H. R. 3590—522 
tuition remission) and a student stipend (described 
in paragraph (2)) in each school year for a period 
of years (not to exceed 4 school years) determined 
by the student, during which period the student is 
enrolled in the Track at an affiliated or other partici-
pating health professions institution pursuant to an 
agreement between the Track and such institution; 
and 
‘‘(ii) subject to subparagraph (B), the student 
agrees— 
‘‘(I) to accept the provision of such tuition and 
student stipend to the student; 
‘‘(II) to maintain enrollment at the Track until 
the student completes the course of study involved; 
‘‘(III) while enrolled in such course of study, 
to maintain an acceptable level of academic 
standing (as determined by the Surgeon General); 
‘‘(IV) if pursuing a degree from a school of 
medicine or osteopathic medicine, dental, public 
health, or nursing school or a physician assistant, 
pharmacy, or behavioral and mental health profes-
sional program, to complete a residency or intern-
ship in a specialty that the Surgeon General deter-
mines is appropriate; and 
‘‘(V) to serve for a period of time (referred 
to in this part as the ‘period of obligated service’) 
within the Commissioned Corps of the Public 
Health Service equal to 2 years for each school 
year during which such individual was enrolled 
at the College, reduced as provided for in para-
graph (3); 
‘‘(B) a provision that any financial obligation of the 
United States arising out of a contract entered into under 
this part and any obligation of the student which is condi-
tioned thereon, is contingent upon funds being appropriated 
to carry out this part; 
‘‘(C) a statement of the damages to which the United 
States is entitled for the student’s breach of the contract; 
and 
‘‘(D) such other statements of the rights and liabilities 
of the Secretary and of the individual, not inconsistent 
with the provisions of this part. 
‘‘(2) TUITION AND STUDENT STIPEND.— 
‘‘(A) TUITION REMISSION RATES.—The Surgeon General, 
based on the recommendations of the National Health Care 
Workforce Commission, shall establish Federal tuition 
remission rates to be used by the Track to provide 
reimbursement to affiliated and other participating health 
professions institutions for the cost of educational services 
provided by such institutions to Track students. The agree-
ment entered into by such participating institutions under 
paragraph (1)(A)(i) shall contain an agreement to accept 
as payment in full the established remission rate under 
this subparagraph. 
‘‘(B) STIPEND.—The Surgeon General, based on the rec-
ommendations of the National Health Care Workforce
H. R. 3590—523 
Commission, shall establish and update Federal stipend 
rates for payment to students under this part. 
‘‘(3) REDUCTIONS IN THE PERIOD OF OBLIGATED SERVICE.— 
The period of obligated service under paragraph (1)(A)(ii)(V) 
shall be reduced— 
‘‘(A) in the case of a student who elects to participate 
in a high-needs speciality residency (as determined by the 
National Health Care Workforce Commission), by 3 months 
for each year of such participation (not to exceed a total 
of 12 months); and 
‘‘(B) in the case of a student who, upon completion 
of their residency, elects to practice in a Federal medical 
facility (as defined in section 781(e)) that is located in 
a health professional shortage area (as defined in section 
332), by 3 months for year of full-time practice in such 
a facility (not to exceed a total of 12 months). 
‘‘(c) SECOND 2 YEARS OF SERVICE.—During the third and fourth 
years in which a medical, dental, physician assistant, pharmacy, 
behavioral and mental health, public health, or nursing student 
is enrolled in the Track, training should be designed to prioritize 
clinical rotations in Federal medical facilities in health professional 
shortage areas, and emphasize a balance of hospital and community- 
based experiences, and training within interdisciplinary teams. 
‘‘(d) DENTIST, PHYSICIAN ASSISTANT, PHARMACIST, BEHAVIORAL 
AND MENTAL HEALTH PROFESSIONAL, PUBLIC HEALTH PROFES-
SIONAL, AND NURSE TRAINING.—The Surgeon General shall estab-
lish provisions applicable with respect to dental, physician assistant, 
pharmacy, behavioral and mental health, public health, and nursing 
students that are comparable to those for medical students under 
this section, including service obligations, tuition support, and sti-
pend support. The Surgeon General shall give priority to health 
professions training institutions that train medical, dental, physi-
cian assistant, pharmacy, behavioral and mental health, public 
health, and nursing students for some significant period of time 
together, but at a minimum have a discrete and shared core cur-
riculum. 
