1212 
model under paragraph (1), that the design of 
such model ensure that such model is budget 
neutral initially with respect to expenditures 
under the applicable title. 
‘‘(B) TERMINATION.—The Secretary shall 
terminate or modify the design and implemen-
tation of a model unless the Secretary deter-
mines (and the Chief Actuary of the Centers for 
Medicare & Medicaid Services, with respect to 
spending under the applicable title, certifies), 
after testing has begun, that the model is ex-
pected to— 
‘‘(i) improve the quality of care (as 
determined by the Administrator of the 
Centers for Medicare & Medicaid Services) 
without increasing spending under such 
title; 
‘‘(ii) reduce spending under such titles 
without reducing the quality of care; or 
‘‘(iii) do both. 
Such termination may occur at any time after 
such testing has begun and before completion of 
the testing. 
‘‘(4) EVALUATION.—
1213 
‘‘(A) IN
GENERAL.—The Secretary shall 
conduct an evaluation of each model tested 
under this subsection. Such evaluation shall in-
clude an analysis of— 
‘‘(i) the quality of care furnished 
under the model, including through the use 
of patient-level outcomes measures; and 
‘‘(ii) the changes in spending under 
the applicable titles by reason of the 
model. 
The Secretary shall make the results of each 
evaluation under this paragraph available to the 
public in a timely fashion. 
‘‘(B) MEASURE
SELECTION.—To the ex-
tent feasible, the Secretary shall select meas-
ures under this paragraph that reflect national 
priorities for quality improvement and patient- 
centered care consistent with the measures de-
veloped under section 1192(c)(1). 
‘‘(5) TESTING
PERIOD.—In no case shall a 
model be tested under this subsection for more than 
a 7-year period. 
‘‘(c) EXPANSION OF MODELS (PHASE II).—The Sec-
retary may expand the duration and the scope of a model 
that is being tested under subsection (b) (including imple-
1214 
mentation on a nationwide basis), to the extent deter-
mined appropriate by the Secretary, if— 
‘‘(1) the Secretary determines that such expan-
sion is expected— 
‘‘(A) to improve the quality of patient care 
without increasing spending under the applica-
ble titles; 
‘‘(B) to reduce spending under applicable 
titles without reducing the quality of care; or 
‘‘(C) to do both; 
‘‘(2) the Chief Actuary of the Centers for Medi-
care & Medicaid Services certifies that such expan-
sion would reduce (or not result in any increase in) 
net program spending under applicable titles; and 
‘‘(3) the Secretary determines that such expan-
sion would not deny or limit the coverage or provi-
sion of benefits under the applicable title for applica-
ble individuals. 
‘‘(d) IMPLEMENTATION.— 
‘‘(1) WAIVER AUTHORITY.—The Secretary may 
waive such requirements of titles XI and XVIII and 
of sections 1902 and 1903(m) as may be necessary 
solely for purposes of carrying out this section with 
respect to testing models described in subsection (b).
1215 
‘‘(2) LIMITATIONS ON REVIEW.—There shall be 
no administrative or judicial review under section 
1869, section 1878, or otherwise of— 
‘‘(A) the selection of models for testing or 
expansion under this section; 
‘‘(B) the elements, parameters, scope, and 
duration of such models for testing or dissemi-
nation; 
‘‘(C) the termination or modification of the 
design and implementation of a model under 
subsection (b)(3)(B); and 
‘‘(D) determinations about expansion of 
the duration and scope of a model under sub-
section (c) including the determination that a 
model is not expected to meet criteria described 
in paragraphs (1) or (2) of such subsection. 
‘‘(3) ADMINISTRATION.—Chapter 35 of title 44, 
United States Code, shall not apply to the testing 
and evaluation of models or expansion of such mod-
els under this section. 
‘‘(4) FUNDING FOR TESTING ITEMS AND SERV-
ICES AND ADMINISTRATIVE COSTS.— 
‘‘(A) ADDITIONAL BENEFITS.—There shall 
be available until expended, equally divided 
from the Federal Supplementary Hospital In-
1216 
surance Trust Fund and Federal Supple-
mentary Medical Insurance Trust Fund for 
payments for additional benefits for items and 
services under models tested under subsection 
(b) not otherwise covered under this title and 
applicable to benefits under this title, and for 
researching, designing, implementing, and eval-
uating such models, $350,000,000 for fiscal 
year 2010, $440,000,000 for fiscal year 2011, 
$550,000,000 for fiscal year 2012, and, for a 
subsequent fiscal year, the amount determined 
under this subparagraph for the preceding fis-
cal year increased by the annual percentage 
rate of increase in total expenditures under this 
title for the subsequent fiscal year as estimated 
in the latest available Annual Report of the 
Board of Trustees as described in section 
1841(b)(2). 
‘‘(B) MEDICAID.—For administrative costs 
of the Centers for Medicare & Medicaid Serv-
ices for administering this section with respect 
to title XIX, from any amounts in the Treasury 
not otherwise appropriated there are appro-
priated to the Secretary for the Centers for 
Medicare & Medicaid Services Program Man-
1217 
agement Account $25,000,000 for each fiscal 
year beginning with fiscal year 2010. Amounts 
appropriated under this subparagraph for a fis-
cal year shall be available until expended. 
‘‘(e) REPORT TO CONGRESS.—Beginning in 2012, 
and not less than once every other year thereafter, the 
Secretary shall submit to Congress a report on activities 
under this section. Each such report shall describe the 
payment models tested under subsection (b), including the 
number of individuals described in subsection (a)(4)(A)(i) 
and of individuals described in subsection (a)(4)(A)(ii) 
participating in such models and payments made under 
applicable titles for services on behalf of such individuals, 
any models chosen for expansion under subsection (c), and 
the results from evaluations under subsection (b)(4). In 
addition, each such report shall provide such recommenda-
tions as the Secretary believes are appropriate for legisla-
tive action to facilitate the development and expansion of 
successful payment models.’’. 
(b) MEDICAID CONFORMING AMENDMENT.—Section 
1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), 
as amended by sections 1631(b), 1703(a), 1729, 1753, 
1757(a), and 1759(a), is amended— 
(1) in paragraph (78), by striking ‘‘and’’ at the 
end;
1218 
(2) in paragraph (79), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (79) the fol-
lowing new paragraph: 
‘‘(80) provide for implementation of the pay-
ment models specified by the Secretary under section 
1115A(c) for implementation on a nationwide basis 
unless the State demonstrates to the satisfaction of 
the Secretary that implementation would not be ad-
ministratively feasible or appropriate to the health 
care delivery system of the State.’’. 
