I

107TH CONGRESS

1ST SESSION H. R. 2173

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

programs regarding the practice of pharmacy.

IN THE HOUSE OF REPRESENTATIVES

JUNE 14, 2001

Mr. MCGOVERN (for himself, Mr. SIMPSON, Mr. RUSH, Mr. SHIMKUS, Mr.

ROSS, Mr. WHITFIELD, Mr. PICKERING, Mr. SHOWS, Ms. MCKINNEY,

and Mr. LANGEVIN) introduced the following bill; which was referred to

the Committee on Energy and Commerce

A BILL

To amend the Public Health Service Act with respect to

health professions programs regarding the practice of

pharmacy.

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 ‘‘Pharmacy Education

5 Aid Act of 2001’’.

6 SEC. 2. FINDINGS.

7 The Congress finds as follows:

8 (1) Pharmacists are an important link in our

9 Nation’s health care system. A critical shortage of
2

•HR 2173 IH

1 pharmacists is threatening the ability of community

2 pharmacies to continue to provide important pre3 scription related services.

4 (2) The Institute of Medicine (‘‘IOM’’) pre5 pared a landmark report on medical errors, includ6 ing medication errors. In the report, entitled ‘‘To

7 Err is Human: Building a Safer Health System’’,

8 IOM indicated that medication errors can be par9 tially attributed to factors such as staff shortages;

10 having too many customers places great pressure on

11 available staff, leading to a lack of concentration.

12 (3) In section 5 of Public Law 106–129, the

13 Congress acknowledged a growing demand for phar14 macists by requiring the Secretary of Health and

15 Human Services to conduct a study to determine

16 whether there is a shortage of pharmacists in the

17 United States and, if so, to what extent.

18 (4) The study required by Public Law 106–129

19 was conducted by the Health Resources and Services

20 Administration (‘‘HRSA’’). The report from the

21 study was submitted to the Congress in December

22 2000, and is entitled ‘‘The Pharmacist Workforce: A

23 Study in Supply and Demand for Pharmacists’’.

24 (5) The findings described in the HRSA report

25 include the following:
3

•HR 2173 IH

1 (A) ‘‘While the overall supply of phar2 macists has increased in the past decade, there

3 has been an unprecedented demand for phar4 macists and for pharmaceutical care services,

5 which has not been met by the currently avail6 able supply.’’

7 (B) The ‘‘evidence clearly indicates the

8 emergence of a shortage of pharmacists over

9 the past two years.’’

10 (C) ‘‘The factors causing the current

11 shortage are of a nature not likely to abate in

12 the near future without fundamental changes in

13 pharmacy practice and education.’’

14 (6) In the report, HRSA projects that the num15 ber of prescriptions filled by community pharmacists

16 will increase 20 percent by 2004. In contrast, the

17 number of community pharmacists is expected to in18 crease only 6 percent by 2005.

19 (7) The demand for pharmacists will increase

20 as prescription drug use continues to grow.

21 (8) The Federal Government has a role and the

22 responsibility, through programs such as the Na23 tional Health Service Corps and programs under

24 title VII of the Public Health Service Act, to ensure

25 access to pharmacists services. Although the statu-
4

•HR 2173 IH

1 tory provisions for the program for the National

2 Health Service Corps expressly reference physicians,

3 dentists, certified nurse midwives, certified nurse

4 practitioners, and physician assistants, there is no

5 statutory reference to pharmacists. The National

6 Health Service Corps statute should provide for the

7 significant participation of pharmacists.

8 SEC. 3. INCLUSION OF PRACTICE OF PHARMACY IN PRO9 GRAM FOR NATIONAL HEALTH SERVICE

10 CORPS.

11 (a) INCLUSION IN CORPS MISSION.—Section

12 331(a)(3) of the Public Health Service Act (42 U.S.C.

13 254d(a)(3)) is amended—

14 (1) in subparagraph (D), by adding at the end

15 the following: ‘‘Such term includes pharmacist serv16 ices.’’; and

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

18 ‘‘(E)(i) The term ‘pharmacist services’ in19 cludes medication therapy management services.

20 ‘‘(ii) The term ‘medication therapy man21 agement services’, with respect to pharmacist

22 services, includes services to assure that medi23 cations are used appropriately by patients; to

24 enhance patients’ understanding of the appro25 priate use of medications; to increase patients’
5

•HR 2173 IH

1 adherence to prescription medication regimens;

2 to reduce the risk of adverse events associated

3 with medications; and to reduce the need for

4 other costly medical services through better

5 management of medication therapy. Such serv6 ices may include case management, disease

7 management, drug therapy management, pa8 tient training and education, counseling, drug

9 therapy problem resolution, medication adminis10 tration, the provision of special packaging, or

11 other services that enhance the use of prescrip12 tion medications.’’.

