[House Report 116-214]
[From the U.S. Government Publishing Office]


116th Congress    }                                     {       Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                     {      116-214

======================================================================



 
EDUCATING MEDICAL PROFESSIONALS AND OPTIMIZING WORKFORCE EFFICIENCY AND 
                    READINESS FOR HEALTH ACT OF 2019

                                _______
                                

 September 24, 2019.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 2781]

    The Committee on Energy and Commerce, to whom was referred 
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, having 
considered the same, report favorably thereon with an amendment 
and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................8
 II. Background and Need for the Legislation..........................8
III. Committee Hearings..............................................11
 IV. Committee Consideration.........................................12
  V. Committee Votes.................................................12
 VI. Oversight Findings..............................................12
VII. New Budget Authority, Entitlement Authority, and Tax Expenditure12
VIII.Federal Mandates Statement......................................13

 IX. Statement of General Performance Goals and Objectives...........13
  X. Duplication of Federal Programs.................................13
 XI. Committee Cost Estimate.........................................13
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits.....13
XIII.Advisory Committee Statement....................................13

XIV. Applicability to Legislative Branch.............................13
 XV. Section-by-Section Analysis of the Legislation..................14
XVI. Changes in Existing Law Made by the Bill, as Reported...........16

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

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.
                  ``(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 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.''.

                         I. Purpose and Summary

    H.R. 2781, the ``Educating Medical Professionals and 
Optimizing Workforce Efficiency and Readiness for Health Act of 
2019'' or the ``EMPOWER for Health Act of 2019'', was 
introduced on May 16, 2019, by Reps. Jan Schakowsky (D-IL) and 
Michael Burgess (R-TX) and referred to the Committee on Energy 
and Commerce. H.R. 2781 would reauthorize funding at the Health 
Resources and Services Administration (HRSA) for health 
professions workforce, education, and training programs. The 
legislation expands efforts to increase diversity, improve 
geriatrics education and training, and grow the pediatric 
health care workforce. The five-year reauthorization includes 
annual authorizations of: $24.897 million for Centers of 
Excellence; $51.419 million for Scholarships for Disadvantaged 
Students; $1.25 million for Loan Repayments and Fellowships 
Regarding Faculty Positions; $14.899 million for the Health 
Careers Opportunity Program; $51.371 million for Primary Care 
Training and Enhancement; $42.707 million for Oral Health 
Training; $42,075,000 for Area Health Education Centers; $5.947 
million for the National Center for Health Workforce Analysis; 
$17.85 million for Public Health Workforce grants; $51 million 
for Education and Training Related to Geriatrics; $30 million 
for pediatric medical subspecialists and surgical specialist 
loan repayment; and $20 million for child and adolescent mental 
and behavioral health professionals loan repayment. The bill 
also creates a new authorization of $5 million to increase 
workforce diversity in the professions of physical therapy, 
occupational therapy, audiology, and speech-language pathology.

                II. Background and Need for Legislation

    Title VII of the Public Health Service Act includes 
programs administered primarily through HRSA to support and 
educate the medical, dental, public health, and allied health 
professional workforce through grants that flow to institutions 
and directly to professionals and pre-professionals.\1\ Some 
estimates have projected that the United States could 
experience a shortfall of over 100,000 physicians by 2032,\2\ 
and Title VII workforce programs aim to reduce that shortage by 
bolstering the health workforce. With the goal of improving 
health and achieving health equity, many of the programs in 
Title VII place a particular emphasis on ensuring the United 
States has a diverse health workforce, which has been shown to 
improve patient satisfaction, patient-clinician communication, 
and access to care for patients belonging to minority 
populations.\3\
---------------------------------------------------------------------------
    \1\Bernice Reyes-Akinbileje, Cong. Research Serv., R43177, Health 
Workforce Programs in Title VII of the Public Health Service Act 
(2013).
    \2\Assoc. of American Medical Colleges, The Complexities of 
Physician Supply and Demand: Projections from 2017 to 2032 4 (2019).
    \3\Health Resources and Services Admin., Sex, Race, and Ethnic 
Diversity of U.S. Health Occupations (2011-2015) 2-3 (2017).
---------------------------------------------------------------------------
    H.R. 2781 provides reauthorizations and updates for Title 
VII programs, and makes modifications to the programs, 
including the creation of a new workforce diversity program in 
the professions of physical therapy, occupational therapy, 
audiology, and speech-language pathology.
    The Centers of Excellence Program provides grants to health 
professions schools and other public and nonprofit health or 
educational entities to focus on recruitment, training, and 
retention of underrepresented minority students and faculty.\4\ 
In the 2017-2018 academic year, the Centers of Excellence 
Program supported 168 training programs or activities, and more 
than 97 percent of trainees were underrepresented minorities in 
the health professions, and 69 percent were from financially 
and/or educationally disadvantaged backgrounds.\5\
---------------------------------------------------------------------------
    \4\Health Resources and Services Admin., Fiscal Year 2020 
Justification of Estimates for Appropriations Committees 89 (2019).
    \5\Id.
---------------------------------------------------------------------------
    The Scholarships for Disadvantaged Students Program 
provides grants to health professional and nursing schools to 
be used as scholarships for students from disadvantaged 
backgrounds, a majority of whom are underrepresented 
minorities.\6\ In the 2017-2018 school year, 3,047 students 
received scholarship amounts up to $30,000 for their health 
professional and nursing educations.\7\
---------------------------------------------------------------------------
    \6\Id. at 92.
    \7\Id.
---------------------------------------------------------------------------
    The Faculty Loan Repayment Program pays up to $20,000 of 
principal and interest, per year, on loans held by health 
profession graduates from disadvantaged backgrounds who serve 
as faculty at health professions colleges or universities for 
at least two years.\8\
---------------------------------------------------------------------------
    \8\Id. at 87.
---------------------------------------------------------------------------
    The Health Careers Opportunity Program (HCOP) promotes 
interest in health careers and avenues for young students from 
economically and educationally disadvantaged backgrounds to 
gain the skills needed to compete for, enter, and graduate from 
health professional schools and schools for the allied health 
professions.\9\ Entities eligible to receive HCOP awards 
include health professional schools and other public or private 
nonprofit health or educational entities, including non-
academic nonprofit entities focused on health care that have 
partnered with educational entities to serve disadvantaged 
students underrepresented in the health professions.
---------------------------------------------------------------------------
    \9\Id. at 95.
---------------------------------------------------------------------------
    The Primary Care Training and Enhancement Program 
strengthens the primary care workforce by creating accredited 
professional training programs in the field of family medicine, 
general internal medicine, or general pediatrics. The program 
includes support for the Primary Care Medicine and Dentistry 
Clinician Educator Career Development Awards, which fund 
innovative projects that aim to transform health delivery 
systems.\10\
---------------------------------------------------------------------------
    \10\Id. at 102-103.
---------------------------------------------------------------------------
    Oral Health Training Programs include training for general, 
pediatric, and public health dentists and dental hygiene 
providers. In the 2017-2018 academic year, the program trained 
9,562 dental and dental hygiene students, 495 dental residents 
and fellows, and 332 dental faculty members.\11\
---------------------------------------------------------------------------
    \11\Id. at 107-108.
---------------------------------------------------------------------------
    Area Health Education Centers (AHEC) coordinate and enhance 
education and training networks within communities, academic 
institutions, and community-based organizations. The networks 
support increased diversity among health professionals, spread 
the health workforce throughout the country, enhance quality, 
and improve care delivery in rural and underserved areas.\12\ 
In the 2017-2018 academic year, the AHEC program supported more 
than 3,600 different types of training programs that drew the 
participation of 297,169 students and residents.\13\
---------------------------------------------------------------------------
    \12\Health Resources and Services Administration, National Center 
for Workforce Analysis, Area Health Education Centers Program, 
bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/program-
highlights/2018/area-health-education-centers-2018.pdf (2018).
    \13\Id.
---------------------------------------------------------------------------
    The National Center for Health Workforce Analysis (NCHWA) 
collects and analyzes workforce data and information while 
evaluating the effectiveness of workforce investments. NCHWA 
models projections of future supply and demand of the health 
care workforce.
    Title VII also funds public health workforce development 
through Public Health Training Centers (PHTC) Program and the 
Preventive Medicine Residency (PMR) Program. PHTCs strengthen 
the public health workforce by providing education, training, 
and consultation to state, local, and tribal public health 
departments. Approximately 63 percent of the most recent cohort 
of training sites in the PHTC program were in underserved 
communities.\14\ The PMR program provides stipends for medical 
residents training in preventive medicine to defer costs of 
living expenses, tuition, and fees.\15\
---------------------------------------------------------------------------
    \14\Supra note 4 at 130-131.
    \15\Id.
---------------------------------------------------------------------------
    The Geriatrics Workforce Enhancement Program (GWEP) and 
Geriatrics Academic Career Awards (GACA) program provide 
training to students, faculty, providers, direct service 
workers, patients, families, and lay and family caregivers to 
address gaps in health care for older adults.\16\ According to 
the NCHWA, by 2025, all regions in the U.S. are projected to 
have a shortage of geriatricians.\17\ These programs make 
important investments in the future of the geriatric workforce.
---------------------------------------------------------------------------
    \16\Id. at 120-121.
    \17\Health Recourses and Services Administration, National Center 
for Health Workforce Analysis.
---------------------------------------------------------------------------
    The Investment in Tomorrow's Pediatric Health Care 
Workforce loan repayment program provides loan repayment to 
health professionals in pediatric medical subspecialties, 
pediatric surgical specialties, or child and adolescent mental 
and behavioral health. Eligible individuals must have 
familiarity with evidence-based methods and cultural and 
linguistic competence health care services and demonstrate 
financial need.
    Members of the physical therapy, occupational therapy, and 
speech-language pathology professions are predominantly white 
and female.\18\ Researchers have noted that achieving greater 
diversity among healthcare workforce will produce a more 
culturally competent workforce, improve access to high-quality 
care for the medically underserved, increase the breadth and 
depth of the U.S. health research agenda, and expand the pool 
of medically trained executives and policymakers ready to serve 
in leadership positions in the health care system.\19\ Despite 
the benefits of a more diverse workforce, health professional 
education programs have struggled to diversify the pool of 
health professional students and the future health care 
workforce.\20\ The diversity workforce program for physical 
therapists, occupational therapists, audiologists, and speech-
language pathologists, authorized by this legislation, is 
modeled on the successful nursing workforce diversity grants 
program in Title VIII of the Public Health Service Act\21\ and 
would provide student scholarships or stipends to eligible 
entities (defined as accredited education programs carrying out 
a program for recruiting and retaining students 
underrepresented in the processions of physical therapy, 
occupational therapy, audiology, and speech-language pathology, 
including racial or ethnic minorities or students from 
disadvantaged backgrounds) on behalf of eligible individuals 
(defined as an individual who is a member of a class of persons 
who are underrepresented in the professions described above, 
has a financial need for a scholarship or stipend, and is 
enrolled at an audiology, speech-language pathology, physical 
therapy, or occupational therapy program as a full-time student 
at an eligible entity.
---------------------------------------------------------------------------
    \18\Health Resources and Services Admin., Sex, Race, and Ethnic 
Diversity of U.S. Health Occupations (2011-2015) Tables 1-2 (2017).
    \19\Jordan J. Cohen, Barbara A. Gabriel, and Charles Terrell, The 
Case for Diversity in the Health Care Workforce, Health Affairs, Vol. 
21, Issue 5, at 90 (2002).
    \20\See In the Nation's Compelling Interest: Ensuring Diversity in 
the Health-Care Workforce (Brian D. Smedley, Adrienne Stith Butler, 
Lonnie R. Bristow, eds., Institute of Medicine of the National 
Academies 2004).
    \21\See 42 U.S.C. Sec. 296m.
---------------------------------------------------------------------------
    The diversity workforce program for physical therapists, 
occupational therapists, audiologists, and speech-language 
pathologists, authorized by this legislation, is modeled on the 
successful nursing workforce diversity grants program in Title 
VIII of the Public Health Service Act\22\ and would provide 
student scholarships or stipends to eligible entities (defined 
as accredited education programs carrying out a program for 
recruiting and retaining students underrepresented in the 
processions of physical therapy, occupational therapy, 
audiology, and speech-language pathology, including racial or 
ethnic minorities or students from disadvantaged backgrounds) 
on behalf of eligible individuals (defined as an individual who 
is a member of a class of persons who are underrepresented in 
the professions described above, has a financial need for a 
scholarship or stipend, and is enrolled at an audiology, 
speech-language pathology, physical therapy, or occupational 
therapy program as a full-time student at an eligible entity).
---------------------------------------------------------------------------
    \22\See 42 U.S.C. Sec. 296m.
---------------------------------------------------------------------------