SEC. 1908. APPLICATION OF EMERGENCY SERVICES LAWS. 
Nothing in this Act shall be construed to relieve any 
health care provider from providing emergency services as 
required by State or Federal law, including section 1867 
of the Social Security Act (popularly known as 
‘‘EMTALA’’). 
SEC. 1909. DISREGARD UNDER THE SUPPLEMENTAL SECU-
RITY INCOME PROGRAM OF COMPENSATION 
FOR PARTICIPATION IN CLINICAL TRIALS 
FOR RARE DISEASES OR CONDITIONS. 
(a) INCOME DISREGARD.—Section 1612(b) of the So-
cial Security Act (42 U.S.C. 1382a(b)) is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(24);
1219 
(2) by striking the period at the end of para-
graph (25) and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(26) The first $2,000 per year received by 
such individual (or such spouse) for participation in 
a clinical trial to test a treatment for a rare disease 
or condition (within the meaning of section 5(b)(2) 
of the Orphan Drug Act (Public Law 97–414)), 
that— 
‘‘(A) has been reviewed and approved by 
an institutional review board that— 
‘‘(i) is established to protect the rights 
and welfare of human subjects partici-
pating in research; and 
‘‘(ii) meet the standards for such bod-
ies set forth in part 46 of title 45, Code of 
Federal Regulations; and 
‘‘(B) meets the standards for protection of 
human subjects for clinical research (as set 
forth in such part).’’. 
(b) RESOURCE DISREGARD.—Section 1613(a) of 
such Act (42 U.S.C. 1382b(a)) is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(15);
1220 
(2) by striking the period at the end of para-
graph (16) and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (16) the fol-
lowing: 
‘‘(17) the first $2,000 per year received by such 
individual (or such spouse) for participation in a 
clinical trial, as described in section 1612(b)(26).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to benefits payable for calendar 
months beginning after the earlier of— 
(1) the date the Commissioner of Social Secu-
rity promulgates regulations to carry out the amend-
ments; or 
(2) the 180-day period that begins with the 
date of the enactment of this Act. 
DIVISION 
C—PUBLIC 
HEALTH 
AND WORKFORCE DEVELOP-
MENT 
SEC. 2001. TABLE OF CONTENTS; REFERENCES. 
(a) TABLE OF CONTENTS.—The table of contents of 
this division is as follows: 
Sec. 2001. Table of contents; references. 
Sec. 2002. Public Health Investment Fund. 
Sec. 2003. Deficit neutrality. 
TITLE I—COMMUNITY HEALTH CENTERS 
Sec. 2101. Increased funding. 
TITLE II—WORKFORCE
1221 
Subtitle A—Primary Care Workforce 
PART 1—NATIONAL HEALTH SERVICE CORPS 
Sec. 2201. National Health Service Corps. 
Sec. 2202. Authorizations of appropriations. 
PART 2—PROMOTION OF PRIMARY CARE AND DENTISTRY 
Sec. 2211. Frontline health providers. 
‘‘SUBPART XI—HEALTH PROFESSIONAL NEEDS AREAS 
‘‘Sec. 340H. In general. 
‘‘Sec. 340I. Loan repayments. 
‘‘Sec. 340J. Report. 
‘‘Sec. 340K. Allocation. 
Sec. 2212. Primary care student loan funds. 
Sec. 2213. Training in family medicine, general internal medicine, general pedi-
atrics, geriatrics, and physician assistants. 
Sec. 2214. Training of medical residents in community-based settings. 
Sec. 2215. Training for general, pediatric, and public health dentists and dental 
hygienists. 
Sec. 2216. Authorization of appropriations. 
Sec. 2217. Study on effectiveness of scholarships and loan repayments. 
Subtitle B—Nursing Workforce 
Sec. 2221. Amendments to Public Health Service Act. 
Subtitle C—Public Health Workforce 
Sec. 2231. Public Health Workforce Corps. 
‘‘SUBPART XII—PUBLIC HEALTH WORKFORCE 
‘‘Sec. 340L. Public Health Workforce Corps. 
‘‘Sec. 340M. Public Health Workforce Scholarship Program. 
‘‘Sec. 340N. Public Health Workforce Loan Repayment Program. 
Sec. 2232. Enhancing the public health workforce. 
Sec. 2233. Public health training centers. 
Sec. 2234. Preventive medicine and public health training grant program. 
Sec. 2235. Authorization of appropriations. 
Subtitle D—Adapting Workforce to Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR DIVERSITY 
Sec. 2241. Scholarships for disadvantaged students, loan repayments and fel-
lowships regarding faculty positions, and educational assistance 
in the health professions regarding individuals from disadvan-
taged backgrounds. 
Sec. 2242. Nursing workforce diversity grants. 
Sec. 2243. Coordination of diversity and cultural competency programs. 
PART 2—INTERDISCIPLINARY TRAINING PROGRAMS 
Sec. 2251. Cultural and linguistic competency training for health professionals. 
Sec. 2252. Innovations in interdisciplinary care training.
1222 
PART 3—ADVISORY COMMITTEE ON HEALTH WORKFORCE EVALUATION AND 
ASSESSMENT 
Sec. 2261. Health workforce evaluation and assessment. 
PART 4—HEALTH WORKFORCE ASSESSMENT 
Sec. 2271. Health workforce assessment. 
PART 5—AUTHORIZATION OF APPROPRIATIONS 
Sec. 2281. Authorization of appropriations. 
TITLE III—PREVENTION AND WELLNESS 
Sec. 2301. Prevention and wellness. 
‘‘TITLE XXXI—PREVENTION AND WELLNESS 
‘‘Subtitle A—Prevention and Wellness Trust 
‘‘Sec. 3111. Prevention and Wellness Trust. 
‘‘Subtitle B—National Prevention and Wellness Strategy 
‘‘Sec. 3121. National Prevention and Wellness Strategy. 
‘‘Subtitle C—Prevention Task Forces 
‘‘Sec. 3131. Task Force on Clinical Preventive Services. 
‘‘Sec. 3132. Task Force on Community Preventive Services. 
‘‘Subtitle D—Prevention and Wellness Research 
‘‘Sec. 3141. Prevention and wellness research activity coordination. 
‘‘Sec. 3142. Community prevention and wellness research grants. 
‘‘Sec. 3143. Research on subsidies and rewards to encourage wellness and 
healthy behaviors. 
‘‘Subtitle E—Delivery of Community Prevention and Wellness Services 
‘‘Sec. 3151. Community prevention and wellness services grants. 
