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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2781 Referred in Senate (RFS)]

<DOC>
116th CONGRESS
  1st Session
                                H. R. 2781

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            October 29, 2019

     Received; read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 AN ACT

 
  To amend title VII of the Public Health Service Act to reauthorize 
certain programs relating to the health professions workforce, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Educating Medical Professionals and 
Optimizing Workforce Efficiency and Readiness for Health Act of 2019'' 
or the ``EMPOWER for Health Act of 2019''.

SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS WORKFORCE PROGRAMS.

    (a) Centers of Excellence.--Subsection (i) of section 736 of the 
Public Health Service Act (42 U.S.C. 293) is amended to read as 
follows:
    ``(i) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $24,897,000 for each of fiscal 
years 2020 through 2024.''.
    (b) Health Professions Training for Diversity.--Section 740 of the 
Public Health Service Act (42 U.S.C. 293d) is amended--
            (1) in subsection (a), by striking ``$51,000,000 for fiscal 
        year 2010, and such sums as may be necessary for each of the 
        fiscal years 2011 through 2014'' and inserting ``$51,419,000 
        for each of fiscal years 2020 through 2024'';
            (2) in subsection (b), by striking ``$5,000,000 for each of 
        the fiscal years 2010 through 2014'' and inserting ``$1,250,000 
        for each of fiscal years 2020 through 2024''; and
            (3) in subsection (c), by striking ``$60,000,000 for fiscal 
        year 2010 and such sums as may be necessary for each of the 
        fiscal years 2011 through 2014'' and inserting ``$20,000,000 
        for each of fiscal years 2020 through 2024''.
    (c) Primary Care Training and Enhancement.--Section 747(c)(1) of 
the Public Health Service Act (42 U.S.C. 293k(c)(1)) is amended by 
striking ``$125,000,000 for fiscal year 2010, and such sums as may be 
necessary for each of fiscal years 2011 through 2014'' and inserting 
``$51,371,000 for each of fiscal years 2020 through 2024''.
    (d) Training in General, Pediatric, and Public Health Dentistry.--
Section 748(f) of the Public Health Service Act (42 U.S.C. 293k-2(f)) 
is amended by striking ``$30,000,000 for fiscal year 2010 and such sums 
as may be necessary for each of fiscal years 2011 through 2015'' and 
inserting ``$42,707,000 for each of fiscal years 2020 through 2024''.
    (e) Area Health Education Centers.--Section 751(j)(1) of the Public 
Health Service Act (42 U.S.C. 294a(j)(1)) is amended by striking 
``$125,000,000 for each of the fiscal years 2010 through 2014'' and 
inserting ``$42,075,000 for each of fiscal years 2020 through 2024''.
    (f) National Center for Healthcare Workforce Analysis.--
            (1) In general.--Section 761(e)(1)(A) of the Public Health 
        Service Act (42 U.S.C. 294n(e)(1)(A)) is amended by striking 
        ``$7,500,000 for each of fiscal years 2010 through 2014'' and 
        inserting ``$5,947,000 for each of fiscal years 2020 through 
        2024''.
            (2) Technical correction.--Section 761(e)(2) of the Public 
        Health Service Act (42 U.S.C. 294n(e)(2)) is amended by 
        striking ``subsection (a)'' and inserting ``paragraph (1)''.
    (g) Public Health Workforce.--Section 770(a) of the Public Health 
Service Act (42 U.S.C. 295e(a)) is amended by striking ``$43,000,000 
for fiscal year 2011, and such sums as may be necessary for each of the 
fiscal years 2012 through 2015'' and inserting ``$17,850,000 for each 
of fiscal years 2020 through 2024''.

SEC. 3. EDUCATION AND TRAINING RELATING TO GERIATRICS.

    Section 753 of the Public Health Service Act (42 U.S.C. 294c) is 
amended to read as follows:

``SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.

