TITLE VII—HEALTH PROFESSIONS EDUCATION

Public Health Service Act-Title VII (Health Professions

Education)

[As Amended Through P.L. 117–328, Enacted December 29, 2022]

øCurrency: This publication is a compilation of the text of title VII of Chapter 373

of the 78th Congress. It was last amended by the public law listed in the As

Amended Through note above and below at the bottom of each page of the pdf

version and reflects current law through the date of the enactment of the public

law listed at https://www.govinfo.gov/app/collection/comps/¿

øNote: While this publication does not represent an official version of any Federal

statute, substantial efforts have been made to ensure the accuracy of its contents.

The official version of Federal law is found in the United States Statutes at Large

and in the United States Code. The legal effect to be given to the Statutes at

Large and the United States Code is established by statute (1 U.S.C. 112, 204).¿

TITLE VII—HEALTH PROFESSIONS

EDUCATION

PART A—STUDENT LOANS

Subpart I—Insured Health Education Assistance

Loans to Graduate Students

SEC. 701. ø292¿ STATEMENT OF PURPOSE.

The purpose of this subpart is to enable the Secretary to pro-

vide a Federal program of student loan insurance for students in

(and certain former students of) eligible institutions (as defined in

section 719).

SEC. 702. ø292a¿ SCOPE AND DURATION OF LOAN INSURANCE PRO-

GRAM.

(a) I

ENERAL

.—The total principal amount of new loans

made and installments paid pursuant to lines of credit (as defined

in section 719) to borrowers covered by Federal loan insurance

under this subpart shall not exceed $350,000,000 for fiscal year

1993, $375,000,000 for fiscal year 1994, and $425,000,000 for fiscal

year 1995. If the total amount of new loans made and installments

paid pursuant to lines of credit in any fiscal year is less than the

ceiling established for such year, the difference between the loans

made and installments paid and the ceiling shall be carried over

to the next fiscal year and added to the ceiling applicable to that

fiscal year, and if in any fiscal year no ceiling has been established,

any difference carried over shall constitute the ceiling for making

new loans (including loans to new borrowers) and paying install-

ments for such fiscal year. Thereafter, Federal loan insurance pur-

suant to this subpart may be granted only for loans made (or for

loan installments paid pursuant to lines of credit) to enable stu-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00001 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

2 Sec. 702 PUBLIC HEALTH SERVICE ACT

dents, who have obtained prior loans insured under this subpart,

to continue or complete their educational program or to obtain a

loan under section 705(a)(1)(B) to pay interest on such prior loans;

but no insurance may be granted for any loan made or installment

paid after September 30, 1998. The total principal amount of Fed-

eral loan insurance available under this subsection shall be grant-

ed by the Secretary without regard to any apportionment for the

purpose of chapter 15 of title 31, United States Code, and without

regard to any similar limitation.

(b) C

ERTAIN

IMITATIONS AND

RIORITIES

.—

(1) L

IMITATIONS REGARDING LENDERS

STATES

OR AREAS

.—

The Secretary may, if necessary to assure an equitable dis-

tribution of the benefits of this subpart, assign, within the

maximum amounts specified in subsection (a), Federal loan in-

surance quotas applicable to eligible lenders, or to States or

areas, and may from time to time reassign unused portions of

these quotas.

(2) P

RIORITY FOR CERTAIN LENDERS

.—In providing certifi-

cates of insurance under section 706 through comprehensive

contracts, the Secretary shall give priority to eligible lenders

that agree—

(A) to make loans to students at interest rates below

the rates prevailing, during the period involved, for loans

covered by Federal loan insurance pursuant to this sub-

part; or

(B) to make such loans under terms that are otherwise

favorable to the student relative to the terms under which

eligible lenders are generally making such loans during

such period.

UTHORITY OF

TUDENT

OAN

ARKETING

SSOCIATION

.—

(1) I

N GENERAL

.—Subject to paragraph (2), the Student

Loan Marketing Association, established under part B of title

IV of the Higher Education Act of 1965, is authorized to make

advances on the security of, purchase, service, sell, consolidate,

or otherwise deal in loans which are insured by the Secretary

under this subpart, except that if any loan made under this

subpart is included in a consolidated loan pursuant to the au-

thority of the Association under part B of title IV of the Higher

Education Act of 1965, the interest rate on such consolidated

loan shall be set at the weighted average interest rate of all

such loans offered for consolidation and the resultant per cen-

tum shall be rounded downward to the nearest one-eighth of

1 per centum, except that the interest rate shall be no less

than the applicable interest rate of the guaranteed student

loan program established under part B of title IV of the Higher

Education Act of 1965. In the case of such a consolidated loan,

the borrower shall be responsible for any interest which ac-

crues prior to the beginning of the repayment period of the

loan, or which accrues during a period in which principal need

not be paid (whether or not such principal is in fact paid) by

reason of any provision of the Higher Education Act of 1965.

(2) A

PPLICABILITY OF CERTAIN FEDERAL REGULATIONS

.—

With respect to Federal regulations for lenders, this subpart

may not be construed to preclude the applicability of such reg-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00002 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

3 Sec. 705 PUBLIC HEALTH SERVICE ACT

ulations to the Student Loan Marketing Association or to any

other entity in the business of purchasing student loans, in-

cluding such regulations with respect to applications, contracts,

and due diligence.

SEC. 703. ø292b¿ LIMITATIONS ON INDIVIDUAL INSURED LOANS AND

ON LOAN INSURANCE.

(a) I

ENERAL

.—The total of the loans made to a student in

any academic year or its equivalent (as determined by the Sec-

retary) which may be covered by Federal loan insurance under this

subpart may not exceed $20,000 in the case of a student enrolled

in a school of medicine, osteopathic medicine, dentistry, veterinary

medicine, optometry, or podiatric medicine, and $12,500 in the case

of a student enrolled in a school of pharmacy, public health, allied

health, or chiropractic, or a graduate program in health adminis-

tration or behavioral and mental health practice, including clinical

psychology. The aggregate insured unpaid principal amount for all

such insured loans made to any borrower shall not at any time ex-

ceed $80,000 in the case of a borrower who is or was a student en-

rolled in a school of medicine, osteopathic medicine, dentistry, vet-

erinary medicine, optometry, or podiatric medicine, and $50,000 in

the case of a borrower who is or was a student enrolled in a school

of pharmacy, public health, allied health, or chiropractic, or a grad-

uate program in health administration or clinical psychology. The

annual insurable limit per student shall not be exceeded by a line

of credit under which actual payments by the lender to the bor-

rower will not be made in any year in excess of the annual limit.

(b) E

XTENT OF

NSURANCE

IABILITY

.—The insurance liability

on any loan insured by the Secretary under this subpart shall be

100 percent of the unpaid balance of the principal amount of the

loan plus interest. The full faith and credit of the United States is

pledged to the payment of all amounts which may be required to

be paid under the provisions of section 707 or 714.

SEC. 704. ø292c¿ SOURCES OF FUNDS.

Loans made by eligible lenders in accordance with this subpart

shall be insurable by the Secretary whether made from funds fully

owned by the lender or from funds held by the lender in a trust

or similar capacity and available for such loans.

SEC. 705. ø292d¿ ELIGIBILITY OF BORROWERS AND TERMS OF IN-

SURED LOANS.

(a) I

ENERAL

.—A loan by an eligible lender shall be insur-

able by the Secretary under the provisions of this subpart only if—

(1) made to—

(A) a student who—

(i)(I) has been accepted for enrollment at an eligi-

ble institution, or (II) in the case of a student attend-

ing an eligible institution, is in good standing at that

institution, as determined by the institution;

(ii) is or will be a full-time student at the eligible

institution;

(iii) has agreed that all funds received under such

loan shall be used solely for tuition, other reasonable

educational expenses, including fees, books, and lab-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00003 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

4 Sec. 705 PUBLIC HEALTH SERVICE ACT

oratory expenses, and reasonable living expenses, in-

curred by such students; and

(iv) in the case of a pharmacy student, has satis-

factorily completed three years of training; or

(B) an individual who—

(i) has previously had a loan insured under this

subpart when the individual was a full-time student at

an eligible institution;

(ii) is in a period during which, pursuant to para-

graph (2), the principal amount of such previous loan

need not be paid; and

(iii) has agreed that all funds received under the

proposed loan shall be used solely for repayment of in-

terest due on previous loans made under this subpart;

(2) evidenced by a note or other written agreement

which—

(A) is made without security and without endorse-

ment, except that if the borrower is a minor and such note

or other written agreement executed by him would not,

under the applicable law, create a binding obligation, an

endorsement may be required;

(B) provides for repayment of the principal amount of

the loan in installments over a period of not less than 10

years (unless sooner repaid) nor more than 25 years begin-

ning not earlier than 9 months nor later than 12 months

after the date of—

(i) the date on which—

(I) the borrower ceases to be a participant in

an accredited internship or residency program of

not more than four years in duration;

(II) the borrower completes the fourth year of

an accredited internship or residency program of

more than four years in duration; or

(III) the borrower, if not a participant in a

program described in subclause (I) or (II), ceases

to carry, at an eligible institution, the normal full-

time academic workload as determined by the in-

stitution; or

(ii) the date on which a borrower who is a grad-

uate of an eligible institution ceases to be a partici-

pant in a fellowship training program not in excess of

two years or a participant in a full-time educational

activity not in excess of two years, which—

(I) is directly related to the health profession

for which the borrower prepared at an eligible in-

stitution, as determined by the Secretary; and

(II) may be engaged in by the borrower during

such a two-year period which begins within twelve

months after the completion of the borrower’s par-

ticipation in a program described in subclause (I)

or (II) of clause (i) or prior to the completion of the

borrower’s participation in such program,

except as provided in subparagraph (C), except that the

period of the loan may not exceed 33 years from the date

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00004 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

5 Sec. 705 PUBLIC HEALTH SERVICE ACT

So in law. Probably should include another closing parenthesis.

of execution of the note or written agreement evidencing it,

and except that the note or other written instrument may

contain such provisions relating to repayment in the event

of default in the payment of interest or in the payment of

the costs of insurance premiums, or other default by the

borrower, as may be authorized by regulations of the Sec-

retary in effect at the time the loan is made;

interest need not be paid, but interest shall accrue, during

any period (i) during which the borrower is pursuing a

full-time course of study at an eligible institution (or at an

institution defined by section 102(a) of the Higher Edu-

cation Act of 1965); (ii) not in excess of four years during

which the borrower is a participant in an accredited in-

ternship or residency program (including any period in

such a program described in subclause (I) or subclause (II)

of subparagraph (B)(i)); (iii) not in excess of three years,

during which the borrower is a member of the Armed

Forces of the United States; (iv) not in excess of three

years during which the borrower is in service as a volun-

teer under the Peace Corps Act; (v) not in excess of three

years during which the borrower is a member of the Na-

tional Health Service Corps; (vi) not in excess of three

years during which the borrower is in service as a full-time

volunteer under title I of the Domestic Volunteer Service

Act of 1973; (vii) not in excess of 3 years, for a borrower

who has completed an accredited internship or residency

training program in osteopathic general practice, family

medicine, general internal medicine, preventive medicine,

or general pediatrics and who is practicing primary care;

(viii) not in excess of 1 year, for borrowers who are grad-

uates of schools of chiropractic; (ix) any period not in ex-

cess of two years which is described in subparagraph

(B)(ii); (x) not in excess of three years, during which the

borrower is providing health care services to Indians

through an Indian health program (as defined in section

108(a)(2)(A) of the Indian Health Care Improvement Act

(25 U.S.C. 1616a(a)(2)(A))

; and (xi) in addition to all other

deferments for which the borrower is eligible under clauses

(i) through (x), any period during which the borrower is a

member of the Armed Forces on active duty during the

Persian Gulf conflict, and any period described in clauses

(i) through (xi) shall not be included in determining the

25-year period described in subparagraph (B);

(D) provides for interest on the unpaid principal bal-

ance of the loan at a yearly rate, not exceeding the applica-

ble maximum rate prescribed and defined by the Secretary

(within the limits set forth in subsection (b)) on a national,

regional, or other appropriate basis, which interest shall

be compounded not more frequently than annually and

payable in installments over the period of the loan except

as provided in subparagraph (C), except that the note or

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00005 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

6 Sec. 705 PUBLIC HEALTH SERVICE ACT

other written agreement may provide that payment of any

interest may be deferred until not later than the date upon

which repayment of the first installment of principal falls

due or the date repayment of principal is required to re-

sume (whichever is applicable) and may further provide

that, on such date, the amount of the interest which has

so accrued may be added to the principal for the purposes

of calculating a repayment schedule;

(E) offers, in accordance with criteria prescribed by

regulation by the Secretary, a schedule for repayment of

principal and interest under which payment of a portion of

the principal and interest otherwise payable at the begin-

ning of the repayment period (as defined in such regula-

tions) is deferred until a later time in the period;

(F) entitles the borrower to accelerate without penalty

repayment of the whole or any part of the loan;

(G) provides that the check for the proceeds of the loan

shall be made payable jointly to the borrower and the eligi-

ble institution in which the borrower is enrolled; and

(H) contains such other terms and conditions con-

sistent with the provisions of this subpart and with the

regulations issued by the Secretary pursuant to this sub-

part, as may be agreed upon by the parties to such loan,

including, if agreed upon, a provision requiring the bor-

rower to pay to the lender, in addition to principal and in-

terest, amounts equal to the insurance premiums payable

by the lender to the Secretary with respect to such loan;

and

(3) subject to the consent of the student and subject to ap-

plicable law, the eligible lender has obtained from the student

appropriate demographic information regarding the student,

including racial or ethnic background.

(b) L

IMITATION ON

ATE OF

NTEREST

.—The rate of interest

prescribed and defined by the Secretary for the purpose of sub-

section (a)(2)(D) may not exceed the average of the bond equivalent

rates of the 91-day Treasury bills auctioned for the previous quar-

ter plus 3 percentage points, rounded to the next higher one-eighth

of 1 percent.

INIMUM

NNUAL

AYMENT BY

ORROWER

.—The total of

the payments by a borrower during any year or any repayment pe-

riod with respect to the aggregate amount of all loans to that bor-

rower which are insured under this subpart shall not be less than

the annual interest on the outstanding principal, except as pro-

vided in subsection (a)(2)(C), unless the borrower, in the written

agreement described in subsection (a)(2), agrees to make payments

during any year or any repayment period in a lesser amount.

(d) A

PPLICABILITY OF

ERTAIN

AWS ON

ATE OR

MOUNT OF

NTEREST

.—No provision of any law of the United States (other

than subsections (a)(2)(D) and (b)) or of any State that limits the

rate or amount of interest payable on loans shall apply to a loan

insured under this subpart.

(e) D

ETERMINATION

EGARDING

ORBEARANCE

.—Any period of

time granted to a borrower under this subpart in the form of for-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00006 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

7 Sec. 706 PUBLIC HEALTH SERVICE ACT

bearance on the loan shall not be included in the 25-year total loan

repayment period under subsection (a)(2)(C).

(f) L

OAN

EPAYMENT

CHEDULE

.—Lenders and holders under

this subpart shall offer borrowers graduated loan repayment sched-

ules that, during the first 5 years of loan repayment, are based on

the borrower’s debt-to-income ratio.

(g) R

ULE OF

ONSTRUCTION

EGARDING

ETERMINATION OF

EED OF

TUDENTS

.—With respect to any determination of the fi-

nancial need of a student for a loan covered by Federal loan insur-

ance under this subpart, this subpart may not be construed to limit

the authority of any school to make such allowances for students

with special circumstances as the school determines appropriate.

(h) D

EFINITIONS

.—For purposes of this section:

(1) The term ‘‘active duty’’ has the meaning given such

term in section 101(18) of title 37, United States Code, except

that such term does not include active duty for training.

(2) The term ‘‘Persian Gulf conflict’’ means the period be-

ginning on August 2, 1990, and ending on the date thereafter

prescribed by Presidential proclamation or by law.

SEC. 706. ø292e¿ CERTIFICATE OF LOAN INSURANCE; EFFECTIVE DATE

OF INSURANCE.

(a) I

ENERAL

.—

(1) A

UTHORITY FOR ISSUANCE OF CERTIFICATE

.—If, upon ap-

plication by an eligible lender, made upon such form, con-

taining such information, and supported by such evidence as

the Secretary may require, and otherwise in conformity with

this section, the Secretary finds that the applicant has made

a loan to an eligible borrower which is insurable under the pro-

visions of this subpart, he may issue to the applicant a certifi-

cate of insurance covering the loan and setting forth the

amount and terms of the insurance.

(2) E

FFECTIVE DATE OF INSURANCE

.—Insurance evidenced

by a certificate of insurance pursuant to subsection (a)(1) shall

become effective upon the date of issuance of the certificate, ex-

cept that the Secretary is authorized, in accordance with regu-

lations, to issue commitments with respect to proposed loans,

or with respect to lines (or proposed lines) of credit, submitted

by eligible lenders, and in that event, upon compliance with

subsection (a)(1) by the lender, the certificate of insurance may

be issued effective as of the date when any loan, or any pay-

ment by the lender pursuant to a line of credit, to be covered

by such insurance is made to a student described in section

705(a)(1). Such insurance shall cease to be effective upon 60

days’ default by the lender in the payment of any installment

of the premiums payable pursuant to section 708.

(3) C

ERTAIN AGREEMENTS FOR LENDERS

.—An application

submitted pursuant to subsection (a)(1) shall contain—

(A) an agreement by the applicant to pay, in accord-

ance with regulations, the premiums fixed by the Sec-

retary pursuant to section 708; and

(B) an agreement by the applicant that if the loan is

covered by insurance the applicant will submit such sup-

plementary reports and statements during the effective pe-

riod of the loan agreement, upon such forms, at such

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00007 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

8 Sec. 706 PUBLIC HEALTH SERVICE ACT

times, and containing such information as the Secretary

may prescribe by or pursuant to regulation.

(b) A

UTHORITY

EGARDING

OMPREHENSIVE

NSURANCE

ERAGE

.—

(1) I

N GENERAL

.—In lieu of requiring a separate insurance

application and issuing a separate certificate of insurance for

each loan made by an eligible lender as provided in subsection

(a), the Secretary may, in accordance with regulations con-

sistent with section 702, issue to any eligible lender applying

therefor a certificate of comprehensive insurance coverage

which shall, without further action by the Secretary, insure all

insurable loans made by that lender, on or after the date of the

certificate and before a specified cutoff date, within the limits

of an aggregate maximum amount stated in the certificate.

Such regulations may provide for conditioning such insurance,

with respect to any loan, upon compliance by the lender with

such requirements (to be stated or incorporated by reference in

the certificate) as in the Secretary’s judgment will best achieve

the purpose of this subsection while protecting the financial in-

terest of the United States and promoting the objectives of this

subpart, including (but not limited to) provisions as to the re-

porting of such loans and information relevant thereto to the

Secretary and as to the payment of initial and other premiums

and the effect of default therein, and including provision for

confirmation by the Secretary from time to time (through en-

dorsement of the certificate) of the coverage of specific new

loans by such certificate, which confirmation shall be incontest-

able by the Secretary in the absence of fraud or misrepresenta-

tion of fact or patent error.

(2) L

INES OF CREDIT BEYOND CUTOFF DATE

.—If the holder

of a certificate of comprehensive insurance coverage issued

under this subsection grants to a borrower a line of credit ex-

tending beyond the cutoff date specified in that certificate,

loans or payments thereon made by the holder after that date

pursuant to the line of credit shall not be deemed to be in-

cluded in the coverage of that certificate except as may be spe-

cifically provided therein; but, subject to the limitations of sec-

tion 702, the Secretary may, in accordance with regulations,

make commitments to insure such future loans or payments,

and such commitments may be honored either as provided in

subsection (a) or by inclusion of such insurance in comprehen-

sive coverage under this subsection for the period or periods in

which such future loans or payments are made.

SSIGNMENT OF

NSURANCE

IGHTS

.—The rights of an eligi-

ble lender arising under insurance evidenced by a certificate of in-

surance issued to it under this section may be assigned by such

lender, subject to regulation by the Secretary, only to—

(1) another eligible lender (including a public entity in the

business of purchasing student loans); or

(2) the Student Loan Marketing Association.

(d) E

FFECT OF

EFINANCING OR

ONSOLIDATION OF

BLIGA

TIONS

.—The consolidation of the obligations of two or more feder-

ally insured loans obtained by a borrower in any fiscal year into

a single obligation evidenced by a single instrument of indebted-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00008 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

9 Sec. 707 PUBLIC HEALTH SERVICE ACT

ness or the refinancing of a single loan shall not affect the insur-

ance by the United States. If the loans thus consolidated are cov-

ered by separate certificates of insurance issued under subsection

(a), the Secretary may upon surrender of the original certificates

issue a new certificate of insurance in accordance with that sub-

section upon the consolidated obligation. If the loans thus consoli-

dated are covered by a single comprehensive certificate issued

under subsection (b), the Secretary may amend that certificate ac-

cordingly.

(e) R

ULE OF

ONSTRUCTION

EGARDING

ONSOLIDATION OF

EBTS AND

EFINANCING

.—Nothing in this section shall be con-

strued to preclude the lender and the borrower, by mutual agree-

ment, from consolidating all of the borrower’s loans insured under

this subpart into a single instrument (or, if the borrower obtained

only 1 loan insured under this subpart, refinancing the loan 1 time)

under the terms applicable to an insured loan made at the same

time as the consolidation. The lender or loan holder should provide

full information to the borrower concerning the advantages and dis-

advantages of loan consolidation or refinancing. Nothing in this

section shall be construed to preclude the consolidation of the bor-

rower’s loans insured under this subpart under section 428C of the

Higher Education Act of 1965. Any loans insured pursuant to this

subpart that are consolidated under section 428C of such Act shall

not be eligible for special allowance payments under section 438 of

such Act.

SEC. 707. ø292f¿ DEFAULT OF BORROWER.

(a) C

ONDITIONS FOR

AYMENT TO

ENEFICIARY

.—

(1) I

N GENERAL

.—Upon default by the borrower on any

loan covered by Federal loan insurance pursuant to this sub-

part, and after a substantial collection effort (including, subject

to subsection (h), commencement and prosecution of an action)

as determined under regulations of the Secretary, the insur-

ance beneficiary shall promptly notify the Secretary and the

Secretary shall, if requested (at that time or after further col-

lection efforts) by the beneficiary, or may on his own motion,

if the insurance is still in effect, pay to the beneficiary the

amount of the loss sustained by the insured upon that loan as

soon as that amount has been determined, except that, if the

insurance beneficiary including any servicer of the loan is not

designated for ‘‘exceptional performance’’, as set forth in para-

graph (2), the Secretary shall pay to the beneficiary a sum

equal to 98 percent of the amount of the loss sustained by the

insured upon that loan.

(2) E

XCEPTIONAL PERFORMANCE

.—

(A) A

UTHORITY

.—Where the Secretary determines that

an eligible lender, holder, or servicer has a compliance per-

formance rating that equals or exceeds 97 percent, the Sec-

retary shall designate that eligible lender, holder, or

servicer, as the case may be, for exceptional performance.

(B) C

OMPLIANCE PERFORMANCE RATING

.—For purposes

of subparagraph (A), a compliance performance rating is

determined with respect to compliance with due diligence

in the disbursement, servicing, and collection of loans

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00009 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

10 Sec. 707 PUBLIC HEALTH SERVICE ACT

under this subpart for each year for which the determina-

tion is made. Such rating shall be equal to the percentage

of all due diligence requirements applicable to each loan,

on average, as established by the Secretary, with respect

to loans serviced during the period by the eligible lender,

holder, or servicer.

NNUAL AUDITS FOR LENDERS

HOLDERS

AND

SERVICERS

.—Each eligible lender, holder, or servicer desir-

ing a designation under subparagraph (A) shall have an

annual financial and compliance audit conducted with re-

spect to the loan portfolio of such eligible lender, holder,

or servicer, by a qualified independent organization from a

list of qualified organizations identified by the Secretary

and in accordance with standards established by the Sec-

retary. The standards shall measure the lender’s, holder’s,

or servicer’s compliance with due diligence standards and

shall include a defined statistical sampling technique de-

signed to measure the performance rating of the eligible

lender, holder, or servicer for the purpose of this section.

Each eligible lender, holder, or servicer shall submit the

audit required by this section to the Secretary.

(D) S

ECRETARY

’

S DETERMINATIONS

.—The Secretary

shall make the determination under subparagraph (A)

based upon the audits submitted under this paragraph and

any information in the possession of the Secretary or sub-

mitted by any other agency or office of the Federal Govern-

ment.

(E) Q

UARTERLY COMPLIANCE AUDIT

.—To maintain its

status as an exceptional performer, the lender, holder, or

servicer shall undergo a quarterly compliance audit at the

end of each quarter (other than the quarter in which sta-

tus as an exceptional performer is established through a fi-

nancial and compliance audit, as described in subpara-

graph (C)), and submit the results of such audit to the Sec-

retary. The compliance audit shall review compliance with

due diligence requirements for the period beginning on the

day after the ending date of the previous audit, in accord-

ance with standards determined by the Secretary.

(F) R

EVOCATION AUTHORITY

.—The Secretary shall re-

voke the designation of a lender, holder, or servicer under

subparagraph (A) if any quarterly audit required under

subparagraph (E) is not received by the Secretary by the

date established by the Secretary or if the audit indicates

the lender, holder, or servicer has failed to meet the stand-

ards for designation as an exceptional performer under

subparagraph (A). A lender, holder, or servicer receiving a

compliance audit not meeting the standard for designation

as an exceptional performer may reapply for designation

under subparagraph (A) at any time.

(G) D

OCUMENTATION

.—Nothing in this section shall

restrict or limit the authority of the Secretary to require

the submission of claims documentation evidencing serv-

icing performed on loans, except that the Secretary may

not require exceptional performers to submit greater docu-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00010 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

11 Sec. 707 PUBLIC HEALTH SERVICE ACT

mentation than that required for lenders, holders, and

servicers not designated under subparagraph (A).

(H) C

OST OF AUDITS

.—Each eligible lender, holder, or

servicer shall pay for all the costs associated with the au-

dits required under this section.

(I) A

DDITIONAL REVOCATION AUTHORITY

.—Notwith-

standing any other provision of this section, a designation

under subparagraph (A) may be revoked at any time by

the Secretary if the Secretary determines that the eligible

lender, holder, or servicer has failed to maintain an overall

level of compliance consistent with the audit submitted by

the eligible lender, holder, or servicer under this para-

graph or if the Secretary asserts that the lender, holder,

or servicer may have engaged in fraud in securing designa-

tion under subparagraph (A) or is failing to service loans

in accordance with program requirements.

(J) N

ONCOMPLIANCE

.—A lender, holder, or servicer

designated under subparagraph (A) that fails to service

loans or otherwise comply with applicable program regula-

tions shall be considered in violation of the Federal False

Claims Act.

(b) S

UBROGATION

.—Upon payment by the Secretary of the

amount of the loss pursuant to subsection (a), the United States

shall be subrogated for all of the rights of the holder of the obliga-

tion upon the insured loan and shall be entitled to an assignment

of the note or other evidence of the insured loan by the insurance

beneficiary. If the net recovery made by the Secretary on a loan

after deduction of the cost of that recovery (including reasonable

administrative costs) exceeds the amount of the loss, the excess

shall be paid over to the insured. The Secretary may sell without

recourse to eligible lenders (or other entities that the Secretary de-

termines are capable of dealing in such loans) notes or other evi-

dence of loans received through assignment under the first sen-

tence.

ORBEARANCE

.—Nothing in this section or in this subpart

shall be construed to preclude any forbearance for the benefit of the

borrower which may be agreed upon by the parties to the insured

loan and approved by the Secretary or to preclude forbearance by

the Secretary in the enforcement of the insured obligation after

payment on that insurance.

(d) R

EASONABLE

ARE AND

ILIGENCE

EGARDING

OANS

.—

Nothing in this section or in this subpart shall be construed to ex-

cuse the eligible lender or holder of a federally insured loan from

exercising reasonable care and diligence in the making of loans

under the provisions of this subpart and from exercising a substan-

tial effort in the collection of loans under the provisions of this sub-

part. If the Secretary, after reasonable notice and opportunity for

hearing to an eligible lender, finds that the lender has failed to ex-

ercise such care and diligence, to exercise such substantial efforts,

to make the reports and statements required under section

706(a)(3), or to pay the required Federal loan insurance premiums,

he shall disqualify that lender from obtaining further Federal in-

surance on loans granted pursuant to this subpart until he is satis-

fied that its failure has ceased and finds that there is reasonable

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00011 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

12 Sec. 707 PUBLIC HEALTH SERVICE ACT

assurance that the lender will in the future exercise necessary care

and diligence, exercise substantial effort, or comply with such re-

quirements, as the case may be.

(e) D

EFINITIONS

.—For purposes of this section:

(1) The term ‘‘insurance beneficiary’’ means the insured or

its authorized assignee in accordance with section 706(c).

(2) The term ‘‘amount of the loss’’ means, with respect to

a loan, unpaid balance of the principal amount and interest on

such loan, less the amount of any judgment collected pursuant

to default proceedings commenced by the eligible lender or

holder involved.

(3) The term ‘‘default’’ includes only such defaults as have

existed for 120 days.

(4) The term ‘‘servicer’’ means any agency acting on behalf

of the insurance beneficiary.

(f) R

EDUCTIONS IN

EDERAL

EIMBURSEMENTS OR

AYMENTS

FOR

EFAULTING

ORROWERS

.—The Secretary shall, after notice

and opportunity for a hearing, cause to be reduced Federal reim-

bursements or payments for health services under any Federal law

to borrowers who are practicing their professions and have de-

faulted on their loans insured under this subpart in amounts up to

the remaining balance of such loans. Procedures for reduction of

payments under the medicare program are provided under section

1892 of the Social Security Act. Notwithstanding such section 1892,

any funds recovered under this subsection shall be deposited in the

insurance fund established under section 710.

(g) C

ONDITIONS FOR

ISCHARGE OF

EBT IN

ANKRUPTCY

.—

Notwithstanding any other provision of Federal or State law, a

debt that is a loan insured under the authority of this subpart may

be released by a discharge in bankruptcy under any chapter of title

11, United States Code, only if such discharge is granted—

(1) after the expiration of the seven-year period beginning

on the first date when repayment of such loan is required, ex-

clusive of any period after such date in which the obligation to

pay installments on the loan is suspended;

(2) upon a finding by the Bankruptcy Court that the non-

discharge of such debt would be unconscionable; and

(3) upon the condition that the Secretary shall not have

waived the Secretary’s rights to apply subsection (f) to the bor-

rower and the discharged debt.

(h) R

EQUIREMENT

EGARDING

CTIONS FOR

EFAULT

.—

(1) I

N GENERAL

.—With respect to the default by a borrower

on any loan covered by Federal loan insurance under this sub-

part, the Secretary shall, under subsection (a), require an eligi-

ble lender or holder to commence and prosecute an action for

such default unless—

(A) in the determination of the Secretary—

(i) the eligible lender or holder has made reason-

able efforts to serve process on the borrower involved

and has been unsuccessful with respect to such efforts,

(ii) prosecution of such an action would be fruit-

less because of the financial or other circumstances of

the borrower;

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00012 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

13 Sec. 708 PUBLIC HEALTH SERVICE ACT

(B) for such loans made before the date of the enact-

ment of the Health Professions Reauthorization Act of

1988, the loan involved was made in an amount of less

than $5,000; or

volved was made in an amount of less than $2,500.

(2) R

ELATIONSHIP TO CLAIM FOR PAYMENT

.—With respect to

an eligible lender or holder that has commenced an action pur-

suant to subsection (a), the Secretary shall make the payment

required in such subsection, or deny the claim for such pay-

ment, not later than 60 days after the date on which the Sec-

retary determines that the lender or holder has made reason-

able efforts to secure a judgment and collect on the judgment

entered into pursuant to this subsection.

(3) S

TATE COURT JUDGMENTS

.—With respect to any State

court judgment that is obtained by a lender or holder against

a borrower for default on a loan insured under this subpart

and that is subrogated to the United States under subsection

(b), any United States attorney may register such judgment

with the Federal courts for enforcement.

(i) I

NAPPLICABILITY OF

EDERAL AND

TATE

TATUTE OF

IMI

TATIONS ON

CTIONS FOR

OAN

OLLECTION

.—Notwithstanding any

other provision of Federal or State law, there shall be no limitation

on the period within which suit may be filed, a judgment may be

enforced, or an offset, garnishment, or other action may be initiated

or taken by the Secretary, the Attorney General, or other adminis-

trative head of another Federal agency, as the case may be, for the

repayment of the amount due from a borrower on a loan made

under this subpart that has been assigned to the Secretary under

subsection (b).

(j) S

CHOOL

OLLECTION

SSISTANCE

.—An institution or post-

graduate training program attended by a borrower may assist in

the collection of any loan of that borrower made under this subpart

which becomes delinquent, including providing information con-

cerning the borrower to the Secretary and to past and present lend-

ers and holders of the borrower’s loans, contacting the borrower in

order to encourage repayment, and withholding services in accord-

ance with regulations issued by the Secretary under section

715(a)(7). The institution or postgraduate training program shall

not be subject to section 809 of the Fair Debt Collection Practices

Act for purposes of carrying out activities authorized by this sec-

tion.

SEC. 708. ø292g¿ RISK-BASED PREMIUMS.

(a) A

UTHORITY

.—With respect to a loan made under this sub-

part on or after January 1, 1993, the Secretary, in accordance with

subsection (b), shall assess a risk-based premium on an eligible

borrower and, if required under this section, an eligible institution

that is based on the default rate of the eligible institution involved

(as defined in section 719).

(b) A

SSESSMENT OF

REMIUM

.—Except as provided in sub-

section (d)(2), the risk-based premium to be assessed under sub-

section (a) shall be as follows:

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00013 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

14 Sec. 708 PUBLIC HEALTH SERVICE ACT

(1) L

RISK RATE

.—With respect to an eligible borrower

seeking to obtain a loan for attendance at an eligible institu-

tion that has a default rate of not to exceed five percent, such

borrower shall be assessed a risk-based premium in an amount

equal to 6 percent of the principal amount of the loan.

