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from longitudinal evaluations (as described in 
subsection (d)(2)) on performance measures (as 
developed under sections 749(d)(3), 757(d)(3), 
and 762(a)(3)). 
‘‘(3) COLLABORATION AND DATA SHARING.— 
‘‘(A) IN
GENERAL.—The National Center 
shall collaborate with Federal agencies and rel-
evant professional and educational organizations 
or societies for the purpose of linking data re-
garding grants awarded under this title. 
‘‘(B) CONTRACTS FOR HEALTH WORKFORCE 
ANALYSIS.—For the purpose of carrying out the 
activities described in subparagraph (A), the Na-
tional Center may enter into contracts with rel-
evant professional and educational organizations 
or societies. 
‘‘(c) STATE AND REGIONAL CENTERS FOR HEALTH 
WORKFORCE ANALYSIS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants to, or enter into contracts with, eligible entities 
for purposes of— 
‘‘(A) collecting, analyzing, and reporting 
data regarding programs under this title to the 
National Center and to the public; and 
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‘‘(B) providing technical assistance to local 
and regional entities on the collection, analysis, 
and reporting of data. 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible for a 
grant or contract under this subsection, an entity 
shall— 
‘‘(A) be a State, a State workforce invest-
ment board, a public health or health professions 
school, an academic health center, or an appro-
priate public or private nonprofit entity; and 
‘‘(B) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(d) INCREASE IN GRANTS FOR LONGITUDINAL EVAL-
UATIONS.— 
‘‘(1) IN GENERAL.—The Secretary shall increase 
the amount awarded to an eligible entity under this 
title for a longitudinal evaluation of individuals who 
have received education, training, or financial assist-
ance from programs under this title. 
‘‘(2) CAPABILITY.—A longitudinal evaluation 
shall be capable of— 
‘‘(A) studying practice patterns; and 
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‘‘(B) collecting and reporting data on per-
formance measures developed under sections 
749(d)(3), 757(d)(3), and 762(a)(3). 
‘‘(3) GUIDELINES.—A longitudinal evaluation 
shall comply with guidelines issued under sections 
749(d)(4), 757(d)(4), and 762(a)(4). 
‘‘(4) ELIGIBLE ENTITIES.—To be eligible to ob-
tain an increase under this section, an entity shall be 
a recipient of a grant or contract under this title.’’; 
and 
(3) in subsection (e), as so redesignated— 
(A) by striking paragraph (1) and inserting 
the following: 
‘‘(1) IN GENERAL.— 
‘‘(A) NATIONAL
CENTER.—To carry out 
subsection (b), there are authorized to be appro-
priated $7,500,000 for each of fiscal years 2010 
through 2014. 
‘‘(B) STATE AND REGIONAL CENTERS.—To 
carry out subsection (c), there are authorized to 
be appropriated $4,500,000 for each of fiscal 
years 2010 through 2014. 
‘‘(C) GRANTS FOR LONGITUDINAL EVALUA-
TIONS.—To carry out subsection (d), there are 
authorized to be appropriated such sums as may 
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be necessary for fiscal years 2010 through 
2014.’’; and 
(4) in paragraph (2), by striking ‘‘subsection 
(a)’’ and inserting ‘‘paragraph (1)’’. 
(b) TRANSFERS.—Not later than 180 days after the 
date of enactment of this Act, the responsibilities and re-
sources of the National Center for Health Workforce Anal-
ysis, as in effect on the date before the date of enactment 
of this Act, shall be transferred to the National Center for 
Health Care Workforce Analysis established under section 
761 of the Public Health Service Act, as amended by sub-
section (a). 
(c) USE OF LONGITUDINAL EVALUATIONS.—Section 
791(a)(1) of the Public Health Service Act (42 U.S.C. 
295j(a)(1)) is amended— 
(1) in subparagraph (A), by striking ‘‘or’’ at the 
end; 
(2) in subparagraph (B), by striking the period 
and inserting ‘‘; or’’; and 
(3) by adding at the end the following: 
‘‘(C) utilizes a longitudinal evaluation (as 
described in section 761(d)(2)) and reports data 
from such system to the national workforce data-
base 
(as 
established 
under 
section 
761(b)(2)(E)).’’. 
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(d) PERFORMANCE MEASURES; GUIDELINES FOR LON-
GITUDINAL EVALUATIONS.— 
(1) ADVISORY COMMITTEE ON TRAINING IN PRI-
MARY
CARE
MEDICINE
AND
DENTISTRY.—Section 
748(d) of the Public Health Service Act is amended— 
(A) in paragraph (1), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (2), by striking the period 
and inserting a semicolon; and 
(C) by adding at the end the following: 
‘‘(3) develop, publish, and implement perform-
ance measures for programs under this part; 
‘‘(4) develop and publish guidelines for longitu-
dinal evaluations (as described in section 761(d)(2)) 
for programs under this part; and 
‘‘(5) recommend appropriation levels for pro-
grams under this part.’’. 
(2) ADVISORY
COMMITTEE
ON
INTERDISCIPLI-
NARY, COMMUNITY-BASED LINKAGES.—Section 756(d) 
of the Public Health Service Act is amended— 
(A) in paragraph (1), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (2), by striking the period 
and inserting a semicolon; and 
(C) by adding at the end the following: 
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‘‘(3) develop, publish, and implement perform-
ance measures for programs under this part; 
‘‘(4) develop and publish guidelines for longitu-
dinal evaluations (as described in section 761(d)(2)) 
for programs under this part; and 
‘‘(5) recommend appropriation levels for pro-
grams under this part.’’. 
(3) ADVISORY COUNCIL ON GRADUATE MEDICAL 
EDUCATION.—Section 762(a) of the Public Health 
Service Act (42 U.S.C. 294o(a)) is amended— 
(A) in paragraph (1), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (2), by striking the period 
and inserting a semicolon; and 
(C) by adding at the end the following: 
‘‘(3) develop, publish, and implement perform-
ance measures for programs under this title, except 
for programs under part C or D; 
‘‘(4) develop and publish guidelines for longitu-
dinal evaluations (as described in section 761(d)(2)) 
for programs under this title, except for programs 
under part C or D; and 
‘‘(5) recommend appropriation levels for pro-
grams under this title, except for programs under 
part C or D.’’. 
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Subtitle C—Increasing the Supply 
of the Health Care Workforce 
SEC. 5201. FEDERALLY SUPPORTED STUDENT LOAN FUNDS. 
(a) MEDICAL
SCHOOLS
AND
PRIMARY
HEALTH 
CARE.—Section 723 of the Public Health Service Act (42 
U.S.C. 292s) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by striking subpara-
graph (B) and inserting the following: 
‘‘(B) to practice in such care for 10 years 
(including residency training in primary health 
care) or through the date on which the loan is 
repaid in full, whichever occurs first.’’; and 
(B) by striking paragraph (3) and inserting 
the following: 
‘‘(3) 
NONCOMPLIANCE
BY
STUDENT.—Each 
agreement entered into with a student pursuant to 
paragraph (1) shall provide that, if the student fails 
to comply with such agreement, the loan involved will 
begin to accrue interest at a rate of 2 percent per 
year greater than the rate at which the student would 
pay if compliant in such year.’’; and 
(2) by adding at the end the following: 
‘‘(d) SENSE OF CONGRESS.—It is the sense of Congress 
that funds repaid under the loan program under this sec-
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tion should not be transferred to the Treasury of the United 
States or otherwise used for any other purpose other than 
to carry out this section.’’. 
(b) STUDENT LOAN GUIDELINES.—The Secretary of 
Health and Human Services shall not require parental fi-
nancial information for an independent student to deter-
mine financial need under section 723 of the Public Health 
Service Act (42 U.S.C. 292s) and the determination of need 
for such information shall be at the discretion of applicable 
school loan officer. The Secretary shall amend guidelines 
issued by the Health Resources and Services Administra-
tion in accordance with the preceding sentence. 
SEC. 5202. NURSING STUDENT LOAN PROGRAM. 
(a) LOAN AGREEMENTS.—Section 836(a) of the Public 
Health Service Act (42 U.S.C. 297b(a)) is amended— 
(1) by striking ‘‘$2,500’’ and inserting ‘‘$3,300’’; 
(2) by striking ‘‘$4,000’’ and inserting ‘‘$5,200’’; 
and 
(3) by striking ‘‘$13,000’’ and all that follows 
through the period and inserting ‘‘$17,000 in the case 
of any student during fiscal years 2010 and 2011. 
After fiscal year 2011, such amounts shall be adjusted 
to provide for a cost-of-attendance increase for the 
yearly loan rate and the aggregate of the loans.’’. 
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(b) LOAN PROVISIONS.—Section 836(b) of the Public 
Health Service Act (42 U.S.C. 297b(b)) is amended— 
(1) in paragraph (1)(C), by striking ‘‘1986’’ and 
inserting ‘‘2000’’; and 
(2) in paragraph (3), by striking ‘‘the date of en-
actment of the Nurse Training Amendments of 1979’’ 
and inserting ‘‘September 29, 1995’’. 
SEC. 5203. HEALTH CARE WORKFORCE LOAN REPAYMENT 
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—Recruitment and Retention Programs 
‘‘SEC. 
775. 
INVESTMENT 
IN 
TOMORROW’S 
PEDIATRIC 
HEALTH CARE WORKFORCE. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
and carry out a pediatric specialty loan repayment pro-
gram under which the eligible individual agrees to be em-
ployed full-time for a specified period (which shall not be 
less than 2 years) in providing pediatric medical sub-
specialty, pediatric surgical specialty, or child and adoles-
cent mental and behavioral health care, including substance 
abuse prevention and treatment services. 
‘‘(b) PROGRAM ADMINISTRATION.—Through the pro-
gram established under this section, the Secretary shall 
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enter into contracts with qualified health professionals 
under which— 
‘‘(1) such qualified health professionals will 
agree to provide pediatric medical subspecialty, pedi-
atric surgical specialty, or child and adolescent men-
tal and behavioral health care in an area with a 
shortage of the specified pediatric subspecialty that 
has a sufficient pediatric population to support such 
pediatric subspecialty, as determined by the Sec-
retary; and 
‘‘(2) the Secretary agrees to make payments on 
the principal and interest of undergraduate, grad-
uate, or graduate medical education loans of profes-
sionals described in paragraph (1) of not more than 
$35,000 a year for each year of agreed upon service 
under such paragraph for a period of not more than 
3 years during the qualified health professional’s— 
‘‘(A) participation in an accredited pedi-
atric medical subspecialty, pediatric surgical 
specialty, or child and adolescent mental health 
subspecialty residency or fellowship; or 
‘‘(B) employment as a pediatric medical 
subspecialist, pediatric surgical specialist, or 
child and adolescent mental health professional 
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serving an area or population described in such 
paragraph. 
‘‘(c) IN GENERAL.— 
‘‘(1) ELIGIBLE INDIVIDUALS.— 
‘‘(A) PEDIATRIC MEDICAL SPECIALISTS AND 
PEDIATRIC
SURGICAL
SPECIALISTS.—For pur-
poses of contracts with respect to pediatric med-
ical specialists and pediatric surgical specialists, 
the term ‘qualified health professional’ means a 
licensed physician who— 
‘‘(i) is entering or receiving training 
in an accredited pediatric medical sub-
specialty or pediatric surgical specialty 
residency or fellowship; or 
‘‘(ii) has completed (but not prior to 
the end of the calendar year in which this 
section is enacted) the training described in 
subparagraph (B). 
