II 

116TH CONGRESS 

2D SESSION S. 4055 

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 

JUNE 24, 2020 

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 2020, 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.—From the amounts made avail24 able under section 10503(b)(3) of the Patient Protection 

25 and Affordable Care Act for each of fiscal years 2021 


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1 through 2025, 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 notifies the site at 

23 which the individual is fulfilling his or her obli24 gated service requirements under such contract. 


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1 ‘‘(C) NO CREDIT TOWARD OBLIGATED

2 SERVICE.—No period of service under the Na3 tional Disaster Medical System described in 

4 subsection (c)(1) shall be counted toward satis5 fying a period of obligated service under the 

6 Scholarship Program or Loan Repayment Pro7 gram. 

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

9 DISASTER MEDICAL SYSTEM.— 

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

11 participating in the program under this section shall 

12 participate in the activities of the National Disaster 

13 Medical System under section 2812 in the same 

14 manner and to the same extent as other participants 

15 in such system. 

16 ‘‘(2) RIGHTS AND REQUIREMENTS.—An indi17 vidual participating in the program under this sec18 tion shall be considered participants in the National 

19 Disaster Medical System and shall be subject to the 

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

21 section 2812. 

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

23 this section, the Secretary, in coordination with the Ad24 ministrator of the Health Resources and Services Admin25 istration and the Assistant Secretary for Preparedness 


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

2 commitments, deployment protocols, coordination efforts, 

3 training requirements, liability, workforce development, 

4 and such other considerations as the Secretary determines 

5 appropriate. Such action plan shall— 

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

7 the National Health Service Corps and National 

8 Disaster Medical Service; 

9 ‘‘(2) ensure an adequate health care workforce 

10 during a public health emergency declared by the 

11 Secretary under section 319 of this Act, a major dis12 aster declared by the President under section 401 of 

13 the Robert T. Stafford Disaster Relief and Emer14 gency Assistance Act, an emergency declared by the 

15 President under section 501 of the Robert T. Staf16 ford Disaster Relief and Emergency Assistance Act, 

17 or a national emergency declared by the President 

18 under the National Emergencies Act; and 

19 ‘‘(3) describe how the program established 

20 under this section will be implemented in a manner 

21 consistent with, and in furtherance of, the assess22 ments and goals for workforce and training de23 scribed in the review conducted by the Secretary 

24 under section 2812(b)(2). 


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1 ‘‘(e) CONTRACTS FOR CERTAIN PARTICIPATING INDI2 VIDUALS.—An individual who is participating in the emer3 gency service program under this section shall receive loan 

4 repayments in an amount equal to 50 percent of the high5 est new award made for the year under the National 

6 Health Service Corps Loan Repayment Program pursuant 

7 to a contract entered into at the same time under section 

8 338B(g), in a manner similar to the manner in which pay9 ments are made under such section, pursuant to the terms 

10 of a contract between the Secretary and such individual. 

11 The Secretary shall establish a system of contracting for 

12 purposes of this subsection which shall be similar to the 

13 contract requirements and terms under subsections (c), 

14 (d), and (f) of section 338B. Amounts received by an indi15 vidual under this subsection shall be in addition to any 

16 amounts received by an individual described in subsection 

17 (b)(2) pursuant to the Scholarship Program under section 

18 338A or the Loan Repayment Program under section 

19 338B, as applicable. 

20 ‘‘(f) BREACH OF CONTRACT.—If an individual 

21 breaches the written contract of the individual under sub22 section (e) by failing either to begin such individual’s serv23 ice obligation in accordance with such contract or to com24 plete such service obligation, the United States shall be 


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1 entitled to recover from the individual an amount equal 

2 to the sum of— 

3 ‘‘(1) the total of the amounts paid by the 

4 United States under such contract on behalf of the 

5 individual for any period of such service not served; 

6 ‘‘(2) an amount equal to the product of the 

7 number of months of service that were not com8 pleted by the individual, multiplied by $3,750; and 

9 ‘‘(3) the interest on the amounts described in 

10 paragraphs (1) and (2), at the maximum legal pre11 vailing rate, as determined by the Treasurer of the 

12 United States, from the date of the breach. 

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

14 of enactment of this section, the Secretary shall submit 

15 to the Committee on Health, Education, Labor, and Pen16 sions of the Senate and the Committee on Energy and 

17 Commerce of the House of Representatives a report that 

18 evaluates the demonstration project established under this 

19 section, including— 

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

21 access in underserved areas and health professional 

22 shortage areas and on public health emergency re23 sponse capacity; 

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

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1 pact on the demographic representation among, and 

2 the fields or specialties pursued by, students in ap3 proved graduate training programs in medicine, os4 teopathic medicine, dentistry, behavioral and mental 

5 health, or other health profession; 

6 ‘‘(3) the impact of such program on the enroll7 ment, participation, and completion of requirements 

8 in the underlying scholarship and loan repayment 

9 programs of the National Health Service Corps; 

10 ‘‘(4) the effects of such program on the Na11 tional Disaster Medical System’s response capability, 

12 readiness, and workforce strength; and 

13 ‘‘(5) recommendations for improving the dem14 onstration project described in this section, and any 

15 other considerations as the Secretary determines ap16 propriate.’’. 

17 SEC. 3. FUNDING FOR THE NURSE CORPS SCHOLARSHIP 

18 AND LOAN REPAYMENT PROGRAM. 

19 (a) FUNDING.—There are hereby appropriated, out 

20 of amounts in the Treasury not otherwise appropriated, 

21 $1,000,000,000 for fiscal year 2020, for purposes of car22 rying out section 846 of the Public Health Service Act 

23 (42 U.S.C. 297n), to remain available until expended, ex24 cept that— 


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1 (1) of the amount appropriated under this 

2 heading and made available for scholarships and 

3 loan repayment, not less than 40 percent shall be al4 located for eligible applicants who are members of 

5 groups that are historically underrepresented in 

6 health care professions, including racial and ethnic 

7 minorities and individuals from low-income urban 

8 and rural communities; and 

9 (2) to carry out the requirements of paragraph 

10 (1), the Secretary may coordinate with entities re11 ceiving funding under section 821 to identify, re12 cruit, and select individuals to receive such scholar13 ships. 

14 (b) EMERGENCY DESIGNATION.— 

15 (1) IN GENERAL.—The amounts provided by 

16 this section are designated as an emergency require17 ment pursuant to section 4(g) of the Statutory Pay18 As-You-Go Act of 2010 (2 U.S.C. 933(g)). 

19 (2) DESIGNATION IN SENATE.—In the Senate, 

20 this section is designated as an emergency require21 ment pursuant to section 4112(a) of H. Con. Res. 

22 71 (115th Congress), the concurrent resolution on 

23 the budget for fiscal year 2018. 

Æ 


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