Health Professions Training Improvement Act of 1991 - Amends the Public Health Service Act to require that, in making competitive grants under provisions relating to health research and teaching facilities and training of professional health personnel or provisions relating to nurse education, priority be given to applicants providing certain services or having certain interactions with medically underserved communities. Requires that, after FY 1994, at least 50 percent of the amounts appropriated for such grants be awarded to institutions which meet requirements regarding the percentage of their graduates practicing in such communities.
Mandates grants to health professions institutions to expand training programs targeted at individuals desiring to serve the needs of such communities. Authorizes appropriations.
Mandates grants to regional consortia (comprised of at least one medical school and at least one health professions school that is not a medical school) to enhance and expand coordination among various health professions programs, particularly in medically underserved rural areas. Authorizes appropriations.
S 1148 IS 102d CONGRESS 1st Session S. 1148 To amend title VII of the Public Health Service Act to improve certain health professions training programs, and for other purposes. IN THE SENATE OF THE UNITED STATES May 23 (legislative day, APRIL 25), 1991 Mrs. KASSEBAUM introduced the following bill; which was read twice and referred to the Committee on Labor and Human Resources A BILL To amend title VII of the Public Health Service Act to improve certain health professions training programs, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the `Health Professions Training Improvement Act of 1991'. SEC. 2. REFERENCES. Except as otherwise provided, whenever in this Act an amendment or repeal is expressed in terms of an amendment to, or repeal of, a section or other provision, the reference shall be considered to be made to a section or other provision of the Public Health Service Act (42 U.S.C. 201 et seq.). SEC. 3. MEDICALLY UNDERSERVED AREA TRAINING INCENTIVES. Part A of title VII (42 U.S.C. 292 et seq.) is amended by adding at the end thereof the following new section: `SEC. 711. PRIORITIES IN AWARDING OF GRANTS. `(a) ALLOCATION OF COMPETITIVE GRANT FUNDS- In awarding competitive grants under this title or title VIII, the Secretary shall, among applicants that meet the eligibility requirements under such titles, give priority to entities submitting applications that-- `(1) can demonstrate that such entities-- `(A) have a high permanent rate for placing graduates in practice settings which serve residents of medically underserved communities; and `(B) have a curriculum that includes-- `(i) the rotation of medical students and residents to clinical settings whose focus is to serve medically underserved communities; `(ii) the appointment of health professionals whose practices serve medically underserved communities to act as preceptors to supervise training in such settings; `(iii) classroom instruction on practice opportunities involving medically underserved communities; `(iv) service contingent scholarship or loan repayment programs for students and residents to encourage practice in or service to underserved communities; `(v) the recruitment of students who are most likely to elect to practice in or provide service to medically underserved communities; `(vi) other training methodologies that demonstrate a significant commitment to the expansion of the proportion of graduates that elect to practice in or serve the needs of medically underserved communities; or `(2) contain an organized plan for the expeditious development of the placement rate and curriculum described in paragraph (1). `(b) SERVICE IN MEDICALLY UNDERSERVED COMMUNITIES- Not less than 50 percent of the amounts appropriated for fiscal year 1995, and for each subsequent fiscal year, for competitive grants under this title or title VIII, shall be used to award grants to institutions that are otherwise eligible for grants under such titles, and that can demonstrate that-- `(1) not less than 15 percent of the graduates of such institutions during the preceding 2-year period are engaged in full-time practice serving the needs of medically underserved communities; or `(2) the number of the graduates of such institutions that are practicing in a medically underserved community has increased by not less than 50 percent over that proportion of such graduates for the previous 2-year period. `(c) WAIVERS- A health professions school may petition the Secretary for a temporary waiver of the priorities of this section. Such waiver shall be approved if the health professions school demonstrates that the State in which such school is located is not suffering from a shortage of primary care providers, as determined by the Secretary. Such waiver shall not be for a period in excess of 2 years. `(d) DEFINITIONS- As used in this section: `(1) GRADUATE- The term `graduate' means, unless otherwise specified, an individual who has successfully completed all training and residency requirements necessary for full certification in the health professions discipline that such individual has selected. `(2) MEDICALLY UNDERSERVED COMMUNITY- The term `medically underserved community' means-- `(A) an area designated under section 332 as a health professional shortage area; `(B) an area designated as a medically underserved area under this Act; `(C) populations served by migrant health centers under section 329, community health centers under section 330, or Federally qualified health centers under section 1905(l)(2)(B) of the Social Security Act; `(D) a community that is certified as underserved by the Secretary for purposes of participation in the rural health clinic program under title XVIII of the Social Security Act; or `(E) a community that meets the criteria for the designation described in subparagraph (A) or (B) but that has not been so designated.'