II 

117TH CONGRESS 

1ST SESSION S. 3244 

To amend the Public Health Service Act to establish a Bio-Preparedness 

and Infectious Diseases Workforce Loan Repayment Program. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 18, 2021 

Ms. BALDWIN (for herself, Ms. COLLINS, Ms. ROSEN, Ms. MURKOWSKI, Mrs. 

GILLIBRAND, and Mr. CARDIN) introduced the following bill; which was 

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

and Pensions 

A BILL 

To amend the Public Health Service Act to establish a BioPreparedness and Infectious Diseases Workforce Loan 

Repayment Program. 

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 ‘‘Bolstering Infectious 

5 Outbreaks Preparedness Workforce Act of 2021’’ or the 

6 ‘‘BIO Preparedness Workforce Act of 2021’’. 


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1 SEC. 2. ESTABLISHMENT OF A BIO-PREPAREDNESS AND IN2 FECTIOUS DISEASES WORKFORCE LOAN RE3 PAYMENT PROGRAM. 

4 Subpart 3 of part E of title VII of the Public Health 

5 Service Act (42 U.S.C. 295f et seq.) is amended by insert6 ing after section 776 (42 U.S.C. 295f–1) the following: 

7 ‘‘SEC. 776A BIO-PREPAREDNESS AND INFECTIOUS DIS8 EASES WORKFORCE LOAN REPAYMENT PRO9 GRAM. 

10 ‘‘(a) ESTABLISHMENT.—The Secretary, acting 

11 through the Administrator of the Health Resources and 

12 Services Administration, shall establish the Bio-Prepared13 ness and Infectious Diseases Workforce Loan Repayment 

14 Program (referred to in this section as the ‘Program’) to 

15 ensure an adequate supply of health care professionals en16 gaged in bio-preparedness and response activities de17 scribed in subsection (c)(2)(A)(1) and health care profes18 sionals engaged in infectious disease care described in sub19 section (c)(2)(A)(ii). 

20 ‘‘(b) ELIGIBILITY.— 

21 ‘‘(1) IN GENERAL.—To be eligible to participate 

22 in the Program, an individual shall— 

23 ‘‘(A)(i) be accepted for enrollment, or be 

24 enrolled, as a student in an accredited academic 

25 educational institution in a State or territory in 

26 the final year of a course of study or program 


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1 leading to a health professions degree or certifi2 cate described in paragraph (2); or 

3 ‘‘(ii) have graduated, during the preceding 

4 10-year period, from an accredited educational 

5 institution in a State or territory and received 

6 a health professions degree or certificate de7 scribed in paragraph (2); 

8 ‘‘(B) be a United States citizen; 

9 ‘‘(C)(i) submit an application to the Sec10 retary to participate in the Program; and 

11 ‘‘(ii) execute a written contract as required 

12 in subsection (c); and 

13 ‘‘(D) not have received, for the same serv14 ice, a reduction of loan obligations under— 

15 ‘‘(i) section 338B, 338I, 776, or 846; 

16 or 

17 ‘‘(ii) section 428K or 428L of the 

18 Higher Education Act of 1965. 

19 ‘‘(2) HEALTH PROFESSIONS DEGREE OR CER20 TIFICATE.—A health professions degree or certificate 

21 described in this paragraph is a degree or certificate 

22 for— 

23 ‘‘(A) a doctor of medicine; 

24 ‘‘(B) a doctor of osteopathic medicine; 

25 ‘‘(C) a doctor of philosophy; 


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1 ‘‘(D) a doctor of pharmacy; 

2 ‘‘(E) certification as a registered nurse; 

3 ‘‘(F) a bachelor of science in nursing; 

4 ‘‘(G) a master of science in nursing; 

5 ‘‘(H) certification as a nurse practitioner; 

6 ‘‘(I) certification as a physician assistant; 

7 ‘‘(J) a doctor of public health; 

8 ‘‘(K) a master of public health; 

9 ‘‘(L) a master of science in epidemiology; 

10 ‘‘(M) a bachelor of science in medical tech11 nology; 

12 ‘‘(N) certification in medical technology or 

13 as a medical lab scientist; 

14 ‘‘(O) a doctor of dental surgery, doctor of 

15 medicine in dentistry, or doctor of dental medi16 cine; and 

17 ‘‘(P) completion of any other program de18 termined appropriate by the Secretary. 

