,,ii  #aaith ,,congress  #b;d ,session  
,s4 #edhi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #bc1
 #bjbf,mr4 ,van ,hollen 7for himself1   
,mr4 ,booker1 and ,ms4 ,klobuchar7      
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 authorize a scholarship and loan     
repayment program to incentivize        
physicians to enter into the field of   
sickle cell disease research1 treatment1
 and patient care1 and for other        
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,sickle ,cell ,care 
,expansion ,act of #bjbf4  #b4          
,advancing treatment and research       
pertaining to sickle cell disease ,part 
,d of title ,,iii of the ,public ,health
 ,service ,act 7#db ,u4,s4,c4 #bed;b et 
seq47 is amended by adding at the end   
the following3  ,,xiii ,advancing       
treatment and research pertaining to    

sickle cell disease  #cdj;,j4           
,scholarship and loan repayment program 
7a7 ,in general ,to advance learning    
regarding sickle cell disease and to    
enhance the supply of physicians to     
treat such disease1 especially with     
respect to adult populations1 the       
,secretary1 acting through the          
,administrator of the ,health ,resources
 and ,services ,administration1 shall   
carry out a program consisting of       
entering into contracts with individuals
 under which-- 7#a7 the ,secretary      
awards a scholarship under subsection   
7b7 or agrees to make loan repayments   
under subsection 7c7 with respect to    
each individual2 and  7#b7 the          
individual agrees to serve for a period 
7in this section referred to as the     
period of obligated service7 as a       
physician engaged in-- 7,a7 sickle cell 
disease research2 or  7,b7 service in a 
public or private setting that is       
primarily focused on treatment and      
education related to sickle cell disease

 in a health care facility1 clinic1     
rural health clinic1 mobile medical     
asset1 or other facility as determined  
by the ,secretary4  7b7 ,scholarships   
7#a7 ,eligibility ,to be eligible to    
participate in the scholarship program  
under this section1 an individual       
shall-- 7,a7 be accepted for enrollment1
 or be enrolled1 as a full-time student 
in an accredited 7as determined by the  
,secretary7 educational institution in a
 ,state and in a course of study or     
program offered by such institution and 
approved by the ,secretary1 leading to a
 degree in medicine or osteopathic      
medicine2  7,b7 submit an application to
 participate in the scholarship program2
 and  7,c7 sign and submit to the       
,secretary1 at the time of submission of
 such application1 a written contract   
7described in paragraph 7#b77 to accept 
payment of a scholarship and to serve   
7in accordance with this section7 for   
the applicable period of obligated      
service4  7#b7 ,written contract ,the   

written contract under this subsection  
between the ,secretary and an individual
 shall contain-- 7,a7 an agreement      
that-- 7i7 subject to paragraph 7#a71   
the ,secretary agrees to provide the    
individual with a scholarship in each   
such school year or years for a period  
of years 7not to exceed #d school years7
 determined by the individual1 during   
which period the individual is pursuing 
a course of study described in paragraph
 7#a77;,a72 and  7ii7 subject to        
paragraph 7#a71 the individual agrees   
to-- 7,i7 accept provision of such a    
scholarship to the individual2  7,,ii7  
maintain enrollment in a course of study
 described in paragraph 7#a77;,a7 until 
the individual completes the course of  
study2  7,,iii7 maintain an acceptable  
level of academic standing2  7,,iv7     
complete a residency in a specialty that
 the ,secretary determines is consistent
 with pursuit of a fellowship in        
hematology2  7,v7 complete a fellowship 
in the specialty of hematology2 and     

7,,vi7 serve for a time period equal to 
one year for each school year for which 
the individual was provided a           
scholarship under this section2  7,b7 a 
provision that any financial obligation 
of the ,united ,states arising out of   
the contract and any obligation of the  
individual which is conditioned thereon1
 is contingent upon funds being         
appropriated for scholarships under this
 section2  7,c7 a statement of the      
damages to which the ,united ,states is 
entitled if the individual should breach
 the contract2 and  7,d7 such other     
statements of the rights and liabilities
 of the ,secretary and of the individual
 as the ,secretary determines           
appropriate1 not inconsistent with the  
provisions of this section4  7c7 ,loan  
repayments  7#a7 ,eligibility ,to be    
eligible to participate in the loan     
repayment program under this section1 an
 individual shall-- 7,a7 have a degree  
in medicine or osteopathic medicine2 be 
enrolled in an approved graduate        

