SUBCHAPTER V—HEALTH PROFESSIONS EDUCATION
Health Workforce Coordination
"(a)
"(1)
"(2)
"(A) include performance measures to determine the extent to which the programs described in paragraph (1) are strengthening the Nation's health care system;
"(B) identify any gaps that exist between the outcomes of programs described in paragraph (1) and projected health care workforce needs identified in workforce projection reports conducted by the Health Resources and Services Administration;
"(C) identify actions to address the gaps described in subparagraph (B); and
"(D) identify barriers, if any, to implementing the actions identified under subparagraph (C).
"(b)
"(1) evaluate the performance of such programs, including the extent to which such programs are efficient and effective and are meeting the nation's [sic] health workforce needs; and
"(2) identify opportunities to improve the quality and consistency of the information collected to evaluate within and across such programs, and to implement such improvements.
"(c)
Part A—Student Loans
subpart i—insured health education assistance loans to graduate students
§292. Statement of purpose
The purpose of this subpart is to enable the Secretary to provide a Federal program of student loan insurance for students in (and certain former students of) eligible institutions (as defined in
(July 1, 1944, ch. 373, title VII, §701, as added
Prior Provisions
A prior section 292, act July 1, 1944, ch. 373, title VII, §700, as added Oct. 12, 1976,
Another prior section 292, act July 1, 1944, ch. 373, title VII, §701, as added July 30, 1956, ch. 779, §2,
A prior section 701 of act July 1, 1944, was classified to
Effective Date
Transfer of Health Education Assistance Loan Program
"(a)
"(b)
"(c)
"(d)
"(e)
Study on Effectiveness of Health Professions Programs
§292a. Scope and duration of loan insurance program
(a) In general
The total principal amount of new loans made and installments paid pursuant to lines of credit (as defined in
(b) Certain limitations and priorities
(1) Limitations regarding lenders, States, or areas
The Secretary may, if necessary to assure an equitable distribution of the benefits of this subpart, assign, within the maximum amounts specified in subsection (a), Federal loan insurance quotas applicable to eligible lenders, or to States or areas, and may from time to time reassign unused portions of these quotas.
(2) Priority for certain lenders
In providing certificates of insurance under
(A) to make loans to students at interest rates below the rates prevailing, during the period involved, for loans covered by Federal loan insurance pursuant to this subpart; or
(B) to make such loans under terms that are otherwise favorable to the student relative to the terms under which eligible lenders are generally making such loans during such period.
(c) Authority of Student Loan Marketing Association
(1) In general
Subject to paragraph (2), the Student Loan Marketing Association, established under part B of title IV of the Higher Education Act of 1965 [
(2) Applicability of certain Federal regulations
With respect to Federal regulations for lenders, this subpart may not be construed to preclude the applicability of such regulations to the Student Loan Marketing Association or to any other entity in the business of purchasing student loans, including such regulations with respect to applications, contracts, and due diligence.
(July 1, 1944, ch. 373, title VII, §702, as added
References in Text
The Higher Education Act of 1965, referred to in subsec. (c)(1), is
Prior Provisions
A prior section 292a, act July 1, 1944, ch. 373, title VII, §701, formerly §724, as added Sept. 24, 1963,
Another prior section 292a, act July 1, 1944, ch. 373, title VII, §702, as added July 30, 1956, ch. 779, §2,
A prior section 702 of act July 1, 1944, was classified to
§292b. Limitations on individual insured loans and on loan insurance
(a) In general
The total of the loans made to a student in any academic year or its equivalent (as determined by the Secretary) which may be covered by Federal loan insurance under this subpart may not exceed $20,000 in the case of a student enrolled in a school of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, or podiatric medicine, and $12,500 in the case of a student enrolled in a school of pharmacy, public health, allied health, or chiropractic, or a graduate program in health administration or behavioral and mental health practice, including clinical psychology. The aggregate insured unpaid principal amount for all such insured loans made to any borrower shall not at any time exceed $80,000 in the case of a borrower who is or was a student enrolled in a school of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, or podiatric medicine, and $50,000 in the case of a borrower who is or was a student enrolled in a school of pharmacy, public health, allied health, or chiropractic, or a graduate program in health administration or clinical psychology. The annual insurable limit per student shall not be exceeded by a line of credit under which actual payments by the lender to the borrower will not be made in any year in excess of the annual limit.
(b) Extent of insurance liability
The insurance liability on any loan insured by the Secretary under this subpart shall be 100 percent of the unpaid balance of the principal amount of the loan plus interest. The full faith and credit of the United States is pledged to the payment of all amounts which may be required to be paid under the provisions of
(July 1, 1944, ch. 373, title VII, §703, as added
Prior Provisions
A prior section 292b, act July 1, 1944, ch. 373, title VII, §702, formerly §725, as added Sept. 24, 1963,
Another prior section 292b, act July 1, 1944, ch. 373, title VII, §703, as added July 30, 1956, ch. 779, §2,
A prior section 703 of act July 1, 1994, was classified to
Amendments
1998—Subsec. (a).
§292c. Sources of funds
Loans made by eligible lenders in accordance with this subpart shall be insurable by the Secretary whether made from funds fully owned by the lender or from funds held by the lender in a trust or similar capacity and available for such loans.
(July 1, 1944, ch. 373, title VII, §704, as added
Prior Provisions
A prior section 292c, act July 1, 1944, ch. 373, title VII, §703, formerly §799, as added Nov. 2, 1970,
Another prior section 292c, act July 1, 1944, ch. 373, title VII, §704, as added July 30, 1956, 779, §2,
A prior section 704 of act July 1, 1944, was classified to
§292d. Eligibility of borrowers and terms of insured loans
(a) In general
A loan by an eligible lender shall be insurable by the Secretary under the provisions of this subpart only if—
(1) made to—
(A) a student who—
(i)(I) has been accepted for enrollment at an eligible institution, or (II) in the case of a student attending an eligible institution, is in good standing at that institution, as determined by the institution;
(ii) is or will be a full-time student at the eligible institution;
(iii) has agreed that all funds received under such loan shall be used solely for tuition, other reasonable educational expenses, including fees, books, and laboratory expenses, and reasonable living expenses, incurred by such students;
(iv) if required under
(v) in the case of a pharmacy student, has satisfactorily completed three years of training; or
(B) an individual who—
(i) has previously had a loan insured under this subpart when the individual was a full-time student at an eligible institution;
(ii) is in a period during which, pursuant to paragraph (2), the principal amount of such previous loan need not be paid;
(iii) has agreed that all funds received under the proposed loan shall be used solely for repayment of interest due on previous loans made under this subpart; and
(iv) if required under
(2) evidenced by a note or other written agreement which—
(A) is made without security and without endorsement, except that if the borrower is a minor and such note or other written agreement executed by him would not, under the applicable law, create a binding obligation, an endorsement may be required;
(B) provides for repayment of the principal amount of the loan in installments over a period of not less than 10 years (unless sooner repaid) nor more than 25 years beginning not earlier than 9 months nor later than 12 months after the date of—
(i) the date on which—
(I) the borrower ceases to be a participant in an accredited internship or residency program of not more than four years in duration;
(II) the borrower completes the fourth year of an accredited internship or residency program of more than four years in duration; or
(III) the borrower, if not a participant in a program described in subclause (I) or (II), ceases to carry, at an eligible institution, the normal full-time academic workload as determined by the institution; or
(ii) the date on which a borrower who is a graduate of an eligible institution ceases to be a participant in a fellowship training program not in excess of two years or a participant in a full-time educational activity not in excess of two years, which—
(I) is directly related to the health profession for which the borrower prepared at an eligible institution, as determined by the Secretary; and
(II) may be engaged in by the borrower during such a two-year period which begins within twelve months after the completion of the borrower's participation in a program described in subclause (I) or (II) of clause (i) or prior to the completion of the borrower's participation in such program,
except as provided in subparagraph (C), except that the period of the loan may not exceed 33 years from the date of execution of the note or written agreement evidencing it, and except that the note or other written instrument may contain such provisions relating to repayment in the event of default in the payment of interest or in the payment of the costs of insurance premiums, or other default by the borrower, as may be authorized by regulations of the Secretary in effect at the time the loan is made;
(C) provides that periodic installments of principal and interest need not be paid, but interest shall accrue, during any period (i) during which the borrower is pursuing a full-time course of study at an eligible institution (or at an institution defined by
(D) provides for interest on the unpaid principal balance of the loan at a yearly rate, not exceeding the applicable maximum rate prescribed and defined by the Secretary (within the limits set forth in subsection (b)) on a national, regional, or other appropriate basis, which interest shall be compounded not more frequently than annually and payable in installments over the period of the loan except as provided in subparagraph (C), except that the note or other written agreement may provide that payment of any interest may be deferred until not later than the date upon which repayment of the first installment of principal falls due or the date repayment of principal is required to resume (whichever is applicable) and may further provide that, on such date, the amount of the interest which has so accrued may be added to the principal for the purposes of calculating a repayment schedule;
(E) offers, in accordance with criteria prescribed by regulation by the Secretary, a schedule for repayment of principal and interest under which payment of a portion of the principal and interest otherwise payable at the beginning of the repayment period (as defined in such regulations) is deferred until a later time in the period;
(F) entitles the borrower to accelerate without penalty repayment of the whole or any part of the loan;
(G) provides that the check for the proceeds of the loan shall be made payable jointly to the borrower and the eligible institution in which the borrower is enrolled; and
(H) contains such other terms and conditions consistent with the provisions of this subpart and with the regulations issued by the Secretary pursuant to this subpart, as may be agreed upon by the parties to such loan, including, if agreed upon, a provision requiring the borrower to pay to the lender, in addition to principal and interest, amounts equal to the insurance premiums payable by the lender to the Secretary with respect to such loan; and
(3) subject to the consent of the student and subject to applicable law, the eligible lender has obtained from the student appropriate demographic information regarding the student, including racial or ethnic background.
(b) Limitation on rate of interest
The rate of interest prescribed and defined by the Secretary for the purpose of subsection (a)(2)(D) may not exceed the average of the bond equivalent rates of the 91-day Treasury bills auctioned for the previous quarter plus 3 percentage points, rounded to the next higher one-eighth of 1 percent.
(c) Minimum annual payment by borrower
The total of the payments by a borrower during any year or any repayment period with respect to the aggregate amount of all loans to that borrower which are insured under this subpart shall not be less than the annual interest on the outstanding principal, except as provided in subsection (a)(2)(C), unless the borrower, in the written agreement described in subsection (a)(2), agrees to make payments during any year or any repayment period in a lesser amount.
(d) Applicability of certain laws on rate or amount of interest
No provision of any law of the United States (other than subsections (a)(2)(D) and (b)) or of any State that limits the rate or amount of interest payable on loans shall apply to a loan insured under this subpart.
(e) Determination regarding forbearance
Any period of time granted to a borrower under this subpart in the form of forbearance on the loan shall not be included in the 25-year total loan repayment period under subsection (a)(2)(C).
(f) Loan repayment schedule
Lenders and holders under this subpart shall offer borrowers graduated loan repayment schedules that, during the first 5 years of loan repayment, are based on the borrower's debt-to-income ratio.
(g) Rule of construction regarding determination of need of students
With respect to any determination of the financial need of a student for a loan covered by Federal loan insurance under this subpart, this subpart may not be construed to limit the authority of any school to make such allowances for students with special circumstances as the school determines appropriate.
(h) Definitions
For purposes of this section:
(1) The term "active duty" has the meaning given such term in
(2) The term "Persian Gulf conflict" means the period beginning on August 2, 1990, and ending on the date thereafter prescribed by Presidential proclamation or by law.
(July 1, 1944, ch. 373, title VII, §705, as added
References in Text
The Peace Corps Act, referred to in subsec. (a)(2)(C), is
The Domestic Volunteer Service Act of 1973, referred to in subsec. (a)(2)(C), is
Prior Provisions
A prior section 292d, act July 1, 1944, ch. 373, title VII, §704, formerly §799A, as added Nov. 2, 1970,
Another prior section 292d, act July 1, 1944, ch. 373, title VII, §705, as added July 30, 1956, ch. 779, §2,
A prior section 705 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (a)(2)(C).
