I 
119TH CONGRESS 
1ST SESSION H. R. 4425 
To amend the Public Health Service Act to increase the number of permanent 
faculty in palliative care at accredited allopathic and osteopathic medical 
schools, nursing schools and other programs, including social work, physi-
cian assistant, and chaplaincy education programs, to promote education 
and research in palliative care and hospice, and to support the develop-
ment of faculty careers in academic palliative and hospice care. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 16, 2025 
Mr. CARTER of Georgia (for himself and Mr. BERA) introduced the following 
bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to increase the 
number of permanent faculty in palliative care at accred-
ited allopathic and osteopathic medical schools, nursing 
schools and other programs, including social work, physi-
cian assistant, and chaplaincy education programs, to 
promote education and research in palliative care and 
hospice, and to support the development of faculty ca-
reers in academic palliative and hospice care. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Palliative Care and 
Hospice Education and Training Act’’. 
SEC. 2. PALLIATIVE CARE AND HOSPICE EDUCATION AND 
TRAINING. 
(a) IN GENERAL.—Part D of title VII of the Public 
Health Service Act (42 U.S.C. 294 et seq.) is amended 
by inserting after section 759 the following: 
‘‘SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION 
AND TRAINING. 
‘‘(a) PALLIATIVE CARE AND HOSPICE EDUCATION 
PROGRAMS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this section to entities de-
scribed in paragraph (1), (3), or (4) of section 
799B, and section 801(2), for the establishment or 
operation of Palliative Care and Hospice Education 
Programs that meet the requirements of paragraph 
(2). 
‘‘(2) REQUIREMENTS.— 
‘‘(A) IN GENERAL.—A Palliative Care and 
Hospice Education Program receiving an award 
under this section shall support the training of 
health professionals in palliative and hospice 
care, including traineeships or fellowships. Such 
programs shall emphasize, as appropriate, pa-
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tient and family engagement, integration of pal-
liative and hospice care with primary and spe-
cialty care, and collaboration with community 
partners to address gaps in health care for indi-
viduals with serious or life-threatening illnesses. 
‘‘(B) ACTIVITIES.—Activities conducted by 
a program under this section may include the 
following: 
‘‘(i) Clinical training on providing in-
tegrated palliative and hospice care serv-
ices. 
‘‘(ii) 
Interprofessional 
training 
to 
practitioners from multiple disciplines and 
specialties, including training on the provi-
sion of care to individuals with serious or 
life-threatening illnesses. 
‘‘(iii) Establishing or maintaining 
training-related 
community-based 
pro-
grams for individuals with serious or life- 
threatening illnesses and caregivers to im-
prove quality of life, and where appro-
priate, health outcomes for individuals who 
have serious or life-threatening illnesses. 
‘‘(C) 
NONDUPLICATION.—A 
Palliative 
Care and Hospice Education Program under 
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this section shall not duplicate the activities of 
existing education centers funded under this 
section or under section 753 or 865. 
‘‘(3) PRIORITIES
IN
MAKING
AWARDS.—In 
awarding grants and contracts under paragraph (1), 
the Secretary— 
‘‘(A) shall give priority to programs that 
demonstrate coordination with another Federal 
or State program, or another public or private 
entity; 
‘‘(B) shall give priority to applicants with 
programs or activities that are expected to sub-
stantially benefit— 
‘‘(i) individuals in rural or medically 
underserved areas, frontier health profes-
sional shortage areas (as defined in section 
799B), or Indian Tribes or Tribal organi-
zations; 
‘‘(ii) pediatric populations; or 
‘‘(iii) racial and ethnic minority popu-
lations; and 
‘‘(C) may give priority to any program 
that— 
‘‘(i) integrates palliative and hospice 
care into primary care practice; 
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‘‘(ii) provides training to integrate 
palliative and hospice care into other spe-
cialties across care settings, including 
practicing clinical specialists, health care 
administrators, 
faculty 
without 
back-
grounds in palliative or hospice care, and 
students from all health professions; 
‘‘(iii) emphasizes integration of pallia-
tive and hospice care into existing service 
delivery locations and care across settings, 
including primary care clinics, medical 
homes, Federally qualified health centers, 
ambulatory care clinics, hospitals, includ-
ing critical access hospitals, emergency 
care settings, assisted living and nursing 
facilities, and home- and community-based 
settings; 
‘‘(iv) supports the training and re-
training of faculty, primary and specialty 
care providers, other direct care providers, 
and other appropriate professionals on pal-
liative or hospice care; 
‘‘(v) emphasizes education and en-
gagement of family or caregivers on pallia-
tive and hospice care management within 
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the context of chronic disease management 
and strategies to meet the needs of such 
family or caregivers; or 
‘‘(vi) proposes to conduct outreach to 
communities that have a shortage of pallia-
tive and hospice workforce professionals. 
