[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2997 Reported in Senate (RS)]
<DOC>
Calendar No. 372
116th CONGRESS
1st Session
S. 2997
To revise and extend health workforce programs under title VII of the
Public Health Service Act.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 9, 2019
Mr. Reed (for himself, Mr. Enzi, and Ms. McSally) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
December 17, 2019
Reported by Mr. Alexander, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To revise and extend health workforce programs under title VII of the
Public Health Service Act.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Title VII Health Care
Workforce Act of 2019''.</DELETED>
<DELETED>SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS WORKFORCE
PROGRAMS.</DELETED>
<DELETED> Title VII of the Public Health Service Act (42 U.S.C. 292
et seq.) is amended--</DELETED>
<DELETED> (1) in section 736 (42 U.S.C. 293), by striking
subsection (i) and inserting the following:</DELETED>
<DELETED> ``(i) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $23,711,000 for each of
fiscal years 2020 through 2024.'';</DELETED>
<DELETED> (2) in section 740 (42 U.S.C. 293d)--</DELETED>
<DELETED> (A) 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 ``$48,970,000 for each of
fiscal years 2020 through 2024'';</DELETED>
<DELETED> (B) in subsection (b), by striking
``$5,000,000 for each of the fiscal years 2010 through
2014'' and inserting ``$1,190,000 for each of fiscal
years 2020 through 2024'';</DELETED>
<DELETED> (C) 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 ``$14,189,000 for each of fiscal
years 2020 through 2024''; and</DELETED>
<DELETED> (D) in subsection (d), by striking ``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'' and inserting:
``Not later than September 30, 2024, and every five
years thereafter, the Secretary shall prepare and
submit to the Committee on Health, Education, Labor,
and Pensions of the Senate, and the Committee on Energy
and Commerce of the House of
Representatives,'';</DELETED>
<DELETED> (3) in section 747 (42 U.S.C. 293k)--</DELETED>
<DELETED> (A) in subsection (a)(1)(G), by striking
``to plan, develop, and operate a demonstration program
that provides training'' and inserting: ``to plan,
develop, and operate a program that identifies or
develops innovative models of providing care, and
trains primary care physicians on such models
and'';</DELETED>
<DELETED> (B) in subsection (b)(3)(E), by striking
``substance-related disorders'' and inserting
``substance use disorders''; and</DELETED>
<DELETED> (C) in subsection (c)(1), 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 ``$48,924,000 for each of fiscal
years 2020 through 2024'';</DELETED>
<DELETED> (4) in section 748 (42 U.S.C. 293k-2)--</DELETED>
<DELETED> (A) in subsection (c)(5), by striking
``substance-related disorders'' and inserting
``substance use disorders''; and</DELETED>
<DELETED> (B) in subsection (f), 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 ``$28,531,000 for each of fiscal
years 2020 through 2024'';</DELETED>
<DELETED> (5) in section 749(d)(2) (42 U.S.C. 293l(d)(2)),
by striking ``Committee on Labor and Human Resources of the
Senate, and the Committee on Commerce of the House of
Representatives'' and inserting ``Committee on Health,
Education, Labor, and Pensions of the Senate, and the Committee
on Energy and Commerce of the House of
Representatives'';</DELETED>
<DELETED> (6) in section 751(j)(1) (42 U.S.C. 294a(j)(1)),
by striking ``$125,000,000 for each of the fiscal years 2010
through 2014'' and inserting ``$39,250,000 for each of fiscal
years 2020 through 2024'';</DELETED>
<DELETED> (7) in section 754(b)(1)(A) (42 U.S.C.
294d(b)(1)(A)), by striking ``new and innovative'' and
inserting ``innovative or evidence-based'';</DELETED>
<DELETED> (8) in section 755(b)(1)(A) (42 U.S.C.