    ``(a) Geriatrics Workforce Enhancement Programs.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this subsection to entities described in 
        paragraph (1), (3), or (4) of section 799B, section 801(2), or 
        section 865(d), or other health professions schools or programs 
        approved by the Secretary, for the establishment or operation 
        of geriatrics workforce enhancement programs that meet the 
        requirements of paragraph (2).
            ``(2) Requirements.--A geriatrics workforce enhancement 
        program meets the requirements of this paragraph if such 
        program supports the development of a health care workforce 
        that maximizes patient and family engagement and improves 
        health outcomes for older adults by integrating geriatrics with 
        primary care and other appropriate specialties. Special 
        emphasis should be placed on providing the primary care 
        workforce with the knowledge and skills to care for older 
        adults and collaborating with community partners to address 
        gaps in health care for older adults through individual, 
        system, community, and population level changes. Areas of 
        programmatic focus may include the following:
                    ``(A) Transforming clinical training environments 
                to integrated geriatrics and primary care delivery 
                systems to ensure trainees are well prepared to 
                practice in and lead in such systems.
                    ``(B) Developing providers from multiple 
                disciplines and specialties to work interprofessionally 
                to assess and address the needs and preferences of 
                older adults and their families and caregivers at the 
                individual, community, and population levels with 
                cultural and linguistic competency.
                    ``(C) Creating and delivering community-based 
                programs that will provide older adults and their 
                families and caregivers with the knowledge and skills 
                to improve health outcomes and the quality of care for 
                such adults.
                    ``(D) Providing Alzheimer's disease and related 
                dementias (ADRD) education to the families and 
                caregivers of older adults, direct care workers, health 
                professions students, faculty, and providers.
            ``(3) Duration.--The Secretary shall award grants and 
        contracts under paragraph (1) for a period not to exceed five 
        years.
            ``(4) Application.--To be eligible to receive a grant or 
        contract under paragraph (1), an entity described in such 
        paragraph shall submit to the Secretary an application at such 
        time, in such manner, and containing such information as the 
        Secretary may require, including the specific measures the 
        applicant will use to demonstrate that the project is improving 
        the quality of care provided to older adults in the applicant's 
        region, which may include--
                    ``(A) improvements in access to care provided by a 
                health professional with training in geriatrics or 
                gerontology;
                    ``(B) improvements in family caregiver capacity to 
                care for older adults;
                    ``(C) patient outcome data demonstrating an 
                improvement in older adult health status or care 
                quality; and
                    ``(D) reports on how the applicant will implement 
                specific innovations with the target audience to 
                improve older adults' health status or the quality of 
                care.
            ``(5) Equitable geographic distribution.--The Secretary may 
        award grants and contracts under paragraph (1) in a manner 
        which will equitably distribute such grants among the various 
        regions of the United States.
            ``(6) Qualifications.--In awarding grants and contracts 
        under paragraph (2), the Secretary shall consider programs 
        that--
                    ``(A) have the goal of improving and providing 
                comprehensive coordinated care of older adults, 
                including medical, dental, and psychosocial needs;
                    ``(B) demonstrate coordination with other 
                programmatic efforts funded under this program or other 
                public or private entities;
                    ``(C) support the training and retraining of 
                faculty, preceptors, primary care providers, and 
                providers in other specialties to increase their 
                knowledge of geriatrics and gerontology;
                    ``(D) provide clinical experiences across care 
                settings, including ambulatory care, hospitals, post-
                acute care, nursing homes, federally qualified health 
                centers, and home and community-based services;
                    ``(E) emphasize education and engagement of family 
                caregivers on disease self-management, medication 
                management, and stress reduction strategies;
                    ``(F) provide training to the health care workforce 
                on disease self-management, motivational interviewing, 
                medication management, and stress reduction strategies;
                    ``(G) provide training to the health care workforce 
                on social determinants of health in order to better 
                address the geriatric health care needs of diverse 
                populations with cultural and linguistic competency;
