who continue to
practice at the site where the individual fulfilled his or
her obligated service under the Scholarship Program or Loan
Repayment Program through the time of the application to the
program under this section; and
``(II) secondly, to qualified individuals who continue to
practice in any site approved for obligated service under the
Scholarship Program or Loan Repayment Program other than the
site at which the individual served.
``(ii) Increased funding amounts.--The Secretary may grant
increased award amounts to certain participants in the
program under this section based on the site where a
participant fulfilled his or her obligated service under the
Scholarship Program or Loan Repayment Program.
``(C) Private practice.--An individual participating in the
emergency service under this section may practice a health
profession in any private capacity when not obligated to
fulfill the requirements described in subsection (c).
``(2) Current nhsc members.--
``(A) In general.--An individual who is participating in
the Scholarship Program under section 338A or the Loan
Repayment Program under section 338B may apply to
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participate in the program under this section while
fulfilling the individual's obligated services under such
program.
``(B) Clarifications.--Notwithstanding any other provision
of law or any contract with respect to service requirements
under the Scholarship Program or Loan Repayment Program, an
individual fulfilling service requirements described in
subsection (c) shall not be considered in breach of such
contract under such Scholarship Program or Loan Repayment
Program, provided that the individual give advance and
reasonable notification to the site at which the individual
is fulfilling his or her obligated service requirements under
such contract, and the site approves the individual's
deployment through the National Disaster Medical System.
``(C) No credit toward obligated service.--No period of
service under the National Disaster Medical System described
in subsection (c)(1) shall be counted toward satisfying a
period of obligated service under the Scholarship Program or
Loan Repayment Program.
``(c) Participants as Members of the National Disaster
Medical System.--
``(1) Service requirements.--An individual participating in
the program under this section shall participate in the
activities of the National Disaster Medical System under
section 2812 in the same manner and to the same extent as
other participants in such system.
``(2) Rights and requirements.--An individual participating
in the program under this section shall be considered
participants in the National Disaster Medical System and
shall be subject to the rights and requirements of
subsections (c) and (d) of section 2812.
``(d) Emergency Service Plan.--In carrying out this
section, the Secretary, in consultation with the
Administrator of the Health Resources and Services
Administration and the Assistant Secretary for Preparedness
and Response, shall establish an action plan for the service
commitments, deployment protocols, coordination efforts,
training requirements, liability, workforce development, and
such other considerations as the Secretary determines
appropriate. Such action plan shall--
``(1) ensure adherence to the missions of both the National
Health Service Corps and National Disaster Medical Service;
``(2) outline the type of providers determined by the
Assistant Secretary to be priorities for participation in the
program established under this section;
``(3) describe how such deployments will be determined and
prioritized in a manner consistent with--
``(A) the National Health Service Corps contracts; and
``(B) the National Disaster Medical System's deployment
policy of not hindering civilian responders already engaged
in an emergency response;
``(4) ensure an adequate health care workforce during a
public health emergency declared by the Secretary under
section 319 of this Act, a major disaster declared by the
President under section 401 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act, an emergency
declared by the President under section 501 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act, or a
national emergency declared by the President under the
National Emergencies Act; and
``(5) describe how the program established under this
section will be implemented in a manner consistent with, and
in furtherance of, the assessments and goals for workforce
and training described in the review conducted by the
Secretary under section 2812(b)(2).
``(e) Contracts for Certain Participating Individuals.--An
individual who is participating in the emergency service
program under this section shall receive loan repayments in
an amount up to 50 percent (as determined by the Secretary)
of the highest new award made for the year under the National
Health Service Corps Loan Repayment Program pursuant to a
contract entered into at the same time under section 338B(g),
in a manner similar to the manner in which payments are made
under such section, pursuant to the terms of a contract
between the Secretary and such individual. The Secretary
shall establish a system of contracting for purposes of this
subsection which shall be similar to the contract
requirements and terms under subsections (c), (d), and (f) of
section 338B. Amounts received by an individual under this
subsection shall be in addition to any amounts received by an
individual described in subsection (b)(2) pursuant to the
Scholarship Program under section 338A or the Loan Repayment
Program under section 338B, as applicable.
``(f) Breach of Contract, Termination, Waiver, and
Suspension.--
``(1) Recovery of amounts in the event of a breach.--If an
individual breaches the written contract of the individual
under subsection (e) by failing either to begin such
individual's service obligation in accordance with such
contract or to complete such service obligation, the United
States shall be entitled to recover from the individual an
amount equal to the sum of--
``(A) the total of the amounts paid by the United States
under such contract on behalf of the individual for any
period of such service not served;
``(B) an amount equal to the product of the number of
months of service that were not completed by the individual,
multiplied by $3,750; and
``(C) the interest on the amounts described in
subparagraphs (A) and (B), at the maximum legal prevailing
rate, as determined by the Treasurer of the United States,
from the date of the breach.
``(2) Termination of contract.--The Secretary may terminate
a contract under subsection (e) in accordance with the
termination standards that are--
``(A) applicable to contracts entered into under section
338B; and
``(B) in effect in the fiscal year in which such contract
was entered.
``(3) Waiver or suspension of obligation.--If an individual
participating in the program under this section submits a
written request to the Secretary, the Secretary may waive or
suspend a service or payment obligation arising under this
subsection or a contract under subsection (e), in whole or in
part, in accordance with the standards set forth in section
62.12 of title 42, Code of Federal Regulations (or any
successor regulations).
``(g) Report.--Not later than 4 years after the date of
enactment of this section, the Secretary shall submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House
of Representatives a report that evaluates the demonstration
project established under this section, including--
``(1) the effects of such program on health care access in
underserved areas and health professional shortage areas and
on public health emergency response capacity;
``(2) the effects of such program on the health care
provider workforce pipeline, including any impact on the
demographic representation among, and the fields or
specialties pursued by, students in approved graduate
training programs in medicine, osteopathic medicine,
dentistry, behavioral and mental health, or other health
profession;
``(3) the impact of such program on the enrollment,
participation, and completion of requirements in the
underlying scholarship and loan repayment programs of the
National Health Service Corps;
``(4) the effects of such program on the National Disaster
Medical System's response capability, readiness, and
workforce strength; and
``(5) recommendations for improving the demonstration
project described in this section, and any other
considerations as the Secretary determines appropriate.''.
SEC. 3. FUNDING FOR THE NURSE CORPS SCHOLARSHIP AND LOAN
REPAYMENT PROGRAM.
There are hereby appropriated, out of amounts in the
Treasury not otherwise appropriated, $1,000,000,000 for
fiscal year 2021, for purposes of carrying out section 846 of
the Public Health Service Act (42 U.S.C. 297n), to remain
available until expended, except that--
(1) of the amount appropriated under this heading and made
available for scholarships and loan repayment, not less than
40 percent shall be allocated for eligible applicants who are
members of groups that are historically underrepresented in
health care professions, including racial and ethnic
minorities and individuals from low-income urban and rural
communities; and
(2) to carry out the requirements of paragraph (1), the
Secretary may coordinate with entities receiving funding
under section 821 to identify, recruit, and select
individuals to receive such scholarships.
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