,,ii #aadth ,,congress #b;d ,session ,s4 #caij ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #ac1 #bjaf ,mr4 ,franken 7for himself and ,ms4 ,heitkamp7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to enhance the rural health workforce1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,strengthening ,our ,rural ,health ,workforce ,act of #bjaf4 #b4 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4 ,sec4 #b4 ,table of contents4 ,,title ,i--,comprehensive strategic planning for workforce needs ,sec4 #aja4 ,national ,health ,care ,workforce ,commission4 ,,title ,,ii--,increasing the adoption of rural training track programs ,sec4 #bja4 ,clarifying description of rural training tracks4 ,sec4 #bjb4 ,,gao study and report on ,medicare payments for graduate medical education4 ,sec4 #bjc4 ,distribution of additional residency positions4 ,,title ,,iii--,supporting primary care workforce ,sec4 #cja4 ,reauthorization of primary care residency expansion program4 ,sec4 #cjb4 ,reauthorization of area health education centers4 ,,title ,,iv--,supporting emerging professions ,sec4 #dja4 ,authorizing appropriations for ,quentin ,n4 ,burdick program for rural interdisciplinary training4 ,sec4 #djb4 ,dental therapists4 ,sec4 #djc4 ,allied health professionals4 ,sec4 #djd4 ,community health workers4 ,sec4 #dje4 ,,gao report4 ,,title ,v--,mental health workforce ,sec4 #eja4 ,establishing mental health and substance use disorder curriculum4 ,sec4 #ejb4 ,streamlining mental and behavioral health workforce programs4 ,i ,comprehensive strategic planning for workforce needs #aja4 ,national ,health ,care ,workforce ,commission ,section #eaja of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bidq7 is amended-- 7a7 in subsection 7h7-- 7#a7 by striking paragraphs 7#a7 and 7#b7 and inserting the following3 7#a7 ,appropriations ,there are authorized to be appropriated1 and there are appropriated1 out of any monies in the ,treasury not otherwise appropriated1 #aj1jjj1jjj for each fiscal year to carry out this section4 2 and 7#b7 by redesignating paragraph 7#c7 as paragraph 7#b72 and 7b7 in subsection 7d7-- 7#a7 in paragraph 7#g71 by adding at the end ,whenever feasible1 ,congress and the ,department of ,health and ,human ,services shall recognize and implement such recommendations42 and 7#b7 by adding at the end the following3 7#i7 ,data tracking 7,a7 ,data tracking mechanism ,the ,commission shall develop1 or enter into a contract with another entity to develop1 a mechanism for tracking information on the career paths of graduates of medical schools and residency programs1 as described in subparagraph 7,b71 and shall make such information publicly available4 7,b7 ,recordkeeping ,the ,commission shall collect or ensure the collection of data1 using the mechanism developed under subparagraph 7,a71 concerning-- 7i7 the specialty and subspecialty training of all graduates of medical schools receiving ,federal funding2 and 7ii7 the professional trajectory of all graduates of medical schools receiving ,federal funding for not less than #ae years after each individual graduates from medical school1 including data concerning graduates who practice medicine-- 7,i7 in underserved areas such as health professional shortage areas 7as designated by the ,secretary under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e772 7,,ii7 with medically underserved populations 7as defined in section #ccj7;b77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7b77#c7772 7,,iii7 in ,federally-qualified health centers 7as defined in section #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b7772 7,,iv7 in rural health clinics 7as defined in section #ahfa7;aa77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#b7772 7,v7 in the health care system of the ,department of ,veterans ,affairs2 and 7,,vi7 in clinics of the ,indian ,health ,services4 4 ,,ii ,increasing the adoption of rural training track programs #bja4 ,clarifying description of rural training tracks ,section #ahhf7;h77#d77;,h77iv7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7h77#d77;,h77iv77 is amended by adding at the end the following new sentence3 ,the ,secretary1 in coordination with representatives of the ,centers for ,medicare ,medicaid ,services1 the ,health ,resources ,services ,administration1 and the ,federal ,office of ,rural ,health ,policy1 shall develop a consistent definition of approved medical residency training programs 7or rural tracks7 in a rural area for purposes of this section and any other residency training program administered by the ,secretary44 #bjb4 ,,gao study and report on ,medicare payments for graduate medical education 