II 

108TH CONGRESS 

2D SESSION S. 2739

To improve the training and retention of health professionals under titles 

VII and VIII of the Public Health Service Act, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 22, 2004

Mr. BINGAMAN introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL

To improve the training and retention of health professionals 

under titles VII and VIII of the Public Health Service 

Act, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Investing in America’s Future Act of 2004’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows:

Sec. 1. Short title; table of contents. 

TITLE I—ALLIED HEALTH 

Sec. 101. Findings. 

Sec. 102. Purposes. 
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Sec. 103. Amendments to Public Health Service Act. 

TITLE II—HEALTH WORKFORCE ADVISORY COMMISSION 

Sec. 201. Health Workforce Advisory Commission. 

TITLE III—PHYSICIAN DEMONSTRATION PROJECTS IN RURAL 

STATES 

Sec. 301. Definitions. 

Sec. 302. Rural States physician recruitment and retention demonstration program. 

Sec. 303. Establishment of the health professions database. 

Sec. 304. Evaluation and reports. 

Sec. 305. Contracting flexibility. 

TITLE IV—HEALTH CAREERS OPPORTUNITY PROGRAM 

Sec. 401. Purpose. 

Sec. 402. Authorization of appropriations. 

TITLE V—PROGRAM OF EXCELLENCE IN HEALTH PROFESSIONS 

EDUCATION FOR UNDERREPRESENTED MINORITIES 

Sec. 501. Purpose. 

Sec. 502. Authorization of appropriation. 

TITLE VI—HEALTH PROFESSIONS STUDENT LOAN FUND; AUTHORIZATIONS OF APPROPRIATIONS REGARDING STUDENTS 

FROM DISADVANTAGED BACKGROUNDS 

Sec. 601. Student loans. 

Sec. 602. National Health Service Corps; recruitment and fellowships for individuals from disadvantaged backgrounds. 

TITLE VII—MISCELLANEOUS PROVISIONS 

Sec. 703. Study by the Institute of Medicine.

1 TITLE I—ALLIED HEALTH 

2 SEC. 101. FINDINGS. 

3 Congress makes the following findings: 

4 (1) The Bureau of the Census and other re5 ports highlight the increased demand for acute and 

6 chronic health care services among both the general 

7 population and a rapidly growing aging portion of 

8 the population. 
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1 (2) The calls for reduction in medical errors, in2 creased patient safety, and increased quality of care 

3 have resulted in an amplified call for allied health 

4 professionals to provide health care services. 

5 (3) Several allied health professions are charac6 terized by workforce shortages, declining enrollments 

7 in allied health education programs, or a combina8 tion of both factors, and hospital officials have re9 ported vacancy rates in positions occupied by allied 

10 health professionals. 

11 (4) Many allied health education programs are 

12 facing significant economic pressure that could force 

13 their closure due to an insufficient number of stu14 dents. 

15 SEC. 102. PURPOSES. 

16 The purpose of this title is to ensure that the United 

17 States health care industry will have a supply of allied 

18 health professionals needed to support the Nation’s health 

19 care system in this decade and beyond by—

20 (1) providing incentives for members of the 

21 United States population to seek and complete high22 quality allied health education and training; and 

23 (2) providing additional funding to ensure that 

24 such education and training can be provided to allied 

25 health students. 
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1 SEC. 103. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 

2 (a) IN GENERAL.—Part E of title VII of the Public 

3 Health Service Act (42 U.S.C. 294n et seq.) is amended 

4 by adding at the end the following: 

5 ‘‘Subpart 3—Allied Health 

6 Professionals 

7 ‘‘SEC. 775. DEFINITIONS. 

8 ‘‘In this subpart: 

9 ‘‘(1) ALLIED HEALTH EDUCATION PROGRAM.—

10 The term ‘allied health education program’ means 

11 any education program at an accredited institution 

12 of higher education leading to a certificate, an asso13 ciate’s degree, a bachelor’s degree, or a post bacca14 laureate degree in an allied health profession. 

15 ‘‘(2) ALLIED HEALTH PROFESSION.—The term 

16 ‘allied health profession’ means any profession prac17 ticed by an individual in his or her capacity as an 

18 allied health professional. 

19 ‘‘(3) ELEMENTARY SCHOOL; SECONDARY

20 SCHOOL.—The terms ‘elementary school’ and ‘sec21 ondary school’ have the meanings give to those 

22 terms in section 9101 of the Elementary and Sec23 ondary Education Act of 1965 (20 U.S.C. 7801). 

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

25 The term ‘institution of higher education’ has the
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1 meaning given to that term in section 101 of the 

2 Higher Education Act of 1965 (20 U.S.C. 1001). 

3 ‘‘SEC. 775A. PUBLIC SERVICE ANNOUNCEMENTS. 

4 ‘‘The Secretary shall develop and issue public service 

5 announcements that advertise and promote the allied 

6 health professions, highlight the advantages and rewards 

7 of the allied health professions, and encourage individuals 

8 from disadvantaged communities and backgrounds to 

9 enter the allied health professions. 

10 ‘‘SEC. 775B. STATE AND LOCAL PUBLIC SERVICE AN11 NOUNCEMENTS. 

12 ‘‘(a) IN GENERAL.—The Secretary shall award 

13 grants to eligible entities to support State and local adver14 tising campaigns through appropriate media outlets to 

15 promote the allied health professions, highlight the advan16 tages and rewards of the allied health professions, and en17 courage individuals from disadvantaged communities and 

18 backgrounds to enter the allied health professions. 

19 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term 

20 ‘eligible entity’ means an entity that is—

21 ‘‘(1) a professional, national, or State allied 

22 health association; 

23 ‘‘(2) a State health care provider; or 

24 ‘‘(3) an association of entities that are each a 

25 health care facility, an allied health education pro-
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1 gram, or an entity that provides similar services or 

2 serves a like function. 

3 ‘‘SEC. 775C. ALLIED HEALTH RECRUITMENT GRANT PRO4 GRAM. 

5 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall 

6 award grants to eligible entities to increase allied health 

7 professions education opportunities. 

8 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term 

9 ‘eligible entity’ means an entity that is—

10 ‘‘(1) a professional, national, or State allied 

11 health association; 

12 ‘‘(2) a State health care provider; or 

13 ‘‘(3) an association of entities that are each a 

14 health care facility, an allied health education pro15 gram, or an entity that provides similar services or 

16 serves a like function. 

17 ‘‘(c) USE OF FUNDS.—An eligible entity that receives 

18 a grant under this section shall use funds received under 

19 such grant to—

20 ‘‘(1) support outreach programs at elementary 

21 schools and secondary schools that inform guidance 

22 counselors and students of education opportunities 

23 regarding the allied health professions; 

24 ‘‘(2) carry out special projects to increase allied 

25 health professions education opportunities for indi-
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1 viduals who are from disadvantaged backgrounds 

2 (including racial and ethnic minorities underrep3 resented in the allied health professions) by pro4 viding student scholarships or stipends, pre-entry 

5 preparation, and retention activities; 

6 ‘‘(3) provide assistance to public and nonprofit 

7 private educational institutions to support remedial 

8 education programs for allied health professions stu9 dents who require assistance with math, science, 

10 English, and medical terminology; 

11 ‘‘(4) meet the costs of child care and transpor12 tation for individuals who are taking part in an al13 lied health education program; or 

14 ‘‘(5) support community-based partnerships 

15 seeking to recruit allied health professionals in rural 

16 communities, urban medically underserved commu17 nities, and other communities experiencing an allied 

18 health professions shortage. 

