Strengthening America’s Health Care Readiness Act
Bill: S.54 | Sponsor: Sen. Durbin, Richard J. (D-IL)
Policy area: Health

Summary:
Strengthening America's Health Care Readiness Act
This bill establishes an emergency services demonstration program within the Department of Health and Human Services (HHS) to provide supplemental student loan repayment to current and former National Health Services Corps (NHSC) participants. The NHSC provides scholarships and student loan repayment awards to health care providers who agree to work in areas with health care provider shortages.
To receive supplemental payments, individuals must agree to participate in the National Disaster Medical System. This system is a partnership between HHS, the Department of Defense, and other federal departments that responds to public health and other emergencies, including by deploying medical response teams.
The bill also increases FY2021 funding for the NHSC, as well as similar programs for nurses. It reserves some of this funding for individuals who are members of groups that are historically underrepresented in health care professions. The funds for the Nurse Corps Scholarship and Repayment Program are designated as an emergency requirement, which exempts the funds from discretionary spending limits and other budget enforcement rules.

To address health workforce shortages and disparities highlighted by 
   the COVID-19 pandemic through additional funding for the National 
 Health Service Corps and the Nurse Corps, and to establish a National 
     Health Service Corps Emergency Service demonstration project.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening America's Health Care 
Readiness Act''.

SEC. 2. ADDITIONAL FUNDING FOR THE NATIONAL HEALTH SERVICE CORPS.

    (a) Additional Funding.--Section 10503(b) of the Patient Protection 
and Affordable Care Act (42 U.S.C. 254b-2(b)) is amended--
            (1) in paragraph (1)(F), by striking ``and'' at the end;
            (2) in paragraph (2)(H), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(3) to be transferred to the Secretary of Health and 
        Human Services $5,000,000,000 for fiscal year 2021, to provide 
        additional funding to carry out the National Health Service 
        Corps Scholarship Program under section 338A of the Public 
        Health Service Act, the National Health Service Corps Loan 
        Program under section 338B of such Act, and the National Health 
        Service Corps Emergency Service under section 2812A of such 
        Act.''.
    (b) Criteria for Use of Additional Funding for In-Demand 
Professionals.--Not less than 40 percent of the amounts made available 
under paragraph (3) of section 10503(b) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 254b-2(b)) (as amended by subsection 
(a)) shall be allocated to awards to eligible applicants to the 
National Health Service Corps Scholarship Program under section 338A of 
the Public Health Service Act (42 U.S.C. 254l), the National Health 
Service Corps Loan Repayment Program under section 338B of such Act (42 
U.S.C. 254l-1), or the National Health Service Corps Emergency Service 
under section 2812A of such Act (as added by subsection (c)) who are 
members of groups that are historically underrepresented in health care 
professions, including racial and ethnic minorities and individuals 
from low-income urban and rural communities. To carry out the 
requirements of this subsection, the Secretary may coordinate with 
entities receiving funding under section 739 or 821 of the Public 
Health Service Act (42 U.S.C. 293c, 296m) to identify, provide 
mentorship and support, and recruit such eligible applicants.
    (c) National Health Service Corps Emergency Service Demonstration 
Project.--Part B of title XXVIII of the Public Health Service Act is 
amended by inserting after section 2812 (42 U.S.C. 300hh-11) the 
following:

``SEC. 2812A. NATIONAL HEALTH SERVICE CORPS EMERGENCY SERVICE 
              DEMONSTRATION PROJECT.

