Index for HR3962: Affordable Health Care for America Act

To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

Mr. Dingell (for himself, Mr. Rangel, Mr. Waxman, Mr. George Miller of California, Mr. Stark, Mr. Pallone, and Mr. Andrews) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

(a) Fulfillment of obligated service requirement through half-Time service.—

(1) WAIVERS.—Subsection (i) of section 331 (42 U.S.C. 254d) is amended—

(A) in paragraph (1), by striking “In carrying out subpart III” and all that follows through the period and inserting “In carrying out subpart III, the Secretary may, in accordance with this subsection, issue waivers to individuals who have entered into a contract for obligated service under the Scholarship Program or the Loan Repayment Program under which the individuals are authorized to satisfy the requirement of obligated service through providing clinical practice that is half-time.”;

(B) in paragraph (2)—

(i) in subparagraphs (A)(ii) and (B), by striking “less than full time” each place it appears and inserting “half time”;

(ii) in subparagraphs (C) and (F), by striking “less than full-time service” each place it appears and inserting “half-time service”; and

(iii) by amending subparagraphs (D) and (E) to read as follows:

“(D) the entity and the Corps member agree in writing that the Corps member will perform half-time clinical practice;

“(E) the Corps member agrees in writing to fulfill all of the service obligations under section 338C through half-time clinical practice and either—

“(i) double the period of obligated service that would otherwise be required; or

“(ii) in the case of contracts entered into under section 338B, accept a minimum service obligation of 2 years with an award amount equal to 50 percent of the amount that would otherwise be payable for full-time service; and”; and

(C) in paragraph (3), by striking “In evaluating a demonstration project described in paragraph (1)” and inserting “In evaluating waivers issued under paragraph (1)”.

(2) DEFINITIONS.—Subsection (j) of section 331 (42 U.S.C. 254d) is amended by adding at the end the following:

“(5) The terms ‘full time’ and ‘full-time’ mean a minimum of 40 hours per week in a clinical practice, for a minimum of 45 weeks per year.

“(6) The terms ‘half time’ and ‘half-time’ mean a minimum of 20 hours per week (not to exceed 39 hours per week) in a clinical practice, for a minimum of 45 weeks per year.”.

(b) Reappointment to National Advisory Council.—Section 337(b)(1) (42 U.S.C. 254j(b)(1)) is amended by striking “Members may not be reappointed to the Council.”.

(c) Loan repayment amount.—Section 338B(g)(2)(A) (42 U.S.C. 254l–1(g)(2)(A)) is amended by striking “$35,000” and inserting “$50,000, plus, beginning with fiscal year 2012, an amount determined by the Secretary on an annual basis to reflect inflation,”.

(d) Treatment of teaching as obligated service.—Subsection (a) of section 338C (42 U.S.C. 254m) is amended by adding at the end the following: “The Secretary may treat teaching as clinical practice for up to 20 percent of such period of obligated service.”.

(a) National Health Service Corps program.—Section 338 (42 U.S.C. 254k) is amended—

(1) in subsection (a), by striking “2012” and inserting “2015”; and

(2) by adding at the end the following:

(b) Scholarship and loan repayment programs.—Subpart III of part D of title III of the Public Health Service Act (42 U.S.C. 254l et seq.) is amended—

(1) in section 338H(a)—

(A) in paragraph (4), by striking “and” at the end;

(B) in paragraph (5), by striking the period at the end and inserting “; and”; and

(C) by adding at the end the following:

“(6) for each of fiscal years 2013 through 2015, such sums as may be necessary.”; and

(2) by inserting after section 338H the following:

“For the purpose of carrying out this subpart, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $254,000,000 for fiscal year 2011.

“(2) $266,000,000 for fiscal year 2012.

“(3) $278,000,000 for fiscal year 2013.

“(4) $292,000,000 for fiscal year 2014.

“(5) $306,000,000 for fiscal year 2015.”.

Part D of title III (42 U.S.C. 254b et seq.) is amended by adding at the end the following:

“(a) Program.—The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a program, to be known as the Frontline Health Providers Loan Repayment Program, to address unmet health care needs in health professional needs areas through loan repayments under section 340I.

“(b) Designation of health professional needs areas.—

“(1) IN GENERAL.—In this subpart, the term ‘health professional needs area’ means an area, population, or facility that is designated by the Secretary in accordance with paragraph (2).

“(2) DESIGNATION.—To be designated by the Secretary as a health professional needs area under this subpart:

“(A) In the case of an area, the area must be a rational area for the delivery of health services.

“(B) The area, population, or facility must have, in one or more health disciplines, specialties, or subspecialties for the population served, as determined by the Secretary—

“(i) insufficient capacity of health professionals; or

“(ii) high needs for health services, including services to address health disparities.

“(C) With respect to the delivery of primary health services, the area, population, or facility must not include a health professional shortage area (as designated under section 332), except that the area, population, or facility may include such a health professional shortage area in which there is an unmet need for such services.