19 ‘‘SEC. 775D. GRANTS FOR HEALTH CAREER ACADEMIES. 

20 ‘‘(a) IN GENERAL.—The Secretary shall award 

21 grants to eligible entities for the purpose of assisting such 

22 entities in collaborating to carry out programs that form 

23 education pipelines to facilitate the entry of students of 

24 secondary schools, especially underrepresented racial and 
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1 ethnic minorities, into careers in the allied health profes2 sions. 

3 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term 

4 ‘eligible entity’ means an institution that offers an allied 

5 health education program, a health care facility, or a sec6 ondary school. 

7 ‘‘SEC. 775E. ALLIED HEALTH PROFESSION, PRACTICE, AND 

8 RETENTION GRANTS. 

9 ‘‘(a) EDUCATION PRIORITY AREAS.—The Secretary 

10 may award grants to or enter into contracts with eligible 

11 entities for—

12 ‘‘(1) expanding the enrollment in allied health 

13 profession education programs, especially by under14 represented racial and ethnic minority students; and 

15 ‘‘(2) providing allied health education through 

16 new technologies and methods, including distance 

17 learning methodologies. 

18 ‘‘(b) PRACTICE PRIORITY AREAS.—The Secretary 

19 may award grants to or enter into contracts with eligible 

20 entities for—

21 ‘‘(1) establishing or expanding allied health pro22 fessions practice arrangements in noninstitutional 

23 settings to demonstrate methods to improve access 

24 to primary health care in rural areas and other 

25 medically underserved communities; 
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1 ‘‘(2) providing care for underserved populations 

2 and other high-risk groups such as the elderly, indi3 viduals with HIV/AIDS, substance abusers, the 

4 homeless, and victims of domestic violence; 

5 ‘‘(3) providing managed care, information man6 agement, quality improvement, and other skills need7 ed to practice in existing and emerging organized 

8 health care systems; or 

9 ‘‘(4) developing generational and cultural com10 petencies among allied health professionals. 

11 ‘‘(c) RETENTION PRIORITY AREAS.—

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

13 grants to and enter into contracts with eligible enti14 ties to enhance the allied health professions work15 force by initiating and maintaining allied health re16 tention programs pursuant to paragraph (2) or (3). 

17 ‘‘(2) GRANTS FOR CAREER LADDER PROGRAMS.—The 

18 Secretary may award grants to and enter into contracts 

19 with eligible entities for programs—

20 ‘‘(A) to promote career advancement for 

21 allied health professionals in a variety of train22 ing settings, cross training or specialty training 

23 among diverse population groups, and the ad24 vancement of individuals; and
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1 ‘‘(B) to assist individuals in obtaining edu2 cation and training required to enter the allied 

3 health professions and advance within such pro4 fessions, such as by providing career counseling 

5 and mentoring. 

6 ‘‘(3) ENHANCING PATIENT CARE DELIVERY

7 SYSTEMS.—

8 ‘‘(A) GRANTS.—The Secretary may award 

9 grants to eligible entities to improve the reten10 tion of allied health professionals and enhance 

11 patient care that is directly related to allied 

12 health activities by enhancing collaboration and 

13 communication among allied health profes14 sionals and other health care professionals, and 

15 by promoting the involvement of allied health 

16 professionals in the organizational and clinical 

17 decisionmaking processes of a health care facil18 ity. 

19 ‘‘(B) PREFERENCE.—In making awards of 

20 grants under this paragraph, the Secretary 

21 shall give preference to applicants that have not 

22 previously received an award under this para23 graph and to applicants from rural, under24 served areas. 
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1 ‘‘(C) CONTINUATION OF AN AWARD.—The 

2 Secretary shall make continuation of any award 

3 under this paragraph beyond the second year of 

4 such award contingent on the recipient of such 

5 award having demonstrated to the Secretary 

6 measurable and substantive improvement in al7 lied health professional retention or patient 

8 care. 

9 ‘‘(d) ELIGIBLE ENTITY.—In this section, the term 

10 ‘eligible entity’ means a health care facility, or any part11 nership or coalition including a health care facility or an 

12 allied health education program. 

13 ‘‘SEC. 775F. DEVELOPING MODELS AND BEST PRACTICES 

14 PROGRAM. 

15 ‘‘(a) MODELS AND BEST PRACTICES.—

16 ‘‘(1) GRANTS.—The Secretary shall award 

17 grants to eligible entities to enable such entities to 

18 carry out demonstrations of models and best prac19 tices in allied health for the purpose of developing 

20 innovative strategies or approaches for the retention 

21 of allied health professionals. 

22 ‘‘(2) DISTRIBUTION OF GRANTS.—The Sec23 retary shall ensure the distribution of grants under 

24 this subsection to a range of types and sizes of fa25 cilities, including facilities located in rural, urban, 
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1 and suburban areas and a variety of geographic re2 gions. 

3 ‘‘(3) USE OF FUND.—The Secretary may not 

4 make a grant to an eligible entity under this sub5 section unless the entity agrees to use funds received 

6 under the grant to carry out demonstrations of mod7 els and best practices in allied health for the purpose 

8 of—

9 ‘‘(A) promoting retention and satisfaction 

10 of allied health professionals; 

11 ‘‘(B) promoting opportunities for allied 

12 health professionals to pursue education, career 

13 advancement, and organizational recognition; 

14 and 

15 ‘‘(C) developing continuing education pro16 grams that instruct allied health professionals 

17 on how to use emerging medical technologies 

18 and how to address current and future health 

19 care needs. 

20 ‘‘(b) MODELS OF EXCELLENCE.—The Secretary shall 

21 award grants to area health education centers to enable 

22 such centers to enter into contracts with allied health edu23 cation programs—

24 ‘‘(1) to expand the operation of area health 

25 education centers to work in communities to develop 
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1 models of excellence for allied health professionals; 

2 or 

3 ‘‘(2) to expand any junior or senior secondary 

4 school mentoring programs to include an allied 

5 health professions mentoring program. 

6 ‘‘(c) DEFINITION.—In this section the term ‘eligible 

7 entity’ means a health care facility, or any partnership or 

8 coalition containing a health care facility and an allied 

9 health education program. 

10 ‘‘SEC. 775G. ALLIED HEALTH FACULTY LOAN PROGRAM. 

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

12 through the Administrator of the Health Resources and 

13 Services Administration, may enter into an agreement 

14 with any institution of higher education offering an allied 

15 health education program for the establishment and oper16 ation of a faculty loan fund in accordance with this sec17 tion, to increase the number of qualified allied health fac18 ulty. 