    ``(a) In General.--For each of fiscal years 2022 through 2026, from 
the amounts made available under section 10503(b)(3) of the Patient 
Protection and Affordable Care Act, to the extent permitted by, and 
consistent with, the requirements of applicable State law, the 
Secretary shall allocate up to $50,000,000 to establishing, as a 
demonstration project, a National Health Service Corps Emergency 
Service (referred to in this section as the `emergency service') under 
which a qualified individual currently or previously participating in 
the National Health Service Corps agrees to engage in service through 
the National Disaster Medical System established under section 2812, as 
described in this section.
    ``(b) Participants.--
            ``(1) NHSC alumni.--
                    ``(A) Qualified individuals.--An individual may be 
                eligible to participate in the emergency service under 
                this section if such individual participated in the 
                Scholarship Program under section 338A or the Loan 
                Repayment Program under section 338B, and who satisfied 
                the obligated service requirements under such program, 
                in accordance with the individual's contract.
                    ``(B) Priority and increased funding amounts.--
                            ``(i) Priority.--In selecting eligible 
                        individuals to participate in the program under 
                        this paragraph, the Secretary shall give 
                        priority--
                                    ``(I) first, to qualified 
                                individuals who continue to practice at 
                                the site where the individual fulfilled 
                                his or her obligated service under the 
                                Scholarship Program or Loan Repayment 
                                Program through the time of the 
                                application to the program under this 
                                section; and
                                    ``(II) secondly, to qualified 
                                individuals who continue to practice in 
                                any site approved for obligated service 
                                under the Scholarship Program or Loan 
                                Repayment Program other than the site 
                                at which the individual served.
                            ``(ii) Increased funding amounts.--The 
                        Secretary may grant increased award amounts to 
                        certain participants in the program under this 
                        section based on the site where a participant 
                        fulfilled his or her obligated service under 
                        the Scholarship Program or Loan Repayment 
                        Program.
                    ``(C) Private practice.--An individual 
                participating in the emergency service under this 
                section may practice a health profession in any private 
                capacity when not obligated to fulfill the requirements 
                described in subsection (c).
            ``(2) Current nhsc members.--
                    ``(A) In general.--An individual who is 
                participating in the Scholarship Program under section 
                338A or the Loan Repayment Program under section 338B 
                may apply to participate in the program under this 
                section while fulfilling the individual's obligated 
                services under such program.
                    ``(B) Clarifications.--Notwithstanding any other 
                provision of law or any contract with respect to 
                service requirements under the Scholarship Program or 
                Loan Repayment Program, an individual fulfilling 
                service requirements described in subsection (c) shall 
                not be considered in breach of such contract under such 
                Scholarship Program or Loan Repayment Program, provided 
                that the individual give advance and reasonable 
                notification to the site at which the individual is 
                fulfilling his or her obligated service requirements 
                under such contract, and the site approves the 
                individual's deployment through the National Disaster 
                Medical System.
                    ``(C) No credit toward obligated service.--No 
                period of service under the National Disaster Medical 
                System described in subsection (c)(1) shall be counted 
                toward satisfying a period of obligated service under 
                the Scholarship Program or Loan Repayment Program.
    ``(c) Participants as Members of the National Disaster Medical 
System.--
            ``(1) Service requirements.--An individual participating in 
        the program under this section shall participate in the 
        activities of the National Disaster Medical System under 
        section 2812 in the same manner and to the same extent as other 
        participants in such system.
            ``(2) Rights and requirements.--An individual participating 
        in the program under this section shall be considered 
        participants in the National Disaster Medical System and shall 
        be subject to the rights and requirements of subsections (c) 
        and (d) of section 2812.
    ``(d) Emergency Service Plan.--In carrying out this section, the 
Secretary, in consultation with the Administrator of the Health 
Resources and Services Administration and the Assistant Secretary for 
Preparedness and Response, shall establish an action plan for the 
service commitments, deployment protocols, coordination efforts, 
training requirements, liability, workforce development, and such other 
considerations as the Secretary determines appropriate. Such action 
plan shall--
            ``(1) ensure adherence to the missions of both the National 
        Health Service Corps and National Disaster Medical Service;
            ``(2) outline the type of providers determined by the 
        Assistant Secretary to be priorities for participation in the 
        program established under this section;
            ``(3) describe how such deployments will be determined and 
        prioritized in a manner consistent with--
                    ``(A) the National Health Service Corps contracts; 
                and
                    ``(B) the National Disaster Medical System's 
