[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2491 Introduced in Senate (IS)]
108th CONGRESS
2d Session
S. 2491
To amend the Public Health Service Act to promote and improve the
allied health professions.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 2, 2004
Ms. Cantwell (for herself, Mr. Bingaman, and Mr. Lieberman) introduced
the following bill; which was read twice and referred to the Committee
on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to promote and improve the
allied health professions.
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 ``Allied Health Reinvestment Act''.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--Congress makes the following findings:
(1) The United States Census Bureau and other reports
highlight the increased demand for acute and chronic healthcare
services among both the general population and a rapidly
growing aging portion of the population.
(2) The calls for reduction in medical errors, increased
patient safety, and quality of care have resulted in an
amplified call for allied health professionals to provide
healthcare services.
(3) Several allied health professions are characterized by
workforce shortages, declining enrollments in allied health
education programs, or a combination of both factors, and
hospital officials have reported vacancy rates in positions
occupied by allied health professionals.
(4) Many allied health education programs are facing
significant economic pressure that could force their closure
due to an insufficient number of students.
(b) Purpose.--It is the purpose of this Act to provide incentives
for individuals to seek and complete high quality allied health
education and training and provide additional funding to ensure that
such education and training can be provided to allied health students
so that the United States healthcare industry with have a supply of
allied health professionals needed to support the health care system of
the United States in this decade and beyond.
SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
Title VII of the Public Health Service Act (42 U.S.C. 292 et seq.)
is amended by adding at the end the following:
``PART G--ALLIED HEALTH PROFESSIONALS
``SEC. 799C. DEFINITIONS.
``In this part:
``(1) Allied health education program.--The term `allied
health education program' means any postsecondary educational
program offered by an institution accredited by an agency or
commission recognized by the Department of Education, or
leading to a State certificate or license or any other
educational program approved by the Secretary. Such term
includes colleges, universities, or schools of allied health
and equivalent entities that include programs leading to a
certificate, associate, baccalaureate, or graduate level degree
in an allied health profession.
``(2) Allied health professions.--The term `allied health
professions' includes professions in the following areas at the
certificate, associate, baccalaureate, or graduate level:
``(A) Dental hygiene.
``(B) Dietetics or nutrition.
``(C) Emergency medical services.
``(D) Health information management.
``(E) Clinical laboratory sciences and medical
technology.
``(F) Cytotechnology.
``(G) Occupational therapy.
``(H) Physical therapy.
``(I) Radiologic technology.
``(J) Nuclear medical technology.
``(K) Rehabilitation counseling.
``(L) Respiratory therapy.
``(M) Speech-language pathology and audiology.
``(N) Any other profession determined appropriate
by the Secretary.
``(3) Health care facility.--The term `health care
facility' means an outpatient health care facility, hospital,
nursing home, home health care agency, hospice, federally
qualified health center, nurse managed health center, rural
health clinic, public health clinic, or any similar healthcare
facility or practice that employs allied health professionals.
``SEC. 799C-1. PUBLIC SERVICE ANNOUNCEMENTS.
``The Secretary shall develop and issue public service
announcements that shall--
``(1) advertise and promote the allied health professions;
``(2) highlight the advantages and rewards of the allied
health professions; and
``(3) encourage individuals from diverse communities and
backgrounds to enter the allied health professions.
``SEC. 799C-2. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS.
``(a) In General.--The Secretary shall award grants to designated
eligible entities to support State and local advertising campaigns that
are conducted through appropriate media outlets (as determined by the
Secretary) to--
``(1) promote the allied health professions;
``(2) highlight the advantages and rewards of the allied
health professions; and
``(3) encourage individuals from disadvantaged communities
and backgrounds to enter the allied health professions.
``(b) Eligible Entity.--To be eligible to receive a grant under
subsection (a), an entity shall--
``(1) be a professional, national, or State allied health
association, State health care provider, or association of one
or more health care facilities, allied health education
programs, or other entities that provides similar services or
serves a like function; 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.