(2) M

EDIUM

RISK RATE

.—

(A) I

N GENERAL

.—With respect to an eligible borrower

seeking to obtain a loan for attendance at an eligible insti-

tution that has a default rate of in excess of five percent

but not to exceed 10 percent—

(i) such borrower shall be assessed a risk-based

premium in an amount equal to 8 percent of the prin-

cipal amount of the loan; and

(ii) such institution shall be assessed a risk-based

premium in an amount equal to 5 percent of the prin-

cipal amount of the loan.

(B) D

EFAULT MANAGEMENT PLAN

.—An institution of

the type described in subparagraph (A) shall prepare and

submit to the Secretary for approval, an annual default

management plan, that shall specify the detailed short-

term and long-term procedures that such institution will

have in place to minimize defaults on loans to borrowers

under this subpart. Under such plan the institution shall,

among other measures, provide an exit interview to all

borrowers that includes information concerning repayment

schedules, loan deferments, forbearance, and the con-

sequences of default.

(3) H

IGH

RISK RATE

.—

(A) I

N GENERAL

.—With respect to an eligible borrower

seeking to obtain a loan for attendance at an eligible insti-

tution that has a default rate of in excess of 10 percent but

not to exceed 20 percent—

(i) such borrower shall be assessed a risk-based

premium in an amount equal to 8 percent of the prin-

cipal amount of the loan; and

(ii) such institution shall be assessed a risk-based

premium in an amount equal to 10 percent of the prin-

cipal amount of the loan.

(B) D

EFAULT MANAGEMENT PLAN

.—An institution of

the type described in subparagraph (A) shall prepare and

submit to the Secretary for approval a plan that meets the

requirements of paragraph (2)(B).

(4) I

NELIGIBILITY

.—An individual shall not be eligible to

obtain a loan under this subpart for attendance at an institu-

tion that has a default rate in excess of 20 percent.

EDUCTION OF

ISK

-B

ASED

REMIUM

.—Lenders shall reduce

by 50 percent the risk-based premium to eligible borrowers if a

credit worthy parent or other responsible party co-signs the loan

note.

(d) A

DMINISTRATIVE

AIVERS

.—

(1) H

EARING

.—The Secretary shall afford an institution not

less than one hearing, and may consider mitigating cir-

cumstances, prior to making such institution ineligible for par-

ticipation in the program under this subpart.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00014 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

15 Sec. 709 PUBLIC HEALTH SERVICE ACT

(2) E

XCEPTIONS

.—In carrying out this section with respect

to an institution, the Secretary may grant an institution a

waiver of requirements of paragraphs (2) through (4) of sub-

section (b) if the Secretary determines that the default rate for

such institution is not an accurate indicator because the vol-

ume of the loans under this subpart made by such institution

has been insufficient.

(3) T

RANSITION FOR CERTAIN INSTITUTIONS

.—During the 3-

year period beginning on the effective date of the Health Pro-

fessions Education Extension Amendments of 1992—

(A) subsection (b)(4) shall not apply with respect to

any eligible institution that is a Historically Black College

or University; and

(B) any such institution that has a default rate in ex-

cess of 20 percent, and any eligible borrower seeking a

loan for attendance at the institution, shall be subject to

subsection (b)(3) to the same extent and in the same man-

ner as eligible institutions and borrowers described in such

subsection.

(e) P

AYOFF

EDUCE

ISK

ATEGORY

.—An institution may

pay off the outstanding principal and interest owed by the bor-

rowers of such institution who have defaulted on loans made under

this subpart in order to reduce the risk category of the institution.

SEC. 709. ø292h¿ OFFICE FOR HEALTH EDUCATION ASSISTANCE LOAN

DEFAULT REDUCTION.

(a) E

STABLISHMENT

.—The Secretary shall establish, within the

Division of Student Assistance of the Bureau of Health Professions,

an office to be known as the Office for Health Education Assistance

Loan Default Reduction (in this section referred to as the ‘‘Office’’).

(b) P

URPOSE AND

UNCTIONS

.—It shall be the purpose of the

Office to achieve a reduction in the number and amounts of de-

faults on loans guaranteed under this subpart. In carrying out such

purpose the Office shall—

(1) conduct analytical and evaluative studies concerning

loans and loan defaults;

(2) carry out activities designed to reduce loan defaults;

(3) respond to special circumstances that may exist in the

financial lending environment that may lead to loan defaults;

(4) coordinate with other Federal entities that are involved

with student loan programs, including—

(A) with respect to the Department of Education, in

the development of a single student loan application form,

a single student loan deferment form, a single disability

form, and a central student loan database; and

(B) with respect to the Department of Justice, in the

recovery of payments from health professionals who have

defaulted on loans guaranteed under this subpart; and

(5) provide technical assistance to borrowers, lenders, hold-

ers, and institutions concerning deferments and collection ac-

tivities.

DDITIONAL

UTIES

.—In conjunction with the report sub-

mitted under subsection (b), the Office shall—

(1) compile, and publish in the Federal Register, a list of

the borrowers who are in default under this subpart; and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00015 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

16 Sec. 710 PUBLIC HEALTH SERVICE ACT

(2) send the report and notices of default with respect to

these borrowers to relevant Federal agencies and to schools,

school associations, professional and specialty associations,

State licensing boards, hospitals with which such borrowers

may be associated, and any other relevant organizations.

(d) A

LLOCATION OF

UNDS FOR

FFICE

.—In the case of

amounts reserved under section 710(a)(2)(B) for obligation under

this subsection, the Secretary may obligate the amounts for the

purpose of administering the Office, including 7 full-time equiva-

lent employment positions for such Office. With respect to such

purpose, amounts made available under the preceding sentence are

in addition to amounts made available to the Health Resources and

Services Administration for program management for the fiscal

year involved. With respect to such employment positions, the posi-

tions are in addition to the number of full-time equivalent employ-

ment positions that otherwise is authorized for the Department of

Health and Human Services for the fiscal year involved.

SEC. 710. ø292i¿ INSURANCE ACCOUNT.

(a) I

ENERAL

.—

(1) E

STABLISHMENT

.—There is hereby established a stu-

dent loan insurance account (in this section referred to as the

‘‘Account’’) which shall be available without fiscal year limita-

tion to the Secretary for making payments in connection with

the collection and default of loans insured under this subpart

by the Secretary.

(2) F

UNDING

.—

(A) Except as provided in subparagraph (B), all

amounts received by the Secretary as premium charges for

insurance and as receipts, earnings, or proceeds derived

from any claim or other assets acquired by the Secretary

in connection with his operations under this subpart, and

any other moneys, property, or assets derived by the Sec-

retary from the operations of the Secretary in connection

with this section, shall be deposited in the Account.

(B) With respect to amounts described in subpara-

graph (A) that are received by the Secretary for fiscal year

1993 and subsequent fiscal years, the Secretary may, be-

fore depositing such amounts in the Account, reserve from

the amounts each such fiscal year not more than

$1,000,000 for obligation under section 709(d).

(3) E

XPENDITURES

.—All payments in connection with the

default of loans insured by the Secretary under this subpart

shall be paid from the Account.

(b) C

ONTINGENT

UTHORITY FOR

SSUANCE OF

OTES OR

THER

BLIGATIONS

.—If at any time the moneys in the Account are insuf-

ficient to make payments in connection with the collection or de-

fault of any loan insured by the Secretary under this subpart, the

Secretary of the Treasury may lend the Account such amounts as

may be necessary to make the payments involved, subject to the

Federal Credit Reform Act of 1990.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00016 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

17 Sec. 712 PUBLIC HEALTH SERVICE ACT

So in law. See section 102 of Public Law 102–408 (106 Stat. 1994). Probably should be ‘‘right

of redemption’’.

SEC. 711. ø292j¿ POWERS AND RESPONSIBILITIES OF SECRETARY.

(a) I

ENERAL

.—In the performance of, and with respect to,

the functions, powers, and duties vested in the Secretary by this

subpart, the Secretary is authorized as follows:

(1) To prescribe such regulations as may be necessary to

carry out the purposes of this subpart.

(2) To sue and be sued in any district court of the United

States. Such district courts shall have jurisdiction of civil ac-

tions arising under this subpart without regard to the amount

in controversy, and any action instituted under this subsection

by or against the Secretary shall survive notwithstanding any

change in the person occupying the office of Secretary or any

vacancy in that office. No attachment, injunction, garnishment,

or other similar process, mesne or final, shall be issued against

the Secretary or property under the control of the Secretary.

Nothing herein shall be constructed to except litigation arising

out of activities under this subpart from the application of sec-

tions 517 and 547 of title 28 of the United States Code.

(3) To include in any contract for Federal loan insurance

such terms, conditions, and covenants relating to repayment of

principal and payments of interest, relating to his obligations

and rights and to those of eligible lenders, and borrowers in

case of default, and relating to such other matters as the Sec-

retary determines to be necessary to assure that the purposes

of this subpart will be achieved. Any term, condition, and cov-

enant made pursuant to this paragraph or any other provisions

of this subpart may be modified by the Secretary if the Sec-

retary determines that modification is necessary to protect the

financial interest of the United States.

(4) Subject to the specific limitations in the subpart, to

consent to the modification of any note or other instrument evi-

dencing a loan which has been insured by him under this sub-

part (including modifications with respect to the rate of inter-

est, time of payment of any installment of principal and inter-

est or any portion thereof, or any other provision).

(5) To enforce, pay, compromise, waive, or release any

right, title, claim, lien, or demand, however acquired, including

any equity or any right or

redemption.

(b) A

NNUAL

UDGET

; A

CCOUNTS

.—The Secretary shall, with re-

spect to the financial operations arising by reason of this subpart—

(1) prepare annually and submit a budget program as pro-

vided for wholly owned Government corporations by the Gov-

ernment Corporation Control Act; and

(2) maintain with respect to insurance under this subpart

an integral set of accounts.

SEC. 712. ø292k¿ PARTICIPATION BY FEDERAL CREDIT UNIONS IN FED-

ERAL, STATE, AND PRIVATE STUDENT LOAN INSURANCE

PROGRAMS.

Notwithstanding any other provision of law, Federal credit

unions shall, pursuant to regulations of the Administrator of the

National Credit Union Administration, have power to make in-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00017 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

18 Sec. 713 PUBLIC HEALTH SERVICE ACT

sured loans to eligible students in accordance with the provisions

of this subpart relating to Federal insured loans.

SEC. 713. ø292l¿ DETERMINATION OF ELIGIBLE STUDENTS.

For purposes of determining eligible students under this part,

in the case of a public school in a State that offers an accelerated,

integrated program of study combining undergraduate premedical

education and medical education leading to advanced entry, by con-

tractual agreement, into an accredited four-year school of medicine

which provides the remaining training leading to a degree of doctor

of medicine, whenever in this part a provision refers to a student

at a school of medicine, such reference shall include only a student

enrolled in any of the last four years of such accelerated, integrated

program of study.

SEC. 714. ø292m¿ REPAYMENT BY SECRETARY OF LOANS OF DECEASED

OR DISABLED BORROWERS.

If a borrower who has received a loan dies or becomes perma-

nently and totally disabled (as determined in accordance with regu-

lations of the Secretary), the Secretary shall discharge the bor-

rower’s liability on the loan by repaying the amount owed on the

loan from the account established under section 710.

SEC. 715. ø292n¿ ADDITIONAL REQUIREMENTS FOR INSTITUTIONS AND

LENDERS.

(a) I

ENERAL

.—Notwithstanding any other provision of this

subpart, the Secretary is authorized to prescribe such regulations

as may be necessary to provide for—

(1) a fiscal audit of an eligible institution with regard to

any funds obtained from a borrower who has received a loan

insured under this subpart;

(2) the establishment of reasonable standards of financial

responsibility and appropriate institutional capability for the

administration by an eligible institution of a program of stu-

dent financial aid with respect to funds obtained from a stu-

dent who has received a loan insured under this subpart;

(3) the limitation, suspension, or termination of the eligi-

bility under this subpart of any otherwise eligible institution,

whenever the Secretary has determined, after notice and af-

fording an opportunity for hearing, that such institution has

violated or failed to carry out any regulation prescribed under

this subpart;

(4) the collection of information from the borrower, lender,

or eligible institution to assure compliance with the provisions

of section 705;

(5) the assessing of tuition or fees to borrowers in amounts

that are the same or less than the amount of tuition and fees

assessed to nonborrowers;

(6) the submission, by the institution or the lender to the

Office of Health Education Assistance Loan Default Reduction,

of information concerning each loan made under this subpart,

including the date when each such loan was originated, the

date when each such loan is sold, the identity of the loan hold-

er and information concerning a change in the borrower’s sta-

tus;

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00018 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

19 Sec. 719 PUBLIC HEALTH SERVICE ACT

(7) the withholding of services, including academic tran-

scripts, financial aid transcripts, and alumni services, by an in-

stitution from a borrower upon the default of such borrower of

a loan under this subpart, except in case of a borrower who has

filed for bankruptcy; and

(8) the offering, by the lender to the borrower, of a variety

of repayment options, including fixed-rate, graduated repay-

ment with negative amortization permitted, and income de-

pendent payments for a limited period followed by level month-

ly payments.

(b) R

ECORDING BY

NSTITUTION OF

NFORMATION ON

DENTS

.—The Secretary shall require an eligible institution to

record, and make available to the lender and to the Secretary upon

request, the name, address, postgraduate destination, and other

reasonable identifying information for each student of such institu-

tion who has a loan insured under this subpart.

ORKSHOP FOR

TUDENT

ORROWERS

.—Each participating

eligible institution must have, at the beginning of each academic

year, a workshop concerning the provisions of this subpart that all

student borrowers shall be required to attend.

SEC. 719. ø292o¿ DEFINITIONS.

For purposes of this subpart:

(1) The term ‘‘eligible institution’’ means, with respect to

a fiscal year, a school of medicine, osteopathic medicine, den-

tistry, veterinary medicine, optometry, podiatric medicine,

pharmacy, public health, allied health, or chiropractic, or a

graduate program in health administration or behavioral and

mental health practice, including clinical psychology.

(2) The term ‘‘eligible lender’’ means an eligible institution

that became a lender under this subpart prior to September

15, 1992, an agency or instrumentality of a State, a financial

or credit institution (including an insurance company) which is

subject to examination and supervision by an agency of the

United States or of any State, a pension fund approved by the

Secretary for this purpose, or a nonprofit private entity des-

ignated by the State, regulated by the State, and approved by

the Secretary.

(3) The term ‘‘line of credit’’ means an arrangement or

agreement between the lender and the borrower whereby a

loan is paid out by the lender to the borrower in annual in-

stallments, or whereby the lender agrees to make, in addition

to the initial loan, additional loans in subsequent years.

(4) The term ‘‘school of allied health’’ means a program in

a school of allied health (as defined in section 799) which leads

to a masters’ degree or a doctoral degree.

(5)(A) The term ‘‘default rate’’, in the case of an eligible en-

tity, means the percentage constituted by the ratio of—

(i) the principal amount of loans insured under this

subpart—

(I) that are made with respect to the entity and

that enter repayment status after April 7, 1987; and

(II) for which amounts have been paid under sec-

tion 707(a) to insurance beneficiaries, exclusive of any

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00019 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

20 Sec. 720 PUBLIC HEALTH SERVICE ACT

Paragraph (6) was added by Section 525(e), Title V of Division H of Public Law 113-76. This

paragraph becomes effective on the date on which the transfer of the HEAL program under sub-

section (a) of such act takes effect.

loan for which amounts have been so paid as a result

of the death or total and permanent disability of the

borrower; exclusive of any loan for which the borrower

begins payments to the Secretary on the loan pursu-

ant to section 707(b) and maintains payments for 12

consecutive months in accordance with the agreement

involved (with the loan subsequently being included or

excluded, as the case may be, as amounts paid under

section 707(a) according to whether further defaults

occur and whether with respect to the default involved

compliance with such requirement regarding 12 con-

secutive months occurs); and exclusive of any loan on

which payments may not be recovered by reason of the

obligation under the loan being discharged in bank-

ruptcy under title 11, United States Code; to

(ii) the total principal amount of loans insured under

this subpart that are made with respect to the entity and

that enter repayment status after April 7, 1987.

(B) For purposes of subparagraph (A), a loan insured

under this subpart shall be considered to have entered repay-

ment status if the applicable period described in subparagraph

(B) of section 705(a)(2) regarding the loan has expired (without

regard to whether any period described in subparagraph (C) of

such section is applicable regarding the loan).

entity’’ means an eligible institution, an eligible lender, or a

holder, as the case may be.

(D) For purposes of subparagraph (A), a loan is made with

respect to an eligible entity if—

(i) in the case of an eligible institution, the loan was made

to students of the institution;

(ii) in the case of an eligible lender, the loan was made by

the lender; and

(iii) in the case of a holder, the loan was purchased by the

holder.

(6)

The term ‘‘Secretary’’ means the Secretary of Edu-

cation.

SEC. 720. ø292p¿ AUTHORIZATION OF APPROPRIATIONS.

(a) I

ENERAL

.—For fiscal year 1993 and subsequent fiscal

years, there are authorized to be appropriated such sums as may

be necessary for the adequacy of the student loan insurance ac-

count under this subpart and for the purpose of administering this

subpart.

(b) A

VAILABILITY OF

UMS

.—Sums appropriated under sub-

section (a) shall remain available until expended.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00020 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

21 Sec. 721 PUBLIC HEALTH SERVICE ACT

Subpart II—Federally-Supported Student Loan

Funds

SEC. 721. ø292q¿ AGREEMENTS FOR OPERATION OF SCHOOL LOAN

FUNDS.

(a) F

UND

GREEMENTS

.—The Secretary is authorized to enter

into an agreement for the establishment and operation of a student

loan fund in accordance with this subpart with any public or other

nonprofit school of medicine, osteopathic medicine, dentistry, phar-

macy, podiatric medicine, optometry, or veterinary medicine.

(b) R

EQUIREMENTS

.—Each agreement entered into under this

section shall—

(1) provide for establishment of a student loan fund by the

school;

(2) provide for deposit in the fund of—

(A) the Federal capital contributions to the fund;

(B) an amount equal to not less than one-ninth of such

Federal capital contributions, contributed by such institu-

tion;

from the fund;

(D) collections pursuant to section 722(j); and

(E) any other earnings of the fund;

(3) provide that the fund shall be used only for loans to

students of the school in accordance with the agreement and

for costs of collection of such loans and interest thereon;

(4) provide that loans may be made from such funds only

to students pursuing a full-time course of study at the school

leading to a degree of doctor of medicine, doctor of dentistry or

an equivalent degree, doctor of osteopathy, bachelor of science

in pharmacy or an equivalent degree, doctor of pharmacy or an

equivalent degree, doctor of podiatric medicine or an equiva-

lent degree, doctor of optometry or an equivalent degree, or

doctor of veterinary medicine or an equivalent degree;

(5) provide that the school shall advise, in writing, each

applicant for a loan from the student loan fund of the provi-

sions of section 722 under which outstanding loans from the

student loan fund may be paid (in whole or in part) by the Sec-

retary; and

(6) contain such other provisions as are necessary to pro-

tect the financial interests of the United States.

AILURE OF

CHOOL

OLLECT

OANS

.—

(1) I

N GENERAL

.—Any standard established by the Sec-

retary by regulation for the collection by schools of medicine,

osteopathic medicine, dentistry, pharmacy, podiatric medicine,

optometry, or veterinary medicine of loans made pursuant to

loan agreements under this subpart shall provide that the fail-

ure of any such school to collect such loans shall be measured

in accordance with this subsection. This subsection may not be

construed to require such schools to reimburse the student

loan fund under this subpart for loans that became

uncollectible prior to August 1985 or to penalize such schools

with respect to such loans.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00021 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

22 Sec. 722 PUBLIC HEALTH SERVICE ACT

(2) E

XTENT OF FAILURE

.—The measurement of a school’s

failure to collect loans made under this subpart shall be the

ratio (stated as a percentage) that the defaulted principal

amount outstanding of such school bears to the matured loans

of such school.

(3) D

EFINITIONS

.—For purposes of this subsection:

(A) The term ‘‘default’’ means the failure of a borrower

of a loan made under this subpart to—

(i) make an installment payment when due; or

(ii) comply with any other term of the promissory

note for such loan,

except that a loan made under this subpart shall not be

considered to be in default if the loan is discharged in

bankruptcy or if the school reasonably concludes from

written contracts with the borrower that the borrower in-

tends to repay the loan.

(B) The term ‘‘defaulted principal amount outstanding’’

means the total amount borrowed from the loan fund of a

school that has reached the repayment stage (minus any

principal amount repaid or canceled) on loans—

(i) repayable monthly and in default for at least

120 days; and

(ii) repayable less frequently than monthly and in

default for at least 180 days;

year beginning on the date on which the borrower ceases

to pursue a full-time course of study at a school of medi-

cine, osteopathic medicine, dentistry, pharmacy, podiatric

medicine, optometry, or veterinary medicine; and

(D) The term ‘‘matured loans’’ means the total prin-

cipal amount of all loans made by a school under this sub-

part minus the total principal amount of loans made by

such school to students who are—

(i) enrolled in a full-time course of study at such

school; or

(ii) in their grace period.

SEC. 722. ø292r¿ LOAN PROVISIONS.

(a) A

MOUNT OF

OAN

.—

(1) I

N GENERAL

.—Loans from a student loan fund (estab-

lished under an agreement with a school under section 721)

may not, subject to paragraph (2), exceed for any student for

a school year (or its equivalent) the cost of attendance (includ-

ing tuition, other reasonable educational expenses, and reason-

able living costs) for that year at the educational institution at-

tended by the student (as determined by such educational in-

stitution).

(2) T

HIRD AND FOURTH YEARS OF MEDICAL SCHOOL

.—For

purposes of paragraph (1), the amount of the loan may, in the

case of the third or fourth year of a student at a school of med-

icine or osteopathic medicine, be increased to the extent nec-

essary to pay the balances of loans that, from sources other

than the student loan fund under section 721, were made to

the individual for attendance at the school. The authority to

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00022 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

23 Sec. 722 PUBLIC HEALTH SERVICE ACT

make such an increase is subject to the school and the student

agreeing that such amount (as increased) will be expended to

pay such balances.

(b) T

ERMS AND

ONDITIONS

.—Subject to section 723, any such

loans shall be made on such terms and conditions as the school

may determine, but may be made only to a student who is in need

of the amount thereof to pursue a full-time course of study at the

school leading to a degree of doctor of medicine, doctor of dentistry

or an equivalent degree, doctor of osteopathy, bachelor of science in

pharmacy or an equivalent degree, doctor of pharmacy or an equiv-

alent degree, doctor of podiatric medicine or an equivalent degree,

doctor of optometry or an equivalent degree, or doctor of veterinary

medicine or an equivalent degree.

EPAYMENT

; E

XCLUSIONS

ROM

EPAYMENT

ERIOD

.—Such

loans shall be repayable in equal or graduated periodic install-

ments (with the right of the borrower to accelerate repayment) over

the period of not less than 10 years nor more than 25 years, at the

discretion of the institution, which begins one year after the stu-

dent ceases to pursue a full-time course of study at a school of med-

icine, osteopathic medicine, dentistry, pharmacy, podiatry, optom-

etry, or veterinary medicine, excluding from such period—

(1) all periods—

(A) not in excess of three years of active duty per-

formed by the borrower as a member of a uniformed serv-

ice;

(B) not in excess of three years during which the bor-

rower serves as a volunteer under the Peace Corps Act;

vanced professional training, including internships and

residencies; and

(D) during which the borrower is pursuing a full-time

course of study at such a school; and

(2) a period—

(A) not in excess of two years during which a borrower

who is a full-time student in such a school leaves the

school, with the intent to return to such school as a full-

time student, in order to engage in a full-time educational

activity which is directly related to the health profession

for which the borrower is preparing, as determined by the

Secretary; or

(B) not in excess of two years during which a borrower

who is a graduate of such a school is a participant in a fel-

lowship training program or a full-time educational activ-

ity which—

(i) is directly related to the health profession for

which such borrower prepared at such school, as deter-

mined by the Secretary; and

(ii) may be engaged in by the borrower during

such a two-year period which begins within twelve

months after the completion of the borrower’s partici-

pation in advanced professional training described in

paragraph (1)(C) or prior to the completion of such

borrower’s participation in such training.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00023 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

24 Sec. 722 PUBLIC HEALTH SERVICE ACT

So in law. See section 102 of Public Law 102–408 (106 Stat. 1994). Probably should be ‘‘made

under this subpart’’.

(d) C

ANCELLATION OF

IABILITY

.—The liability to repay the un-

paid balance of such a loan and accrued interest thereon shall be

canceled upon the death of the borrower, or if the Secretary deter-

mines that he has become permanently, and totally disabled.

(e) R

ATE OF

NTEREST

.—Such loans shall bear interest, on the

unpaid balance of the loan, computed only for periods for which the

loan is repayable, at the rate of 5 percent per year.

(f) S

ECURITY OR

NDORSEMENT

.—Loans shall be made under

this subpart without security or endorsement, except that if the

borrower is a minor and the note or other evidence of obligation ex-

ecuted by him would not, under the applicable law, create a bind-

ing obligation, either security or endorsement may be required.

(g) T

RANSFERRING AND

SSIGNING

OANS

.—No note or other

evidence of a loan made under this subpart may be transferred or

assigned by the school making the loan except that, if the bor-

rowers transfer to another school participating in the program

under this subpart, such note or other evidence of a loan may be

transferred to such other school.

(h) C

HARGE

ITH

ESPECT TO

NSURANCE FOR

ERTAIN

CELLATIONS

.—Subject to regulations of the Secretary, a school may

assess a charge with respect to loans made this

subpart to cover

the costs of insuring against cancellation of liability under sub-

section (d).

(i) C

HARGE

ITH

ESPECT TO

ATE

AYMENTS

.—Subject to reg-

ulations of the Secretary, and in accordance with this section, a

school shall assess a charge with respect to a loan made under this

subpart for failure of the borrower to pay all or any part of an in-

stallment when it is due and, in the case of a borrower who is enti-

tled to deferment of the loan under subsection (c), for any failure

to file timely and satisfactory evidence of such entitlement. No such

charge may be made if the payment of such installment or the fil-

ing of such evidence is made within 60 days after the date on

which such installment or filing is due. The amount of any such

charge may not exceed an amount equal to 6 percent of the amount

of such installment. The school may elect to add the amount of any

such charge to the principal amount of the loan as of the first day

after the day on which such installment or evidence was due, or to

make the amount of the charge payable to the school not later than

the due date of the next installment after receipt by the borrower

of notice of the assessment of the charge.

(j) A

UTHORITY OF

CHOOLS

EGARDING

ATE OF

AYMENT

.—A

school may provide, in accordance with regulations of the Sec-

retary, that during the repayment period of a loan from a loan fund

established pursuant to an agreement under this subpart payments

of principal and interest by the borrower with respect to all the

outstanding loans made to him from loan funds so established shall

be at a rate equal to not less than $40 per month.

(k) A

UTHORITY

EGARDING

EPAYMENTS BY

ECRETARY

.—Upon

application by a person who received, and is under an obligation

to repay, any loan made to such person as a health professions stu-

dent to enable him to study medicine, osteopathy, dentistry, veteri-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00024 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

25 Sec. 723 PUBLIC HEALTH SERVICE ACT

nary medicine, optometry, pharmacy, or podiatry, the Secretary

may undertake to repay (without liability to the applicant) all or

any part of such loan, and any interest or portion thereof out-

standing thereon, upon his determination, pursuant to regulations

establishing criteria therefor, that the applicant—

(1) failed to complete such studies leading to his first pro-

fessional degree;

(2) is in exceptionally needy circumstances;

(3) is from a low-income or disadvantaged family as those

terms may be defined by such regulations; and

(4) has not resumed, or cannot reasonably be expected to

resume, the study of medicine, osteopathy, dentistry, veteri-

nary medicine, optometry, pharmacy, or podiatric medicine,

within two years following the date upon which he terminated

such studies.

(l) C

OLLECTION

FFORTS BY

ECRETARY

.—The Secretary is au-

thorized to attempt to collect any loan which was made under this

subpart, which is in default, and which was referred to the Sec-

retary by a school with which the Secretary has an agreement

under this subpart, on behalf of that school under such terms and

conditions as the Secretary may prescribe (including reimburse-

ment from the school’s student loan fund for expenses the Sec-

retary may reasonably incur in attempting collection), but only if

the school has complied with such requirements as the Secretary

may specify by regulation with respect to the collection of loans

under this subpart. A loan so referred shall be treated as a debt

subject to section 5514 of title 5, United States Code. Amounts col-

lected shall be deposited in the school’s student loan fund. When-

ever the Secretary desires the institution of a civil action regarding

any such loan, the Secretary shall refer the matter to the Attorney

General for appropriate action.

(m) E

LIMINATION OF

TATUTE OF

IMITATION FOR

OAN

LECTIONS

.—

(1) P

URPOSE

.—It is the purpose of this subsection to en-

sure that obligations to repay loans under this section are en-

forced without regard to any Federal or State statutory, regu-

latory, or administrative limitation on the period within which

debts may be enforced.

(2) P

ROHIBITION

.—Notwithstanding any other provision of

Federal or State law, no limitation shall terminate the period

within which suit may be filed, a judgment may be enforced,

or an offset, garnishment, or other action may be initiated or

taken by a school that has an agreement with the Secretary

pursuant to section 721 that is seeking the repayment of the

amount due from a borrower on a loan made under this sub-

part after the default of the borrower on such loan.

SEC. 723. ø292s¿ MEDICAL SCHOOLS AND PRIMARY HEALTH CARE.

(a) R

EQUIREMENTS FOR

TUDENTS

.—

(1) I

N GENERAL

.—Subject to the provisions of this sub-

section, in the case of student loan funds established under

section 721 by schools of medicine or osteopathic medicine,

each agreement entered into under such section with such a

school shall provide (in addition to the provisions required in

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00025 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

26 Sec. 723 PUBLIC HEALTH SERVICE ACT

subsection (b) of such section) that the school will make a loan

from such fund to a student only if the student agrees—

(A) to enter and complete a residency training pro-

gram in primary health care not later than 4 years after

the date on which the student graduates from such school;

and

(B) to practice in such care for 10 years (including

residency training in primary health care) or through the

date on which the loan is repaid in full, whichever occurs

first.

(2) I

NAPPLICABILITY TO CERTAIN STUDENTS

.—

(A) The requirement established in paragraph (1) re-

garding the student loan fund of a school does not apply

to a student if—

(i) the first loan to the student from such fund is

made before July 1, 1993; or

(ii) the loan is made from—

(I) a Federal capital contribution under sec-

tion 721 that is made from amounts appropriated

under section 724(f) (in this section referred to as

an ‘‘exempt Federal capital contribution’’); or

(II) a school contribution made under section

721 pursuant to such a Federal capital contribu-

tion (in this section referred to as an ‘‘exempt

school contribution’’).

(B) A Federal capital contribution under section 721

may not be construed as being an exempt Federal capital

contribution if the contribution was made from amounts

appropriated before October 1, 1990. A school contribution

under section 721 may not be construed as being an ex-

empt school contribution if the contribution was made pur-

suant to a Federal capital contribution under such section

that was made from amounts appropriated before such

date.

(3) N

ONCOMPLIANCE BY STUDENT

.—Each agreement en-

tered into with a student pursuant to paragraph (1) shall pro-

vide that, if the student fails to comply with such agreement,

the loan involved will begin to accrue interest at a rate of 2

percent per year greater than the rate at which the student

would pay if compliant in such year.

(4) W

AIVERS

.—

(A) With respect to the obligation of an individual

under an agreement made under paragraph (1) as a stu-

dent, the Secretary shall provide for the partial or total

waiver or suspension of the obligation whenever compli-

ance by the individual is impossible, or would involve ex-

treme hardship to the individual, and if enforcement of the

obligation with respect to the individual would be uncon-

scionable.

(B) For purposes of subparagraph (A), the obligation of

an individual shall be waived if—

(i) the status of the individual as a student of the

school involved is terminated before graduation from

the school, whether voluntarily or involuntarily; and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00026 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

27 Sec. 723 PUBLIC HEALTH SERVICE ACT

So in law. See section 2014(c)(2)(A)(i) of Public Law 103–43 (107 Stat. 216). The semicolon

probably should be a comma.

(ii) the individual does not, after such termination,

resume attendance at the school or begin attendance

at any other school of medicine or osteopathic medi-

cine.

purposes of subparagraph (B), the obligation of the indi-

vidual under the agreement under paragraph (1) shall be

considered to have been suspended for the period in which

the individual was not in attendance.

(D) This paragraph may not be construed as author-

izing the waiver or suspension of the obligation of a stu-

dent to repay, in accordance with section 722, loans from

student loan funds under section 721.

(b) R

EQUIREMENTS FOR

CHOOLS

.—

(1) I

N GENERAL

.—Subject to the provisions of this sub-

section, in the case of student loan funds established under

section 721 by schools of medicine or osteopathic medicine,

each agreement entered into under such section with such a

school shall provide (in addition to the provisions required in

subsection (b) of such section) that, for the 1-year period end-

ing on June 30, 1997;

and for the 1-year period ending on

June 30 of each subsequent fiscal year, the school will meet not

less than 1 of the conditions described in paragraph (2) with

respect to graduates of the school whose date of graduation

from the school occurred approximately 4 years before the end

of the 1-year period involved.

(2) D

ESCRIPTION OF CONDITIONS

.—With respect to grad-

uates described in paragraph (1) (in this paragraph referred to

as ‘‘designated graduates’’), the conditions referred to in such

paragraph for a school for a 1-year period are as follows:

(A) Not less than 50 percent of designated graduates

of the school meet the criterion of either being in a resi-

dency training program in primary health care, or being

engaged in a practice in such care (having completed such

a program).