294e(b)(1)(A)), by striking ``the elderly'' and inserting
``geriatric populations or for maternal and child
health'';</DELETED>
<DELETED> (9) in section 761(e) (42 U.S.C. 294n(e))--
</DELETED>
<DELETED> (A) in paragraph (1)(A), by striking
``$7,500,000 for each of fiscal years 2010 through
2014'' and inserting ``$5,663,000 for each of fiscal
years 2020 through 2024''; and</DELETED>
<DELETED> (B) in paragraph (2), by striking
``subsection (a)'' and inserting ``paragraph
(1)'';</DELETED>
<DELETED> (10) in section 762 (42 U.S.C. 294o)--</DELETED>
<DELETED> (A) in subsection (a)(1), by striking
``Committee on Labor and Human Resources'' and
inserting ``Committee on Health, Education, Labor, and
Pensions'';</DELETED>
<DELETED> (B) in subsection (b)--</DELETED>
<DELETED> (i) in paragraph (2), by striking
``Health Care Financing Administration'' and
inserting ``Centers for Medicare & Medicaid
Services'';</DELETED>
<DELETED> (ii) by redesignating paragraphs
(4) through (6) as paragraphs (5) through (7),
respectively; and</DELETED>
<DELETED> (iii) by inserting after paragraph
(3), the following:</DELETED>
<DELETED> ``(4) the Administrator of the Health Resources
and Services Administration;'';</DELETED>
<DELETED> (C) by striking subsections (i), (j), and
(k) and inserting the following:</DELETED>
<DELETED> ``(i) Reports.--Not later than September 30, 2023, and not
less than every 5 years thereafter, the Council shall submit to the
Secretary, and to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce of the
House of Representatives, a report on the recommendations described in
subsection (a).''; and</DELETED>
<DELETED> (D) by redesignating subsection (l) as
subsection (j);</DELETED>
<DELETED> (11) in section 766(b)(1) (42 U.S.C. 295a(b)(1)),
by striking ``that plans'' and all that follows through the
period and inserting ``that plans, develops, operates, and
evaluates projects to improve preventive medicine, health
promotion and disease prevention, or access to and quality of
health care services in rural or medically underserved
communities.''; and</DELETED>
<DELETED> (12) in section 770(a) (42 U.S.C. 295e(a)), 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 ``$17,000,000 for each of fiscal years
2020 through 2024''.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Title VII Health Care Workforce
Reauthorization Act of 2019''.
SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS WORKFORCE PROGRAMS.
Title VII of the Public Health Service Act (42 U.S.C. 292 et seq.)
is amended--
(1) in section 736 (42 U.S.C. 293), by striking subsection
(i) and inserting the following:
``(i) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $23,711,000 for each of fiscal
years 2021 through 2025.'';
(2) in section 740 (42 U.S.C. 293d)--
(A) 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 ``$48,970,000 for each of fiscal years 2021
through 2025'';
(B) in subsection (b), by striking ``$5,000,000 for
each of the fiscal years 2010 through 2014'' and
inserting ``$1,190,000 for each of fiscal years 2021
through 2025'';
(C) 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 ``$14,189,000 for each of fiscal years 2021
through 2025''; and
(D) in subsection (d), by striking ``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'' and inserting: ``Not later
than September 30, 2025, and every five years
thereafter, the Secretary shall prepare and submit to
the Committee on Health, Education, Labor, and Pensions
of the Senate, and the Committee on Energy and Commerce
of the House of Representatives,'';
(3) in section 747 (42 U.S.C. 293k)--
(A) in subsection (a)--
(i) in paragraph (1)(G), by striking ``to
plan, develop, and operate a demonstration
program that provides training'' and inserting:
``to plan, develop, and operate a program that
identifies or develops innovative models of
providing care, and trains primary care
physicians on such models and''; and
(ii) by adding at the end the following:
``(3) Priorities in making awards.--In awarding grants or
contracts under paragraph (1), the Secretary may give priority