``SEC. 799C-3. ALLIED HEALTH RECRUITMENT GRANT PROGRAM.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to increase allied health professions education
opportunities.
``(b) Eligible Entity.--To be eligible to receive a grant under
subsection (a), an entity shall--
``(1) be a professional, national, or State allied health
association, State health care provider, or association of one
or more health care facilities, allied health education
programs, or other eligible entities that provides similar
services or serves a like function; 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.
``(c) Use of Funds.--An entity shall use amounts received under a
grant under subsection (a) to--
``(1) support outreach programs at elementary and secondary
schools that inform guidance counselors and students of
education opportunities regarding the allied health
professions;
``(2) carry out special projects to increase allied health
education opportunities for individuals who are from
disadvantaged backgrounds (including racial and ethnic
minorities that are underrepresented among the allied health
professions) by providing student scholarships or stipends,
pre-entry preparation, and retention activities;
``(3) provide assistance to public and nonprofit private
educational institutions to support remedial education programs
for allied health students who require assistance with math,
science, English, and medical terminology;
``(4) meet the costs of child care and transportation for
individuals who are taking part in an allied health education
program at any level; and
``(5) support community-based partnerships seeking to
recruit allied health professionals in rural communities and
medically underserved urban communities, and other communities
experiencing an allied health professions shortage.
``SEC. 799C-4. GRANTS FOR HEALTH CAREER ACADEMIES.
``(a) In General.--The Secretary shall award grants to eligible
entities to assist such entities in collaborating to carry out programs
that form education pipelines to facilitate the entry of students of
secondary educational institutions, especially underrepresented racial
and ethnic minorities, into careers in the allied health professions.
``(b) Eligible Entity.--To be eligible to receive a grant under
subsection (a), an entity shall--
``(1) be an institution that offers allied health education
programs, a health care facility, or a secondary educational
institution; 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.
``SEC. 799C-5. ALLIED HEALTH EDUCATION, PRACTICE, AND RETENTION GRANTS.
``(a) Education Priority Areas.--The Secretary may award grants to
or enter into contracts with eligible entities to--
``(1) expand the enrollment of individuals in allied health
education programs, especially the enrollment of
underrepresented racial and ethnic minority students; and
``(2) provide education through new technologies and
methods, including distance-learning methodologies.
``(b) Practice Priority Areas.--The Secretary may award grants to
or enter into contracts with eligible entities to--
``(1) establish or expand allied health practice
arrangements in noninstitutional settings to demonstrate
methods to improve access to primary health care in rural areas
and other medically underserved communities;
``(2) provide care for underserved populations and other
high-risk groups such as the elderly, individuals with HIV/
AIDS, substance abusers, the homeless, and victims of domestic
violence;
``(3) provide managed care, information management, quality
improvement, and other skills needed to practice in existing
and emerging organized health care systems; or
``(4) develop generational and cultural competencies among
allied health professionals.
``(c) Retention Priority Areas.--
``(1) In general.--The Secretary may award grants to and
enter into contracts with eligible entities to enhance the
allied health professions workforce by initiating and
maintaining allied health retention programs described in
paragraph (2) or (3).
``(2) Grants for career ladder programs.--The Secretary may
award grants to and enter into contracts with eligible entities
for programs--
``(A) to promote career advancement for allied
health personnel in a variety of training settings,
cross training or specialty training among diverse
population groups, and the advancement of individuals;
and
``(B) to assist individuals in obtaining the
education and training required to enter the allied
health professions and advance within such professions,
such as by providing career counseling and mentoring.
``(3) Enhancing patient care delivery systems.--
``(A) Grants.--The Secretary may award grants to
eligible entities to improve the retention of allied
health professionals and to enhance patient care that
is directly related to allied health activities by
enhancing collaboration and communication among allied
health professionals and other health care
professionals, and by promoting allied health
involvement in the organizational and clinical
decision-making processes of a health care facility.
