I 117th CONGRESS 2d Session H. R. 9105 IN THE HOUSE OF REPRESENTATIVES September 30, 2022 Ms. Lee of California (for herself, Ms. Chu , and Mr. Bera ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to authorize the establishment of the National Medical Corps Program to create pathway programs for community college students to pursue premedical training and enter medical school, and for other purposes.

1. Short title This Act may be cited as the National Medical Corps Act or the NMC Act . 2. National Medical Corps programs 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: 741A. National Medical Corps programs (a) In general The Secretary, in consultation with the Secretary of Education and the Secretary of Labor, shall make grants to, and enter into contracts with, eligible entities for the purpose of establishing programs to assist community college students to pursue premedical training and enter medical school (referred to in this section as an NMC Program , by addressing— (1) the shortage of primary care physicians and psychiatrists in vulnerable and underserved communities; and (2) the widening disparities in access to care in such communities. (b) Eligible entity An entity is eligible to receive a grant or enter into a contract under this section if the entity is a school of medicine, an institution of higher education, or a public or private nonprofit health or educational institution (other than a school of nursing) that— (1) forms a consortium that includes, at a minimum— (A) 3 community colleges in the region in which the consortium serves; (B) one 4-year public or private nonprofit undergraduate institution in the region; (C) one public or private nonprofit accredited medical school located in a State; (D) one primary care association or consortium of community health centers; (E) at least one community health center, inclusive of federally qualified health centers, federally qualified health center look-alikes, rural health centers, migrant health centers, frontier health centers, indian health service clinics, and free clinics; and (F) other such entities as considered appropriate by the Secretary; and (2) has established, or commits to establish, a community advisory board that is— (A) comprised of local business, education, health industry, and other community leaders to oversee and guide the programmatic direction of the program; and (B) intended to guide the unique establishment of regional partnerships and opportunities for students along the pathway to support the accomplishment of its targets for student outcomes. (c) Application; selection (1) Application An eligible entity seeking a grant under this section shall submit an application at such time and in such manner as the Secretary may require. Such application shall contain— (A) the name of the entity selected to operate as the lead entity of the consortium; (B) documentation supporting the entity’s eligibility; and (C) such other information as the Secretary may require. (2) Selection The Secretary shall select, on a competitive basis— (A) 20 eligible entities in the first full calendar year beginning on or after the date of the enactment of this section; and (B) 20 eligible entities in each of the 5 subsequent calendar years. (d) Conditions on awards The recipient of a grant shall, as a condition on receiving such a grant agree— (1) that a student selected to participate in an NMC Program (referred to in this section as a National Medical Corps Scholar or an NMC Scholar ) shall be— (A) a community college student who has completed at least one semester of community college and is intending to transfer to a 4-year college pre-medical program with the intent to pursue a career in primary care medicine or psychiatry; (B) from an economically or educationally disadvantaged background; and (C) a citizen, national, or lawful permanent resident of the United States; (2) to verify that each individual seeking to be selected as an NMC Scholar— (A) intends to pursue practice as a physician who practices primary care or psychiatry; (B) intends to serve in the National Health Service Corps; or (C) has been determined under subsection (f) to be from an economically or educationally disadvantaged background; (3) to provide to each NMC Scholar a student-identifying marker prior to entering medical school and to require that the NMC Scholar, as a condition on receipt of support, provides to the grant recipient the National Provider Identifier of the NMC Scholar when the Scholar enters medical school; (4) to select and support (through the provision of scholarships and wrap around services) not fewer than 50 NMC Scholars each year of the grant, selected from three or more of the populations described in subsection (e); (5) to track the academic and career pathway of such NMC scholars from community college through medical school; (6) to provide individualized guidance with respect to pursuing an alternate career pathway to NMC scholars that elect not to pursue a career as physicians in primary care or psychiatry; and (7) to limit the amount of an award to an NMC Scholar in a fiscal year to the costs of attendance for the applicable school year. (e) Populations described The populations described in this subsection are each of the following: (1) Individuals enrolled in 2-year community college programs with the intention to transfer to a 4-year institution of higher education. (2) Community college