I 
117TH CONGRESS 
2D SESSION 
H. R. 8790 
To amend the Public Health Service Act to help build a stronger health 
care workforce. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 9, 2022 
Mr. RUIZ introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committee on Ways 
and Means, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend the Public Health Service Act to help build a 
stronger health care workforce. 
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 ‘‘Building a Health Care 
Workforce for the Future Act’’. 
SEC. 2. GRANTS TO STATES FOR SCHOLARSHIP PROGRAMS. 
Subpart III of part D of title III of the Public Health 
Service Act (42 U.S.C. 254l et seq.) is amended by adding 
at the end the following: 
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‘‘SEC. 338O. GRANTS TO STATES FOR SCHOLARSHIP PRO-
GRAMS. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to eligible States to enable such States to imple-
ment scholarship programs to ensure, with respect to the 
provision of health services, an adequate supply of physi-
cians, dentists, behavioral and mental health professionals, 
certified nurse midwives, certified nurse practitioners, 
physician assistants, pharmacists, and other health profes-
sionals as determined by the Secretary. 
‘‘(b) ELIGIBLE STATES.—To be eligible to receive a 
grant under this section, a State shall submit to the Sec-
retary an application containing such information as the 
Secretary determines necessary to carry out this section. 
‘‘(c) ELIGIBLE PARTICIPANTS.—To be eligible to par-
ticipate in a scholarship program carried out with a grant 
received under this section, an individual shall— 
‘‘(1) be accepted for enrollment, or be enrolled, 
as a full-time student— 
‘‘(A) in an accredited (as determined by 
the Secretary) educational institution in a 
State; and 
‘‘(B) in a course of study or program, of-
fered by such institution and approved by the 
Secretary, leading to a degree in medicine, den-
tistry, nursing, pharmacy, or other health pro-
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fession, or an appropriate degree from a grad-
uate program of behavioral and mental health; 
‘‘(2) submit to the State an application to par-
ticipate in the program; and 
‘‘(3) sign and submit to the State, at the time 
of the submission of the application under paragraph 
(2), a written contract that requires the individual 
to— 
‘‘(A) accept payments under the scholar-
ship; 
‘‘(B) maintain a minimum level of aca-
demic standing during the period of the schol-
arship, as determined by the Secretary; 
‘‘(C) if applicable, complete an accredited 
residency training program; 
‘‘(D) become licensed in the applicant’s 
State of residence; and 
‘‘(E) serve as a provider for one year in— 
‘‘(i) a health professional shortage 
area (as defined under section 332); 
‘‘(ii) a medically underserved commu-
nity (as defined under section 799B); or 
‘‘(iii) any other shortage area defined 
by the State and approved by the Sec-
retary; 
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in the applicant’s State of residence for every 
year in which the applicant received a scholar-
ship. 
‘‘(d) DESIGNATION OF AREAS.—To be eligible to re-
ceive a grant under this section, a State shall adequately 
demonstrate to the Secretary that the State has des-
ignated appropriate health professional or specialty short-
age areas. 
‘‘(e) REQUIRED DISCLOSURES.—In disseminating 
application and contract forms to individuals desiring to 
participate in a scholarship program funded under this 
section, the State shall include with such forms a sum-
mary of the rights and liabilities of an individual whose 
application is approved (and whose contract is accepted), 
including a clear explanation of the damages to which the 
State is entitled in the case of the individual’s breach of 
the contract. 
‘‘(f) AWARDING OF CONTRACTS.— 
‘‘(1) IN GENERAL.—A State that enters into a 
contract with an individual under subsection (c)(3) 
shall, with respect to the program in which the indi-
vidual is enrolled, agree to pay— 
‘‘(A) all tuition and costs associated with 
the program; 
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‘‘(B) any other reasonable educational ex-
penses, including fees, books, and laboratory ex-
penses, related to the program; and 
‘‘(C) a cost-of-living stipend in an amount 
to be determined by the Secretary. 
‘‘(2) CONSIDERATION BY STATE.—In entering 
into contracts with individuals that meet the require-
ments of subsection (c), the State shall consider the 
extent of the applicant’s demonstrated interest in 
the provision of care services in a particular provider 
shortage area. 