7a7 ,study ,the ,comptroller ,general of the ,united ,states shall conduct a study on the effectiveness of payments for graduate medical education costs and indirect costs for medical education under subsections 7h7 and 7d77#e77;,b7 of section #ahhf of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww71 including efforts to distribute unused residency positions under subsection 7h77#h7 of such section1 to meet the primary care and mental health needs of individuals living in rural areas4 ,such study shall include-- 7#a7 an analysis of the number of additional residency positions available as a result of such distribution that are being used to train residents who practice in rural areas after completing their residency2 and 7#b7 identification of approved medical residency training programs with proven track records in training primary care physicians and psychiatrists who practice in rural areas4 7b7 ,report ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report containing the results of the study conducted under subsection 7a71 together with recommendations for such legislation and administrative action as the ,comptroller ,general determines appropriate4 #bjc4 ,distribution of additional residency positions 7a7 ,in general ,section #ahhf7;h7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7h77 is amended-- 7#a7 in paragraph 7#d77;,f77i71 by striking and 7#h7 and inserting 1 7#h71 and 7#i72 7#b7 in paragraph 7#d77;,h77i71 by striking and 7#h7 and inserting 1 7#h71 and 7#i72 7#c7 in paragraph 7#g77;,e71 by inserting paragraph 7#i71 after paragraph 7#h712 and 7#d7 by adding at the end the following new paragraph3 7#i7 ,distribution of additional residency positions 7,a7 ,reductions in limit based on unused positions 7i7 ,in general ,except as provided in clause 7ii71 if a hospital's reference resident level 7as defined in subparagraph 7,h77 is less than the otherwise applicable resident limit 7as defined in such subparagraph71 effective for portions of cost reporting periods occurring on or after ,july #a1 #bjbj1 the otherwise applicable resident limit shall be reduced by #fe percent of the difference between such otherwise applicable resident limit and such reference resident level4 7ii7 ,exceptions ,this subparagraph shall not apply to-- 7,i7 a hospital with fewer than #bej acute care inpatient beds that is located in a rural area 7as defined in subsection 7d77#b77;,d77ii771 including a hospital treated as being located in a rural area under subsection 7d77#h77;,e72 7,,ii7 a hospital that was part of a qualifying entity which had a voluntary residency reduction plan approved under paragraph 7#f77;,b7 or under the authority of section #djb of ,public ,law #ij-bdh1 if the hospital demonstrates to the ,secretary that it has a specified plan in place for filling the unused positions by not later than #b years after the date of enactment of this paragraph2 or 7,,iii7 a hospital described in paragraph 7#d77;,h77v74 7,b7 ,distribution 7i7 ,in general ,the ,secretary shall increase the otherwise applicable resident limit for each qualifying hospital that submits an application under this subparagraph by such number as the ,secretary may approve for portions of cost reporting periods occurring on or after ,july #a1 #bjbj4 ,the aggregate number of increases in the otherwise applicable resident limit under this subparagraph shall be equal to the aggregate reduction in such limits attributable to subparagraph 7,a7 7as estimated by the ,secretary74 7ii7 ,requirements ,subject to clause 7iii71 a hospital that receives an increase in the otherwise applicable resident limit under this subparagraph shall ensure1 during the #e-year period beginning on the date of such increase1 that-- 7,i7 the number of full-time equivalent primary care residents1 as defined in paragraph 7#e77;,h7 7as determined by the ,secretary71 excluding any additional positions under subclause 7,,ii71 is not less than the average number of full-time equivalent primary care residents 7as so determined7 during the #c most recent cost reporting periods ending prior to the date of enactment of this paragraph2 and 7,,ii7 not less than #ge percent of the positions attributable to such increase are in a primary care1 psychiatry1 or general surgery residency 7as determined by the ,secretary74 ,the ,secretary may determine whether a hospital has met the requirements under this clause during such #e-year period in such manner and at such time as the ,secretary determines appropriate1 including at the end of such #e-year period4 7iii7 ,redistribution of positions if hospital no longer meets certain requirements ,in the case where the ,secretary determines that a hospital described in clause 7ii7 does not meet either of the requirements under subclause 7,i7 or 7,,ii7 of such clause1 the ,secretary shall-- 7,i7 reduce the otherwise applicable resident limit of the hospital by the amount by which such limit was increased under this paragraph2 and 7,,ii7 provide for the distribution of positions attributable to such reduction in accordance with the requirements of this paragraph4 7,c7 ,considerations in redistribution ,in determining for which hospitals the increase in the otherwise applicable resident limit is provided under subparagraph 7,b71 the ,secretary shall take into account-- 7i7 the demonstration likelihood of the hospital filling the positions made available under this paragraph within the first #c cost reporting periods beginning on or after ,july #a1 #bjbj1 as determined by the ,secretary2 and 7ii7 whether the hospital has an accredited rural training track 7as described in paragraph 7#d77;,h77iv774 7,d7 ,priority for certain areas ,in determining for which hospitals the increase in the otherwise applicable resident limit is provided under subparagraph 7,b71 subject to subparagraph 7,e71 the ,secretary shall distribute the increase to hospitals based on the following factors3 7i7 ,whether the hospital and the approved medical residency training program of the hospital have a proven track record of primary care and rural support 7as determined by the ,secretary74 7ii7 ,whether the hospital is located in a ,state1 a territory of the ,united ,states1 or the ,district of ,columbia that is among the top #bj ,states1 territories1 or ,districts in terms of the ratio of the geographic area of the ,state1 territory1 or ,district in square miles that is rural compared to the geographic area in each other ,state1 territory1 or ,district in square miles that is rural 7as determined by the ,secretary based solely on the most recent available population data published by the ,bureau of the ,census74 7iii7 ,whether the hospital is located in a rural area 7as defined in subsection 7d77#b77;,d77ii771 including a hospital treated as being located in a rural area under subsection 7d77#h77;,e74 7,e7 ,reservation of positions for certain hospitals 7i7 ,in general ,subject to clause 7ii71 the ,secretary shall reserve the positions available for distribution under this paragraph as follows3 7,i7 #gj percent of such positions for distribution to hospitals described in clause 7i7 of subparagraph 7,d74 7,,ii7 #cj percent of such positions for distribution to hospitals described in clauses 7ii7 and 7iii7 of such subparagraph4 7ii7 ,exception if positions not redistributed by ,july #a1 #bjbj ,in the case where the ,secretary does not distribute positions to hospitals in accordance with clause 7i7 by ,july #a1 #bjbj1 the ,secretary shall distribute such positions to other hospitals in accordance with the considerations described in subparagraph 7,c7 and the priority described in subparagraph 7,d74 7,f7 ,limitation ,a hospital may not receive more than #ge full-time equivalent additional residency positions under this paragraph4 7,g7 ,application of per resident amounts for primary care and nonprimary care ,with respect to additional residency positions in a hospital attributable to the increase provided under this paragraph1 the approved ,,fte per resident amounts are deemed to be equal to the hospital per resident amounts for primary care and nonprimary care computed under paragraph 7#b77;,d7 for that hospital4 7,h7 ,definitions ,in this paragraph1 the terms reference resident level1 resident level1 and otherwise applicable resident limit have the meaning given such terms in paragraph 7#h77;,h74 7,i7 ,affiliation ,the provisions of this paragraph shall be applied to hospitals which are members of the same affiliated group 7as defined by the ,secretary under paragraph 7#d77;,h77ii77 and the reference resident level for each such hospital shall be the reference resident level with respect to the cost reporting period that results in the smallest difference between the reference resident level and the otherwise applicable resident limit4 4 7b7 ,,ime 7#a7 ,in general ,section #ahhf7;d77#e77;,b77v7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#e77;,b77v771 in the second sentence1 is amended by striking and 7h77#h7 and inserting 1 7h77#h71 and 7h77#i74 7#b7 ,conforming amendment ,section #ahhf7;d77#e77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#e77;,b77 is amended by adding at the end the following new clause3 7xi7 ,for discharges occurring on or after ,july #a1 #bjbj1 insofar as an additional payment amount under this subparagraph is