“(c) Eligibility.—To be eligible to participate in the Program, an individual shall—

“(1) hold a degree in a course of study or program (approved by the Secretary) from a school defined in section 799B(1)(A) (other than a school of public health);

“(2) hold a degree in a course of study or program (approved by the Secretary) from a school or program defined in subparagraph (C), (D), or (E)(4) of section 799B(1), as designated by the Secretary;

“(3) be enrolled as a full-time student—

“(A) in a school or program defined in subparagraph (C), (D), or (E)(4) of section 799B(1), as designated by the Secretary, or a school described in paragraph (1); and

“(B) in the final year of a course of study or program, offered by such school or program and approved by the Secretary, leading to a degree in a discipline referred to in subparagraph (A) (other than a graduate degree in public health), (C), (D), or (E)(4) of section 799B(1);

“(4) be a practitioner described in section 1842(b)(18)(C) or 1848(k)(3)(B)(iii) or (iv) of the Social Security Act; or

“(5) be a practitioner in the field of respiratory therapy, medical technology, or radiologic technology.

“(d) Definitions.—In this subpart:

“(1) The term ‘health disparities’ has the meaning given to the term in section 3171.

“(2) The term ‘primary health services’ has the meaning given to such term in section 331(a)(3)(D).

“(a) Loan repayments.—The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall enter into contracts with individuals under which—

“(1) the individual agrees—

“(A) to serve as a full-time primary health services provider or as a full-time or part-time provider of other health services for a period of time equal to 2 years or such longer period as the individual may agree to;

“(B) to serve in a health professional needs area in a health discipline, specialty, or a subspecialty for which the area, population, or facility is designated as a health professional needs area under section 340H; and

“(C) in the case of an individual described in section 340H(c)(3) who is in the final year of study and who has accepted employment as a primary health services provider or provider of other health services in accordance with subparagraphs (A) and (B), to complete the education or training and maintain an acceptable level of academic standing (as determined by the educational institution offering the course of study or training); and

“(2) the Secretary agrees to pay, for each year of such service, an amount on the principal and interest of the undergraduate or graduate educational loans (or both) of the individual that is not more than 50 percent of the average award made under the National Health Service Corps Loan Repayment Program under subpart III in that year.

“(b) Practice setting.—A contract entered into under this section shall allow the individual receiving the loan repayment to satisfy the service requirement described in subsection (a)(1) through employment in a solo or group practice, a clinic, an accredited public or private nonprofit hospital, or any other health care entity, as deemed appropriate by the Secretary.

“(c) Application of certain provisions.—The provisions of subpart III of part D shall, except as inconsistent with this section, apply to the loan repayment program under this subpart in the same manner and to the same extent as such provisions apply to the National Health Service Corps Loan Repayment Program established under section 338B.

“(d) Insufficient number of applicants.—If there are an insufficient number of applicants for loan repayments under this section to obligate all appropriated funds, the Secretary shall transfer the unobligated funds to the National Health Service Corps for the purpose of recruiting applicants and entering into contracts with individuals so as to ensure a sufficient number of participants in the National Health Service Corps for the following year.

“The Secretary shall submit to the Congress an annual report on the program carried out under this subpart.

“Of the amount of funds obligated under this subpart each fiscal year for loan repayments—

“(1) 90 percent shall be for physicians and other health professionals providing primary health services; and

“(2) 10 percent shall be for health professionals not described in paragraph (1).”.

(a) In general.—Section 735 (42 U.S.C. 292y) is amended—

(1) by redesignating subsection (f) as subsection (g); and

(2) by inserting after subsection (e) the following:

“(f) Determination of financial need.—The Secretary—

“(1) may require, or authorize a school or other entity to require, the submission of financial information to determine the financial resources available to any individual seeking assistance under this subpart; and

“(2) shall take into account the extent to which such individual is financially independent in determining whether to require or authorize the submission of such information regarding such individual’s family members.”.

(b) Revised guidelines.—The Secretary of Health and Human Services shall—

(1) strike the second sentence of section 57.206(b)(1) of title 42, Code of Federal Regulations; and

(2) make such other revisions to guidelines and regulations in effect as of the date of the enactment of this Act as may be necessary for consistency with the amendments made by paragraph (1).

Section 747 (42 U.S.C. 293k) is amended—

(1) by amending the section heading to read as follows: “Primary care training and enhancement”;

(2) by redesignating subsection (e) as subsection (g); and

(3) by striking subsections (a) through (d) and inserting the following:

“(a) Program.—The Secretary shall establish a primary care training and capacity building program consisting of awarding grants and contracts under subsections (b) and (c).

