[Congressional Record Volume 170, Number 119 (Tuesday, July 23, 2024)]
[Senate]
[Pages S5199-S5201]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. DURBIN:
  S. 4744. A bill to amend the Higher Education Act of 1965 to 
establish fair and consistent eligibility requirements for graduate 
medical schools operating outside the United States and Canada; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DURBIN. Madam 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:
       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 ``Foreign Medical School 
     Accountability Fairness Act of 2024''.

     SEC. 2. PURPOSE.

       The purpose of this Act is to establish consistent 
     eligibility requirements for graduate medical schools 
     operating outside of the United States and Canada in order to 
     increase accountability and protect United States students 
     and taxpayer dollars.

     SEC. 3. FINDINGS.

       Congress finds the following:
       (1) Three for-profit schools in the Caribbean have 
     historically received nearly \3/4\ of all Federal funding 
     under title IV of the Higher Education Act of 1965 (20 U.S.C. 
     1070 et seq.) that goes to students enrolled at foreign 
     graduate medical schools, despite those three schools being 
     exempt from meeting the same eligibility requirements as the 
     majority of graduate medical schools located outside of the 
     United States and Canada.
       (2) The National Committee on Foreign Medical Education and 
     Accreditation and the Department of Education recommend that 
     all foreign graduate medical schools should be required to 
     meet the same eligibility requirements to participate in 
     Federal funding under title IV of the Higher Education Act of 
     1965 (20 U.S.C. 1070 et seq.).
       (3) The attrition rate at United States medical schools 
     averaged 3.2 percent between 1998 and 2018, while rates at 
     for-profit Caribbean medical schools have been known to reach 
     30 percent.
       (4) In 2024, residency match rates for foreign trained 
     graduates averaged 67 percent compared to 93.5 percent for 
     graduates of allopathic medical schools in the United States 
     and 92.3 percent for graduates of osteopathic medical schools 
     in the United States.
       (5) On average, students at for-profit medical schools 
     operating outside of the United States and Canada amass more 
     student debt than students at medical schools in the United 
     States.

     SEC. 4. REPEAL GRANDFATHER PROVISIONS.

       Section 102(a)(2) of the Higher Education Act of 1965 (20 
     U.S.C. 1002(a)(2)) is amended--
       (1) in subparagraph (A), by striking clause (i) and 
     inserting the following:
       ``(i) in the case of a graduate medical school located 
     outside the United States--

       ``(I) at least 60 percent of those enrolled in, and at 
     least 60 percent of the graduates of, the graduate medical 
     school outside the United States were not persons described 
     in

[[Page S5200]]

     section 484(a)(5) in the year preceding the year for which a 
     student is seeking a loan under part D of title IV; and
       ``(II) at least 75 percent of the individuals who were 
     students or graduates of the graduate medical school outside 
     the United States or Canada (both nationals of the United 
     States and others) taking the examinations administered by 
     the Educational Commission for Foreign Medical Graduates 
     received a passing score in the year preceding the year for 
     which a student is seeking a loan under part D of title 
     IV;''; and

       (2) in subparagraph (B)(iii), by adding at the end the 
     following:

       ``(V) Expiration of authority.--The authority of a graduate 
     medical school described in subclause (I) to qualify for 
     participation in the loan programs under part D of title IV 
     pursuant to this clause shall expire beginning on the first 
     July 1 following the date of enactment of the Foreign Medical 
     School Accountability Fairness Act of 2024.''.

     SEC. 5. LOSS OF ELIGIBILITY.

       If a graduate medical school loses eligibility to 
     participate in the loan programs under part D of title IV of 
     the Higher Education Act of 1965 (20 U.S.C. 1087a et seq.) 
     due to the enactment of the amendments made by section 4, 
     then a student enrolled at such graduate medical school on or 
     before the date of enactment of this Act may, notwithstanding 
     such loss of eligibility, continue to be eligible to receive 
     a loan under such part D while attending such graduate 
     medical school in which the student was enrolled upon the 
     date of enactment of this Act, subject to the student 
     continuing to meet all applicable requirements for 
     satisfactory academic progress, until the earliest of--
       (1) withdrawal by the student from the graduate medical 
     school;
       (2) completion of the program of study by the student at 
     the graduate medical school; or
       (3) the fourth June 30 after such loss of eligibility.
  Mr. DURBIN. Madam 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:
                                 ______
                                 
      By Mr. DURBIN (for himself and Mr. Blumenthal):
  S. 4745. A bill to establish the Federal Food Administration to 
protect the public health by ensuring the safety of food, preventing 
foodborne illness, maintaining safety reviews and reassessments of food 
additives, reducing the prevalence of diet-related chronic diseases, 
enforcing pesticide residue tolerances, improving the surveillance of 
foodborne pathogens, and for other purposes; to the Committee on 
Health, Education, Labor, and Pensions.
       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 ``Federal Food Administration 
     Act of 2024''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Administration.--The term ``Administration'', except as 
     otherwise provided, means the Federal Food Administration 
     established under section 101(a)(1).
       (2) Commissioner.--The term ``Commissioner'', except as 
     otherwise provided, means the Commissioner of Foods appointed 
     under section 101(a)(2).
       (3) Facility.--The term ``facility'' means any factory, 
     warehouse, or establishment that is subject to the 
     requirements of section 415 or 419 of the Federal Food, Drug, 
     and Cosmetic Act (21 U.S.C. 350d; 350h).