attributable to resident positions distributed to a hospital under subsection 7h77#i77;,b71 the indirect teaching adjustment factor shall be computed in the same manner as provided under clause 7ii7 with respect to such resident positions4 4 7c7 ,conforming amendment ,section #dbb7;b77#b7 of the ,medicare ,prescription ,drug1 ,improvement1 and ,modernization ,act of #bjjc 7,public ,law #ajh-agc7 is amended by striking and 7#h7 and inserting 1 7#h71 and 7#i74 ,,iii ,supporting primary care workforce #cja4 ,reauthorization of primary care residency expansion program ,section #gdg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bick7 is amended-- 7#a7 in subsection 7b77#c77;,e71 by striking vulnerable populations and inserting individuals with a mental illness or substance use disorder or other vulnerable populations12 and 7#b7 in subsection 7c7-- 7,a7 in paragraph 7#a71 by striking #abe1jjj1jjj and all that follows through the period at the end and inserting #afh1jjj1jjj for the period of fiscal years #bjag through #bjba42 and 7,b7 in paragraph 7#c71 by striking #bjaj through #bjad and inserting #bjag through #bjba4 #cjb4 ,reauthorization of area health education centers ,section #gea7;j77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;a7j77#a77 is amended by striking #abe1jjj1jjj for each of the fiscal years #bjaj through #bjad and inserting #dj1jjj1jjj for each of fiscal years #bjag through #bjba4 ,,iv ,supporting emerging professions #dja4 ,authorizing appropriations for ,quentin ,n4 ,burdick program for rural interdisciplinary training ,section #ged of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #gid;d7 is amended by adding at the end the following3 7e7 ,authorization of appropriations ,there are authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjag through #bjba to carry out this section4 4 #djb4 ,dental therapists 7a7 ,training in general1 pediatric1 and public health dentistry ,section #gdh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bick-#b7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 in subparagraph 7,a71 by inserting dental therapists1 after practicing dentists12 and 7,b7 in subparagraph 7,b71 by inserting dental therapists1 after practicing dentists12 and 7#b7 in subsection 7b7-- 7,a7 by striking programs in dental or dental hygiene and inserting programs in dental1 dental therapy1 or dental hygiene2 and 7,b7 by striking dental students1 residents1 and dental hygiene students and inserting dental students1 residents1 dental therapy students1 and dental hygiene students4 7b7 ,funding for primary dental demonstration program 7#a7 ,timeframe ,section #cdj;,g-#a7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;g-#a7;b77 is amended-- 7,a7 by striking #b years and inserting #aj years2 and 7,b7 by striking #g years and inserting #ad years4 7#b7 ,sense of ,senate ,it is the sense of the ,senate that-- 7,a7 section #cdj;,g-#a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;g-#a7 should be fully funded for each of fiscal years #bjag through #bjba2 and 7,b7 any appropriations ,act appropriating amounts for fiscal year #bjag1 or any subsequent fiscal year through fiscal year #bjba1 should not contain any language prohibiting the availability of funds for such section4 #djc4 ,allied health professionals 7a7 ,definition of allied health professionals ,section #gii;,b7#e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #biep7#e77 is amended-- 7#a7 in subparagraph 7,b77v71 by striking 2 and and inserting 1 including services related to managing the implementation and operation of health information technology22 7#b7 in subparagraph 7,c71 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7,d7 who may be licensed or certified to practice in an emerging health care profession as defined by the ,secretary1 which may include community paramedics1 dental therapists1 doulas1 and other community health workers4 4 7b7 ,loan forgiveness for allied health professionals ,section #dbh,k7h7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajgh-aa7;h77 is amended-- 7#a7 by striking this section such sums and inserting this section-- 7#a7 such sums 2 7#b7 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7#b7 such sums as may be necessary for each of fiscal years #bjag through #bjba to provide loan forgiveness in accordance with this section for individuals meeting the requirements of subsection 7b77#ah74 4 7c7 ,training for mid-,career public and allied health professionals ,section #ggg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bie;f-#b7 is amended-- 7#a7 in subsection 7b77#b71 by inserting 1 including individuals who are foreign-trained health