II 

Calendar No. 553 

118TH CONGRESS 

2D SESSION S. 3022 

[Report No. 118–240] 

To amend the Indian Health Care Improvement Act to allow Indian Health 

Service scholarship and loan recipients to fulfill service obligations 

through half-time clinical practice, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 4, 2023 

Ms. CORTEZ MASTO (for herself and Mr. MULLIN) introduced the following 

bill; which was read twice and referred to the Committee on Indian Affairs 

NOVEMBER 12, 2024 

Reported by Mr. SCHATZ, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To amend the Indian Health Care Improvement Act to allow 

Indian Health Service scholarship and loan recipients 

to fulfill service obligations through half-time clinical 

practice, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘IHS Workforce Parity 

3 Act of 2023’’. 

4 SEC. 2. INDIAN HEALTH SERVICE SCHOLARSHIP AND LOAN 

5 RECIPIENTS. 

6 (a) INDIAN HEALTH PROFESSIONS SCHOLAR7 SHIPS.—Section 104(b)(3) of the Indian Health Care Im8 provement Act (25 U.S.C. 1613a(b)(3)) is amended by 

9 striking the paragraph designation and all that follows 

10 through the end of subparagraph (A) and inserting the 

11 following: 

12 ‘‘(3)(A) The active duty service obligation under a 

13 written contract with the Secretary under section 338A 

14 of the Public Health Service Act (42 U.S.C. 254l) that 

15 an individual has entered into under that section shall, 

16 if that individual is a recipient of an Indian Health Schol17 arship— 

18 ‘‘(i) be met by full-time (as defined in section 

19 331(j) of the Public Health Service Act (42 U.S.C. 

20 254d(j))) practice— 

21 ‘‘(I) in the Service; 

22 ‘‘(II) in a program conducted under a con23 tract entered into under the Indian Self-Deter24 mination and Education Assistance Act (25 

25 U.S.C. 5301 et seq.); 


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1 ‘‘(III) in a program assisted under title V; 

2 or 

3 ‘‘(IV) in the private practice of the applica4 ble profession if, as determined by the Sec5 retary, in accordance with guidelines issued by 

6 the Secretary, the practice— 

7 ‘‘(aa) is situated in a physician or 

8 other health professional shortage area; 

9 and 

10 ‘‘(bb) addresses the health care needs 

11 of a substantial number of Indians; or 

12 ‘‘(ii) be met by half-time (as defined in section 

13 331(j) of the Public Health Service Act (42 U.S.C. 

14 254d(j))) practice in a program described in any of 

15 subclauses (I) through (IV) of clause (i) if the indi16 vidual agrees, in writing— 

17 ‘‘(I) to double the period of obligated serv18 ice that would otherwise be required; or 

19 ‘‘(II) accept a minimum service obligation 

20 of 2 years with an award amount equal to 50 

21 percent of the amount that would otherwise be 

22 payable for full-time (as so defined) service.’’. 

23 (b) INDIAN HEALTH SERVICE LOAN REPAYMENT

24 PROGRAM.—Section 108(f)(1)(B) of the Indian Health 

25 Care Improvement Act (25 U.S.C. 1616a(f)(1)(B)) is 


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1 amended by striking clause (iii) and inserting the fol2 lowing: 

3 ‘‘(iii) to serve for a period of time (re4 ferred to in this section as the ‘period of 

5 obligated service’) equal to— 

6 ‘‘(I) 2 years, or a longer period 

7 of time as the individual may agree to 

8 serve, in the full-time (as defined in 

9 section 331(j) of the Public Health 

10 Service Act (42 U.S.C. 254d(j))) clin11 ical practice of the profession of the 

12 individual in an Indian health pro13 gram to which the individual may be 

14 assigned by the Secretary; or 

15 ‘‘(II)(aa) 4 years, or a longer pe16 riod of time as the individual may 

17 agree to serve, in the half-time (as de18 fined in that section) clinical practice 

19 of the profession of the individual in 

20 an Indian health program to which 

21 the individual may be assigned by the 

22 Secretary; or 

23 ‘‘(bb) not less than 2 years in the 

24 half-time (as so defined) clinical prac25 tice of the profession of the individual 


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1 in an Indian health program to which 

2 the individual may be assigned by the 

3 Secretary with a loan payment 

4 amount equal to 50 percent of the 

5 amount that would otherwise be pay6 able for full-time (as so defined) serv7 ice;’’. 

8 SECTION 1. SHORT TITLE. 

9 This Act may be cited as the ‘‘IHS Workforce Parity 

10 Act of 2024’’. 

11 SEC. 2. INDIAN HEALTH SERVICE SCHOLARSHIP AND LOAN 

12 RECIPIENTS. 

13 (a) INDIAN HEALTH PROFESSIONS SCHOLARSHIPS.— 

14 Section 104(b)(3) of the Indian Health Care Improvement 

15 Act (25 U.S.C. 1613a(b)(3)) is amended by striking the 

16 paragraph designation and all that follows through the end 

17 of subparagraph (A) and inserting the following: 

18 ‘‘(3)(A) The active duty service obligation under a 

19 written contract with the Secretary under section 338A of 

20 the Public Health Service Act (42 U.S.C. 254l) that an in21 dividual has entered into under that section shall, if that 

22 individual is a recipient of an Indian Health Scholar23 ship— 


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1 ‘‘(i) be met by full-time (as defined in section 

2 331(j) of the Public Health Service Act (42 U.S.C. 