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 2781:
    The Subcommittee on Health held a hearing in the 115th 
Congress entitled ``Supporting Tomorrow's Health Providers: 
Examining Workforce Programs Under the Public Health Service 
Act.'' Witnesses at the hearing included:
     Adrian Billings, M.D., Ph.D., FAAFP, Chief Medical 
Officer, Preventive Care Health Services and Associate 
Professor, Department of Family and Community Medicine, Texas 
Tech University Health Sciences Center-Permian Basin.
     Neil S. Calman, M.D., FAAFP, President, American 
Association of Teaching Health Centers, President and CEO, 
Institute for Family Health, Chair, Department of Family 
Medicine and Community Health, Icahn School of Medicine at 
Mount Sinai.
     Janice A. Knebl, D.O., M.B.A., Dallas Southwest 
Osteopathic Physicians Endowed Chair and Professor in 
Geriatrics, University of North Texas Health Science Center.
     Juliann Sebastian, Ph.D., R.N., FAAN, Chair of the 
Board of Directors, American Association of Colleges of 
Nursing, Dean and Professor, College of Nursing, University of 
Nebraska Medical Center.

                      IV. Committee Consideration

    H.R. 2781, the ``Educating Medical Professionals and 
Optimizing Workforce Efficiency and Readiness for Health Act of 
2019'' or the ``EMPOWER for Health Act of 2019'', was 
introduced on May 16, 2019, by Reps. Jan Schakowsky (D-IL) and 
Michael Burgess (R-TX) and referred to the Committee on Energy 
and Commerce. Subsequently, the bill was referred to the 
Subcommittee on Health on May 17, 2019. The Subcommittee met in 
open markup session, pursuant to notice, on July 11, 2019, for 
consideration of H.R. 2781. Amendments offered by Mr. Burgess 
and Mr. Rush were both agreed to by a voice vote. Subsequently, 
the Subcommittee on Health agreed to a motion by Ms. Eshoo, 
Chairwoman of the Subcommittee, to forward favorably H.R. 2781, 
amended, to the full Committee on Energy and Commerce by a 
voice vote.
    On July 17, 2019, the full Committee met in open markup 
session, pursuant to notice, to consider H.R. 2781, as amended 
by the subcommittee. During markup of the bill, an amendment 
offered by Ms. Schakowsky (D-IL) was agreed to by a voice vote. 
At the conclusion of consideration of the bill, the full 
Committee on Energy and Commerce agreed to a motion by Mr. 
Pallone, Chairman of the Committee, to order the bill H.R. 2781 
reported favorably to the House, amended, by a voice vote, a 
quorum being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. 
There were no recorded votes taken in connection with ordering 
H.R. 2781 reported or on any amendments to the bill.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, credit 
authority, or an increase or decrease in revenues or tax 
expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to amend 
title VII of the Public Health Service Act to reauthorize 
certain programs relating to the health professions workforce.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 2781 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 2781 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title 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''.

Section 2. Reauthorization of health professions workforce programs

    Section 2 reauthorizes funding for health professions 
workforce programs for five years, through 2024, and includes 
the following annual authorizations: $24,897,000 for Centers of 
Excellence; $51,419,000 for scholarships for disadvantaged 
students; $1,250,000 for faculty loan repayment; $20,000,000 
for the Health Careers Opportunities Program; $51,371,000 for 
primary care training and enhancement; $42,707,000 for training 
in general, pediatric, and public health dentistry; $42,075,000 
for area health education centers; $5,947,000 for the National 
Center for Healthcare Workforce Analysis; and $17,850,000 for 
public health workforce programs.

Section 3. Education and training related to geriatrics

    Section 3 reauthorizes the Geriatrics Workforce Enhancement 
Programs (GWEPs) and officially authorizes the Geriatric 
Academic Career Awards (GACAs) program. GWEPs are required to 
place special emphasis 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. Priority for GWEP awards will be 
given to communities that have a shortage of workforce 
professionals and states in which no entity has previously 
received a GWEP award. Award amounts are determined by the 
Secretary, and Section 3, paragraph 8 notes that those program 
applications 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.
    The GACA program would provide awards to eligible entities 
(specifically accredited schools of allopathic or osteopathic 
medicine, nursing, social work, psychology, dentistry, 
pharmacy, allied health, or other types of accredited health 
professions schools or graduate programs deemed eligible by the 
Secretary), on behalf of eligible individuals (specifically: an 
individual who has a junior, nontenured faculty appointment at 
accredited schools of allopathic or osteopathic medicine, 
nursing, social work, psychology, dentistry, pharmacy, allied 
health, or other types of accredited health professions schools 
or graduate programs deemed eligible by the Secretary; 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 meets 
other requirements). Award amounts for physicians shall be 
$100,000 for fiscal year (FY) 2020, and that amount should 
increase in future years to reflect the increase in the 
Consumer Price Index. The Secretary can determine award amounts 
for non-physicians. The term of any GACAs may not exceed five 
years. Under a special rule, if during an award period an 
individual is promoted to associate professor during the course 
of an award, and thereby no longer meets the criteria of being 
a junior nontenured faculty appointee, the individual may 
continue to be treated as an eligible individual through the 
full term of the award. In issuing awards, the Secretary shall 
pay particular attention to geriatrics health care workforce 
needs among underserved populations, diverse communities, and 
rural areas, and shall ensure that grants are equitably 
distributed across the various geographical regions of the 
United States, including rural and underserved areas. Any funds 
awarded under a GACA must only be used to supplement, and not 
supplant, the amount of Federal, State, and local funds 
otherwise expended by such an individual.
    For both GWEPs and GACAs, $51,000,000 is authorized 
annually from FY 2020 to FY 2024 to carry out the programs. 
Funds for GACAs may not be made available unless the amount 
made available to carry out the GACA program is more than the 
amount made to carry out GWEPs and GACAs in FY 2017.

Section 4. Investment in Tomorrow's Pediatric Health Care Workforce

    This section reauthorizes the Investment in Tomorrow's 
Pediatric Health Care Workforce Program, which requires the 
Secretary to establish and carry out a pediatric specialty loan 
repayment program for qualified health professionals who agree 
to serve not less than two years in which the professional 
participates in an accredited pediatric subspecialty, pediatric 
surgical specialty, child and adolescent psychiatry 
subspecialty, or child and adolescent mental and behavioral 
health residency or fellowship; or employed full-time in 
providing such care in an area with a shortage of health care 
professionals practicing in these specialties or subspecialties 
and a sufficient pediatric population to support the addition 
of a practitioner in such specialties. Under the program, the 
Secretary would agree 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 per year for each year of agreed upon service 
for not more than three years. This section describes an 
individual's required educational and professional 
qualifications relevant to each respective specialty or 
subspecialty, and further requires that eligible individuals 
must agree to work in or for a provider serving an area or 
community with a shortage of eligible qualified health 
professionals, and the professional is a United States citizen, 
a permanent legal United States resident, or is lawfully 
present in the United States. This section authorizes 
$30,000,000 annually to carry out this program for pediatric 
medical subspecialists and pediatric surgical specialists and 
$20,000,000 annually to carry out this program for child and 
adolescent psychiatry and behavioral health professionals. The 
authorizations run from FY 2020 through FY 2024.

Section 5. Increasing workforce diversity in the professions of 
        physical therapy, occupational therapy, audiology, and speech-
        language pathology

    Section 5 creates a workforce diversity program which pays 
scholarships or stipends to eligible entities on behalf of 
eligible students underrepresented in the fields of physical 
therapy, occupational therapy, audiology, or speech-language 
pathology. This section authorizes $5,000,000 annually for FYs 
2020 through 2024 for purposes of carrying out this program.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, and existing law in which no 
change is proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE VII--HEALTH PROFESSIONS EDUCATION

           *       *       *       *       *       *       *


           PART B--HEALTH PROFESSIONS TRAINING FOR DIVERSITY

SEC. 736. CENTERS OF EXCELLENCE.

