,,ii #aaeth ,,congress #b;d ,session ,s4 #cjie ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #bj1 #bjah,mr4 ,reed 7for himself and ,mr4 ,blunt7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to help build a stronger health care workforce4 #a4 ,short title ,this ,act may be cited as the ,building a ,health ,care ,workforce for the ,future ,act4 #b4 ,grants to ,states for scholarship 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 ,in general ,the ,secretary shall award grants to eligible ,states to enable such ,states to implement scholarship programs to ensure1 with respect to the provision of health services1 an adequate supply of physicians1 dentists1 behavioral and mental health professionals1 certified nurse midwives1 certified nurse practitioners1 physician assistants1 and pharmacists or other health profession as determined by the ,secretary4 7b7 ,eligible ,states ,to be eligible to receive a grant under this section1 a ,state shall submit to the ,secretary an application containing such information as the ,secretary determines necessary to carry out this section4 7c7 ,eligible participants ,to be eligible to participate in a scholarship program carried out with a grant received under this section1 an individual shall-- 7#a7 be accepted for enrollment1 or be enrolled1 as a full-time student-- 7,a7 in an accredited 7as determined by the ,secretary7 educational institution in a ,state2 and 7,b7 in a course of study or program1 offered by such institution and approved by the ,secretary1 leading to a degree in medicine1 dentistry1 school of pharmacy1 other health profession designated by the ,secretary1 nursing college1 or an appropriate degree from a graduate program of behavioral and mental health2 7#b7 submit to the ,state1 an application to participate in the program2 and 7#c7 sign and submit to the ,state1 at the time of the submission of the application under paragraph 7#b71 a written contract that requires the individual to-- 7,a7 accept payments under the scholarship2 7,b7 maintain a minimum level of academic standing during the period of the scholarship1 as determined by the ,secretary2 7,c7 if applicable1 complete an accredited residency training program2 7,d7 become licensed in the applicant's ,state of residence2 and 7,e7 serve as a provider for #a year for every year that the applicant received a scholarship1 within the applicant's ,state of residence1 in-- 7i7 a health professional shortage area 7as defined by the ,national ,health ,service ,corps under section #ccb72 7ii7 a medically underserved area 7as defined for purposes of section #ccj72 or 7iii7 any other shortage area defined by the ,state and approved by the ,secretary4 7d7 ,designation of areas ,to be eligible to receive a grant under this section1 a ,state shall adequately demonstrate to the ,secretary that the ,state has designated appropriate health professions or specialty shortage areas4 7e7 ,required disclosures ,in disseminating application and contract forms to individuals desiring to participate in a scholarship program funded under this section1 the ,state shall include with such forms a summary of the rights and liabilities of an individual whose application is approved 7and whose contract is accepted71 including a clear explanation of the damages to which the ,state is entitled in the case of the individual's breach of the contract4 7f7 ,awarding of contracts 7#a7 ,in general ,a ,state that enters into a contract with an individual under subsection 7c77#c7 shall1 with respect to the program in which the individual is enrolled1 agree to pay-- 7,a7 all tuition and costs associated with the program2 7,b7 any other reasonable educational expenses1 including fees1 books1 and laboratory expenses1 related to the program2 and 7,c7 a cost-of-living stipend in an amount to be determined by the ,secretary4 7#b7 ,consideration by ,state ,in entering into contracts with individuals that meet the requirements of subsection 7c71 the ,state shall consider the extent of the applicant's demonstrated interest in the provision of care services in a particular provider shortage area4 7g7 ,matching funds ,a ,state receiving a grant under this section shall1 with respect to the costs of making payments on behalf of individuals under the scholarship program implemented by the ,state under the grant1 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 #a of ,federal funds provided under the grant4 7h7 ,direct administration by ,state agency ,the scholarship program of any ,state receiving a grant under this section shall be administered directly by a ,state agency4 7i7 ,report by ,secretary ,not later than #d years after the date of enactment of this section1 and every #e years thereafter1 the ,secretary shall submit to ,congress a report concerning-- 7#a7 the number of scholarships awarded under the ,state scholarship program2 7#b7 the number of scholarship recipients1 broken down by practice area1 serving in the profession originally awarded a scholarship for #a year after the completion of the service period required under subsection 7c77#c77;,e72 7#c7 the number of scholarship recipients1 broken down by provider type1 practicing in an underserved area #a year after the completion of the service period required under subsection 7c77#c77;,e72 7#d7 data on any changes in health professional shortage areas or medically underserved areas within the ,state2 7#e7 remaining gaps in such health professional shortage areas or medically underserved areas2 7#f7 the number of additional full-time physicians that would be required to eliminate such health professional shortage areas or medically underserved areas in the ,state2 7#g7 the number of individuals who received a scholarship but failed to comply with its requirements2 7#h7 the action taken by the ,state to recoup scholarship funds in the case of any non-compliance2 and 7#i7 recommendations to improve the program under this section4 7j7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section1 #bj1jjj1jjj for each of fiscal years #bjai through #bjbc4 ,not less than #ej percent of the amount appropriated for a fiscal year under this subsection shall be used to provide scholarships to providers who intend to pursue careers in primary care4 4 #c4 ,increasing mentoring and transforming competencies in primary care ,title ,,vii of the ,public ,health ,service ,act is amended by inserting after section #gdg;,a 7#db ,u4,s4,c4 #bick-#a71 the following3 #gdg;,b4 ,developing effective primary care mentors and improving mentorship