1993—Subsec. (a)(2)(H), (I).
Effective Date of 1998 Amendments
Amendment by
1 So in original. Probably should be preceded by a closing parenthesis.
§292e. Certificate of loan insurance; effective date of insurance
(a) In general
(1) Authority for issuance of certificate
If, upon application by an eligible lender, made upon such form, containing such information, and supported by such evidence as the Secretary may require, and otherwise in conformity with this section, the Secretary finds that the applicant has made a loan to an eligible borrower which is insurable under the provisions of this subpart, he may issue to the applicant a certificate of insurance covering the loan and setting forth the amount and terms of the insurance.
(2) Effective date of insurance
Insurance evidenced by a certificate of insurance pursuant to subsection (a)(1) shall become effective upon the date of issuance of the certificate, except that the Secretary is authorized, in accordance with regulations, to issue commitments with respect to proposed loans, or with respect to lines (or proposed lines) of credit, submitted by eligible lenders, and in that event, upon compliance with subsection (a)(1) by the lender, the certificate of insurance may be issued effective as of the date when any loan, or any payment by the lender pursuant to a line of credit, to be covered by such insurance is made to a student described in
(3) Certain agreements for lenders
An application submitted pursuant to subsection (a)(1) shall contain—
(A) an agreement by the applicant to pay, in accordance with regulations, the premiums fixed by the Secretary pursuant to
(B) an agreement by the applicant that if the loan is covered by insurance the applicant will submit such supplementary reports and statements during the effective period of the loan agreement, upon such forms, at such times, and containing such information as the Secretary may prescribe by or pursuant to regulation.
(b) Authority regarding comprehensive insurance coverage
(1) In general
In lieu of requiring a separate insurance application and issuing a separate certificate of insurance for each loan made by an eligible lender as provided in subsection (a), the Secretary may, in accordance with regulations consistent with
(2) Lines of credit beyond cutoff date
If the holder of a certificate of comprehensive insurance coverage issued under this subsection grants to a borrower a line of credit extending beyond the cutoff date specified in that certificate, loans or payments thereon made by the holder after that date pursuant to the line of credit shall not be deemed to be included in the coverage of that certificate except as may be specifically provided therein; but, subject to the limitations of
(c) Assignment of insurance rights
The rights of an eligible lender arising under insurance evidenced by a certificate of insurance issued to it under this section may be assigned by such lender, subject to regulation by the Secretary, only to—
(1) another eligible lender (including a public entity in the business of purchasing student loans); or
(2) the Student Loan Marketing Association.
(d) Effect of refinancing or consolidation of obligations
The consolidation of the obligations of two or more federally insured loans obtained by a borrower in any fiscal year into a single obligation evidenced by a single instrument of indebtedness or the refinancing of a single loan shall not affect the insurance by the United States. If the loans thus consolidated are covered by separate certificates of insurance issued under subsection (a), the Secretary may upon surrender of the original certificates issue a new certificate of insurance in accordance with that subsection upon the consolidated obligation. If the loans thus consolidated are covered by a single comprehensive certificate issued under subsection (b), the Secretary may amend that certificate accordingly.
(e) Rule of construction regarding consolidation of debts and refinancing
Nothing in this section shall be construed to preclude the lender and the borrower, by mutual agreement, from consolidating all of the borrower's loans insured under this subpart into a single instrument (or, if the borrower obtained only 1 loan insured under this subpart, refinancing the loan 1 time) under the terms applicable to an insured loan made at the same time as the consolidation. The lender or loan holder should provide full information to the borrower concerning the advantages and disadvantages of loan consolidation or refinancing. Nothing in this section shall be construed to preclude the consolidation of the borrower's loans insured under this subpart under
(July 1, 1944, ch. 373, title VII, §706, as added
Prior Provisions
A prior section 292e, act July 1, 1944, ch. 373, title VII, §705, as added Oct. 12, 1976,
Another prior section 292e, act July 1, 1944, ch. 373, title VII, §706, as added July 30, 1956, 779, §2,
A prior section 706 of act July 1, 1944, was classified to
Another prior section 706 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (d).
Subsec. (e).
§292f. Default of borrower
(a) Conditions for payment to beneficiary
(1) In general
Upon default by the borrower on any loan covered by Federal loan insurance pursuant to this subpart, and after a substantial collection effort (including, subject to subsection (h), commencement and prosecution of an action) as determined under regulations of the Secretary, the insurance beneficiary shall promptly notify the Secretary and the Secretary shall, if requested (at that time or after further collection efforts) by the beneficiary, or may on his own motion, if the insurance is still in effect, pay to the beneficiary the amount of the loss sustained by the insured upon that loan as soon as that amount has been determined, except that, if the insurance beneficiary including any servicer of the loan is not designated for "exceptional performance", as set forth in paragraph (2), the Secretary shall pay to the beneficiary a sum equal to 98 percent of the amount of the loss sustained by the insured upon that loan.
(2) Exceptional performance
(A) Authority
Where the Secretary determines that an eligible lender, holder, or servicer has a compliance performance rating that equals or exceeds 97 percent, the Secretary shall designate that eligible lender, holder, or servicer, as the case may be, for exceptional performance.
(B) Compliance performance rating
For purposes of subparagraph (A), a compliance performance rating is determined with respect to compliance with due diligence in the disbursement, servicing, and collection of loans under this subpart for each year for which the determination is made. Such rating shall be equal to the percentage of all due diligence requirements applicable to each loan, on average, as established by the Secretary, with respect to loans serviced during the period by the eligible lender, holder, or servicer.
(C) Annual audits for lenders, holders, and servicers
Each eligible lender, holder, or servicer desiring a designation under subparagraph (A) shall have an annual financial and compliance audit conducted with respect to the loan portfolio of such eligible lender, holder, or servicer, by a qualified independent organization from a list of qualified organizations identified by the Secretary and in accordance with standards established by the Secretary. The standards shall measure the lender's, holder's, or servicer's compliance with due diligence standards and shall include a defined statistical sampling technique designed to measure the performance rating of the eligible lender, holder, or servicer for the purpose of this section. Each eligible lender, holder, or servicer shall submit the audit required by this section to the Secretary.
(D) Secretary's determinations
The Secretary shall make the determination under subparagraph (A) based upon the audits submitted under this paragraph and any information in the possession of the Secretary or submitted by any other agency or office of the Federal Government.
(E) Quarterly compliance audit
To maintain its status as an exceptional performer, the lender, holder, or servicer shall undergo a quarterly compliance audit at the end of each quarter (other than the quarter in which status as an exceptional performer is established through a financial and compliance audit, as described in subparagraph (C)), and submit the results of such audit to the Secretary. The compliance audit shall review compliance with due diligence requirements for the period beginning on the day after the ending date of the previous audit, in accordance with standards determined by the Secretary.
(F) Revocation authority
The Secretary shall revoke the designation of a lender, holder, or servicer under subparagraph (A) if any quarterly audit required under subparagraph (E) is not received by the Secretary by the date established by the Secretary or if the audit indicates the lender, holder, or servicer has failed to meet the standards for designation as an exceptional performer under subparagraph (A). A lender, holder, or servicer receiving a compliance audit not meeting the standard for designation as an exceptional performer may reapply for designation under subparagraph (A) at any time.
(G) Documentation
Nothing in this section shall restrict or limit the authority of the Secretary to require the submission of claims documentation evidencing servicing performed on loans, except that the Secretary may not require exceptional performers to submit greater documentation than that required for lenders, holders, and servicers not designated under subparagraph (A).
(H) Cost of audits
Each eligible lender, holder, or servicer shall pay for all the costs associated with the audits required under this section.
(I) Additional revocation authority
Notwithstanding any other provision of this section, a designation under subparagraph (A) may be revoked at any time by the Secretary if the Secretary determines that the eligible lender, holder, or servicer has failed to maintain an overall level of compliance consistent with the audit submitted by the eligible lender, holder, or servicer under this paragraph or if the Secretary asserts that the lender, holder, or servicer may have engaged in fraud in securing designation under subparagraph (A) or is failing to service loans in accordance with program requirements.
(J) Noncompliance
A lender, holder, or servicer designated under subparagraph (A) that fails to service loans or otherwise comply with applicable program regulations shall be considered in violation of the Federal False Claims Act.
(b) Subrogation
Upon payment by the Secretary of the amount of the loss pursuant to subsection (a), the United States shall be subrogated for all of the rights of the holder of the obligation upon the insured loan and shall be entitled to an assignment of the note or other evidence of the insured loan by the insurance beneficiary. If the net recovery made by the Secretary on a loan after deduction of the cost of that recovery (including reasonable administrative costs) exceeds the amount of the loss, the excess shall be paid over to the insured. The Secretary may sell without recourse to eligible lenders (or other entities that the Secretary determines are capable of dealing in such loans) notes or other evidence of loans received through assignment under the first sentence.
(c) Forbearance
Nothing in this section or in this subpart shall be construed to preclude any forbearance for the benefit of the borrower which may be agreed upon by the parties to the insured loan and approved by the Secretary or to preclude forbearance by the Secretary in the enforcement of the insured obligation after payment on that insurance.
(d) Reasonable care and diligence regarding loans
Nothing in this section or in this subpart shall be construed to excuse the eligible lender or holder of a federally insured loan from exercising reasonable care and diligence in the making of loans under the provisions of this subpart and from exercising a substantial effort in the collection of loans under the provisions of this subpart. If the Secretary, after reasonable notice and opportunity for hearing to an eligible lender, finds that the lender has failed to exercise such care and diligence, to exercise such substantial efforts, to make the reports and statements required under
(e) Definitions
For purposes of this section:
(1) The term "insurance beneficiary" means the insured or its authorized assignee in accordance with
(2) The term "amount of the loss" means, with respect to a loan, unpaid balance of the principal amount and interest on such loan, less the amount of any judgment collected pursuant to default proceedings commenced by the eligible lender or holder involved.
(3) The term "default" includes only such defaults as have existed for 120 days.
(4) The term "servicer" means any agency acting on behalf of the insurance beneficiary.
(f) Reductions in Federal reimbursements or payments for defaulting borrowers
The Secretary shall, after notice and opportunity for a hearing, cause to be reduced Federal reimbursements or payments for health services under any Federal law to borrowers who are practicing their professions and have defaulted on their loans insured under this subpart in amounts up to the remaining balance of such loans. Procedures for reduction of payments under the medicare program are provided under
(g) Conditions for discharge of debt in bankruptcy
Notwithstanding any other provision of Federal or State law, a debt that is a loan insured under the authority of this subpart may be released by a discharge in bankruptcy under any chapter of title 11, only if such discharge is granted—
(1) after the expiration of the seven-year period beginning on the first date when repayment of such loan is required, exclusive of any period after such date in which the obligation to pay installments on the loan is suspended;
(2) upon a finding by the Bankruptcy Court that the nondischarge of such debt would be unconscionable; and
(3) upon the condition that the Secretary shall not have waived the Secretary's rights to apply subsection (f) to the borrower and the discharged debt.
(h) Requirement regarding actions for default
(1) In general
With respect to the default by a borrower on any loan covered by Federal loan insurance under this subpart, the Secretary shall, under subsection (a), require an eligible lender or holder to commence and prosecute an action for such default unless—
(A) in the determination of the Secretary—
(i) the eligible lender or holder has made reasonable efforts to serve process on the borrower involved and has been unsuccessful with respect to such efforts, or
(ii) prosecution of such an action would be fruitless because of the financial or other circumstances of the borrower;
(B) for such loans made before November 4, 1988, the loan involved was made in an amount of less than $5,000; or
(C) for such loans made after November 4, 1988, the loan involved was made in an amount of less than $2,500.
(2) Relationship to claim for payment
With respect to an eligible lender or holder that has commenced an action pursuant to subsection (a), the Secretary shall make the payment required in such subsection, or deny the claim for such payment, not later than 60 days after the date on which the Secretary determines that the lender or holder has made reasonable efforts to secure a judgment and collect on the judgment entered into pursuant to this subsection.
