,,ii  #aai? ,,congress  #b;d ,session   
,s4 #edhi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bc1         
#bjbf,mr4 ,van ,holl5 7= himself1 ,mr4  
,book]1 & ,ms4 ,klobu*>7 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        
au?orize a s*ol>%ip & loan repaym5t     
program to inc5tivize physicians to ent]
 into ! field ( sickle cell disease     
rese>*1 treatm5t1 & pati5t c>e1 & = o!r 
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,sickle ,cell ,c>e         
,expansion ,act ( #bjbf4  #b4 ,advanc+  
treatm5t & rese>* p]ta9+ to sickle cell 
disease ,"p ,d ( title ,,iii ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#bed;b et seq47 is am5d$ by add+ at !   
end ! foll[+3  ,,xiii ,advanc+ treatm5t 
& rese>* p]ta9+ to sickle cell disease  
#cdj;,j4 ,s*ol>%ip & loan repaym5t      
program  7a7 ,9 g5]al ,to advance le>n+ 
reg>d+ sickle cell disease & to enhance 

! supply ( physicians to treat su*      
disease1 especially ) respect to adult  
populations1 ! ,secret>y1 act+ ?r\gh !  
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 %all c>ry out a 
program consi/+ ( ent]+ into contracts )
 individuals "u :i*-- 7#a7 ! ,secret>y  
aw>ds a s*ol>%ip "u subsection 7b7 or   
agrees to make loan repaym5ts "u        
subsection 7c7 ) respect to ea*         
individual2 &  7#b7 ! individual agrees 
to s]ve = a p]iod 79 ?is section ref]r$ 
to z ! p]iod ( obligat$ s]vice7 z a     
physician engag$ 9-- 7,a7 sickle cell   
disease rese>*2 or  7,b7 s]vice 9 a     
public or private sett+ t is prim>ily   
focus$ on treatm5t & education relat$ to
 sickle cell disease 9 a heal? c>e      
facility1 cl9ic1 rural heal? cl9ic1     
mobile m$ical asset1 or o!r facility z  
det]m9$ by ! ,secret>y4  7b7 ,s*ol>%ips 
7#a7 ,eligibility ,to be eligible to    
p>ticipate 9 ! s*ol>%ip program "u ?is  
section1 an individual %all-- 7,a7 be   
accept$ = enrollm5t1 or be enroll$1 z a 

full-"t /ud5t 9 an accr$it$ 7z det]m9$  
by ! ,secret>y7 educational in/itution 9
 a ,/ate & 9 a c\rse ( /udy or program  
(f]$ by su* in/itution & approv$ by !   
,secret>y1 lead+ to a degree 9 m$ic9e or
 o/eopa?ic m$ic9e2  7,b7 submit an      
application to p>ticipate 9 ! s*ol>%ip  
program2 &  7,c7 sign & submit to !     
,secret>y1 at ! "t ( submission ( su*   
application1 a writt5 contract 7describ$
 9 p>agraph 7#b77 to accept paym5t ( a  
s*ol>%ip & to s]ve 79 accordance ) ?is  
section7 = ! applicable p]iod ( obligat$
 s]vice4  7#b7 ,writt5 contract ,!      
writt5 contract "u ?is subsection betwe5
 ! ,secret>y & an individual %all       
conta9-- 7,a7 an agreem5t t-- 7i7       
subject to p>agraph 7#a71 ! ,secret>y   
agrees to provide ! individual ) a      
s*ol>%ip 9 ea* su* s*ool ye> or ye>s = a
 p]iod ( ye>s 7n to exce$ #d s*ool ye>s7
 det]m9$ by ! individual1 dur+ :i* p]iod
 ! individual is pursu+ a c\rse ( /udy  
describ$ 9 p>agraph 7#a77;,a72 &  7ii7  
subject to p>agraph 7#a71 ! individual  