19 ‘‘(c) CONTRACT.— 

20 ‘‘(1) IN GENERAL.—The written contract (re21 ferred to in this section as the ‘written contract’) be22 tween the Secretary and an individual shall con23 tain— 

24 ‘‘(A) an agreement on the part of the Sec25 retary that the Secretary will repay on behalf of 


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1 the individual loans incurred by the individual 

2 in the pursuit of the relevant degree or certifi3 cate in accordance with the terms of the con4 tract; 

5 ‘‘(B) an agreement on the part of the indi6 vidual that the individual will serve as a health 

7 care professional engaged in a qualified role for 

8 a period of time (referred to in this section as 

9 the ‘period of obligated service’) equal to the 

10 greater of— 

11 ‘‘(i) 3 years; or 

12 ‘‘(ii) such longer period of time as de13 termined appropriate by the Secretary and 

14 the individual; 

15 ‘‘(C) a provision that any financial obliga16 tion of the United States arising out of a con17 tract entered into under this section and any 

18 obligation of the individual that is conditioned 

19 thereon, is contingent on funds being appro20 priated for loan repayments under this section; 

21 ‘‘(D) a statement of the damages to which 

22 the United States is entitled, under this section 

23 for the individual’s breach of the contract; and 


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1 ‘‘(E) such other statements of the rights 

2 and liabilities of the Secretary and of the indi3 vidual, not inconsistent with this section. 

4 ‘‘(2) QUALIFIED ROLE.— 

5 ‘‘(A) IN GENERAL.—In this subsection, the 

6 term ‘qualified role’ means either of the fol7 lowing: 

8 ‘‘(i) BIO-PREPAREDNESS HEALTH

9 CARE PROFESSIONAL.—A role in which the 

10 health care professional spends not less 

11 than 50 percent of their time engaged in 

12 bio-preparedness and response activities, 

13 including— 

14 ‘‘(I) developing and updating re15 sponse, surge, and isolation capacity 

16 plans and protocols; 

17 ‘‘(II) collaborating with State, 

18 local, and Tribal health departments 

19 on preparedness and response efforts; 

20 ‘‘(III) training health care facil21 ity personnel in matters related to 

22 bio-preparedness; 

23 ‘‘(IV) purchasing and managing 

24 equipment (such as personal protec25 tive equipment) for public health 


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1 emergencies, including those declared 

2 under section 319; 

3 ‘‘(V) executing readiness assess4 ments for public health emergencies, 

5 including those declared under section 

6 319; 

7 ‘‘(VI) repurposing areas of a 

8 health care facility to manage patient 

9 influx; 

10 ‘‘(VII) communicating with the 

11 public regarding preventing or re12 sponding to public health emergencies, 

13 including those declared under section 

14 319; 

15 ‘‘(VIII) performing infection pre16 vention and control and environmental 

17 disinfection; 

18 ‘‘(IX) conducting epidemiologic 

19 surveillance and investigations; and 

20 ‘‘(X) conducting antimicrobial 

21 stewardship. 

22 ‘‘(ii) INFECTIOUS DISEASES HEALTH

23 CARE PROFESSIONAL.—A role (including 

24 through a fellowship) in which the health 

25 care professional spends not less than 50 


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1 percent of their time engaging in infectious 

2 disease care— 

3 ‘‘(I) in a medically underserved 

4 community; 

5 ‘‘(II) for a medically underserved 

6 population as defined in section 

7 330(b)(3); 

8 ‘‘(III) at a Federally qualified 

9 health center or rural health clinic (as 

10 those terms are defined in section 

11 1861(aa) of the Social Security Act); 

12 ‘‘(IV) at a health center receiving 

13 assistance under section 330; 

14 ‘‘(V) at a Federal medical facil15 ity; 

16 ‘‘(VI) in a health program, or at 

17 a facility operated, by an Indian Tribe 

18 or Tribal organization (as those terms 

19 are defined in section 4 of the Indian 

20 Self-Determination and Education As21 sistance Act) or by an urban Indian 

22 organization as defined in section 4 of 

23 the Indian Health Care Improvement 

24 Act; 


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1 ‘‘(VII) in a health professional 

2 shortage area as designated under 

3 section 332; 

4 ‘‘(VIII) at an entity receiving as5 sistance under title XXVI for the pro6 vision of clinical services; 

7 ‘‘(IX) at a critical access hospital 

8 (as defined in section 1861(mm)(1) of 

9 the Social Security Act); 

10 ‘‘(X) in a frontier health profes11 sional shortage area; or 

12 ‘‘(XI) at an accredited public 

13 academic educational institution in a 

14 State or territory or health care set15 ting affiliated with such an institu16 tion. 

17 ‘‘(B) EMPLOYMENT BY PUBLIC HEALTH

18 AGENCY.—The term ‘qualified role’ does not in19 clude a role in which the health care profes20 sional is employed by a Federal, State, local, or 

21 Tribal public health agency or is in a related 

22 training fellowship, as recognized by the Sec23 retary, excluding— 

24 ‘‘(i) a role under clause (i) of subpara25 graph (A) in which the health care profesVerDate Sep 11 2014 03:15 Nov 20, 2021 Jkt 029200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3244.IS S3244

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1 sional is employed at a medical facility de2 scribed in subclause (XI) of subparagraph 

3 (A)(ii); 

4 ‘‘(ii) a role under clause (ii) of sub5 paragraph (A) in which the health care 

6 professional is employed at a medical facil7 ity described in subclause (V), (VI), or 

8 (XI) of subparagraph (A)(ii); or 

9 ‘‘(iii) a role under clause (i) or (ii) of 

10 subparagraph (A) in which the health care 

11 professional is employed in any other set12 ting specified by the Secretary. 

