S. 1754Senate115th Congress (2017-2019)In Committee

Training the Next Generation of Primary Care Doctors Act of 2017

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Updated April 15, 2026 at 5:47 PM UTC

The bill reauthorizes the program that pays teaching health centers for graduate medical residency training, aiming to keep and grow residency programs that prepare primary‑care doctors for underserved and rural communities. It provides funding for existing programs and adds new funding to support the creation of new residency slots, with priority given to centers in shortage or rural areas. The law also adds reporting requirements to track outcomes and costs.

Key Provisions

Reauthorizes payments to qualified teaching health centers for maintaining, expanding, and establishing approved graduate medical residency programs.
Allocates $116.5 million each fiscal year 2018‑2020 for existing programs and $10 million (FY 2019) and $19 million (FY 2020) for new programs, limiting administrative costs to 5 % of the total.
Limits new program growth to up to 60 full‑time‑equivalent residents in FY 2019 and up to 120 in FY 2020, with caps on overall resident numbers relative to 2017 levels.
Prioritizes funding for centers that serve health professional shortage areas, medically underserved communities, or are located in rural areas.
Requires annual reports on the number of patients treated, visits, and the percentage of graduates entering primary‑care practice and working in shortage or rural areas.
Mandates a report by March 31 2020 on the direct and indirect costs of graduate medical residency training at teaching health centers.
Updates definitions and makes technical corrections to the Public Health Service Act related to teaching health centers.

Legislative Activity

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1 earlier action

SenateIntro Referral Latest Action

Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (Sponsor introductory remarks on measure: CR S4831)

Health, Education, Labor, and Pensions Committee

August 3, 2017

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SenateIntro Referral

Introduced in Senate

August 3, 2017

SenateIntro Referral

Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (Sponsor introductory remarks on measure: CR S4831)

Health, Education, Labor, and Pensions Committee

August 3, 2017

Floor Debate

2 members

What members said about S. 1754 on the floor

2 Republicans

Sen. Susan M. CollinsR-ME · Aug 3, 2017

Madam President, I rise today to introduce legislation with my colleague from Montana, Senator Tester, that would extend an important program to fund Teaching Health Centers, which support the health and well-being of families in rural and medically underserved communities. I am pleased that Senators Cochran, Manchin, Daines, Harris, and Boozman, have joined us as cosponsors.

In the background of the health care debate, there is another crisis that looms. We are facing a severe shortage of doctors. By 2025, we will need more than 100,000 new primary care doctors to meet the growing demand for health care services across the Country. The shortage is especially critical in rural and underserved communities, which are often those that have been hit hardest by the opioid epidemic. The most significant shortages are in family medicine, general internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and dentistry.

These shortages have reached crisis levels in many places. In clinics and health centers in Aroostook County, Maine's northernmost county where I grew up, I hear stories about vacancies forcing Mainers to travel many miles simply to see a primary care doctor or dentist.

For the past six years, one program, the Teaching Health Centers Graduate Medical Education Program, has worked to fill these gaps. This program helps to train medical residents in community-based settings, including low-income, underserved rural and urban neighborhoods. For example, since 2011, the Penobscot Community Health Care Center has trained 31 residents and served more than 15,000 dental patients in Bangor, Maine.

We need to meet people in the communities in which they live and work. This program is training the next generation of physicians, and has produced real results. When compared with traditional Medicare graduate medical education residents, those who train at teaching health centers are significantly more likely to practice primary care and remain in underserved or rural communities. The numbers speak for themselves: 82 percent of Teaching Health Center, or THC, residents choose to practice primary care, compared to 23 percent of traditional Medicare Graduate Medical Education residents; and 55 percent of THC residents choose to remain in underserved communities, compared to 26 percent of traditional Medicare GME residents.