professionals before the period2 7#b7 by redesignating subsection 7c7 as subsection 7d72 7#c7 by inserting after subsection 7b7 the following3 7c7 ,preference 7#a7 ,eligible institutions ,in making grants under this section1 the ,secretary shall prioritize awarding grants to eligible entities located in rural or underserved areas4 7#b7 ,eligible individuals ,in awarding scholarships to eligible individuals under this section1 an eligible entity shall prioritize individuals from rural or underserved communities4 2 and 7#d7 in subsection 7d71 as so redesignated1 by striking #bjae and inserting #bjba4 #djd4 ,community health workers ,section #cii,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#aa7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#d71 by striking 2 or2 7,b7 in paragraph 7#e71 by striking the period and inserting 2 or2 and 7,c7 by adding at the end the following3 7#f7 to educate1 guide1 and provide assistance with patients enrolled in patient-centered medical homes1 accountable care organizations 7as such term is used in section #ahii of the ,social ,security ,act71 other ,state certified medical or health care homes1 or other coordinated care models4 2 and 7#b7 in subsection 7d77#a7-- 7,a7 in subparagraph 7,b71 by striking or after the semicolon2 7,b7 in subparagraph 7,c71 by inserting or after the semicolon2 and 7,c7 by adding at the end the following3 7,d7 that meet the requirements of subparagraph 7,a71 7,b71 or 7,c7 and are designated as a health professional shortage area under section #ccb7;a72 4 #dje4 ,,gao report 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall prepare and submit to ,congress a report on emerging health care professions as defined by the ,secretary of ,health and ,human ,services4 7b7 ,contents ,the report prepared under subsection 7a7 shall include recommendations on-- 7#a7 improving data collection with respect to emerging health care professions1 such as community health workers1 community paramedics1 and dental therapists2 7#b7 establishing a systematic way for ,federal officials to track ,state financing and use of community health workers1 community paramedics1 and dental therapists2 7#c7 improving methodologies to calculate the return on investment associated with supporting emerging health care professions and the impact of such professions on health care quality2 7#d7 standards for certification and training of individuals in emerging health care professions2 7#e7 establishing a process to ensure that the ,secretary of ,health and ,human ,services continually-- 7,a7 assesses emerging health care professions for quality and consistency2 and 7,b7 recognizes and incorporates these professions in health care delivery2 and 7#f7 establishing a centralized source for evidence on emerging health care professions to facilitate the establishment of best practices for expanded use of emerging health care professions4 ,v ,mental health workforce #eja4 ,establishing mental health and substance use disorder curriculum 7a7 ,in general ,subpart ,i of part ,c of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic,k et seq47 is amended by inserting after section #gdg;,a the following3 #gdg;,b4 ,establishing mental health and substance use disorder curriculum 7a7 ,support and development of mental health and substance use disorder training programs 7#a7 ,in general ,the ,secretary may make grants to1 or enter into contracts with1 a school of medicine or osteopathic medicine1 a nursing school1 a physician assistant training program1 a school of pharmacy1 a school of social work1 an accredited public or nonprofit private hospital1 or a public or private nonprofit entity which the ,secretary has determined is capable of carrying out such grant or contract to establish1 maintain1 or improve-- 7,a7 academic units or programs that include content and clinical experiences related to mental health and substance use disorder fields1 with a special focus on addiction2 7,b7 programs that enhance interdisciplinary recruitment1 training1 and faculty development for the purposes of improving clinical teaching and research in mental health and substance use disorder fields1 including addiction2 7,c7 programs that develop1 assess1 and disseminate evidence-based practices for the design of academic units1 training programs1 and faculty development initiatives in mental health and substance use disorder fields1 including addiction2 and 7,d7 recommendations for medical education curriculum content standards regarding mental health and substance use disorders1 including addiction1 to ensure that students are able to recognize1 diagnose1 and treat mental health and