II 

110TH CONGRESS 

2D SESSION S. 3708 

To amend the Public Health Service Act with respect to health professions 

education, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 19, 2008 

Mrs. CLINTON 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 with respect to 

health professions education, 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 ‘‘Health Professions and 

5 Primary Care Reinvestment Act’’. 

6 SEC. 2. TABLE OF CONTENTS; REFERENCES IN ACT. 

7 (a) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Table of contents; references in Act. 

Sec. 3. Federally supported student loan funds. 

Sec. 4. Centers of excellence. 

Sec. 5. Health professions training for diversity. 


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Sec. 6. Training in family medicine, general internal medicine, general pediatrics, and physician assistantship; community health needs assessments; primary care training institutes. 

Sec. 7. Training in general and pediatric dentistry; loan repayments. 

Sec. 8. Interdisciplinary, community-based linkages. 

Sec. 9. Geriatrics education and training. 

Sec. 10. Training in graduate psychology education. 

Sec. 11. Health professions workforce information and analysis. 

Sec. 12. Health workforce information, evaluation, and assessment. 

Sec. 13. Funding for dental public health and preventive medicine. 

Sec. 14. Academic health departments grant program. 

Sec. 15. Definitions. 

1 (b) REFERENCES IN ACT.—Except as otherwise spec2 ified, amendments made by this Act to a section or other 

3 provision of law are amendments to such section or other 

4 provision of the Public Health Service Act (42 U.S.C. 201 

5 et seq.). 

6 SEC. 3. FEDERALLY SUPPORTED STUDENT LOAN FUNDS. 

7 (a) PURPOSE.—Subpart II of title VII (42 U.S.C. 

8 292q et seq.) is amended by inserting after the subpart 

9 heading the following: 

10 ‘‘SEC. 720A. PURPOSE. 

11 ‘‘The purpose of this subpart is to improve the sup12 ply, distribution, diversity, and quality of health profes13 sionals in the healthcare workforce by— 

14 ‘‘(1) making health professionals more acces15 sible to low-income, underserved, uninsured, minor16 ity, health disparity, and rural populations; 

17 ‘‘(2) improving the training of primary care 

18 physicians, dentists, physician assistants, behavioral 

19 and mental health professionals, public health pro20 fessionals, and other health professionals; and 


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1 ‘‘(3) training faculty educators in the health 

2 professions.’’. 

3 (b) LOAN PROVISIONS.—Section 722 (42 U.S.C. 

4 292r) is amended by striking subsection (e) and inserting 

5 the following: 

6 ‘‘(e) RATE OF INTEREST.—Such loans shall bear in7 terest, on the unpaid balance of the loan, computed only 

8 for periods for which the loan is repayable, at the rate 

9 of 2 percent less than the applicable rate of interest de10 scribed in section 427A(l)(1) of the Higher Education Act 

11 of 1965 (20 U.S.C. 1077a(l)(1)) per year.’’. 

12 (c) MEDICAL SCHOOLS AND PRIMARY HEALTH

13 CARE.—Section 723 (42 U.S.C. 292s) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (1), by striking subpara16 graph (B) and inserting the following: 

17 ‘‘(B) to practice in such care for 10 years 

18 (including residency training in primary health 

19 care) or through the date on which the loan is 

20 repaid in full, whichever occurs first.’’; and 

21 (B) by striking paragraph (3) and insert22 ing the following: 

23 ‘‘(3) NONCOMPLIANCE BY STUDENT.—Each 

24 agreement entered into with a student pursuant to 

25 paragraph (1) shall provide that, if the student fails 


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1 to comply with such agreement, the loan involved 

2 will begin to accrue interest at a rate of 2 percent 

3 per year greater than the rate at which the student 

4 would pay if compliant in such year.’’; and 

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

6 ‘‘(d) SENSE OF CONGRESS.—It is the sense of Con7 gress that funds repaid under the loan program under this 

8 section should not be transferred to the Treasury of the 

9 United States or otherwise used for any other purpose 

10 other than to carry out this section.’’. 

11 (d) STUDENT LOAN GUIDELINES.—The Secretary of 

12 Health and Human Services shall not require parental fi13 nancial information from a student to determine financial 

14 need under section 723 of the Public Health Service Act 

15 (42 U.S.C. 292s) and the determination of need for such 

16 information shall be at the discretion of applicable school 

17 loan officer. The Secretary shall amend guidelines issued 

18 by the Health Resources and Services Administration in 

19 accordance with the preceding sentence. 

20 SEC. 4. CENTERS OF EXCELLENCE. 

21 Section 736 of the Public Health Service Act (42 

22 U.S.C. 293) is amended— 

23 (1) by striking subsection (a) and inserting the 

24 following: 


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1 ‘‘(a) IN GENERAL.—The Secretary shall make grants 

2 to, and enter into contracts with, public and nonprofit pri3 vate health or educational entities, including designated 

4 health professions schools described in subsection (c), for 

5 the purpose of assisting the entities in supporting pro6 grams of excellence in health professions education for 

7 underrepresented minorities in health professions.’’; 

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

9 following: 

10 ‘‘(b) REQUIRED USE OF FUNDS.—The Secretary 

11 may not make a grant under subsection (a) unless the des12 ignated health professions school agrees, subject to sub13 section (c)(1)(C), to use the funds awarded under the 

14 grant to— 

15 ‘‘(1) develop a large competitive applicant pool 

16 through linkages with institutions of higher edu17 cation, local school districts, and other community18 based entities and establish an education pipeline for 

19 health professions careers; 

20 ‘‘(2) establish, strengthen, or expand programs 

21 to enhance the academic performance of underrep22 resented minority in health professions students at23 tending the school; 

24 ‘‘(3) improve the capacity of such school to 

25 train, recruit, and retain underrepresented minority 


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1 faculty members including the payment of such sti2 pends and fellowships as the Secretary may deter3 mine appropriate; 

4 ‘‘(4) carry out activities to improve the informa5 tion resources, clinical education, curricula, and cul6 tural and linguistic competence of the graduates of 

7 the school, as it relates to minority health issues; 

8 ‘‘(5) facilitate faculty and student research on 

9 health issues particularly affecting racial and ethnic 

10 minority groups, including research on issues relat11 ing to the delivery of culturally competent healthcare 

12 (as defined in section 270); 

13 ‘‘(6) establish and implement a program to 

14 train students of the school in providing health serv15 ices to racial and ethnic minority individuals through 

16 training provided to such students at community17 based health facilities that— 

18 ‘‘(A) provide such health services; and 

19 ‘‘(B) are located at a site remote from the 

20 main site of the teaching facilities of the school; 

21 ‘‘(7) provide stipends as the Secretary deter22 mines appropriate, in amounts as the Secretary de23 termines appropriate; and 


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1 ‘‘(8) conduct accountability and other reporting 

2 activities, as required by the Secretary in subsection 

3 (i).’’; 

4 (3) in subsection (c)— 

5 (A) by amending paragraph (1) to read as 

6 follows: 

7 ‘‘(1) DESIGNATED SCHOOLS.— 

8 ‘‘(A) IN GENERAL.—The designated health 

9 professions schools referred to in subsection (a) 

10 are such schools that meet each of the condi11 tions specified in subparagraphs (B) and (C), 

12 and that— 

13 ‘‘(i) meet each of the conditions speci14 fied in paragraph (2)(A); 

15 ‘‘(ii) meet each of the conditions spec16 ified in paragraph (3); 

17 ‘‘(iii) meet each of the conditions 

18 specified in paragraph (4); or 

19 ‘‘(iv) meet each of the conditions spec20 ified in paragraph (5). 

21 ‘‘(B) GENERAL CONDITIONS.—The condi22 tions specified in this subparagraph are that a 

23 designated health professions school— 

24 ‘‘(i) has a significant number of 

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1 fessions students enrolled in the school, in2 cluding individuals accepted for enrollment 

3 in the school; 

4 ‘‘(ii) has been effective in assisting 

5 such students of the school to complete the 

6 program of education and receive the de7 gree involved; 

8 ‘‘(iii) has been effective in recruiting 

9 such students to enroll in and graduate 

10 from the school, including providing schol11 arships and other financial assistance to 

12 such students and encouraging such stu13 dents from all levels of the educational 

14 pipeline to pursue health professions ca15 reers; and 

16 ‘‘(iv) has made significant recruitment 

17 efforts to increase the number of underrep18 resented minority in health professions in19 dividuals serving in faculty or administra20 tive positions at the school. 

21 ‘‘(C) CONSORTIUM.—The condition speci22 fied in this subparagraph is that, in accordance 

23 with subsection (e)(1), the designated health 

24 profession school involved has with other health 

25 profession schools (designated or otherwise) 


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1 formed a consortium to carry out the purposes 

2 described in subsection (b) at the schools of the 

3 consortium. 

4 ‘‘(D) APPLICATION OF CRITERIA TO

5 OTHER PROGRAMS.—In the case of any criteria 

6 established by the Secretary for purposes of de7 termining whether schools meet the conditions 

8 described in subparagraph (B), this section may 

9 not, with respect to racial and ethnic minority 

10 groups, be construed to authorize, require, or 

11 prohibit the use of such criteria in any program 

12 other than the program established in this sec13 tion.’’; 

14 (B) by amending paragraph (2) to read as 

15 follows: 

16 ‘‘(2) CENTERS OF EXCELLENCE AT CERTAIN

17 HISTORICALLY BLACK COLLEGES AND UNIVER18 SITIES.— 

19 ‘‘(A) CONDITIONS.—The conditions speci20 fied in this subparagraph are that a designated 

21 health professions school is a school described 

22 in section 799B(1). 

23 ‘‘(B) USE OF GRANT.—In addition to the 

24 purposes described in subsection (b), a grant 

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1 fessions school meeting the conditions described 

2 in subparagraph (A) may be expended— 

3 ‘‘(i) to develop a plan to achieve insti4 tutional improvements, including financial 

5 independence, to enable the school to sup6 port programs of excellence in health pro7 fessions education for underrepresented 

8 minority individuals; and 

9 ‘‘(ii) to provide improved access to the 

10 library and informational resources of the 

11 school. 

12 ‘‘(C) EXCEPTION.—The requirements of 

13 paragraph (1)(C) shall not apply to a histori14 cally black college or university that receives 

15 funding under this paragraph or paragraph 

16 (5).’’; and 

17 (C) by amending paragraphs (3) through 

18 (5) to read as follows: 

19 ‘‘(3) HISPANIC CENTERS OF EXCELLENCE.— 

20 The conditions specified in this paragraph are 

21 that— 

22 ‘‘(A) with respect to Hispanic individuals, 

23 each of clauses (i) through (iv) of paragraph 

24 (1)(B) applies to the designated health profes25 sions school involved; 


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1 ‘‘(B) the school agrees, as a condition of 

2 receiving a grant under subsection (a) of this 

3 section, that the school will, in carrying out the 

4 duties described in subsection (b) of this sec5 tion, give priority to carrying out the duties 

6 with respect to Hispanic individuals; and 

7 ‘‘(C) the school agrees, as a condition of 

8 receiving a grant under subsection (a) of this 

9 section, that— 

10 ‘‘(i) the school will establish an ar11 rangement with 1 or more public or non12 profit community-based Hispanic serving 

13 organizations, or public or nonprofit pri14 vate institutions of higher education, in15 cluding schools of nursing, whose enroll16 ment of students has traditionally included 

17 a significant number of Hispanic individ18 uals, the purposes of which will be to carry 

19 out a program— 

20 ‘‘(I) to identify Hispanic students 

21 who are interested in a career in the 

22 health profession involved; and 

23 ‘‘(II) to facilitate the educational 

24 preparation of such students to enter 

25 the health professions school; and 


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1 ‘‘(ii) the school will make efforts to 

2 recruit Hispanic students, including stu3 dents who have participated in the under4 graduate or other matriculation program 

5 carried out under arrangements established 

6 by the school pursuant to clause (i)(II) and 

7 will assist Hispanic students regarding the 

8 completion of the educational requirements 

9 for a degree from the school. 

10 ‘‘(4) NATIVE AMERICAN CENTERS OF EXCEL11 LENCE.—Subject to subsection (e), the conditions 

12 specified in this paragraph are that— 

13 ‘‘(A) with respect to Native Americans, 

14 each of clauses (i) through (iv) of paragraph 

15 (1)(B) applies to the designated health profes16 sions school involved; 

17 ‘‘(B) the school agrees, as a condition of 

18 receiving a grant under subsection (a) of this 

19 section, that the school will, in carrying out the 

20 duties described in subsection (b) of this sec21 tion, give priority to carrying out the duties 

22 with respect to Native Americans; and 

23 ‘‘(C) the school agrees, as a condition of 

24 receiving a grant under subsection (a) of this 

25 section, that— 


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1 ‘‘(i) the school will establish an ar2 rangement with 1 or more public or non3 profit private institutions of higher edu4 cation, including schools of nursing, whose 

5 enrollment of students has traditionally in6 cluded a significant number of Native 

7 Americans, the purpose of which arrange8 ment will be to carry out a program— 

9 ‘‘(I) to identify Native American 

10 students, from the institutions of 

11 higher education referred to in clause 

12 (i), who are interested in health pro13 fessions careers; and 

14 ‘‘(II) to facilitate the educational 

15 preparation of such students to enter 

16 the designated health professions 

17 school; and 

18 ‘‘(ii) the designated health professions 

19 school will make efforts to recruit Native 

20 American students, including students who 

21 have participated in the undergraduate 

22 program carried out under arrangements 

23 established by the school pursuant to 

24 clause (i) and will assist Native American 

25 students regarding the completion of the 


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1 educational requirements for a degree from 

2 the designated health professions school. 

