,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #bijb  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #bj1 #bjai,ms4
 ,smi? 7= h]self & ,mr4 ,b>rasso7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to enhance ! rural heal?    
work=ce1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,/r5g!n+
 ,our ,rural ,heal? ,work=ce ,act (     
#bjai4  ,i ,support+ prim>y c>e work=ce 
#aja4 ,reau?orization ( prim>y c>e tra9+
 & enhancem5t program ,section #gdg ( ! 
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bick7 is am5d$-- 7#a7 9      
subsection 7a71 by add+ at ! end !      
foll[+3  7#c7 ,priorities 9 mak+ aw>ds  
7,a7 ,9 g5]al ,9 aw>d+ grants or        
contracts "u p>agraph 7#a71 ! ,secret>y 
%all give priority to qualifi$          
applicants t tra9 resid5ts 9 rural &    
,tribal tra9+ locations = equal to or   
great] ?an #ej p]c5t ( tra9+ "t4  7,b7  
,rural tra9+ location ,9 ?is p>agraph1 !

 t]m rural tra9+ location means a       
location 9 :i* tra9+ occurs t1 bas$ on !
 #bjaj c5sus or any subsequ5t c5sus     
adju/m5t1 meets "o or m ( ! foll[+      
crit]ia3  7i7 ,! tra9+ occurs 9 a       
location t is a rural area 7z def9$ 9   
section #ahhf7;d77#b77;,d7 ( ! ,social  
,security ,act74  7ii7 ,! tra9+ occurs  
on an ,indian res]vation1 public doma9  
,indian allotm5t1 =m] ,indian res]vation
 9 ,oklahoma1 or l& held by an          
incorporat$ ,native gr\p1 regional      
corporation1 or village corporation "u !
 provisions ( ! ,alaska ,native ,claims 
,settlem5t ,act4  7iii7 ,! tra9+ occurs 
9 a location t has a rural-urban commut+
 area code equal to or great] ?an #d4j4 
7iv7 ,! tra9+ occurs 9 a location t is  
)9 #aj miles ( a sole community hospital
 7z def9$ 9 subsection                  
7d77#e77;,d77iii774  2 &  7#b7 9        
subsection 7c7-- 7,a7 9 p>agraph 7#a71  
by /rik+ #abe1jjj1jjj & all t foll[s    
?r\gh ! p]iod at ! end & ins]t+         
#abe1jjj1jjj = fiscal ye> #bjbj1 & su*  

sums z may be necess>y = ea* ( fiscal   
ye>s #bjba ?r\gh #bjbd42 &  7,b7 9      
p>agraph 7#c71 by /rik+ #bjaj ?r\gh     
#bjad & ins]t+ #bjbj ?r\gh #bjbd4  #ajb4
 ,reau?orization ( area heal? education 
c5t]s ,section #gea7;j77#a7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bid;a7j77#a77 is am5d$ by /rik+        
#abe1jjj1jjj = ea* ( ! fiscal ye>s #bjaj
 ?r\gh #bjad & ins]t+ #abe1jjj1jjj = ea*
 ( fiscal ye>s #bjbj ?r\gh #bjbd4  ,,ii 
,rural ,heal? ,c>e ,work=ce ,commission 
#bja4 ,rural ,heal? ,c>e ,work=ce       
,commission  7a7 ,purpose ,x is !       
purpose ( ?is section to e/abli% a      
,national ,rural ,heal? ,c>e ,work=ce   
,commission t develops %ort- & long-t]m 
solutions to address ! sy/emic work=ce  
%ortages 9 rural & fronti] localities1  
&--  7#a7 communicates & coord9ates ) ! 
,dep>tm5t ( ,heal? & ,human ,s]vices    
7includ+ ! ,indian ,heal? ,s]vice71 !   
,dep>tm5t ( ,agriculture1 ! ,dep>tm5t ( 
,labor1 ,! ,dep>tm5t ( ,vet]ans         
,affairs1 ! ,dep>tm5t ( ,homel&         