“(b) Support and development of primary care training programs.—

“(1) IN GENERAL.—The Secretary shall make grants to, or enter into contracts with, eligible entities—

“(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, general pediatrics, or geriatrics for medical students, interns, residents, or practicing physicians;

“(B) to provide financial assistance in the form of traineeships and fellowships to medical students, interns, residents, or practicing physicians, who are participants in any such program, and who plan to specialize or work in family medicine, general internal medicine, general pediatrics, or geriatrics;

“(C) to plan, develop, operate, or participate in an accredited program for the training of physicians who plan to teach in family medicine, general internal medicine, general pediatrics, or geriatrics training programs including in community-based settings;

“(D) to provide financial assistance in the form of traineeships and fellowships to practicing physicians who are participants in any such programs and who plan to teach in a family medicine, general internal medicine, general pediatrics, or geriatrics training program; and

“(E) to plan, develop, operate, or participate in an accredited program for physician assistant education, and for the training of individuals who plan to teach in programs to provide such training.

“(2) ELIGIBILITY.—To be eligible for a grant or contract under paragraph (1), an entity shall be—

“(A) an accredited school of medicine or osteopathic medicine, public or nonprofit private hospital, or physician assistant training program;

“(B) a public or private nonprofit entity; or

“(C) a consortium of 2 or more entities described in subparagraphs (A) and (B).

“(c) Capacity building in primary care.—

“(1) IN GENERAL.—The Secretary shall make grants to or enter into contracts with eligible entities to establish, maintain, or improve—

“(A) academic administrative units (including departments, divisions, or other appropriate units) in the specialties of family medicine, general internal medicine, general pediatrics, or geriatrics; or

“(B) programs that improve clinical teaching in such specialties.

“(2) ELIGIBILITY.—To be eligible for a grant or contract under paragraph (1), an entity shall be an accredited school of medicine or osteopathic medicine.

“(d) Preference.—In awarding grants or contracts under this section, the Secretary shall give preference to entities that have a demonstrated record of at least one of the following:

“(1) Training a high or significantly improved percentage of health professionals who provide primary care.

“(2) Training individuals who are from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among primary care professionals).

“(3) A high rate of placing graduates in practice settings having the principal focus of serving in underserved areas or populations experiencing health disparities (including serving patients eligible for medical assistance under title XIX of the Social Security Act or for child health assistance under title XXI of such Act or those with special health care needs).

“(4) Supporting teaching programs that address the health care needs of vulnerable populations.

“(e) Report.—The Secretary shall submit to the Congress an annual report on the program carried out under this section.

“(f) Definition.—In this section, the term ‘health disparities’ has the meaning given the term in section 3171.”.

Title VII (42 U.S.C. 292 et seq.) is amended—

(1) by redesignating section 748 as 749A; and

(2) by inserting after section 747 the following:

Title VII (42 U.S.C. 292 et seq.) is amended—

(1) in section 791(a)(1), by striking “747 and 750” and inserting “747, 749, and 750”; and

(2) by inserting after section 748, as added, the following:

(a) In general.—Part F of title VII (42 U.S.C. 295j et seq.) is amended by adding at the end the following:

“(a) Promotion of primary care and dentistry.—For the purpose of carrying out subpart XI of part D of title III and sections 747, 748, and 749, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $240,000,000 for fiscal year 2011.

“(2) $253,000,000 for fiscal year 2012.

“(3) $265,000,000 for fiscal year 2013.

“(4) $278,000,000 for fiscal year 2014.

“(5) $292,000,000 for fiscal year 2015.”.

(b) Existing authorization of appropriations.—Subsection (g)(1), as so redesignated, of section 747 (42 U.S.C. 293k) is amended by striking “2002” and inserting “2015”.

(a) Study.—The Comptroller General of the United States shall conduct a study to determine the effectiveness of scholarship and loan repayment programs under subparts III and XI of part D of title III of the Public Health Service Act, as amended or added by sections 2201 and 2211, including whether scholarships or loan repayments are more effective in—

(1) incentivizing physicians, and other providers, to pursue careers in primary care specialties;

(2) retaining such primary care providers; and

(3) encouraging such primary care providers to practice in underserved areas.

(b) Report.—Not later than 12 months after the date of the enactment of this Act, the Comptroller General shall submit to the Congress a report on the results of the study under subsection (a).

(a) Definitions.—Section 801 (42 U.S.C. 296 et seq.) is amended—

(1) in paragraph (1), by inserting “nurse-managed health centers,” after “nursing centers,”; and

(2) by adding at the end the following:

“(16) NURSE-MANAGED HEALTH CENTER.—The term ‘nurse-managed health center’—

“(A) means a nurse-practice arrangement, managed by one or more advanced practice nurses, that provides primary care or wellness services to underserved or vulnerable populations and is associated with an accredited school of nursing, Federally qualified health center, or independent nonprofit health or social services agency; and

“(B) shall not be construed as changing State law requirements applicable to an advanced practice nurse or the authorized scope of practice of such a nurse.”.

(b) Grants for health professions education.—Title VIII (42 U.S.C. 296 et seq.) is amended by striking section 807.

