,,ii #aagth ,,congress #b;d ,session ,s4 #cdig ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,january #ac 7legislative day1 ,january #aj71 #bjbb,mr4 ,inhofe 7for himself and ,ms4 ,rosen7 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 establish a grant program to award grants to public institutions of higher education located in a covered ,state1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,medical ,student ,education ,authorization ,act of #bjbb4 #b4 ,findings ,congress finds the following3 7#a7 ,access to high quality primary care is associated with improved health outcomes and lower health care costs4 7#b7 ,substantial disparities exist in the distribution of primary care providers4 7#c7 ,shortages of health care providers affect ,tribal1 rural1 and medically underserved communities more than the populations of more densely populated areas1 resulting in such communities experiencing significant health challenges and disparities4 7#d7 ,american ,indian1 ,alaskan ,natives1 and ,native ,hawaiians tend to have lower health status1 lower life expectancy1 and disproportionate disease burden when compared to other ,americans4 7#e7 ,having training experiences in1 living among1 and being a member of ,tribal1 rural1 and medically underserved communities increases cultural awareness and can influence career choice for physicians to better serve such populations4 7#f7 ,research shows there is a relationship between the characteristics of a physician and the eventual practice location1 including being part of an underrepresented minority or growing up in a rural area4 #c4 ,education program to support primary health service for underserved populations ,part ,b of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic et seq47 is amended by adding at the end the following3 #gdb4 ,education program to support primary health service for underserved populations 7a7 ,establishment ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall establish a grant program to award grants to public institutions of higher education located in a covered ,state to carry out the activities described in subsection 7d7 for the purposes of-- 7#a7 expanding and supporting education for medical students who are preparing to become physicians in a covered ,state2 and 7#b7 preparing and encouraging each such student training in a covered ,state to serve ,tribal1 rural1 or medically underserved communities as a primary care physician after completing such training4 7b7 ,eligibility ,in order to be eligible to receive a grant under this section1 a public institution of higher education shall submit an application to the ,secretary that includes-- 7#a7 a certification that such institution will use amounts provided to the institution to carry out the activities described in subsection 7d72 and 7#b7 a description of how such institution will carry out such activities4 7c7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to public institutions of higher education that-- 7#a7 are located in a ,state with not fewer than #b federally recognized ,tribes2 and 7#b7 demonstrate a public-private partnership4 7d7 ,authorized activities ,an eligible entity that receives a grant under this section shall use the funds made available under such grant to carry out the following activities3 7#a7 ,support or expand community-based experiential training for medical students who will practice in or serve ,tribal1 rural1 and medically underserved communities4 7#b7 ,develop and operate programs to train medical students in primary care services4 7#c7 ,develop and implement curricula that-- 7,a7 includes a defined set of clinical and community-based training activities that emphasize care for ,tribal1 rural1 or medically underserved communities2 7,b7 is applicable to primary care practice with respect to individuals from ,tribal1 rural1 or medically underserved communities2 7,c7 identifies and addresses challenges to health equity1 including the needs of ,tribal1 rural1 and medically underserved communities2 7,d7 supports the use of telehealth technologies and practices2 7,e7 considers social determinants of health in care plan development2 7,f7 integrates behavioral health care into primary care practice1 including prevention and treatment of opioid disorders and other substance use disorders2 7,g7 promotes interprofessional training that supports a patient-centered model of care2 and 7,h7 builds cultural and linguistic competency4 7#d7 ,increase the capacity of faculty to implement the curricula described in paragraph 7#c74 7#e7 ,develop or expand strategic partnerships to improve health outcomes for individuals from ,tribal1 rural1 and medically underserved communities1 including with-- 7,a7 federally recognized ,tribes1 ,tribal colleges1 and ,tribal organizations2 7,b7 ,federally-qualified health centers2 7,c7 rural health clinics2 7,d7 ,indian health programs2 7,e7 primary care delivery sites and systems2 and 7,f7 other community-based organizations4 7#f7 ,develop a plan to track graduates' chosen specialties for residency and the ,states in which such residency programs are located4 7#g7 ,develop1 implement1 and evaluate methods to improve recruitment and retention of medical students from ,tribal1 rural1 and medically underserved communities4 7#h7 ,train and support instructors to serve ,tribal1 rural1 and medically underserved communities4 7#i7 ,prepare medical students for transition into primary care residency training and future practice4 7#aj7 ,provide scholarships to medical students4 7e7 ,grant period ,a grant under this section shall be awarded for a period of not more than #e years4 7f7 ,grant amount ,each fiscal year1 the amount of a grant made to a public institution of higher education under this section shall be in amount that is not less than #a1jjj1jjj4 7g7 ,matching requirement ,each public institution of higher education that receives a grant under this section shall provide1 from non-,federal sources1 an amount equal to or greater than #aj percent of the total amount of ,federal funds provided to the institution each fiscal year during the period of the grant 7which may be provided in cash or in kind74 7h7 ,definitions ,in this section3 7#a7 ,covered ,state ,the term covered ,state means a ,state that is in the top quartile of ,states by projected unmet demand for primary care providers1 as determined by the ,secretary4 7#b7 ,federally-qualified health center ,the term ,federally-qualified health center has the meaning given such term in section #aije7l77#b77;,b7 of the ,social ,security ,act4 7#c7 ,indian health program ,the term ,indian health program has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act4 7#d7 ,institution of higher education ,the term institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife1 provided that such institution is public in nature4 7#e7 ,medically underserved community ,the term medically underserved community has the meaning given such term in section #gii;,b4 7#f7 ,rural health clinic ,the term rural health clinic has the meaning given such term in section #ahfa7;aa7 of the ,social ,security ,act4 7#g7 ,rural population ,the term rural population means the population of a geographical area located-- 7,a7 in a non-metropolitan county2 or 7,b7 in a metropolitan county designated as rural by the ,administrator of the ,health ,resources and ,services ,administration4 7#h7 ,tribal population ,the term ,tribal population means the population of any ,indian ,tribe recognized by the ,secretary of the ,interior pursuant to section #ajd of the ,federally ,recognized ,indian ,tribe ,list ,act of #aiid4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aej1jjj1jjj for each of fiscal years #bjbc through #bjbg4 4