126 
TITLE VII—PROMOTION OF PRI-
MARY HEALTH CARE; DEVEL-
OPMENT OF HEALTH SERV-
ICE CAPACITY; PROGRAMS TO 
ASSIST THE MEDICALLY UN-
DERSERVED 
Subtitle A—Promotion and Expan-
sion of Primary Care Profes-
sional Training 
SEC. 701. ROLE OF BOARD; ESTABLISHMENT OF PRIMARY 
CARE PROFESSIONAL OUTPUT GOALS. 
(a) IN GENERAL.—The Board is responsible for— 
(1) coordinating health professional education 
policies and goals, in consultation with the Secretary 
of Health and Human Services (in this title referred 
to as the ‘‘Secretary’’), to achieve the national goals 
specified in subsection (b); 
(2) overseeing the health professional education 
expenditures of the State health security programs 
from the account established under section 602(c); 
(3) developing and maintaining, in cooperation 
with the Secretary, a system to monitor the number 
and specialties of individuals through their health 
professional education, any postgraduate training, 
and professional practice; and 
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(4) developing, coordinating, and promoting 
other policies that expand the number of primary 
care practitioners. 
(b) NATIONAL GOALS.—The national goals specified 
in this subsection are as follows: 
(1) GRADUATE MEDICAL EDUCATION.—By not 
later than 5 years after the date of the enactment 
of this Act, at least 50 percent of the residents in 
medical residency education programs (as defined in 
subsection (e)(1)) are primary care residents (as de-
fined in subsection (e)(3)). 
(2) 
MIDLEVEL
PRIMARY
CARE
PRACTI-
TIONERS.—To assure an adequate supply of primary 
care practitioners, there shall be a number, specified 
by the Board, of midlevel primary care practitioners 
(as defined in subsection (e)(2)) employed in the 
health care system as of January 1, 2011. 
(c) METHOD FOR ATTAINMENT OF NATIONAL GOAL 
FOR
GRADUATE
MEDICAL
EDUCATION; 
PROGRAM 
GOALS.— 
(1) IN GENERAL.—The Board shall establish a 
method of applying the national goal in subsection 
(b)(1) to program goals for each medical residency 
education program or to medical residency education 
consortia. 
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(2) 
CONSIDERATION.—The 
program 
goals 
under paragraph (1) shall be based on the distribu-
tion of medical schools and other teaching facilities 
within each State health security program, and the 
number of positions for graduate medical education. 
(3) MEDICAL RESIDENCY EDUCATION CONSOR-
TIUM.—In this subsection, the term ‘‘medical resi-
dency education consortium’’ means a consortium of 
medical residency education programs in a contig-
uous geographic area (which may be an interstate 
area) if the consortium— 
(A) includes at least 1 medical school with 
a teaching hospital and related teaching set-
tings; and 
(B) has an affiliation with qualified com-
munity-based primary health service providers 
described in section 202(a) and with at least 1 
comprehensive health service organization es-
tablished under section 303. 
(4) ENFORCEMENT THROUGH STATE HEALTH 
SECURITY
BUDGETS.—The Board shall develop a 
formula for reducing payments to State health secu-
rity programs (that provide for payments to a med-
ical residency education program) that failed to meet 
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the goal for the program established under this sub-
section. 
(d) METHOD FOR ATTAINMENT OF NATIONAL GOAL 
FOR MIDLEVEL PRIMARY CARE PRACTITIONERS.—To as-
sist in attaining the national goal identified in subsection 
(b)(2), the Board shall— 
(1) advise the Public Health Service on alloca-
tions of funding under titles VII and VIII of the 
Public Health Service Act, the National Health 
Service Corps, and other programs in order to in-
crease the supply of midlevel primary care practi-
tioners; and 
(2) commission a study of the potential benefits 
and disadvantages of expanding the scope of practice 
authorized under State laws for any class of midlevel 
primary care practitioners. 
(e) DEFINITIONS.—In this title: 
(1) MEDICAL
RESIDENCY
EDUCATION
PRO-
GRAM.—The term ‘‘medical residency education pro-
gram’’ means a program that provides education 
and training to graduates of medical schools in order 
to meet requirements for licensing and certification 
as a physician, and includes the medical school su-
pervising the program and includes the hospital or 
other facility in which the program is operated. 
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(2) 
MIDLEVEL
PRIMARY
CARE
PRACTI-
TIONER.—The term ‘‘midlevel primary care practi-
tioner’’ means a clinical nurse practitioner, certified 
nurse midwife, physician assistance, or other non-
physician practitioner, specified by the Board, as au-
thorized to practice under State law. 
