1317 
•AMDT. NO. 2786 
(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 insert-
ing 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 Con-
gress that funds repaid under the loan program under this 
section 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 
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•AMDT. NO. 2786 
Health Service Act (42 U.S.C. 292s) and the determina-
tion 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 Administration in accordance with the preceding 
sentence. 
SEC. 5202. NURSING STUDENT LOAN PROGRAM. 
(a) LOAN AGREEMENTS.—Section 836(a) of the Pub-
lic 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.’’. 
(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 
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•AMDT. NO. 2786 
(2) in paragraph (3), by striking ‘‘the date of 
enactment 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 estab-
lish and carry out a pediatric specialty loan repayment 
program under which the eligible individual agrees to be 
employed 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 sub-
stance abuse prevention and treatment services. 
‘‘(b) PROGRAM ADMINISTRATION.—Through the pro-
gram established under this section, the Secretary shall 
enter into contracts with qualified health professionals 
under which— 
‘‘(1) such qualified health professionals will 
agree to provide pediatric medical subspecialty, pedi-
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•AMDT. NO. 2786 
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 
serving an area or population described in such 
paragraph. 
‘‘(c) IN GENERAL.— 
‘‘(1) ELIGIBLE INDIVIDUALS.— 
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•AMDT. NO. 2786 
‘‘(A) PEDIATRIC
MEDICAL
SPECIALISTS 
AND
PEDIATRIC
SURGICAL
SPECIALISTS.—For 
purposes of contracts with respect to pediatric 
medical specialists and pediatric surgical spe-
cialists, 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 
contracts with respect to child and adolescent 
mental and behavioral health care, the term 
‘qualified health professional’ means a health 
care professional who— 
‘‘(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, 
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•AMDT. NO. 2786 
school social work, substance abuse dis-
order prevention and treatment, marriage 
and family therapy, school counseling, or 
professional counseling; 
‘‘(ii) has a license or certification in a 
State to practice allopathic medicine, os-
teopathic 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 pro-
fessional who completed (but not before 
the end of the calendar year in which this 
section is enacted) specialized training or 
clinical experience in child and adolescent 
mental health described in clause (i). 
‘‘(2) 
ADDITIONAL
ELIGIBILITY
REQUIRE-
MENTS.—The Secretary may not enter into a con-
tract under this subsection with an eligible indi-
vidual unless— 
‘‘(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; 
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•AMDT. NO. 2786 
‘‘(B) the individual is a United States cit-
izen or a permanent legal United States resi-
dent; and 
‘‘(C) if the individual is enrolled in a grad-
uate program, the program is accredited, and 
the individual has an acceptable level of aca-
demic standing (as determined by the Sec-
retary). 
‘‘(d) PRIORITY.—In entering into contracts under 
this subsection, the Secretary shall give priority to appli-
cants who— 
‘‘(1) are or will be working in a school or other 
pre-kindergarten, elementary, or secondary edu-
cation 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) and $20,000,000 for each of fiscal years 2010 
through 2013 to carry out subsection (c)(1)(B).’’. 
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•AMDT. NO. 2786 
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 estab-
lish the Public Health Workforce Loan Repayment Pro-
gram (referred to in this section as the ‘Program’) to as-
sure an adequate supply of public health professionals to 
eliminate critical 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 
certificate; and have accepted employment with a 
Federal, State, local, or tribal public health agency, 
or a related training fellowship, as recognized by the 
Secretary, to commence upon graduation; 
‘‘(B)(i) have graduated, during the preceding 
10-year period, from an accredited educational insti-
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•AMDT. NO. 2786 
tution 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 
recognized 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 
reduction 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 Sec-
retary 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 pursuit 
of the relevant degree or certificate in accordance 
with the terms of the contract; 
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•AMDT. NO. 2786 
‘‘(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 (referred to in this section as the ‘period of ob-
ligated 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 
determined 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 in-
dividual that is conditioned thereon, is contingent on 
funds being appropriated for loan repayments under 
this section; 
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•AMDT. NO. 2786 
‘‘(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 principal, interest, and related expenses on gov-
ernment and commercial loans received by the indi-
vidual regarding the undergraduate or graduate edu-
cation 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 con-
tracts to serve under subsection (c) the Secretary 
may pay up to $35,000 on behalf of the individual 
for loans described 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 eligi-
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•AMDT. NO. 2786 
ble loan balance for each year of obligated service of 
the individual. 
‘‘(3) TAX LIABILITY.—For the purpose of pro-
viding reimbursements for tax liability resulting 
from payments under paragraph (2) on behalf of an 
individual, the Secretary shall, in addition to such 
payments, 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 re-
spect to an individual receiving a degree or certificate from 
a health professions or other related school, the date of 
the initiation 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 repay-
ment 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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•AMDT. NO. 2786 
SEC. 5205. ALLIED HEALTH WORKFORCE RECRUITMENT 
AND RETENTION PROGRAMS. 
