169 
(1) resources to strengthen institutional metrics 
and capacity to execute institutionwide health work-
force goals that can serve as models for increasing 
health equity in communities across the country; 
(2) collaborations among a cohort of institu-
tions in implementing systemic change, partnership 
development, and programmatic efforts supportive of 
health equity goals across disciplines and popu-
lations; and 
(3) enhanced or newly developed data systems 
and research infrastructure capable of informing 
current and future workforce efforts and building a 
foundation for a broader research agenda targeting 
urban health disparities. 
(c) STRATEGIC PARTNERSHIPS.—As a condition on 
receipt of a grant under subsection (a), an academic insti-
tution shall agree to use the grant to develop a strategic 
partnership with the community in which the institution 
is located for the purposes of— 
(1) strengthening connections between the insti-
tution and the community— 
(A) to improve evaluation of and address 
the community’s health and health workforce 
needs; and 
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(B) to engage the community in health 
workforce development; 
(2) developing, enhancing, or accelerating inno-
vative undergraduate and graduate programs in the 
biomedical sciences and health professions; and 
(3) strengthening pipeline programs in the bio-
medical sciences and health professions, including by 
developing partnerships between institutions of high-
er education and elementary and secondary schools 
to recruit the next generation of health professionals 
earlier in the pipeline to a health care career. 
SEC. 310. LOAN FORGIVENESS FOR MENTAL AND BEHAV-
IORAL HEALTH SOCIAL WORKERS. 
Section 455 of the Higher Education Act of 1965 (20 
U.S.C. 1087e) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(r) REPAYMENT PLAN FOR MENTAL AND BEHAV-
IORAL HEALTH SOCIAL WORKERS.— 
‘‘(1) IN GENERAL.—The Secretary shall cancel 
the balance of interest and principal due on any eli-
gible Federal Direct Loan not in default for a bor-
rower who— 
‘‘(A) has made 120 monthly payments on 
the eligible Federal Direct Loan after October 
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1, 2014, pursuant to any one or a combination 
of the following— 
‘‘(i) payments under an income-based 
repayment plan under section 493C; 
‘‘(ii) payments under a standard re-
payment plan under subsection (d)(1)(A), 
based on a 10-year repayment period; 
‘‘(iii) monthly payments under a re-
payment plan under subsection (d)(1) or 
(g) of not less than the monthly amount 
calculated 
under 
subsection 
(d)(1)(A), 
based on a 10-year repayment period; or 
‘‘(iv) payments under an income con-
tingent repayment plan under subsection 
(d)(1)(D); and 
‘‘(B)(i) is employed as a mental health or 
behavioral health social worker, as defined by 
the Secretary by regulation, at the time of such 
forgiveness; and 
‘‘(ii) has been employed as such a mental 
health or behavioral health social worker during 
the period in which the borrower makes each of 
the 120 payments as described in subparagraph 
(A). 
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‘‘(2) LOAN CANCELLATION AMOUNT.—After the 
conclusion of the employment period described in 
paragraph (1), the Secretary shall cancel the obliga-
tion to repay the balance of principal and interest 
due as of the time of such cancellation, on the eligi-
ble Federal Direct Loans made to the borrower 
under this part. 
‘‘(3) INELIGIBILITY FOR DOUBLE BENEFITS.— 
No borrower may, for the same employment as a 
mental heath or behavioral health social worker, re-
ceive a reduction of loan obligations under both this 
subsection and section 455(m), 428J, 428K, 428L, 
or 460. 
‘‘(4) DEFINITION
OF
ELIGIBLE
FEDERAL
DI-
RECT LOAN.—In this subsection, the term ‘eligible 
Federal Direct Loan’ means a Federal Direct Staf-
ford Loan, Federal Direct PLUS Loan, Federal Di-
rect Unsubsidized Stafford Loan, or a Federal Di-
rect Consolidation Loan.’’. 
SEC. 311. HEALTH PROFESSIONS WORKFORCE FUND. 
(a) PURPOSE.—It is the purpose of this section to 
establish a Health Professions Workforce Fund to be ad-
ministered through the Health Resources and Services Ad-
ministration within the Department of Health and Human 
Services to provide for expanded and sustained national 
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investment in the health professions and nursing work-
force development programs under title VII and title VIII 
of the Public Health Service Act. 
