,i #aacth ,,congress #b;d ,session ,h4 ,r4 #ebbc ,,in ,,the ,,house ,,of ,,representatives ,july #bh1 #bjad ,mr4 ,mc,dermott introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to authorize grants to ,states for the purpose of assisting the ,states in operating an ,,rdocs program in order to provide for the increased availability of primary health care services in health professional shortage areas4 #a4 ,short title ,this ,act may be cited as the ,restoring the ,doctors of ,our ,country through ,scholarships ,act of #bjad or the ,,rdocs ,act of #bjad4 #b4 ,findings ,the ,congress finds the following3 7#a7 ,due to an aging population1 the retirement of a generation of physicians1 and #cj1jjj1jjj newly insured under the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaj-adh71 the ,united ,states is expected to experience an acute physician workforce shortage in the coming decades1 particularly in primary care4 ,if unaddressed1 this shortage will compromise the health of the population as well as the ability of the ,united ,states to remain competitive in the world4 7#b7 ,by #bjbj1 the shortage of primary care doctors is expected to reach #de1jjj4 7#c7 ,the shortage will disproportionately impact rural communities and underserved urban communities4 7#d7 ,the ,reserve ,officers' ,training ,corps 7,,rotc7 model of education and training is a respected and effective way of meeting the ,nation's need for educated and trained officers in the ,united ,states ,armed ,forces1 and can be applied to solving the ,nation's primary care shortage4 7#e7 ,there are #aj applicants for each ,national ,health ,service ,corps scholarship awarded1 indicating the unmet demand for medical scholarships4 #c4 ,grants to ,states for ,restoring the ,doctors of ,our ,country through ,scholarships 7,,rdocs7 programs ,subpart ,,iii of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl et seq47 is amended by adding at the end the following3 #cch,n4 ,grants to ,states for scholarship programs 7a7 ,grants to ,states 7#a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall make grants to ,states for the purpose of assisting the ,states in operating a program described in paragraph 7#b7 7referred to in this section as an ,,rdocs program7 in order to provide for the increased availability of primary health care services in health professional shortage areas4 7#b7 ,applications ,to seek a grant under this section1 a ,state shall submit an application in such form1 in such manner1 and containing such agreements1 assurances1 and information as the ,secretary determines to be necessary to carry out this section4 7#c7 ,total number of new ,,rdocs scholars each year ,subject to the availability of appropriations1 the ,secretary shall ensure that a total of at least #d1jjj new ,,rdocs scholars are awarded scholarships under this section each academic year4 7b7 ,scholarship program described ,an ,,rdocs program is a program of entering into contracts between the ,state involved and an ,,rdocs scholar under which-- 7#a7 the ,state involved agrees-- 7,a7 to pay all tuition and costs for the ,,rdocs scholar's undergraduate medical education1 to the participating undergraduate medical program1 for a period of study not exceeding #dh consecutive months2 and 7,b7 to pay1 during such period1 a cost-of-living stipend1 in an amount to be determined by the ,secretary1 to the ,,rdocs scholar2 and 7#b7 the ,,rdocs scholar agrees-- 7,a7 to be admitted into and maintain enrollment in a participating undergraduate medical program in the ,,rdocs scholar's ,state of residence 7or if such ,state of residence operates no such program1 in a participating undergraduate medical program in a ,state within an associated region72 7,b7 when enrolled in such program1 to maintain a minimum level 7to be determined by the ,secretary7 of academic standing2 7,c7 to complete an accredited residency training program in a primary care specialty2 7,d7 to become licensed to practice medicine in the applicant's ,state of residence2 7,e7 to receive and maintain board certification in a primary care speciality2 and 7,f7 to complete a #e-year post-graduate period of service in a health professional shortage area4 7c7 ,priority in awarding scholarships ,in selecting ,,rdocs scholars and awarding scholarship contracts described in subsection 7b71 the ,state involved shall give preference to applicants who are enrolled in-- 7#a7 an accelerated track family-medicine program2 or 7#b7 a program that includes clinical training in rural or underserved urban communities4 7d7 ,direct administration by ,state agency ,the ,,rdocs program of any ,state receiving a grant under this section shall be administered directly by a ,state agency4 7e7 ,requirement of matching funds 7#a7 ,in general ,any ,state receiving a grant under this section shall1 with respect to the costs of making payments on behalf of individuals under scholarship contracts described in subsection 7b71 make available 7directly or through donations from public or private entities7 non-,federal contributions in cash toward such costs in an amount equal to not less than #a for each #i of ,federal funds provided through the grant4 7#b7 ,determination of amount of non-federal contribution ,in determining the amount of non-,federal contributions in cash that a ,state has provided pursuant to paragraph 7#a7-- 7,a7 any amounts provided to the ,state by the ,federal ,government shall not be included2 and 7,b7 any amounts expended by the ,state as administrative funds to operate its ,,rdocs program may1 at the ,state's discretion1 be included4 7f7 ,coordination with ,federal program 7#a7 ,assignments for health professional shortage areas under federal program ,any ,state receiving a grant under this section shall1 in carrying out its ,,rdocs program1 assign ,,rdocs officers participating in the program only to public and nonprofit private entities located in and providing health services in health