to qualified applicants that train residents in rural areas,
including for Tribes or Tribal Organizations in such areas.'';
(B) in subsection (b)(3)(E), by striking
``substance-related disorders'' and inserting
``substance use disorders''; and
(C) in subsection (c)(1), 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 ``$48,924,000 for each of fiscal
years 2021 through 2025'';
(4) in section 748 (42 U.S.C. 293k-2)--
(A) in subsection (c)(5), by striking ``substance-
related disorders'' and inserting ``substance use
disorders''; and
(B) in subsection (f), 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 ``$28,531,000 for each of fiscal years 2021
through 2025'';
(5) in section 749(d)(2) (42 U.S.C. 293l(d)(2)), by
striking ``Committee on Labor and Human Resources of the
Senate, and the Committee on Commerce of the House of
Representatives'' and inserting ``Committee on Health,
Education, Labor, and Pensions of the Senate, and the Committee
on Energy and Commerce of the House of Representatives'';
(6) in section 751(j)(1) (42 U.S.C. 294a(j)(1)), by
striking ``$125,000,000 for each of the fiscal years 2010
through 2014'' and inserting ``$39,250,000 for each of fiscal
years 2021 through 2025'';
(7) in section 754(b)(1)(A) (42 U.S.C. 294d(b)(1)(A)), by
striking ``new and innovative'' and inserting ``innovative or
evidence-based'';
(8) in section 755(b)(1)(A) (42 U.S.C. 294e(b)(1)(A)), by
striking ``the elderly'' and inserting ``geriatric populations
or for maternal and child health'';
(9) in section 761(e) (42 U.S.C. 294n(e))--
(A) in paragraph (1)(A), by striking ``$7,500,000
for each of fiscal years 2010 through 2014'' and
inserting ``$5,663,000 for each of fiscal years 2021
through 2025''; and
(B) in paragraph (2), by striking ``subsection
(a)'' and inserting ``paragraph (1)'';
(10) in section 762 (42 U.S.C. 294o)--
(A) in subsection (a)(1), by striking ``Committee
on Labor and Human Resources'' and inserting
``Committee on Health, Education, Labor, and
Pensions'';
(B) in subsection (b)--
(i) in paragraph (2), by striking ``Health
Care Financing Administration'' and inserting
``Centers for Medicare & Medicaid Services'';
(ii) by redesignating paragraphs (4)
through (6) as paragraphs (5) through (7),
respectively; and
(iii) by inserting after paragraph (3), the
following:
``(4) the Administrator of the Health Resources and
Services Administration;'';
(C) by striking subsections (i), (j), and (k) and
inserting the following:
``(i) Reports.--Not later than September 30, 2023, and not less
than every 5 years thereafter, the Council shall submit to the
Secretary, and to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce of the
House of Representatives, a report on the recommendations described in
subsection (a).''; and
(D) by redesignating subsection (l) as subsection
(j);
(11) in section 766(b)(1) (42 U.S.C. 295a(b)(1)), by
striking ``that plans'' and all that follows through the period
and inserting ``that plans, develops, operates, and evaluates
projects to improve preventive medicine, health promotion and
disease prevention, or access to and quality of health care
services in rural or medically underserved communities.'';
(12) in section 770(a) (42 U.S.C. 295e(a)), 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 ``$17,000,000 for each of fiscal years 2021 through
2025''; and
(13) in section 775(e) (42 U.S.C. 295f(e)), by striking
``$30,000,000'' and all that follows through the period and
inserting ``such sums as may be necessary for each of fiscal
years 2021 through 2025.''.
SEC. 3. HEALTH WORKFORCE COORDINATION.
(a) Strategic Plan.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, the Secretary of Health and Human
Services (referred to in this Act as the ``Secretary''), in
consultation with the Advisory Committee on Training in Primary
Care Medicine and Dentistry and the Advisory Council on
Graduate Medical Education, shall develop a comprehensive and
coordinated plan with respect to the health care workforce
development programs of the Department of Health and Human
Services, including education and training programs.