‘‘(g) MATCHING FUNDS.—A State receiving a grant 
under this section shall, with respect to the costs of mak-
ing payments on behalf of individuals under the scholar-
ship program implemented by the State under the grant, 
make available (directly or through donations from public 
or private entities) non-Federal contributions in cash to-
ward such costs in an amount equal to not less than $1 
for each $1 of Federal funds provided under the grant. 
‘‘(h) DIRECT ADMINISTRATION BY STATE AGENCY.— 
The scholarship program of any State receiving a grant 
under this section shall be administered directly by a State 
agency. 
‘‘(i) REPORT BY SECRETARY.—Not later than four 
years after the date of enactment of this section, and every 
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five years thereafter, the Secretary shall submit to Con-
gress a report concerning— 
‘‘(1) the number of scholarships awarded under 
the State scholarship program; 
‘‘(2) the number of scholarship recipients, bro-
ken down by practice area, serving in the profession 
originally awarded a scholarship for one year after 
the completion of the service period required under 
subsection (c)(3)(E); 
‘‘(3) the number of scholarship recipients, bro-
ken down by provider type, practicing in a medically 
underserved community one year after the comple-
tion of the service period required under subsection 
(c)(3)(E); 
‘‘(4) data on any changes in health professional 
shortage areas or medically underserved commu-
nities within the State; 
‘‘(5) remaining gaps in such health professional 
shortage areas or medically underserved commu-
nities; 
‘‘(6) the number of additional full-time physi-
cians that would be required to eliminate such 
health professional shortage areas or medically un-
derserved communities in the State; 
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‘‘(7) the number of individuals who received a 
scholarship but failed to comply with the require-
ments of the scholarship; 
‘‘(8) the action taken by the State to recoup 
scholarship funds in the case of any non-compliance; 
and 
‘‘(9) recommendations to improve the program 
under this section. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$20,000,000 for each of fiscal years 2023 through 2027. 
Not less than 50 percent of the amount appropriated for 
a fiscal year under this subsection shall be used to provide 
scholarships to providers who intend on pursuing careers 
in primary care.’’. 
SEC. 3. INCREASING MENTORING AND TRANSFORMING 
COMPETENCIES IN PRIMARY CARE. 
Title VII of the Public Health Service Act is amended 
by inserting after section 747A (42 U.S.C. 293k–1) the 
following: 
‘‘SEC. 747B. DEVELOPING EFFECTIVE PRIMARY CARE MEN-
TORS AND IMPROVING MENTORSHIP OPPOR-
TUNITIES FOR MEDICAL STUDENTS. 
‘‘(a) GRANTS TO CULTIVATE PRIMARY CARE MEN-
TORS AND IMPROVE PRIMARY CARE MENTORSHIP OPPOR-
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TUNITIES FOR MEDICAL STUDENTS.—The Secretary may 
award grants to eligible medical schools to assist such 
schools in developing and strengthening primary care 
mentorship programs and cultivating leaders in primary 
care among students. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an entity shall— 
‘‘(1) be an accredited medical school or college 
of osteopathic medicine; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require, including an 
assurance that the applicant will use amounts re-
ceived under the grant to— 
‘‘(A) 
establish 
or 
enhance 
existing 
mentorship programs, including— 
‘‘(i) incentivizing medical school fac-
ulty (through financial or other reward 
systems) to participate as a mentor of 
other primary care physician faculty mem-
bers and students; 
‘‘(ii) providing resources for aspiring 
mentors to participate in workshops or 
other learning experiences in which pri-
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mary care physicians can learn about effec-
tive strategies in primary care mentoring; 
‘‘(iii) enabling successful primary care 
mentors on medical school faculty to spend 
time at another institution where they can 
promote best practices in mentoring pri-
mary care leaders and students; and 
‘‘(iv) developing web-based resources 
for mentors to interact regularly and share 
successful strategies; or 
‘‘(B) cultivate interest and leaders in pri-
mary care among students, including— 
‘‘(i) offering students that identify in-
terest in primary care upon matriculation 
longitudinal experiences in primary care to 
care for and track the health and wellness 
of patients throughout medical school; 
‘‘(ii) arranging partnerships with pri-
vate practices, insurers, schools of public 
health, public health departments, and 
community-based service projects with the 
goal of providing students with the oppor-
tunity to interact with primary care men-
tors from a variety of health care settings; 
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‘‘(iii) providing stipends or other 
forms of financial resources to students 
who work with designated mentors in the 
field of primary care in underserved urban 
and rural communities; and 
‘‘(iv) supporting opportunities for stu-
dents to engage in practice redesign or 
other efforts in which primary care physi-
cians are taking a leadership role in deliv-
ery system reform. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$20,000,000 for each of fiscal years 2023 through 2029. 