agrees to-- 7,i7 accept provision ( su* 
a s*ol>%ip to ! individual2  7,,ii7     
ma9ta9 enrollm5t 9 a c\rse ( /udy       
describ$ 9 p>agraph 7#a77;,a7 until !   
individual completes ! c\rse ( /udy2    
7,,iii7 ma9ta9 an acceptable level (    
academic /&+2  7,,iv7 complete a        
resid5cy 9 a specialty t ! ,secret>y    
det]m9es is consi/5t ) pursuit ( a      
fell[%ip 9 hematology2  7,v7 complete a 
fell[%ip 9 ! specialty ( hematology2 &  
7,,vi7 s]ve = a "t p]iod equal to "o ye>
 = ea* s*ool ye> = :i* ! individual 0   
provid$ a s*ol>%ip "u ?is section2  7,b7
 a provision t any f9ancial obligation (
 ! ,unit$ ,/ates aris+ out ( ! contract 
& any obligation ( ! individual :i* is  
condition$ !reon1 is cont+5t ^u funds   
be+ appropriat$ = s*ol>%ips "u ?is      
section2  7,c7 a /atem5t ( ! damages to 
:i* ! ,unit$ ,/ates is entitl$ if !     
individual %\ld brea* ! contract2 &     
7,d7 su* o!r /atem5ts ( ! rights &      
liabilities ( ! ,secret>y & ( !         
individual z ! ,secret>y det]m9es       

appropriate1 n inconsi/5t ) ! provisions
 ( ?is section4  7c7 ,loan repaym5ts    
7#a7 ,eligibility ,to be eligible to    
p>ticipate 9 ! loan repaym5t program "u 
?is section1 an individual %all-- 7,a7 h
 a degree 9 m$ic9e or o/eopa?ic m$ic9e2 
be enroll$ 9 an approv$ graduate tra9+  
program 9 m$ic9e or o/eopa?ic m$ic9e2 or
 be enroll$ z a full-"t /ud5t 9 an      
accr$it$ 7z det]m9$ by ! ,secret>y7     
educational in/itution 9 a ,/ate1 & 9 ! 
f9al ye> ( a c\rse ( /udy (f]$ by su*   
in/itution & approv$ by ! ,secret>y1    
lead+ to a degree 9 m$ic9e or o/eopa?ic 
m$ic9e2  7,b7 submit an application to  
p>ticipate 9 ! loan repaym5t program2 & 
7,c7 sign & submit to ! ,secret>y1 at ! 
"t ( submission ( su* application1 a    
writt5 contract 7describ$ 9 p>agraph    
7#b77 to accept paym5t by ! ,secret>y ( 
! educational loans ( ! individual 9    
consid]ation ( ! individual s]v+ = a    
p]iod ( obligat$ s]vice4  7#b7 ,writt5  
contract ,! writt5 contract "u ?is      
subsection betwe5 ! ,secret>y & an      

individual %all conta9-- 7,a7 an        
agreem5t t-- 7i7 subject to p>agraph    
7#a71 ! ,secret>y agrees to pay on      
behalf ( ! individual ! pr9cipal1       
int]e/1 & relat$ exp5ses on gov]nm5t &  
comm]cial loans receiv$ by ! individual 
reg>d+ ! und]graduate or graduate       
education ( ! individual 7or bo?71 :i*  
loans 7 made =-- 7,i7 tuition exp5ses2  
7,,ii7 all o!r reasonable educational   
exp5ses1 includ+ fees1 books1 &         
laboratory exp5ses1 incurr$ by !        
individual2 or  7,,iii7 reasonable liv+ 
exp5ses z det]m9$ by ! ,secret>y2 &     
7ii7 subject to p>agraph 7#a71 !        
individual agrees to-- 7,i7 accept loan 
paym5ts on behalf ( ! individual2       
7,,ii7 ma9ta9 enrollm5t 9 a c\rse ( /udy
 describ$ 9 p>agraph 7#a77;,a7 7if      
applicable7 until ! individual completes
 ! c\rse ( /udy2  7,,iii7 ma9ta9 an     
acceptable level ( academic /&+2  7,,iv7
 complete a resid5cy 9 a specialty t !  
,secret>y det]m9es is consi/5t ) pursuit
 ( a fell[%ip 9 hematology2 &  7,v7     

