Bill Summary
This legislation aims to reauthorize and establish various programs to support and improve the health professions workforce. This includes establishing geriatrics workforce enhancement programs to train and integrate geriatrics into primary care, creating pediatric specialty loan repayment agreements to address shortages in pediatric healthcare professionals, and providing scholarships and stipends for individuals pursuing degrees in physical therapy, occupational therapy, audiology, and speech-language pathology. The legislation also authorizes appropriations for these programs and requires reporting on outcomes and recommendations from national organizations.
Possible Impacts
1. Healthcare professionals specializing in geriatrics will receive training and resources to better care for older adults, leading to improved health outcomes for this population.
2. Eligible individuals pursuing careers in pediatric specialties can have their student loans repaid through a federal program, potentially increasing the number of pediatric healthcare professionals in areas with shortages.
3. Students pursuing degrees in physical therapy, occupational therapy, audiology, and speech-language pathology will have access to scholarships and stipends, making these fields more financially feasible and potentially increasing workforce diversity in these professions.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2781 Referred in Senate (RFS)]
<DOC>
116th CONGRESS
1st Session
H. R. 2781
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 29, 2019
Received; read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
AN ACT
To amend title VII of the Public Health Service Act to reauthorize
certain programs relating to the health professions workforce, and for
other purposes.
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 ``Educating Medical Professionals and
Optimizing Workforce Efficiency and Readiness for Health Act of 2019''
or the ``EMPOWER for Health Act of 2019''.
SEC. 2. REAUTHORIZATION OF HEALTH PROFESSIONS WORKFORCE PROGRAMS.
(a) Centers of Excellence.--Subsection (i) of section 736 of the
Public Health Service Act (42 U.S.C. 293) is amended to read as
follows:
``(i) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $24,897,000 for each of fiscal
years 2020 through 2024.''.
(b) Health Professions Training for Diversity.--Section 740 of the
Public Health Service Act (42 U.S.C. 293d) is amended--
(1) in subsection (a), by striking ``$51,000,000 for fiscal
year 2010, and such sums as may be necessary for each of the
fiscal years 2011 through 2014'' and inserting ``$51,419,000
for each of fiscal years 2020 through 2024'';
(2) in subsection (b), by striking ``$5,000,000 for each of
the fiscal years 2010 through 2014'' and inserting ``$1,250,000
for each of fiscal years 2020 through 2024''; and
(3) in subsection (c), by striking ``$60,000,000 for fiscal
year 2010 and such sums as may be necessary for each of the
fiscal years 2011 through 2014'' and inserting ``$20,000,000
for each of fiscal years 2020 through 2024''.
(c) Primary Care Training and Enhancement.--Section 747(c)(1) of
the Public Health Service Act (42 U.S.C. 293k(c)(1)) is amended by
striking ``$125,000,000 for fiscal year 2010, and such sums as may be
necessary for each of fiscal years 2011 through 2014'' and inserting
``$51,371,000 for each of fiscal years 2020 through 2024''.
(d) Training in General, Pediatric, and Public Health Dentistry.--
Section 748(f) of the Public Health Service Act (42 U.S.C. 293k-2(f))
is amended by striking ``$30,000,000 for fiscal year 2010 and such sums
as may be necessary for each of fiscal years 2011 through 2015'' and
inserting ``$42,707,000 for each of fiscal years 2020 through 2024''.
(e) Area Health Education Centers.--Section 751(j)(1) of the Public
Health Service Act (42 U.S.C. 294a(j)(1)) is amended by striking
``$125,000,000 for each of the fiscal years 2010 through 2014'' and
inserting ``$42,075,000 for each of fiscal years 2020 through 2024''.
(f) National Center for Healthcare Workforce Analysis.--
(1) In general.--Section 761(e)(1)(A) of the Public Health
Service Act (42 U.S.C. 294n(e)(1)(A)) is amended by striking
``$7,500,000 for each of fiscal years 2010 through 2014'' and
inserting ``$5,947,000 for each of fiscal years 2020 through
2024''.
