,i #aaith ,,congress #b;d ,session ,h4 ,r4 #hfbi ,,in ,,the ,,house ,,of ,,representatives ,april #cj1 #bjbf,mr4 ,ruiz 7for himself and ,mr4 ,bilirakis7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to strengthen recruitment1 training1 and retention of the health center workforce to improve access to care and health outcomes in rural and underserved communities1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,developing the ,community ,health ,workforce ,act of #bjbf4 #b4 ,improving recruitment and retention of ,federal qualified health center staff 7a7 ,priority to ,f,q,h,cs and rural health clinics ,section #ccc7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;f7a77 is amended by adding at the end the following3 7#d7 ,in approving applications for assignment of members of the ,corps1 the ,secretary shall1 notwithstanding paragraph 7#c71 give priority to applications with respect to health professional shortage areas that are ,federally qualified health centers and rural health clinics1 as defined in section #ahfa7;aa7 of the ,social ,security ,act4 4 7b7 ,loan repayment program 7#a7 ,in general ,the ,secretary of ,health and ,human ,services shall award grants to ,federally qualified health centers 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa777 for the purpose of addressing health professional workforce shortages by making loan repayments on behalf of health care professionals serving at such centers4 7#b7 ,applications ,to seek a grant under paragraph 7#a71 a ,federally qualified health center shall submit an application to the ,secretary of ,health and ,human ,services at such time1 in such manner1 and containing such information as the ,secretary may require4 ,at a minimum1 such an application shall include-- 7,a7 a description of the center's capacity to address specific regional workforce shortages1 supported by data2 7,b7 a plan for making loan repayments as described in paragraph 7#a72 and 7,c7 a description of the center's use of an interdisciplinary approach to care 7such as through the use of teams to provide care that include physicians1 nurses1 social workers1 community health workers1 pharmacists1 and other health care professionals74 #c4 ,community ,health ,center ,workforce ,pipeline ,program 7a7 ,grants ,to recruit1 train1 and retain a community-,based health center workforce 7#a7 ,in general ,section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is amended-- 7,a7 by redesignating subsection 7r7 as subsection 7u72 and 7,b7 by inserting after subsection 7q7 the following new subsection3 7r7 ,recruiting1 training1 and retaining a community-,based workforce ,the ,secretary may award grants to health centers for the purpose of assisting such centers in-- 7#a7 recruiting and hiring staff with the skills and experience necessary to effectively serve health center patient populations in rural and underserved areas2 and 7#b7 supporting career advancement and workforce development opportunities for such staff4 4 7b7 ,f,q,h,cs deemed eligible ,to register as apprenticeship program ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,labor shall revise the regulations under part #bi of title #bi1 ,code of ,federal ,regulations1 as in effect on the date of the enactment of this ,act1 so that ,federally qualified health centers 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa777 are eligible to register as apprenticeship programs under such part4 7c7 ,health centers career opportunities ,section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is further amended by inserting after subsection 7r71 as inserted by subsection 7a7 of this section1 the following3 7s7 ,health centers career opportunities 7#a7 ,in general ,the ,secretary may award grants to institutions of higher education1 including community colleges and minority-serving institutions1 to establish partnerships with one or more health centers funded under this section for training students in health professions4 7#b7 ,use of funds 7,a7 ,costs ,an institution of higher education receiving a grant under this subsection may use the grant to pay the costs of training1 including the salary of the clinicians or other educators who provide the training4 7,b7 ,training supported ,the training supported pursuant to a grant under this subsection may include formal training and mentorships4 7,c7 ,types of training ,the types of training supported pursuant to a grant under this subsection may include clinical1 information technology1 operations1 finance1 or other training for students of health professions1 as determined by the institution of higher education receiving the grant in partnership with the health center involved4 7#c7 ,definitions ,in this subsection3 7,a7 ,the term institution of higher education means an institution of higher education described in subsection 7a7 or 7b7 of section #aja of the ,higher ,education ,act of #aife4 7,b7 ,the term minority-serving institution means an institution of higher education described in section #cga7;a7 of the ,higher ,education ,act of #aife4 4 7d7 ,behavioral health specialists ,section #ccj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7 is further amended by inserting after subsection 7s71 as inserted by subsection 7c7 of this section1 the following3 7t7 ,behavioral health specialists 7#a7 ,in general ,the ,secretary may award grants to health centers to establish1 operate1 or expand training programs for behavioral health specialists4 7#b7 ,use of funds ,the training programs for behavioral health specialists supported pursuant to a grant under this subsection may include-- 7,a7 stipends for personnel to operate the training programs2 7,b7 apprenticeship programs2 and 7,c7 other recruitment and retention activities for behavioral health specialists4 4 #d4 ,expanding hospital and ,,fqhc partnerships for graduate medical education 7a7 ,payments to teaching health centers 7#a7 ,in general ,section #cdj;,h of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7 is amended-- 7,a7 in subsection 7a77#a71 by inserting 1 or that have in effect a covered agreement with a sponsoring institution so listed1 after relevant accrediting body2 and 7,b7 in subsection 7j71 by adding at the end the following new paragraph3 7#e7 ,covered agreement ,the term covered agreement means a written contract1 memorandum of understanding1 or other written agreement entered into for not less than #b years for the purpose of conducting an approved graduate medical residency training program4 4 7#b7 ,effective date ,the amendment made by paragraph 7#a7 shall apply with respect to expenses incurred on or after ,october #a1 #bjbe4 7b7 ,medicare ,,gme cap ,section #ahhf7;h7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7h77 is amended-- 7#a7 in subsection 7#d77;,f71 by striking and 7#aj7 and inserting 7#aj71 and 7#aa72 and 7#b7 by adding at the end the following new paragraph3 7#aa7 ,training programs at ,federally qualified health centers 7,a7 ,in general ,for cost reporting periods beginning on or after ,october #a1 #bjbe1 in the case of a hospital that has an approved medical residency training program where a significant portion of such program occurs at a ,federally qualified health center 7as determined by the ,secretary71 the ,secretary shall increase the otherwise applicable resident limit for such hospital by #c full-time equivalent residency positions4 7,b7 ,definitions ,in this paragraph3 7i7 ,otherwise applicable resident limit ,the term otherwise applicable resident limit means1 with respect to a hospital1 the limit otherwise applicable under subparagraphs 7,f77i7 and 7,h7 of paragraph 7#d7 on the resident level for the hospital determined without regard to this paragraph but taking into account paragraphs 7#g77;,a71 7#g77;,b71 7#h77;,a71 7#h77;,b71 7#i77;,a71 and 7#aj77;,a74 7ii7 ,resident level ,the term resident level has the meaning given such term in paragraph 7#g77;,c77i74 4 #e4 ,expanding ,,fqhc services 7a7 ,behavioral health professional and case manager services 7#a7 ,medicare ,section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77 is amended-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,b71 by inserting such services furnished on or after ,october #a1 #bjbe1 by a behavioral health consultant1 peer support specialist1 or other behavioral health professional 7as such terms are defined by the ,secretary71 before and such services2 7ii7 in subparagraph 7,c71 by striking and at the end2 7iii7 in subparagraph 7,d71 by striking the comma at the end and inserting 1 and2 and 7iv7 by inserting after subparagraph 7,d7 the following new subparagraph3 7,e7 case management services furnished on or after ,october #a1 #bjbe1 by a case manager 7as defined by the ,secretary71 2 and 7,b7 in paragraph 7#c77;,a71 by striking 7,d7 and inserting 7,e74 7#b7 ,medicaid ,section #aije7l77#b77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,a77 is amended by inserting and 7,e7 before of section4 7b7 ,guidance on ,state ,medicaid payments to ,f,q,h,cs ,section #aijb7;bb7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7bb77 is amended by adding at the end the following new paragraph3 7#g7 ,study and guidance on payment adjustments ,not later than ,october #a1 #bjbe1 and not less frequently than annually thereafter1 the ,secretary shall-- 7,a7 conduct a study on any differences in the methods by which ,state plans adjust the payment amount under paragraph 7#c7 for services furnished during a fiscal year2 and 7,b7 based on the results of the study conducted under subparagraph 7,a71 issue guidance to ,state plans on best practices for adjusting the payment amount under paragraph 7#c7 for services furnished during a fiscal year4 4