II 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Sickle Cell Care Ex5 pansion Act of 2022’’. 


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1 SEC. 2. ADVANCING TREATMENT AND RESEARCH PER2 TAINING TO SICKLE CELL DISEASE. 

3 Part D of title III of the Public Health Service Act 

4 (42 U.S.C. 254b et seq.) is amended by adding at the end 

5 the following: 

6 ‘‘Subpart XIII—Advancing Treatment and Research 

7 Pertaining to Sickle Cell Disease 

8 ‘‘SEC. 340J. SCHOLARSHIP AND LOAN REPAYMENT PRO9 GRAM. 

10 ‘‘(a) IN GENERAL.—To advance learning regarding 

11 sickle cell disease and to enhance the supply of physicians 

12 to treat such disease, especially with respect to adult popu13 lations, the Secretary, acting through the Administrator 

14 of the Health Resources and Services Administration, 

15 shall carry out a program consisting of entering into con16 tracts with individuals under which— 

17 ‘‘(1) the Secretary awards a scholarship under 

18 subsection (b) or agrees to make loan repayments 

19 under subsection (c) with respect to each individual; 

20 and 

21 ‘‘(2) the individual agrees to serve for a period 

22 (in this section referred to as the ‘period of obligated 

23 service’) as a physician engaged in— 

24 ‘‘(A) sickle cell disease research; or 

25 ‘‘(B) service in a public or private setting 

26 that is primarily focused on treatment and eduVerDate Sep 11 2014 21:46 Jun 20, 2022 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4425.IS S4425

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1 cation related to sickle cell disease in a health 

2 care facility, clinic, rural health clinic, mobile 

3 medical asset, or other facility as determined by 

4 the Secretary. 

5 ‘‘(b) SCHOLARSHIPS.— 

6 ‘‘(1) ELIGIBILITY.—To be eligible to participate 

7 in the scholarship program under this section, an in8 dividual shall— 

9 ‘‘(A) be accepted for enrollment, or be en10 rolled, as a full-time student in an accredited 

11 (as determined by the Secretary) educational 

12 institution in a State and in a course of study 

13 or program offered by such institution and ap14 proved by the Secretary, leading to a degree in 

15 medicine or osteopathic medicine; 

16 ‘‘(B) submit an application to participate 

17 in the scholarship program; and 

18 ‘‘(C) sign and submit to the Secretary, at 

19 the time of submittal of such application, a 

20 written contract (described in paragraph (2)) to 

21 accept payment of a scholarship and to serve 

22 (in accordance with this section) for the appli23 cable period of obligated service. 


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1 ‘‘(2) WRITTEN CONTRACT.—The written con2 tract under this subsection between the Secretary 

3 and an individual shall contain— 

4 ‘‘(A) an agreement that— 

5 ‘‘(i) subject to paragraph (1), the Sec6 retary agrees to provide the individual with 

7 a scholarship in each such school year or 

8 years for a period of years (not to exceed 

9 four school years) determined by the indi10 vidual, during which period the individual 

11 is pursuing a course of study described in 

12 paragraph (1)(A); and 

13 ‘‘(ii) subject to paragraph (1), the in14 dividual agrees to— 

15 ‘‘(I) accept provision of such a 

16 scholarship to the individual; 

17 ‘‘(II) maintain enrollment in a 

18 course of study described in para19 graph (1)(A) until the individual com20 pletes the course of study; 

21 ‘‘(III) maintain an acceptable 

22 level of academic standing; 

23 ‘‘(IV) complete a residency in a 

24 specialty that the Secretary deterVerDate Sep 11 2014 21:46 Jun 20, 2022 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4425.IS S4425

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1 mines is consistent with pursuit of a 

2 fellowship in hematology; 

3 ‘‘(V) complete a fellowship in the 

4 specialty of hematology; and 

5 ‘‘(VI) serve for a time period 

6 equal to one year for each school year 

7 for which the individual was provided 

8 a scholarship under this section; 

9 ‘‘(B) a provision that any financial obliga10 tion of the United States arising out of the con11 tract and any obligation of the individual which 

12 is conditioned thereon, is contingent upon funds 

13 being appropriated for scholarships under this 

14 section; 

15 ‘‘(C) a statement of the damages to which 

16 the United States is entitled if the individual 

17 should breach the contract; and 

18 ‘‘(D) such other statements of the rights 

19 and liabilities of the Secretary and of the indi20 vidual as the Secretary determines appropriate, 

21 not inconsistent with the provisions of this sec22 tion. 