(B) Not less than 25 percent of the designated grad-

uates of the school meet such criterion, and such percent-

age is not less than 5 percentage points above the percent-

age of such graduates meeting such criterion for the pre-

ceding 1-year period.

medicine with student loans funds under section 721, the

school involved is at or above the 75th percentile of such

schools whose designated graduates meet such criterion.

(3) D

ETERMINATIONS BY SECRETARY

.—Not later than 90

days after the close of each 1-year period described in para-

graph (1), the Secretary shall make a determination of whether

the school involved has for such period complied with such

paragraph and shall in writing inform the school of the deter-

mination. Such determination shall be made only after consid-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00027 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

28 Sec. 723 PUBLIC HEALTH SERVICE ACT

eration of the report submitted to the Secretary by the school

under paragraph (6).

(4) N

ONCOMPLIANCE BY SCHOOL

.—

(A)(i) Subject to subparagraph (C), each agreement

under section 721 with a school of medicine or osteopathic

medicine shall provide that, if the school fails to comply

with paragraph (1) for a 1-year period under such para-

graph, the school—

(I) will pay to the Secretary the amount appli-

cable under subparagraph (B) for the period; and

(II) will pay such amount not later than 90

days after the school is informed under paragraph

(3) of the determination of the Secretary regarding

such period.

(ii) Any amount that a school is required to pay under

clause (i) may be paid from the student loan fund of the

school under section 721.

(B) For purposes of subparagraph (A), the amount ap-

plicable for a school, subject to subparagraph (C), is—

(i) for the 1-year period ending June 30, 1997, an

amount equal to 10 percent of the income received

during such period by the student loan fund of the

school under section 721;

(ii) for the 1-year period ending June 30, 1998, an

amount equal to 20 percent of the income received

during such period by the student loan fund; and

(iii) for any subsequent 1-year period under para-

graph (1), an amount equal to 30 percent of the in-

come received during such period by the student loan

fund.

dent loan fund has received for purposes of subparagraph

(B), the Secretary shall exclude any income derived from

exempt contributions. Payments made to the Secretary

under subparagraph (A) may not be made with such con-

tributions or with income derived from such contributions.

(5) E

XPENDITURE OF PAYMENTS

.—

(A) Amounts paid to the Secretary under paragraph

(4) shall be expended to make Federal capital contribu-

tions to student loan funds under section 721 of schools

that are in compliance with paragraph (1).

(B) A Federal capital contribution under section 721

may not be construed as being an exempt Federal capital

contribution if the contribution is made from payments

under subparagraph (A). A school contribution under such

section may not be construed as being an exempt school

contribution if the contribution is made pursuant to a Fed-

eral capital contribution from such payments.

(6) R

EPORTS BY SCHOOLS

.—Each agreement under section

721 with a school of medicine or osteopathic medicine shall

provide that the school will submit to the Secretary a report

for each 1-year period under paragraph (1) that provides such

information as the Secretary determines to be necessary for

carrying out this subsection. Each such report shall include

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00028 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

29 Sec. 724 PUBLIC HEALTH SERVICE ACT

statistics concerning the current training or practice status of

all graduates of such school whose date of graduation from the

school occurred approximately 4 years before the end of the 1-

year period involved.

EFINITIONS

.—For purposes of this section:

(1) The term ‘‘exempt contributions’’ means exempt Fed-

eral capital contributions and exempt school contributions.

(2) The term ‘‘exempt Federal capital contribution’’ means

a Federal capital contribution described in subclause (I) of sub-

section (a)(2)(A)(ii).

(3) The term ‘‘exempt school contribution’’ means a school

contribution described in subclause (II) of subsection

(a)(2)(A)(ii).

(4) The term ‘‘income’’, with respect to a student fund

under section 721, means payments of principal and interest

on any loan made from the fund, and any other earnings of the

fund.

(5) The term ‘‘primary health care’’ means family medicine,

general internal medicine, general pediatrics, preventive medi-

cine, or osteopathic general practice.

(d) S

ENSE OF

ONGRESS

.—It is the sense of Congress that

funds repaid under the loan program under this section should not

be transferred to the Treasury of the United States or otherwise

used for any other purpose other than to carry out this section.

SEC. 724. ø292t¿ INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.

(a) F

UND

GREEMENTS

EGARDING

ERTAIN

MOUNTS

.—With

respect to amounts appropriated under subsection (f), each agree-

ment entered into under section 721 with a school shall provide (in

addition to the provisions required in subsection (b) of such section)

that—

(1) any Federal capital contribution made to the student

loan fund of the school from such amounts, together with the

school contribution appropriate under subsection (b)(2)(B) of

such section to the amount of the Federal capital contribution,

will be utilized only for the purpose of—

(A) making loans to individuals from disadvantaged

backgrounds; and

(B) the costs of the collection of the loans and interest

on the loans; and

(2) collections of principal and interest on loans made pur-

suant to paragraph (1), and any other earnings of the student

loan fund attributable to amounts that are in the fund pursu-

ant to such paragraph, will be utilized only for the purpose de-

scribed in such paragraph.

(b) M

INIMUM

UALIFICATIONS FOR

CHOOLS

.—The Secretary

may not make a Federal capital contribution for purposes of sub-

section (a) for a fiscal year unless the health professions school in-

volved—

(1) is carrying out a program for recruiting and retaining

students from disadvantaged backgrounds, including racial and

ethnic minorities; and

(2) is carrying out a program for recruiting and retaining

minority faculty.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00029 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

30 Sec. 724 PUBLIC HEALTH SERVICE ACT

ERTAIN

GREEMENTS

EGARDING

DUCATION OF

DENTS

; D

ATE

ERTAIN FOR

OMPLIANCE

.—The Secretary may not

make a Federal capital contribution for purposes of subsection (a)

for a fiscal year unless the health professions school involved

agrees—

(1) to ensure that adequate instruction regarding minority

health issues is provided for in the curricula of the school;

(2) with respect to health clinics providing services to a

significant number of individuals who are from disadvantaged

backgrounds, including members of minority groups, to enter

into arrangements with 1 or more such clinics for the purpose

of providing students of the school with experience in providing

clinical services to such individuals;

(3) with respect to public or nonprofit private secondary

educational institutions and undergraduate institutions of

higher education, to enter into arrangements with 1 or more

such institutions for the purpose of carrying out programs re-

garding the educational preparation of disadvantaged students,

including minority students, to enter the health professions

and regarding the recruitment of such individuals into the

health professions;

(4) to establish a mentor program for assisting disadvan-

taged students, including minority students, regarding the

completion of the educational requirements for degrees from

the school;

(5) to be carrying out each of the activities specified in any

of paragraphs (1) through (4) by not later than 1 year after the

date on which the first Federal capital contribution is made to

the school for purposes of subsection (a); and

(6) to continue carrying out such activities, and the activi-

ties specified in paragraphs (1) and (2) of subsection (b),

throughout the period during which the student loan fund es-

tablished pursuant to section 721(b) is in operation.

(d) A

VAILABILITY OF

THER

MOUNTS

.—With respect to Federal

capital contributions to student loan funds under agreements

under section 721(b), any such contributions made before October

1, 1990, together with the school contributions appropriate under

paragraph (2)(B) of such section to the amount of the Federal cap-

ital contributions, may be utilized for the purpose of making loans

to individuals from disadvantaged backgrounds, subject to section

723(a)(2)(B).

(e) D

EFINITION

.—For purposes of this section, the term ‘‘dis-

advantaged’’, with respect to an individual, shall be defined by the

Secretary.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—

ø(1) Repealed by section 132(b) of Public Law 105–392

(112 Stat. 3575).¿

(2) S

PECIAL CONSIDERATION FOR CERTAIN SCHOOLS

.—In

making Federal capital contributions to student loan funds for

purposes of subsection (a), the Secretary shall give special con-

sideration to health professions schools that have enrollments

of underrepresented minorities above the national average for

health professions schools.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00030 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

31 Sec. 726 PUBLIC HEALTH SERVICE ACT

SEC. 725. ø292u¿ ADMINISTRATIVE PROVISIONS.

The Secretary may agree to modifications of agreements or

loans made under this subpart, and may compromise, waive, or re-

lease any right, title, claim, or demand of the United States arising

or acquired under this subpart.

SEC. 726. ø292v¿ PROVISION BY SCHOOLS OF INFORMATION TO STU-

DENTS.

(a) I

ENERAL

.—With respect to loans made by a school

under this subpart after June 30, 1986, each school, in order to

carry out the provisions of sections 721 and 722, shall, at any time

such school makes such a loan to a student under this subpart,

provide thorough and adequate loan information on loans made

under this subpart to the student. The loan information required

to be provided to the student by this subsection shall include—

(1) the yearly and cumulative maximum amounts that may

be borrowed by the student;

(2) the terms under which repayment of the loan will

begin;

(3) the maximum number of years in which the loan must

be repaid;

(4) the interest rate that will be paid by the borrower and

the minimum amount of the required monthly payment;

(5) the amount of any other fees charged to the borrower

by the lender;

(6) any options the borrower may have for deferral, can-

cellation, prepayment, consolidation, or other refinancing of the

loan;

(7) a definition of default on the loan and a specification

of the consequences which will result to the borrower if the

borrower defaults, including a description of any arrangements

which may be made with credit bureau organizations;

(8) to the extent practicable, the effect of accepting the

loan on the eligibility of the borrower for other forms of stu-

dent assistance; and

(9) a description of the actions that may be taken by the

Federal Government to collect the loan, including a description

of the type of information concerning the borrower that the

Federal Government may disclose to (A) officers, employees, or

agents of the Department of Health and Human Services, (B)

officers, employees, or agents of schools with which the Sec-

retary has an agreement under this subpart, or (C) any other

person involved in the collection of a loan under this subpart.

(b) S

TATEMENT

EGARDING

OAN

.—Each school shall, imme-

diately prior to the graduation from such school of a student who

receives a loan under this subpart after June 30, 1986, provide

such student with a statement specifying—

(1) each amount borrowed by the student under this sub-

part;

(2) the total amount borrowed by the student under this

subpart; and

(3) a schedule for the repayment of the amounts borrowed

under this subpart, including the number, amount, and fre-

quency of payments to be made.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00031 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

32 Sec. 727 PUBLIC HEALTH SERVICE ACT

Title VII does not have sections 729 through 734. See section 102 of Public Law 102–408

(106 Stat. 1994, 2021).

SEC. 727. ø292w¿ PROCEDURES FOR APPEAL OF TERMINATION OF

AGREEMENTS.

In any case in which the Secretary intends to terminate an

agreement with a school under this subpart, the Secretary shall

provide the school with a written notice specifying such intention

and stating that the school may request a formal hearing with re-

spect to such termination. If the school requests such a hearing

within 30 days after the receipt of such notice, the Secretary shall

provide such school with a hearing conducted by an administrative

law judge.

SEC. 728. ø292x¿ DISTRIBUTION OF ASSETS FROM LOAN FUNDS.

(a) D

ISTRIBUTION

FTER

ERMINATION OF

UND

.—If a school

terminates a loan fund established under an agreement pursuant

to section 721(b), or if the Secretary for good cause terminates the

agreement with the school, there shall be a capital distribution as

follows:

(1) The Secretary shall first be paid an amount which

bears the same ratio to such balance in such fund on the date

of termination of the fund as the total amount of the Federal

capital contributions to such fund by the Secretary pursuant to

section 721(b)(2)(A) bears to the total amount in such fund de-

rived from such Federal capital contributions and from funds

deposited therein pursuant to section 721(b)(2)(B).

(2) The remainder of such balance shall be paid to the

school.

(b) P

AYMENT OF

ROPORTIONATE

HARE TO

ECRETARY

.—If a

capital distribution is made under subsection (a), the school in-

volved shall, after the capital distribution, pay to the Secretary, not

less often than quarterly, the same proportionate share of amounts

received by the school in payment of principal or interest on loans

made from the loan fund established pursuant to section 721(b) as

was determined by the Secretary under subsection (a).

SEC. 735.

ø292y¿ GENERAL PROVISIONS.

(a) D

ATE

ERTAIN FOR

PPLICATIONS

.—The Secretary shall

from time to time set dates by which schools must file applications

for Federal capital contributions.

(b) C

ONTINGENT

EDUCTION IN

LLOTMENTS

.—If the total of

the amounts requested for any fiscal year in such applications ex-

ceeds the amounts appropriated under this section for that fiscal

year, the allotment to the loan fund of each such school shall be

reduced to whichever of the following is the smaller: (A) the

amount requested in its application; or (B) an amount which bears

the same ratio to the amounts appropriated as the number of stu-

dents estimated by the Secretary to be enrolled in such school dur-

ing such fiscal year bears to the estimated total number of students

in all such schools during such year. Amounts remaining after al-

lotment under the preceding sentence shall be reallotted in accord-

ance with clause (B) of such sentence among schools whose applica-

tions requested more than the amounts so allotted to their loan

funds, but with such adjustments as may be necessary to prevent

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00032 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

33 Sec. 735 PUBLIC HEALTH SERVICE ACT

the total allotted to any such school’s loan fund from exceeding the

total so requested by it.

LLOTMENT OF

XCESS

UNDS

.—Funds available in any fis-

cal year for payment to schools under this subpart which are in ex-

cess of the amount appropriated pursuant to this section for that

year shall be allotted among schools in such manner as the Sec-

retary determines will best carry out the purposes of this subpart.

(d) P

AYMENT OF

NSTALLMENTS TO

CHOOLS

.—Allotments to a

loan fund of a school shall be paid to it from time to time in such

installments as the Secretary determines will not result in unnec-

essary accumulations in the loan fund at such school.

(e) D

ISPOSITION OF

UNDS

ETURNED TO

ECRETARY

.—

(1) E

XPENDITURE FOR FEDERAL CAPITAL CONTRIBUTIONS

.—

Subject to section 723(b)(5), any amounts from student loan

funds under section 721 that are returned to the Secretary by

health professions schools shall be expended to make Federal

capital contributions to such funds.

(2) D

ATE CERTAIN FOR CONTRIBUTIONS

.—Amounts de-

scribed in paragraph (1) that are returned to the Secretary

shall be obligated before the end of the succeeding fiscal year.

(3) P

REFERENCE IN MAKING CONTRIBUTIONS

.—In making

Federal capital contributions to student loans funds under sec-

tion 721 for a fiscal year from amounts described in paragraph

(1), the Secretary shall give preference to health professions

schools of the same disciplines as the health professions

schools returning such amounts for the period during which

the amounts expended for such contributions were received by

the Secretary. Any such amounts that, prior to being so re-

turned, were available only for the purpose of loans under this

subpart to individuals from disadvantaged backgrounds shall

be available only for such purpose.

(f) F

UNDING FOR

ERTAIN

EDICAL

CHOOLS

.—

(1) A

UTHORIZATION OF APPROPRIATIONS

.—For the purpose

of making Federal capital contributions to student loan funds

established under section 721 by schools of medicine or osteo-

pathic medicine, there is authorized to be appropriated

$10,000,000 for each of the fiscal years 1994 through 1996.

(2) M

INIMUM REQUIREMENTS

.—

(A) Subject to subparagraph (B), the Secretary may

make a Federal capital contribution pursuant to paragraph

(1) only if the school of medicine or osteopathic medicine

involved meets the conditions described in subparagraph

(A) of section 723(b)(2) or the conditions described in sub-

paragraph (C) of such section.

(B) For purposes of subparagraph (A), the conditions

referred to in such subparagraph shall be applied with re-

spect to graduates of the school involved whose date of

graduation occurred approximately 3 years before June 30

of the fiscal year preceding the fiscal year for which the

Federal capital contribution involved is made.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00033 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

34 Sec. 736 PUBLIC HEALTH SERVICE ACT

PART B—HEALTH PROFESSIONS TRAINING

FOR DIVERSITY

SEC. 736. ø293¿ CENTERS OF EXCELLENCE.

(a) I

ENERAL

.—The Secretary shall make grants to, and

enter into contracts with, designated health professions schools de-

scribed in subsection (c), and other public and nonprofit health or

educational entities, for the purpose of assisting the schools in sup-

porting programs of excellence in health professions education for

under-represented minority individuals.

(b) R

EQUIRED

SE OF

UNDS

.—The Secretary may not make a

grant under subsection (a) unless the designated health professions

school involved agrees, subject to subsection (c)(1)(C), to expend the

grant—

(1) to develop a large competitive applicant pool through

linkages with institutions of higher education, local school dis-

tricts, and other community-based entities and establish an

education pipeline for health professions careers;

(2) to establish, strengthen, or expand programs to en-

hance the academic performance of under-represented minority

students attending the school;

(3) to improve the capacity of such school to train, recruit,

and retain under-represented minority faculty including the

payment of such stipends and fellowships as the Secretary may

determine appropriate;

(4) to carry out activities to improve the information re-

sources, clinical education, curricula and cultural competence

of the graduates of the school, as it relates to minority health

issues;

(5) to facilitate faculty and student research on health

issues particularly affecting under-represented minority

groups, including research on issues relating to the delivery of

health care;

(6) to carry out a program to train students of the school

in providing health services to a significant number of under-

represented minority individuals through training provided to

such students at community-based health facilities that—

(A) provide such health services; and

(B) are located at a site remote from the main site of

the teaching facilities of the school; and

(7) to provide stipends as the Secretary determines appro-

priate, in amounts as the Secretary determines appropriate.

ENTERS OF

XCELLENCE

.—

(1) D

ESIGNATED SCHOOLS

.—

(A) I

N GENERAL

.—The designated health professions

schools referred to in subsection (a) are such schools that

meet each of the conditions specified in subparagraphs (B)

and (C), and that—

(i) meet each of the conditions specified in para-

graph (2)(A);

(ii) meet each of the conditions specified in para-

graph (3);

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00034 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

35 Sec. 736 PUBLIC HEALTH SERVICE ACT

(iii) meet each of the conditions specified in para-

graph (4); or

(iv) meet each of the conditions specified in para-

graph (5).

(B) G

ENERAL CONDITIONS

.—The conditions specified in

this subparagraph are that a designated health professions

school—

(i) has a significant number of under-represented

minority individuals enrolled in the school, including

individuals accepted for enrollment in the school;

(ii) has been effective in assisting under-rep-

resented minority students of the school to complete

the program of education and receive the degree in-

volved;

(iii) has been effective in recruiting under-rep-

resented minority individuals to enroll in and grad-

uate from the school, including providing scholarships

and other financial assistance to such individuals and

encouraging under-represented minority students from

all levels of the educational pipeline to pursue health

professions careers; and

(iv) has made significant recruitment efforts to in-

crease the number of under-represented minority indi-

viduals serving in faculty or administrative positions

at the school.

ONSORTIUM

.—The condition specified in this sub-

paragraph is that, in accordance with subsection (e)(1), the

designated health profession school involved has with

other health profession schools (designated or otherwise)

formed a consortium to carry out the purposes described in

subsection (b) at the schools of the consortium.

(D) A

PPLICATION OF CRITERIA TO OTHER PROGRAMS

.—In

the case of any criteria established by the Secretary for

purposes of determining whether schools meet the condi-

tions described in subparagraph (B), this section may not,

with respect to racial and ethnic minorities, be construed

to authorize, require, or prohibit the use of such criteria in

any program other than the program established in this

section.

(2) C

ENTERS OF EXCELLENCE AT CERTAIN HISTORICALLY

BLACK COLLEGES AND UNIVERSITIES

.—

(A) C

ONDITIONS

.—The conditions specified in this sub-

paragraph are that a designated health professions

school—

(i) is a school described in section 799B(1); and

(ii) received a contract under section 788B for fis-

cal year 1987, as such section was in effect for such

fiscal year.

(B) U

SE OF GRANT

.—In addition to the purposes de-

scribed in subsection (b), a grant under subsection (a) to

a designated health professions school meeting the condi-

tions described in subparagraph (A) may be expended—

(i) to develop a plan to achieve institutional im-

provements, including financial independence, to en-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00035 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

36 Sec. 736 PUBLIC HEALTH SERVICE ACT

So in law. Probably should read ‘‘paragraph (2) or (5)’’.

able the school to support programs of excellence in

health professions education for under-represented mi-

nority individuals; and

(ii) to provide improved access to the library and

informational resources of the school.

XCEPTION

.—The requirements of paragraph (1)(C)

shall not apply to a historically black college or university

that receives funding under paragraphs (2) or (5)

(3) H

ISPANIC CENTERS OF EXCELLENCE

.—The conditions

specified in this paragraph are that—

(A) with respect to Hispanic individuals, each of

clauses (i) through (iv) of paragraph (1)(B) applies to the

designated health professions school involved;

(B) the school agrees, as a condition of receiving a

grant under subsection (a), that the school will, in carrying

out the duties described in subsection (b), give priority to

carrying out the duties with respect to Hispanic individ-

uals; and

grant under subsection (a), that—

(i) the school will establish an arrangement with

1 or more public or nonprofit community based His-

panic serving organizations, or public or nonprofit pri-

vate institutions of higher education, including schools

of nursing, whose enrollment of students has tradi-

tionally included a significant number of Hispanic in-

dividuals, the purposes of which will be to carry out a

program—

(I) to identify Hispanic students who are in-

terested in a career in the health profession in-

volved; and

(II) to facilitate the educational preparation of

such students to enter the health professions

school; and

(ii) the school will make efforts to recruit Hispanic

students, including students who have participated in

the undergraduate or other matriculation program

carried out under arrangements established by the

school pursuant to clause (i)(II) and will assist His-

panic students regarding the completion of the edu-

cational requirements for a degree from the school.

(4) N

ATIVE AMERICAN CENTERS OF EXCELLENCE

.—Subject to

subsection (e), the conditions specified in this paragraph are

that—

(A) with respect to Native Americans, each of clauses

(i) through (iv) of paragraph (1)(B) applies to the des-

ignated health professions school involved;

(B) the school agrees, as a condition of receiving a

grant under subsection (a), that the school will, in carrying

out the duties described in subsection (b), give priority to

carrying out the duties with respect to Native Americans;

and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00036 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

37 Sec. 736 PUBLIC HEALTH SERVICE ACT

grant under subsection (a), that—

(i) the school will establish an arrangement with

1 or more public or nonprofit private institutions of

higher education, including schools of nursing, whose

enrollment of students has traditionally included a

significant number of Native Americans, the purpose

of which arrangement will be to carry out a program—

(I) to identify Native American students, from

the institutions of higher education referred to in

clause (i), who are interested in health professions

careers; and

(II) to facilitate the educational preparation of

such students to enter the designated health pro-

fessions school; and

(ii) the designated health professions school will

make efforts to recruit Native American students, in-

cluding students who have participated in the under-

graduate program carried out under arrangements es-

tablished by the school pursuant to clause (i) and will

assist Native American students regarding the comple-

tion of the educational requirements for a degree from

the designated health professions school.

(5) O

THER CENTERS OF EXCELLENCE

.—The conditions speci-

fied in this paragraph are—

(A) with respect to other centers of excellence, the con-

ditions described in clauses (i) through (iv) of paragraph

(1)(B); and

(B) that the health professions school involved has an

enrollment of under-represented minorities above the na-

tional average for such enrollments of health professions

schools.

(d) D

ESIGNATION AS

ENTER OF

XCELLENCE

.—

(1) I

N GENERAL

.—Any designated health professions school

receiving a grant under subsection (a) and meeting the condi-

tions described in paragraph (2) or (5) of subsection (c) shall,

for purposes of this section, be designated by the Secretary as

a Center of Excellence in Under-Represented Minority Health

Professions Education.

(2) H

ISPANIC CENTERS OF EXCELLENCE

.—Any designated

health professions school receiving a grant under subsection (a)

and meeting the conditions described in subsection (c)(3) shall,

for purposes of this section, be designated by the Secretary as

a Hispanic Center of Excellence in Health Professions Edu-

cation.

(3) N

ATIVE AMERICAN CENTERS OF EXCELLENCE

.—Any des-

ignated health professions school receiving a grant under sub-

section (a) and meeting the conditions described in subsection

(c)(4) shall, for purposes of this section, be designated by the

Secretary as a Native American Center of Excellence in Health

Professions Education. Any consortium receiving such a grant

pursuant to subsection (e) shall, for purposes of this section, be

so designated.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00037 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

38 Sec. 736 PUBLIC HEALTH SERVICE ACT

(e) A

UTHORITY

EGARDING

ATIVE

MERICAN

ENTERS OF

CELLENCE

.—With respect to meeting the conditions specified in

subsection (c)(4), the Secretary may make a grant under subsection

(a) to a designated health professions school that does not meet

such conditions if—

(1) the school has formed a consortium in accordance with

subsection (d)(1); and

(2) the schools of the consortium collectively meet such

conditions, without regard to whether the schools individually

meet such conditions.

(f) D

URATION OF

RANT

.—The period during which payments

are made under a grant under subsection (a) may not exceed 5

years. Such payments shall be subject to annual approval by the

Secretary and to the availability of appropriations for the fiscal

year involved to make the payments.

(g) D

EFINITIONS

.—In this section:

(1) D

ESIGNATED HEALTH PROFESSIONS SCHOOL

.—

(A) I

N GENERAL

.—The term ‘‘health professions school’’

means, except as provided in subparagraph (B), a school of

medicine, a school of osteopathic medicine, a school of den-

tistry, a school of pharmacy, or a graduate program in be-

havioral or mental health.

(B) E

XCEPTION

.—The definition established in sub-

paragraph (A) shall not apply to the use of the term ‘‘des-

ignated health professions school’’ for purposes of sub-

section (c)(2).

(2) P

ROGRAM OF EXCELLENCE

.—The term ‘‘program of ex-

cellence’’ means any program carried out by a designated

health professions school with a grant made under subsection

(a), if the program is for purposes for which the school involved

is authorized in subsection (b) or (c) to expend the grant.

(3) N

ATIVE AMERICANS

.—The term ‘‘Native Americans’’

means American Indians, Alaskan Natives, Aleuts, and Native

Hawaiians.

(h) F

ORMULA FOR

LLOCATIONS

.—

(1) A

LLOCATIONS

.—Based on the amount appropriated

under subsection (i) for a fiscal year, the following subpara-

graphs shall apply as appropriate:

(A) I

N GENERAL

.—If the amounts appropriated under

subsection (i) for a fiscal year are $24,000,000 or less—

(i) the Secretary shall make available $12,000,000

for grants under subsection (a) to health professions

schools that meet the conditions described in sub-

section (c)(2)(A); and

(ii) and available after grants are made with

funds under clause (i), the Secretary shall make avail-

able—

(I) 60 percent of such amount for grants

under subsection (a) to health professions schools

that meet the conditions described in paragraph

(3) or (4) of subsection (c) (including meeting the

conditions under subsection (e)); and

(II) 40 percent of such amount for grants

under subsection (a) to health professions schools

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00038 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

39 Sec. 736 PUBLIC HEALTH SERVICE ACT

that meet the conditions described in subsection

(c)(5).

(B) F

UNDING IN EXCESS OF $24

000

.—If amounts ap-

propriated under subsection (i) for a fiscal year exceed

$24,000,000 but are less than $30,000,000—

(i) 80 percent of such excess amounts shall be

made available for grants under subsection (a) to

health professions schools that meet the requirements

described in paragraph (3) or (4) of subsection (c) (in-

cluding meeting conditions pursuant to subsection (e));

and

(ii) 20 percent of such excess amount shall be

made available for grants under subsection (a) to

health professions schools that meet the conditions de-

scribed in subsection (c)(5).

UNDING IN EXCESS OF $30

000

.—If amounts ap-

propriated under subsection (i) for a fiscal year exceed

$30,000,000 but are less than $40,000,000, the Secretary

shall make available—

(i) not less than $12,000,000 for grants under sub-

section (a) to health professions schools that meet the

conditions described in subsection (c)(2)(A);

(ii) not less than $12,000,000 for grants under

subsection (a) to health professions schools that meet

the conditions described in paragraph (3) or (4) of sub-

section (c) (including meeting conditions pursuant to

subsection (e));

(iii) not less than $6,000,000 for grants under sub-

section (a) to health professions schools that meet the

conditions described in subsection (c)(5); and

(iv) after grants are made with funds under

clauses (i) through (iii), any remaining excess amount

for grants under subsection (a) to health professions

schools that meet the conditions described in para-

graph (2)(A), (3), (4), or (5) of subsection (c).

(D) F

UNDING IN EXCESS OF $40

000

.—If amounts ap-

propriated under subsection (i) for a fiscal year are

$40,000,000 or more, the Secretary shall make available—

(i) not less than $16,000,000 for grants under sub-

section (a) to health professions schools that meet the

conditions described in subsection (c)(2)(A);

(ii) not less than $16,000,000 for grants under

subsection (a) to health professions schools that meet

the conditions described in paragraph (3) or (4) of sub-

section (c) (including meeting conditions pursuant to

subsection (e));

(iii) not less than $8,000,000 for grants under sub-

section (a) to health professions schools that meet the

conditions described in subsection (c)(5); and

(iv) after grants are made with funds under

clauses (i) through (iii), any remaining funds for

grants under subsection (a) to health professions

schools that meet the conditions described in para-

graph (2)(A), (3), (4), or (5) of subsection (c).

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00039 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

40 Sec. 737 PUBLIC HEALTH SERVICE ACT

(2) N

O LIMITATION

.—Nothing in this subsection shall be

construed as limiting the centers of excellence referred to in

this section to the designated amount, or to preclude such enti-

ties from competing for grants under this section.

(3) M

AINTENANCE OF EFFORT

.—

(A) I

N GENERAL

.—With respect to activities for which

a grant made under this part are authorized to be ex-

pended, the Secretary may not make such a grant to a cen-

ter of excellence for any fiscal year unless the center

agrees to maintain expenditures of non-Federal amounts

for such activities at a level that is not less than the level

of such expenditures maintained by the center for the fis-

cal year preceding the fiscal year for which the school re-

ceives such a grant.

(B) U

SE OF FEDERAL FUNDS

.—With respect to any Fed-

eral amounts received by a center of excellence and avail-

able for carrying out activities for which a grant under this

part is authorized to be expended, the center shall, before

expending the grant, expend the Federal amounts obtained

from sources other than the grant, unless given prior ap-

proval from the Secretary.

(i) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there is authorized to be appropriated $23,711,000 for each of

fiscal years 2021 through 2025.

SEC. 737. ø293a¿ SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.

(a) I

ENERAL

.—The Secretary may make a grant to an eligi-

ble entity (as defined in subsection (d)(1)) under this section for the

awarding of scholarships by schools to any full-time student who

is an eligible individual as defined in subsection (d). Such scholar-

ships may be expended only for tuition expenses, other reasonable

educational expenses, and reasonable living expenses incurred in

the attendance of such school.

(b) P

REFERENCE IN

ROVIDING

CHOLARSHIPS

.—The Secretary

may not make a grant to an entity under subsection (a) unless the

health professions and nursing schools involved agree that, in pro-

viding scholarships pursuant to the grant, the schools will give

preference to students for whom the costs of attending the schools

would constitute a severe financial hardship and, notwithstanding

other provisions of this section, to former recipients of scholarships

under sections 736 and 740(d)(2)(B) (as such sections existed on the

day before the date of enactment of this section).

MOUNT OF

WARD

.—In awarding grants to eligible entities

that are health professions and nursing schools, the Secretary shall

give priority to eligible entities based on the proportion of grad-

uating students going into primary care, the proportion of under-

represented minority students, and the proportion of graduates

working in medically underserved communities.

(d) D

EFINITIONS

.—In this section:

(1) E

LIGIBLE ENTITIES

.—The term ‘‘eligible entities’’ means

an entity that—

(A) is a school of medicine, osteopathic medicine, den-

tistry, nursing (as defined in section 801), pharmacy,

podiatric medicine, optometry, veterinary medicine, public

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00040 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

41 Sec. 738 PUBLIC HEALTH SERVICE ACT

health, chiropractic, or allied health, a school offering a

graduate program in behavioral and mental health prac-

tice, or an entity providing programs for the training of

physician assistants; and

(B) is carrying out a program for recruiting and retain-

ing students from disadvantaged backgrounds, including

students who are members of racial and ethnic minority

groups.

(2) E

LIGIBLE INDIVIDUAL

.—The term ‘‘eligible individual’’

means an individual who—

(A) is from a disadvantaged background;

(B) has a financial need for a scholarship; and

ble health professions or nursing school as a full-time stu-

dent in a program leading to a degree in a health profes-

sion or nursing.

SEC. 738. ø293b¿ LOAN REPAYMENTS AND FELLOWSHIPS REGARDING

FACULTY POSITIONS.

(a) L

OAN

EPAYMENTS

.—

(1) E

STABLISHMENT OF PROGRAM

.—The Secretary shall es-

tablish a program of entering into contracts with individuals

described in paragraph (2) under which the individuals agree

to serve as members of the faculties of schools described in

paragraph (3) in consideration of the Federal Government

agreeing to pay, for each year of such service, not more than

$30,000 of the principal and interest of the educational loans

of such individuals.

(2) E

LIGIBLE INDIVIDUALS

.—The individuals referred to in

paragraph (1) are individuals from disadvantaged backgrounds

who—

(A) have a degree in medicine, osteopathic medicine,

dentistry, nursing, or another health profession;

(B) are enrolled in an approved graduate training pro-

gram in medicine, osteopathic medicine, dentistry, nursing,

or other health profession; or

(i) in an accredited (as determined by the Sec-

retary) school described in paragraph (3); and

(ii) in the final year of a course of a study or pro-

gram, offered by such institution and approved by the

Secretary, leading to a degree from such a school.

(3) E

LIGIBLE HEALTH PROFESSIONS SCHOOLS

.—The schools

described in this paragraph are schools of medicine, nursing

(as schools of nursing are defined in section 801), osteopathic

medicine, dentistry, pharmacy, allied health, podiatric medi-

cine, optometry, veterinary medicine, or public health, schools

offering physician assistant education programs, or schools of-

fering graduate programs in behavioral and mental health.