(3) State court judgments
With respect to any State court judgment that is obtained by a lender or holder against a borrower for default on a loan insured under this subpart and that is subrogated to the United States under subsection (b), any United States attorney may register such judgment with the Federal courts for enforcement.
(i) Inapplicability of Federal and State statute of limitations on actions for loan collection
Notwithstanding any other provision of Federal or State law, there shall be no limitation on the period within which suit may be filed, a judgment may be enforced, or an offset, garnishment, or other action may be initiated or taken by the Secretary, the Attorney General, or other administrative head of another Federal agency, as the case may be, for the repayment of the amount due from a borrower on a loan made under this subpart that has been assigned to the Secretary under subsection (b).
(j) School collection assistance
An institution or postgraduate training program attended by a borrower may assist in the collection of any loan of that borrower made under this subpart which becomes delinquent, including providing information concerning the borrower to the Secretary and to past and present lenders and holders of the borrower's loans, contacting the borrower in order to encourage repayment, and withholding services in accordance with regulations issued by the Secretary under
(July 1, 1944, ch. 373, title VII, §707, as added
References in Text
The Federal False Claims Act, referred to in subsec. (a)(2)(J), probably means the False Claims Act which was the popular name for sections 231, 232, 233, and 235 of former Title 31, Money and Finance. Sections 231, 232, 233, and 235 were repealed by
Prior Provisions
A prior section 292f, act July 1, 1944, ch. 373, title VII, §706, as added Oct. 12, 1976,
Another prior section 292f, act July 1, 1944, ch. 373, title VII, §707, as added July 30, 1956, ch. 779, §2,
A prior section 707 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (a).
Subsec. (e)(4).
Subsec. (g).
1993—Subsec. (g)(1).
Subsec. (j).
Effective Date of 1998 Amendment
"(1) on or after the date of enactment of this Act [Nov. 13, 1998]; or
"(2) prior to such date of enactment in which a discharge has not been granted."
§292g. Risk-based premiums
(a) Authority
With respect to a loan made under this subpart on or after January 1, 1993, the Secretary, in accordance with subsection (b), shall assess a risk-based premium on an eligible borrower and, if required under this section, an eligible institution that is based on the default rate of the eligible institution involved (as defined in
(b) Assessment of premium
Except as provided in subsection (d)(2), the risk-based premium to be assessed under subsection (a) shall be as follows:
(1) Low-risk rate
With respect to an eligible borrower seeking to obtain a loan for attendance at an eligible institution that has a default rate of not to exceed five percent, such borrower shall be assessed a risk-based premium in an amount equal to 6 percent of the principal amount of the loan.
(2) Medium-risk rate
(A) In general
With respect to an eligible borrower seeking to obtain a loan for attendance at an eligible institution that has a default rate of in excess of five percent but not to exceed 10 percent—
(i) such borrower shall be assessed a risk-based premium in an amount equal to 8 percent of the principal amount of the loan; and
(ii) such institution shall be assessed a risk-based premium in an amount equal to 5 percent of the principal amount of the loan.
(B) Default management plan
An institution of the type described in subparagraph (A) shall prepare and submit to the Secretary for approval, an annual default management plan, that shall specify the detailed short-term and long-term procedures that such institution will have in place to minimize defaults on loans to borrowers under this subpart. Under such plan the institution shall, among other measures, provide an exit interview to all borrowers that includes information concerning repayment schedules, loan deferments, forbearance, and the consequences of default.
(3) High-risk rate
(A) In general
With respect to an eligible borrower seeking to obtain a loan for attendance at an eligible institution that has a default rate of in excess of 10 percent but not to exceed 20 percent—
(i) such borrower shall be assessed a risk-based premium in an amount equal to 8 percent of the principal amount of the loan; and
(ii) such institution shall be assessed a risk-based premium in an amount equal to 10 percent of the principal amount of the loan.
(B) Default management plan
An institution of the type described in subparagraph (A) shall prepare and submit to the Secretary for approval a plan that meets the requirements of paragraph (2)(B).
(4) Ineligibility
An individual shall not be eligible to obtain a loan under this subpart for attendance at an institution that has a default rate in excess of 20 percent.
(c) Reduction of risk-based premium
Lenders shall reduce by 50 percent the risk-based premium to eligible borrowers if a credit worthy parent or other responsible party co-signs the loan note.
(d) Administrative waivers
(1) Hearing
The Secretary shall afford an institution not less than one hearing, and may consider mitigating circumstances, prior to making such institution ineligible for participation in the program under this subpart.
(2) Exceptions
In carrying out this section with respect to an institution, the Secretary may grant an institution a waiver of requirements of paragraphs (2) through (4) of subsection (b) if the Secretary determines that the default rate for such institution is not an accurate indicator because the volume of the loans under this subpart made by such institution has been insufficient.
(3) Transition for certain institutions
During the 3-year period beginning on October 13, 1992—
(A) subsection (b)(4) shall not apply with respect to any eligible institution that is a Historically Black College or University; and
(B) any such institution that has a default rate in excess of 20 percent, and any eligible borrower seeking a loan for attendance at the institution, shall be subject to subsection (b)(3) to the same extent and in the same manner as eligible institutions and borrowers described in such subsection.
(e) Payoff to reduce risk category
An institution may pay off the outstanding principal and interest owed by the borrowers of such institution who have defaulted on loans made under this subpart in order to reduce the risk category of the institution.
(July 1, 1944, ch. 373, title VII, §708, as added
Prior Provisions
A prior section 292g, act July 1, 1944, ch. 373, title VII, §707, as added Oct. 12, 1976,
Another prior section 292g, act July 1, 1944, ch. 373, title VII, §708, as added July 30, 1956, ch. 779, §2,
A prior section 708 of act July 1, 1944, was classified to
Effective Date
Section effective Jan. 1, 1993, and until such date, former
§292h. Office for Health Education Assistance Loan Default Reduction
(a) Establishment
The Secretary shall establish, within the Division of Student Assistance of the Bureau of Health Professions, an office to be known as the Office for Health Education Assistance Loan Default Reduction (in this section referred to as the "Office").
(b) Purpose and functions
It shall be the purpose of the Office to achieve a reduction in the number and amounts of defaults on loans guaranteed under this subpart. In carrying out such purpose the Office shall—
(1) conduct analytical and evaluative studies concerning loans and loan defaults;
(2) carry out activities designed to reduce loan defaults;
(3) respond to special circumstances that may exist in the financial lending environment that may lead to loan defaults;
(4) coordinate with other Federal entities that are involved with student loan programs, including—
(A) with respect to the Department of Education, in the development of a single student loan application form, a single student loan deferment form, a single disability form, and a central student loan database; and
(B) with respect to the Department of Justice, in the recovery of payments from health professionals who have defaulted on loans guaranteed under this subpart; and
(5) provide technical assistance to borrowers, lenders, holders, and institutions concerning deferments and collection activities.
(c) Additional duties
In conjunction with the report submitted under subsection (b), the Office shall—
(1) compile, and publish in the Federal Register, a list of the borrowers who are in default under this subpart; and
(2) send the report and notices of default with respect to these borrowers to relevant Federal agencies and to schools, school associations, professional and specialty associations, State licensing boards, hospitals with which such borrowers may be associated, and any other relevant organizations.
(d) Allocation of funds for Office
In the case of amounts reserved under
(July 1, 1944, ch. 373, title VII, §709, as added
Prior Provisions
A prior section 292h, act July 1, 1944, ch. 373, title VII, §708, as added Oct. 12, 1976,
Another prior section 292h, act July 1, 1944, ch. 373, title VII, §709, as added July 30, 1956, ch. 779, §2,
A prior section 709 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (b).
"(A) the default rates for each—
"(i) institution described in
"(ii) lender participating in the loan program under this subpart; and
"(iii) loan holder under this subpart;
"(B) the total amounts recovered pursuant to
"(C) a plan for improving the extent of such recoveries during the current fiscal year."
§292i. Insurance account
(a) In general
(1) Establishment
There is hereby established a student loan insurance account (in this section referred to as the "Account") which shall be available without fiscal year limitation to the Secretary for making payments in connection with the collection and default of loans insured under this subpart by the Secretary.
(2) Funding
(A) Except as provided in subparagraph (B), all amounts received by the Secretary as premium charges for insurance and as receipts, earnings, or proceeds derived from any claim or other assets acquired by the Secretary in connection with his operations under this subpart, and any other moneys, property, or assets derived by the Secretary from the operations of the Secretary in connection with this section, shall be deposited in the Account.
(B) With respect to amounts described in subparagraph (A) that are received by the Secretary for fiscal year 1993 and subsequent fiscal years, the Secretary may, before depositing such amounts in the Account, reserve from the amounts each such fiscal year not more than $1,000,000 for obligation under
(3) Expenditures
All payments in connection with the default of loans insured by the Secretary under this subpart shall be paid from the Account.
(b) Contingent authority for issuance of notes or other obligations
If at any time the moneys in the Account are insufficient to make payments in connection with the collection or default of any loan insured by the Secretary under this subpart, the Secretary of the Treasury may lend the Account such amounts as may be necessary to make the payments involved, subject to the Federal Credit Reform Act of 1990 [
(July 1, 1944, ch. 373, title VII, §710, as added
References in Text
The Federal Credit Reform Act of 1990, referred to in subsec. (b), is title V of
Prior Provisions
A prior section 292i, act July 1, 1944, ch. 373, title VII, §709, as added Oct. 12, 1976,
Another prior section 292i, act July 1, 1944, ch. 373, title VII, §710, as added July 30, 1956, ch. 779, §2,
A prior section 710 of act July 1, 1944, was classified to
Another prior section 710 of act July 1, 1944, was renumbered section 709 by
Amendments
1998—Subsec. (a)(2)(B).
§292j. Powers and responsibilities of Secretary
(a) In general
In the performance of, and with respect to, the functions, powers, and duties vested in the Secretary by this subpart, the Secretary is authorized as follows:
(1) To prescribe such regulations as may be necessary to carry out the purposes of this subpart.
(2) To sue and be sued in any district court of the United States. Such district courts shall have jurisdiction of civil actions arising under this subpart without regard to the amount in controversy, and any action instituted under this subsection by or against the Secretary shall survive notwithstanding any change in the person occupying the office of Secretary or any vacancy in that office. No attachment, injunction, garnishment, or other similar process, mesne or final, shall be issued against the Secretary or property under the control of the Secretary. Nothing herein shall be constructed to except litigation arising out of activities under this subpart from the application of
(3) To include in any contract for Federal loan insurance such terms, conditions, and covenants relating to repayment of principal and payments of interest, relating to his obligations and rights and to those of eligible lenders, and borrowers in case of default, and relating to such other matters as the Secretary determines to be necessary to assure that the purposes of this subpart will be achieved. Any term, condition, and covenant made pursuant to this paragraph or any other provisions of this subpart may be modified by the Secretary if the Secretary determines that modification is necessary to protect the financial interest of the United States.
(4) Subject to the specific limitations in the subpart, to consent to the modification of any note or other instrument evidencing a loan which has been insured by him under this subpart (including modifications with respect to the rate of interest, time of payment of any installment of principal and interest or any portion thereof, or any other provision).
(5) To enforce, pay, compromise, waive, or release any right, title, claim, lien, or demand, however acquired, including any equity or any right or 1 redemption.
(b) Annual budget; accounts
The Secretary shall, with respect to the financial operations arising by reason of this subpart—
(1) prepare annually and submit a budget program as provided for wholly owned Government corporations by
(2) maintain with respect to insurance under this subpart an integral set of accounts.
(July 1, 1944, ch. 373, title VII, §711, as added
Codification
In subsec. (b)(1), "
Prior Provisions
A prior section 292j, act July 1, 1944, ch. 373, title VII, §709, formerly §710, as added Oct. 12, 1976,
Another prior section 292j, act July 1, 1944, ch. 373, title VII, §711, as added Sept. 24, 1963,
1 So in original. Probably should be "of".
§292k. Participation by Federal credit unions in Federal, State, and private student loan insurance programs
Notwithstanding any other provision of law, Federal credit unions shall, pursuant to regulations of the Administrator of the National Credit Union Administration, have power to make insured loans to eligible students in accordance with the provisions of this subpart relating to Federal insured loans.