,security1 ! ,dep>tm5t ( ,education1 !  
,dep>tm5t ( ! ,int]ior1 & any ,f$]al    
advisory committees det]m9$ appropriate 
by ! ,secret>y ( ,heal? & ,human        
,s]vices1 on relat$ activities adm9i/]$ 
by "o or m ( su* ,dep>tm5ts &           
committees2  7#b7 develops & commissions
 evaluations ( education & tra9+        
activities ne$$ to address %ortages 9   
geographically div]se rural & ,indian   
,tribal communities2  7#c7 id5tifies    
legislative1 adm9i/rative1 & o!r b>ri]s 
to address+ %ortages & improv+          
coord9ation at ! ,f$]al1 ,/ate1 ,tribal1
 & local levels & recomm5d ways to      
address su* b>ri]s2  7#d7 enc\rages !   
developm5t & implem5tation ( /rategies  
to address rural1 ,tribal1 & fronti]    
population ne$s2 &  7#e7 id5tifies      
innovative models us$ to improve access 
to & quality ( c>e 9 und]s]v$ rural     
areas ) %ortages4  7b7 ,e/abli%m5t ,!re 
is h]eby e/abli%$ ! ,national ,work=ce  
,commission on ,rural & ,fronti] ,heal? 
,c>e 7ref]r$ to 9 ?is section z !       

,commission74  7c7 ,memb]%ip  7#a7      
,numb] & appo9tm5t ,! ,commission %all  
be compos$ ( n less ?an #i memb]s to be 
appo9t$ by ! ,comptroll] ,g5]al1 )\t    
reg>d to section #e ( ! ,f$]al ,advisory
 ,committee ,act 7#e ,u4,s4,c4 ,app471 &
 %all consult ) ! ,adm9i/rator ( !      
,heal? ,res\rces & ,s]vices             
,adm9i/ration 7ref]r$ to 9 ?is section z
 ! ,adm9i/rator74  7#b7 ,qualifications 
7,a7 ,9 g5]al ,! memb]%ip ( !           
,commission %all include a div]se       
composite ( individuals-- 7i7 :o are--  
7,i7 lead]s ( rural1 ,tribal1 & fronti] 
heal? c>e work=ce education or tra9+    
programs or rural tra9+ tracks2  7,,ii7 
nationally recogniz$ = _! exp]tise 9--  
7aa7 rural1 ,tribal1 or fronti] heal?   
c>e labor m>ket analysis2  7bb7 rural1  
,tribal1 or fronti] heal? c>e facility  
managem5t2  7cc7 rural heal? integrat$  
deliv]y sy/ems2  7dd7 provid+ rural1    
,tribal1 & fronti] heal? c>e s]vices2   
7ee7 rural1 ,tribal1 & fronti] heal? c>e
 ne$s1 tr5ds1 & disp>ities2  7ff7 rural1

 ,tribal1 & fronti] behavioral heal?2 or
  7gg7 rural1 ,tribal1 & fronti] heal?  
work=ce %ortages2  7,,iii7 rural heal?  
work=ce recruitm5t & ret5tion exp]ts2 & 
7,,iv7 relevant pr(essional association 
memb]s2 &  7ii7 :o w provide a          
comb9ation ( pr(essional p]spectives1 & 
broad geographic repres5tation ( rural &
 fronti] communities4  7,b7 ,e?ical     
disclosure ,! ,adm9i/rator %all e/abli% 
a sy/em = public disclosure by !        
,commission ( f9ancial & o!r pot5tial   
conflicts ( int]e/ relat+ to ! memb]s ( 
! ,commission4 ,su* memb]s %all be      
treat$ z employees ( ,congress =        
purposes ( apply+ title ,i ( ! ,e?ics 9 
,gov]nm5t ,act ( #aigh4 ,su* memb]s %all
 n be treat$ z special gov]nm5t         
employees "u title #ah1 ,unit$ ,/ates   
,code4  7#c7 ,t]ms  7,a7 ,9 g5]al ,!    
t]ms ( memb]s ( ! ,commission %all be = 
#c ye>s except t ! ,comptroll] ,g5]al   
%all designate /agg]$ t]ms = ! memb]s   
fir/ appo9t$4  7,b7 ,vacancies ,any     
memb] appo9t$ to fill a vacancy occurr+ 

