[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 506 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 506
To amend the Public Health Service Act to establish a scholarship and
loan repayment program for public health preparedness workforce
development to eliminate critical public health preparedness workforce
shortages in Federal, State, local, and tribal public health agencies.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 3, 2005
Mr. Hagel (for himself, Mr. Durbin, Ms. Cantwell, Mr. Lautenberg, and
Mrs. Murray) 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 establish a scholarship and
loan repayment program for public health preparedness workforce
development to eliminate critical public health preparedness workforce
shortages in Federal, State, local, and tribal public health agencies.
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 ``Public Health Preparedness Workforce
Development Act of 2005''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The ability of the public health system to prevent,
respond to, and recover from bioterrorism or acute outbreaks of
infectious diseases and other health threats and emergencies
depends upon the existence of adequate numbers of well-trained
public health professionals in Federal, State, local, and
tribal public health departments. The public health system has
an aging staff nearing retirement with no clear pipeline of
highly-skilled and capable employees to fill the void. The
average age of the State public health workforce is 47, 7 years
older than the average age of the nation's workforce. More than
50 percent of the States cite the lack of qualified individuals
or individuals willing to relocate as being a major barrier to
preparedness.
(2) The National Association of State Personnel Executives
reports that State governments could lose more than 30 percent
of their workforce to retirement, private-sector employers, and
alternative careers by 2006. The rates for State public health
departments are as high as 45 percent.
(3) The ratio of public health workers to the population
has dropped from 219 per 100,000 in 1980 to 158 per 100,000 in
2000.
(4) Approximately 42 percent of the current epidemiology
workforce in State and territorial health departments lacks
formal academic training in epidemiology.
(5) Thirteen State public health laboratories are without
doctoral-level molecular scientists on staff, 23 have only one,
and only 15 States have any staff redundancy at this level.
(6) Public health nurses comprise the largest segment of
the public health workforce. The leaders of State public health
nursing average more than 30 years service and are very close
to retirement. In one State nearly 40 percent of the public
health nursing workforce is eligible for retirement today.
(7) Nearly half of the Federal employees in occupations
critical to United States biodefense will be eligible to retire
within the next 5 years. The high number of employees nearing
retirement is accompanied by alarmingly small numbers of
younger employees doing biodefense work for the Federal
government.
(8) The Partnership for Public Service reports that in the
field of microbiology, there are four times as many employees
over age 40 as under age 40 at the Centers for Disease Control
and Prevention. Among employees with medical backgrounds at the
Centers for Disease Control and Prevention and the Food and
Drug Administration, there are more than twice as many
employees over 40 years of age as under 40.
(9) Bureau of Labor Statistics data project that the demand
for physicians and related occupations is expected to be 26
percent greater in 2012 than 2002, but the number of medical
professionals entering the labor market has remained generally
constant over the last 20 years.
SEC. 3. PUBLIC HEALTH WORKFORCE SCHOLARSHIP AND LOAN REPAYMENT PROGRAM.
Part E of title VII of the Public Health Service Act (42 U.S.C.
294n et seq.) is amended by adding at the end the following:
``Subpart 3--Public Health Workforce Scholarship and Loan Repayment
Program
``SEC. 780. PUBLIC HEALTH WORKFORCE SCHOLARSHIP PROGRAM.
``(a) Establishment.--The Secretary shall establish the Public
Health Workforce Scholarship Program (referred to in this section as
the `Program') to assure an adequate supply of public health
professionals to eliminate critical public health preparedness
workforce shortages in Federal, State, local, and tribal public health
agencies.
``(b) Eligibility.--To be eligible to participate in the Program,
an individual shall--
``(1) be accepted for enrollment, or be enrolled, as a
full-time student--
``(A) in an accredited (as determined by the
Secretary) educational institution in a State or
territory; and
``(B) in a course of study or program, offered by
such institution and approved by the Secretary, leading
to a health professions degree (graduate,
undergraduate, or associate) or certificate, which may
include laboratory sciences, epidemiology,
environmental health, health communications, health
education and behavioral sciences, information
sciences, or public administration;
``(2) be a United States citizen;
``(3) submit an application to the Secretary to participate
in the Program; and
``(4) sign and submit to the Secretary, at the time of the
submittal of such application, a written contract (described in
subsection (d)) to serve, upon the completion of the course of
study or program involved, for the applicable period of
obligated service in the full-time employment of a Federal, State,
local, or tribal public health agency.
``(c) Dissemination of Information.--
``(1) Application and contract forms.--The Secretary shall
disseminate application forms and contract forms to individuals
desiring to participate in the Program. The Secretary shall
include with such forms--
``(A) a fair summary of the rights and liabilities
of an individual whose application is approved (and
whose contract is accepted) by the Secretary, including
in the summary a clear explanation of the damages to
which the United States is entitled to recover in the
case of the individual's breach of the contract; and
``(B) information relating to the service
obligation and such other information as may be
necessary for the individual to understand the
individual's prospective participation in the Program.