(July 1, 1944, ch. 373, title VII, §712, as added
Prior Provisions
A prior section 292k, act July 1, 1944, ch. 373, title VII, §710, formerly §711, as added Oct. 12, 1976,
Transfer of Functions
Functions vested in Administrator of National Credit Union Administration transferred and vested in National Credit Union Administration Board pursuant to
§292l. Determination of eligible students
For purposes of determining eligible students under this part, in the case of a public school in a State that offers an accelerated, integrated program of study combining undergraduate premedical education and medical education leading to advanced entry, by contractual agreement, into an accredited four-year school of medicine which provides the remaining training leading to a degree of doctor of medicine, whenever in this part a provision refers to a student at a school of medicine, such reference shall include only a student enrolled in any of the last four years of such accelerated, integrated program of study.
(July 1, 1944, ch. 373, title VII, §713, as added
§292m. Repayment by Secretary of loans of deceased or disabled borrowers
If a borrower who has received a loan dies or becomes permanently and totally disabled (as determined in accordance with regulations of the Secretary), the Secretary shall discharge the borrower's liability on the loan by repaying the amount owed on the loan from the account established under
(July 1, 1944, ch. 373, title VII, §714, as added
§292n. Additional requirements for institutions and lenders
(a) In general
Notwithstanding any other provision of this subpart, the Secretary is authorized to prescribe such regulations as may be necessary to provide for—
(1) a fiscal audit of an eligible institution with regard to any funds obtained from a borrower who has received a loan insured under this subpart;
(2) the establishment of reasonable standards of financial responsibility and appropriate institutional capability for the administration by an eligible institution of a program of student financial aid with respect to funds obtained from a student who has received a loan insured under this subpart;
(3) the limitation, suspension, or termination of the eligibility under this subpart of any otherwise eligible institution, whenever the Secretary has determined, after notice and affording an opportunity for hearing, that such institution has violated or failed to carry out any regulation prescribed under this subpart;
(4) the collection of information from the borrower, lender, or eligible institution to assure compliance with the provisions of
(5) the assessing of tuition or fees to borrowers in amounts that are the same or less than the amount of tuition and fees assessed to nonborrowers;
(6) the submission, by the institution or the lender to the Office of Health Education Assistance Loan Default Reduction, of information concerning each loan made under this subpart, including the date when each such loan was originated, the date when each such loan is sold, the identity of the loan holder and information concerning a change in the borrower's status;
(7) the withholding of services, including academic transcripts, financial aid transcripts, and alumni services, by an institution from a borrower upon the default of such borrower of a loan under this subpart, except in case of a borrower who has filed for bankruptcy; and
(8) the offering, by the lender to the borrower, of a variety of repayment options, including fixed-rate, graduated repayment with negative amortization permitted, and income dependent payments for a limited period followed by level monthly payments.
(b) Recording by institution of information on students
The Secretary shall require an eligible institution to record, and make available to the lender and to the Secretary upon request, the name, address, postgraduate destination, and other reasonable identifying information for each student of such institution who has a loan insured under this subpart.
(c) Workshop for student borrowers
Each participating eligible institution must have, at the beginning of each academic year, a workshop concerning the provisions of this subpart that all student borrowers shall be required to attend.
(July 1, 1944, ch. 373, title VII, §715, as added
§292o. Definitions
For purposes of this subpart:
(1) The term "eligible institution" means, with respect to a fiscal year, a school of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, allied health, or chiropractic, or a graduate program in health administration or behavioral and mental health practice, including clinical psychology.
(2) The term "eligible lender" means an eligible institution that became a lender under this subpart prior to September 15, 1992, an agency or instrumentality of a State, a financial or credit institution (including an insurance company) which is subject to examination and supervision by an agency of the United States or of any State, a pension fund approved by the Secretary for this purpose, or a nonprofit private entity designated by the State, regulated by the State, and approved by the Secretary.
(3) The term "line of credit" means an arrangement or agreement between the lender and the borrower whereby a loan is paid out by the lender to the borrower in annual installments, or whereby the lender agrees to make, in addition to the initial loan, additional loans in subsequent years.
(4) The term "school of allied health" means a program in a school of allied health (as defined in
(5)(A) The term "default rate", in the case of an eligible entity, means the percentage constituted by the ratio of—
(i) the principal amount of loans insured under this subpart—
(I) that are made with respect to the entity and that enter repayment status after April 7, 1987; and
(II) for which amounts have been paid under
(ii) the total principal amount of loans insured under this subpart that are made with respect to the entity and that enter repayment status after April 7, 1987.
(B) For purposes of subparagraph (A), a loan insured under this subpart shall be considered to have entered repayment status if the applicable period described in subparagraph (B) of
(C) For purposes of subparagraph (A), the term "eligible entity" means an eligible institution, an eligible lender, or a holder, as the case may be.
(D) For purposes of subparagraph (A), a loan is made with respect to an eligible entity if—
(i) in the case of an eligible institution, the loan was made to students of the institution;
(ii) in the case of an eligible lender, the loan was made by the lender; and
(iii) in the case of a holder, the loan was purchased by the holder.
(6) The term "Secretary" means the Secretary of Education.
(July 1, 1944, ch. 373, title VII, §719, as added
Amendments
2014—Par. (6).
1998—Par. (1).
Effective Date of 2014 Amendment
§292p. Authorization of appropriations
(a) In general
For fiscal year 1993 and subsequent fiscal years, there are authorized to be appropriated such sums as may be necessary for the adequacy of the student loan insurance account under this subpart and for the purpose of administering this subpart.
(b) Availability of sums
Sums appropriated under subsection (a) shall remain available until expended.
(July 1, 1944, ch. 373, title VII, §720, as added
Prior Provisions
A prior section 720 of act July 1, 1944, was classified to
subpart ii—federally-supported student loan funds
§292q. Agreements for operation of school loan funds
(a) Fund agreements
The Secretary is authorized to enter into an agreement for the establishment and operation of a student loan fund in accordance with this subpart with any public or other nonprofit school of medicine, osteopathic medicine, dentistry, pharmacy, podiatric medicine, optometry, or veterinary medicine.
(b) Requirements
Each agreement entered into under this section shall—
(1) provide for establishment of a student loan fund by the school;
(2) provide for deposit in the fund of—
(A) the Federal capital contributions to the fund;
(B) an amount equal to not less than one-ninth of such Federal capital contributions, contributed by such institution;
(C) collections of principal and interest on loans made from the fund;
(D) collections pursuant to
(E) any other earnings of the fund;
(3) provide that the fund shall be used only for loans to students of the school in accordance with the agreement and for costs of collection of such loans and interest thereon;
(4) provide that loans may be made from such funds only to students pursuing a full-time course of study at the school leading to a degree of doctor of medicine, doctor of dentistry or an equivalent degree, doctor of osteopathy, bachelor of science in pharmacy or an equivalent degree, doctor of pharmacy or an equivalent degree, doctor of podiatric medicine or an equivalent degree, doctor of optometry or an equivalent degree, or doctor of veterinary medicine or an equivalent degree;
(5) provide that the school shall advise, in writing, each applicant for a loan from the student loan fund of the provisions of
(6) contain such other provisions as are necessary to protect the financial interests of the United States.
(c) Failure of school to collect loans
(1) In general
Any standard established by the Secretary by regulation for the collection by schools of medicine, osteopathic medicine, dentistry, pharmacy, podiatric medicine, optometry, or veterinary medicine of loans made pursuant to loan agreements under this subpart shall provide that the failure of any such school to collect such loans shall be measured in accordance with this subsection. This subsection may not be construed to require such schools to reimburse the student loan fund under this subpart for loans that became uncollectible prior to August 1985 or to penalize such schools with respect to such loans.
(2) Extent of failure
The measurement of a school's failure to collect loans made under this subpart shall be the ratio (stated as a percentage) that the defaulted principal amount outstanding of such school bears to the matured loans of such school.
(3) Definitions
For purposes of this subsection:
(A) The term "default" means the failure of a borrower of a loan made under this subpart to—
(i) make an installment payment when due; or
(ii) comply with any other term of the promissory note for such loan,
except that a loan made under this subpart shall not be considered to be in default if the loan is discharged in bankruptcy or if the school reasonably concludes from written contracts with the borrower that the borrower intends to repay the loan.
(B) The term "defaulted principal amount outstanding" means the total amount borrowed from the loan fund of a school that has reached the repayment stage (minus any principal amount repaid or canceled) on loans—
(i) repayable monthly and in default for at least 120 days; and
(ii) repayable less frequently than monthly and in default for at least 180 days;
(C) The term "grace period" means the period of one year beginning on the date on which the borrower ceases to pursue a full-time course of study at a school of medicine, osteopathic medicine, dentistry, pharmacy, podiatric medicine, optometry, or veterinary medicine; and
(D) The term "matured loans" means the total principal amount of all loans made by a school under this subpart minus the total principal amount of loans made by such school to students who are—
(i) enrolled in a full-time course of study at such school; or
(ii) in their grace period.
(July 1, 1944, ch. 373, title VII, §721, as added
Prior Provisions
A prior section 721 of act July 1, 1944, was classified to
§292r. Loan provisions
(a) Amount of loan
(1) In general
Loans from a student loan fund (established under an agreement with a school under
(2) Third and fourth years of medical school
For purposes of paragraph (1), the amount of the loan may, in the case of the third or fourth year of a student at a school of medicine or osteopathic medicine, be increased to the extent necessary to pay the balances of loans that, from sources other than the student loan fund under
(b) Terms and conditions
Subject to
(1) who is in need of the amount thereof to pursue a full-time course of study at the school leading to a degree of doctor of medicine, doctor of dentistry or an equivalent degree, doctor of osteopathy, bachelor of science in pharmacy or an equivalent degree, doctor of pharmacy or an equivalent degree, doctor of podiatric medicine or an equivalent degree, doctor of optometry or an equivalent degree, or doctor of veterinary medicine or an equivalent degree; and
(2) who, if required under
(c) Repayment; exclusions from repayment period
Such loans shall be repayable in equal or graduated periodic installments (with the right of the borrower to accelerate repayment) over the period of not less than 10 years nor more than 25 years, at the discretion of the institution, which begins one year after the student ceases to pursue a full-time course of study at a school of medicine, osteopathic medicine, dentistry, pharmacy, podiatry, optometry, or veterinary medicine, excluding from such period—
(1) all periods—
(A) not in excess of three years of active duty performed by the borrower as a member of a uniformed service;
(B) not in excess of three years during which the borrower serves as a volunteer under the Peace Corps Act [
(C) during which the borrower participates in advanced professional training, including internships and residencies; and
(D) during which the borrower is pursuing a full-time course of study at such a school; and
(2) a period—
(A) not in excess of two years during which a borrower who is a full-time student in such a school leaves the school, with the intent to return to such school as a full-time student, in order to engage in a full-time educational activity which is directly related to the health profession for which the borrower is preparing, as determined by the Secretary; or
(B) not in excess of two years during which a borrower who is a graduate of such a school is a participant in a fellowship training program or a full-time educational activity which—
(i) is directly related to the health profession for which such borrower prepared at such school, as determined by the Secretary; and
(ii) may be engaged in by the borrower during such a two-year period which begins within twelve months after the completion of the borrower's participation in advanced professional training described in paragraph (1)(C) or prior to the completion of such borrower's participation in such training.
(d) Cancellation of liability
The liability to repay the unpaid balance of such a loan and accrued interest thereon shall be canceled upon the death of the borrower, or if the Secretary determines that he has become permanently, and totally disabled.
(e) Rate of interest
Such loans shall bear interest, on the unpaid balance of the loan, computed only for periods for which the loan is repayable, at the rate of 5 percent per year.
(f) Security or endorsement
Loans shall be made under this subpart without security or endorsement, except that if the borrower is a minor and the note or other evidence of obligation executed by him would not, under the applicable law, create a binding obligation, either security or endorsement may be required.