training program in medicine or         
osteopathic medicine2 or be enrolled as 
a full-time student in an accredited 7as
 determined by the ,secretary7          
educational institution in a ,state1 and
 in the final year of a course of study 
offered by such institution and approved
 by the ,secretary1 leading to a degree 
in medicine or osteopathic medicine2    
7,b7 submit an application to           
participate in the loan repayment       
program2 and  7,c7 sign and submit to   
the ,secretary1 at the time of          
submission of such application1 a       
written contract 7described in paragraph
 7#b77 to accept payment by the         
,secretary of the educational loans of  
the individual in consideration of the  
individual serving for a period of      
obligated service4  7#b7 ,written       
contract ,the written contract under    
this subsection between the ,secretary  
and an individual shall contain-- 7,a7  
an agreement that-- 7i7 subject to      
paragraph 7#a71 the ,secretary agrees to

 pay on behalf of the individual the    
principal1 interest1 and related        
expenses on government and commercial   
loans received by the individual        
regarding the undergraduate or graduate 
education of the individual 7or both71  
which loans were made for-- 7,i7 tuition
 expenses2  7,,ii7 all other reasonable 
educational expenses1 including fees1   
books1 and laboratory expenses1 incurred
 by the individual2 or  7,,iii7         
reasonable living expenses as determined
 by the ,secretary2 and  7ii7 subject to
 paragraph 7#a71 the individual agrees  
to-- 7,i7 accept loan payments on behalf
 of the individual2  7,,ii7 maintain    
enrollment in a course of study         
described in paragraph 7#a77;,a7 7if    
applicable7 until the individual        
completes the course of study2  7,,iii7 
maintain an acceptable level of academic
 standing2  7,,iv7 complete a residency 
in a specialty that the ,secretary      
determines is consistent with pursuit of
 a fellowship in hematology2 and  7,v7  

complete a fellowship in hematology2    
7,b7 a provision that any financial     
obligation of the ,united ,states       
arising out of the contract and any     
obligation of the individual which is   
conditioned thereon1 is contingent upon 
funds being appropriated for loan       
repayments under this section2  7,c7 a  
statement of the damages to which the   
,united ,states is entitled if the      
individual should breach the contract2  
and  7,d7 such other statements of the  
rights and liabilities of the ,secretary
 and of the individual as the ,secretary
 determines appropriate1 not            
inconsistent with the provisions of this
 section4  7d7 ,priority ,in awarding   
contracts under this section for        
scholarships and loan repayments1 the   
,secretary may prioritize making awards 
to individuals from disadvantaged       
backgrounds4  7e7 ,definition ,in this  
section1 the term sickle cell disease   
research means research into the        
detection1 diagnosis1 treatment1 or     

control of sickle cell disease4  7f7    
,authorization of appropriations ,to    
carry out this section1 there is        
authorized to be appropriated           
#aej1jjj1jjj for each of fiscal years   
#bjbg through #bjcb4  #cdj;,j-#a4       
,community-based grants to engage the   
sickle cell disease population by       
designing education and advocacy        
programs and policies for health and    
community services  7a7 ,in general ,the
 ,secretary shall carry out a program   
consisting of awarding grants to        
eligible entities for the establishment 
and support of education and advocacy   
programs that engage the sickle cell    
disease population1 their families1 or  
,state and local governments in order   
to-- 7#a7 improve sickle cell disease   
health literacy1 including mental health
 awareness and educational attainment2  
7#b7 disseminate information on health  
and community services related to sickle
 cell disease2 or  7#c7 improve access  
to care and treatment decision-making   

processes related to sickle cell        
disease4  7b7 ,applications ,to seek a  
grant under subsection 7a71 an eligible 
entity shall submit an application to   
the ,secretary at such time1 in such    
manner1 and containing such information 
and assurances as the ,secretary may    
require4  7c7 ,consideration ,in        
determining whether to award a grant    
under this section to an applicant1 and 
the amount of a grant under this        
section1 the ,secretary shall consider  
the need for sickle cell education or   
services in the area to be served using 
the grant4  7d7 ,definition ,in this    
section1 the term eligible entity       
means-- 7#a7 a community-based          
organization or faith-based organization
 or clinic that provides services to1 or
 engages in1 advocacy for individuals   
with sickle cell disease2  7#b7 a       
nonprofit organization providing        
comprehensive care to populations with  
sickle cell disease1 including any such 
nonprofit organization that is a        

