(1) The ability of the public health system to 
prevent, respond to, and recover from bioterrorism, 
acute outbreaks of infectious diseases, or other 
health threats and emergencies, and to prevent and 
reduce chronic disease, depends upon the existence 
of adequate numbers of well-trained public health 
professionals in Federal, State, local, and tribal pub-
lic health departments and health centers. 
(2) The public health system has an aging staff 
nearing retirement with no clear pipeline of highly 
skilled and capable employees to fill the void, with 
the average age of the State public health workforce 
at 47 years. 
(3) Retirement rates in some State public 
health agencies were as high as 20 percent as of 
June 2007, and projected to be as high as 45 per-
cent in 2009. 
(4) The ratio of public health workers to the 
population has dropped from 219 per 100,000 in 
1980 to 158 per 100,000 in 2000, while responsibil-
ities of such workers have continued to expand. 
(5) Public health nurses comprise the largest 
segment of the public health workforce. A study by 
the Institute of Medicine in 2003 identified nursing 
as facing one of the most severe shortages of public 
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health workers. The average age of public health 
nurses is nearly 50 years, with the leaders of State 
public health nursing averaging more than 30 years 
of service. In one State nearly 40 percent of the 
public health nursing workforce was eligible for re-
tirement as of June 2007. 
(6) According to the Association of State and 
Territorial Health Officials, most of the approxi-
mately 6,400 graduates from accredited schools of 
public health took jobs in the private sector in 2004. 
The Bureau of Labor Statistics projects that there 
will be an increase in private sector demand for 
highly educated graduates in scientific fields during 
the 10-year period ending in 2017. Public health 
agencies will have difficulty competing for those 
highly skilled scientists. 
(7) As of June 2007, approximately 42 percent 
of the epidemiology workforce in State and terri-
torial health departments lacked formal academic 
training in epidemiology. States have reported that 
approximately 47 percent more epidemiologists are 
needed to adequately prevent and control avian in-
fluenza and other emerging diseases. 
(8) The Partnership for Public Service reports 
that in the field of microbiology, there are more than 
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4 times as many full-time permanent employees over 
age 40 as under age 40 at the Centers for Disease 
Control and Prevention. Among full-time permanent 
employees with medical backgrounds at the Centers 
for Disease Control and Prevention and the Food 
and Drug Administration, there are 3 times as many 
employees over 40 years of age as under 40. 
(9) More than 50 percent of States cite the lack 
of qualified individuals or individuals willing to relo-
cate as being a major barrier to preparedness. A 
study conducted by the Health Resources and Serv-
ices Association reported difficulty with recruiting 
more educated, skilled public health providers to 
work in traditionally medically underserved areas, 
such as rural populations. Public health agencies 
continue to face an unmet need for public health 
workers who are bilingual and culturally competent. 
(10) Lack of access to advanced education, in-
cluding baccalaureate nursing and graduate studies, 
is a significant barrier to upgrading the existing 
public health workforce, particularly in rural areas. 
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SEC. 3. PUBLIC HEALTH WORKFORCE RECRUITMENT AND 
RETENTION PROGRAMS. 
Part E of title VII of the Public Health Service Act 
(42 U.S.C. 294n et seq.) is amended by adding at the end 
the following: 
‘‘Subpart 3—Public Health Workforce Recruitment 
and Retention Programs 
‘‘SEC. 780. PUBLIC HEALTH WORKFORCE SCHOLARSHIP 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Scholarship Program 
(referred to in this section as the ‘Program’) to assure 
an adequate supply of public health professionals to elimi-
nate critical public health workforce shortages in Federal, 
State, local, and tribal public health agencies and health 
centers. 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, 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 
or territory; and 
‘‘(B) in a course of study or program, of-
fered by such institution and approved by the 
Secretary, leading to a health professions de-
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gree (graduate, undergraduate, or associate) or 
certificate, which may include public health, 
laboratory 
sciences, 
epidemiology, 
environ-
mental health, health communications, health 
education and behavioral sciences, information 
sciences, or public administration; 
‘‘(2) be a United States citizen; 
‘‘(3) submit an application to the Secretary to 
participate in the Program; and 
‘‘(4) sign and submit to the Secretary, at the 
time of the submission of such application, a written 
contract (described in subsection (d)) to serve, upon 
the completion of the course of study or program in-
volved, for the applicable period of obligated service 
in the full-time employment of a Federal, State, 
local, or tribal public health agency or a health cen-
ter. 
‘‘(c) DISSEMINATION OF INFORMATION.— 
‘‘(1) APPLICATION
AND
CONTRACT
FORMS.— 
The Secretary shall disseminate application forms 
and contract forms to individuals desiring to partici-
pate in the Program. The Secretary shall include 
with such forms— 
‘‘(A) a fair summary of the rights and li-
abilities of an individual whose application is 
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approved (and whose contract is accepted) by 
the Secretary, including in the summary a clear 
explanation of the damages to which the United 
States is entitled in the case of the individual’s 
breach of the contract; and 
‘‘(B) information relating to the service ob-
ligation and such other information as may be 
necessary for the individual to understand the 
individual’s prospective participation in the Pro-
gram. 