Teaching health centers are serving Americans from coast to coast. A total of 742 THC residents are serving in 27 states and the District of Columbia. The program is competitive, and trains the best of the best. For each residency position, THC programs receive more than 100 applications. In 2017, THC residents and faculty will provide more than one million primary care medical visits to underserved communities.

Teaching Health Centers have demonstrated a record of success, and it is imperative that we support them. Our legislation would reauthorize the Teaching Health Centers Graduate Medical Education Program for three years. It would also allow new programs to expand within existing centers and the creation of entirely new teaching health centers.

This bill is widely supported by leading community health and physician organizations, including the American Association of Teaching Health Centers, National Association of Community Health Centers, American Academy of Family Physicians, American Association of Colleges of Osteopathic Medicine, American Osteopathic Association, American Council of OB/GYNs, Society of Teachers of Family Medicine, and Council of Academic Family Medicine. We have also received letters of support from teaching health centers in Maine, Montana, Tennessee, Iowa, Oklahoma, North Carolina, California, Mississippi, Pennsylvania, Washington, Texas, Connecticut, New York, Illinois, Massachusetts, and Idaho.

In the face of nationwide physician shortages, our legislation would provide a solution for communities today and a path forward to train the physicians of tomorrow. I urge all of my colleagues to join in support of this important legislation, the Training the Next Generation of Primary Care Doctors Act of 2017.

Madam President, I ask unanimous consent that the letters be printed in the Record.

Sen. Susan M. CollinsR-ME · Aug 3, 2017

Madam President, I ask unanimous consent that the letters be printed in the Record.

Sen. John CornynR-TX · Aug 3, 2017

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

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Introduced in SenateIssued August 3, 2017

115th CONGRESS

1st Session

S. 1754

IN THE SENATE OF THE UNITED STATES

August 3, 2017

Ms. Collins (for herself, Mr. Tester, Mr. Cochran, Mr. Manchin, Mr. Daines, Ms. Harris, and Mr. Boozman) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To reauthorize section 340H of the Public Health Service Act to continue to encourage the expansion, maintenance, and establishment of approved graduate medical residency programs at qualified teaching health centers, and for other purposes.

Short title

This Act may be cited as the Training the Next Generation of Primary Care Doctors Act of 2017.

Findings

The Congress finds as follows:

(1)

The program of payments to teaching health centers for graduate medical education under section 340H of the Public Health Service Act (42 U.S.C. 256h) was enacted in 2010 to address the crisis-level shortage of primary care physicians, especially in rural and medically underserved communities.

(2)

Teaching health center residents and faculty will provide more than one million primary care medical visits in 2017 to underserved communities.

(3)

When compared with traditional Medicare GME residents, residents who train at teaching health centers are more likely to practice primary care and remain in underserved or rural communities.

(4)

The teaching health center program not only plays a vital role in training the Nation’s next generation of primary care physicians (including dentists), but helps bridge the Nation’s physician shortfall.

(5)

For these reasons, it is of vital importance to continue the program under section 340H of the Public Health Service Act (42 U.S.C. 256h) at a sustainable level of funding per full-time equivalent resident, as recommended in the fact sheet of the Health Resources and Services Administration entitled Cost Estimates for Training Residents in a Teaching Health Center.

Reauthorization of program of payments to teaching health centers that operate graduate medical education programs

(a)

Payments

Subsection (a) of section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended to read as follows:

(a)

Payments

(1)

In general

Subject to subsection (h)(2), the Secretary shall make payments under this section for direct expenses and indirect expenses to qualified teaching health centers that are listed as sponsoring institutions by the relevant accrediting body for—

(A)

maintenance of existing approved graduate medical residency training programs;

(B)

expansion of existing approved graduate medical residency training programs; and

(C)

establishment of new approved graduate medical residency training programs.

(2)

New programs

(A)

Payments

The Secretary shall make payments under paragraph (1)(C)—

(i)

for fiscal year 2019, for a total of up to 60 full-time equivalent residents at new approved graduate medical residency programs; and

(ii)

for fiscal year 2020, for a total of up to 120 full-time equivalent residents at new approved graduate medical residency programs.