(2) Technical correction.--Section 761(e)(2) of the Public
Health Service Act (42 U.S.C. 294n(e)(2)) is amended by
striking ``subsection (a)'' and inserting ``paragraph (1)''.
(g) Public Health Workforce.--Section 770(a) of the Public Health
Service Act (42 U.S.C. 295e(a)) is amended by striking ``$43,000,000
for fiscal year 2011, and such sums as may be necessary for each of the
fiscal years 2012 through 2015'' and inserting ``$17,850,000 for each
of fiscal years 2020 through 2024''.
SEC. 3. EDUCATION AND TRAINING RELATING TO GERIATRICS.
Section 753 of the Public Health Service Act (42 U.S.C. 294c) is
amended to read as follows:
``SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.
``(a) Geriatrics Workforce Enhancement Programs.--
``(1) In general.--The Secretary shall award grants or
contracts under this subsection to entities described in
paragraph (1), (3), or (4) of section 799B, section 801(2), or
section 865(d), or other health professions schools or programs
approved by the Secretary, for the establishment or operation
of geriatrics workforce enhancement programs that meet the
requirements of paragraph (2).
``(2) Requirements.--A geriatrics workforce enhancement
program meets the requirements of this paragraph if such
program supports the development of a health care workforce
that maximizes patient and family engagement and improves
health outcomes for older adults by integrating geriatrics with
primary care and other appropriate specialties. Special
emphasis should be placed on providing the primary care
workforce with the knowledge and skills to care for older
adults and collaborating with community partners to address
gaps in health care for older adults through individual,
system, community, and population level changes. Areas of
programmatic focus may include the following:
``(A) Transforming clinical training environments
to integrated geriatrics and primary care delivery
systems to ensure trainees are well prepared to
practice in and lead in such systems.
``(B) Developing providers from multiple
disciplines and specialties to work interprofessionally
to assess and address the needs and preferences of
older adults and their families and caregivers at the
individual, community, and population levels with
cultural and linguistic competency.
``(C) Creating and delivering community-based
programs that will provide older adults and their
families and caregivers with the knowledge and skills
to improve health outcomes and the quality of care for
such adults.
``(D) Providing Alzheimer's disease and related
dementias (ADRD) education to the families and
caregivers of older adults, direct care workers, health
professions students, faculty, and providers.
``(3) Duration.--The Secretary shall award grants and
contracts under paragraph (1) for a period not to exceed five
years.
``(4) Application.--To be eligible to receive a grant or
contract under paragraph (1), an entity described in such
paragraph shall submit to the Secretary an application at such
time, in such manner, and containing such information as the
Secretary may require, including the specific measures the
applicant will use to demonstrate that the project is improving
the quality of care provided to older adults in the applicant's
region, which may include--
``(A) improvements in access to care provided by a
health professional with training in geriatrics or
gerontology;
``(B) improvements in family caregiver capacity to
care for older adults;
``(C) patient outcome data demonstrating an
improvement in older adult health status or care
quality; and
``(D) reports on how the applicant will implement
specific innovations with the target audience to
improve older adults' health status or the quality of
care.
``(5) Equitable geographic distribution.--The Secretary may
award grants and contracts under paragraph (1) in a manner
which will equitably distribute such grants among the various
regions of the United States.