(4) R

EQUIREMENTS REGARDING FACULTY POSITIONS

.—The

Secretary may not enter into a contract under paragraph (1)

unless—

(A) the individual involved has entered into a contract

with a school described in paragraph (3) to serve as a

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00041 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

42 Sec. 738 PUBLIC HEALTH SERVICE ACT

member of the faculty of the school for not less than 2

years; and

(B) the contract referred to in subparagraph (A) pro-

vides that—

(i) the school will, for each year for which the indi-

vidual will serve as a member of the faculty under the

contract with the school, make payments of the prin-

cipal and interest due on the educational loans of the

individual for such year in an amount equal to the

amount of such payments made by the Secretary for

the year;

(ii) the payments made by the school pursuant to

clause (i) on behalf of the individual will be in addition

to the pay that the individual would otherwise receive

for serving as a member of such faculty; and

(iii) the school, in making a determination of the

amount of compensation to be provided by the school

to the individual for serving as a member of the fac-

ulty, will make the determination without regard to

the amount of payments made (or to be made) to the

individual by the Federal Government under para-

graph (1).

(5) A

PPLICABILITY OF CERTAIN PROVISIONS

.—The provisions

of sections 338C, 338G, and 338I shall apply to the program

established in paragraph (1) to the same extent and in the

same manner as such provisions apply to the National Health

Service Corps Loan Repayment Program established in subpart

III of part D of title III, including the applicability of provi-

sions regarding reimbursements for increased tax liability and

regarding bankruptcy.

(6) W

AIVER REGARDING SCHOOL CONTRIBUTIONS

.—The Sec-

retary may waive the requirement established in paragraph

(4)(B) if the Secretary determines that the requirement will

impose an undue financial hardship on the school involved.

(b) F

ELLOWSHIPS

.—

(1) I

N GENERAL

.—The Secretary may make grants to and

enter into contracts with eligible entities to assist such entities

in increasing the number of underrepresented minority individ-

uals who are members of the faculty of such schools.

(2) A

PPLICATIONS

.—To be eligible to receive a grant or con-

tract under this subsection, an entity shall provide an assur-

ance, in the application submitted by the entity, that—

(A) amounts received under such a grant or contract

will be used to award a fellowship to an individual only if

the individual meets the requirements of paragraphs (3)

and (4); and

(B) each fellowship awarded pursuant to the grant or

contract will include—

(i) a stipend in an amount not exceeding 50 per-

cent of the regular salary of a similar faculty member

for not to exceed 3 years of training; and

(ii) an allowance for other expenses, such as travel

to professional meetings and costs related to special-

ized training.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00042 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

43 Sec. 739 PUBLIC HEALTH SERVICE ACT

(3) E

LIGIBILITY

.—To be eligible to receive a grant or con-

tract under paragraph (1), an applicant shall demonstrate to

the Secretary that such applicant has or will have the ability

to—

(A) identify, recruit and select underrepresented mi-

nority individuals who have the potential for teaching, ad-

ministration, or conducting research at a health profes-

sions institution;

(B) provide such individuals with the skills necessary

to enable them to secure a tenured faculty position at such

institution, which may include training with respect to

pedagogical skills, program administration, the design and

conduct of research, grants writing, and the preparation of

articles suitable for publication in peer reviewed journals;

in their preparation for an academic career, including the

provision of counselors; and

(D) provide health services to rural or medically un-

derserved populations.

(4) R

EQUIREMENTS

.—To be eligible to receive a grant or

contract under paragraph (1) an applicant shall—

(A) provide an assurance that such applicant will

make available (directly through cash donations) $1 for

every $1 of Federal funds received under this section for

the fellowship;

(B) provide an assurance that institutional support

will be provided for the individual for the second and third

years at a level that is equal to the total amount of institu-

tional funds provided in the year in which the grant or

contract was awarded;

receive the fellowship will be a member of the faculty of

the applicant school; and

(D) provide an assurance that the individual that will

receive the fellowship will have, at a minimum, appro-

priate advanced preparation (such as a master’s or doc-

toral degree) and special skills necessary to enable such in-

dividual to teach and practice.

(5) D

EFINITION

.—For purposes of this subsection, the term

‘‘underrepresented minority individuals’’ means individuals

who are members of racial or ethnic minority groups that are

underrepresented in the health professions including nursing.

SEC. 739. ø293c¿ EDUCATIONAL ASSISTANCE IN THE HEALTH PROFES-

SIONS REGARDING INDIVIDUALS FROM DISADVANTAGED

BACKGROUNDS.

(a) I

ENERAL

.—

(1) A

UTHORITY FOR GRANTS

.—For the purpose of assisting

individuals from disadvantaged backgrounds, as determined in

accordance with criteria prescribed by the Secretary, to under-

take education to enter a health profession, the Secretary may

make grants to and enter into contracts with schools of medi-

cine, osteopathic medicine, public health, dentistry, veterinary

medicine, optometry, pharmacy, allied health, chiropractic, and

podiatric medicine, public and nonprofit private schools that

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00043 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

44 Sec. 739 PUBLIC HEALTH SERVICE ACT

offer graduate programs in behavioral and mental health, pro-

grams for the training of physician assistants, and other public

or private nonprofit health or educational entities to assist in

meeting the costs described in paragraph (2).

(2) A

UTHORIZED EXPENDITURES

.—A grant or contract under

paragraph (1) may be used by the entity to meet the cost of—

(A) identifying, recruiting, and selecting individuals

from disadvantaged backgrounds, as so determined, for

education and training in a health profession;

(B) facilitating the entry of such individuals into such

a school;

designed to assist such individuals to complete successfully

their education at such a school;

(D) providing, for a period prior to the entry of such

individuals into the regular course of education of such a

school, preliminary education and health research training

designed to assist them to complete successfully such reg-

ular course of education at such a school, or referring such

individuals to institutions providing such preliminary edu-

cation;

(E) publicizing existing sources of financial aid avail-

able to students in the education program of such a school

or who are undertaking training necessary to qualify them

to enroll in such a program;

(F) paying such scholarships as the Secretary may de-

termine for such individuals for any period of health pro-

fessions education at a health professions school;

(G) paying such stipends as the Secretary may ap-

prove for such individuals for any period of education in

student-enhancement programs (other than regular

courses), except that such a stipend may not be provided

to an individual for more than 12 months, and such a sti-

pend shall be in an amount determined appropriate by the

Secretary (notwithstanding any other provision of law re-

garding the amount of stipends);

(H) carrying out programs under which such individ-

uals gain experience regarding a career in a field of pri-

mary health care through working at facilities of public or

private nonprofit community-based providers of primary

health services; and

(I) conducting activities to develop a larger and more

competitive applicant pool through partnerships with insti-

tutions of higher education, school districts, and other

community-based entities.

(3) D

EFINITION

.—In this section, the term ‘‘regular course

of education of such a school’’ as used in subparagraph (D) in-

cludes a graduate program in behavioral or mental health.

(b) R

EQUIREMENTS FOR

WARDS

.—In making awards to eligible

entities under subsection (a)(1), the Secretary shall give preference

to approved applications for programs that involve a comprehensive

approach by several public or nonprofit private health or edu-

cational entities to establish, enhance and expand educational pro-

grams that will result in the development of a competitive appli-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00044 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

45 Sec. 740 PUBLIC HEALTH SERVICE ACT

cant pool of individuals from disadvantaged backgrounds who de-

sire to pursue health professions careers. In considering awards for

such a comprehensive partnership approach, the following shall

apply with respect to the entity involved:

(1) The entity shall have a demonstrated commitment to

such approach through formal agreements that have common

objectives with institutions of higher education, school dis-

tricts, and other community-based entities.

(2) Such formal agreements shall reflect the coordination

of educational activities and support services, increased link-

ages, and the consolidation of resources within a specific geo-

graphic area.

(3) The design of the educational activities involved shall

provide for the establishment of a competitive health profes-

sions applicant pool of individuals from disadvantaged back-

grounds by enhancing the total preparation (academic and so-

cial) of such individuals to pursue a health professions career.

(4) The programs or activities under the award shall focus

on developing a culturally competent health care workforce

that will serve the unserved and underserved populations

within the geographic area.

QUITABLE

LLOCATION OF

INANCIAL

SSISTANCE

.—The

Secretary, to the extent practicable, shall ensure that services and

activities under subsection (a) are adequately allocated among the

various racial and ethnic populations who are from disadvantaged

backgrounds.

(d) M

ATCHING

EQUIREMENTS

.—The Secretary may require

that an entity that applies for a grant or contract under subsection

(a), provide non-Federal matching funds, as appropriate, to ensure

the institutional commitment of the entity to the projects funded

under the grant or contract. As determined by the Secretary, such

non-Federal matching funds may be provided directly or through

donations from public or private entities and may be in cash or in-

kind, fairly evaluated, including plant, equipment, or services.

SEC. 740. ø293d¿ AUTHORIZATION OF APPROPRIATION.

(a) S

CHOLARSHIPS

.—There are authorized to be appropriated to

carry out section 737, $51,470,000 for each of fiscal years 2021

through 2025. Of the amount appropriated in any fiscal year, the

Secretary shall ensure that not less than 16 percent shall be dis-

tributed to schools of nursing.

(b) L

OAN

EPAYMENTS AND

ELLOWSHIPS

.—For the purpose of

carrying out section 738, there is authorized to be appropriated,

$1,190,000 for each of fiscal years 2021 through 2025.

DUCATIONAL

SSISTANCE IN

EALTH

ROFESSIONS

EGARD

ING

NDIVIDUALS FOR

ISADVANTAGED

ACKGROUNDS

.—For the pur-

pose of grants and contracts under section 739(a)(1), there is au-

thorized to be appropriated $15,000,000 for each of fiscal years

2021 through 2025. The Secretary may use not to exceed 20 per-

cent of the amount appropriated for a fiscal year under this sub-

section to provide scholarships under section 739(a)(2)(F).

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00045 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

46 Sec. 741 PUBLIC HEALTH SERVICE ACT

The amendment made to subsection (d) by section 3401(2)(D) of division A of Public Law

116–136 was carried out to reflect the probable intent of Congress. Such amendment struck ‘‘Not

[L]ater than...’’ and inserted new text, however, it should have been made to strike ‘‘Not later

than...’’.

(d)

EPORT

.—Not later than September 30, 2025, and every

five years thereafter, the Secretary shall prepare and submit to the

Committee on Health, Education, Labor, and Pensions of the Sen-

ate, and the Committee on Energy and Commerce of the House of

Representatives, a report concerning the efforts of the Secretary to

address the need for a representative mix of individuals from his-

torically minority health professions schools, or from institutions or

other entities that historically or by geographic location have a

demonstrated record of training or educating underrepresented mi-

norities, within various health professions disciplines, on peer re-

view councils.

SEC. 741. ø293e¿ GRANTS FOR HEALTH PROFESSIONS EDUCATION.

(a) C

ULTURAL

OMPETENCY

, P

REVENTION

AND

UBLIC

EALTH

AND

NDIVIDUALS

ITH

ISABILITY

RANTS

.—

(1) I

N GENERAL

.—The Secretary, acting through the Ad-

ministrator of the Health Resources and Services Administra-

tion, may make awards of grants, contracts, or cooperative

agreements to public and nonprofit private entities (including

tribal entities) for the development, evaluation, and dissemina-

tion of research, demonstration projects, and model curricula

for cultural competency, prevention, public health proficiency,

reducing health disparities, and aptitude for working with indi-

viduals with disabilities training for use in health professions

schools and continuing education programs, and for other pur-

poses determined as appropriate by the Secretary.

(2) E

LIGIBLE ENTITIES

.—Unless specifically required other-

wise in this title, the Secretary shall accept applications for

grants or contracts under this section from health professions

schools, academic health centers, State or local governments,

or other appropriate public or private nonprofit entities (or con-

sortia of entities, including entities promoting multidisciplinary

approaches) for funding and participation in health professions

training activities. The Secretary may accept applications from

for-profit private entities as determined appropriate by the

Secretary.

(b) C

OLLABORATION

.—In carrying out subsection (a), the Sec-

retary shall collaborate with health professional societies, licensing

and accreditation entities, health professions schools, and experts

in minority health and cultural competency, prevention, and public

health and disability groups, community-based organizations, and

other organizations as determined appropriate by the Secretary.

The Secretary shall coordinate with curricula and research and

demonstration projects developed under section 807.

ISSEMINATION

.—

(1) I

N GENERAL

.—Model curricula developed under this

section shall be disseminated through the Internet Clearing-

house under section 270 and such other means as determined

appropriate by the Secretary.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00046 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

47 Sec. 747 PUBLIC HEALTH SERVICE ACT

(2) E

VALUATION

.—The Secretary shall evaluate the adop-

tion and the implementation of cultural competency, preven-

tion, and public health, and working with individuals with a

disability training curricula, and the facilitate inclusion of

these competency measures in quality measurement systems

as appropriate.

(d) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section such sums as may be

necessary for each of fiscal years 2010 through 2015.

PART C—TRAINING IN FAMILY MEDICINE,

GENERAL INTERNAL MEDICINE, GENERAL

PEDIATRICS, PHYSICIAN ASSISTANTS, GEN-

ERAL DENTISTRY, AND PEDIATRIC DEN-

TISTRY

Subpart I—Medical Training Generally

SEC. 747. ø293k¿ PRIMARY CARE TRAINING AND ENHANCEMENT.

(a) S

UPPORT AND

EVELOPMENT OF

RIMARY

ARE

RAINING

ROGRAMS

.—

(1) I

N GENERAL

.—The Secretary may make grants to, or

enter into contracts with, an accredited public or nonprofit pri-

vate hospital, school of medicine or osteopathic medicine, aca-

demically affiliated physician assistant training program, or a

public or private nonprofit entity which the Secretary has de-

termined is capable of carrying out such grant or contract—

(A) to plan, develop, operate, or participate in an ac-

credited professional training program, including an ac-

credited residency or internship program in the field of

family medicine, general internal medicine, or general pe-

diatrics for medical students, interns, residents, or prac-

ticing physicians as defined by the Secretary;

(B) to provide need-based financial assistance in the

form of traineeships and fellowships to medical students,

interns, residents, practicing physicians, or other medical

personnel, who are participants in any such program, and

who plan to specialize or work in the practice of the fields

defined in subparagraph (A);

training of physicians who plan to teach in family medi-

cine, general internal medicine, or general pediatrics train-

ing programs;

(D) to plan, develop, and operate a program for the

training of physicians teaching in community-based set-

tings;

(E) to provide financial assistance in the form of

traineeships and fellowships to physicians who are partici-

pants in any such programs and who plan to teach or con-

duct research in a family medicine, general internal medi-

cine, or general pediatrics training program;

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00047 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

48 Sec. 747 PUBLIC HEALTH SERVICE ACT

(F) to plan, develop, and operate a physician assistant

education program, and for the training of individuals who

will teach in programs to provide such training;

(G) to plan, develop, and operate a program that iden-

tifies or develops innovative models of providing care, and

trains primary care physicians on such models and in new

competencies, as recommended by the Advisory Committee

on Training in Primary Care Medicine and Dentistry and

the National Health Care Workforce Commission estab-

lished in section 5101 of the Patient Protection and Afford-

able Care Act, which may include—

(i) providing training to primary care physicians

relevant to providing care through patient-centered

medical homes (as defined by the Secretary for pur-

poses of this section);

(ii) developing tools and curricula relevant to pa-

tient-centered medical homes; and

(iii) providing continuing education to primary

care physicians relevant to patient-centered medical

homes; and

(H) to plan, develop, and operate joint degree pro-

grams to provide interdisciplinary and interprofessional

graduate training in public health and other health profes-

sions to provide training in environmental health, infec-

tious disease control, disease prevention and health pro-

motion, epidemiological studies and injury control.

(2) D

URATION OF AWARDS

.—The period during which pay-

ments are made to an entity from an award of a grant or con-

tract under this subsection shall be 5 years.

(3) P

RIORITIES IN MAKING AWARDS

.—In awarding grants or

contracts under paragraph (1), the Secretary may give priority

to qualified applicants that train residents in rural areas, in-

cluding for Tribes or Tribal Organizations in such areas.

(b) C

APACITY

UILDING IN

RIMARY

ARE

.—

(1) I

N GENERAL

.—The Secretary may make grants to or

enter into contracts with accredited schools of medicine or os-

teopathic medicine to establish, maintain, or improve—

(A) academic units or programs that improve clinical

teaching and research in fields defined in subsection

(a)(1)(A); or

(B) programs that integrate academic administrative

units in fields defined in subsection (a)(1)(A) to enhance

interdisciplinary recruitment, training, and faculty devel-

opment.

(2) P

REFERENCE IN MAKING AWARDS UNDER THIS SUB

SECTION

.—In making awards of grants and contracts under

paragraph (1), the Secretary shall give preference to any quali-

fied applicant for such an award that agrees to expend the

award for the purpose of—

(A) establishing academic units or programs in fields

defined in subsection (a)(1)(A); or

(B) substantially expanding such units or programs.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00048 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

49 Sec. 747 PUBLIC HEALTH SERVICE ACT

(3) P

RIORITIES IN MAKING AWARDS

.—In awarding grants or

contracts under paragraph (1), the Secretary shall give priority

to qualified applicants that—

(A) proposes a collaborative project between academic

administrative units of primary care;

(B) proposes innovative approaches to clinical teaching

using models of primary care, such as the patient centered

medical home, team management of chronic disease, and

interprofessional integrated models of health care that in-

corporate transitions in health care settings and integra-

tion physical and mental health provision;

of providers, or that have demonstrated significant im-

provements in the percentage of providers trained, who

enter and remain in primary care practice;

(D) have a record of training individuals who are from

underrepresented minority groups or from a rural or dis-

advantaged background;

(E) provide training in the care of vulnerable popu-

lations such as children, older adults, homeless individ-

uals, victims of abuse or trauma, individuals with mental

health or substance use disorders, individuals with HIV/

AIDS, and individuals with disabilities;

(F) establish formal relationships and submit joint ap-

plications with federally qualified health centers, rural

health clinics, area health education centers, or clinics lo-

cated in underserved areas or that serve underserved pop-

ulations;

(G) teach trainees the skills to provide interprofes-

sional, integrated care through collaboration among health

professionals;

(H) provide training in enhanced communication with

patients, evidence-based practice, chronic disease manage-

ment, preventive care, health information technology, or

other competencies as recommended by the Advisory Com-

mittee on Training in Primary Care Medicine and Den-

tistry and the National Health Care Workforce Commis-

sion established in section 5101 of the Patient Protection

and Affordable Care Act; or

(I) provide training in cultural competency and health

literacy.

(4) D

URATION OF AWARDS

.—The period during which pay-

ments are made to an entity from an award of a grant or con-

tract under this subsection shall be 5 years.

UTHORIZATION OF

PPROPRIATIONS

.—

(1) I

N GENERAL

.—For purposes of carrying out this section

(other than subsection (b)(1)(B)), there are authorized to be ap-

propriated $48,924,000 for each of fiscal years 2021 through

2025.

(2) T

RAINING PROGRAMS

.—Fifteen percent of the amount

appropriated pursuant to paragraph (1) in each such fiscal

year shall be allocated to the physician assistant training pro-

grams described in subsection (a)(1)(F), which prepare students

for practice in primary care.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00049 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

50 Sec. 747A PUBLIC HEALTH SERVICE ACT

(3) I

NTEGRATING ACADEMIC ADMINISTRATIVE UNITS

.—For

purposes of carrying out subsection (b)(1)(B), there are author-

ized to be appropriated $750,000 for each of fiscal years 2010

through 2014.

SEC. 747A. ø293k–1¿ TRAINING OPPORTUNITIES FOR DIRECT CARE

WORKERS.

(a) I

ENERAL

.—The Secretary shall award grants to eligible

entities to enable such entities to provide new training opportuni-

ties for direct care workers who are employed in long-term care set-

tings such as nursing homes (as defined in section 1908(e)(1) of the

Social Security Act (42 U.S.C. 1396g(e)(1)), assisted living facilities

and skilled nursing facilities, intermediate care facilities for indi-

viduals with mental retardation, home and community based set-

tings, and any other setting the Secretary determines to be appro-

priate.

(b) E

LIGIBILITY

.—To be eligible to receive a grant under this

section, an entity shall—

(1) be an institution of higher education (as defined in sec-

tion 102 of the Higher Education Act of 1965 (20 U.S.C. 1002))

that—

(A) is accredited by a nationally recognized accrediting

agency or association listed under section 101(c) of the

Higher Education Act of 1965 (20 U.S.C. 1001(c)); and

(B) has established a public-private educational part-

nership with a nursing home or skilled nursing facility,

agency or entity providing home and community based

services to individuals with disabilities, or other long-term

care provider; and

(2) submit to the Secretary an application at such time, in

such manner, and containing such information as the Sec-

retary may require.

SE OF

UNDS

.—An eligible entity shall use amounts

awarded under a grant under this section to provide assistance to

eligible individuals to offset the cost of tuition and required fees for

enrollment in academic programs provided by such entity.

(d) E

LIGIBLE

NDIVIDUAL

.—

(1) E

LIGIBILITY

.—To be eligible for assistance under this

section, an individual shall be enrolled in courses provided by

a grantee under this subsection and maintain satisfactory aca-

demic progress in such courses.

(2) C

ONDITION OF ASSISTANCE

.—As a condition of receiving

assistance under this section, an individual shall agree that,

following completion of the assistance period, the individual

will work in the field of geriatrics, disability services, long term

services and supports, or chronic care management for a min-

imum of 2 years under guidelines set by the Secretary.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section, $10,000,000 for the pe-

riod of fiscal years 2011 through 2013.

SEC. 748. ø293k–2¿ TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC

HEALTH DENTISTRY.

(a) S

UPPORT AND

EVELOPMENT OF

ENTAL

RAINING

GRAMS

.—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00050 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

51 Sec. 748 PUBLIC HEALTH SERVICE ACT

(1) I

N GENERAL

.—The Secretary may make grants to, or

enter into contracts with, a school of dentistry, public or non-

profit private hospital, or a public or private nonprofit entity

which the Secretary has determined is capable of carrying out

such grant or contract—

(A) to plan, develop, and operate, or participate in, an

approved professional training program in the field of gen-

eral dentistry, pediatric dentistry, or public health den-

tistry for dental students, residents, practicing dentists,

dental hygienists, or other approved primary care dental

trainees, that emphasizes training for general, pediatric, or

public health dentistry;

(B) to provide financial assistance to dental students,

residents, practicing dentists, and dental hygiene students

who are in need thereof, who are participants in any such

program, and who plan to work in the practice of general,

pediatric, public heath dentistry, or dental hygiene;

training of oral health care providers who plan to teach in

general, pediatric, public health dentistry, or dental hy-

giene;

(D) to provide financial assistance in the form of

traineeships and fellowships to dentists who plan to teach

or are teaching in general, pediatric, or public health den-

tistry;

(E) to meet the costs of projects to establish, maintain,

or improve dental faculty development programs in pri-

mary care (which may be departments, divisions or other

units);

(F) to meet the costs of projects to establish, maintain,

or improve predoctoral and postdoctoral training in pri-

mary care programs;

(G) to create a loan repayment program for faculty in

dental programs; and

(H) to provide technical assistance to pediatric train-

ing programs in developing and implementing instruction

regarding the oral health status, dental care needs, and

risk-based clinical disease management of all pediatric

populations with an emphasis on underserved children.

(2) F

ACULTY LOAN REPAYMENT

.—

(A) I

N GENERAL

.—A grant or contract under subsection

(a)(1)(G) may be awarded to a program of general, pedi-

atric, or public health dentistry described in such sub-

section to plan, develop, and operate a loan repayment pro-

gram under which—

(i) individuals agree to serve full-time as faculty

members; and

(ii) the program of general, pediatric or public

health dentistry agrees to pay the principal and inter-

est on the outstanding student loans of the individ-

uals.

(B) M

ANNER OF PAYMENTS

.—With respect to the pay-

ments described in subparagraph (A)(ii), upon completion

by an individual of each of the first, second, third, fourth,

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00051 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

52 Sec. 748 PUBLIC HEALTH SERVICE ACT

and fifth years of service, the program shall pay an

amount equal to 10, 15, 20, 25, and 30 percent, respec-

tively, of the individual’s student loan balance as cal-

culated based on principal and interest owed at the initi-

ation of the agreement.

(b) E

LIGIBLE

NTITY

.—For purposes of this subsection, entities

eligible for such grants or contracts in general, pediatric, or public

health dentistry shall include entities that have programs in dental

or dental hygiene schools, or approved residency or advanced edu-

cation programs in the practice of general, pediatric, or public

health dentistry. Eligible entities may partner with schools of pub-

lic health to permit the education of dental students, residents, and

dental hygiene students for a master’s year in public health at a

school of public health.

RIORITIES IN

AKING

WARDS

.—With respect to training

provided for under this section, the Secretary shall give priority in

awarding grants or contracts to the following:

(1) Qualified applicants that propose collaborative projects

between departments of primary care medicine and depart-

ments of general, pediatric, or public health dentistry.

(2) Qualified applicants that have a record of training the

greatest percentage of providers, or that have demonstrated

significant improvements in the percentage of providers, who

enter and remain in general, pediatric, or public health den-

tistry.

(3) Qualified applicants that have a record of training indi-

viduals who are from a rural or disadvantaged background, or

from underrepresented minorities.

(4) Qualified applicants that establish formal relationships

with Federally qualified health centers, rural health centers, or

accredited teaching facilities and that conduct training of stu-

dents, residents, fellows, or faculty at the center or facility.

(5) Qualified applicants that conduct teaching programs

targeting vulnerable populations such as older adults, home-

less individuals, victims of abuse or trauma, individuals with

mental health or substance use disorders, individuals with dis-

abilities, and individuals with HIV/AIDS, and in the risk-based

clinical disease management of all populations.

(6) Qualified applicants that include educational activities

in cultural competency and health literacy.

(7) Qualified applicants that have a high rate for placing

graduates in practice settings that serve underserved areas or

health disparity populations, or who achieve a significant in-

crease in the rate of placing graduates in such settings.

(8) Qualified applicants that intend to establish a special

populations oral health care education center or training pro-

gram for the didactic and clinical education of dentists, dental

health professionals, and dental hygienists who plan to teach

oral health care for people with developmental disabilities, cog-

nitive impairment, complex medical problems, significant phys-

ical limitations, and vulnerable elderly.

(d) A

PPLICATION

.—An eligible entity desiring a grant under

this section shall submit to the Secretary an application at such

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00052 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

53 Sec. 749 PUBLIC HEALTH SERVICE ACT

So in law. The reference to ‘‘this Act’’ means the Public Health Service Act, which was en-

acted July 1, 1944. Probably should be a reference to the Health Professions Education Partner-

ships Act of 1998, which added section 748. That Act is Public Law 105–392, enacted November

13, 1998. (Section 102(4) of that Public Law (112 Stat. 3539) added section 748.)

time, in such manner, and containing such information as the Sec-

retary may require.

(e) D

URATION OF

WARD

.—The period during which payments

are made to an entity from an award of a grant or contract under

subsection (a) shall be 5 years. The provision of such payments

shall be subject to annual approval by the Secretary and subject to

the availability of appropriations for the fiscal year involved to

make the payments.

(f) A

UTHORIZATIONS OF

PPROPRIATIONS

.—For the purpose of

carrying out subsections (a) and (b), there is authorized to be ap-

propriated $28,531,000 for each of fiscal years 2021 through 2025.

(g) C

ARRYOVER

UNDS

.—An entity that receives an award

under this section may carry over funds from 1 fiscal year to an-

other without obtaining approval from the Secretary. In no case

may any funds be carried over pursuant to the preceding sentence

for more than 3 years.

SEC. 749. ø293l¿ ADVISORY COMMITTEE ON TRAINING IN PRIMARY

CARE MEDICINE AND DENTISTRY.

(a) E

STABLISHMENT

.—The Secretary shall establish an advisory

committee to be known as the Advisory Committee on Training in

Primary Care Medicine and Dentistry (in this section referred to as

the ‘‘Advisory Committee’’).

(b) C

OMPOSITION

.—

(1) I

N GENERAL

.—The Secretary shall determine the appro-

priate number of individuals to serve on the Advisory Com-

mittee. Such individuals shall not be officers or employees of

the Federal Government.

(2) A

PPOINTMENT

.—Not later than 90 days after the date

of enactment of this Act

, the Secretary shall appoint the

members of the Advisory Committee from among individuals

who are health professionals. In making such appointments,

the Secretary shall ensure a fair balance between the health

professions, that at least 75 percent of the members of the Ad-

visory Committee are health professionals, a broad geographic

representation of members and a balance between urban and

rural members. Members shall be appointed based on their

competence, interest, and knowledge of the mission of the pro-

fession involved.

(3) M

INORITY REPRESENTATION

.—In appointing the mem-

bers of the Advisory Committee under paragraph (2), the Sec-

retary shall ensure the adequate representation of women and

minorities.

ERMS

.—

(1) I

N GENERAL

.—A member of the Advisory Committee

shall be appointed for a term of 3 years, except that of the

members first appointed—

(A)

⁄

of such members shall serve for a term of 1

year;

(B)

⁄

of such members shall serve for a term of 2

years; and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00053 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

54 Sec. 749 PUBLIC HEALTH SERVICE ACT

So in law. Probably should be ‘‘Advisory Committee’’. See section 102(4) of Public Law 105–

392 (112 Stat. 3539).

(C)

⁄

of such members shall serve for a term of 3

years.

(2) V

ACANCIES

.—

(A) I

N GENERAL

.—A vacancy on the Advisory Com-

mittee shall be filled in the manner in which the original

appointment was made and shall be subject to any condi-

tions which applied with respect to the original appoint-

ment.

(B) F

ILLING UNEXPIRED TERM

.—An individual chosen

to fill a vacancy shall be appointed for the unexpired term

of the member replaced.

(d) D

UTIES

.—The Advisory Committee shall—

(1) provide advice and recommendations to the Secretary

concerning policy and program development and other matters

of significance concerning the activities under section 747;

(2) not later than 3 years after the date of enactment of

this section, and annually thereafter, prepare and submit to

the Secretary, and 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 describing

the activities of the Committee, including findings and rec-

ommendations made by the Committee concerning the activi-

ties under section 747;

(3) develop, publish, and implement performance measures

for programs under this part;

(4) develop and publish guidelines for longitudinal evalua-

tions (as described in section 761(d)(2)) for programs under this

part; and

(5) recommend appropriation levels for programs under

this part.

(e) M

EETINGS AND

OCUMENTS

.—

(1) M

EETINGS

.—The Advisory Committee shall meet not

less than 2 times each year. Such meetings shall be held joint-

ly with other related entities established under this title where

appropriate.

(2) D

OCUMENTS

.—Not later than 14 days prior to the con-

vening of a meeting under paragraph (1), the Advisory Com-

mittee shall prepare and make available an agenda of the mat-

ters to be considered by the Advisory Committee at such meet-

ing. At any such meeting, the Advisory Council

shall dis-

tribute materials with respect to the issues to be addressed at

the meeting. Not later than 30 days after the adjourning of

such a meeting, the Advisory Committee shall prepare and

make available a summary of the meeting and any actions

taken by the Committee based upon the meeting.

(f) C

OMPENSATION AND

XPENSES

.—

(1) C

OMPENSATION

.—Each member of the Advisory Com-

mittee shall be compensated at a rate equal to the daily equiv-

alent of the annual rate of basic pay prescribed for level IV of

the Executive Schedule under section 5315 of title 5, United

States Code, for each day (including travel time) during which

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00054 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

55 Sec. 749A PUBLIC HEALTH SERVICE ACT

such member is engaged in the performance of the duties of

the Committee.

(2) E

XPENSES

.—The members of the Advisory Committee

shall be allowed travel expenses, including per diem in lieu of

subsistence, at rates authorized for employees of agencies

under subchapter I of chapter 57 of title 5, United States Code,

while away from their homes or regular places of business in

the performance of services for the Committee.

(g) C

HAPTER

ITLE

5, U

NITED

TATES

ODE

.—Chapter 10

of title 5, United States Code, shall apply to the Advisory Com-

mittee under this section only to the extent that the provisions of

chapter 10 of title 5, United States Code, do not conflict with the

requirements of this section.

SEC. 749A. ø293l–1¿ TEACHING HEALTH CENTERS DEVELOPMENT

GRANTS.

(a) P

ROGRAM

UTHORIZED

.—The Secretary may award grants

under this section to teaching health centers for the purpose of es-

tablishing new accredited or expanded primary care residency pro-

grams.

(b) A

MOUNT AND

URATION

.—Grants awarded under this sec-

tion shall be for a term of not more than 3 years and the maximum

award may not be more than $500,000.

SE OF

UNDS

.—Amounts provided under a grant under

this section shall be used to cover the costs of—

(1) establishing or expanding a primary care residency

training program described in subsection (a), including costs

associated with—

(A) curriculum development;

(B) recruitment, training and retention of residents

and faculty:

Graduate Medical Education (ACGME), the American Den-

tal Association (ADA), or the American Osteopathic Asso-

ciation (AOA); and

(D) faculty salaries during the development phase; and

(2) technical assistance provided by an eligible entity.

(d) A

PPLICATION

.—A teaching health center seeking a grant

under this section shall submit an application to the Secretary at

such time, in such manner, and containing such information as the

Secretary may require.

(e) P

REFERENCE FOR

ERTAIN

PPLICATIONS

.—In selecting re-

cipients for grants under this section, the Secretary shall give pref-

erence to any such application that documents an existing affili-

ation agreement with an area health education center program as

defined in sections 751 and 799B.

(f) D

EFINITIONS

.—In this section:

(1) E

LIGIBLE ENTITY

.—The term ‘‘eligible entity’’ means an

organization capable of providing technical assistance includ-

ing an area health education center program as defined in sec-

tions 751 and 799B.

(2) P

RIMARY CARE RESIDENCY PROGRAM

.—The term ‘‘pri-

mary care residency program’’ means an approved graduate

medical residency training program (as defined in section

340H) in family medicine, internal medicine, pediatrics, inter-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00055 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

56 Sec. 749B PUBLIC HEALTH SERVICE ACT

nal medicine-pediatrics, obstetrics and gynecology, psychiatry,

general dentistry, pediatric dentistry, and geriatrics.

