Title: Health Heroes 2020 Act
Policy area: Health

Summary:
Health Heroes 2020 Act
This bill appropriates funds for, and makes other changes to, scholarship and loan repayment programs for health care providers who agree to a period of obligated service in a health professional shortage area.
Specifically, the bill provides funds through FY2026 for the National Health Service Corps and otherwise modifies the program, including by (1) authorizing the Department of Health and Human Services (HHS), subject to certain limitations, to reassign corps members to alternative sites during a declared public health emergency; and (2) establishing a demonstration project that allows corps members to fulfill their service obligations through a period of reserve status, during which HHS may deploy them to respond to a declared emergency.

The bill also provides FY2020 funds for the Nurse Corps scholarship and loan repayment programs. These funds are designated as an emergency requirement, which exempts the funds from discretionary spending limits and other budget enforcement rules.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3634 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 3634

 To address health workforce shortages and disparities highlighted by 
   the COVID-19 pandemic through additional funding for the National 
                 Health Service Corps and Nurse Corps.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 6, 2020

 Mr. Durbin (for himself, Ms. Duckworth, Mr. Blumenthal, Ms. Stabenow, 
Mr. Merkley, Mr. Jones, Ms. Klobuchar, Ms. Hirono, Mrs. Gillibrand, Ms. 
    Smith, Mr. Sanders, Ms. Harris, and Ms. Baldwin) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To address health workforce shortages and disparities highlighted by 
   the COVID-19 pandemic through additional funding for the National 
                 Health Service Corps and Nurse Corps.

    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 ``Health Heroes 2020 Act''.

SEC. 2. ADDITIONAL FUNDING FOR THE SCHOLARSHIP PROGRAM OF 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--
                    ``(A) $25,000,000,000 for fiscal year 2020, to 
                provide additional funding to carry out subsection (i) 
                of section 338A of the Public Health Service Act and 
                the National Health Service Corps Loan Program under 
                section 338B of such Act, of which--
                            ``(i) $15,000,000,000 shall be allocated to 
                        the program under section 338A; and
                            ``(ii) $10,000,000,000 shall be allocated 
                        to the program under such section 338B; and
                    ``(B) $690,000,000 for each of fiscal years 2021 
                through 2026, to provide additional amounts 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 Repayment 
                Program under section 338B of such Act, and the reserve 
                service program under section 338O of such Act.''.
    (b) Criteria for Use of Additional Funding for In-Demand 
Professionals.--Section 338A of the Public Health Service Act (42 
U.S.C. 254l) is amended by adding at the end the following:
    ``(i) Not less than 40 percent of the amounts made available to 
carry out this section under 10503(b)(3)(A)(i) of the Patient 
Protection and Affordable Care Act shall be allocated to scholarships 
under this section 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. To carry out the requirements of this 
subsection, the Secretary may coordinate with entities receiving 
funding under section 739 to identify, recruit, and select individuals 
to receive such scholarships.''.
    (c) National Health Service Corps Reserve Demonstration Project.--
            (1) In general.--Subpart III of part D of title III of the 
        Public Health Service Act (42 U.S.C. 254l et seq.) is amended 
        by adding at the end the following:

``SEC. 338O. NATIONAL HEALTH SERVICE CORPS RESERVE SERVICE 
              DEMONSTRATION PROJECT.