‘‘(2) INFORMATION
FOR
SCHOOLS.—The Sec-
retary shall distribute to health professions schools 
and other appropriate accredited academic institu-
tions and relevant Federal, State, local, and tribal 
public health agencies, materials providing informa-
tion on the Program and shall encourage such 
schools, institutions, and agencies to disseminate 
such materials to potentially eligible students. 
‘‘(3) UNDERSTANDABILITY AND TIMING.—The 
application form, contract form, and all other infor-
mation furnished by the Secretary under this section 
shall— 
‘‘(A) be written in a manner calculated to 
be understood by the average individual apply-
ing to participate in the Program; and 
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‘‘(B) be made available by the Secretary on 
a date sufficiently early to ensure that such in-
dividuals have adequate time to carefully review 
and evaluate such forms and information. 
‘‘(d) CONTRACT.—The written contract between the 
Secretary and an individual shall contain— 
‘‘(1) an agreement on the part of the Secretary 
that the Secretary will provide the individual with a 
scholarship for a period of years (not to exceed 4 
academic years) during which the individual shall 
pursue an approved course of study or program to 
prepare the individual to serve in the public health 
workforce; 
‘‘(2) an agreement on the part of the individual 
that the individual will— 
‘‘(A) maintain full-time enrollment in the 
approved course of study or program described 
in subsection (b)(1) until the individual com-
pletes that course of study or program; 
‘‘(B) while enrolled in the course of study 
or program, maintain an acceptable level of aca-
demic standing (as determined under regula-
tions of the Secretary by the educational insti-
tution offering such course of study or pro-
gram); and 
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‘‘(C) immediately upon graduation, serve 
in the full-time employment of a Federal, State, 
local, or tribal public health agency or a health 
center in a position related to the course of 
study or program for which the contract was 
awarded for a period of time (referred to in this 
section as the ‘period of obligated service’) 
equal to the greater of— 
‘‘(i) 1 year for each academic year for 
which the individual was provided a schol-
arship under the Program; or 
‘‘(ii) 2 years; 
‘‘(3) an agreement by both parties as to the na-
ture and extent of the scholarship assistance, which 
may include— 
‘‘(A) payment of the tuition expenses of 
the individual; 
‘‘(B) payment of all other reasonable edu-
cational expenses of the individual including 
fees, books, equipment, and laboratory ex-
penses; and 
‘‘(C) payment of a stipend of not more 
than $1,200 per month for each month of the 
academic year involved (indexed to account for 
increases in the Consumer Price Index); 
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‘‘(4) a provision that any financial obligation of 
the United States arising out of a contract entered 
into under this subsection and any obligation of the 
individual which is conditioned thereon, is contingent 
upon funds being appropriated for scholarships 
under this section; 
‘‘(5) a statement of the damages to which the 
United States is entitled for the individual’s breach 
of the contract; and 
‘‘(6) such other statements of the rights and li-
abilities of the Secretary and of the individual, not 
inconsistent with the provisions of this section. 
‘‘(e) POSTPONING OBLIGATED SERVICE.—With re-
spect to an individual receiving a degree or certificate from 
a school of medicine, public health, nursing, osteopathic 
medicine, dentistry, veterinary medicine, optometry, po-
diatry, pharmacy, psychology, or social work under a 
scholarship under the Program, the date of the initiation 
of the period of obligated service may be postponed, upon 
the submission by the individual of a petition for such 
postponement and approval by the Secretary, to the date 
on which the individual completes an approved internship, 
residency, or other relevant public health advanced train-
ing program. 
‘‘(f) ADMINISTRATIVE PROVISIONS.— 
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‘‘(1) CONTRACTS
WITH
INSTITUTIONS.—The 
Secretary may contract with an educational institu-
tion in which a participant in the Program is en-
rolled, for the payment to the educational institution 
of the amounts of tuition and other reasonable edu-
cational expenses described in subsection (d)(3). 
‘‘(2) 
EMPLOYMENT
CEILINGS.—Notwith-
standing any other provision of law, individuals who 
have entered into written contracts with the Sec-
retary under this section, while undergoing academic 
training, shall not be counted against any employ-
ment ceiling affecting the Department or any other 
Federal agency. 
‘‘(g) BREACH
OF CONTRACT.—An individual who 
fails to comply with the contract entered into under sub-
section (d) shall be subject to the same financial penalties 
as provided for under section 338E for breaches of schol-
arship contracts under sections 338A. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$35,000,000 for each of the fiscal years 2010 through 
2015. 
‘‘(i) DEFINITION.—For purposes of this subpart, the 
term ‘health center’ has the meaning given such term in 
section 330(a). 
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