(c) Reports.—Part A of title VIII (42 U.S.C. 296 et seq.) is amended by adding at the end the following:

“The Secretary shall submit to the Congress a separate annual report on the activities carried out under each of sections 811, 821, 836, 846A, and 861.”.

(d) Advanced education nursing grants.—Section 811(f) (42 U.S.C. 296j(f)) is amended—

(1) by striking paragraph (2);

(2) by redesignating paragraph (3) as paragraph (2); and

(3) in paragraph (2), as so redesignated, by striking “that agrees” and all that follows through the end and inserting: “that agrees to expend the award—

“(A) to train advanced education nurses who will practice in health professional shortage areas designated under section 332; or

“(B) to increase diversity among advanced education nurses.”.

(e) Nurse education, practice, and retention grants.—Section 831 (42 U.S.C. 296p) is amended—

(1) in subsection (b), by amending paragraph (3) to read as follows:

“(3) providing coordinated care, quality care, and other skills needed to practice nursing; or”; and

(2) by striking subsection (e) and redesignating subsections (f) through (h) as subsections (e) through (g), respectively.

(f) Student loans.—Subsection (a) of section 836 (42 U.S.C. 297b) is amended—

(1) by striking “$2,500” and inserting “$3,300”;

(2) by striking “$4,000” and inserting “$5,200”;

(3) by striking “$13,000” and inserting “$17,000”; and

(4) by adding at the end the following: “Beginning with fiscal year 2012, the dollar amounts specified in this subsection shall be adjusted by an amount determined by the Secretary on an annual basis to reflect inflation.”.

(g) Loan repayment.—Section 846 (42 U.S.C. 297n) is amended—

(1) in subsection (a), by amending paragraph (3) to read as follows:

“(3) who enters into an agreement with the Secretary to serve for a period of not less than 2 years—

“(A) as a nurse at a health care facility with a critical shortage of nurses; or

“(B) as a faculty member at an accredited school of nursing;”; and

(2) in subsection (g)(1), by striking “to provide health services” each place it appears and inserting “to provide health services or serve as a faculty member”.

(h) Nurse faculty loan program.—Paragraph (2) of section 846A(c) (42 U.S.C. 297n–1(c)) is amended by striking “$30,000” and all that follows through the semicolon and inserting “$35,000, plus, beginning with fiscal year 2012, an amount determined by the Secretary on an annual basis to reflect inflation;”.

(i) Public service announcements.—Title VIII (42 U.S.C. 296 et seq.) is amended by striking part H.

(j) Technical and conforming amendments.—Title VIII (42 U.S.C. 296 et seq.) is amended—

(1) by moving section 810 (relating to prohibition against discrimination by schools on the basis of sex) so that it follows section 809, as added by subsection (c);

(2) in sections 835, 836, 838, 840, and 842, by striking the term “this subpart” each place it appears and inserting “this part”;

(3) in section 836(h), by striking the last sentence;

(4) in section 836, by redesignating subsection (l) as subsection (k);

(5) in section 839, by striking “839” and all that follows through “(a)” and inserting “839. (a)”;

(6) in section 835(b), by striking “841” each place it appears and inserting “871”;

(7) by redesignating section 841 as section 871, moving part F to the end of the title, and redesignating such part as part H;

(8) in part G—

(A) by redesignating section 845 as section 851; and

(B) by redesignating part G as part F; and

(9) in part I—

(A) by redesignating section 855 as section 861; and

(B) by redesignating part I as part G.

(k) Funding.—

(1) IN GENERAL.—Part H, as redesignated, of title VIII is amended by adding at the end the following:

“For the purpose of carrying out this title, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $115,000,000 for fiscal year 2011.

“(2) $122,000,000 for fiscal year 2012.

“(3) $127,000,000 for fiscal year 2013.

“(4) $134,000,000 for fiscal year 2014.

“(5) $140,000,000 for fiscal year 2015.”.

(2) EXISTING AUTHORIZATIONS OF APPROPRIATIONS.—

(A) SECTIONS 831, 846, 846A, AND 861.—Sections 831(g) (as so redesignated), 846(i)(1) (42 U.S.C. 297n(i)(1)), 846A(f) (42 U.S.C. 297n–1(f)), and 861(e) (as so redesignated) are amended by striking “2007” each place it appears and inserting “2015”.

(B) SECTION 871.—Section 871, as so redesignated by subsection (j), is amended to read as follows:

“For the purpose of carrying out parts B, C, and D (subject to section 851(g)), there are authorized to be appropriated such sums as may be necessary for each fiscal year through fiscal year 2015.”.

Part D of title III (42 U.S.C. 254b et seq.), as amended by section 2211, is amended by adding at the end the following:

“(a) Establishment.—There is established, within the Service, the Public Health Workforce Corps (in this subpart referred to as the ‘Corps’), for the purpose of ensuring an adequate supply of public health professionals throughout the Nation. The Corps shall consist of—

“(1) such officers of the Regular and Reserve Corps of the Service as the Secretary may designate;

“(2) such civilian employees of the United States as the Secretary may appoint; and

“(3) such other individuals who are not employees of the United States.