``(B) Preference.--In making awards of grants under
this paragraph, the Secretary shall give preferences to
applicants that have not previously received an award
under this paragraph and to applicants from rural,
underserved areas.
``(C) Continuation of an award.--The Secretary
shall make continuation of any award under this
paragraph beyond the second year of such award
contingent on the recipient of such award having
demonstrated to the Secretary measurable and
substantive improvement in allied health personnel
retention or patient care.
``(d) Eligible Entity.--To be eligible to receive a grant under
this section, an entity shall--
``(1) be a health care facility, or any partnership or
coalition containing a health care facility or allied health
education program; 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.
``SEC. 799C-6. DEVELOPING MODELS AND BEST PRACTICES PROGRAM.
``(a) Authorized.--The Secretary shall award grants to eligible
entities to enable such entities to carry out demonstration programs
using models and best practices in allied health for the purpose of
developing innovative strategies or approaches for the retention of
allied health professionals.
``(b) Eligible Entity.--To be eligible to receive a grant under
this section, an entity shall--
``(1) be a health care facility, or any partnership or
coalition containing a health care facility or allied health
education program; 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.
``(c) Distribution of Grants.--In awarding grants under this
section, the Secretary shall ensure that grantee represent a variety of
geographic regions and a range of different types and sizes of
facilities, including facilities located in rural, urban, and suburban
areas.
``(d) Use of Funds.--An entity shall use amounts received under a
grant under this section to carry out demonstration programs of models
and best practices in allied health for the purpose of--
``(1) promoting retention and satisfaction of allied health
professionals;
``(2) promoting opportunities for allied health
professionals to pursue education, career advancement, and
organizational recognition; and
``(3) developing continuing education programs that
instruct allied health professionals in how to use emerging
medical technologies and how to address current and future
health care needs.
``(e) Area Health Education Centers.--The Secretary shall award
grants to area health education centers to enable such centers to enter
into contracts with allied health education programs to expand the
operation of area health education centers to work in communities to
develop models of excellence for allied health professionals or to
expand any junior and senior high school mentoring programs to include
an allied health professions mentoring program.
``SEC. 799C-7. ALLIED HEALTH FACULTY LOAN PROGRAM.
``(a) Establishment.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration, may
enter into an agreement with any institution offering an eligible
allied health education program for the establishment and operation of
a faculty loan fund in accordance with this section (referred to in
this section as the `loan fund'), to increase the number of qualified
allied health faculty.
``(b) Agreements.--Each agreement entered into under this section
shall--
``(1) provide for the establishment of a loan fund by the
institution offering the allied health education program
involved;
``(2) provide for deposit in the loan fund of--
``(A) the Federal capital contributions to the
fund;
``(B) an amount provided by the institution
involved which shall be equal to not less than one-
ninth of the amount of the Federal capital contribution
under subparagraph (A);
``(C) any collections of principal and interest on
loans made from the fund; and
``(D) any other earnings of the fund;
``(3) provide that the loan fund will be used only for the
provision of loans to faculty of the allied health education
program in accordance with subsection (c) and for the costs of
the collection of such loans and the interest thereon;
``(4) provide that loans may be made from such fund only to
faculty who are pursuing a full-time course of study or, at the
discretion of the Secretary, a part-time course of study in an
advanced degree program; and
``(5) contain such other provisions determined appropriate
by the Secretary to protect the financial interests of the
United States.
