I 

117TH CONGRESS 

2D SESSION H. R. 6397 

To amend the Public Health Service Act to establish a grant program to 

award grants to public institutions of higher education located in a 

covered State, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 13, 2022 

Mr. COLE (for himself, Ms. TITUS, and Mr. MULLIN) introduced the following 

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

A BILL 

To amend the Public Health Service Act to establish a grant 

program to award grants to public institutions of higher 

education located in a covered State, 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 ‘‘Medical Student Edu5 cation Authorization Act of 2022’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Access to high quality primary care is asso2 ciated with improved health outcomes and lower 

3 health care costs. 

4 (2) Substantial disparities exist in the distribu5 tion of primary care providers. 

6 (3) Shortages of health care providers affect 

7 Tribal, rural, and medically underserved commu8 nities more than the populations of more densely 

9 populated areas, resulting in such communities expe10 riencing significant health challenges and disparities. 

11 (4) American Indian, Alaskan Natives, and Na12 tive Hawaiians tend to have lower health status, 

13 lower life expectancy, and disproportionate disease 

14 burden when compared to other Americans. 

15 (5) Having training experiences in, living 

16 among, and being a member of Tribal, rural, and 

17 medically underserved communities increases cul18 tural awareness and can influence career choice for 

19 physicians to better serve such populations. 

20 (6) Research shows there is a relationship be21 tween the characteristics of a physician and the 

22 eventual practice location, including being part of an 

23 underrepresented minority or growing up in a rural 

24 area. 


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1 SEC. 3. EDUCATION PROGRAM TO SUPPORT PRIMARY 

2 HEALTH SERVICE FOR UNDERSERVED POPU3 LATIONS. 

4 Part B of title VII of the Public Health Service Act 

5 (42 U.S.C. 293 et seq.) is amended by adding at the end 

6 the following: 

7 ‘‘SEC. 742. EDUCATION PROGRAM TO SUPPORT PRIMARY 

8 HEALTH SERVICE FOR UNDERSERVED POPU9 LATIONS. 

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

11 through the Administrator of the Health Resources and 

12 Services Administration, shall establish a grant program 

13 to award grants to public institutions of higher education 

14 located in a covered State to carry out the activities de15 scribed in subsection (d) for the purposes of— 

16 ‘‘(1) expanding and supporting education for 

17 medical students who are preparing to become physi18 cians in a covered State; and 

19 ‘‘(2) preparing and encouraging each such stu20 dent training in a covered State to serve Tribal, 

21 rural, or medically underserved communities as a 

22 primary care physician after completing such train23 ing. 

24 ‘‘(b) ELIGIBILITY.—In order to be eligible to receive 

25 a grant under this section, a public institution of higher 


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1 education shall submit an application to the Secretary that 

2 includes— 

3 ‘‘(1) a certification that such institution will use 

4 amounts provided to the institution to carry out the 

5 activities described in subsection (d); and 

6 ‘‘(2) a description of how such institution will 

7 carry out such activities. 

8 ‘‘(c) PRIORITY.—In awarding grants under this sec9 tion, the Secretary shall give priority to public institutions 

10 of higher education that— 

11 ‘‘(1) are located in a State with not fewer than 

12 2 federally recognized Tribes; and 

13 ‘‘(2) demonstrate a public-private partnership. 

14 ‘‘(d) AUTHORIZED ACTIVITIES.—An eligible entity 

15 that receives a grant under this section shall use the funds 

16 made available under such grant to carry out the following 

17 activities: 

18 ‘‘(1) Support or expand community-based expe19 riential training for medical students who will prac20 tice in or serve Tribal, rural, and medically under21 served communities. 

22 ‘‘(2) Develop and operate programs to train 

23 medical students in primary care services. 

24 ‘‘(3) Develop and implement curricula that— 


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1 ‘‘(A) includes a defined set of clinical and 

2 community-based training activities that em3 phasize care for Tribal, rural, or medically un4 derserved communities; 

5 ‘‘(B) is applicable to primary care practice 

6 with respect to individuals from Tribal, rural, 

7 or medically underserved communities; 

8 ‘‘(C) identifies and addresses challenges to 

9 health equity, including the needs of Tribal, 

10 rural, and medically underserved communities; 

11 ‘‘(D) supports the use of telehealth tech12 nologies and practices; 

13 ‘‘(E) considers social determinants of 

14 health in care plan development; 

15 ‘‘(F) integrates behavioral health care into 

16 primary care practice, including prevention and 

17 treatment of opioid disorders and other sub18 stance use disorders; 

19 ‘‘(G) promotes interprofessional training 

20 that supports a patient-centered model of care; 

21 and 

22 ‘‘(H) builds cultural and linguistic com23 petency. 