                    ``(H) integrate geriatrics competencies and 
                interprofessional collaborative practice into health 
                care education and training curricula for residents, 
                fellows, and students;
                    ``(I) substantially benefit rural or underserved 
                populations of older adults or conduct outreach to 
                communities that have a shortage of geriatric workforce 
                professionals;
                    ``(J) integrate behavioral health competencies into 
                primary care practice, especially with respect to elder 
                abuse, pain management, and advance care planning; or
                    ``(K) offer short-term intensive courses that--
                            ``(i) focus on geriatrics, gerontology, 
                        chronic care management, and long-term care 
                        that provide supplemental training for faculty 
                        members in medical schools and other health 
                        professions schools or graduate programs in 
                        psychology, pharmacy, nursing, social work, 
                        dentistry, public health, allied health, or 
                        other health disciplines, as approved by the 
                        Secretary; and
                            ``(ii) are open to current faculty, and 
                        appropriately credentialed volunteer faculty 
                        and practitioners, to upgrade their knowledge 
                        and clinical skills for the care of older 
                        adults and adults with functional and cognitive 
                        limitations and to enhance their 
                        interdisciplinary teaching skills.
            ``(7) Priority.--In awarding grants under paragraph (1), 
        particularly with respect to awarding, in fiscal year 2020, any 
        amount appropriated for such fiscal year for purposes of 
        carrying out this subsection that is in excess of the amount 
        appropriated for the most previous fiscal year for which 
        appropriations were made for such purposes, the Secretary may 
        give priority to entities that operate--
                    ``(A) in communities that have a shortage of 
                geriatric workforce professionals; and
                    ``(B) in States in which no entity has previously 
                received an award under such paragraph (including as in 
                effect before the date of enactment of the Educating 
                Medical Professionals and Optimizing Workforce 
                Efficiency and Readiness for Health Act of 2019).
            ``(8) Award amounts.--Awards under paragraph (1) shall be 
        in an amount determined by the Secretary. Entities that submit 
        applications under this subsection that describe a plan for 
        providing geriatric education and training for home health 
        workers and family caregivers are eligible to receive $100,000 
        per year more than entities that do not include a description 
        of such a plan.
            ``(9) Reporting.--Each entity awarded a grant under 
        paragraph (1) shall submit an annual report to the Secretary on 
        financial and programmatic performance under such grant, which 
        may include factors such as the number of trainees, the number 
        of professions and disciplines, the number of partnerships with 
        health care delivery sites, the number of faculty and 
        practicing professionals who participated in continuing 
        education programs, and such other factors as the Secretary may 
        require.
    ``(b) Geriatric Academic Career Awards.--
            ``(1) Establishment of program.--The Secretary shall 
        establish a program to award grants, to be known as Geriatric 
        Academic Career Awards, to eligible entities applying on behalf 
        of eligible individuals to promote the career development of 
        such individuals as academic geriatricians or other academic 
        geriatrics health professionals.
            ``(2) Eligibility.--
                    ``(A) Eligible entity.--For purposes of this 
                subsection, the term `eligible entity' means--
                            ``(i) an accredited school of allopathic 
                        medicine, osteopathic medicine, nursing, social 
                        work, psychology, dentistry, pharmacy, or 
                        allied health; or
                            ``(ii) another type of accredited health 
                        professions school or graduate program deemed 
                        by the Secretary to be eligible under this 
                        subsection.
                    ``(B) Eligible individual.--
                            ``(i) In general.--For purposes of this 
                        subsection, the term `eligible individual' 
                        means an individual who--
                                    ``(I) has a junior, nontenured, 
                                faculty appointment at an accredited 
                                school of allopathic medicine, 
                                osteopathic medicine, nursing, social 
                                work, psychology, dentistry, pharmacy, 
                                or allied health or at another type of 
                                accredited health professions school or 
                                graduate program described in 
                                subparagraph (A)(ii);
                                    ``(II)(aa) is board certified or 
                                board eligible in internal medicine, 
                                family practice, psychiatry, or 