``(2) Information for schools.--The Secretary shall
distribute to health professions schools and other appropriate
accredited academic institutions and relevant Federal, State,
local, and tribal public health agencies, materials providing
information on the Program and shall encourage such schools,
institutions, and agencies to disseminate such materials to
potentially eligible students.
``(3) Understandability and timing.--The application form,
contract form, and all other information furnished by the
Secretary under this section shall--
``(A) be written in a manner calculated to be
understood by the average individual applying to
participate in the Program; and
``(B) be made available by the Secretary on a date
sufficiently early to ensure that such individuals have
adequate time to carefully review and evaluate such
forms and information.
``(d) Contract.--The written contract (referred to in this section)
between the Secretary and an individual shall contain--
``(1) an agreement on the part of the Secretary that the
Secretary will provide the individual with a scholarship for a
period of years (not to exceed 4 academic years) during which
the individual shall pursue an approved course of study or
program to prepare the individual to serve in the public health
workforce;
``(2) an agreement on the part of the individual that the
individual will--
``(A) maintain full-time enrollment in the approved
course of study or program described in subsection
(b)(1) until the individual completes that course of
study or program;
``(B) while enrolled in the course of study or
program, maintain an acceptable level of academic
standing (as determined under regulations of the
Secretary by the educational institution offering such
course of study or program); and
``(C) immediately upon graduation, serve in the
full-time employment of a Federal, State, local, or
tribal public health agency in a position related to
the course of study or program for which the contract
was awarded for a period of time (referred to in this
section as the `period of obligated service') equal to
the greater of--
``(i) 1 year for each academic year for
which the individual was provided a scholarship
under the Program; or
``(ii) 2 years;
``(3) an agreement by both parties as to the nature and
extent of the scholarship assistance, which may include--
``(A) payment of the tuition expenses of the
individual;
``(B) payment of all other reasonable educational
expenses of the individual including fees, books,
equipment and laboratory expenses; and
``(C) payment of a stipend of not more than $1,200
per month for each month of the academic year involved
(indexed to account for increases in the Consumer Price
Index); and
``(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 which is
conditioned thereon, is contingent upon funds being
appropriated for scholarships under this section;
``(5) a statement of the damages to which the United States
is entitled for the individual's breach of the contract; and
``(6) such other statements of the rights and liabilities
of the Secretary and of the individual, not inconsistent with
the provisions of this section.
``(e) Postponing Obligated Service.--With respect to an individual
receiving a degree or certificate from a school of medicine, public
health, nursing, osteopathic medicine, dentistry, veterinary medicine,
optometry, podiatry, pharmacy, psychology, or social work under a
scholarship under the Program, the date of the initiation of the period
of obligated service may be postponed, upon the submission by the
individual of a petition for such postponement and approval by the
Secretary, to the date on which the individual completes an approved
internship, residency, or other relevant public health preparedness
advanced training program.
``(f) Administrative Provisions.--
``(1) Contracts with institutions.--The Secretary may
contract with an educational institution in which a participant
in the Program is enrolled, for the payment to the educational
institution of the amounts of tuition and other reasonable
educational expenses described in subsection (d)(3).
``(2) Employment ceilings.--Notwithstanding any other
provision of law, individuals who have entered into written
contracts with the Secretary under this section, while
undergoing academic training, shall not be counted against any
employment ceiling affecting the Department or any other
Federal agency.
``(g) Breach of Contract.--An individual who fails to comply with
the contract entered into under subsection (d) shall be subject to the
same financial penalties as provided for under section 338E for
breaches of scholarship contracts under sections 338A.
``SEC. 781. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT PROGRAM.
``(a) Establishment.--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 public health
professionals to eliminate critical public health preparedness
workforce shortages in Federal, State, local, and tribal public health
agencies.