``(6) Qualifications.--In awarding grants and contracts
under paragraph (2), the Secretary shall consider programs
that--
``(A) have the goal of improving and providing
comprehensive coordinated care of older adults,
including medical, dental, and psychosocial needs;
``(B) demonstrate coordination with other
programmatic efforts funded under this program or other
public or private entities;
``(C) support the training and retraining of
faculty, preceptors, primary care providers, and
providers in other specialties to increase their
knowledge of geriatrics and gerontology;
``(D) provide clinical experiences across care
settings, including ambulatory care, hospitals, post-
acute care, nursing homes, federally qualified health
centers, and home and community-based services;
``(E) emphasize education and engagement of family
caregivers on disease self-management, medication
management, and stress reduction strategies;
``(F) provide training to the health care workforce
on disease self-management, motivational interviewing,
medication management, and stress reduction strategies;
``(G) provide training to the health care workforce
on social determinants of health in order to better
address the geriatric health care needs of diverse
populations with cultural and linguistic competency;
``(H) integrate geriatrics competencies and
interprofessional collaborative practice into health
care education and training curricula for residents,
fellows, and students;
``(I) substantially benefit rural or underserved
populations of older adults or conduct outreach to
communities that have a shortage of geriatric workforce
professionals;
``(J) integrate behavioral health competencies into
primary care practice, especially with respect to elder
abuse, pain management, and advance care planning; or
``(K) offer short-term intensive courses that--
``(i) focus on geriatrics, gerontology,
chronic care management, and long-term care
that provide supplemental training for faculty
members in medical schools and other health
professions schools or graduate programs in
psychology, pharmacy, nursing, social work,
dentistry, public health, allied health, or
other health disciplines, as approved by the
Secretary; and
``(ii) are open to current faculty, and
appropriately credentialed volunteer faculty
and practitioners, to upgrade their knowledge
and clinical skills for the care of older
adults and adults with functional and cognitive
limitations and to enhance their
interdisciplinary teaching skills.
``(7) Priority.--In awarding grants under paragraph (1),
particularly with respect to awarding, in fiscal year 2020, any
amount appropriated for such fiscal year for purposes of
carrying out this subsection that is in excess of the amount
appropriated for the most previous fiscal year for which
appropriations were made for such purposes, the Secretary may
give priority to entities that operate--
``(A) in communities that have a shortage of
geriatric workforce professionals; and
``(B) in States in which no entity has previously
received an award under such paragraph (including as in
effect before the date of enactment of the Educating
Medical Professionals and Optimizing Workforce
Efficiency and Readiness for Health Act of 2019).
``(8) Award amounts.--Awards under paragraph (1) shall be
in an amount determined by the Secretary. Entities that submit
applications under this subsection that describe a plan for
providing geriatric education and training for home health
workers and family caregivers are eligible to receive $100,000
per year more than entities that do not include a description
of such a plan.
``(9) Reporting.--Each entity awarded a grant under
paragraph (1) shall submit an annual report to the Secretary on
financial and programmatic performance under such grant, which
may include factors such as the number of trainees, the number
of professions and disciplines, the number of partnerships with
health care delivery sites, the number of faculty and
practicing professionals who participated in continuing
education programs, and such other factors as the Secretary may
require.
``(b) Geriatric Academic Career Awards.--
``(1) Establishment of program.--The Secretary shall
establish a program to award grants, to be known as Geriatric
Academic Career Awards, to eligible entities applying on behalf
of eligible individuals to promote the career development of
such individuals as academic geriatricians or other academic
geriatrics health professionals.
``(2) Eligibility.--
``(A) Eligible entity.--For purposes of this
subsection, the term `eligible entity' means--
``(i) an accredited school of allopathic
medicine, osteopathic medicine, nursing, social
work, psychology, dentistry, pharmacy, or
allied health; or
``(ii) another type of accredited health
professions school or graduate program deemed
by the Secretary to be eligible under this
subsection.
``(B) Eligible individual.--
``(i) In general.--For purposes of this
subsection, the term `eligible individual'
means an individual who--
``(I) has a junior, nontenured,
faculty appointment at an accredited
school of allopathic medicine,
osteopathic medicine, nursing, social
work, psychology, dentistry, pharmacy,
or allied health or at another type of
accredited health professions school or
graduate program described in
subparagraph (A)(ii);
``(II)(aa) is board certified or
board eligible in internal medicine,
family practice, psychiatry, or
licensed dentistry, or has completed
the training required for the
individual's discipline; and
``(bb) is employed at an eligible
entity; or
``(III) has completed an approved
fellowship program in geriatrics or
gerontology, or has completed specialty
training in geriatrics or gerontology
as required for the individual's
discipline and any additional
geriatrics or gerontology training as
required by the Secretary.