‘‘(4) EXPANSION
OF
EXISTING
PROGRAMS.— 
Nothing in this section shall be construed to— 
‘‘(A) prevent the Secretary from providing 
grants or contracts to expand existing education 
programs, including geriatric education pro-
grams established under section 753 or 865, to 
provide for education and training focused spe-
cifically on palliative care, including for non- 
geriatric populations; or 
‘‘(B) limit the number of education pro-
grams that may be funded in a community. 
‘‘(b) PALLIATIVE MEDICINE PHYSICIAN TRAINING.— 
‘‘(1) IN GENERAL.—The Secretary may make 
grants to, and enter into contracts with, schools of 
medicine, schools of osteopathic medicine, teaching 
hospitals, and graduate medical education programs 
for the purpose of providing support for projects 
that fund the training of physicians who plan to 
teach or practice palliative medicine. 
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‘‘(2) REQUIREMENTS.—Each project for which 
a grant or contract is made under this subsection 
shall— 
‘‘(A) be staffed by full-time teaching physi-
cians who have experience or training in inter-
professional team-based palliative medicine; 
‘‘(B) be based in a hospice and palliative 
medicine fellowship program accredited by the 
Accreditation Council for Graduate Medical 
Education; 
‘‘(C) provide training in interprofessional 
team-based palliative medicine through a vari-
ety of service rotations, such as consultation 
services, acute care services, extended care fa-
cilities, ambulatory care and comprehensive 
evaluation units, hospices, home care, and com-
munity care programs; 
‘‘(D) develop specific performance-based 
measures to evaluate the competency of train-
ees; and 
‘‘(E) provide training in interprofessional 
team-based palliative medicine through one or 
both of the training options described in para-
graph (3). 
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‘‘(3) TRAINING OPTIONS.—The training options 
referred to in subparagraph (E) of paragraph (2) 
are as follows: 
‘‘(A) 1-year retraining programs in hospice 
and palliative medicine for physicians who are 
faculty at schools of medicine and osteopathic 
medicine, or others determined appropriate by 
the Secretary. 
‘‘(B) 1- or 2-year training programs that 
are designed to provide training in interprofes-
sional team-based hospice and palliative medi-
cine for physicians who have completed grad-
uate medical education programs in any med-
ical specialty leading to board eligibility in hos-
pice and palliative medicine pursuant to the 
American Board of Medical Specialties. 
‘‘(4) DEFINITIONS.—For purposes of this sub-
section, the term ‘graduate medical education’ 
means a program sponsored by a school of medicine, 
a school of osteopathic medicine, a hospital, or a 
public or private institution that— 
‘‘(A) offers postgraduate medical training 
in the specialties and subspecialties of medicine; 
and 
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‘‘(B) has been accredited by the Accredita-
tion Council for Graduate Medical Education or 
the American Osteopathic Association through 
its Committee on Postdoctoral Training. 
‘‘(c) PALLIATIVE CARE AND HOSPICE ACADEMIC CA-
REER AWARDS.— 
‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec-
retary shall establish a program to provide awards, 
to be known as the ‘Palliative Care and Hospice 
Academic Career Awards’, to allopathic and osteo-
pathic medical schools, nursing schools, and other 
programs, including social work, physician assistant, 
and chaplaincy education programs, or other schools 
or programs identified by the Secretary applying on 
behalf of eligible individuals to promote the career 
development of such individuals as academic hospice 
and palliative care specialists. 
‘‘(2) ELIGIBLE INDIVIDUALS.—For purposes of 
this subsection, the term ‘eligible individual’ means 
an individual who— 
‘‘(A) is board certified or board eligible in 
hospice and palliative medicine or has com-
pleted required specialty training in palliative 
and hospice care in the disciplines of nursing, 
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social work, physician assistant, chaplaincy, or 
other discipline identified by the Secretary; and 
‘‘(B) has a junior (nontenured) faculty ap-
pointment at an accredited (as determined by 
the Secretary) allopathic or osteopathic medical 
school, nursing school, or other programs, in-
cluding social work, physician assistant, chap-
laincy, or other education programs identified 
by the Secretary. 
‘‘(3) LIMITATIONS.—No award under para-
graph (1) may be made to an eligible individual un-
less the entity on behalf of the eligible individual— 
‘‘(A) has submitted to the Secretary an ap-
plication, at such time, in such manner, and 
containing such information as the Secretary 
may require, and the Secretary has approved 
such application; 
‘‘(B) provides, in such form and manner as 
the Secretary may require, assurances that the 
individual will meet the service requirement de-
scribed in paragraph (6); and 
‘‘(C) provides, in such form and manner as 
the Secretary may require, assurances that the 
individual has a full-time faculty appointment 
in a health professions institution and docu-
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mented commitment from such institution to 
spend a majority of the total funded time of 
such individual on teaching and developing 
skills in education in interprofessional team- 
based palliative care. 
