[Congressional Record Volume 167, Number 194 (Thursday, November 4, 2021)]
[Senate]
[Pages S7934-S7935]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 4430. Mr. INHOFE submitted an amendment intended to be proposed to 
amendment SA 3867 submitted by Mr. Reed and intended to be proposed to 
the bill H.R. 4350, to authorize appropriations for fiscal year 2022 
for military activities of the Department of Defense, for military 
construction, and for defense activities of the Department of Energy, 
to prescribe military personnel strengths for such fiscal year, and for 
other purposes; which was ordered to lie on the table; as follows:

        At the appropriate place in subtitle G of title X, insert 
     the following:

     SEC. __. EDUCATION PROGRAM TO SUPPORT PRIMARY HEALTH SERVICE 
                   FOR UNDERSERVED POPULATIONS.

       (a) Findings.--Congress finds the following:
       (1) Access to high quality primary care is associated with 
     improved health outcomes and lower health care costs.
       (2) Substantial disparities exist in the distribution of 
     primary care providers.
       (3) Shortages of health care providers affect Tribal, 
     rural, and medically underserved communities more than the 
     populations of more densely populated areas, resulting in 
     such communities experiencing significant health challenges 
     and disparities.
       (4) American Indian, Alaskan Natives, and Native Hawaiians 
     tend to have lower health status, lower life expectancy, and 
     disproportionate disease burden when compared to other 
     Americans.
       (5) Having training experiences in, living among, and being 
     a member of Tribal, rural, and medically underserved 
     communities increases cultural awareness and can influence 
     career choice for physicians to better serve such 
     populations.
       (6) Research shows there is a relationship between the 
     characteristics of a physician and the eventual practice 
     location, including being part of an underrepresented 
     minority or growing up in a rural area.
       (b) Establishment of Program.--Part B of title VII of the 
     Public Health Service Act (42 U.S.C. 293 et seq.) is amended 
     by adding at the end the following:

     ``SEC. 742. EDUCATION PROGRAM TO SUPPORT PRIMARY HEALTH 
                   SERVICE FOR UNDERSERVED POPULATIONS.

       ``(a) Establishment.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, shall establish a grant program to award 
     grants to public institutions of higher education located in 
     a covered State to carry out the activities described in 
     subsection (d) for the purposes of--
       ``(1) expanding and supporting education for medical 
     students who are preparing to become physicians in a covered 
     State; and
       ``(2) preparing and encouraging each such student training 
     in a covered State to serve Tribal, rural, or medically 
     underserved communities as a primary care physician after 
     completing such training.
       ``(b) Eligibility.--In order to be eligible to receive a 
     grant under this section, a public institution of higher 
     education shall submit an application to the Secretary that 
     includes--
       ``(1) a certification that such institution will use 
     amounts provided to the institution to carry out the 
     activities described in subsection (d); and

[[Page S7935]]

       ``(2) a description of how such institution will carry out 
     such activities.
       ``(c) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to public institutions of 
     higher education that--
       ``(1) are located in a State with not fewer than 2 
     federally recognized Tribes; and
       ``(2) demonstrate a public-private partnership.
       ``(d) Authorized Activities.--An eligible entity that 
     receives a grant under this section shall use the funds made 
     available under such grant to carry out the following 
     activities:
       ``(1) Support or expand community-based experiential 
     training for medical students who will practice in or serve 
     Tribal, rural, and medically underserved communities.
       ``(2) Develop and operate programs to train medical 
     students in primary care services.
       ``(3) Develop and implement curricula that--
       ``(A) includes a defined set of clinical and community-
     based training activities that emphasize care for Tribal, 
     rural, or medically underserved communities;
       ``(B) is applicable to primary care practice with respect 
     to individuals from Tribal, rural, or medically underserved 
     communities;
       ``(C) identifies and addresses challenges to health equity, 
     including the needs of Tribal, rural, and medically 
     underserved communities;
       ``(D) supports the use of telehealth technologies and 
     practices;
       ``(E) considers social determinants of health in care plan 
     development;
       ``(F) integrates behavioral health care into primary care 
     practice, including prevention and treatment of opioid 
     disorders and other substance use disorders;
       ``(G) promotes interprofessional training that supports a 
     patient-centered model of care; and
       ``(H) builds cultural and linguistic competency.
       ``(4) Increase the capacity of faculty to implement the 
     curricula described in paragraph (3).
       ``(5) Develop or expand strategic partnerships to improve 
     health outcomes for individuals from Tribal, rural, and 
     medically underserved communities, including with--
       ``(A) federally recognized Tribes, Tribal colleges, and 
     Tribal organizations;
       ``(B) Federally-qualified health centers;
       ``(C) rural health clinics;
       ``(D) Indian health programs;
       ``(E) primary care delivery sites and systems; and
       ``(F) other community-based organizations.
       ``(6) Develop a plan to track graduates' chosen specialties 
     for residency and the States in which such residency programs 
     are located.
       ``(7) Develop, implement, and evaluate methods to improve 
     recruitment and retention of medical students from Tribal, 
     rural, and medically underserved communities.
       ``(8) Train and support instructors to serve Tribal, rural, 
     and medically underserved communities.
       ``(9) Prepare medical students for transition into primary 
     care residency training and future practice.
       ``(10) Provide scholarships to medical students.
       ``(e) Grant Period.--A grant under this section shall be 
     awarded for a period of not more than 5 years.
       ``(f) Grant Amount.--Each fiscal year, the amount of a 
     grant made to a public institution of higher education under 
     this section shall be in amount that is not less than 
     $1,000,000.
       ``(g) Matching Requirement.--Each public institution of 
     higher education that receives a grant under this section 
     shall provide, from non-Federal sources, an amount equal to 
     or greater than 10 percent of the total amount of Federal 
     funds provided to the institution each fiscal year during the 
     period of the grant (which may be provided in cash or in 
     kind).
       ``(h) Definitions.--In this section:
       ``(1) Covered state.--The term `covered State' means a 
     State that is in the top quartile of States by projected 
     unmet demand for primary care providers, as determined by the 
     Secretary
       ``(2) Federally-qualified health center.--The term 
     `Federally-qualified health center' has the meaning given 
     such term in section 1905(l)(2)(B) of the Social Security 
     Act.
       ``(3) Indian health program.--The term `Indian health 
     program' has the meaning given such term in section 4 of the 
     Indian Health Care Improvement Act.
       ``(4) Institution of higher education.--The term 
     `institution of higher education' has the meaning given such 
     term in section 101 of the Higher Education Act of 1965, 
     provided that such institution is public in nature.
       ``(5) Medically underserved community.--The term `medically 
     underserved community' has the meaning given such term in 
     section 799B.
       ``(6) Rural health clinic.--The term `rural health clinic' 
     has the meaning given such term in section 1861(aa) of the 
     Social Security Act.
       ``(7) Rural population.--The term `rural population' means 
     the population of a geographical area located--
       ``(A) in a non-metropolitan county; or
       ``(B) in a metropolitan county designated as rural by the 
     Administrator of the Health Resources and Services 
     Administration.
       ``(8) Tribal population.--The term `Tribal population' 
     means the population of any Indian Tribe recognized by the 
     Secretary of the Interior pursuant to section 104 of the 
     Federally Recognized Indian Tribe List Act of 1994.
       ``(i) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $150,000,000 for 
     each of fiscal years 2023 through 2027.''.
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