professional shortage areas4 7#b7 ,remedies for breach of contracts ,the ,secretary may not make a grant under subsection 7a7 unless the ,state involved agrees that the scholarship contracts provided by the ,state pursuant to subsection 7b7 will provide remedies for any breach of the contracts by the ,,rdocs scholars and ,,rdocs officers involved4 7#c7 ,limitation regarding contract inducements ,any ,state receiving a grant under this section shall ensure that contracts between the ,state and ,,rdocs scholars under this section do not include any terms more favorable to the ,,rdocs scholars than the most favorable terms which the ,secretary is authorized to provide in contracts under the ,national ,health ,service ,corps ,scholarship ,program under section #cch;,a1 including terms regarding the availability of remedies for any breach of the contracts by the health professionals involved4 7g7 ,restrictions on use of funds ,any ,state receiving a grant under this section shall not expend the grant funds for any purpose other than making payments on behalf of or to ,,rdocs scholars under contracts entered into pursuant to this section4 7h7 ,reports by ,states ,any ,state receiving a grant under this section shall submit to the ,secretary-- 7#a7 a report on the ,state's ,,rdocs program not later than ,january #aj of each fiscal year immediately following any fiscal year for which the ,state has received such a grant2 and 7#b7 such other reports regarding the ,state's ,,rdocs program1 as are determined to be appropriate by the ,secretary4 7i7 ,reports by ,secretary ,the ,secretary shall report annually to the relevant committees on the physician workforce in the ,united ,states1 and shall include in each such report-- 7#a7 data on the physician shortage1 if any1 disaggregated by ,state and region2 and 7#b7 a gap analysis of the primary care practitioners needed in each ,state and region1 and #e- and #aj-year estimates of the funding needed to close the gap through the ,,rdocs program4 7j7 ,noncompliance 7#a7 ,in general ,the ,secretary may not make payments under this section to a ,state for any fiscal year subsequent to the first fiscal year of such payments unless the ,secretary determines that1 for the immediately preceding fiscal year1 the ,state has complied with each of the agreements made by the ,state under this section4 7#b7 ,reduction in grant relative to number of breached contracts 7,a7 ,determination of number of breached contracts ,before making a grant under this section to a ,state for a fiscal year1 the ,secretary shall determine the number of contracts provided pursuant to the ,state's ,,rdocs program with respect to which there has been an initial breach by the ,,rdocs scholars or officers involved during the fiscal year preceding the fiscal year for which the ,state is applying to receive the grant4 7,b7 ,reduction of grants ,subject to paragraph 7#c71 in the case of a ,state with #a or more initial breaches for purposes of subparagraph 7,a71 the ,secretary shall reduce the amount of a grant under this section to the ,state for the fiscal year involved by an amount equal to the sum of-- 7i7 the expenditures of ,federal funds made regarding the contracts involved2 and 7ii7 an amount representing interest on the amount of such expenditures1 determined with respect to each contract on the basis of the maximum legal rate prevailing for loans made during the time amounts were paid under the contract1 as determined by the ,treasurer of the ,united ,states4 7#c7 ,waiver regarding reduction in grant ,the ,secretary may waive the requirement of paragraph 7#b77;,b7 with respect to the initial breach of a contract if the ,secretary determines that such breach by the ,,rdocs scholar or officer involved was attributable solely to the professional having a serious illness4 7k7 ,definitions ,for the purposes of this section3 7#a7 ,accelerated track family-medicine program ,the term accelerated track family-medicine program refers to an appropriately accredited1 integrated course of study in which a candidate can complete undergraduate medical education and graduate medical education in #f years4 7#b7 ,associated region ,the term associated region refers to-- 7,a7 the area encompassing the boundaries of ,washington1 ,wyoming1 ,alaska1 ,montana1 and ,idaho2 7,b7 the area encompassing the boundaries of ,maine1 ,new ,hampshire1 ,massachusetts1 ,rhode ,island1 ,connecticut1 and ,vermont2 7,c7 the area encompassing the boundaries of ,delaware and ,pennsylvania2 or 7,d7 the area encompassing the boundaries of ,maryland1 the ,district of ,columbia1 and ,virginia4 7#c7 ,board certification ,the term board certification means a certification to practice medicine in a specialty1 by an appropriate medical specialty board4 7#d7 ,health professional shortage area ,the term health professional shortage area means a health professional shortage area designated under section #ccb4 7#e7 ,participating undergraduate medical program ,the term participating undergraduate medical program means an allopathic or osteopathic undergraduate medical program operated by a ,state4 7#f7 ,primary care specialty ,the term primary care specialty means pediatrics1 geriatric1 gerontology1 family medicine1 or general internal medicine4 7#g7 ,,rdocs officer ,the term ,,rdocs officer means an ,,rdocs program participant who has completed undergraduate medical training1 but has not yet fulfilled the remaining requirements of his or her scholarship contract under subsection 7b74 7#h7 ,,rdocs scholar ,the term ,,rdocs scholar means an individual participating in an ,,rdocs program pursuant to a scholarship contract under subsection 7b71 who has not yet completed undergraduate medical education4 7#i7 ,relevant committees ,the term relevant committees means the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives4 7#aj7 ,state ,the term ,state means each of the #ej ,states and the ,district of ,columbia4 4