‘‘(B) CHILD AND ADOLESCENT MENTAL AND 
BEHAVIORAL
HEALTH.—For purposes of con-
tracts with respect to child and adolescent men-
tal and behavioral health care, the term ‘quali-
fied health professional’ means a health care pro-
fessional who— 
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‘‘(i) has received specialized training 
or clinical experience in child and adoles-
cent mental health in psychiatry, psy-
chology, school psychology, behavioral pedi-
atrics, psychiatric nursing, social work, 
school social work, substance abuse disorder 
prevention and treatment, marriage and 
family therapy, school counseling, or profes-
sional counseling; 
‘‘(ii) has a license or certification in a 
State to practice allopathic medicine, osteo-
pathic medicine, psychology, school psy-
chology, psychiatric nursing, social work, 
school social work, marriage and family 
therapy, school counseling, or professional 
counseling; or 
‘‘(iii) is a mental health service profes-
sional who completed (but not before the end 
of the calendar year in which this section is 
enacted) specialized training or clinical ex-
perience in child and adolescent mental 
health described in clause (i). 
‘‘(2) ADDITIONAL ELIGIBILITY REQUIREMENTS.— 
The Secretary may not enter into a contract under 
this subsection with an eligible individual unless— 
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‘‘(A) the individual agrees to work in, or for 
a provider serving, a health professional shortage 
area or medically underserved area, or to serve 
a medically underserved population; 
‘‘(B) the individual is a United States cit-
izen or a permanent legal United States resident; 
and 
‘‘(C) if the individual is enrolled in a grad-
uate program, the program is accredited, and the 
individual has an acceptable level of academic 
standing (as determined by the Secretary). 
‘‘(d) PRIORITY.—In entering into contracts under this 
subsection, the Secretary shall give priority to applicants 
who— 
‘‘(1) are or will be working in a school or other 
pre-kindergarten, elementary, or secondary education 
setting; 
‘‘(2) have familiarity with evidence-based meth-
ods and cultural and linguistic competence health 
care services; and 
‘‘(3) demonstrate financial need. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $30,000,000 for each of fiscal 
years 2010 through 2014 to carry out subsection (c)(1)(A) 
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and $20,000,000 for each of fiscal years 2010 through 2013 
to carry out subsection (c)(1)(B).’’. 
SEC. 5204. 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.), as amended by section 5203, is 
further amended by adding at the end the following: 
‘‘SEC. 776. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
the Public Health Workforce Loan Repayment Program (re-
ferred to in this section as the ‘Program’) to assure an ade-
quate supply of public health professionals to eliminate crit-
ical public health workforce shortages in Federal, State, 
local, and tribal public health agencies. 
‘‘(b) ELIGIBILITY.—To be eligible to participate in the 
Program, an individual shall— 
‘‘(1)(A) be accepted for enrollment, or be en-
rolled, as a student in an accredited academic edu-
cational institution in a State or territory in the 
final year of a course of study or program leading to 
a public health or health professions degree or certifi-
cate; and have accepted employment with a Federal, 
State, local, or tribal public health agency, or a re-
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lated training fellowship, as recognized by the Sec-
retary, to commence upon graduation; 
‘‘(B)(i) have graduated, during the preceding 10- 
year period, from an accredited educational institu-
tion in a State or territory and received a public 
health or health professions degree or certificate; and 
‘‘(ii) be employed by, or have accepted employ-
ment with, a Federal, State, local, or tribal public 
health agency or a related training fellowship, as rec-
ognized by the Secretary; 
‘‘(2) be a United States citizen; and 
‘‘(3)(A) submit an application to the Secretary 
to participate in the Program; 
‘‘(B) execute a written contract as required in 
subsection (c); and 
‘‘(4) not have received, for the same service, a re-
duction of loan obligations under section 455(m), 
428J, 428K, 428L, or 460 of the Higher Education 
Act of 1965. 
‘‘(c) CONTRACT.—The written contract (referred to in 
this section as the ‘written contract’) between the Secretary 
and an individual shall contain— 
‘‘(1) an agreement on the part of the Secretary 
that the Secretary will repay on behalf of the indi-
vidual loans incurred by the individual in the pur-
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suit of the relevant degree or certificate in accordance 
with the terms of the contract; 
‘‘(2) an agreement on the part of the individual 
that the individual will serve in the full-time employ-
ment of a Federal, State, local, or tribal public health 
agency or a related fellowship program in a position 
related to the course of study or program for which 
the contract was awarded for a period of time (re-
ferred to in this section as the ‘period of obligated 
service’) equal to the greater of— 
‘‘(A) 3 years; or 
‘‘(B) such longer period of time as deter-
mined appropriate by the Secretary and the in-
dividual; 
‘‘(3) an agreement, as appropriate, on the part 
of the individual to relocate to a priority service area 
(as determined by the Secretary) in exchange for an 
additional loan repayment incentive amount to be de-
termined by the Secretary; 
‘‘(4) 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 indi-
vidual that is conditioned thereon, is contingent on 
funds being appropriated for loan repayments under 
this section; 
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‘‘(5) a statement of the damages to which the 
United States is entitled, under this section 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 this section. 
‘‘(d) PAYMENTS.— 
‘‘(1) IN GENERAL.—A loan repayment provided 
for an individual under a written contract under the 
Program shall consist of payment, in accordance with 
paragraph (2), on behalf of the individual of the prin-
cipal, interest, and related expenses on government 
and commercial loans received by the individual re-
garding the undergraduate or graduate education of 
the individual (or both), which loans were made for 
tuition expenses incurred by the individual. 
‘‘(2) PAYMENTS FOR YEARS SERVED.—For each 
year of obligated service that an individual contracts 
to serve under subsection (c) the Secretary may pay 
up to $35,000 on behalf of the individual for loans de-
scribed in paragraph (1). With respect to participants 
under the Program whose total eligible loans are less 
than $105,000, the Secretary shall pay an amount 
that does not exceed 1⁄3 of the eligible loan balance for 
each year of obligated service of the individual. 
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‘‘(3) TAX LIABILITY.—For the purpose of pro-
viding reimbursements for tax liability resulting from 
payments under paragraph (2) on behalf of an indi-
vidual, the Secretary shall, in addition to such pay-
ments, make payments to the individual in an 
amount not to exceed 39 percent of the total amount 
of loan repayments made for the taxable year in-
volved. 
‘‘(e) POSTPONING OBLIGATED SERVICE.—With respect 
to an individual receiving a degree or certificate from a 
health professions or other related school, the date of the ini-
tiation of the period of obligated service may be postponed 
as approved by the Secretary. 
‘‘(f) BREACH OF CONTRACT.—An individual who fails 
to comply with the contract entered into under subsection 
(c) shall be subject to the same financial penalties as pro-
vided for under section 338E for breaches of loan repayment 
contracts under section 338B. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$195,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of fiscal years 2011 through 2015.’’. 
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SEC. 5205. ALLIED HEALTH WORKFORCE RECRUITMENT 
AND RETENTION PROGRAMS. 
(a) PURPOSE.—The purpose of this section is to assure 
an adequate supply of allied health professionals to elimi-
nate critical allied health workforce shortages in Federal, 
State, local, and tribal public health agencies or in settings 
where patients might require health care services, including 
acute care facilities, ambulatory care facilities, personal 
residences and other settings, as recognized by the Secretary 
of Health and Human Services by authorizing an Allied 
Health Loan Forgiveness Program. 
(b) ALLIED HEALTH WORKFORCE RECRUITMENT AND 
RETENTION PROGRAM.—Section 428K of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1078–11) is amended— 
(1) in subsection (b), by adding at the end the 
following: 
‘‘(18) ALLIED
HEALTH
PROFESSIONALS.—The 
individual is employed full-time as an allied health 
professional— 
‘‘(A) in a Federal, State, local, or tribal 
public health agency; or 
‘‘(B) in a setting where patients might re-
quire health care services, including acute care 
facilities, ambulatory care facilities, personal 
residences and other settings located in health 
professional shortage areas, medically under-
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served areas, or medically underserved popu-
lations, as recognized by the Secretary of Health 
and Human Services.’’; and 
(2) in subsection (g)— 
(A) 
by 
redesignating 
paragraphs 
(1) 
through (9) as paragraphs (2) through (10), re-
spectively; and 
(B) by inserting before paragraph (2) (as 
redesignated by subparagraph (A)) the following: 
‘‘(1) ALLIED HEALTH PROFESSIONAL.—The term 
‘allied health professional’ means an allied health 
professional as defined in section 799B(5) of the Pub-
lic Heath Service Act (42 U.S.C. 295p(5)) who— 
‘‘(A) has graduated and received an allied 
health professions degree or certificate from an 
institution of higher education; and 
‘‘(B) is employed with a Federal, State, 
local or tribal public health agency, or in a set-
ting where patients might require health care 
services, including acute care facilities, ambula-
tory care facilities, personal residences and other 
settings located in health professional shortage 
areas, medically underserved areas, or medically 
underserved populations, as recognized by the 
Secretary of Health and Human Services.’’. 
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SEC. 5206. GRANTS FOR STATE AND LOCAL PROGRAMS. 
(a) IN GENERAL.—Section 765(d) of the Public Health 
Service Act (42 U.S.C. 295(d)) is amended— 
(1) in paragraph (7), by striking ‘‘; or’’ and in-
serting a semicolon; 
(2) by redesignating paragraph (8) as para-
graph (9); and 
(3) by inserting after paragraph (7) the fol-
lowing: 
‘‘(8) public health workforce loan repayment pro-
grams; or’’. 
(b) TRAINING FOR MID-CAREER PUBLIC HEALTH PRO-
FESSIONALS.—Part E of title VII of the Public Health Serv-
ice Act (42 U.S.C. 294n et seq.), as amended by section 
5204, is further amended by adding at the end the fol-
lowing: 
‘‘SEC. 777. TRAINING FOR MID-CAREER PUBLIC AND ALLIED 
HEALTH PROFESSIONALS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to, or enter into contracts with, any eligible entity to award 
scholarships to eligible individuals to enroll in degree or 
professional training programs for the purpose of enabling 
mid-career professionals in the public health and allied 
health workforce to receive additional training in the field 
of public health and allied health. 
‘‘(b) ELIGIBILITY.— 
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‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible enti-
ty’ indicates an accredited educational institution 
that offers a course of study, certificate program, or 
professional training program in public or allied 
health or a related discipline, as determined by the 
Secretary 
‘‘(2) ELIGIBLE INDIVIDUALS.—The term ‘eligible 
individuals’ includes those individuals employed in 
public and allied health positions at the Federal, 
State, tribal, or local level who are interested in re-
taining or upgrading their education. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$60,000,000 for fiscal year 2010 and such sums as may be 
necessary for each of fiscal years 2011 through 2015. Fifty 
percent of appropriated funds shall be allotted to public 
health mid-career professionals and 50 percent shall be al-
lotted to allied health mid-career professionals.’’. 
SEC. 5207. FUNDING FOR NATIONAL HEALTH SERVICE 
CORPS. 
Section 338H(a) of the Public Health Service Act (42 
U.S.C. 254q(a)) is amended to read as follows: 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized to 
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be appropriated, out of any funds in the Treasury not oth-
erwise appropriated, the following: 
‘‘(1) For fiscal year 2010, $320,461,632. 
‘‘(2) For fiscal year 2011, $414,095,394. 
‘‘(3) For fiscal year 2012, $535,087,442. 
‘‘(4) For fiscal year 2013, $691,431,432. 
‘‘(5) For fiscal year 2014, $893,456,433. 
‘‘(6) For fiscal year 2015, $1,154,510,336. 
‘‘(7) For fiscal year 2016, and each subsequent 
fiscal year, the amount appropriated for the pre-
ceding fiscal year adjusted by the product of— 
‘‘(A) one plus the average percentage in-
crease in the costs of health professions education 
during the prior fiscal year; and 
‘‘(B) one plus the average percentage change 
in the number of individuals residing in health 
professions shortage areas designated under sec-
tion 333 during the prior fiscal year, relative to 
the number of individuals residing in such areas 
during the previous fiscal year.’’. 
SEC. 5208. NURSE-MANAGED HEALTH CLINICS. 
(a) PURPOSE.—The purpose of this section is to fund 
the development and operation of nurse-managed health 
clinics. 