(a) PURPOSE.—The purpose of this section is to as-
sure an adequate supply of allied health professionals to 
eliminate critical allied health workforce shortages in Fed-
eral, 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 author-
izing an Allied Health Loan Forgiveness Program. 
(b) ALLIED HEALTH WORKFORCE RECRUITMENT 
AND RETENTION PROGRAM.—Section 428K of the Higher 
Education Act of 1965 (20 U.S.C. 1078–11) is amend-
ed— 
(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 
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•AMDT. NO. 2786 
professional shortage areas, medically under-
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 fol-
lowing: 
‘‘(1) ALLIED
HEALTH
PROFESSIONAL.—The 
term ‘allied health professional’ means an allied 
health professional as defined in section 799B(5) of 
the Public 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 
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•AMDT. NO. 2786 
shortage areas, medically underserved areas, or 
medically underserved populations, as recog-
nized by the Secretary of Health and Human 
Services.’’. 
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 
programs; or’’. 
(b) TRAINING FOR MID-CAREER PUBLIC HEALTH 
PROFESSIONALS.—Part E of title VII of the Public 
Health Service Act (42 U.S.C. 294n et seq.), as amended 
by section 5204, is further amended by adding at the end 
the following: 
‘‘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 de-
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•AMDT. NO. 2786 
gree 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.— 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ 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 ‘eligi-
ble 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 allotted to allied health mid-career professionals.’’. 
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•AMDT. NO. 2786 
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 be appropriated, out of any funds in the Treasury not 
otherwise 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 edu-
cation 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 section 333 during the prior fiscal year, 
relative to the number of individuals residing in 
such areas during the previous fiscal year.’’. 
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•AMDT. NO. 2786 
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. 
(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 
center, or independent nonprofit health or social 
services agency. 
‘‘(b) AUTHORITY
TO AWARD GRANTS.—The Sec-
retary shall award grants for the cost of the operation of 
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•AMDT. NO. 2786 
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— 
‘‘(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 
continue 
providing 
comprehensive 
primary 
health care services or wellness services without 
regard to income or insurance status of the pa-
tient 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. 
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•AMDT. NO. 2786 
‘‘(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 
‘‘(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.— 
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‘‘(1) IN GENERAL.—There shall be in the Serv-
ice a commissioned Regular Corps and a Ready Re-
serve Corps for service in time of national emer-
gency. 
‘‘(2) REQUIREMENT.—All commissioned officers 
shall be citizens of the United States and shall be 
appointed without regard to the civil-service laws 
and compensated without regard to the Classifica-
tion 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 sub-
ject 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, 
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to be a commissioned officer within the Commis-
sioned Corps of the Service. 
‘‘(b) ASSIMILATING RESERVE CORP OFFICERS INTO 
THE REGULAR CORPS.—Effective on the date of enact-
ment of the Patient Protection and Affordable Care Act, 
all individuals classified as officers in the Reserve Corps 
under this section (as such section existed on the day be-
fore the date 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 
notice (similar to the uniformed service’s reserve 
program) 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 Com-
missioned Corps; 
‘‘(B) be available and ready for involuntary 
calls to active duty during national emergencies 
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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 
emergencies, both foreign and domestic; and 
‘‘(D) be available for service assignment in 
isolated, hardship, and medically underserved 
communities (as defined in section 799B) to 
improve 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 amend-
ed by striking section 747 and inserting the following: 
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‘‘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-
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 medi-
cine, general internal medicine, or general pedi-
atrics for medical students, interns, residents, 
or practicing physicians as defined by the Sec-
retary; 
‘‘(B) to provide need-based financial assist-
ance in the form of traineeships and fellowships 
to medical students, interns, residents, prac-
ticing 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); 
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‘‘(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-
cians who are participants in any such pro-
grams and who plan to teach or conduct re-
search in a family medicine, general internal 
medicine, or general pediatrics training pro-
gram; 
‘‘(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 Ad-
visory Committee on Training in Primary Care 
Medicine and Dentistry and the National 
Health Care Workforce Commission established 
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in section 5101 of the Patient Protection and 
Affordable 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 
‘‘(iii) providing continuing education 
to primary care physicians relevant to pa-
tient-centered medical homes; and 
‘‘(H) to plan, develop, and operate joint 
degree programs to provide interdisciplinary 
and interprofessional graduate training in pub-
lic health and other health professions to pro-
vide training in environmental health, infectious 
disease control, disease prevention and health 
promotion, epidemiological studies and injury 
control. 
‘‘(2) DURATION OF AWARDS.—The period dur-
ing which payments are made to an entity from an 
award of a grant or contract under this subsection 
shall be 5 years. 