23 ‘‘(c) LOAN REPAYMENTS.— 


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1 ‘‘(1) ELIGIBILITY.—To be eligible to participate 

2 in the loan repayment program under this section, 

3 an individual shall— 

4 ‘‘(A) have a degree in medicine or osteo5 pathic medicine; be enrolled in an approved 

6 graduate training program in medicine or osteo7 pathic medicine; or be enrolled as a full-time 

8 student in an accredited (as determined by the 

9 Secretary) educational institution in a State, 

10 and in the final year of a course of study of11 fered by such institution and approved by the 

12 Secretary, leading to a degree in medicine or 

13 osteopathic medicine; 

14 ‘‘(B) submit an application to participate 

15 in the loan repayment program; and 

16 ‘‘(C) sign and submit to the Secretary, at 

17 the time of submittal of such application, a 

18 written contract (described in paragraph (2)) to 

19 accept payment by the Secretary of the edu20 cational loans of the individual in consideration 

21 of the individual serving for a period of obli22 gated service. 

23 ‘‘(2) WRITTEN CONTRACT.—The written con24 tract under this subsection between the Secretary 

25 and an individual shall contain— 


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1 ‘‘(A) an agreement that— 

2 ‘‘(i) subject to paragraph (1), the Sec3 retary agrees to pay on behalf of the indi4 vidual the principal, interest, and related 

5 expenses on government and commercial 

6 loans received by the individual regarding 

7 the undergraduate or graduate education 

8 of the individual (or both), which loans 

9 were made for— 

10 ‘‘(I) tuition expenses; 

11 ‘‘(II) all other reasonable edu12 cational expenses, including fees, 

13 books, and laboratory expenses, in14 curred by the individual; or 

15 ‘‘(III) reasonable living expenses 

16 as determined by the Secretary; and 

17 ‘‘(ii) subject to paragraph (1), the in18 dividual agrees to— 

19 ‘‘(I) accept loan payments on be20 half of the individual; 

21 ‘‘(II) maintain enrollment in a 

22 course of study described in para23 graph (1)(A) (if applicable) until the 

24 individual completes the course of 

25 study; 


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1 ‘‘(III) maintain an acceptable 

2 level of academic standing; 

3 ‘‘(IV) complete a residency in a 

4 specialty that the Secretary deter5 mines is consistent with pursuit of a 

6 fellowship in hematology; and 

7 ‘‘(V) complete a fellowship in he8 matology; 

9 ‘‘(B) a provision that any financial obliga10 tion of the United States arising out of the con11 tract and any obligation of the individual which 

12 is conditioned thereon, is contingent upon funds 

13 being appropriated for loan repayments under 

14 this section; 

15 ‘‘(C) a statement of the damages to which 

16 the United States is entitled if the individual 

17 should breach the contract; and 

18 ‘‘(D) such other statements of the rights 

19 and liabilities of the Secretary and of the indi20 vidual as the Secretary determines appropriate, 

21 not inconsistent with the provisions of this sec22 tion. 

23 ‘‘(d) PRIORITY.—In awarding contracts under this 

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1 retary may prioritize making awards to individuals from 

2 disadvantaged backgrounds. 

3 ‘‘(e) DEFINITION.—In this section, the term ‘sickle 

4 cell disease research’ means research into the detection, 

5 diagnosis, treatment, or control of sickle cell disease. 

6 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

7 carry out this section, there is authorized to be appro8 priated $150,000,000 for each of fiscal years 2023 

9 through 2028. 

10 ‘‘SEC. 340J–1. COMMUNITY-BASED GRANTS TO ENGAGE THE 

11 SICKLE CELL DISEASE POPULATION BY DE12 SIGNING EDUCATION AND ADVOCACY PRO13 GRAMS AND POLICIES FOR HEALTH AND 

14 COMMUNITY SERVICES. 

15 ‘‘(a) IN GENERAL.—The Secretary shall carry out a 

16 program consisting of awarding grants to eligible entities 

17 for the establishment and support of education and advo18 cacy programs that— 

19 ‘‘(1) engage the sickle cell disease population, 

20 their families, or State and local governments in 

21 order to— 

22 ‘‘(A) improve sickle cell disease health lit23 eracy; 


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1 ‘‘(B) disseminate information on health 

2 and community services related to sickle cell 

3 disease; or 

4 ‘‘(C) improve the care and treatment deci5 sion-making process related to sickle cell dis6 ease; and 

7 ‘‘(2) may include education and advocacy re8 garding fertility preservation and surrogacy options 

9 for individuals with sickle cell disease. 