‘‘SEC. 747C. DEVELOPING AND PROMOTING NEW COM-
PETENCIES. 
‘‘(a) GRANTS TO DEVELOP
AND PROMOTE NEW 
COMPETENCIES.—In order to foster curricular innova-
tions to improve the education and training of health care 
providers, the Secretary shall award grants to medical and 
other health professions schools to promote priority com-
petencies (as described in subsection (b)). 
‘‘(b) PRIORITY COMPETENCIES.—In awarding grants 
under subsection (a), the Secretary, acting through the 
Advisory Committee on Training in Primary Care and 
Dentistry, shall select an annual competency to direct the 
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awarding of such grants. Such annual competencies may 
include— 
‘‘(1) patient-centered medical homes; 
‘‘(2) chronic disease management; 
‘‘(3) integration of primary care and mental 
health care; 
‘‘(4) integration of primary care, public and 
population health, and health promotion; 
‘‘(5) cultural competency; 
‘‘(6) domestic violence; 
‘‘(7) improving care in medically undeserved 
areas; and 
‘‘(8) team-based care. 
‘‘(c) GRANT RECIPIENTS.—The Secretary may award 
grants under subsection (a) to programs that provide edu-
cation or training for— 
‘‘(1) physicians; 
‘‘(2) dentists and dental hygienists; 
‘‘(3) physician assistants; 
‘‘(4) mental and behavioral health providers; 
‘‘(5) public and populations health profes-
sionals; or 
‘‘(6) pharmacists. 
‘‘(d) CONSIDERATION IN EVALUATING GRANT APPLI-
CATIONS.—The Secretary shall give consideration to appli-
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cants that are proposing to partner with other medical 
programs, health professions programs, or nursing pro-
grams. 
‘‘(e) GRANTEE REPORTS.—Each recipient of a grant 
under this section shall, not later than 180 days after the 
end of the grant period involved, submit to the Advisory 
Committee, a report on the following (where appropriate): 
‘‘(1) A description of how the funding under 
the grant was used by the grantee. 
‘‘(2) A description of the intended goal of such 
funding. 
‘‘(3) A description of the challenges faced by 
the grantee in reaching the goal described in para-
graph (2). 
‘‘(4) A description of the lessons learned by the 
grantee related to the grant activities. 
‘‘(f) RECOMMENDATIONS OF THE ADVISORY COM-
MITTEE.—The Advisory Committee, based on the informa-
tion submitted under subsection (e), shall annually report 
to the Secretary on outcomes of the activities carried out 
under grants under this section, including specific rec-
ommendations for scaling up innovations to promote edu-
cation and training of health care providers in the priority 
competencies described in subsection (b). 
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‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2023 through 2027.’’. 
SEC. 4. STUDY ON DOCUMENTATION REQUIREMENTS FOR 
COGNITIVE SERVICES. 
Not later than three years after the date of enact-
ment of this Act, the Institute of Medicine shall conduct 
a study and submit a report to Congress concerning the 
documentation requirements for cognitive services (evalua-
tion and management services) required under the Medi-
care and Medicaid programs under titles XVIII and XIX 
of the Social Security Act, respectively, and through pri-
vate health insurers. Such study shall include an evalua-
tion of— 
(1) how documentation requirements designed 
for paper-based records should be modified for elec-
tronic records; 
(2) whether or not the documentation require-
ments are overly burdensome on physicians and de-
tract from patient care; 
(3) the administrative costs to physician prac-
tices of the current documentation requirements; 
(4) the average amount of time required by 
physicians to document cognitive services; 
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(5) options to more appropriately compensate 
physicians for evaluation and management of patient 
care without requiring excessive documentation of 
cognitive services; and 
(6) recommendations for less burdensome alter-
natives or changes to existing documentation re-
quirements of cognitive services. 
Æ 
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