transfer students who are currently enrolled in a 4-year institution of higher education with intention to apply to medical school. (3) Individuals enrolled in medical school who— (A) were previously enrolled for a period of at least 1 year at a community college after completing secondary school but before obtaining a bachelor’s degree; and (B) intend to pursue training in primary care or psychiatry to serve rural or underserved communities. (f) Economically or educationally disadvantaged background To determine if a student seeking to be selected as an NMC Scholar is from an economically or educationally disadvantaged background, the recipient of a grant under this section shall— (1) first determine if such student is from an economically disadvantaged background; and (2) if a student has been determined not to be from an economically disadvantaged background, the recipient shall evaluate whether the student is from a educationally disadvantaged background. (g) Use of funds An eligible entity selected to receive a grant under this section may use funds received through the grant to— (1) conduct outreach toward, and recruitment and enrollment of, NMC Scholars; (2) plan, develop, and operate a program to support NMC Scholars’ career progression into medical school, including providing advising, mentoring, academic supports for transfer, medical school applications, and identifying and pursuing extracurricular and work opportunities aligned with future health careers, such as part-time employment in a health, public health, or primary care-related position; (3) provide financial assistance in the form of scholarships or stipends for NMC Scholars from community college through entry to medical school; (4) coordinate NMC Program activities with other existing Federal, State, local, and institutions resources, including the Health Careers Opportunity program under section 736, area health education centers under section 751, programs and services for disabled students under subtitle A of title II of the Americans with Disabilities Act, and Federal TRIO programs under chapter 1 of subpart 2 of part A of title IV of the Higher Education Act of 1965 ( 20 U.S.C. 1070a–11 et seq. ); (5) implement data sharing, analysis, and the continuous testing of data-informed practices, to foster a statewide collaboration of mutual accountability for improvement, consistent with applicable State and Federal law; (6) cover the costs associated with maintaining the consortium and advisory board; (7) support training in community-based organizations, such as community health centers; (8) develop a partnership agreement and support NMC Scholars with one or more campus-based learning communities, groups, or entities; and (9) implement and adopt premedical advising standards or standardized guidelines as set out by the consortium lead, in collaboration with consortium membership, including community colleges, four-year undergraduate institutions, and participating schools of medicine. (h) Priorities in making awards In awarding grants or contracts under this section, the Secretary may give priority to consortia that include at least one— (1) minority-serving institution, including a historically Black college or university; (2) Hispanic-serving institution; (3) Tribal college or university; (4) Asian American and Pacific Islander serving institution; (5) Native Hawaiian-serving institution; or (6) Native American-serving non-Tribal institution. (i) Coordination with NHSC Individuals selected as NMC Scholars shall receive priority consideration for an award under for National Health Service Corps Scholarship Program under section 338A and the National Health Service Corps Loan Repayment Program under section 338B. (j) Report to Secretary Not later than 1 year after the date of the enactment of this section and every calendar year thereafter, each consortium selected to receive a grant under this section shall submit to the Secretary a report on the following with respect to the preceding year: (1) The selection criteria and process used to ensure that the members of the consortium and advisory board represent the intended communities to be served and the demographics of such members and advisory board. (2) A summary of the roles of the members of the consortium and advisory board. (3) The selection criteria, process, and strategy used by the consortium to recruit, engage, and select NMC Scholars. (4) With respect to the NMC Scholars participating in the NMC Program— (A) self-reported demographic data (including race and ethnicity, sex, sexual orientation, gender identity, date of birth, English proficiency status, fluency in other languages, disadvantaged (educational or economic) background status, disability, the census tract or current address, or other demographic data as appropriate) ; (B) the percentages of NMC Scholars who successfully achieve transfer-level math and English by the completion of their second year enrolled in a community college, disaggregated by race and ethnicity of student populations so enrolled in such a community college; (C) the rate of acceptance to participating 4-year institutions of higher education and 4-year college pre-medical training programs for transfer students applying from participating community colleges; (D) the rate of NMC scholars eligible to transfer, or accepted to attend, a participating 4-year institution of higher education after completing two