19 ‘‘(b) AGREEMENTS.—Each agreement entered into 

20 under this section shall—

21 ‘‘(1) provide for the establishment of a loan 

22 fund by the institution involved; 

23 ‘‘(2) provide for deposit in the fund of—

24 ‘‘(A) the Federal capital contributions to 

25 the fund; 
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1 ‘‘(B) an amount equal to not less than 

2 one-ninth of such Federal capital contributions, 

3 contributed by such institution; 

4 ‘‘(C) collections of principal and interest 

5 on loans made from the fund; and 

6 ‘‘(D) any other earnings of the fund; 

7 ‘‘(3) provide that the fund will be used only for 

8 loans to faculty of allied health education programs 

9 in accordance with subsection (c) and for the costs 

10 of collection of such loans and interest thereon; 

11 ‘‘(4) provide that loans may be made from such 

12 fund only to faculty pursuing a full-time course of 

13 study or, at the discretion of the Secretary, a part14 time course of study in an advanced degree program; 

15 and 

16 ‘‘(5) contain such other provisions as are nec17 essary to protect the financial interests of the 

18 United States. 

19 ‘‘(c) LOAN PROVISIONS.—Loans from any faculty 

20 loan fund established by an institution pursuant to an 

21 agreement under this section shall be made to an indi22 vidual on such terms and conditions as the institution may 

23 determine, except that—
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1 ‘‘(1) such terms and conditions are subject to 

2 any conditions, limitations, and requirements pre3 scribed by the Secretary; 

4 ‘‘(2) in the case of any individual, the total of 

5 the loans for any academic year made by an institu6 tion from loan funds established pursuant to agree7 ments under this section may not exceed $30,000, 

8 plus any amount determined by the Secretary on an 

9 annual basis to reflect inflation; 

10 ‘‘(3) an amount up to 85 percent of any such 

11 loan (plus interest thereon) shall be canceled by the 

12 institution as follows—

13 ‘‘(A) upon completion by the individual of 

14 each of the first, second, and third year of full15 time employment required by the loan agree16 ment entered into under this section, as a fac17 ulty member in an allied health education pro18 gram, the institution shall cancel ll percent 

19 of the principal of, and the interest on, the 

20 amount of such loan unpaid on the first day of 

21 such employment; and 

22 ‘‘(B) upon completion by the individual of 

23 the fourth year of full-time employment, re24 quired by the loan agreement entered into 

25 under this section, as a faculty member in an 
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1 allied health education program, the school 

2 shall cancel 25 percent of the principal of, and 

3 the interest on, the amount of such loan unpaid 

4 on the first day of such employment; 

5 ‘‘(4) such a loan may be used to pay the cost 

6 of tuition, fees, books, laboratory expenses, and 

7 other reasonable education expenses; 

8 ‘‘(5) such a loan shall be repayable in equal or 

9 graduated periodic installments (with the right of 

10 the borrower to accelerate repayment) over the 10-

11 year period that begins 9 months after the individual 

12 ceases to pursue a course of study in an allied health 

13 education program; and 

14 ‘‘(6) such a loan shall—

15 ‘‘(A) beginning on the date that is 3 

16 months after the individual ceases to pursue a 

17 course of study in an allied health education 

18 program, bear interest on the unpaid balance of 

19 the loan at the rate of 3 percent per annum; or 

20 ‘‘(B) subject to subsection (e), if the insti21 tution determines that the individual will not 

22 complete such course of study or serve as a fac23 ulty member as required under the loan agree24 ment under this subsection, bear interest on the 
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1 unpaid balance of the loan at the prevailing 

2 market rate. 

3 ‘‘(d) PAYMENT OF PROPORTIONATE SHARE.—Where 

4 all or any part of a loan, or interest, is canceled under 

5 this section, the Secretary shall pay to the institution and 

6 amount equal to the school’s proportionate share of the 

7 canceled portion, as determined by the Secretary. 

8 ‘‘(e) REVIEW BY SECRETARY.—At the request of the 

9 individual involved, the Secretary may review any deter10 mination by an institution under this section. 

11 ‘‘SEC. 775H. SCHOLARSHIP PROGRAM FOR SERVICE IN 

12 RURAL AND OTHER MEDICALLY UNDER13 SERVED AREAS. 

14 ‘‘(a) SCHOLARSHIP PROGRAM.—

15 ‘‘(1) IN GENERAL.—The Secretary shall carry 

16 out a program of entering into contracts with eligi17 ble individuals under which such individuals agree to 

18 serve as allied health professionals for a period of 

19 not less than 2 years at a health care facility with 

20 a critical shortage of allied health professionals in 

21 consideration of the Federal Government agreeing to 

22 provide to the individuals scholarships for attend23 ance in an allied health education program. 

24 ‘‘(2) ELIGIBLE INDIVIDUALS.—In this sub25 section, the term ‘eligible individual’ means an indi-
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1 vidual who is enrolled or accepted for enrollment as 

2 a full-time or part-time student in an allied health 

3 education program. 

4 ‘‘(3) SERVICE REQUIREMENT.—

5 ‘‘(A) IN GENERAL.—The Secretary may 

6 not enter into a contract with an eligible indi7 vidual under this section unless the individual 

8 agrees to serve as an allied health professional 

9 at a health care facility with a critical shortage 

10 of allied health professionals for a period of 

11 full-time service of not less than 2 years, or for 

12 a period of part-time service in accordance with 

13 subparagraph (B). 

14 ‘‘(B) PART-TIME SERVICE.—An individual 

15 may complete the period of service described in 

16 subparagraph (A) on a part-time basis if the in17 dividual has a written agreement that—

18 ‘‘(i) is entered into by the health care 

19 facility involved and the individual and is 

20 approved by the Secretary; and 

21 ‘‘(ii) provides that the period of obli22 gated service will be extended so that the 

23 aggregate amount of service performed will 

24 equal the amount of service that would be 
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1 performed through a period of full-time 

2 service of not less than 2 years. 

3 ‘‘(4) PREFERENCE.—In awarding scholarships 

4 under this section, the Secretary shall give a pref5 erence to applicants with the greatest financial need, 

6 applicants currently working in a health care facility 

7 who agree to serve the period of obligated service at 

8 such facility, minority allied health applicants, and 

9 applicants with an interest in a practice area of al10 lied health that has unmet needs. 

11 ‘‘(b) REPORTS.—Not later than 18 months after the 

12 date of enactment of this subpart and annually thereafter, 

13 the Secretary shall prepare and submit to Congress a re14 port describing the programs carried out under this sec15 tion, including statements regarding—

16 ‘‘(1) the number of enrollees by specialty or dis17 cipline, scholarships, and grant recipients; 

18 ‘‘(2) the number of graduates; 

19 ‘‘(3) the amount of scholarship payments made; 

20 ‘‘(4) which educational institutions the recipi21 ents attended; 

22 ‘‘(5) the number and placement location of the 

23 scholarship recipients at health care facilities with a 

24 critical shortage of allied health professionals; 

25 ‘‘(6) the default rate and actions required;
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1 ‘‘(7) the amount of outstanding default funds of 

2 the scholarship program; 

3 ‘‘(8) to the extent that it can be determined, 

4 the reason for the default; 

5 ‘‘(9) the demographics of the individuals par6 ticipating in the scholarship program; and 

7 ‘‘(10) an evaluation of the overall costs and 

8 benefits of the program. 

9 ‘‘SEC. 775I. GRANTS FOR CLINICAL EDUCATION, INTERN10 SHIP, RESIDENCY PROGRAMS, AND CON11 TINUING EDUCATION. 

12 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall 

13 award grants to eligible entities to develop allied health 

14 clinical education, internship, residency, and continuing 

15 education programs described in subsection (b). 

16 ‘‘(b) USE OF FUNDS.—The Secretary may not award 

17 a grant to an eligible entity under this section unless the 

18 entity agrees to use the grant to develop clinical education, 

19 internship, residency, and continuing education programs 

20 for graduates of allied health education programs. Each 

21 such clinical education, internship, residency, or con22 tinuing education program shall—

23 ‘‘(1) provide support for allied health education 

24 program faculty and mentors; 
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1 ‘‘(2) provide support for allied health profes2 sionals participating on a full-time or a part-time 

3 basis; and 

4 ‘‘(3) encourage the development of specialties. 

