I 
118TH CONGRESS 
1ST SESSION H. R. 4933 
To amend the Public Health Service Act to modify the loan repayment 
program for the substance use disorder treatment workforce to relieve 
workforce shortages. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 26, 2023 
Mrs. NAPOLITANO (for herself, Ms. KUSTER, Mr. KILMER, Ms. SEWELL, Mr. 
FITZPATRICK, Mr. TRONE, Mr. SCHIFF, Ms. CHU, Ms. PINGREE, Mr. 
RASKIN, Ms. WILLIAMS of Georgia, Mrs. WATSON COLEMAN, Mr. POCAN, 
and Ms. TOKUDA) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to modify the loan 
repayment program for the substance use disorder treat-
ment workforce to relieve workforce shortages. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Mental Health Profes-
sionals Workforce Shortage Loan Repayment Act of 
2023’’. 
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SEC. 2. LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE 
DISORDER TREATMENT WORKFORCE. 
Section 781 of the Public Health Service Act (42 
U.S.C. 295h) is amended— 
(1) In subsection (a)(2), by inserting ‘‘, or the 
individuals each agree to complete a period of service 
in a mental health professional shortage area’’ be-
fore the period; 
(2) in subsection (c)— 
(A) 
by 
redesignating 
paragraphs 
(2) 
through (5) as paragraphs (3) through (6), re-
spectively; and 
(B) by inserting after paragraph (1), the 
following: 
‘‘(2) Any loan used for obtaining a degree from 
an accredited institution of higher education for edu-
cation in mental health or a related field leading to 
a master’s degree, leading to a doctoral degree, or 
consisting of post-doctoral study.’’; 
(3) by striking subsection (d) and inserting the 
following: 
‘‘(d) REQUIREMENTS OF SERVICE.—Any individual 
receiving payments under this program as required by an 
agreement under subsection (a) shall agree— 
‘‘(1) to an annual commitment to full-time em-
ployment, with no more than 1 year passing between 
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any 2 years of covered employment, in substance use 
disorder treatment employment in the United States 
in— 
‘‘(A) a Mental Health Professional Short-
age Area, as designated under section 332; or 
‘‘(B) a county (or a municipality, if not 
contained within any county) where the mean 
drug overdose death rate per 100,000 people 
over the past 3 years for which official data is 
available from the State, is higher than the 
most recent available national average overdose 
death rate per 100,000 people, as reported by 
the Centers for Disease Control and Prevention; 
or 
‘‘(2) to up to 6 years of full-time employment, 
with no more than 1 year passing between any 2 
years of covered employment, in behavioral and men-
tal health employment in the United States in— 
‘‘(A) a mental health professional shortage 
area of greatest need, as determined by the 
Secretary for the purposes of this section, as 
designated under section 332; or 
‘‘(B) any facility, program, center, or clinic 
as determined appropriate by the Secretary for 
purposes of this section because of a shortage 
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of mental health professionals, including private 
physician practices and other medical facilities 
designated under section 332(a) as having such 
a shortage.’’; 
(4) in subsection (e)(2), by inserting ‘‘338B, 
338I, or 846 of this Act, section’’ after ‘‘under sec-
tion’’; 
(5) in subsection (h)(2), by inserting ‘‘and be-
havioral and mental health services employees’’ after 
‘‘treatment employees’’; 
(6) in subsection (i)— 
(A) 
by 
redesignating 
paragraphs 
(1) 
through (3) as paragraphs (2) through (4), re-
spectively; and 
(B) by inserting before paragraph (2) (as 
so redesignated), the following: 
‘‘(1) The term ‘behavioral and mental health 
employment’ means full-time employment (including 
a fellowship) where the primary intent and function 
of the position is the direct treatment or recovery 
support of patients with or in recovery from a behav-
ioral health or mental health disorder, which may in-
clude a physician (with a degree of doctor of medi-
cine or doctor of osteopathy), a psychiatric nurse, a 
social worker, a marriage and family therapist, a 
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mental health counselor, an occupational therapist, a 
psychologist, a psychiatrist, a child and adolescent 
psychiatrist, or a neurologist.’’; and 
(7) in subsection (j), by striking ‘‘$25,000,000 
for each of fiscal years 2019 through 2023’’ and in-
serting ‘‘$100,000,000 for each of fiscal years 2023 
through 2032’’. 
Æ 
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