years, two and one-half years, or three or more years, in special circumstances, of enrollment in a community college. (E) when available, career advancement data, including— (i) whether the scholar was accepted to a 4-year institution of higher education, medical school, another health professions program, or another STEM professions program; (ii) whether the scholar graduated from medical school, another health professions program, or another STEM professions program; (iii) whether the scholar pursued a career in primary care, psychiatry, or another health profession in a rural or underserved setting; (iv) the National Provider Identifier assigned to such student, as available; and (v) such other information as determined to be appropriate by the Secretary. (5) An evaluation of the success of the NMC Program, including with respect to— (A) whether the program was able to support not less than 50 students in the first year of implementation of the program; (B) the number of semesters in community college each such student enrolled in, what type of college or university the student was enrolled in, which degree the student pursued, and which career pathway the student is pursuing; (C) whether the program developed a partnership agreement with one or more campus-based learning communities, groups, or entities, as specified in subsection (g)(8); and (D) whether and to what extent the program was able to align its goals and equity strategies, and maximize the use of available resources and funds, as specified in subsection (d)(4). (k) Report to Congress Not later than the end of fiscal year 2028, the Secretary, acting through the Administrator of the Health Resources and Services Administration, shall submit an annual report to the Congress that— (1) summarizes the information submitted in the evaluation and report under subsections (j) and (k); (2) describes the contracts, strategy, and goals shared between the Secretary and each consortium receiving a grant under this section; (3) includes data on the planned and actual use of funds by the consortium and the Secretary in carrying out this section; (4) assesses the goals and progress of the NMC Program, including the potential impact of NMC Scholars on health care access and quality; and (5) makes recommendations for improvements to the program. (l) Privacy protections In publishing data under this section, the Secretary shall take all necessary steps to protect the privacy of individuals whose information is included in such data, including— (1) complying with privacy protections comparable to those applicable under the HIPAA privacy regulation (as defined in section 1180(b)(3) of the Social Security Act) to covered entities (as defined for purposes of such regulation); (2) not using or disclosing the information generated pursuant to the program for any purpose other than carrying out the program; and (3) not publishing or selling individually identifiable information generated pursuant to the program nor transmitting such data for purposes other than carrying out the program, including not sharing such information with any local, State, or Federal law enforcement agency. (m) Definitions In this section: (1) The term State means each State of the United States, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Virgin Islands of the United States, and any other territory or possession of the United States, and each federally recognized Indian Tribe. (2) The term educationally disadvantaged , with respect to the background of a student seeking to be selected as an NMC scholar, means that the student— (A) is a member of a racial and ethnic minority group (as defined in section 1707) that is under-represented in medicine; (B) resides in a low-income community; (C) is a first-generation college attendee; (D) attended high school— (i) in a health professional shortage area designated under section 332 or a medically underserved area (as defined in section 330I(a)) or in a rural setting (as defined by the Office of Rural Health Policy); or (ii) with a low grade point average (2.0 cumulative on a 4.0 scale), based on most recent annual data available; (iii) based on the most recent annual data available, had either— (I) a low percentage of seniors receiving a high school diploma; or (II) a low percentage of graduates who go to college during the first year after graduation; or (iv) has low per capita funding; or (v) based on the most recent annual data available, a high rate of the enrolled students are eligible for free or reduced-price lunches. (3) The term primary care means, with respect to a physician, practicing as a general practitioner, family practice practitioner, general internist, pediatrician, psychiatrist, or obstetrician or gynecologist. (n) Funding (1) Authorization of appropriations There are authorized to be appropriated to carry out this section— (A) $27,000,000 for fiscal year 2023; (B) $54,000,000 for fiscal year 2024; (C) $81,000,000 for fiscal year 2025; (D) $108,000,000 for fiscal year 2026; and (E) $135,000,000 for fiscal year 2027. (2) Allocation among consortia Of the amount made available under paragraph (1) for a fiscal year, the Secretary shall allot not more than $1, 350,000 to each consortium. (3) Limitation on administrative expenses A consortium may use not more than 30 percent of funds allocated to such consortium for administrative expenses of the consortium in carrying out an NMC Program. .