(3) T

EACHING HEALTH CENTER

.—

(A) I

N GENERAL

.—The term ‘‘teaching health center’’

means an entity that—

(i) is a community based, ambulatory patient care

center; and

(ii) operates a primary care residency program.

(B) I

NCLUSION OF CERTAIN ENTITIES

.—Such term in-

cludes the following:

(i) A Federally qualified health center (as defined

in section 1905(l)(2)(B), of the Social Security Act).

(ii) A community mental health center (as defined

in section 1861(ff)(3)(B) of the Social Security Act).

(iii) A rural health clinic, as defined in section

1861(aa) of the Social Security Act.

(iv) A health center operated by the Indian Health

Service, an Indian tribe or tribal organization, or an

urban Indian organization (as defined in section 4 of

the Indian Health Care Improvement Act).

(v) An entity receiving funds under title X of the

Public Health Service Act.

(g) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated, $25,000,000 for fiscal year 2010, $50,000,000

for fiscal year 2011, $50,000,000 for fiscal year 2012, and such

sums as may be necessary for each fiscal year thereafter to carry

out this section. Not to exceed $5,000,000 annually may be used for

technical assistance program grants.

Subpart II—Training in Underserved

Communities

SEC. 749B. ø293m¿ RURAL PHYSICIAN TRAINING GRANTS.

(a) I

ENERAL

.—The Secretary, acting through the Adminis-

trator of the Health Resources and Services Administration, shall

establish a grant program for the purposes of assisting eligible en-

tities in recruiting students most likely to practice medicine in un-

derserved rural communities, providing rural-focused training and

experience, and increasing the number of recent allopathic and os-

teopathic medical school graduates who practice in underserved

rural communities.

(b) E

LIGIBLE

NTITIES

.—In order to be eligible to receive a

grant under this section, an entity shall—

(1) be a school of allopathic or osteopathic medicine accred-

ited by a nationally recognized accrediting agency or associa-

tion approved by the Secretary for this purpose, or any com-

bination or consortium of such schools; and

(2) submit an application to the Secretary that includes a

certification that such entity will use amounts provided to the

institution as described in subsection (d)(1).

RIORITY

.—In awarding grant funds under this section, the

Secretary shall give priority to eligible entities that—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00056 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

57 Sec. 749B PUBLIC HEALTH SERVICE ACT

(1) demonstrate a record of successfully training students,

as determined by the Secretary, who practice medicine in un-

derserved rural communities;

(2) demonstrate that an existing academic program of the

eligible entity produces a high percentage, as determined by

the Secretary, of graduates from such program who practice

medicine in underserved rural communities;

(3) demonstrate rural community institutional partner-

ships, through such mechanisms as matching or contributory

funding, documented in-kind services for implementation, or

existence of training partners with interprofessional expertise

in community health center training locations or other similar

facilities; or

(4) submit, as part of the application of the entity under

subsection (b), a plan for the long-term tracking of where the

graduates of such entity practice medicine.

(d) U

SE OF

UNDS

.—

(1) E

STABLISHMENT

.—An eligible entity receiving a grant

under this section shall use the funds made available under

such grant to establish, improve, or expand a rural-focused

training program (referred to in this section as the ‘‘Program’’)

meeting the requirements described in this subsection and to

carry out such program.

(2) S

TRUCTURE OF PROGRAM

.—An eligible entity shall—

(A) enroll no fewer than 10 students per class year

into the Program; and

(B) develop criteria for admission to the Program that

gives priority to students—

(i) who have originated from or lived for a period

of 2 or more years in an underserved rural commu-

nity; and

(ii) who express a commitment to practice medi-

cine in an underserved rural community.

(3) C

URRICULA

.—The Program shall require students to en-

roll in didactic coursework and clinical experience particularly

applicable to medical practice in underserved rural commu-

nities, including—

(A) clinical rotations in underserved rural commu-

nities, and in applicable specialties, or other coursework or

clinical experience deemed appropriate by the Secretary;

and

(B) in addition to core school curricula, additional

coursework or training experiences focused on medical

issues prevalent in underserved rural communities.

(4) R

ESIDENCY PLACEMENT ASSISTANCE

.—Where available,

the Program shall assist all students of the Program in obtain-

ing clinical training experiences in locations with postgraduate

programs offering residency training opportunities in under-

served rural communities, or in local residency training pro-

grams that support and train physicians to practice in under-

served rural communities.

(5) P

ROGRAM STUDENT COHORT SUPPORT

.—The Program

shall provide and require all students of the Program to par-

ticipate in group activities designed to further develop, main-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00057 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

58 Sec. 750 PUBLIC HEALTH SERVICE ACT

tain, and reinforce the original commitment of such students to

practice in an underserved rural community.

(e) A

NNUAL

EPORTING

.—An eligible entity receiving a grant

under this section shall submit an annual report to the Secretary

on the success of the Program, based on criteria the Secretary de-

termines appropriate, including the residency program selection of

graduating students who participated in the Program.

(f) R

EGULATIONS

.—Not later than 60 days after the date of en-

actment of this section, the Secretary shall by regulation define

‘‘underserved rural community’’ for purposes of this section.

(g) S

UPPLEMENT

UPPLANT

.—Any eligible entity receiving

funds under this section shall use such funds to supplement, not

supplant, any other Federal, State, and local funds that would oth-

erwise be expended by such entity to carry out the activities de-

scribed in this section.

(h) M

AINTENANCE OF

FFORT

.—With respect to activities for

which funds awarded under this section are to be expended, the en-

tity shall agree to maintain expenditures of non-Federal amounts

for such activities at a level that is not less than the level of such

expenditures maintained by the entity for the fiscal year preceding

the fiscal year for which the entity receives a grant under this sec-

tion.

(i) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated $4,000,000 for each of the fiscal years 2010

through 2013.

PART D—INTERDISCIPLINARY, COMMUNITY-

BASED LINKAGES

SEC. 750. ø294¿ GENERAL PROVISIONS.

(a) C

OLLABORATION

.—To be eligible to receive assistance under

this part, an academic institution shall use such assistance in col-

laboration with 2 or more disciplines.

(b) A

CTIVITIES

.—An entity shall use assistance under this part

to carry out innovative demonstration projects for strategic work-

force supplementation activities as needed to meet national goals

for interdisciplinary, community-based linkages. Such assistance

may be used consistent with this part—

(1) to develop and support training programs;

(2) for faculty development;

(3) for model demonstration programs;

(4) for the provision of stipends for fellowship trainees;

(5) to provide technical assistance; and

(6) for other activities that will produce outcomes con-

sistent with the purposes of this part.

SEC. 751. ø294a¿ AREA HEALTH EDUCATION CENTERS.

(a) E

STABLISHMENT OF

WARDS

.—The Secretary shall make the

following 2 types of awards in accordance with this section:

(1) I

NFRASTRUCTURE DEVELOPMENT AWARD

.—The Secretary

shall make awards to eligible entities to enable such entities

to initiate health care workforce educational programs or to

continue to carry out comparable programs that are operating

at the time the award is made by planning, developing, oper-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00058 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

59 Sec. 751 PUBLIC HEALTH SERVICE ACT

ating, and evaluating an area health education center pro-

gram.

(2) P

OINT OF SERVICE MAINTENANCE AND ENHANCEMENT

AWARD

.—The Secretary shall make awards to eligible entities

to maintain and improve the effectiveness and capabilities of

an existing area health education center program, and make

other modifications to the program that are appropriate due to

changes in demographics, needs of the populations served, or

other similar issues affecting the area health education center

program. For the purposes of this section, the term ‘‘Program’’

refers to the area health education center program.

(b) E

LIGIBLE

NTITIES

; A

PPLICATION

.—

(1) E

LIGIBLE ENTITIES

.—

(A) I

NFRASTRUCTURE DEVELOPMENT

.—For purposes of

subsection (a)(1), the term ‘‘eligible entity’’ means a school

of medicine or osteopathic medicine, an incorporated con-

sortium of such schools, or the parent institutions of such

a school. With respect to a State in which no area health

education center program is in operation, the Secretary

may award a grant or contract under subsection (a)(1) to

a school of nursing.

(B) P

OINT OF SERVICE MAINTENANCE AND ENHANCE

MENT

.—For purposes of subsection (a)(2), the term ‘‘eligible

entity’’ means an entity that has received funds under this

section, is operating an area health education center pro-

gram, including an area health education center or cen-

ters, and has a center or centers that are no longer eligible

to receive financial assistance under subsection (a)(1).

(2) A

PPLICATION

.—An eligible entity desiring to receive an

award under this section shall submit to the Secretary an ap-

plication at such time, in such manner, and containing such in-

formation as the Secretary may require.

SE OF

UNDS

.—

(1) R

EQUIRED ACTIVITIES

.—An eligible entity shall use

amounts awarded under a grant under subsection (a)(1) or

(a)(2) to carry out the following activities:

(A) Develop and implement strategies, in coordination

with the applicable one-stop delivery system under section

121(e) of the Workforce Innovation and Opportunity Act, to

recruit individuals from underrepresented minority popu-

lations or from disadvantaged or rural backgrounds into

health professions, and support such individuals in attain-

ing such careers.

(B) Develop and implement strategies to foster and

provide community-based training and education to indi-

viduals seeking careers in health professions within under-

served areas for the purpose of developing and maintain-

ing a diverse health care workforce that is prepared to de-

liver high-quality care, with an emphasis on primary care,

in underserved areas or for health disparity populations,

in collaboration with other Federal and State health care

workforce development programs, the State workforce

agency, and local workforce investment boards, and in

health care safety net sites.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00059 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

60 Sec. 751 PUBLIC HEALTH SERVICE ACT

health services to underserved areas and health disparity

populations through field placements or preceptorships in

conjunction with community-based organizations, accred-

ited primary care residency training programs, Federally

qualified health centers, rural health clinics, public health

departments, or other appropriate facilities.

(D) Conduct and participate in interdisciplinary train-

ing that involves physicians, physician assistants, nurse

practitioners, nurse midwives, dentists, psychologists,

pharmacists, optometrists, community health workers,

public and allied health professionals, or other health pro-

fessionals, as practicable.

(E) Deliver or facilitate continuing education and in-

formation dissemination programs for health care profes-

sionals, with an emphasis on individuals providing care in

underserved areas and for health disparity populations.

(F) Propose and implement effective program and out-

comes measurement and evaluation strategies.

(G) Establish a youth public health program to expose

and recruit high school students into health careers, with

a focus on careers in public health.

(2) I

NNOVATIVE OPPORTUNITIES

.—An eligible entity may

use amounts awarded under a grant under subsection (a)(1) or

subsection (a)(2) to carry out any of the following activities:

(A) Develop and implement innovative curricula in col-

laboration with community-based accredited primary care

residency training programs, Federally qualified health

centers, rural health clinics, behavioral and mental health

facilities, public health departments, or other appropriate

facilities, with the goal of increasing the number of pri-

mary care physicians and other primary care providers

prepared to serve in underserved areas and health dis-

parity populations.

(B) Coordinate community-based participatory re-

search with academic health centers, and facilitate rapid

flow and dissemination of evidence-based health care infor-

mation, research results, and best practices to improve

quality, efficiency, and effectiveness of health care and

health care systems within community settings.

identified workforce needs and increase and enhance the

health care workforce in the area served by the area

health education center program.

(d) R

EQUIREMENTS

.—

(1) A

REA HEALTH EDUCATION CENTER PROGRAM

.—In car-

rying out this section, the Secretary shall ensure the following:

(A) An entity that receives an award under this sec-

tion shall conduct at least 10 percent of clinical education

required for medical students in community settings that

are removed from the primary teaching facility of the con-

tracting institution for grantees that operate a school of

medicine or osteopathic medicine. In States in which an

entity that receives an award under this section is a nurs-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00060 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

61 Sec. 751 PUBLIC HEALTH SERVICE ACT

ing school or its parent institution, the Secretary shall al-

ternatively ensure that—

(i) the nursing school conducts at least 10 percent

of clinical education required for nursing students in

community settings that are remote from the primary

teaching facility of the school; and

(ii) the entity receiving the award maintains a

written agreement with a school of medicine or osteo-

pathic medicine to place students from that school in

training sites in the area health education center pro-

gram area.

(B) An entity receiving funds under subsection (a)(2)

does not distribute such funding to a center that is eligible

to receive funding under subsection (a)(1).

(2) A

REA HEALTH EDUCATION CENTER

.—The Secretary shall

ensure that each area health education center program in-

cludes at least 1 area health education center, and that each

such center—

(A) is a public or private organization whose structure,

governance, and operation is independent from the award-

ee and the parent institution of the awardee;

(B) is not a school of medicine or osteopathic medicine,

the parent institution of such a school, or a branch campus

or other subunit of a school of medicine or osteopathic

medicine or its parent institution, or a consortium of such

entities;

served by the center which is in a location removed from

the main location of the teaching facilities of the schools

participating in the program with such center and does not

duplicate, in whole or in part, the geographic area or popu-

lation served by any other center;

(D) fosters networking and collaboration among com-

munities and between academic health centers and com-

munity-based centers;

(E) serves communities with a demonstrated need of

health professionals in partnership with academic medical

centers;

(F) addresses the health care workforce needs of the

communities served in coordination with the public work-

force investment system; and

(G) has a community-based governing or advisory

board that reflects the diversity of the communities in-

volved.

(e) M

ATCHING

UNDS

.—With respect to the costs of operating

a program through a grant under this section, to be eligible for fi-

nancial assistance under this section, an entity shall make avail-

able (directly or through contributions from State, county or munic-

ipal governments, or the private sector) recurring non-Federal con-

tributions in cash or in kind, toward such costs in an amount that

is equal to not less than 50 percent of such costs. At least 25 per-

cent of the total required non-Federal contributions shall be in

cash. An entity may apply to the Secretary for a waiver of not more

than 75 percent of the matching fund amount required by the enti-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00061 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

62 Sec. 751 PUBLIC HEALTH SERVICE ACT

ty for each of the first 3 years the entity is funded through a grant

under subsection (a)(1).

(f) L

IMITATION

.—Not less than 75 percent of the total amount

provided to an area health education center program under sub-

section (a)(1) or (a)(2) shall be allocated to the area health edu-

cation centers participating in the program under this section. To

provide needed flexibility to newly funded area health education

center programs, the Secretary may waive the requirement in the

sentence for the first 2 years of a new area health education center

program funded under subsection (a)(1).

(g) A

WARD

.—An award to an entity under this section shall be

not less than $250,000 annually per area health education center

included in the program involved. If amounts appropriated to carry

out this section are not sufficient to comply with the preceding sen-

tence, the Secretary may reduce the per center amount provided for

in such sentence as necessary, provided the distribution established

in subsection (j)(2) is maintained.

(h) P

ROJECT

ERMS

.—

(1) I

N GENERAL

.—Except as provided in paragraph (2), the

period during which payments may be made under an award

under subsection (a)(1) may not exceed—

(A) in the case of a program, 12 years; or

(B) in the case of a center within a program, 6 years.

(2) E

XCEPTION

.—The periods described in paragraph (1)

shall not apply to programs receiving point of service mainte-

nance and enhancement awards under subsection (a)(2) to

maintain existing centers and activities.

(i) I

NAPPLICABILITY OF

ROVISION

.—Notwithstanding any other

provision of this title, section 791(a) shall not apply to an area

health education center funded under this section.

(j) A

UTHORIZATION OF

PPROPRIATIONS

.—

(1) I

N GENERAL

.—There is authorized to be appropriated to

carry out this section $41,250,000 for each of fiscal years 2021

through 2025.

(2) R

EQUIREMENTS

.—Of the amounts appropriated for a fis-

cal year under paragraph (1)—

(A) not more than 35 percent shall be used for awards

under subsection (a)(1);

(B) not less than 60 percent shall be used for awards

under subsection (a)(2);

and contracts to implement outcomes evaluation for the

area health education centers; and

(D) not more than 4 percent shall be used for grants

and contracts to provide technical assistance to entities re-

ceiving awards under this section.

(3) C

ARRYOVER FUNDS

.—An entity that receives an award

under this section may carry over funds from 1 fiscal year to

another without obtaining approval from the Secretary. In no

case may any funds be carried over pursuant to the preceding

sentence for more than 3 years.

(k) S

ENSE OF

ONGRESS

.—It is the sense of the Congress that

every State have an area health education center program in effect

under this section.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00062 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

63 Sec. 752 PUBLIC HEALTH SERVICE ACT

Section 2227(4) of division (FF) of Public Law 117-328 amends section 752(c) by striking

‘‘by require.’’ and inserting the following: ‘‘may require, including—

(1) a description of how participation in activities funded under this section will help im-

prove access to, and quality of, health care services and training needs of primary care phy-

sicians and health care providers; and

(2) a plan for providing peer-to-peer training, as appropriate.’’.

SEC. 752. ø294b¿ CONTINUING EDUCATIONAL SUPPORT FOR HEALTH

PROFESSIONALS SERVING IN RURAL AND UNDERSERVED

COMMUNITIES.

(a) I

ENERAL

.—The Secretary, as appropriate, shall make

grants to, and enter into contracts with, eligible entities to support

access to accredited continuing medical education for primary care

physicians and health care providers at community health centers

or rural health clinics to improve and increase access to care for

patients in rural and medically underserved areas. Such grants or

contracts may be used to improve health care, increase retention,

increase representation of minority health care providers, enhance

the practice environment, increase primary care physician and

health care provider knowledge, and provide information dissemi-

nation and educational support to reduce professional isolation

through the timely dissemination of research findings using rel-

evant resources.

(b) E

LIGIBLE

NTITIES

.—For purposes of this section, the term

‘‘eligible entity’’ means an entity described in section 799(b), such

as a community health center or rural health clinic.

PPLICATION

.—An eligible entity desiring to receive an

award under this section shall submit to the Secretary an applica-

tion at such time, in such manner, and containing such information

as the Secretary may require

The amendment should have struck ‘‘may require.’’ and there-

fore does not execute.

(d) U

SE OF

UNDS

.—

(1) I

N GENERAL

.—An eligible entity shall use amounts

awarded under a grant or contract under this section to pro-

vide innovative supportive activities to enhance education for

primary care physicians and health care providers described in

subsection (a) through distance learning, continuing edu-

cational activities, collaborative conferences, and electronic and

telelearning activities, with priority for primary care providers

who are seeking additional education in specialty fields such as

infectious disease, endocrinology, pediatrics, mental health and

substance use disorders, pain management, geriatrics, and

other areas, as appropriate, in order to—

(A) improve retention of primary care physicians and

health care providers and increase access to specialty

health care services for patients; and

(B) support access to the integration of specialty care

through existing service delivery locations and care across

settings.

(2) C

LARIFICATION

.—Entities may use amounts awarded

under a grant or contract under this section for continuing

educational activities that include a clinical training compo-

nent, including in-person patient care, in the respective com-

munity health center or rural health clinic, with the primary

care physician or health care provider at such site and the clin-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00063 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

64 Sec. 753 PUBLIC HEALTH SERVICE ACT

ical specialist from whom such additional training is being pro-

vided.

(e) A

DMINISTRATIVE

XPENSES

.—An entity that revives a grant

or contract under this section shall use not more than 5 percent of

the amounts received under the grant or contract under this sec-

tion for administrative expenses.

(f) N

DUPLICATION OF

FFORT

.—The Secretary shall ensure

that activities under this section do not unnecessarily duplicate ef-

forts of other programs overseen by the Health Resources and Serv-

ices Administration, including activities described in section 330N.

(g) A

UTHORIZATION

.—There is authorized to be appropriated to

carry out this section $5,000,000 for each of fiscal years 2023

through 2025.

SEC. 753. ø294c¿ EDUCATION AND TRAINING RELATING TO GERI-

ATRICS.

(a) G

ERIATRICS

ORKFORCE

NHANCEMENT

ROGRAM

.—

(1) I

N GENERAL

.—The Secretary shall award grants, con-

tracts, or cooperative agreements under this subsection to enti-

ties described in paragraph (1), (3), or (4) of section 799B, sec-

tion 801(2), or section 865(d), or other health professions

schools or programs approved by the Secretary, for the estab-

lishment or operation of Geriatrics Workforce Enhancement

Programs that meet the requirements of paragraph (2).

(2) R

EQUIREMENTS

.—

(A) I

N GENERAL

.—A Geriatrics Workforce Enhance-

ment Program receiving an award under this section shall

support the training of health professionals in geriatrics,

including traineeships or fellowships. Such programs shall

emphasize, as appropriate, patient and family engagement,

integration of geriatrics with primary care and other ap-

propriate specialties, and collaboration with community

partners to address gaps in health care for older adults.

(B) A

CTIVITIES

.—Activities conducted by a program

under this section may include the following:

(i) Clinical training on providing integrated geri-

atrics and primary care delivery services.

(ii) Interprofessional training to practitioners from

multiple disciplines and specialties, including training

on the provision of care to older adults.

(iii) Establishing or maintaining training-related

community-based programs for older adults and care-

givers to improve health outcomes for older adults.

(iv) Providing education on Alzheimer’s disease

and related dementias to families and caregivers of

older adults, direct care workers, and health profes-

sions students, faculty, and providers.

(3) D

URATION

.—Each grant, contract, or cooperative agree-

ment or contract awarded under paragraph (1) shall be for a

period not to exceed 5 years.

(4) A

PPLICATIONS

.—To be eligible to receive a grant, con-

tract, or cooperative agreement 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.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00064 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

65 Sec. 753 PUBLIC HEALTH SERVICE ACT

(5) P

ROGRAM REQUIREMENTS

.—

(A) I

N GENERAL

.—In awarding grants, contracts, and

cooperative agreements under paragraph (1), the Sec-

retary—

(i) shall give priority to programs that dem-

onstrate coordination with another Federal or State

program or another public or private entity;

(ii) shall give priority to applicants with programs

or activities that are expected to substantially benefit

rural or medically underserved populations of older

adults, or serve older adults in Indian Tribes or Tribal

organizations; and

(iii) may give priority to any program that—

(I) integrates geriatrics into primary care

practice;

(II) provides training to integrate geriatric

care into other specialties across care settings, in-

cluding practicing clinical specialists, health care

administrators, faculty without backgrounds in

geriatrics, and students from all health profes-

sions;

(III) emphasizes integration of geriatric care

into existing service delivery locations and care

across settings, including primary care clinics,

medical homes, Federally qualified health centers,

ambulatory care clinics, critical access hospitals,

emergency care, assisted living and nursing facili-

ties, and home- and community-based services,

which may include adult daycare;

(IV) supports the training and retraining of

faculty, primary care providers, other direct care

providers, and other appropriate professionals on

geriatrics;

(V) emphasizes education and engagement of

family caregivers on disease management and

strategies to meet the needs of caregivers of older

adults; or

(VI) proposes to conduct outreach to commu-

nities that have a shortage of geriatric workforce

professionals.

(B) S

PECIAL CONSIDERATION

.—In awarding grants, con-

tracts, and cooperative agreements under this section, the

Secretary shall give special consideration to entities that

provide services in areas with a shortage of geriatric work-

force professionals.

(6) P

RIORITY

.—The Secretary may provide awardees with

additional support for activities in areas of demonstrated need,

which may include education and training for home health

workers, family caregivers, and direct care workers on care for

older adults.

(7) R

EPORTING

.—

(A) R

EPORTS FROM ENTITIES

.—Each entity awarded a

grant, contract, or cooperative agreement under this sec-

tion shall submit an annual report to the Secretary on the

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00065 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

66 Sec. 753 PUBLIC HEALTH SERVICE ACT

activities conducted under such grant, contract, or coopera-

tive agreement, which may include information on the

number of trainees, the number of professions and dis-

ciplines, the number of partnerships with health care de-

livery sites, the number of faculty and practicing profes-

sionals who participated in such programs, and other in-

formation, as the Secretary may require.

(B) R

EPORT TO CONGRESS

.—Not later than 4 years

after the date of enactment of the Coronavirus Aid, Relief,

and Economic Security Act and every 5 years thereafter,

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 Rep-

resentatives a report that provides a summary of the ac-

tivities and outcomes associated with grants, contracts,

and cooperative agreements made under this section. Such

reports shall include—

(i) information on the number of trainees, faculty,

and professionals who participated in programs under

this section;

(ii) information on the impact of the program con-

ducted under this section on the health status of older

adults, including in areas with a shortage of health

professionals; and

(iii) information on outreach and education pro-

vided under this section to families and caregivers of

older adults.

UBLIC AVAILABILITY

.—The Secretary shall make

reports submitted under paragraph (B) publically available

on the internet website of the Department of Health and

Human Services.

(b) G

ERIATRIC

CADEMIC

AREER

WARDS

.—

(1) E

STABLISHMENT OF PROGRAM

.—The Secretary shall, as

appropriate, establish or maintain a program to provide geri-

atric academic career awards to eligible entities applying on

behalf of eligible individuals to promote the career develop-

ment of such individuals as academic geriatricians or other

academic geriatrics health professionals.

(2) E

LIGIBILITY

.—

(A) E

LIGIBLE ENTITY

.—For purposes of this subsection,

the term ‘‘eligible entity’’ means—

(i) an entity described in paragraph (1), (3), or (4)

of section 799B or section 801(2); or

(ii) another accredited health professions school or

graduate program approved by the Secretary.

(B) E

LIGIBLE INDIVIDUAL

.—For purposes of this sub-

section, the term ‘‘eligible individual’’ means an individual

who—

(i)(I) is board certified or board eligible in internal

medicine, family practice, psychiatry, or licensed den-

tistry, or has completed required training in a dis-

cipline and is employed in an accredited health profes-

sions school or graduate program that is approved by

the Secretary; or

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00066 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

67 Sec. 753 PUBLIC HEALTH SERVICE ACT

(II) has completed an approved fellowship pro-

gram in geriatrics, or has completed specialty training

in geriatrics as required by the discipline and any ad-

ditional geriatrics training as required by the Sec-

retary; and

(ii) has a junior, nontenured, faculty appointment

at an accredited health professions school or graduate

program in geriatrics or a geriatrics health profession.

LARIFICATION

.—If an eligible individual is pro-

moted during the period of an award under this subsection

and thereby no longer meets the criteria of subparagraph

(B)(ii), the individual shall continue to be treated as an eli-

gible individual through the term of the award.

(3) A

PPLICATION REQUIREMENTS

.—In order to receive an

award under paragraph (1), an eligible entity, on behalf of an

eligible individual, shall—

(A) submit to the Secretary an application, at such

time, in such manner, and containing such information as

the Secretary may require;

(B) provide, in such form and manner as the Secretary

may require, assurances that the eligible individual will

meet the service requirement described in paragraph (6);

and

may require, assurances that the individual has a full-time

faculty appointment in a health professions institution and

documented commitment from such eligible entity that the

individual will spend 75 percent of the individual’s time

that is supported by the award on teaching and developing

skills in interdisciplinary education in geriatrics.

(4) E

QUITABLE DISTRIBUTION

.—In making awards under

this subsection, the Secretary shall seek to ensure geographical

distribution among award recipients, including among rural or

medically underserved areas of the United States.

(5) A

MOUNT AND DURATION

.—

(A) A

MOUNT

.—The amount of an award under this

subsection shall be at least $75,000 for fiscal year 2021,

adjusted for subsequent years in accordance with the con-

sumer price index. The Secretary shall determine the

amount of an award under this subsection for individuals

who are not physicians.

(B) D

URATION

.—The Secretary shall make awards

under paragraph (1) for a period not to exceed 5 years.

(6) S

ERVICE REQUIREMENT

.—An individual who receives an

award under this subsection shall provide training in clinical

geriatrics, including the training of interprofessional teams of

health care professionals. The provision of such training shall

constitute at least 75 percent of the obligations of such indi-

vidual under the award.

ONAPPLICABILITY OF

ROVISION

.—Notwithstanding any

other provision of this title, section 791(a) shall not apply to

awards made under this section.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00067 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

68 Sec. 754 PUBLIC HEALTH SERVICE ACT

(d) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated $40,737,000 for each of fiscal years 2021

through 2025 for purposes of carrying out this section.

SEC. 754. ø294d¿ QUENTIN N. BURDICK PROGRAM FOR RURAL INTER-

DISCIPLINARY TRAINING.

(a) G

RANTS

.—The Secretary may make grants or contracts

under this section to help entities fund authorized activities under

an application approved under subsection (c).

(b) U

SE OF

MOUNTS

.—

(1) I

N GENERAL

.—Amounts provided under subsection (a)

shall be used by the recipients to fund interdisciplinary train-

ing projects designed to—

(A) use innovative or evidence-based methods to train

health care practitioners to provide services in rural areas;

(B) demonstrate and evaluate innovative interdiscipli-

nary methods and models designed to provide access to

cost-effective comprehensive health care;

in rural areas;

(D) enhance the amount of relevant research con-

ducted concerning health care issues in rural areas; and

(E) increase the recruitment and retention of health

care practitioners from rural areas and make rural prac-

tice a more attractive career choice for health care practi-

tioners.

(2) M

ETHODS

.—A recipient of funds under subsection (a)

may use various methods in carrying out the projects described

in paragraph (1), including—

(A) the distribution of stipends to students of eligible

applicants;

(B) the establishment of a post-doctoral fellowship pro-

gram;

logistical problems confronting rural health care delivery

systems; or

(D) the purchase or rental of transportation and tele-

communication equipment where the need for such equip-

ment due to unique characteristics of the rural area is

demonstrated by the recipient.

(3) A

DMINISTRATION

.—

(A) I

N GENERAL

.—An applicant shall not use more

than 10 percent of the funds made available to such appli-

cant under subsection (a) for administrative expenses.

(B) T

RAINING

.—Not more than 10 percent of the indi-

viduals receiving training with funds made available to an

applicant under subsection (a) shall be trained as doctors

of medicine or doctors of osteopathy.

IMITATION

.—An institution that receives a grant

under this section shall use amounts received under such

grant to supplement, not supplant, amounts made avail-

able by such institution for activities of the type described

in subsection (b)(1) in the fiscal year preceding the year for

which the grant is received.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00068 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

69 Sec. 755 PUBLIC HEALTH SERVICE ACT

PPLICATIONS

.—Applications submitted for assistance under

this section shall—

(1) be jointly submitted by at least two eligible applicants

with the express purpose of assisting individuals in academic

institutions in establishing long-term collaborative relation-

ships with health care providers in rural areas; and

(2) designate a rural health care agency or agencies for

clinical treatment or training, including hospitals, community

health centers, migrant health centers, rural health clinics,

community behavioral and mental health centers, long-term

care facilities, Native Hawaiian health centers, or facilities op-

erated by the Indian Health Service or an Indian tribe or tribal

organization or Indian organization under a contract with the

Indian Health Service under the Indian Self-Determination

Act.

(d) D

EFINITIONS

.—For the purposes of this section, the term

‘‘rural’’ means geographic areas that are located outside of standard

metropolitan statistical areas.

SEC. 755. ø294e¿ ALLIED HEALTH AND OTHER DISCIPLINES.

(a) I

ENERAL

.—The Secretary may make grants or contracts

under this section to help entities fund activities of the type de-

scribed in subsection (b).

(b) A

CTIVITIES

.—Activities of the type described in this sub-

section include the following:

(1) Assisting entities in meeting the costs associated with

expanding or establishing programs that will increase the

number of individuals trained in allied health professions. Pro-

grams and activities funded under this paragraph may in-

clude—

(A) those that expand enrollments in allied health pro-

fessions with the greatest shortages or whose services are

most needed by geriatric populations or for maternal and

child health;

(B) those that provide rapid transition training pro-

grams in allied health fields to individuals who have bac-

calaureate degrees in health-related sciences;

training programs that link academic centers to rural clin-

ical settings;

(D) those that provide career advancement training for

practicing allied health professionals;

(E) those that expand or establish clinical training

sites for allied health professionals in medically under-

served or rural communities in order to increase the num-

ber of individuals trained;

(F) those that develop curriculum that will emphasize

knowledge and practice in the areas of prevention and

health promotion, geriatrics, long-term care, home health

and hospice care, and ethics;

(G) those that expand or establish interdisciplinary

training programs that promote the effectiveness of allied

health practitioners in geriatric assessment and the reha-

bilitation of the elderly;

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00069 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

70 Sec. 756 PUBLIC HEALTH SERVICE ACT

(H) those that expand or establish demonstration cen-

ters to emphasize innovative models to link allied health

clinical practice, education, and research;

(I) those that provide financial assistance (in the form

of traineeships) to students who are participants in any

such program; and

(i) who plan to pursue a career in an allied health

field that has a demonstrated personnel shortage; and

(ii) who agree upon completion of the training pro-

gram to practice in a medically underserved commu-

nity;

that shall be utilized to assist in the payment of all or part

of the costs associated with tuition, fees and such other sti-

pends as the Secretary may consider necessary; and

(J) those to meet the costs of projects to plan, develop,

and operate or maintain graduate programs in behavioral

and mental health practice.

(2) Planning and implementing projects in preventive and

primary care training for podiatric physicians in approved or

provisionally approved residency programs that shall provide

financial assistance in the form of traineeships to residents

who participate in such projects and who plan to specialize in

primary care.

(3) Carrying out demonstration projects in which chiro-

practors and physicians collaborate to identify and provide ef-

fective treatment for spinal and lower-back conditions.

(4) Increasing educational opportunities in physical ther-

apy, occupational therapy, respiratory therapy, audiology, and

speech-language pathology professions, which may include of-

fering scholarships or stipends and carrying out other activities

to improve retention, for individuals from disadvantaged back-

grounds or individuals who are underrepresented in such pro-

fessions.

SEC. 756. ø294e–1¿ MENTAL AND BEHAVIORAL HEALTH EDUCATION

AND TRAINING GRANTS.