(3) PRIMARY CARE RESIDENT.—The term ‘‘pri-
mary care resident’’ means (in accordance with cri-
teria established by the Board) a resident being 
trained in a distinct program of family practice med-
icine, general practice, general internal medicine, or 
general pediatrics. 
SEC. 702. ESTABLISHMENT OF ADVISORY COMMITTEE ON 
HEALTH PROFESSIONAL EDUCATION. 
(a) IN GENERAL.—The Board shall provide for an 
Advisory Committee on Health Professional Education (in 
this section referred to as the ‘‘Committee’’) to advise the 
Board on its activities under section 701. 
(b) MEMBERSHIP.—The Committee shall be com-
posed of— 
(1) the Chair of the Board, who shall serve as 
Chair of the Committee; and 
(2) 12 members, not otherwise in the employ of 
the United States, appointed by the Board without 
regard to the provisions of title 5, United States 
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Code, governing appointments in the competitive 
service. 
The appointed members shall provide a balanced point of 
view with respect to health professional education, primary 
care disciplines, and health care policy and shall include 
individuals who are representative of medical schools, 
other health professional schools, residency programs, pri-
mary care practitioners, teaching hospitals, professional 
associations, public health organizations, State health se-
curity programs, and consumers. 
(c) TERMS OF MEMBERS.—Each appointed member 
shall hold office for a term of 5 years, except that— 
(1) any member appointed to fill a vacancy oc-
curring during the term for which the member’s 
predecessor was appointed shall be appointed for the 
remainder of that term; and 
(2) the terms of the members first taking office 
shall expire, as designated by the Board at the time 
of appointment, 2 at the end of the second year, 2 
at the end of the third year, 2 at the end of the 
fourth year, and 3 at the end of the fifth year after 
the date of enactment of this Act. 
(d) VACANCIES.— 
(1) IN GENERAL.—The Board shall fill any va-
cancy in the membership of the Committee in the 
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same manner as the original appointment. The va-
cancy shall not affect the power of the remaining 
members to execute the duties of the Committee. 
(2) VACANCY
APPOINTMENTS.—Any member 
appointed to fill a vacancy shall serve for the re-
mainder of the term for which the predecessor of the 
member was appointed. 
(3) REAPPOINTMENT.—The Board may re-
appoint an appointed member of the Committee for 
a second term in the same manner as the original 
appointment. 
(e) DUTIES.—It shall be the duty of the Committee 
to advise the Board concerning graduate medical edu-
cation policies under this title. 
(f) STAFF.—The Committee, its members, and any 
committees of the Committee shall be provided with such 
secretarial, clerical, or other assistance as may be author-
ized by the Board for carrying out their respective func-
tions. 
(g) MEETINGS.—The Committee shall meet as fre-
quently as the Board deems necessary, but not less than 
4 times each year. Upon request by 4 or more members 
it shall be the duty of the Chair to call a meeting of the 
Committee. 
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(h) COMPENSATION.—Members of the Committee 
shall be reimbursed by the Board for travel and per diem 
in lieu of subsistence expenses during the performance of 
duties of the Board in accordance with subchapter I of 
chapter 57 of title 5, United States Code. 
(i) FACA NOT APPLICABLE.—The provisions of the 
Federal Advisory Committee Act shall not apply to the 
Committee. 
SEC. 703. GRANTS FOR HEALTH PROFESSIONS EDUCATION, 
NURSE 
EDUCATION, 
AND 
THE 
NATIONAL 
HEALTH SERVICE CORPS. 
(a) TRANSFERS
TO PUBLIC HEALTH SERVICE.— 
From the amounts provided under subsection (c), the 
Board shall make transfers from the American Health Se-
curity Trust Fund to the Public Health Service under sub-
part II of part D of title III, title VII, and title VIII of 
the Public Health Service Act for the support of the Na-
tional Health Service Corps, health professions education, 
and nursing education, including education of clinical 
nurse practitioners, certified registered nurse anesthetists, 
certified nurse midwives, and physician assistants. Of the 
amounts so transferred in each year, not less than 50 per-
cent shall be expended for the support of the National 
Health Service Corps. 
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(b) RANGE OF FUNDS.—The amount of transfers 
under subsection (a) for any fiscal year shall be an amount 
(specified by the Board each year) not less than 4⁄100 per-
cent and not to exceed 6⁄100 percent of the amounts the 
Board estimates will be expended from the Trust Fund 
in the fiscal year. 