  (a) In General.--The Secretary shall make grants to, and 
enter into contracts with, designated health professions 
schools described in subsection (c), and other public and 
nonprofit health or educational entities, for the purpose of 
assisting the schools in supporting programs of excellence in 
health professions education for under-represented minority 
individuals.
  (b) Required Use of Funds.--The Secretary may not make a 
grant under subsection (a) unless the designated health 
professions school involved agrees, subject to subsection 
(c)(1)(C), to expend the grant--
          (1) to develop a large competitive applicant pool 
        through linkages with institutions of higher education, 
        local school districts, and other community-based 
        entities and establish an education pipeline for health 
        professions careers;
          (2) to establish, strengthen, or expand programs to 
        enhance the academic performance of under-represented 
        minority students attending the school;
          (3) to improve the capacity of such school to train, 
        recruit, and retain under-represented minority faculty 
        including the payment of such stipends and fellowships 
        as the Secretary may determine appropriate;
          (4) to carry out activities to improve the 
        information resources, clinical education, curricula 
        and cultural competence of the graduates of the school, 
        as it relates to minority health issues;
          (5) to facilitate faculty and student research on 
        health issues particularly affecting under-represented 
        minority groups, including research on issues relating 
        to the delivery of health care;
          (6) to carry out a program to train students of the 
        school in providing health services to a significant 
        number of under-represented minority individuals 
        through training provided to such students at 
        community-based health facilities that--
                  (A) provide such health services; and
                  (B) are located at a site remote from the 
                main site of the teaching facilities of the 
                school; and
          (7) to provide stipends as the Secretary determines 
        appropriate, in amounts as the Secretary determines 
        appropriate.
  (c) Centers of Excellence.--
          (1) Designated schools.--
                  (A) In general.--The designated health 
                professions schools referred to in subsection 
                (a) are such schools that meet each of the 
                conditions specified in subparagraphs (B) and 
                (C), and that--
                          (i) meet each of the conditions 
                        specified in paragraph (2)(A);
                          (ii) meet each of the conditions 
                        specified in paragraph (3);
                          (iii) meet each of the conditions 
                        specified in paragraph (4); or
                          (iv) meet each of the conditions 
                        specified in paragraph (5).
                  (B) General conditions.--The conditions 
                specified in this subparagraph are that a 
                designated health professions school--
                          (i) has a significant number of 
                        under-represented minority individuals 
                        enrolled in the school, including 
                        individuals accepted for enrollment in 
                        the school;
                          (ii) has been effective in assisting 
                        under-represented minority students of 
                        the school to complete the program of 
                        education and receive the degree 
                        involved;
                          (iii) has been effective in 
                        recruiting under-represented minority 
                        individuals to enroll in and graduate 
                        from the school, including providing 
                        scholarships and other financial 
                        assistance to such individuals and 
                        encouraging under-represented minority 
                        students from all levels of the 
                        educational pipeline to pursue health 
                        professions careers; and
                          (iv) has made significant recruitment 
                        efforts to increase the number of 
                        under-represented minority individuals 
                        serving in faculty or administrative 
                        positions at the school.
                  (C) Consortium.--The condition specified in 
                this subparagraph is that, in accordance with 
                subsection (e)(1), the designated health 
                profession school involved has with other 
                health profession schools (designated or 
                otherwise) formed a consortium to carry out the 
                purposes described in subsection (b) at the 
                schools of the consortium.
                  (D) Application of criteria to other 
                programs.--In the case of any criteria 
                established by the Secretary for purposes of 
                determining whether schools meet the conditions 
                described in subparagraph (B), this section may 
                not, with respect to racial and ethnic 
                minorities, be construed to authorize, require, 
                or prohibit the use of such criteria in any 
                program other than the program established in 
                this section.
          (2) Centers of excellence at certain historically 
        black colleges and universities.--
                  (A) Conditions.--The conditions specified in 
                this subparagraph are that a designated health 
                professions school--
                          (i) is a school described in section 
                        799B(1); and
                          (ii) received a contract under 
                        section 788B for fiscal year 1987, as 
                        such section was in effect for such 
                        fiscal year.
                  (B) Use of grant.--In addition to the 
                purposes described in subsection (b), a grant 
                under subsection (a) to a designated health 
                professions school meeting the conditions 
                described in subparagraph (A) may be expended--
                          (i) to develop a plan to achieve 
                        institutional improvements, including 
                        financial independence, to enable the 
                        school to support programs of 
                        excellence in health professions 
                        education for under-represented 
                        minority individuals; and
                          (ii) to provide improved access to 
                        the library and informational resources 
                        of the school.
                  (C) Exception.--The requirements of paragraph 
                (1)(C) shall not apply to a historically black 
                college or university that receives funding 
                under paragraphs (2) or (5).
          (3) Hispanic centers of excellence.--The conditions 
        specified in this paragraph are that--
                  (A) with respect to Hispanic individuals, 
                each of clauses (i) through (iv) of paragraph 
                (1)(B) applies to the designated health 
                professions school involved;
                  (B) the school agrees, as a condition of 
                receiving a grant under subsection (a), that 
                the school will, in carrying out the duties 
                described in subsection (b), give priority to 
                carrying out the duties with respect to 
                Hispanic individuals; and
                  (C) the school agrees, as a condition of 
                receiving a grant under subsection (a), that--
                          (i) the school will establish an 
                        arrangement with 1 or more public or 
                        nonprofit community based Hispanic 
                        serving organizations, or public or 
                        nonprofit private institutions of 
                        higher education, including schools of 
                        nursing, whose enrollment of students 
                        has traditionally included a 
                        significant number of Hispanic 
                        individuals, the purposes of which will 
                        be to carry out a program--
                                  (I) to identify Hispanic 
                                students who are interested in 
                                a career in the health 
                                profession involved; and
                                  (II) to facilitate the 
                                educational preparation of such 
                                students to enter the health 
                                professions school; and
                          (ii) the school will make efforts to 
                        recruit Hispanic students, including 
                        students who have participated in the 
                        undergraduate or other matriculation 
                        program carried out under arrangements 
                        established by the school pursuant to 
                        clause (i)(II) and will assist Hispanic 
                        students regarding the completion of 
                        the educational requirements for a 
                        degree from the school.
          (4) Native american centers of excellence.--Subject 
        to subsection (e), the conditions specified in this 
        paragraph are that--
                  (A) with respect to Native Americans, each of 
                clauses (i) through (iv) of paragraph (1)(B) 
                applies to the designated health professions 
                school involved;
                  (B) the school agrees, as a condition of 
                receiving a grant under subsection (a), that 
                the school will, in carrying out the duties 
                described in subsection (b), give priority to 
                carrying out the duties with respect to Native 
                Americans; and
                  (C) the school agrees, as a condition of 
                receiving a grant under subsection (a), that--
                          (i) the school will establish an 
                        arrangement with 1 or more public or 
                        nonprofit private institutions of 
                        higher education, including schools of 
                        nursing, whose enrollment of students 
                        has traditionally included a 
                        significant number of Native Americans, 
                        the purpose of which arrangement will 
                        be to carry out a program--
                                  (I) to identify Native 
                                American students, from the 
                                institutions of higher 
                                education referred to in clause 
                                (i), who are interested in 
                                health professions careers; and
                                  (II) to facilitate the 
                                educational preparation of such 
                                students to enter the 
                                designated health professions 
                                school; and
                          (ii) the designated health 
                        professions school will make efforts to 
                        recruit Native American students, 
                        including students who have 
                        participated in the undergraduate 
                        program carried out under arrangements 
                        established by the school pursuant to 
                        clause (i) and will assist Native 
                        American students regarding the 
                        completion of the educational 
                        requirements for a degree from the 
                        designated health professions school.
          (5) Other centers of excellence.--The conditions 
        specified in this paragraph are--
                  (A) with respect to other centers of 
                excellence, the conditions described in clauses 
                (i) through (iv) of paragraph (1)(B); and
                  (B) that the health professions school 
                involved has an enrollment of under-represented 
                minorities above the national average for such 
                enrollments of health professions schools.
  (d) Designation as Center of Excellence.--
          (1) In general.--Any designated health professions 
        school receiving a grant under subsection (a) and 
        meeting the conditions described in paragraph (2) or 
        (5) of subsection (c) shall, for purposes of this 
        section, be designated by the Secretary as a Center of 
        Excellence in Under-Represented Minority Health 
        Professions Education.
          (2) Hispanic centers of excellence.--Any designated 
        health professions school receiving a grant under 
        subsection (a) and meeting the conditions described in 
        subsection (c)(3) shall, for purposes of this section, 
        be designated by the Secretary as a Hispanic Center of 
        Excellence in Health Professions Education.
          (3) Native american centers of excellence.--Any 
        designated health professions school receiving a grant 
        under subsection (a) and meeting the conditions 
        described in subsection (c)(4) shall, for purposes of 
        this section, be designated by the Secretary as a 
        Native American Center of Excellence in Health 
        Professions Education. Any consortium receiving such a 
        grant pursuant to subsection (e) shall, for purposes of 
        this section, be so designated.
  (e) Authority Regarding Native American Centers of 
Excellence.--With respect to meeting the conditions specified 
in subsection (c)(4), the Secretary may make a grant under 
subsection (a) to a designated health professions school that 
does not meet such conditions if--
          (1) the school has formed a consortium in accordance 
        with subsection (d)(1); and
          (2) the schools of the consortium collectively meet 
        such conditions, without regard to whether the schools 
        individually meet such conditions.
  (f) Duration of Grant.--The period during which payments are 
made under a grant under subsection (a) may not exceed 5 years. 
Such payments shall be subject to annual approval by the 
Secretary and to the availability of appropriations for the 
fiscal year involved to make the payments.
  (g) Definitions.--In this section:
          (1) Designated health professions school.--
                  (A) In general.--The term ``health 
                professions school'' means, except as provided 
                in subparagraph (B), a school of medicine, a 
                school of osteopathic medicine, a school of 
                dentistry, a school of pharmacy, or a graduate 
                program in behavioral or mental health.
                  (B) Exception.--The definition established in 
                subparagraph (A) shall not apply to the use of 
                the term ``designated health professions 
                school'' for purposes of subsection (c)(2).
          (2) Program of excellence.--The term ``program of 
        excellence'' means any program carried out by a 
        designated health professions school with a grant made 
        under subsection (a), if the program is for purposes 
        for which the school involved is authorized in 
        subsection (b) or (c) to expend the grant.
          (3) Native americans.--The term ``Native Americans'' 
        means American Indians, Alaskan Natives, Aleuts, and 
        Native Hawaiians.
  (h) Formula for Allocations.--
          (1) Allocations.--Based on the amount appropriated 
        under subsection (i) for a fiscal year, the following 
        subparagraphs shall apply as appropriate:
                  (A) In general.--If the amounts appropriated 
                under subsection (i) for a fiscal year are 
                $24,000,000 or less--
                          (i) the Secretary shall make 
                        available $12,000,000 for grants under 
                        subsection (a) to health professions 
                        schools that meet the conditions 
                        described in subsection (c)(2)(A); and
                          (ii) and available after grants are 
                        made with funds under clause (i), the 
                        Secretary shall make available--
                                  (I) 60 percent of such amount 
                                for grants under subsection (a) 
                                to health professions schools 
                                that meet the conditions 
                                described in paragraph (3) or 
                                (4) of subsection (c) 
                                (including meeting the 
                                conditions under subsection 
                                (e)); and
                                  (II) 40 percent of such 
                                amount for grants under 
                                subsection (a) to health 
                                professions schools that meet 
                                the conditions described in 
                                subsection (c)(5).
                  (B) Funding in excess of $24,000,000.--If 
                amounts appropriated under subsection (i) for a 
                fiscal year exceed $24,000,000 but are less 
                than $30,000,000--
                          (i) 80 percent of such excess amounts 
                        shall be made available for grants 
                        under subsection (a) to health 
                        professions schools that meet the 
                        requirements described in paragraph (3) 
                        or (4) of subsection (c) (including 
                        meeting conditions pursuant to 
                        subsection (e)); and
                          (ii) 20 percent of such excess amount 
                        shall be made available for grants 
                        under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in subsection 
                        (c)(5).
                  (C) Funding in excess of $30,000,000.--If 
                amounts appropriated under subsection (i) for a 
                fiscal year exceed $30,000,000 but are less 
                than $40,000,000, the Secretary shall make 
                available--
                          (i) not less than $12,000,000 for 
                        grants under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in subsection 
                        (c)(2)(A);
                          (ii) not less than $12,000,000 for 
                        grants under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in paragraph (3) 
                        or (4) of subsection (c) (including 
                        meeting conditions pursuant to 
                        subsection (e));
                          (iii) not less than $6,000,000 for 
                        grants under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in subsection 
                        (c)(5); and
                          (iv) after grants are made with funds 
                        under clauses (i) through (iii), any 
                        remaining excess amount for grants 
                        under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in paragraph 
                        (2)(A), (3), (4), or (5) of subsection 
                        (c).
                  (D) Funding in excess of $40,000,000.--If 
                amounts appropriated under subsection (i) for a 
                fiscal year are $40,000,000 or more, the 
                Secretary shall make available--
                          (i) not less than $16,000,000 for 
                        grants under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in subsection 
                        (c)(2)(A);
                          (ii) not less than $16,000,000 for 
                        grants under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in paragraph (3) 
                        or (4) of subsection (c) (including 
                        meeting conditions pursuant to 
                        subsection (e));
                          (iii) not less than $8,000,000 for 
                        grants under subsection (a) to health 
                        professions schools that meet the 
                        conditions described in subsection 
                        (c)(5); and
                          (iv) after grants are made with funds 
                        under clauses (i) through (iii), any 
                        remaining funds for grants under 
                        subsection (a) to health professions 
                        schools that meet the conditions 
                        described in paragraph (2)(A), (3), 
                        (4), or (5) of subsection (c).
          (2) No limitation.--Nothing in this subsection shall 
        be construed as limiting the centers of excellence 
        referred to in this section to the designated amount, 
        or to preclude such entities from competing for grants 
        under this section.
          (3) Maintenance of effort.--
                  (A) In general.--With respect to activities 
                for which a grant made under this part are 
                authorized to be expended, the Secretary may 
                not make such a grant to a center of excellence 
                for any fiscal year unless the center agrees to 
                maintain expenditures of non-Federal amounts 
                for such activities at a level that is not less 
                than the level of such expenditures maintained 
                by the center for the fiscal year preceding the 
                fiscal year for which the school receives such 
                a grant.
                  (B) Use of federal funds.--With respect to 
                any Federal amounts received by a center of 
                excellence and available for carrying out 
                activities for which a grant under this part is 
                authorized to be expended, the center shall, 
                before expending the grant, expend the Federal 
                amounts obtained from sources other than the 
                grant, unless given prior approval from the 
                Secretary.
  [(i) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section--
          [(1) $50,000,000 for each of the fiscal years 2010 
        through 2015; and
          [(2) and such sums as are necessary for each 
        subsequent fiscal year.]
  (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.