10 ‘‘(b) APPLICATIONS.—To seek a grant under sub11 section (a), an eligible entity shall submit an application 

12 to the Secretary at such time, in such manner, and con13 taining such information and assurances as the Secretary 

14 may require. 

15 ‘‘(c) CONSIDERATION.—In determining whether to 

16 award a grant under this section to an applicant, and the 

17 amount of a grant under this section, the Secretary shall 

18 consider the need for sickle cell education or services in 

19 the area to be served using the grant. 

20 ‘‘(d) DEFINITION.—In this section, the term ‘eligible 

21 entity’ means— 

22 ‘‘(1) a community-based organization or faith23 based organization or clinic that provides services to, 

24 or engages in, advocacy for individuals with sickle 

25 cell disease; 


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1 ‘‘(2) a nonprofit organization providing com2 prehensive care to populations with sickle cell dis3 ease, including any such nonprofit organization that 

4 is a faith-based organization or community-based or5 ganization; or 

6 ‘‘(3) a Federally qualified health center (as de7 fined in section 1861(aa) of the Social Security Act) 

8 or nonprofit organization engaged in providing sickle 

9 cell disease education, information, or treatment 

10 services. 

11 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

12 carry out this section, there is authorized to be appro13 priated $50,000,000 for each of fiscal years 2023 through 

14 2028. 

15 ‘‘SEC. 340J–2. GRANTS FOR SICKLE CELL DISEASE PEDI16 ATRIC TO ADULT TRANSITIONS OF CARE. 

17 ‘‘(a) IN GENERAL.—The Secretary shall carry out a 

18 program of awarding grants to eligible entities for the es19 tablishment and support of programs— 

20 ‘‘(1) that— 

21 ‘‘(A) provide transition support through a 

22 dedicated transition coordinator and manage23 ment of care for sickle cell disease patients be24 tween the ages of 18 and 29 who are aging out 


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1 of pediatric care and receiving adult care for 

2 sickle cell disease; 

3 ‘‘(B) assist sickle cell patients in identi4 fying and maintaining adult primary care pro5 viders and adult specialists for sickle cell dis6 ease compatible with the patient’s health insur7 ance; and 

8 ‘‘(C) provide support services, including 

9 mental health services, for the management of 

10 the patient’s treatments and medical appoint11 ments throughout the transition to adult care; 

12 and 

13 ‘‘(2) which, in the case of an eligible entity that 

14 is a hospital or an institute of higher education, may 

15 include providing training to adult sickle cell disease 

16 care specialists on the medical needs of young sickle 

17 cell disease patients, through— 

18 ‘‘(A) 1- to 2-year long fellowships for any 

19 individual that has completed a residency in 

20 medicine, combined internal medicine and pedi21 atrics, or family medicine; or 

22 ‘‘(B) short-term programs and workshops. 

23 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 

24 a grant under this section, an entity shall— 


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1 ‘‘(1) be a nonprofit organization providing com2 prehensive care to populations with sickle cell dis3 ease, including a hospital or an institute of higher 

4 education, and including any such nonprofit organi5 zation that is a faith-based organization or commu6 nity-based organization; and 

7 ‘‘(2) submit an application to the Secretary at 

8 such time, in such manner, and containing such in9 formation and assurances as the Secretary may re10 quire. 

11 ‘‘(c) CONSIDERATION.—In determining whether to 

12 award a grant under this section to an eligible entity, and 

13 the amount of a grant under this section, the Secretary 

14 shall consider the size of the population the eligible entity 

15 intends to serve. 

16 ‘‘(d) REPORTS.—Eligible entities receiving a grant 

17 under this section shall submit, during the grant period, 

18 an annual report to the Secretary. Each such report 

19 shall— 

20 ‘‘(1) use an established and recognized registry 

21 on measuring quality metrics specified by the Sec22 retary; and 

23 ‘‘(2) include— 

24 ‘‘(A) a description of the activities carried 

25 out using the grant funds; 


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1 ‘‘(B) a summary of the health outcomes 

2 for sickle cell patients benefitting from the 

3 transition coordination and management pro4 gram supported by the grant; and 

5 ‘‘(C) the number of specialists trained and 

6 fellowships funded under the grant, as de7 scribed in subsection (a)(2), as applicable. 

8 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

9 carry out this section, there is authorized to be appro10 priated $70,000,000 for each of fiscal years 2023 through 

11 2028.’’. 

Æ 


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