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(b) GRANTS.—Subpart 1 of part D of title III of the 
Public Health Service Act (42 U.S.C. 254b et seq.) is 
amended by inserting after section 330A the following: 
‘‘SEC. 330A–1. GRANTS TO NURSE–MANAGED HEALTH CLIN-
ICS. 
‘‘(a) DEFINITIONS.— 
‘‘(1) COMPREHENSIVE
PRIMARY
HEALTH
CARE 
SERVICES.—In this section, the term ‘comprehensive 
primary health care services’ means the primary 
health services described in section 330(b)(1). 
‘‘(2) NURSE-MANAGED
HEALTH
CLINIC.—The 
term ‘nurse-managed health clinic’ means a nurse- 
practice arrangement, managed by advanced practice 
nurses, that provides primary care or wellness serv-
ices to underserved or vulnerable populations and 
that is associated with a school, college, university or 
department of nursing, federally qualified health cen-
ter, or independent nonprofit health or social services 
agency. 
‘‘(b) AUTHORITY TO AWARD GRANTS.—The Secretary 
shall award grants for the cost of the operation of nurse- 
managed health clinics that meet the requirements of this 
section. 
‘‘(c) APPLICATIONS.—To be eligible to receive a grant 
under this section, an entity shall— 
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‘‘(1) be an NMHC; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing— 
‘‘(A) assurances that nurses are the major 
providers of services at the NMHC and that at 
least 1 advanced practice nurse holds an execu-
tive management position within the organiza-
tional structure of the NMHC; 
‘‘(B) an assurance that the NMHC will con-
tinue providing comprehensive primary health 
care services or wellness services without regard 
to income or insurance status of the patient for 
the duration of the grant period; and 
‘‘(C) an assurance that, not later than 90 
days of receiving a grant under this section, the 
NMHC will establish a community advisory 
committee, for which a majority of the members 
shall be individuals who are served by the 
NMHC. 
‘‘(d) GRANT AMOUNT.—The amount of any grant 
made under this section for any fiscal year shall be deter-
mined by the Secretary, taking into account— 
‘‘(1) the financial need of the NMHC, consid-
ering State, local, and other operational funding pro-
vided to the NMHC; and 
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‘‘(2) other factors, as the Secretary determines 
appropriate. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purposes of carrying out this section, there are authorized 
to be appropriated $50,000,000 for the fiscal year 2010 and 
such sums as may be necessary for each of the fiscal years 
2011 through 2014.’’. 
SEC. 5209. ELIMINATION OF CAP ON COMMISSIONED 
CORPS. 
Section 202 of the Department of Health and Human 
Services Appropriations Act, 1993 (Public Law 102–394) 
is amended by striking ‘‘not to exceed 2,800’’. 
SEC. 5210. ESTABLISHING A READY RESERVE CORPS. 
Section 203 of the Public Health Service Act (42 
U.S.C. 204) is amended to read as follows: 
‘‘SEC. 203. COMMISSIONED CORPS AND READY RESERVE 
CORPS. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—There shall be in the Service 
a commissioned Regular Corps and a Ready Reserve 
Corps for service in time of national emergency. 
‘‘(2) REQUIREMENT.—All commissioned officers 
shall be citizens of the United States and shall be ap-
pointed without regard to the civil-service laws and 
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compensated without regard to the Classification Act 
of 1923, as amended. 
‘‘(3) APPOINTMENT.—Commissioned officers of 
the Ready Reserve Corps shall be appointed by the 
President and commissioned officers of the Regular 
Corps shall be appointed by the President with the 
advice and consent of the Senate. 
‘‘(4) ACTIVE DUTY.—Commissioned officers of the 
Ready Reserve Corps shall at all times be subject to 
call to active duty by the Surgeon General, including 
active duty for the purpose of training. 
‘‘(5) WARRANT
OFFICERS.—Warrant officers 
may be appointed to the Service for the purpose of 
providing support to the health and delivery systems 
maintained by the Service and any warrant officer 
appointed to the Service shall be considered for pur-
poses of this Act and title 37, United States Code, to 
be a commissioned officer within the Commissioned 
Corps of the Service. 
‘‘(b) ASSIMILATING RESERVE CORP OFFICERS INTO 
THE REGULAR CORPS.—Effective on the date of enactment 
of the Patient Protection and Affordable Care Act, all indi-
viduals classified as officers in the Reserve Corps under this 
section (as such section existed on the day before the date 
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of enactment of such Act) and serving on active duty shall 
be deemed to be commissioned officers of the Regular Corps. 
‘‘(c) PURPOSE AND USE OF READY RESEARCH.— 
‘‘(1) PURPOSE.—The purpose of the Ready Re-
serve Corps is to fulfill the need to have additional 
Commissioned Corps personnel available on short no-
tice (similar to the uniformed service’s reserve pro-
gram) to assist regular Commissioned Corps per-
sonnel to meet both routine public health and emer-
gency response missions. 
‘‘(2) USES.—The Ready Reserve Corps shall— 
‘‘(A) participate in routine training to meet 
the general and specific needs of the Commis-
sioned Corps; 
‘‘(B) be available and ready for involuntary 
calls to active duty during national emergencies 
and public health crises, similar to the uni-
formed service reserve personnel; 
‘‘(C) be available for backfilling critical po-
sitions left vacant during deployment of active 
duty Commissioned Corps members, as well as 
for deployment to respond to public health emer-
gencies, both foreign and domestic; and 
‘‘(D) be available for service assignment in 
isolated, hardship, and medically underserved 
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communities (as defined in section 799B) to im-
prove access to health services. 
‘‘(d) FUNDING.—For the purpose of carrying out the 
duties and responsibilities of the Commissioned Corps 
under this section, there are authorized to be appropriated 
$5,000,000 for each of fiscal years 2010 through 2014 for 
recruitment and training and $12,500,000 for each of fiscal 
years 2010 through 2014 for the Ready Reserve Corps.’’. 
Subtitle D—Enhancing Health Care 
Workforce Education and Training 
SEC. 5301. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
AND PHYSICIAN ASSISTANTSHIP. 
Part C of title VII (42 U.S.C. 293k et seq.) is amended 
by striking section 747 and inserting the following: 
‘‘SEC. 747. PRIMARY CARE TRAINING AND ENHANCEMENT. 
‘‘(a) SUPPORT AND DEVELOPMENT OF PRIMARY CARE 
TRAINING PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary may make 
grants to, or enter into contracts with, an accredited 
public or nonprofit private hospital, school of medi-
cine or osteopathic medicine, academically affiliated 
physician assistant training program, or a public or 
private nonprofit entity which the Secretary has de-
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termined is capable of carrying out such grant or 
contract— 
‘‘(A) to plan, develop, operate, or partici-
pate in an accredited professional training pro-
gram, including an accredited residency or in-
ternship program in the field of family medicine, 
general internal medicine, or general pediatrics 
for medical students, interns, residents, or prac-
ticing physicians as defined by the Secretary; 
‘‘(B) to provide need-based financial assist-
ance in the form of traineeships and fellowships 
to medical students, interns, residents, practicing 
physicians, or other medical personnel, who are 
participants in any such program, and who 
plan to specialize or work in the practice of the 
fields defined in subparagraph (A); 
‘‘(C) to plan, develop, and operate a pro-
gram for the training of physicians who plan to 
teach in family medicine, general internal medi-
cine, or general pediatrics training programs; 
‘‘(D) to plan, develop, and operate a pro-
gram for the training of physicians teaching in 
community-based settings; 
‘‘(E) to provide financial assistance in the 
form of traineeships and fellowships to physi-
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cians who are participants in any such pro-
grams and who plan to teach or conduct research 
in a family medicine, general internal medicine, 
or general pediatrics training program; 
‘‘(F) to plan, develop, and operate a physi-
cian assistant education program, and for the 
training of individuals who will teach in pro-
grams to provide such training; 
‘‘(G) to plan, develop, and operate a dem-
onstration program that provides training in 
new competencies, as recommended by the Advi-
sory Committee on Training in Primary Care 
Medicine and Dentistry and the National Health 
Care Workforce Commission established in sec-
tion 5101 of the Patient Protection and Afford-
able Care Act, which may include— 
‘‘(i) providing training to primary 
care physicians relevant to providing care 
through patient-centered medical homes (as 
defined by the Secretary for purposes of this 
section); 
‘‘(ii) developing tools and curricula 
relevant to patient-centered medical homes; 
and 
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‘‘(iii) providing continuing education 
to primary care physicians relevant to pa-
tient-centered medical homes; and 
‘‘(H) to plan, develop, and operate joint de-
gree programs to provide interdisciplinary and 
interprofessional graduate training in public 
health and other health professions to provide 
training in environmental health, infectious dis-
ease control, disease prevention and health pro-
motion, epidemiological studies and injury con-
trol. 
‘‘(2) DURATION OF AWARDS.—The period during 
which payments are made to an entity from an 
award of a grant or contract under this subsection 
shall be 5 years. 
‘‘(b) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN
GENERAL.—The Secretary may make 
grants to or enter into contracts with accredited 
schools of medicine or osteopathic medicine to estab-
lish, maintain, or improve— 
‘‘(A) academic units or programs that im-
prove clinical teaching and research in fields de-
fined in subsection (a)(1)(A); or 
‘‘(B) programs that integrate academic ad-
ministrative units in fields defined in subsection 
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(a)(1)(A) to enhance interdisciplinary recruit-
ment, training, and faculty development. 
‘‘(2) PREFERENCE IN MAKING AWARDS UNDER 
THIS SUBSECTION.—In making awards of grants and 
contracts under paragraph (1), the Secretary shall 
give preference to any qualified applicant for such an 
award that agrees to expend the award for the pur-
pose of— 
‘‘(A) establishing academic units or pro-
grams in fields defined in subsection (a)(1)(A); 
or 
‘‘(B) substantially expanding such units or 
programs. 
‘‘(3) 
PRIORITIES
IN
MAKING
AWARDS.—In 
awarding grants or contracts under paragraph (1), 
the Secretary shall give priority to qualified appli-
cants that— 
‘‘(A) proposes a collaborative project be-
tween academic administrative units of primary 
care; 
‘‘(B) proposes innovative approaches to 
clinical teaching using models of primary care, 
such as the patient centered medical home, team 
management of chronic disease, and interprofes-
sional integrated models of health care that in-
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corporate transitions in health care settings and 
integration physical and mental health provi-
sion; 
‘‘(C) have a record of training the greatest 
percentage of providers, or that have dem-
onstrated significant improvements in the per-
centage of providers trained, who enter and re-
main in primary care practice; 
‘‘(D) have a record of training individuals 
who are from underrepresented minority groups 
or from a rural or disadvantaged background; 
‘‘(E) provide training in the care of vulner-
able populations such as children, older adults, 
homeless individuals, victims of abuse or trau-
ma, individuals with mental health or substance- 
related disorders, individuals with HIV/AIDS, 
and individuals with disabilities; 
‘‘(F) establish formal relationships and sub-
mit joint applications with federally qualified 
health centers, rural health clinics, area health 
education centers, or clinics located in under-
served areas or that serve underserved popu-
lations; 
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‘‘(G) teach trainees the skills to provide 
interprofessional, integrated care through col-
laboration among health professionals; 
‘‘(H) provide training in enhanced commu-
nication with patients, evidence-based practice, 
chronic disease management, preventive care, 
health information technology, or other com-
petencies as recommended by the Advisory Com-
mittee on Training in Primary Care Medicine 
and Dentistry and the National Health Care 
Workforce Commission established in section 
5101 of the Patient Protection and Affordable 
Care Act; or 
‘‘(I) provide training in cultural com-
petency and health literacy. 
‘‘(4) DURATION OF AWARDS.—The period during 
which payments are made to an entity from an 
award of a grant or contract under this subsection 
shall be 5 years. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—For purposes of carrying out 
this section (other than subsection (b)(1)(B)), there 
are authorized to be appropriated $125,000,000 for 
fiscal year 2010, and such sums as may be necessary 
for each of fiscal years 2011 through 2014. 