“(b) Administration.—Except as provided in subsection (c), the Secretary shall carry out this subpart acting through the Administrator of the Health Resources and Services Administration.

“(c) Placement and assignment.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall develop a methodology for placing and assigning Corps participants as public health professionals. Such methodology may allow for placing and assigning such participants in State, local, and tribal health departments and Federally qualified health centers (as defined in section 1861(aa)(4) of the Social Security Act).

“(d) Application of certain provisions.—The provisions of subpart II shall, except as inconsistent with this subpart, apply to the Public Health Workforce Corps in the same manner and to the same extent as such provisions apply to the National Health Service Corps established under section 331.

“(e) Report.—The Secretary shall submit to the Congress an annual report on the programs carried out under this subpart.

“(a) Establishment.—The Secretary shall establish the Public Health Workforce Scholarship Program (referred to in this section as the ‘Program’) for the purpose described in section 340L(a).

“(b) Eligibility.—To be eligible to participate in the Program, an individual shall—

“(1)(A) be accepted for enrollment, or be enrolled, as a full-time or part-time student in a course of study or program (approved by the Secretary) at an accredited graduate school or program of public health; or

“(B) have demonstrated expertise in public health and be accepted for enrollment, or be enrolled, as a full-time or part-time student in a course of study or program (approved by the Secretary) at—

“(i) an accredited graduate school or program of nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine; or

“(ii) another accredited graduate school or program, as deemed appropriate by the Secretary;

“(2) be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps of the Service or be eligible for selection for civilian service in the Corps; and

“(3) sign and submit to the Secretary a written contract (described in subsection (c)) to serve full-time as a public health professional, upon the completion of the course of study or program involved, for the period of obligated service described in subsection (c)(2)(E).

“(c) Contract.—The written contract between the Secretary and an individual under subsection (b)(3) shall contain—

“(1) an agreement on the part of the Secretary that the Secretary will—

“(A) provide the individual with a scholarship for a period of years (not to exceed 4 academic years) during which the individual shall pursue an approved course of study or program to prepare the individual to serve in the public health workforce; and

“(B) accept (subject to the availability of appropriated funds) the individual into the Corps;

“(2) an agreement on the part of the individual that the individual will—

“(A) accept provision of such scholarship to the individual;

“(B) maintain full-time or part-time enrollment in the approved course of study or program described in subsection (b)(1) until the individual completes that course of study or program;

“(C) while enrolled in the approved course of study or program, maintain an acceptable level of academic standing (as determined by the educational institution offering such course of study or program);

“(D) if applicable, complete a residency or internship; and

“(E) serve full-time as a public health professional for a period of time equal to the greater of—

“(i) 1 year for each academic year for which the individual was provided a scholarship under the Program; or

“(ii) 2 years; and

“(3) an agreement by both parties as to the nature and extent of the scholarship assistance, which may include—

“(A) payment of reasonable educational expenses of the individual, including tuition, fees, books, equipment, and laboratory expenses; and

“(B) payment of a stipend of not more than $1,269 (plus, beginning with fiscal year 2012, an amount determined by the Secretary on an annual basis to reflect inflation) per month for each month of the academic year involved, with the dollar amount of such a stipend determined by the Secretary taking into consideration whether the individual is enrolled full-time or part-time.

“(d) Application of certain provisions.—The provisions of subpart III shall, except as inconsistent with this subpart, apply to the scholarship program under this section in the same manner and to the same extent as such provisions apply to the National Health Service Corps Scholarship Program established under section 338A.

“(a) Establishment.—The Secretary shall establish the Public Health Workforce Loan Repayment Program (referred to in this section as the ‘Program’) for the purpose described in section 340L(a).

“(b) Eligibility.—To be eligible to participate in the Program, an individual shall—

“(1)(A) have a graduate degree from an accredited school or program of public health;

“(B) have demonstrated expertise in public health and have a graduate degree in a course of study or program (approved by the Secretary) from—

“(i) an accredited school or program of nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine; or

“(ii) another accredited school or program approved by the Secretary; or

“(C) be enrolled as a full-time or part-time student in the final year of a course of study or program (approved by the Secretary) offered by a school or program described in subparagraph (A) or (B), leading to a graduate degree;

“(2) be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps of the Service or be eligible for selection for civilian service in the Corps;

“(3) if applicable, complete a residency or internship; and

“(4) sign and submit to the Secretary a written contract (described in subsection (c)) to serve full-time as a public health professional for the period of obligated service described in subsection (c)(2).