(g) Transferring and assigning loans
No note or other evidence of a loan made under this subpart may be transferred or assigned by the school making the loan except that, if the borrowers transfer to another school participating in the program under this subpart, such note or other evidence of a loan may be transferred to such other school.
(h) Charge with respect to insurance for certain cancellations
Subject to regulations of the Secretary, a school may assess a charge with respect to loans made this subpart 1 to cover the costs of insuring against cancellation of liability under subsection (d).
(i) Charge with respect to late payments
Subject to regulations of the Secretary, and in accordance with this section, a school shall assess a charge with respect to a loan made under this subpart for failure of the borrower to pay all or any part of an installment when it is due and, in the case of a borrower who is entitled to deferment of the loan under subsection (c), for any failure to file timely and satisfactory evidence of such entitlement. No such charge may be made if the payment of such installment or the filing of such evidence is made within 60 days after the date on which such installment or filing is due. The amount of any such charge may not exceed an amount equal to 6 percent of the amount of such installment. The school may elect to add the amount of any such charge to the principal amount of the loan as of the first day after the day on which such installment or evidence was due, or to make the amount of the charge payable to the school not later than the due date of the next installment after receipt by the borrower of notice of the assessment of the charge.
(j) Authority of schools regarding rate of payment
A school may provide, in accordance with regulations of the Secretary, that during the repayment period of a loan from a loan fund established pursuant to an agreement under this subpart payments of principal and interest by the borrower with respect to all the outstanding loans made to him from loan funds so established shall be at a rate equal to not less than $40 per month.
(k) Authority regarding repayments by Secretary
Upon application by a person who received, and is under an obligation to repay, any loan made to such person as a health professions student to enable him to study medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, or podiatry, the Secretary may undertake to repay (without liability to the applicant) all or any part of such loan, and any interest or portion thereof outstanding thereon, upon his determination, pursuant to regulations establishing criteria therefor, that the applicant—
(1) failed to complete such studies leading to his first professional degree;
(2) is in exceptionally needy circumstances;
(3) is from a low-income or disadvantaged family as those terms may be defined by such regulations; and
(4) has not resumed, or cannot reasonably be expected to resume, the study of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, or podiatric medicine, within two years following the date upon which he terminated such studies.
(l) Collection efforts by Secretary
The Secretary is authorized to attempt to collect any loan which was made under this subpart, which is in default, and which was referred to the Secretary by a school with which the Secretary has an agreement under this subpart, on behalf of that school under such terms and conditions as the Secretary may prescribe (including reimbursement from the school's student loan fund for expenses the Secretary may reasonably incur in attempting collection), but only if the school has complied with such requirements as the Secretary may specify by regulation with respect to the collection of loans under this subpart. A loan so referred shall be treated as a debt subject to
(m) Elimination of statute of limitation for loan collections
(1) Purpose
It is the purpose of this subsection to ensure that obligations to repay loans under this section are enforced without regard to any Federal or State statutory, regulatory, or administrative limitation on the period within which debts may be enforced.
(2) Prohibition
Notwithstanding any other provision of Federal or State law, no limitation shall terminate the period within which suit may be filed, a judgment may be enforced, or an offset, garnishment, or other action may be initiated or taken by a school that has an agreement with the Secretary pursuant to
(July 1, 1944, ch. 373, title VII, §722, as added
References in Text
The Peace Corps Act, referred to in subsec. (c)(1)(B), is
Prior Provisions
A prior section 722 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (a)(1).
"(A) the cost of tuition for such year at such school, and
"(B) $2,500."
Subsec. (a)(2).
Subsec. (c).
Subsec. (j).
Subsec. (m).
1993—Subsec. (a).
"(1) the cost of tuition for such year at such school, and
"(2) $2,500."
Subsec. (b)(2), (3).
Effective Date of 1998 Amendment
1 So in original. Probably should be "under this subpart".
§292s. Medical schools and primary health care
(a) Requirements for students
(1) In general
Subject to the provisions of this subsection, in the case of student loan funds established under
(A) to enter and complete a residency training program in primary health care not later than 4 years after the date on which the student graduates from such school; and
(B) to practice in such care for 10 years (including residency training in primary health care) or through the date on which the loan is repaid in full, whichever occurs first.
(2) Inapplicability to certain students
(A) The requirement established in paragraph (1) regarding the student loan fund of a school does not apply to a student if—
(i) the first loan to the student from such fund is made before July 1, 1993; or
(ii) the loan is made from—
(I) a Federal capital contribution under
(II) a school contribution made under
(B) A Federal capital contribution under
(3) Noncompliance by student
Each agreement entered into with a student pursuant to paragraph (1) shall provide that, if the student fails to comply with such agreement, the loan involved will begin to accrue interest at a rate of 2 percent per year greater than the rate at which the student would pay if compliant in such year.
(4) Waivers
(A) With respect to the obligation of an individual under an agreement made under paragraph (1) as a student, the Secretary shall provide for the partial or total waiver or suspension of the obligation whenever compliance by the individual is impossible, or would involve extreme hardship to the individual, and if enforcement of the obligation with respect to the individual would be unconscionable.
(B) For purposes of subparagraph (A), the obligation of an individual shall be waived if—
(i) the status of the individual as a student of the school involved is terminated before graduation from the school, whether voluntarily or involuntarily; and
(ii) the individual does not, after such termination, resume attendance at the school or begin attendance at any other school of medicine or osteopathic medicine.
(C) If an individual resumes or begins attendance for purposes of subparagraph (B), the obligation of the individual under the agreement under paragraph (1) shall be considered to have been suspended for the period in which the individual was not in attendance.
(D) This paragraph may not be construed as authorizing the waiver or suspension of the obligation of a student to repay, in accordance with
(b) Requirements for schools
(1) In general
Subject to the provisions of this subsection, in the case of student loan funds established under
(2) Description of conditions
With respect to graduates described in paragraph (1) (in this paragraph referred to as "designated graduates"), the conditions referred to in such paragraph for a school for a 1-year period are as follows:
(A) Not less than 50 percent of designated graduates of the school meet the criterion of either being in a residency training program in primary health care, or being engaged in a practice in such care (having completed such a program).
(B) Not less than 25 percent of the designated graduates of the school meet such criterion, and such percentage is not less than 5 percentage points above the percentage of such graduates meeting such criterion for the preceding 1-year period.
(C) In the case of schools of medicine or osteopathic medicine with student loans funds under
(3) Determinations by Secretary
Not later than 90 days after the close of each 1-year period described in paragraph (1), the Secretary shall make a determination of whether the school involved has for such period complied with such paragraph and shall in writing inform the school of the determination. Such determination shall be made only after consideration of the report submitted to the Secretary by the school under paragraph (6).
(4) Noncompliance by school
(A)(i) Subject to subparagraph (C), each agreement under
(I) will pay to the Secretary the amount applicable under subparagraph (B) for the period; and
(II) will pay such amount not later than 90 days after the school is informed under paragraph (3) of the determination of the Secretary regarding such period.
(ii) Any amount that a school is required to pay under clause (i) may be paid from the student loan fund of the school under
(B) For purposes of subparagraph (A), the amount applicable for a school, subject to subparagraph (C), is—
(i) for the 1-year period ending June 30, 1997, an amount equal to 10 percent of the income received during such period by the student loan fund of the school under
(ii) for the 1-year period ending June 30, 1998, an amount equal to 20 percent of the income received during such period by the student loan fund; and
(iii) for any subsequent 1-year period under paragraph (1), an amount equal to 30 percent of the income received during such period by the student loan fund.
(C) In determining the amount of income that a student loan fund has received for purposes of subparagraph (B), the Secretary shall exclude any income derived from exempt contributions. Payments made to the Secretary under subparagraph (A) may not be made with such contributions or with income derived from such contributions.
(5) Expenditure of payments
(A) Amounts paid to the Secretary under paragraph (4) shall be expended to make Federal capital contributions to student loan funds under
(B) A Federal capital contribution under
(6) Reports by schools
Each agreement under
(c) Definitions
For purposes of this section:
(1) The term "exempt contributions" means exempt Federal capital contributions and exempt school contributions.
(2) The term "exempt Federal capital contribution" means a Federal capital contribution described in subclause (I) of subsection (a)(2)(A)(ii).
(3) The term "exempt school contribution" means a school contribution described in subclause (II) of subsection (a)(2)(A)(ii).
(4) The term "income", with respect to a student fund under
(5) The term "primary health care" means family medicine, general internal medicine, general pediatrics, preventive medicine, or osteopathic general practice.
(d) Sense of Congress
It is the sense of Congress that funds repaid under the loan program under this section should not be transferred to the Treasury of the United States or otherwise used for any other purpose other than to carry out this section.
(July 1, 1944, ch. 373, title VII, §723, as added
References in Text
Prior Provisions
A prior section 723 of act July 1, 1944, was classified to
Amendments
2010—Subsec. (a)(1)(B).
Subsec. (a)(3).
Subsec. (d).
1998—Subsec. (a)(3).
"(A) the balance due on the loan involved will be immediately recomputed from the date of issuance at an interest rate of 12 percent per year, compounded annually; and
"(B) the recomputed balance will be paid not later than the expiration of the 3-year period beginning on the date on which the student fails to comply with the agreement."
Subsec. (b)(1).
Subsecs. (c), (d).
1993—Subsec. (a)(4).
Subsec. (b)(1).
Subsec. (b)(2)(B).
Subsec. (b)(4)(B).
Student Loan Guidelines
1 See References in Text note below.
2 So in original. The semicolon probably should be a comma.
§292t. Individuals from disadvantaged backgrounds
(a) Fund agreements regarding certain amounts
With respect to amounts appropriated under subsection (f), each agreement entered into under
(1) any Federal capital contribution made to the student loan fund of the school from such amounts, together with the school contribution appropriate under subsection (b)(2)(B) of such section to the amount of the Federal capital contribution, will be utilized only for the purpose of—
(A) making loans to individuals from disadvantaged backgrounds; and
(B) the costs of the collection of the loans and interest on the loans; and
(2) collections of principal and interest on loans made pursuant to paragraph (1), and any other earnings of the student loan fund attributable to amounts that are in the fund pursuant to such paragraph, will be utilized only for the purpose described in such paragraph.
(b) Minimum qualifications for schools
The Secretary may not make a Federal capital contribution for purposes of subsection (a) for a fiscal year unless the health professions school involved—
(1) is carrying out a program for recruiting and retaining students from disadvantaged backgrounds, including racial and ethnic minorities; and
(2) is carrying out a program for recruiting and retaining minority faculty.
(c) Certain agreements regarding education of students; date certain for compliance
The Secretary may not make a Federal capital contribution for purposes of subsection (a) for a fiscal year unless the health professions school involved agrees—
(1) to ensure that adequate instruction regarding minority health issues is provided for in the curricula of the school;
(2) with respect to health clinics providing services to a significant number of individuals who are from disadvantaged backgrounds, including members of minority groups, to enter into arrangements with 1 or more such clinics for the purpose of providing students of the school with experience in providing clinical services to such individuals;
(3) with respect to public or nonprofit private secondary educational institutions and undergraduate institutions of higher education, to enter into arrangements with 1 or more such institutions for the purpose of carrying out programs regarding the educational preparation of disadvantaged students, including minority students, to enter the health professions and regarding the recruitment of such individuals into the health professions;
(4) to establish a mentor program for assisting disadvantaged students, including minority students, regarding the completion of the educational requirements for degrees from the school;
(5) to be carrying out each of the activities specified in any of paragraphs (1) through (4) by not later than 1 year after the date on which the first Federal capital contribution is made to the school for purposes of subsection (a); and
(6) to continue carrying out such activities, and the activities specified in paragraphs (1) and (2) of subsection (b), throughout the period during which the student loan fund established pursuant to
(d) Availability of other amounts
With respect to Federal capital contributions to student loan funds under agreements under
(e) "Disadvantaged" defined
For purposes of this section, the term "disadvantaged", with respect to an individual, shall be defined by the Secretary.
