II 118th CONGRESS 2d Session S. 5146 IN THE SENATE OF THE UNITED STATES September 24, 2024 Mr. Sanders (for himself and Mr. Kaine ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To authorize the Secretary of Health and Human Services to award grants to schools of medicine or osteopathic medicine at historically Black colleges and universities and other minority-serving institutions for the purpose of increasing enrollment of medical students.

1. Short title This Act may be cited as the Medical Graduate Investment Act of 2024 . 2. Expanding the number of doctors Subpart 3 of part E of title VII of the Public Health Service Act ( 42 U.S.C. 295f et seq. ) is amended by adding at the end the following: 779. Expanding the number of doctors (a) In general The Secretary shall award grants to eligible entities for the purpose of increasing enrollment of medical students by at least 5 percent each year as compared to the prior year. Grants awarded under this section shall be used for tuition and student fees (excluding living expenses), faculty recruitment and retention (with not more than 20 percent of the cost of salaries covered by such grants), costs associated with equipment (including acquisition of equipment), and costs associated with clinical training of medical students and preparing and encouraging such students to serve as primary care physicians in medically underserved areas, including rural areas, frontier areas, and jurisdictions of Indian Tribes and Tribal organizations, after completing residency training. (b) Eligible entities To be eligible to receive an award under this section, an entity shall— (1) be— (A) an accredited school of medicine or an accredited school of osteopathic medicine at a minority-serving institution of higher education (defined as an institution described in any of paragraphs (1) through (7) of section 371(a) of the Higher Education Act of 1965) or a minority-serving institution of higher education (as so defined) with plans to establish an accredited school of medicine or an accredited school of osteopathic medicine, if such institution provides documentation of such plans, as the Secretary may require; (B) an accredited school of medicine or an accredited school of osteopathic medicine that, at the time of the application, has an agreement with a historically Black college or university (as defined in paragraph (1) of section 371(a) of the Higher Education Act of 1965) to enroll, in the school of medicine or school of osteopathic medicine, students who have completed their undergraduate education at such minority-serving institution of higher education, provided that such school of medicine or school of osteopathic medicine intends to use the award under this section to increase enrollment of such students in accordance with the threshold described in subsection (a); or (C) an accredited school of medicine or an accredited school of osteopathic medicine that— (i) at the time of the application, has an agreement with an Indian Tribe (as defined in section 4 of the Indian Self Determination and Education Assistance Act) to provide medical education for American Indian, Alaska Native, and Native Hawaiian students; or (ii) an accredited school of medicine or an accredited school of osteopathic medicine that trains in Tribal communities or otherwise has a history of graduating a high number of physicians who, after completion of residency, practice in Tribal communities in rural or frontier areas; and (2) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including information on how the entity will sustain increased enrollment of medical students following the expirations of grant funds provided under this section. (c) Grant amounts (1) Minimum award; disbursements The Secretary shall— (A) determine the amount of each award under this section, provided that each eligible entity receiving such an award shall receive a minimum amount of $1,000,000 per year of the 5-year grant period; and (B) disburse the grant amount to each eligible entity receiving such an award in 5 annual increments. (2) Distribution among types of eligible entities In awarding amounts to eligible entities under this section, the Secretary shall disburse grant funding evenly among the following 9 categories (subject to the receipt of applications from eligible entities in each of the categories described in subparagraph (A)): (A) Eligible entities in each category of minority serving institution of higher education described in paragraphs (1) through (7) of section 371(a) of the Higher Education Act of 1965. (B) Eligible entities described in subsection (b)(1)(B). (C) Eligible entities described in subsection (b)(1)(C). (3) Evaluation The Secretary may reserve not more than half of one percent of amounts made available under subsection (f) to evaluate the results of the program under this section during and after the grant period, including the number of new medical students enrolled, such students’ progression to participate in an accredited internship or medical residency program, and rates of passing the United States Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination. (d) Matching requirement The Secretary shall require each eligible entity receiving an award under this section to provide non-Federal matching funds for each year of the grant period, which may be in cash or in-kind, in an amount equal to 25 percent of the total amount of funds awarded under this section for the applicable year. An eligible entity may apply to the Secretary for a waiver of not more than 80 percent of the matching fund amount required for each year the entity receives an award under this section. (e) Reporting (1) Eligible entity reporting (A) In general Each eligible entity receiving a grant under this section shall submit a report to the Secretary, annually for the duration of the grant period, on activities conducted under such grant, including information on the number of new students enrolled, faculty supported, how funds under such grant were used, plans for continuation of the activities in the next budget period, and other information, as the Secretary may require. (B) Contents Each report under subparagraph (A) shall include— (i) an overview of activities conducted under such grant; (ii) associated costs of equipment purchased; (iii) the number of new students enrolled in the applicable school of medicine or school of osteopathic medicine per year (including the number of students from racial and ethnic groups underrepresented among medical students and health professions, students who were Federal Pell Grant recipients, and first-generation college students); (iv) plans for continuation of the activities in the next fiscal year; and (v) any other information the Secretary may require. (2) Reports to Congress Not later than 2 years after the first grants are awarded under 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 includes— (A) an assessment of the effectiveness of the activities associated with grants made under this section; (B) a summary of outcomes and best practices and recommendations on the recruitment and retention of medical students; (C) annual enrollment of students at each school of medicine or school of osteopathic medicine supported by the program; and (D) summaries, including justification, of the allocations of grant funds made by the Secretary. (f) Authorization of appropriations To carry out this section, there are authorized to be appropriated $60,000,000 for each of fiscal years 2026 through 2030, to remain available until expended. (g) Non-Duplication of efforts The Secretary shall ensure that activities carried out under this section do not unnecessarily duplicate efforts of any other Federal program. .