109th CONGRESS
1st Session
S. 473
To amend the Public Health Service Act to promote and improve the
allied health professions.
IN THE SENATE OF THE UNITED STATES
February 28, 2005
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.
`(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:
`(B) Dietetics or nutrition.
`(C) Emergency medical services.
`(D) Health information management.
`(E) Clinical laboratory sciences and medical technology.
`(G) Occupational 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 grantees 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
`(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 2006 through 2011.'.
END