5 ‘‘(c) ELIGIBLE ENTITY.—In this section, the term 

6 ‘eligible entity’ means a partnership of an allied health 

7 education program and a health care facility. 

8 ‘‘SEC. 775J. GRANTS FOR PARTNERSHIPS. 

9 ‘‘(a) IN GENERAL.—The Secretary shall award 

10 grants to eligible entities to enable such entities to form 

11 partnerships to carry out the activities described in this 

12 section. 

13 ‘‘(b) USE OF FUNDS.—An eligible entity that receives 

14 a grant under this section shall use amounts received 

15 under the grant to—

16 ‘‘(1) provide employees of the health care facil17 ity involved advanced training and education in an 

18 allied health education program; 

19 ‘‘(2) establish or expand allied health practice 

20 arrangements in noninstitutional settings to dem21 onstrate methods to improve access to health care in 

22 rural and other medically underserved communities; 

23 ‘‘(3) purchase distance learning technology to 

24 extend general education and training programs to 
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1 rural areas, and to extend specialty education and 

2 training programs to all areas; and 

3 ‘‘(4) establish or expand mentoring, clinical 

4 education, and internship programs for training in 

5 specialty care areas. 

6 ‘‘(c) ELIGIBLE ENTITY.—In this section, the term 

7 ‘eligible entity’ means a partnership of an allied health 

8 education program and a health care facility formed to 

9 carry out the activities described in this section. 

10 ‘‘SEC. 775K. ALLIED HEALTH WORKFORCE DATA COLLEC11 TION AND ANALYSIS. 

12 ‘‘The Secretary, in conjunction with allied health pro13 fessional associations, shall develop a system for collecting 

14 and analyzing allied health workforce data gathered by the 

15 Bureau of Labor Statistics, the Health Resources and 

16 Services Administration, the Department of Health and 

17 Human Services, the Department of Veterans Affairs, the 

18 Center for Medicare & Medicaid Services, the Department 

19 of Defense, allied health professional associations, and re20 gional centers for health workforce studies for the purpose 

21 of—

22 ‘‘(1) determining educational pipeline and prac23 titioner shortages; and 

24 ‘‘(2) projecting future needs for such a work25 force. 
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1 ‘‘SEC. 775L. REPORTS BY GOVERNMENT ACCOUNTABILITY 

2 OFFICE. 

3 ‘‘The Comptroller General of the United States shall 

4 conduct an evaluation of whether the activities carried out 

5 under this subpart have demonstrably increased the num6 ber of applicants to allied health education programs. Not 

7 later than 4 years after the date of the enactment of this 

8 subpart, the Comptroller General shall submit a report to 

9 the Congress on the results of such evaluation. 

10 ‘‘SEC. 775M. AUTHORIZATION OF APPROPRIATIONS. 

11 ‘‘There are authorized to be appropriated to carry out 

12 this subpart, such sums as may be necessary for fiscal 

13 years 2005 through 2009.’’. 

14 (b) CENTERS OF EXCELLENCE.—Subparagraph (A) 

15 of section 736(g)(1) of the Public Health Service Act (42 

16 U.S.C. 293(g)(1)) is amended by inserting ‘‘a school of 

17 allied health,’’ after ‘‘a school of pharmacy,’’. 

18 TITLE II—HEALTH WORKFORCE 

19 ADVISORY COMMISSION 

20 SEC. 201. HEALTH WORKFORCE ADVISORY COMMISSION. 

21 (a) ESTABLISHMENT.—The Comptroller General of 

22 the United States (referred to in this title as the ‘‘Comp23 troller General’’) shall establish a commission to be known 

24 as the Health Workforce Advisory Commission (referred 

25 to in this title as the ‘‘Commission’’). 

26 (b) MEMBERSHIP.—
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1 (1) IN GENERAL.—The Commission shall be 

2 composed of 18 members to be appointed by the 

3 Comptroller General not later than 90 days after the 

4 date of enactment of this Act, and an ex-officio 

5 member who shall serve as the Director of the Com6 mission. 

7 (2) QUALIFICATIONS.—In appointing members 

8 to the Commission under paragraph (1), the Comp9 troller General shall ensure that—

10 (A) the Commission includes individuals 

11 with national recognition for their expertise in 

12 health care workforce issues, including work13 force forecasting, undergraduate and graduate 

14 training, economics, health care and health care 

15 systems financing, public health policy, and 

16 other fields; 

17 (B) the members are geographically rep18 resentative of the United States and maintain a 

19 balance between urban and rural representa20 tives; 

21 (C) the members include a representative 

22 from the commissioned corps of the Public 

23 Health Service; 

24 (D) the members represent the spectrum 

25 of professions in the current and future
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1 healthcare workforce, including physicians, 

2 nurses, and other health professionals and per3 sonnel, and are skilled in the conduct and inter4 pretation of health workforce measurement, 

5 monitoring and analysis, health services, eco6 nomics, and other workforce related research 

7 and technology assessment; 

8 (E) at least 25 percent of the members 

9 who are health care providers are from rural 

10 areas; and 

11 (F) a majority of the members are individ12 uals who are not currently primarily involved in 

13 the provision or management of health profes14 sions education and training programs. 

15 (3) TERMS AND VACANCIES.—

16 (A) TERMS.—The term of service of the 

17 members of the Commission shall be for 3 

18 years, except that the Comptroller General shall 

19 designate staggered terms for members initially 

20 appointed under paragraph (1). 

21 (B) VACANCIES.—Any member of the 

22 Commission who is appointed to fill a vacancy 

23 on the Commission that occurs before the expi24 ration of the term for which the member’s pred-
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1 ecessor was appointed shall be appointed only 

2 for the remainder of that term. 

3 (4) CHAIRPERSON.—

4 (A) DESIGNATION.—The Comptroller Gen5 eral shall designate a member of the Commis6 sion, at the time of the appointment of such 

7 member—

8 (i) to serve as the Chairperson of the 

9 Commission; and 

10 (ii) to serve as the Vice Chairperson 

11 of the Commission. 

12 (B) TERM.—A member of the Commission 

13 shall serve as the Chairperson or Vice Chair14 person of the Commission under subparagraph 

15 (A) for the term of such member. 

16 (C) VACANCY.—In the case of a vacancy in 

17 the Chairpersonship or Vice Chairpersonship, 

18 the Comptroller General shall designate another 

19 member to serve for the remainder of the va20 cant member’s term. 