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SEC. 740. AUTHORIZATION OF APPROPRIATION.

  (a) Scholarships.--There are authorized to be appropriated to 
carry out section 737, [$51,000,000 for fiscal year 2010, and 
such sums as may be necessary for each of the fiscal years 2011 
through 2014] $51,419,000 for each of fiscal years 2020 through 
2024. Of the amount appropriated in any fiscal year, the 
Secretary shall ensure that not less than 16 percent shall be 
distributed to schools of nursing.
  (b) Loan Repayments and Fellowships.--For the purpose of 
carrying out section 738, there is authorized to be 
appropriated, [$5,000,000 for each of the fiscal years 2010 
through 2014] $1,250,000 for each of fiscal years 2020 through 
2024.
  (c) Educational Assistance in Health Professions Regarding 
Individuals for Disadvantaged Backgrounds.--For the purpose of 
grants and contracts under section 739(a)(1), there is 
authorized to be appropriated [$60,000,000 for fiscal year 2010 
and such sums as may be necessary for each of the fiscal years 
2011 through 2014] $20,000,000 for each of fiscal years 2020 
through 2024. The Secretary may use not to exceed 20 percent of 
the amount appropriated for a fiscal year under this subsection 
to provide scholarships under section 739(a)(2)(F).
  (d) Report.--Not later than 6 months after the date of 
enactment of this part, the Secretary shall prepare and submit 
to the appropriate committees of Congress a report concerning 
the efforts of the Secretary to address the need for a 
representative mix of individuals from historically minority 
health professions schools, or from institutions or other 
entities that historically or by geographic location have a 
demonstrated record of training or educating underrepresented 
minorities, within various health professions disciplines, on 
peer review councils.

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PART C--TRAINING IN FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL 
  PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL DENTISTRY, AND PEDIATRIC 
                               DENTISTRY

                 Subpart I--Medical Training Generally

SEC. 747. PRIMARY CARE TRAINING AND ENHANCEMENT.

  (a) Support and Development of Primary Care Training 
Programs.--
          (1) In general.--The Secretary may make grants to, or 
        enter into contracts with, an accredited public or 
        nonprofit private hospital, school of medicine or 
        osteopathic medicine, academically affiliated physician 
        assistant training program, or a public or private 
        nonprofit entity which the Secretary has determined is 
        capable of carrying out such grant or contract--
                  (A) to plan, develop, operate, or participate 
                in an accredited professional training program, 
                including an accredited residency or internship 
                program in the field of family medicine, 
                general internal medicine, or general 
                pediatrics for medical students, interns, 
                residents, or practicing physicians as defined 
                by the Secretary;
                  (B) to provide need-based financial 
                assistance in the form of traineeships and 
                fellowships to medical students, interns, 
                residents, practicing physicians, or other 
                medical personnel, who are participants in any 
                such program, and who plan to specialize or 
                work in the practice of the fields defined in 
                subparagraph (A);
                  (C) to plan, develop, and operate a program 
                for the training of physicians who plan to 
                teach in family medicine, general internal 
                medicine, or general pediatrics training 
                programs;
                  (D) to plan, develop, and operate a program 
                for the training of physicians teaching in 
                community-based settings;
                  (E) to provide financial assistance in the 
                form of traineeships and fellowships to 
                physicians who are participants in any such 
                programs and who plan to teach or conduct 
                research in a family medicine, general internal 
                medicine, or general pediatrics training 
                program;
                  (F) to plan, develop, and operate a physician 
                assistant education program, and for the 
                training of individuals who will teach in 
                programs to provide such training;
                  (G) to plan, develop, and operate a 
                demonstration program that provides training in 
                new competencies, as recommended by the 
                Advisory Committee on Training in Primary Care 
                Medicine and Dentistry and the National Health 
                Care Workforce Commission established in 
                section 5101 of the Patient Protection and 
                Affordable Care Act, which may include--
                          (i) providing training to primary 
                        care physicians relevant to providing 
                        care through patient-centered medical 
                        homes (as defined by the Secretary for 
                        purposes of this section);
                          (ii) developing tools and curricula 
                        relevant to patient-centered medical 
                        homes; and
                          (iii) providing continuing education 
                        to primary care physicians relevant to 
                        patient-centered medical homes; and
                  (H) to plan, develop, and operate joint 
                degree programs to provide interdisciplinary 
                and interprofessional graduate training in 
                public health and other health professions to 
                provide training in environmental health, 
                infectious disease control, disease prevention 
                and health promotion, epidemiological studies 
                and injury control.
          (2) Duration of awards.--The period during which 
        payments are made to an entity from an award of a grant 
        or contract under this subsection shall be 5 years.
  (b) Capacity Building in Primary Care.--
          (1) In general.--The Secretary may make grants to or 
        enter into contracts with accredited schools of 
        medicine or osteopathic medicine to establish, 
        maintain, or improve--
                  (A) academic units or programs that improve 
                clinical teaching and research in fields 
                defined in subsection (a)(1)(A); or
                  (B) programs that integrate academic 
                administrative units in fields defined in 
                subsection (a)(1)(A) to enhance 
                interdisciplinary recruitment, training, and 
                faculty development.
          (2) Preference in making awards under this 
        subsection.--In making awards of grants and contracts 
        under paragraph (1), the Secretary shall give 
        preference to any qualified applicant for such an award 
        that agrees to expend the award for the purpose of--
                  (A) establishing academic units or programs 
                in fields defined in subsection (a)(1)(A); or
                  (B) substantially expanding such units or 
                programs.
          (3) Priorities in making awards.--In awarding grants 
        or contracts under paragraph (1), the Secretary shall 
        give priority to qualified applicants that--
                  (A) proposes a collaborative project between 
                academic administrative units of primary care;
                  (B) proposes innovative approaches to 
                clinical teaching using models of primary care, 
                such as the patient centered medical home, team 
                management of chronic disease, and 
                interprofessional integrated models of health 
                care that incorporate transitions in health 
                care settings and integration physical and 
                mental health provision;
                  (C) have a record of training the greatest 
                percentage of providers, or that have 
                demonstrated significant improvements in the 
                percentage of providers trained, who enter and 
                remain in primary care practice;
                  (D) have a record of training individuals who 
                are from underrepresented minority groups or 
                from a rural or disadvantaged background;
                  (E) provide training in the care of 
                vulnerable populations such as children, older 
                adults, homeless individuals, victims of abuse 
                or trauma, individuals with mental health or 
                substance-related disorders, individuals with 
                HIV/AIDS, and individuals with disabilities;
                  (F) establish formal relationships and submit 
                joint applications with federally qualified 
                health centers, rural health clinics, area 
                health education centers, or clinics located in 
                underserved areas or that serve underserved 
                populations;
                  (G) teach trainees the skills to provide 
                interprofessional, integrated care through 
                collaboration among health professionals;
                  (H) provide training in enhanced 
                communication with patients, evidence-based 
                practice, chronic disease management, 
                preventive care, health information technology, 
                or other competencies as recommended by the 
                Advisory Committee on Training in Primary Care 
                Medicine and Dentistry and the National Health 
                Care Workforce Commission established in 
                section 5101 of the Patient Protection and 
                Affordable Care Act; or
                  (I) provide training in cultural competency 
                and health literacy.
          (4) Duration of awards.--The period during which 
        payments are made to an entity from an award of a grant 
        or contract under this subsection shall be 5 years.
  (c) Authorization of Appropriations.--
          (1) In general.--For purposes of carrying out this 
        section (other than subsection (b)(1)(B)), there are 
        authorized to be appropriated [$125,000,000 for fiscal 
        year 2010, and such sums as may be necessary for each 
        of fiscal years 2011 through 2014] $51,371,000 for each 
        of fiscal years 2020 through 2024.
          (2) Training programs.--Fifteen percent of the amount 
        appropriated pursuant to paragraph (1) in each such 
        fiscal year shall be allocated to the physician 
        assistant training programs described in subsection 
        (a)(1)(F), which prepare students for practice in 
        primary care.
          (3) Integrating academic administrative units.--For 
        purposes of carrying out subsection (b)(1)(B), there 
        are authorized to be appropriated $750,000 for each of 
        fiscal years 2010 through 2014.