opportunities for medical students 7a7 ,grants ,to cultivate primary care mentors and improve primary care mentorship opportunities for medical students ,the ,secretary may award grants to eligible medical schools to assist such schools in developing and strengthening primary care mentorship programs and cultivating leaders in primary care among students4 7b7 ,eligibility ,to be eligible to receive a grant under this section1 an entity shall-- 7#a7 be an accredited medical school or college of osteopathic medicine2 and 7#b7 submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including an assurance that the applicant will use amounts received under the grant to-- 7,a7 establish or enhance existing mentorship programs1 including by-- 7i7 incentivizing medical school faculty 7through financial or other reward systems7 to participate as a mentor of other primary care physician faculty members and students2 7ii7 providing resources for aspiring mentors to participate in workshops or other learning experiences in which primary care physicians can learn about effective strategies in primary care mentoring2 7iii7 enabling successful primary care mentors on medical school faculty to spend time at another institution where they can promote best practices in mentoring primary care leaders and students2 and 7iv7 developing web-based resources for mentors to interact regularly and share successful strategies2 or 7,b7 cultivate interest and leaders in primary care among students1 including by-- 7i7 offering students that identify interest in primary care upon matriculation1 longitudinal experiences in primary care to care for and track the health and wellness of patients throughout medical school2 7ii7 arranging partnerships with private practices1 insurers1 schools of public health1 public health departments1 and community-based service projects with the goal of providing students with the opportunity to interact with primary care mentors from a variety of health care settings2 7iii7 providing stipends or other forms of financial resources to students who work with designated mentors in the field of primary care in underserved urban and rural communities2 and 7iv7 supporting opportunities for students to engage in practice redesign or other efforts in which primary care physicians are taking a leadership role in delivery system reform4 7c7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section1 #bj1jjj1jjj for each of fiscal years #bjai through #bjbe4 #gdg;,c4 ,developing and promoting new competencies 7a7 ,grants ,to develop and promote new competencies ,in order to foster curricular innovations to improve the education and training of health care providers1 the ,secretary shall award grants to medical and other health professions schools to promote priority competencies 7as described in subsection 7b774 7b7 ,priority competencies ,in awarding grants under subsection 7a71 the ,secretary1 acting through the ,advisory ,committee on ,training in ,primary ,care ,medicine and ,dentistry 7referred to in this section as the ,advisory ,committee71 shall select an annual competency to direct the awarding of such grants4 ,such annual competencies may include-- 7#a7 patient-centered medical homes2 7#b7 chronic disease management2 7#c7 integration of primary care and mental health care2 7#d7 integration of primary care1 public and population health1 and health promotion2 7#e7 cultural competency2 7#f7 domestic violence2 7#g7 improving care in medically underserved areas2 and 7#h7 team-based care4 7c7 ,grant recipients ,the ,secretary may award grants under subsection 7a7 to programs that provide education or training for-- 7#a7 physicians2 7#b7 dentists and dental hygienists2 7#c7 physician assistants2 7#d7 mental and behavioral health providers2 7#e7 public and populations health professionals2 or 7#f7 pharmacists4 7d7 ,consideration in evaluating grant applications ,the ,secretary shall give consideration to applicants that are proposing to partner with other medical programs1 health professions programs1 or nursing programs4 7e7 ,grantee reports ,the recipient of a grant under this section shall1 not later than #ahj days after the end of the grant period involved1 submit to the ,advisory ,committee a report on the following 7as appropriate73 7#a7 ,a description of how the funding under the grant was used by the grantee4 7#b7 ,a description of the intended goal of such funding4 7#c7 ,a description of the challenges faced by the grantee in reaching the goal described in paragraph 7#b74 7#d7 ,a description of the lessons learned by the grantee related to the grant activities4 7f7 ,recommendations of the ,advisory ,committee ,the ,advisory ,committee1 based on the information submitted under subsection 7e71 shall annually report to the ,secretary on outcomes of the activities carried out under grants under this section1 including specific recommendations for scaling up innovations to promote education and training of health care providers in the priority competencies described in subsection 7b74 7g7 ,authorization of appropriations ,there are authorized to be appropriated1 #aj1jjj1jjj for each of fiscal years #bjai through #bjbc to carry out this section4 4 #d4 ,study on documentation requirements for cognitive service ,not later than #c years after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall seek to enter into a contract with the ,national ,academy of ,medicine whereby such ,national ,academy conducts a study1 and submits a report to ,congress1 concerning the documentation requirements for cognitive services 7evaluation and management services7 required under the ,medicare and ,medicaid programs under titles ,,xviii and ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq42 #acif et seq471 and through private health insurers4 ,such study shall include an evaluation of-- 7#a7 how documentation requirements designed for paper-based records should be modified for electronic records2 7#b7 whether the documentation requirements are overly burdensome on physicians and detract from patient care2 7#c7 the administrative costs to physician practices of the current documentation requirements2 7#d7 the average amount of time required by physicians to document cognitive services2 7#e7 options to more appropriately compensate physicians for evaluation and management of patient care without requiring excessive documentation of cognitive services2 and 7#f7 recommendations for less burdensome alternatives or changes to existing documentation requirements of cognitive services4