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‘‘(2) TRAINING
PROGRAMS.—Fifteen percent of 
the amount appropriated pursuant to paragraph (1) 
in each such fiscal year shall be allocated to the phy-
sician assistant training programs described in sub-
section (a)(1)(F), which prepare students for practice 
in primary care. 
‘‘(3) INTEGRATING
ACADEMIC
ADMINISTRATIVE 
UNITS.—For purposes of carrying out subsection 
(b)(1)(B), there are authorized to be appropriated 
$750,000 for each of fiscal years 2010 through 2014.’’. 
SEC. 5302. TRAINING OPPORTUNITIES FOR DIRECT CARE 
WORKERS. 
Part C of title VII of the Public Health Service Act 
(42 U.S.C. 293k et seq.) is amended by inserting after sec-
tion 747, as amended by section 5301, the following: 
‘‘SEC. 747A. TRAINING OPPORTUNITIES FOR DIRECT CARE 
WORKERS. 
‘‘(a) IN GENERAL.—The Secretary shall award grants 
to eligible entities to enable such entities to provide new 
training opportunities for direct care workers who are em-
ployed in long-term care settings such as nursing homes (as 
defined in section 1908(e)(1) of the Social Security Act (42 
U.S.C. 1396g(e)(1)), assisted living facilities and skilled 
nursing facilities, intermediate care facilities for individ-
uals with mental retardation, home and community based 
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settings, and any other setting the Secretary determines to 
be appropriate. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an entity shall— 
‘‘(1) be an institution of higher education (as de-
fined in section 102 of the Higher Education Act of 
1965 (20 U.S.C. 1002)) that— 
‘‘(A) is accredited by a nationally recog-
nized accrediting agency or association listed 
under section 101(c) of the Higher Education 
Act of 1965 (20 U.S.C. 1001(c)); and 
‘‘(B) has established a public-private edu-
cational partnership with a nursing home or 
skilled nursing facility, agency or entity pro-
viding home and community based services to 
individuals with disabilities, or other long-term 
care provider; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
‘‘(c) USE OF FUNDS.—An eligible entity shall use 
amounts awarded under a grant under this section to pro-
vide assistance to eligible individuals to offset the cost of 
tuition and required fees for enrollment in academic pro-
grams provided by such entity. 
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‘‘(d) ELIGIBLE INDIVIDUAL.— 
‘‘(1) ELIGIBILITY.—To be eligible for assistance 
under this section, an individual shall be enrolled in 
courses provided by a grantee under this subsection 
and maintain satisfactory academic progress in such 
courses. 
‘‘(2) CONDITION OF ASSISTANCE.—As a condi-
tion of receiving assistance under this section, an in-
dividual shall agree that, following completion of the 
assistance period, the individual will work in the 
field of geriatrics, disability services, long term serv-
ices and supports, or chronic care management for a 
minimum of 2 years under guidelines set by the Sec-
retary. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$10,000,000 for the period of fiscal years 2011 through 
2013.’’. 
SEC. 5303. TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC 
HEALTH DENTISTRY. 
Part C of Title VII of the Public Health Service Act 
(42 U.S.C. 293k et seq.) is amended by— 
(1) redesignating section 748, as amended by sec-
tion 5103 of this Act, as section 749; and 
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(2) inserting after section 747A, as added by sec-
tion 5302, the following: 
‘‘SEC. 748. TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC 
HEALTH DENTISTRY. 
‘‘(a) SUPPORT AND DEVELOPMENT OF DENTAL TRAIN-
ING PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary may make 
grants to, or enter into contracts with, a school of 
dentistry, public or nonprofit private hospital, or a 
public or private nonprofit entity which the Secretary 
has determined is capable of carrying out such grant 
or contract— 
‘‘(A) to plan, develop, and operate, or par-
ticipate in, an approved professional training 
program in the field of general dentistry, pedi-
atric dentistry, or public health dentistry for 
dental students, residents, practicing dentists, 
dental hygienists, or other approved primary 
care dental trainees, that emphasizes training for 
general, pediatric, or public health dentistry; 
‘‘(B) to provide financial assistance to den-
tal students, residents, practicing dentists, and 
dental hygiene students who are in need thereof, 
who are participants in any such program, and 
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who plan to work in the practice of general, pe-
diatric, public heath dentistry, or dental hygiene; 
‘‘(C) to plan, develop, and operate a pro-
gram for the training of oral health care pro-
viders who plan to teach in general, pediatric, 
public health dentistry, or dental hygiene; 
‘‘(D) to provide financial assistance in the 
form of traineeships and fellowships to dentists 
who plan to teach or are teaching in general, pe-
diatric, or public health dentistry; 
‘‘(E) to meet the costs of projects to estab-
lish, maintain, or improve dental faculty devel-
opment programs in primary care (which may 
be departments, divisions or other units); 
‘‘(F) to meet the costs of projects to estab-
lish, maintain, or improve predoctoral and 
postdoctoral training in primary care programs; 
‘‘(G) to create a loan repayment program 
for faculty in dental programs; and 
‘‘(H) to provide technical assistance to pedi-
atric training programs in developing and im-
plementing instruction regarding the oral health 
status, dental care needs, and risk-based clinical 
disease management of all pediatric populations 
with an emphasis on underserved children. 
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‘‘(2) FACULTY LOAN REPAYMENT.— 
‘‘(A) IN
GENERAL.—A grant or contract 
under subsection (a)(1)(G) may be awarded to a 
program of general, pediatric, or public health 
dentistry described in such subsection to plan, 
develop, and operate a loan repayment program 
under which— 
‘‘(i) individuals agree to serve full-time 
as faculty members; and 
‘‘(ii) the program of general, pediatric 
or public health dentistry agrees to pay the 
principal and interest on the outstanding 
student loans of the individuals. 
‘‘(B) MANNER OF PAYMENTS.—With respect 
to the payments described in subparagraph 
(A)(ii), upon completion by an individual of 
each of the first, second, third, fourth, and fifth 
years of service, the program shall pay an 
amount equal to 10, 15, 20, 25, and 30 percent, 
respectively, of the individual’s student loan bal-
ance as calculated based on principal and inter-
est owed at the initiation of the agreement. 
‘‘(b) ELIGIBLE ENTITY.—For purposes of this sub-
section, entities eligible for such grants or contracts in gen-
eral, pediatric, or public health dentistry shall include enti-
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ties that have programs in dental or dental hygiene schools, 
or approved residency or advanced education programs in 
the practice of general, pediatric, or public health dentistry. 
Eligible entities may partner with schools of public health 
to permit the education of dental students, residents, and 
dental hygiene students for a master’s year in public health 
at a school of public health. 
‘‘(c) PRIORITIES IN MAKING AWARDS.—With respect 
to training provided for under this section, the Secretary 
shall give priority in awarding grants or contracts to the 
following: 
‘‘(1) Qualified applicants that propose collabo-
rative projects between departments of primary care 
medicine and departments of general, pediatric, or 
public health dentistry. 
‘‘(2) Qualified applicants that have a record of 
training the greatest percentage of providers, or that 
have demonstrated significant improvements in the 
percentage of providers, who enter and remain in gen-
eral, pediatric, or public health dentistry. 
‘‘(3) Qualified applicants that have a record of 
training individuals who are from a rural or dis-
advantaged background, or from underrepresented mi-
norities. 
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‘‘(4) Qualified applicants that establish formal 
relationships with Federally qualified health centers, 
rural health centers, or accredited teaching facilities 
and that conduct training of students, residents, fel-
lows, or faculty at the center or facility. 
‘‘(5) Qualified applicants that conduct teaching 
programs targeting vulnerable populations such as 
older adults, homeless individuals, victims of abuse or 
trauma, individuals with mental health or substance- 
related disorders, individuals with disabilities, and 
individuals with HIV/AIDS, and in the risk-based 
clinical disease management of all populations. 
‘‘(6) Qualified applicants that include edu-
cational activities in cultural competency and health 
literacy. 
‘‘(7) Qualified applicants that have a high rate 
for placing graduates in practice settings that serve 
underserved areas or health disparity populations, or 
who achieve a significant increase in the rate of plac-
ing graduates in such settings. 
‘‘(8) Qualified applicants that intend to establish 
a special populations oral health care education cen-
ter or training program for the didactic and clinical 
education of dentists, dental health professionals, and 
dental hygienists who plan to teach oral health care 
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for people with developmental disabilities, cognitive 
impairment, complex medical problems, significant 
physical limitations, and vulnerable elderly. 
‘‘(d) APPLICATION.—An eligible entity desiring a 
grant under this section shall submit to the Secretary an 
application at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(e) DURATION OF AWARD.—The period during which 
payments are made to an entity from an award of a grant 
or contract under subsection (a) shall be 5 years. The provi-
sion of such payments shall be subject to annual approval 
by the Secretary and subject to the availability of appro-
priations for the fiscal year involved to make the payments. 
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the 
purpose of carrying out subsections (a) and (b), there is 
authorized to be appropriated $30,000,000 for fiscal year 
2010 and such sums as may be necessary for each of fiscal 
years 2011 through 2015. 
‘‘(g) CARRYOVER FUNDS.—An entity that receives an 
award under this section may carry over funds from 1 fiscal 
year to another without obtaining approval from the Sec-
retary. In no case may any funds be carried over pursuant 
to the preceding sentence for more than 3 years.’’. 
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SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PRO-
VIDERS DEMONSTRATION PROJECT. 
Subpart X of part D of title III of the Public Health 
Service Act (42 U.S.C. 256f et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 340G–1. DEMONSTRATION PROGRAM. 
‘‘(a) IN GENERAL.— 
‘‘(1) AUTHORIZATION.—The Secretary is author-
ized to award grants to 15 eligible entities to enable 
such entities to establish a demonstration program to 
establish training programs to train, or to employ, al-
ternative dental health care providers in order to in-
crease access to dental health care services in rural 
and other underserved communities. 
‘‘(2) DEFINITION.—The term ‘alternative dental 
health care providers’ includes community dental 
health coordinators, advance practice dental hygien-
ists, independent dental hygienists, supervised dental 
hygienists, primary care physicians, dental thera-
pists, dental health aides, and any other health pro-
fessional that the Secretary determines appropriate. 
‘‘(b) TIMEFRAME.—The demonstration projects funded 
under this section shall begin not later than 2 years after 
the date of enactment of this section, and shall conclude not 
later than 7 years after such date of enactment. 
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‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
‘‘(1) be— 
‘‘(A) an institution of higher education, in-
cluding a community college; 
‘‘(B) a public-private partnership; 
‘‘(C) a federally qualified health center; 
‘‘(D) an Indian Health Service facility or a 
tribe or tribal organization (as such terms are 
defined in section 4 of the Indian Self-Deter-
mination and Education Assistance Act); 
‘‘(E) a State or county public health clinic, 
a health facility operated by an Indian tribe or 
tribal organization, or urban Indian organiza-
tion providing dental services; or 
‘‘(F) a public hospital or health system; 
‘‘(2) be within a program accredited by the Com-
mission on Dental Accreditation or within a dental 
education program in an accredited institution; and 
‘‘(3) shall submit an application to the Secretary 
at such time, in such manner, and containing such 
information as the Secretary may require. 
‘‘(d) ADMINISTRATIVE PROVISIONS.— 
‘‘(1) AMOUNT OF GRANT.—Each grant under this 
section shall be in an amount that is not less than 
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$4,000,000 for the 5-year period during which the 
demonstration project being conducted. 
‘‘(2) DISBURSEMENT OF FUNDS.— 
‘‘(A) PRELIMINARY
DISBURSEMENTS.—Be-
ginning 1 year after the enactment of this sec-
tion, the Secretary may disperse to any entity 
receiving a grant under this section not more 
than 20 percent of the total funding awarded to 
such entity under such grant, for the purpose of 
enabling the entity to plan the demonstration 
project to be conducted under such grant. 
