I 

111TH CONGRESS 

1ST SESSION H. R. 914 

To amend title VII of the Public Health Service Act to establish a loan 

program for eligible hospitals to establish residency training programs. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 9, 2009 

Mr. BURGESS (for himself and Mr. GENE GREEN of Texas) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title VII of the Public Health Service Act to 

establish a loan program for eligible hospitals to establish 

residency training programs. 

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 ‘‘Physician Workforce 

5 Enhancement Act of 2009’’. 

6 SEC. 2. HOSPITAL RESIDENCY LOAN PROGRAM. 

7 Subpart 2 of part E of title VII of the Public Health 

8 Service Act is amended by adding at the end the following 

9 new section: 


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1 ‘‘SEC. 771. HOSPITAL RESIDENCY LOAN PROGRAM. 

2 ‘‘(a) ESTABLISHMENT.—Not later than January 1, 

3 2010, the Secretary, acting through the Administrator of 

4 the Health Resources and Services Administration, shall 

5 establish a loan program that provides loans to eligible 

6 hospitals to establish residency training programs. 

7 ‘‘(b) APPLICATION.—No loan may be provided under 

8 this section to an eligible hospital except pursuant to an 

9 application that is submitted and approved in a time, man10 ner, and form specified by the Administrator of the Health 

11 Resources and Services Administration. A loan under this 

12 section shall be on such terms and conditions and meet 

13 such requirements as the Administrator determines appro14 priate, in accordance with the provisions of this section. 

15 ‘‘(c) ELIGIBILITY; PREFERENCE FOR RURAL AND

16 SMALL URBAN AREAS.— 

17 ‘‘(1) ELIGIBLE HOSPITAL DEFINED.—For pur18 poses of this section, an ‘eligible hospital’ means, 

19 with respect to a loan under this section, a hospital 

20 that, as of the date of the submission of an applica21 tion under subsection (b), meets, to the satisfaction 

22 of the Administrator of the Health Resources and 

23 Services Administration, each of the following cri24 teria: 


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1 ‘‘(A) The hospital does not operate a resi2 dency training program and has not previously 

3 operated such a program. 

4 ‘‘(B) The hospital has secured initial ac5 creditation by the American Council for Grad6 uate Medical Education or the American Osteo7 pathic Association. 

8 ‘‘(C) The hospital provides assurances to 

9 the satisfaction of the Administrator of the 

10 Health Resources and Services Administration 

11 that such loan shall be used, consistent with 

12 subsection (d), only for the purposes of estab13 lishing and conducting an allopathic or osteo14 pathic physician residency training program in 

15 at least one of the following medical specialties, 

16 or a combination of the following: 

17 ‘‘(i) Family medicine. 

18 ‘‘(ii) Internal medicine. 

19 ‘‘(iii) Emergency medicine. 

20 ‘‘(iv) Obstetrics or gynecology. 

21 ‘‘(v) General surgery. 

22 ‘‘(vi) Preventive Medicine. 

23 ‘‘(vii) Pediatrics. 

24 ‘‘(viii) Behavioral and Mental Health. 


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1 ‘‘(D) The hospital enters into an agree2 ment with the Administrator that certifies the 

3 hospital will provide for the repayment of the 

4 loan in accordance with subsection (e). 

5 ‘‘(2) PREFERENCE FOR RURAL AND SMALL

6 AREAS.—In making loans under this section, the Ad7 ministrator of the Health Resources and Services 

8 Administration shall give preference to any applicant 

9 for such a loan that is a hospital located in a rural 

10 areas (as such term is defined in section 

11 1886(d)(2)(D) of the Social Security Act) or an 

12 urban area that is not a large urban area (as such 

13 terms are respectively defined in such section). 

14 ‘‘(d) PERMISSIBLE USES OF LOAN FUNDS.—A loan 

15 provided under this section shall be used, with respect to 

16 a residency training program, only for costs directly at17 tributable to the residency training program, except as 

18 otherwise provided by the Administrator of the Health Re19 sources and Services Administration. 

20 ‘‘(e) REPAYMENT OF LOANS.— 

21 ‘‘(1) REPAYMENT PLANS.—For purposes of 

22 subsection (c)(1)(D), a repayment plan for an eligi23 ble hospital is in accordance with this subsection if 

24 it provides for the repayment of the loan amount in 

25 installments, in accordance with a schedule that is 


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1 agreed to by the Administrator of the Health Re2 sources and Services Administration and the hospital 

3 and that is in accordance with this subsection. 

4 ‘‘(2) COMMENCEMENT OF REPAYMENT.—Re5 payment by an eligible hospital of a loan under this 

6 section shall commence not later than the date that 

7 is 18 months after the date on which the loan 

8 amount is disbursed to such hospital. 

9 ‘‘(3) REPAYMENT PERIOD.—A loan made under 

10 this section shall be fully repaid not later than the 

11 date that is 24 months after the date on which the 

12 repayment is required to commence. 

13 ‘‘(4) LOAN PAYABLE IN FULL IF RESIDENCY

14 TRAINING PROGRAM CANCELED.—In the case that 

15 an eligible hospital borrows a loan under this sec16 tion, with respect to a residency training program, 

17 and terminates such program before the date on 

18 which such loan has been fully repaid in accordance 

19 with a plan under paragraph (1), such loan shall be 

20 payable by the hospital not later than 45 days after 

21 the date of such termination. 

22 ‘‘(f) NO INTEREST CHARGED.—The Administrator of 

23 the Health Resources and Services Administration may 

24 not charge or collect interest on any loan made under this 

25 section. 


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1 ‘‘(g) LIMITATION ON TOTAL AMOUNT OF LOAN.— 

2 The cumulative dollar amount of a loan made to an eligible 

3 hospital under this section may not exceed $1,000,000. 

4 ‘‘(h) PENALTIES.—The Administrator of the Health 

5 Resources and Services Administration shall establish pen6 alties to which an eligible hospital receiving a loan under 

7 this section would be subject if such hospital is in violation 

8 of any of the criteria described in subsection (c)(1). 

9 ‘‘(i) REPORTS.—Not later than January 1, 2014, and 

10 annually thereafter (before January 2, 2020), the Admin11 istrator of the Health Resources and Services Administra12 tion shall submit to Congress a report on the efficacy of 

13 the program under this section in increasing the number 

14 of residents practicing in each medical specialty described 

15 in subsection (c)(1)(C) during such year and the extent 

16 to which the program resulted in an increase in the num17 ber of available practitioners in each of such medical spe18 cialties that serve medically underserved populations. 

19 ‘‘(j) FUNDING.— 

20 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— 

21 For the purpose of providing amounts for loans 

22 under this section, there are authorized to be appro23 priated $25,000,000 for the period of fiscal years 

24 2010 through 2020. 


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1 ‘‘(2) AVAILABILITY.—Amounts appropriated 

2 under paragraph (1) shall remain available until ex3 pended. 

4 ‘‘(3) REPAID LOAN AMOUNTS.—Any amount re5 paid by, or recovered from, an eligible hospital under 

6 this section on or before the date of termination de7 scribed in subsection (k) shall be credited to the ap8 propriation account from which the loan amount in9 volved was originally paid. Any amount so credited 

10 shall be available only for the purpose of carrying 

11 out the loan program under this section. Any 

12 amount repaid by, or recovered from, such a hospital 

13 under this section after such date shall be credited 

14 to the general fund in the Treasury. 

15 ‘‘(k) TERMINATION OF PROGRAM.—No loan may be 

16 made under this section after December 31, 2019.’’. 

Æ 


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