(f) Authorization of appropriations
(1) Repealed. Pub. L. 105–392, title I, §132(b), Nov. 13, 1998, 112 Stat. 3575
(2) Special consideration for certain schools
In making Federal capital contributions to student loan funds for purposes of subsection (a), the Secretary shall give special consideration to health professions schools that have enrollments of underrepresented minorities above the national average for health professions schools.
(July 1, 1944, ch. 373, title VII, §724, as added
Prior Provisions
A prior section 724 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (f)(1).
Effective Date of 1998 Amendment
§292u. Administrative provisions
The Secretary may agree to modifications of agreements or loans made under this subpart, and may compromise, waive, or release any right, title, claim, or demand of the United States arising or acquired under this subpart.
(July 1, 1944, ch. 373, title VII, §725, as added
Prior Provisions
A prior section 725 of act July 1, 1944, was classified to
Health Professions Education Fund; Availability of Fund; Deposit in Fund of: Interest Payments or Repayments of Principal on Loans; Transfer of Excess Moneys to General Fund of the Treasury; Authorization of Appropriations for Payments Under Agreements
"(b) The health professions education fund created within the Treasury by section 744(d)(1) of the Public Health Service Act (as in effect before the date of enactment of this Act) [former
"(c) There are authorized to be appropriated without fiscal year limitation such sums as may be necessary to enable the Secretary to make payments under agreements entered into under section 744(b) [former
§292v. Provision by schools of information to students
(a) In general
With respect to loans made by a school under this subpart after June 30, 1986, each school, in order to carry out the provisions of
(1) the yearly and cumulative maximum amounts that may be borrowed by the student;
(2) the terms under which repayment of the loan will begin;
(3) the maximum number of years in which the loan must be repaid;
(4) the interest rate that will be paid by the borrower and the minimum amount of the required monthly payment;
(5) the amount of any other fees charged to the borrower by the lender;
(6) any options the borrower may have for deferral, cancellation, prepayment, consolidation, or other refinancing of the loan;
(7) a definition of default on the loan and a specification of the consequences which will result to the borrower if the borrower defaults, including a description of any arrangements which may be made with credit bureau organizations;
(8) to the extent practicable, the effect of accepting the loan on the eligibility of the borrower for other forms of student assistance; and
(9) a description of the actions that may be taken by the Federal Government to collect the loan, including a description of the type of information concerning the borrower that the Federal Government may disclose to (A) officers, employees, or agents of the Department of Health and Human Services, (B) officers, employees, or agents of schools with which the Secretary has an agreement under this subpart, or (C) any other person involved in the collection of a loan under this subpart.
(b) Statement regarding loan
Each school shall, immediately prior to the graduation from such school of a student who receives a loan under this subpart after June 30, 1986, provide such student with a statement specifying—
(1) each amount borrowed by the student under this subpart;
(2) the total amount borrowed by the student under this subpart; and
(3) a schedule for the repayment of the amounts borrowed under this subpart, including the number, amount, and frequency of payments to be made.
(July 1, 1944, ch. 373, title VII, §726, as added
Prior Provisions
A prior section 726 of act July 1, 1944, was classified to
Another prior section 726 of act July 1, 1944, was classified to
§292w. Procedures for appeal of termination of agreements
In any case in which the Secretary intends to terminate an agreement with a school under this subpart, the Secretary shall provide the school with a written notice specifying such intention and stating that the school may request a formal hearing with respect to such termination. If the school requests such a hearing within 30 days after the receipt of such notice, the Secretary shall provide such school with a hearing conducted by an administrative law judge.
(July 1, 1944, ch. 373, title VII, §727, as added
Prior Provisions
A prior section 727 of act July 1, 1944, was classified to
Another prior section 727 of act July 1, 1944, was classified to
§292x. Distribution of assets from loan funds
(a) Distribution after termination of fund
If a school terminates a loan fund established under an agreement pursuant to
(1) The Secretary shall first be paid an amount which bears the same ratio to such balance in such fund on the date of termination of the fund as the total amount of the Federal capital contributions to such fund by the Secretary pursuant to
(2) The remainder of such balance shall be paid to the school.
(b) Payment of proportionate share to Secretary
If a capital distribution is made under subsection (a), the school involved shall, after the capital distribution, pay to the Secretary, not less often than quarterly, the same proportionate share of amounts received by the school in payment of principal or interest on loans made from the loan fund established pursuant to
(July 1, 1944, ch. 373, title VII, §728, as added
Prior Provisions
A prior section 728 of act July 1, 1944, was classified to
Another prior section 728 of act July 1, 1944, was classified to
§292y. General provisions
(a) Date certain for applications
The Secretary shall from time to time set dates by which schools must file applications for Federal capital contributions.
(b) Contingent reduction in allotments
If the total of the amounts requested for any fiscal year in such applications exceeds the amounts appropriated under this section for that fiscal year, the allotment to the loan fund of each such school shall be reduced to whichever of the following is the smaller: (A) the amount requested in its application; or (B) an amount which bears the same ratio to the amounts appropriated as the number of students estimated by the Secretary to be enrolled in such school during such fiscal year bears to the estimated total number of students in all such schools during such year. Amounts remaining after allotment under the preceding sentence shall be reallotted in accordance with clause (B) of such sentence among schools whose applications requested more than the amounts so allotted to their loan funds, but with such adjustments as may be necessary to prevent the total allotted to any such school's loan fund from exceeding the total so requested by it.
(c) Allotment of excess funds
Funds available in any fiscal year for payment to schools under this subpart which are in excess of the amount appropriated pursuant to this section for that year shall be allotted among schools in such manner as the Secretary determines will best carry out the purposes of this subpart.
(d) Payment of installments to schools
Allotments to a loan fund of a school shall be paid to it from time to time in such installments as the Secretary determines will not result in unnecessary accumulations in the loan fund at such school.
(e) Disposition of funds returned to Secretary
(1) Expenditure for Federal capital contributions
Subject to
(2) Date certain for contributions
Amounts described in paragraph (1) that are returned to the Secretary shall be obligated before the end of the succeeding fiscal year.
(3) Preference in making contributions
In making Federal capital contributions to student loans funds under
(f) Funding for certain medical schools
(1) Authorization of appropriations
For the purpose of making Federal capital contributions to student loan funds established under
(2) Minimum requirements
(A) Subject to subparagraph (B), the Secretary may make a Federal capital contribution pursuant to paragraph (1) only if the school of medicine or osteopathic medicine involved meets the conditions described in subparagraph (A) of
(B) For purposes of subparagraph (A), the conditions referred to in such subparagraph shall be applied with respect to graduates of the school involved whose date of graduation occurred approximately 3 years before June 30 of the fiscal year preceding the fiscal year for which the Federal capital contribution involved is made.
(July 1, 1944, ch. 373, title VII, §735, as added
Prior Provisions
A prior section 735 of act July 1, 1944, was classified to
Amendments
1998—Subsec. (e)(2).
1993—Subsec. (f).
1992—Subsec. (b).
Effective Date of 1992 Amendment
Part B—Health Professions Training for Diversity
§293. Centers of excellence
(a) In general
The Secretary shall make grants to, and enter into contracts with, designated health professions schools described in subsection (c), and other public and nonprofit health or educational entities, for the purpose of assisting the schools in supporting programs of excellence in health professions education for under-represented minority individuals.
(b) Required use of funds
The Secretary may not make a grant under subsection (a) unless the designated health professions school involved agrees, subject to subsection (c)(1)(C), to expend the grant—
(1) to develop a large competitive applicant pool through linkages with institutions of higher education, local school districts, and other community-based entities and establish an education pipeline for health professions careers;
(2) to establish, strengthen, or expand programs to enhance the academic performance of under-represented minority students attending the school;
(3) to improve the capacity of such school to train, recruit, and retain under-represented minority faculty including the payment of such stipends and fellowships as the Secretary may determine appropriate;
(4) to carry out activities to improve the information resources, clinical education, curricula and cultural competence of the graduates of the school, as it relates to minority health issues;
(5) to facilitate faculty and student research on health issues particularly affecting under-represented minority groups, including research on issues relating to the delivery of health care;
(6) to carry out a program to train students of the school in providing health services to a significant number of under-represented minority individuals through training provided to such students at community-based health facilities that—
(A) provide such health services; and
(B) are located at a site remote from the main site of the teaching facilities of the school; and
(7) to provide stipends as the Secretary determines appropriate, in amounts as the Secretary determines appropriate.
(c) Centers of excellence
(1) Designated schools
(A) In general
The designated health professions schools referred to in subsection (a) are such schools that meet each of the conditions specified in subparagraphs (B) and (C), and that—
(i) meet each of the conditions specified in paragraph (2)(A);
(ii) meet each of the conditions specified in paragraph (3);
(iii) meet each of the conditions specified in paragraph (4); or
(iv) meet each of the conditions specified in paragraph (5).
(B) General conditions
The conditions specified in this subparagraph are that a designated health professions school—
(i) has a significant number of under-represented minority individuals enrolled in the school, including individuals accepted for enrollment in the school;
(ii) has been effective in assisting under-represented minority students of the school to complete the program of education and receive the degree involved;
(iii) has been effective in recruiting under-represented minority individuals to enroll in and graduate from the school, including providing scholarships and other financial assistance to such individuals and encouraging under-represented minority students from all levels of the educational pipeline to pursue health professions careers; and
(iv) has made significant recruitment efforts to increase the number of under-represented minority individuals serving in faculty or administrative positions at the school.
(C) Consortium
The condition specified in this subparagraph is that, in accordance with subsection (e)(1), the designated health profession school involved has with other health profession schools (designated or otherwise) formed a consortium to carry out the purposes described in subsection (b) at the schools of the consortium.
(D) Application of criteria to other programs
In the case of any criteria established by the Secretary for purposes of determining whether schools meet the conditions described in subparagraph (B), this section may not, with respect to racial and ethnic minorities, be construed to authorize, require, or prohibit the use of such criteria in any program other than the program established in this section.
(2) Centers of excellence at certain historically black colleges and universities
(A) Conditions
The conditions specified in this subparagraph are that a designated health professions school—
(i) is a school described in
(ii) received a contract under
(B) Use of grant
In addition to the purposes described in subsection (b), a grant under subsection (a) to a designated health professions school meeting the conditions described in subparagraph (A) may be expended—
(i) to develop a plan to achieve institutional improvements, including financial independence, to enable the school to support programs of excellence in health professions education for under-represented minority individuals; and
(ii) to provide improved access to the library and informational resources of the school.
(C) Exception
The requirements of paragraph (1)(C) shall not apply to a historically black college or university that receives funding under paragraphs 1 (2) or (5).
(3) Hispanic centers of excellence
The conditions specified in this paragraph are that—
(A) with respect to Hispanic individuals, each of clauses (i) through (iv) of paragraph (1)(B) applies to the designated health professions school involved;
(B) the school agrees, as a condition of receiving a grant under subsection (a), that the school will, in carrying out the duties described in subsection (b), give priority to carrying out the duties with respect to Hispanic individuals; and
(C) the school agrees, as a condition of receiving a grant under subsection (a), that—
(i) the school will establish an arrangement with 1 or more public or nonprofit community based Hispanic serving organizations, or public or nonprofit private institutions of higher education, including schools of nursing, whose enrollment of students has traditionally included a significant number of Hispanic individuals, the purposes of which will be to carry out a program—
(I) to identify Hispanic students who are interested in a career in the health profession involved; and
(II) to facilitate the educational preparation of such students to enter the health professions school; and
(ii) the school will make efforts to recruit Hispanic students, including students who have participated in the undergraduate or other matriculation program carried out under arrangements established by the school pursuant to clause (i)(II) and will assist Hispanic students regarding the completion of the educational requirements for a degree from the school.