                                licensed dentistry, or has completed 
                                the training required for the 
                                individual's discipline; and
                                    ``(bb) is employed at an eligible 
                                entity; or
                                    ``(III) has completed an approved 
                                fellowship program in geriatrics or 
                                gerontology, or has completed specialty 
                                training in geriatrics or gerontology 
                                as required for the individual's 
                                discipline and any additional 
                                geriatrics or gerontology training as 
                                required by the Secretary.
                            ``(ii) Special rule.--If during the period 
                        of an award under this subsection respecting an 
                        eligible individual, the individual is promoted 
                        to associate professor and thereby no longer 
                        meets the criteria of clause (i)(I), the 
                        individual may continue to be treated as an 
                        eligible individual through the term of the 
                        award.
            ``(3) Limitations.--An eligible entity may not receive an 
        award under paragraph (1) on behalf of an eligible individual 
        unless the eligible entity--
                    ``(A) submits to the Secretary an application, at 
                such time, in such manner, and containing such 
                information as the Secretary may require, and the 
                Secretary approves such application;
                    ``(B) provides, in such form and manner as the 
                Secretary may require, assurances that the eligible 
                individual on whose behalf an application was submitted 
                under subparagraph (A) will meet the service 
                requirement described in paragraph (8); and
                    ``(C) provides, in such form and manner as the 
                Secretary may require, assurances that such individual 
                has a full-time faculty appointment in an accredited 
                health professions school or graduate program and 
                documented commitment from such school or program to 
                spend 75 percent of the individual's time that is 
                supported by the award on teaching and developing 
                skills in interprofessional education in geriatrics.
            ``(4) Requirements.--In awarding grants under this 
        subsection, the Secretary--
                    ``(A) shall give priority to eligible entities that 
                apply on behalf of eligible individuals who are on the 
                faculty of institutions that integrate geriatrics 
                education, training, and best practices into academic 
                program criteria;
                    ``(B) may give priority to eligible entities that 
                operate a geriatrics workforce enhancement program 
                under subsection (a);
                    ``(C) shall ensure that grants are equitably 
                distributed across the various geographical regions of 
                the United States, including rural and underserved 
                areas;
                    ``(D) shall pay particular attention to geriatrics 
                health care workforce needs among underserved 
                populations, diverse communities, and rural areas;
                    ``(E) may not require an eligible individual, or an 
                eligible entity applying on behalf of an eligible 
                individual, to be a recipient of a grant or contract 
                under this part; and
                    ``(F) shall pay the full amount of the award to the 
                eligible entity.
            ``(5) Maintenance of effort.--An eligible entity receiving 
        an award under paragraph (1) on behalf of an eligible 
        individual shall provide assurances to the Secretary that funds 
        provided to such individual under this subsection will be used 
        only to supplement, not to supplant, the amount of Federal, 
        State, and local funds otherwise expended by such individual.
            ``(6) Amount and term.--
                    ``(A) Amount.--The amount of an award under this 
                subsection for eligible individuals who are physicians 
                shall equal $100,000 for fiscal year 2020, adjusted for 
                subsequent fiscal years to reflect the increase in the 
                Consumer Price Index. The Secretary shall determine the 
                amount of an award under this subsection for 
                individuals who are not physicians.
                    ``(B) Term.--The term of any award made under this 
                subsection shall not exceed 5 years.
            ``(7) Service requirement.--An eligible individual on whose 
        behalf an application was submitted and approved under 
        paragraph (3)(A) shall provide training in clinical geriatrics 
        or gerontology, including the training of interprofessional 
        teams of health care professionals.
    ``(c) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $51,000,000 for each of fiscal 
years 2020 through 2024. Notwithstanding the preceding sentence, no 
funds shall be made available to carry out subsection (b) for a fiscal 
year unless the amount made available to carry out this section for 
such fiscal year is more than the amount made available to carry out 
this section for fiscal year 2017.''.