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SEC. 748. TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC HEALTH DENTISTRY.

  (a) Support and Development of Dental Training Programs.--
          (1) In general.--The Secretary may make grants to, or 
        enter into contracts with, a school of dentistry, 
        public or nonprofit private hospital, or a public or 
        private nonprofit entity which the Secretary has 
        determined is capable of carrying out such grant or 
        contract--
                  (A) to plan, develop, and operate, or 
                participate in, an approved professional 
                training program in the field of general 
                dentistry, pediatric dentistry, or public 
                health dentistry for dental students, 
                residents, practicing dentists, dental 
                hygienists, or other approved primary care 
                dental trainees, that emphasizes training for 
                general, pediatric, or public health dentistry;
                  (B) to provide financial assistance to dental 
                students, residents, practicing dentists, and 
                dental hygiene students who are in need 
                thereof, who are participants in any such 
                program, and who plan to work in the practice 
                of general, pediatric, public heath dentistry, 
                or dental hygiene;
                  (C) to plan, develop, and operate a program 
                for the training of oral health care providers 
                who plan to teach in general, pediatric, public 
                health dentistry, or dental hygiene;
                  (D) to provide financial assistance in the 
                form of traineeships and fellowships to 
                dentists who plan to teach or are teaching in 
                general, pediatric, or public health dentistry;
                  (E) to meet the costs of projects to 
                establish, maintain, or improve dental faculty 
                development programs in primary care (which may 
                be departments, divisions or other units);
                  (F) to meet the costs of projects to 
                establish, maintain, or improve predoctoral and 
                postdoctoral training in primary care programs;
                  (G) to create a loan repayment program for 
                faculty in dental programs; and
                  (H) to provide technical assistance to 
                pediatric training programs in developing and 
                implementing instruction regarding the oral 
                health status, dental care needs, and risk-
                based clinical disease management of all 
                pediatric populations with an emphasis on 
                underserved children.
          (2) Faculty loan repayment.--
                  (A) In general.--A grant or contract under 
                subsection (a)(1)(G) may be awarded to a 
                program of general, pediatric, or public health 
                dentistry described in such subsection to plan, 
                develop, and operate a loan repayment program 
                under which--
                          (i) individuals agree to serve full-
                        time as faculty members; and
                          (ii) the program of general, 
                        pediatric or public health dentistry 
                        agrees to pay the principal and 
                        interest on the outstanding student 
                        loans of the individuals.
                  (B) Manner of payments.--With respect to the 
                payments described in subparagraph (A)(ii), 
                upon completion by an individual of each of the 
                first, second, third, fourth, and fifth years 
                of service, the program shall pay an amount 
                equal to 10, 15, 20, 25, and 30 percent, 
                respectively, of the individual's student loan 
                balance as calculated based on principal and 
                interest owed at the initiation of the 
                agreement.
  (b) Eligible Entity.--For purposes of this subsection, 
entities eligible for such grants or contracts in general, 
pediatric, or public health dentistry shall include entities 
that have programs in dental or dental hygiene schools, or 
approved residency or advanced education programs in the 
practice of general, pediatric, or public health dentistry. 
Eligible entities may partner with schools of public health to 
permit the education of dental students, residents, and dental 
hygiene students for a master's year in public health at a 
school of public health.
  (c) Priorities in Making Awards.--With respect to training 
provided for under this section, the Secretary shall give 
priority in awarding grants or contracts to the following:
          (1) Qualified applicants that propose collaborative 
        projects between departments of primary care medicine 
        and departments of general, pediatric, or public health 
        dentistry.
          (2) Qualified applicants that have a record of 
        training the greatest percentage of providers, or that 
        have demonstrated significant improvements in the 
        percentage of providers, who enter and remain in 
        general, pediatric, or public health dentistry.
          (3) Qualified applicants that have a record of 
        training individuals who are from a rural or 
        disadvantaged background, or from underrepresented 
        minorities.
          (4) Qualified applicants that establish formal 
        relationships with Federally qualified health centers, 
        rural health centers, or accredited teaching facilities 
        and that conduct training of students, residents, 
        fellows, or faculty at the center or facility.
          (5) Qualified applicants that conduct teaching 
        programs targeting vulnerable populations such as older 
        adults, homeless individuals, victims of abuse or 
        trauma, individuals with mental health or substance-
        related disorders, individuals with disabilities, and 
        individuals with HIV/AIDS, and in the risk-based 
        clinical disease management of all populations.
          (6) Qualified applicants that include educational 
        activities in cultural competency and health literacy.
          (7) Qualified applicants that have a high rate for 
        placing graduates in practice settings that serve 
        underserved areas or health disparity populations, or 
        who achieve a significant increase in the rate of 
        placing graduates in such settings.
          (8) Qualified applicants that intend to establish a 
        special populations oral health care education center 
        or training program for the didactic and clinical 
        education of dentists, dental health professionals, and 
        dental hygienists who plan to teach oral health care 
        for people with developmental disabilities, cognitive 
        impairment, complex medical problems, significant 
        physical limitations, and vulnerable elderly.
  (d) Application.--An eligible entity desiring a grant under 
this section shall submit to the Secretary an application at 
such time, in such manner, and containing such information as 
the Secretary may require.
  (e) Duration of Award.--The period during which payments are 
made to an entity from an award of a grant or contract under 
subsection (a) shall be 5 years. The provision of such payments 
shall be subject to annual approval by the Secretary and 
subject to the availability of appropriations for the fiscal 
year involved to make the payments.
  (f) Authorizations of Appropriations.--For the purpose of 
carrying out subsections (a) and (b), there is authorized to be 
appropriated [$30,000,000 for fiscal year 2010 and such sums as 
may be necessary for each of fiscal years 2011 through 2015] 
$42,707,000 for each of fiscal years 2020 through 2024.
  (g) Carryover Funds.--An entity that receives an award under 
this section may carry over funds from 1 fiscal year to another 
without obtaining approval from the Secretary. In no case may 
any funds be carried over pursuant to the preceding sentence 
for more than 3 years.

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PART D--INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES

           *       *       *       *       *       *       *


SEC. 751. AREA HEALTH EDUCATION CENTERS.