‘‘(B) SUBSEQUENT
DISBURSEMENTS.—The 
remaining amount of grant funds not dispersed 
under subparagraph (A) shall be dispersed such 
that not less than 15 percent of such remaining 
amount is dispersed each subsequent year. 
‘‘(e) COMPLIANCE WITH STATE REQUIREMENTS.— 
Each entity receiving a grant under this section shall cer-
tify that it is in compliance with all applicable State licens-
ing requirements. 
‘‘(f) EVALUATION.—The Secretary shall contract with 
the Director of the Institute of Medicine to conduct a study 
of the demonstration programs conducted under this section 
that shall provide analysis, based upon quantitative and 
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qualitative data, regarding access to dental health care in 
the United States. 
‘‘(g) CLARIFICATION REGARDING DENTAL HEALTH 
AIDE PROGRAM.—Nothing in this section shall prohibit a 
dental health aide training program approved by the In-
dian Health Service from being eligible for a grant under 
this section. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary to carry out this section.’’. 
SEC. 5305. GERIATRIC EDUCATION AND TRAINING; CAREER 
AWARDS; COMPREHENSIVE GERIATRIC EDU-
CATION. 
(a) WORKFORCE DEVELOPMENT; CAREER AWARDS.— 
Section 753 of the Public Health Service Act (42 U.S.C. 
294c) is amended by adding at the end the following: 
‘‘(d) GERIATRIC WORKFORCE DEVELOPMENT.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this subsection to entities 
that operate a geriatric education center 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 applica-
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tion at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(3) USE OF FUNDS.—Amounts awarded under 
a grant or contract under paragraph (1) shall be used 
to— 
‘‘(A) carry out the fellowship program de-
scribed in paragraph (4); and 
‘‘(B) carry out 1 of the 2 activities de-
scribed in paragraph (5). 
‘‘(4) FELLOWSHIP PROGRAM.— 
‘‘(A) IN GENERAL.—Pursuant to paragraph 
(3), a geriatric education center 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 
geriatrics, chronic care management, and long- 
term care that provide supplemental training for 
faculty members in medical schools and other 
health professions schools with programs in psy-
chology, pharmacy, nursing, social work, den-
tistry, public health, allied health, 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 
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in geriatrics, to upgrade their knowledge and 
clinical skills for the care of older adults and 
adults with functional limitations and to en-
hance their interdisciplinary teaching skills. 
‘‘(B) LOCATION.—A fellowship shall be of-
fered either at the geriatric education center that 
is sponsoring the course, in collaboration with 
other geriatric education centers, or at medical 
schools, schools of dentistry, schools of nursing, 
schools of pharmacy, schools of social work, grad-
uate programs in psychology, or allied health 
and other health professions schools approved by 
the Secretary with which the geriatric education 
centers are affiliated. 
‘‘(C) CME CREDIT.—Participation in a fel-
lowship under this paragraph shall be accepted 
with respect to complying with continuing health 
profession education requirements. As a condi-
tion of such acceptance, the recipient shall agree 
to subsequently provide a minimum of 18 hours 
of voluntary instructional support through a 
geriatric education center that is providing clin-
ical training to students or trainees in long-term 
care settings. 
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‘‘(5) ADDITIONAL
REQUIRED
ACTIVITIES
DE-
SCRIBED.—Pursuant to paragraph (3), a geriatric 
education center that receives an award under this 
subsection shall use such funds to carry out 1 of the 
following 2 activities. 
‘‘(A) FAMILY CAREGIVER AND DIRECT CARE 
PROVIDER TRAINING.—A geriatric education cen-
ter that receives an award under this subsection 
shall offer at least 2 courses each year, at no 
charge or nominal cost, to family caregivers and 
direct care providers that are designed to provide 
practical training for supporting frail elders and 
individuals with disabilities. The Secretary shall 
require such Centers to work with appropriate 
community partners to develop training pro-
gram content and to publicize the availability of 
training courses in their service areas. All fam-
ily caregiver and direct care provider training 
programs shall include instruction on the man-
agement of psychological and behavioral aspects 
of dementia, communication techniques for work-
ing with individuals who have dementia, and the 
appropriate, safe, and effective use of medica-
tions for older adults. 
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‘‘(B) 
INCORPORATION
OF
BEST
PRAC-
TICES.—A geriatric education center that re-
ceives an award under this subsection shall de-
velop and include material on depression and 
other mental disorders common among older 
adults, medication safety issues for older adults, 
and management of the psychological and behav-
ioral aspects of dementia and communication 
techniques with individuals who have dementia 
in all training courses, where appropriate. 
‘‘(6) TARGETS.—A geriatric education center 
that receives an award under this subsection shall 
meet targets approved by the Secretary for providing 
geriatric training to a certain number of faculty or 
practitioners during the term of the award, as well as 
other parameters established by the Secretary. 
‘‘(7) AMOUNT OF AWARD.—An award under this 
subsection shall be in an amount of $150,000. Not 
more than 24 geriatric education centers may receive 
an award under this subsection. 
‘‘(8) MAINTENANCE
OF
EFFORT.—A geriatric 
education center that receives an award under this 
subsection shall provide assurances to the Secretary 
that funds provided to the geriatric education center 
under this subsection will be used only to supplement, 
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not to supplant, the amount of Federal, State, and 
local funds otherwise expended by the geriatric edu-
cation center. 
‘‘(9) AUTHORIZATION OF APPROPRIATIONS.—In 
addition to any other funding available to carry out 
this section, there is authorized to be appropriated to 
carry out this subsection, $10,800,000 for the period 
of fiscal year 2011 through 2014. 
‘‘(e) GERIATRIC CAREER INCENTIVE AWARDS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this section to individuals 
described in paragraph (2) to foster greater interest 
among a variety of health professionals in entering 
the field of geriatrics, long-term care, and chronic 
care management. 
‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 
received an award under paragraph (1), an indi-
vidual shall— 
‘‘(A) be an advanced practice nurse, a clin-
ical social worker, a pharmacist, or student of 
psychology who is pursuing a doctorate or other 
advanced degree in geriatrics or related fields in 
an accredited health professions school; and 
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‘‘(B) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(3) CONDITION OF AWARD.—As a condition of 
receiving an award under this subsection, an indi-
vidual shall agree that, following completion of the 
award period, the individual will teach or practice in 
the field of geriatrics, long-term care, or chronic care 
management for a minimum of 5 years under guide-
lines set by the Secretary. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, $10,000,000 for the period of fiscal 
years 2011 through 2013.’’. 
(b) EXPANSION OF ELIGIBILITY FOR GERIATRIC ACA-
DEMIC CAREER AWARDS; PAYMENT TO INSTITUTION.—Sec-
tion 753(c) of the Public Health Service Act 294(c)) is 
amended— 
(1) by redesignating paragraphs (4) and (5) as 
paragraphs (5) and (6), respectively; 
(2) by striking paragraph (2) through paragraph 
(3) and inserting the following: 
‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 
receive an Award under paragraph (1), an individual 
shall— 
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‘‘(A) be board certified or board eligible in 
internal medicine, family practice, psychiatry, 
or licensed dentistry, or have completed any re-
quired training in a discipline and employed in 
an accredited health professions school that is 
approved by the Secretary; 
‘‘(B) have completed an approved fellowship 
program in geriatrics or have completed spe-
cialty training in geriatrics as required by the 
discipline and any addition geriatrics training 
as required by the Secretary; and 
‘‘(C) have a junior (non-tenured) faculty 
appointment at an accredited (as determined by 
the Secretary) school of medicine, osteopathic 
medicine, nursing, social work, psychology, den-
tistry, pharmacy, or other allied health dis-
ciplines in an accredited health professions 
school that is approved by the Secretary. 
‘‘(3) LIMITATIONS.—No Award under paragraph 
(1) may be made to an eligible individual unless the 
individual— 
‘‘(A) has submitted to the Secretary an ap-
plication, at such time, in such manner, and 
containing such information as the Secretary 
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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-
mented commitment from such institution to 
spend 75 percent of the total time of such indi-
vidual on teaching and developing skills in 
interdisciplinary education in geriatrics. 
‘‘(4) MAINTENANCE OF EFFORT.—An eligible in-
dividual that receives an Award under paragraph (1) 
shall provide assurances to the Secretary that funds 
provided to the eligible individual under this sub-
section will be used only to supplement, not to sup-
plant, the amount of Federal, State, and local funds 
otherwise expended by the eligible individual.’’; and 
(3) in paragraph (5), as so designated— 
(A) in subparagraph (A)— 
(i) by inserting ‘‘for individuals who 
are physicians’’ after ‘‘this section’’; and 
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(ii) by inserting after the period at the 
end the following: ‘‘The Secretary shall de-
termine the amount of an Award under this 
section for individuals who are not physi-
cians.’’; and 
(B) by adding at the end the following: 
‘‘(C) PAYMENT TO INSTITUTION.—The Sec-
retary shall make payments to institutions which 
include schools of medicine, osteopathic medicine, 
nursing, social work, psychology, dentistry, and 
pharmacy, or other allied health discipline in an 
accredited health professions school that is ap-
proved by the Secretary.’’. 
(c) COMPREHENSIVE GERIATRIC EDUCATION.—Sec-
tion 855 of the Public Health Service Act (42 U.S.C. 298) 
is amended— 
(1) in subsection (b)— 
(A) in paragraph (3), by striking ‘‘or’’ at 
the end; 
(B) in paragraph (4), by striking the period 
and inserting ‘‘; or’’; and 
(C) by adding at the end the following: 
‘‘(5) establish traineeships for individuals who 
are preparing for advanced education nursing degrees 
in geriatric nursing, long-term care, gero-psychiatric 
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nursing or other nursing areas that specialize in the 
care of the elderly population.’’; and 
(2) in subsection (e), by striking ‘‘2003 through 
2007’’ and inserting ‘‘2010 through 2014’’. 
SEC. 5306. MENTAL AND BEHAVIORAL HEALTH EDUCATION 
AND TRAINING GRANTS. 
(a) IN GENERAL.—Part D of title VII (42 U.S.C. 294 
et seq.) is amended by— 
(1) striking section 757; 
(2) redesignating section 756 (as amended by 
section 5103) as section 757; and 
(3) inserting after section 755 the following: 
‘‘SEC. 756. MENTAL AND BEHAVIORAL HEALTH EDUCATION 
AND TRAINING GRANTS. 
‘‘(a) GRANTS
AUTHORIZED.—The Secretary may 
award grants to eligible institutions of higher education to 
support the recruitment of students for, and education and 
clinical experience of the students in— 
‘‘(1) baccalaureate, master’s, and doctoral degree 
programs of social work, as well as the development 
of faculty in social work; 
‘‘(2) accredited master’s, doctoral, internship, 
and post-doctoral residency programs of psychology 
for the development and implementation of inter-
disciplinary training of psychology graduate students 
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for providing behavioral and mental health services, 
including substance abuse prevention and treatment 
services; 
‘‘(3) accredited institutions of higher education 
or accredited professional training programs that are 
establishing or expanding internships or other field 
placement programs in child and adolescent mental 
health in psychiatry, psychology, school psychology, 
behavioral pediatrics, psychiatric nursing, social 
work, school social work, substance abuse prevention 
and treatment, marriage and family therapy, school 
counseling, or professional counseling; and 
‘‘(4) State-licensed mental health nonprofit and 
for-profit organizations to enable such organizations 
to pay for programs for preservice or in-service train-
ing of paraprofessional child and adolescent mental 
health workers. 
‘‘(b) ELIGIBILITY REQUIREMENTS.—To be eligible for 
a grant under this section, an institution shall dem-
onstrate— 
‘‘(1) participation in the institutions’ programs 
of individuals and groups from different racial, eth-
nic, cultural, geographic, religious, linguistic, and 
class backgrounds, and different genders and sexual 
orientations; 
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‘‘(2) knowledge and understanding of the con-
cerns of the individuals and groups described in sub-
section (a); 
‘‘(3) any internship or other field placement pro-
gram assisted under the grant will prioritize cultural 
and linguistic competency; 
‘‘(4) the institution will provide to the Secretary 
such data, assurances, and information as the Sec-
retary may require; and 
‘‘(5) with respect to any violation of the agree-
ment between the Secretary and the institution, the 
institution will pay such liquidated damages as pre-
scribed by the Secretary by regulation. 
