Summary: S.1754 — 105th Congress (1997-1998)All Information (Except Text)

Bill summaries are authored by CRS.

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Passed House amended (10/13/1998)

TABLE OF CONTENTS:

Title I: Health Professions Education and Financial

Assistance Programs

Subtitle A: Health Professions Education Programs

Subtitle B: Nursing Workforce Development

Subtitle C: Financial Assistance

Title II: Office of Minority Health

Title III: Selected Initiatives

Title IV: Miscellaneous Provisions

Health Professions Education Partnerships Act of 1998 - Title I: Health Professions Education and Financial Assistance Programs - Subtitle A: Health Professions Education Programs - Amends the Public Health Service Act to replace provisions relating to the training of health personnel from disadvantaged backgrounds with provisions mandating grants and contracts for programs of excellence in health professions education for underrepresented minority individuals, including to develop large applicant pools, enhance academic performance, train, recruit, and retain faculty, improve resources and curricula, facilitate research, train students to provide health services to under-represented minority individuals, and provide stipends. Authorizes appropriations.

Authorizes grants to specified types of health professions schools for scholarships for students from disadvantaged backgrounds who have a financial need for a scholarship, with grant priority based on the proportion of graduates going into primary care, the proportion of underrepresented minority students, and the proportion of graduates working in medically underserved communities. Authorizes appropriations.

Mandates a program of contracts for educational loan repayment (for individuals from disadvantaged backgrounds) in return for service as faculty members at specified types of health professions schools. Authorizes appropriations.

Authorizes grants and contracts to increase the number of underrepresented minority faculty members. Authorizes appropriations.

Authorizes grants and contracts to assist individuals from disadvantaged backgrounds to undertake education to enter a health profession and for scholarships for health professions education. Authorizes appropriations.

Repeals provisions relating to obligated service regarding certain programs.

(Sec. 102) Repeals provisions relating to area health education center programs.

Modifies provisions relating to training in family medicine by adding: (1) references to internal medicine and general pediatrics; (2) provisions regarding the training of physician assistants; and (3) provisions regarding programs of general or pediatric dentistry. Authorizes appropriations.

Repeals provisions regarding: (1) training in internal medicine, general pediatrics, general dentistry, physician assistants, and podiatric medicine; and (2) traineeships, fellowships, and the amount of grants.

Establishes the Advisory Committee on Training in Primary Care Medicine and Dentistry.

(Sec. 103) Replaces provisions relating to training in certain health professions with provisions requiring that, in order to receive assistance under the amendments made by this section, an academic institution use the assistance in collaboration with two or more disciplines. Requires the recipient to carry out innovative demonstration projects for strategic workforce supplementation to meet national goals for interdisciplinary, community-based linkages.

Mandates grants and contracts for area health education center programs meeting certain objectives, including recruiting and training health professionals from and for underserved areas and underserved populations.

Requires that, in order to be eligible for funds under this paragraph, a health education training center be an entity otherwise eligible for funds under the paragraph immediately above and meet other specified requirements, including addressing persistent and severe unmet health care needs in States bordering the United States and Mexico, in Florida, and other areas. Requires that funding be made available.

Mandates grants and contracts for the establishment or operation of geriatric education centers.

Authorizes grants and contracts 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.

Mandates a program to provide Geriatric Academic Career Awards to promote the career development of individuals as academic geriatricians. Requires Award recipients to provide clinical geriatrics training.

Authorizes grants or contracts to help fund interdisciplinary training projects involving: (1) training health practitioners for rural areas; (2) demonstrating cost-effective comprehensive health care; (3) delivering rural health care; (4) enhancing rural health care research; and (5) recruiting and retaining practitioners from rural areas and making rural practice more attractive. Allows the use of student stipends, post-doctoral fellowships, faculty training, and the purchase or rental of transportation and telecommunication equipment.

Authorizes grants or contracts for: (1) expanding or establishing programs to increase the number of allied health professionals; (2) projects in preventive and primary care training for podiatric physicians in residency programs providing traineeships; and (3) demonstration projects involving collaboration between chiropractors and physicians to identify and provide effective treatment for spinal and lower back conditions.

Mandates establishment of the Advisory Committee on Interdisciplinary, Community-Based Linkages.

Authorizes appropriations to carry out this section.

(Sec. 104) Replaces provisions relating to special training projects with provisions authorizing grants or contracts for information collection, analysis, research, and the development of a non-Federal analytic and research infrastructure, all related to the health professions workforce, related issues, and future directions. Authorizes appropriations.

Amends the Health Professions Education Extension Amendments of 1992 to extend the dates for the final report and termination of the Council on Graduate Medical Education. Allows amounts otherwise appropriated under specified provisions to be used to support the Council's activities. Transfers the amended provisions to the Public Health Service Act.

(Sec. 105) Amends the Public Health Service Act to authorize grants or contracts: (1) to increase the public health workforce and enhance its quality and ability to meet health care needs; and (2) for the operation of public health training centers.

Authorizes grants for graduate or specialized training in public health, to assist in providing traineeships in health professions fields in which there is a severe shortage of health professionals.

