[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4425 Introduced in Senate (IS)]
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117th CONGRESS
2d Session
S. 4425
To amend the Public Health Service Act to authorize a scholarship and
loan repayment program to incentivize physicians to enter into the
field of sickle cell disease research and treatment, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 16, 2022
Mr. Van Hollen (for himself and Mr. Booker) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to authorize a scholarship and
loan repayment program to incentivize physicians to enter into the
field of sickle cell disease research and treatment, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Sickle Cell Care Expansion Act of
2022''.
SEC. 2. ADVANCING TREATMENT AND RESEARCH PERTAINING TO SICKLE CELL
DISEASE.
Part D of title III of the Public Health Service Act (42 U.S.C.
254b et seq.) is amended by adding at the end the following:
``Subpart XIII--Advancing Treatment and Research Pertaining to Sickle
Cell Disease
``SEC. 340J. SCHOLARSHIP AND LOAN REPAYMENT PROGRAM.
``(a) In General.--To advance learning regarding sickle cell
disease and to enhance the supply of physicians to treat such disease,
especially with respect to adult populations, the Secretary, acting
through the Administrator of the Health Resources and Services
Administration, shall carry out a program consisting of entering into
contracts with individuals under which--
``(1) the Secretary awards a scholarship under subsection
(b) or agrees to make loan repayments under subsection (c) with
respect to each individual; and
``(2) the individual agrees to serve for a period (in this
section referred to as the `period of obligated service') as a
physician engaged in--
``(A) sickle cell disease research; or
``(B) service in a public or private setting that
is primarily focused on treatment and education related
to sickle cell disease in a health care facility,
clinic, rural health clinic, mobile medical asset, or
other facility as determined by the Secretary.
``(b) Scholarships.--
``(1) Eligibility.--To be eligible to participate in the
scholarship program under this section, an individual shall--
``(A) be accepted for enrollment, or be enrolled,
as a full-time student in an accredited (as determined
by the Secretary) educational institution in a State
and in a course of study or program offered by such
institution and approved by the Secretary, leading to a
degree in medicine or osteopathic medicine;
``(B) submit an application to participate in the
scholarship program; and
``(C) sign and submit to the Secretary, at the time
of submittal of such application, a written contract
(described in paragraph (2)) to accept payment of a
scholarship and to serve (in accordance with this
section) for the applicable period of obligated
service.
``(2) Written contract.--The written contract under this
subsection between the Secretary and an individual shall
contain--
``(A) an agreement that--
``(i) subject to paragraph (1), the
Secretary agrees to provide the individual with
a scholarship in each such school year or years
for a period of years (not to exceed four
school years) determined by the individual,
during which period the individual is pursuing
a course of study described in paragraph
(1)(A); and
``(ii) subject to paragraph (1), the
individual agrees to--
``(I) accept provision of such a
scholarship to the individual;
``(II) maintain enrollment in a
course of study described in paragraph
(1)(A) until the individual completes
the course of study;
``(III) maintain an acceptable
level of academic standing;
``(IV) complete a residency in a
specialty that the Secretary determines
is consistent with pursuit of a
fellowship in hematology;
``(V) complete a fellowship in the
specialty of hematology; and
``(VI) serve for a time period
equal to one year for each school year
for which the individual was provided a
scholarship under this section;
``(B) a provision that any financial obligation of
the United States arising out of the contract and any
obligation of the individual which is conditioned
thereon, is contingent upon funds being appropriated
for scholarships under this section;
``(C) a statement of the damages to which the
United States is entitled if the individual should
breach the contract; and
``(D) such other statements of the rights and
liabilities of the Secretary and of the individual as
the Secretary determines appropriate, not inconsistent
with the provisions of this section.
``(c) Loan Repayments.--
``(1) Eligibility.--To be eligible to participate in the
loan repayment program under this section, an individual
shall--
``(A) have a degree in medicine or osteopathic
medicine; be enrolled in an approved graduate training
program in medicine or osteopathic medicine; or be
enrolled as a full-time student in an accredited (as
determined by the Secretary) educational institution in
a State, and in the final year of a course of study
offered by such institution and approved by the
Secretary, leading to a degree in medicine or
osteopathic medicine;
``(B) submit an application to participate in the
loan repayment program; and
``(C) sign and submit to the Secretary, at the time
of submittal of such application, a written contract
(described in paragraph (2)) to accept payment by the
Secretary of the educational loans of the individual in
consideration of the individual serving for a period of
obligated service.
