II 

111TH CONGRESS 

1ST SESSION S. 1720 

To amend title VII of the Public Health Service Act to provide improved 

training and primary care. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2009 

Mr. REED (for himself and Mr. LEAHY) introduced the following bill; which 

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

Labor, and Pensions 

A BILL 

To amend title VII of the Public Health Service Act to 

provide improved training and primary care. 

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 ‘‘Health Professions and 

5 Primary Care Reinvestment Act’’. 

6 SEC. 2. EDUCATION AND TRAINING FOR DELIVERY SYSTEM 

7 REFORM. 

8 (a) MEDICAL HOME TRAINING.—Section 747(a) of 

9 the Public Health Service Act (42 U.S.C. 293k(a)) is 

10 amended— 


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1 (1) in paragraph (5), by striking ‘‘and’’ at the 

2 end; 

3 (2) in paragraph (6), by striking the period and 

4 inserting ‘‘; and’’; and 

5 (3) by inserting after paragraph (6) the fol6 lowing: 

7 ‘‘(7) to plan, develop, and operate a demonstra8 tion program that provides training in new com9 petencies, as recommended by the Advisory Com10 mittee on Training in Primary Care Medicine and 

11 Dentistry, which may include— 

12 ‘‘(A) providing training to primary care 

13 providers relevant to providing care through pa14 tient-centered medical homes (as defined by the 

15 Secretary for purposes of this paragraph, tak16 ing into account the criteria of the National 

17 Committee for Quality Assurance and other cer18 tifying entities); 

19 ‘‘(B) developing tools and curricula rel20 evant to patient-centered medical homes; and 

21 ‘‘(C) providing continuing education rel22 evant to patient-centered medical homes.’’. 

23 (b) PRIORITIES OF DELIVERY SYSTEM REFORM.— 

24 Section 747 of the Public Health Service Act (42 U.S.C. 


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1 293k) is amended by striking subsection (c) and inserting 

2 the following: 

3 ‘‘(c) PRIORITIES IN MAKING AWARDS.—In awarding 

4 grants or contracts under this section, the Secretary shall 

5 give priority to qualified applicants that— 

6 ‘‘(1) have a record of training the greatest per7 centage of providers, or that have demonstrated sig8 nificant improvements in the percentage of providers 

9 trained, who enter and remain in primary care prac10 tice; 

11 ‘‘(2) have a record of training individuals who 

12 are from underrepresented minority groups or from 

13 a rural or disadvantaged background; 

14 ‘‘(3) provide training in the care of vulnerable 

15 populations such as children, older adults, homeless 

16 individuals, victims of abuse or trauma, individuals 

17 with mental health or substance-related disorders, 

18 individuals with HIV/AIDS, and individuals with 

19 disabilities; 

20 ‘‘(4) establish formal relationships and submit 

21 joint applications with federally qualified health cen22 ters, rural health clinics, area health education cen23 ters, or clinics located in underserved areas or that 

24 serve underserved populations; 


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1 ‘‘(5) provide training in interdisciplinary, inte2 grated care through collaboration among health pro3 fessionals, including physician assistants, nurse 

4 practitioners, pharmacists, dentists, geriatricians, 

5 and mental and behavioral health professionals; 

6 ‘‘(6) provide training in enhanced communica7 tion with patients, evidence-based practice, chronic 

8 disease management, preventive care, health infor9 mation technology, or other competencies as rec10 ommended by the Advisory Committee on Training 

11 in Primary Care Medicine and Dentistry; or 

12 ‘‘(7) provide training in cultural competency 

13 and health literacy.’’. 

14 (c) OTHER AMENDMENTS.—Section 747 of the Pub15 lic Health Service Act (42 U.S.C. 293k) is amended— 

16 (1) in subsection (d)— 

17 (A) by striking ‘‘subsection (a) may not ex18 ceed’’ and inserting ‘‘this section shall be’’; and 

19 (B) by striking the second sentence; and 

20 (2) by striking subsection (e) and inserting the 

21 following: 

22 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For 

23 purposes of carrying out this section, there are authorized 

24 to be appropriated $125,000,000 for each of fiscal years 

25 2010 through 2014. Fifteen percent of the amount approVerDate Nov 24 2008 02:20 Sep 26, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1720.IS S1720

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1 priated in each such fiscal year shall be allocated to the 

2 physician assistant training programs described in sub3 section (a)(5), which prepare students for practice in pri4 mary care.’’. 