faith-based organization or             
community-based organization2 or  7#c7 a
 ,federally qualified health center 7as 
defined in section #ahfa7;aa7 of the    
,social ,security ,act7 or nonprofit    
organization engaged in providing sickle
 cell disease education1 information1 or
 treatment services4  7e7 ,authorization
 of appropriations ,to carry out this   
section1 there is authorized to be      
appropriated #ej1jjj1jjj for each of    
fiscal years #bjbg through #bjcb4       
#cdj;,j-#b4 ,grants for sickle cell     
disease pediatric to adult transitions  
of care  7a7 ,in general ,the ,secretary
 shall carry out a program of awarding  
grants to eligible entities for the     
establishment and support of programs-- 
7#a7 that-- 7,a7 provide transition     
support through a dedicated transition  
coordinator and management of care for  
sickle cell disease patients between the
 ages of #ah and #bi who are aging out  
of pediatric care and receiving adult   
care for sickle cell disease2  7,b7     

assist sickle cell patients in          
identifying and maintaining adult       
primary care providers and adult        
specialists for sickle cell disease     
compatible with the patient's health    
insurance2 and  7,c7 provide support    
services1 including mental health       
services1 for the management of the     
patient's treatments and medical        
appointments throughout the transition  
to adult care2 and  7#b7 which1 in the  
case of an eligible entity that is a    
hospital or an institute of higher      
education1 may include providing        
training to adult sickle cell disease   
care specialists on the medical needs of
 young sickle cell disease patients1    
through-- 7,a7 #a- to #b-year long      
fellowships for any individual that has 
completed a residency in medicine1      
combined internal medicine and          
pediatrics1 or family medicine2 or  7,b7
 short-term programs and workshops4  7b7
 ,eligible entities ,to be eligible to  
receive a grant under this section1 an  

entity shall-- 7#a7 be a nonprofit      
organization providing comprehensive    
care to populations with sickle cell    
disease1 including a hospital or an     
institute of higher education1 and      
including any such nonprofit            
organization that is a faith-based      
organization or community-based         
organization2 and  7#b7 submit an       
application to the ,secretary at such   
time1 in such manner1 and containing    
such information and assurances as the  
,secretary may require4  7c7            
,consideration ,in determining whether  
to award a grant under this section to  
an eligible entity1 and the amount of a 
grant under this section1 the ,secretary
 shall consider the size of the         
population the eligible entity intends  
to serve4  7d7 ,reports  7#a7 ,reporting
 by eligible entities ,eligible entities
 receiving a grant under this section   
shall submit1 during the grant period1  
an annual report to the ,secretary4     
,each such report shall-- 7,a7 use an   

established and recognized registry on  
measuring quality metrics specified by  
the ,secretary2 and  7,b7 include-- 7i7 
a description of the activities carried 
out using the grant funds2  7ii7 a      
summary of the health outcomes for      
sickle cell patients benefitting from   
the transition coordination and         
management program supported by the     
grant2 and  7iii7 the number of         
specialists trained and fellowships     
funded under the grant1 as described in 
subsection 7a77#b71 as applicable4  7#b7
 ,reporting by the ,secretary ,not later
 than #b years after the date of        
enactment of the ,sickle ,cell ,care    
,expansion ,act of #bjbf1 and annually  
thereafter1 the ,secretary shall submit 
to the ,committee on ,health1           
,education1 ,labor1 and ,pensions of the
 ,senate and the ,committee on ,energy  
and ,commerce of the ,house of          
,representatives a report on activities 
carried out by eligible entities under  
this section1 based on the reports      

submitted to the ,secretary under       
paragraph 7#a74  7e7 ,authorization of  
appropriations ,to carry out this       
section1 there is authorized to be      
appropriated #gj1jjj1jjj for each of    
fiscal years #bjbg through #bjcb4  4