numbers that are disproportionate to their numbers 
in the population of the region, and may not use any 
individuals as subjects for training or demonstration 
in a manner beyond that required for the immediate 
purpose of the training or demonstration or without 
their explicit consent. 
The National Health Board shall establish, not later than 
one year after the effective date of health services, guide-
lines for the application of these principles and for the 
phased integration of health worker education programs, 
including medical, dental, osteopathic, and nursing school 
programs, in existence on the date of enactment of this 
Act into the schools established under this section. 
(c) ADMISSIONS POLICIES.—Admissions policies for 
education programs in schools shall— 
(1) emphasize previous health-related work ex-
perience, as evaluated by health workers (including 
peers), by individuals who have received health care 
services from the applicant, and by faculty members; 
(2) minimize the use of criteria of academic 
performance other than such criteria as have been 
shown to be significantly related to future work per-
formance;
(3) give preference to segments of the popu-
lation of the region underrepresented among health 
workers; 
(4) to the extent consistent with paragraph (3), 
provide for admission of individuals so that the stu-
dent body approximates the population of the region 
by race, sex, family income, and language; and 
(5) require that the applicant agree, if accepted 
into the school, to perform health care services in ac-
cordance with section 312. 
(d) CURRICULUM POLICIES.—The National Health 
Board, in consultation with its local and regional authori-
ties, shall establish and implement curriculum policies for 
educational programs in schools. Such policies shall— 
(1) give priority in study and field work to the 
leading causes of illness and death in the region, in-
cluding environmental, biological, and social deter-
minants of mortality and morbidity; 
(2) give special consideration to studying the 
social, as well as biological, causation and prevention 
of illness and disease, and to the differing health 
care needs of populations facing special health risks 
and having special cultures and lifestyles within the 
region;
(3) provide that all students shall take a com-
mon, initial sequence of courses and that students 
preparing for more advanced types of health work 
shall take studies that are progressively more spe-
cialized and differentiated; 
(4) emphasize work study experience in all 
types of health care facilities in the region, including 
community and workplace facilities, facilities for the 
aged, mentally ill, and mentally retarded, health care 
facilities in prisons and other correctional institu-
tions, alcohol and drug rehabilitation facilities, envi-
ronmental health facilities, and all other health care 
facilities of the Service in communities and districts 
in the region; 
(5) emphasize the appropriate and safe use, 
and discourage the overuse, of drugs and medical 
techniques; and 
(6) facilitate the development by all health 
workers of skills in decisionmaking and assessment 
of user needs in cooperation with other health work-
ers and with users. 
(e) FACULTY HIRING PROCEDURES.—Faculty hiring 
procedures in schools shall, to the maximum extent fea-
sible, create a faculty which approximates the population 
of the region by race, sex, and language.
(f) GOVERNANCE PLANS.—Governance plans for the 
management of a school shall give significant decision-
making powers to staff and students of the school. 
SEC. 312. SERVICE REQUIREMENT. 
(a) SERVICE REQUIREMENT.— 
(1) IN GENERAL.—No individual may be en-
rolled in a school unless the individual agrees to per-
form health care services as an employee of the 
Service in the job category for which training is 
being provided— 
(A) for a period of time equal to the period 
of such enrollment in the school but not less 
than 2 years; 
(B) beginning not later than 1 year after 
the date of the individual’s graduation from the 
school; and 
(C) for an area with the highest priority 
ranking under subsection (c) that agrees to em-
ploy the individual. 
(2) DEFERRAL.—An individual’s obligation to 
perform service under an agreement described in 
paragraph (1) shall be deferred only for a period 
during which the individual is physically or mentally 
incapable of performing such service.
(3) COMPLETION OF SERVICE REQUIRED.—No 
individual who has made an agreement described in 
paragraph (1) may be employed other than in ac-
cordance with subsection (c), until the individual has 
completed the period of obligated service in accord-
ance with this section. 
(4) PENALTY FOR BREACH OF AGREEMENT.— 
Except as provided in paragraph (5), if an individual 
breaches an agreement under paragraph (1) by fail-
ing (for any reason) either to begin such individual’s 
service obligation or to complete such service obliga-
tion, the Service shall be entitled to recover from the 
individual an amount determined in accordance with 
the formula A=C (1–s / (t)) in which— 
(A) ‘‘A’’ is the amount the Service is enti-
tled to recover; 
(B) ‘‘C’’ is an amount determined by the 
National Health Board to be the costs to the 
Service of the education program and allowance 
received by the individual and the interest on 
such costs which would be payable if at the 
time the costs were undertaken they were loans 
bearing interest at the maximum legal pre-
vailing rate, as determined by the Treasurer of 
the United States;
(C) ‘‘t’’ is the total number of months in 
the individual’s period of obligated service; and 
(D) ‘‘s’’ is the number of months of such 
period served by the individual. Any amount of 
damages which the Service is entitled to recover 
under this paragraph shall, within the 1-year 
period beginning on the date of the breach of 
the agreement, be paid to the Service. 
(5) CANCELLATION.— 
(A) UPON DEATH.—Any obligation of an 
individual under this subsection for service or 
payment of damages shall be canceled upon the 
death of the individual. 
(B) EXTREME
HARDSHIP
EXCEPTION.— 
The National Health Board shall provide for 
the waiver or suspension of any obligation of 
service or payment by an individual under this 
subtitle whenever compliance by the individual 
is impossible or would involve extreme hardship 
to the individual and if enforcement of such ob-
ligation with respect to any individual would be 
unconscionable. 
(C) LIMITATION ON DISCHARGE IN BANK-
RUPTCY.—Any obligation of an individual under 
this subtitle for payment of damages may be re-