21 (c) DUTIES.—The Commission shall—

22 (1) review the health workforce policies imple23 mented—
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1 (A) under titles XVIII and XIX of the So2 cial Security Act (42 U.S.C. 1395, 1396 et 

3 seq.); 

4 (B) under titles VII and VIII of the Public 

5 Health Service Act (42 U.S.C. 292, 296 et 

6 seq.); 

7 (C) by the National Institutes of Health; 

8 (D) by the Department of Health and 

9 Human Services; 

10 (E) by the Department of Veterans Af11 fairs; and 

12 (F) by other departments and agencies as 

13 appropriate; 

14 (2) analyze and make recommendations to im15 prove the methods used to measure and monitor the 

16 health workforce and the relationship between the 

17 number and make up of such personnel and the ac18 cess of individuals to appropriate health care; 

19 (3) review the impact of health workforce poli20 cies and other factors on the ability of the health 

21 care system to provide optimal medical and health 

22 care services; 

23 (4) analyze and make recommendations per24 taining to Federal incentives (financial, regulatory, 

25 and otherwise) and Federal programs that are in 
28

•S 2739 IS 

1 place to promote the education of an appropriate 

2 number and mix of health professionals to provide 

3 access to appropriate health care in the United 

4 States; 

5 (5) analyze and make recommendations about 

6 the appropriate supply and distribution of physi7 cians, nurses, and other health professionals and 

8 personnel to achieve a health care system that is 

9 safe, effective, patient centered, timely, equitable, 

10 and efficient; 

11 (6) analyze the role and global implications of 

12 internationally trained physicians, nurses, and other 

13 health professionals and personnel in the United 

14 States health workforce; 

15 (7) analyze and make recommendations about 

16 achieving appropriate diversity in the United States 

17 health workforce; 

18 (8) conduct public meetings to discuss health 

19 workforce policy issues and help formulate rec20 ommendations for Congress and the Secretary of 

21 Health and Human Services; 

22 (9) in the course of meetings conducted under 

23 paragraph (8), consider the results of staff research, 

24 presentations by policy experts, and comments from 

25 interested parties; 
29

•S 2739 IS 

1 (10) make recommendations to Congress con2 cerning health workforce policy issues; 

3 (11) not later than April 15, 2005, and each 

4 April 15 thereafter, submit a report to Congress 

5 containing the results of the reviews conducted 

6 under this subsection and the recommendations de7 veloped under this subsection; 

8 (12) periodically, as determined appropriate by 

9 the Commission, submit reports to Congress con10 cerning specific issues that the Commission deter11 mines are of high importance; and 

12 (13) carry out any other activities determined 

13 appropriate by the Secretary of Health and Human 

14 Services. 

15 (d) ONGOING DUTIES CONCERNING REPORTS AND

16 REVIEWS.—

17 (1) COMMENTING ON REPORTS.—

18 (A) SUBMISSION TO COMMISSION.—The 

19 Secretary of Health and Human Services shall 

20 transmit to the Commission a copy of each re21 port that is submitted by the Secretary to Con22 gress if such report is required by law and re23 lates to health workforce policy. 

24 (B) REVIEW.—The Commission shall re25 view a report transmitted under subparagraph
30

•S 2739 IS 

1 (A) and, not later than 6 months after the date 

2 on which the report is transmitted, submit to 

3 the appropriate committees of Congress written 

4 comments concerning such report. Such com5 ments may include such recommendations as 

6 the Commission determines appropriate. 

7 (2) AGENDA AND ADDITIONAL REVIEWS.—

8 (A) IN GENERAL.—The Commission shall 

9 consult periodically with the chairman and 

10 ranking members of the appropriate committees 

11 of Congress concerning the agenda and 

12 progress of the Commission. 

13 (B) ADDITIONAL REVIEWS.—The Commis14 sion may from time to time conduct additional 

15 reviews and submit additional reports to the ap16 propriate committees of Congress on topics re17 lating to Federal health workforce-related pro18 grams and as may be requested by the chair19 man and ranking members of such committees. 

20 (3) AVAILABILITY OF REPORTS.—The Commis21 sion shall transmit to the Secretary of Health and 

22 Human Services a copy of each report submitted by 

23 the Commission under this section and shall make 

24 such reports available to the public. 

25 (e) POWERS OF THE COMMISSION.—
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•S 2739 IS 

1 (1) GENERAL POWERS.—Subject to such review 

2 as the Comptroller General determines to be nec3 essary to ensure the efficient administration of the 

4 Commission, the Commission may—

5 (A) employ and fix the compensation of the 

6 Executive Director and such other personnel as 

7 may be necessary to carry out its duties; 

8 (B) seek such assistance and support as 

9 may be required in the performance of its du10 ties from appropriate Federal departments and 

11 agencies; 

12 (C) enter into contracts or make other ar13 rangements as may be necessary for the con14 duct of the work of the Commission; 

15 (D) make advance, progress, and other 

16 payments that relate to the work of the Com17 mission; 

18 (E) provide transportation and subsistence 

19 for personnel who are serving without com20 pensation; and 

21 (F) prescribe such rules and regulations as 

22 the Commission determines necessary with re23 spect to the internal organization and operation 

24 of the Commission. 
32

•S 2739 IS 

1 (2) INFORMATION.—To carry out its duties 

2 under this section, the Commission—

3 (A) shall have unrestricted access to all de4 liberations, records, and nonproprietary data 

5 maintained by the Government Accountability 

6 Office; 

7 (B) may secure directly from any depart8 ment or agency of the United States informa9 tion necessary to enable the Commission to 

10 carry out its duties under this section, on a 

11 schedule that is agreed upon between the Chair12 person and the head of the department or agen13 cy involved; 

14 (C) shall utilize existing information (pub15 lished and unpublished) collected and assessed 

16 either by the staff of the Commission or under 

17 other arrangements; 

18 (D) may conduct, or award grants or con19 tracts for the conduct of, original research and 

20 experimentation where information available 

21 under subparagraphs (A) and (B) is inad22 equate; 

23 (E) may adopt procedures to permit any 

24 interested party to submit information to be 
33

•S 2739 IS 

1 used by the Commission in making reports and 

2 recommendations under this section; and 

3 (F) may carry out other activities deter4 mined appropriate by the Commission. 

5 (f) ADMINISTRATIVE PROVISIONS.—

6 (1) COMPENSATION.—While serving on the 

7 business of the Commission a member of the Com8 mission shall be entitled to compensation at the per 

9 diem equivalent of the rate provided for under level 

10 IV of the Executive Schedule under title 5, United 

11 States Code. 

12 (2) MEETINGS.—The Commission shall meet at 

13 the call of the Chairperson. 

14 (3) EXECUTIVE DIRECTOR AND STAFF.—The 

15 Comptroller General shall appoint an individual to 

16 serve as the interim Executive Director of the Com17 mission until the members of the Commission are 

18 able to select a permanent Executive Director under 

19 subsection (e)(1)(A). 

20 (4) ETHICAL DISCLOSURE.—The Comptroller 

21 General shall establish a system for public disclosure 

22 by members of the Commission of financial and 

23 other potential conflicts of interest relating to such 

24 members.
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•S 2739 IS 

1 (5) AUDITS.—The Commission shall be subject 

2 to periodic audit by the Comptroller General. 

3 (g) FUNDING.—

4 (1) REQUESTS.—The Commission shall submit 

5 requests for appropriations in the same manner as 

6 the Comptroller General submits such requests. 

7 Amounts appropriated for the Commission shall be 

8 separate from amounts appropriated for the Comp9 troller General. 

10 (2) AUTHORIZATION OF APPROPRIATIONS.—

11 There are authorized to be appropriated to carry out 

12 this section, $6,000,000 for fiscal year 2005, and 

13 such sums as may be necessary for each subsequent 

14 fiscal year, of which—

15 (A) 80 percent of such appropriated 

16 amount shall be made available from the Fed17 eral Hospital Insurance Trust Fund under sec18 tion 1817 of the Social Security Act (42 U.S.C. 

19 1395i); and 

20 (B) 20 percent of such appropriated 

21 amount shall be made available from amounts 

22 appropriated to carry out title XIX of such Act 

23 (42 U.S.C. 1396 et seq.). 