``(ii) Special rule.--If during the period
of an award under this subsection respecting an
eligible individual, the individual is promoted
to associate professor and thereby no longer
meets the criteria of clause (i)(I), the
individual may continue to be treated as an
eligible individual through the term of the
award.
``(3) Limitations.--An eligible entity may not receive an
award under paragraph (1) on behalf of an eligible individual
unless the eligible entity--
``(A) submits to the Secretary an application, at
such time, in such manner, and containing such
information as the Secretary may require, and the
Secretary approves such application;
``(B) provides, in such form and manner as the
Secretary may require, assurances that the eligible
individual on whose behalf an application was submitted
under subparagraph (A) will meet the service
requirement described in paragraph (8); and
``(C) provides, in such form and manner as the
Secretary may require, assurances that such individual
has a full-time faculty appointment in an accredited
health professions school or graduate program and
documented commitment from such school or program to
spend 75 percent of the individual's time that is
supported by the award on teaching and developing
skills in interprofessional education in geriatrics.
``(4) Requirements.--In awarding grants under this
subsection, the Secretary--
``(A) shall give priority to eligible entities that
apply on behalf of eligible individuals who are on the
faculty of institutions that integrate geriatrics
education, training, and best practices into academic
program criteria;
``(B) may give priority to eligible entities that
operate a geriatrics workforce enhancement program
under subsection (a);
``(C) shall ensure that grants are equitably
distributed across the various geographical regions of
the United States, including rural and underserved
areas;
``(D) shall pay particular attention to geriatrics
health care workforce needs among underserved
populations, diverse communities, and rural areas;
``(E) may not require an eligible individual, or an
eligible entity applying on behalf of an eligible
individual, to be a recipient of a grant or contract
under this part; and
``(F) shall pay the full amount of the award to the
eligible entity.
``(5) Maintenance of effort.--An eligible entity receiving
an award under paragraph (1) on behalf of an eligible
individual shall provide assurances to the Secretary that funds
provided to such individual under this subsection will be used
only to supplement, not to supplant, the amount of Federal,
State, and local funds otherwise expended by such individual.
``(6) Amount and term.--
``(A) Amount.--The amount of an award under this
subsection for eligible individuals who are physicians
shall equal $100,000 for fiscal year 2020, adjusted for
subsequent fiscal years to reflect the increase in the
Consumer Price Index. The Secretary shall determine the
amount of an award under this subsection for
individuals who are not physicians.
``(B) Term.--The term of any award made under this
subsection shall not exceed 5 years.
``(7) Service requirement.--An eligible individual on whose
behalf an application was submitted and approved under
paragraph (3)(A) shall provide training in clinical geriatrics
or gerontology, including the training of interprofessional
teams of health care professionals.
``(c) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $51,000,000 for each of fiscal
years 2020 through 2024. Notwithstanding the preceding sentence, no
funds shall be made available to carry out subsection (b) for a fiscal
year unless the amount made available to carry out this section for
such fiscal year is more than the amount made available to carry out
this section for fiscal year 2017.''.
SEC. 4. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE WORKFORCE.
Section 775 of the Public Health Service Act (42 U.S.C. 295f) is
amended to read as follows:
``SEC. 775. INVESTMENT IN TOMORROW'S PEDIATRIC HEALTH CARE WORKFORCE.