  (a) Establishment of Awards.--The Secretary shall make the 
following 2 types of awards in accordance with this section:
          (1) Infrastructure development award.--The Secretary 
        shall make awards to eligible entities to enable such 
        entities to initiate health care workforce educational 
        programs or to continue to carry out comparable 
        programs that are operating at the time the award is 
        made by planning, developing, operating, and evaluating 
        an area health education center program.
          (2) Point of service maintenance and enhancement 
        award.--The Secretary shall make awards to eligible 
        entities to maintain and improve the effectiveness and 
        capabilities of an existing area health education 
        center program, and make other modifications to the 
        program that are appropriate due to changes in 
        demographics, needs of the populations served, or other 
        similar issues affecting the area health education 
        center program. For the purposes of this section, the 
        term ``Program'' refers to the area health education 
        center program.
  (b) Eligible Entities; Application.--
          (1) Eligible entities.--
                  (A) Infrastructure development.--For purposes 
                of subsection (a)(1), the term ``eligible 
                entity'' means a school of medicine or 
                osteopathic medicine, an incorporated 
                consortium of such schools, or the parent 
                institutions of such a school. With respect to 
                a State in which no area health education 
                center program is in operation, the Secretary 
                may award a grant or contract under subsection 
                (a)(1) to a school of nursing.
                  (B) Point of service maintenance and 
                enhancement.--For purposes of subsection 
                (a)(2), the term ``eligible entity'' means an 
                entity that has received funds under this 
                section, is operating an area health education 
                center program, including an area health 
                education center or centers, and has a center 
                or centers that are no longer eligible to 
                receive financial assistance under subsection 
                (a)(1).
          (2) Application.--An eligible entity desiring to 
        receive an award under this section shall submit to the 
        Secretary an application at such time, in such manner, 
        and containing such information as the Secretary may 
        require.
  (c) Use of Funds.--
          (1) Required activities.--An eligible entity shall 
        use amounts awarded under a grant under subsection 
        (a)(1) or (a)(2) to carry out the following activities:
                  (A) Develop and implement strategies, in 
                coordination with the applicable one-stop 
                delivery system under section 134(c) of the 
                Workforce Investment Act of 1998, to recruit 
                individuals from underrepresented minority 
                populations or from disadvantaged or rural 
                backgrounds into health professions, and 
                support such individuals in attaining such 
                careers.
                  (B) Develop and implement strategies to 
                foster and provide community-based training and 
                education to individuals seeking careers in 
                health professions within underserved areas for 
                the purpose of developing and maintaining a 
                diverse health care workforce that is prepared 
                to deliver high-quality care, with an emphasis 
                on primary care, in underserved areas or for 
                health disparity populations, in collaboration 
                with other Federal and State health care 
                workforce development programs, the State 
                workforce agency, and local workforce 
                investment boards, and in health care safety 
                net sites.
                  (C) Prepare individuals to more effectively 
                provide health services to underserved areas 
                and health disparity populations through field 
                placements or preceptorships in conjunction 
                with community-based organizations, accredited 
                primary care residency training programs, 
                Federally qualified health centers, rural 
                health clinics, public health departments, or 
                other appropriate facilities.
                  (D) Conduct and participate in 
                interdisciplinary training that involves 
                physicians, physician assistants, nurse 
                practitioners, nurse midwives, dentists, 
                psychologists, pharmacists, optometrists, 
                community health workers, public and allied 
                health professionals, or other health 
                professionals, as practicable.
                  (E) Deliver or facilitate continuing 
                education and information dissemination 
                programs for health care professionals, with an 
                emphasis on individuals providing care in 
                underserved areas and for health disparity 
                populations.
                  (F) Propose and implement effective program 
                and outcomes measurement and evaluation 
                strategies.
                  (G) Establish a youth public health program 
                to expose and recruit high school students into 
                health careers, with a focus on careers in 
                public health.
          (2) Innovative opportunities.--An eligible entity may 
        use amounts awarded under a grant under subsection 
        (a)(1) or subsection (a)(2) to carry out any of the 
        following activities:
                  (A) Develop and implement innovative 
                curricula in collaboration with community-based 
                accredited primary care residency training 
                programs, Federally qualified health centers, 
                rural health clinics, behavioral and mental 
                health facilities, public health departments, 
                or other appropriate facilities, with the goal 
                of increasing the number of primary care 
                physicians and other primary care providers 
                prepared to serve in underserved areas and 
                health disparity populations.
                  (B) Coordinate community-based participatory 
                research with academic health centers, and 
                facilitate rapid flow and dissemination of 
                evidence-based health care information, 
                research results, and best practices to improve 
                quality, efficiency, and effectiveness of 
                health care and health care systems within 
                community settings.
                  (C) Develop and implement other strategies to 
                address identified workforce needs and increase 
                and enhance the health care workforce in the 
                area served by the area health education center 
                program.
  (d) Requirements.--
          (1) Area health education center program.--In 
        carrying out this section, the Secretary shall ensure 
        the following:
                  (A) An entity that receives an award under 
                this section shall conduct at least 10 percent 
                of clinical education required for medical 
                students in community settings that are removed 
                from the primary teaching facility of the 
                contracting institution for grantees that 
                operate a school of medicine or osteopathic 
                medicine. In States in which an entity that 
                receives an award under this section is a 
                nursing school or its parent institution, the 
                Secretary shall alternatively ensure that--
                          (i) the nursing school conducts at 
                        least 10 percent of clinical education 
                        required for nursing students in 
                        community settings that are remote from 
                        the primary teaching facility of the 
                        school; and
                          (ii) the entity receiving the award 
                        maintains a written agreement with a 
                        school of medicine or osteopathic 
                        medicine to place students from that 
                        school in training sites in the area 
                        health education center program area.
                  (B) An entity receiving funds under 
                subsection (a)(2) does not distribute such 
                funding to a center that is eligible to receive 
                funding under subsection (a)(1).
          (2) Area health education center.--The Secretary 
        shall ensure that each area health education center 
        program includes at least 1 area health education 
        center, and that each such center--
                  (A) is a public or private organization whose 
                structure, governance, and operation is 
                independent from the awardee and the parent 
                institution of the awardee;
                  (B) is not a school of medicine or 
                osteopathic medicine, the parent institution of 
                such a school, or a branch campus or other 
                subunit of a school of medicine or osteopathic 
                medicine or its parent institution, or a 
                consortium of such entities;
                  (C) designates an underserved area or 
                population to be served by the center which is 
                in a location removed from the main location of 
                the teaching facilities of the schools 
                participating in the program with such center 
                and does not duplicate, in whole or in part, 
                the geographic area or population served by any 
                other center;
                  (D) fosters networking and collaboration 
                among communities and between academic health 
                centers and community-based centers;
                  (E) serves communities with a demonstrated 
                need of health professionals in partnership 
                with academic medical centers;
                  (F) addresses the health care workforce needs 
                of the communities served in coordination with 
                the public workforce investment system; and
                  (G) has a community-based governing or 
                advisory board that reflects the diversity of 
                the communities involved.
  (e) Matching Funds.--With respect to the costs of operating a 
program through a grant under this section, to be eligible for 
financial assistance under this section, an entity shall make 
available (directly or through contributions from State, county 
or municipal governments, or the private sector) recurring non-
Federal contributions in cash or in kind, toward such costs in 
an amount that is equal to not less than 50 percent of such 
costs. At least 25 percent of the total required non-Federal 
contributions shall be in cash. An entity may apply to the 
Secretary for a waiver of not more than 75 percent of the 
matching fund amount required by the entity for each of the 
first 3 years the entity is funded through a grant under 
subsection (a)(1).
  (f) Limitation.--Not less than 75 percent of the total amount 
provided to an area health education center program under 
subsection (a)(1) or (a)(2) shall be allocated to the area 
health education centers participating in the program under 
this section. To provide needed flexibility to newly funded 
area health education center programs, the Secretary may waive 
the requirement in the sentence for the first 2 years of a new 
area health education center program funded under subsection 
(a)(1).
  (g) Award.--An award to an entity under this section shall be 
not less than $250,000 annually per area health education 
center included in the program involved. If amounts 
appropriated to carry out this section are not sufficient to 
comply with the preceding sentence, the Secretary may reduce 
the per center amount provided for in such sentence as 
necessary, provided the distribution established in subsection 
(j)(2) is maintained.
  (h) Project Terms.--
          (1) In general.--Except as provided in paragraph (2), 
        the period during which payments may be made under an 
        award under subsection (a)(1) may not exceed--
                  (A) in the case of a program, 12 years; or
                  (B) in the case of a center within a program, 
                6 years.
          (2) Exception.--The periods described in paragraph 
        (1) shall not apply to programs receiving point of 
        service maintenance and enhancement awards under 
        subsection (a)(2) to maintain existing centers and 
        activities.
  (i) Inapplicability of Provision.--Notwithstanding any other 
provision of this title, section 791(a) shall not apply to an 
area health education center funded under this section.
  (j) Authorization of Appropriations.--
          (1) In general.--There is authorized to be 
        appropriated to carry out this section [$125,000,000 
        for each of the fiscal years 2010 through 2014] 
        $42,075,000 for each of fiscal years 2020 through 2024.
          (2) Requirements.--Of the amounts appropriated for a 
        fiscal year under paragraph (1)--
                  (A) not more than 35 percent shall be used 
                for awards under subsection (a)(1);
                  (B) not less than 60 percent shall be used 
                for awards under subsection (a)(2);
                  (C) not more than 1 percent shall be used for 
                grants and contracts to implement outcomes 
                evaluation for the area health education 
                centers; and
                  (D) not more than 4 percent shall be used for 
                grants and contracts to provide technical 
                assistance to entities receiving awards under 
                this section.
          (3) Carryover funds.--An entity that receives an 
        award under this section may carry over funds from 1 
        fiscal year to another without obtaining approval from 
        the Secretary. In no case may any funds be carried over 
        pursuant to the preceding sentence for more than 3 
        years.
  (k) Sense of Congress.--It is the sense of the Congress that 
every State have an area health education center program in 
effect under this section.

           *       *       *       *       *       *       *


[SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.