Authorizes grants and contracts for residency programs in preventive medicine and dental public health and related financial assistance to residency trainees.

Authorizes grants for: (1) traineeships in health administration, hospital administration, or health policy analysis and planning; and (2) related preparation of students for employment with public or nonprofit private entities.

Authorizes appropriations to carry out this section.

(Sec. 106) Repeals or removes provisions of the Public Health Service Act relating to: (1) research on certain health professions issues; (2) chiropractic demonstration projects; (3) the submission of specified information in conjunction with applications for grants or contracts; and (4) the development and publication of certain statistics, the handling of certain personal data, and the submission of certain reports. Imposes new application requirements and lists permitted uses of funds. Requires competitive awarding of grants and contracts.

Adds professional counselors to the list of health professions personnel about whom information may be collected and analyzed.

(Sec. 107) Requires that programs that have graduated less than three classes be given funding priority if they meet certain criteria relating to serving underserved populations or underserved communities.

(Sec. 108) Adds references to behavioral health and to counseling to various generally applicable to health professions education provisions. Includes in the definition of "medically underserved community" an area or population designated by a State governor as a shortage area or medically underserved community. Modifies the definition of "program for the training of physician assistants." Defines "psychologist."

Subtitle B: Nursing Workforce Development - Nursing Education and Practice Improvement Act of 1998 - Replaces Public Health Service Act title VIII (Nurse Education) (except provisions relating to student loans, the loan repayment program, and sex discrimination) with a new title on nursing workforce development. Requires that grants and contracts be awarded competitively.

Authorizes grants and contracts to: (1) enhance advanced nursing education and practice and traineeships for individuals in advanced nursing education programs; (2) increase nursing education opportunities for individuals from disadvantaged backgrounds by providing scholarships or stipends, pre-entry preparation, and retention activities; and (3) strengthen capacity for basic nurse education and practice. Authorizes appropriations and regulates related allocations.

Establishes the National Advisory Council on Nurse Education and Practice.

Subtitle C: Financial Assistance - Chapter 1: School-Based Revolving Loan Funds - Modifies requirements: (1) schools must (in order to participate in the student loan program under specified provisions) meet regarding the percentages of graduates going into primary care; and (2) regarding student noncompliance with loan agreements. Removes a requirement for an annual report to specified congressional committees regarding administration of provisions relating to student loan funds in the context of medical schools and primary care.

(Sec. 132) Extends the authorization of appropriations for Federal capital contributions to student loan funds under provisions relating to students from disadvantaged backgrounds. Repeals the authorization effective October 1, 2002.

(Sec. 133) Allows loan repayment to be extended for up to ten years in specified circumstances. Increases minimum principal and interest payments. Prohibits, notwithstanding any other provisions of Federal or State law, any limit on the period within which a nursing school may seek repayment. Specifies the consequences (applicable if so provided in the agreement) imposed on default concerning an agreement to provide service in consideration for an award of Federal funds regarding nursing education.

(Sec. 134) Modifies provisions controlling the maximum limit on a loan made to a student for a school year. Allows repayment to be made over ten to 25 (currently, over ten) years, at the option of the institution. Increases minimum principal and interest payments. Prohibits, notwithstanding any other provisions of Federal or State law, any limit on the period within which a nursing school may seek repayment.

Sets a deadline for obligation of amounts from student loan funds under certain provisions that are returned to the Secretary by health professions schools.

Chapter 2: Insured Health Education Assistance Loans to Graduate Students - Authorizes loan payment deferral for up to three years while the borrower is providing health care services to Indians through an Indian health program.

Removes a requirement that the Office for Health Education Assistance Loan Default Reduction submit an annual report to specified congressional committees.

Limits the maximum annual dollar amount of a loan to a student in a graduate program in behavioral and mental health practice, including clinical psychology, and includes institutions offering such programs in the definition of "eligible institution."

(Sec. 142) Removes provisions mandating performance standards for lenders and holders of loans. Allows Federal payment of the loan after default, unless the lender, holder, or servicer has a compliance performance rating under 97 percent, in which case payment must be made at 98 percent of the loss.

(Sec. 144) Allows, notwithstanding any other provision of Federal or State law, an insured loan to be discharged in bankruptcy. (Current law allows such discharge, but makes no reference to other provisions of law.)

(Sec. 145) Prohibits construing specified provisions as prohibiting refinancing of a single loan.

Title II: Office of Minority Health - Modifies the duties of the Office of Minority Health. Establishes the Advisory Committee on Minority Health. Requires that grants, cooperative agreements, and contracts be awarded on a competitive basis. Authorizes appropriations for the Office. Authorizes appropriations for the National Center for Health Statistics, requiring it to collect data on Hispanics and American Indians and to develop special area population studies on major Asian American and Pacific Islander populations. Relocates the Office in the Office of Public Health and Science (currently, in the Office of the Assistant Secretary for Health).

Title III: Selected Initiatives - Amends provisions relating to grants to States for operation of offices of rural health to remove a requirement that non-Federal matching funds be in cash. Extends the authorization of appropriations. Increases the dollar appropriation level after which additional grants are prohibited.

