I 

111TH CONGRESS 

1ST SESSION H. R. 2891 

To amend the Public Health Service Act to direct the Secretary of Health 

and Human Services to establish a Frontline Providers Loan Repayment 

Program. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 16, 2009 

Mr. BRALEY of Iowa (for himself and Mr. SPACE) introduced the following 

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

A BILL 

To amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a 

Frontline Providers Loan Repayment Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Access to Frontline 

5 Health Care Act of 2009’’. 


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1 SEC. 2. FRONTLINE PROVIDERS LOAN REPAYMENT PRO2 GRAM. 

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

4 (42 U.S.C. 254b et seq.) is amended by adding at the end 

5 the following: 

6 ‘‘Subpart XI—Frontline Health Care Services 

7 ‘‘SEC. 340H. FRONTLINE PROVIDERS LOAN REPAYMENT 

8 PROGRAM. 

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

10 and carry out a Frontline Providers Loan Repayment Pro11 gram (in this section referred to as the ‘Loan Repayment 

12 Program’) under which, pursuant to contracts in accord13 ance with this section— 

14 ‘‘(1) the Secretary agrees to make student loan 

15 repayments; and 

16 ‘‘(2) the individual agrees to serve as a health 

17 professional for a period of full-time service of not 

18 less than 2 years at a health care facility serving a 

19 frontline care scarcity area. 

20 ‘‘(b) ELIGIBILITY.—To be eligible to participate in 

21 the Loan Repayment Program, an individual must— 

22 ‘‘(1) submit an application to participate in the 

23 Loan Repayment Program in such form and manner 

24 and at such time as specified by the Secretary; and 


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1 ‘‘(2) sign and submit to the Secretary, at the 

2 time of submittal of such application, a written con3 tract (described in subsection (d)). 

4 ‘‘(c) PARTICIPATION IN PROGRAM.— 

5 ‘‘(1) IN GENERAL.—An individual becomes a 

6 participant in the Loan Repayment Program only 

7 upon the approval of the Secretary of the individ8 ual’s application submitted under subsection (b)(1) 

9 and the Secretary’s acceptance of the contract sub10 mitted by the individual under subsection (b)(2). 

11 ‘‘(2) PREFERENCE.—In awarding contracts 

12 under this section, the Secretary shall give pref13 erence to applicants who have undertaken training 

14 or coursework in interdisciplinary studies. 

15 ‘‘(3) RECRUITMENT FOR INTERDISCIPLINARY

16 PROGRAMS.—The Secretary shall— 

17 ‘‘(A) determine the frontline care scarcity 

18 areas in which to place contract recipients 

19 under this section; and 

20 ‘‘(B) in making such determination, give 

21 preference to areas with a demonstrated pro22 gram of interdisciplinary health care, or with 

23 demonstrated plans to initiate interdisciplinary 

24 approaches to community health care. 


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1 ‘‘(4) NOTICE.—The Secretary shall provide 

2 written notice to an individual promptly upon the 

3 Secretary’s approving, under paragraph (1), of the 

4 individual’s participation in the Loan Repayment 

5 Program. 

6 ‘‘(d) CONTRACT.—The contract described in this sub7 section is a written contract between the Secretary and 

8 an individual that contains— 

9 ‘‘(1) an agreement that— 

10 ‘‘(A) the Secretary agrees to provide the 

11 individual with student loan repayment (de12 scribed in subsection (e)) for a period of time 

13 as determined by the Secretary, to pay off debts 

14 incurred during the course of the study or pro15 gram described in subsection (g)(2)(B); and 

16 ‘‘(B) the individual agrees— 

17 ‘‘(i) to accept provision of such a stu18 dent loan repayment to the individual; and 

19 ‘‘(ii) to provide frontline care services 

20 for a period of full-time service of not less 

21 than 2 years at a health care facility serv22 ing a frontline care scarcity area; 

23 ‘‘(2) a provision that any financial obligation of 

24 the United States arising out of a contract entered 

25 into under this section and any obligation of the inVerDate Nov 24 2008 00:49 Jun 18, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2891.IH H2891

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1 dividual which is conditioned thereon, is contingent 

2 upon funds being appropriated for student loan re3 payment under this section; 

4 ‘‘(3) a statement of the damages to which the 

5 United States is entitled, under subsection (f), for 

6 the individual’s breach of the contract; and 

7 ‘‘(4) such other statements as the Secretary 

8 deems appropriate of the rights and liabilities of the 

9 Secretary and of the individual, not inconsistent 

10 with the provisions of this section. 