(c) FUNDS SUPPLEMENTAL TO OTHER FUNDS.—The 
funds provided under this section with respect to provision 
of services are in addition to, and not in replacement of, 
funds made available under the provisions referred to in 
subsection (a) and shall be administered in accordance 
with the terms of such provisions. The Board shall make 
no transfer of funds under this section for any fiscal year 
for which the total appropriations for the programs au-
thorized by such provisions are less than the total amount 
appropriated for such programs in fiscal year 2006. 
Subtitle B—Direct Health Care 
Delivery 
SEC. 711. SETASIDE FOR PUBLIC HEALTH. 
(a) TRANSFERS
TO PUBLIC HEALTH SERVICE.— 
From the amounts provided under subsection (c), the 
Board shall make transfers from the American Health Se-
curity Trust Fund to the Public Health Service for the 
following purposes (other than payment for services cov-
ered under title II): 
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(1) For payments to States under the maternal 
and child health block grants under title V of the 
Social Security Act. 
(2) For prevention and treatment of tuber-
culosis under section 317 of the Public Health Serv-
ice Act. 
(3) For the prevention and treatment of sexu-
ally transmitted diseases under section 318 of the 
Public Health Service Act. 
(4) Preventive health block grants under part A 
of title XIX of the Public Health Service Act. 
(5) Grants to States for community mental 
health services under subpart I of part B of title 
XIX of the Public Health Service Act. 
(6) Grants to States for prevention and treat-
ment of substance abuse under subpart II of part B 
of title XIX of the Public Health Service Act. 
(7) Grants for HIV health care services under 
parts A, B, and C of title XXVI of the Public 
Health Service Act. 
(8) Public health formula grants described in 
subsection (d). 
(b) RANGE OF FUNDS.—The amount of transfers 
under subsection (a) for any fiscal year shall be an amount 
(specified by the Board each year) not less than 1⁄10 per-
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cent and not to exceed 14⁄100 percent of the amounts the 
Board estimates will be expended from the Trust Fund 
in the fiscal year. 
(c) FUNDS SUPPLEMENTAL TO OTHER FUNDS.—The 
funds provided under this section with respect to provision 
of services are in addition to, and not in replacement of, 
funds made available under the programs referred to in 
subsection (a) and shall be administered in accordance 
with the terms of such programs. 
(d) REQUIRED REPORTS ON HEALTH STATUS.—The 
Secretary shall require each State receiving funds under 
this section to submit annual reports to the Secretary on 
the health status of the population and measurable objec-
tives for improving the health of the public in the State. 
Such reports shall include the following: 
(1) A comparison of the measures of the State 
and local public health system compared to relevant 
objectives set forth in ‘‘Healthy People 2000’’ or 
subsequent national objectives set by the Secretary. 
(2) A description of health status measures to 
be improved within the State (at the State and local 
levels) through expanded public health functions and 
health promotion and disease prevention programs. 
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(3) Measurable outcomes and process objectives 
for improving health status, and a report on out-
comes from the previous year. 
(4) Information regarding how Federal funding 
has improved population-based prevention activities 
and programs. 
(5) A description of the core public health func-
tions to be carried out at the local level. 
(6) A description of the relationship between 
the State’s public health system, community-based 
health promotion and disease prevention providers, 
and the State health security program. 
(e) LIMITATION ON FUND TRANSFERS.—The Board 
shall make no transfer of funds under this section for any 
fiscal year for which the total appropriations for such pro-
grams are less than the total amount appropriated for 
such programs in fiscal year 2006. 
(f) PUBLIC HEALTH FORMULA GRANTS.—The Sec-
retary shall provide stable funds to States through for-
mula grants for the purpose of carrying out core public 
health functions to monitor and protect the health of com-
munities from communicable diseases and exposure to 
toxic environmental pollutants, occupational hazards, 
harmful products, and poor health outcomes. Such func-
tions include the following: 
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(1) Data collection, analysis, and assessment of 
public health data, vital statistics, and personal 
health data to assess community health status and 
outcomes reporting. This function includes the ac-
quisition and installation of hardware and software, 
and personnel training and technical assistance to 
operate and support automated and integrated infor-
mation systems. 
(2) Activities to protect the environment and to 
assure the safety of housing, workplaces, food, and 
water. 
(3) Investigation and control of adverse health 
conditions, and threats to the health status of indi-
viduals and the community. This function includes 
the identification and control of outbreaks of infec-
tious disease, patterns of chronic disease and injury, 
and cooperative activities to reduce the levels of vio-
lence. 
(4) Health promotion and disease prevention 
activities for which there is a significant need and a 
high priority of the Public Health Service. 
(5) The provision of public health laboratory 
services to complement private clinical laboratory 
services, including— 
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