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 Sec-
retary of Health and Human Services to establish a 
Frontline Providers Loan Repayment Program. 
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 ‘‘Access to Frontline 
Health Care Act of 2009’’. 
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SEC. 2. FRONTLINE PROVIDERS LOAN REPAYMENT PRO-
GRAM. 
Part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end 
the following: 
‘‘Subpart XI—Frontline Health Care Services 
‘‘SEC. 340H. FRONTLINE PROVIDERS LOAN REPAYMENT 
PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary shall establish 
and carry out a Frontline Providers Loan Repayment Pro-
gram (in this section referred to as the ‘Loan Repayment 
Program’) under which, pursuant to contracts in accord-
ance with this section— 
‘‘(1) the Secretary agrees to make student loan 
repayments; and 
‘‘(2) the individual agrees to serve as a health 
professional for a period of full-time service of not 
less than 2 years at a health care facility serving a 
frontline care scarcity area. 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Loan Repayment Program, an individual must— 
‘‘(1) submit an application to participate in the 
Loan Repayment Program in such form and manner 
and at such time as specified by the Secretary; and 
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‘‘(2) sign and submit to the Secretary, at the 
time of submittal of such application, a written con-
tract (described in subsection (d)). 
‘‘(c) PARTICIPATION IN PROGRAM.— 
‘‘(1) IN GENERAL.—An individual becomes a 
participant in the Loan Repayment Program only 
upon the approval of the Secretary of the individ-
ual’s application submitted under subsection (b)(1) 
and the Secretary’s acceptance of the contract sub-
mitted by the individual under subsection (b)(2). 
‘‘(2) PREFERENCE.—In awarding contracts 
under this section, the Secretary shall give pref-
erence to applicants who have undertaken training 
or coursework in interdisciplinary studies. 
‘‘(3) RECRUITMENT
FOR
INTERDISCIPLINARY 
PROGRAMS.—The Secretary shall— 
‘‘(A) determine the frontline care scarcity 
areas in which to place contract recipients 
under this section; and 
‘‘(B) in making such determination, give 
preference to areas with a demonstrated pro-
gram of interdisciplinary health care, or with 
demonstrated plans to initiate interdisciplinary 
approaches to community health care. 
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‘‘(4) NOTICE.—The Secretary shall provide 
written notice to an individual promptly upon the 
Secretary’s approving, under paragraph (1), of the 
individual’s participation in the Loan Repayment 
Program. 
‘‘(d) CONTRACT.—The contract described in this sub-
section is a written contract between the Secretary and 
an individual that contains— 
‘‘(1) an agreement that— 
‘‘(A) the Secretary agrees to provide the 
individual with student loan repayment (de-
scribed in subsection (e)) for a period of time 
as determined by the Secretary, to pay off debts 
incurred during the course of the study or pro-
gram described in subsection (g)(2)(B); and 
‘‘(B) the individual agrees— 
‘‘(i) to accept provision of such a stu-
dent loan repayment to the individual; and 
‘‘(ii) to provide frontline care services 
for a period of full-time service of not less 
than 2 years at a health care facility serv-
ing a frontline care scarcity area; 
‘‘(2) a provision that any financial obligation of 
the United States arising out of a contract entered 
into under this section and any obligation of the in-
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dividual which is conditioned thereon, is contingent 
upon funds being appropriated for student loan re-
payment under this section; 
‘‘(3) a statement of the damages to which the 
United States is entitled, under subsection (f), for 
the individual’s breach of the contract; and 
‘‘(4) such other statements as the Secretary 
deems appropriate of the rights and liabilities of the 
Secretary and of the individual, not inconsistent 
with the provisions of this section. 
‘‘(e) STUDENT LOAN REPAYMENT.— 
‘‘(1) AMOUNT.—The amount of an annual stu-
dent loan repayment under this section on behalf of 
an individual shall be determined by the Secretary, 
and shall take into consideration the need to pay a 
sufficient amount to enable recruiting of health care 
providers into the loan repayment program under 
this section. 
‘‘(2) PAYMENTS
DIRECTLY
TO
LOAN
PRO-
VIDER.—The Secretary may contract with an indi-
vidual’s loan provider, for the payment to the loan 
provider, on behalf of the individual, of the amounts 
of a student loan repayment described in paragraph 
(1). 
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‘‘(f) BREACH
OF
CONTRACT.—If an individual 
breaches a written contract under this section by failing 
to begin such individual’s service obligation, or to complete 
such service obligation, the United States shall be entitled 
to recover from the individual an amount that is equal 
to the sum of— 
‘‘(1) the total amount which has been paid to 
the individual, or on behalf of the individual, under 
the contract; and 
‘‘(2) any amount of interest, as determined by 
the Secretary. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) The term ‘frontline care scarcity area’ 
means an area, population group, or facility that— 
‘‘(A) is designated as a health professional 
shortage area under section 332; or 
‘‘(B) is designated by the State in which 
the area is located as having a shortage of 
frontline care services. 
‘‘(2) The term ‘frontline care services’ means 
health care services— 
‘‘(A) in the field of general surgery, optom-
etry, ophthalmology, chiropractic, physical ther-
apy, audiology, speech language pathology, 
pharmacies, public health, podiatric medicine, 
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dietetics, occupational therapy, general pediat-
rics, respiratory therapy, medical technology, 
otolaryngology, or radiologic technology; and 
‘‘(B) provided by a general surgeon, op-
tometrist, ophthalmologist, chiropractor, phys-
ical therapist, audiologist, speech language pa-
thologist, pharmacist, public health profes-
sional, podiatric physician, registered dietician, 
occupational therapist, pediatrician, respiratory 
therapist, medical technologist, otolaryngologist, 
or radiologic technologist who has completed an 
appropriate course of study or program, offered 
by an accredited institution of higher education 
in the United States. 
‘‘(h) AUTHORIZED OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated the following: 
‘‘(1) For fiscal year 2010, $78,000,000. 
‘‘(2) For fiscal year 2011, $93,000,000. 
‘‘(3) For fiscal year 2012, $108,000,000. 
‘‘(4) For fiscal year 2013, $123,000,000. 
‘‘(5) For fiscal year 2014, $138,000,000. 
‘‘(6) For fiscal year 2015, $153,000,000. 
‘‘(7) For fiscal year 2016, and each subsequent 
fiscal year, the amount appropriated for the pre-
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