13 (b) SCHOLARSHIP PROGRAM.—Section 338A(a)(1) of

14 the Public Health Service Act (42 U.S.C. 254l(a)(1)) is

15 amended by inserting ‘‘pharmacists,’’ after ‘‘physicians,’’.

16 (c) LOAN REPAYMENT PROGRAM.—Section

17 338B(a)(1) of the Public Health Service Act (42 U.S.C.

18 254l–1(a)(1)) is amended by inserting ‘‘pharmacists,’’

19 after ‘‘physicians,’’.

20 (d) FUNDING.—Section 338H(b)(2) of the Public

21 Health Service Act (42 U.S.C. 254q(b)(2)) is amended—

22 (1) in subparagraph (A), by inserting before the

23 period the following: ‘‘, which may include such con24 tracts for individuals who are in a course of study

25 or program leading to a pharmacy degree’’; and
6

•HR 2173 IH

1 (2) by adding at the end the following subpara2 graph:

3 ‘‘(C) SCHOLARSHIPS FOR FIRST-YEAR

4 STUDY IN PHARMACY.—Of the amounts appro5 priated under paragraph (1) for a fiscal year,

6 the Secretary shall obligate not less than 10

7 percent for the purpose of providing contracts

8 for scholarships under this subpart to individ9 uals who are entering the first year of study in

10 a course of study or program leading to a phar11 macy degree. Amounts obligated under this sub12 paragraph shall be in addition to amounts obli13 gated under subparagraph (A).’’.

14 SEC. 4. CERTAIN HEALTH PROFESSIONS PROGRAMS RE15 GARDING PRACTICE OF PHARMACY.

16 Part E of title VII of the Public Health Service Act

17 (42 U.S.C. 294n et seq.) is amended by adding at the end

18 the following subpart:

19 ‘‘Subpart 3—Certain Workforce Programs

20 ‘‘SEC. 771. PRACTICING-PHARMACIST WORKFORCE.

21 ‘‘(a) RECRUITING AND RETAINING STUDENTS AND

22 FACULTY.—

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

24 awards of grants or contracts to qualifying schools

25 of pharmacy (as defined in subsection (f)) for the
7

•HR 2173 IH

1 purpose of carrying out programs for recruiting and

2 retaining students and teaching faculty for such

3 schools, including programs to provide scholarships

4 for attendance at such schools to full-time students

5 who have financial need for the scholarships and

6 who demonstrate a commitment to becoming prac7 ticing pharmacists or faculty regarding the practice

8 of pharmacy.

9 ‘‘(2) PREFERENCE IN PROVIDING SCHOLAR10 SHIPS.—An award may not be made under para11 graph (1) unless the qualifying school of pharmacy

12 involved agrees that, in providing scholarships pur13 suant to the award, the school will give preference

14 to students for whom the costs of attending the

15 school would constitute a severe financial hardship.

16 ‘‘(b) LOAN REPAYMENT PROGRAM REGARDING FAC17 ULTY POSITIONS.—

18 ‘‘(1) IN GENERAL.—The Secretary may estab19 lish a program of entering into contracts with indi20 viduals described in paragraph (2) under which the

21 individuals agree to serve as members of the fac22 ulties of qualifying schools of pharmacy in consider23 ation of the Federal Government agreeing to pay,

24 for each year of such service, not more than $20,000
8

•HR 2173 IH

1 of the principal and interest of the educational loans

2 of such individuals.

3 ‘‘(2) ELIGIBLE INDIVIDUALS.—The individuals

4 referred to in paragraph (1) are individuals who—

5 ‘‘(A) have a doctoral degree in pharmacy

6 or the pharmaceutical sciences; or

7 ‘‘(B) are enrolled in a school of pharmacy

8 and are in the final academic year of such

9 school in a program leading to such a doctoral

10 degree.

11 ‘‘(3) REQUIREMENTS REGARDING FACULTY PO12 SITIONS.—The Secretary may not enter into a con13 tract under paragraph (1) unless—

14 ‘‘(A) the individual involved has entered

15 into a contract with a qualifying school of phar16 macy to serve as a member of the faculty of the

17 school for not less than 2 years;

18 ‘‘(B) the contract referred to in subpara19 graph (A) provides that, in serving as a mem20 ber of the faculty pursuant to such subpara21 graph, the individual will—

22 ‘‘(i) serve full time; or

23 ‘‘(ii) serve as a member of the adjunct

24 clinical faculty and in so serving will ac25 tively supervise pharmacy students for 25
9

•HR 2173 IH

1 academic weeks per year (or such greater

2 number of academic weeks as may be spec3 ified in the contract); and

4 ‘‘(C) such contract provides that—

5 ‘‘(i) the school will, for each year for

6 which the individual will serve as a mem7 ber of the faculty under the contract with

8 the school, make payments of the principal

9 and interest due on the educational loans

10 of the individual for such year in an

11 amount equal to the amount of such pay12 ments made by the Secretary for the year;