3 ‘‘(5) OTHER CENTERS OF EXCELLENCE.—The 

4 conditions specified in this paragraph are— 

5 ‘‘(A) with respect to other centers of excel6 lence, the conditions described in clauses (i) 

7 through (iv) of paragraph (1)(B); and 

8 ‘‘(B) that the health professions school in9 volved has an enrollment of underrepresented 

10 minorities in health professions significantly 

11 above the national average for such enrollments 

12 of health professions schools.’’; and 

13 (4) by striking subsection (h) and inserting the 

14 following: 

15 ‘‘(h) FORMULA FOR ALLOCATIONS.— 

16 ‘‘(1) ALLOCATIONS.—Based on the amount ap17 propriated under subsection (i) for a fiscal year, the 

18 following subparagraphs shall apply as appropriate: 

19 ‘‘(A) IN GENERAL.—If the amounts appro20 priated under subsection (i) for a fiscal year are 

21 $24,000,000 or less— 

22 ‘‘(i) the Secretary shall make available 

23 $12,000,000 for grants under subsection 

24 (a) to health professions schools that meet 


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1 the conditions described in subsection 

2 (c)(2)(A); and 

3 ‘‘(ii) and available after grants are 

4 made with funds under clause (i), the Sec5 retary shall make available— 

6 ‘‘(I) 60 percent of such amount 

7 for grants under subsection (a) to 

8 health professions schools that meet 

9 the conditions described in paragraph 

10 (3) or (4) of subsection (c) (including 

11 meeting the conditions under sub12 section (e)); and 

13 ‘‘(II) 40 percent of such amount 

14 for grants under subsection (a) to 

15 health professions schools that meet 

16 the conditions described in subsection 

17 (c)(5). 

18 ‘‘(B) FUNDING IN EXCESS OF

19 $24,000,000.—If amounts appropriated under 

20 subsection (i) for a fiscal year exceed 

21 $24,000,000 but are less than $30,000,000— 

22 ‘‘(i) 80 percent of such excess 

23 amounts shall be made available for grants 

24 under subsection (a) to health professions 

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1 scribed in paragraph (3) or (4) of sub2 section (c) (including meeting conditions 

3 pursuant to subsection (e)); and 

4 ‘‘(ii) 20 percent of such excess 

5 amount shall be made available for grants 

6 under subsection (a) to health professions 

7 schools that meet the conditions described 

8 in subsection (c)(5). 

9 ‘‘(C) FUNDING IN EXCESS OF

10 $30,000,000.—If amounts appropriated under 

11 subsection (i) for a fiscal year exceed 

12 $30,000,000 but are less than $40,000,000, the 

13 Secretary shall make available— 

14 ‘‘(i) not less than $12,000,000 for 

15 grants under subsection (a) to health pro16 fessions schools that meet the conditions 

17 described in subsection (c)(2)(A); 

18 ‘‘(ii) not less than $12,000,000 for 

19 grants under subsection (a) to health pro20 fessions schools that meet the conditions 

21 described in paragraph (3) or (4) of sub22 section (c) (including meeting conditions 

23 pursuant to subsection (e)); 

24 ‘‘(iii) not less than $6,000,000 for 

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1 fessions schools that meet the conditions 

2 described in subsection (c)(5); and 

3 ‘‘(iv) after grants are made with 

4 funds under clauses (i) through (iii), any 

5 remaining excess amount for grants under 

6 subsection (a) to health professions schools 

7 that meet the conditions described in para8 graph (2)(A), (3), (4), or (5) of subsection 

9 (c). 

10 ‘‘(D) FUNDING IN EXCESS OF

11 $40,000,000.—If amounts appropriated under 

12 subsection (i) for a fiscal year are $40,000,000 

13 or more, the Secretary shall make available— 

14 ‘‘(i) not less than $16,000,000 for 

15 grants under subsection (a) to health pro16 fessions schools that meet the conditions 

17 described in subsection (c)(2)(A); 

18 ‘‘(ii) not less than $16,000,000 for 

19 grants under subsection (a) to health pro20 fessions schools that meet the conditions 

21 described in paragraph (3) or (4) of sub22 section (c) (including meeting conditions 

23 pursuant to subsection (e)); 

24 ‘‘(iii) not less than $8,000,000 for 

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1 fessions schools that meet the conditions 

2 described in subsection (c)(5); and 

3 ‘‘(iv) after grants are made with 

4 funds under clauses (i) through (iii), any 

5 remaining funds for grants under sub6 section (a) to health professions schools 

7 that meet the conditions described in para8 graph (2)(A), (3), (4), or (5) of subsection 

9 (c). 

10 ‘‘(2) NO LIMITATION.—Nothing in this sub11 section shall be construed as limiting the centers of 

12 excellence referred to in this section to the des13 ignated amount, or to preclude such entities from 

14 competing for grants under this section. 

15 ‘‘(3) MAINTENANCE OF EFFORT.— 

16 ‘‘(A) IN GENERAL.—With respect to activi17 ties for which a grant made under this part are 

18 authorized to be expended, the Secretary may 

19 not make such a grant to a center of excellence 

20 for any fiscal year unless the center agrees to 

21 maintain expenditures of non-Federal amounts 

22 for such activities at a level that is not less 

23 than the level of such expenditures maintained 

24 by the center for the fiscal year preceding the 


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1 fiscal year for which the school receives such a 

2 grant. 

3 ‘‘(B) USE OF FEDERAL FUNDS.—With re4 spect to any Federal amounts received by a cen5 ter of excellence and available for carrying out 

6 activities for which a grant under this part is 

7 authorized to be expended, the center shall, be8 fore expending the grant, expend the Federal 

9 amounts obtained from sources other than the 

10 grant, unless given prior approval from the Sec11 retary. 

12 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to carry out this sec14 tion— 

15 ‘‘(1) $50,000,000 for each of the fiscal years 

16 2009 through 2013; and 

17 ‘‘(2) and such sums as are necessary for each 

18 subsequent fiscal year.’’. 

19 SEC. 5. HEALTH PROFESSIONS TRAINING FOR DIVERSITY. 

20 (a) LOAN REPAYMENTS AND FELLOWSHIPS REGARD21 ING FACULTY POSITIONS.—Section 738(a)(1) (42 U.S.C. 

22 293b(a)(1)) is amended by striking ‘‘$20,000 of the prin23 cipal and interest of the educational loans of such individ24 uals.’’ and inserting ‘‘$30,000 of the principal and interest 

25 of the educational loans of such individuals. With respect 


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1 to such an individual who enters into a new contract under 

2 the preceding sentence with the Secretary after 2009, the 

3 amount paid by the Federal Government pursuant to such 

4 contract shall be increased by the percentage increase in 

5 the gross domestic product since the beginning of the pre6 vious year.’’. 

7 (b) SCHOLARSHIPS FOR DISADVANTAGED STU8 DENTS.—Section 740(a) (42 U.S.C. 293d(a)) is amended 

9 by striking ‘‘$37,000,000’’ and all that follows through 

10 ‘‘2002’’ and inserting ‘‘$51,000,000 for fiscal year 2008, 

11 and such sums as may be necessary for each of the fiscal 

12 years 2009 through 2013’’. 

13 (c) REAUTHORIZATION FOR LOAN REPAYMENTS AND

14 FELLOWSHIPS REGARDING FACULTY POSITIONS.—Sec15 tion 740(b) (42 U.S.C. 293d(b)) is amended by striking 

16 ‘‘appropriated’’ and all that follows through the period at 

17 the end and inserting ‘‘appropriated, $5,000,000 for each 

18 of the fiscal years 2009 through 2013. For fiscal year 

19 2014 and each subsequent fiscal year, there is authorized 

20 to be appropriated the amount authorized for the pre21 ceding fiscal year increased by the percentage increase in 

22 the gross domestic product during such preceding fiscal 

23 year.’’. 

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1 VIDUALS FROM A DISADVANTAGED BACKGROUND.—Sec2 tion 740(c) of the Public Health Service Act (42 U.S.C. 

3 293d(c)) is amended by striking the first sentence and in4 serting the following: ‘‘For the purpose of grants and con5 tracts under section 739(a)(1), there is authorized to be 

6 appropriated $60,000,000 for fiscal year 2009 and such 

7 sums as may be necessary for each of the fiscal years 2010 

8 through 2013.’’ 

9 SEC. 6. TRAINING IN FAMILY MEDICINE, GENERAL INTER10 NAL MEDICINE, GENERAL PEDIATRICS, AND 

11 PHYSICIAN ASSISTANTSHIP; COMMUNITY 

12 HEALTH NEEDS ASSESSMENTS; PRIMARY 

13 CARE TRAINING INSTITUTES. 

14 Part C of title VII (42 U.S.C. 293k et seq.) is amend15 ed by striking section 747 and inserting the following: 

16 ‘‘SEC. 747. PRIMARY CARE TRAINING AND ENHANCEMENT. 

17 ‘‘(a) SUPPORT AND DEVELOPMENT OF PRIMARY

18 CARE TRAINING PROGRAMS.— 

19 ‘‘(1) IN GENERAL.—The Secretary may make 

20 grants to, or enter into contracts with, an accredited 

21 public or nonprofit private hospital, school of medi22 cine or osteopathic medicine, academically affiliated 

23 physician assistant training program, or a public or 

24 private nonprofit entity which the Secretary has deVerDate Aug 31 2005 23:39 Nov 21, 2008 Jkt 079200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\S3708.IS S3708

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1 termined is capable of carrying out such grant or 

2 contract— 

3 ‘‘(A) to plan, develop, operate, or partici4 pate in an accredited professional training pro5 gram, including an accredited residency or in6 ternship program in the field of family medi7 cine, general internal medicine, or general pedi8 atrics for medical students, interns, residents, 

9 or practicing physicians as defined by the Sec10 retary; 

11 ‘‘(B) to provide need-based financial assist12 ance in the form of traineeships and fellowships 

13 to medical students, interns, residents, prac14 ticing physicians, or other medical personnel, 

15 who are participants in any such program, and 

16 who plan to specialize or work in the practice 

17 of family medicine, general internal medicine, or 

18 general pediatrics; 

19 ‘‘(C) to plan, develop, and operate a pro20 gram for the training of physicians who plan to 

21 teach in family medicine, general internal medi22 cine, or general pediatrics training programs; 

23 ‘‘(D) to plan, develop, and operate a pro24 gram for the training of physicians teaching in 

25 community-based settings; 


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1 ‘‘(E) to provide financial assistance in the 

2 form of traineeships and fellowships to physi3 cians who are participants in any such pro4 grams and who plan to teach or conduct re5 search in a family medicine, general internal 

6 medicine, or general pediatrics training pro7 gram; 

8 ‘‘(F) to plan, develop, and operate a physi9 cian assistant education program, and for the 

10 training of individuals who will teach in pro11 grams to provide such training; 

12 ‘‘(G) to plan, develop, and operate an 

13 interdisciplinary training program that includes 

14 at least 1 of the following which demonstrates 

15 a team approach to care and may demonstrate 

16 a patient-centered medical home model: 

17 ‘‘(i) A program designed to teach 

18 trainees the skills to provide interdiscipli19 nary patient care through collaboration 

20 among various professionals, including 

21 those trained in geriatrics, physician as22 sistants, nurse practitioners, pharmacists, 

23 or social workers. 

24 ‘‘(ii) A program developed in collabo25 ration with dental students or residency 


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1 training programs to improve integration 

2 and access to dental care. 

3 ‘‘(iii) A program developed in collabo4 ration with psychologists and other behav5 ioral and mental health professionals to in6 tegrate mental and behavioral health and 

7 primary health care; and 

8 ‘‘(H) to plan, develop and operate joint de9 gree programs to provide interdisciplinary grad10 uate training in public health and other health 

11 professions to provide training in environmental 

12 health, infectious disease control, disease pre13 vention and health promotion, epidemiological 

14 studies and injury control. 

15 ‘‘(2) DURATION OF AWARDS.—The period dur16 ing which payments are made to an entity from an 

17 award of a grant or contract under this subsection 

18 shall be 5 years. 

19 ‘‘(b) CAPACITY BUILDING IN PRIMARY CARE.— 

20 ‘‘(1) IN GENERAL.—The Secretary may make 

21 grants to or enter into contracts with accredited 

22 schools of medicine or osteopathic medicine to estab23 lish, maintain, or improve academic units (which 

24 may be departments, divisions, or other units) or 

25 programs that improve clinical teaching and reVerDate Aug 31 2005 23:39 Nov 21, 2008 Jkt 079200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S3708.IS S3708

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1 search in family medicine, general internal medicine, 

2 or general pediatrics. 

3 ‘‘(2) PREFERENCE IN MAKING AWARDS UNDER

4 THIS SUBSECTION.—In making awards of grants 

5 and contracts under paragraph (1), the Secretary 

6 shall give preference to any qualified applicant for 

7 such an award that agrees to expend the award for 

8 the purpose of— 

9 ‘‘(A) establishing academic units or pro10 grams in family medicine; or 

11 ‘‘(B) substantially expanding such units or 

12 programs. 