‘‘Subtitle F—Core Public Health Infrastructure 
‘‘Sec. 3161. Core public health infrastructure for State, local, and tribal 
health departments. 
‘‘Sec. 3162. Core public health infrastructure and activities for CDC. 
‘‘Subtitle G—General Provisions 
‘‘Sec. 3171. Definitions. 
TITLE IV—QUALITY AND SURVEILLANCE 
Sec. 2401. Implementation of best practices in the delivery of health care. 
Sec. 2402. Assistant Secretary for Health Information. 
Sec. 2403. Authorization of appropriations. 
TITLE V—OTHER PROVISIONS
1223 
Subtitle A—Drug Discount for Rural and Other Hospitals; 340B Program 
Integrity 
Sec. 2501. Expanded participation in 340B program. 
Sec. 2502. Improvements to 340B program integrity. 
Sec. 2503. Effective date. 
Subtitle B—Programs 
PART 1—GRANTS FOR CLINICS AND CENTERS 
Sec. 2511. School-based health clinics. 
Sec. 2512. Nurse-Managed health centers. 
Sec. 2513. Federally qualified behavioral health centers. 
PART 2—OTHER GRANT PROGRAMS 
Sec. 2521. Comprehensive programs to provide education to nurses and create 
a pipeline to nursing. 
Sec. 2522. Mental and behavioral health training. 
Sec. 2523. Reauthorization of telehealth and telemedicine grant programs. 
Sec. 2524. No child left unimmunized against influenza: demonstration pro-
gram using elementary and secondary schools as influenza vac-
cination centers. 
Sec. 2525. Extension of Wisewoman Program. 
Sec. 2526. Healthy teen initiative to prevent teen pregnancy. 
Sec. 2527. National training initiatives on autism spectrum disorders. 
Sec. 2528. Implementation of medication management services in treatment of 
chronic diseases. 
Sec. 2529. Postpartum depression. 
Sec. 2530. Grants to promote positive health behaviors and outcomes. 
Sec. 2531. Medical liability alternatives. 
Sec. 2532. Infant mortality pilot programs. 
Sec. 2533. Secondary school health sciences training program. 
Sec. 2534. Community-based collaborative care networks. 
Sec. 2535. Community-based overweight and obesity prevention program. 
Sec. 2536. Reducing student-to-school nurse ratios. 
Sec. 2537. Medical-legal partnerships. 
Sec. 2538. Screening, brief intervention, referral, and treatment for mental 
health and substance abuse disorders. 
Sec. 2539. Grants to assist in developing medical schools in federally-designated 
health professional shortage areas. 
PART 3—EMERGENCY CARE-RELATED PROGRAMS 
Sec. 2551. Trauma care centers. 
Sec. 2552. Emergency care coordination. 
Sec. 2553. Pilot programs to improve emergency medical care. 
Sec. 2554. Assisting veterans with military emergency medical training to be-
come State-licensed or certified emergency medical technicians 
(EMTs). 
Sec. 2555. Dental emergency responders: public health and medical response. 
Sec. 2556. Dental emergency responders: homeland security. 
PART 4—PAIN CARE AND MANAGEMENT PROGRAMS 
Sec. 2561. Institute of Medicine Conference on Pain.
1224 
Sec. 2562. Pain research at National Institutes of Health. 
Sec. 2563. Public awareness campaign on pain management. 
Subtitle C—Food and Drug Administration 
PART 1—IN GENERAL 
Sec. 2571. National medical device registry. 
Sec. 2572. Nutrition labeling of standard menu items at chain restaurants and 
of articles of food sold from vending machines. 
Sec. 2573. Protecting consumer access to generic drugs. 
PART 2—BIOSIMILARS 
Sec. 2575. Licensure pathway for biosimilar biological products. 
Sec. 2576. Fees relating to biosimilar biological products. 
Sec. 2577. Amendments to certain patent provisions. 
Subtitle D—Community Living Assistance Services and Supports 
Sec. 2581. Establishment of national voluntary insurance program for pur-
chasing community living assistance services and support 
(CLASS program). 
‘‘TITLE XXXII—COMMUNITY LIVING ASSISTANCE SERVICES AND 
SUPPORTS 
‘‘Sec. 3201. Purpose. 
‘‘Sec. 3202. Definitions. 
‘‘Sec. 3203. CLASS Independence Benefit Plan. 
‘‘Sec. 3204. Enrollment and disenrollment requirements. 
‘‘Sec. 3205. Benefits. 
‘‘Sec. 3206. CLASS Independence Fund. 
‘‘Sec. 3207. CLASS Independence Advisory Council. 
‘‘Sec. 3208. Regulations; annual report. 
‘‘Sec. 3209. Inspector General’s report. 
Subtitle E—Miscellaneous 
Sec. 2585. States failing to adhere to certain employment obligations. 
Sec. 2586. Health centers under Public Health Service Act; liability protections 
for volunteer practitioners. 
Sec. 2587. Report to Congress on the current state of parasitic diseases that 
have been overlooked among the poorest Americans. 
Sec. 2588. Office of Women’s Health. 
Sec. 2588A. Offices of Minority Health. 
Sec. 2589. Long-Term Care and Family Caregiver Support. 
Sec. 2590. Web site on health care labor market and related educational and 
training opportunities. 
Sec. 2591. Online health workforce training programs. 
Sec. 2592. Access for individuals with disabilities. 
Sec. 2593. Duplicative grant programs. 
Sec. 2594. Diabetes screening collaboration and outreach program. 
Sec. 2595. Improvement of vital statistics collection. 
Sec. 2596. National Health Services Corps demonstration on incentive pay-
ments.
1225 
(b) REFERENCES.—Except as otherwise specified, 
whenever in this division an amendment is expressed in 
terms of an amendment to a section or other provision, 
the reference shall be considered to be made to a section 
or other provision of the Public Health Service Act (42 
U.S.C. 201 et seq.). 
SEC. 2002. PUBLIC HEALTH INVESTMENT FUND. 
(a) ESTABLISHMENT OF FUNDS.— 
(1) IN
GENERAL.—Subject to section 2003, 
there is hereby established in the Treasury a sepa-
rate account to be known as the ‘‘Public Health In-
vestment Fund’’ (referred to in this section and sec-
tion 2003 as the ‘‘Fund’’). 