(a) G

RANTS

UTHORIZED

.—The Secretary may award grants to

eligible institutions to support the recruitment of students for, and

education and clinical experience of the students in—

(1) accredited institutions of higher education or accredited

professional training programs that are establishing or expand-

ing internships or other field placement programs in mental

health in psychiatry, psychology, school psychology, behavioral

pediatrics, psychiatric nursing (which may include master’s

and doctoral level programs), social work, school social work,

substance use disorder prevention and treatment, marriage

and family therapy, occupational therapy (which may include

master’s and doctoral level programs), school counseling, or

professional counseling, including such programs with a focus

on child and adolescent mental health, trauma, and transi-

tional-age youth;

(2) accredited doctoral, internship, and post-doctoral resi-

dency programs of health service psychology (including clinical

psychology, counseling, and school psychology) for the develop-

ment and implementation of interdisciplinary training of psy-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00070 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

71 Sec. 756 PUBLIC HEALTH SERVICE ACT

chology graduate students for providing behavioral health serv-

ices, including trauma-informed care and substance use dis-

order prevention and treatment services, as well as the devel-

opment of faculty in health service psychology;

(3) accredited master’s and doctoral degree programs of so-

cial work for the development and implementation of inter-

disciplinary training of social work graduate students for pro-

viding behavioral health services, including trauma-informed

care and substance use disorder prevention and treatment

services, and the development of faculty in social work; and

(4) State-licensed mental health nonprofit and for-profit or-

ganizations to enable such organizations to pay for programs

for preservice or in-service training in a behavioral health-re-

lated paraprofessional field with preference for preservice or

in-service training of paraprofessional child and adolescent

mental health workers, including training to increase skills

and capacity to meet the needs of children and adolescents who

have experienced trauma.

(b) E

LIGIBILITY

EQUIREMENTS

.—To be eligible for a grant

under this section, an institution shall demonstrate—

(1) an ability to recruit and place the students described

in subsection (a) in areas with a high need and high demand

population;

(2) participation in the institutions’ programs of individ-

uals and groups from different racial, ethnic, cultural, geo-

graphic, religious, linguistic, and class backgrounds, and dif-

ferent genders and sexual orientations;

(3) knowledge and understanding of the concerns of the in-

dividuals and groups described in paragraph (2), especially in-

dividuals with mental disorder symptoms or diagnoses, par-

ticularly children and adolescents, and transitional-age youth;

(4) any internship or other field placement program as-

sisted under the grant will prioritize cultural and linguistic

competency; and

(5) the institution will provide to the Secretary such data,

assurances, and information as the Secretary may require.

NSTITUTIONAL

EQUIREMENT

.—For grants awarded under

paragraphs (2) and (3) of subsection (a), at least 4 of the grant re-

cipients shall be historically black colleges or universities or other

minority-serving institutions.

(d) P

RIORITY

.—In selecting grant recipients under this section,

the Secretary shall give priority to—

(1) programs that have demonstrated the ability to train

psychology, psychiatry, and social work professionals to work

in integrated care settings for purposes of recipients under

paragraphs (1), (2), and (3) of subsection (a); and

(2) programs for paraprofessionals that emphasize the role

of the family and the lived experience of the consumer and

family-paraprofessional partnerships for purposes of recipients

under subsection (a)(4).

(e) R

EPORT TO

ONGRESS

.—Not later than 4 years after the

date of enactment of the Helping Families in Mental Health Crisis

Reform Act of 2016, the Secretary shall include in the biennial re-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00071 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

72 Sec. 757 PUBLIC HEALTH SERVICE ACT

So in law. The reference to ‘‘this Act’’ means the Public Health Service Act, which was en-

acted July 1, 1944. Probably should be a reference to the Health Professions Education Partner-

ships Act of 1998, which added section 756. That Act is Public Law 105–392, enacted November

13, 1998. (Section 103 of that Public Law (112 Stat. 3541) added section 756.)

port submitted to Congress under section 501(m) an assessment on

the effectiveness of the grants under this section in—

(1) providing graduate students support for experiential

training (internship or field placement);

(2) recruiting students interested in behavioral health

practice;

(3) recruiting students in accordance with subsection

(b)(1);

(4) developing and implementing interprofessional training

and integration within primary care;

(5) developing and implementing accredited field place-

ments and internships; and

(6) collecting data on the number of students trained in be-

havioral health care and the number of available accredited in-

ternships and field placements.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—For each of fiscal

years 2023 through 2027, there are authorized to be appropriated

to carry out this section $50,000,000, to be allocated as follows:

(1) For grants described in subsection (a)(1), $15,000,000.

(2) For grants described in subsection (a)(2), $15,000,000.

(3) For grants described in subsection (a)(3), $10,000,000.

(4) For grants described in subsection (a)(4), $10,000,000.

SEC. 757. ø294f¿ ADVISORY COMMITTEE ON INTERDISCIPLINARY, COM-

MUNITY-BASED LINKAGES.

(a) E

STABLISHMENT

.—The Secretary shall establish an advisory

committee to be known as the Advisory Committee on Interdiscipli-

nary, Community-Based Linkages (in this section referred to as the

‘‘Advisory Committee’’).

(b) C

OMPOSITION

.—

(1) I

N GENERAL

.—The Secretary shall determine the appro-

priate number of individuals to serve on the Advisory Com-

mittee. Such individuals shall not be officers or employees of

the Federal Government.

(2) A

PPOINTMENT

.—Not later than 90 days after the date

of enactment of this Act

, the Secretary shall appoint the

members of the Advisory Committee from among individuals

who are health professionals from schools of the types de-

scribed in sections 751(b)(1)(A), 753(b), and 755(b). In making

such appointments, the Secretary shall ensure a fair balance

between the health professions, that at least 75 percent of the

members of the Advisory Committee are health professionals,

a broad geographic representation of members and a balance

between urban and rural members. Members shall be ap-

pointed based on their competence, interest, and knowledge of

the mission of the profession involved.

(3) M

INORITY REPRESENTATION

.—In appointing the mem-

bers of the Advisory Committee under paragraph (2), the Sec-

retary shall ensure the adequate representation of women and

minorities.

ERMS

.—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00072 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

73 Sec. 757 PUBLIC HEALTH SERVICE ACT

So in law. Probably should be ‘‘Advisory Committee’’. See section 103 of Public Law 105–

392 (112 Stat. 3541).

(1) I

N GENERAL

.—A member of the Advisory Committee

shall be appointed for a term of 3 years, except that of the

members first appointed—

(A)

⁄

of the members shall serve for a term of 1 year;

(B)

⁄

of the members shall serve for a term of 2

years; and

(C)

⁄

of the members shall serve for a term of 3

years.

(2) V

ACANCIES

.—

(A) I

N GENERAL

.—A vacancy on the Advisory Com-

mittee shall be filled in the manner in which the original

appointment was made and shall be subject to any condi-

tions which applied with respect to the original appoint-

ment.

(B) F

ILLING UNEXPIRED TERM

.—An individual chosen

to fill a vacancy shall be appointed for the unexpired term

of the member replaced.

(d) D

UTIES

.—The Advisory Committee shall—

(1) provide advice and recommendations to the Secretary

concerning policy and program development and other matters

of significance concerning the activities under this part;

(2) not later than 3 years after the date of enactment of

this section, and annually thereafter, prepare and submit to

the Secretary, and the Committee on Labor and Human Re-

sources of the Senate, and the Committee on Commerce of the

House of Representatives, a report describing the activities of

the Committee, including findings and recommendations made

by the Committee concerning the activities under this part;

(3) develop, publish, and implement performance measures

for programs under this part;

(4) develop and publish guidelines for longitudinal evalua-

tions (as described in section 761(d)(2)) for programs under this

part; and

(5) recommend appropriation levels for programs under

this part.

(e) M

EETINGS AND

OCUMENTS

.—

(1) M

EETINGS

.—The Advisory Committee shall meet not

less than 3 times each year. Such meetings shall be held joint-

ly with other related entities established under this title where

appropriate.

(2) D

OCUMENTS

.—Not later than 14 days prior to the con-

vening of a meeting under paragraph (1), the Advisory Com-

mittee shall prepare and make available an agenda of the mat-

ters to be considered by the Advisory Committee at such meet-

ing. At any such meeting, the Advisory Council

shall dis-

tribute materials with respect to the issues to be addressed at

the meeting. Not later than 30 days after the adjourning of

such a meeting, the Advisory Committee shall prepare and

make available a summary of the meeting and any actions

taken by the Committee based upon the meeting.

(f) C

OMPENSATION AND

XPENSES

.—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00073 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

74 Sec. 759 PUBLIC HEALTH SERVICE ACT

(1) C

OMPENSATION

.—Each member of the Advisory Com-

mittee shall be compensated at a rate equal to the daily equiv-

alent of the annual rate of basic pay prescribed for level IV of

the Executive Schedule under section 5315 of title 5, United

States Code, for each day (including travel time) during which

such member is engaged in the performance of the duties of

the Committee.

(2) E

XPENSES

.—The members of the Advisory Committee

shall be allowed travel expenses, including per diem in lieu of

subsistence, at rates authorized for employees of agencies

under subchapter I of chapter 57 of title 5, United States Code,

while away from their homes or regular places of business in

the performance of services for the Committee.

(g) C

HAPTER

ITLE

5, U

NITED

TATES

ODE

.—Chapter 10

of title 5, United States Code, shall apply to the Advisory Com-

mittee under this section only to the extent that the provisions of

chapter 10 of title 5, United States Code, do not conflict with the

requirements of this section.

øNote: Section 758 was repealed by section 501(b)(2) of Public Law

113–4; enacted March 7, 2013, 127 Stat. 54.¿

SEC. 759. ø294i¿ PROGRAM FOR EDUCATION AND TRAINING IN PAIN

CARE.

(a) I

ENERAL

.—The Secretary may make awards of grants,

cooperative agreements, and contracts to health professions

schools, hospices, tribal health programs (as defined in section 4 of

the Indian Health Care Improvement Act), and other public and

nonprofit private entities for the development and implementation

of programs to provide education and training to health care pro-

fessionals in pain care.

(b) C

ERTAIN

OPICS

.—An entity receiving an award under this

section shall develop a comprehensive education and training plan

that includes information and education on—

(1) recognized means for assessing, diagnosing, preventing,

treating, and managing pain and related signs and symptoms,

including non-addictive medical products and non-pharmaco-

logic treatments and the medically appropriate use of con-

trolled substances;

(2) applicable Federal, State, and local laws, regulations,

rules, and policies on controlled substances, including opioids;

(3) interdisciplinary approaches to the delivery of pain

care, including delivery through specialized centers providing

comprehensive pain care treatment expertise, integrated, evi-

dence-based pain management, and, as appropriate, non-

pharmacotherapy;

(4) cultural, linguistic, literacy, geographic, and other bar-

riers to care in underserved populations;

(5) recent findings, developments, and advancements in

pain care research and the provision of pain care, which may

include non-addictive medical products and non-pharmacologic

treatments intended to treat pain; and

(6) the dangers of opioid abuse and misuse, detection of

early warning signs of opioid use disorders (which may include

best practices related to screening for opioid use disorders,

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00074 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

75 Sec. 760 PUBLIC HEALTH SERVICE ACT

training on screening, brief intervention, and referral to treat-

ment), and safe disposal options for prescription medications

(including such options provided by law enforcement or other

innovative deactivation mechanisms).

VALUATION OF

ROGRAMS

.—The Secretary shall (directly

or through grants or contracts) provide for the evaluation of pro-

grams implemented under subsection (a) in order to determine the

effect of such programs on knowledge and practice of pain care.

(d) P

AIN

ARE

EFINED

.—For purposes of this section the term

‘‘pain care’’ means the assessment, diagnosis, prevention, treat-

ment, or management of acute or chronic pain regardless of causa-

tion or body location.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section, such sums as may be

necessary for each of the fiscal years 2019 through 2023. Amounts

appropriated under this subsection shall remain available until ex-

pended.

SEC. 760. ø294k¿ TRAINING DEMONSTRATION PROGRAM.

(a) I

ENERAL

.—The Secretary shall establish a training dem-

onstration program to award grants to eligible entities to support—

(1) training for medical residents and fellows to practice

psychiatry and addiction medicine in underserved, community-

based settings that integrate primary care with mental health

and substance use disorder prevention and treatment services;

(2) training (including for individuals completing clinical

training requirements for licensure) for nurse practitioners,

physician assistants, health service psychologists, counselors,

nurses, and social workers to provide mental health and sub-

stance use disorder services in underserved community-based

settings that integrate primary care and mental health and

substance use disorder services, including such settings that

serve pediatric populations; and

(3) establishing, maintaining, or improving academic units

or programs that—

(A) provide training for students or faculty, including

through clinical experiences and research, to improve the

ability to be able to recognize, diagnose, and treat mental

health and substance use disorders, with a special focus on

addiction or pediatric populations; or

(B) develop evidence-based practices or recommenda-

tions for the design of the units or programs described in

subparagraph (A), including curriculum content standards.

(b) A

CTIVITIES

.—

(1) T

RAINING FOR RESIDENTS AND FELLOWS

.—A recipient of

a grant under subsection (a)(1)—

(A) shall use the grant funds—

(i)(I) to plan, develop, and operate a training pro-

gram for medical psychiatry residents and fellows in

addiction medicine practicing in eligible entities de-

scribed in subsection (c)(1); or

(II) to train new psychiatric residents and fellows

in addiction medicine to provide and expand access to

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00075 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

76 Sec. 760 PUBLIC HEALTH SERVICE ACT

integrated mental health and substance use disorder

services; and

(ii) to provide at least 1 training track that is—

(I) a virtual training track that includes an

in-person rotation at a teaching health center or

in a community-based setting, followed by a vir-

tual rotation in which the resident or fellow con-

tinues to support the care of patients at the teach-

ing health center or in the community-based set-

ting through the use of health information tech-

nology and, as appropriate, telehealth services;

(II) an in-person training track that includes

a rotation, during which the resident or fellow

practices at a teaching health center or in a com-

munity-based setting; or

(III) an in-person training track that includes

a rotation during which the resident practices in

a community-based setting that specializes in the

treatment of infants, children, adolescents, or

pregnant or postpartum women; and

(B) may use the grant funds to provide additional sup-

port for the administration of the program or to meet the

costs of projects to establish, maintain, or improve faculty

development, or departments, divisions, or other units nec-

essary to implement such training.

(2) T

RAINING FOR OTHER PROVIDERS

.—A recipient of a

grant under subsection (a)(2)—

(A) shall use the grant funds to plan, develop, or oper-

ate a training program to provide mental health and sub-

stance use disorder services in underserved, community-

based settings (including such settings that serve pediatric

populations), as appropriate, that integrate primary care

and mental health and substance use disorder prevention

and treatment services; and

(B) may use the grant funds to provide additional sup-

port for the administration of the program or to meet the

costs of projects to establish, maintain, or improve faculty

development, or departments, divisions, or other units nec-

essary to implement such program.

(3) A

CADEMIC UNITS OR PROGRAMS

.—A recipient of a grant

under subsection (a)(3) shall enter into a partnership with or-

ganizations such as an education accrediting organization

(such as the Liaison Committee on Medical Education, the Ac-

creditation Council for Graduate Medical Education, the Com-

mission on Osteopathic College Accreditation, the Accreditation

Commission for Education in Nursing, the Commission on Col-

legiate Nursing Education, the Accreditation Council for Phar-

macy Education, the Council on Social Work Education, Amer-

ican Psychological Association Commission on Accreditation, or

the Accreditation Review Commission on Education for the

Physician Assistant) to carry out activities under subsection

(a)(3).

LIGIBLE

NTITIES

.—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00076 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

77 Sec. 760 PUBLIC HEALTH SERVICE ACT

Double comma so in law. See the amendment made by section 1311(b)(5)(A) of division FF

of Public Law 117-328.

(1) T

RAINING FOR RESIDENTS AND FELLOWS

.—To be eligible

to receive a grant under subsection (a)(1), an entity shall—

(A) be a consortium consisting of—

(i) at least one teaching health center; and

(ii) the sponsoring institution (or parent institu-

tion of the sponsoring institution) of—

(I) a psychiatry residency program that is ac-

credited by the Accreditation Council of Graduate

Medical Education (or the parent institution of

such a program); or

(II) a fellowship in addiction medicine, as de-

termined appropriate by the Secretary; or

(B) be an entity described in subparagraph (A)(ii) that

provides opportunities for residents or fellows to train in

community-based settings that integrate primary care with

mental health and substance use disorder prevention and

treatment services.

(2) T

RAINING FOR OTHER PROVIDERS

.—To be eligible to re-

ceive a grant under subsection (a)(2), an entity shall be—

(A) a teaching health center (as defined in section

749A(f));

(B) a Federally qualified health center (as defined in

section 1905(l)(2)(B) of the Social Security Act);

section 1861(ff)(3)(B) of the Social Security Act);

(D) a rural health clinic (as defined in section 1861(aa)

of the Social Security Act);

(E) a health center operated by the Indian Health

Service, an Indian tribe, a tribal organization, or an urban

Indian organization (as defined in section 4 of the Indian

Health Care Improvement Act); or

(F) an entity with a demonstrated record of success in

providing training for nurse practitioners, physician assist-

ants, health service psychologists counselors, nurses,,

and social workers, including such entities that serve pedi-

atric populations.

(3) A

CADEMIC UNITS OR PROGRAMS

.—To be eligible to re-

ceive a grant under subsection (a)(3), an entity shall be a

school of medicine or osteopathic medicine, a nursing school, a

physician assistant training program, a school of pharmacy, a

school of social work, an accredited public or nonprofit private

hospital, an accredited medical residency program, or a public

or private nonprofit entity which the Secretary has determined

is capable of carrying out such grant.

(d) P

RIORITY

.—

(1) I

N GENERAL

.—In awarding grants under subsection

(a)(1) or (a)(2), the Secretary shall give priority to eligible enti-

ties that—

(A) demonstrate sufficient size, scope, and capacity to

undertake the requisite training of an appropriate number

of psychiatric residents, fellows, health service psycholo-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00077 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

78 Sec. 760 PUBLIC HEALTH SERVICE ACT

Lack of commas so in law. See the amendments made by section 1311(b)(6)(A) and (B) of

division FF of Public Law 117-328.

Double comma so in law. See the amendment made by section 1311(b)(6)(B) of division FF

of Public Law 117-328.

gists, nurses

nurse practitioners, physician assist-

ants

counselors,,

or social workers in addiction medi-

cine per year to meet the needs of the area served;

(B) demonstrate experience in training providers to

practice team-based care that integrates mental health

and substance use disorder prevention and treatment serv-

ices with primary care in community-based settings, which

may include such settings that serve pediatric populations;

tion technology and, as appropriate, telehealth to sup-

port—

(i) the delivery of mental health and substance

use disorder services at the eligible entities described

in subsections (c)(1) and (c)(2); and

(ii) community health centers in integrating pri-

mary care and mental health and substance use dis-

order treatment; or

(D) have the capacity to expand access to mental

health and substance use disorder services in areas with

demonstrated need, as determined by the Secretary, such

as tribal, rural, or other underserved communities.

(2) A

CADEMIC UNITS OR PROGRAMS

.—In awarding grants

under subsection (a)(3), the Secretary shall give priority to eli-

gible entities that—

(A) have a record of training the greatest percentage

of mental health and substance use disorder providers who

enter and remain in these fields or who enter and remain

in settings with integrated primary care and mental and

substance use disorder prevention and treatment services;

(B) have a record of training individuals who are from

underrepresented minority groups, including native popu-

lations, or from a rural or disadvantaged background;

trauma-informed care, as appropriate) of vulnerable popu-

lations such as infants, children, adolescents, pregnant

and postpartum women, older adults, homeless individ-

uals, victims of abuse or trauma, individuals with disabil-

ities, and other groups as defined by the Secretary;

(D) teach trainees the skills to provide interprofes-

sional, integrated care through collaboration among health

professionals; or

(E) provide training in cultural competency and health

literacy.

(e) D

URATION

.—Grants awarded under this section shall be for

a minimum of 5 years.

(f) S

TUDY AND

EPORT

.—

(1) S

TUDY

.—

(A) I

N GENERAL

.—The Secretary, acting through the

Administrator of the Health Resources and Services Ad-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00078 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

79 Sec. 761 PUBLIC HEALTH SERVICE ACT

ministration, shall conduct a study on the results of the

demonstration program under this section.

(B) D

ATA SUBMISSION

.—Not later than 90 days after

the completion of the first year of the training program

and each subsequent year that the program is in effect,

each recipient of a grant under subsection (a) shall submit

to the Secretary such data as the Secretary may require

for analysis for the report described in paragraph (2).

(2) R

EPORT TO CONGRESS

.—Not later than 1 year after re-

ceipt of the data described in paragraph (1)(B), the Secretary

shall submit to Congress a report that includes—

(A) an analysis of the effect of the demonstration pro-

gram under this section on the quality, quantity, and dis-

tribution of mental health and substance use disorder

services;

(B) an analysis of the effect of the demonstration pro-

gram on the prevalence of untreated mental health and

substance use disorders in the surrounding communities of

health centers participating in the demonstration; and

program should be expanded.

(g) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section, and $31,700,000 for

each of fiscal years 2023 through 2027.

PART E—HEALTH PROFESSIONS AND PUBLIC

HEALTH WORKFORCE

Subpart 1—Health Professions Workforce

Information and Analysis

SEC. 761. ø294n¿ HEALTH PROFESSIONS WORKFORCE INFORMATION

AND ANALYSIS.

(a) P

URPOSE

.—It is the purpose of this section to—

(1) provide for the development of information describing

the health professions workforce and the analysis of workforce

related issues; and

(2) provide necessary information for decision-making re-

garding future directions in health professions and nursing

programs in response to societal and professional needs.

(b) N

ATIONAL

ENTER FOR

EALTH

ARE

ORKFORCE

NAL

YSIS

.—

(1) E

STABLISHMENT

.—The Secretary shall establish the Na-

tional Center for Health Workforce Analysis (referred to in this

section as the ‘‘National Center’’).

(2) P

URPOSES

.—The National Center, in coordination to the

extent practicable with the National Health Care Workforce

Commission (established in section 5101 of the Patient Protec-

tion and Affordable Care Act), and relevant regional and State

centers and agencies, shall—

(A) provide for the development of information describ-

ing and analyzing the health care workforce and workforce

related issues;

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00079 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

80 Sec. 761 PUBLIC HEALTH SERVICE ACT

(B) carry out the activities under section 792(a);

(D) develop and publish performance measures and

benchmarks for programs under this title; and

(E) establish, maintain, and publicize a national Inter-

net registry of each grant awarded under this title and a

database to collect data from longitudinal evaluations (as

described in subsection (d)(2)) on performance measures

(as developed under sections 749(d)(3), 757(d)(3), and

762(a)(3)).

(3) C

OLLABORATION AND DATA SHARING

.—

(A) I

N GENERAL

.—The National Center shall collabo-

rate with Federal agencies and relevant professional and

educational organizations or societies for the purpose of

linking data regarding grants awarded under this title.

(B) C

ONTRACTS FOR HEALTH WORKFORCE ANALYSIS

.—

For the purpose of carrying out the activities described in

subparagraph (A), the National Center may enter into con-

tracts with relevant professional and educational organiza-

tions or societies.

TATE AND

EGIONAL

ENTERS FOR

EALTH

ORKFORCE

NALYSIS

.—

(1) I

N GENERAL

.—The Secretary shall award grants to, or

enter into contracts with, eligible entities for purposes of—

(A) collecting, analyzing, and reporting data regarding

programs under this title to the National Center and to

the public; and

(B) providing technical assistance to local and regional

entities on the collection, analysis, and reporting of data.

(2) E

LIGIBLE ENTITIES

.—To be eligible for a grant or con-

tract under this subsection, an entity shall—

(A) be a State, a State workforce investment board, a

public health or health professions school, an academic

health center, or an appropriate public or private nonprofit

entity; and

(B) submit to the Secretary an application at such

time, in such manner, and containing such information as

the Secretary may require.

(d) I

NCREASE IN

RANTS FOR

ONGITUDINAL

VALUATIONS

.—

(1) I

N GENERAL

.—The Secretary shall increase the amount

awarded to an eligible entity under this title for a longitudinal

evaluation of individuals who have received education, train-

ing, or financial assistance from programs under this title.

(2) C

APABILITY

.—A longitudinal evaluation shall be capa-

ble of—

(A) studying practice patterns; and

(B) collecting and reporting data on performance

measures developed under sections 749(d)(3), 757(d)(3),

and 762(a)(3).

(3) G

UIDELINES

.—A longitudinal evaluation shall comply

with guidelines issued under sections 749(d)(4), 757(d)(4), and

762(a)(4).

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00080 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

81 Sec. 762 PUBLIC HEALTH SERVICE ACT

(4) E

LIGIBLE ENTITIES

.—To be eligible to obtain an increase

under this section, an entity shall be a recipient of a grant or

contract under this title.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—

(1) I

N GENERAL

.—

(A) N

ATIONAL CENTER

.—To carry out subsection (b),

there are authorized to be appropriated $5,663,000 for

each of fiscal years 2021 through 2025.

(B) S

TATE AND REGIONAL CENTERS

.—To carry out sub-

section (c), there are authorized to be appropriated

$4,500,000 for each of fiscal years 2010 through 2014.

RANTS FOR LONGITUDINAL EVALUATIONS

.—To

carry out subsection (d), there are authorized to be appro-

priated such sums as may be necessary for fiscal years

2010 through 2014.

(2) R

ESERVATION

.—Of the amounts appropriated under

paragraph (1) for a fiscal year, the Secretary shall reserve not

less than $600,000 for conducting health professions research

and for carrying out data collection and analysis in accordance

with section 792.

(3) A

VAILABILITY OF ADDITIONAL FUNDS

.—Amounts other-

wise appropriated for programs or activities under this title

may be used for activities under subsection (b) with respect to

the programs or activities from which such amounts were

made available.

SEC. 762. ø294o¿ ADVISORY COUNCIL ON GRADUATE MEDICAL EDU-

CATION.

(a) E

STABLISHMENT

; D

UTIES

.—There is established the Council

on Graduate Medical Education (in this section referred to as the

‘‘Council’’). The Council shall—

(1) make recommendations to the Secretary of Health and

Human Services (in this section referred to as the ‘‘Secretary’’),

and to the Committee on Health, Education, Labor, and Pen-

sions of the Senate, and the Committee on Energy and Com-

merce of the House of Representatives, with respect to—

(A) the supply and distribution of physicians in the

United States;

(B) current and future shortages or excesses of physi-

cians in medical and surgical specialties and subspecial-

ties;

(D) appropriate Federal policies with respect to the

matters specified in subparagraphs (A), (B), and (C), in-

cluding policies concerning changes in the financing of un-

dergraduate and graduate medical education programs

and changes in the types of medical education training in

graduate medical education programs;

(E) appropriate efforts to be carried out by hospitals,

schools of medicine, schools of osteopathic medicine, and

accrediting bodies with respect to the matters specified in

subparagraphs (A), (B), and (C), including efforts for

changes in undergraduate and graduate medical education

programs; and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00081 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

82 Sec. 762 PUBLIC HEALTH SERVICE ACT

(F) deficiencies in, and needs for improvements in, ex-

isting data bases concerning the supply and distribution

of, and postgraduate training programs for, physicians in

the United States and steps that should be taken to elimi-

nate those deficiencies;

(2) encourage entities providing graduate medical edu-

cation to conduct activities to voluntarily achieve the rec-

ommendations of the Council under paragraph (1)(E);

(3) develop, publish, and implement performance measures

for programs under this title, except for programs under part

C or D;

(4) develop and publish guidelines for longitudinal evalua-

tions (as described in section 761(d)(2)) for programs under this

title, except for programs under part C or D; and

(5) recommend appropriation levels for programs under

this title, except for programs under part C or D.

(b) C

OMPOSITION

.—The Council shall be composed of—

(1) the Assistant Secretary for Health or the designee of

the Assistant Secretary;

(2) the Administrator of the Centers for Medicare & Med-

icaid Services;

(3) the Chief Medical Director of the Department of Vet-

erans Affairs;

(4) the Administrator of the Health Resources and Services

Administration;

(5) 6 members appointed by the Secretary to include rep-

resentatives of practicing primary care physicians, national

and specialty physician organizations, foreign medical grad-

uates, and medical student and house staff associations;

(6) 4 members appointed by the Secretary to include rep-

resentatives of schools of medicine and osteopathic medicine

and public and private teaching hospitals; and

(7) 4 members appointed by the Secretary to include rep-

resentatives of health insurers, business, and labor.

ERMS OF

PPOINTED

EMBERS

.—

(1) I

N GENERAL

;

STAGGERED ROTATION

.—Members of the

Council appointed under paragraphs (4), (5), and (6) of sub-

section (b) shall be appointed for a term of 4 years, except that

the term of office of the members first appointed shall expire,

as designated by the Secretary at the time of appointment, 4

at the end of 1 year, 4 at the end of 2 years, 3 at the end of

3 years, and 3 at the end of 4 years.

(2) D

ATE CERTAIN FOR APPOINTMENT

.—The Secretary shall

appoint the first members to the Council under paragraphs (4),

(5), and (6) of subsection (b) within 60 days after the date of

enactment of this section.

(d) C

HAIR

.—The Council shall elect one of its members as

Chairman of the Council.

(e) Q

UORUM

.—Nine members of the Council shall constitute a

quorum, but a lesser number may hold hearings.

(f) V

ACANCIES

.—Any vacancy in the Council shall not affect its

power to function.

(g) C

OMPENSATION

.—Each member of the Council who is not

otherwise employed by the United States Government shall receive

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00082 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

83 Sec. 763 PUBLIC HEALTH SERVICE ACT

Appropriations Acts for the Department of Health and Human Services for fiscal years 2004

and 2005 provided for the continued operation of the Council. See section 219 of division E of

Public Law 108–199 (118 Stat. 255) and section 218 of division F of Public Law 108–447 (118

Stat. 3141). Each of such sections refers to ‘‘the Council on Graduate Education established by

section 301 of Public Law 102–408’’. Such section 301 was transferred to the Public Health Serv-

ice Act as section 762 above by section 104(b) of Public Law 105–392 (112 Stat. 3552).

compensation at a rate equal to the daily rate prescribed for GS–

18 under the General Schedule under section 5332 of title 5,

United States Code, for each day, including traveltime, such mem-

ber is engaged in the actual performance of duties as a member of

the Council. A member of the Council who is an officer or employee

of the United States Government shall serve without additional

compensation. All members of the Council shall be reimbursed for

travel, subsistence, and other necessary expenses incurred by them

in the performance of their duties.

(h) C

ERTAIN

UTHORITIES AND

UTIES

.—

(1) A

UTHORITIES

.—In order to carry out the provisions of

this section, the Council is authorized to—

(A) collect such information, hold such hearings, and

sit and act at such times and places, either as a whole or

by subcommittee, and request the attendance and testi-

mony of such witnesses and the production of such books,

records, correspondence, memoranda, papers, and docu-

ments as the Council or such subcommittee may consider

available; and

(B) request the cooperation and assistance of Federal

departments, agencies, and instrumentalities, and such de-

partments, agencies, and instrumentalities are authorized

to provide such cooperation and assistance.

(2) C

OORDINATION OF ACTIVITIES

.—The Council shall co-

ordinate its activities with the activities of the Secretary under

section 792 of the Public Health Service Act. The Secretary

shall, in cooperation with the Council and pursuant to the rec-

ommendations of the Council, take such steps as are prac-

ticable to eliminate deficiencies in the data base established

under such section 792 and shall make available in its reports

such comprehensive data sets as are developed pursuant to

this section.

(i) R

EPORTS

.—Not later than September 30, 2023, and not less

than every 5 years thereafter, the Council

shall submit to the

Secretary, and to the Committee on Health, Education, Labor, and

Pensions of the Senate and the Committee on Energy and Com-

merce of the House of Representatives, a report on the rec-

ommendations described in subsection (a).

(j) F

UNDING

.—Amounts otherwise appropriated under this title

may be utilized by the Secretary to support the activities of the

Council.

SEC. 763. ø294p¿ TRAINING FOR HEALTH CARE PROVIDERS.

(a) G

RANT

ROGRAM

.—The Secretary shall establish a program

to award grants to accredited schools of allopathic medicine, osteo-

pathic medicine, and nursing, and other health professional train-

ing programs for the training of health care professionals to im-

prove the provision of prenatal care, labor care, birthing, and

postpartum care for racial and ethnic minority populations, includ-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00083 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

84 Sec. 764 PUBLIC HEALTH SERVICE ACT

There are two sections designated as section 764. For details, see footnote in second section

764 below.

ing with respect to perceptions and biases that may affect the ap-

proach to, and provision of, care.

(b) E

LIGIBILITY

.—To be eligible for a grant under subsection

(a), an entity described in such subsection shall submit to the Sec-

retary an application at such time, in such manner, and containing

such information as the Secretary may require.

EPORTING

EQUIREMENTS

.—

(1) P

ERIODIC GRANTEE REPORTS

.—Each entity awarded a

grant under this section shall periodically submit to the Sec-

retary a report on the status of activities conducted using the

grant, including a description of the impact of such training on

patient outcomes, as applicable.

(2) R

EPORT TO CONGRESS

.—Not later than September 30,

2026, the Secretary shall submit a report to Congress on the

activities conducted using grants under subsection (a) and any

best practices identified and disseminated under subsection (d).

(d) B

EST

RACTICES

.—The Secretary may identify and dissemi-

nate best practices for the training described in subsection (a).

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there are authorized to be appropriated $5,000,000 for each of

fiscal years 2023 through 2027.

SEC. 764. ø294s¿ RURAL MATERNAL AND OBSTETRIC CARE TRAINING

DEMONSTRATION.

(a) I

ENERAL

.—The Secretary shall award grants to accred-

ited schools of allopathic medicine, osteopathic medicine, and nurs-

ing, and other appropriate health professional training programs,

to establish a training demonstration program to support—

(1) training for physicians, medical residents, fellows,

nurse practitioners, physician assistants, nurses, certified

nurse midwives, relevant home visiting workforce professionals

and paraprofessionals, or other professionals who meet rel-

evant State training and licensing requirements, as applicable,

to reduce preventable maternal mortality and severe maternal

morbidity by improving prenatal care, labor care, birthing, and

postpartum care in rural community-based settings; and

(2) developing recommendations for such training pro-

grams.

