[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 410 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 410
To amend the Public Health Service Act to increase the number of
primary care physicians serving health professional shortage areas, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 11, 2007
Mr. Conyers (for himself, Mrs. Christensen, Mr. Davis of Illinois, Mr.
Bishop of Georgia, Ms. Jackson-Lee of Texas, and Mr. Jackson of
Illinois) introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to increase the number of
primary care physicians serving health professional shortage areas, 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 ``United States Physician Shortage
Elimination Act of 2007''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The average life expectancy in the United States has
increased to 80 years of age, causing an ever-increasing demand
for medical care.
(2) In 1975, United States medical schools graduated
approximately 12,716 physicians. Half of these physicians
entered programs of medical studies as graduates of United
States colleges and universities. The other half consisted of
graduates of foreign institutions admitted to United States
medical schools under the J-1 Visa Program.
(3) Presently, the number of applicants, foreign and
domestic, seeking admission to United States medical schools
has decreased to approximately 39,109.
(4) During the last 20 years, median tuition and fees at
medical schools have increased by 229 percent (122 percent
adjusted for inflation) in private schools and by 479 percent
(256 percent adjusted for inflation) in public schools.
(5) The Association of American Medical Colleges, in its
Statement on the Physician Workforce, dated June, 2006, called
for an increase of 1,500 National Health Service Corps program
awards per year to help meet the need for physicians caring for
underserved populations and to help address rising medical
student indebtedness.
(6) The National Health Service Corps program has a proven
record of supplying physicians to underserved areas, and has
played an important role in expanding access for underserved
populations in rural and inner city communities.
(7) Continued expansion of the National Health Service
Corps program is strongly recommended.
(8) The growing debt incurred by graduating medical
students is likely to increase the interest and willingness of
graduates of United States medical schools to apply for
National Health Service Corps program funding and awards.
(9) One third (250,000) of active physicians are over the
age of 55 and are likely to retire in the next ten years, while
the population will have increased by 24 percent. These
demographic changes will cause the population-to-physician
ratio to peak by the year 2020.
(10) The Indiana State Medical Licensing Board has
estimated that in 20 years there will be 200,000 fewer
physicians available to deliver medical services.
(11) In 2005, the Council on Graduate Medical Education
stated in a report to Congress that there will be a shortage of
not fewer than 90,000 full-time physicians by 2020.
(12) A decrease in Federal spending to carry out programs
authorized by title VII of the Public Health Service Act
threatens the viability of programs used to solve the problem
of inadequate access to health care.
(13) A continuing decline in the number of family
physicians may lead to renewed shortages of safety net and
rural physicians.
(14) There is a declining ability to recruit qualified
medical students from rural and underserved areas, coupled with
greater difficulty on the part of community health centers and
other clinics to attract adequate personnel.
SEC. 3. REAUTHORIZATION OF NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP
PROGRAM AND LOAN REPAYMENT PROGRAM.
(a) Reauthorization of Appropriations.--Section 338H(a) of the
Public Health Service Act (42 U.S.C. 254q(a)) is amended by striking
``$146,250,000'' and all that follows through the period and inserting
``$300,000,000 for each of fiscal years 2007 through 2011.''.
(b) Scholarships for Medical Students.--Section 338H of such Act is
further amended by adding at the end the following:
``(d) Scholarships for Medical Students.--Of the amounts
appropriated under subsection (a) for a fiscal year, the Secretary
shall obligate $30,000,000 for contracts for scholarships under this
subpart to individuals who are accepted for enrollment, or enrolled, in
a course of study or program described in section 338A(b)(1)(B) that
leads to a degree in medicine or osteopathic medicine.''.
SEC. 4. REAUTHORIZATION OF CERTAIN PROGRAMS PROVIDING GRANTS FOR HEALTH
PROFESSIONS TRAINING FOR DIVERSITY.
(a) Grants for Centers of Excellence.--Section 736(h)(1) of the
Public Health Service Act (42 U.S.C. 293(h)(1)) is amended by striking
``$26,000,000'' and all that follows through ``2002'' and inserting
``$33,610,000 for each of fiscal years 2007 through 2011''.
(b) Educational Assistance for Individuals From Disadvantaged
Backgrounds.--Section 740(c) of such Act (42 U.S.C. 293d(c)) is amended
by striking ``$29,400,000'' and all that follows through the period and
inserting ``$35,650,000 for each of fiscal years 2007 through 2011.'' .