‘‘(4) MAINTENANCE
OF
EFFORT.—An entity 
which receives an award under paragraph (1) shall 
provide assurances to the Secretary that funds pro-
vided to the eligible individual under this subsection 
will be used only to supplement, not to supplant, the 
amount of Federal, State, and local funds otherwise 
expended by the eligible individual. 
‘‘(5) AMOUNT AND TERM.— 
‘‘(A) AMOUNT.—The amount of an award 
under this subsection shall be equal to the 
award amount provided for under section 
753(b)(5)(A) for the fiscal year involved. 
‘‘(B) TERM.—The term of an award made 
under this subsection shall not exceed 5 years. 
‘‘(C) PAYMENT
TO
INSTITUTION.—The 
Secretary shall make payments for awards 
under this subsection to institutions, including 
allopathic and osteopathic medical schools, 
nursing schools, and other programs, including 
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social work, physician assistant, or chaplaincy 
education programs. 
‘‘(6) SERVICE
REQUIREMENT.—An individual 
who receives an award under this subsection shall 
provide training in palliative care and hospice, in-
cluding the training of interprofessional teams of 
health care professionals. The provision of such 
training shall constitute a majority of the total fund-
ed obligations of such individual under the award. 
‘‘(d) PALLIATIVE
CARE
WORKFORCE
DEVELOP-
MENT.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this subsection to entities 
that operate a Palliative Care and Hospice Edu-
cation Program pursuant to subsection (a)(1). 
‘‘(2) APPLICATION.—To be eligible for an 
award under paragraph (1), an entity described in 
such paragraph shall submit to the Secretary an ap-
plication at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
‘‘(3) USE OF FUNDS.—Amounts awarded under 
a grant or contract under paragraph (1) shall be 
used to carry out the fellowship program described 
in paragraph (4). 
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‘‘(4) FELLOWSHIP PROGRAM.— 
‘‘(A) IN
GENERAL.—Pursuant to para-
graph (3), a Palliative Care and Hospice Edu-
cation Program that receives an award under 
this subsection shall use such funds to offer 
short-term intensive courses (referred to in this 
subsection as a ‘fellowship’) that focus on inter-
professional team-based palliative care that pro-
vide supplemental training for faculty members 
in allopathic and osteopathic medical schools, 
nursing schools, and other programs, including 
psychology, pharmacy, social work, physician 
assistant, and chaplaincy education programs, 
or other health disciplines, as approved by the 
Secretary. Such a fellowship shall be open to 
current faculty, and appropriately credentialed 
volunteer faculty and practitioners, who do not 
have formal training in palliative care, to up-
grade their knowledge and clinical skills for the 
care of individuals with serious or life-threat-
ening illness and to enhance their interdiscipli-
nary and interprofessional teaching skills. 
‘‘(B) LOCATION.—A fellowship under this 
paragraph shall be offered either at the Pallia-
tive Care and Hospice Education Program that 
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is sponsoring the course, in collaboration with 
other Palliative Care and Hospice Education 
Programs, or at allopathic and osteopathic med-
ical schools, nursing schools, or other programs, 
including pharmacy, social work, physician as-
sistant, chaplaincy, and psychology education 
programs, or other health professions schools 
and programs approved by the Secretary. 
‘‘(5) TARGETS.—A Palliative Care and Hospice 
Education Program that receives an award under 
paragraph (1) shall meet targets approved by the 
Secretary for providing training in interprofessional 
team-based palliative care to a certain number of 
faculty or practitioners during the term of the 
award, as well as other parameters established by 
the Secretary. 
‘‘(6) AMOUNT OF AWARD.—Each award under 
paragraph (1) shall be not more than $150,000. Not 
more than 24 Palliative Care and Hospice Education 
Programs may receive an award under such para-
graph. 
‘‘(7) MAINTENANCE OF EFFORT.—A Palliative 
Care and Hospice Education Program that receives 
an award under paragraph (1) shall provide assur-
ances to the Secretary that funds provided to the 
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Program under the award will be used only to sup-
plement, not to supplant, the amount of Federal, 
State, and local funds otherwise expended by such 
Program. 
‘‘(e) PALLIATIVE CARE AND HOSPICE CAREER IN-
CENTIVE AWARDS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this subsection to institu-
tions, including allopathic and osteopathic medical 
schools, nursing schools, and other programs, includ-
ing social work, physician assistant, psychology, 
chaplaincy, and pharmacy education programs, or 
other programs approved by the Secretary, applying 
on behalf of individuals described in paragraph (2) 
to foster greater interest among a variety of health 
professionals in entering the field of palliative care. 
‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 
receive an award under paragraph (1), an individual 
shall— 
‘‘(A) be an advanced practice nurse, a so-
cial worker, physician assistant, pharmacist, 
chaplain, psychologist, or other health care pro-
fessional pursuing a doctorate, masters, or 
other advanced degree with a focus in inter-
professional team-based palliative care or re-
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lated fields in an accredited school or education 
program; and 
‘‘(B) submit to the Secretary an applica-
tion at such time, in such manner, and con-
taining such information as the Secretary may 
require. 
‘‘(3) CONDITIONS OF AWARD.—As a condition 
of receiving an award under paragraph (1), an indi-
vidual shall agree that, following completion of the 
award period, the individual will teach or practice 
palliative care in health-related educational, home, 
hospice, or long-term care settings for a minimum of 
5 years under guidelines established by the Sec-
retary. 
‘‘(4) PAYMENT
TO
INSTITUTION.—The Sec-
retary shall make payments for awards under para-
graph (1) to institutions that include allopathic and 
osteopathic medical schools, nursing schools, and 
other programs, including social work, physician as-
sistant, psychology, chaplaincy, and pharmacy edu-
cation programs or other programs approved by the 
Secretary. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
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$15,000,000 for each of the fiscal years 2026 through 
2030.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall be effective beginning on the date that 
is 90 days after the date of enactment of this Act. 
SEC. 3. HOSPICE AND PALLIATIVE NURSING. 
(a) NURSE EDUCATION, PRACTICE, AND QUALITY 
GRANTS.—Section 831(b)(3) of the Public Health Service 
Act (42 U.S.C. 296p(b)(3)) is amended by inserting ‘‘hos-
pice and palliative nursing,’’ after ‘‘coordinated care,’’. 
(b) PALLIATIVE CARE
AND HOSPICE EDUCATION 
AND TRAINING PROGRAMS.—Part D of title VIII of the 
Public Health Service Act (42 U.S.C. 296p et seq.) is 
amended by adding at the end the following: 
‘‘SEC. 832. PALLIATIVE CARE AND HOSPICE EDUCATION 
AND TRAINING. 
‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties to develop and implement, in coordination with pro-
grams under section 759A, programs and initiatives to 
train and educate individuals in providing interprofes-
sional team-based palliative care in health-related edu-
cational, hospital, hospice, home, or long-term care set-
tings. 
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‘‘(b) USE OF FUNDS.—An eligible entity that receives 
a grant under subsection (a) shall use funds under such 
grant to— 
‘‘(1) provide training to individuals who will 
provide palliative care in health-related educational, 
hospital, home, hospice, or long-term care settings; 
‘‘(2) develop and disseminate curricula relating 
to palliative care in health-related educational, hos-
pital, home, hospice, or long-term care settings; 
‘‘(3) train faculty members in palliative care in 
health-related educational, hospital, home, hospice, 
or long-term care settings; or 
‘‘(4) provide continuing education to individuals 
who provide palliative care in health-related edu-
cational, home, hospice, or long-term care settings. 
‘‘(c) APPLICATION.—An eligible entity desiring a 
grant under subsection (a) shall submit an application to 
the Secretary at such time, in such manner, and con-
taining such information as the Secretary may reasonably 
require. 
‘‘(d) ELIGIBLE ENTITY.—For purposes of this sec-
tion, the term ‘eligible entity’ shall include a school of 
nursing, a health care facility, a program leading to cer-
tification as a certified nurse assistant, a partnership of 
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such a school and facility, or a partnership of such a pro-
gram and facility. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of the fiscal years 2026 through 
2030.’’. 
SEC. 4. DISSEMINATION OF PALLIATIVE CARE INFORMA-
TION. 
Part A of title IX of the Public Health Service Act 
(42 U.S.C. 299 et seq.) is amended by adding at the end 
the following new section: 
‘‘SEC. 904. DISSEMINATION OF PALLIATIVE CARE INFORMA-
TION. 
‘‘(a) IN GENERAL.—Under the authority under sec-
tion 902(a) to disseminate information on health care and 
on systems for the delivery of such care, the Director may 
disseminate information to inform patients, families, and 
health professionals about the benefits of palliative care 
throughout the continuum of care for patients with serious 
or life-threatening illness. 
‘‘(b) INFORMATION DISSEMINATED.— 
‘‘(1) MANDATORY INFORMATION.—If the Direc-
tor elects to disseminate information under sub-
section (a), such dissemination shall include the fol-
lowing: 
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