“(c) Contract.—The written contract between the Secretary and an individual under subsection (b)(4) shall contain—

“(1) an agreement by the Secretary to repay on behalf of the individual loans incurred by the individual in the pursuit of the relevant public health workforce educational degree in accordance with the terms of the contract;

“(2) an agreement by the individual to serve full-time as a public health professional for a period of time equal to 2 years or such longer period as the individual may agree to; and

“(3) in the case of an individual described in subsection (b)(1)(C) who is in the final year of study and who has accepted employment as a public health professional, in accordance with section 340L(c), an agreement on the part of the individual to complete the education or training, maintain an acceptable level of academic standing (as determined by the educational institution offering the course of study or training), and serve the period of obligated service described in paragraph (2).

“(d) Payments.—

“(1) IN GENERAL.—A loan repayment provided for an individual under a written contract under the Program shall consist of payment, in accordance with paragraph (2), on behalf of the individual of the principal, interest, and related expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for reasonable educational expenses, including tuition, fees, books, equipment, and laboratory expenses, incurred by the individual.

“(2) PAYMENTS FOR YEARS SERVED.—

“(A) IN GENERAL.—For each year of obligated service that an individual contracts to serve under subsection (c), the Secretary may pay up to $35,000 (plus, beginning with fiscal year 2012, an amount determined by the Secretary on an annual basis to reflect inflation) on behalf of the individual for loans described in paragraph (1).

“(B) REPAYMENT SCHEDULE.—Any arrangement made by the Secretary for the making of loan repayments in accordance with this subsection shall provide that any repayments for a year of obligated service shall be made no later than the end of the fiscal year in which the individual completes such year of service.

“(e) Application of certain provisions.—The provisions of subpart III shall, except as inconsistent with this subpart, apply to the loan repayment program under this section in the same manner and to the same extent as such provisions apply to the National Health Service Corps Loan Repayment Program established under section 338B.”.

Section 765 (42 U.S.C. 295) is amended to read as follows:

“(a) Program.—The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with the Director of the Centers for Disease Control and Prevention, shall establish a public health workforce training and enhancement program consisting of awarding grants and contracts under subsection (b).

“(b) Grants and contracts.—The Secretary shall award grants to, or enter into contracts with, eligible entities—

“(1) to plan, develop, operate, or participate in, an accredited professional training program in the field of public health (including such a program in nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine) for members of the public health workforce, including midcareer professionals;

“(2) to provide financial assistance in the form of traineeships and fellowships to students who are participants in any such program and who plan to specialize or work in the field of public health;

“(3) to plan, develop, operate, or participate in a program for the training of public health professionals who plan to teach in any program described in paragraph (1); and

“(4) to provide financial assistance in the form of traineeships and fellowships to public health professionals who are participants in any program described in paragraph (1) and who plan to teach in the field of public health, including nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine.

“(c) Eligibility.—To be eligible for a grant or contract under this section, an entity shall be—

“(1) an accredited health professions school, including an accredited school or program of public health; nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine;

“(2) a State, local, or tribal health department;

“(3) a public or private nonprofit entity; or

“(4) a consortium of 2 or more entities described in paragraphs (1) through (3).

“(d) Preference.—In awarding grants or contracts under this section, the Secretary shall give preference to entities that have a demonstrated record of at least one of the following:

“(1) Training a high or significantly improved percentage of public health professionals who serve in underserved communities.

“(2) Training individuals who are from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among public health professionals).

“(3) Training individuals in public health specialties experiencing a significant shortage of public health professionals (as determined by the Secretary).

“(4) Training a high or significantly improved percentage of public health professionals serving in the Federal Government or a State, local, or tribal government.

“(e) Report.—The Secretary shall submit to the Congress an annual report on the program carried out under this section.”.

Section 766 (42 U.S.C. 295a) is amended—

(1) in subsection (b)(1), by striking “in furtherance of the goals established by the Secretary for the year 2000” and inserting “in furtherance of the goals established by the Secretary in the national prevention and wellness strategy under section 3121”; and

(2) by adding at the end the following:

“(d) Report.—The Secretary shall submit to the Congress an annual report on the program carried out under this section.”.

Section 768 (42 U.S.C. 295c) is amended to read as follows:

“(a) Grants.—The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with the Director of the Centers for Disease Control and Prevention, shall award grants to, or enter into contracts with, eligible entities to provide training to graduate medical residents in preventive medicine specialties.

“(b) Eligibility.—To be eligible for a grant or contract under subsection (a), an entity shall be—

“(1) an accredited school of public health or school of medicine or osteopathic medicine;

“(2) an accredited public or private nonprofit hospital;

“(3) a State, local, or tribal health department; or

“(4) a consortium of 2 or more entities described in paragraphs (1) through (3).

“(c) Use of funds.—Amounts received under a grant or contract under this section shall be used to—

“(1) plan, develop (including the development of curricula), operate, or participate in an accredited residency or internship program in preventive medicine or public health;

“(2) defray the costs of practicum experiences, as required in such a program; and

“(3) establish, maintain, or improve—

“(A) academic administrative units (including departments, divisions, or other appropriate units) in preventive medicine and public health; or

“(B) programs that improve clinical teaching in preventive medicine and public health.