3 254d(j))) practice— 

4 ‘‘(I) in the Service; 

5 ‘‘(II) in a program conducted under a con6 tract entered into under the Indian Self-Deter7 mination and Education Assistance Act (25 

8 U.S.C. 5301 et seq.); 

9 ‘‘(III) in a program assisted under title V; 

10 or 

11 ‘‘(IV) in the private practice of the applica12 ble profession if, as determined by the Secretary, 

13 in accordance with guidelines issued by the Sec14 retary, the practice— 

15 ‘‘(aa) is situated in a physician or 

16 other health professional shortage area; and 

17 ‘‘(bb) addresses the health care needs of 

18 a substantial number of Indians; or 

19 ‘‘(ii) be met by half-time (as defined in section 

20 331(j) of the Public Health Service Act (42 U.S.C. 

21 254d(j))) practice in a program described in any of 

22 subclauses (I) through (IV) of clause (i) if the indi23 vidual agrees, in writing— 

24 ‘‘(I) to double the period of obligated service 

25 that would otherwise be required if the indiVerDate Sep 11 2014 00:11 Nov 13, 2024 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6203 E:\BILLS\S3022.RS S3022

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1 vidual were satisfying the period of obligated 

2 service through full-time (as so defined) practice; 

3 and 

4 ‘‘(II) that if the individual fails to begin or 

5 complete the period of obligated service described 

6 in subclause (I), the procedures described in sec7 tion 108(l)(2) for determining damages for 

8 breach of contract will be used after converting 

9 that period of obligated service or service per10 formed into its full-time equivalent.’’. 

11 (b) INDIAN HEALTH SERVICE LOAN REPAYMENT PRO12 GRAM.—Section 108 of the Indian Health Care Improve13 ment Act (25 U.S.C. 1616a) is amended— 

14 (1) in subsection (f)(1)(B), by striking clause 

15 (iii) and inserting the following: 

16 ‘‘(iii) to serve for a period of time (re17 ferred to in this section as the ‘period of ob18 ligated service’) equal to— 

19 ‘‘(I) 2 years, or a longer period of 

20 time as the individual may agree to 

21 serve, in the full-time (as defined in 

22 section 331(j) of the Public Health 

23 Service Act (42 U.S.C. 254d(j))) clin24 ical practice of the profession of the in25 dividual in an Indian health program 


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1 to which the individual may be as2 signed by the Secretary; 

3 ‘‘(II) 4 years, or a longer period 

4 of time as the individual may agree to 

5 serve, in the half-time (as defined in 

6 that section) clinical practice of the 

7 profession of the individual in an In8 dian health program to which the indi9 vidual may be assigned by the Sec10 retary, subject to the condition that if 

11 the individual has agreed to serve for 

12 a period longer than 2 years of full13 time (as so defined) service, as de14 scribed in subclause (I), the half-time 

15 (as so defined) service obligation shall 

16 be the amount of time required for the 

17 individual to complete an equivalent 

18 amount of service on a half-time (as so 

19 defined) basis; or 

20 ‘‘(III) 2 years in the half-time (as 

21 so defined) clinical practice of the pro22 fession of the individual in an Indian 

23 health program to which the individual 

24 may be assigned by the Secretary with 

25 a loan payment amount equal to 50 


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1 percent of the amount that would oth2 erwise be payable for full-time (as so 

3 defined) service for that same period of 

4 obligated service; and 

5 ‘‘(iv) in the case of an individual com6 pleting a period of obligated service through 

7 half-time (as so defined) clinical practice, 

8 that if the individual fails to begin or com9 plete that period of obligated service, the 

10 procedures described in subsection (l)(2) for 

11 determining damages for breach of contract 

12 under this section will be used after con13 verting the period of obligated service or 

14 service performed into its full-time (as so 

15 defined) equivalent;’’; and 

16 (2) in subsection (l)(2), in the undesignated mat17 ter following subparagraph (D), by inserting the fol18 lowing before ‘‘Amounts’’: ‘‘Periods of obligated serv19 ice completed in half-time (as defined in section 

20 331(j) of the Public Health Service Act (42 U.S.C. 

21 254d(j))) clinical practice shall be converted to their 

22 full-time (as defined in that section) equivalents for 

23 purposes of determining damages for breach of con24 tract under this paragraph.’’. 


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Calendar No. 553 

118TH CONGRESS 

2D SESSION S. 3022 

[Report No. 118–240] 

A BILL 

To amend the Indian Health Care Improvement 

purposes. through half-time clinical practice, and for other and loan recipients to fulfill service obligations Act to allow Indian Health Service scholarship 

NOVEMBER 12, 2024 

Reported with an amendment 


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