                deployment policy of not hindering civilian responders 
                already engaged in an emergency response;
            ``(4) ensure an adequate health care workforce during a 
        public health emergency declared by the Secretary under section 
        319 of this Act, a major disaster declared by the President 
        under section 401 of the Robert T. Stafford Disaster Relief and 
        Emergency Assistance Act, an emergency declared by the 
        President under section 501 of the Robert T. Stafford Disaster 
        Relief and Emergency Assistance Act, or a national emergency 
        declared by the President under the National Emergencies Act; 
        and
            ``(5) describe how the program established under this 
        section will be implemented in a manner consistent with, and in 
        furtherance of, the assessments and goals for workforce and 
        training described in the review conducted by the Secretary 
        under section 2812(b)(2).
    ``(e) Contracts for Certain Participating Individuals.--An 
individual who is participating in the emergency service program under 
this section shall receive loan repayments in an amount up to 50 
percent (as determined by the Secretary) of the highest new award made 
for the year under the National Health Service Corps Loan Repayment 
Program pursuant to a contract entered into at the same time under 
section 338B(g), in a manner similar to the manner in which payments 
are made under such section, pursuant to the terms of a contract 
between the Secretary and such individual. The Secretary shall 
establish a system of contracting for purposes of this subsection which 
shall be similar to the contract requirements and terms under 
subsections (c), (d), and (f) of section 338B. Amounts received by an 
individual under this subsection shall be in addition to any amounts 
received by an individual described in subsection (b)(2) pursuant to 
the Scholarship Program under section 338A or the Loan Repayment 
Program under section 338B, as applicable.
    ``(f) Breach of Contract, Termination, Waiver, and Suspension.--
            ``(1) Recovery of amounts in the event of a breach.--If an 
        individual breaches the written contract of the individual 
        under subsection (e) by failing either to begin such 
        individual's service obligation in accordance with such 
        contract or to complete such service obligation, the United 
        States shall be entitled to recover from the individual an 
        amount equal to the sum of--
                    ``(A) the total of the amounts paid by the United 
                States under such contract on behalf of the individual 
                for any period of such service not served;
                    ``(B) an amount equal to the product of the number 
                of months of service that were not completed by the 
                individual, multiplied by $3,750; and
                    ``(C) the interest on the amounts described in 
                subparagraphs (A) and (B), at the maximum legal 
                prevailing rate, as determined by the Treasurer of the 
                United States, from the date of the breach.
            ``(2) Termination of contract.--The Secretary may terminate 
        a contract under subsection (e) in accordance with the 
        termination standards that are--
                    ``(A) applicable to contracts entered into under 
                section 338B; and
                    ``(B) in effect in the fiscal year in which such 
                contract was entered.
            ``(3) Waiver or suspension of obligation.--If an individual 
        participating in the program under this section submits a 
        written request to the Secretary, the Secretary may waive or 
        suspend a service or payment obligation arising under this 
        subsection or a contract under subsection (e), in whole or in 
        part, in accordance with the standards set forth in section 
        62.12 of title 42, Code of Federal Regulations (or any 
        successor regulations).
    ``(g) Report.--Not later than 4 years after the date of enactment 
of this section, the Secretary shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report that 
evaluates the demonstration project established under this section, 
including--
            ``(1) the effects of such program on health care access in 
        underserved areas and health professional shortage areas and on 
        public health emergency response capacity;
            ``(2) the effects of such program on the health care 
        provider workforce pipeline, including any impact on the 
        demographic representation among, and the fields or specialties 
        pursued by, students in approved graduate training programs in 
        medicine, osteopathic medicine, dentistry, behavioral and 
        mental health, or other health profession;
            ``(3) the impact of such program on the enrollment, 
        participation, and completion of requirements in the underlying 
        scholarship and loan repayment programs of the National Health 
        Service Corps;
            ``(4) the effects of such program on the National Disaster 
        Medical System's response capability, readiness, and workforce 
        strength; and
            ``(5) recommendations for improving the demonstration 
        project described in this section, and any other considerations 
        as the Secretary determines appropriate.''.

SEC. 3. FUNDING FOR THE NURSE CORPS SCHOLARSHIP AND LOAN REPAYMENT 
              PROGRAM.

    There are hereby appropriated, out of amounts in the Treasury not 
otherwise appropriated, $1,000,000,000 for fiscal year 2021, for 
purposes of carrying out section 846 of the Public Health Service Act 
(42 U.S.C. 297n), to remain available until expended, except that--
            (1) of the amount appropriated under this heading and made 
        available for scholarships and loan repayment, not less than 40 
        percent shall be allocated for eligible applicants who are 
        members of groups that are historically underrepresented in 
        health care professions, including racial and ethnic minorities 
        and individuals from low-income urban and rural communities; 
        and
            (2) to carry out the requirements of paragraph (1), the 
        Secretary may coordinate with entities receiving funding under 
        section 821 to identify, recruit, and select individuals to 
        receive such scholarships.
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