(Sec. 302) Removes the minimum and maximum limits on the number of grants to States for certain programs concerning Alzheimer's disease or related disorders. Allows respite care under such programs to be provided to individuals living in single family homes or in congregate settings. Allows grant funds to be used to improve access to home-based or community-based long-term care services. Removes a grant duration limitation. Extends the authorization of appropriations.

(Sec. 303) Extends the authorization of appropriations for immunization program grants for no-charge immunizations for children, adolescents, and adults (currently, for individuals).

Title IV: Miscellaneous Provisions - Deems active service of Public Health Service commissioned officers to be active military service in the U.S. armed forces for purposes of all laws regarding discrimination on the basis of race and other specified factors. Authorizes leave without pay status for attendance at an educational institution or training program when it is in the best interest of the Service. Declares that provisions mandating confidentiality of certain substance abuse records do not apply to any interchange of records within the uniformed services (currently, within the armed forces).

(Sec. 403) Requires that a person who has received a clinical traineeship in counseling under specified provisions serve for specified periods.

(Sec. 404) Extends the authorization of appropriations for grants for screenings, referrals, and education regarding lead poisoning.

(Sec. 405) Extends the authorization of appropriations for grants for the prevention, control, and elimination of tuberculosis and related research, demonstration projects, public information, and health professional training. Authorizes the set-aside of a specified percentage (currently, a specified dollar amount) for areas with a substantial number of, or a substantial rate of increase in, cases.

(Sec. 406) Increases the dollar limit on educational loan repayments for health professionals who contract to conduct prevention activities as employees of the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry. Extends the authorization of appropriations for the repayment program and requires that amounts appropriated remain available until the end of the second fiscal year after they are appropriated.

(Sec. 407) Amends the Family Violence Prevention and Services Act to authorize appropriations to carry out provisions regarding grants for community projects to coordinate intervention and prevention of domestic violence. Provides for a study of the training needs of health professionals concerning the detection and referral of victims of family or acquaintance violence.

(Sec. 408) Amends the Public Health Service Act to extend the authorization of appropriations for grants for programs to increase the availability of primary health services in health professional shortage areas.

(Sec. 409) Authorizes the Director of the National Institutes of Health (NIH) to: (1) conduct and support research training for which fellowship support is not provided under National Research Service Awards provisions and that does not consist of residency training of health professionals; and (2) appoint health care professionals, subject to provisions of the U.S. Code relating to appointments and classifications in the competitive service.

(Sec. 410) Increases the dollar limit on educational loan repayments for health professionals under repayment programs relating to: (1) research on acquired immune deficiency syndrome (AIDS); (2) research on contraception and infertility; (3) research generally; and (4) clinical research by health professionals from disadvantaged backgrounds. Extends the authorization of appropriations for the loan repayment program relating to AIDS research.

(Sec. 411) Allows reservation of up to $2.5 million (currently, requires reservation of $5 million) for construction, renovation, or other improvement of regional centers for primate research.

(Sec. 412) Allows a grant or cooperative agreement (currently, a grant, cooperative agreement, or contract), the direct cost of which exceeds $50,000, to be made only if it is recommended after peer review and by the appropriate advisory council.

(Sec. 413) Extends the authorizations of appropriations to carry out specified provisions relating to trauma care and to health information and health promotion.

(Sec. 415) Limits grants for emergency medical services for children to three years with an optional fourth year (currently, to two years). Allows only three (currently, one) grant in a State per fiscal year. Extends the authorization of appropriations.

(Sec. 416) Amends the National Institutes of Health Revitalization Act of 1993 to remove provisions requiring that entities receiving funds under that Act comply with specified provisions of the Act popularly known as the Buy American Act.

(Sec. 417) Amends Public Health Service Act provisions relating to the determination of the amount of grants to States to improve the quality, availability, and organization of health care and support services for individuals and families with HIV disease to list the Virgin Islands and Guam with States. (Currently, they are listed with U.S. territories. Listing them with States changes which formula is used for determining the amount of grants to the Virgin Islands and Guam.)

(Sec. 418) Changes the name of the National Foundation for Biomedical Research to the Foundation for the National Institutes of Health. Authorizes the Foundation to transfer (currently, prohibits the Foundation from transferring) funds to NIH, requiring that any transferred funds be subject to all Federal limits on Federally-funded research. Increases and makes permanent the Foundation's authorization of appropriations.

(Sec. 419) Fetal Alcohol Syndrome and Fetal Alcohol Effect Prevention and Services Act - Establishes a comprehensive Fetal Alcohol Syndrome and Fetal Alcohol Effect prevention, intervention and services delivery program. Requires that the program include an education and public awareness program, a prevention and diagnosis program, and an applied research program. Authorizes related grants, cooperative agreements, contracts, and technical assistance. Mandates a procedure for disseminating diagnostic criteria. Establishes the National task force on Fetal Alcohol Syndrome and Fetal Alcohol Effect to foster coordination among governmental agencies, academic bodies, and community groups. Authorizes appropriations. Makes the provisions of this paragraph inapplicable seven years after all task force members have been appointed.