‘‘(c) INSTITUTIONAL REQUIREMENT.—For grants au-
thorized under subsection (a)(1), at least 4 of the grant re-
cipients shall be historically black colleges or universities 
or other minority-serving institutions. 
‘‘(d) PRIORITY.— 
‘‘(1) In selecting the grant recipients in social 
work under subsection (a)(1), the Secretary shall give 
priority to applicants that— 
‘‘(A) are accredited by the Council on So-
cial Work Education; 
‘‘(B) have a graduation rate of not less than 
80 percent for social work students; and 
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‘‘(C) exhibit an ability to recruit social 
workers from and place social workers in areas 
with a high need and high demand population. 
‘‘(2) In selecting the grant recipients in graduate 
psychology under subsection (a)(2), the Secretary 
shall give priority to institutions in which training 
focuses on the needs of vulnerable groups such as older 
adults and children, individuals with mental health 
or substance-related disorders, victims of abuse or 
trauma and of combat stress disorders such as 
posttraumatic stress disorder and traumatic brain in-
juries, homeless individuals, chronically ill persons, 
and their families. 
‘‘(3) In selecting the grant recipients in training 
programs in child and adolescent mental health under 
subsections (a)(3) and (a)(4), the Secretary shall give 
priority to applicants that— 
‘‘(A) have demonstrated the ability to collect 
data on the number of students trained in child 
and adolescent mental health and the popu-
lations served by such students after graduation 
or completion of preservice or in-service train-
ing; 
‘‘(B) have demonstrated familiarity with 
evidence-based methods in child and adolescent 
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mental health services, including substance abuse 
prevention and treatment services; 
‘‘(C) have programs designed to increase the 
number of professionals and paraprofessionals 
serving high-priority populations and to appli-
cants who come from high-priority communities 
and plan to serve medically underserved popu-
lations, in health professional shortage areas, or 
in medically underserved areas; 
‘‘(D) offer curriculum taught collaboratively 
with a family on the consumer and family lived 
experience or the importance of family-profes-
sional or family-paraprofessional partnerships; 
and 
‘‘(E) provide services through a community 
mental health program described in section 
1913(b)(1). 
‘‘(e) AUTHORIZATION OF APPROPRIATION.—For the 
fiscal years 2010 through 2013, there is authorized to be 
appropriated to carry out this section— 
‘‘(1) $8,000,000 for training in social work in 
subsection (a)(1); 
‘‘(2) $12,000,000 for training in graduate psy-
chology in subsection (a)(2), of which not less than 
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$10,000,000 
shall 
be 
allocated 
for 
doctoral, 
postdoctoral, and internship level training; 
‘‘(3) $10,000,000 for training in professional 
child and adolescent mental health in subsection 
(a)(3); and 
‘‘(4) $5,000,000 for training in paraprofessional 
child and adolescent work in subsection (a)(4).’’. 
(b) CONFORMING AMENDMENTS.—Section 757(b)(2) of 
the Public Health Service Act, as redesignated by subsection 
(a), is amended by striking ‘‘sections 751(a)(1)(A), 
751(a)(1)(B), 753(b), 754(3)(A), and 755(b)’’ and inserting 
‘‘sections 751(b)(1)(A), 753(b), and 755(b)’’. 
SEC. 5307. CULTURAL COMPETENCY, PREVENTION, AND 
PUBLIC HEALTH AND INDIVIDUALS WITH DIS-
ABILITIES TRAINING. 
(a) TITLE VII.—Section 741 of the Public Health 
Service Act (42 U.S.C. 293e) is amended— 
(1) in subsection (a)— 
(A) by striking the subsection heading and 
inserting ‘‘CULTURAL
COMPETENCY, PREVEN-
TION, AND PUBLIC HEALTH AND INDIVIDUALS 
WITH DISABILITY GRANTS’’; and 
(B) in paragraph (1), by striking ‘‘for the 
purpose of’’ and all that follows through the pe-
riod at the end and inserting ‘‘for the develop-
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ment, evaluation, and dissemination of research, 
demonstration projects, and model curricula for 
cultural competency, prevention, public health 
proficiency, reducing health disparities, and ap-
titude for working with individuals with disabil-
ities training for use in health professions schools 
and continuing education programs, and for 
other purposes determined as appropriate by the 
Secretary.’’; and 
(2) by striking subsection (b) and inserting the 
following: 
‘‘(b) COLLABORATION.—In carrying out subsection (a), 
the Secretary shall collaborate with health professional soci-
eties, licensing and accreditation entities, health professions 
schools, and experts in minority health and cultural com-
petency, prevention, and public health and disability 
groups, community-based organizations, and other organi-
zations as determined appropriate by the Secretary. The 
Secretary shall coordinate with curricula and research and 
demonstration projects developed under section 807. 
‘‘(c) DISSEMINATION.— 
‘‘(1) IN
GENERAL.—Model curricula developed 
under this section shall be disseminated through the 
Internet Clearinghouse under section 270 and such 
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other means as determined appropriate by the Sec-
retary. 
‘‘(2) EVALUATION.—The Secretary shall evaluate 
the adoption and the implementation of cultural com-
petency, prevention, and public health, and working 
with individuals with a disability training curricula, 
and the facilitate inclusion of these competency meas-
ures in quality measurement systems as appropriate. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section such 
sums as may be necessary for each of fiscal years 2010 
through 2015.’’. 
(b) TITLE VIII.—Section 807 of the Public Health 
Service Act (42 U.S.C. 296e–1) is amended— 
(1) in subsection (a)— 
(A) by striking the subsection heading and 
inserting ‘‘CULTURAL
COMPETENCY, PREVEN-
TION, AND PUBLIC HEALTH AND INDIVIDUALS 
WITH DISABILITY GRANTS’’; and 
(B) by striking ‘‘for the purpose of’’ and all 
that follows through ‘‘health care.’’ and inserting 
‘‘for the development, evaluation, and dissemina-
tion of research, demonstration projects, and 
model curricula for cultural competency, preven-
tion, public health proficiency, reducing health 
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disparities, and aptitude for working with indi-
viduals with disabilities training for use in 
health professions schools and continuing edu-
cation programs, and for other purposes deter-
mined as appropriate by the Secretary.’’; and 
(2) by redesignating subsection (b) as subsection 
(d); 
(3) by inserting after subsection (a) the fol-
lowing: 
‘‘(b) COLLABORATION.—In carrying out subsection (a), 
the Secretary shall collaborate with the entities described 
in section 741(b). The Secretary shall coordinate with cur-
ricula and research and demonstration projects developed 
under such section 741. 
‘‘(c) DISSEMINATION.—Model curricula developed 
under this section shall be disseminated and evaluated in 
the same manner as model curricula developed under sec-
tion 741, as described in subsection (c) of such section.’’; 
and 
(4) in subsection (d), as so redesignated— 
(A) by striking ‘‘subsection (a)’’ and insert-
ing ‘‘this section’’; and 
(B) by striking ‘‘2001 through 2004’’ and 
inserting ‘‘2010 through 2015’’. 
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SEC. 5308. ADVANCED NURSING EDUCATION GRANTS. 
Section 811 of the Public Health Service Act (42 
U.S.C. 296j) is amended— 
(1) in subsection (c)— 
(A) in the subsection heading, by striking 
‘‘AND NURSE MIDWIFERY PROGRAMS’’; and 
(B) by striking ‘‘and nurse midwifery’’; 
(2) in subsection (f)— 
(A) by striking paragraph (2); and 
(B) by redesignating paragraph (3) as 
paragraph (2); and 
(3) by redesignating subsections (d), (e), and (f) 
as subsections (e), (f), and (g), respectively; and 
(4) by inserting after subsection (c), the fol-
lowing: 
‘‘(d) AUTHORIZED NURSE-MIDWIFERY PROGRAMS.— 
Midwifery programs that are eligible for support under this 
section are educational programs that— 
‘‘(1) have as their objective the education of mid-
wives; and 
‘‘(2) are accredited by the American College of 
Nurse-Midwives Accreditation Commission for Mid-
wifery Education.’’. 
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SEC. 5309. NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS. 
(a) IN GENERAL.—Section 831 of the Public Health 
Service Act (42 U.S.C. 296p) is amended— 
(1) in the section heading, by striking ‘‘RETEN-
TION’’ and inserting ‘‘QUALITY’’; 
(2) in subsection (a)— 
(A) in paragraph (1), by adding ‘‘or’’ after 
the semicolon; 
(B) by striking paragraph (2); and 
(C) by redesignating paragraph (3) as 
paragraph (2); 
(3) in subsection (b)(3), by striking ‘‘managed 
care, quality improvement’’ and inserting ‘‘coordi-
nated care’’; 
(4) in subsection (g), by inserting ‘‘, as defined 
in section 801(2),’’ after ‘‘school of nursing’’; and 
(5) in subsection (h), by striking ‘‘2003 through 
2007’’ and inserting ‘‘2010 through 2014’’. 
(b) NURSE RETENTION GRANTS.—Title VIII of the 
Public Health Service Act is amended by inserting after 
section 831 (42 U.S.C. 296b) the following: 
‘‘SEC. 831A. NURSE RETENTION GRANTS. 
‘‘(a) RETENTION PRIORITY AREAS.—The Secretary 
may award grants to, and enter into contracts with, eligible 
entities to enhance the nursing workforce by initiating and 
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maintaining nurse retention programs pursuant to sub-
section (b) or (c). 
‘‘(b) GRANTS FOR CAREER LADDER PROGRAM.—The 
Secretary may award grants to, and enter into contracts 
with, eligible entities for programs— 
‘‘(1) to promote career advancement for individ-
uals including licensed practical nurses, licensed vo-
cational nurses, certified nurse assistants, home 
health aides, diploma degree or associate degree 
nurses, to become baccalaureate prepared registered 
nurses or advanced education nurses in order to meet 
the needs of the registered nurse workforce; 
‘‘(2) developing and implementing internships 
and residency programs in collaboration with an ac-
credited school of nursing, as defined by section 
801(2), to encourage mentoring and the development 
of specialties; or 
‘‘(3) to assist individuals in obtaining education 
and training required to enter the nursing profession 
and advance within such profession. 
‘‘(c) ENHANCING
PATIENT
CARE
DELIVERY
SYS-
TEMS.— 
‘‘(1) GRANTS.—The Secretary may award grants 
to eligible entities to improve the retention of nurses 
and enhance patient care that is directly related to 
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nursing activities by enhancing collaboration and 
communication among nurses and other health care 
professionals, and by promoting nurse involvement in 
the organizational and clinical decision-making proc-
esses of a health care facility. 
‘‘(2) PRIORITY.—In making awards of grants 
under this subsection, the Secretary shall give pref-
erence to applicants that have not previously received 
an award under this subsection (or section 831(c) as 
such section existed on the day before the date of en-
actment of this section). 
‘‘(3) CONTINUATION
OF
AN
AWARD.—The Sec-
retary shall make continuation of any award under 
this subsection beyond the second year of such award 
contingent on the recipient of such award having 
demonstrated to the Secretary measurable and sub-
stantive improvement in nurse retention or patient 
care. 
‘‘(d) OTHER PRIORITY AREAS.—The Secretary may 
award grants to, or enter into contracts with, eligible enti-
ties to address other areas that are of high priority to nurse 
retention, as determined by the Secretary. 
‘‘(e) REPORT.—The Secretary shall submit to the Con-
gress before the end of each fiscal year a report on the grants 
awarded and the contracts entered into under this section. 
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Each such report shall identify the overall number of such 
grants and contracts and provide an explanation of why 
each such grant or contract will meet the priority need of 
the nursing workforce. 