(2) FUNDING.— 
(A) There shall be deposited into the 
Fund— 
(i) 
for 
fiscal 
year 
2011, 
$4,600,000,000; 
(ii) 
for 
fiscal 
year 
2012, 
$5,600,000,000; 
(iii) 
for 
fiscal 
year 
2013, 
$6,900,000,000; 
(iv) 
for 
fiscal 
year 
2014, 
$7,800,000,000; and
1226 
(v) 
for 
fiscal 
year 
2015, 
$9,000,000,000. 
(B) Amounts deposited into the Fund shall 
be derived from general revenues of the Treas-
ury only for the fiscal years set forth in this 
section, and amounts appropriated from the 
Fund shall remain available until expended. 
(b) AUTHORIZATION OF APPROPRIATIONS FROM THE 
FUND.— 
(1) NEW FUNDING.— 
(A) IN
GENERAL.—Subject to section 
2003, amounts in the Fund are authorized to 
be appropriated for carrying out activities 
under designated public health provisions. 
(B) DESIGNATED PROVISIONS.—For pur-
poses of this paragraph, the term ‘‘designated 
public health provisions’’ means the provisions 
for which amounts are authorized to be appro-
priated under section 330(s), 338(c), 338H–1, 
799C, 872, or 3111 of the Public Health Serv-
ice Act, as added by this division. 
(2) BASELINE FUNDING.— 
(A) IN GENERAL.—Amounts in the Fund 
are authorized to be appropriated (as described 
in paragraph (1)) for a fiscal year only if (ex-
1227 
cluding any amounts in or appropriated from 
the Fund) the amounts specified in subpara-
graph (B) for the fiscal year involved are equal 
to or greater than the amounts specified in sub-
paragraph (B) for fiscal year 2008. 
(B) AMOUNTS SPECIFIED.—The amounts 
specified in this subparagraph, with respect to 
a fiscal year, are the amounts appropriated (ex-
cluding any amounts in or appropriated from 
the Fund) for the following: 
(i) Community health centers (includ-
ing funds appropriated under the authority 
of section 330 of the Public Health Service 
Act (42 U.S.C. 254b)). 
(ii) The National Health Service 
Corps Program (including funds appro-
priated under the authority of section 338 
of such Act (42 U.S.C. 254k)). 
(iii) The National Health Service 
Corps Scholarship and Loan Repayment 
Programs (including funds appropriated 
under the authority of section 338H of 
such Act (42 U.S.C. 254q)). 
(iv) Primary care education programs 
(including funds appropriated under the
1228 
authority of sections 736, 740, 741, and 
747 of such Act (42 U.S.C. 293, 293d, 
and 293k)). 
(v) Sections 761 and 770 of such Act 
(42 U.S.C. 294n and 295e). 
(vi) Nursing workforce development 
(including funds appropriated under the 
authority of title VIII of such Act (42 
U.S.C. 296 et seq.)). 
(vii) The National Center for Health 
Statistics (including funds appropriated 
under the authority of sections 304, 306, 
307, and 308 of such Act (42 U.S.C. 
242b, 242k, 242l, and 242m)). 
(viii) The Agency for Healthcare Re-
search and Quality (including funds made 
available under the authority of title IX of 
such Act (42 U.S.C. 299 et seq.)). 
SEC. 2003. DEFICIT NEUTRALITY. 
(a) AVAILABILITY.—Funds appropriated or made 
available pursuant to sections 330(s), 338(c), 338H–1, 
799C, 872, or 3111 of the Public Health Service Act, as 
added by this division, are only available for the purposes 
set forth in this Act. Appropriations shall not be available 
and are precluded from obligation for any other purpose.
1229 
(b) ESTIMATION OF BUDGETARY IMPACT.—For the 
purposes of estimating the spending effects of this Act, 
the authorization of appropriations from the Fund, to the 
extent amounts in the Fund are derived from the general 
revenues of the Treasury, shall be treated as new direct 
spending and attributed to this Act. 
(c) BUDGETARY TREATMENT.—For the purposes of 
section 257 of the Balanced Budget and Emergency Def-
icit Control Act of 1985, the Fund, to the extent amounts 
in the Fund are derived from the general revenues of the 
Treasury, and not in excess of amounts subsequently ap-
propriated from the Fund, shall be deemed to be included 
on the list of appropriations referenced under section 
250(c)(17) of that Act. 
TITLE I—COMMUNITY HEALTH 
CENTERS 
SEC. 2101. INCREASED FUNDING. 
Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (r)(1)— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by inserting at the end the following:
1230 
‘‘(F) such sums as may be necessary for 
each of fiscal years 2013 through 2015.’’; and 
(2) by inserting after subsection (r) the fol-
lowing: 
‘‘(s) ADDITIONAL FUNDING.—For the purpose of 
carrying out this section, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) For fiscal year 2011, $1,000,000,000. 
‘‘(2) For fiscal year 2012, $1,500,000,000. 
‘‘(3) For fiscal year 2013, $2,500,000,000. 
‘‘(4) For fiscal year 2014, $3,000,000,000. 
‘‘(5) For fiscal year 2015, $4,000,000,000.’’. 
TITLE II—WORKFORCE 
Subtitle A—Primary Care 
Workforce 
PART 1—NATIONAL HEALTH SERVICE CORPS 
SEC. 2201. NATIONAL HEALTH SERVICE CORPS. 
(a) FULFILLMENT
OF OBLIGATED SERVICE RE-
QUIREMENT THROUGH HALF-TIME SERVICE.— 
(1) WAIVERS.—Subsection (i) of section 331 
(42 U.S.C. 254d) is amended— 
(A) in paragraph (1), by striking ‘‘In car-
rying out subpart III’’ and all that follows
1231 
through the period and inserting ‘‘In carrying 
out subpart III, the Secretary may, in accord-
ance with this subsection, issue waivers to indi-
viduals who have entered into a contract for ob-
ligated service under the Scholarship Program 
or the Loan Repayment Program under which 
the individuals are authorized to satisfy the re-
quirement of obligated service through pro-
viding clinical practice that is half-time.’’; 
(B) in paragraph (2)— 
(i) in subparagraphs (A)(ii) and (B), 
by striking ‘‘less than full time’’ each place 
it appears and inserting ‘‘half time’’; 
(ii) in subparagraphs (C) and (F), by 
striking ‘‘less than full-time service’’ each 
place it appears and inserting ‘‘half-time 
service’’; and 
(iii) by amending subparagraphs (D) 
and (E) to read as follows: 
‘‘(D) the entity and the Corps member agree in 
writing that the Corps member will perform half- 
time clinical practice; 
‘‘(E) the Corps member agrees in writing to 
fulfill all of the service obligations under section
1232 
338C through half-time clinical practice and ei-
ther— 
‘‘(i) double the period of obligated service 
that would otherwise be required; or 
‘‘(ii) in the case of contracts entered into 
under section 338B, accept a minimum service 
obligation of 2 years with an award amount 
equal to 50 percent of the amount that would 
otherwise be payable for full-time service; and’’; 
and 
(C) in paragraph (3), by striking ‘‘In eval-
uating a demonstration project described in 
paragraph (1)’’ and inserting ‘‘In evaluating 
waivers issued under paragraph (1)’’. 