complete a fell[%ip 9 hematology2  7,b7 
a provision t any f9ancial obligation ( 
! ,unit$ ,/ates aris+ out ( ! contract &
 any obligation ( ! individual :i* is   
condition$ !reon1 is cont+5t ^u funds   
be+ appropriat$ = loan repaym5ts "u ?is 
section2  7,c7 a /atem5t ( ! damages to 
:i* ! ,unit$ ,/ates is entitl$ if !     
individual %\ld brea* ! contract2 &     
7,d7 su* o!r /atem5ts ( ! rights &      
liabilities ( ! ,secret>y & ( !         
individual z ! ,secret>y det]m9es       
appropriate1 n inconsi/5t ) ! provisions
 ( ?is section4  7d7 ,priority ,9 aw>d+ 
contracts "u ?is section = s*ol>%ips &  
loan repaym5ts1 ! ,secret>y may         
prioritize mak+ aw>ds to individuals f  
disadvantag$ backgr\nds4  7e7 ,def9ition
 ,9 ?is section1 ! t]m sickle cell      
disease rese>* means rese>* into !      
detection1 diagnosis1 treatm5t1 or      
control ( sickle cell disease4  7f7     
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  
appropriat$ #aej1jjj1jjj = ea* ( fiscal 

ye>s #bjbg ?r\gh #bjcb4  #cdj;,j-#a4    
,community-bas$ grants to engage !      
sickle cell disease population by       
design+ education & advocacy programs & 
policies = heal? & community s]vices    
7a7 ,9 g5]al ,! ,secret>y %all c>ry out 
a program consi/+ ( aw>d+ grants to     
eligible entities = ! e/abli%m5t &      
support ( education & advocacy programs 
t engage ! sickle cell disease          
population1 _! families1 or ,/ate &     
local gov]nm5ts 9 ord] to-- 7#a7 improve
 sickle cell disease heal? lit]acy1     
includ+ m5tal heal? aw>5ess &           
educational atta9m5t2  7#b7 dissem9ate  
in=mation on heal? & community s]vices  
relat$ to sickle cell disease2 or  7#c7 
improve access to c>e & treatm5t        
decision-mak+ processes relat$ to sickle
 cell disease4  7b7 ,applications ,to   
seek a grant "u subsection 7a71 an      
eligible entity %all submit an          
application to ! ,secret>y at su* "t1 9 
su* mann]1 & conta9+ su* in=mation &    
assurances z ! ,secret>y may require4   

7c7 ,consid]ation ,9 det]m9+ :e!r to    
aw>d a grant "u ?is section to an       
applicant1 & ! am\nt ( a grant "u ?is   
section1 ! ,secret>y %all consid] ! ne$ 
= sickle cell education or s]vices 9 !  
area to be s]v$ us+ ! grant4  7d7       
,def9ition ,9 ?is section1 ! t]m        
eligible entity means-- 7#a7 a          
community-bas$ organization or fai?-bas$
 organization or cl9ic t provides       
s]vices to1 or engages 91 advocacy =    
individuals ) sickle cell disease2  7#b7
 a nonpr(it organization provid+        
compreh5sive c>e to populations ) sickle
 cell disease1 includ+ any su* nonpr(it 
organization t is a fai?-bas$           
organization or community-bas$          
organization2 or  7#c7 a ,f$]ally       
qualifi$ heal? c5t] 7z def9$ 9 section  
#ahfa7;aa7 ( ! ,social ,security ,act7  
or nonpr(it organization engag$ 9       
provid+ sickle cell disease education1  
in=mation1 or treatm5t s]vices4  7e7    
,au?orization ( appropriations ,to c>ry 
out ?is section1 !re is au?oriz$ to be  