‘‘(e) ELITE FEDERAL DISASTER TEAMS.—The Surgeon General, 
in consultation with the Secretary, the Director of the Centers 
for Disease Control and Prevention, and other appropriate military 
and Federal government agencies, shall develop criteria for the 
appointment of highly qualified Track faculty, medical, dental, 
physician assistant, pharmacy, behavioral and mental health, public 
health, and nursing students, and graduates to elite Federal dis-
aster preparedness teams to train and to respond to public health 
emergencies, natural disasters, bioterrorism events, and other emer-
gencies. 
‘‘(f) STUDENT DROPPED FROM TRACK IN AFFILIATE SCHOOL.— 
A medical, dental, physician assistant, pharmacy, behavioral and 
mental health, public health, or nursing student who, under regula-
tions prescribed by the Surgeon General, is dropped from the Track 
in an affiliated school for deficiency in conduct or studies, or for 
other reasons, shall be liable to the United States for all tuition 
and stipend support provided to the student.
H. R. 3590—524 
‘‘SEC. 274. FUNDING. 
‘‘Beginning with fiscal year 2010, the Secretary shall transfer 
from the Public Health and Social Services Emergency Fund such 
sums as may be necessary to carry out this part.’’. 
Subtitle E—Supporting the Existing Health 
Care Workforce 
SEC. 5401. CENTERS OF EXCELLENCE. 
Section 736 of the Public Health Service Act (42 U.S.C. 293) 
is amended by striking subsection (h) and inserting the following: 
‘‘(h) FORMULA FOR ALLOCATIONS.— 
‘‘(1) ALLOCATIONS.—Based on the amount appropriated 
under subsection (i) for a fiscal year, the following subpara-
graphs shall apply as appropriate: 
‘‘(A) IN GENERAL.—If the amounts appropriated under 
subsection (i) for a fiscal year are $24,000,000 or less— 
‘‘(i) the Secretary shall make available $12,000,000 
for grants under subsection (a) to health professions 
schools that meet the conditions described in sub-
section (c)(2)(A); and 
‘‘(ii) and available after grants are made with funds 
under clause (i), the Secretary shall make available— 
‘‘(I) 60 percent of such amount for grants under 
subsection (a) to health professions schools that 
meet the conditions described in paragraph (3) 
or (4) of subsection (c) (including meeting the 
conditions under subsection (e)); and 
‘‘(II) 40 percent of such amount for grants 
under subsection (a) to health professions schools 
that meet the conditions described in subsection 
(c)(5). 
‘‘(B) FUNDING
IN
EXCESS
OF
$24,000,000.—If amounts 
appropriated under subsection (i) for a fiscal year exceed 
$24,000,000 but are less than $30,000,000— 
‘‘(i) 80 percent of such excess amounts shall be 
made available for grants under subsection (a) to 
health professions schools that meet the requirements 
described in paragraph (3) or (4) of subsection (c) 
(including meeting conditions pursuant to subsection 
(e)); and 
‘‘(ii) 20 percent of such excess amount shall be 
made available for grants under subsection (a) to 
health professions schools that meet the conditions 
described in subsection (c)(5). 
‘‘(C) FUNDING
IN
EXCESS
OF
$30,000,000.—If amounts 
appropriated under subsection (i) for a fiscal year exceed 
$30,000,000 but are less than $40,000,000, the Secretary 
shall make available— 
‘‘(i) not less than $12,000,000 for grants under 
subsection (a) to health professions schools that meet 
the conditions described in subsection (c)(2)(A); 
‘‘(ii) not less than $12,000,000 for grants under 
subsection (a) to health professions schools that meet 
the conditions described in paragraph (3) or (4) of
H. R. 3590—525 
subsection (c) (including meeting conditions pursuant 
to subsection (e)); 
‘‘(iii) not less than $6,000,000 for grants under 
subsection (a) to health professions schools that meet 
the conditions described in subsection (c)(5); and 
‘‘(iv) after grants are made with funds under 
clauses (i) through (iii), any remaining excess amount 
for grants under subsection (a) to health professions 
schools that meet the conditions described in para-
graph (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 Secretary shall make available— 
‘‘(i) not less than $16,000,000 for grants under 
subsection (a) to health professions schools that meet 
the conditions described in subsection (c)(2)(A); 
‘‘(ii) not less than $16,000,000 for grants under 
subsection (a) to health professions schools that meet 
the conditions described in paragraph (3) or (4) of 
subsection (c) (including meeting conditions pursuant 
to subsection (e)); 
‘‘(iii) not less than $8,000,000 for grants under 
subsection (a) to health professions schools that meet 
the conditions described in subsection (c)(5); and 
‘‘(iv) after grants are made with funds under 
clauses (i) through (iii), any remaining funds for grants 
under subsection (a) to health professions schools that 
meet the conditions 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 activities 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 maintain expenditures of non-Federal amounts 
for such activities at a level that is not less than the 
level of such expenditures maintained by the center for 
the fiscal year preceding the fiscal year for which the 
school receives such a grant. 