substance use disorders4 7#b7 ,partnership required ,to be eligible to receive a grant or contract under paragraph 7#a71 an entity shall enter into a partnership with a medical education accrediting organization 7such as the ,liaison ,committee on ,medical ,education1 the ,accreditation ,council for ,graduate ,medical ,education1 the ,commission on ,osteopathic ,college ,accreditation1 the ,accreditation ,commission for ,education in ,nursing1 the ,commission on ,collegiate ,nursing ,education1 the ,accreditation ,council for ,pharmacy ,education1 the ,council on ,social ,work ,education1 or the ,accreditation ,review ,commission on ,education for the ,physician ,assistant74 7b7 ,preference in making awards under this section ,in making awards of grants and contracts under subsection 7a71 the ,secretary shall give preference to any qualified applicant for such an award that agrees to expend the award for the purpose of-- 7#a7 establishing academic units or programs in mental health and substance use disorder fields1 including addiction medicine2 or 7#b7 substantially expanding such units or programs4 7c7 ,priorities in making awards ,in awarding grants or contracts under subsection 7a71 the ,secretary shall give priority to qualified applicants that-- 7#a7 have a record of training the greatest percentage of mental health and substance use disorder providers1 including addiction providers1 who enter and remain in mental health and substance use disorder fields2 7#b7 have a record of training the greatest percentage of providers1 or that have demonstrated significant improvements in the percentage of providers trained1 who enter and remain in settings with integrated primary and mental health and substance use disorder health care service1 or have a record of establishing multidisciplinary addiction medicine fellowship training programs2 7#c7 have a record of training individuals who are from underrepresented minority groups1 including native populations1 or from a rural or disadvantaged background2 7#d7 provide training in the care of rural and vulnerable populations1 such as children1 pregnant and post-partum women1 older adults1 homeless individuals1 victims of trafficking1 victims of abuse or trauma1 and other groups as defined by the ,secretary2 7#e7 teach trainees the skills to provide interprofessional1 integrated care through collaboration among health professionals2 or 7#f7 provide training in cultural competency and health literacy4 7d7 ,duration of awards ,the period during which payments are made to an entity from an award of a grant or contract under this section shall be #e years4 7e7 ,authorization of appropriations ,for purposes of carrying out this section1 there are authorized to be appropriated such sums as may be necessary for each of fiscal years #bjag through #bjba4 4 7b7 ,increasing transparency regarding graduate medical education on mental health and substance use disorders ,not later than #e years after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,health and ,human ,services shall submit to ,congress a report that describes the activities that hospitals receiving funding under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 have underway to promote interdisciplinary care teams and provide training for all medical residents1 medical students1 and faculty in mental health and substance use disorders1 including addiction medicine4 #ejb4 ,streamlining mental and behavioral health workforce programs 7a7 ,in general ,part ,d of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid et seq47 is amended-- 7#a7 by striking sections #gee 7#db ,u4,s4,c4 #bid;e7 and #gef 7#db ,u4,s4,c4 #bid;e-#a72 7#b7 by redesignating sections #geg 7#db ,u4,s4,c4 #bid;f7 and #gei 7#db ,u4,s4,c4 #bid;i7 as sections #gef and #geg1 respectively2 and 7#c7 by inserting after section #ged the following3 #gee4 ,mental and behavioral health education and training grants 7a7 ,grants authorized ,the ,secretary may award grants to eligible institutions of higher education to support the recruitment of students for1 and education and clinical experience of the students in-- 7#a7 accredited institutions of higher education or accredited professional training programs that are establishing or expanding internships or other field placement programs in mental health in psychiatry1 psychology1 school psychology1 behavioral pediatrics1 psychiatric nursing1 social work1 school social work1 substance use disorder prevention and treatment1 marriage and family therapy1 occupational therapy1 school counseling1 or professional counseling1 including such internships or programs with a focus on child and adolescent