appropriat$ #ej1jjj1jjj = ea* ( fiscal  
ye>s #bjbg ?r\gh #bjcb4  #cdj;,j-#b4    
,grants = sickle cell disease p$iatric  
to adult transitions ( c>e  7a7 ,9 g5]al
 ,! ,secret>y %all c>ry out a program ( 
aw>d+ grants to eligible entities = !   
e/abli%m5t & support ( programs-- 7#a7  
t-- 7,a7 provide transition support     
?r\gh a d$icat$ transition coord9ator & 
managem5t ( c>e = sickle cell disease   
pati5ts betwe5 ! ages ( #ah & #bi :o are
 ag+ out ( p$iatric c>e & receiv+ adult 
c>e = sickle cell disease2  7,b7 assi/  
sickle cell pati5ts 9 id5tify+ & ma9ta9+
 adult prim>y c>e provid]s & adult      
speciali/s = sickle cell disease        
compatible ) ! pati5t's heal? insurance2
 &  7,c7 provide support s]vices1       
includ+ m5tal heal? s]vices1 = !        
managem5t ( ! pati5t's treatm5ts &      
m$ical appo9tm5ts ?r\gh\t ! transition  
to adult c>e2 &  7#b7 :i*1 9 ! case ( an
 eligible entity t is a hospital or an  
in/itute ( high] education1 may include 
provid+ tra9+ to adult sickle cell      

disease c>e speciali/s on ! m$ical ne$s 
( "y sickle cell disease pati5ts1       
?r\gh-- 7,a7 #a- to #b-ye> long         
fell[%ips = any individual t has        
complet$ a resid5cy 9 m$ic9e1 comb9$    
int]nal m$ic9e & p$iatrics1 or family   
m$ic9e2 or  7,b7 %ort-t]m programs &    
work%ops4  7b7 ,eligible entities ,to be
 eligible to receive a grant "u ?is     
section1 an entity %all-- 7#a7 be a     
nonpr(it organization provid+           
compreh5sive c>e to populations ) sickle
 cell disease1 includ+ a hospital or an 
in/itute ( high] education1 & includ+   
any su* nonpr(it organization t is a    
fai?-bas$ organization or community-bas$
 organization2 &  7#b7 submit an        
application to ! ,secret>y at su* "t1 9 
su* mann]1 & conta9+ su* in=mation &    
assurances z ! ,secret>y may require4   
7c7 ,consid]ation ,9 det]m9+ :e!r to    
aw>d a grant "u ?is section to an       
eligible entity1 & ! am\nt ( a grant "u 
?is section1 ! ,secret>y %all consid] ! 
size ( ! population ! eligible entity   

int5ds to s]ve4  7d7 ,reports  7#a7     
,report+ by eligible entities ,eligible 
entities receiv+ a grant "u ?is section 
%all submit1 dur+ ! grant p]iod1 an     
annual report to ! ,secret>y4 ,ea* su*  
report %all-- 7,a7 use an e/abli%$ &    
recogniz$ regi/ry on measur+ quality    
metrics specifi$ by ! ,secret>y2 &  7,b7
 include-- 7i7 a description ( !        
activities c>ri$ out us+ ! grant funds2 
7ii7 a summ>y ( ! heal? outcomes =      
sickle cell pati5ts b5efitt+ f !        
transition coord9ation & managem5t      
program support$ by ! grant2 &  7iii7 ! 
numb] ( speciali/s tra9$ & fell[%ips    
fund$ "u ! grant1 z describ$ 9          
subsection 7a77#b71 z applicable4  7#b7 
,report+ by ! ,secret>y ,n lat] ?an #b  
ye>s aft] ! date ( enactm5t ( ! ,sickle 
,cell ,c>e ,expansion ,act ( #bjbf1 &   
annually !reaft]1 ! ,secret>y %all      
submit to ! ,committee on ,heal?1       
,education1 ,labor1 & ,p5sions ( !      
,s5ate & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives a  

report on activities c>ri$ out by       
eligible entities "u ?is section1 bas$  
on ! reports submitt$ to ! ,secret>y "u 
p>agraph 7#a74  7e7 ,au?orization (     
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#gj1jjj1jjj = ea* ( fiscal ye>s #bjbg   
?r\gh #bjcb4  4