(2) Requirements.--The plan under paragraph (1) shall--
(A) include performance measures to determine the
extent to which the programs described in paragraph (1)
are strengthening the Nation's health care system;
(B) identify any gaps that exist between the
outcomes of programs described in paragraph (1) and
projected health care workforce needs identified in
workforce projection reports conducted by the Health
Resources and Services Administration;
(C) identify actions to address the gaps described
in subparagraph (B); and
(D) identify barriers, if any, to implementing the
actions identified under subparagraph (C).
(b) Coordination With Other Agencies.--The Secretary shall
coordinate with the heads of other Federal agencies and departments
that fund or administer health care workforce development programs,
including education and training programs, to--
(1) evaluate the performance of such programs, including
the extent to which such programs are efficient and effective
and are meeting the nation's health workforce needs; and
(2) identify opportunities to improve the quality and
consistency of the information collected to evaluate within and
across such programs, and to implement such improvements.
(c) Report.--Not later than 2 years after the date of enactment of
this Act, the Secretary shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate, and the Committee on
Energy and Commerce of the House of Representatives, a report
describing the plan developed under subsection (a) and actions taken to
implement such plan.
SEC. 4. 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 Program.--
``(1) In general.--The Secretary shall award grants,
contracts, or cooperative agreements 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) In general.--A Geriatrics Workforce
Enhancement Program receiving an award under this
section shall support the training of health
professionals in geriatrics, including traineeships or
fellowships. Such programs shall emphasize, as
appropriate, patient and family engagement, integration
of geriatrics with primary care and other appropriate
specialties, and collaboration with community partners
to address gaps in health care for older adults.
``(B) Activities.--Activities conducted by a
program under this section may include the following:
``(i) Clinical training on providing
integrated geriatrics and primary care delivery
services.
``(ii) Interprofessional training to
practitioners from multiple disciplines and
specialties, including training on the
provision of care to older adults.
``(iii) Establishing or maintaining
training-related community-based programs for
older adults and caregivers to improve health
outcomes for older adults.
``(iv) Providing education on Alzheimer's
disease and related dementias to families and
caregivers of older adults, direct care
workers, and health professions students,
faculty, and providers.
``(3) Duration.--Each grant, contract, or cooperative
agreement or contract awarded under paragraph (1) shall be for
a period not to exceed 5 years.
``(4) Applications.--To be eligible to receive a grant,
contract, or cooperative agreement 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.
``(5) Program requirements.--
``(A) In general.--In awarding grants, contracts,
and cooperative agreements under paragraph (1), the
Secretary--
``(i) shall give priority to programs that
demonstrate coordination with another Federal
or State program or another public or private
entity;
``(ii) shall give priority to applicants
with programs or activities that are expected
to substantially benefit rural or medically
underserved populations of older adults, or
serve older adults in Indian Tribes or Tribal
organizations; and
``(iii) may give priority to any program
that--
``(I) integrates geriatrics into
primary care practice;
``(II) provides training to
integrate geriatric care into other
specialties across care settings,
including practicing clinical
specialists, health care
administrators, faculty without
backgrounds in geriatrics, and students
from all health professions;
``(III) emphasizes integration of
geriatric care into existing service
delivery locations and care across
settings, including primary care
clinics, medical homes, Federally
qualified health centers, ambulatory
care clinics, critical access
hospitals, emergency care, assisted
living and nursing facilities, and
home- and community-based services,
which may include adult daycare;
``(IV) supports the training and
retraining of faculty, primary care
providers, other direct care providers,
and other appropriate professionals on
geriatrics;
``(V) emphasizes education and
engagement of family caregivers on
disease management and strategies to
meet the needs of caregivers of older
adults; or
``(VI) proposes to conduct outreach
to communities that have a shortage of
geriatric workforce professionals.
``(B) Special consideration.--In awarding grants,
contracts, and cooperative agreements under this
section, the Secretary shall give special consideration
to entities that provide services in areas with a
shortage of geriatric workforce professionals.