‘‘(f) ELIGIBLE ENTITY.—For purposes of this section, 
the term ‘eligible entity’ includes an accredited school of 
nursing, as defined by section 801(2), a health care facility, 
or a partnership of such a school and facility. 
‘‘(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 2010 
through 2012.’’. 
SEC. 5310. LOAN REPAYMENT AND SCHOLARSHIP PRO-
GRAM. 
(a) LOAN REPAYMENTS AND SCHOLARSHIPS.—Section 
846(a)(3) of the Public Health Service Act (42 U.S.C. 
297n(a)(3)) is amended by inserting before the semicolon 
the following: ‘‘, or in a accredited school of nursing, as 
defined by section 801(2), as nurse faculty’’. 
(b) TECHNICAL
AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by redesignating section 810 (relating to pro-
hibition against discrimination by schools on the 
basis of sex) as section 809 and moving such section 
so that it follows section 808; 
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(2) in sections 835, 836, 838, 840, and 842, by 
striking the term ‘‘this subpart’’ each place it appears 
and inserting ‘‘this part’’; 
(3) in section 836(h), by striking the last sen-
tence; 
(4) in section 836, by redesignating subsection 
(l) as subsection (k); 
(5) in section 839, by striking ‘‘839’’ and all 
that follows through ‘‘(a)’’ and inserting ‘‘839. (a)’’; 
(6) in section 835(b), by striking ‘‘841’’ each 
place it appears and inserting ‘‘871’’; 
(7) by redesignating section 841 as section 871, 
moving part F to the end of the title, and redesig-
nating such part as part I; 
(8) in part G— 
(A) by redesignating section 845 as section 
851; and 
(B) by redesignating part G as part F; 
(9) in part H— 
(A) by redesignating sections 851 and 852 
as sections 861 and 862, respectively; and 
(B) by redesignating part H as part G; and 
(10) in part I— 
(A) by redesignating section 855, as amend-
ed by section 5305, as section 865; and 
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(B) by redesignating part I as part H. 
SEC. 5311. NURSE FACULTY LOAN PROGRAM. 
(a) IN GENERAL.—Section 846A of the Public Health 
Service Act (42 U.S.C. 297n–1) is amended— 
(1) in subsection (a)— 
(A) in the subsection heading, by striking 
‘‘ESTABLISHMENT’’ and inserting ‘‘SCHOOL OF 
NURSING STUDENT LOAN FUND’’; and 
(B) by inserting ‘‘accredited’’ after ‘‘agree-
ment with any’’; 
(2) in subsection (c)— 
(A) in paragraph (2), by striking ‘‘$30,000’’ 
and all that follows through the semicolon and 
inserting ‘‘$35,500, during fiscal years 2010 and 
2011 fiscal years (after fiscal year 2011, such 
amounts shall be adjusted to provide for a cost- 
of-attendance increase for the yearly loan rate 
and the aggregate loan;’’; and 
(B) in paragraph (3)(A), by inserting ‘‘an 
accredited’’ after ‘‘faculty member in’’; 
(3) in subsection (e), by striking ‘‘a school’’ and 
inserting ‘‘an accredited school’’; and 
(4) in subsection (f), by striking ‘‘2003 through 
2007’’ and inserting ‘‘2010 through 2014’’. 
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(b) ELIGIBLE INDIVIDUAL STUDENT LOAN REPAY-
MENT.—Title VIII of the Public Health Service Act is 
amended by inserting after section 846A (42 U.S.C. 297n– 
1) the following: 
‘‘SEC. 847. ELIGIBLE INDIVIDUAL STUDENT LOAN REPAY-
MENT. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Administrator of the Health Resources and Services Admin-
istration, may enter into an agreement with eligible indi-
viduals for the repayment of education loans, in accordance 
with this section, to increase the number of qualified nurs-
ing faculty. 
‘‘(b) AGREEMENTS.—Each agreement entered into 
under this subsection shall require that the eligible indi-
vidual shall serve as a full-time member of the faculty of 
an accredited school of nursing, for a total period, in the 
aggregate, of at least 4 years during the 6-year period be-
ginning on the later of— 
‘‘(1) the date on which the individual receives a 
master’s or doctorate nursing degree from an accred-
ited school of nursing; or 
‘‘(2) the date on which the individual enters into 
an agreement under this subsection. 
‘‘(c) AGREEMENT PROVISIONS.—Agreements entered 
into pursuant to subsection (b) shall be entered into on such 
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terms and conditions as the Secretary may determine, ex-
cept that— 
‘‘(1) not more than 10 months after the date on 
which the 6-year period described under subsection (b) 
begins, but in no case before the individual starts as 
a full-time member of the faculty of an accredited 
school of nursing the Secretary shall begin making 
payments, for and on behalf of that individual, on the 
outstanding principal of, and interest on, any loan of 
that individual obtained to pay for such degree; 
‘‘(2) for an individual who has completed a mas-
ter’s in nursing or equivalent degree in nursing— 
‘‘(A) payments may not exceed $10,000 per 
calendar year; and 
‘‘(B) total payments may not exceed 
$40,000 during the 2010 and 2011 fiscal years 
(after fiscal year 2011, such amounts shall be ad-
justed to provide for a cost-of-attendance increase 
for the yearly loan rate and the aggregate loan); 
and 
‘‘(3) for an individual who has completed a doc-
torate or equivalent degree in nursing— 
‘‘(A) payments may not exceed $20,000 per 
calendar year; and 
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‘‘(B) total payments may not exceed 
$80,000 during the 2010 and 2011 fiscal years 
(adjusted for subsequent fiscal years as provided 
for in the same manner as in paragraph (2)(B)). 
‘‘(d) BREACH OF AGREEMENT.— 
‘‘(1) IN GENERAL.—In the case of any agreement 
made under subsection (b), the individual is liable to 
the Federal Government for the total amount paid by 
the Secretary under such agreement, and for interest 
on such amount at the maximum legal prevailing 
rate, if the individual fails to meet the agreement 
terms required under such subsection. 
‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.—In 
the case of an individual making an agreement for 
purposes of paragraph (1), the Secretary shall provide 
for the waiver or suspension of liability under such 
paragraph if compliance by the individual with the 
agreement involved is impossible or would involve ex-
treme hardship to the individual or if enforcement of 
the agreement with respect to the individual would be 
unconscionable. 
‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject to 
paragraph (2), any amount that the Federal Govern-
ment is entitled to recover under paragraph (1) shall 
be paid to the United States not later than the expi-
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ration of the 3-year period beginning on the date the 
United States becomes so entitled. 
‘‘(4) AVAILABILITY.—Amounts recovered under 
paragraph (1) shall be available to the Secretary for 
making loan repayments under this section and shall 
remain available for such purpose until expended. 
‘‘(e) ELIGIBLE INDIVIDUAL DEFINED.—For purposes 
of this section, the term ‘eligible individual’ means an indi-
vidual who— 
‘‘(1) is a United States citizen, national, or law-
ful permanent resident; 
‘‘(2) holds an unencumbered license as a reg-
istered nurse; and 
‘‘(3) has either already completed a master’s or 
doctorate nursing program at an accredited school of 
nursing or is currently enrolled on a full-time or 
part-time basis in such a program. 
‘‘(f) PRIORITY.—For the purposes of this section and 
section 846A, funding priority will be awarded to School 
of Nursing Student Loans that support doctoral nursing 
students or Individual Student Loan Repayment that sup-
port doctoral nursing students. 
‘‘(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
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such sums as may be necessary for each of fiscal years 2010 
through 2014.’’. 
SEC. 5312. AUTHORIZATION OF APPROPRIATIONS FOR 
PARTS B THROUGH D OF TITLE VIII. 
Section 871 of the Public Health Service Act, as redes-
ignated and moved by section 5310, is amended to read as 
follows: 
‘‘SEC. 871. AUTHORIZATION OF APPROPRIATIONS. 
‘‘For the purpose of carrying out parts B, C, and D 
(subject to section 851(g)), there are authorized to be appro-
priated $338,000,000 for fiscal year 2010, and such sums 
as may be necessary for each of the fiscal years 2011 
through 2016.’’. 
SEC. 5313. GRANTS TO PROMOTE THE COMMUNITY HEALTH 
WORKFORCE. 
(a) IN GENERAL.—Part P of title III of the Public 
Health Service Act (42 U.S.C. 280g et seq.) is amended by 
adding at the end the following: 
‘‘SEC. 399V. GRANTS TO PROMOTE POSITIVE HEALTH BE-
HAVIORS AND OUTCOMES. 
‘‘(a) GRANTS AUTHORIZED.—The Director of the Cen-
ters for Disease Control and Prevention, in collaboration 
with the Secretary, shall award grants to eligible entities 
to promote positive health behaviors and outcomes for popu-
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lations in medically underserved communities through the 
use of community health workers. 
‘‘(b) USE OF FUNDS.—Grants awarded under sub-
section (a) shall be used to support community health work-
ers— 
‘‘(1) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
alent in medically underserved communities, particu-
larly racial and ethnic minority populations; 
‘‘(2) to educate and provide guidance regarding 
effective strategies to promote positive health behav-
iors and discourage risky health behaviors; 
‘‘(3) to educate and provide outreach regarding 
enrollment in health insurance including the Chil-
dren’s Health Insurance Program under title XXI of 
the Social Security Act, Medicare under title XVIII 
of such Act and Medicaid under title XIX of such Act; 
‘‘(4) to identify, educate, refer, and enroll under-
served populations to appropriate healthcare agencies 
and community-based programs and organizations in 
order to increase access to quality healthcare services 
and to eliminate duplicative care; or 
‘‘(5) to educate, guide, and provide home visita-
tion services regarding maternal health and prenatal 
care. 
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‘‘(c) APPLICATION.—Each eligible entity that desires 
to receive a grant under subsection (a) shall submit an ap-
plication to the Secretary, at such time, in such manner, 
and accompanied by such information as the Secretary 
may require. 
‘‘(d) PRIORITY.—In awarding grants under subsection 
(a), the Secretary shall give priority to applicants that— 
‘‘(1) propose to target geographic areas— 
‘‘(A) with a high percentage of residents 
who are eligible for health insurance but are un-
insured or underinsured; 
‘‘(B) with a high percentage of residents 
who suffer from chronic diseases; or 
‘‘(C) with a high infant mortality rate; 
‘‘(2) have experience in providing health or 
health-related social services to individuals who are 
underserved with respect to such services; and 
‘‘(3) have documented community activity and 
experience with community health workers. 
‘‘(e) COLLABORATION WITH ACADEMIC INSTITUTIONS 
AND THE ONE-STOP DELIVERY SYSTEM.—The Secretary 
shall encourage community health worker programs receiv-
ing funds under this section to collaborate with academic 
institutions and one-stop delivery systems under section 
134(c) of the Workforce Investment Act of 1998. Nothing 
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in this section shall be construed to require such collabora-
tion. 
‘‘(f) EVIDENCE-BASED
INTERVENTIONS.—The Sec-
retary shall encourage community health worker programs 
receiving funding under this section to implement a process 
or an outcome-based payment system that rewards commu-
nity health workers for connecting underserved populations 
with the most appropriate services at the most appropriate 
time. Nothing in this section shall be construed to require 
such a payment. 
‘‘(g) QUALITY ASSURANCE
AND COST EFFECTIVE-
NESS.—The Secretary shall establish guidelines for assuring 
the quality of the training and supervision of community 
health workers under the programs funded under this sec-
tion and for assuring the cost-effectiveness of such programs. 
‘‘(h) MONITORING.—The Secretary shall monitor com-
munity health worker programs identified in approved ap-
plications under this section and shall determine whether 
such programs are in compliance with the guidelines estab-
lished under subsection (g). 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to community health worker 
programs identified in approved applications under this 
section with respect to planning, developing, and operating 
programs under the grant. 
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‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated, such sums as may be nec-
essary to carry out this section for each of fiscal years 2010 
through 2014. 