  [(a) Geriatric Education Centers.--
          [(1) In general.--The Secretary shall award grants or 
        contracts under this section to entities described in 
        paragraphs (1), (3), or (4) of section 799B, and 
        section 801(2), for the establishment or operation of 
        geriatric education centers.
          [(2) Requirements.--A geriatric education center is a 
        program that--
                  [(A) improves the training of health 
                professionals in geriatrics, including 
                geriatric residencies, traineeships, or 
                fellowships;
                  [(B) develops and disseminates curricula 
                relating to the treatment of the health 
                problems of elderly individuals;
                  [(C) supports the training and retraining of 
                faculty to provide instruction in geriatrics;
                  [(D) supports continuing education of health 
                professionals who provide geriatric care; and
                  [(E) provides students with clinical training 
                in geriatrics in nursing homes, chronic and 
                acute disease hospitals, ambulatory care 
                centers, and senior centers.
  [(b) Geriatric Training Regarding Physicians and Dentists.--
          [(1) In general.--The Secretary may make grants to, 
        and enter into contracts with, schools of medicine, 
        schools of osteopathic medicine, teaching hospitals, 
        and graduate medical education programs, for the 
        purpose of providing support (including residencies, 
        traineeships, and fellowships) for geriatric training 
        projects to train physicians, dentists and behavioral 
        and mental health professionals who plan to teach 
        geriatric medicine, geriatric behavioral or mental 
        health, or geriatric dentistry.
          [(2) Requirements.--Each project for which a grant or 
        contract is made under this subsection shall--
                  [(A) be staffed by full-time teaching 
                physicians who have experience or training in 
                geriatric medicine or geriatric behavioral or 
                mental health;
                  [(B) be staffed, or enter into an agreement 
                with an institution staffed by full-time or 
                part-time teaching dentists who have experience 
                or training in geriatric dentistry;
                  [(C) be staffed, or enter into an agreement 
                with an institution staffed by full-time or 
                part-time teaching behavioral mental health 
                professionals who have experience or training 
                in geriatric behavioral or mental health;
                  [(D) be based in a graduate medical education 
                program in internal medicine or family medicine 
                or in a department of geriatrics or behavioral 
                or mental health;
                  [(E) provide training in geriatrics and 
                exposure to the physical and mental 
                disabilities of elderly individuals through a 
                variety of service rotations, such as geriatric 
                consultation services, acute care services, 
                dental services, geriatric behavioral or mental 
                health units, day and home care programs, 
                rehabilitation services, extended care 
                facilities, geriatric ambulatory care and 
                comprehensive evaluation units, and community 
                care programs for elderly individuals with 
                intellectual disabilities; and
                  [(F) provide training in geriatrics through 
                one or both of the training options described 
                in subparagraphs (A) and (B) of paragraph (3).
          [(3) Training options.--The training options referred 
        to in subparagraph (F) of paragraph (2) shall be as 
        follows:
                  [(A) A 1-year retraining program in 
                geriatrics for--
                          [(i) physicians who are faculty 
                        members in departments of internal 
                        medicine, family medicine, gynecology, 
                        geriatrics, and behavioral or mental 
                        health at schools of medicine and 
                        osteopathic medicine;
                          [(ii) dentists who are faculty 
                        members at schools of dentistry or at 
                        hospital departments of dentistry; and
                          [(iii) behavioral or mental health 
                        professionals who are faculty members 
                        in departments of behavioral or mental 
                        health; and
                  [(B) A 2-year internal medicine or family 
                medicine fellowship program providing emphasis 
                in geriatrics, which shall be designed to 
                provide training in clinical geriatrics and 
                geriatrics research for--
                          [(i) physicians who have completed 
                        graduate medical education programs in 
                        internal medicine, family medicine, 
                        behavioral or mental health, neurology, 
                        gynecology, or rehabilitation medicine;
                          [(ii) dentists who have demonstrated 
                        a commitment to an academic career and 
                        who have completed postdoctoral dental 
                        training, including postdoctoral dental 
                        education programs or who have relevant 
                        advanced training or experience; and
                          [(iii) behavioral or mental health 
                        professionals who have completed 
                        graduate medical education programs in 
                        behavioral or mental health.
          [(4) Definitions.--For purposes of this subsection:
                  [(A) The term ``graduate medical education 
                program'' means a program sponsored by a school 
                of medicine, a school of osteopathic medicine, 
                a hospital, or a public or private institution 
                that--
                          [(i) offers postgraduate medical 
                        training in the specialties and 
                        subspecialties of medicine; and
                          [(ii) has been accredited by the 
                        Accreditation Council for Graduate 
                        Medical Education or the American 
                        Osteopathic Association through its 
                        Committee on Postdoctoral Training.
                  [(B) The term ``post-doctoral dental 
                education program'' means a program sponsored 
                by a school of dentistry, a hospital, or a 
                public or private institution that--
                          [(i) offers post-doctoral training in 
                        the specialties of dentistry, advanced 
                        education in general dentistry, or a 
                        dental general practice residency; and
                          [(ii) has been accredited by the 
                        Commission on Dental Accreditation.
  [(c) Geriatric Faculty Fellowships.--
          [(1) Establishment of program.--The Secretary shall 
        establish a program to provide Geriatric Academic 
        Career Awards to eligible individuals to promote the 
        career development of such individuals as academic 
        geriatricians.
          [(2) Eligible individuals.--To be eligible to receive 
        an Award under paragraph (1), an individual shall--
                  [(A) be board certified or board eligible in 
                internal medicine, family practice, psychiatry, 
                or licensed dentistry, or have completed any 
                required training in a discipline and employed 
                in an accredited health professions school that 
                is approved by the Secretary;
                  [(B) have completed an approved fellowship 
                program in geriatrics or have completed 
                specialty training in geriatrics as required by 
                the discipline and any addition geriatrics 
                training as required by the Secretary; and
                  [(C) have a junior (non-tenured) faculty 
                appointment at an accredited (as determined by 
                the Secretary) school of medicine, osteopathic 
                medicine, nursing, social work, psychology, 
                dentistry, pharmacy, or other allied health 
                disciplines in an accredited health professions 
                school that is approved by the Secretary.
          [(3) Limitations.--No Award under paragraph (1) may 
        be made to an eligible individual unless the 
        individual--
                  [(A) has submitted to the Secretary an 
                application, at such time, in such manner, and 
                containing such information as the Secretary 
                may require, and the Secretary has approved 
                such application;
                  [(B) provides, in such form and manner as the 
                Secretary may require, assurances that the 
                individual will meet the service requirement 
                described in paragraph (6); and
                  [(C) provides, in such form and manner as the 
                Secretary may require, assurances that the 
                individual has a full-time faculty appointment 
                in a health professions institution and 
                documented commitment from such institution to 
                spend 75 percent of the total time of such 
                individual on teaching and developing skills in 
                interdisciplinary education in geriatrics.
          [(4) Maintenance of effort.--An eligible individual 
        that receives an Award under paragraph (1) shall 
        provide assurances to the Secretary that funds provided 
        to the eligible individual under this subsection will 
        be used only to supplement, not to supplant, the amount 
        of Federal, State, and local funds otherwise expended 
        by the eligible individual.
          [(5) Amount and term.--
                  [(A) Amount.--The amount of an Award under 
                this section for individuals who are physicians 
                shall equal $50,000 for fiscal year 1998, 
                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 section for individuals who 
                are not physicians.
                  [(B) Term.--The term of any Award made under 
                this subsection shall not exceed 5 years.
                  [(C) Payment to institution.--The Secretary 
                shall make payments to institutions which 
                include schools of medicine, osteopathic 
                medicine, nursing, social work, psychology, 
                dentistry, and pharmacy, or other allied health 
                discipline in an accredited health professions 
                school that is approved by the Secretary.
          [(6) Service requirement.--An individual who receives 
        an Award under this subsection shall provide training 
        in clinical geriatrics, including the training of 
        interdisciplinary teams of health care professionals. 
        The provision of such training shall constitute at 
        least 75 percent of the obligations of such individual 
        under the Award.
  [(d) Geriatric Workforce Development.--
          [(1) In general.--The Secretary shall award grants or 
        contracts under this subsection to entities that 
        operate a geriatric education center pursuant to 
        subsection (a)(1).
          [(2) Application.--To be eligible for an award 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.
          [(3) Use of funds.--Amounts awarded under a grant or 
        contract under paragraph (1) shall be used to--
                  [(A) carry out the fellowship program 
                described in paragraph (4); and
                  [(B) carry out 1 of the 2 activities 
                described in paragraph (5).
          [(4) Fellowship program.--
                  [(A) In general.--Pursuant to paragraph (3), 
                a geriatric education center that receives an 
                award under this subsection shall use such 
                funds to offer short-term intensive courses 
                (referred to in this subsection as a 
                ``fellowship'') that focus on geriatrics, 
                chronic care management, and long-term care 
                that provide supplemental training for faculty 
                members in medical schools and other health 
                professions schools with programs in 
                psychology, pharmacy, nursing, social work, 
                dentistry, public health, allied health, or 
                other health disciplines, as approved by the 
                Secretary. Such a fellowship shall be open to 
                current faculty, and appropriately credentialed 
                volunteer faculty and practitioners, who do not 
                have formal training in geriatrics, to upgrade 
                their knowledge and clinical skills for the 
                care of older adults and adults with functional 
                limitations and to enhance their 
                interdisciplinary teaching skills.
                  [(B) Location.--A fellowship shall be offered 
                either at the geriatric education center that 
                is sponsoring the course, in collaboration with 
                other geriatric education centers, or at 
                medical schools, schools of dentistry, schools 
                of nursing, schools of pharmacy, schools of 
                social work, graduate programs in psychology, 
                or allied health and other health professions 
                schools approved by the Secretary with which 
                the geriatric education centers are affiliated.
                  [(C) CME credit.--Participation in a 
                fellowship under this paragraph shall be 
                accepted with respect to complying with 
                continuing health profession education 
                requirements. As a condition of such 
                acceptance, the recipient shall agree to 
                subsequently provide a minimum of 18 hours of 
                voluntary instructional support through a 
                geriatric education center that is providing 
                clinical training to students or trainees in 
                long-term care settings.
          [(5) Additional required activities described.--
        Pursuant to paragraph (3), a geriatric education center 
        that receives an award under this subsection shall use 
        such funds to carry out 1 of the following 2 
        activities.
                  [(A) Family caregiver and direct care 
                provider training.--A geriatric education 
                center that receives an award under this 
                subsection shall offer at least 2 courses each 
                year, at no charge or nominal cost, to family 
                caregivers and direct care providers that are 
                designed to provide practical training for 
                supporting frail elders and individuals with 
                disabilities. The Secretary shall require such 
                Centers to work with appropriate community 
                partners to develop training program content 
                and to publicize the availability of training 
                courses in their service areas. All family 
                caregiver and direct care provider training 
                programs shall include instruction on the 
                management of psychological and behavioral 
                aspects of dementia, communication techniques 
                for working with individuals who have dementia, 
                and the appropriate, safe, and effective use of 
                medications for older adults.
                  [(B) Incorporation of best practices.--A 
                geriatric education center that receives an 
                award under this subsection shall develop and 
                include material on depression and other mental 
                disorders common among older adults, medication 
                safety issues for older adults, and management 
                of the psychological and behavioral aspects of 
                dementia and communication techniques with 
                individuals who have dementia in all training 
                courses, where appropriate.
          [(6) Targets.--A geriatric education center that 
        receives an award under this subsection shall meet 
        targets approved by the Secretary for providing 
        geriatric training to a certain number of faculty or 
        practitioners during the term of the award, as well as 
        other parameters established by the Secretary.
          [(7) Amount of award.--An award under this subsection 
        shall be in an amount of $150,000. Not more than 24 
        geriatric education centers may receive an award under 
        this subsection.
          [(8) Maintenance of effort.--A geriatric education 
        center that receives an award under this subsection 
        shall provide assurances to the Secretary that funds 
        provided to the geriatric education center under this 
        subsection will be used only to supplement, not to 
        supplant, the amount of Federal, State, and local funds 
        otherwise expended by the geriatric education center.
          [(9) Authorization of appropriations.--In addition to 
        any other funding available to carry out this section, 
        there is authorized to be appropriated to carry out 
        this subsection, $10,800,000 for the period of fiscal 
        year 2011 through 2014.
  [(e) Geriatric Career Incentive Awards.--
          [(1) In general.--The Secretary shall award grants or 
        contracts under this section to individuals described 
        in paragraph (2) to foster greater interest among a 
        variety of health professionals in entering the field 
        of geriatrics, long-term care, and chronic care 
        management.
          [(2) Eligible individuals.--To be eligible to 
        received an award under paragraph (1), an individual 
        shall--
                  [(A) be an advanced practice nurse, a 
                clinical social worker, a pharmacist, or 
                student of psychology who is pursuing a 
                doctorate or other advanced degree in 
                geriatrics or related fields in an accredited 
                health professions school; and
                  [(B) submit to the Secretary an application 
                at such time, in such manner, and containing 
                such information as the Secretary may require.
          [(3) Condition of award.--As a condition of receiving 
        an award under this subsection, an individual shall 
        agree that, following completion of the award period, 
        the individual will teach or practice in the field of 
        geriatrics, long-term care, or chronic care management 
        for a minimum of 5 years under guidelines set by the 
        Secretary.
          [(4) Authorization of appropriations.--There is 
        authorized to be appropriated to carry out this 
        subsection, $10,000,000 for the period of fiscal years 
        2011 through 2013.]