13 ‘‘(3) PRIORITY IN MAKING AWARDS.—In mak14 ing awards of grants and contracts under paragraph 

15 (1), the Secretary shall give priority to any qualified 

16 applicant for such an award that proposes— 

17 ‘‘(A) a collaborative project between aca18 demic administrative units of primary care; and 

19 ‘‘(B) innovative approaches to clinical 

20 teaching using models of primary care, such as 

21 the patient centered medical home, team man22 agement of chronic disease, and interdiscipli23 nary integrated models of health care that in24 corporate transitions in health care settings and 


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1 integration physical and mental health provi2 sion. 

3 ‘‘(4) DURATION OF AWARDS.—The period dur4 ing which payments are made to an entity from an 

5 award of a grant or contract under this subsection 

6 shall be 5 years. 

7 ‘‘(c) COMMUNITY HEALTH NEEDS ASSESSMENT.— 

8 ‘‘(1) IN GENERAL.—The Secretary may award 

9 grants or enter into contracts with eligible entities to 

10 conduct community health needs assessments as de11 scribed by this subsection. 

12 ‘‘(2) ELIGIBLE ENTITY.—For purposes of this 

13 subsection, the term ‘eligible entity’ means an entity 

14 described in section 799(b). 

15 ‘‘(3) APPLICATION.—To receive a grant under 

16 this section, an eligible entity shall submit to the 

17 Secretary an application at such time, in such man18 ner, and containing such information as the Sec19 retary may require. 

20 ‘‘(4) CONTENT.—A community health needs as21 sessment shall— 

22 ‘‘(A) identify community needs for a health 

23 care workforce and collaborative programs and 

24 partnerships to address the needs; 


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1 ‘‘(B) identify barriers to health care in un2 derserved areas, health disparity populations, or 

3 regions experiencing significant changes in the 

4 cultural and linguistic demographics of their 

5 populations, including border communities; and 

6 ‘‘(C) provide assurance that the entity or 

7 entities conducting such assessment will assess 

8 how to— 

9 ‘‘(i) link community organizations and 

10 academic health centers to address commu11 nity health workforce training needs; 

12 ‘‘(ii) support development of a work13 force reflective of the cultural, linguistic, 

14 racial, and ethnic makeup of the popu15 lation involved; 

16 ‘‘(iii) address the barriers identified in 

17 subparagraph (B), with an emphasis on 

18 community based participatory research 

19 which includes local communities and pre20 pares members of the identified popu21 lations to participate in improving health 

22 care in these communities; 

23 ‘‘(iv) enhance the development of the 

24 workforce practicing in primary care; 


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1 ‘‘(v) enhance the development of the 

2 workforce serving underserved areas and 

3 health disparity populations; 

4 ‘‘(vi) build capacity and develop com5 petency within the health care delivery and 

6 public health systems; and 

7 ‘‘(vii) be responsive to national and 

8 local health issues impacting the work9 force, such as problems specific to children, 

10 emerging chronic diseases, an aging popu11 lation, infectious diseases, mental health or 

12 substance related disorders, or bioterrorism 

13 by employing such approaches as health 

14 promotion, health literacy, pharmaceutical 

15 case management, interdisciplinary inte16 grated models of health care that include 

17 both physical and mental health, cultural 

18 and linguistic competency, or approaches 

19 that reduce health disparities. 

20 ‘‘(5) TERM AND AMOUNT OF AWARD.—A grant 

21 awarded under this subsection shall be— 

22 ‘‘(A) for a term of 2 years; and 

23 ‘‘(B) in an amount of $150,000 for each 

24 year of the 2-year term. 

25 ‘‘(d) PRIMARY CARE TRAINING INSTITUTES.— 


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1 ‘‘(1) PURPOSE.—The purpose of the Primary 

2 Care Training Institute program established under 

3 this subsection is to— 

4 ‘‘(A) prepare and train primary care pro5 viders by enhancing and coordinating multiple 

6 aims within academic health centers in order to 

7 lead to improving patient care delivered to 

8 health disparity populations and reduce health 

9 disparities; 

10 ‘‘(B) enhance the status of primary care 

11 within undergraduate and graduate medical 

12 education through influencing priorities in prac13 tice, education, and research; 

14 ‘‘(C) develop innovative approaches to pri15 mary care education and scholarship by trans16 forming and integrating health care systems 

17 through interdisciplinary, team-based, and col18 laborative models that may demonstrate im19 proved quality or lower costs; and 

20 ‘‘(D) create economies of scale through 

21 academic and community collaborations by ena22 bling academic infrastructure support for mul23 tiple community programs. 

24 ‘‘(2) ESTABLISHMENT.—Grants or contracts 

25 awarded under this subsection shall establish new 


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1 centers for primary care education and research 

2 within academic units of family medicine, general in3 ternal medicine, or general pediatrics within aca4 demic health centers. Such new centers shall be 

5 known as Primary Care Training Institutes (referred 

6 to in this section as ‘PCTIs’). 

7 ‘‘(3) AUTHORITY TO AWARD GRANTS.—The 

8 Secretary may make grants to or enter into con9 tracts with eligible entities to develop and implement 

10 PCTIs in accordance with this subsection. 

11 ‘‘(4) ELIGIBLE ENTITY.—For purposes of this 

12 subsection, the term ‘eligible entity’ means a pri13 mary care (including family medicine, general inter14 nal medicine, and general pediatrics) academic ad15 ministrative unit. 

16 ‘‘(5) APPLICATION; REQUIREMENT FOR NEEDS

17 ASSESSMENT.—An eligible entity desiring a grant 

18 under this subsection shall submit to the Secretary 

19 an application at such time, in such manner, and 

20 containing— 

21 ‘‘(A)(i) a community health needs assess22 ment conducted by such eligible entity through 

23 a grant awarded under subsection (c); or 

24 ‘‘(ii) a community health needs assessment 

25 conducted by such entity through other means 


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1 and that meets the requirements of subsection 

2 (c); and 

3 ‘‘(B) such information as the Secretary 

4 may require. 

5 ‘‘(6) FUNCTIONS.—An eligible entity shall use 

6 amounts awarded under a grant under this sub7 section to carry out the purpose described in para8 graph (1), through— 

9 ‘‘(A) establishment of a PCTI to improve 

10 primary care training and practice, to improve 

11 recruitment of underrepresented minority stu12 dents into primary care careers, and to improve 

13 the number and percentage of trained profes14 sionals serving in underserved areas and health 

15 disparity populations; and 

16 ‘‘(B) the establishment of infrastructure to 

17 support the PCTI including development of, 

18 and training in— 

19 ‘‘(i) curriculum designs; 

20 ‘‘(ii) education evaluation tools; 

21 ‘‘(iii) online interactive educational 

22 curricula; 

23 ‘‘(iv) community-based and population 

24 research study designs; 


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1 ‘‘(v) applied behavioral science and 

2 psychology educational programs; 

3 ‘‘(vi) clinical epidemiology; 

4 ‘‘(vii) models for teaching caring for 

5 older adults; 

6 ‘‘(viii) models for health services deliv7 ery; 

8 ‘‘(ix) public health and preventive 

9 medicine; and 

10 ‘‘(x) models for teaching cultural com11 petency and health literacy. 

12 ‘‘(7) REQUIREMENTS.— 

13 ‘‘(A) REQUIRED ACTIVITIES.—Each eligi14 ble entity that establishes a PCTI under this 

15 subsection shall, through such PCTI— 

16 ‘‘(i) collaborate across disciplines in17 cluding family medicine, general internal 

18 medicine, general pediatrics, or with dis19 ciplines such as physician assistants and 

20 those certified in geriatrics or gerontology, 

21 general dentistry, behavioral and mental 

22 health, or public health; 

23 ‘‘(ii) establish and maintain formal 

24 partnerships with area health education 

25 centers, Federally qualified health centers, 


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1 rural health clinics, hospital and nonhos2 pital-based teaching clinics, Geriatric Edu3 cation Centers, Geriatric Research Edu4 cation and Clinical Centers, or other facili5 ties focused on social and health needs of 

6 older adults or other underserved areas, 

7 health disparity populations, and other vul8 nerable populations, such as older adults, 

9 homeless individuals, victims of abuse or 

10 trauma, individuals with mental health or 

11 substance-related disorders, and individ12 uals with HIV/AIDS; 

13 ‘‘(iii) create new models of teaching 

14 and evaluating patient care based on the 

15 patient centered medical home model, 

16 interdisciplinary integrated models of 

17 health care that incorporate both physical 

18 and mental health, drug therapy manage19 ment, or other new models of effective pa20 tient care utilizing a team or collaborative 

21 approach; 

22 ‘‘(iv) conduct research and education 

23 that improves or is relevant to community 

24 practice and that is carried out in commu25 nity or primary care settings, and that 


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1 may address such issues as environmental 

2 health, infectious disease control, disease 

3 prevention, health promotion, and injury 

4 control; 

5 ‘‘(v) increase the number of trainees 

6 and faculty from underrepresented minor7 ity groups, and from rural disadvantaged 

8 backgrounds; and 

9 ‘‘(vi) address the changing national, 

10 regional, and local health care needs and 

11 priorities as identified in the community 

12 health needs assessment submitted by such 

13 eligible entity in the application under this 

14 subsection. 

15 ‘‘(B) VOLUNTARY ACTIVITIES.—Each eligi16 ble entity that establishes a PCTI under this 

17 subsection may, through such PCTI, integrate 

18 programs along the educational continuum, in19 cluding high school and college pipeline pro20 grams, predoctoral education in primary care, 

21 primary care residency training, faculty devel22 opment, fellowship programs, and primary care 

23 research infrastructure programs and inter24 disciplinary joint degree programs in graduate 


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1 public health training and other health profes2 sions. 

3 ‘‘(8) TERM AND AMOUNT OF AWARD.—A grant 

4 awarded under this subsection shall be— 

5 ‘‘(A) for a term of 5 years; and 

6 ‘‘(B) in an amount of $750,000 for each 

7 year of the 5-year term. 

8 ‘‘(e) PRIORITIES IN MAKING AWARDS.—With respect 

9 to the training provided for under this section, the Sec10 retary shall give priority in awarding grants or contracts 

11 to the following: 

12 ‘‘(1) Qualified applicants that have a record of 

13 training individuals who are from underrepresented 

14 minority groups or from a rural or disadvantaged 

15 background. 

16 ‘‘(2) Qualified applicants that establish formal 

17 relationships with Federally qualified health centers, 

18 rural health centers, or accredited teaching facilities 

19 located in underserved areas or serve health dis20 parity populations, and that conduct training of stu21 dents, residents, fellows, or faculty at the center or 

22 facility. 

23 ‘‘(3) Qualified applicants that conduct teaching 

24 programs targeting vulnerable populations such as 

25 older adults, homeless individuals, victims of abuse 


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1 or trauma, individuals with mental health or sub2 stance-related disorders, and individuals with HIV/ 

3 AIDS. 

4 ‘‘(4) Qualified applicants that include edu5 cational activities in care of older adults. 

6 ‘‘(5) Qualified applicants that conduct teaching 

7 programs in an interdiscliplinary setting dem8 onstrating a team or collaborative approach to care. 

9 ‘‘(6) Qualified applicants that include edu10 cational activities in cultural competency and health 

11 literacy. 

12 ‘‘(f) PREFERENCE IN MAKING AWARDS UNDER THIS

13 SECTION.—In making awards of grants or contracts 

14 under this section, the Secretary shall give preference to 

15 any qualified applicant that— 

16 ‘‘(1) has a high rate for placing graduates in 

17 practice settings having the principle focus of serv18 ing underserved areas or health disparity popu19 lations; 

20 ‘‘(2) during the 2-year period preceding the fis21 cal year for which such an award is sought, has 

22 achieved a significant increase in the rate of placing 

23 graduates in such settings; or 

24 ‘‘(3) have a record of training the greatest per25 centage of providers, or that have demonstrated sigVerDate Aug 31 2005 23:39 Nov 21, 2008 Jkt 079200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6201 E:\BILLS\S3708.IS S3708

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1 nificant improvements in the percentage of pro2 viders, who enter and remain in primary care prac3 tice. 

4 ‘‘(g) APPLICATION.—An eligible entity desiring a 

5 grant under this section shall submit to the Secretary an 

6 application at such time, in such manner, and containing 

7 such information as the Secretary may require. 

8 ‘‘(h) DUTIES OF SECRETARY.—The Secretary shall, 

9 in carrying out this section and section 748— 

10 ‘‘(1) require collaboration— 

11 ‘‘(A) among the pertinent workforce pro12 grams within this title and the Department of 

13 Health and Human Services; and 

14 ‘‘(B) among such pertinent programs ad15 ministered by the Department of Labor and the 

16 Department of Education; 

17 ‘‘(2) use and adequately support existing pro18 grams to address new Departmental initiatives, as 

19 appropriate; 

20 ‘‘(3) take into consideration capabilities of ex21 isting programs before creating separate or parallel 

22 programs; and 

23 ‘‘(4) evaluate and publicly report on the effec24 tiveness of such programs on an annual basis. 


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1 ‘‘(i) RURAL BACKGROUND DEFINED.—For purposes 

2 of this section, the term ‘rural background’ means, with 

3 respect to an individual, having grown up, lived a substan4 tial portion of such individual’s life, or attended high 

5 school in a federally designated rural or nonmetropolitan 

6 area. 