(2) DEFINITIONS.—Subsection (j) of section 
331 (42 U.S.C. 254d) is amended by adding at the 
end the following: 
‘‘(5) The terms ‘full time’ and ‘full-time’ mean 
a minimum of 40 hours per week in a clinical prac-
tice, for a minimum of 45 weeks per year. 
‘‘(6) The terms ‘half time’ and ‘half-time’ mean 
a minimum of 20 hours per week (not to exceed 39 
hours per week) in a clinical practice, for a min-
imum of 45 weeks per year.’’.
1233 
(b) REAPPOINTMENT TO NATIONAL ADVISORY COUN-
CIL.—Section 337(b)(1) (42 U.S.C. 254j(b)(1)) is amend-
ed by striking ‘‘Members may not be reappointed to the 
Council.’’. 
(c) 
LOAN
REPAYMENT
AMOUNT.—Section 
338B(g)(2)(A) (42 U.S.C. 254l–1(g)(2)(A)) is amended 
by striking ‘‘$35,000’’ and inserting ‘‘$50,000, plus, be-
ginning with fiscal year 2012, an amount determined by 
the Secretary on an annual basis to reflect inflation,’’. 
(d) TREATMENT OF TEACHING AS OBLIGATED SERV-
ICE.—Subsection (a) of section 338C (42 U.S.C. 254m) 
is amended by adding at the end the following: ‘‘The Sec-
retary may treat teaching as clinical practice for up to 
20 percent of such period of obligated service.’’. 
SEC. 2202. AUTHORIZATIONS OF APPROPRIATIONS. 
(a) NATIONAL
HEALTH
SERVICE
CORPS
PRO-
GRAM.—Section 338 (42 U.S.C. 254k) is amended— 
(1) in subsection (a), by striking ‘‘2012’’ and 
inserting ‘‘2015’’; and 
(2) by adding at the end the following: 
‘‘(c) For the purpose of carrying out this subpart, 
in addition to any other amounts authorized to be appro-
priated for such purpose, there are authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, the following:
1234 
‘‘(1) $63,000,000 for fiscal year 2011. 
‘‘(2) $66,000,000 for fiscal year 2012. 
‘‘(3) $70,000,000 for fiscal year 2013. 
‘‘(4) $73,000,000 for fiscal year 2014. 
‘‘(5) $77,000,000 for fiscal year 2015.’’. 
(b) SCHOLARSHIP
AND LOAN REPAYMENT PRO-
GRAMS.—Subpart III of part D of title III of the Public 
Health Service Act (42 U.S.C. 254l et seq.) is amended— 
(1) in section 338H(a)— 
(A) in paragraph (4), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (5), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(6) for each of fiscal years 2013 through 
2015, such sums as may be necessary.’’; and 
(2) by inserting after section 338H the fol-
lowing: 
‘‘SEC. 338H–1. ADDITIONAL FUNDING. 
‘‘For the purpose of carrying out this subpart, in ad-
dition to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $254,000,000 for fiscal year 2011.
1235 
‘‘(2) $266,000,000 for fiscal year 2012. 
‘‘(3) $278,000,000 for fiscal year 2013. 
‘‘(4) $292,000,000 for fiscal year 2014. 
‘‘(5) $306,000,000 for fiscal year 2015.’’. 
PART 2—PROMOTION OF PRIMARY CARE AND 
DENTISTRY 
SEC. 2211. FRONTLINE HEALTH PROVIDERS. 
Part D of title III (42 U.S.C. 254b et seq.) is amend-
ed by adding at the end the following: 
‘‘Subpart XI—Health Professional Needs Areas 
‘‘SEC. 340H. IN GENERAL. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall establish a program, to be known as 
the Frontline Health Providers Loan Repayment Pro-
gram, to address unmet health care needs in health profes-
sional needs areas through loan repayments under section 
340I. 
‘‘(b) DESIGNATION
OF
HEALTH
PROFESSIONAL 
NEEDS AREAS.— 
‘‘(1) IN GENERAL.—In this subpart, the term 
‘health professional needs area’ means an area, pop-
ulation, or facility that is designated by the Sec-
retary in accordance with paragraph (2).
1236 
‘‘(2) DESIGNATION.—To be designated by the 
Secretary as a health professional needs area under 
this subpart: 
‘‘(A) In the case of an area, the area must 
be a rational area for the delivery of health 
services. 
‘‘(B) The area, population, or facility must 
have, in one or more health disciplines, special-
ties, or subspecialties for the population served, 
as determined by the Secretary— 
‘‘(i) insufficient capacity of health 
professionals; or 
‘‘(ii) high needs for health services, in-
cluding services to address health dispari-
ties. 
‘‘(C) With respect to the delivery of pri-
mary health services, the area, population, or 
facility must not include a health professional 
shortage area (as designated under section 
332), except that the area, population, or facil-
ity may include such a health professional 
shortage area in which there is an unmet need 
for such services. 
‘‘(c) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall—
1237 
‘‘(1) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school de-
fined in section 799B(1)(A) (other than a school of 
public health); 
‘‘(2) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school or 
program defined in subparagraph (C), (D), or 
(E)(4) of section 799B(1), as designated by the Sec-
retary; 
‘‘(3) be enrolled as a full-time student— 
‘‘(A) in a school or program defined in 
subparagraph (C), (D), or (E)(4) of section 
799B(1), as designated by the Secretary, or a 
school described in paragraph (1); and 
‘‘(B) in the final year of a course of study 
or program, offered by such school or program 
and approved by the Secretary, leading to a de-
gree in a discipline referred to in subparagraph 
(A) (other than a graduate degree in public 
health), (C), (D), or (E)(4) of section 799B(1); 
‘‘(4) be a practitioner described in section 
1842(b)(18)(C) or 1848(k)(3)(B)(iii) or (iv) of the 
Social Security Act; or
1238 
‘‘(5) be a practitioner in the field of respiratory 
therapy, medical technology, or radiologic tech-
nology. 