``(c) Loan Provisions.--Loans from any faculty loan fund
established pursuant to an agreement under this section shall be made
to an individual on such terms and conditions as the allied health
education program may determine, except that--
``(1) such terms and conditions are subject to any
conditions, limitations, and requirements prescribed by the
Secretary;
``(2) in the case of any individual, the total of the loans
for any academic year made by an allied health education
program from loan funds established pursuant to agreements
under this section may not exceed $30,000, plus any amount
determined by the Secretary on an annual basis to reflect
inflation;
``(3) upon completion by the individual of each of the
first, second, and third year of full-time employment, as
required under the loan agreement, as a faculty member in an
allied health education program, the program shall cancel 20
percent of the principal and interest due on the amount of the
unpaid portion of the loan on the first day of such employment;
``(4) upon completion by the individual of the fourth year
of full-time employment, as required under the loan agreement,
as a faculty member in an allied health education program, the
program shall cancel 25 percent of the principal and interest
due on the amount of the unpaid portion of the loan on the
first day of such employment;
``(5) the loan may be used to pay the cost of tuition,
fees, books, laboratory expenses, and other reasonable
education expenses;
``(6) the loan shall be repayable in equal or graduated
periodic installments (with the right of the borrower to
accelerate repayment) over the 10-year period that begins 9
months after the individual ceases to pursue a course of study
in an allied health education program; and
``(7) such loan shall--
``(A) beginning on the date that is 3 months after
the individual ceases to pursue a course of study in an
allied health education program, bear interest on the
unpaid balance of the loan at the rate of 3 percent per
year; or
``(B) subject to subsection (e), if the allied
health education program determines that the individual
will not complete such course of study or serve as a
faculty member as required under the loan agreement
under this subsection, bear interest on the unpaid
balance of the loan at the prevailing market rate.
``(d) Payment of Proportionate Share.--Where all or any part of a
loan (including interest thereon) is canceled under this section, the
Secretary shall pay to the allied health education program involved an
amount equal to the program's proportionate share of the canceled
portion, as determined by the Secretary.
``(e) Review by Secretary.--At the request of the individual
involved, the Secretary may review any determination by an allied
health education program under this section.
``SEC. 799C-8. SCHOLARSHIP PROGRAM FOR SERVICE IN RURAL AND OTHER
MEDICALLY UNDERSERVED AREAS.
``(a) Program Authorized.--The Secretary shall establish a
scholarship program (referred to in this section as the `program') to
provide scholarships to individuals seeking allied health education who
agree to provide service in rural and other medically underserved areas
with allied health personnel shortages.
``(b) Preference.--In awarding scholarships under this section, the
Secretary shall give preference to--
``(1) applicants who demonstrate the greatest financial
need;
``(2) applicants who agree to serve in health care
facilities experiencing allied health shortages in rural and
other medically underserved areas;
``(3) applicants who are currently working in a health care
facility who agree to serve the period of obligated service at
such facility;
``(4) minority applicants; and
``(5) applicants with an interest in a practice area of
allied health that has unmet needs.
``(c) Program Requirements.--
``(1) Contracts.--Under the program, the Secretary shall
enter into contracts with eligible individuals under which such
individuals agree to serve as allied health professionals for a
period of not less than 2 years at a health care facility with
a critical shortage of allied health professionals in
consideration of the Federal Government agreeing to provide to
the individuals scholarships for attendance in an allied health
education program.
``(2) Eligible individuals.--In this subsection, the term
`eligible individual' means an individual who is enrolled or
accepted for enrollment as a full-time or part-time student in
an allied health education program.
``(3) Service requirement.--
``(A) In general.--The Secretary may not enter into
a contract with an eligible individual under this
section unless the individual agrees to serve as an
allied health professional at a health care facility
with a critical shortage of allied health professionals
for a period of full-time service of not less than 2
years, or for a period of part-time service in
accordance with subparagraph (B).
``(B) Part-time service.--An individual may
complete the period of service described in
subparagraph (A) on a part-time basis if the individual
has a written agreement that--
``(i) is entered into by the facility and
the individual and is approved by the
Secretary; and
``(ii) provides that the period of
obligated service will be extended so that the
aggregate amount of service performed will
equal the amount of service that would be
performed through a period of full-time service
of not less than 2 years.