7 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 

8 ‘‘(1) TRAINING PROGRAMS.—There is author9 ized to be appropriated to carry out subsections (a) 

10 and (b), $125,000,000 for each of the fiscal years 

11 2009 through 2014, of which 15 percent of the 

12 amount appropriated in each such fiscal year shall 

13 be allocated to physician assistant training programs 

14 as described under subsection (a)(1)(F), which pre15 pare students for practice in primary care settings. 

16 ‘‘(2) COMMUNITY HEALTH NEEDS ASSESS17 MENTS.—There is authorized to be appropriated to 

18 carry out subsection (c)— 

19 ‘‘(A) $1,800,000 for fiscal year 2009; and 

20 ‘‘(B) $3,600,000 for each of the fiscal 

21 years 2010 through 2013. 

22 ‘‘(3) PRIMARY CARE TRAINING INSTITUTES.— 

23 There is authorized to be appropriated to carry out 

24 subsection (d)— 

25 ‘‘(A) $6,000,000 for fiscal year 2009; 


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1 ‘‘(B) $12,000,000 for fiscal year 2010; 

2 ‘‘(C) $18,000,000 for fiscal year 2011; 

3 ‘‘(D) $24,000,000 for fiscal year 2012; 

4 and 

5 ‘‘(E) $30,000,000 for fiscal year 2013. 

6 ‘‘(4) CARRYOVER FUNDS.—An entity that re7 ceives an award under this section may carry over 

8 funds from 1 fiscal year to another without obtain9 ing approval from the Secretary. In no case may any 

10 funds be carried over pursuant to the preceding sen11 tence for more than 3 years, and in the case of a 

12 community health needs assessment under sub13 section (c), for more than 1 year.’’. 

14 SEC. 7. TRAINING IN GENERAL AND PEDIATRIC DEN15 TISTRY; LOAN REPAYMENTS. 

16 (a) TRAINING IN GENERAL AND PEDIATRIC DEN17 TISTRY.—Part C of Title VII (42 U.S.C. 293k et seq.) 

18 is amended by— 

19 (1) redesignating section 748 as section 749; 

20 and 

21 (2) inserting after section 747 the following: 

22 ‘‘SEC. 748. TRAINING IN GENERAL AND PEDIATRIC DEN23 TISTRY. 

24 ‘‘(a) SUPPORT AND DEVELOPMENT OF DENTAL

25 TRAINING PROGRAMS.— 


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1 ‘‘(1) IN GENERAL.—The Secretary may make 

2 grants to, or enter into contracts with, a school of 

3 dentistry, public or nonprofit private hospital, or a 

4 public or private nonprofit entity which the Sec5 retary has determined is capable of carrying out 

6 such grant or contract— 

7 ‘‘(A) to plan, develop, and operate, or par8 ticipate in, an approved professional training 

9 program in the field of general dentistry, or pe10 diatric dentistry for dental students, residents, 

11 or practicing dentists, that emphasizes training 

12 for general dentistry or pediatric dentistry; 

13 ‘‘(B) to provide financial assistance to den14 tal students, residents, and practicing dentists 

15 who are in need thereof, who are participants in 

16 any such program, and who plan to work in the 

17 practice of general or pediatric dentistry; 

18 ‘‘(C) to plan, develop, and operate a pro19 gram for the training of dentists who plan to 

20 teach in general or pediatric dentistry; and 

21 ‘‘(D) to provide financial assistance in the 

22 form of traineeships and fellowships to dentists 

23 who plan to teach or are teaching in general or 

24 pediatric dentistry. 


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1 ‘‘(2) ELIGIBLE ENTITY.—For purposes of this 

2 subsection, entities eligible for such grants or con3 tracts in general or pediatric dentistry shall include 

4 entities that have programs in dental schools, or ap5 proved residency or advanced education programs in 

6 the practice of general or pediatric dentistry. 

7 ‘‘(b) ACADEMIC ADMINISTRATIVE UNITS.— 

8 ‘‘(1) IN GENERAL.—The Secretary may make 

9 grants to or enter into contracts with schools of den10 tistry to meet the costs of projects to establish, 

11 maintain, or improve academic administrative units 

12 (which may be departments, divisions, or other 

13 units) to provide clinical instruction in general or pe14 diatric dentistry. 

15 ‘‘(2) PRIORITY IN MAKING AWARDS.—In mak16 ing awards of grants and contracts under paragraph 

17 (1), the Secretary shall give priority to any qualified 

18 applicant for such an award that proposes a collabo19 rative project between departments of primary care 

20 medicine and departments of general and pediatric 

21 dentistry. 

22 ‘‘(3) PREFERENCE IN MAKING AWARDS.—In 

23 making awards of grants and contracts under para24 graph (1), the Secretary shall give preference to any 


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1 qualified applicant for such an award that agrees to 

2 expend the award for the purpose of— 

3 ‘‘(A) establishing an academic administra4 tive unit for programs in general or pediatric 

5 dentistry; and 

6 ‘‘(B) substantially expanding the programs 

7 of such a unit. 

8 ‘‘(c) PRIORITIES IN MAKING AWARDS UNDER THIS

9 SECTION.—With respect to training provided for under 

10 this section, the Secretary shall give priority in awarding 

11 grants or contracts to the following: 

12 ‘‘(1) Qualified applicants that have a record of 

13 training the greatest percentage of providers, or that 

14 have demonstrated significant improvements in the 

15 percentage of providers, who enter and remain in 

16 general or pediatric dentistry. 

17 ‘‘(2) Qualified applicants that have a record of 

18 training individuals who are from a rural or dis19 advantaged background, or from underrepresented 

20 minorities. 

21 ‘‘(3) Qualified applicants that establish formal 

22 relationships with Federally qualified health centers, 

23 rural health centers, or accredited teaching facilities 

24 and that conduct training of students, residents, fel25 lows, or faculty at the center or facility. 


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1 ‘‘(4) Qualified applicants that conduct teaching 

2 programs targeting vulnerable populations such as 

3 older adults, homeless individuals, victims of abuse 

4 or trauma, individuals with mental health or sub5 stance-related disorders, and individuals with HIV/ 

6 AIDS. 

7 ‘‘(5) Qualified applicants that include edu8 cational activities in cultural competency and health 

9 literacy. 

10 ‘‘(d) PREFERENCE IN MAKING AWARDS.—In making 

11 awards of grants or contracts under this section, the Sec12 retary shall give preference to any qualified applicant 

13 that— 

14 ‘‘(1) has a high rate for placing graduates in 

15 practice settings having the principal focus of serv16 ing in underserved areas or health disparity popu17 lations; or 

18 ‘‘(2) during the 2-year period before the fiscal 

19 year for which such an award is sought, has 

20 achieved a significant increase in the rate of placing 

21 graduates in such settings. 

22 ‘‘(e) APPLICATION.—An eligible entity desiring a 

23 grant under this section shall submit to the Secretary an 

24 application at such time, in such manner, and containing 

25 such information as the Secretary may require. 


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1 ‘‘(f) DURATION OF AWARD.—The period during 

2 which payments are made to an entity from an award of 

3 a grant or contract under subsection (a) shall be 5 years. 

4 The provision of such payments shall be subject to annual 

5 approval by the Secretary of the payments and subject to 

6 the availability of appropriations for the fiscal year in7 volved to make the payments. 

8 ‘‘(g) FUNDING.—For the purpose of carrying out 

9 subsections (a) and (b), there is authorized to be appro10 priated $20,000,000 for each of the fiscal years 2009 

11 through 2013. 

12 ‘‘(h) CARRYOVER FUNDS.—An entity that receives an 

13 award under this section may carry over funds from 1 fis14 cal year to another without obtaining approval from the 

15 Secretary. In no case may any funds be carried over pur16 suant to the preceding sentence for more than 3 years.’’. 

17 (b) LOAN REPAYMENTS FOR DENTAL PROFES18 SIONALS.— 

19 (1) IN GENERAL.—Section 738(a) (42 U.S.C. 

20 293b(a)) is amended by inserting at the end the fol21 lowing: 

22 ‘‘(7) PRIORITY FOR DENTAL PROFESSIONALS.— 

23 In entering into contracts under this subsection, the 

24 Secretary shall give priority to individuals who— 


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1 ‘‘(A) are teaching or doing research in an 

2 academic dental setting in general or pediatric 

3 dentistry; 

4 ‘‘(B) have a degree in dentistry; 

5 ‘‘(C) are enrolled in an approved graduate 

6 training program in dentistry; or 

7 ‘‘(D) are enrolled as full-time students— 

8 ‘‘(i) in an accredited (as determined 

9 by the Secretary) school of dentistry; and 

10 ‘‘(ii) in the final year of a course of 

11 a study or program, offered by such insti12 tution and approved by the Secretary, lead13 ing to a degree from such a school.’’. 

14 (2) AUTHORIZATION OF APPROPRIATIONS.— 

15 Section 740(b) (42 U.S.C. 293d(b)) is amended by 

16 adding at the end the following: ‘‘In addition to any 

17 amounts authorized under this subsection, there is 

18 authorized to be appropriated to enter into contracts 

19 under section 738(a) with individuals described in 

20 section 738(a)(7), $500,000 for fiscal year 2009, 

21 $1,000,000 for fiscal year 2010, $1,500,000 for fis22 cal year 2011, and $2,000,000 for each of the fiscal 

23 years 2012 and 2013.’’. 


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1 SEC. 8. INTERDISCIPLINARY, COMMUNITY-BASED LINK2 AGES. 

3 (a) AREA HEALTH EDUCATION CENTERS.—Section 

4 751 (42 U.S.C. 294a) is amended to read as follows: 

5 ‘‘SEC. 751. AREA HEALTH EDUCATION CENTERS. 

6 ‘‘(a) DEFINITIONS; ESTABLISHMENT OF AWARDS.— 

7 ‘‘(1) DEFINITIONS.—In this section: 

8 ‘‘(A) AREA HEALTH EDUCATION CEN9 TER.—The terms ‘area health education center’ 

10 or ‘center’ mean a public or nonprofit private 

11 organization that has a cooperative agreement 

12 or contract in effect with an entity that has re13 ceived an award under subsection (b) or (c), 

14 satisfies the requirements in subsection (d)(1), 

15 and has as one of its principal functions the op16 eration of an area health education center. Ap17 propriate organizations may include hospitals, 

18 health organizations with accredited primary 

19 care training programs, accredited physician as20 sistant educational programs associated with a 

21 college or university, and universities or colleges 

22 not operating a school of medicine or osteo23 pathic medicine. 

24 ‘‘(B) AREA HEALTH EDUCATION CENTER

25 PROGRAM.—The terms ‘area health education 

26 center program’ or ‘program’ mean cooperative 


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1 program consisting of an entity that has re2 ceived an award under subsection (b) or (c) for 

3 the purpose of planning, developing, operating, 

4 and evaluating an area health education center 

5 program and one or more area health education 

6 centers, which carries out the required activities 

7 described in subsection (b)(4) or (c)(4), satisfies 

8 the program requirements in this section, and 

9 has as one of its principal functions identifying 

10 and implementing strategies and activities that 

11 address health care workforce needs in its serv12 ice area. 

13 ‘‘(C) RURAL BACKGROUND.—For purposes 

14 of this section, the term ‘rural background’ 

15 means, with respect to an individual, having 

16 grown up, lived a substantial portion of such in17 dividual’s life, or attended high school in a fed18 erally designated rural or nonmetropolitan area. 

19 ‘‘(2) ESTABLISHMENT.—The Secretary shall 

20 make awards in accordance with this section. 

21 ‘‘(b) INFRASTRUCTURE DEVELOPMENT AWARD.— 

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

23 awards to eligible entities to enable such entities to 

24 initiate health care workforce educational programs 

25 or to continue to carry out comparable programs 


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1 that are operating at the time the award is made by 

2 planning, developing, operating, and evaluating of an 

3 area health education center program. 

4 ‘‘(2) ELIGIBLE ENTITY.—For purposes of this 

5 subsection, an ‘eligible entity’ means a school of 

6 medicine or osteopathic medicine, an incorporated 

7 consortium of such schools, or the parent institu8 tions of such a school. With respect to a State in 

9 which no area health education center program is in 

10 operation, the Secretary may award a grant or con11 tract under paragraph (1) to a school of nursing. 

12 ‘‘(3) APPLICATION.—An eligible entity desiring 

13 to receive an award under this subsection shall sub14 mit to the Secretary an application at such time, in 

15 such manner, and containing such information as 

16 the Secretary may require. 

17 ‘‘(4) USE OF FUNDS.— 

18 ‘‘(A) REQUIRED ACTIVITIES.—An eligible 

19 entity shall use amounts awarded under a grant 

20 under paragraph (1) to carry out the following 

21 activities: 

22 ‘‘(i) Develop and implement strategies 

23 to recruit individuals from underrep24 resented minority populations or from dis25 advantaged or rural backgrounds into 


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1 health professions, and support such indi2 viduals in attaining such careers. 

3 ‘‘(ii) Develop and implement strate4 gies to foster and provide community-based 

5 training and education to individuals seek6 ing careers in health professions within un7 derserved areas for the purpose of devel8 oping and maintaining a diverse health 

9 care workforce that is prepared to deliver 

10 high-quality care, with an emphasis on pri11 mary care, in underserved areas or for 

12 health disparity populations, in collabora13 tion with other Federal and State health 

14 care workforce development programs, and 

15 in health care safety net sites. 