13 ‘‘(3) HEALTH CARE PROFESSIONAL.—In this 

14 section, the term ‘health care professional’ in15 cludes— 

16 ‘‘(A) with respect to an individual in a role 

17 described in paragraph (2)(A)(i), an individual 

18 who is— 

19 ‘‘(i) a physician; 

20 ‘‘(ii) a clinical pharmacist; 

21 ‘‘(iii) a physician assistant; 

22 ‘‘(iv) an advanced practice registered 

23 nurse; 

24 ‘‘(v) an infection preventionist; or 

25 ‘‘(vi) a laboratory professional; or 


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1 ‘‘(B) with respect to an individual in a role 

2 described in paragraph (2)(A)(ii), an individual 

3 who is— 

4 ‘‘(i) a physician; 

5 ‘‘(ii) a clinical pharmacist; 

6 ‘‘(iii) a physician assistant; 

7 ‘‘(iv) a dentist; or 

8 ‘‘(v) an advanced practice registered 

9 nurse. 

10 ‘‘(d) PAYMENTS.— 

11 ‘‘(1) IN GENERAL.—A loan repayment provided 

12 for an individual under a written contract under the 

13 Program shall consist of payment, in accordance 

14 with paragraph (2), on behalf of the individual of 

15 the principal, interest, and related expenses on gov16 ernment and commercial loans received by the indi17 vidual regarding the undergraduate or graduate edu18 cation of the individual (or both), which loans were 

19 made for tuition expenses incurred by the individual. 

20 ‘‘(2) PAYMENTS FOR YEARS SERVED.—For 

21 each year of obligated service that an individual con22 tracts to serve under subsection (c), the Secretary 

23 may pay up to $50,000 on behalf of the individual 

24 for loans described in paragraph (1). With respect to 

25 participants under the Program whose total eligible 


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1 loans are less than $150,000, the Secretary shall 

pay an amount that does not exceed 1 2 ⁄3 of the eligi3 ble loan balance for each year of obligated service of 

4 the individual. 

5 ‘‘(3) TAX LIABILITY.—For the purpose of pro6 viding reimbursements for tax liability resulting 

7 from payments under paragraph (2) on behalf of an 

8 individual, the Secretary shall, in addition to such 

9 payments, make payments to the individual in an 

10 amount not to exceed 39 percent of the total amount 

11 of loan repayments made for the taxable year in12 volved. 

13 ‘‘(e) POSTPONING OBLIGATED SERVICE.—With re14 spect to any individual participating in the Program, the 

15 date of the initiation of the period of obligated service may 

16 be postponed as approved by the Secretary. 

17 ‘‘(f) BREACH OF CONTRACT.—An individual who fails 

18 to comply with the contract entered into under subsection 

19 (c) shall be subject to the same financial penalties as pro20 vided for under section 338E for breaches of loan repay21 ment contracts under section 338B. 

22 ‘‘(g) CONSIDERATIONS.—In awarding contracts 

23 under this section, the Secretary may— 


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1 ‘‘(1) distribute contracts under this section eq2 uitably among geographic areas of the United 

3 States; and 

4 ‘‘(2) ensure that contracts under this section 

5 help to increase the number of underrepresented mi6 nority individuals (as defined in section 738(b)(5)) 

7 serving as heath care professionals in roles described 

8 in clauses (i) and (ii) of subsection (c)(2)(A). 

9 ‘‘(h) ADDITIONAL CRITERIA.—The Secretary— 

10 ‘‘(1) may establish, in addition to the criteria 

11 and rules specified in this section, such criteria and 

12 rules to carry out this section as the Secretary deter13 mines are needed; and 

14 ‘‘(2) shall give notice to the committees speci15 fied in subsection (i) of any criteria and rules so es16 tablished. 

17 ‘‘(i) REPORT TO CONGRESS.—Not later than 3 years 

18 after the date of enactment of this section, and every other 

19 year thereafter, the Secretary shall prepare and submit 

20 to the Committee on Health, Education, Labor, and Pen21 sions of the Senate and the Committee on Energy and 

22 Commerce of the House of Representatives a report on— 

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

24 have qualified for loan repayments under this sec25 tion; and 


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1 ‘‘(2) the impact of this section on the avail2 ability of— 

3 ‘‘(A) health care professionals engaged in 

4 bio-preparedness and response activities de5 scribed in subsection (c)(2)(A)(i), and health 

6 care professionals engaged in infectious disease 

7 care described in subsection (c)(2)(A)(ii), na8 tionally; and 

9 ‘‘(B) health care professionals engaged in 

10 infectious disease care described in subsection 

11 (c)(2)(A)(ii) in the areas and settings listed in 

12 such subsection. 

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

14 is authorized to be appropriated to carry out this section 

15 $50,000,000 for each of fiscal years 2023 through 2027.’’. 

Æ 


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