``(d) Reports.--Not later than 18 months after the date of
enactment of this part, and annually thereafter, the Secretary shall
prepare and submit to the appropriate committees of Congress a report
describing the program carried out under this section, including
statements regarding--
``(1) the number of enrollees by specialty or discipline,
scholarships, and grant recipients;
``(2) the number of graduates;
``(3) the amount of scholarship payments made;
``(4) which educational institution the recipients
attended;
``(5) the number and placement location of the scholarship
recipients at health care facilities with a critical shortage
of allied health professionals;
``(6) the default rate and actions required;
``(7) the amount of outstanding default funds of the
scholarship program;
``(8) to the extent that it can be determined, the reason
for the default;
``(9) the demographics of the individuals participating in
the scholarship program; and
``(10) an evaluation of the overall costs and benefits of
the program.
``SEC. 799C-9. GRANTS FOR CLINICAL EDUCATION, INTERNSHIP, AND RESIDENCY
PROGRAMS.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to develop clinical education, internship, and
residency programs that encourage mentoring and the development of
specialties.
``(b) Eligible Entities.--To be eligible for a grant under this
section an entity shall--
``(1) be a partnership of an allied health education
program and a health care facility; 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.
``(c) Use of Funds.--An eligible entity shall use amounts received
under a grant under this section to--
``(1) develop clinical education, internship, and residency
programs and curriculum and training programs for graduates of
an allied health education program;
``(2) provide support for faculty and mentors; and
``(3) provide support for allied health professionals
participating in clinical education, internship, and residency
programs on both a full-time and part-time basis.
``SEC. 799C-10. GRANTS FOR PARTNERSHIPS.
``(a) In General.--The Secretary shall award grants to eligible
entities to enable such entities to form partnerships to carry out the
activities described in this section.
``(b) Eligible Entity.--To be eligible to receive a grant under
this section, and entity shall--
``(1) be a partnership between an allied health education
program and a health care facility; 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.
``(c) Use of Funds.--An eligible entity shall use amounts received
under a grant under this section to--
``(1) provide employees of the health care facility that is
a member of the partnership involved advanced training and
education in a allied health education program;
``(2) establish or expand allied health practice
arrangements in non-institutional settings to demonstrate
methods to improve access to health care in rural and other
medically underserved communities;
``(3) purchase distance learning technology to extend
general education and training programs to rural areas, and to
extend specialty education and training programs to all areas;
and
``(4) establish or expand mentoring, clinical education,
and internship programs for training in specialty care areas.
``SEC. 799C-11. ALLIED HEALTH PROFESSIONS TRAINING FOR DIVERSITY.
``The Secretary, acting in conjunction with allied health
professional associations, shall develop a system for collecting and
analyzing allied health workforce data gathered by the Bureau of Labor
Statistics, the Health Resources and Services Administration, other
entities within the Department of Health and Human Services, the
Department of Veterans Affairs, the Center for Medicare & Medicaid
Services, the Department of Defense, allied health professional
associations, and regional centers for health workforce studies to
determine educational pipeline and practitioner shortages, and project
future needs for such a workforce.
``SEC. 799C-12. ALLIED HEALTH PROFESSIONS TRAINING FOR DIVERSITY.
``The Secretary shall include schools of allied health among the
health professions schools that are eligible to receive grants under
this part for the purpose of assisting such schools in supporting
Centers of Excellence in health professions education for under-
represented minority individuals.
``SEC. 799C-13. REPORTS BY GENERAL ACCOUNTING OFFICE.
``Not later than 4 years after the date of enactment of this part,
the Comptroller General of the United States shall conduct an
evaluation of whether the programs carried out under this part have
demonstrably increased the number of applicants to allied health
education programs and prepare and submit to the appropriate committees
of Congress a report concerning the results of such evaluation.
``SEC. 799C-14. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated to carry out this part,
such sums as may be necessary for each of fiscal years 2005 through
2010.''.
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