``(b) Eligibility.--To be eligible to participate in the Program,
an individual shall--
``(1)(A) be accepted for enrollment, or be enrolled, as a
full-time or part-time student in an accredited academic
educational institution in a State or territory in the final
year of a course of study or program offered by that
institution leading to a health professions degree or
certificate, which may include a degree (graduate,
undergraduate, or associate) or certificate relating to
laboratory sciences, epidemiology, environmental health, health
communications, health education and behavioral sciences,
information sciences, or public administration; or
``(B) have graduated, within 10 years, from an accredited
educational institution in a State or territory and received a
health professions degree (graduate, undergraduate, or
associate) or certificate, which may include a degree
(graduate, undergraduate, or associate) or certificate relating
to laboratory sciences, epidemiology, environmental health,
health communications, health education and behavioral
sciences, information sciences, or public administration;
``(2)(A) in the case of an individual described in
paragraph (1)(A), have accepted employment with a Federal,
State, local, or tribal public health agency, as recognized by
the Secretary, to commence upon graduation; or
``(B) in the case of an individual described in paragraph
(1)(B), be employed by, or have accepted employment with, a
Federal, State, local, or tribal public health agency, as
recognized by the Secretary;
``(3) be a United States citizen;
``(4) submit an application to the Secretary to participate
in the Program; and
``(5) sign and submit to the Secretary, at the time of the
submittal of such application, a written contract (described in
subsection (d)) to serve for the applicable period of obligated
service in the full-time employment of a Federal, State, local,
or tribal public health agency.
``(c) Dissemination of Information.--
``(1) Application and contract forms.--The Secretary shall
disseminate application forms and contract forms to individuals
desiring to participate in the Program. The Secretary shall
include with such forms--
``(A) a fair summary of the rights and liabilities
of an individual whose application is approved (and
whose contract is accepted) by the Secretary, including
in the summary a clear explanation of the damages to
which the United States is entitled to recover in the
case of the individual's breach of the contract; and
``(B) information relating to the service
obligation and such other information as may be
necessary for the individual to understand the
individual's prospective participation in the Program.
``(2) Information for schools.--The Secretary shall
distribute to health professions schools and other appropriate
accredited academic institutions and relevant Federal, State,
local, and tribal public health agencies, materials providing
information on the Program and shall encourage such schools,
institutions, and agencies to disseminate such materials to
potentially eligible students.
``(3) Understandability and timing.--The application form,
contract form, and all other information furnished by the
Secretary under this section shall--
``(A) be written in a manner calculated to be
understood by the average individual applying to
participate in the Program; and
``(B) be made available by the Secretary on a date
sufficiently early to ensure that such individuals have
adequate time to carefully review and evaluate such
forms and information.
``(d) Contract.--The written contract (referred to in this section)
between the Secretary and an individual shall contain--
``(1) an agreement on the part of the Secretary that the
Secretary will repay on behalf of the individual loans incurred
by the individual in the pursuit of the relevant public health
preparedness workforce educational degree or certificate in
accordance with the terms of the contract;
``(2) an agreement on the part of the individual that the
individual will serve, immediately upon graduation in the case
of an individual described in subsection (b)(1)(A) service, or
in the case of an individual described in subsection (b)(1)(B)
continue to serve, in the full-time employment of a Federal,
State, local, or tribal public health agency in a position
related to the course of study or program for which the
contract was awarded for a period of time (referred to in this
section as the `period of obligated service') equal to the
greater of--
``(i) 3 years; or
``(ii) such longer period of time as
determined appropriate by the Secretary and the
individual;
``(3) an agreement, as appropriate, on the part of the
individual to relocate for the entire period of obligated
service to a political jurisdiction designated by the Secretary
to be a priority service area in exchange for an additional
loan repayment incentive amount that does not exceed 20 percent
of the individual's eligible loan repayment award per academic
year such that the total of the loan repayment and the
incentive amount shall not exceed \1/3\ of the eligible loan
balance per year;
``(4) in the case of an individual described in subsection
(b)(1)(A) who is in the final year of study and who has
accepted employment with a Federal, State, local, or tribal
public health agency upon graduation, an agreement on the part
of the individual to complete the education or training,
maintain an acceptable level of academic standing (as
determined by the education institution offering the course of
study or training), and agree to the period of obligated
service;
``(5) 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 thereon, is contingent on funds being appropriated
for loan repayments under this section;
``(6) a statement of the damages to which the United States
is entitled, under this section for the individual's breach of
the contract; and
``(7) such other statements of the rights and liabilities
of the Secretary and of the individual, not inconsistent with
this section.
``(e) Payments.--
``(1) In general.--A loan repayment provided for an
individual under a written contract under the Program shall
consist of payment, in accordance with paragraph (2), on behalf
of the individual of the principal, interest, and related
expenses on government and commercial loans received by the
individual regarding the undergraduate or graduate education of
the individual (or both), which loans were made for--
``(A) tuition expenses; or
``(B) all other reasonable educational expenses,
including fees, books, and laboratory expenses,
incurred by the individual.
``(2) Payments for years served.--
``(A) In general.--For each year of obligated
service that an individual contracts to serve under
subsection (d) the Secretary may pay up to $35,000 on
behalf of the individual for loans described in
paragraph (1). With respect to participants under the
Program whose total eligible loans are less than
$105,000, the Secretary shall pay an amount that does
not exceed \1/3\ of the eligible loan balance for each
year of obligated service of the individual.