    ``(a) In General.--From the amounts made available under section 
10503(b)(3)(B) of the Patient Protection and Affordable Care Act for 
each of fiscal years 2021 through 2024, the Secretary shall, to the 
extent permitted by, and consistent with, the requirements of 
applicable State law, use such sums as the Secretary determines 
necessary to establish, as a demonstration project, a National Health 
Service Corps Reserve Service (referred to in this section as the 
`reserve service') under which a qualified individual agrees to engage 
in service for a period specified in a contract under this section in 
such reserve service under this section.
    ``(b) Reserve Service Requirements.--An individual whose obligated 
service under a contract under section 338A is provided, pursuant to a 
contract under subsection (a), as reserve service, and any other 
participating individual described in subparagraph (B) of subsection 
(c)(2) may practice a health profession in any private capacity, 
subject to the following requirements:
            ``(1) In the event of a public health emergency declared 
        under section 319, a major disaster declared by the President 
        under section 401 of the Robert T. Stafford Disaster Relief and 
        Emergency Assistance Act, or 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, 
        for the duration of such emergency or disaster, such individual 
        shall be subject to serve in such capacity as the Secretary 
        shall determine appropriate to carry out the purposes of this 
        section, and in accordance with the Secretary's plan to 
        increase surge capacity in response to public health 
        emergencies or disasters. Such service may be furnished in 
        coordination with the Corps described in section 204, a State, 
        territorial, or local public health department, or through the 
        process described in section 319(e).
            ``(2) Not less frequently than 2 days each month, and for a 
        total of not fewer than 30 days each year, as directed by the 
        Secretary, such individual shall--
                    ``(A) conduct trainings on public health 
                preparedness and response activities, which may be in 
                coordination with the State, territorial, or local 
                health department; or
                    ``(B) furnish health care services to low-income 
                individuals in a health professional shortage area (as 
                defined under section 332(a)), a medically underserved 
                population (as defined under section 330(b)(3)), or a 
                medically underserved area or area at high risk of a 
                public health emergency as designated by the Secretary.
    ``(c) Qualified Individuals.--An individual may be eligible to 
participate in the reserve service under this section if such 
individual meets one of the following criteria:
            ``(1) An individual participating in the Scholarship 
        Program under section 338A may satisfy the obligated service 
        requirement under such program if the individual's contract 
        provides for such service.
            ``(2) An individual who participated in the Loan Repayment 
        Program under section 338B and who satisfied the obligated 
        service requirements under such program, in accordance with the 
        individual's contract.
            ``(3) An individual who--
                    ``(A) did not participate in the Scholarship 
                Program under section 338A or the Loan Repayment 
                Program under section 338B;
                    ``(B) has a graduate degree in medicine, 
                osteopathic medicine, dentistry, or another health 
                profession, or an appropriate graduate degree from a 
                program of behavioral or mental health, or is certified 
                as a nurse midwife, nurse practitioner, or physician 
                assistant;
                    ``(C) holds a license issued by a State, the 
                District of Columbia, or a territory to practice the 
                applicable profession;
                    ``(D) is otherwise qualified to practice, and has 
                experience practicing, in a profession--
                            ``(i) described in section 338B(a)(1); or
                            ``(ii) another high-demand health care 
                        field or specialty that the Secretary 
                        identifies, through a process conducted every 3 
                        years, as a field or specialty of national 
                        priority, based on relative workforce 
                        shortages, expected workforce changes, or 
                        projected changes in patient needs; and
                    ``(E) satisfies any other eligibility or 
                application requirements specified by the Secretary in 
                order to demonstrate the individual's qualifications.
    ``(d) Reserve Service Plan.--In carrying out this section, the 
Secretary shall establish, in coordination with the Surgeon General and 
State, tribal, and local health departments, an action plan for the 
service commitments, priority areas, coordination efforts, training 
requirements, and such other considerations as the Secretary determines 
appropriate, to ensure the complementary, additive capacity of such 
individuals providing reserve service.
    ``(e) Contracts for Certain Participating Individuals.--An 
individual described in subparagraph (B) of subsection (c)(2) who is 
participating in the reserve service program under this section shall 
receive loan repayments in an amount equal to 50 percent of the amount 
of payments that would be required with respect to a participant of the 
same clinical profession in the 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.
    ``(f) Report.--Not later than 5 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, 
        public health emergency response capacity, and the provider 
        workforce pipeline; and
            ``(2) any other considerations as the Secretary determines 
        appropriate.''.
            (2) Conforming amendments.--
                    (A) Scholarship program.--Section 338A of the 
                Public Health Service Act (42 U.S.C. 254l) is amended--
                            (i) in subsection (b)(2), by inserting ``, 
                        or be eligible for, or hold, an appointment in 
                        the reserve service under section 338O'' before 
                        the semicolon;
                            (ii) in subsection (c)(2)(B), by inserting 
                        ``or through reserve service under an agreement 
                        under section 338O'' after ``section 338D''; 
                        and
                            (iii) in the flush text of subsection 
                        (f)(1)(B)(v), by inserting ``, including 
                        service under the reserve service in accordance 
                        with section 338O, as applicable'' before the 
                        semicolon at the end.
                    (B) Obligated service.--Section 338C of the Public 
                Health Service Act (42 U.S.C. 254m) is amended--
                            (i) in subsection (a), by inserting ``or 
                        338O'' after ``section 338D''; and
                            (ii) in subsection (c)--
                                    (I) in paragraph (1), by striking 
                                ``, or'' and inserting a semicolon;
                                    (II) in paragraph (2), by striking 
                                ``agreement,'' and inserting 
                                ``agreement; or''; and
                                    (III) by inserting after paragraph 
                                (2) the following:
            ``(3) in the case of an individual who enters into an 
        agreement with the Secretary under section 338O, on the date 
        specified in such agreement,''.

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

    (a) Funding.--There are hereby appropriated, out of amounts in the 
Treasury not otherwise appropriated, $5,000,000,000 for fiscal year 
2020, 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, not less than 40 percent shall be 
        allocated to scholarships 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.
    (b) Emergency Designation.--
            (1) In general.--The amounts provided by this section are 
        designated as an emergency requirement pursuant to section 4(g) 
        of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(g)).
            (2) Designation in senate.--In the Senate, this section is 
        designated as an emergency requirement pursuant to section 
        4112(a) of H. Con. Res. 71 (115th Congress), the concurrent 
        resolution on the budget for fiscal year 2018.

SEC. 4. FLEXIBILITY FOR MEMBERS OF NATIONAL HEALTH SERVICE CORPS DURING 
              EMERGENCY PERIODS.

    Section 333 of the Public Health Service Act (42 U.S.C. 254f) is 
amended by adding at the end the following:
    ``(f) During any public health emergency declared by the Secretary 
under section 319, the Secretary may, notwithstanding any other 
provision of this section, assign Corps members, with the voluntary 
agreement of such Corps members, to provide such health services at 
such places, and for such number of hours, as the Secretary determines 
necessary to respond to such emergency, provided that the total number 
of hours required are the same as were required of such members prior 
to the change of assignment.''.
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