,,ii  #aag? ,,congress  #b;d ,session   
,s4 #cdig  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,janu>y #ac            
7legislative day1 ,janu>y #aj71         
#bjbb,mr4 ,inh(e 7= himself & ,ms4      
,ros57 introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act to e/abli% a grant program 
to aw>d grants to public in/itutions (  
high] education locat$ 9 a cov]$ ,/ate1 
& = o!r purposes4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,m$ical ,/ud5t     
,education ,au?orization ,act ( #bjbb4  
#b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7
 ,access to high quality prim>y c>e is  
associat$ ) improv$ heal? outcomes & l[]
 heal? c>e co/s4  7#b7 ,sub/antial      
disp>ities exi/ 9 ! di/ribution ( prim>y
 c>e provid]s4  7#c7 ,%ortages ( heal?  
c>e provid]s affect ,tribal1 rural1 &   
m$ically und]s]v$ communities m ?an !   
populations ( m d5sely populat$ areas1  
result+ 9 su* communities exp]i5c+      

significant heal? *all5ges & disp>ities4
  7#d7 ,am]ican ,indian1 ,alaskan       
,natives1 & ,native ,hawaiians t5d to h 
l[] heal? /atus1 l[] life expectancy1 & 
disproportionate disease burd5 :5 comp>$
 to o!r ,am]icans4  7#e7 ,hav+ tra9+    
exp]i5ces 91 liv+ among1 & be+ a memb] (
 ,tribal1 rural1 & m$ically und]s]v$    
communities increases cultural aw>5ess &
 c influ5ce c>e] *oice = physicians to  
bett] s]ve su* populations4  7#f7       
,rese>* %[s !re is a relation%ip betwe5 
! *>act]i/ics ( a physician & ! ev5tual 
practice location1 includ+ be+ "p ( an  
und]repres5t$ m9ority or gr[+ up 9 a    
rural area4  #c4 ,education program to  
support prim>y heal? s]vice = und]s]v$  
populations ,"p ,b ( title ,,vii ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bic et seq47 is am5d$ by add+
 at ! end ! foll[+3  #gdb4 ,education   
program to support prim>y heal? s]vice =
 und]s]v$ populations  7a7 ,e/abli%m5t  
,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator 
( ! ,heal? ,res\rces & ,s]vices         

,adm9i/ration1 %all e/abli% a grant     
program to aw>d grants to public        
in/itutions ( high] education locat$ 9 a
 cov]$ ,/ate to c>ry out ! activities   
describ$ 9 subsection 7d7 = ! purposes  
(-- 7#a7 exp&+ & support+ education =   
m$ical /ud5ts :o are prep>+ to become   
physicians 9 a cov]$ ,/ate2 &  7#b7     
prep>+ & enc\rag+ ea* su* /ud5t tra9+ 9 
a cov]$ ,/ate to s]ve ,tribal1 rural1 or
 m$ically und]s]v$ communities z a      
prim>y c>e physician aft] complet+ su*  
tra9+4  7b7 ,eligibility ,9 ord] to be  
eligible to receive a grant "u ?is      
section1 a public in/itution ( high]    
education %all submit an application to 
! ,secret>y t includes-- 7#a7 a         
c]tification t su* in/itution w use     
am\nts provid$ to ! in/itution to c>ry  
out ! activities describ$ 9 subsection  
7d72 &  7#b7 a description ( h[ su*     
in/itution w c>ry out su* activities4   
7c7 ,priority ,9 aw>d+ grants "u ?is    
section1 ! ,secret>y %all give priority 
to public in/itutions ( high] education 

t-- 7#a7 are locat$ 9 a ,/ate ) n few]  
?an #b f$]ally recogniz$ ,tribes2 &     
7#b7 demon/rate a public-private        
p>tn]%ip4  7d7 ,au?oriz$ activities ,an 
eligible entity t receives a grant "u   
?is section %all use ! funds made       
available "u su* grant to c>ry out !    
foll[+ activities3 7#a7 ,support or exp&
 community-bas$ exp]i5tial tra9+ =      
m$ical /ud5ts :o w practice 9 or s]ve   
,tribal1 rural1 & m$ically und]s]v$     
communities4  7#b7 ,develop & op]ate    
programs to tra9 m$ical /ud5ts 9 prim>y 
c>e s]vices4  7#c7 ,develop & implem5t  
curricula t-- 7,a7 includes a def9$ set 
( cl9ical & community-bas$ tra9+        
activities t emphasize c>e = ,tribal1   
rural1 or m$ically und]s]v$ communities2
  7,b7 is applicable to prim>y c>e      
practice ) respect to individuals f     
,tribal1 rural1 or m$ically und]s]v$    
communities2  7,c7 id5tifies & addresses
 *all5ges to heal? equity1 includ+ !    
ne$s ( ,tribal1 rural1 & m$ically       
und]s]v$ communities2  7,d7 supports !  