(b) ESTABLISHING
THE
HEALTH
PROFESSIONS 
WORKFORCE FUND.—There is authorized to be appro-
priated, and there is appropriated, out of any monies in 
the Treasury not otherwise appropriated, to the Health 
Professions Workforce Fund— 
(1) $355,000,000 for fiscal year 2015; 
(2) $375,000,000 for fiscal year 2016; 
(3) $392,000,000 for fiscal year 2017; 
(4) $412,000,000 for fiscal year 2018; 
(5) $432,000,000 for fiscal year 2019; 
(6) $454,000,000 for fiscal year 2020; 
(7) $476,000,000 for fiscal year 2021; 
(8) $500,000,000 for fiscal year 2022; 
(9) $525,000,000 for fiscal year 2023; and 
(10) $552,000,000 for fiscal year 2024. 
(c) FUNDING.— 
(1) For the purpose of carrying out health pro-
fessions education programs authorized under title 
VII of the Public Health Service Act, in addition to 
any other amounts authorized to be appropriated for 
such purpose, there is authorized to be appropriated 
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out of any monies in the Health Professions Work-
force Fund, the following: 
(A) $240,000,000 for fiscal year 2015. 
(B) $253,000,000 for fiscal year 2016. 
(C) $265,000,000 for fiscal year 2017. 
(D) $278,000,000 for fiscal year 2018. 
(E) $292,000,000 for fiscal year 2019. 
(F) $307,000,000 for fiscal year 2020. 
(G) $322,000,000 for fiscal year 2021. 
(H) $338,000,000 for fiscal year 2022. 
(I) $355,000,000 for fiscal year 2023. 
(J) $373,000,000 for fiscal year 2024. 
(2) For the purpose of carrying out nursing 
workforce development programs authorized under 
Title VIII of the Public Health Service Act, in addi-
tion to any other amounts authorized to be appro-
priated for such purpose, there is authorized to be 
appropriated out of any monies in the Health Pro-
fessions Workforce Fund, the following: 
(A) $115,000,000 for fiscal year 2015. 
(B) $122,000,000 for fiscal year 2016. 
(C) $127,000,000 for fiscal year 2017. 
(D) $134,000,000 for fiscal year 2018. 
(E) $140,000,000 for fiscal year 2019. 
(F) $147,000,000 for fiscal year 2020. 
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(G) $154,000,000 for fiscal year 2021. 
(H) $162,000,000 for fiscal year 2022. 
(I) $170,000,000 for fiscal year 2023. 
(J) $179,000,000 for fiscal year 2024. 
SEC. 312. FINDINGS; SENSE OF CONGRESS RELATING TO 
GRADUATE MEDICAL EDUCATION. 
(a) FINDINGS.—Congress finds the following: 
(1) Projections by the Association of American 
Medical Colleges (AAMC) and other expert entities, 
such as the Health Resources and Services Adminis-
tration (HRSA), have indicated a nationwide short-
age of up to 130,600 physicians, split evenly be-
tween primary care and specialists, by 2025. 
(2) The coverage of an additional 25 million 
uninsured Americans under the Patient Protection 
and Affordable Care Act is expected to increase the 
projected shortage by 25 percent. 
(3) The United States Census projects that the 
Nation’s population will grow from 310 million in 
2010 to 400 million in 2044, with the Nation be-
coming majority-minority in 2043, and the number 
of Medicare beneficiaries increasing from 50.7 mil-
lion in 2012 to 90 million in 2045. 
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(4) One-third of currently practicing physicians 
are over 55 years of age and likely to retire in the 
next 20 years. 
(5) A nationwide physician shortage will result 
in many Americans waiting longer and traveling far-
ther for health care; seeking nonemergent care in 
emergency departments; and delaying treatment 
until their health care needs become more serious, 
complex, and costly. 
(6) Changing demographics (such as an aging 
population), new health care delivery models (such 
as medical homes), and other factors (such as dis-
aster preparedness) are contributing to a shortage of 
both generalist and specialist physicians. 
(7) These shortages will have the most severe 
impact on vulnerable and underserved populations, 
including racial/ethnic minorities and the approxi-
mately 20 percent of Americans who live in rural or 
inner-city locations designated as health professional 
shortage areas. 