(4) Native American centers of excellence
Subject to subsection (e), the conditions specified in this paragraph are that—
(A) with respect to Native Americans, each of clauses (i) through (iv) of paragraph (1)(B) applies to the designated health professions school involved;
(B) the school agrees, as a condition of receiving a grant under subsection (a), that the school will, in carrying out the duties described in subsection (b), give priority to carrying out the duties with respect to Native Americans; and
(C) the school agrees, as a condition of receiving a grant under subsection (a), that—
(i) the school will establish an arrangement with 1 or more public or nonprofit private institutions of higher education, including schools of nursing, whose enrollment of students has traditionally included a significant number of Native Americans, the purpose of which arrangement will be to carry out a program—
(I) to identify Native American students, from the institutions of higher education referred to in clause (i), who are interested in health professions careers; and
(II) to facilitate the educational preparation of such students to enter the designated health professions school; and
(ii) the designated health professions school will make efforts to recruit Native American students, including students who have participated in the undergraduate program carried out under arrangements established by the school pursuant to clause (i) and will assist Native American students regarding the completion of the educational requirements for a degree from the designated health professions school.
(5) Other centers of excellence
The conditions specified in this paragraph are—
(A) with respect to other centers of excellence, the conditions described in clauses (i) through (iv) of paragraph (1)(B); and
(B) that the health professions school involved has an enrollment of under-represented minorities above the national average for such enrollments of health professions schools.
(d) Designation as center of excellence
(1) In general
Any designated health professions school receiving a grant under subsection (a) and meeting the conditions described in paragraph (2) or (5) of subsection (c) shall, for purposes of this section, be designated by the Secretary as a Center of Excellence in Under-Represented Minority Health Professions Education.
(2) Hispanic centers of excellence
Any designated health professions school receiving a grant under subsection (a) and meeting the conditions described in subsection (c)(3) shall, for purposes of this section, be designated by the Secretary as a Hispanic Center of Excellence in Health Professions Education.
(3) Native American centers of excellence
Any designated health professions school receiving a grant under subsection (a) and meeting the conditions described in subsection (c)(4) shall, for purposes of this section, be designated by the Secretary as a Native American Center of Excellence in Health Professions Education. Any consortium receiving such a grant pursuant to subsection (e) shall, for purposes of this section, be so designated.
(e) Authority regarding Native American centers of excellence
With respect to meeting the conditions specified in subsection (c)(4), the Secretary may make a grant under subsection (a) to a designated health professions school that does not meet such conditions if—
(1) the school has formed a consortium in accordance with subsection (d)(1); and
(2) the schools of the consortium collectively meet such conditions, without regard to whether the schools individually meet such conditions.
(f) Duration of grant
The period during which payments are made under a grant under subsection (a) may not exceed 5 years. Such payments shall be subject to annual approval by the Secretary and to the availability of appropriations for the fiscal year involved to make the payments.
(g) Definitions
In this section:
(1) Designated health professions school
(A) In general
The term "health professions school" means, except as provided in subparagraph (B), a school of medicine, a school of osteopathic medicine, a school of dentistry, a school of pharmacy, or a graduate program in behavioral or mental health.
(B) Exception
The definition established in subparagraph (A) shall not apply to the use of the term "designated health professions school" for purposes of subsection (c)(2).
(2) Program of excellence
The term "program of excellence" means any program carried out by a designated health professions school with a grant made under subsection (a), if the program is for purposes for which the school involved is authorized in subsection (b) or (c) to expend the grant.
(3) Native Americans
The term "Native Americans" means American Indians, Alaskan Natives, Aleuts, and Native Hawaiians.
(h) Formula for allocations
(1) Allocations
Based on the amount appropriated under subsection (i) for a fiscal year, the following subparagraphs shall apply as appropriate:
(A) In general
If the amounts appropriated under subsection (i) for a fiscal year are $24,000,000 or less—
(i) the Secretary shall make available $12,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(2)(A); and
(ii) and 2 available after grants are made with funds under clause (i), the Secretary shall make available—
(I) 60 percent of such amount for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (3) or (4) of subsection (c) (including meeting the conditions under subsection (e)); and
(II) 40 percent of such amount for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(5).
(B) Funding in excess of $24,000,000
If amounts appropriated under subsection (i) for a fiscal year exceed $24,000,000 but are less than $30,000,000—
(i) 80 percent of such excess amounts shall be made available for grants under subsection (a) to health professions schools that meet the requirements described in paragraph (3) or (4) of subsection (c) (including meeting conditions pursuant to subsection (e)); and
(ii) 20 percent of such excess amount shall be made available for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(5).
(C) Funding in excess of $30,000,000
If amounts appropriated under subsection (i) for a fiscal year exceed $30,000,000 but are less than $40,000,000, the Secretary shall make available—
(i) not less than $12,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(2)(A);
(ii) not less than $12,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (3) or (4) of subsection (c) (including meeting conditions pursuant to subsection (e));
(iii) not less than $6,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(5); and
(iv) after grants are made with funds under clauses (i) through (iii), any remaining excess amount for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (2)(A), (3), (4), or (5) of subsection (c).
(D) Funding in excess of $40,000,000
If amounts appropriated under subsection (i) for a fiscal year are $40,000,000 or more, the Secretary shall make available—
(i) not less than $16,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(2)(A);
(ii) not less than $16,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (3) or (4) of subsection (c) (including meeting conditions pursuant to subsection (e));
(iii) not less than $8,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(5); and
(iv) after grants are made with funds under clauses (i) through (iii), any remaining funds for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (2)(A), (3), (4), or (5) of subsection (c).
(2) No limitation
Nothing in this subsection shall be construed as limiting the centers of excellence referred to in this section to the designated amount, or to preclude such entities from competing for grants under this section.
(3) Maintenance of effort
(A) In general
With respect to activities for which a grant made under this part are authorized to be expended, the Secretary may not make such a grant to a center of excellence for any fiscal year unless the center agrees to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the center for the fiscal year preceding the fiscal year for which the school receives such a grant.
(B) Use of Federal funds
With respect to any Federal amounts received by a center of excellence and available for carrying out activities for which a grant under this part is authorized to be expended, the center shall, before expending the grant, expend the Federal amounts obtained from sources other than the grant, unless given prior approval from the Secretary.
(i) Authorization of appropriations
To carry out this section, there is authorized to be appropriated $23,711,000 for each of fiscal years 2021 through 2025.
(July 1, 1944, ch. 373, title VII, §736, as added
References in Text
Prior Provisions
A prior section 293, act July 1, 1944, ch. 373, title VII, §736, as added
Another prior section 293, act July 1, 1944, ch. 373, title VII, §720, as added Sept. 24, 1963,
A prior section 736 of act July 1, 1944, was classified to
Amendments
2020—Subsec. (i).
"(1) $50,000,000 for each of the fiscal years 2010 through 2015; and
"(2) and such sums as are necessary for each subsequent fiscal year."
2010—Subsecs. (h), (i).
Savings Provision
1 So in original. Probably should be "paragraph".
2 So in original. The word "and" probably should not appear.
§293a. Scholarships for disadvantaged students
(a) In general
The Secretary may make a grant to an eligible entity (as defined in subsection (d)(1)) under this section for the awarding of scholarships by schools to any full-time student who is an eligible individual as defined in subsection (d). Such scholarships may be expended only for tuition expenses, other reasonable educational expenses, and reasonable living expenses incurred in the attendance of such school.
(b) Preference in providing scholarships
The Secretary may not make a grant to an entity under subsection (a) unless the health professions and nursing schools involved agree that, in providing scholarships pursuant to the grant, the schools will give preference to students for whom the costs of attending the schools would constitute a severe financial hardship and, notwithstanding other provisions of this section, to former recipients of scholarships under
(c) Amount of award
In awarding grants to eligible entities that are health professions and nursing schools, the Secretary shall give priority to eligible entities based on the proportion of graduating students going into primary care, the proportion of underrepresented minority students, and the proportion of graduates working in medically underserved communities.
(d) Definitions
In this section:
(1) Eligible entities
The term "eligible entities" means an entity that—
(A) is a school of medicine, osteopathic medicine, dentistry, nursing (as defined in
(B) is carrying out a program for recruiting and retaining students from disadvantaged backgrounds, including students who are members of racial and ethnic minority groups.
(2) Eligible individual
The term "eligible individual" means an individual who—
(A) is from a disadvantaged background;
(B) has a financial need for a scholarship; and
(C) is enrolled (or accepted for enrollment) at an eligible health professions or nursing school as a full-time student in a program leading to a degree in a health profession or nursing.
(July 1, 1944, ch. 373, title VII, §737, as added
Prior Provisions
A prior section 293a, act July 1, 1944, ch. 373, title VII, §737, as added
Another prior section 293a, act July 1, 1944, ch. 373, title VII, §721, as added Sept. 24, 1963,
A prior section 737 of act July 1, 1944, was classified to
§293b. Loan repayments and fellowships regarding faculty positions
(a) Loan repayments
(1) Establishment of program
The Secretary shall establish a program of entering into contracts with individuals described in paragraph (2) under which the individuals agree to serve as members of the faculties of schools described in paragraph (3) in consideration of the Federal Government agreeing to pay, for each year of such service, not more than $30,000 of the principal and interest of the educational loans of such individuals.
(2) Eligible individuals
The individuals referred to in paragraph (1) are individuals from disadvantaged backgrounds who—
(A) have a degree in medicine, osteopathic medicine, dentistry, nursing, or another health profession;
(B) are enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, nursing, or other health profession; or
(C) are enrolled as full-time students—
(i) in an accredited (as determined by the Secretary) school described in paragraph (3); and
(ii) in the final year of a course of a study or program, offered by such institution and approved by the Secretary, leading to a degree from such a school.
(3) Eligible health professions schools
The schools described in this paragraph are schools of medicine, nursing (as schools of nursing are defined in
(4) Requirements regarding faculty positions
The Secretary may not enter into a contract under paragraph (1) unless—
(A) the individual involved has entered into a contract with a school described in paragraph (3) to serve as a member of the faculty of the school for not less than 2 years; and
(B) the contract referred to in subparagraph (A) provides that—
(i) the school will, for each year for which the individual will serve as a member of the faculty under the contract with the school, make payments of the principal and interest due on the educational loans of the individual for such year in an amount equal to the amount of such payments made by the Secretary for the year;
(ii) the payments made by the school pursuant to clause (i) on behalf of the individual will be in addition to the pay that the individual would otherwise receive for serving as a member of such faculty; and
(iii) the school, in making a determination of the amount of compensation to be provided by the school to the individual for serving as a member of the faculty, will make the determination without regard to the amount of payments made (or to be made) to the individual by the Federal Government under paragraph (1).
(5) Applicability of certain provisions
The provisions of
(6) Waiver regarding school contributions
The Secretary may waive the requirement established in paragraph (4)(B) if the Secretary determines that the requirement will impose an undue financial hardship on the school involved.
(b) Fellowships
(1) In general
The Secretary may make grants to and enter into contracts with eligible entities to assist such entities in increasing the number of underrepresented minority individuals who are members of the faculty of such schools.
(2) Applications
To be eligible to receive a grant or contract under this subsection, an entity shall provide an assurance, in the application submitted by the entity, that—
(A) amounts received under such a grant or contract will be used to award a fellowship to an individual only if the individual meets the requirements of paragraphs (3) and (4); and
(B) each fellowship awarded pursuant to the grant or contract will include—
(i) a stipend in an amount not exceeding 50 percent of the regular salary of a similar faculty member for not to exceed 3 years of training; and
(ii) an allowance for other expenses, such as travel to professional meetings and costs related to specialized training.
(3) Eligibility
To be eligible to receive a grant or contract under paragraph (1), an applicant shall demonstrate to the Secretary that such applicant has or will have the ability to—
(A) identify, recruit and select underrepresented minority individuals who have the potential for teaching, administration, or conducting research at a health professions institution;
(B) provide such individuals with the skills necessary to enable them to secure a tenured faculty position at such institution, which may include training with respect to pedagogical skills, program administration, the design and conduct of research, grants writing, and the preparation of articles suitable for publication in peer reviewed journals;
(C) provide services designed to assist such individuals in their preparation for an academic career, including the provision of counselors; and
(D) provide health services to rural or medically underserved populations.