16 ‘‘(iii) Prepare individuals to more ef17 fectively provide health services to under18 served areas and health disparity popu19 lations through field placements or precep20 torships in conjunction with community21 based organizations, accredited primary 

22 care residency training programs, Feder23 ally qualified health centers, rural health 

24 clinics, public health departments, or other 

25 appropriate facilities. 


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1 ‘‘(iv) Conduct and participate in inter2 disciplinary training that involves physi3 cians, physician assistants, nurse practi4 tioners, nurse midwives, dentists, psycholo5 gists, pharmacists, public health, or other 

6 health professionals, as practicable. 

7 ‘‘(v) Deliver or facilitate continuing 

8 education and information dissemination 

9 programs for health care professionals, 

10 with an emphasis on individuals providing 

11 care in underserved areas and for health 

12 disparity populations. 

13 ‘‘(vi) Propose and implement effective 

14 program and outcomes measurement and 

15 evaluation strategies. 

16 ‘‘(B) INNOVATIVE OPPORTUNITIES.—An 

17 eligible entity may use amounts awarded under 

18 a grant under paragraph (1) to carry out any 

19 of the following activities: 

20 ‘‘(i) Develop and implement innovative 

21 curricula in collaboration with community22 based accredited primary care residency 

23 training programs, Federally qualified 

24 health centers, rural health clinics, behav25 ioral and mental health facilities, public 


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1 health departments, or other appropriate 

2 facilities, with the goal of increasing the 

3 number of primary care physicians and 

4 other primary care providers prepared to 

5 serve in underserved areas and health dis6 parity populations. 

7 ‘‘(ii) Coordinate community-based 

8 participatory research with academic 

9 health centers, and facilitate rapid flow 

10 and dissemination of evidence-based health 

11 care information, research results, and best 

12 practices to improve quality, efficiency, and 

13 effectiveness of health care and health care 

14 systems within community settings. 

15 ‘‘(iii) Develop and implement other 

16 strategies to address identified workforce 

17 needs and increase and enhance the health 

18 care workforce in the area served by the 

19 area health education center program. 

20 ‘‘(c) POINT OF SERVICE MAINTENANCE AND EN21 HANCEMENT AWARD.— 

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

23 awards to eligible entities to maintain and improve 

24 the effectiveness and capabilities of an existing area 

25 health education center program, and make other 


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1 modifications to the program that are appropriate 

2 due to changes in demographics, needs of the popu3 lations served, or other similar issues affecting the 

4 program. 

5 ‘‘(2) ELIGIBLE ENTITY.—For purposes of this 

6 subsection, the term ‘eligible entity’ means an entity 

7 that has received funds under this section (as this 

8 section was in effect on the day before the date of 

9 enactment of the Health Professions and Primary 

10 Care Reinvestment Act), is operating an area health 

11 education center program, including area health edu12 cation centers, and has a center or centers that are 

13 no longer eligible to receive financial assistance 

14 under subsection (b). 

15 ‘‘(3) APPLICATION.—An eligible entity desiring 

16 to receive an award under this subsection shall sub17 mit to the Secretary an application at such time, in 

18 such manner, and containing such information as 

19 the Secretary may require. 

20 ‘‘(4) USE OF FUNDS.— 

21 ‘‘(A) REQUIRED ACTIVITIES.—An eligible 

22 entity shall use amounts awarded under a grant 

23 under paragraph (1) to carry out the following 

24 activities: 


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1 ‘‘(i) Develop and implement strategies 

2 to recruit individuals from underrep3 resented minority groups, underserved 

4 areas, or with rural backgrounds into 

5 health care careers, and support such indi6 viduals in attaining such careers. 

7 ‘‘(ii) Develop and implement strate8 gies to foster and provide community-based 

9 training and education to individuals seek10 ing careers in health professions within un11 derserved areas for the purpose of devel12 oping and maintaining a diverse health 

13 care workforce that is prepared to deliver 

14 high-quality care, with an emphasis on pri15 mary care, in underserved areas and to 

16 health disparity populations, in collabora17 tion with other Federal and State health 

18 care workforce development programs, and 

19 in health care safety net sites. 

20 ‘‘(iii) Prepare individuals to more ef21 fectively provide health services to under22 served areas or health disparity popu23 lations through field placements or precep24 torships in conjunction with community25 based organizations, accredited primary 


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1 care residency training programs, Feder2 ally qualified health centers, rural health 

3 clinics, behavioral and mental health facili4 ties, public health departments, or other 

5 appropriate facilities. 

6 ‘‘(iv) Conduct and participate in inter7 disciplinary training that involves physi8 cians, physician assistants, nurse practi9 tioners, nurse midwives, dentists, psycholo10 gists, pharmacists, public health, or other 

11 health professionals, as practicable. 

12 ‘‘(v) Deliver or facilitate continuing 

13 education and information dissemination 

14 programs for health care professionals, 

15 with an emphasis on individuals providing 

16 care in underserved areas and for health 

17 disparity populations. 

18 ‘‘(vi) Propose and implement effective 

19 program and outcomes measurement and 

20 evaluation strategies. 

21 ‘‘(B) INNOVATIVE OPPORTUNITIES.—An 

22 eligible entity shall use amounts awarded under 

23 a grant under paragraph (1) to carry out at 

24 least 1 of the following activities: 


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1 ‘‘(i) Develop innovative curricula in 

2 collaboration with community-based ac3 credited primary care residency training 

4 programs, Federally qualified health cen5 ters, rural health clinics, behavioral and 

6 mental health facilities, public health de7 partments, or other appropriate facilities, 

8 with the goal of increasing the number of 

9 primary care physicians and other primary 

10 care providers prepared to serve in under11 served areas and health disparity popu12 lations. 

13 ‘‘(ii) Coordinate community-based 

14 participatory research with academic 

15 health centers, and facilitate rapid flow 

16 and dissemination of evidence-based health 

17 care information, research results, and best 

18 practices to improve quality, efficiency, and 

19 effectiveness of health care and health care 

20 systems within community settings. 

21 ‘‘(iii) Develop and implement other 

22 strategies to address identified workforce 

23 needs and increase and enhance the health 

24 care workforce in the area served by the 

25 area health education center program. 


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1 ‘‘(d) REQUIREMENTS.— 

2 ‘‘(1) AREA HEALTH EDUCATION CENTER PRO3 GRAM.—In carrying out this section, the Secretary 

4 shall ensure the following: 

5 ‘‘(A) An entity that receives an award 

6 under this section shall conduct at least 10 per7 cent of clinical education required for medical 

8 students in community settings that are re9 moved from the primary teaching facility of the 

10 contracting institution for grantees that operate 

11 a school of medicine or osteopathic medicine. In 

12 States in which an entity that receives an 

13 award under this section is a nursing school or 

14 its parent institution, the Secretary shall alter15 natively ensure that— 

16 ‘‘(i) the nursing school places at least 

17 10 percent of its students in training sites 

18 affiliated with an area health education 

19 center that is remote from the primary 

20 teaching facility of the school; and 

21 ‘‘(ii) the entity receiving the award 

22 maintains a written agreement with a 

23 school of medicine or osteopathic medicine 

24 to place students from that school in trainVerDate Aug 31 2005 23:39 Nov 21, 2008 Jkt 079200 PO 00000 Frm 00056 Fmt 6652 Sfmt 6201 E:\BILLS\S3708.IS S3708

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1 ing sites in the area health education cen2 ter program area. 

3 ‘‘(B) An entity receiving funds under sub4 section (c) does not distribute such funding to 

5 a center that is eligible to receive funding under 

6 subsection (b). 

7 ‘‘(2) AREA HEALTH EDUCATION CENTER.—The 

8 Secretary shall ensure that each area health edu9 cation center program includes at least 1 area health 

10 education center, and that each such center— 

11 ‘‘(A) is a public or private organization 

12 whose structure, governance, and operation is 

13 independent from the awardee and the parent 

14 institution of the awardee; 

15 ‘‘(B) is not a school of medicine or osteo16 pathic medicine, the parent institution of such 

17 a school, or a branch campus or other subunit 

18 of a school of medicine or osteopathic medicine 

19 or its parent institution, or a consortium of 

20 such entities; 

21 ‘‘(C) designates an underserved area or 

22 population to be served by the center which is 

23 in a location removed from the main location of 

24 the teaching facilities of the schools partici25 pating in the program with such center and 


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1 does not duplicate, in whole or in part, the geo2 graphic area or population served by any other 

3 center; 

4 ‘‘(D) fosters networking and collaboration 

5 among communities and between academic 

6 health centers and community-based centers; 

7 ‘‘(E) serves communities with a dem8 onstrated need of health professionals in part9 nership with academic medical centers; 

10 ‘‘(F) addresses the health care workforce 

11 needs of the communities served; 

12 ‘‘(G) has a community-based governing or 

13 advisory board that reflects the diversity of the 

14 communities involved; 

15 ‘‘(H) addresses changes in local community 

16 health and demographics identified in— 

17 ‘‘(i) a community health needs assess18 ment that was conducted by the area 

19 health education center through a grant 

20 awarded under section 748(a); or 

21 ‘‘(ii) a community health needs as22 sessment that was conducted by such cen23 ter through other means and that meets 

24 the requirements of section 748(a); and 


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1 ‘‘(I) evaluates and reports to the Sec2 retary, in collaboration with the area health 

3 education center program of which the center is 

4 a part, concerning the effectiveness of the cen5 ter on an annual basis. 

6 ‘‘(e) DUTIES OF THE SECRETARY.—In carrying out 

7 this section, the Secretary shall— 

8 ‘‘(1) require collaboration— 

9 ‘‘(A) among the pertinent workforce pro10 grams under this title and the Department of 

11 Health and Human Services; and 

12 ‘‘(B) among such pertinent programs ad13 ministered by the Department of Labor and the 

14 Department of Education; 

15 ‘‘(2) use and adequately support existing pro16 grams to address new initiatives of the Department 

17 of Health and Human Services, as appropriate; 

18 ‘‘(3) take into consideration capabilities of ex19 isting programs prior to establishing separate or 

20 parallel programs; and 

21 ‘‘(4) evaluate and publicly report on the effec22 tiveness of such programs on an annual basis. 

23 ‘‘(f) MATCHING FUNDS.—With respect to the costs 

24 of operating a program through a grant under this section, 

25 to be eligible for financial assistance under this section, 


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1 an entity shall make available (directly or through con2 tributions from State, county or municipal governments, 

3 or the private sector) recurring non-Federal contributions 

4 in cash or in kind, toward such costs in an amount that 

5 is equal to not less than 50 percent of such costs. At least 

6 25 percent of the total required non-Federal contributions 

7 shall be in cash. An entity may apply to the Secretary 

8 for a waiver of not more than 75 percent of the matching 

9 fund amount required by the entity for each of the first 

10 3 years the entity is funded through a grant under sub11 section (b). 

12 ‘‘(g) LIMITATION.—Not less than 75 percent of the 

13 total amount provided to an area health education center 

14 program under subsection (b) or (c) shall be allocated to 

15 the area health education centers participating in the pro16 gram under this section. To provide needed flexibility to 

17 newly funded area health education center programs, the 

18 Secretary may waive the requirement in the sentence for 

19 the first 2 years of a new area health education center 

20 program funded under subsection (b). 

21 ‘‘(h) AWARD.—An award to an entity under this sec22 tion shall be not less than $250,000 annually per area 

23 health education center included in the program involved. 

24 If amounts appropriated to carry out this section are not 

25 sufficient to comply with the preceding sentence, the SecVerDate Aug 31 2005 23:39 Nov 21, 2008 Jkt 079200 PO 00000 Frm 00060 Fmt 6652 Sfmt 6201 E:\BILLS\S3708.IS S3708

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1 retary may reduce the per center amount provided for in 

2 such sentence as necessary, provided the distribution es3 tablished in subsection (l)(2) is maintained. 

4 ‘‘(i) PROJECT TERMS.— 

5 ‘‘(1) IN GENERAL.—Except as provided in para6 graph (2), the period during which payments may be 

7 made under an award under subsection (b) may not 

8 exceed— 

9 ‘‘(A) in the case of a program, 12 years; 

10 or 

11 ‘‘(B) in the case of a center within a pro12 gram, 6 years. 

13 ‘‘(2) EXCEPTION.—The periods described in 

14 paragraph (1) shall not apply to programs receiving 

15 point of service maintenance and enhancement 

16 awards under subsection (c) to maintain existing 

17 centers and activities. 

18 ‘‘(j) INAPPLICABILITY OF PROVISION.—Notwith19 standing any other provision of this title, section 791(a) 

20 shall not apply to an area health education center funded 

21 under this section. 

22 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.— 

23 ‘‘(1) IN GENERAL.—There is authorized to be 

24 appropriated to carry out this section $125,000,000 

25 for each of the fiscal years 2009 through 2013. 


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1 ‘‘(2) REQUIREMENTS.—Of the amounts appro2 priated for a fiscal year under subparagraph (A)— 

3 ‘‘(A) not more than 35 percent shall be 

4 used for awards under subsection (b); 

5 ‘‘(B) not less than 60 percent shall be used 

6 for awards under subsection (c); 

7 ‘‘(C) not more than 1 percent shall be used 

8 for grants and contracts to implement outcomes 

9 evaluation for the area health education cen10 ters; and 

11 ‘‘(D) not more than 4 percent shall be 

12 used for grants and contracts to provide tech13 nical assistance to entities receiving awards 

14 under this section. 