``(a) In General.--The Secretary shall establish and carry out a
program of entering into pediatric specialty loan repayment agreements
with qualified health professionals under which--
``(1) the qualified health professional agrees to a period
of not less than 2 years of obligated service during which the
professional will--
``(A) participate in an accredited pediatric
medical subspecialty, pediatric surgical specialty,
child and adolescent psychiatry subspecialty, or child
and adolescent mental and behavioral health residency
or fellowship; or
``(B) be employed full-time in providing pediatric
medical subspecialty care, pediatric surgical specialty
care, child and adolescent psychiatry subspecialty
care, or child and adolescent mental and behavioral
health care, including substance use disorder
prevention and treatment services, in an area with--
``(i) a shortage of health care
professionals practicing in the pediatric
medical subspecialty, the pediatric surgical
specialty, the child and adolescent psychiatry
subspecialty, or child and adolescent mental
and behavioral health, as applicable; and
``(ii) a sufficient pediatric population,
as determined by the Secretary, to support the
addition of a practitioner in the pediatric
medical subspecialty, the pediatric surgical
specialty, the child and adolescent psychiatry
subspecialty, or child and adolescent mental
and behavioral health, as applicable; and
``(2) the Secretary agrees to make payments on the
principal and interest of undergraduate, graduate, or graduate
medical education loans of the qualified health professional of
not more than $35,000 a year for each year of agreed upon
service under paragraph (1) for a period of not more than 3
years.
``(b) Eligibility Requirements.--
``(1) Pediatric medical specialists and pediatric surgical
specialists.--For purposes of loan repayment agreements under
this section with respect to pediatric medical subspecialty and
pediatric surgical specialty practitioners, the term `qualified
health professional' means a licensed physician who--
``(A) is entering or receiving training in an
accredited pediatric medical subspecialty or pediatric
surgical subspecialty residency or fellowship; or
``(B) has completed (but not prior to the end of
the calendar year in which the Educating Medical
Professionals and Optimizing Workforce Efficiency and
Readiness for Health Act of 2019 is enacted) the
training described in subparagraph (A).
``(2) Child and adolescent psychiatry and mental and
behavioral health.--For purposes of loan repayment agreements
under this section with respect to child and adolescent mental
and behavioral health care, the term `qualified health
professional' means a health care professional who--
``(A) has received specialized training or clinical
experience in child and adolescent mental health in
psychiatry, psychology, school psychology, or
psychiatric nursing;
``(B) has a license or certification in a State to
practice allopathic medicine, osteopathic medicine,
psychology, school psychology, or psychiatric nursing;
or
``(C) is a mental health service professional who
has completed (but not before the end of the calendar
year in which the Educating Medical Professionals and
Optimizing Workforce Efficiency and Readiness for
Health Act of 2019 is enacted) specialized training or
clinical experience in child and adolescent mental
health described in subparagraph (A).
``(3) Additional eligibility requirements.--The Secretary
may not enter into a loan repayment agreement under this
section with a qualified health professional unless--
``(A) the professional agrees to work in, or for a
provider serving, an area or community with a shortage
of eligible qualified health professionals (as defined
in paragraphs (1) and (2));
``(B) the professional is a United States citizen,
a permanent legal United States resident, or lawfully
present in the United States; and
``(C) if the professional is enrolled in a graduate
program, the program is accredited, and the
professional has an acceptable level of academic
standing (as determined by the Secretary).
``(c) Priority.--In entering into loan repayment agreements under
this section, the Secretary shall give priority to applicants who--
``(1) have familiarity with evidence-based methods and
cultural and linguistic competence in health care services; and
``(2) demonstrate financial need.
``(d) Authorization of Appropriations.--There are authorized to be
appropriated for each of fiscal years 2020 through 2024--
``(1) $30,000,000 to carry out this section with respect to
loan repayment agreements with qualified health professionals
described in subsection (b)(1); and
``(2) $20,000,000 to carry out this section with respect to
loan repayment agreements with respect to qualified health
professionals described in subsection (b)(2).''.
SEC. 5. INCREASING WORKFORCE DIVERSITY IN THE PROFESSIONS OF PHYSICAL
THERAPY, OCCUPATIONAL THERAPY, AUDIOLOGY, AND SPEECH-
LANGUAGE PATHOLOGY.