SEC. 5. EXPANSION OF RESIDENCY TRAINING PROGRAMS AND PRIMARY CARE
SERVICES OFFERED BY COMMUNITY HEALTH CENTERS.
Part C of title VII of the Public Health Service Act (42 U.S.C.
293k et seq.) is amended--
(1) by adding before section 747 the following:
``Subpart I--In General''; and
(2) by adding after section 748 the following:
``Subpart II--Additional Programs
``SEC. 749. GRANTS TO EXPAND MEDICAL RESIDENCY TRAINING PROGRAMS AT
COMMUNITY HEALTH CENTERS.
``(a) Program Authorized.--The Secretary may make grants to
community health centers--
``(1) to establish, at the centers, new or alternative-
campus accredited medical residency training programs
affiliated with a hospital or other health care facility; or
``(2) to fund new residency positions within existing
accredited medical residency training programs at the centers
and their affiliated partners.
``(b) Use of Funds.--Amounts from a grant under this section shall
be used to cover the costs of establishing or expanding a medical
residency training program described in subsection (a), including costs
associated with--
``(1) curriculum development;
``(2) equipment acquisition;
``(3) recruitment, training, and retention of residents and
faculty; and
``(4) residency stipends.
``(c) Applications.--A community health center seeking a grant
under this section shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may require.
``(d) Preference.--In selecting recipients for a grant under this
section, the Secretary shall give preference to funding medical
residency training programs focusing on primary health care.
``(e) Definition.--In this section:
``(1) The term `accredited', as applied to a new or
alternative-campus medical residency training program, means a
program that is accredited by a recognized body or bodies
approved for such purpose by the Accreditation Council for
Graduate Medical Education, except that a new medical residency
training program that, by reason of an insufficient period of
operation, is not eligible for accreditation on or before the
date of submission of an application under subsection (c) shall
be deemed accredited if the Accreditation Council for Graduate
Medical Education finds, after consultation with the
appropriate accreditation body or bodies, that there is
reasonable assurance that the program will meet the
accreditation standards of such body or bodies prior to the
date of graduation of the first entering class in that program.
``(2) The term `community health center' means a health
center as defined in section 330.
``SEC. 749A. GRANTS TO IMPROVE DELIVERY OF PRIMARY CARE SERVICES IN
COMMUNITY HEALTH CENTERS.
``(a) Primary Care Access Grants.--
``(1) Program authorized.--The Secretary, acting through
the Administrator of the Health Resources and Services
Administration, may make grants to community health centers for
the purpose of increasing the number of medical service
providers associated with such centers.
``(2) Grants.--A recipient of a grant under this subsection
shall be eligible to receive such grants for a total of 5
fiscal years.
``(3) Use of funds.--A recipient of a grant under this
subsection shall use amounts from the grant for one or more of
the following activities:
``(A) To recruit residents for medical residency
training programs at the community health center.
``(B) To establish a multi-community physician
mentoring program to encourage upper level residents to
remain in the State in which the community health
center and medical residency training program are
located.
``(C) To enter into contracts for technical
assistance for the purpose of recruiting or retaining
primary health care staff.
``(D) To enter into contracts for technical
assistance in preparing contracts with local providers
of primary health care to provide services for
medically underserved communities.
``(4) Application.--A community health center seeking a
grant under this subsection shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may require.
``(b) Grants for Primary Care Facility Capital Expenditures.--
``(1) Program authorized.--The Secretary, acting through
the Administrator of the Health Resources and Services
Administration, may make grants to community health centers for
the purpose of increasing primary health care capabilities
through the construction, expansion, or renovation of
facilities.
``(2) Grants.--A recipient of a grant under this subsection
shall be eligible to receive such grants for a total of 5
fiscal years.
``(3) Use of funds.--A recipient of a grant under this
subsection shall use amounts from the grant for one or more of
the following activities:
``(A) To acquire or lease facilities.
``(B) To construct new facilities.
``(C) To repair or modernize existing facilities.
``(D) To purchase or lease medical equipment.
``(c) Definition.--The term `community health center' means a
health center as defined in section 330.
``SEC. 749B. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated $200,000,000 for fiscal
year 2007 and such sums as may be necessary for each fiscal year
thereafter to carry out this subpart.''.
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