24 (h) DEFINITION.—In this title, the term ‘‘appropriate 

25 committees of Congress’’ means the Committee on Fi-
35

•S 2739 IS 

1 nance of the Senate and the Committee on Ways and 

2 Means of the House of Representatives. 

3 TITLE III—PHYSICIAN DEM4 ONSTRATION PROJECTS IN 

5 RURAL STATES 

6 SEC. 301. DEFINITIONS. 

7 In this title: 

8 (1) COGME.—The term ‘‘COGME’’ means the 

9 Council on Graduate Medical Education established 

10 under section 762 of the Public Health Service Act 

11 (42 U.S.C. 294o). 

12 (2) DEMONSTRATION PROGRAM.—The term 

13 ‘‘demonstration program’’ means the Rural States 

14 Physician Recruitment and Retention Demonstration 

15 Program established by the Secretary under section 

16 302(a). 

17 (3) DEMONSTRATION STATES.—The term 

18 ‘‘demonstration States’’ means each State identified 

19 by the Secretary, based upon data from the most re20 cent year for which data are available—

21 (A) that has an uninsured population 

22 above 16 percent (as determined by the Bureau 

23 of the Census); 

24 (B) for which the sum of the number of in25 dividuals who are entitled to benefits under the 
36

•S 2739 IS 

1 medicare program under title XVIII of the So2 cial Security Act (42 U.S.C. 1395 et seq.) and 

3 the number of individuals who are eligible for 

4 medical assistance under the medicaid program 

5 under title XIX of such Act (42 U.S.C. 1396 et 

6 seq.) equals or exceeds 20 percent of the total 

7 population of the State (as determined by the 

8 Centers for Medicare & Medicaid Services); and 

9 (C) that has an estimated number of indi10 viduals in the State without access to a primary 

11 care provider of at least 17 percent (as pub12 lished in ‘‘HRSA’s Bureau of Primary Health 

13 Care: BPHC State Profiles’’). 

14 (4) ELIGIBLE RESIDENCY OR FELLOWSHIP

15 GRADUATE.—The term ‘‘eligible residency or fellow16 ship graduate’’ means a graduate of an approved 

17 medical residency training program (as defined in 

18 section 1886(h)(5)(A) of the Social Security Act (42 

19 U.S.C. 1395ww(h)(5)(A))) in a shortage physician 

20 specialty. 

21 (5) HEALTH PROFESSIONS DATABASE.—The 

22 term ‘‘Health Professions Database’’ means the 

23 database established under section 303(a). 

24 (6) MEDICARE PROGRAM.—The term ‘‘medicare 

25 program’’ means the health benefits program under 
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•S 2739 IS 

1 title XVIII of the Social Security Act (42 U.S.C. 

2 1395 et seq.). 

3 (7) MEDPAC.—The term ‘‘MedPAC’’ means 

4 the Medicare Payment Advisory Commission estab5 lished under section 1805 of the Social Security Act 

6 (42 U.S.C. 1395b–6). 

7 (8) SECRETARY.—The term ‘‘Secretary’’ means 

8 the Secretary of Health and Human Services. 

9 (9) SHORTAGE PHYSICIAN SPECIALTY.—The 

10 term ‘‘shortage physician specialty’’ means a medical 

11 or surgical specialty identified in a demonstration 

12 State by the Secretary based on—

13 (A) an analysis and comparison of national 

14 data and demonstration State data; and 

15 (B) recommendations from appropriate 

16 Federal, State, and private commissions, cen17 ters, councils, medical and surgical physician 

18 specialty boards, and medical societies or asso19 ciations involved in physician workforce, edu20 cation and training, and payment issues. 

21 SEC. 302. RURAL STATES PHYSICIAN RECRUITMENT AND 

22 RETENTION DEMONSTRATION PROGRAM. 

23 (a) ESTABLISHMENT.—

24 (1) IN GENERAL.—The Secretary shall establish 

25 a Rural States Physician Recruitment and Retention 
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•S 2739 IS 

1 Demonstration Program for the purpose of amelio2 rating physician shortage, recruitment, and retention 

3 problems in rural States in accordance with the re4 quirements of this section. 

5 (2) CONSULTATION.—For purposes of estab6 lishing the demonstration program, the Secretary 

7 shall consult with—

8 (A) COGME; 

9 (B) MedPAC; 

10 (C) a representative of each demonstration 

11 State medical society or association; 

12 (D) the health workforce planning and 

13 physician training authority of each demonstra14 tion State; and 

15 (E) any other entity described in section 

16 301(9)(B). 

17 (b) DURATION.—The Secretary shall conduct the 

18 demonstration program for a period of 10 years. 

19 (c) CONDUCT OF PROGRAM.—

20 (1) FUNDING OF ADDITIONAL RESIDENCY AND

21 FELLOWSHIP POSITIONS.—

22 (A) IN GENERAL.—As part of the dem23 onstration program, the Secretary (acting 

24 through the Administrator of the Centers for 

25 Medicare & Medicaid Services) shall—
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•S 2739 IS 

1 (i) notwithstanding section 

2 1886(h)(4)(F) of the Social Security Act 

3 (42 U.S.C. 1395ww(h)(4)(F)) increase, by 

4 up to 50 percent of the total number of 

5 residency and fellowship positions approved 

6 at each medical residency training program 

7 in each demonstration State, the number 

8 of residency and fellowship positions in 

9 each shortage physician specialty; and 

10 (ii) subject to subparagraph (C), pro11 vide funding under subsections (d)(5)(B) 

12 and (h) of section 1886 of the Social Secu13 rity Act (42 U.S.C. 1395ww) for each posi14 tion added under clause (i). 

15 (B) ESTABLISHMENT OF ADDITIONAL PO16 SITIONS.—

17 (i) IDENTIFICATION.—The Secretary 

18 shall identify each additional residency and 

19 fellowship position created as a result of 

20 the application of subparagraph (A). 

21 (ii) NEGOTIATION AND CONSULTA22 TION.—The Secretary shall negotiate and 

23 consult with representatives of each ap24 proved medical residency training program 

25 in a demonstration State at which a posi-
40

•S 2739 IS 

1 tion identified under clause (i) is created 

2 for purposes of supporting such position. 

3 (C) CONTRACTS WITH SPONSORING INSTI4 TUTIONS.—

5 (i) IN GENERAL.—The Secretary shall 

6 condition the availability of funding for 

7 each residency and fellowship position 

8 identified under subparagraph (B)(i) on 

9 the execution of a contract containing such 

10 provisions as the Secretary determines are 

11 appropriate, including the provision de12 scribed in clause (ii) by each sponsoring in13 stitution. 

14 (ii) PROVISION DESCRIBED.—

15 (I) IN GENERAL.—Except as pro16 vided in subclause (II), the provision 

17 described in this clause is a provision 

18 that provides that, during the resi19 dency or fellowship, the resident or 

20 fellow shall spend not less than 10 

21 percent of the training time providing 

22 specialty services to underserved and 

23 rural community populations other 

24 than an underserved population of the 

25 sponsoring institution. 
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•S 2739 IS 

1 (II) EXCEPTIONS.—The Sec2 retary, in consultation with COGME, 

3 shall identify shortage physician spe4 cialties and subspecialties for which 

5 the application of the provision de6 scribed in subclause (I) would be in7 appropriate and the Secretary may 

8 waive the requirement under clause (i) 

9 that such provision be included in the 

10 contract of a resident or fellow with 

11 such a specialty or subspecialty. 