13 ‘‘(ii) the payments made by the school

14 pursuant to clause (i) on behalf of the indi15 vidual will be in addition to the pay that

16 the individual would otherwise receive for

17 serving as a member of such faculty; and

18 ‘‘(iii) the school, in making a deter19 mination of the amount of compensation to

20 be provided by the school to the individual

21 for serving as a member of the faculty, will

22 make the determination without regard to

23 the amount of payments made (or to be

24 made) to the individual by the Federal

25 Government under paragraph (1).
10

•HR 2173 IH

1 ‘‘(4) APPLICABILITY OF CERTAIN PROVI2 SIONS.—The provisions of sections 338C, 338G, and

3 338I shall apply to the program established in para4 graph (1) to the same extent and in the same man5 ner as such provisions apply to the National Health

6 Service Corps Loan Repayment Program established

7 in subpart III of part D of title III, including the

8 applicability of provisions regarding reimbursements

9 for increased tax liability and provisions regarding

10 bankruptcy.

11 ‘‘(5) WAIVER REGARDING SCHOOL CONTRIBU12 TIONS.—The Secretary may waive the requirement

13 established in paragraph (3)(C) if the Secretary de14 termines that the requirement will impose an undue

15 financial hardship on the school involved.

16 ‘‘(c) INFORMATION TECHNOLOGY.—The Secretary

17 may make awards of grants or contracts to qualifying

18 schools of pharmacy for the purpose of assisting such

19 schools in acquiring and installing computer-based sys20 tems to provide pharmaceutical education. Education pro21 vided through such systems may be graduate education,

22 professional education, or continuing education. The com23 puter-based systems may be designed to provide on-site

24 education, or education at remote sites (commonly re25 ferred to as distance learning), or both.
11

•HR 2173 IH

1 ‘‘(d) FACILITIES.—

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

3 awards of grants or contracts to qualifying schools

4 of pharmacy for construction projects to expand, re5 model, renovate, or alter existing facilities for such

6 schools or to provide new facilities for the schools.

7 ‘‘(2) CERTAIN RESTRICTIONS.—An award

8 under paragraph (1) may not be expended for the

9 costs of acquiring land or for off-site improvements.

10 ‘‘(3) RECAPTURE OF PAYMENTS.—If, during

11 the 20-year period beginning on the date of the com12 pletion of construction pursuant to paragraph (1)—

13 ‘‘(A) the school of pharmacy involved, or

14 other owner of the facility, ceases to be a public

15 or nonprofit private entity; or

16 ‘‘(B) the facility involved ceases to be used

17 for the purposes for which it was constructed

18 (unless the Secretary determines, in accordance

19 with regulations, that there is good cause for

20 releasing the school or other owner from such

21 obligation);

22 the United States is entitled to recover from the

23 school or other owner of the facility the amount

24 bearing the same ratio to the current value (as de25 termined by an agreement between the parties or by
12

•HR 2173 IH

1 action brought in the United States District Court

2 for the district in which such facility is situated) of

3 the facility as the amount of the Federal participa4 tion bore to the cost of the construction of such fa5 cility.

6 ‘‘(e) REQUIREMENT REGARDING EDUCATION IN

7 PRACTICE OF PHARMACY.—With respect to the qualifying

8 school of pharmacy involved, the Secretary shall ensure

9 that programs and activities carried out with Federal

10 funds provided under this section have the goal of edu11 cating students to become licensed pharmacists, or the

12 goal of providing for faculty to educate students to become

13 licensed pharmacists.

14 ‘‘(f) QUALIFYING SCHOOL OF PHARMACY.—For pur15 poses of this section, the term ‘qualifying school of phar16 macy’ means a school of pharmacy (as defined in section

17 799B) that, in providing clinical experience for students,

18 requires that the students serve in a clinical rotation in

19 which pharmacist services (as defined in section

20 331(a)(3)(E)) are provided at or for—

21 ‘‘(1) a medical facility that serves a substantial

22 number of individuals who reside in or are members

23 of a medically underserved community (as so de24 fined);
13

•HR 2173 IH

1 ‘‘(2) an entity described in any of subpara2 graphs (A) through (L) of section 340B(a)(4) (relat3 ing to the definition of covered entity);

4 ‘‘(3) a health care facility of the Department of

5 Veterans Affairs or of any of the Armed Forces of

6 the United States;

7 ‘‘(4) a health care facility of the Bureau of

8 Prisons;

9 ‘‘(5) a health care facility operated by, or with

10 funds received from, the Indian Health Service; or

11 ‘‘(6) a disproportionate share hospital under

12 section 1923 of the Social Security Act.

13 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the

14 purpose of carrying out this section, there are authorized

15 to be appropriated such sums as may be necessary for

16 each of the fiscal years 2002 through 2006.’’.

Æ