``(B) Repayment schedule.--Any arrangement made by
the Secretary for the making of loan repayments in
accordance with this subsection shall provide that any
repayments for a year of obligated service shall be
made no later than the end of the fiscal year in which
the individual completes such year of service.
``(3) Tax liability.--For the purpose of providing
reimbursements for tax liability resulting from payments under
paragraph (2) on behalf of an individual--
``(A) 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; and
``(B) may make such additional payments as the
Secretary determines to be appropriate with respect to
such purpose.
``(4) Payment schedule.--The Secretary may enter into an
agreement with the holder of any loan for which payments are
made under the Program to establish a schedule for the making
of such payments.
``(f) Postponing Obligated Service.--With respect to an individual
receiving a degree or certificate from a school of medicine, public
health, nursing, osteopathic medicine, dentistry, veterinary medicine,
optometry, podiatry, pharmacy, psychology, or social work, the date of
the initiation of the period of obligated service may be postponed,
upon the submission by the individual of a petition for such
postponement and approval by the Secretary, to the date on which the
individual completes an approved internship, residency, or other
relevant public health preparedness advanced training program.
``(g) Administrative Provisions.--
``(1) Hiring priority.--Notwithstanding any other provision
of law, Federal, State, local, and tribal public health
agencies may give hiring priority to any individual who has
qualified for and is willing to execute a contract to
participate in the Program.
``(2) Employment ceilings.--Notwithstanding any other
provision of law, individuals who have entered into written
contracts with the Secretary under this section, who are
serving as full-time employees of a State, local, or tribal
public health agency, or who are in the last year of
public health workforce academic preparation, shall not be counted
against any employment ceiling affecting the Department or any other
Federal agency.
``(h) Breach of Contract.--An individual who fails to comply with
the contract entered into under subsection (d) shall be subject to the
same financial penalties as provided for under section 338E for
breaches of loan repayment contracts under section 338B.
``SEC. 782. GRANTS FOR STATE AND LOCAL PROGRAMS.
``(a) In General.--For the purpose of operating State, local, and
tribal public health workforce loan repayment programs, the Secretary
shall award a grant to any public health agency that receives public
health preparedness cooperative agreements, or other successor
cooperative agreements, from the Department of Health and Human
Services.
``(b) Requirements.--A State or local loan repayment program
operated with a grant under subsection (a) shall incorporate all
provisions of the Public Health Workforce Loan Repayment Program under
section 781, including the ability to designate priority service areas
within the relevant political jurisdiction.
``(c) Administration.--The head of the State or local office that
receives a grant under subsection (a) shall be responsible for
contracting and operating the loan repayment program under the grant.
``(d) Rule of Construction.--Nothing in this section shall be
construed to obligate or limit any State, local, or tribal government
entity from implementing independent or supplemental public health
workforce development programs within their borders.
``SEC. 783. CATALOGUE OF FEDERAL PUBLIC HEALTH WORKFORCE EMPLOYMENT
OPPORTUNITIES.
``(a) In General.--The Director of the Office of Personnel
Management, in cooperation with the Secretary, shall ensure that within
the Office of Personnel Management's website, there is an on-line
catalogue of public health workforce employment opportunities in the
Federal Government.
``(b) Requirements.--To the extent practical, the catalogue
described in subsection (a) shall include--
``(1) existing and projected job openings in the Federal
public health workforce; and
``(2) a general discussion of the occupations that comprise
the Federal public health workforce.
``(c) Information.--The Secretary shall include a copy of the
catalogue, or a prominent reference to the catalogue, in--
``(1) the information for schools provided under section
780(c)(2) and 781(c)(2); and
``(2) the application forms provided under sections
780(c)(1) and 781(c)(1).
``SEC. 784. AUTHORIZATION OF APPROPRIATIONS.
``(a) Scholarship Program.--For the purpose of carrying out section
780, there is authorized to be appropriated $35,000,000 for fiscal year
2006, and such sums as may be necessary for each of fiscal years 2007
through 2011.
``(b) Loan Repayment Programs.--
``(1) In general.--For the purpose of carrying out sections
781 and 782, there is authorized to be appropriated
$195,000,000 for fiscal year 2006, and such sums as may be
necessary for each of fiscal years 2007 through 2011.
``(2) Allocation.--Not less than 80 percent of the amount
appropriated under paragraph (1) in each fiscal year shall be
made available to carry out section 782.
``SEC. 785. SEVERABILITY.
``If any provision of this subpart, or the application of such
provision to any person or circumstance, is held to be
unconstitutional, the remainder of this subpart and the application of
the provisions of this subpart to any person or circumstance shall not
be affected thereby.''.
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