(8) United States medical schools have com-
mitted to and have initiated a 30 percent increase 
in enrollment by 2017 to help reduce the Nation’s 
shortage of quality physicians. 
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(9) An increase in United States medical school 
graduates must be accompanied by an increase of 
4,000 graduate medical education (GME) training 
positions each year. 
(10) Graduate medical education programs and 
teaching hospitals provide venues in which the next 
generation of physicians learns to work collabo-
ratively with other physicians and health profes-
sionals, adopt more efficient care delivery models 
(such as care coordination and medical homes), in-
corporate health information technology and elec-
tronic health records in every aspect of their work, 
apply new methods of assuring quality and safety, 
and participate in groundbreaking clinical and public 
health research. 
(11) The Medicare Program under title XVIII 
of the Social Security Act (having more beneficiaries 
than any other health care program), supports its 
‘‘fair share’’ of the costs associated with graduate 
medical education (GME). 
(12) In general, the level of support of graduate 
medical education by the Medicare Program has 
been capped since 1997 and has not been increased 
to support the expansion of graduate medical edu-
cation programs needed to avert the projected physi-
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cian shortage or to accommodate the increase in 
United States medical school graduates. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that eliminating the limit of the number of residency 
positions that receive some level of Medicare support 
under section 1886(h) of the Social Security Act (42 
U.S.C. 1395ww(h)), also referred to as the Medical grad-
uate medical education cap, is critical to— 
(1) ensuring an appropriate supply of physi-
cians to meet the Nation’s health care needs; 
(2) facilitating equitable access for all who seek 
health care; and 
(3) mitigating disparities in health and health 
care. 
SEC. 313. CAREER SUPPORT FOR SKILLED INTERNATION-
ALLY EDUCATED HEALTH PROFESSIONALS. 
(a) FINDINGS.—Congress finds the following: 
(1) According to the Association of Schools of 
Public Health, projections indicate a nationwide 
shortage of up to 250,000 public health workers 
needed by 2020. 
(2) Similar trends are projected for other health 
professions indicating shortages across disciplines, 
including within the fields of nursing, dentistry, 
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pharmacy, mental and behavioral health, primary 
care, and community and allied health. 
(3) A nationwide health workforce shortage will 
result in serious health threats and more severe and 
costly health care needs, due to, in part, a delayed 
response to food-borne outbreaks, emerging infec-
tious diseases, and natural disasters, fewer cancer 
screenings and delayed treatment. 
(4) Vulnerable and underserved populations and 
health professional shortage areas will be most se-
verely impacted by the health workforce shortage. 
(5) According to the Migration Policy Institute, 
over 2 million college-educated immigrants in the 
United States today are unemployed or under-
employed in low- or semi-skilled jobs that fail to 
draw on their education and expertise. 
(6) Approximately two out of every five inter-
nationally educated immigrants are unemployed or 
underemployed. 
(7) According to Drexel University Center for 
Labor Markets and Policy, underemployment for 
internationally educated immigrant women is 28 per-
cent higher than for their male counterparts. 
(8) According to the Drexel University Center 
for Labor Markets and Policy, the mean annual 
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SEC. 426. RURAL HEALTH CARE SERVICES. 
Section 330A of the Public Health Service Act (42 
U.S.C. 254c) is amended to read as follows: 
‘‘SEC. 330A. RURAL HEALTH CARE SERVICES OUTREACH, 
RURAL HEALTH NETWORK DEVELOPMENT, 
DELTA RURAL DISPARITIES AND HEALTH 
SYSTEMS DEVELOPMENT, AND SMALL RURAL 
HEALTH CARE PROVIDER QUALITY IMPROVE-
MENT GRANT PROGRAMS. 
‘‘(a) PURPOSE.—The purpose of this section is to 
provide for grants— 
‘‘(1) under subsection (b), to promote rural 
health care services outreach; 
‘‘(2) under subsection (c), to provide for the 
planning and implementation of integrated health 
care networks in rural areas; 
‘‘(3) under subsection (d), to assist rural com-
munities in the Delta Region to reduce health dis-
parities and to promote and enhance health system 
development; and 
‘‘(4) under subsection (e), to provide for the 
planning and implementation of small rural health 
care provider quality improvement activities. 
‘‘(b) RURAL HEALTH CARE SERVICES OUTREACH 
GRANTS.— 
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