SEC. 4. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE WORKFORCE.

    Section 775 of the Public Health Service Act (42 U.S.C. 295f) is 
amended to read as follows:

``SEC. 775. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE WORKFORCE.

    ``(a) In General.--The Secretary shall establish and carry out a 
program of entering into pediatric specialty loan repayment agreements 
with qualified health professionals under which--
            ``(1) the qualified health professional agrees to a period 
        of not less than 2 years of obligated service during which the 
        professional will--
                    ``(A) participate in an accredited pediatric 
                medical subspecialty, pediatric surgical specialty, 
                child and adolescent psychiatry subspecialty, or child 
                and adolescent mental and behavioral health residency 
                or fellowship; or
                    ``(B) be employed full-time in providing pediatric 
                medical subspecialty care, pediatric surgical specialty 
                care, child and adolescent psychiatry subspecialty 
                care, or child and adolescent mental and behavioral 
                health care, including substance use disorder 
                prevention and treatment services, in an area with--
                            ``(i) a shortage of health care 
                        professionals practicing in the pediatric 
                        medical subspecialty, the pediatric surgical 
                        specialty, the child and adolescent psychiatry 
                        subspecialty, or child and adolescent mental 
                        and behavioral health, as applicable; and
                            ``(ii) a sufficient pediatric population, 
                        as determined by the Secretary, to support the 
                        addition of a practitioner in the pediatric 
                        medical subspecialty, the pediatric surgical 
                        specialty, the child and adolescent psychiatry 
                        subspecialty, or child and adolescent mental 
                        and behavioral health, as applicable; and
            ``(2) the Secretary agrees to make payments on the 
        principal and interest of undergraduate, graduate, or graduate 
        medical education loans of the qualified health professional of 
        not more than $35,000 a year for each year of agreed upon 
        service under paragraph (1) for a period of not more than 3 
        years.
    ``(b) Eligibility Requirements.--
            ``(1) Pediatric medical specialists and pediatric surgical 
        specialists.--For purposes of loan repayment agreements under 
        this section with respect to pediatric medical subspecialty and 
        pediatric surgical specialty practitioners, the term `qualified 
        health professional' means a licensed physician who--
                    ``(A) is entering or receiving training in an 
                accredited pediatric medical subspecialty or pediatric 
                surgical subspecialty residency or fellowship; or
                    ``(B) has completed (but not prior to the end of 
                the calendar year in which the Educating Medical 
                Professionals and Optimizing Workforce Efficiency and 
                Readiness for Health Act of 2019 is enacted) the 
                training described in subparagraph (A).
            ``(2) Child and adolescent psychiatry and mental and 
        behavioral health.--For purposes of loan repayment agreements 
        under this section with respect to child and adolescent mental 
        and behavioral health care, the term `qualified health 
        professional' means a health care professional who--
                    ``(A) has received specialized training or clinical 
                experience in child and adolescent mental health in 
                psychiatry, psychology, school psychology, or 
                psychiatric nursing;
                    ``(B) has a license or certification in a State to 
                practice allopathic medicine, osteopathic medicine, 
                psychology, school psychology, or psychiatric nursing; 
                or
                    ``(C) is a mental health service professional who 
                has completed (but not before the end of the calendar 
                year in which the Educating Medical Professionals and 
                Optimizing Workforce Efficiency and Readiness for 
                Health Act of 2019 is enacted) specialized training or 
                clinical experience in child and adolescent mental 
                health described in subparagraph (A).
            ``(3) Additional eligibility requirements.--The Secretary 
        may not enter into a loan repayment agreement under this 
        section with a qualified health professional unless--
                    ``(A) the professional agrees to work in, or for a 
                provider serving, an area or community with a shortage 
                of eligible qualified health professionals (as defined 
                in paragraphs (1) and (2));
                    ``(B) the professional is a United States citizen, 
                a permanent legal United States resident, or lawfully 
                present in the United States; and
                    ``(C) if the professional is enrolled in a graduate 
                program, the program is accredited, and the 
                professional has an acceptable level of academic 
                standing (as determined by the Secretary).
    ``(c) Priority.--In entering into loan repayment agreements under 
this section, the Secretary shall give priority to applicants who--
            ``(1) have familiarity with evidence-based methods and 
        cultural and linguistic competence in health care services; and
            ``(2) demonstrate financial need.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated for each of fiscal years 2020 through 2024--
            ``(1) $30,000,000 to carry out this section with respect to 
        loan repayment agreements with qualified health professionals 
        described in subsection (b)(1); and
            ``(2) $20,000,000 to carry out this section with respect to 
        loan repayment agreements with respect to qualified health 
        professionals described in subsection (b)(2).''.

SEC. 5. INCREASING WORKFORCE DIVERSITY IN THE PROFESSIONS OF PHYSICAL 
              THERAPY, OCCUPATIONAL THERAPY, AUDIOLOGY, AND SPEECH-
              LANGUAGE PATHOLOGY.