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•AMDT. NO. 2786 
‘‘(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 
(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 purpose 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), 
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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 inter-
professional integrated models of health care 
that incorporate transitions in health care set-
tings and integration physical and mental 
health provision; 
‘‘(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 sub-
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•AMDT. NO. 2786 
stance-related disorders, individuals with HIV/ 
AIDS, and individuals with disabilities; 
‘‘(F) establish formal relationships and 
submit 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; 
‘‘(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 
Committee on Training in Primary Care Medi-
cine and Dentistry and the National Health 
Care Workforce Commission established in sec-
tion 5101 of the Patient Protection and Afford-
able Care Act; or 
‘‘(I) provide training in cultural com-
petency and health literacy. 
‘‘(4) DURATION OF AWARDS.—The period dur-
ing which payments are made to an entity from an 
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•AMDT. NO. 2786 
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. 
‘‘(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 prac-
tice 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 
section 747, as amended by section 5301, the following: 
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•AMDT. NO. 2786 
‘‘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 
employed in long-term care settings such as nursing 
homes (as defined in section 1908(e)(1) of the Social Se-
curity Act (42 U.S.C. 1396g(e)(1)), assisted living facili-
ties and skilled nursing facilities, intermediate care facili-
ties for individuals with mental retardation, home and 
community based settings, and any other setting the Sec-
retary 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 
defined 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 
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•AMDT. NO. 2786 
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. 
‘‘(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 
Secretary. 
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•AMDT. NO. 2786 
‘‘(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 
section 5103 of this Act, as section 749; and 
(2) inserting after section 747A, as added by 
section 5302, the following: 
‘‘SEC. 748. TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC 
HEALTH DENTISTRY. 
‘‘(a) SUPPORT
AND DEVELOPMENT
OF DENTAL 
TRAINING 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 Sec-
retary 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-
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•AMDT. NO. 2786 
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 there-
of, who are participants in any such program, 
and who plan to work in the practice of general, 
pediatric, public heath dentistry, or dental hy-
giene; 
‘‘(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, 
pediatric, 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); 
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•AMDT. NO. 2786 
‘‘(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 pe-
diatric training programs in developing and im-
plementing instruction regarding the oral health 
status, dental care needs, and risk-based clin-
ical disease management of all pediatric popu-
lations with an emphasis on underserved chil-
dren. 
‘‘(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. 
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•AMDT. NO. 2786 
‘‘(B) MANNER
OF
PAYMENTS.—With re-
spect to the payments described in subpara-
graph (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 per-
cent, respectively, of the individual’s student 
loan balance as calculated based on principal 
and interest owed at the initiation of the agree-
ment. 
‘‘(b) ELIGIBLE ENTITY.—For purposes of this sub-
section, entities eligible for such grants or contracts in 
general, pediatric, or public health dentistry shall include 
entities that have programs in dental or dental hygiene 
schools, or approved residency or advanced education pro-
grams 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: 
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‘‘(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 
general, 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 
minorities. 
‘‘(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 sub-
stance-related disorders, individuals with disabilities, 
and individuals with HIV/AIDS, and in the risk- 
based clinical disease management of all populations. 
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‘‘(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 
placing graduates in such settings. 
‘‘(8) Qualified applicants that intend to estab-
lish a special populations oral health care education 
center or training program for the didactic and clin-
ical education of dentists, dental health profes-
sionals, and dental hygienists who plan to teach oral 
health care for people with developmental disabil-
ities, cognitive impairment, complex medical prob-
lems, 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 provision of such payments shall be subject to annual 
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approval by the Secretary and subject to the availability 
of appropriations 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 fis-
cal year to another without obtaining approval from the 
Secretary. In no case may any funds be carried over pur-
suant to the preceding sentence for more than 3 years.’’. 
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 au-
thorized to award grants to 15 eligible entities to en-
able such entities to establish a demonstration pro-
gram to establish training programs to train, or to 
employ, alternative dental health care providers in 
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•AMDT. NO. 2786 
(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 
midwives; and 
‘‘(2) are accredited by the American College of 
Nurse-Midwives Accreditation Commission for Mid-
wifery Education.’’. 
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— 
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‘‘(B) any other category of information de-
termined appropriate by the Secretary. 
‘‘(2) In the case of a manufacturer or author-
ized distributor of record which makes distributions 
by means other than mail or common carrier under 
subsection (d)(3) of such section 503, the identity 
and quantity of drug samples requested and the 
identity and quantity of drug samples distributed 
under such subsection during that year, aggregated 
by— 
‘‘(A) the name, address, professional des-
ignation, and signature of the practitioner mak-
ing the request under subparagraph (A)(i) of 
such subsection, or of any individual who makes 
or signs for the request on behalf of the practi-
tioner; and 
‘‘(B) any other category of information de-
termined appropriate by the Secretary. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) APPLICABLE DRUG.—The term ‘applicable 
drug’ means a drug— 
‘‘(A) which is subject to subsection (b) of 
such section 503; and 
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