I 
111TH CONGRESS 
1ST SESSION H. R. 3098 
To amend the Public Health Service Act to attract and retain trained health 
care professionals and direct care workers dedicated to providing quality 
care to the growing population of older Americans. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 26, 2009 
Ms. KILPATRICK of Michigan introduced the following bill; which was referred 
to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to attract and 
retain trained health care professionals and direct care 
workers dedicated to providing quality care to the grow-
ing population of older Americans. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Caring for an Aging 
America Act of 2009’’. 
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SEC. 2. GERIATRIC AND GERONTOLOGY LOAN REPAYMENT 
PROGRAM. 
Part E of title VII of the Public Health Service Act 
(42 U.S.C. 295 et seq.) is amended by adding at the end 
the following: 
‘‘Subpart 3—Strengthening Recruitment and 
Retention for Geriatric Care Practice 
‘‘SEC. 771. GERIATRIC AND GERONTOLOGY LOAN REPAY-
MENT PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish a Geriatric and Gerontology Loan Repayment Pro-
gram within the Health Resources and Services Adminis-
tration to ensure an adequate supply of physicians, physi-
cian assistants, nurse practitioners, clinical nurse special-
ists, pharmacists, psychologists, and social workers 
trained in geriatrics or gerontology and to reduce critical 
workforce shortages in geriatric care practice. 
‘‘(b) CONTRACTS.—Under the program established 
under subsection (a), the Secretary shall enter into con-
tracts with individuals described in subsection (d) under 
which the individuals agree to provide full-time clinical 
practice and service to older adults for a minimum of 2 
years. 
‘‘(c) PAYMENT FOR YEARS OF SERVICE.—In consid-
eration of the Federal Government agreeing to pay, for 
each year of service under a contract under this section, 
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not more than $35,000 of the principal and interest of 
the educational loans of the individual involved for each 
of the first 2 years of service, the individual shall carry 
out activities in accordance with subsection (d)(4). For 
subsequent years, loan repayments of up to $40,000 per 
year for a third or fourth year of service may be made 
available. 
‘‘(d) ELIGIBLE INDIVIDUALS.—An individual de-
scribed in this subsection is an individual— 
‘‘(1) who— 
‘‘(A) is a physician, including an osteo-
pathic physician, who has completed specialty 
training in geriatric medicine or geriatric psy-
chiatry; 
‘‘(B) is a nurse practitioner or clinical 
nurse specialist who has completed specialty 
training in geriatrics or gerontology; 
‘‘(C) is a pharmacist who has completed 
specialty training in geriatrics; 
‘‘(D) is a social worker who has completed 
specialty training in gerontology; 
‘‘(E) is a physician assistant who has com-
pleted specialty training in geriatrics; 
‘‘(F) is a psychologist who has completed 
specialty training in gerontology; or 
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‘‘(G) otherwise— 
‘‘(i) has a degree in medicine, phar-
macy, osteopathic medicine, clinical or 
counseling psychology (doctoral degree pro-
gram), social work (master’s or doctoral 
degree program), or who is a certified 
nurse practitioner, certified clinical nurse 
specialist, or physician assistant; and 
‘‘(ii) is enrolled in, or has successfully 
completed, an accredited program of spe-
cialty training in geriatric medicine, geri-
atric psychiatry, geriatric pharmacothera-
py, geropsychology, gerontological social 
work, gerontological nursing, or equivalent 
geriatric care practice (as determined by 
the Secretary); 
‘‘(2) who has obtained an educational loan for 
costs associated with graduate training in medicine, 
pharmacy, psychology, or social work, or costs asso-
ciated with becoming a nurse practitioner, clinical 
nurse specialist, or physician assistant; 
‘‘(3) who is appropriately licensed, without re-
striction (as determined by the Secretary), in the 
State in which the individual practices; 
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‘‘(4) who agrees to provide clinical services to 
older adults for a period of not less than 2 years in 
a setting determined appropriate by the Secretary; 
and 
‘‘(5) has demonstrated the capability through 
education or training to work with frail older adults 
and older adults with disabilities, including individ-
uals with dementia, urinary incontinence, and prob-
lems with balance or mobility, and raising awareness 
of medication issues for older adults. 