24 ‘‘(4) Increase the capacity of faculty to imple25 ment the curricula described in paragraph (3). 


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1 ‘‘(5) Develop or expand strategic partnerships 

2 to improve health outcomes for individuals from 

3 Tribal, rural, and medically underserved commu4 nities, including with— 

5 ‘‘(A) federally recognized Tribes, Tribal 

6 colleges, and Tribal organizations; 

7 ‘‘(B) Federally-qualified health centers; 

8 ‘‘(C) rural health clinics; 

9 ‘‘(D) Indian health programs; 

10 ‘‘(E) primary care delivery sites and sys11 tems; and 

12 ‘‘(F) other community-based organizations. 

13 ‘‘(6) Develop a plan to track graduates’ chosen 

14 specialties for residency and the States in which 

15 such residency programs are located. 

16 ‘‘(7) Develop, implement, and evaluate methods 

17 to improve recruitment and retention of medical stu18 dents from Tribal, rural, and medically underserved 

19 communities. 

20 ‘‘(8) Train and support instructors to serve 

21 Tribal, rural, and medically underserved commu22 nities. 

23 ‘‘(9) Prepare medical students for transition 

24 into primary care residency training and future 

25 practice. 


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1 ‘‘(10) Provide scholarships to medical students. 

2 ‘‘(e) GRANT PERIOD.—A grant under this section 

3 shall be awarded for a period of not more than 5 years. 

4 ‘‘(f) GRANT AMOUNT.—Each fiscal year, the amount 

5 of a grant made to a public institution of higher education 

6 under this section shall be not less than $1,000,000. 

7 ‘‘(g) MATCHING REQUIREMENT.—Each public insti8 tution of higher education that receives a grant under this 

9 section shall provide, from non-Federal sources, an 

10 amount equal to or greater than 10 percent of the total 

11 amount of Federal funds provided to the institution each 

12 fiscal year during the period of the grant (which may be 

13 provided in cash or in kind). 

14 ‘‘(h) DEFINITIONS.—In this section: 

15 ‘‘(1) COVERED STATE.—The term ‘covered 

16 State’ means a State that is in the top quartile of 

17 States by projected unmet demand for primary care 

18 providers, as determined by the Secretary. 

19 ‘‘(2) FEDERALLY-QUALIFIED HEALTH CEN20 TER.—The term ‘Federally-qualified health center’ 

21 has the meaning given such term in section 

22 1905(l)(2)(B) of the Social Security Act. 

23 ‘‘(3) INDIAN HEALTH PROGRAM.—The term 

24 ‘Indian health program’ has the meaning given such 


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1 term in section 4 of the Indian Health Care Im2 provement Act. 

3 ‘‘(4) INSTITUTION OF HIGHER EDUCATION.— 

4 The term ‘institution of higher education’ has the 

5 meaning given such term in section 101 of the High6 er Education Act of 1965, provided that such insti7 tution is public in nature. 

8 ‘‘(5) MEDICALLY UNDERSERVED COMMUNITY.— 

9 The term ‘medically underserved community’ has the 

10 meaning given such term in section 799B. 

11 ‘‘(6) RURAL HEALTH CLINIC.—The term ‘rural 

12 health clinic’ has the meaning given such term in 

13 section 1861(aa) of the Social Security Act. 

14 ‘‘(7) RURAL POPULATION.—The term ‘rural 

15 population’ means the population of a geographical 

16 area located— 

17 ‘‘(A) in a non-metropolitan county; or 

18 ‘‘(B) in a metropolitan county designated 

19 as rural by the Administrator of the Health Re20 sources and Services Administration. 

21 ‘‘(8) TRIBAL POPULATION.—The term ‘Tribal 

22 population’ means the population of any Indian 

23 Tribe recognized by the Secretary of the Interior 

24 pursuant to section 104 of the Federally Recognized 

25 Indian Tribe List Act of 1994. 


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1 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section 

3 $150,000,000 for each of fiscal years 2023 through 

4 2027.’’. 

Æ 


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