5 SEC. 3. HEALTH WORKFORCE INFORMATION AND ANAL6 YSIS. 

7 (a) IN GENERAL.—Section 761 of the Public Health 

8 Service Act (42 U.S.C. 294m) is amended— 

9 (1) by redesignating subsection (c) as sub10 section (e); 

11 (2) by striking subsection (b) and inserting the 

12 following: 

13 ‘‘(b) NATIONAL CENTER FOR HEALTH WORKFORCE

14 ANALYSIS.— 

15 ‘‘(1) ESTABLISHMENT.—The Secretary shall es16 tablish the National Center for Health Workforce 

17 Analysis (referred to in this section as the ‘‘National 

18 Center’’) within the Department of Health and 

19 Human Services. 

20 ‘‘(2) PURPOSES.—The purposes of the National 

21 Center are to— 

22 ‘‘(A) carry out the activities under section 

23 792(a); and 

24 ‘‘(B) collect, analyze, and report data re25 lated to health workforce issues in coordination 


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1 with the State and Regional Centers for Health 

2 Workforce Analysis described in subsection (c) 

3 (referred to in this section as the ‘‘State and 

4 Regional Centers’’). 

5 ‘‘(3) FUNCTIONS.—The National Center shall— 

6 ‘‘(A) annually evaluate the effectiveness of 

7 programs under this title, based on data re8 ported by recipients of contracts or grants 

9 under this title, data collected from the State 

10 and Regional Centers described in subsection 

11 (c), and analyses conducted under paragraph 

12 (4); 

13 ‘‘(B) develop and publish benchmarks for 

14 performance for programs under this title; 

15 ‘‘(C) regularly produce and report to the 

16 relevant committees of Congress estimates of 

17 the supply, demand, and distribution of health 

18 professionals, such as physicians, dentists, 

19 nurses, physician assistants, pharmacists, men20 tal and behavioral health professionals, public 

21 health workers, and long-term care workers, as 

22 appropriate; 

23 ‘‘(D) establish, maintain, and make pub24 licly available through the Internet a national 


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1 health workforce database to collect data 

2 from— 

3 ‘‘(i) longitudinal tracking systems (as 

4 defined in section 761(d)(2)) on perform5 ance measures (as developed under sec6 tions 748(d)(3), 756(d)(3), and 762(a)(3)); 

7 and 

8 ‘‘(ii) the State and Regional Centers 

9 described in subsection (c); 

10 ‘‘(E) establish and maintain a registry of 

11 each grant awarded under this title, including 

12 data on the project director, the institution, the 

13 type and year of the award, and the residency, 

14 fellowship, or internship program, as appro15 priate; and 

16 ‘‘(F) biennially submit to the relevant com17 mittees of Congress a report on the activities of 

18 the National Center during the previous 2-year 

19 period. 

20 ‘‘(4) COLLABORATION AND DATA SHARING.— 

21 ‘‘(A) IN GENERAL.—The National Center 

22 shall collaborate with Federal agencies, health 

23 professions education organizations, health pro24 fessions organizations, and professional medical 

25 societies for the purpose of linking data regardVerDate Nov 24 2008 02:20 Sep 26, 2009 Jkt 079200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1720.IS S1720

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1 ing grants awarded under this title with 1 or 

2 more of the following: 

3 ‘‘(i) Data maintained by the Centers 

4 for Medicare & Medicaid Services. 

5 ‘‘(ii) Data on participation in the Na6 tional Health Service Corps. 

7 ‘‘(iii) Data sets maintained by health 

8 professions education organizations, health 

9 professions organizations, or professional 

10 medical societies. 

11 ‘‘(iv) Other data sets, as the Secretary 

12 determines appropriate. 

13 ‘‘(B) CONTRACTS FOR HEALTH WORK14 FORCE ANALYSIS.—For the purpose of carrying 

15 out the activities described in subparagraph 

16 (A), the National Center may enter into con17 tracts with health professions education organi18 zations, health professions organizations, or 

19 professional medical societies. 