    Title VII of the Public Health Service Act is amended--
            (1) by redesignating part G (42 U.S.C. 295j et seq.) as 
        part H; and
            (2) by inserting after part F (42 U.S.C. 294n et seq.) the 
        following new part:

``PART G--INCREASING WORKFORCE DIVERSITY IN THE PROFESSIONS OF PHYSICAL 
THERAPY, OCCUPATIONAL THERAPY, AUDIOLOGY, AND SPEECH-LANGUAGE PATHOLOGY

``SEC. 783. SCHOLARSHIPS AND STIPENDS.

    ``(a) In General.--The Secretary may award grants and contracts to 
eligible entities to increase educational opportunities in the 
professions of physical therapy, occupational therapy, audiology, and 
speech-language pathology for eligible individuals by--
            ``(1) providing student scholarships or stipends, including 
        for--
                    ``(A) completion of an accelerated degree program;
                    ``(B) completion of an associate's, bachelor's, 
                master's, or doctoral degree program; and
                    ``(C) entry by a diploma or associate's degree 
                practitioner into a bridge or degree completion 
                program;
            ``(2) providing assistance for completion of prerequisite 
        courses or other preparation necessary for acceptance for 
        enrollment in the eligible entity; and
            ``(3) carrying out activities to increase the retention of 
        students in one or more programs in the professions of physical 
        therapy, occupational therapy, audiology, and speech-language 
        pathology.
    ``(b) Consideration of Recommendations.--In carrying out subsection 
(a), the Secretary shall take into consideration the recommendations of 
national organizations representing the professions of physical 
therapy, occupational therapy, audiology, and speech-language 
pathology, including the American Physical Therapy Association, the 
American Occupational Therapy Association, the American Speech-
Language-Hearing Association, the American Academy of Audiology, and 
the Academy of Doctors of Audiology.
    ``(c) Required Information and Conditions for Award Recipients.--
            ``(1) In general.--The Secretary may require recipients of 
        awards under this section to report to the Secretary concerning 
        the annual admission, retention, and graduation rates for 
        eligible individuals in programs of the recipient leading to a 
        degree in any of the professions of physical therapy, 
        occupational therapy, audiology, and speech-language pathology.
            ``(2) Falling rates.--If any of the rates reported by a 
        recipient under paragraph (1) fall below the average for such 
        recipient over the two years preceding the year covered by the 
        report, the recipient shall provide the Secretary with plans 
        for immediately improving such rates.
            ``(3) Ineligibility.--A recipient described in paragraph 
        (2) shall be ineligible for continued funding under this 
        section if the plan of the recipient fails to improve the rates 
        within the 1-year period beginning on the date such plan is 
        implemented.
    ``(d) Definitions.--In this section:
            ``(1) Eligible entities.--The term `eligible entity' means 
        an education program that--
                    ``(A) is accredited by--
                            ``(i) the Council on Academic Accreditation 
                        in Audiology and Speech-Language Pathology or 
                        the Accreditation Commission for Audiology 
                        Education;
                            ``(ii) the Commission on Accreditation in 
                        Physical Therapy Education; or
                            ``(iii) the Accreditation Council for 
                        Occupational Therapy Education; and
                    ``(B) is carrying out a program for recruiting and 
                retaining students underrepresented in the professions 
                of physical therapy, occupational therapy, audiology, 
                and speech-language pathology (including racial or 
                ethnic minorities, or students from disadvantaged 
                backgrounds).
            ``(2) Eligible individual.--The term `eligible individual' 
        means an individual who--
                    ``(A) is a member of a class of persons who are 
                underrepresented in the professions of physical 
                therapy, occupational therapy, audiology, and speech-
                language pathology (including individuals who are 
                racial or ethnic minorities, or are from disadvantaged 
                backgrounds);
                    ``(B) has a financial need for a scholarship or 
                stipend; and
                    ``(C) is enrolled (or accepted for enrollment) at 
                an audiology, speech-language pathology, physical 
                therapy, or occupational therapy program as a full-time 
                student at an eligible entity.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2020 through 2024.''.

            Passed the House of Representatives October 28, 2019.

            Attest:

                                             CHERYL L. JOHNSON,

                                                                 Clerk.
```