‘‘(B) USE
OF
FEDERAL
FUNDS.—With respect to any 
Federal amounts received by a center 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 
obtained from sources other than the grant, unless 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.’’.
H. R. 3590—526 
SEC. 5402. HEALTH CARE PROFESSIONALS TRAINING FOR DIVERSITY. 
(a) LOAN REPAYMENTS AND FELLOWSHIPS REGARDING 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 educational loans of such individuals.’’ and 
inserting ‘‘$30,000 of the principal and interest of the educational 
loans of such individuals.’’. 
(b) SCHOLARSHIPS
FOR DISADVANTAGED STUDENTS.—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 nec-
essary for each of the fiscal years 2011 through 2014’’. 
(c) REAUTHORIZATION FOR LOAN REPAYMENTS AND FELLOWSHIPS 
REGARDING FACULTY POSITIONS.—Section 740(b) of such Act (42 
U.S.C. 293d(b)) is amended by striking ‘‘appropriated’’ and all that 
follows through the period at the end and inserting ‘‘appropriated, 
$5,000,000 for each of the fiscal years 2010 through 2014.’’. 
(d) REAUTHORIZATION FOR EDUCATIONAL ASSISTANCE IN THE 
HEALTH PROFESSIONS REGARDING INDIVIDUALS FROM A DISADVAN-
TAGED BACKGROUND.—Section 740(c) of such Act (42 U.S.C. 293d(c)) 
is amended by striking the first sentence and inserting the fol-
lowing: ‘‘For the purpose of grants and contracts under section 
739(a)(1), there is authorized to be appropriated $60,000,000 for 
fiscal year 2010 and such sums as may be necessary for each 
of the fiscal years 2011 through 2014.’’ 
SEC. 5403. INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES. 
(a) AREA HEALTH EDUCATION CENTERS.—Section 751 of the 
Public Health Service Act (42 U.S.C. 294a) is amended to read 
as follows: 
‘‘SEC. 751. AREA HEALTH EDUCATION CENTERS. 
‘‘(a) ESTABLISHMENT OF AWARDS.—The Secretary shall make 
the following 2 types of awards in accordance with this section: 
‘‘(1) INFRASTRUCTURE
DEVELOPMENT
AWARD.—The Sec-
retary shall make awards to eligible entities to enable such 
entities to initiate health care workforce educational programs 
or to continue to carry out comparable programs that are oper-
ating at the time the award is made by planning, developing, 
operating, and evaluating an area health education center pro-
gram. 
‘‘(2) POINT OF SERVICE MAINTENANCE AND ENHANCEMENT 
AWARD.—The Secretary shall make awards to eligible entities 
to maintain and improve the effectiveness and capabilities of 
an existing area health education center program, and make 
other modifications to the program that are appropriate due 
to changes in demographics, needs of the populations served, 
or other similar issues affecting the area health education 
center program. For the purposes of this section, the term 
‘Program’ refers to the area health education center program. 
‘‘(b) ELIGIBLE ENTITIES; APPLICATION.— 
‘‘(1) ELIGIBLE ENTITIES.— 
‘‘(A) INFRASTRUCTURE DEVELOPMENT.—For purposes of 
subsection (a)(1), the term ‘eligible entity’ means a school 
of medicine or osteopathic medicine, an incorporated 
consortium of such schools, or the parent institutions of 
such a school. With respect to a State in which no area
H. R. 3590—527 
health education center program is in operation, the Sec-
retary may award a grant or contract under subsection 
(a)(1) to a school of nursing. 
‘‘(B) POINT OF SERVICE MAINTENANCE AND ENHANCE-
MENT.—For purposes of subsection (a)(2), the term ‘eligible 
entity’ means an entity that has received funds under 
this section, is operating an area health education center 
program, including an area health education center or cen-
ters, and has a center or centers that are no longer eligible 
to receive financial assistance under subsection (a)(1). 
‘‘(2) APPLICATION.—An eligible entity desiring to receive 
an award 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. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) REQUIRED
ACTIVITIES.—An eligible entity shall use 
amounts awarded under a grant under subsection (a)(1) or 
(a)(2) to carry out the following activities: 
‘‘(A) Develop and implement strategies, in coordination 
with the applicable one-stop delivery system under section 
134(c) of the Workforce Investment Act of 1998, to recruit 
individuals from underrepresented minority populations or 
from disadvantaged or rural backgrounds into health 
professions, and support such individuals in attaining such 
careers. 