20 ‘‘(c) STATE AND REGIONAL CENTERS FOR HEALTH

21 WORKFORCE ANALYSIS.— 

22 ‘‘(1) IN GENERAL.—The Secretary shall award 

23 grants to, or enter into contracts with, eligible enti24 ties for purposes of— 


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1 ‘‘(A) collecting, analyzing, and reporting to 

2 the National Center data regarding programs 

3 under this title and data related to health work4 force issues; 

5 ‘‘(B) conducting, broadly disseminating, 

6 and making publicly available through the 

7 Internet research and reports on State, re8 gional, and national health workforce issues, in9 cluding research on the supply, demand, and 

10 distribution of health professionals; 

11 ‘‘(C) evaluating the effectiveness of pro12 grams under this title and other policies related 

13 to health workforce issues; and 

14 ‘‘(D) providing technical assistance to local 

15 and regional entities on the collection, analysis, 

16 and reporting of data related to health work17 force issues. 

18 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible for a 

19 grant or contract under this subsection, an entity 

20 shall— 

21 ‘‘(A) be a State, a State workforce com22 mission, a public health or health professions 

23 school, an academic health center, or an appro24 priate public or private nonprofit entity or a 

25 partnership of such entities; and 


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1 ‘‘(B) submit to the Secretary an applica2 tion at such time, in such manner, and con3 taining such information as the Secretary may 

4 require. 

5 ‘‘(d) INCREASE IN GRANTS FOR LONGITUDINAL

6 TRACKING SYSTEMS.— 

7 ‘‘(1) IN GENERAL.—The Secretary shall in8 crease the amount of a grant or contract awarded to 

9 an eligible entity under this title for the establish10 ment and maintenance of a longitudinal tracking 

11 system.’’. 

12 ‘‘(2) DEFINITION.— 

13 ‘‘(A) IN GENERAL.—For purposes of para14 graph (1), the term ‘longitudinal tracking sys15 tem’ means a system that tracks students, resi16 dents, fellows, interns, or faculty who have re17 ceived education, training, or financial assist18 ance from programs under this title over a pe19 riod of not less than 5 years, as specified by the 

20 Secretary. 

21 ‘‘(B) CAPABILITY.—A longitudinal track22 ing system shall be capable of— 

23 ‘‘(i) tracking participation in the Na24 tional Health Service Corps, practice in 

25 federally qualified health centers, practice 


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1 in health professional shortage areas and 

2 medically underserved areas, and practice 

3 in primary care; and 

4 ‘‘(ii) collecting and reporting data on 

5 performance measures developed under 

6 sections 748(d)(3), 756(d)(3), and 

7 762(a)(3). 

8 ‘‘(C) GUIDELINES.—A longitudinal track9 ing system shall comply with guidelines issued 

10 under sections 748(d)(4), 756(d)(4), and 

11 762(a)(4). 

12 ‘‘(3) ELIGIBLE ENTITIES.—To be eligible to ob13 tain an increase under this section, an entity shall 

14 be a recipient of a grant or contract under this title 

15 and have not previously received an increase under 

16 this section.’’; and 

17 (3) in subsection (e), as so redesignated— 

18 (A) by striking paragraph (1) and insert19 ing the following: 

20 ‘‘(1) IN GENERAL.— 

21 ‘‘(A) NATIONAL CENTER FOR HEALTH

22 WORKFORCE ANALYSIS.—To carry out sub23 section (b), there are authorized to be appro24 priated $1,000,000 for each of fiscal years 


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1 2010 through 2014, and such sums as may be 

2 necessary for each subsequent fiscal year. 

3 ‘‘(B) STATE AND REGIONAL CENTERS.— 

4 To carry out subsection (c), there are author5 ized to be appropriated $4,500,000 for each of 

6 fiscal years 2010 through 2014, and such sums 

7 as may be necessary for each subsequent fiscal 

8 year. 

9 ‘‘(C) GRANTS FOR LONGITUDINAL TRACK10 ING SYSTEMS.—To carry out subsection (d), 

11 there are authorized to be appropriated such 

12 sums as may be necessary for fiscal years 2010 

13 through 2014. 

14 ‘‘(D) CARRYOVER FUNDS.—An entity that 

15 receives an award under this section may carry 

16 over funds from 1 fiscal year to another without 

17 obtaining approval from the Secretary. In no 

18 case may any funds be carried over pursuant to 

19 the preceding sentence for more than 3 years.’’; 

20 and 

21 (B) in paragraph (2), by striking ‘‘sub22 section (a)’’ and inserting ‘‘paragraph (1)’’. 

