II 

117TH CONGRESS 

1ST SESSION S. 54 

To address health workforce shortages and disparities highlighted by the 

COVID–19 pandemic through additional funding for the National Health 

Service Corps and the Nurse Corps, and to establish a National Health 

Service Corps Emergency Service demonstration project. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 26, 2021 

Mr. DURBIN (for himself and Mr. RUBIO) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To address health workforce shortages and disparities highlighted by the COVID–19 pandemic through additional 

funding for the National Health Service Corps and the 

Nurse Corps, and to establish a National Health Service 

Corps Emergency Service demonstration project. 

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 ‘‘Strengthening Amer5 ica’s Health Care Readiness Act’’. 


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1 SEC. 2. ADDITIONAL FUNDING FOR THE NATIONAL HEALTH 

2 SERVICE CORPS. 

3 (a) ADDITIONAL FUNDING.—Section 10503(b) of the 

4 Patient Protection and Affordable Care Act (42 U.S.C. 

5 254b–2(b)) is amended— 

6 (1) in paragraph (1)(F), by striking ‘‘and’’ at 

7 the end; 

8 (2) in paragraph (2)(H), by striking the period 

9 and inserting ‘‘; and’’; and 

10 (3) by adding at the end the following: 

11 ‘‘(3) to be transferred to the Secretary of 

12 Health and Human Services $5,000,000,000 for fis13 cal year 2021, to provide additional funding to carry 

14 out the National Health Service Corps Scholarship 

15 Program under section 338A of the Public Health 

16 Service Act, the National Health Service Corps Loan 

17 Program under section 338B of such Act, and the 

18 National Health Service Corps Emergency Service 

19 under section 2812A of such Act.’’. 

20 (b) CRITERIA FOR USE OF ADDITIONAL FUNDING

21 FOR IN-DEMAND PROFESSIONALS.—Not less than 40 per22 cent of the amounts made available under paragraph (3) 

23 of section 10503(b) of the Patient Protection and Afford24 able Care Act (42 U.S.C. 254b–2(b)) (as amended by sub25 section (a)) shall be allocated to awards to eligible appli26 cants to the National Health Service Corps Scholarship 


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1 Program under section 338A of the Public Health Service 

2 Act (42 U.S.C. 254l), the National Health Service Corps 

3 Loan Repayment Program under section 338B of such 

4 Act (42 U.S.C. 254l–1), or the National Health Service 

5 Corps Emergency Service under section 2812A of such 

6 Act (as added by subsection (c)) who are members of 

7 groups that are historically underrepresented in health 

8 care professions, including racial and ethnic minorities 

9 and individuals from low-income urban and rural commu10 nities. To carry out the requirements of this subsection, 

11 the Secretary may coordinate with entities receiving fund12 ing under section 739 or 821 of the Public Health Service 

13 Act (42 U.S.C. 293c, 296m) to identify, provide 

14 mentorship and support, and recruit such eligible appli15 cants. 

16 (c) NATIONAL HEALTH SERVICE CORPS EMERGENCY

17 SERVICE DEMONSTRATION PROJECT.—Part B of title 

18 XXVIII of the Public Health Service Act is amended by 

19 inserting after section 2812 (42 U.S.C. 300hh–11) the fol20 lowing: 

21 ‘‘SEC. 2812A. NATIONAL HEALTH SERVICE CORPS EMER22 GENCY SERVICE DEMONSTRATION PROJECT. 

23 ‘‘(a) IN GENERAL.—For each of fiscal years 2022 

24 through 2026, from the amounts made available under 

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1 able Care Act, to the extent permitted by, and consistent 

2 with, the requirements of applicable State law, the Sec3 retary shall allocate up to $50,000,000 to establishing, as 

4 a demonstration project, a National Health Service Corps 

5 Emergency Service (referred to in this section as the 

6 ‘emergency service’) under which a qualified individual 

7 currently or previously participating in the National 

8 Health Service Corps agrees to engage in service through 

9 the National Disaster Medical System established under 

10 section 2812, as described in this section. 

11 ‘‘(b) PARTICIPANTS.— 

12 ‘‘(1) NHSC ALUMNI.— 

13 ‘‘(A) QUALIFIED INDIVIDUALS.—An indi14 vidual may be eligible to participate in the 

15 emergency service under this section if such in16 dividual participated in the Scholarship Pro17 gram under section 338A or the Loan Repay18 ment Program under section 338B, and who 

19 satisfied the obligated service requirements 

20 under such program, in accordance with the in21 dividual’s contract. 