‘‘(d) DEFINITIONS.—In this subpart: 
‘‘(1) The term ‘health disparities’ has the 
meaning given to the term in section 3171. 
‘‘(2) The term ‘primary health services’ has the 
meaning given to such term in section 331(a)(3)(D). 
‘‘SEC. 340I. LOAN REPAYMENTS. 
‘‘(a) LOAN REPAYMENTS.—The Secretary, acting 
through the Administrator of the Health Resources and 
Services Administration, shall enter into contracts with in-
dividuals under which— 
‘‘(1) the individual agrees— 
‘‘(A) to serve as a full-time primary health 
services provider or as a full-time or part-time 
provider of other health services for a period of 
time equal to 2 years or such longer period as 
the individual may agree to; 
‘‘(B) to serve in a health professional 
needs area in a health discipline, specialty, or a 
subspecialty for which the area, population, or 
facility is designated as a health professional 
needs area under section 340H; and
1239 
‘‘(C) in the case of an individual described 
in section 340H(c)(3) who is in the final year 
of study and who has accepted employment as 
a primary health services provider or provider 
of other health services in accordance with sub-
paragraphs (A) and (B), to complete the edu-
cation or training and maintain an acceptable 
level of academic standing (as determined by 
the educational institution offering the course 
of study or training); and 
‘‘(2) the Secretary agrees to pay, for each year 
of such service, an amount on the principal and in-
terest of the undergraduate or graduate educational 
loans (or both) of the individual that is not more 
than 50 percent of the average award made under 
the National Health Service Corps Loan Repayment 
Program under subpart III in that year. 
‘‘(b) PRACTICE SETTING.—A contract entered into 
under this section shall allow the individual receiving the 
loan repayment to satisfy the service requirement de-
scribed in subsection (a)(1) through employment in a solo 
or group practice, a clinic, an accredited public or private 
nonprofit hospital, or any other health care entity, as 
deemed appropriate by the Secretary.
1240 
‘‘(c) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III of part D shall, except as incon-
sistent with this section, apply to the loan repayment pro-
gram under this subpart in the same manner and to the 
same extent as such provisions apply to the National 
Health Service Corps Loan Repayment Program estab-
lished under section 338B. 
‘‘(d) INSUFFICIENT NUMBER OF APPLICANTS.—If 
there are an insufficient number of applicants for loan re-
payments under this section to obligate all appropriated 
funds, the Secretary shall transfer the unobligated funds 
to the National Health Service Corps for the purpose of 
recruiting applicants and entering into contracts with indi-
viduals so as to ensure a sufficient number of participants 
in the National Health Service Corps for the following 
year. 
‘‘SEC. 340J. REPORT. 
‘‘The Secretary shall submit to the Congress an an-
nual report on the program carried out under this subpart. 
‘‘SEC. 340K. ALLOCATION. 
‘‘Of the amount of funds obligated under this subpart 
each fiscal year for loan repayments— 
‘‘(1) 90 percent shall be for physicians and 
other health professionals providing primary health 
services; and
1241 
‘‘(2) 10 percent shall be for health professionals 
not described in paragraph (1).’’. 
SEC. 2212. PRIMARY CARE STUDENT LOAN FUNDS. 
(a) IN GENERAL.—Section 735 (42 U.S.C. 292y) is 
amended— 
(1) by redesignating subsection (f) as sub-
section (g); and 
(2) by inserting after subsection (e) the fol-
lowing: 
‘‘(f) DETERMINATION OF FINANCIAL NEED.—The 
Secretary— 
‘‘(1) may require, or authorize a school or other 
entity to require, the submission of financial infor-
mation to determine the financial resources available 
to any individual seeking assistance under this sub-
part; and 
‘‘(2) shall take into account the extent to which 
such individual is financially independent in deter-
mining whether to require or authorize the submis-
sion of such information regarding such individual’s 
family members.’’. 
(b) REVISED GUIDELINES.—The Secretary of Health 
and Human Services shall—
1242 
(1) strike the second sentence of section 
57.206(b)(1) of title 42, Code of Federal Regula-
tions; and 
(2) make such other revisions to guidelines and 
regulations in effect as of the date of the enactment 
of this Act as may be necessary for consistency with 
the amendments made by paragraph (1). 
SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
GERIATRICS, AND PHYSICIAN ASSISTANTS. 
Section 747 (42 U.S.C. 293k) is amended— 
(1) by amending the section heading to read as 
follows: ‘‘PRIMARY
CARE
TRAINING
AND
EN-
HANCEMENT’’; 
(2) by redesignating subsection (e) as sub-
section (g); and 
(3) by striking subsections (a) through (d) and 
inserting the following: 
‘‘(a) PROGRAM.—The Secretary shall establish a pri-
mary care training and capacity building program con-
sisting of awarding grants and contracts under sub-
sections (b) and (c). 
‘‘(b) SUPPORT
AND DEVELOPMENT
OF PRIMARY 
CARE TRAINING PROGRAMS.—
1244 
ticing physicians who are participants in any 
such programs and who plan to teach in a fam-
ily medicine, general internal medicine, general 
pediatrics, or geriatrics training program; and 
‘‘(E) to plan, develop, operate, or partici-
pate in an accredited program for physician as-
sistant education, and for the training of indi-
viduals who plan to teach in programs to pro-
vide such training. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall 
be— 
‘‘(A) an accredited school of medicine or 
osteopathic medicine, public or nonprofit private 
hospital, or physician assistant training pro-
gram; 
‘‘(B) a public or private nonprofit entity; 
or 
‘‘(C) a consortium of 2 or more entities de-
scribed in subparagraphs (A) and (B). 
‘‘(c) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
grants to or enter into contracts with eligible entities 
to establish, maintain, or improve—
1245 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall be 
an accredited school of medicine or osteopathic med-
icine. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of health professionals who provide pri-
mary care. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among primary care 
professionals). 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health
1246 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the health care needs of vulnerable popu-
lations. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given the term in section 
3171.’’. 
SEC. 2214. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) by redesignating section 748 as 749A; and 
(2) by inserting after section 747 the following: 
‘‘SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
‘‘(a) PROGRAM.—The Secretary shall establish a pro-
gram for the training of medical residents in community- 
based settings consisting of awarding grants and contracts 
under this section.
1247 
‘‘(b) DEVELOPMENT AND OPERATION OF COMMU-
NITY-BASED
PROGRAMS.—The Secretary shall make 
grants to, or enter into contracts with, eligible entities— 
‘‘(1) to plan and develop a new primary care 
residency training program, which may include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruiting and training residents and 
faculty; and 
‘‘(C) other activities designated to result in 
accreditation of such a program; or 
‘‘(2) to operate or participate in an established 
primary care residency training program, which may 
include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruitment and training of residents; 
and 
‘‘(C) retention of faculty. 