15 ‘‘(3) CARRYOVER FUNDS.—An entity that re16 ceives an award under this section may carry over 

17 funds from 1 fiscal year to another without obtain18 ing approval from the Secretary. In no case may any 

19 funds be carried over pursuant to the preceding sen20 tence for more than 3 years. 

21 ‘‘(l) SENSE OF CONGRESS.—It is the sense of the 

22 Congress that every State have an area health education 

23 center program in effect under this section.’’. 

24 (b) CONTINUING EDUCATIONAL SUPPORT FOR

25 HEALTH PROFESSIONALS SERVING IN UNDERSERVED


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1 COMMUNITIES.—Part D of title VII (42 U.S.C. 294 et 

2 seq.) is amended by striking section 752 and inserting the 

3 following: 

4 ‘‘SEC. 752. CONTINUING EDUCATIONAL SUPPORT FOR 

5 HEALTH PROFESSIONALS SERVING IN UN6 DERSERVED COMMUNITIES. 

7 ‘‘(a) IN GENERAL.—The Secretary shall make grants 

8 to, and enter into contracts with, eligible entities to im9 prove health care, increase retention, increase representa10 tion of minority faculty members, enhance the practice en11 vironment, and provide information dissemination and 

12 educational support to reduce professional isolation 

13 through the timely dissemination of research findings 

14 using relevant resources. 

15 ‘‘(b) ELIGIBLE ENTITIES.—For purposes of this sec16 tion, the term ‘eligible entity’ means an entity described 

17 in section 799(b). 

18 ‘‘(c) APPLICATION.—An eligible entity desiring to re19 ceive an award under this section shall submit to the Sec20 retary an application at such time, in such manner, and 

21 containing such information as the Secretary may require. 

22 ‘‘(d) USE OF FUNDS.—An eligible entity shall use 

23 amounts awarded under a grant or contract under this 

24 section to provide innovative supportive activities to en25 hance education through distance learning, continuing 


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1 educational activities, collaborative conferences, and elec2 tronic and telelearning activities, with preference for pri3 mary care, including physician assistants, general and pe4 diatric dental providers, psychologists, and other mental 

5 health providers, and physicians teaching in federally des6 ignated underserved areas. 

7 ‘‘(e) AUTHORIZATION.—There is authorized to be ap8 propriated to carry out this section $5,000,000 for each 

9 of the fiscal years 2009 through 2014, and such sums as 

10 may be necessary for each subsequent fiscal year.’’. 

11 SEC. 9. GERIATRICS EDUCATION AND TRAINING. 

12 (a) GERIATRIC EDUCATION CENTERS.—Section 

13 753(a) (42 U.S.C. 294c(a)) is amended— 

14 (1) in paragraph (1), by striking ‘‘in para15 graphs (1), (3), or (4) of section 799B, and section 

16 801(2),’’ and inserting ‘‘in paragraph (1), (3), or (4) 

17 of section 799B and section 801(2), health para18 professional programs, community health worker 

19 programs, and programs for informal caregivers,’’; 

20 (2) in paragraph (2)— 

21 (A) in subparagraph (A), by inserting ‘‘al22 lied health professionals, community health 

23 workers, and informal caregivers’’ after ‘‘health 

24 professionals’’; 


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1 (B) in subparagraph (D), by inserting ‘‘al2 lied health professionals, community health 

3 workers, and informal caregivers’’ after ‘‘health 

4 professionals’’; and 

5 (C) in subparagraph (E), by striking ‘‘and 

6 senior centers’’ and inserting ‘‘or senior cen7 ters’’; and 

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

9 ‘‘(3) TERM OF GRANT.—The term of any award 

10 made under this subsection shall not exceed 5 years. 

11 ‘‘(4) DATA COLLECTIONS AND REPORTING.— 

12 ‘‘(A) SUBMISSION TO CENTER.—Each enti13 ty that receives an award under this subsection 

14 shall submit to the National Health Workforce 

15 Analysis Center established under section 761, 

16 standardized and specific workforce data, as de17 termined by the Secretary and in a form and 

18 manner specified by the Secretary. 

19 ‘‘(B) ANNUAL REPORT TO CONGRESS.— 

20 Such National Health Workforce Analysis Cen21 ter shall, on an annual basis, submit to Con22 gress and the Secretary a report the describes 

23 the information received by such Center under 

24 subparagraph (A) during the previous year.’’. 


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1 (b) GERIATRIC TRAINING REGARDING PHYSICIANS, 

2 DENTISTS, AND THE HEALTH PROFESSIONS.—Section 

3 753(b) (42 U.S.C. 294c(b)) is amended— 

4 (1) in the subsection heading, by striking 

5 ‘‘PHYSICIANS AND DENTISTS’’ and inserting ‘‘PHY6 SICIANS, DENTISTS, AND THE HEALTH PROFES7 SIONS’’; and 

8 (2) by striking paragraph (1) and inserting the 

9 following: 

10 ‘‘(1) IN GENERAL.—The Secretary may make 

11 grants to, and enter into contracts with, schools of 

12 medicine, schools of osteopathic medicine, academic 

13 dental institutions, teaching hospitals, physician as14 sistant education programs, graduate medical or 

15 dental education programs, and graduate programs 

16 in behavioral or mental health, for the purpose of 

17 providing support (including internships, residencies, 

18 traineeships, and fellowships) for geriatric training 

19 projects to train physicians, physician assistants, 

20 dentists, and behavioral and mental health profes21 sionals who plan to teach geriatric medicine, geri22 atric behavioral or mental health, or geriatric den23 tistry.’’. 

24 (c) GERIATRIC ACADEMIC CAREER AWARDS.—Sec25 tion 753(c) (42 U.S.C. 294c(c)) is amended by striking 


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1 paragraph (1) through paragraph (3) and inserting the 

2 following: 

3 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec4 retary shall establish a program to provide Geriatric 

5 Academic Career Awards to eligible entities to pro6 mote the career development of individuals as aca7 demic geriatricians or gerontologists. 

8 ‘‘(2) ELIGIBLE ENTITY.— 

9 ‘‘(A) IN GENERAL.—For purposes of this 

10 section, the term ‘eligible entity’ means an enti11 ty described in section 799(b). 

12 ‘‘(B) AWARDS TO INDIVIDUALS FROM ELI13 GIBLE ENTITIES.—An eligible entity shall pro14 vide funding to an individual through a grant 

15 received under this section only if such indi16 vidual— 

17 ‘‘(i) is board certified or board eligible 

18 in internal medicine, family medicine, or 

19 psychiatry, or is a certified and licensed 

20 nurse, pharmacist, psychologist, social 

21 worker, or physician assistant, employed by 

22 an approved school; 

23 ‘‘(ii) has completed an approved in24 ternship or fellowship program in geri25 atrics; and 


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1 ‘‘(iii) has a junior or midlevel faculty 

2 appointment at an accredited (as deter3 mined by the Secretary) school of medicine 

4 or osteopathic medicine, physician assist5 ant education program, or graduate pro6 gram in behavioral or mental health. 

7 ‘‘(3) LIMITATIONS.—No Award under para8 graph (1) may be made to an eligible entity unless 

9 the entity— 

10 ‘‘(A) has submitted to the Secretary an ap11 plication, at such time, in such manner, and 

12 containing such information as the Secretary 

13 may require, and the Secretary has approved 

14 such application; and 

15 ‘‘(B) provides, in such form and manner as 

16 the Secretary may require, assurances that the 

17 entity will provide funding only to individuals 

18 associated with such entity that will meet the 

19 service requirement described in paragraph 

20 (5).’’. 

21 (d) AUTHORIZATION OF APPROPRIATIONS.—Section 

22 753 is (42 U.S.C. 294c) is amended by adding at the end 

23 the following: 

24 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

25 is authorized to be appropriated to carry out this section 


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1 $50,000,000 for each of the fiscal years 2009 through 

2 2013.’’. 

3 (e) OTHER PROVISIONS.— 

4 (1) RURAL INTERDISCIPLINARY TRAINING.— 

5 Title VII (42 U.S.C. 292 et seq.) is amended by 

6 striking section 754. 

7 (2) ALLIED HEALTH AND OTHER DIS8 CIPLINES.—Section 755 (42 U.S.C. 294e) is amend9 ed— 

10 (A) in subsection (a) by striking ‘‘may 

11 make’’ and inserting ‘‘shall make’’; 

12 (B) in subsection (b)(1)— 

13 (i) in subparagraph (H), by striking 

14 the semicolon at the end and inserting ‘‘; 

15 and’’; 

16 (ii) in subparagraph (I) by striking 

17 ‘‘necessary; and’’ and inserting a period; 

18 and 

19 (iii) striking subparagraph (J); and 

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

21 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

22 is authorized to be appropriated to carry out this section 

23 $12,000,000 for each of the fiscal years 2009 through 

24 2013.’’. 


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1 SEC. 10. TRAINING IN GRADUATE PSYCHOLOGY EDU2 CATION. 

3 (a) IN GENERAL.—Part D of title VII (42 U.S.C. 

4 294 et seq.) is amended by— 

5 (1) striking section 757; 

6 (2) redesignating section 756 as section 757; 

7 and 

8 (3) inserting after section 755 the following: 

9 ‘‘SEC. 756. TRAINING IN GRADUATE PSYCHOLOGY EDU10 CATION. 

11 ‘‘(a) IN GENERAL.—The Secretary may award 

12 grants, cooperative agreements and contracts to accredited 

13 graduate programs of psychology including public or non14 profit private hospitals for the development and implemen15 tation of interdisciplinary training of psychology graduate 

16 students for providing behavioral and mental health serv17 ices. Such training shall focus on the needs of vulnerable 

18 groups such as older adults and children, individuals with 

19 mental health or substance-related disorders, victims of 

20 abuse or trauma and of combat stress disorders such as 

21 posttraumatic stress disorder and traumatic brain inju22 ries, homeless individuals, chronically ill persons, and their 

23 families. 

24 ‘‘(b) PROGRAM SITES.—Training under subsection 

25 (a) may be provided through accredited graduate pro26 grams of psychology including public or nonprofit private 


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1 hospitals and such other sites as the Secretary determines 

2 to be appropriate. 

3 ‘‘(c) EVALUATION OF PROGRAMS.—The Secretary 

4 shall directly or through grants or contracts provide for 

5 the evaluation of programs implemented under subsection 

6 (a) in order to determine the effect of such programs on 

7 increasing the number of psychologists who provide behav8 ioral and mental health services to identified underserved 

9 areas or health disparity populations. 

10 ‘‘(d) AUTHORIZATION OF APPROPRIATION.—There is 

11 authorized to be appropriated to carry out this section 

12 $10,000,000 for each of the fiscal years 2009 through 

13 2013.’’. 

14 (b) CONFORMING AMENDMENTS.—Section 

15 757(b)(2), as redesignated by subsection (a), is amended 

16 by striking ‘‘sections 751(a)(1)(A), 751(a)(1)(B), 753(b), 

17 754(3)(A), and 755(b)’’ and inserting ‘‘sections 751(b), 

18 753(b), and 755(b)’’. 

19 SEC. 11. HEALTH PROFESSIONS WORKFORCE INFORMA20 TION AND ANALYSIS. 

21 (a) IN GENERAL.—Section 761 (42 U.S.C. 294n) is 

22 amended— 

23 (1) by redesignating subsection (c) as sub24 section (e); 


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

2 following: 

3 ‘‘(b) NATIONAL CENTER FOR HEALTH WORKFORCE

4 ANALYSIS.— 

5 ‘‘(1) ESTABLISHMENT.—The Secretary shall es6 tablish the National Center for Health Workforce 

7 Analysis within the Department of Health and 

8 Human Services. The Secretary shall appoint a Di9 rector in consultation with the Advisory Committee 

10 on Health Workforce Information, Evaluation, and 

11 Assessment established under section 764 (in this 

12 section referred to as the ‘Committee’). 

13 ‘‘(2) IN GENERAL.—The National Center for 

14 Health Workforce Analysis shall— 

15 ‘‘(A) carry out the duties of the Secretary 

16 under section 792(a); and 

17 ‘‘(B) collect, analyze, and report data re18 garding workforce issues, as determined appro19 priate by the Committee in coordination with 

20 the Regional Centers designated under sub21 section (c). 