“(d) Report.—The Secretary shall submit to the Congress an annual report on the program carried out under this section.”.

(a) In general.—Section 799C, as added by section 2216 of this Act, is amended by adding at the end the following:

“(b) Public health workforce.—For the purpose of carrying out subpart XII of part D of title III and sections 765, 766, and 768, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $51,000,000 for fiscal year 2011.

“(2) $54,000,000 for fiscal year 2012.

“(3) $57,000,000 for fiscal year 2013.

“(4) $59,000,000 for fiscal year 2014.

“(5) $62,000,000 for fiscal year 2015.”.

(b) Existing authorization of appropriations.—Subsection (a) of section 770 (42 U.S.C. 295e) is amended by striking “2002” and inserting “2015”.

Paragraph (1) of section 738(a) (42 U.S.C. 293b(a)) is amended by striking “not more than $20,000” and all that follows through the end of the paragraph and inserting: “not more than $35,000 (plus, beginning with fiscal year 2012, an amount determined by the Secretary on an annual basis to reflect inflation) of the principal and interest of the educational loans of such individuals.”.

Subsection (b) of section 821 (42 U.S.C. 296m) is amended—

(1) in the heading, by striking “Guidance” and inserting “Consultation”; and

(2) by striking “shall take into consideration” and all that follows through “consult with nursing associations” and inserting “shall, as appropriate, consult with nursing associations”.

(a) In general.—Title VII (42 U.S.C. 292 et seq.) is amended by inserting after section 739 the following:

“The Secretary shall, to the extent practicable, coordinate the activities carried out under this part and section 821 in order to enhance the effectiveness of such activities and avoid duplication of effort.”.

(b) Report.—Section 736 (42 U.S.C. 293) is amended—

(1) by redesignating subsection (h) as subsection (i); and

(2) by inserting after subsection (g) the following:

“(h) Report.—The Secretary shall submit to the Congress an annual report on the activities carried out under this section.”.

Section 741 (42 U.S.C. 293e) is amended—

(1) in the section heading, by striking “Grants for Health Professions Education” and inserting “Cultural and linguistic competency training for health professionals”;

(2) by redesignating subsection (b) as subsection (h); and

(3) by striking subsection (a) and inserting the following:

“(a) Program.—The Secretary shall establish a cultural and linguistic competency training program for health professionals, including nurse professionals, consisting of awarding grants and contracts under subsection (b).

“(b) Cultural and linguistic competency training.—The Secretary shall award grants to, or enter into contracts with, eligible entities—

“(1) to test, develop, and evaluate models of cultural and linguistic competency training (including continuing education) for health professionals; and

“(2) to implement cultural and linguistic competency training programs for health professionals developed under paragraph (1) or otherwise.

“(c) Eligibility.—To be eligible for a grant or contract under subsection (b), an entity shall be—

“(1) an accredited health professions school or program;

“(2) an academic health center;

“(3) a public or private nonprofit entity; or

“(4) a consortium of 2 or more entities described in paragraphs (1) through (3).

“(d) Preference.—In awarding grants and contracts under this section, the Secretary shall give preference to entities that have a demonstrated record of at least one of the following:

“(1) Addressing, or partnering with an entity with experience addressing, the cultural and linguistic competency needs of the population to be served through the grant or contract.

“(2) Addressing health disparities.

“(3) Placing health professionals in regions experiencing significant changes in the cultural and linguistic demographics of populations, including communities along the United States-Mexico border.

“(4) Carrying out activities described in subsection (b) with respect to more than one health profession discipline, specialty, or subspecialty.

“(e) Consultation.—The Secretary shall carry out this section in consultation with the heads of appropriate health agencies and offices in the Department of Health and Human Services, including the Office of Minority Health and the National Center on Minority Health and Health Disparities.

“(f) Definition.—In this section, the term ‘health disparities’ has the meaning given to the term in section 3171.

“(g) Report.—The Secretary shall submit to the Congress an annual report on the program carried out under this section.”.

Part D of title VII (42 U.S.C. 294 et seq.) is amended by adding at the end the following:

“(a) Program.—The Secretary shall establish an innovations in interdisciplinary care training program consisting of awarding grants and contracts under subsection (b).

“(b) Training programs.—The Secretary shall award grants to, or enter into contracts with, eligible entities—

“(1) to test, develop, and evaluate health professional training programs (including continuing education) designed to promote—

“(A) the delivery of health services through interdisciplinary and team-based models, which may include patient-centered medical home models, medication therapy management models, and models integrating physical, mental, or oral health services; and

“(B) coordination of the delivery of health care within and across settings, including health care institutions, community-based settings, and the patient’s home; and

“(2) to implement such training programs developed under paragraph (1) or otherwise.