‘‘(B) Develop and implement strategies to foster and 
provide community-based training and education to individ-
uals seeking careers in health professions within under-
served areas for the purpose of developing and maintaining 
a diverse health care workforce that is prepared to deliver 
high-quality care, with an emphasis on primary care, in 
underserved areas or for health disparity populations, in 
collaboration with other Federal and State health care 
workforce development programs, the State workforce 
agency, and local workforce investment boards, and in 
health care safety net sites. 
‘‘(C) Prepare individuals to more effectively provide 
health services to underserved areas and health disparity 
populations through field placements or preceptorships in 
conjunction with community-based organizations, accred-
ited primary care residency training programs, Federally 
qualified health centers, rural health clinics, public health 
departments, or other appropriate facilities. 
‘‘(D) Conduct and participate in interdisciplinary 
training that involves physicians, physician assistants, 
nurse practitioners, nurse midwives, dentists, psycholo-
gists, 
pharmacists, 
optometrists, 
community 
health 
workers, public and allied health professionals, or other 
health professionals, as practicable. 
‘‘(E) Deliver or facilitate continuing education and 
information dissemination programs for health care profes-
sionals, with an emphasis on individuals providing care 
in underserved areas and for health disparity populations. 
‘‘(F) Propose and implement effective program and out-
comes measurement and evaluation strategies.
H. R. 3590—528 
‘‘(G) Establish a youth public health program to expose 
and recruit high school students into health careers, with 
a focus on careers in public health. 
‘‘(2) INNOVATIVE OPPORTUNITIES.—An eligible entity may 
use amounts awarded under a grant under subsection (a)(1) 
or subsection (a)(2) to carry out any of the following activities: 
‘‘(A) Develop and implement innovative curricula in 
collaboration with community-based accredited primary 
care residency training programs, Federally qualified 
health centers, rural health clinics, behavioral and mental 
health facilities, public health departments, or other appro-
priate facilities, with the goal of increasing the number 
of primary care physicians and other primary care pro-
viders prepared to serve in underserved areas and health 
disparity populations. 
‘‘(B) 
Coordinate 
community-based 
participatory 
research with academic health centers, and facilitate rapid 
flow and dissemination of evidence-based health care 
information, research results, and best practices to improve 
quality, efficiency, and effectiveness of health care and 
health care systems within community settings. 
‘‘(C) Develop and implement other strategies to address 
identified workforce needs and increase and enhance the 
health care workforce in the area served by the area health 
education center program. 
‘‘(d) REQUIREMENTS.— 
‘‘(1) AREA HEALTH EDUCATION CENTER PROGRAM.—In car-
rying out this section, the Secretary shall ensure the following: 
‘‘(A) An entity that receives an award under this section 
shall conduct at least 10 percent of clinical education 
required for medical students in community settings that 
are removed from the primary teaching facility of the con-
tracting institution for grantees that operate a school of 
medicine or osteopathic medicine. In States in which an 
entity that receives an award under this section is a 
nursing school or its parent institution, the Secretary shall 
alternatively ensure that— 
‘‘(i) the nursing school conducts at least 10 percent 
of clinical education required for nursing students in 
community settings that are remote from the primary 
teaching facility of the school; and 
‘‘(ii) the entity receiving the award maintains a 
written agreement with a school of medicine or osteo-
pathic medicine to place students from that school 
in training sites in the area health education center 
program area. 
‘‘(B) An entity receiving funds under subsection (a)(2) 
does not distribute such funding to a center that is eligible 
to receive funding under subsection (a)(1). 
‘‘(2) AREA HEALTH EDUCATION CENTER.—The Secretary shall 
ensure that each area health education center program includes 
at least 1 area health education center, and that each such 
center— 
‘‘(A) is a public or private organization whose structure, 
governance, and operation is independent from the awardee 
and the parent institution of the awardee;
H. R. 3590—529 
‘‘(B) is not a school of medicine or osteopathic medicine, 
the parent institution of such a school, or a branch campus 
or other subunit of a school of medicine or osteopathic 
medicine or its parent institution, or a consortium of such 
entities; 
‘‘(C) designates an underserved area or population to 
be served by the center which is in a location removed 
from the main location of the teaching facilities of the 
schools participating in the program with such center and 
does not duplicate, in whole or in part, the geographic 
area or population served by any other center; 
‘‘(D) fosters networking and collaboration among 
communities and between academic health centers and 
community-based centers; 
‘‘(E) serves communities with a demonstrated need 
of health professionals in partnership with academic med-
ical centers; 
‘‘(F) addresses the health care workforce needs of the 
communities served in coordination with the public 
workforce investment system; and 
‘‘(G) has a community-based governing or advisory 
board that reflects the diversity of the communities 
involved. 
