II 

110TH CONGRESS 

1ST SESSION S. 1120 

To amend the Public Health Service Act to provide grants for the training 

of graduate medical residents in preventive medicine and public health. 

IN THE SENATE OF THE UNITED STATES 

APRIL 17, 2007 

Mr. HARKIN (for himself, Mr. ISAKSON, Mr. BINGAMAN, and Mr. LIEBERMAN) 

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 provide grants 

for the training of graduate medical residents in preventive medicine and public health. 

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 ‘‘Preventive Medicine 

5 and Public Health Training Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) The American Board of Preventive medicine 

9 defines preventive medicine as ‘‘that specialty of 


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1 medical practice which focuses on the health of indi2 viduals and defined populations in order to protect, 

3 promote and maintain health and well-being and 

4 prevent disease, disability and premature death’’. 

5 (2) Specialists in preventive medicines are 

6 uniquely trained in both clinical medicine and public 

7 health. They have the skills needed to understand 

8 and reduce the risks of disease, disability and death 

9 in individuals and in population groups. 

10 (3) Preventive medicine includes both clinical 

11 and non-clinical aspects. Clinicians see patients on a 

12 daily basis and provide services in screening, health 

13 counseling, and immunization to diabetics, cardiac 

14 patients, and others who can benefit from prevention 

15 and lifestyle modification. Non-clinical preventive 

16 medicine includes health policy, social and behavioral 

17 aspects of health and disease, epidemiology, or other 

18 areas in which populations, not individual patients 

19 are not the primary focus. Many preventive medicine 

20 physicians practice both clinical and non-clinical 

21 medicine. 

22 (4) Of the 24 medical specialities recognized by 

23 the American Board of Medical Specialties, preven24 tive medicine is the only specialty that requires 

25 training in both clinical medicine and public health. 


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1 (5) While preventive medicine doctors are em2 ployed in all health sectors, they often serve in lead 

3 roles within the public health force, working in State 

4 and local health departments, as well as Federal 

5 Government agencies, such as the Centers for Dis6 ease Control and Prevention and the National Insti7 tutes of Health. 

8 (6) In the workplace, preventive medicine doc9 tors in occupational medicine parallel the general 

10 public health system in dealing with illnesses and in11 juries in workplace populations through worker pro12 tection, personal health promotion, hazard control, 

13 business continuity and effective medical manage14 ment. 

15 (7) There is an extreme shortage of doctors in 

16 the public health field. For example, only 23 percent 

17 of local health agencies are directed by physicians 

18 and 8 percent are directed by physicians who have 

19 masters of public health degrees or are fellows in the 

20 American College of Preventive Medicine. 

21 (8) Many of these physicians are nearing retire22 ment, and the average age of a public health doctor 

23 today is 58 years. 

24 (9) The Health Resources and Services Admin25 istration reports that the demand for public health 


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1 professionals will grow at twice the rate of all occu2 pations between 2000 and 2010. 

3 (10) In addition, as the body of evidence sup4 porting the effectiveness of clinical and population5 based interventions to prevent and control diseases 

6 continues to expand, so does the need for specialists 

7 trained in preventive medicine. 

8 (11) The Health Resources and Services Ad9 ministration reported that in 2000, there were 7,011 

10 preventive medicine specialists. This was a decrease 

11 from 7,734 in 1970. 

12 (12) The number of preventive medicine resi13 dency programs has decreased from 90 in 1998– 

14 1999 to 76 programs today. Over this same period, 

15 the number of preventive medicine residents declined 

16 from 420 to 364. 

17 (13) In 2000, less than 3 percent of all medical 

18 school faculty also held masters degrees in public 

19 health. An even smaller number had completed pre20 ventive medicine training or were board certified in 

21 preventive medicine. 

22 (14) Preventive medicine trained physicians are 

23 an essential part of the public health workforce and 

24 are critical to the Nation’s ability to protect its citiVerDate Aug 31 2005 21:13 Apr 23, 2007 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1120.IS S1120

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1 zens from biological threats, including avian influ2 enza and emerging threats from bioterrorism. 

3 SEC. 3. PREVENTIVE MEDICINE AND PUBLIC HEALTH 

4 TRAINING GRANT PROGRAM. 

5 Part D of title III of the Public Health Service Act 

6 (42 U.S.C. 254b et seq.) is amended by adding at the end 

7 the following: 

8 ‘‘Subpart XI—Preventive Medicine Training 

9 ‘‘SEC. 340H. PREVENTIVE MEDICINE AND PUBLIC HEALTH 

10 TRAINING GRANT PROGRAM. 

11 ‘‘(a) GRANTS.—The Secretary, acting through the 

12 Director of the Centers for Disease Control and Preven13 tion, may award grants to, or enter into contracts with, 

14 eligible entities to provide training to graduate medical 

15 residents in preventive medicine specialties. 

16 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

17 or contract under subsection (a), an entity shall— 

18 ‘‘(1) be a school of public health, public health 

19 department, school of medicine or osteopathic medi20 cine, public or private hospital, or public or private 

21 non-profit entity; 

22 ‘‘(2) submit to the Secretary an application at 

23 such time, in such manner, and containing such in24 formation as the Secretary may require; and 


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1 ‘‘(3) maintain and adhere to a Letter of Agree2 ment with a local community health center (if avail3 able in the local area involved) that supports 

4 practicum training of preventive medicine residents, 

5 if practicable. 

6 ‘‘(c) USE OF FUNDS.—Amounts received under a 

7 grant or contract under this section shall be used to— 

8 ‘‘(1) to plan, develop, and operate residency 

9 programs for preventive medicine or public health; 

10 ‘‘(2) provide financial assistance, including tui11 tion and stipends, to resident physicians (MD or 

12 DO) who plan to specialize in preventive medicine or 

13 public health; 

14 ‘‘(3) defray the costs associated with the plan15 ning, development, and operation of preventive medi16 cine or public health programs, including the devel17 opment of curriculum to be used in such programs, 

18 and the costs of practicum experiences; and 

19 ‘‘(4) provide for the improvement of academic 

20 administrative units. 

21 ‘‘(d) DURATION OF AWARD.—A grant or contract 

22 under this section shall be for a term not to exceed 5 

23 years. 

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

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


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1 $43,000,000 for fiscal year 2008, and such sums as may 

2 be necessary for each succeeding fiscal year.’’. 

Æ 


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