be=e ! expiration ( ! t]m = :i* !       
memb]'s pr$ecessor 0 appo9t$ %all be    
appo9t$ only = ! rema9d] ( t t]m4 ,a    
memb] may s]ve aft] ! expiration ( t    
memb]'s t]m until a successor has tak5  
(fice4  7#d7 ,comp5sation ,:ile s]v+ on 
! bus9ess ( ! ,commission 7includ+      
travel "t71 a memb] ( ! ,commission %all
 be entitl$ to comp5sation at ! p] diem 
equival5t ( ! rate provid$ = level ,,iv 
( ! ,executive ,s*$ule "u section #ecae 
( title #e1 ,unit$ ,/ates ,code1 & :ile 
s s]v+ away f home & ! memb]'s regul>   
place ( bus9ess1 a memb] may be all[$   
travel exp5ses1 z au?oriz$ by ! ,*airman
 ( ! ,commission4  7#e7 ,*airman1 vice  
*airman ,! ,comptroll] ,g5]al %all      
designate a memb] ( ! ,commission1 at ! 
"t ( appo9tm5t ( ! memb]1 z ,*airman & a
 memb] z ,vice ,*airman = t t]m (       
appo9tm5t1 except t 9 ! case ( vacancy (
 ! *airman%ip or vice *airman%ip1 !     
,comptroll] ,g5]al may designate ano!r  
memb] = ! rema9d] ( t memb]'s t]m4  7#f7
 ,meet+s ,! ,commission %all meet at !  

call ( ! *airman1 b no less frequ5tly   
?an on a biannual basis4  7d7 ,duties   
7#a7 ,id5tify ne$s & b>ri]s ,!          
,commission %all-- 7,a7 id5tify         
adm9i/rative1 regulatory1 & /atutory    
b>ri]s t prev5t maximum utilization (   
curr5t rural & ,tribal heal? work=ce    
programs ) a special focus on ,tribal & 
fronti] work=ce programs2 &  7,b7       
id5tify population heal? ne$s & tr5ds1  
heal? disp>ities1 & m9ority population  
heal? ne$s 9 rural1 ,tribal1 & fronti]  
localities4  7#b7 ,recomm5d solutions to
 b>ri]s ,! ,commission %all-- 7,a7      
recognize ! ef=ts ( ,f$]al1 ,/ate1      
,tribal1 & local p>tn]%ips to support   
c>e]s 9 ! provision ( heal? c>e s]vices 
9 rural areas2  7,b7 explore & report on
 nontraditional c>e sett+s & deliv]y (  
c>e2  7,c7 dissem9ate in=mation to rural
 heal? c>e adm9i/rators on promis+      
ret5tion practices = rural1 ,tribal1 &  
fronti] heal? c>e pr(essionals2 &  7,d7 
recomm5d solutions to ,f$]al            
adm9i/rative1 regulatory1 & /atutory    

b>ri]s t impact ! recruitm5t1 education 
& tra9+1 & ret5tion ( ! rural1 ,tribal1 
& fronti] heal? c>e work=ce4  7#c7      
,specific topics to be review$ ,9 c>ry+ 
out ?is subsection1 ! ,commission %all  
review-- 7,a7 curr5t rural1 ,tribal1 &  
fronti] heal? c>e work=ce supply &      
di/ribution1 includ+ demographics1 skill
 sets1 public heal? exp]tise1 & dem&s1 )
 project$ dem&s dur+ ! subsequ5t #aj- & 
#be-ye> p]iods2  7,b7 rural1 ,tribal1 & 
fronti] heal? c>e work=ce education &   
tra9+ capacity1 includ+ !-- 7i7 numb] ( 
/ud5ts :o h complet$ education & tra9+1 
includ+ regi/]$ appr5tice%ips2  7ii7    
numb] ( qualifi$ faculty2  7iii7 !      
education & tra9+ infra/ructure2 &  7iv7
 ! education & tra9+ dem&s1 ) project$  
dem&s dur+ ! subsequ5t #aj- & #be-ye>   
p]iods2  7,c7 ! impact ( ! rural &      
,tribal hospital & rural hospital unit  
closures on rural1 ,tribal1 & fronti]   
communities2  7,d7 ! ,national ,heal?   
,s]vice ,corps "u subp>t ,,ii ( "p ,d ( 
title ,,iii ( ! ,public ,heal? ,s]vice  

