II 

115TH CONGRESS 

2D SESSION S. 2524 

To amend the Public Health Service Act to authorize a loan repayment 

program for substance use disorder treatment employees, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 8, 2018 

Mr. DONNELLY (for himself, Ms. MURKOWSKI, and Ms. HASSAN) 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 

loan repayment program for substance use disorder 

treatment employees, 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 ‘‘Substance Use Dis5 order Workforce Loan Repayment Act of 2018’’. 

6 SEC. 2. LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE 

7 DISORDER TREATMENT EMPLOYEES. 

8 Title VII of the Public Health Service Act is amend9 ed— 


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1 (1) by redesignating part F as part G; and 

2 (2) by inserting after part E (42 U.S.C. 294n 

3 et seq.) the following: 

4 ‘‘PART F—SUBSTANCE USE DISORDER 

5 TREATMENT EMPLOYEES 

6 ‘‘SEC. 781. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 

7 USE DISORDER TREATMENT EMPLOYEES. 

8 ‘‘(a) IN GENERAL.—The Secretary, acting through 

9 the Administrator of the Health Resources and Services 

10 Administration, shall carry out a program under which— 

11 ‘‘(1) the Secretary enters into agreements with 

12 individuals to make payments in accordance with 

13 subsection (b) on the principal of and interest on 

14 any eligible loan; and 

15 ‘‘(2) the individuals each agree to complete a 

16 period of service in a substance use disorder treat17 ment job, as described in subsection (d). 

18 ‘‘(b) PAYMENTS.—For each year of obligated service 

19 by an individual pursuant to an agreement under sub20 section (a), the Secretary shall make a payment to such 

21 individual as follows: 

22 ‘‘(1) SERVICE IN A SHORTAGE AREA.—The Sec23 retary shall pay— 

24 ‘‘(A) for each year of obligated service by 

25 an individual pursuant to an agreement under 


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subsection (a), 1 1 ⁄6 of the principal of and inter2 est on each eligible loan of the individual which 

3 is outstanding on the date the individual began 

4 service pursuant to the agreement; and 

5 ‘‘(B) for completion of the sixth and final 

6 year of such service, the remainder of such 

7 principal and interest. 

8 ‘‘(2) MAXIMUM AMOUNT.—The total amount of 

9 payments under this section to any individual shall 

10 not exceed $250,000. 

11 ‘‘(c) ELIGIBLE LOANS.—The loans eligible for repay12 ment under this section are each of the following: 

13 ‘‘(1) Any loan for education or training for a 

14 substance use disorder treatment job. 

15 ‘‘(2) Any loan under part E of title VIII (relat16 ing to nursing student loans). 

17 ‘‘(3) Any Federal Direct Stafford Loan, Fed18 eral Direct PLUS Loan, Federal Direct Unsub19 sidized Stafford Loan, or Federal Direct Consolida20 tion Loan (as such terms are used in section 455 of 

21 the Higher Education Act of 1965). 

22 ‘‘(4) Any Federal Perkins Loan under part E 

23 of title I of the Higher Education Act of 1965. 

24 ‘‘(5) Any other Federal loan as determined ap25 propriate by the Secretary. 


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1 ‘‘(d) PERIOD OF SERVICE.—The period of service re2 quired by an agreement under subsection (a) shall consist 

3 of up to 6 years of full-time employment, with no more 

4 than one year passing between any two years of covered 

5 employment, in a substance use disorder treatment job in 

6 the United States in— 

7 ‘‘(1) a Mental Health Professional Shortage 

8 Area, as designated under section 332; or 

9 ‘‘(2) a county (or a municipality, if not con10 tained within any county) where the mean drug 

11 overdose death rate per 100,000 people over the past 

12 3 years for which official data is available from the 

13 State, is higher than the most recent available na14 tional average overdose death rate per 100,000 peo15 ple, as reported by the Centers for Disease Control 

16 and Prevention. 

17 ‘‘(e) INELIGIBILITY FOR DOUBLE BENEFITS.—No 

18 borrower may, for the same service, receive a reduction 

19 of loan obligations or a loan repayment under both— 

20 ‘‘(1) this subsection; and 

21 ‘‘(2) any federally supported loan forgiveness 

22 program, including under section 338B, 338I, or 

23 846 of this Act, or section 428J, 428L, 455(m), or 

24 460 of the Higher Education Act of 1965. 

25 ‘‘(f) BREACH.— 


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1 ‘‘(1) LIQUIDATED DAMAGES FORMULA.—The 

2 Secretary may establish a liquidated damages for3 mula to be used in the event of a breach of an 

4 agreement entered into under subsection (a). 

5 ‘‘(2) LIMITATION.—The failure by an individual 

6 to complete the full period of service obligated pur7 suant to such an agreement, taken alone, shall not 

8 constitute a breach of the agreement, so long as the 

9 individual completed in good faith the years of serv10 ice for which payments were made to the individual 

11 under this section. 

12 ‘‘(g) ADDITIONAL CRITERIA.—The Secretary— 

13 ‘‘(1) may establish such criteria and rules to 

14 carry out this section as the Secretary determines 

15 are needed and in addition to the criteria and rules 

16 specified in this section; and 

17 ‘‘(2) shall give notice to the committees speci18 fied in subsection (h) of any criteria and rules so es19 tablished. 

20 ‘‘(h) REPORT TO CONGRESS.—Not later than 5 years 

21 after the date of enactment of the Substance Use Disorder 

22 Workforce Loan Repayment Act of 2018, and every other 

23 year thereafter, the Secretary shall prepare and submit 

24 to the Committee on Energy and Commerce of the House 


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1 of Representatives and the Committee on Health, Edu2 cation, Labor, and Pensions of the Senate a report on— 

3 ‘‘(1) the number and location of borrowers who 

4 have qualified for loan repayments under this sec5 tion; and 

6 ‘‘(2) the impact of this section on the avail7 ability of substance use disorder treatment employ8 ees nationally and in shortage areas and counties de9 scribed in subsection (d). 

10 ‘‘(i) DEFINITION.—In this section: 

11 ‘‘(1) The term ‘municipality’ means a city, 

12 town, or other public body created by or pursuant to 

13 State law, or an Indian Tribe. 

14 ‘‘(2) The term ‘substance use disorder treat15 ment job’ means a full-time job (including a fellow16 ship)— 

17 ‘‘(A) where the primary intent and func18 tion of the job is the direct treatment or recov19 ery support of patients with or in recovery from 

20 a substance use disorder, such as a physician, 

21 physician assistant, registered nurse, nurse 

22 practitioner, advanced practice registered nurse, 

23 social worker, recovery coach, mental health 

24 counselor, addictions counselor, psychologist or 

25 other behavioral health professional, or any 


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1 other relevant professional as determined by the 

2 Secretary; and 

3 ‘‘(B) which is located at a substance use 

4 disorder treatment program, private physician 

5 practice, hospital or health system-affiliated in6 patient treatment center or outpatient clinic 

7 (including an academic medical center-affiliated 

8 treatment program), correctional facility or pro9 gram, youth detention center or program, inpa10 tient psychiatric facility, crisis stabilization 

11 unit, community health center, community men12 tal health or other specialty community behav13 ioral health center, recovery center, school, com14 munity-based organization, telehealth platform, 

15 migrant health center, health program or facil16 ity operated by a tribe or tribal organization, 

17 Federal medical facility, or any other facility as 

18 determined appropriate for purposes of this sec19 tion by the Secretary. 

20 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

21 are authorized to be appropriated to carry out this section 

22 $25,000,000 for each of fiscal years 2019 through 2028.’’. 

Æ 


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