``(2) Written contract.--The written contract under this
subsection between the Secretary and an individual shall
contain--
``(A) an agreement that--
``(i) subject to paragraph (1), the
Secretary agrees to pay on behalf of the
individual 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--
``(I) tuition expenses;
``(II) all other reasonable
educational expenses, including fees,
books, and laboratory expenses,
incurred by the individual; or
``(III) reasonable living expenses
as determined by the Secretary; and
``(ii) subject to paragraph (1), the
individual agrees to--
``(I) accept loan payments on
behalf of the individual;
``(II) maintain enrollment in a
course of study described in paragraph
(1)(A) (if applicable) until the
individual completes the course of
study;
``(III) maintain an acceptable
level of academic standing;
``(IV) complete a residency in a
specialty that the Secretary determines
is consistent with pursuit of a
fellowship in hematology; and
``(V) complete a fellowship in
hematology;
``(B) a provision that any financial obligation of
the United States arising out of the contract and any
obligation of the individual which is conditioned
thereon, is contingent upon funds being appropriated
for loan repayments under this section;
``(C) a statement of the damages to which the
United States is entitled if the individual should
breach the contract; and
``(D) such other statements of the rights and
liabilities of the Secretary and of the individual as
the Secretary determines appropriate, not inconsistent
with the provisions of this section.
``(d) Priority.--In awarding contracts under this section for
scholarships and loan repayments, the Secretary may prioritize making
awards to individuals from disadvantaged backgrounds.
``(e) Definition.--In this section, the term `sickle cell disease
research' means research into the detection, diagnosis, treatment, or
control of sickle cell disease.
``(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $150,000,000 for each of fiscal
years 2023 through 2028.
``SEC. 340J-1. COMMUNITY-BASED GRANTS TO ENGAGE THE SICKLE CELL DISEASE
POPULATION BY DESIGNING EDUCATION AND ADVOCACY PROGRAMS
AND POLICIES FOR HEALTH AND COMMUNITY SERVICES.
``(a) In General.--The Secretary shall carry out a program
consisting of awarding grants to eligible entities for the
establishment and support of education and advocacy programs that--
``(1) engage the sickle cell disease population, their
families, or State and local governments in order to--
``(A) improve sickle cell disease health literacy;
``(B) disseminate information on health and
community services related to sickle cell disease; or
``(C) improve the care and treatment decision-
making process related to sickle cell disease; and
``(2) may include education and advocacy regarding
fertility preservation and surrogacy options for individuals
with sickle cell disease.
``(b) Applications.--To seek a grant under subsection (a), an
eligible entity shall submit an application to the Secretary at such
time, in such manner, and containing such information and assurances as
the Secretary may require.
``(c) Consideration.--In determining whether to award a grant under
this section to an applicant, and the amount of a grant under this
section, the Secretary shall consider the need for sickle cell
education or services in the area to be served using the grant.
``(d) Definition.--In this section, the term `eligible entity'
means--
``(1) a community-based organization or faith-based
organization or clinic that provides services to, or engages
in, advocacy for individuals with sickle cell disease;
``(2) a nonprofit organization providing comprehensive care
to populations with sickle cell disease, including any such
nonprofit organization that is a faith-based organization or
community-based organization; or
``(3) a Federally qualified health center (as defined in
section 1861(aa) of the Social Security Act) or nonprofit
organization engaged in providing sickle cell disease
education, information, or treatment services.
``(e) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $50,000,000 for each of fiscal
years 2023 through 2028.
``SEC. 340J-2. GRANTS FOR SICKLE CELL DISEASE PEDIATRIC TO ADULT
TRANSITIONS OF CARE.
``(a) In General.--The Secretary shall carry out a program of
awarding grants to eligible entities for the establishment and support
of programs--
``(1) that--
``(A) provide transition support through a
dedicated transition coordinator and management of care
for sickle cell disease patients between the ages of 18
and 29 who are aging out of pediatric care and
receiving adult care for sickle cell disease;
``(B) assist sickle cell patients in identifying
and maintaining adult primary care providers and adult
specialists for sickle cell disease compatible with the
patient's health insurance; and
``(C) provide support services, including mental
health services, for the management of the patient's
treatments and medical appointments throughout the
transition to adult care; and
``(2) which, in the case of an eligible entity that is a
hospital or an institute of higher education, may include
providing training to adult sickle cell disease care
specialists on the medical needs of young sickle cell disease
patients, through--
``(A) 1- to 2-year long fellowships for any
individual that has completed a residency in medicine,
combined internal medicine and pediatrics, or family
medicine; or
``(B) short-term programs and workshops.
``(b) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall--
``(1) be a nonprofit organization providing comprehensive
care to populations with sickle cell disease, including a
hospital or an institute of higher education, and including any
such nonprofit organization that is a faith-based organization
or community-based organization; and
``(2) submit an application to the Secretary at such time,
in such manner, and containing such information and assurances
as the Secretary may require.
``(c) Consideration.--In determining whether to award a grant under
this section to an eligible entity, and the amount of a grant under
this section, the Secretary shall consider the size of the population
the eligible entity intends to serve.
``(d) Reports.--Eligible entities receiving a grant under this
section shall submit, during the grant period, an annual report to the
Secretary. Each such report shall--
``(1) use an established and recognized registry on
measuring quality metrics specified by the Secretary; and
``(2) include--
``(A) a description of the activities carried out
using the grant funds;
``(B) a summary of the health outcomes for sickle
cell patients benefitting from the transition
coordination and management program supported by the
grant; and
``(C) the number of specialists trained and
fellowships funded under the grant, as described in
subsection (a)(2), as applicable.
``(e) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $70,000,000 for each of fiscal
years 2023 through 2028.''.
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