‘‘(e) APPLICABILITY
OF CERTAIN PROVISIONS.— 
With respect to the National Health Service Corps Loan 
Repayment Program established in subpart III of part D 
of title III of this Act, the provisions of such subpart shall, 
except as inconsistent with this section, apply to the pro-
gram established in this section in the same manner and 
to the same extent as such provisions apply to the Na-
tional Health Service Corps Loan Repayment Program. 
‘‘(f) NATIONAL ADVISORY COUNCIL ON THE GERI-
ATRIC
AND
GERONTOLOGY
LOAN
REPAYMENT
PRO-
GRAM.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish a National Advisory Council on the Geriatric 
and Gerontology Loan Repayment Program (re-
ferred to in this section as the ‘Council’) that shall 
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be composed of not to exceed 11 members to be ap-
pointed by the Secretary. 
‘‘(2) DUTIES.—The Council shall consult with, 
advise, and make recommendations to the Secretary 
with respect to the Secretary’s administration of the 
program established under subsection (a). 
‘‘(3) ADMINISTRATIVE
PROVISIONS.—Members 
of the Council shall be appointed for a term of 3 
years and shall be representative of the health pro-
fessions, and professional associations, that are eligi-
ble to enter into agreements under this section. 
‘‘(g) REPORTS.—Not later than 2 years after the date 
of the enactment of this section, and annually thereafter, 
the Secretary shall prepare and submit to the appropriate 
committees of Congress a report that describes— 
‘‘(1) the program established under this section 
(including the number and amount of loan repay-
ments, the number and practice locations of the loan 
repayment recipients, the demographics of the indi-
viduals participating in the program, the default 
rate and actions required upon default, and to the 
extent that it can be determined, the reasons for 
such defaults); 
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‘‘(2) how the program interacts with other Fed-
eral loan repayment programs for primary health 
care professionals; and 
‘‘(3) the overall costs and benefits of the pro-
gram. 
‘‘(h) DEFINITION.—In this section: 
‘‘(1) GERIATRICS.—The term ‘geriatrics’ means 
the branch of medicine that deals with the problems 
and diseases of older adults and aging, including 
chronic conditions and geriatric syndromes such as 
dementia, delirium, urinary incontinence, osteoporo-
sis, falls or gait disorders, or sleep disorders. 
‘‘(2) GERONTOLOGY.—The term ‘gerontology’ 
means the multidisciplinary study of the aging proc-
ess and individuals as they grow from middle age 
through later life. Such term encompasses the social, 
cognitive, psychological, biological and economic as-
pects of aging. 
‘‘(3) SPECIALTY
TRAINING.—The term ‘spe-
cialty training’ means coursework in geriatrics and 
gerontology and clinical training, including intern-
ships, residency programs, or fellowships, in a geri-
atric setting. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
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$4,000,000 for fiscal year 2010, $9,500,000 for fiscal year 
2011, $16,000,000 for fiscal year 2012, $24,000,000 for 
fiscal year 2013, and $30,500,000 for fiscal year 2014.’’. 
SEC. 3. EXPANSION OF NURSING EDUCATION LOAN REPAY-
MENT PROGRAM. 
Section 846 of the Public Health Service Act (42 
U.S.C. 297n) is amended— 
(1) by redesignating subsection (i) as subsection 
(j); and 
(2) by inserting after subsection (h), the fol-
lowing: 
‘‘(i) GERIATRIC CARE PRACTICE
IN LONG-TERM 
CARE SETTINGS.— 
‘‘(1) LOAN
REPAYMENTS.—In providing for 
loan repayments under this section, the Secretary 
shall ensure that eligible individuals include reg-
istered nurses who complete specialty training in 
geriatrics or gerontology and who elect to provide 
nursing services to older adults in home and commu-
nity-based or facility-based long-term care settings, 
or any other program determined appropriate by the 
Secretary. 
‘‘(2) DEFINITION.—In this subsection, the term 
‘specialty training’ means coursework in geriatrics 
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and gerontology and clinical training, including in-
ternships or fellowships, in a geriatric setting. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, $1,500,000 for fiscal year 2010, 
$3,000,000 for fiscal year 2011, $5,000,000 for fis-
cal year 2012, $7,000,000 for fiscal year 2013, and 
$8,500,000 for fiscal year 2014.’’. 