‘‘(c) ELIGIBLE ENTITY.—To be eligible to receive a 
grant or contract under subsection (b), an entity shall— 
‘‘(1) be designated as a recipient of payment 
for the direct costs of medical education under sec-
tion 1886(k) of the Social Security Act; 
‘‘(2) be designated as an approved teaching 
health center under section 1502(d) of the Afford-
able Health Care for America Act and continuing to
1248 
participate in the demonstration project under such 
section; 
‘‘(3) be an applicant for designation described 
in paragraph (1) or (2) and have demonstrated to 
the Secretary appropriate involvement of an accred-
ited teaching hospital to carry out the inpatient re-
sponsibilities associated with a primary care resi-
dency training program; or 
‘‘(4) be eligible to be designated as described in 
paragraph (1) or (2), not be an applicant as de-
scribed in paragraph (3), and have demonstrated ap-
propriate involvement of an accredited teaching hos-
pital to carry out the inpatient responsibilities asso-
ciated with a primary care residency training pro-
gram. 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under paragraph (1) or (2) of subsection (b), the 
Secretary shall give preference to entities that— 
‘‘(1) support teaching programs that address 
the health care needs of vulnerable populations; or 
‘‘(2) are a Federally qualified health center (as 
defined in section 1861(aa)(4) of the Social Security 
Act) or a rural health clinic (as defined in section 
1861(aa)(2) of such Act).
1249 
‘‘(e) ADDITIONAL PREFERENCES FOR ESTABLISHED 
PROGRAMS.—In awarding grants and contracts under 
subsection (b)(2), the Secretary shall give preference to 
entities that have a demonstrated record of training— 
‘‘(1) a high or significantly improved percentage 
of health professionals who provide primary care; 
‘‘(2) individuals who are from disadvantaged 
backgrounds (including racial and ethnic minorities 
underrepresented among primary care professionals); 
or 
‘‘(3) individuals who practice in settings having 
the principal focus of serving underserved areas or 
populations experiencing health disparities (including 
serving patients eligible for medical assistance under 
title XIX of the Social Security Act or for child 
health assistance under title XXI of such Act or 
those with special health care needs). 
‘‘(f) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section— 
‘‘(A) shall not exceed 3 years for awards 
under subsection (b)(1); and 
‘‘(B) shall not exceed 5 years for awards 
under subsection (b)(2). 
‘‘(2) SPECIAL RULES.—
1250 
‘‘(A) An award of a grant or contract 
under subsection (b)(1) shall not be renewed. 
‘‘(B) The period of a grant or contract 
awarded to an entity under subsection (b)(2) 
shall not overlap with the period of any grant 
or contact awarded to the same entity under 
subsection (b)(1). 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) HEALTH DISPARITIES.—The term ‘health 
disparities’ has the meaning given the term in sec-
tion 3171. 
‘‘(2) PRIMARY CARE RESIDENT.—The term ‘pri-
mary care resident’ has the meaning given the term 
in section 1886(h)(5)(H) of the Social Security Act. 
‘‘(3) PRIMARY CARE RESIDENCY TRAINING PRO-
GRAM.—The term ‘primary care residency training 
program’ means an approved medical residency 
training program described in section 1886(h)(5)(A) 
of the Social Security Act for primary care residents 
that is— 
‘‘(A) in the case of entities seeking awards 
under subsection (b)(1), actively applying to be
1251 
accredited by the Accreditation Council for 
Graduate Medical Education or the American 
Osteopathic Association; or 
‘‘(B) in the case of entities seeking awards 
under subsection (b)(2), so accredited. 
‘‘(i) ALLOCATION OF FUNDS.—Of the amount appro-
priated pursuant to section 799C(a) for a fiscal year, not 
more than 17 percent of such amount shall be made avail-
able to carry out this section.’’. 
SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) in section 791(a)(1), by striking ‘‘747 and 
750’’ and inserting ‘‘747, 749, and 750’’; and 
(2) by inserting after section 748, as added, the 
following: 
‘‘SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
training program for oral health professionals consisting 
of awarding grants and contracts under this section. 
‘‘(b) SUPPORT
AND
DEVELOPMENT
OF
ORAL 
HEALTH TRAINING PROGRAMS.—The Secretary shall
1252 
make grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for oral 
health professionals; 
‘‘(2) to provide financial assistance to oral 
health professionals who are in need thereof, who 
are participants in any such program, and who plan 
to work in general, pediatric, or public health den-
tistry, or dental hygiene; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry, or dental hygiene; 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry or dental hygiene; 
‘‘(5) to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of general, pedi-
atric, or public health dentistry; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties;
1253 
‘‘(6) to plan, develop, operate, or participate in 
predoctoral and postdoctoral training in general, pe-
diatric, or public health dentistry programs; 
‘‘(7) to plan, develop, operate, or participate in 
a loan repayment program for full-time faculty in a 
program of general, pediatric, or public health den-
tistry; and 
‘‘(8) to provide technical assistance to pediatric 
dental training programs in developing and imple-
menting instruction regarding the oral health status, 
dental care needs, and risk-based clinical disease 
management of all pediatric populations with an em-
phasis on underserved children. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under this section, an entity shall be— 
‘‘(1) an accredited school of dentistry, training 
program in dental hygiene, or public or nonprofit 
private hospital; 
‘‘(2) a training program in dental hygiene at an 
accredited institution of higher education; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of— 
‘‘(A) 1 or more of the entities described in 
paragraphs (1) through (3); and 
‘‘(B) an accredited school of public health.
1254 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of oral health professionals who practice 
general, pediatric, or public health dentistry. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among oral health pro-
fessionals). 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the oral health needs of vulnerable popu-
lations. 
‘‘(5) Providing instruction regarding the oral 
health status, oral health care needs, and risk-based
1255 
clinical disease management of all pediatric popu-
lations with an emphasis on underserved children. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘oral health professional’ means 
an individual training or practicing— 
‘‘(A) in general dentistry, pediatric den-
tistry, public health dentistry, or dental hy-
giene; or 
‘‘(B) another oral health specialty, as 
deemed appropriate by the Secretary.’’. 
SEC. 2216. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Part F of title VII (42 U.S.C. 