‘‘(e) MATCHING FUNDS.—With respect to the costs of operating 
a program through a grant under this section, to be eligible for 
financial assistance under this section, an entity shall make avail-
able (directly or through contributions from State, county or munic-
ipal governments, or the private sector) recurring non-Federal con-
tributions in cash or in kind, toward such costs in an amount 
that is equal to not less than 50 percent of such costs. At least 
25 percent of the total required non-Federal contributions shall 
be in cash. An entity may apply to the Secretary for a waiver 
of not more than 75 percent of the matching fund amount required 
by the entity for each of the first 3 years the entity is funded 
through a grant under subsection (a)(1). 
‘‘(f) LIMITATION.—Not less than 75 percent of the total amount 
provided to an area health education center program under sub-
section (a)(1) or (a)(2) shall be allocated to the area health education 
centers participating in the program under this section. To provide 
needed flexibility to newly funded area health education center 
programs, the Secretary may waive the requirement in the sentence 
for the first 2 years of a new area health education center program 
funded under subsection (a)(1). 
‘‘(g) AWARD.—An award to an entity under this section shall 
be not less than $250,000 annually per area health education center 
included in the program involved. If amounts appropriated to carry 
out this section are not sufficient to comply with the preceding 
sentence, the Secretary may reduce the per center amount provided 
for in such sentence as necessary, provided the distribution estab-
lished in subsection (j)(2) is maintained. 
‘‘(h) PROJECT TERMS.— 
‘‘(1) IN GENERAL.—Except as provided in paragraph (2), 
the period during which payments may be made under an 
award under subsection (a)(1) may not exceed— 
‘‘(A) in the case of a program, 12 years; or 
‘‘(B) in the case of a center within a program, 6 years.
H. R. 3590—530 
‘‘(2) EXCEPTION.—The periods described in paragraph (1) 
shall not apply to programs receiving point of service mainte-
nance and enhancement awards under subsection (a)(2) to 
maintain existing centers and activities. 
‘‘(i) INAPPLICABILITY OF PROVISION.—Notwithstanding any other 
provision of this title, section 791(a) shall not apply to an area 
health education center funded under this section. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—There is authorized to be appropriated 
to carry out this section $125,000,000 for each of the fiscal 
years 2010 through 2014. 
‘‘(2) REQUIREMENTS.—Of the amounts appropriated for a 
fiscal year under paragraph (1)— 
‘‘(A) not more than 35 percent shall be used for awards 
under subsection (a)(1); 
‘‘(B) not less than 60 percent shall be used for awards 
under subsection (a)(2); 
‘‘(C) not more than 1 percent shall be used for grants 
and contracts to implement outcomes evaluation for the 
area health education centers; and 
‘‘(D) not more than 4 percent shall be used for grants 
and contracts to provide technical assistance to entities 
receiving awards under this section. 
‘‘(3) 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 Secretary. In 
no case may any funds be carried over pursuant to the pre-
ceding sentence for more than 3 years. 
‘‘(k) SENSE
OF CONGRESS.—It is the sense of the Congress 
that every State have an area health education center program 
in effect under this section.’’. 
(b) CONTINUING EDUCATIONAL SUPPORT FOR HEALTH PROFES-
SIONALS SERVING IN UNDERSERVED COMMUNITIES.—Part D of title 
VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is 
amended by striking section 752 and inserting the following: 
‘‘SEC. 
752. 
CONTINUING 
EDUCATIONAL 
SUPPORT 
FOR 
HEALTH 
PROFESSIONALS SERVING IN UNDERSERVED COMMU-
NITIES. 
‘‘(a) IN GENERAL.—The Secretary shall make grants to, and 
enter into contracts with, eligible entities to improve health care, 
increase retention, increase representation of minority faculty mem-
bers, enhance the practice environment, and provide information 
dissemination and educational support to reduce professional isola-
tion through the timely dissemination of research findings using 
relevant resources. 
‘‘(b) ELIGIBLE ENTITIES.—For purposes of this section, the term 
‘eligible entity’ means an entity described in section 799(b). 
‘‘(c) APPLICATION.—An eligible entity desiring to receive an 
award under this section shall submit to the Secretary an applica-
tion at such time, in such manner, and containing such information 
as the Secretary may require. 
‘‘(d) USE
OF FUNDS.—An eligible entity shall use amounts 
awarded under a grant or contract under this section to provide