SEC. 4. EXPANSION OF CAREER LADDER PROGRAMS. 
Section 831 of the Public Health Service Act (42 
U.S.C. 296p) is amended— 
(1) in subsection (c)(1)(A)— 
(A) by striking ‘‘to promote career’’ and 
inserting the following: ‘‘to— 
‘‘(i) promote career’’; and 
(B) by adding at the end the following: 
‘‘(ii) focus on specialty training in 
providing long-term care services for nurs-
ing personnel (including registered nurses, 
licensed practical nurses, licensed voca-
tional nurses, certified nurse assistants, 
home health aides, personal care attend-
ants, or any other related worker category 
designated by the Secretary) who provide 
services in home and community-based or 
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facility-based 
long-term 
care 
settings; 
and’’; and 
(2) in subsection (h), by adding at the end the 
following: ‘‘There is authorized to be appropriated 
for grants under subsection (c)(1)(A)(ii), $4,000,000 
for fiscal year 2010, $4,000,000 for each of fiscal 
years 2011 through 2013, and $3,500,000 for fiscal 
year 2014.’’. 
SEC. 5. HEALTH AND LONG-TERM CARE WORKFORCE ADVI-
SORY PANEL FOR AN AGING AMERICA. 
Subpart 3 of part E of title VII of the Public Health 
Service Act (as added by section 2) is further amended 
by adding at the end the following: 
‘‘SEC. 772. HEALTH AND LONG-TERM CARE WORKFORCE 
ADVISORY PANEL FOR AN AGING AMERICA. 
‘‘(a) ESTABLISHMENT.—The Secretary, in consulta-
tion with the Secretary of Labor, shall establish a Health 
and Long-Term Care Workforce Advisory Panel (referred 
to in this section as the ‘Panel’) to— 
‘‘(1) examine workforce issues related to health 
and long-term care for the aging population; and 
‘‘(2) provide advice to each such Secretary and 
to the appropriate committees of Congress con-
cerning workforce issues related to health and long- 
term care for the aging population. 
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‘‘(b) MEMBERSHIP.—The Panel shall be composed of 
not to exceed 20 individuals to be appointed by the Sec-
retary. 
‘‘(c) DUTIES.—The Panel shall— 
‘‘(1) analyze the existing geriatric health and 
long-term care workforce data infrastructure; 
‘‘(2) make recommendations for new or addi-
tional uniform data elements across regions and 
States that is necessary to track supply, demand, 
and workforce shortages related to health and long- 
term care for the aging population; 
‘‘(3) conduct a research project to identify in-
centives for recruitment and retention of new popu-
lations of clinicians and providers who agree to serve 
vulnerable older adults in geriatric and long-term 
care settings and make recommendations for one or 
more demonstrations, including the design, imple-
mentation and evaluation of outcomes; and 
‘‘(4) carry out other activities determined ap-
propriate by the Secretary. 
‘‘(d) FOCUS OF RESEARCH PROJECT.—In carrying 
out the research project under subsection (c)(3), the Sec-
retary in consultation with the Panel shall focus on indi-
viduals who are not otherwise eligible for loan repayment 
incentives under this title or title VIII, such as retired 
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military clinicians or other retired health professionals, 
health care professionals seeking a mid-career change, and 
direct care workers in long-term care settings. To carry 
out such research project, the Secretary may award grants 
or contracts. Eligible entities shall include State or local 
government, health professions schools, academic health 
centers, and other appropriate public or private non-profit 
entities. 
‘‘(e) ADMINISTRATIVE PROVISIONS.—Members of the 
Panel shall be appointed for a term of not to exceed 3 
years (as determined by the Secretary at the time of ap-
pointment), shall convene at least twice per year, and shall 
be representative of diverse public and private sector ex-
pertise and interests, including representation from the 
Department of Health and Human Services (including the 
Health Resources and Services Administration, the Agen-
cy for Healthcare Research and Quality, and the Adminis-
tration on Aging), the Department of Labor (including the 
Bureau of Labor Statistics, the Employment and Training 
Administration, and the Employment Standards Adminis-
tration), other Federal officials as the Secretary deter-
mines appropriate, academic institutions, consumer orga-
nizations, national aging advocates, health professional 
and paraprofessional associations, organized labor, nation-
ally recognized researchers in the area of geriatric care 
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