[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

[[Page S155]]

     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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