22 ‘‘(B) PRIORITY AND INCREASED FUNDING

23 AMOUNTS.— 

24 ‘‘(i) PRIORITY.—In selecting eligible 

25 individuals to participate in the program 


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1 under this paragraph, the Secretary shall 

2 give priority— 

3 ‘‘(I) first, to qualified individuals 

4 who continue to practice at the site 

5 where the individual fulfilled his or 

6 her obligated service under the Schol7 arship Program or Loan Repayment 

8 Program through the time of the ap9 plication to the program under this 

10 section; and 

11 ‘‘(II) secondly, to qualified indi12 viduals who continue to practice in 

13 any site approved for obligated service 

14 under the Scholarship Program or 

15 Loan Repayment Program other than 

16 the site at which the individual served. 

17 ‘‘(ii) INCREASED FUNDING

18 AMOUNTS.—The Secretary may grant in19 creased award amounts to certain partici20 pants in the program under this section 

21 based on the site where a participant ful22 filled his or her obligated service under the 

23 Scholarship Program or Loan Repayment 

24 Program. 


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1 ‘‘(C) PRIVATE PRACTICE.—An individual 

2 participating in the emergency service under 

3 this section may practice a health profession in 

4 any private capacity when not obligated to ful5 fill the requirements described in subsection (c). 

6 ‘‘(2) CURRENT NHSC MEMBERS.— 

7 ‘‘(A) IN GENERAL.—An individual who is 

8 participating in the Scholarship Program under 

9 section 338A or the Loan Repayment Program 

10 under section 338B may apply to participate in 

11 the program under this section while fulfilling 

12 the individual’s obligated services under such 

13 program. 

14 ‘‘(B) CLARIFICATIONS.—Notwithstanding 

15 any other provision of law or any contract with 

16 respect to service requirements under the Schol17 arship Program or Loan Repayment Program, 

18 an individual fulfilling service requirements de19 scribed in subsection (c) shall not be considered 

20 in breach of such contract under such Scholar21 ship Program or Loan Repayment Program, 

22 provided that the individual give advance and 

23 reasonable notification to the site at which the 

24 individual is fulfilling his or her obligated serv25 ice requirements under such contract, and the 


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1 site approves the individual’s deployment 

2 through the National Disaster Medical System. 

3 ‘‘(C) NO CREDIT TOWARD OBLIGATED

4 SERVICE.—No period of service under the Na5 tional Disaster Medical System described in 

6 subsection (c)(1) shall be counted toward satis7 fying a period of obligated service under the 

8 Scholarship Program or Loan Repayment Pro9 gram. 

10 ‘‘(c) PARTICIPANTS AS MEMBERS OF THE NATIONAL

11 DISASTER MEDICAL SYSTEM.— 

12 ‘‘(1) SERVICE REQUIREMENTS.—An individual 

13 participating in the program under this section shall 

14 participate in the activities of the National Disaster 

15 Medical System under section 2812 in the same 

16 manner and to the same extent as other participants 

17 in such system. 

18 ‘‘(2) RIGHTS AND REQUIREMENTS.—An indi19 vidual participating in the program under this sec20 tion shall be considered participants in the National 

21 Disaster Medical System and shall be subject to the 

22 rights and requirements of subsections (c) and (d) of 

23 section 2812. 

24 ‘‘(d) EMERGENCY SERVICE PLAN.—In carrying out 

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1 ministrator of the Health Resources and Services Admin2 istration and the Assistant Secretary for Preparedness 

3 and Response, shall establish an action plan for the service 

4 commitments, deployment protocols, coordination efforts, 

5 training requirements, liability, workforce development, 

6 and such other considerations as the Secretary determines 

7 appropriate. Such action plan shall— 

8 ‘‘(1) ensure adherence to the missions of both 

9 the National Health Service Corps and National 

10 Disaster Medical Service; 

11 ‘‘(2) outline the type of providers determined by 

12 the Assistant Secretary to be priorities for participa13 tion in the program established under this section; 

14 ‘‘(3) describe how such deployments will be de15 termined and prioritized in a manner consistent 

16 with— 

17 ‘‘(A) the National Health Service Corps 

18 contracts; and 

19 ‘‘(B) the National Disaster Medical Sys20 tem’s deployment policy of not hindering civil21 ian responders already engaged in an emer22 gency response; 

23 ‘‘(4) ensure an adequate health care workforce 

24 during a public health emergency declared by the 

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1 aster declared by the President under section 401 of 

2 the Robert T. Stafford Disaster Relief and Emer3 gency Assistance Act, an emergency declared by the 

4 President under section 501 of the Robert T. Staf5 ford Disaster Relief and Emergency Assistance Act, 

6 or a national emergency declared by the President 

7 under the National Emergencies Act; and 

8 ‘‘(5) describe how the program established 

9 under this section will be implemented in a manner 

10 consistent with, and in furtherance of, the assess11 ments and goals for workforce and training de12 scribed in the review conducted by the Secretary 

13 under section 2812(b)(2). 