23 (b) TRANSFER OF FUNCTIONS.—Not later than 180 

24 days after the date of enactment of this Act, all of the 

25 functions, authorities, and resources of the National CenVerDate Nov 24 2008 02:20 Sep 26, 2009 Jkt 079200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1720.IS S1720

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1 ter for Health Workforce Analysis of the Health Resources 

2 and Services Administration, as in effect on the date be3 fore the date of enactment of this Act, shall be transferred 

4 to the National Center for Health Workforce Analysis es5 tablished under section 761 of the Public Health Service 

6 Act, as amended by subsection (a). 

7 (c) PREFERENCE FOR USE OF LONGITUDINAL

8 TRACKING SYSTEMS.—Section 791(a)(1) of the Public 

9 Health Service Act (42 U.S.C. 295j(a)(1)) is amended— 

10 (1) in subparagraph (A), by striking ‘‘or’’ at 

11 the end; 

12 (2) in subparagraph (B), by striking the period 

13 and inserting ‘‘; or’’; and 

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

15 ‘‘(C) utilizes a longitudinal tracking system 

16 (as defined in section 761(d)(2)) and reports 

17 data from such system to the national work18 force database (as established under section 

19 761(b)(3)(D)).’’. 

20 (d) PERFORMANCE MEASURES; GUIDELINES FOR

21 LONGITUDINAL TRACKING SYSTEMS.— 

22 (1) ADVISORY COMMITTEE ON TRAINING IN PRI23 MARY CARE MEDICINE AND DENTISTRY.—Section 

24 748(d) of the Public Health Service Act (42 U.S.C. 

25 293l(d)) is amended— 


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

2 the end; 

3 (B) in paragraph (2), by striking the pe4 riod and inserting a semicolon; and 

5 (C) by adding at the end the following: 

6 ‘‘(3) not later than 3 years after the date of en7 actment of the Health Professions and Primary Care 

8 Reinvestment Act, develop, publish, and implement 

9 performance measures, which shall be quantitative to 

10 the extent possible, for programs under this part; 

11 ‘‘(4) develop and publish guidelines for longitu12 dinal tracking systems (as defined in section 

13 761(d)(2)) for programs under this part; and 

14 ‘‘(5) recommend appropriation levels for pro15 grams under this part.’’. 

16 (2) ADVISORY COMMITTEE ON INTERDISCIPLI17 NARY, COMMUNITY-BASED LINKAGES.—Section 

18 756(d) of the Public Health Service Act (42 U.S.C. 

19 294f(d)) is amended— 

20 (A) in paragraph (1), by striking ‘‘and’’ at 

21 the end; 

22 (B) in paragraph (2), by striking the pe23 riod and inserting a semicolon; and 

24 (C) by adding at the end the following: 


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1 ‘‘(3) not later than 3 years after the date of en2 actment of the Health Professions and Primary Care 

3 Reinvestment Act, develop, publish, and implement 

4 performance measures, which shall be quantitative to 

5 the extent possible, for programs under this part; 

6 ‘‘(4) develop and publish guidelines for longitu7 dinal tracking systems (as defined in section 

8 761(d)(2)) for programs under this part; and 

9 ‘‘(5) recommend appropriation levels for pro10 grams under this part.’’. 

11 (3) ADVISORY COUNCIL ON GRADUATE MEDICAL

12 EDUCATION.—Section 762(a) of the Public Health 

13 Service Act (42 U.S.C. 294o(a)) is amended— 

14 (A) in paragraph (1), by striking ‘‘and’’ at 

15 the end; 

16 (B) in paragraph (2), by striking the pe17 riod and inserting a semicolon; and 

18 (C) by adding at the end the following: 

19 ‘‘(3) not later than 3 years after the date of en20 actment of the Health Professions and Primary Care 

21 Reinvestment Act, develop, publish, and implement 

22 performance measures, which shall be quantitative to 

23 the extent possible, for programs under this title, ex24 cept for programs under part C or D; 


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1 ‘‘(4) develop and publish guidelines for longitu2 dinal tracking systems (as defined in section 

3 761(d)(2)) for programs under this title, except for 

4 programs under part C or D; and 

5 ‘‘(5) recommend appropriation levels for pro6 grams under this title, except for programs under 

7 part C or D.’’. 

Æ 


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