11 ‘‘(e) STUDENT LOAN REPAYMENT.— 

12 ‘‘(1) AMOUNT.—The amount of an annual stu13 dent loan repayment under this section on behalf of 

14 an individual shall be determined by the Secretary, 

15 and shall take into consideration the need to pay a 

16 sufficient amount to enable recruiting of health care 

17 providers into the loan repayment program under 

18 this section. 

19 ‘‘(2) PAYMENTS DIRECTLY TO LOAN PRO20 VIDER.—The Secretary may contract with an indi21 vidual’s loan provider, for the payment to the loan 

22 provider, on behalf of the individual, of the amounts 

23 of a student loan repayment described in paragraph 

24 (1). 


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1 ‘‘(f) BREACH OF CONTRACT.—If an individual 

2 breaches a written contract under this section by failing 

3 to begin such individual’s service obligation, or to complete 

4 such service obligation, the United States shall be entitled 

5 to recover from the individual an amount that is equal 

6 to the sum of— 

7 ‘‘(1) the total amount which has been paid to 

8 the individual, or on behalf of the individual, under 

9 the contract; and 

10 ‘‘(2) any amount of interest, as determined by 

11 the Secretary. 

12 ‘‘(g) DEFINITIONS.—In this section: 

13 ‘‘(1) The term ‘frontline care scarcity area’ 

14 means an area, population group, or facility that— 

15 ‘‘(A) is designated as a health professional 

16 shortage area under section 332; or 

17 ‘‘(B) is designated by the State in which 

18 the area is located as having a shortage of 

19 frontline care services. 

20 ‘‘(2) The term ‘frontline care services’ means 

21 health care services— 

22 ‘‘(A) in the field of general surgery, optom23 etry, ophthalmology, chiropractic, physical ther24 apy, audiology, speech language pathology, 

25 pharmacies, public health, podiatric medicine, 


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1 dietetics, occupational therapy, general pediat2 rics, respiratory therapy, medical technology, 

3 otolaryngology, or radiologic technology; and 

4 ‘‘(B) provided by a general surgeon, op5 tometrist, ophthalmologist, chiropractor, phys6 ical therapist, audiologist, speech language pa7 thologist, pharmacist, public health profes8 sional, podiatric physician, registered dietician, 

9 occupational therapist, pediatrician, respiratory 

10 therapist, medical technologist, otolaryngologist, 

11 or radiologic technologist who has completed an 

12 appropriate course of study or program, offered 

13 by an accredited institution of higher education 

14 in the United States. 

15 ‘‘(h) AUTHORIZED OF APPROPRIATIONS.—For the 

16 purpose of carrying out this section, there are authorized 

17 to be appropriated the following: 

18 ‘‘(1) For fiscal year 2010, $78,000,000. 

19 ‘‘(2) For fiscal year 2011, $93,000,000. 

20 ‘‘(3) For fiscal year 2012, $108,000,000. 

21 ‘‘(4) For fiscal year 2013, $123,000,000. 

22 ‘‘(5) For fiscal year 2014, $138,000,000. 

23 ‘‘(6) For fiscal year 2015, $153,000,000. 

24 ‘‘(7) For fiscal year 2016, and each subsequent 

25 fiscal year, the amount appropriated for the preVerDate Nov 24 2008 00:49 Jun 18, 2009 Jkt 079200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2891.IH H2891

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1 ceding fiscal year adjusted by one plus the average 

2 percentage increase in the costs of health professions 

3 education during the prior fiscal year. 

4 ‘‘(i) IMPLEMENTATION.—The Secretary shall begin 

5 implementation of the loan repayment program under this 

6 section within 180 days of the date of the enactment of 

7 this section.’’. 

Æ 


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