295j et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 799C. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘(a) PROMOTION
OF PRIMARY CARE
AND DEN-
TISTRY.—For the purpose of carrying out subpart XI of 
part D of title III and sections 747, 748, and 749, in addi-
tion to any other amounts authorized to be appropriated
1256 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $240,000,000 for fiscal year 2011. 
‘‘(2) $253,000,000 for fiscal year 2012. 
‘‘(3) $265,000,000 for fiscal year 2013. 
‘‘(4) $278,000,000 for fiscal year 2014. 
‘‘(5) $292,000,000 for fiscal year 2015.’’. 
(b) EXISTING
AUTHORIZATION
OF
APPROPRIA-
TIONS.—Subsection (g)(1), as so redesignated, of section 
747 (42 U.S.C. 293k) is amended by striking ‘‘2002’’ and 
inserting ‘‘2015’’. 
SEC. 2217. STUDY ON EFFECTIVENESS OF SCHOLARSHIPS 
AND LOAN REPAYMENTS. 
(a) STUDY.—The Comptroller General of the United 
States shall conduct a study to determine the effectiveness 
of scholarship and loan repayment programs under sub-
parts III and XI of part D of title III of the Public Health 
Service Act, as amended or added by sections 2201 and 
2211, including whether scholarships or loan repayments 
are more effective in— 
(1) incentivizing physicians, and other pro-
viders, to pursue careers in primary care specialties; 
(2) retaining such primary care providers; and
1257 
(3) encouraging such primary care providers to 
practice in underserved areas. 
(b) REPORT.—Not later than 12 months after the 
date of the enactment of this Act, the Comptroller General 
shall submit to the Congress a report on the results of 
the study under subsection (a). 
Subtitle B—Nursing Workforce 
SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 
(a) DEFINITIONS.—Section 801 (42 U.S.C. 296 et 
seq.) is amended— 
(1) in paragraph (1), by inserting ‘‘nurse-man-
aged health centers,’’ after ‘‘nursing centers,’’; and 
(2) by adding at the end the following: 
‘‘(16) NURSE-MANAGED
HEALTH
CENTER.— 
The term ‘nurse-managed health center’— 
‘‘(A) means a nurse-practice arrangement, 
managed by one or more advanced practice 
nurses, that provides primary care or wellness 
services to underserved or vulnerable popu-
lations and is associated with an accredited 
school of nursing, Federally qualified health 
center, or independent nonprofit health or social 
services agency; and 
‘‘(B) shall not be construed as changing 
State law requirements applicable to an ad-
1258 
vanced practice nurse or the authorized scope of 
practice of such a nurse.’’. 
(b) GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION.—Title VIII (42 U.S.C. 296 et seq.) is amended 
by striking section 807. 
(c) REPORTS.—Part A of title VIII (42 U.S.C. 296 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 809. REPORTS. 
‘‘The Secretary shall submit to the Congress a sepa-
rate annual report on the activities carried out under each 
of sections 811, 821, 836, 846A, and 861.’’. 
(d) ADVANCED EDUCATION NURSING GRANTS.—Sec-
tion 811(f) (42 U.S.C. 296j(f)) is amended— 
(1) by striking paragraph (2); 
(2) by redesignating paragraph (3) as para-
graph (2); and 
(3) in paragraph (2), as so redesignated, by 
striking ‘‘that agrees’’ and all that follows through 
the end and inserting: ‘‘that agrees to expend the 
award— 
‘‘(A) to train advanced education nurses 
who will practice in health professional shortage 
areas designated under section 332; or 
‘‘(B) to increase diversity among advanced 
education nurses.’’.
1259 
(e) NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS.—Section 831 (42 U.S.C. 296p) is amended— 
(1) in subsection (b), by amending paragraph 
(3) to read as follows: 
‘‘(3) providing coordinated care, quality care, 
and other skills needed to practice nursing; or’’; and 
(2) by striking subsection (e) and redesignating 
subsections (f) through (h) as subsections (e) 
through (g), respectively. 
(f) STUDENT LOANS.—Subsection (a) of section 836 
(42 U.S.C. 297b) is amended— 
(1) 
by 
striking 
‘‘$2,500’’ 
and 
inserting 
‘‘$3,300’’; 
(2) 
by 
striking 
‘‘$4,000’’ 
and 
inserting 
‘‘$5,200’’; 
(3) by striking ‘‘$13,000’’ and inserting 
‘‘$17,000’’; and 
(4) by adding at the end the following: ‘‘Begin-
ning with fiscal year 2012, the dollar amounts speci-
fied in this subsection shall be adjusted by an 
amount determined by the Secretary on an annual 
basis to reflect inflation.’’. 
(g) LOAN REPAYMENT.—Section 846 (42 U.S.C. 
297n) is amended—
1260 
(1) in subsection (a), by amending paragraph 
(3) to read as follows: 
‘‘(3) who enters into an agreement with the 
Secretary to serve for a period of not less than 2 
years— 
‘‘(A) as a nurse at a health care facility 
with a critical shortage of nurses; or 
‘‘(B) as a faculty member at an accredited 
school of nursing;’’; and 
(2) in subsection (g)(1), by striking ‘‘to provide 
health services’’ each place it appears and inserting 
‘‘to provide health services or serve as a faculty 
member’’. 
(h) NURSE FACULTY LOAN PROGRAM.—Paragraph 
(2) of section 846A(c) (42 U.S.C. 297n–1(c)) is amended 
by striking ‘‘$30,000’’ and all that follows through the 
semicolon and inserting ‘‘$35,000, plus, beginning with 
fiscal year 2012, an amount determined by the Secretary 
on an annual basis to reflect inflation;’’. 
(i) PUBLIC SERVICE ANNOUNCEMENTS.—Title VIII 
(42 U.S.C. 296 et seq.) is amended by striking part H. 
(j) TECHNICAL AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by moving section 810 (relating to prohibi-
tion against discrimination by schools on the basis of
1273 
lish a public health workforce training and enhancement 
program consisting of awarding grants and contracts 
under subsection (b). 
‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to plan, develop, operate, or participate in, 
an accredited professional training program in the 
field of public health (including such a program in 
nursing; health administration, management, or pol-
icy; preventive medicine; laboratory science; veteri-
nary medicine; or dental medicine) for members of 
the public health workforce, including midcareer pro-
fessionals; 
‘‘(2) to provide financial assistance in the form 
of traineeships and fellowships to students who are 
participants in any such program and who plan to 
specialize or work in the field of public health; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of public health profes-
sionals who plan to teach in any program described 
in paragraph (1); and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to public health pro-
fessionals who are participants in any program de-