22 ‘‘(3) FUNCTIONS.—The National Center for 

23 Health Workforce Analysis shall— 

24 ‘‘(A) describe and evaluate the effective25 ness of the programs under this part, and 


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1 under other sections of this title determined rel2 evant by the Committee, including evaluating 

3 and reporting on workforce diversity, distribu4 tion in underserved areas and for health dis5 parity populations, primary care capacity and 

6 other needs, including the establishment of 

7 benchmarks for such programs; 

8 ‘‘(B) use grantee data and data collected 

9 from regional workforce analysis centers des10 ignated under subsection (c) in conjunction 

11 with National DataNet to regularly evaluate 

12 program performance through— 

13 ‘‘(i) comparing benchmarks; 

14 ‘‘(ii) assessing the effectiveness of 

15 programs in meeting the specified goals of 

16 this title; and 

17 ‘‘(iii) tracking recognized subspecial18 ties of the physician and dentistry work19 force and nonphysician providers including 

20 physician assistants, advance practice 

21 nurses, psychologists, pharmacists, public 

22 health workers, and other professionals as 

23 appropriate by measuring and reporting on 

24 changes in workforce production and dis25 tribution, and population health; 


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1 ‘‘(C) produce and report to the relevant 

2 committees of Congress an estimate of the sup3 ply and need for physicians, nurses, dentists, 

4 psychologists, pharmacists, and other health 

5 professionals, as directed by the Committee, 

6 that— 

7 ‘‘(i) uses the best available methods 

8 for estimating supply and needs; 

9 ‘‘(ii) provides that any models or sta10 tistical software be subject to review and 

11 made available to the public; and 

12 ‘‘(iii) is routinely (such as biennially) 

13 compiled and reported for physicians alter14 nating with other professions; 

15 ‘‘(D) maintain uniform data sets in coordi16 nation with, and responsive to, the regional cen17 ters designated under subsection (c) that— 

18 ‘‘(i) can be used to estimate State and 

19 county supply and needs of physicians, 

20 nurses, dentists, and other health profes21 sionals; 

22 ‘‘(ii) can be used to develop in the 

23 identification of health professional short24 age areas and medically underserved areas; 

25 and 


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1 ‘‘(iii) shall be updated and made avail2 able to the public via the Internet or other 

3 electronic means; and 

4 ‘‘(E) collaborate with agencies in the De5 partment of Health and Human Services, the 

6 Department of Labor, and the Department of 

7 Education in data collection and maintenance 

8 of uniform data sets as determined appropriate 

9 by the Secretary and the Committee. 

10 ‘‘(4) REPORT.—On biennial basis, the Director 

11 shall submit to the relevant Congressional commit12 tees a report on the activities, information gathered, 

13 and findings of the Center during the previous 2- 

14 year period. 

15 ‘‘(c) REGIONAL CENTERS FOR WORKFORCE ANAL16 YSIS.— 

17 ‘‘(1) ESTABLISHMENT.—The Secretary shall 

18 designate 6 to 10 entities described in paragraph (2) 

19 as regional workforce analysis centers. 

20 ‘‘(2) ENTITIES.—An entity described in this 

21 paragraph shall be a public health or health profes22 sions school, an academic health center, or other ap23 propriate public or private nonprofit entity or part24 nerships of such entities determined by the SecVerDate Aug 31 2005 23:39 Nov 21, 2008 Jkt 079200 PO 00000 Frm 00075 Fmt 6652 Sfmt 6201 E:\BILLS\S3708.IS S3708

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1 retary to be capable of carrying out the functions de2 scribed in paragraph (3). 

3 ‘‘(3) FUNCTIONS.—An entity designated under 

4 this subsection shall— 

5 ‘‘(A) function cooperatively with the na6 tional and other regional centers to— 

7 ‘‘(i) collect data on programs carried 

8 out under this part, and under other sec9 tions of this title determined relevant by 

10 the Committee, in a consistent manner; 

11 ‘‘(ii) develop and maintain standard12 ized approaches toward reporting con13 formity across regional centers; 

14 ‘‘(iii) collaborate with the National 

15 Center for Health Workforce Analysis, the 

16 Committee, and other regional centers, on 

17 the development and distribution of re18 gional and national studies and reports to 

19 a wide audience, including policymakers; 

20 ‘‘(iv) coordinate with identified local 

21 and regional sources of health profes22 sionals workforce data, such as State 

23 workforce commissions, for reporting to 

24 national level; and 


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1 ‘‘(v) develop program evaluations and 

2 assessments, as described in subsection 

3 (b); 

4 ‘‘(B) serve as a regional resource for moni5 toring the impact of policies and programs on 

6 the healthcare workforce, including— 

7 ‘‘(i) developing and maintaining a 

8 nongovernment analytic and research in9 frastructure related to the purposes de10 scribed in subsection (b); and 

11 ‘‘(ii) working with States and State 

12 agencies, including State primary care of13 fices and State workforce commissions, to 

14 identify areas that qualify as shortage des15 ignations and supporting the development 

16 of such shortage designation requests; and 

17 ‘‘(C) provide technical assistance to local 

18 and regional entities on data collection and 

19 analysis related to healthcare workforce issues, 

20 including— 

21 ‘‘(i) supporting studies that lead to 

22 understanding the impact of a diverse 

23 workforce on health outcomes, both de24 scriptive and analytic; 


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1 ‘‘(ii) supporting studies that lead to 

2 understanding the impact of the primary 

3 care workforce on health outcomes, both 

4 descriptive and analytic; and 

5 ‘‘(iii) supporting studies that lead to 

6 understanding the impact of geographic 

7 distribution on health outcomes, both de8 scriptive and analytic; and 

9 ‘‘(D) initiate and conduct research on 

10 high-priority health workforce questions, in ac11 cordance with subparagraph (A). 

12 ‘‘(4) GRANTS OR CONTRACTS TO CONDUCT RE13 SEARCH.— 

14 ‘‘(A) IN GENERAL.—The Secretary shall 

15 award grants or contracts to regional centers 

16 for workforce analysis for the conduct of re17 search on high-priority workforce questions de18 scribed in paragraph (3)(D), including— 

19 ‘‘(i) national studies on emerging 

20 issues; 

21 ‘‘(ii) State health workforce profiles; 

22 and 

23 ‘‘(iii) future health workforce issues 

24 and trends. 


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1 ‘‘(B) DURATION OF AWARD.—The period 

2 during which payments are made to an entity 

3 from an award of a grant or contract under this 

4 paragraph shall not exceed 3 years. 

5 ‘‘(C) DISSEMINATION OF INFORMATION.— 

6 Amounts awarded under this paragraph shall 

7 include amounts necessary for the dissemina8 tion of reports produced pursuant to the award. 

9 ‘‘(d) GRANTS TO ASSESS AND MONITOR THE SUPPLY

10 AND NEED OF HEALTH PROFESSIONALS.— 

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

12 grants to, and enter into contracts with, eligible en13 tities for the purpose of monitoring the supply, need 

14 for, and diversity and distribution of, physicians, 

15 psychologists, dentists, physician assistants, and 

16 other health professionals as determined by, and 

17 based on health workforce needs assessments pro18 vided by the National Center for Health Workforce 

19 Analysis under subsection (b). 

20 ‘‘(2) ELIGIBLE ENTITY.—For purposes of this 

21 subsection, the term ‘eligible entity’ means an entity 

22 described in section 799(b) and regional centers for 

23 health workforce analysis under subsection (c). 

24 ‘‘(3) APPLICATION.—To be eligible for a grant 

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1 mit to the Secretary an application at such time, in 

2 such manner, and containing such information as 

3 the Secretary may require. 

4 ‘‘(4) USE OF FUNDS.—An entity shall use 

5 amounts awarded under a grant or contract under 

6 this subsection to collaborate with the National and 

7 regional centers under subsections (b) and (c) to 

8 conduct research on workforce issues, as determined 

9 by the Director of the National Center for Health 

10 Workforce Analysis in consultation with the Com11 mittee. Such research shall include— 

12 ‘‘(A) collecting, analyzing, and reporting 

13 data pertinent to State and regional workforce 

14 issues that may contribute to the national un15 derstanding of workforce supply and need; 

16 ‘‘(B) setting up and monitoring data sets 

17 appropriate to specific workforce supply and 

18 need; and 

19 ‘‘(C) other projects as deemed appropriate 

20 by such Director and Committee.’’; and 

21 (3) in subsection (e) (as so redesignated)— 

22 (A) by striking paragraph (1) and insert23 ing the following: 

24 ‘‘(1) IN GENERAL.— 


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1 ‘‘(A) NATIONAL CENTER FOR WORKFORCE

2 ANALYSIS.—There are authorized to be appro3 priated to carry out subsection (b) (to fund the 

4 National Center for Workforce Analysis), 

5 $1,000,000 for each of the fiscal years 2009 

6 through 2013, and such sums as may be nec7 essary for each fiscal year thereafter. 

8 ‘‘(B) REGIONAL CENTERS.—There are au9 thorized to be appropriated $4,500,000 to carry 

10 out subsection (c) (to fund each of the regional 

11 centers), an amount not to exceed $750,000 for 

12 each of the centers for each of the fiscal years 

13 2009 through 2013, and such sums as may be 

14 necessary for each fiscal year thereafter. 

15 ‘‘(C) AWARDS TO CONDUCT RESEARCH.— 

16 There are authorized to be appropriated to 

17 carry out subsection (c)(4), $2,000,000 for each 

18 of the fiscal years 2009 through 2013. Any 

19 amount appropriated pursuant to the preceding 

20 sentence shall be in addition to any amount ap21 propriated pursuant to subparagraph (B). 

22 ‘‘(D) AWARDS TO ASSESS AND MONITOR

23 THE SUPPLY AND NEED OF HEALTH PROFES24 SIONALS.—There are authorized to be appro25 priated to carry out subsection (d), $1,000,000 


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1 for each of the fiscal years 2009 through 2013, 

2 and such sums as may be necessary for each 

3 fiscal year thereafter. 

4 ‘‘(E) CARRYOVER FUNDS.—An entity that 

5 receives an award under this section may carry 

6 over funds from 1 fiscal year to another without 

7 obtaining approval from the Secretary. In no 

8 case may any funds be carried over pursuant to 

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

10 and 

11 (B) in paragraph (2), by striking ‘‘sub12 section (a)’’ and inserting ‘‘paragraph (1)’’. 

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

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

15 functions and authorities carried out by the National Cen16 ter for Health Workforce Analysis of the Health Resources 

17 and Services Administration as in effect on the day before 

18 the date of enactment of this Act shall be transferred to 

19 the National Center for Health Workforce Analysis estab20 lished under section 761(b) of the Public Health Service 

21 Act (as amended by subsection (a)). 

22 SEC. 12. HEALTH WORKFORCE INFORMATION, EVALUA23 TION, AND ASSESSMENT. 

24 (a) HEALTH PROFESSIONAL WORKFORCE INFORMA25 TION AND ANALYSIS.—Subpart 1 of part E of title VII 


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1 (42 U.S.C. 294n et seq.) is amended by adding at the end 

2 the following: 

3 ‘‘SEC. 764. HEALTH WORKFORCE INFORMATION, EVALUA4 TION, AND ASSESSMENT. 

5 ‘‘(a) ADVISORY COMMITTEE.—The Secretary shall 

6 establish an advisory committee to be known as the Advi7 sory Committee on Health Workforce Information, Eval8 uation, and Assessment (referred to in this section as the 

9 ‘Advisory Committee’). 

10 ‘‘(b) MEMBERSHIP.— 

11 ‘‘(1) IN GENERAL.—The Secretary shall deter12 mine the appropriate number of individuals to serve 

13 on the Advisory Committee, which shall include— 

14 ‘‘(A) the Director of Health Resources and 

15 Services Administration (or his or her des16 ignee); 

17 ‘‘(B) the Director of the National Health 

18 Service Corps (or his or her designee); 

19 ‘‘(C) a director of an area health education 

20 center program or area health education center 

21 under section 751; 

22 ‘‘(D) the chairperson of the Accreditation 

23 Council on Graduate Medical Education; 

24 ‘‘(E) the Director of the National Center 

25 for Healthcare Workforce Analysis; 


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1 ‘‘(F) the Chair of the National Advisory 

2 Council on Nurse Education and Practice; 

3 ‘‘(G) at least 1 representative of— 

4 ‘‘(i) the Department of Labor; 

5 ‘‘(ii) the Department of Education; 

6 ‘‘(iii) the Advisory Committee on 

7 Training in Primary Care Medicine and 

8 Dentistry; 

9 ‘‘(iv) a regional workforce analysis 

10 center designated under section 761(c); 

11 and 

12 ‘‘(v) a State-level primary care organi13 zation; and 

14 ‘‘(H) one representative from each of the 

15 practicing clinical professions described in para16 graph (2). 

17 ‘‘(2) PRACTICING CLINICAL PROFESSIONS.— 

18 The practicing clinical professions described in this 

19 paragraph include— 

20 ‘‘(A) one of each of the physician special21 ties representing primary care including family 

22 medicine, pediatrics, general internal medicine, 

23 and general geriatrics; 

24 ‘‘(B) physician assistants; 


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1 ‘‘(C) general or pediatric dental profes2 sionals; 

3 ‘‘(D) psychology professionals; 

4 ‘‘(E) nursing professionals; 

5 ‘‘(F) pharmacy professionals; 

6 ‘‘(G) public health professionals; and 

7 ‘‘(H) preventive medicine physicians. 

8 ‘‘(3) REQUIREMENTS.—In providing for the 

9 membership of the Advisory Committee, the Sec10 retary shall ensure that— 

11 ‘‘(A) the members adequately represent 

12 urban and federally designated rural and non13 metropolitan areas from throughout the Nation 

14 and that there is at least 1 clinical professional 

15 representing a rural and an urban Federally 

16 qualified health center; 

17 ‘‘(B) the members adequately represent 

18 underrepresented populations in the health pro19 fessions; and 

20 ‘‘(C) the members are selected based on 

21 competence, interest, and knowledge of the mis22 sion and professions involved. 

23 ‘‘(4) INITIAL APPOINTMENT.—The Secretary 

24 shall make the initial appointment under this section 

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1 tion with the Comptroller General of the United 

2 States. 

3 ‘‘(5) CHAIRPERSON.—The chairperson of the 

4 Advisory Committee shall be selected by a vote of 

5 the members of the Committee. 