,act 7#db ,u4,s4,c4 #bed;d et seq471 !  
,/ate ,loan ,repaym5t ,program "u       
section #cch;,i ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bedq-#a71 !
 education loan1 s*ol>%ip1 & grant      
programs "u titles ,,vii & ,,viii ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bib et seq4 & #bif et seq471 
z well z public s]vice loan =giv5ess    
programs adm9i/]$ by ! ,dep>tm5t (      
,education2 &  7,e7 ! impact ( c>e      
deliv]y models1 "s ( :i* include ! use (
 te*nology1 community heal? work]s1 &   
non-traditional p>tn]s t lev]age        
team-bas$ c>e to improve outcomes &     
address heal? c>e co/s4  7#d7 ,high     
priority areas ,9 c>ry+ out ?is         
subsection1 high priority %\ld be giv5  
to-- 7,a7 ! education1 developm5t1      
recruitm5t & ret5tion ( individuals--   
7i7 to fill prim>y c>e %ortages ( all   
levels ( lic5sure2  7ii7 to und]take    
rural & ,tribal physician tra9+ tracks &
 programs2  7iii7 to fill ob/etric      
s]vices %ortages2  7iv7 to address oral 

heal? c>e work=ce capacity at all       
levels2  7v7 to address behavioral heal?
 c>e work=ce capacity at all levels2    
7vi7 to address addiction m$ic9e work=ce
 %ortages2  7vii7 to fill ! em]g5cy     
m$ical s]vice work=ce2  7viii7 to       
address ! work=ce ne$s ( an ag+         
population2 &  7ix7 to s]ve z teleheal? 
provid]s2 &  7,b7 ! developm5t ( new    
rural & ,tribal work=ce & deliv]y models
 to bett] meet *ang+ ne$s ( rural       
communities4  7#e7 ,recomm5dations ,!   
,commission %all submit recomm5dations  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions ( ! ,s5ate & !       
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives1 & appropriate  
dep>tm5ts ( ! ,adm9i/ration4  7#f7      
,consult & obta9+ data ,! ,commission   
%all consult ) & obta9 necess>y data f  
all relevant ,f$]al ag5cies 7includ+ !  
,dep>tm5t ( ,heal? & ,human ,s]vices1 ! 
,dep>tm5t ( ,agriculture1 ! ,dep>tm5t ( 
,labor1 ,! ,dep>tm5t ( ,vet]ans         
,affairs1 ! ,dep>tm5t ( ,homel&         

,security1 ! ,dep>tm5t ( ,education1 & !
 ,dep>tm5t ( ! ,int]ior71 ,congress1 !  
,m$ic>e ,paym5t ,advisory ,commission1 !
 ,m$icaid & ,,*ip ,paym5t & ,access     
,commission1 &1 to ! ext5t practicable1 
,/ate & local ag5cies1 volunt>y heal?   
c>e organizations1 pr(essional          
societies1 & o!r relevant public-private
 heal? c>e p>tn]%ips4  7#g7 ,detail (   
f$]al gov]nm5t employees ,an employee ( 
! ,f$]al ,gov]nm5t may be detail$ to !  
,commission )\t reimbursem5t4 ,! detail 
( su* an employee %all be )\t           
int]ruption or loss ( civil s]vice      
/atus4  7#h7 ,data collection ,9 ord] to
 c>ry out its functions "u ?is section1 
! ,commission %all-- 7,a7 utilize exi/+ 
in=mation1 bo? publi%$ & unpubli%$1 :]e 
possible1 includ+ 9 coord9ation ) !     
,bureau ( ,labor ,/ati/ics2  7,b7 c>ry  
out1 or aw>d grants or contracts = !    
c>ry+ out (1 orig9al rese>* &           
developm5t1 :]e exi/+ in=mation is      
inadequate1 &  7,c7 adopt proc$ures     
all[+ int]e/$ p>ties to submit in=mation