‘‘(k) DEFINITIONS.—In this section: 
‘‘(1) COMMUNITY HEALTH WORKER.—The term 
‘community health worker’, as defined by the Depart-
ment of Labor as Standard Occupational Classifica-
tion [21–1094] means an individual who promotes 
health or nutrition within the community in which 
the individual resides— 
‘‘(A) by serving as a liaison between com-
munities and healthcare agencies; 
‘‘(B) by providing guidance and social as-
sistance to community residents; 
‘‘(C) by enhancing community residents’ 
ability 
to 
effectively 
communicate 
with 
healthcare providers; 
‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health; 
‘‘(F) by providing referral and follow-up 
services or otherwise coordinating care; and 
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‘‘(G) by proactively identifying and enroll-
ing eligible individuals in Federal, State, local, 
private or nonprofit health and human services 
programs. 
‘‘(2) COMMUNITY SETTING.—The term ‘commu-
nity setting’ means a home or a community organiza-
tion located in the neighborhood in which a partici-
pant in the program under this section resides. 
‘‘(3) ELIGIBLE ENTITY.—The term ‘eligible enti-
ty’ means a public or nonprofit private entity (in-
cluding a State or public subdivision of a State, a 
public health department, a free health clinic, a hos-
pital, or a Federally-qualified health center (as de-
fined in section 1861(aa) of the Social Security Act)), 
or a consortium of any such entities. 
‘‘(4) MEDICALLY UNDERSERVED COMMUNITY.— 
The term ‘medically underserved community’ means a 
community identified by a State— 
‘‘(A) that has a substantial number of indi-
viduals who are members of a medically under-
served 
population, 
as 
defined 
by 
section 
330(b)(3); and 
‘‘(B) a significant portion of which is a 
health professional shortage area as designated 
under section 332.’’. 
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SEC. 5314. FELLOWSHIP TRAINING IN PUBLIC HEALTH. 
Part E of title VII of the Public Health Service Act 
(42 U.S.C. 294n et seq.), as amended by section 5206, is 
further amended by adding at the end the following: 
‘‘SEC. 778. FELLOWSHIP TRAINING IN APPLIED PUBLIC 
HEALTH 
EPIDEMIOLOGY, 
PUBLIC 
HEALTH 
LABORATORY 
SCIENCE, 
PUBLIC 
HEALTH 
INFORMATICS, AND EXPANSION OF THE EPI-
DEMIC INTELLIGENCE SERVICE. 
‘‘(a) IN GENERAL.—The Secretary may carry out ac-
tivities to address documented workforce shortages in State 
and local health departments in the critical areas of applied 
public health epidemiology and public health laboratory 
science and informatics and may expand the Epidemic In-
telligence Service. 
‘‘(b) SPECIFIC USES.—In carrying out subsection (a), 
the Secretary shall provide for the expansion of existing fel-
lowship programs operated through the Centers for Disease 
Control and Prevention in a manner that is designed to 
alleviate shortages of the type described in subsection (a). 
‘‘(c) OTHER PROGRAMS.—The Secretary may provide 
for the expansion of other applied epidemiology training 
programs that meet objectives similar to the objectives of 
the programs described in subsection (b). 
‘‘(d) WORK OBLIGATION.—Participation in fellowship 
training programs under this section shall be deemed to be 
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service for purposes of satisfying work obligations stipulated 
in contracts under section 338I(j). 
‘‘(e) GENERAL SUPPORT.—Amounts may be used from 
grants awarded under this section to expand the Public 
Health Informatics Fellowship Program at the Centers for 
Disease Control and Prevention to better support all public 
health systems at all levels of government. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section 
$39,500,000 for each of fiscal years 2010 through 2013, of 
which— 
‘‘(1) $5,000,000 shall be made available in each 
such fiscal year for epidemiology fellowship training 
program activities under subsections (b) and (c); 
‘‘(2) $5,000,000 shall be made available in each 
such fiscal year for laboratory fellowship training 
programs under subsection (b); 
‘‘(3) $5,000,000 shall be made available in each 
such fiscal year for the Public Health Informatics 
Fellowship Program under subsection (e); and 
‘‘(4) $24,500,000 shall be made available for ex-
panding the Epidemic Intelligence Service under sub-
section (a).’’. 
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SEC. 5315. UNITED STATES PUBLIC HEALTH SCIENCES 
TRACK. 
Title II of the Public Health Service Act (42 U.S.C. 
202 et seq.) is amended by adding at the end the following: 
‘‘PART D—UNITED STATES PUBLIC HEALTH 
SCIENCES TRACK 
‘‘SEC. 271. ESTABLISHMENT. 
‘‘(a) UNITED STATES PUBLIC HEALTH SERVICES 
TRACK.— 
‘‘(1) IN GENERAL.—There is hereby authorized to 
be established a United States Public Health Sciences 
Track (referred to in this part as the ‘Track’), at sites 
to be selected by the Secretary, with authority to 
grant appropriate advanced degrees in a manner that 
uniquely emphasizes team-based service, public health, 
epidemiology, and emergency preparedness and re-
sponse. It shall be so organized as to graduate not less 
than— 
‘‘(A) 150 medical students annually, 10 of 
whom shall be awarded studentships to the Uni-
formed Services University of Health Sciences; 
‘‘(B) 100 dental students annually; 
‘‘(C) 250 nursing students annually; 
‘‘(D) 100 public health students annually; 
‘‘(E) 100 behavioral and mental health pro-
fessional students annually; 
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meet the conditions described in paragraph 
(2)(A), (3), (4), or (5) of subsection (c). 
‘‘(D) FUNDING IN EXCESS OF $40,000,000.— 
If amounts appropriated under subsection (i) for 
a fiscal year are $40,000,000 or more, the Sec-
retary shall make available— 
‘‘(i) not less than $16,000,000 for 
grants under subsection (a) to health profes-
sions schools that meet the conditions de-
scribed in subsection (c)(2)(A); 
‘‘(ii) not less than $16,000,000 for 
grants under subsection (a) to health profes-
sions schools that meet the conditions de-
scribed in paragraph (3) or (4) of sub-
section (c) (including meeting conditions 
pursuant to subsection (e)); 
‘‘(iii) not less than $8,000,000 for 
grants under subsection (a) to health profes-
sions schools that meet the conditions de-
scribed in subsection (c)(5); and 
‘‘(iv) after grants are made with funds 
under clauses (i) through (iii), any remain-
ing funds for grants under subsection (a) to 
health professions schools that meet the con-
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ditions described in paragraph (2)(A), (3), 
(4), or (5) of subsection (c). 
‘‘(2) NO LIMITATION.—Nothing in this subsection 
shall be construed as limiting the centers of excellence 
referred to in this section to the designated amount, 
or to preclude such entities from competing for grants 
under this section. 
‘‘(3) MAINTENANCE OF EFFORT.— 
‘‘(A) IN GENERAL.—With respect to activi-
ties for which a grant made under this part are 
authorized to be expended, the Secretary may not 
make such a grant to a center of excellence for 
any fiscal year unless the center agrees to main-
tain expenditures of non-Federal amounts for 
such activities at a level that is not less than the 
level of such expenditures maintained by the cen-
ter for the fiscal year preceding the fiscal year 
for which the school receives such a grant. 
‘‘(B) USE OF FEDERAL FUNDS.—With re-
spect to any Federal amounts received by a cen-
ter of excellence and available for carrying out 
activities for which a grant under this part is 
authorized to be expended, the center shall, before 
expending the grant, expend the Federal amounts 
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obtained from sources other than the grant, un-
less given prior approval from the Secretary. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section— 
‘‘(1) $50,000,000 for each of the fiscal years 2010 
through 2015; and 
‘‘(2) and such sums as are necessary for each 
subsequent fiscal year.’’. 
SEC. 5402. HEALTH CARE PROFESSIONALS TRAINING FOR 
DIVERSITY. 
(a) LOAN REPAYMENTS AND FELLOWSHIPS REGARD-
ING FACULTY POSITIONS.—Section 738(a)(1) of the Public 
Health Service Act (42 U.S.C. 293b(a)(1)) is amended by 
striking ‘‘$20,000 of the principal and interest of the edu-
cational loans of such individuals.’’ and inserting ‘‘$30,000 
of the principal and interest of the educational loans of such 
individuals.’’. 
(b) 
SCHOLARSHIPS
FOR
DISADVANTAGED
STU-
DENTS.—Section 740(a) of such Act (42 U.S.C. 293d(a)) 
is amended by striking ‘‘$37,000,000’’ and all that follows 
through ‘‘2002’’ and inserting ‘‘$51,000,000 for fiscal year 
2010, and such sums as may be necessary for each of the 
fiscal years 2011 through 2014’’. 
(c) REAUTHORIZATION FOR LOAN REPAYMENTS AND 
FELLOWSHIPS REGARDING FACULTY POSITIONS.—Section 
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ernization Act of 2003 (Public Law 108–173) is amended 
by striking ‘‘section 1886(h)(7)’’ and all that follows and 
inserting ‘‘paragraphs (7) and (8) of subsection (h) of sec-
tion 1886 of the Social Security Act’’. 
SEC. 5504. COUNTING RESIDENT TIME IN NONPROVIDER 
SETTINGS. 
(a) GME.—Section 1886(h)(4)(E) of the Social Secu-
rity Act (42 U.S.C. 1395ww(h)(4)(E)) is amended— 
(1) by striking ‘‘shall be counted and that all the 
time’’ and inserting ‘‘shall be counted and that— 
‘‘(i) effective for cost reporting periods 
beginning before July 1, 2010, all the 
time;’’; 
(2) in clause (i), as inserted by paragraph (1), 
by striking the period at the end and inserting ‘‘; 
and’’; 
(3) by inserting after clause (i), as so inserted, 
the following new clause: 
‘‘(ii) effective for cost reporting periods 
beginning on or after July 1, 2010, all the 
time so spent by a resident shall be counted 
towards the determination of full-time 
equivalency, without regard to the setting in 
which the activities are performed, if a hos-
pital incurs the costs of the stipends and 
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projects for purposes of developing core training com-
petencies and certification programs for personal or 
home care aides. The Secretary shall— 
‘‘(A) evaluate the efficacy of the core train-
ing competencies described in paragraph (3)(A) 
for newly hired personal or home care aides and 
the methods used by States to implement such 
core training competencies in accordance with 
the issues specified in paragraph (3)(B); and 
‘‘(B) ensure that the number of hours of 
training provided by States under the dem-
onstration project with respect to such core 
training competencies are not less than the num-
ber of hours of training required under any ap-
plicable State or Federal law or regulation. 
‘‘(2) DURATION.—A demonstration project shall 
be conducted under this subsection for not less than 
3 years. 
‘‘(3) CORE TRAINING COMPETENCIES FOR PER-
SONAL OR HOME CARE AIDES.— 
‘‘(A) IN GENERAL.—The core training com-
petencies for personal or home care aides de-
scribed in this subparagraph include com-
petencies with respect to the following areas: 
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fiscal year is equal to an amount determined appro-
priate by the Secretary. 
‘‘(2) FACTORS.—In determining the amount 
under paragraph (1), the Secretary shall— 
‘‘(A) evaluate indirect training costs rel-
ative to supporting a primary care residency 
program in qualified teaching health centers; 
and 
‘‘(B) based on this evaluation, assure that 
the aggregate of the payments for indirect ex-
penses under this section and the payments for 
direct graduate medical education as determined 
under subsection (c) in a fiscal year do not ex-
ceed the amount appropriated for such expenses 
as determined in subsection (g). 
‘‘(3) INTERIM PAYMENT.—Before the Secretary 
makes a payment under this subsection pursuant to 
a determination of indirect expenses under paragraph 
(1), the Secretary may provide to qualified teaching 
health centers a payment, in addition to any pay-
ment made under subsection (c), for expected indirect 
expenses associated with the additional costs of teach-
ing residents for a fiscal year, based on an estimate 
by the Secretary. 
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