6 ‘‘(6) TERMS.— 

7 ‘‘(A) IN GENERAL.—Except as provided in 

8 subparagraph (B), each member of the Advi9 sory Committee shall be appointed for a period 

10 of 3 years. 

11 ‘‘(B) STAGGERED TERMS.—Of the mem12 bers first appointed to the Advisory Committee 

13 under paragraph (4)— 

‘‘(i) 1 14 ⁄3 shall be appointed for a period 

15 of 1 year; 

‘‘(ii) 1 16 ⁄3 shall be appointed for a pe17 riod of 2 years; and 

‘‘(iii) 1 18 ⁄3 shall be appointed for a pe19 riod of 3 years. 

20 ‘‘(c) DUTIES.—The Advisory Committee shall carry 

21 out the following activities: 

22 ‘‘(1) Make recommendations regarding the clas23 sifications of the health care workforce in collabora24 tion with the Department of Labor to ensure the 


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1 consistency of data collection, and update these rec2 ommendations at least every 5 years. 

3 ‘‘(2) Make recommendations regarding stand4 ardized methodology and procedures to enumerate 

5 the health care workforce, and update these rec6 ommendations at least every 5 years. 

7 ‘‘(3) Direct that adequate data be collected to 

8 evaluate the impact on the distribution and deploy9 ment of the health care workforce in settings such 

10 as Federally qualified health centers, the National 

11 Health Service Corps, and to underserved areas or 

12 populations. 

13 ‘‘(4)(A) Make recommendations regarding 

14 standardized measures and procedures for reporting, 

15 including reporting with respect to— 

16 ‘‘(i) student entry and retention in the 

17 health professions, with focus on primary care 

18 fields and general dentistry; 

19 ‘‘(ii) increasing the diversity of the health 

20 professional population; 

21 ‘‘(iii) improving the distribution of health 

22 professionals in the United States; 

23 ‘‘(iv) strengthening the public health and 

24 health care delivery infrastructure; 


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1 ‘‘(v) providing access to care relative to 

2 workforce distribution; 

3 ‘‘(vi) improving the quality of health care 

4 through education, training, and collaboration 

5 with appropriate entities to identify and define 

6 excellence in health services delivery which is ef7 ficient, effective, evidence-based, and timely and 

8 may include— 

9 ‘‘(I) community-based quality im10 provement and best practices networks; 

11 ‘‘(II) community-based participatory 

12 research networks; 

13 ‘‘(III) continuing professional edu14 cation programs; and 

15 ‘‘(IV) distance learning technologies 

16 and methodologies; 

17 ‘‘(vii) practice improvement through the 

18 implementation of new systems of care, such as 

19 health information technology, chronic care 

20 models, interdisciplinary and collaborative care, 

21 cultural competency, and health literacy and 

22 other models; and 

23 ‘‘(viii) assessing the link between the pipe24 line programs and staffing of health profes25 sional shortage areas, medically underserved 


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1 areas, and the National Health Service Corps 

2 as well as other Federal safety net programs. 

3 ‘‘(B) Update the recommendations under sub4 paragraph (A) at least every 5 years. 

5 ‘‘(5) Define successful performance outcome 

6 measures within programs under this title. 

7 ‘‘(6) Define processes by which funding recipi8 ents will collaborate with regional workforce analysis 

9 centers under section 761(c) to collect and share 

10 data with other such centers for further analysis. 

11 ‘‘(7) Other duties as deemed appropriate by the 

12 Secretary in consultation with the Committee. 

13 ‘‘(d) WORKING GROUPS AND SUBCOMMITTEES.—The 

14 Advisory Committee may establish working groups or 

15 other subcommittees to carry out functions determined to 

16 be appropriate by the Advisory Committee and the Chair17 man and meet separately for these purposes. 

18 ‘‘(e) MEETINGS.—The full Advisory Committee shall 

19 meet at least 3 times annually. 

20 ‘‘(f) TERMINATION.—The Advisory Committee shall 

21 not be terminated prior to the later of— 

22 ‘‘(1) the date that is 5 years after the date of 

23 enactment of this section; or 

24 ‘‘(2) the date on which funding is not made 

25 available for the Advisory Committee. 


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1 ‘‘(g) FACA.—The Federal Advisory Committee Act 

2 (5 U.S.C. App.) shall apply to the Advisory Committee 

3 under this section only to the extent that the provisions 

4 of such Act do not conflict with the requirements of this 

5 section.’’. 

6 (b) PUBLIC HEALTH WORKFORCE GENERAL PROVI7 SIONS.—Section 765 (42 U.S.C. 295) is amended— 

8 (1) in subsection (b)(1)(A), by striking ‘‘or den9 tal public health’’ and inserting ‘‘dental public 

10 health, or behavioral and mental health’’; and 

11 (2) in subsection (d)— 

12 (A) in paragraph (5)(A)— 

13 (i) by inserting ‘‘internship and’’ after 

14 ‘‘new’’; 

15 (ii) by inserting ‘‘internship and’’ 

16 after ‘‘existing’’; 

17 (iii) by striking ‘‘and dental public 

18 health, that’’ and inserting ‘‘, dental public 

19 health, and behavioral and mental health, 

20 that’’; and 

21 (iv) by striking ‘‘and dental public 

22 health; and’’ and inserting ‘‘, dental public 

23 health, and behavioral and mental health; 

24 and’’; 


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1 (B) in paragraph (5)(B), by inserting ‘‘in2 ternship and’’ after ‘‘assistance to’’; and 

3 (C) in paragraph (6), by inserting ‘‘behav4 ioral and mental health,’’ after ‘‘public health 

5 dentistry,’’ 

6 SEC. 13. FUNDING FOR DENTAL PUBLIC HEALTH AND PRE7 VENTIVE MEDICINE. 

8 Section 768 (42 U.S.C. 295c) is amended by adding 

9 at the end the following: 

10 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

11 is authorized to be appropriated— 

12 ‘‘(1) for dental public health programs carried 

13 out under this section— 

14 ‘‘(A) $1,000,000 for each of the fiscal 

15 years 2009 through 2013; and 

16 ‘‘(B) such sums as may be necessary for 

17 each fiscal year thereafter; and 

18 ‘‘(2) for public health (other than dental public 

19 health) and preventive medicine programs carried 

20 out under this section— 

21 ‘‘(A) $16,000,000 for each of the fiscal 

22 years 2009 through 2013; and 

23 ‘‘(B) such sums as may be necessary for 

24 each fiscal year thereafter.’’. 


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1 SEC. 14. ACADEMIC HEALTH DEPARTMENTS GRANT PRO2 GRAM. 

3 Subpart 2 of part E (42 U.S.C. 295 et seq.) is 

4 amended by adding at the end the following: 

5 ‘‘SEC. 771. ACADEMIC HEALTH DEPARTMENTS GRANT PRO6 GRAM. 

7 ‘‘(a) ESTABLISHMENT.— 

8 ‘‘(1) IN GENERAL.—In order to improve the 

9 training of public health students, the Secretary, 

10 acting in conjunction with the Director of the Cen11 ters for Disease Control and Prevention and in con12 sultation with the Association of Schools of Public 

13 Health, shall carry out the Academic Health Depart14 ments grant program (referred to in this section as 

15 the ‘Program’) under which the Secretary shall 

16 award competitive grants, of not more than 

17 $250,000 each, to eligible partnerships to establish 

18 Academic Health Departments. 

19 ‘‘(2) ACADEMIC HEALTH DEPARTMENT.—For 

20 purposes of this section, the term ‘Academic Health 

21 Department’ means a program administered by an 

22 eligible partnership that provides for collaboration 

23 between the academic and practice aspects of public 

24 health. The purpose of such a department is to in25 crease the number of graduates in public health who 

26 work in State and local health departments, increase 


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1 the relevance of the curriculum in schools and pro2 grams of public health to health department prac3 tice, and to increase the use of academic theories, 

4 knowledge, and methodologies in the work of health 

5 departments. 

6 ‘‘(b) ELIGIBILITY.—For purposes of this section, an 

7 eligible partnership is a partnership, with respect to estab8 lishing an Academic Health Department, consisting of— 

9 ‘‘(1) a State or local public health department; 

10 and 

11 ‘‘(2) an accredited school of public health or an 

12 accredited public health degree program. 

13 ‘‘(c) USE OF FUNDS.—An eligible partnership de14 scribed in subsection (b) may use funds provided under 

15 a grant made under subsection (a) for the following pur16 poses, with respect to an Academic Health Department: 

17 ‘‘(1) To conduct training needs assessment sur18 veys. 

19 ‘‘(2) To provide for curriculum development. 

20 ‘‘(3) To provide for training and academic in21 struction. 

22 ‘‘(4) To conduct leadership seminars. 

23 ‘‘(5) To facilitate appropriate staff of the State 

24 or local health department participating in the eligi25 ble partnership to teach with the school of public 


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1 health or public health degree program participating 

2 in such partnership. 

3 ‘‘(6) To facilitate faculty and students of the 

4 school of public health or public health degree pro5 gram participating in the eligible partnership to 

6 work in the health department participating in such 

7 partnership. 

8 ‘‘(7) To provide for a project coordinator. 

9 ‘‘(8) To provide for subgrants to organizations 

10 to conduct activities consistent with the goals of the 

11 Program. 

12 ‘‘(9) Other appropriate activities specified by 

13 the Secretary to recruit public health students to full 

14 time employment in a health department after grad15 uation. 

16 ‘‘(d) REPORTS.— 

17 ‘‘(1) GRANT RECIPIENT REPORTS TO THE SEC18 RETARY.—Each recipient of a grant awarded under 

19 subsection (a) shall submit to the Secretary a report 

20 for each year for which the recipient received such 

21 a grant on the results and outcomes of the activities 

22 funded by such grant during such year. 

23 ‘‘(2) REPORTS TO CONGRESS.—For the 3-year 

24 period beginning on the date of the establishment of 

25 the Program, and for each subsequent 3-year period 


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1 in which the Program is in existence, the Secretary 

2 shall submit to Congress a report on the results and 

3 outcomes of the Program during such 3-year period, 

4 including the number of Academic Health Depart5 ments funded by grants under the Program, the 

6 number of students trained through grants under 

7 the Program, and the number of trainees partici8 pating in such Academic Health Departments who 

9 remain in public health professions. 

10 ‘‘(3) EVALUATION OF PROGRAM.—Not later 

11 than the date that is 5 years after the date of the 

12 establishment of the Program, the Secretary shall 

13 submit to Congress a report that examines the re14 sults and outcomes of the Program and recommends 

15 the extent to which the Program should be contin16 ued. 

17 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

18 is authorized to be appropriated to carry out this section, 

19 $4,000,000 for each of the fiscal years 2009 through 

20 2013.’’. 

21 SEC. 15. DEFINITIONS. 

22 Section 799B (42 U.S.C. 295p) is amended— 

23 (1) by striking paragraph (3) and inserting the 

24 following: 


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1 ‘‘(3) PHYSICIAN ASSISTANT EDUCATION PRO2 GRAM.—The term ‘physician assistant education 

3 program’ means an educational program in a public 

4 or private institution in a State that— 

5 ‘‘(A) has as its objective the education of 

6 individuals who, upon completion of their stud7 ies in the program, be qualified to provide pri8 mary care medical services with the supervision 

9 of a physician; and 

10 ‘‘(B) is accredited by the Accreditation Re11 view Commission on Education for the Physi12 cian Assistant.’’; and 

13 (2) by adding at the end the following: 

14 ‘‘(12) FEDERALLY QUALIFIED HEALTH CEN15 TER.—The term ‘Federally qualified health center’ 

16 has the meaning given that term in section 1861(aa) 

17 of the Social Security Act. 

18 ‘‘(13) RURAL HEALTH CLINIC.—The term 

19 ‘rural health clinic’ has the meaning given that term 

20 in section 1861(aa) of the Social Security Act. 

21 ‘‘(14) CULTURAL COMPETENCY.—The term 

22 ‘culturally competency’— 

23 ‘‘(A) with respect to health-related serv24 ices, means the ability to provide healthcare tai25 lored to meet the social, cultural, and linguistic 


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1 needs of patients from diverse backgrounds; 

2 and 

3 ‘‘(B) when used to describe education or 

4 training, means education or training designed 

5 to prepare those receiving the education or 

6 training to provide health-related services tai7 lored to meet the social, cultural, and linguistic 

8 needs of patients from diverse backgrounds. 

9 ‘‘(15) HEALTH DISPARITY POPULATION.—The 

10 term ‘health disparity population’ has the meaning 

11 given such term in section 903(d)(1). 

12 ‘‘(16) HEALTH LITERACY.—The term ‘health 

13 literacy’ means the degree to which an individual has 

14 the capacity to obtain, communicate, process, and 

15 understand health information (including the reg16 ister and language in which the information is pro17 vided) and services in order to make appropriate 

18 health decisions. 

19 ‘‘(17) INDIAN.—The term ‘Indian’ has the 

20 meaning given such term in section 4 of the Indian 

21 Health Care Improvement Act (25 U.S.C. 1603). 

22 ‘‘(18) MINORITY GROUP.—The term ‘minority 

23 group’ has the meaning given the term ‘racial and 

24 ethnic minority group’ in section 1707.’’. 

Æ 


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