 = ! ,commission's use 9 mak+ reports & 
recomm5dations4  7e7 ,/ate heal? c>e    
work=ce developm5t grants  7#a7         
,e/abli%m5t ,! ,secret>y ( ,heal? &     
,human ,s]vices 7ref]r$ to 9 ?is        
subsection z ! ,secret>y71 act+ ?r\gh ! 
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 %all e/abli% a  
competitive heal? c>e work=ce developm5t
 grant program 7ref]r$ to 9 ?is         
subsection z ! program7 to aw>d grants  
to accompli% ! objectives describ$ 9    
p>agraph 7#d74  7#b7 ,eligibility ,!    
,secret>y1 act+ ?r\gh ! ,adm9i/rator ( !
 ,f$]al ,(fice ( ,rural ,heal? ,policy1 
%all det]m9e eligibility crit]ia =      
grants "u ?is subsection4  7#c7 ,fiscal 
& adm9i/rative ag5t ,! ,heal? ,res\rces 
& ,s]vices ,adm9i/ration ( ! ,dep>tm5t (
 ,heal? & ,human ,s]vices %all be !     
fiscal & adm9i/rative ag5t = grants     
aw>d$ "u ?is subsection4 ,su*           
,adm9i/ration is au?oriz$ to c>ry out ! 
program1 9 consultation ) ! ,commission1
 :i* %all review reports on !           

developm5t1 implem5tation1 & evaluation 
activities "u ! grant program1 includ+--
  7,a7 adm9i/]+ ! grants2  7,b7 provid+ 
te*nical assi/ance to grantees2 &  7,c7 
report+ p]=mance in=mation to !         
,commission4  7#d7 ,grants ,! ,secret>y1
 act+ ?r\gh ! ,adm9i/rator ( ,rural     
,heal? ,policy1 %all aw>d grants "u !   
program = a p]iod to be det]m9$ by !    
,secret>y--  7,a7 to enable grantees to 
develop a compreh5sive plan to address  
work=ce %ortages 9 rural areas2  7,b7 to
 implem5t ! recomm5dations ( !          
,commission2  7,c7 to c>ry out          
activities lead+ to compreh5sive rural &
 ,tribal heal? c>e work=ce developm5t   
/rategies1 includ+ public heal? work=ce 
developm5t1 at ! ,/ate & local levels2 &
  7,d7 9 a mann] t ensures su* grants   
supplem5t r ?an supplant ! ef=ts (      
grantees to address rural heal? work=ce 
*all5ges4  7f7 ,au?orization (          
appropriations  7#a7 ,au?orization ,!re 
are au?oriz$ to be appropriat$ su* sums 
z may be necess>y to c>ry out ?is       

section4  7#b7 ,set aside ,! ,secret>y  
%all set aside #e p]c5t ( am\nts        
appropriat$ "u ?is subsection = direct  
grants to ,indian ,tribes 7z su* t]m is 
def9$ 9 section #d ( ! ,indian ,heal?   
,c>e ,improvem5t ,act 7#be ,u4,s4,c4    
#afjc77 & ,tribal organizations 7z su*  
t]m is def9$ 9 section #d ( ! ,indian   
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #dej;b774
  7#c7 ,gifts & s]vices ,! ,commission  
may n accept gifts1 bequea?s1 or        
donations ( prop]ty1 b may accept & use 
donations ( s]vices = purposes ( c>ry+  
out ?is section4  7g7 ,def9itions  7#a7 
,heal? c>e work=ce ,9 ?is section1 ! t]m
 heal? c>e work=ce has ! mean+ giv5 su* 
t]m 9 section #eaja7;i77#a7 ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #bidq74  7#b7 ,tribal ,9 ?is  
section1 ! t]m ,tribal has ! same mean+ 
giv5 su* t]m 9 section #d ( ! ,indian   
,heal? ,c>e ,improvem5t ,act 7#be       
,u4,s4,c4 #afjc74