``(6) Priority.--The Secretary may provide awardees with
additional support for activities in areas of demonstrated
need, which may include education and training for home health
workers, family caregivers, and direct care workers on care for
older adults.
``(7) Reporting.--
``(A) Reports from entities.--Each entity awarded a
grant, contract, or cooperative agreement under this
section shall submit an annual report to the Secretary
on the activities conducted under such grant, contract,
or cooperative agreement, which may include information
on 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 such
programs, and other information, as the Secretary may
require.
``(B) Report to congress.--Not later than 4 years
after the date of enactment of the Title VII Health
Care Workforce Reauthorization Act of 2019 and every 5
years thereafter, the Secretary shall submit to the
Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of
the House of Representatives a report that provides a
summary of the activities and outcomes associated with
grants, contracts, and cooperative agreements made
under this section. Such reports shall include--
``(i) information on the number of
trainees, faculty, and professionals who
participated in programs under this section;
``(ii) information on the impact of the
program conducted under this section on the
health status of older adults, including in
areas with a shortage of health professionals;
and
``(iii) information on outreach and
education provided under this section to
families and caregivers of older adults.
``(C) Public availability.--The Secretary shall
make reports submitted under paragraph (B) publically
available on the internet website of the Department of
Health and Human Services.
``(b) Geriatric Academic Career Awards.--
``(1) Establishment of program.--The Secretary shall, as
appropriate, establish or maintain a program to provide
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 entity described in paragraph (1),
(3), or (4) of section 799B or section 801(2);
or
``(ii) another accredited health
professions school or graduate program approved
by the Secretary.
``(B) Eligible individual.--For purposes of this
subsection, the term `eligible individual' means an
individual who--
``(i)(I) is board certified or board
eligible in internal medicine, family practice,
psychiatry, or licensed dentistry, or has
completed required training in a discipline and
is employed in an accredited health professions
school or graduate program that is approved by
the Secretary; or
``(II) has completed an approved fellowship
program in geriatrics, or has completed
specialty training in geriatrics as required by
the discipline and any additional geriatrics
training as required by the Secretary; and
``(ii) has a junior, nontenured, faculty
appointment at an accredited health professions
school or graduate program in geriatrics or a
geriatrics health profession.
``(3) Application requirements.--In order to receive an
award under paragraph (1), an eligible entity, on behalf of an
eligible individual, shall--
``(A) submit to the Secretary an application, at
such time, in such manner, and containing such
information as the Secretary may require;
``(B) provide, in such form and manner as the
Secretary may require, assurances that the eligible
individual will meet the service requirement described
in paragraph (6); and
``(C) provide, 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 eligible entity that the individual will spend 75
percent of the individual's time that is supported by
the award on teaching and developing skills in
interdisciplinary education in geriatrics.
``(4) Equitable distribution.--In making awards under this
subsection, the Secretary shall seek to ensure geographical
distribution among award recipients, including among rural or
medically underserved areas of the United States.
``(5) Amount and duration.--
``(A) Amount.--The amount of an award under this
subsection shall be at least $75,000 for fiscal year
2020, adjusted for subsequent years in accordance with
the consumer price index. The Secretary shall determine
the amount of an award under this subsection for
individuals who are not physicians.
``(B) Duration.--The Secretary shall make awards
under paragraph (1) for a period not to exceed 5 years.
``(6) Service requirement.--An individual who receives an
award under this subsection shall provide training in clinical
geriatrics, including the training of interprofessional 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.
``(c) Nonapplicability of Provision.--Notwithstanding any other
provision of this title, section 791(a) shall not apply to awards made
under this section.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated $40,737,000 for each of fiscal years 2021 through 2025 for
purposes of carrying out this section.''.
Calendar No. 372
116th CONGRESS
1st Session
S. 2997
_______________________________________________________________________
A BILL
To revise and extend health workforce programs under title VII of the
Public Health Service Act.
_______________________________________________________________________
December 17, 2019
Reported with an amendment