Title VII of the Public Health Service Act is amended--
(1) by redesignating part G (42 U.S.C. 295j et seq.) as
part H; and
(2) by inserting after part F (42 U.S.C. 294n et seq.) the
following new part:
``PART G--INCREASING WORKFORCE DIVERSITY IN THE PROFESSIONS OF PHYSICAL
THERAPY, OCCUPATIONAL THERAPY, AUDIOLOGY, AND SPEECH-LANGUAGE PATHOLOGY
``SEC. 783. SCHOLARSHIPS AND STIPENDS.
``(a) In General.--The Secretary may award grants and contracts to
eligible entities to increase educational opportunities in the
professions of physical therapy, occupational therapy, audiology, and
speech-language pathology for eligible individuals by--
``(1) providing student scholarships or stipends, including
for--
``(A) completion of an accelerated degree program;
``(B) completion of an associate's, bachelor's,
master's, or doctoral degree program; and
``(C) entry by a diploma or associate's degree
practitioner into a bridge or degree completion
program;
``(2) providing assistance for completion of prerequisite
courses or other preparation necessary for acceptance for
enrollment in the eligible entity; and
``(3) carrying out activities to increase the retention of
students in one or more programs in the professions of physical
therapy, occupational therapy, audiology, and speech-language
pathology.
``(b) Consideration of Recommendations.--In carrying out subsection
(a), the Secretary shall take into consideration the recommendations of
national organizations representing the professions of physical
therapy, occupational therapy, audiology, and speech-language
pathology, including the American Physical Therapy Association, the
American Occupational Therapy Association, the American Speech-
Language-Hearing Association, the American Academy of Audiology, and
the Academy of Doctors of Audiology.
``(c) Required Information and Conditions for Award Recipients.--
``(1) In general.--The Secretary may require recipients of
awards under this section to report to the Secretary concerning
the annual admission, retention, and graduation rates for
eligible individuals in programs of the recipient leading to a
degree in any of the professions of physical therapy,
occupational therapy, audiology, and speech-language pathology.
``(2) Falling rates.--If any of the rates reported by a
recipient under paragraph (1) fall below the average for such
recipient over the two years preceding the year covered by the
report, the recipient shall provide the Secretary with plans
for immediately improving such rates.
``(3) Ineligibility.--A recipient described in paragraph
(2) shall be ineligible for continued funding under this
section if the plan of the recipient fails to improve the rates
within the 1-year period beginning on the date such plan is
implemented.
``(d) Definitions.--In this section:
``(1) Eligible entities.--The term `eligible entity' means
an education program that--
``(A) is accredited by--
``(i) the Council on Academic Accreditation
in Audiology and Speech-Language Pathology or
the Accreditation Commission for Audiology
Education;
``(ii) the Commission on Accreditation in
Physical Therapy Education; or
``(iii) the Accreditation Council for
Occupational Therapy Education; and
``(B) is carrying out a program for recruiting and
retaining students underrepresented in the professions
of physical therapy, occupational therapy, audiology,
and speech-language pathology (including racial or
ethnic minorities, or students from disadvantaged
backgrounds).
``(2) Eligible individual.--The term `eligible individual'
means an individual who--
``(A) is a member of a class of persons who are
underrepresented in the professions of physical
therapy, occupational therapy, audiology, and speech-
language pathology (including individuals who are
racial or ethnic minorities, or are from disadvantaged
backgrounds);
``(B) has a financial need for a scholarship or
stipend; and
``(C) is enrolled (or accepted for enrollment) at
an audiology, speech-language pathology, physical
therapy, or occupational therapy program as a full-time
student at an eligible entity.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $5,000,000 for each of fiscal
years 2020 through 2024.''.
Passed the House of Representatives October 28, 2019.
Attest:
CHERYL L. JOHNSON,
Clerk.