     SEC. 3. EFFECTIVE DATE.

       This Act, including the amendments made by this Act, shall 
     take effect 180 days after the date of enactment of this Act.

     SEC. 4. FUNDING.

       (a) Transfer of Funds.--The appropriations, allocations, 
     and other funds that relate to the authorities, functions and 
     agencies transferred under section 102 shall be transferred 
     to the Administration.
       (b) Authorization of Appropriations.--There are authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary for fiscal year 2025 and each fiscal year 
     thereafter.

         TITLE I--ESTABLISHMENT OF FEDERAL FOOD ADMINISTRATION

     SEC. 101. ESTABLISHMENT OF FEDERAL FOOD ADMINISTRATION.

       (a) Establishment.--
       (1) In general.--There is established within the Department 
     of Health and Human Services an agency to be known as the 
     ``Federal Food Administration''.
       (2) Head of administration.--The Administration shall be 
     headed by the Commissioner of Foods, who shall have food 
     safety expertise, and be appointed by the President, by and 
     with the advice and consent of the Senate.
       (3) Effect.--The Federal Food and Drug Administration shall 
     be renamed the ``Federal Drug Administration'' and retain 
     responsibility for carrying out its responsibilities related 
     to drugs, cosmetics, devices, biological products, color 
     additives, and tobacco. The Commissioner of Food and Drugs 
     shall be renamed the ``Commissioner of Drugs'', and shall 
     retain the responsibilities of the Commissioner of Food and 
     Drugs, as of the day before the date of enactment of this 
     Act, except such responsibilities that relate to food, which 
     shall be assumed by the Commissioner of Food. Each reference 
     in law, regulation, document, paper, or other record of the 
     United States to the ``Food and Drug Administration'' shall 
     be deemed a reference to the ``Federal Drug Administration'', 
     and each reference in law, regulation, document, paper, or 
     other record of the United States to the ``Commissioner of 
     Food and Drugs'' shall be deemed a reference to the 
     ``Commissioner of Drugs''.
       (b) Duties of the Commissioner.--The Commissioner shall--
       (1) administer and enforce all authorities under chapter IV 
     of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 341 et 
     seq.);
       (2) serve as a representative to international food safety 
     bodies and discussions;
       (3) promulgate and enforce regulations to ensure the 
     security of the food supply from all forms of contamination, 
     including intentional contamination; and
       (4) oversee--
       (A) implementation of Federal food efforts;
       (B) inspection, labeling, enforcement, and research efforts 
     to protect the public health;
       (C) development of consistent and science-based standards 
     for safe food;
       (D) safety reviews and reassessments of food additives;
       (E) establishment and enforcement of tolerances for 
     poisonous or deleterious substances;
       (F) monitoring and enforcement of pesticide residue 
     tolerances in or on foods;
       (G) coordination and prioritization of food research and 
     education programs with other Federal agencies;
       (H) prioritization of Federal food efforts and deployment 
     of Federal food resources to achieve the greatest benefit in 
     reducing foodborne illness and diet-related chronic diseases;
       (I) coordination of the Federal response to foodborne 
     illness outbreaks with other Federal and State agencies;
       (J) integration of Federal food activities with State and 
     local agencies; and
       (K) assignment of tolerances for animal drugs used in food-
     producing animals.

     SEC. 102. TRANSFER OF AUTHORITY, FUNCTIONS AND AGENCIES.

       (a) Transfer of Authority.--The Administration shall assume 
     responsibility for carrying out chapter IV of the Federal 
     Food, Drug, and Cosmetic Act (21 U.S.C. 341 et seq.) and 
     maintain all enforcement authorities with respect to food 
     held by the Food and Drug Administration on the date of 
     enactment of this Act.
       (b) Transfer of Functions.--For each Federal agency, 
     office, and center specified in subsection (c), there are 
     transferred to the Administration all functions that the head 
     of the Federal agency exercised on the day before the date of 
     enactment of this Act (including all related functions of any 
     officer or employee of the Federal agency) that relate to 
     administration or enforcement of the food law, as determined 
     by the President.
       (c) Transferred Agencies.--The Federal agencies referred to 
     in subsection (b) are--
       (1) the resources and facilities of the Center for Food 
     Safety and Applied Nutrition of the Food and Drug 
     Administration that administer chapter IV of the Federal 
     Food, Drug, and Cosmetics Act (21 U.S.C. 341 et seq.);
       (2) the resources and facilities of the Office of 
     Regulatory Affairs of the Food and Drug Administration that 
     administer and conduct inspections of food and feed 
     facilities and imports;
       (3) the resources and facilities of the Center for 
     Veterinary Medicine of the Food and Drug Administration that 
     administer chapter IV of the Federal Food, Drug, and 
     Cosmetics Act (21 U.S.C. 341 et seq.);
       (4) the Office of Food Policy and Response of the Food and 
     Drug Administration; and
       (5) such other offices, services, or agencies as the 
     President designates by Executive order to carry out this 
     Act.
       (d) Conforming Amendment.--Subchapter A of chapter VII of 
     the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 371 et 
     seq.) is amended by adding at the end the following:

     ``SEC. 716. REGULATION OF FOOD.

       ``Notwithstanding any other provision of this Act, 
     beginning on the date that is 180 days after the date of 
     enactment of the Federal Food Administration Act of 2024, any 
     authority under this Act that relates to food shall be under 
     the authority of the Federal Food Administration, and shall 
     be carried out by the Commissioner of Food. Any reference in 
     this Act to authorities related to food held by the Secretary 
     shall be deemed to be a reference to authorities held by the 
     Commissioner of Food.''.

     SEC. 103. ADDITIONAL DUTIES OF THE ADMINISTRATION.

       (a) Officers and Employees.--The Commissioner may--
       (1) appoint officers and employees for the Administration 
     in accordance with the provisions of title 5, United States 
     Code, relating to appointment in the competitive service; and
       (2) fix the compensation of those officers and employees in 
     accordance with chapter 51 and with subchapter III of chapter 
     53 of that title, relating to classification and General 
     Schedule pay rates.
       (b) Experts and Consultants.--The Administration may--
       (1) procure the services of temporary or intermittent 
     experts and consultants as authorized by section 3109 of 
     title 5, United States Code; and

[[Page S5201]]

       (2) pay in connection with those services the travel 
     expenses of the experts and consultants, including 
     transportation and per diem in lieu of subsistence while away 
     from the homes or regular places of business of the 
     individuals, as authorized by section 5703 of that title.
       (c) Bureaus, Offices, and Divisions.--The Commissioner may 
     establish within the Administration such bureaus, offices, 
     and divisions as the Commissioner determines are necessary to 
     perform the duties of the Commissioner.
       (d) Advisory Committees.--
       (1) In general.--The Commissioner shall establish advisory 
     committees that consist of representative of scientific 
     expert bodies, academics, industry specialists, and 
     consumers.
       (2) Duties.--The duties of an advisory committee 
     established under paragraph (1) may include developing 
     recommendations with respect to the development of regulatory 
     science and processes, research, communications, performance 
     standards, and inspection.

               TITLE II--ADMINISTRATION OF FOODS PROGRAM

     SEC. 201. ESTABLISHMENT OF INSPECTION PROGRAM.

       (a) In General.--The Commissioner shall establish an 
     inspection program, which shall include inspections of food 
     facilities subject to subsection (b) and in accordance with 
     section 202.
       (b) Facility Categories.--Not later than 6 months after the 
     date of enactment of this Act, the Commissioner shall issue 
     formal guidance defining the criteria by which food 
     facilities will be divided into ``high-risk,'' ``intermediate 
     risk,'' and ``low-risk'' facilities.
       (c) Inspection Frequencies.--Frequency of inspections of 
     food facilities under this Act shall be based on the 
     categories defined pursuant to subjection (b) and in 
     accordance with section 202.

     SEC. 202. INSPECTIONS OF FOOD FACILITIES.

       (a) Frequency of Inspections.--
       (1) High-risk facilities.--The Commissioner shall inspect 
     high-risk facilities not less than once per a year.
       (2) ``intermediate-risk facilities .--The Commissioner 
     shall inspect intermediate-risk facilities not less than once 
     every 2 years.
       (3) ``low-risk facilities.--The Commissioner shall inspect 
     low risk facilities, which shall include warehouses or 
     similar facilities that engage in packaging or distribution, 
     and pose very minimal public health risk, not less than once 
     every 3 years.
       (b) Infant Formula Manufacturing Facilities.--The 
     Commissioner shall inspect the facilities of each 
     manufacturer of infant formula not less than every 6 months.
       (c) Federal and State Cooperation.--The Commissioner shall 
     contract with State officials to carry out half of the safety 
     inspections required under this section.

     SEC. 203. COMPLIANCE CHECKS.

       Not later than 30 days after issuing a form that is 
     equivalent to an FDA Form 483 to a facility, pursuant to an 
     inspection under section 704 of Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 374), the Commissioner shall conduct 
     a follow-up compliance check with the facility.

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