use ( teleheal? te*nologies & practices2
  7,e7 consid]s social det]m9ants (     
heal? 9 c>e plan developm5t2  7,f7      
integrates behavioral heal? c>e into    
prim>y c>e practice1 includ+ prev5tion &
 treatm5t ( opioid disord]s & o!r       
sub/ance use disord]s2  7,g7 promotes   
int]pr(essional tra9+ t supports a      
pati5t-c5t]$ model ( c>e2 &  7,h7 builds
 cultural & l+ui/ic compet5cy4  7#d7    
,increase ! capacity ( faculty to       
implem5t ! curricula describ$ 9 p>agraph
 7#c74  7#e7 ,develop or exp& /rategic  
p>tn]%ips to improve heal? outcomes =   
individuals f ,tribal1 rural1 & m$ically
 und]s]v$ communities1 includ+ )-- 7,a7 
f$]ally recogniz$ ,tribes1 ,tribal      
colleges1 & ,tribal organizations2  7,b7
 ,f$]ally-qualifi$ heal? c5t]s2  7,c7   
rural heal? cl9ics2  7,d7 ,indian heal? 
programs2  7,e7 prim>y c>e deliv]y sites
 & sy/ems2 &  7,f7 o!r community-bas$   
organizations4  7#f7 ,develop a plan to 
track graduates' *os5 specialties =     
resid5cy & ! ,/ates 9 :i* su* resid5cy  

programs are locat$4  7#g7 ,develop1    
implem5t1 & evaluate me?ods to improve  
recruitm5t & ret5tion ( m$ical /ud5ts f 
,tribal1 rural1 & m$ically und]s]v$     
communities4  7#h7 ,tra9 & support      
in/ructors to s]ve ,tribal1 rural1 &    
m$ically und]s]v$ communities4  7#i7    
,prep>e m$ical /ud5ts = transition into 
prim>y c>e resid5cy tra9+ & future      
practice4  7#aj7 ,provide s*ol>%ips to  
m$ical /ud5ts4  7e7 ,grant p]iod ,a     
grant "u ?is section %all be aw>d$ = a  
p]iod ( n m ?an #e ye>s4  7f7 ,grant    
am\nt ,ea* fiscal ye>1 ! am\nt ( a grant
 made to a public in/itution ( high]    
education "u ?is section %all be 9 am\nt
 t is n less ?an #a1jjj1jjj4  7g7 ,mat*+
 requirem5t ,ea* public in/itution (    
high] education t receives a grant "u   
?is section %all provide1 f non-,f$]al  
s\rces1 an am\nt equal to or great] ?an 
#aj p]c5t ( ! total am\nt ( ,f$]al funds
 provid$ to ! in/itution ea* fiscal ye> 
dur+ ! p]iod ( ! grant 7:i* may be      
provid$ 9 ca% or 9 k9d74  7h7           

,def9itions ,9 ?is section3 7#a7 ,cov]$ 
,/ate ,! t]m cov]$ ,/ate means a ,/ate t
 is 9 ! top qu>tile ( ,/ates by project$
 unmet dem& = prim>y c>e provid]s1 z    
det]m9$ by ! ,secret>y4  7#b7           
,f$]ally-qualifi$ heal? c5t] ,! t]m     
,f$]ally-qualifi$ heal? c5t] has ! mean+
 giv5 su* t]m 9 section                 
#aije7l77#b77;,b7 ( ! ,social ,security 
,act4  7#c7 ,indian heal? program ,! t]m
 ,indian heal? program has ! mean+ giv5 
su* t]m 9 section #d ( ! ,indian ,heal? 
,c>e ,improvem5t ,act4  7#d7 ,in/itution
 ( high] education ,! t]m in/itution (  
high] education has ! mean+ giv5 su* t]m
 9 section #aja ( ! ,high] ,education   
,act ( #aife1 provid$ t su* in/itution  
is public 9 nature4  7#e7 ,m$ically     
und]s]v$ community ,! t]m m$ically      
und]s]v$ community has ! mean+ giv5 su* 
t]m 9 section #gii;,b4  7#f7 ,rural     
heal? cl9ic ,! t]m rural heal? cl9ic has
 ! mean+ giv5 su* t]m 9 section         
#ahfa7;aa7 ( ! ,social ,security ,act4  
7#g7 ,rural population ,! t]m rural     

population means ! population ( a       
geographical area locat$-- 7,a7 9 a     
non-metropolitan c\nty2 or  7,b7 9 a    
metropolitan c\nty designat$ z rural by 
! ,adm9i/rator ( ! ,heal? ,res\rces &   
,s]vices ,adm9i/ration4  7#h7 ,tribal   
population ,! t]m ,tribal population    
means ! population ( any ,indian ,tribe 
recogniz$ by ! ,secret>y ( ! ,int]ior   
pursuant to section #ajd ( ! ,f$]ally   
,recogniz$ ,indian ,tribe ,li/ ,act (   
#aiid4  7i7 ,au?orization (             
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is section     
#aej1jjj1jjj = ea* ( fiscal ye>s #bjbc  
?r\gh #bjbg4  4