(b) A

PPLICATION

.—To be eligible to receive a grant under sub-

section (a), an entity shall submit to the Secretary an application

at such time, in such manner, and containing such information as

the Secretary may require.

CTIVITIES

.—

(1) T

RAINING FOR HEALTH CARE PROFESSIONALS

.— A recipi-

ent of a grant under subsection (a)—

(A) shall use the grant funds to plan, develop, and op-

erate a training program to provide prenatal care, labor

care, birthing, and postpartum care in rural areas; and

(B) may use the grant funds to provide additional sup-

port for the administration of the program or to meet the

costs of projects to establish, maintain, or improve faculty

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00084 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

85 Sec. 764 PUBLIC HEALTH SERVICE ACT

Second section 764 is so in law. See amendment made by section 4 of P.L. 117-105.

development, or departments, divisions, or other units nec-

essary to implement such training.

(2) T

RAINING PROGRAM REQUIREMENTS

.—The recipient of a

grant under subsection (a) shall ensure that training programs

carried out under the grant are evidence-based and address

improving prenatal care, labor care, birthing, and postpartum

care in rural areas, and such programs may include training

on topics such as—

(A) maternal mental health, including perinatal de-

pression and anxiety;

(B) substance use disorders;

uals living in rural areas; and

(D) improving the provision of prenatal care, labor

care, birthing, and postpartum care for racial and ethnic

minority populations, including with respect to perceptions

and biases that may affect the approach to, and provision

of, care.

(d) E

VALUATION AND

EPORT

.—

(1) E

VALUATION

.—

(A) I

N GENERAL

.—The Secretary shall evaluate the

outcomes of the demonstration program under this section.

(B) D

ATA SUBMISSION

.—Recipients of a grant under

subsection (a) shall submit to the Secretary performance

metrics and other related data in order to evaluate the

program for the report described in paragraph (2).

(2) R

EPORT TO CONGRESS

.—Not later than January 1, 2026,

the Secretary shall submit to Congress a report that includes—

(A) an analysis of the effects of the demonstration pro-

gram under this section on the quality, quantity, and dis-

tribution of maternal health care services, including pre-

natal care, labor care, birthing, and postpartum care serv-

ices, and the demographics of the recipients of those serv-

ices;

(B) an analysis of maternal and infant health out-

comes (including quality of care, morbidity, and mortality)

before and after implementation of the program in the

communities served by entities participating in the dem-

onstration; and

program should be continued.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section $5,000,000 for each of

fiscal years 2023 through 2027.

SEC. 764. ø294t¿ PROGRAMS TO PROMOTE MENTAL HEALTH AMONG

THE HEALTH PROFESSIONAL WORKFORCE.

(a) P

ROGRAMS TO

ROMOTE

ENTAL

EALTH

MONG

EALTH

ARE

ROFESSIONALS

.—

(1) I

N GENERAL

.—The Secretary shall award grants or con-

tracts to health care entities, including entities that provide

health care services, such as hospitals, community health cen-

ters, and rural health clinics, or to medical professional asso-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00085 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

86 Sec. 765 PUBLIC HEALTH SERVICE ACT

ciations, to establish or enhance evidence-based or evidence-in-

formed programs dedicated to improving mental health and re-

siliency for health care professionals.

(2) U

SE OF FUNDS

.—An eligible entity receiving a grant or

contract under this subsection shall use funds received through

the grant or contract to implement a new program or enhance

an existing program to promote mental health among health

care professionals, which may include—

(A) improving awareness among health care profes-

sionals about risk factors for, and signs of, suicide and

mental health or substance use disorders, in accordance

with evidence-based or evidence-informed practices;

(B) establishing new, or enhancing existing, evidence-

based or evidence-informed programs for preventing sui-

cide and improving mental health and resiliency among

health care professionals;

port programs among health care professionals; or

(D) providing mental health care, follow-up services

and care, or referral for such services and care, as appro-

priate.

(3) P

RIORITY

.—In awarding grants and contracts under

this subsection, the Secretary shall give priority to eligible en-

tities in health professional shortage areas or rural areas.

(b) T

RAINING

RANTS

.—The Secretary may establish a program

to award grants to health professions schools, academic health cen-

ters, State or local governments, Indian Tribes or Tribal organiza-

tions, or other appropriate public or private nonprofit entities (or

consortia of entities, including entities promoting multidisciplinary

approaches) to support the training of health care students, resi-

dents, or health care professionals in evidence-based or evidence-

informed strategies to address mental and substance use disorders

and improve mental health and resiliency among health care pro-

fessionals.

RANT

ERMS

.—A grant or contract awarded under sub-

section (a) or (b) shall be for a period of 3 years.

(d) A

PPLICATION

UBMISSION

.—An entity seeking a grant or

contract under subsection (a) or (b) shall submit an application to

the Secretary at such time, in such manner, and accompanied by

such information as the Secretary may require.

(e) R

EPORTING

.—An entity awarded a grant or contract under

subsection (a) or (b) shall periodically submit to the Secretary a re-

port evaluating the activities supported by the grant or contract.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion and section 5 of the Dr. Lorna Breen Health Care Provider

Protection Act, there are authorized to be appropriated $35,000,000

for each of fiscal years 2022 through 2024.

Subpart 2—Public Health Workforce

SEC. 765. ø295¿ GENERAL PROVISIONS.

(a) I

ENERAL

.—The Secretary may award grants or contracts

to eligible entities to increase the number of individuals in the pub-

lic health workforce, to enhance the quality of such workforce, and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00086 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

87 Sec. 765 PUBLIC HEALTH SERVICE ACT

to enhance the ability of the workforce to meet national, State, and

local health care needs.

(b) E

LIGIBILITY

.—To be eligible to receive a grant or contract

under subsection (a) an entity shall—

(1) be—

(A) a health professions school, including an accredited

school or program of public health, health administration,

preventive medicine, or dental public health or a school

providing health management programs;

(B) an academic health center;

(D) any other appropriate public or private nonprofit

entity; and

(2) prepare and submit to the Secretary an application at

such time, in such manner, and containing such information as

the Secretary may require.

REFERENCE

.—In awarding grants or contracts under this

section the Secretary may grant a preference to entities—

(1) serving individuals who are from disadvantaged back-

grounds (including underrepresented racial and ethnic minori-

ties); and

(2) graduating large proportions of individuals who serve

in underserved communities.

(d) A

CTIVITIES

.—Amounts provided under a grant or contract

awarded under this section may be used for—

(1) the costs of planning, developing, or operating dem-

onstration training programs;

(2) faculty development;

(3) trainee support;

(4) technical assistance;

(5) to meet the costs of projects—

(A) to plan and develop new residency training pro-

grams and to maintain or improve existing residency

training programs in preventive medicine and dental pub-

lic health, that have available full-time faculty members

with training and experience in the fields of preventive

medicine and dental public health; and

(B) to provide financial assistance to residency train-

ees enrolled in such programs;

(6) the retraining of existing public health workers as well

as for increasing the supply of new practitioners to address pri-

ority public health, preventive medicine, public health den-

tistry, and health administration needs;

(7) preparing public health professionals for employment

at the State and community levels;

(8) public health workforce loan repayment programs; or

(9) other activities that may produce outcomes that are

consistent with the purposes of this section.

(e) T

RAINEESHIPS

.—

(1) I

N GENERAL

.—With respect to amounts used under this

section for the training of health professionals, such training

programs shall be designed to—

(A) make public health education more accessible to

the public and private health workforce;

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00087 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

88 Sec. 766 PUBLIC HEALTH SERVICE ACT

(B) increase the relevance of public health academic

preparation to public health practice in the future;

traditional on-campus programs in practice-based sites; or

(D) develop educational methods and distance-based

approaches or technology that address adult learning re-

quirements and increase knowledge and skills related to

community-based cultural diversity in public health edu-

cation.

(2) S

EVERE SHORTAGE DISCIPLINES

.—Amounts provided

under grants or contracts under this section may be used for

the operation of programs designed to award traineeships to

students in accredited schools of public health who enter edu-

cational programs in fields where there is a severe shortage of

public health professionals, including epidemiology, biostatis-

tics, environmental health, toxicology, public health nursing,

nutrition, preventive medicine, maternal and child health, and

behavioral and mental health professions.

SEC. 766. ø295a¿ PUBLIC HEALTH TRAINING CENTERS.

(a) I

ENERAL

.—The Secretary may make grants or contracts

for the operation of public health training centers.

(b) E

LIGIBLE

NTITIES

.—

(1) I

N GENERAL

.—A public health training center shall be

an accredited school of public health, or another public or non-

profit private institution accredited for the provision of grad-

uate or specialized training in public health, that plans, devel-

ops, operates, and evaluates projects to improve preventive

medicine, health promotion and disease prevention, or access

to and quality of health care services in rural or medically un-

derserved communities.

(2) P

REFERENCE

.—In awarding grants or contracts under

this section the Secretary shall give preference to accredited

schools of public health.

ERTAIN

EQUIREMENTS

.—With respect to a public health

training center, an award may not be made under subsection (a)

unless the program agrees that it—

(1) will establish or strengthen field placements for stu-

dents in public or nonprofit private health agencies or organi-

zations;

(2) will involve faculty members and students in collabo-

rative projects to enhance public health services to medically

underserved communities;

(3) will specifically designate a geographic area or medi-

cally underserved population to be served by the center that

shall be in a location removed from the main location of the

teaching facility of the school that is participating in the pro-

gram with such center; and

(4) will assess the health personnel needs of the area to be

served by the center and assist in the planning and develop-

ment of training programs to meet such needs.

SEC. 767. ø295b¿ PUBLIC HEALTH TRAINEESHIPS.

(a) I

ENERAL

.—The Secretary may make grants to accred-

ited schools of public health, and to other public or nonprofit pri-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00088 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

89 Sec. 769 PUBLIC HEALTH SERVICE ACT

vate institutions accredited for the provision of graduate or special-

ized training in public health, for the purpose of assisting such

schools and institutions in providing traineeships to individuals de-

scribed in subsection (b)(3).

(b) C

ERTAIN

EQUIREMENTS

.—

(1) A

MOUNT

.—The amount of any grant under this section

shall be determined by the Secretary.

(2) U

SE OF GRANT

.—Traineeships awarded under grants

made under subsection (a) shall provide for tuition and fees

and such stipends and allowances (including travel and sub-

sistence expenses and dependency allowances) for the trainees

as the Secretary may deem necessary.

(3) E

LIGIBLE INDIVIDUALS

.—The individuals referred to in

subsection (a) are individuals who are pursuing a course of

study in a health professions field in which there is a severe

shortage of health professionals (which fields include the fields

of epidemiology, environmental health, biostatistics, toxicology,

nutrition, and maternal and child health).

SEC. 768. ø295c¿ PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAIN-

ING GRANT PROGRAM.

(a) G

RANTS

.—The Secretary, acting through the Administrator

of the Health Resources and Services Administration and in con-

sultation with the Director of the Centers for Disease Control and

Prevention, shall award grants to, or enter into contracts with, eli-

gible entities to provide training to graduate medical residents in

preventive medicine specialties.

(b) E

LIGIBILITY

.—To be eligible for a grant or contract under

subsection (a), an entity shall be—

(1) an accredited school of public health or school of medi-

cine or osteopathic medicine;

(2) an accredited public or private nonprofit hospital;

(3) a State, local, or tribal health department; or

(4) a consortium of 2 or more entities described in para-

graphs (1) through (3).

SE OF

UNDS

.—Amounts received under a grant or con-

tract under this section shall be used to—

(1) plan, develop (including the development of curricula),

operate, or participate in an accredited residency or internship

program in preventive medicine or public health;

(2) defray the costs of practicum experiences, as required

in such a program; and

(3) establish, maintain, or improve—

(A) academic administrative units (including depart-

ments, divisions, or other appropriate units) in preventive

medicine and public health; or

(B) programs that improve clinical teaching in preven-

tive medicine and public health.

(d) R

EPORT

.—The Secretary shall submit to the Congress an

annual report on the program carried out under this section.

SEC. 769. ø295d¿ HEALTH ADMINISTRATION TRAINEESHIPS AND SPE-

CIAL PROJECTS.

(a) I

ENERAL

.—The Secretary may make grants to State or

local governments (that have in effect preventive medical and den-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00089 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

90 Sec. 770 PUBLIC HEALTH SERVICE ACT

tal public health residency programs) or public or nonprofit private

educational entities (including graduate schools of social work and

business schools that have health management programs) that

offer a program described in subsection (b)—

(1) to provide traineeships for students enrolled in such a

program; and

(2) to assist accredited programs health administration in

the development or improvement of programs to prepare stu-

dents for employment with public or nonprofit private entities.

(b) R

ELEVANT

ROGRAMS

.—The program referred to in sub-

section (a) is an accredited program in health administration, hos-

pital administration, or health policy analysis and planning, which

program is accredited by a body or bodies approved for such pur-

pose by the Secretary of Education and which meets such other

quality standards as the Secretary of Health and Human Services

by regulation may prescribe.

REFERENCE IN

AKING

RANTS

.—In making grants under

subsection (a), the Secretary shall give preference to qualified ap-

plicants that meet the following conditions:

(1) Not less than 25 percent of the graduates of the appli-

cant are engaged in full-time practice settings in medically un-

derserved communities.

(2) The applicant recruits and admits students from medi-

cally underserved communities.

(3) For the purpose of training students, the applicant has

established relationships with public and nonprofit providers of

health care in the community involved.

(4) In training students, the applicant emphasizes employ-

ment with public or nonprofit private entities.

(d) C

ERTAIN

ROVISIONS

EGARDING

RAINEESHIPS

.—

(1) U

SE OF GRANT

.—Traineeships awarded under grants

made under subsection (a) shall provide for tuition and fees

and such stipends and allowances (including travel and sub-

sistence expenses and dependency allowances) for the trainees

as the Secretary may deem necessary.

(2) P

REFERENCE FOR CERTAIN STUDENTS

.—Each entity ap-

plying for a grant under subsection (a) for traineeships shall

assure to the satisfaction of the Secretary that the entity will

give priority to awarding the traineeships to students who

demonstrate a commitment to employment with public or non-

profit private entities in the fields with respect to which the

traineeships are awarded.

SEC. 770. ø295e¿ AUTHORIZATION OF APPROPRIATIONS.

(a) I

ENERAL

.—For the purpose of carrying out this subpart,

there is authorized to be appropriated $17,000,000 for each of fiscal

years 2021 through 2025.

(b) L

IMITATION

EGARDING

ERTAIN

ROGRAM

.—In obligating

amounts appropriated under subsection (a), the Secretary may not

obligate more than 30 percent for carrying out section 767.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00090 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

91 Sec. 775 PUBLIC HEALTH SERVICE ACT

Subpart 3—Recruitment and Retention Programs

SEC. 775. ø295f¿ INVESTMENT IN TOMORROW’S PEDIATRIC HEALTH

CARE WORKFORCE.

(a) E

STABLISHMENT

.—The Secretary shall establish and carry

out a pediatric specialty loan repayment program under which the

eligible individual agrees to be employed full-time for a specified

period (which shall not be less than 2 years) in providing pediatric

medical subspecialty, pediatric surgical specialty, or child and ado-

lescent mental and behavioral health care, including substance

abuse prevention and treatment services.

(b) P

ROGRAM

DMINISTRATION

.—Through the program estab-

lished under this section, the Secretary shall enter into contracts

with qualified health professionals under which—

(1) such qualified health professionals will agree to provide

pediatric medical subspecialty, pediatric surgical specialty, or

child and adolescent mental and behavioral health care in an

area with a shortage of the specified pediatric subspecialty that

has a sufficient pediatric population to support such pediatric

subspecialty, as determined by the Secretary; and

(2) the Secretary agrees to make payments on the prin-

cipal and interest of undergraduate, graduate, or graduate

medical education loans of professionals described in para-

graph (1) of not more than $35,000 a year for each year of

agreed upon service under such paragraph for a period of not

more than 3 years during the qualified health professional’s—

(A) participation in an accredited pediatric medical

subspecialty, pediatric surgical specialty, or child and ado-

lescent mental health subspecialty residency or fellowship;

(B) employment as a pediatric medical subspecialist,

pediatric surgical specialist, or child and adolescent mental

health professional serving an area or population described

in such paragraph.

ENERAL

.—

(1) E

LIGIBLE INDIVIDUALS

.—

(A) P

EDIATRIC MEDICAL SPECIALISTS AND PEDIATRIC

SURGICAL SPECIALISTS

.—For purposes of contracts with re-

spect to pediatric medical specialists and pediatric surgical

specialists, the term ‘‘qualified health professional’’ means

a licensed physician who—

(i) is entering or receiving training in an accred-

ited pediatric medical subspecialty or pediatric sur-

gical specialty residency or fellowship; or

(ii) has completed (but not prior to the end of the

calendar year in which this section is enacted) the

training described in subparagraph (B).

(B) C

HILD AND ADOLESCENT MENTAL AND BEHAVIORAL

HEALTH

.—For purposes of contracts with respect to child

and adolescent mental and behavioral health care, the

term ‘‘qualified health professional’’ means a health care

professional who—

(i) has received specialized training or clinical ex-

perience in child and adolescent mental health in psy-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00091 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

92 Sec. 776 PUBLIC HEALTH SERVICE ACT

chiatry, psychology, school psychology, behavioral pe-

diatrics, psychiatric nursing, social work, school social

work, substance abuse disorder prevention and treat-

ment, marriage and family therapy, school counseling,

or professional counseling;

(ii) has a license or certification in a State to prac-

tice allopathic medicine, osteopathic medicine, psy-

chology, school psychology, psychiatric nursing, social

work, school social work, marriage and family therapy,

school counseling, or professional counseling; or

(iii) is a mental health service professional who

completed (but not before the end of the calendar year

in which this section is enacted) specialized training or

clinical experience in child and adolescent mental

health described in clause (i).

(2) A

DDITIONAL ELIGIBILITY REQUIREMENTS

.—The Secretary

may not enter into a contract under this subsection with an eli-

gible individual unless—

(A) the individual agrees to work in, or for a provider

serving, a health professional shortage area or medically

underserved area, or to serve a medically underserved pop-

ulation;

(B) the individual is a United States citizen or a per-

manent legal United States resident; and

the program is accredited, and the individual has an ac-

ceptable level of academic standing (as determined by the

Secretary).

(d) P

RIORITY

.—In entering into contracts under this subsection,

the Secretary shall give priority to applicants who—

(1) are or will be working in a school or other pre-kinder-

garten, elementary, or secondary education setting;

(2) have familiarity with evidence-based methods and cul-

tural and linguistic competence health care services; and

(3) demonstrate financial need.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated such sums as may be necessary for each of fiscal

years 2021 through 2025.

SEC. 776. ø295f–1¿ PUBLIC HEALTH WORKFORCE LOAN REPAYMENT

PROGRAM.

(a) E

STABLISHMENT

.—The Secretary shall establish the Public

Health Workforce Loan Repayment Program (referred to in this

section as the ‘‘Program’’) to assure an adequate supply of, and en-

courage recruitment and retention of, public health professionals to

eliminate critical public health workforce shortages in State, local,

and Tribal public health agencies.

(b) E

LIGIBILITY

.—To be eligible to participate in the Program,

an individual shall—

(1)(A)(i) be accepted for enrollment, or be enrolled, as a

student in an accredited institution of higher education or

school of public health in the final semester (or equivalent) of

a program leading to a certificate or degree, including a mas-

ter’s or doctoral degree, in public health, epidemiology, labora-

tory sciences, data systems, data science, data analytics,

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00092 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

93 Sec. 776 PUBLIC HEALTH SERVICE ACT

informatics, statistics, or another subject matter related to

public health; and

(ii) be employed by, or have accepted employment with, a

State, local, or Tribal public health agency, or a related train-

ing fellowship at such State, local, or Tribal public health

agency, as recognized by the Secretary, to commence upon

graduation; or

(B)(i) have graduated, during the preceding 10-year period,

from an accredited institution of higher education or school of

public health and received a certificate or degree, including a

master’s or doctoral degree, in public health, epidemiology, lab-

oratory sciences, data systems, data science, data analytics,

informatics, statistics, or another subject matter related to

public health; and

(ii) be employed by, or have accepted employment with, a

State, local, or Tribal public health agency or a related training

fellowship at such State, local, or Tribal public health agency,

as recognized by the Secretary;

(2) be a United States citizen; and

(3)(A) submit an application to the Secretary to participate

in the Program;

(B) execute a written contract as required in subsection (c);

and

(4) not have received, for the same service, a reduction of

loan obligations under section 455(m), 428J, 428K, 428L, or

460 of the Higher Education Act of 1965.

ONTRACT

.—The written contract (referred to in this section

as the ‘‘written contract’’) between the Secretary and an individual

shall contain—

(1) an agreement on the part of the Secretary that the Sec-

retary will repay on behalf of the individual loans incurred by

the individual in the pursuit of the relevant degree or certifi-

cate in accordance with the terms of the contract;

(2) an agreement on the part of the individual that the in-

dividual will serve in the full-time employment of a State,

local, or Tribal public health agency or a related fellowship

program in a position related to the course of study or program

for which the contract was awarded for a period of time (re-

ferred to in this section as the ‘‘period of obligated service’’) of

at least 3 consecutive years;

(3) an agreement, as appropriate, on the part of the indi-

vidual to relocate to a priority service area (as determined by

the Secretary) in exchange for an additional loan repayment

incentive amount to be determined by the Secretary;

(4) a provision that any financial obligation of the United

States arising out of a contract entered into under this section

and any obligation of the individual that is conditioned there-

on, is contingent on funds being appropriated for loan repay-

ments under this section;

(5) a statement of the damages to which the United States

is entitled, under this section for the individual’s breach of the

contract; and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00093 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

94 Sec. 776 PUBLIC HEALTH SERVICE ACT

(6) such other statements of the rights and liabilities of the

Secretary and of the individual, not inconsistent with this sec-

tion.

(d) P

AYMENTS

.—

(1) I

N GENERAL

.—A loan repayment provided for an indi-

vidual under a written contract under the Program shall con-

sist of payment, in accordance with paragraph (2), for the indi-

vidual toward the outstanding principal and interest on edu-

cation loans incurred by the individual in the pursuit of the

relevant degree or certificate described in subsection (b)(1) in

accordance with the terms of the contract.

(2) P

AYMENTS FOR YEARS SERVED

.—

(A) I

N GENERAL

.—For each year of obligated service

that an individual contracts to serve under subsection (c)

the Secretary may pay up to $50,000 on behalf of the indi-

vidual for loans described in paragraph (1). With respect

to participants under the Program whose total eligible

loans are less than $150,000, the Secretary shall pay an

amount that does not exceed

⁄

of the eligible loan balance

for each year of obligated service of the individual.

(B) C

ONSIDERATIONS

.—The Secretary may take action

in making awards under this section to ensure that—

(i) an appropriate proportion of contracts are

awarded to individuals who are eligible to participate

in the program pursuant to subsection (b)(1)(A); and

(ii) contracts awarded under this section are equi-

tably distributed among—

(I) the geographical regions of the United

States;

(II) local, State, and Tribal public health de-

partments; and

(III) such public health departments under

subclause (II) serving rural and urban areas.

(3) T

AX LIABILITY

.—For the purpose of providing reim-

bursements for tax liability resulting from payments under

paragraph (2) on behalf of an individual, the Secretary shall,

in addition to such payments, make payments to the individual

in an amount not to exceed 39 percent of the total amount of

loan repayments made for the taxable year involved.

(e) P

OSTPONING

BLIGATED

ERVICE

.—With respect to an indi-

vidual with a contract to serve under subsection (c), the date of the

initiation of the period of obligated service may be postponed as ap-

proved by the Secretary.

(f) B

REACH OF

ONTRACT

.—An individual who fails to comply

with the contract entered into under subsection (c) shall be subject

to the same financial penalties as provided for under section 338E

for breaches of loan repayment contracts under section 338B. In

the event that a participant fails to either begin or complete the

obligated service requirement of the loan repayment contract under

this section, the Secretary may waive or suspend either the

unfulfilled service or the assessed damages as provided for under

section 338E(d), as appropriate.

(g) E

LIGIBLE

OANS

.—The loans eligible for repayment under

this section are each of the following:

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00094 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

95 Sec. 776 PUBLIC HEALTH SERVICE ACT

(1) Any loan for education or training for employment by

a health department.

(2) Any loan under part E of title VIII (relating to nursing

student loans).

(3) Any Federal Direct Stafford Loan, Federal Direct PLUS

Loan, Federal Direct Unsubsidized Stafford Loan, or Federal

Direct Consolidation Loan (as such terms are used in section

455 of the Higher Education Act of 1965).

(4) Any Federal Perkins Loan under part E of title I of the

Higher Education Act of 1965.

(5) Any other Federal loan, as the Secretary determines

appropriate.

(h) P

ILOT

ROGRAM

.—

(1) I

N GENERAL

.—The Secretary shall, as appropriate, es-

tablish a pilot program, to be known as the Bio-Preparedness

Workforce Pilot Program, to provide for loan repayment for

health professionals with expertise in infectious diseases and

emergency preparedness and response activities to ensure an

adequate supply of such professionals. Such program shall be

administered consistent with the requirements of this section,

except that, to be eligible to participate in the pilot program,

an individual shall—

(A)(i) be accepted for enrollment, or be enrolled, as a

student in an accredited institution of higher education in

the final semester (or equivalent) of a program leading to

a health professions degree or certificate program relevant

to such program; or

(ii) have graduated, during the preceding 10-year pe-

riod, from an accredited institution of higher education

with a health professions degree or certificate program rel-

evant to such program; and

(B) be employed by, or have accepted employment

with—

(i) a Federal health care facility;

(ii) a nonprofit health care facility that is located

in a health professional shortage area (as defined in

section 332), a frontier health professional shortage

area (as defined in section 799B), or a medically un-

derserved community (as defined in section 799B);

(iii) an entity receiving assistance under title

XXVI for the provision of clinical services;

(iv) a health program, or a facility, operated by an

Indian Tribe or Tribal organization (as those terms

are defined in section 4 of the Indian Self-Determina-

tion and Education Assistance Act) or by an urban In-

dian organization (as defined in section 4 of the Indian

Health Care Improvement Act); or

(v) another relevant entity determined appropriate

by the Secretary, as a health professional with exper-

tise in infectious diseases or emergency preparedness

and response.

(2) N

DUPLICATION OF EFFORT

.—The Secretary shall en-

sure that the pilot program established under paragraph (1)

does not unnecessarily duplicate the National Health Service

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00095 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

96 Sec. 777 PUBLIC HEALTH SERVICE ACT

Corps Loan Repayment Program, or any other loan repayment

program operated by the Department of Health and Human

Services.

(3) E

VALUATION AND REPORT TO CONGRESS

.—

(A) I

N GENERAL

.—The Secretary shall evaluate the

pilot program at the conclusion of the first cycle of recipi-

ents funded by the pilot program.

(B) R

EPORT

.—

(i) I

N GENERAL

.—The Secretary shall submit to

the Committee on Health, Education, Labor, and Pen-

sions of the Senate and the Committee on Energy and

Commerce of the House of Representatives a report on

the evaluation under subparagraph (A). The report

shall include, at a minimum, outcomes information

from the pilot program, including any impact on re-

cruitment and retention of health professionals with

expertise in infectious diseases and emergency pre-

paredness and response activities.

(ii) R

ECOMMENDATION

.—The report under this

subparagraph shall include a recommendation by the

Secretary as to whether the pilot program under this

subsection should be extended.

(i) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized to

be appropriated to carry out this section $100,000,000 for each of

fiscal years 2023 through 2025.

SEC. 777. ø295f–2¿ TRAINING FOR MID-CAREER PUBLIC AND ALLIED

HEALTH PROFESSIONALS.

(a) I

ENERAL

.—The Secretary may make grants to, or enter

into contracts with, any eligible entity to award scholarships to eli-

gible individuals to enroll in degree or professional training pro-

grams for the purpose of enabling mid-career professionals in the

public health and allied health workforce to receive additional

training in the field of public health and allied health.

(b) E

LIGIBILITY

.—

(1) E

LIGIBLE ENTITY

.—The term ‘‘eligible entity’’ indicates

an accredited educational institution that offers a course of

study, certificate program, or professional training program in

public or allied health or a related discipline, as determined by

the Secretary

(2) E

LIGIBLE INDIVIDUALS

.—The term ‘‘eligible individuals’’

includes those individuals employed in public and allied health

positions at the Federal, State, tribal, or local level who are in-

terested in retaining or upgrading their education.

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section, $60,000,000 for fiscal

year 2010 and such sums as may be necessary for each of fiscal

years 2011 through 2015. Fifty percent of appropriated funds shall

be allotted to public health mid-career professionals and 50 percent

shall be allotted to allied health mid-career professionals.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00096 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

97 Sec. 781 PUBLIC HEALTH SERVICE ACT

SEC. 778. ø295f–3¿ FELLOWSHIP TRAINING IN APPLIED PUBLIC

HEALTH EPIDEMIOLOGY, PUBLIC HEALTH LABORATORY

SCIENCE, PUBLIC HEALTH INFORMATICS, AND EXPAN-

SION OF THE EPIDEMIC INTELLIGENCE SERVICE.

(a) I

ENERAL

.—The Secretary may carry out activities to ad-

dress documented workforce shortages in State and local health de-

partments in the critical areas of applied public health epidemi-

ology and public health laboratory science and informatics and may

expand the Epidemic Intelligence Service.

(b) S

PECIFIC

SES

.—In carrying out subsection (a), the Sec-

retary shall provide for the expansion of existing fellowship pro-

grams operated through the Centers for Disease Control and Pre-

vention in a manner that is designed to alleviate shortages of the

type described in subsection (a).

THER

ROGRAMS

.—The Secretary may provide for the ex-

pansion of other applied epidemiology training programs that meet

objectives similar to the objectives of the programs described in

subsection (b).

(d) W

ORK

BLIGATION

.—Participation in fellowship training

programs under this section shall be deemed to be service for pur-

poses of satisfying work obligations stipulated in contracts under

section 338I(j).

(e) G

ENERAL

UPPORT

.—Amounts may be used from grants

awarded under this section to expand the Public Health

Informatics Fellowship Program at the Centers for Disease Control

and Prevention to better support all public health systems at all

levels of government.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section $39,500,000 for each of

fiscal years 2010 through 2013, of which—

(1) $5,000,000 shall be made available in each such fiscal

year for epidemiology fellowship training program activities

under subsections (b) and (c);

(2) $5,000,000 shall be made available in each such fiscal

year for laboratory fellowship training programs under sub-

section (b);

(3) $5,000,000 shall be made available in each such fiscal

year for the Public Health Informatics Fellowship Program

under subsection (e); and

(4) $24,500,000 shall be made available for expanding the

Epidemic Intelligence Service under subsection (a).

PART F—SUBSTANCE USE DISORDER

TREATMENT WORKFORCE

SEC. 781. ø295h¿ LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE

DISORDER TREATMENT WORKFORCE.

(a) I

ENERAL

.—The Secretary, acting through the Adminis-

trator of the Health Resources and Services Administration, shall

carry out a program under which—

(1) the Secretary enters into agreements with individuals

to make payments in accordance with subsection (b) on the

principal of and interest on any eligible loan; and

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00097 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

98 Sec. 781 PUBLIC HEALTH SERVICE ACT

(2) the individuals each agree to the requirements of serv-

ice in substance use disorder treatment employment, as de-

scribed in subsection (d).

(b) P

AYMENTS

.—For each year of obligated service by an indi-

vidual pursuant to an agreement under subsection (a), the Sec-

retary shall make a payment to such individual as follows:

(1) S

ERVICE IN A SHORTAGE AREA

.—The Secretary shall

pay—

(A) for each year of obligated service by an individual

pursuant to an agreement under subsection (a),

⁄

of the

principal of and interest on each eligible loan of the indi-

vidual which is outstanding on the date the individual

began service pursuant to the agreement; and

(B) for completion of the sixth and final year of such

service, the remainder of such principal and interest.

(2) M

AXIMUM AMOUNT

.—The total amount of payments

under this section to any individual shall not exceed $250,000.

LIGIBLE

OANS

.—The loans eligible for repayment under

this section are each of the following:

(1) Any loan for education or training for a substance use

disorder treatment employment.

(2) Any loan under part E of title VIII (relating to nursing

student loans).

(3) Any Federal Direct Stafford Loan, Federal Direct PLUS

Loan, Federal Direct Unsubsidized Stafford Loan, or Federal

Direct Consolidation Loan (as such terms are used in section

455 of the Higher Education Act of 1965).

(4) Any Federal Perkins Loan under part E of title I of the

Higher Education Act of 1965.

(5) Any other Federal loan as determined appropriate by

the Secretary.

(d) R

EQUIREMENTS OF

ERVICE

.—Any individual receiving pay-

ments under this program as required by an agreement under sub-

section (a) shall agree to an annual commitment to full-time em-

ployment, with no more than 1 year passing between any 2 years

of covered employment, in substance use disorder treatment em-

ployment in the United States in—

(1) a Mental Health Professional Shortage Area, as des-

ignated under section 332; or

(2) a county (or a municipality, if not contained within any

county) where the mean drug overdose death rate per 100,000

people over the past 3 years for which official data is available

from the State, is higher than the most recent available na-

tional average overdose death rate per 100,000 people, as re-

ported by the Centers for Disease Control and Prevention.

(e) I

NELIGIBILITY FOR

OUBLE

ENEFITS

.—No borrower may,

for the same service, receive a reduction of loan obligations or a

loan repayment under both—

(1) this section; and

(2) any Federally supported loan forgiveness program, in-

cluding under section 338B, 338I, or 846 of this Act, or section

428J, 428L, 455(m), or 460 of the Higher Education Act of

1965.

(f) B

REACH

.—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00098 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

99 Sec. 781 PUBLIC HEALTH SERVICE ACT

(1) L

IQUIDATED DAMAGES FORMULA

.—The Secretary may

establish a liquidated damages formula to be used in the event

of a breach of an agreement entered into under subsection (a).

