I 117th CONGRESS 2d Session H. R. 6397 IN THE HOUSE OF REPRESENTATIVES January 13, 2022 Mr. Cole (for himself, Ms. Titus , and Mr. Mullin ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State, and for other purposes.

1. Short title This Act may be cited as the Medical Student Education Authorization Act of 2022 . 2. Findings Congress finds the following: (1) Access to high quality primary care is associated with improved health outcomes and lower health care costs. (2) Substantial disparities exist in the distribution of primary care providers. (3) Shortages of health care providers affect Tribal, rural, and medically underserved communities more than the populations of more densely populated areas, resulting in such communities experiencing significant health challenges and disparities. (4) American Indian, Alaskan Natives, and Native Hawaiians tend to have lower health status, lower life expectancy, and disproportionate disease burden when compared to other Americans. (5) Having training experiences in, living among, and being a member of Tribal, rural, and medically underserved communities increases cultural awareness and can influence career choice for physicians to better serve such populations. (6) Research shows there is a relationship between the characteristics of a physician and the eventual practice location, including being part of an underrepresented minority or growing up in a rural area. 3. Education program to support primary health service for underserved populations Part B of title VII of the Public Health Service Act ( 42 U.S.C. 293 et seq. ) is amended by adding at the end the following: 742. Education program to support primary health service for underserved populations (a) Establishment The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a grant program to award grants to public institutions of higher education located in a covered State to carry out the activities described in subsection (d) for the purposes of— (1) expanding and supporting education for medical students who are preparing to become physicians in a covered State; and (2) preparing and encouraging each such student training in a covered State to serve Tribal, rural, or medically underserved communities as a primary care physician after completing such training. (b) Eligibility In order to be eligible to receive a grant under this section, a public institution of higher education shall submit an application to the Secretary that includes— (1) a certification that such institution will use amounts provided to the institution to carry out the activities described in subsection (d); and (2) a description of how such institution will carry out such activities. (c) Priority In awarding grants under this section, the Secretary shall give priority to public institutions of higher education that— (1) are located in a State with not fewer than 2 federally recognized Tribes; and (2) demonstrate a public-private partnership. (d) Authorized activities An eligible entity that receives a grant under this section shall use the funds made available under such grant to carry out the following activities: (1) Support or expand community-based experiential training for medical students who will practice in or serve Tribal, rural, and medically underserved communities. (2) Develop and operate programs to train medical students in primary care services. (3) Develop and implement curricula that— (A) includes a defined set of clinical and community-based training activities that emphasize care for Tribal, rural, or medically underserved communities; (B) is applicable to primary care practice with respect to individuals from Tribal, rural, or medically underserved communities; (C) identifies and addresses challenges to health equity, including the needs of Tribal, rural, and medically underserved communities; (D) supports the use of telehealth technologies and practices; (E) considers social determinants of health in care plan development; (F) integrates behavioral health care into primary care practice, including prevention and treatment of opioid disorders and other substance use disorders; (G) promotes interprofessional training that supports a patient-centered model of care; and (H) builds cultural and linguistic competency. (4) Increase the capacity of faculty to implement the curricula described in paragraph (3). (5) Develop or expand strategic partnerships to improve health outcomes for individuals from Tribal, rural, and medically underserved communities, including with— (A) federally recognized Tribes, Tribal colleges, and Tribal organizations; (B) Federally-qualified health centers; (C) rural health clinics; (D) Indian health programs; (E) primary care delivery sites and systems; and (F) other community-based organizations. (6) Develop a plan to track graduates’ chosen specialties for residency and the States in which such residency programs are located. (7) Develop, implement, and evaluate methods to improve recruitment and retention of medical students from Tribal, rural, and medically underserved communities. (8) Train and support instructors to serve Tribal, rural, and medically underserved communities. (9) Prepare medical students for transition into primary care residency training and future practice. (10) Provide scholarships to medical students. (e) Grant period A grant under this section shall be awarded for a period of not more than 5 years. (f) Grant amount Each fiscal year, the amount of a grant made to a public institution of higher education under this section shall be not less than $1,000,000. (g) Matching requirement Each public institution of higher education that receives a grant under this section shall provide, from non-Federal sources, an amount equal to or greater than 10 percent of the total amount of Federal funds provided to the institution each fiscal year during the period of the grant (which may be provided in cash or in kind). (h) Definitions In this section: (1) Covered State The term covered State means a State that is in the top quartile of States by projected unmet demand for primary care providers, as determined by the Secretary. (2) Federally-qualified health center The term Federally-qualified health center has the meaning given such term in section 1905(l)(2)(B) of the Social Security Act. (3) Indian health program The term Indian health program has the meaning given such term in section 4 of the Indian Health Care Improvement Act. (4) Institution of higher education The term institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965, provided that such institution is public in nature. (5) Medically underserved community The term medically underserved community has the meaning given such term in section 799B. (6) Rural health clinic The term rural health clinic has the meaning given such term in section 1861(aa) of the Social Security Act. (7) Rural population The term rural population means the population of a geographical area located— (A) in a non-metropolitan county; or (B) in a metropolitan county designated as rural by the Administrator of the Health Resources and Services Administration. (8) Tribal population The term Tribal population means the population of any Indian Tribe recognized by the Secretary of the Interior pursuant to section 104 of the Federally Recognized Indian Tribe List Act of 1994. (i) Authorization of appropriations There is authorized to be appropriated to carry out this section $150,000,000 for each of fiscal years 2023 through 2027. .