12 (D) LIMITATIONS.—

13 (i) PERIOD OF PAYMENT.—The Sec14 retary may not fund any residency or fel15 lowship position identified under subpara16 graph (B)(i) for a period of more than 5 

17 years. 

18 (ii) REASSESSMENT OF NEED.—The 

19 Secretary shall reassess the status of the 

20 shortage physician specialty in the dem21 onstration State prior to entering into any 

22 contract under subparagraph (C) after the 

23 date that is 5 years after the date on 

24 which the Secretary establishes the dem25 onstration program. 
42

•S 2739 IS 

1 (2) LOAN REPAYMENT AND FORGIVENESS PRO2 GRAM.—

3 (A) IN GENERAL.—As part of the dem4 onstration program, the Secretary (acting 

5 through the Administrator of the Health Re6 sources and Services Administration) shall es7 tablish a loan repayment and forgiveness pro8 gram, through the holder of the loan, under 

9 which the Secretary assumes the obligation to 

10 repay a qualified loan amount for an edu11 cational loan of an eligible residency or fellow12 ship graduate—

13 (i) for whom the Secretary has ap14 proved an application submitted under 

15 subparagraph (D); and 

16 (ii) with whom the Secretary has en17 tered into a contract under subparagraph 

18 (C). 

19 (B) QUALIFIED LOAN AMOUNT.—

20 (i) IN GENERAL.—Subject to clause 

21 (ii), the Secretary shall repay the lesser 

22 of—

23 (I) 25 percent of the loan obliga24 tion of a graduate on a loan that is 

25 outstanding during the period that the 
43

•S 2739 IS 

1 eligible residency or fellowship grad2 uate practices in the area designated 

3 by the contract entered into under 

4 subparagraph (C); or 

5 (II) $25,000 per graduate per 

6 year of such obligation during such 

7 period. 

8 (ii) LIMITATION.—The aggregate 

9 amount under this subparagraph may not 

10 exceed $125,000 for any graduate and the 

11 Secretary may not repay or forgive more 

12 than 30 loans per year in each demonstra13 tion State under this paragraph. 

14 (C) CONTRACTS WITH RESIDENTS AND

15 FELLOWS.—

16 (i) IN GENERAL.—Each eligible resi17 dency or fellowship graduate desiring re18 payment of a loan under this paragraph 

19 shall execute a contract containing the pro20 visions described in clause (ii). 

21 (ii) PROVISIONS.—The provisions de22 scribed in this clause are provisions that 

23 require the eligible residency or fellowship 

24 graduate—
44

•S 2739 IS 

1 (I) to practice in a health profes2 sional shortage area of a demonstra3 tion State during the period in which 

4 a loan is being repaid or forgiven 

5 under this section; and 

6 (II) to provide health services re7 lating to the shortage physician spe8 cialty of the graduate that was funded 

9 with the loan being repaid or forgiven 

10 under this section during such period. 

11 (D) APPLICATION.—

12 (i) IN GENERAL.—Each eligible resi13 dency or fellowship graduate desiring re14 payment of a loan under this paragraph 

15 shall submit an application to the Sec16 retary at such time, in such manner, and 

17 accompanied by such information as the 

18 Secretary may reasonably require. 

19 (ii) REASSESSMENT OF NEED.—The 

20 Secretary shall reassess the shortage physi21 cian specialty in the demonstration State 

22 prior to accepting an application for repay23 ment of any loan under this paragraph 

24 after the date that is 5 years after the date 
45

•S 2739 IS 

1 on which the demonstration program is es2 tablished.

3 (E) CONSTRUCTION.—Nothing in the sec4 tion shall be construed to authorize any refund5 ing of any repayment of a loan. 

6 (F) PREVENTION OF DOUBLE BENE7 FITS.—No borrower may, for the same service, 

8 receive a benefit under both this paragraph and 

9 any loan repayment or forgiveness program 

10 under title VII of the Public Health Service Act 

11 (42 U.S.C. 292 et seq.). 

12 (d) WAIVER OF MEDICARE REQUIREMENTS.—The 

13 Secretary is authorized to waive any requirement of the 

14 medicare program, or approve equivalent or alternative 

15 ways of meeting such a requirement, if such waiver is nec16 essary to carry out the demonstration program, including 

17 the waiver of any limitation on the amount of payment 

18 or number of residents under section 1886 of the Social 

19 Security Act (42 U.S.C. 1395ww). 

20 (e) APPROPRIATIONS.—

21 (1) FUNDING OF ADDITIONAL RESIDENCY AND

22 FELLOWSHIP POSITIONS.—Any expenditures result23 ing from the establishment of the funding of addi24 tional residency and fellowship positions under sub25 section (c)(1) shall be made from the Federal Hos-
46

•S 2739 IS 

1 pital Insurance Trust Fund under section 1817 of 

2 the Social Security Act (42 U.S.C. 1395i). 

3 (2) LOAN REPAYMENT AND FORGIVENESS PRO4 GRAM.—There are authorized to be appropriated 

5 such sums as may be necessary to carry out the loan 

6 repayment and forgiveness program established 

7 under subsection (c)(2). 

8 SEC. 303. ESTABLISHMENT OF THE HEALTH PROFESSIONS 

9 DATABASE. 

10 (a) ESTABLISHMENT OF THE HEALTH PROFESSIONS

11 DATABASE.—

12 (1) IN GENERAL.—Not later than 7 months 

13 after the date of enactment of this Act, the Sec14 retary (acting through the Administrator of the 

15 Health Resources and Services Administration) shall 

16 establish a State-specific health professions database 

17 to track health professionals in each demonstration 

18 State with respect to specialty certifications, practice 

19 characteristics, professional licensure, practice types, 

20 locations, education, and training, as well as obliga21 tions under the demonstration program as a result 

22 of the execution of a contract under paragraph 

23 (1)(C) or (2)(C) of section 302(c). 

24 (2) DATA SOURCES.—In establishing the 

25 Health Professions Database, the Secretary shall use 
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•S 2739 IS 

1 the latest available data from existing health work2 force files, including the American Medical Associa3 tion Master File, State databases, specialty medical 

4 society data sources and information, and such other 

5 data points as may be recommended by COGME, 

6 MedPAC, the National Center for Workforce Infor7 mation and Analysis, or the medical society of the 

8 respective demonstration State. 

9 (b) AVAILABILITY.—

10 (1) DURING THE PROGRAM.—During the dem11 onstration program, data from the Health Profes12 sions Database shall be made available to the Sec13 retary, each demonstration State, and the public for 

14 the purposes of—

15 (A) developing a baseline with respect to a 

16 State’s health professions workforce and to 

17 track changes in a demonstration State’s health 

18 professions workforce; 

19 (B) tracking direct and indirect graduate 

20 medical education payments to hospitals; 

21 (C) tracking the forgiveness and repay22 ment of loans for educating physicians; and 

23 (D) tracking commitments by physicians 

24 under the demonstration program. 
48

•S 2739 IS 

1 (2) FOLLOWING THE PROGRAM.—Following the 

2 termination of the demonstration program, a dem3 onstration State may elect to maintain the Health 

4 Professions Database for such State at its expense. 

5 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

6 are authorized to be appropriated such sums as may be 

7 necessary for the purpose of carrying out this section. 

8 SEC. 304. EVALUATION AND REPORTS. 

9 (a) EVALUATION.—

10 (1) IN GENERAL.—COGME and MedPAC shall 

11 jointly conduct a comprehensive evaluation of the 

12 demonstration program. 