“(c) Eligibility.—To be eligible for a grant or contract under subsection (b), an entity shall be—

“(1) an accredited health professions school or program;

“(2) an academic health center;

“(3) a public or private nonprofit entity (including an area health education center or a geriatric education center); or

“(4) a consortium of 2 or more entities described in paragraphs (1) through (3).

“(d) Preferences.—In awarding grants and contracts under this section, the Secretary shall give preference to entities that have a demonstrated record of at least one of the following:

“(1) Training a high or significantly improved percentage of health professionals who serve in underserved communities.

“(2) Broad interdisciplinary team-based collaborations.

“(3) Addressing health disparities.

“(e) Report.—The Secretary shall submit to the Congress an annual report on the program carried out under this section.

“(f) Definitions.—In this section:

“(1) The term ‘health disparities’ has the meaning given the term in section 3171.

“(2) The term ‘interdisciplinary’ means collaboration across health professions and specialties, which may include public health, nursing, allied health, dietetics or nutrition, and appropriate health specialties.”.

Subpart 1 of part E of title VII (42 U.S.C. 294n et seq.) is amended by adding at the end the following:

(a) In general.—Section 761 (42 U.S.C. 294n) is amended—

(1) by redesignating subsection (c) as subsection (e); and

(2) by striking subsections (a) and (b) and inserting the following:

“(a) In general.—The Secretary shall, based upon the classifications and standardized methodologies and procedures developed by the Advisory Committee on Health Workforce Evaluation and Assessment under section 764(b)—

“(1) collect data on the health workforce (as defined in section 764(i)), disaggregated by field, discipline, and specialty, with respect to—

“(A) the supply (including retention) of health professionals relative to the demand for such professionals;

“(B) the diversity of health professionals (including with respect to race, ethnic background, and sex); and

“(C) the geographic distribution of health professionals; and

“(2) collect such data on individuals participating in the programs authorized by subtitles A, B, and C and part 1 of subtitle D of title II of division C of the Affordable Health Care for America Act.

“(b) Grants and contracts for health workforce analysis.—

“(1) IN GENERAL.—The Secretary may award grants to, or enter into contracts with, eligible entities to carry out subsection (a).

“(2) ELIGIBILITY.—To be eligible for a grant or contract under this subsection, an entity shall be—

“(A) an accredited health professions school or program;

“(B) an academic health center;

“(C) a State, local, or tribal government;

“(D) a public or private entity; or

“(E) a consortium of 2 or more entities described in subparagraphs (A) through (D).

“(c) Collaboration and data sharing.—The Secretary shall collaborate with Federal departments and agencies, health professions organizations (including health professions education organizations), and professional medical societies for the purpose of carrying out subsection (a).

“(d) Report.—The Secretary shall submit to the Congress an annual report on the data collected under subsection (a).”.

(b) Period before completion of national strategy.—Pending completion of the classifications and standardized methodologies and procedures developed by the Advisory Committee on Health Workforce Evaluation and Assessment under section 764(b) of the Public Health Service Act, as added by section 2261, the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration and in consultation with such Advisory Committee, may make a judgment about the classifications, methodologies, and procedures to be used for collection of data under section 761(a) of the Public Health Service Act, as amended by this section.

(a) In general.—Section 799C, as added and amended, is further amended by adding at the end the following:

“(c) Health professions training for diversity.—For the purpose of carrying out sections 736, 737, 738, 739, and 739A, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $90,000,000 for fiscal year 2011.

“(2) $97,000,000 for fiscal year 2012.

“(3) $100,000,000 for fiscal year 2013.

“(4) $104,000,000 for fiscal year 2014.

“(5) $110,000,000 for fiscal year 2015.

“(d) Interdisciplinary training programs, Advisory Committee on Health Workforce Evaluation and Assessment, and health workforce assessment.—For the purpose of carrying out sections 741, 759, 761, and 764, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $87,000,000 for fiscal year 2011.

“(2) $97,000,000 for fiscal year 2012.

“(3) $103,000,000 for fiscal year 2013.

“(4) $105,000,000 for fiscal year 2014.

“(5) $113,000,000 for fiscal year 2015.”.

(b) Existing authorizations of appropriations.—

(1) SECTION 736.—Paragraph (1) of section 736(i) (42 U.S.C. 293(h)), as redesignated, is amended by striking “2002” and inserting “2015”.

(2) SECTIONS 737, 738, AND 739.—Subsections (a), (b), and (c) of section 740 are amended by striking “2002” each place it appears and inserting “2015”.

(3) SECTION 741.—Subsection (h), as so redesignated, of section 741 is amended—

(A) by striking “and” after “fiscal year 2003,”; and

(B) by inserting “, and such sums as may be necessary for each subsequent fiscal year through the end of fiscal year 2015” before the period at the end.

(4) SECTION 761.—Subsection (e)(1), as so redesignated, of section 761 is amended by striking “2002” and inserting “2015”.