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.
                  (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 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.

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         PART E--HEALTH PROFESSIONS AND PUBLIC HEALTH WORKFORCE

    Subpart 1--Health Professions Workforce Information and Analysis

SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.

  (a) Purpose.--It is the purpose of this section to--
          (1) provide for the development of information 
        describing the health professions workforce and the 
        analysis of workforce related issues; and
          (2) provide necessary information for decision-making 
        regarding future directions in health professions and 
        nursing programs in response to societal and 
        professional needs.
  (b) National Center for Health Care Workforce Analysis.--
          (1) Establishment.--The Secretary shall establish the 
        National Center for Health Workforce Analysis (referred 
        to in this section as the ``National Center'').
          (2) Purposes.--The National Center, in coordination 
        to the extent practicable with the National Health Care 
        Workforce Commission (established in section 5101 of 
        the Patient Protection and Affordable Care Act), and 
        relevant regional and State centers and agencies, 
        shall--
                  (A) provide for the development of 
                information describing and analyzing the health 
                care workforce and workforce related issues;
                  (B) carry out the activities under section 
                792(a);
                  (C) annually evaluate programs under this 
                title;
                  (D) develop and publish performance measures 
                and benchmarks for programs under this title; 
                and
                  (E) establish, maintain, and publicize a 
                national Internet registry of each grant 
                awarded under this title and a database to 
                collect data from longitudinal evaluations (as 
                described in subsection (d)(2)) on performance 
                measures (as developed under sections 
                749(d)(3), 757(d)(3), and 762(a)(3)).
          (3) Collaboration and data sharing.--
                  (A) In general.--The National Center shall 
                collaborate with Federal agencies and relevant 
                professional and educational organizations or 
                societies for the purpose of linking data 
                regarding grants awarded under this title.
                  (B) Contracts for health workforce 
                analysis.--For the purpose of carrying out the 
                activities described in subparagraph (A), the 
                National Center may enter into contracts with 
                relevant professional and educational 
                organizations or societies.
  (c) State and Regional Centers for Health Workforce 
Analysis.--
          (1) In general.--The Secretary shall award grants to, 
        or enter into contracts with, eligible entities for 
        purposes of--
                  (A) collecting, analyzing, and reporting data 
                regarding programs under this title to the 
                National Center and to the public; and
                  (B) providing technical assistance to local 
                and regional entities on the collection, 
                analysis, and reporting of data.
          (2) Eligible entities.--To be eligible for a grant or 
        contract under this subsection, an entity shall--
                  (A) be a State, a State workforce investment 
                board, a public health or health professions 
                school, an academic health center, or an 
                appropriate public or private nonprofit entity; 
                and
                  (B) submit to the Secretary an application at 
                such time, in such manner, and containing such 
                information as the Secretary may require.
  (d) Increase in Grants for Longitudinal Evaluations.--
          (1) In general.--The Secretary shall increase the 
        amount awarded to an eligible entity under this title 
        for a longitudinal evaluation of individuals who have 
        received education, training, or financial assistance 
        from programs under this title.
          (2) Capability.--A longitudinal evaluation shall be 
        capable of--
                  (A) studying practice patterns; and
                  (B) collecting and reporting data on 
                performance measures developed under sections 
                749(d)(3), 757(d)(3), and 762(a)(3).
          (3) Guidelines.--A longitudinal evaluation shall 
        comply with guidelines issued under sections 749(d)(4), 
        757(d)(4), and 762(a)(4).
          (4) Eligible entities.--To be eligible to obtain an 
        increase under this section, an entity shall be a 
        recipient of a grant or contract under this title.
  (e) Authorization of Appropriations.--
          (1) In general.--
                  (A) National center.--To carry out subsection 
                (b), there are authorized to be appropriated 
                [$7,500,000 for each of fiscal years 2010 
                through 2014] $5,947,000 for each of fiscal 
                years 2020 through 2024.
                  (B) State and regional centers.--To carry out 
                subsection (c), there are authorized to be 
                appropriated $4,500,000 for each of fiscal 
                years 2010 through 2014.
                  (C) Grants for longitudinal evaluations.--To 
                carry out subsection (d), there are authorized 
                to be appropriated such sums as may be 
                necessary for fiscal years 2010 through 2014.
          (2) Reservation.--Of the amounts appropriated under 
        [subsection (a)] paragraph (1) for a fiscal year, the 
        Secretary shall reserve not less than $600,000 for 
        conducting health professions research and for carrying 
        out data collection and analysis in accordance with 
        section 792.
          (3) Availability of additional funds.--Amounts 
        otherwise appropriated for programs or activities under 
        this title may be used for activities under subsection 
        (b) with respect to the programs or activities from 
        which such amounts were made available.

           *       *       *       *       *       *       *


Subpart 2--Public Health Workforce

           *       *       *       *       *       *       *


SEC. 770. AUTHORIZATION OF APPROPRIATIONS.

  (a) In General.--For the purpose of carrying out this 
subpart, there is authorized to be appropriated [$43,000,000 
for fiscal year 2011, and such sums as may be necessary for 
each of the fiscal years 2012 through 2015] $17,850,000 for 
each of fiscal years 2020 through 2024.
  (b) Limitation Regarding Certain Program.--In obligating 
amounts appropriated under subsection (a), the Secretary may 
not obligate more than 30 percent for carrying out section 767.

             Subpart 3--Recruitment and Retention Programs

[SEC. 775. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE WORKFORCE.

  [(a) Establishment.--The Secretary shall establish and carry 
out a pediatric specialty loan repayment program under which 
the eligible individual agrees to be employed full-time for a 
specified period (which shall not be less than 2 years) in 
providing pediatric medical subspecialty, pediatric surgical 
specialty, or child and adolescent mental and behavioral health 
care, including substance abuse prevention and treatment 
services.
  [(b) Program Administration.--Through the program established 
under this section, the Secretary shall enter into contracts 
with qualified health professionals under which--
          [(1) such qualified health professionals will agree 
        to provide pediatric medical subspecialty, pediatric 
        surgical specialty, or child and adolescent mental and 
        behavioral health care in an area with a shortage of 
        the specified pediatric subspecialty that has a 
        sufficient pediatric population to support such 
        pediatric subspecialty, as determined by the Secretary; 
        and
          [(2) the Secretary agrees to make payments on the 
        principal and interest of undergraduate, graduate, or 
        graduate medical education loans of professionals 
        described in paragraph (1) of not more than $35,000 a 
        year for each year of agreed upon service under such 
        paragraph for a period of not more than 3 years during 
        the qualified health professional's--
                  [(A) participation in an accredited pediatric 
                medical subspecialty, pediatric surgical 
                specialty, or child and adolescent mental 
                health subspecialty residency or fellowship; or
                  [(B) employment as a pediatric medical 
                subspecialist, pediatric surgical specialist, 
                or child and adolescent mental health 
                professional serving an area or population 
                described in such paragraph.
  [(c) In General.--
          [(1) Eligible individuals.--
                  [(A) Pediatric medical specialists and 
                pediatric surgical specialists.--For purposes 
                of contracts with respect to pediatric medical 
                specialists and pediatric surgical specialists, 
                the term ``qualified health professional'' 
                means a licensed physician who--
                          [(i) is entering or receiving 
                        training in an accredited pediatric 
                        medical subspecialty or pediatric 
                        surgical specialty residency or 
                        fellowship; or
                          [(ii) has completed (but not prior to 
                        the end of the calendar year in which 
                        this section is enacted) the training 
                        described in subparagraph (B).
                  [(B) Child and adolescent mental and 
                behavioral health.--For purposes of contracts 
                with respect to child and adolescent mental and 
                behavioral health care, the term ``qualified 
                health professional'' means a health care 
                professional who--
                          [(i) has received specialized 
                        training or clinical experience in 
                        child and adolescent mental health in 
                        psychiatry, psychology, school 
                        psychology, behavioral pediatrics, 
                        psychiatric nursing, social work, 
                        school social work, substance abuse 
                        disorder prevention and treatment, 
                        marriage and family therapy, school 
                        counseling, or professional counseling;
                          [(ii) has a license or certification 
                        in a State to practice allopathic 
                        medicine, osteopathic medicine, 
                        psychology, school psychology, 
                        psychiatric nursing, social work, 
                        school social work, marriage and family 
                        therapy, school counseling, or 
                        professional counseling; or
                          [(iii) is a mental health service 
                        professional who completed (but not 
                        before the end of the calendar year in 
                        which this section is enacted) 
                        specialized training or clinical 
                        experience in child and adolescent 
                        mental health described in clause (i).
          [(2) Additional eligibility requirements.--The 
        Secretary may not enter into a contract under this 
        subsection with an eligible individual unless--
                  [(A) the individual agrees to work in, or for 
                a provider serving, a health professional 
                shortage area or medically underserved area, or 
                to serve a medically underserved population;
                  [(B) the individual is a United States 
                citizen or a permanent legal United States 
                resident; and
                  [(C) if the individual is enrolled in a 
                graduate program, the program is accredited, 
                and the individual has an acceptable level of 
                academic standing (as determined by the 
                Secretary).
  [(d) Priority.--In entering into contracts under this 
subsection, the Secretary shall give priority to applicants 
who--
          [(1) are or will be working in a school or other pre-
        kindergarten, elementary, or secondary education 
        setting;
          [(2) have familiarity with evidence-based methods and 
        cultural and linguistic competence health care 
        services; and
          [(3) demonstrate financial need.
  [(e) Authorization of Appropriations.--There is authorized to 
be appropriated $30,000,000 for each of fiscal years 2010 
through 2014 to carry out subsection (c)(1)(A) and $20,000,000 
for each of fiscal years 2010 through 2013 to carry out 
subsection (c)(1)(B).]

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).

           *       *       *       *       *       *       *


 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.

PART [G] H--GENERAL PROVISIONS

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