. SEC. 4. MEDICALLY UNDERSERVED AREA TRAINING GRANTS. Part F of title VII (42 U.S.C. 295g et seq.) is amended by adding at the end thereof the following new section: `SEC. 790B. MEDICALLY UNDERSERVED AREA TRAINING GRANT PROGRAM. `(a) GRANTS- The Secretary shall award grants to health professions institutions to expand training programs that are targeted at those individuals desiring to practice in or serve the needs of medically underserved communities. `(b) PLAN- As part of an application submitted for a grant under this section, the applicant shall prepare and submit a plan that describes the proposed use of funds that may be provided to the applicant under the grant. `(c) PRIORITY- In awarding grants under this section, the Secretary shall give priority to applicants that demonstrate the greatest likelihood of expanding the proportion of graduates who choose to practice in or serve the needs of medically underserved areas. `(d) USE OF FUNDS- An institution that receives a grant under this section shall use amounts received under such grant to establish or enhance procedures or efforts to-- `(1) rotate health professions students from such institution to clinical settings whose focus is to serve the residents of medically underserved communities; `(2) appoint health professionals whose practices serve medically underserved areas to serve as preceptors to supervise training in such settings; `(3) provide classroom instruction on practice opportunities involving medically underserved communities; `(4) provide service contingent scholarship or loan repayment programs for students and residents to encourage practice in or service to underserved communities; `(5) recruit students who are most likely to elect to practice in or provide service to medically underserved communities; or `(6) provide other training methodologies that demonstrate a significant commitment to the expansion of the proportion of graduates that elect to practice in or serve the needs of medically underserved communities. `(e) ADMINISTRATION- `(1) REQUIRED CONTRIBUTION- An institution that receives a grant under this section shall contribute, from non-Federal sources, either in cash or in-kind, an amount equal to not less than 50 percent of the amount of the grant to the activities to be undertaken with the grant funds. `(2) LIMITATION- An institution that receives a grant under this section, shall use amounts received under such grant to supplement, not supplant, amounts made available by such institution for activities of the type described in subsection (d) in the fiscal year preceding the year for which the grant is received. `(f) DEFINITIONS- As used in this section: `(1) GRADUATE- the term `graduate' means, unless otherwise specified, an individual who has successfully completed all training and residency requirements necessary for full certification in the health professions discipline that such individual has selected. `(2) MEDICALLY UNDERSERVED COMMUNITY- The term `medically underserved community' means-- `(A) an area designated under section 332 as a health professional shortage area; `(B) an area designated as a medically underserved area under this Act; `(C) populations served by migrant health centers under section 329, community health centers under section 330, or Federally qualified health centers under section 1905(l)(2)(B) of the Social Security Act; `(D) a community that is certified as underserved by the Secretary for purposes of participation in the rural health clinic program under title XVIII of the Social Security Act; or `(E) a community that meets the criteria for the designation described in subparagraph (A) or (B) but that has not been so designated.'. `(g) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated to carry out this section, $15,000,000 for each of the fiscal years 1992 and 1993, and such sums as may be necessary for each of the fiscal years 1994 and 1995.'. SEC. 5. HEALTH PROFESSIONS INTEGRATION GRANTS. Part F of title VII (42 U.S.C. 295g et seq.) (as amended by section 5) is further amended by adding at the end thereof the following new section: `SEC. 790C. HEALTH PROFESSIONS INTEGRATION GRANT PROGRAM. `(a) GRANTS- The Secretary shall award grants to eligible regional consortia to enhance and expand coordination among various health professions programs, particularly in medically underserved rural areas. `(b) ELIGIBLE REGIONAL CONSORTIUM- `(1) IN GENERAL- To be eligible to receive a grant under subsection (a), an entity must-- `(A) be a regional consortium consisting of at least one medical school and at least one other health professions school that is not a medical school; and `(B) prepare and submit an application containing a plan of the type described in paragraph (2). `(2) PLAN- As part of the application submitted by a consortium under paragraph (1)(B), the consortium shall prepare and submit a plan that describes the proposed use of funds that may be provided to the consortium under the grant. `(c) USE OF FUNDS- A consortium that receives a grant under this section shall use amounts received under such grant to establish or enhance-- `(1) strategies for better clinical cooperation among different types of health professionals; `(2) classroom instruction on integrated practice opportunities, particularly targeted toward rural areas; `(3) integrated clinical clerkship programs that make use of students in differing health professions schools; or `(4) other training methodologies that demonstrate a significant commitment to the expansion of clinical cooperation among different types of health professionals, particularly in underserved rural areas. `(d) LIMITATION- A consortium that receives a grant under this section, shall use amounts received under such grant to supplement, not supplant, amounts made available by such institution for activities of the type described in subsection (c) in the fiscal year preceding the year for which the grant is received. `(e) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated to carry out this section, $7,000,000 for each of the fiscal years 1992 and 1993, and such sums as may be necessary for each of the fiscal years 1994 and 1995.'.
Introduced in Senate
Read twice and referred to the Committee on Labor and Human Resources.
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