(2) L

IMITATION

.—The failure by an individual to complete

the full period of service obligated pursuant to such an agree-

ment, taken alone, shall not constitute a breach of the agree-

ment, so long as the individual completed in good faith the

years of service for which payments were made to the indi-

vidual under this section.

(g) A

DDITIONAL

RITERIA

.—The Secretary—

(1) may establish such criteria and rules to carry out this

section as the Secretary determines are needed and in addition

to the criteria and rules specified in this section; and

(2) shall give notice to the committees specified in sub-

section (h) of any criteria and rules so established.

(h) R

EPORT TO

ONGRESS

.—Not later than 5 years after the

date of enactment of this section, and every other year thereafter,

the Secretary shall prepare and submit to the Committee on En-

ergy and Commerce of the House of Representatives and the Com-

mittee on Health, Education, Labor, and Pensions of the Senate a

report on—

(1) the number and location of borrowers who have quali-

fied for loan repayments under this section; and

(2) the impact of this section on the availability of sub-

stance use disorder treatment employees nationally and in

shortage areas and counties described in subsection (d).

(i) D

EFINITION

.—In this section:

(1) The terms ‘‘Indian tribe’’ and ‘‘tribal organization’’ have

the meanings given those terms in section 4 of the Indian Self-

Determination and Education Assistance Act.

(2) The term ‘‘municipality’’ means a city, town, or other

public body created by or pursuant to State law, or an Indian

tribe.

(3) The term ‘‘substance use disorder treatment employ-

ment’’ means full-time employment (including a fellowship)—

(A) where the primary intent and function of the posi-

tion is the direct treatment or recovery support of patients

with or in recovery from a substance use disorder, includ-

ing master’s level social workers, psychologists, counselors,

marriage and family therapists, psychiatric mental health

practitioners, occupational therapists, psychology doctoral

interns, and behavioral health paraprofessionals and phy-

sicians, physician assistants, and nurses, who are licensed

or certified in accordance with applicable State and Fed-

eral laws; and

(B) which is located at a substance use disorder treat-

ment program, private physician practice, hospital or

health system-affiliated inpatient treatment center or out-

patient clinic (including an academic medical center-affili-

ated treatment program), correctional facility or program,

youth detention center or program, inpatient psychiatric

facility, crisis stabilization unit, community health center,

community mental health or other specialty community be-

havioral health center, recovery center, school, community-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00099 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

100 Sec. 791 PUBLIC HEALTH SERVICE ACT

based organization, telehealth platform, migrant health

center, health program or facility operated by an Indian

tribe or tribal organization, Federal medical facility, or any

other facility as determined appropriate for purposes of

this section by the Secretary.

(j) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section $25,000,000 for each of

fiscal years 2019 through 2023.

PART G—GENERAL PROVISIONS

SEC. 791. ø295j¿ PREFERENCES AND REQUIRED INFORMATION IN CER-

TAIN PROGRAMS.

(a) P

REFERENCES IN

AKING

WARDS

.—

(1) I

N GENERAL

.—Subject to paragraph (2), in making

awards of grants or contracts under any of sections 747 and

750, the Secretary shall give preference to any qualified appli-

cant that—

(A) has a high rate for placing graduates in practice

settings having the principal focus of serving residents of

medically underserved communities;

(B) during the 2-year period preceding the fiscal year

for which such an award is sought, has achieved a signifi-

cant increase in the rate of placing graduates in such set-

tings; or

section 761(d)(2)) and reports data from such system to the

national workforce database (as established under section

761(b)(2)(E)).

(2) L

IMITATION REGARDING PEER REVIEW

.—For purposes of

paragraph (1), the Secretary may not give an applicant pref-

erence if the proposal of the applicant is ranked at or below the

20th percentile of proposals that have been recommended for

approval by peer review groups.

(b) D

EFINITION

.—For purposes of this section, the term ‘‘grad-

uate’’ means, unless otherwise specified, an individual who has suc-

cessfully completed all training and residency requirements nec-

essary for full certification in the health profession selected by the

individual.

XCEPTIONS FOR

ROGRAMS

.—

(1) I

N GENERAL

.—To permit new programs to compete eq-

uitably for funding under this section, those new programs

that meet at least 4 of the criteria described in paragraph (3)

shall qualify for a funding preference under this section.

(2) D

EFINITION

.—As used in this subsection, the term ‘‘new

program’’ means any program that has graduated less than

three classes. Upon graduating at least three classes, a pro-

gram shall have the capability to provide the information nec-

essary to qualify the program for the general funding pref-

erences described in subsection (a).

(3) C

RITERIA

.—The criteria referred to in paragraph (1) are

the following:

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00100 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

101 Sec. 792 PUBLIC HEALTH SERVICE ACT

(A) The mission statement of the program identifies a

specific purpose of the program as being the preparation of

health professionals to serve underserved populations.

(B) The curriculum of the program includes content

which will help to prepare practitioners to serve under-

served populations.

under the program in medically underserved communities.

(D) A minimum of 20 percent of the clinical faculty of

the program spend at least 50 percent of their time pro-

viding or supervising care in medically underserved com-

munities.

(E) The entire program or a substantial portion of the

program is physically located in a medically underserved

community.

(F) Student assistance, which is linked to service in

medically underserved communities following graduation,

is available to the students in the program.

(G) The program provides a placement mechanism for

deploying graduates to medically underserved commu-

nities.

SEC. 792. ø295k¿ HEALTH PROFESSIONS DATA.

(a) I

ENERAL

.—The Secretary shall establish a program, in-

cluding a uniform health professions data reporting system, to col-

lect, compile, and analyze data on health professions personnel

which program shall initially include data respecting all physicians

and dentists in the States. The Secretary is authorized to expand

the program to include, whenever he determines it necessary, the

collection, compilation, and analysis of data respecting phar-

macists, optometrists, podiatrists, veterinarians, public health per-

sonnel, audiologists, speech pathologists, health care administra-

tion personnel, nurses, allied health personnel, medical tech-

nologists, chiropractors, clinical psychologists, professional coun-

selors, and any other health personnel in States designated by the

Secretary to be included in the program. Such data shall include

data respecting the training, licensure status (including perma-

nent, temporary, partial, limited, or institutional), place or places

of practice, professional specialty, practice characteristics, place

and date of birth, sex, and socioeconomic background of health pro-

fessions personnel and such other demographic information regard-

ing health professions personnel as the Secretary may require.

(b) C

ERTAIN

UTHORITIES AND

EQUIREMENTS

.—

(1) S

OURCES OF INFORMATION

.—In carrying out subsection

(a), the Secretary shall collect available information from ap-

propriate local, State, and Federal agencies and other appro-

priate sources.

(2) C

ONTRACTS FOR STUDIES OF HEALTH PROFESSIONS

.—The

Secretary shall conduct or enter into contracts for the conduct

of analytic and descriptive studies of the health professions, in-

cluding evaluations and projections of the supply of, and re-

quirements for, the health professions by specialty and geo-

graphic location. Such studies shall include studies deter-

mining by specialty and geographic location the number of

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00101 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

102 Sec. 792 PUBLIC HEALTH SERVICE ACT

So in law. Probably should be redesignated as (c).

So in law. Probably should be redesignated as (d).

health professionals (including allied health professionals and

health care administration personnel) who are members of mi-

nority groups, including Hispanics, and studies providing by

specialty and geographic location evaluations and projections of

the supply of, and requirements for, health professionals (in-

cluding allied health professionals and health care administra-

tion personnel) to serve minority groups, including Hispanics.

(3) G

RANTS AND CONTRACTS REGARDING STATES

.—The Sec-

retary is authorized to make grants and to enter into contracts

with States (or an appropriate nonprofit private entity in any

State) for the purpose of participating in the program estab-

lished under subsection (a). The Secretary shall determine the

amount and scope of any such grant or contract. To be eligible

for a grant or contract under this paragraph a State or entity

shall submit an application in such form and manner and con-

taining such information as the Secretary shall require. Such

application shall include reasonable assurance, satisfactory to

the Secretary, that—

(A) such State (or nonprofit entity within a State) will

establish a program of mandatory annual registration of

the health professions personnel described in subsection

(a) who reside or practice in such State and of health insti-

tutions licensed by such State, which registration shall in-

clude such information as the Secretary shall determine to

be appropriate;

(B) such State or entity shall collect such information

and report it to the Secretary in such form and manner as

the Secretary shall prescribe; and

ments of subsection (e).

(d)

EPORTS TO

ONGRESS

.—The Secretary shall submit to

the Congress on October 1, 1993, and biennially thereafter, the fol-

lowing reports:

(1) A comprehensive report regarding the status of health

personnel according to profession, including a report regarding

the analytic and descriptive studies conducted under this sec-

tion.

(2) A comprehensive report regarding applicants to, and

students enrolled in, programs and institutions for the training

of health personnel, including descriptions and analyses of stu-

dent indebtedness, student need for financial assistance, finan-

cial resources to meet the needs of students, student career

choices such as practice specialty and geographic location and

the relationship, if any, between student indebtedness and ca-

reer choices.

(e)

EQUIREMENTS

EGARDING

ERSONAL

ATA

.—

(1) I

N GENERAL

.—The Secretary and each program entity

shall in securing and maintaining any record of individually

identifiable personal data (hereinafter in this subsection re-

ferred to as ‘‘personal data’’) for purposes of this section—

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00102 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

103 Sec. 792 PUBLIC HEALTH SERVICE ACT

So in law. Probably should be redesignated as (e).

(A) inform any individual who is asked to supply per-

sonal data whether he is legally required, or may refuse,

to supply such data and inform him of any specific con-

sequences, known to the Secretary or program entity, as

the case may be, of providing or not providing such data;

(B) upon request, inform any individual if he is the

subject of personal data secured or maintained by the Sec-

retary or program entity, as the case may be, and make

the data available to him in a form comprehensible to him;

use is not within the purposes of this section unless an in-

formed consent has been obtained from the individual who

is the subject of such data; and

(D) upon request, inform any individual of the use

being made of personal data respecting such individual

and of the identity of the individuals and entities which

will use the data and their relationship to the programs

under this section.

(2) C

ONSENT AS PRECONDITION TO DISCLOSURE

.—Any entity

which maintains a record of personal data and which receives

a request from the Secretary or a program entity for such data

for purposes of this section shall not transfer any such data to

the Secretary or to a program entity unless the individual

whose personal data is to be so transferred gives an informed

consent for such transfer.

(3) D

ISCLOSURE BY SECRETARY

.—

(A) Notwithstanding any other provision of law, per-

sonal data collected by the Secretary or any program enti-

ty under this section may not be made available or dis-

closed by the Secretary or any program entity to any per-

son other than the individual who is the subject of such

data unless (i) such person requires such data for purposes

of this section, or (ii) in response to a demand for such

data made by means of compulsory legal process. Any indi-

vidual who is the subject of personal data made available

or disclosed under clause (ii) shall be notified of the de-

mand for such data.

(B) Subject to all applicable laws regarding confiden-

tiality, only the data collected by the Secretary under this

section which is not personal data shall be made available

to bona fide researchers and policy analysts (including the

Congress) for the purposes of assisting in the conduct of

studies respecting health professions personnel.

(4) D

EFINITION

.—For purposes of this subsection, the term

‘‘program entity’’ means any public or private entity which col-

lects, compiles, or analyzes health professions data under a

grant, contract, or other arrangement with the Secretary under

this section.

(g)

ECHNICAL

SSISTANCE

.—The Secretary shall provide

technical assistance to the States and political subdivisions thereof

in the development of systems (including model laws) concerning

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00103 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

104 Sec. 794 PUBLIC HEALTH SERVICE ACT

So in law. Probably should be redesignated as (f).

Section 793 was repealed by section 106(a)(2)(C) of Public Law 105–392 (112 Stat. 3557).

Section 795 was repealed by section 101(b)(1) of Public Law 105–392 (112 Stat. 3537).

confidentiality and comparability of data collected pursuant to this

section.

(h)

RANTS AND

ONTRACTS

EGARDING

ONPROFIT

NTI

TIES

.—

(1) I

N GENERAL

.—In carrying out subsection (a), the Sec-

retary may make grants, or enter into contracts and coopera-

tive agreements with, and provide technical assistance to, any

nonprofit entity in order to establish a uniform allied health

professions data reporting system to collect, compile, and ana-

lyze data on the allied health professions personnel.

(2) R

EPORTS

.—With respect to reports required in sub-

section (d), each such report made on or after October 1, 1991,

shall include a description and analysis of data collected pursu-

ant to paragraph (1).

SEC. 794.

ø295m¿ PROHIBITION AGAINST DISCRIMINATION ON BASIS

OF SEX.

The Secretary may not make a grant, loan guarantee, or inter-

est subsidy payment under this title to, or for the benefit of, any

school of medicine, osteopathic medicine, dentistry, veterinary med-

icine, optometry, pharmacy, podiatric medicine, or public health or

any training center for allied health personnel, or graduate pro-

gram in clinical psychology, unless the application for the grant,

loan guarantee, or interest subsidy payment contains assurances

satisfactory to the Secretary that the school or training center will

not discriminate on the basis of sex in the admission of individuals

to its training programs. The Secretary may not enter into a con-

tract under this title with any such school or training center unless

the school, training center, or graduate program furnishes assur-

ances satisfactory to the Secretary that it will not discriminate on

the basis of sex in the admission of individuals to its training pro-

grams. In the case of a school of medicine which—

(1) on the date of the enactment of this sentence is in the

process of changing its status as an institution which admits

only female students to that of an institution which admits

students without regard to their sex, and

(2) is carrying out such change in accordance with a plan

approved by the Secretary,

the provisions of the preceding sentences of this section shall apply

only with respect to a grant, contract, loan guarantee, or interest

subsidy to, or for the benefit of such a school for a fiscal year begin-

ning after June 30, 1979.

SEC. 796.

ø295n–1¿ APPLICATION.

(a) I

ENERAL

.—To be eligible to receive a grant or contract

under this title, an eligible entity shall prepare and submit to the

Secretary an application that meets the requirements of this sec-

tion, at such time, in such manner, and containing such informa-

tion as the Secretary may require.

(b) P

LAN

.—An application submitted under this section shall

contain the plan of the applicant for carrying out a project with

amounts received under this title. Such plan shall be consistent

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00104 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

105 Sec. 799 PUBLIC HEALTH SERVICE ACT

with relevant Federal, State, or regional health professions pro-

gram plans.

ERFORMANCE

UTCOME

TANDARDS

.—An application sub-

mitted under this section shall contain a specification by the appli-

cant entity of performance outcome standards that the project to be

funded under the grant or contract will be measured against. Such

standards shall address relevant health workforce needs that the

project will meet. The recipient of a grant or contract under this

section shall meet the standards set forth in the grant or contract

application.

(d) L

INKAGES

.—An application submitted under this section

shall contain a description of the linkages with relevant edu-

cational and health care entities, including training programs for

other health professionals as appropriate, that the project to be

funded under the grant or contract will establish. To the extent

practicable, grantees under this section shall establish linkages

with health care providers who provide care for underserved com-

munities and populations.

SEC. 797. ø295n–2¿ USE OF FUNDS.

(a) I

ENERAL

.—Amounts provided under a grant or contract

awarded under this title may be used for training program develop-

ment and support, faculty development, model demonstrations,

trainee support including tuition, books, program fees and reason-

able living expenses during the period of training, technical assist-

ance, workforce analysis, dissemination of information, and explor-

ing new policy directions, as appropriate to meet recognized health

workforce objectives, in accordance with this title.

(b) M

AINTENANCE OF

FFORT

.—With respect to activities for

which a grant awarded under this title is to be expended, the enti-

ty shall agree to maintain expenditures of non-Federal amounts for

such activities at a level that is not less than the level of such ex-

penditures maintained by the entity for the fiscal year preceding

the fiscal year for which the entity receives such a grant.

SEC. 798. ø295o¿ MATCHING REQUIREMENT.

The Secretary may require that an entity that applies for a

grant or contract under this title provide non-Federal matching

funds, as appropriate, to ensure the institutional commitment of

the entity to the projects funded under the grant. As determined

by the Secretary, such non-Federal matching funds may be pro-

vided directly or through donations from public or private entities

and may be in cash or in-kind, fairly evaluated, including plant,

equipment, or services.

SEC. 799. ø295o–1¿ GENERALLY APPLICABLE PROVISIONS.

(a) A

WARDING OF

RANTS AND

ONTRACTS

.—The Secretary

shall ensure that grants and contracts under this title are awarded

on a competitive basis, as appropriate, to carry out innovative dem-

onstration projects or provide for strategic workforce supplemen-

tation activities as needed to meet health workforce goals and in

accordance with this title. Contracts may be entered into under

this title with public or private entities as may be necessary.

(b) E

LIGIBLE

NTITIES

.—Unless specifically required otherwise

in this title, the Secretary shall accept applications for grants or

contracts under this title from health professions schools, academic

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00105 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

106 Sec. 799 PUBLIC HEALTH SERVICE ACT

So in law. Probably should read ‘‘section’’.

health centers, State or local governments, or other appropriate

public or private nonprofit entities for funding and participation in

health professions and nursing training activities. The Secretary

may accept applications from for-profit private entities if deter-

mined appropriate by the Secretary.

NFORMATION

EQUIREMENTS

.—

(1) I

N GENERAL

.—Recipients of grants and contracts under

this title shall meet information requirements as specified by

the Secretary.

(2) D

ATA COLLECTION

.—The Secretary shall establish pro-

cedures to ensure that, with respect to any data collection re-

quired under this title, such data is collected in a manner that

takes into account age, sex, race, and ethnicity.

(3) U

SE OF FUNDS

.—The Secretary shall establish proce-

dures to permit the use of amounts appropriated under this

title to be used for data collection purposes.

(4) E

VALUATIONS

.—The Secretary shall establish proce-

dures to ensure the annual evaluation of programs and

projects operated by recipients of grants or contracts under this

title. Such procedures shall ensure that continued funding for

such programs and projects will be conditioned upon a dem-

onstration that satisfactory progress has been made by the pro-

gram or project in meeting the objectives of the program or

project.

(d) T

RAINING

ROGRAMS

.—Training programs conducted with

amounts received under this title shall meet applicable accredita-

tion and quality standards.

(e) D

URATION OF

SSISTANCE

.—

(1) I

N GENERAL

.—Subject to paragraph (2), in the case of

an award to an entity of a grant, cooperative agreement, or

contract under this title, the period during which payments are

made to the entity under the award may not exceed 5 years.

The provision of payments under the award shall be subject to

annual approval by the Secretary of the payments and subject

to the availability of appropriations for the fiscal year involved

to make the payments. This paragraph may not be construed

as limiting the number of awards under the program involved

that may be made to the entity.

(2) L

IMITATION

.—In the case of an award to an entity of a

grant, cooperative agreement, or contract under this title,

paragraph (1) shall apply only to the extent not inconsistent

with any other provision of this title that relates to the period

during which payments may be made under the award.

(f) P

EER

EVIEW

EGARDING

ERTAIN

ROGRAMS

.—

(1) I

N GENERAL

.—Each application for a grant under this

title, except any scholarship or loan program, including those

under sections

701, 721, or 723, shall be submitted to a peer

review group for an evaluation of the merits of the proposals

made in the application. The Secretary may not approve such

an application unless a peer review group has recommended

the application for approval.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00106 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

107 Sec. 799B PUBLIC HEALTH SERVICE ACT

(2) C

OMPOSITION

.—Each peer review group under this sub-

section shall be composed principally of individuals who are

not officers or employees of the Federal Government. In pro-

viding for the establishment of peer review groups and proce-

dures, the Secretary shall ensure sex, racial, ethnic, and geo-

graphic balance among the membership of such groups.

(3) A

DMINISTRATION

.—This subsection shall be carried out

by the Secretary acting through the Administrator of the

Health Resources and Services Administration.

(g) P

REFERENCE OR

RIORITY

ONSIDERATIONS

.—In considering

a preference or priority for funding which is based on outcome

measures for an eligible entity under this title, the Secretary may

also consider the future ability of the eligible entity to meet the

outcome preference or priority through improvements in the eligi-

ble entity’s program design.

(h) A

NALYTIC

CTIVITIES

.—The Secretary shall ensure that—

(1) cross-cutting workforce analytical activities are carried

out as part of the workforce information and analysis activities

under section 761; and

(2) discipline-specific workforce information and analytical

activities are carried out as part of—

(A) the community-based linkage program under part

D; and

(B) the health workforce development program under

subpart 2 of part E.

(i) O

STEOPATHIC

CHOOLS

.—For purposes of this title, any ref-

erence to—

(1) medical schools shall include osteopathic medical

schools; and

(2) medical students shall include osteopathic medical stu-

dents.

SEC. 799A. ø295o–2¿ TECHNICAL ASSISTANCE.

Funds appropriated under this title may be used by the Sec-

retary to provide technical assistance in relation to any of the au-

thorities under this title.

SEC. 799B. ø295p¿ DEFINITIONS.

For purposes of this title:

(1)(A) The terms ‘‘school of medicine’’, ‘‘school of dentistry’’,

‘‘school of osteopathic medicine’’, ‘‘school of pharmacy’’, ‘‘school

of optometry’’, ‘‘school of podiatric medicine’’, ‘‘school of veteri-

nary medicine’’, ‘‘school of public health’’, and ‘‘school of chiro-

practic’’ mean an accredited public or nonprofit private school

in a State that provides training leading, respectively, to a de-

gree of doctor of medicine, a degree of doctor of dentistry or an

equivalent degree, a degree of doctor of osteopathy, a degree of

bachelor of science in pharmacy or an equivalent degree or a

degree of doctor of pharmacy or an equivalent degree, a degree

of doctor of optometry or an equivalent degree, a degree of doc-

tor of podiatric medicine or an equivalent degree, a degree of

doctor of veterinary medicine or an equivalent degree, a grad-

uate degree in public health or an equivalent degree, and a de-

gree of doctor of chiropractic or an equivalent degree, and in-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00107 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

108 Sec. 799B PUBLIC HEALTH SERVICE ACT

Section 108(a)(2) of Public Law 105–392 (112 Stat. 3560) provides that paragraph (1)(D) is

amended by inserting ‘‘behavioral health and mental health practice,’’ before ‘‘clinical’’. The

amendment cannot be executed because the amendment does not specify to which instance of

the term ‘‘clinical’’ the amendment applies.

cluding advanced training related to such training provided by

any such school.

(B) The terms ‘‘graduate program in health administra-

tion’’ and ‘‘graduate program in clinical psychology’’ mean an

accredited graduate program in a public or nonprofit private

institution in a State that provides training leading, respec-

tively, to a graduate degree in health administration or an

equivalent degree and a doctoral degree in clinical psychology

or an equivalent degree.

and ‘‘graduate program in marriage and family therapy’’ and

‘‘graduate program in professional counseling’’ mean an accred-

ited graduate program in a public or nonprofit private institu-

tion in a State that provides training, respectively, in a con-

centration in health or mental health care leading to a grad-

uate degree in social work and a concentration leading to a

graduate degree in marriage and family therapy and a con-

centration leading to a graduate degree in counseling.

(D)

The term ‘‘graduate program in behavioral health

and mental health practice’’ means a graduate program in clin-

ical psychology, clinical social work, professional counseling, or

marriage and family therapy.

(E) The term ‘‘accredited’’, when applied to a school of

medicine, osteopathic medicine, dentistry, veterinary medicine,

optometry, podiatry, pharmacy, public health, or chiropractic,

or a graduate program in health administration, clinical psy-

chology, clinical social work, professional counseling, or mar-

riage and family therapy, means a school or program that is

accredited by a recognized body or bodies approved for such

purpose by the Secretary of Education, except that a new

school or program that, by reason of an insufficient period of

operation, is not, at the time of application for a grant or con-

tract under this title, eligible for accreditation by such a recog-

nized body or bodies, shall be deemed accredited for purposes

of this title, if the Secretary of Education finds, after consulta-

tion with the appropriate accreditation body or bodies, that

there is reasonable assurance that the school or program will

meet the accreditation standards of such body or bodies prior

to the beginning of the academic year following the normal

graduation date of the first entering class in such school or

program.

(2) The term ‘‘teaching facilities’’ means areas dedicated

for use by students, faculty, or administrative or maintenance

personnel for clinical purposes, research activities, libraries,

classrooms, offices, auditoriums, dining areas, student activi-

ties, or other related purposes necessary for, and appropriate

to, the conduct of comprehensive programs of education. Such

term includes interim facilities but does not include off-site im-

provements or living quarters.

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00108 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

109 Sec. 799B PUBLIC HEALTH SERVICE ACT

(3) P

HYSICIAN ASSISTANT EDUCATION PROGRAM

.—The term

‘‘physician assistant education program’’ means an educational

program in a public or private institution in a State that—

(A) has as its objective the education of individuals

who, upon completion of their studies in the program, be

qualified to provide primary care medical services with the

supervision of a physician; and

(B) is accredited by the Accreditation Review Commis-

sion on Education for the Physician Assistant.

(4) The term ‘‘school of allied health’’ means a public or

nonprofit private college, junior college, or university or hos-

pital-based educational entity that—

(A) provides, or can provide, programs of education to

enable individuals to become allied health professionals or

to provide additional training for allied health profes-

sionals;

(B) provides training for not less than a total of twenty

persons in the allied health curricula (except that this sub-

paragraph shall not apply to any hospital-based edu-

cational entity);

and

(D) is accredited by a recognized body or bodies ap-

proved for such purposes by the Secretary of Education, or

which provides to the Secretary satisfactory assurance by

such accrediting body or bodies that reasonable progress is

being made toward accreditation.

(5) The term ‘‘allied health professionals’’ means a health

professional (other than a registered nurse or physician assist-

ant)—

(A) who has received a certificate, an associate’s de-

gree, a bachelor’s degree, a master’s degree, a doctoral de-

gree, or postbaccalaureate training, in a science relating to

health care;

(B) who shares in the responsibility for the delivery of

health care services or related services, including—

(i) services relating to the identification, evalua-

tion, and prevention of disease and disorders;

(ii) dietary and nutrition services;

(iii) health promotion services;

(iv) rehabilitation services; or

(v) health systems management services; and

cine, a degree of doctor of osteopathy, a degree of doctor

of dentistry or an equivalent degree, a degree of doctor of

veterinary medicine or an equivalent degree, a degree of

doctor of optometry or an equivalent degree, a degree of

doctor of podiatric medicine or an equivalent degree, a de-

gree of bachelor of science in pharmacy or an equivalent

degree, a degree of doctor of pharmacy or an equivalent de-

gree, a graduate degree in public health or an equivalent

degree, a degree of doctor of chiropractic or an equivalent

degree, a graduate degree in health administration or an

equivalent degree, a doctoral degree in clinical psychology

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00109 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

110 Sec. 799B PUBLIC HEALTH SERVICE ACT

The reference in paragraph (6)(B) to section 329 refers to section 329 of the Act of July 1,

1944, which was omitted in the general amendment of subpart I of part D of this title by section

2 of Public Law 104-299 (110 Stat. 3626; October 11, 1996). Section 340A, referred to in para-

graph (6)(B), was repealed by section 4(a)(3) of Public Law 104-299.

or an equivalent degree, or a degree in social work or an

equivalent degree or a degree in counseling or an equiva-

lent degree.

(6) The term ‘‘medically underserved community’’ means

an urban or rural area or population that—

(A) is eligible for designation under section 332 as a

health professional shortage area;

(B) is eligible to be served by a migrant health center

under section 329

, a community health center under sec-

tion 330

, a grantee under section 330(h) (relating to

homeless individuals), or a grantee under section 340A

(relating to residents of public housing);

termined under criteria issued by the Secretary under sec-

tion 1861(aa)(2) of the Social Security Act (relating to rural

health clinics); or

(D) is designated by a State Governor (in consultation

with the medical community) as a shortage area or medi-

cally underserved community.

(7) The term ‘‘Department’’ means the Department of

Health and Human Services.

(8) The term ‘‘nonprofit’’ refers to the status of an entity

owned and operated by one or more corporations or associa-

tions no part of the net earnings of which inures, or may law-

fully inure, to the benefit of any private shareholder or indi-

vidual.

(9) The term ‘‘State’’ includes, in addition to the several

States, only the District of Columbia, the Commonwealth of

Puerto Rico, the Commonwealth of the Northern Mariana Is-

lands, the Virgin Islands, Guam, American Samoa, and the

Trust Territory of the Pacific Islands.

(10)(A) Subject to subparagraph (B), the term ‘‘underrep-

resented minorities’’ means, with respect to a health profes-

sion, racial and ethnic populations that are underrepresented

in the health profession relative to the number of individuals

who are members of the population involved.

(B) For purposes of subparagraph (A), Asian individuals

shall be considered by the various subpopulations of such indi-

viduals.

(11) The term ‘‘psychologist’’ means an individual who—

(A) holds a doctoral degree in psychology; and

(B) is licensed or certified on the basis of the doctoral

degree in psychology, by the State in which the individual

practices, at the independent practice level of psychology

to furnish diagnostic, assessment, preventive, and thera-

peutic services directly to individuals.

(12) A

REA HEALTH EDUCATION CENTER

.—The term ‘‘area

health education center’’ means a public or nonprofit private

organization that has a cooperative agreement or contract in

effect with an entity that has received an award under sub-

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00110 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

111 Sec. 799B PUBLIC HEALTH SERVICE ACT

section (a)(1) or (a)(2) of section 751, satisfies the requirements

in section 751(d)(1), and has as one of its principal functions

the operation of an area health education center. Appropriate

organizations may include hospitals, health organizations with

accredited primary care training programs, accredited physi-

cian assistant educational programs associated with a college

or university, and universities or colleges not operating a

school of medicine or osteopathic medicine.

(13) A

REA HEALTH EDUCATION CENTER PROGRAM

.—The

term ‘‘area health education center program’’ means coopera-

tive program consisting of an entity that has received an

award under subsection (a)(1) or (a)(2) of section 751 for the

purpose of planning, developing, operating, and evaluating an

area health education center program and one or more area

health education centers, which carries out the required activi-

ties described in section 751(c), satisfies the program require-

ments in such section, has as one of its principal functions

identifying and implementing strategies and activities that ad-

dress health care workforce needs in its service area, in coordi-

nation with the local workforce investment boards.

(14) C

LINICAL SOCIAL WORKER

.—The term ‘‘clinical social

worker’’ has the meaning given the term in section 1861(hh)(1)

of the Social Security Act (42 U.S.C. 1395x(hh)(1)).

(15) C

ULTURAL COMPETENCY

.—The term ‘‘cultural com-

petency’’ shall be defined by the Secretary in a manner con-

sistent with section 1707(d)(3).

(16) D

IRECT CARE WORKER

.—The term ‘‘direct care worker’’

has the meaning given that term in the 2010 Standard Occu-

pational Classifications of the Department of Labor for Home

Health Aides [31–1011], Psychiatric Aides [31–1013], Nursing

Assistants [31–1014], and Personal Care Aides [39–9021].

(17) F

EDERALLY QUALIFIED HEALTH CENTER

.—The term

‘‘Federally qualified health center’’ has the meaning given that

term in section 1861(aa) of the Social Security Act (42 U.S.C.

1395x(aa)).

(18) F

RONTIER HEALTH PROFESSIONAL SHORTAGE AREA

.—

The term ‘‘frontier health professional shortage area’’ means an

area—

(A) with a population density less than 6 persons per

square mile within the service area; and

(B) with respect to which the distance or time for the

population to access care is excessive.

(19) G

RADUATE PSYCHOLOGY

.—The term ‘‘graduate psy-

chology’’ means an accredited program in professional psy-

chology.

(20) H

EALTH DISPARITY POPULATION

.—The term ‘‘health

disparity population’’ has the meaning given such term in sec-

tion 903(d)(1).

(21) H

EALTH LITERACY

.—The term ‘‘health literacy’’ means

the degree to which an individual has the capacity to obtain,

communicate, process, and understand health information and

services in order to make appropriate health decisions.

(22) M

ENTAL HEALTH SERVICE PROFESSIONAL

.—The term

‘‘mental health service professional’’ means an individual with

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00111 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022

112 Sec. 799B PUBLIC HEALTH SERVICE ACT

a graduate or postgraduate degree from an accredited institu-

tion of higher education in psychiatry, psychology, school psy-

chology, behavioral pediatrics, psychiatric nursing, social work,

school social work, substance abuse disorder prevention and

treatment, marriage and family counseling, school counseling,

or professional counseling.

(23) O

STOP DELIVERY SYSTEM CENTER

.—The term ‘‘one-

stop delivery system’’ means a one-stop delivery system de-

scribed in section 121(e) of the Workforce Innovation and Op-

portunity Act.

(24) P

ARAPROFESSIONAL CHILD AND ADOLESCENT MENTAL

HEALTH WORKER

.—The term ‘‘paraprofessional child and ado-

lescent mental health worker’’ means an individual who is not

a mental or behavioral health service professional, but who

works at the first stage of contact with children and families

who are seeking mental or behavioral health services, includ-

ing substance abuse prevention and treatment services.

(25) R

ACIAL AND ETHNIC MINORITY GROUP

;

RACIAL AND ETH

NIC MINORITY POPULATION

.—The terms ‘‘racial and ethnic mi-

nority group’’ and ‘‘racial and ethnic minority population’’ have

the meaning given the term ‘‘racial and ethnic minority group’’

in section 1707.

(26) R

URAL HEALTH CLINIC

.—The term ‘‘rural health clinic’’

has the meaning given that term in section 1861(aa) of the So-

cial Security Act (42 U.S.C. 1395x(aa)).

VerDate Nov 24 2008 13:02 Mar 03, 2023 Jkt 000000 PO 00000 Frm 00112 Fmt 9001 Sfmt 9001 G:\COMP\PHSA\PHSAVHPE.BEL HOLC

March 3, 2023

G:\COMP\PHSA\PUBLIC HEALTH SERVICE ACT-TITLE VIIHEALTH PR....XML

As Amended Through P.L. 117-328, Enacted December 29, 2022