14 ‘‘(e) CONTRACTS FOR CERTAIN PARTICIPATING INDI15 VIDUALS.—An individual who is participating in the emer16 gency service program under this section shall receive loan 

17 repayments in an amount up to 50 percent (as determined 

18 by the Secretary) of the highest new award made for the 

19 year under the National Health Service Corps Loan Re20 payment Program pursuant to a contract entered into at 

21 the same time under section 338B(g), in a manner similar 

22 to the manner in which payments are made under such 

23 section, pursuant to the terms of a contract between the 

24 Secretary and such individual. The Secretary shall estab25 lish a system of contracting for purposes of this subsection 


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1 which shall be similar to the contract requirements and 

2 terms under subsections (c), (d), and (f) of section 338B. 

3 Amounts received by an individual under this subsection 

4 shall be in addition to any amounts received by an indi5 vidual described in subsection (b)(2) pursuant to the 

6 Scholarship Program under section 338A or the Loan Re7 payment Program under section 338B, as applicable. 

8 ‘‘(f) BREACH OF CONTRACT, TERMINATION, WAIVER, 

9 AND SUSPENSION.— 

10 ‘‘(1) RECOVERY OF AMOUNTS IN THE EVENT

11 OF A BREACH.—If an individual breaches the written 

12 contract of the individual under subsection (e) by 

13 failing either to begin such individual’s service obli14 gation in accordance with such contract or to com15 plete such service obligation, the United States shall 

16 be entitled to recover from the individual an amount 

17 equal to the sum of— 

18 ‘‘(A) the total of the amounts paid by the 

19 United States under such contract on behalf of 

20 the individual for any period of such service not 

21 served; 

22 ‘‘(B) an amount equal to the product of 

23 the number of months of service that were not 

24 completed by the individual, multiplied by 

25 $3,750; and 


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1 ‘‘(C) the interest on the amounts described 

2 in subparagraphs (A) and (B), at the maximum 

3 legal prevailing rate, as determined by the 

4 Treasurer of the United States, from the date 

5 of the breach. 

6 ‘‘(2) TERMINATION OF CONTRACT.—The Sec7 retary may terminate a contract under subsection 

8 (e) in accordance with the termination standards 

9 that are— 

10 ‘‘(A) applicable to contracts entered into 

11 under section 338B; and 

12 ‘‘(B) in effect in the fiscal year in which 

13 such contract was entered. 

14 ‘‘(3) WAIVER OR SUSPENSION OF OBLIGA15 TION.—If an individual participating in the program 

16 under this section submits a written request to the 

17 Secretary, the Secretary may waive or suspend a 

18 service or payment obligation arising under this sub19 section or a contract under subsection (e), in whole 

20 or in part, in accordance with the standards set 

21 forth in section 62.12 of title 42, Code of Federal 

22 Regulations (or any successor regulations). 

23 ‘‘(g) REPORT.—Not later than 4 years after the date 

24 of enactment of this section, the Secretary shall submit 

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1 sions of the Senate and the Committee on Energy and 

2 Commerce of the House of Representatives a report that 

3 evaluates the demonstration project established under this 

4 section, including— 

5 ‘‘(1) the effects of such program on health care 

6 access in underserved areas and health professional 

7 shortage areas and on public health emergency re8 sponse capacity; 

9 ‘‘(2) the effects of such program on the health 

10 care provider workforce pipeline, including any im11 pact on the demographic representation among, and 

12 the fields or specialties pursued by, students in ap13 proved graduate training programs in medicine, os14 teopathic medicine, dentistry, behavioral and mental 

15 health, or other health profession; 

16 ‘‘(3) the impact of such program on the enroll17 ment, participation, and completion of requirements 

18 in the underlying scholarship and loan repayment 

19 programs of the National Health Service Corps; 

20 ‘‘(4) the effects of such program on the Na21 tional Disaster Medical System’s response capability, 

22 readiness, and workforce strength; and 

23 ‘‘(5) recommendations for improving the dem24 onstration project described in this section, and any 


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1 other considerations as the Secretary determines ap2 propriate.’’. 

3 SEC. 3. FUNDING FOR THE NURSE CORPS SCHOLARSHIP 

4 AND LOAN REPAYMENT PROGRAM. 

5 There are hereby appropriated, out of amounts in the 

6 Treasury not otherwise appropriated, $1,000,000,000 for 

7 fiscal year 2021, for purposes of carrying out section 846 

8 of the Public Health Service Act (42 U.S.C. 297n), to re9 main available until expended, except that— 

10 (1) of the amount appropriated under this 

11 heading and made available for scholarships and 

12 loan repayment, not less than 40 percent shall be al13 located for eligible applicants who are members of 

14 groups that are historically underrepresented in 

15 health care professions, including racial and ethnic 

16 minorities and individuals from low-income urban 

17 and rural communities; and 

18 (2) to carry out the requirements of paragraph 

19 (1), the Secretary may coordinate with entities re20 ceiving funding under section 821 to identify, re21 cruit, and select individuals to receive such scholar22 ships. 

Æ 


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