13 (2) MATTERS EVALUATED.—The evaluation 

14 conducted under paragraph (1) shall include an 

15 analysis of the effectiveness of the funding of addi16 tional residency and fellowship positions and the 

17 loan repayment and forgiveness program on physi18 cian recruitment, retention, and specialty mix in 

19 each demonstration State. 

20 (b) PROGRESS REPORTS.—

21 (1) COGME.—Not later than 1 year after the 

22 date on which the Secretary establishes the dem23 onstration program, 5 years after such date, and 10 

24 years after such date, COGME shall submit a report
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•S 2739 IS 

1 on the progress of the demonstration program to the 

2 Secretary and Congress. 

3 (2) MEDPAC.—MedPAC shall submit biennial 

4 reports on the progress of the demonstration pro5 gram to the Secretary and Congress. 

6 (c) FINAL REPORT.—Not later than 1 year after the 

7 date on which the demonstration program terminates, 

8 COGME and MedPAC shall submit a final report to the 

9 President, Congress, and the Secretary which shall contain 

10 a detailed statement of the findings and conclusions of 

11 COGME and MedPAC, together with such recommenda12 tions for legislation and administrative actions as COGME 

13 and MedPAC consider appropriate. 

14 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to COGME such sums 

16 as may be necessary for the purpose of carrying out this 

17 section. 

18 SEC. 305. CONTRACTING FLEXIBILITY. 

19 For purposes of conducting the demonstration pro20 gram and establishing and administering the Health Pro21 fessions Database, the Secretary may procure temporary 

22 and intermittent services under section 3109(b) of title 5, 

23 United States Code. 
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•S 2739 IS 

1 TITLE IV—HEALTH CAREERS 

2 OPPORTUNITY PROGRAM 

3 SEC. 401. PURPOSE. 

4 It is the purpose of this title to diversify the 

5 healthcare workforce by increasing the number of individ6 uals from disadvantaged backgrounds in the health and 

7 allied health professions by enhancing the academic skills 

8 of students from disadvantaged backgrounds and sup9 porting them in successfully completing, entering, and 

10 graduating from health professions training programs. 

11 SEC. 402. AUTHORIZATION OF APPROPRIATIONS. 

12 Section 740(c) of the Public Health Service Act (42 

13 U.S.C. 293d(c)) is amended by striking ‘‘$29,400,000’’ 

14 and all that follows through ‘‘2002’’ and inserting 

15 ‘‘$50,000,000 for fiscal year 2005, and such sums as may 

16 be necessary for each of fiscal years 2006 through 2010’’. 

17 TITLE V—PROGRAM OF EXCEL18 LENCE IN HEALTH PROFES19 SIONS EDUCATION FOR 

20 UNDERREPRESENTED MI21 NORITIES 

22 SEC. 501. PURPOSE. 

23 It is the purpose of this title to diversify the 

24 healthcare workforce by supporting programs of excellence 

25 in designated health professions schools that demonstrate 
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•S 2739 IS 

1 a commitment to underrepresented minority populations 

2 with a focus on minority health issues, cultural and lin3 guistic competence, and eliminating health disparities. 

4 SEC. 502. AUTHORIZATION OF APPROPRIATION. 

5 Section 736(h)(1) of the Public Health Service Act 

6 (42 U.S.C. 293(h)(1)) is amended to read as follows: 

7 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

8 For the purpose of making grants under subsection 

9 (a), there are authorized to be appropriated 

10 $50,000,000 for fiscal year 2005, and such sums as 

11 may be necessary for each of the fiscal years 2006 

12 through 2010.’’. 

13 TITLE VI—HEALTH PROFES14 SIONS STUDENT LOAN FUND; 

15 AUTHORIZATIONS OF APPRO16 PRIATIONS REGARDING STU17 DENTS FROM DISADVAN18 TAGED BACKGROUNDS 

19 SEC. 601. STUDENT LOANS. 

20 Section 724(f) of the Public Health Service Act (42 

21 U.S.C. 292t(f)) is amended by inserting before paragraph 

22 (2), the following: 

23 ‘‘(1) IN GENERAL.—With respect to making 

24 Federal capital contributions to student loan funds 

25 for purposes of subsection (a), there are authorized 
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•S 2739 IS 

1 to be appropriated $35,000,000 for fiscal year 2005, 

2 and such sums as may be necessary for each of the 

3 fiscal years 2006 through 2010.’’. 

4 SEC. 602. NATIONAL HEALTH SERVICE CORPS; RECRUIT5 MENT AND FELLOWSHIPS FOR INDIVIDUALS 

6 FROM DISADVANTAGED BACKGROUNDS. 

7 (a) IN GENERAL.—Section 331(b) of the Public 

8 Health Service Act (42 U.S.C. 254d(b)) is amended by 

9 adding at the end the following: 

10 ‘‘(3) The Secretary shall ensure that the individuals 

11 with respect to whom activities under paragraphs (1) and 

12 (2) are carried out include individuals from disadvantaged 

13 backgrounds, including activities carried out to provide 

14 health professions students with information on the Schol15 arship and Repayment Programs.’’. 

16 (b) ASSIGNMENT OF CORPS PERSONNEL.—Section 

17 333(a) of the Public Health Service Act (42 U.S.C. 

18 254f(a)) is amended by adding at the end the following: 

19 ‘‘(4) In assigning Corps personnel under this section, 

20 the Secretary shall give preference to applicants who re21 quest assignment to a federally qualified health center (as 

22 defined in section 1905(1)(2)(B) of the Social Security 

23 Act) or to a provider organization that has a majority of 

24 patients who are minorities or individuals from low-income 
53

•S 2739 IS 

1 families (families with a family income that is less than 

2 200 percent of the Official Poverty Line).’’. 

3 TITLE VII—MISCELLANEOUS 

4 PROVISIONS 

5 SEC. 703. STUDY BY THE INSTITUTE OF MEDICINE. 

6 (a) CONTRACT.—Not later than 90 days after the 

7 date of enactment of this Act, the Secretary of Health and 

8 Human Services shall enter into a contract with the Insti9 tute of Medicine for the conduct of a study and the prepa10 ration of a report on the role of United States medical 

11 schools in meeting the physician needs of the United 

12 States. 

13 (b) REQUIREMENTS.—In conducting the study under 

14 the contract under subsection (a), the Institute of Medi15 cine shall—

16 (1) examine the supply structure of United 

17 States undergraduate medical education and make 

18 recommendations concerning the advisability of ex19 panding, enhancing, or modifying such structure to 

20 achieve a higher degree of self-sufficiency and equity 

21 in such medical education and to position medical 

22 schools for the future demands generated by the 

23 growing population of the United States; and 

24 (2) examine the role of United States medical 

25 schools in reducing racial and ethnic disparities in 
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•S 2739 IS 

1 medical education opportunities and in population 

2 health outcomes as well as in reducing the drain on 

3 the medical education systems of other countries. 

4 (c) REPORT.—The contract under subsection (a) 

5 shall require the Institute of Medicine to submit a report 

6 to the Secretary of Health and Human Services on the 

7 results of the study not later than 12 months after the 

8 date on which the contract is entered into. The Secretary 

9 shall submit such report to the Committee on Health, 

10 Education, Labor, and Pensions of the Senate and the 

11 Committee on Commerce of the House of Representatives.

Æ