mental health and transitional-age youth2 7#b7 accredited doctoral1 internship1 and post-doctoral residency programs of health service psychology1 including clinical psychology1 counseling1 and school psychology1 for the development and implementation of interdisciplinary training of psychology graduate students for providing behavioral and mental health services1 including substance use disorder prevention and treatment services1 and the development of faculty in health service psychology2 7#c7 accredited master's and doctoral degree programs of social work for the development and implementation of interdisciplinary training of social work graduate students for providing behavioral and mental health services1 including substance use disorder prevention and treatment services1 and the development of faculty in social work2 or 7#d7 ,state-licensed mental health nonprofit and for-profit organizations to enable such organizations to pay for programs for preservice or in-service training in a behavioral health-related paraprofessional field with preference for preservice or in-service training of paraprofessional child and adolescent mental health workers4 7b7 ,eligibility requirements ,to be eligible for a grant under this section1 an institution of higher education shall demonstrate-- 7#a7 an ability to recruit and place the students described in subsection 7a7 in areas with a high need and high demand population or rural or underserved areas2 7#b7 that individuals and groups from different racial1 ethnic1 cultural1 geographic1 religious1 linguistic1 and class backgrounds1 and different genders and sexual orientations1 participate in the programs of the institution2 7#c7 knowledge and understanding of the concerns of the individuals and groups described in paragraph 7#b71 especially individuals with mental health symptoms or diagnoses1 particularly children and adolescents1 and transitional-age youth2 7#d7 that any internship or other field placement program assisted through the grant will prioritize cultural and linguistic competency2 and 7#e7 that the institution of higher education will provide to the ,secretary such data1 assurances1 and information as the ,secretary may require4 7c7 ,institutional requirement ,for grants awarded under paragraphs 7#b7 and 7#c7 of subsection 7a71 at least #d of the grant recipients shall be historically black colleges or universities or other minority-serving institutions4 7d7 ,priority ,in selecting grant recipients1 the ,secretary shall give priority to-- 7#a7 for grants awarded under paragraphs 7#a71 7#b71 and 7#c7 of subsection 7a71 programs that have demonstrated the ability to train psychology and social work professionals to work in integrated care settings2 7#b7 for a grant under subsection 7a77#d71 programs for paraprofessionals that emphasize the role of the family and the lived experience of the consumer and family-paraprofessional partnerships2 and 7#c7 programs with a record of training individuals from rural and underserved communities and placing graduates in these communities4 7e7 ,report to ,congress ,not later than #b years after the date of enactment of the ,strengthening ,our ,rural ,health ,workforce ,act of #bjaf1 and annually thereafter1 the ,secretary shall submit to ,congress a report on the effectiveness of the grants under this section in-- 7#a7 providing graduate students support for experiential training 7internship or field placement72 7#b7 recruiting of students interested in behavioral health practice2 7#c7 developing and implementing interprofessional training and integration within primary care2 7#d7 developing and implementing accredited field placements and internships2 and 7#e7 collecting data on the number of students trained in mental health and the number of available accredited internships and field placements4 7f7 ,authorization of appropriation ,there are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjag through #bjba4 4 7b7 ,conforming amendments ,the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bja et seq471 as amended by subsection 7a71 is further amended-- 7#a7 in section #cch;,a7d77#b77;,a7 7#db ,u4,s4,c4 #bedl7d77#b77;,a771 by striking or under section #geh2 7#b7 in section #gef7;b77#b7 7#db ,u4,s4,c4 #bid;f7b77#b771 as so redesignated1 by striking 1 #gec7;b71 and #gee7;b7 and inserting and #gec7;b72 and 7#c7 in section #gfa 7#db ,u4,s4,c4 #bidn7-- 7,a7 in subsection 7b77#b77;,e71 by striking #geg7;d77#c7 and inserting #gef7;d77#c72 7,b7 in subsection 7d77#b77;,b71 by striking #geg7;d77#c7 and inserting #gef7;d77#c72 and 7,c7 in subsection 7d77#c71 by striking #geg7;d77#d7 and inserting #gef7;d77#d74