(B)

Priority

Subject to subparagraph (C), in making payments pursuant to paragraph (1)(C), the Secretary shall give priority to qualified teaching health centers that—

(i)

serve a health professional shortage area with a designation in effect under section 332 or a medically underserved community (as defined in section 799B); or

(ii)

are located in a rural area (as defined in section 1886(d)(2)(D) of the Social Security Act).

(C)

Limitations

The number of full-time equivalent residents for which a qualified teaching health center receives payments pursuant to paragraph (1)(C) for a fiscal year shall not exceed by more than 6 the number of full-time equivalent residents for which the center received such payments for the preceding fiscal year. The total number of full-time equivalent residents at all qualified teaching health centers for which payments are made by the Secretary under subparagraphs (A) and (B) of subsection (a)(1) shall not exceed the total number of full-time equivalent residents at all qualified teaching health centers for which payments were made by the Secretary as of January 1, 2017, pursuant to this section.

(b)

Funding

Subsection (g) of the first section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended to read as follows:

(g)

Funding

(1)

Existing programs

Out of any money in the Treasury not otherwise appropriated, there are appropriated for payments under subparagraphs (A) and (B) of subsection (a)(1) $116,500,000 for each of fiscal years 2018, 2019, and 2020, to remain available until expended.

(2)

Incentive for new programs

Out of any money in the Treasury not otherwise appropriated, there are appropriated for payments under subsection (a)(1)(C), $10,000,000 for fiscal year 2019 and $19,000,000 for fiscal year 2020, to remain available until expended.

(3)

Administrative expenses

Of the amount made available to carry out this section for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering this section.

(c)

Annual reporting

Paragraph (1) of subsection (h) of the first section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended—

(1)

by redesignating subparagraph (D) as subparagraph (H); and

(2)

by inserting after subparagraph (C) the following:

(D)

The number of patients treated by residents described in paragraph (4).

(E)

The number of visits by patients treated by residents described in paragraph (4).

(F)

Of the number of residents described in paragraph (4) who completed their residency training at the end of such residency academic year, the number and percentage of such residents entering primary care practice (meaning any of the areas of practice listed in the definition of a primary care residency program in section 749A).

(G)

(i)

primarily serving a health professional shortage area with a designation in effect under section 332 or a medically underserved community (as defined in section 799B); or

(ii)

located in a rural area (as defined in section 1886(d)(2)(D) of the Social Security Act).

(d)

Report on training costs

Not later than March 31, 2020, the Secretary of Health and Human Services shall submit to the Congress a report on the direct graduate expenses of approved graduate medical residency training programs, and the indirect expenses associated with the additional costs of teaching residents, of qualified teaching health centers (as such terms are used or defined in section 340H of the Public Health Service Act (42 U.S.C. 256h)).

(e)

Definition

Subsection (j) of the first section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended—

(1)

by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and

(2)

by inserting after paragraph (1) the following:

(2)

New approved graduate medical residency training program

The term new approved graduate medical residency training program means an approved graduate medical residency training program for which the sponsoring qualified teaching health center has not received a payment under this section for a previous fiscal year (other than pursuant to subsection (a)(1)(C)).

(f)

Technical corrections

Part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended—

(1)

in subsection (f) of the first section 340H (42 U.S.C. 256h), by striking hospital each place it appears and inserting teaching health center;

(2)

by redesignating the second subpart XI (relating to a community-based collaborative care network program) as subpart XII; and

(3)

by redesignating the second section 340H (42 U.S.C. 256i) as section 340I.

(g)

Payments for previous fiscal years

The provisions of the first section 340H of the Public Health Service Act (42 U.S.C. 256h), as in effect on the day before the date of enactment of this Act, shall continue to apply with respect to payments under such section for fiscal years before fiscal year 2018.