(4) Requirements
To be eligible to receive a grant or contract under paragraph (1) an applicant shall—
(A) provide an assurance that such applicant will make available (directly through cash donations) $1 for every $1 of Federal funds received under this section for the fellowship;
(B) provide an assurance that institutional support will be provided for the individual for the second and third years at a level that is equal to the total amount of institutional funds provided in the year in which the grant or contract was awarded;
(C) provide an assurance that the individual that will receive the fellowship will be a member of the faculty of the applicant school; and
(D) provide an assurance that the individual that will receive the fellowship will have, at a minimum, appropriate advanced preparation (such as a master's or doctoral degree) and special skills necessary to enable such individual to teach and practice.
(5) Definition
For purposes of this subsection, the term "underrepresented minority individuals" means individuals who are members of racial or ethnic minority groups that are underrepresented in the health professions including nursing.
(July 1, 1944, ch. 373, title VII, §738, as added
References in Text
Subpart III of part D of subchapter II, referred to in subsec. (a)(5), is classified to
Prior Provisions
A prior section 293b, act July 1, 1944, ch. 373, title VII, §738, as added
Another prior section 293b, act July 1, 1944, ch. 373, title VII, §722, as added Sept. 24, 1963,
A prior section 738 of act July 1, 1944, was classified to
Amendments
2010—Subsec. (a)(1).
Subsec. (a)(3).
§293c. Educational assistance in the health professions regarding individuals from disadvantaged backgrounds
(a) In general
(1) Authority for grants
For the purpose of assisting individuals from disadvantaged backgrounds, as determined in accordance with criteria prescribed by the Secretary, to undertake education to enter a health profession, the Secretary may make grants to and enter into contracts with schools of medicine, osteopathic medicine, public health, dentistry, veterinary medicine, optometry, pharmacy, allied health, chiropractic, and podiatric medicine, public and nonprofit private schools that offer graduate programs in behavioral and mental health, programs for the training of physician assistants, and other public or private nonprofit health or educational entities to assist in meeting the costs described in paragraph (2).
(2) Authorized expenditures
A grant or contract under paragraph (1) may be used by the entity to meet the cost of—
(A) identifying, recruiting, and selecting individuals from disadvantaged backgrounds, as so determined, for education and training in a health profession;
(B) facilitating the entry of such individuals into such a school;
(C) providing counseling, mentoring, or other services designed to assist such individuals to complete successfully their education at such a school;
(D) providing, for a period prior to the entry of such individuals into the regular course of education of such a school, preliminary education and health research training designed to assist them to complete successfully such regular course of education at such a school, or referring such individuals to institutions providing such preliminary education;
(E) publicizing existing sources of financial aid available to students in the education program of such a school or who are undertaking training necessary to qualify them to enroll in such a program;
(F) paying such scholarships as the Secretary may determine for such individuals for any period of health professions education at a health professions school;
(G) paying such stipends as the Secretary may approve for such individuals for any period of education in student-enhancement programs (other than regular courses), except that such a stipend may not be provided to an individual for more than 12 months, and such a stipend shall be in an amount determined appropriate by the Secretary (notwithstanding any other provision of law regarding the amount of stipends);
(H) carrying out programs under which such individuals gain experience regarding a career in a field of primary health care through working at facilities of public or private nonprofit community-based providers of primary health services; and
(I) conducting activities to develop a larger and more competitive applicant pool through partnerships with institutions of higher education, school districts, and other community-based entities.
(3) Definition
In this section, the term "regular course of education of such a school" as used in subparagraph (D) includes a graduate program in behavioral or mental health.
(b) Requirements for awards
In making awards to eligible entities under subsection (a)(1), the Secretary shall give preference to approved applications for programs that involve a comprehensive approach by several public or nonprofit private health or educational entities to establish, enhance and expand educational programs that will result in the development of a competitive applicant pool of individuals from disadvantaged backgrounds who desire to pursue health professions careers. In considering awards for such a comprehensive partnership approach, the following shall apply with respect to the entity involved:
(1) The entity shall have a demonstrated commitment to such approach through formal agreements that have common objectives with institutions of higher education, school districts, and other community-based entities.
(2) Such formal agreements shall reflect the coordination of educational activities and support services, increased linkages, and the consolidation of resources within a specific geographic area.
(3) The design of the educational activities involved shall provide for the establishment of a competitive health professions applicant pool of individuals from disadvantaged backgrounds by enhancing the total preparation (academic and social) of such individuals to pursue a health professions career.
(4) The programs or activities under the award shall focus on developing a culturally competent health care workforce that will serve the unserved and underserved populations within the geographic area.
(c) Equitable allocation of financial assistance
The Secretary, to the extent practicable, shall ensure that services and activities under subsection (a) are adequately allocated among the various racial and ethnic populations who are from disadvantaged backgrounds.
(d) Matching requirements
The Secretary may require that an entity that applies for a grant or contract under subsection (a), provide non-Federal matching funds, as appropriate, to ensure the institutional commitment of the entity to the projects funded under the grant or contract. As determined by the Secretary, such non-Federal matching funds may be provided directly or through donations from public or private entities and may be in cash or in-kind, fairly evaluated, including plant, equipment, or services.
(July 1, 1944, ch. 373, title VII, §739, as added
Prior Provisions
A prior section 293c, act July 1, 1944, ch. 373, title VII, §739, as added
Another prior section 293c, act July 1, 1944, ch. 373, title VII, §723, as added Sept. 24, 1963,
A prior section 739 of act July 1, 1944, was classified to
§293d. Authorization of appropriation
(a) Scholarships
There are authorized to be appropriated to carry out
(b) Loan repayments and fellowships
For the purpose of carrying out
(c) Educational assistance in health professions regarding individuals from disadvantaged backgrounds
For the purpose of grants and contracts under
(d) Report
Not later than September 30, 2025, and every five years thereafter, the Secretary shall prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report concerning the efforts of the Secretary to address the need for a representative mix of individuals from historically minority health professions schools, or from institutions or other entities that historically or by geographic location have a demonstrated record of training or educating underrepresented minorities, within various health professions disciplines, on peer review councils.
(July 1, 1944, ch. 373, title VII, §740, as added
Prior Provisions
A prior section 293d, act July 1, 1944, ch. 373, title VII, §740, as added
Another prior section 293d, act July 1, 1944, ch. 373, title VII, §724, formerly §727, as added Sept. 24, 1963,
Another prior section 293d, act July 1, 1944, ch. 373, title VII, §701, formerly §724, as added Sept. 24, 1963,
A prior section 740 of act July 1, 1944, was classified to
Amendments
2020—Subsec. (a).
Subsec. (b).
Subsec. (c).
Subsec. (d).
2010—Subsec. (a).
Subsec. (b).
Subsec. (c).
§293e. Grants for health professions education
(a) Cultural competency, prevention, and public health and individuals with disability grants
(1) In general
The Secretary, acting through the Administrator of the Health Resources and Services Administration, may make awards of grants, contracts, or cooperative agreements to public and nonprofit private entities (including tribal entities) for the development, evaluation, and dissemination of research, demonstration projects, and model curricula for cultural competency, prevention, public health proficiency, reducing health disparities, and aptitude for working with individuals with disabilities training for use in health professions schools and continuing education programs, and for other purposes determined as appropriate by the Secretary.
(2) Eligible entities
Unless specifically required otherwise in this subchapter, the Secretary shall accept applications for grants or contracts under this section from health professions schools, academic health centers, State or local governments, or other appropriate public or private nonprofit entities (or consortia of entities, including entities promoting multidisciplinary approaches) for funding and participation in health professions training activities. The Secretary may accept applications from for-profit private entities as determined appropriate by the Secretary.
(b) Collaboration
In carrying out subsection (a), the Secretary shall collaborate with health professional societies, licensing and accreditation entities, health professions schools, and experts in minority health and cultural competency, prevention, and public health and disability groups, community-based organizations, and other organizations as determined appropriate by the Secretary. The Secretary shall coordinate with curricula and research and demonstration projects developed under
(c) Dissemination
(1) In general
Model curricula developed under this section shall be disseminated through the Internet Clearinghouse under section 270 1 and such other means as determined appropriate by the Secretary.
(2) Evaluation
The Secretary shall evaluate the adoption and the implementation of cultural competency, prevention, and public health, and working with individuals with a disability training curricula, and the facilitate 2 inclusion of these competency measures in quality measurement systems as appropriate.
(d) Authorization of appropriations
There is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2010 through 2015.
(July 1, 1944, ch. 373, title VII, §741, as added
Prior Provisions
A prior section 293e, act July 1, 1944, ch. 373, title VII, §725, formerly §728, as added Sept. 24, 1963,
Another prior section 293e, act July 1, 1944, ch. 373, title VII, §702, formerly §725, as added Sept. 24, 1963,
A prior section 293f, act July 1, 1944, ch. 373, title VII, §726, formerly §729, as added Nov. 18, 1971,
Another prior section 293f, act July 1, 1944, ch. 373, title VII, §726, as added Sept. 24, 1963,
A prior section 293g, act July 1, 1944, ch. 373, title VII, §727, as added Sept. 24, 1963,
A prior section 293h, act July 1, 1944, ch. 373, title VII, §728, as added Sept. 24, 1963,
A prior section 293i, act July 1, 1944, ch. 373, title VII, §729, as added Nov. 18, 1971,
Amendments
2010—Subsec. (a).
Subsec. (a)(1).
Subsecs. (b) to (d).
National Conference on Health Professions Education and Health Disparities
"(a)
"(b)
"(c)
"(d)
"(e)
1 So in original. Act July 1, 1944, does not contain a section 270.
Part C—Training in Family Medicine, General Internal Medicine, General Pediatrics, Physician Assistants, General Dentistry, and Pediatric Dentistry
subpart 1—medical training generally
§293j. Repealed. Pub. L. 105–392, title I, §102(2), Nov. 13, 1998, 112 Stat. 3537
Section, act July 1, 1944, ch. 373, title VII, §746, as added
A prior section 746 of act July 1, 1944, was classified to
§293k. Primary care training and enhancement
(a) Support and development of primary care training programs
(1) In general
The Secretary may make grants to, or enter into contracts with, an accredited public or nonprofit private hospital, school of medicine or osteopathic medicine, academically affiliated physician assistant training program, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract—
(A) to plan, develop, operate, or participate in an accredited professional training program, including an accredited residency or internship program in the field of family medicine, general internal medicine, or general pediatrics for medical students, interns, residents, or practicing physicians as defined by the Secretary;
(B) to provide need-based financial assistance in the form of traineeships and fellowships to medical students, interns, residents, practicing physicians, or other medical personnel, who are participants in any such program, and who plan to specialize or work in the practice of the fields defined in subparagraph (A);
(C) to plan, develop, and operate a program for the training of physicians who plan to teach in family medicine, general internal medicine, or general pediatrics training programs;
(D) to plan, develop, and operate a program for the training of physicians teaching in community-based settings;
(E) to provide financial assistance in the form of traineeships and fellowships to physicians who are participants in any such programs and who plan to teach or conduct research in a family medicine, general internal medicine, or general pediatrics training program;
(F) to plan, develop, and operate a physician assistant education program, and for the training of individuals who will teach in programs to provide such training;
(G) to plan, develop, and operate a program that identifies or develops innovative models of providing care, and trains primary care physicians on such models and in new competencies, as recommended by the Advisory Committee on Training in Primary Care Medicine and Dentistry and the National Health Care Workforce Commission established in
(i) providing training to primary care physicians relevant to providing care through patient-centered medical homes (as defined by the Secretary for purposes of this section);
(ii) developing tools and curricula relevant to patient-centered medical homes; and
(iii) providing continuing education to primary care physicians relevant to patient-centered medical homes; and
(H) to plan, develop, and operate joint degree programs to provide interdisciplinary and interprofessional graduate training in public health and other health professions to provide training in environmental health, infectious disease control, disease prevention and health promotion, epidemiological studies and injury control.
(2) Duration of awards
The period during which payments are made to an entity from an award of a grant or contract under this subsection shall be 5 years.
(3) Priorities in making awards
In awarding grants or contracts under paragraph (1), the Secretary may give priority to qualified applicants that train residents in rural areas, including for Tribes or Tribal Organizations in such areas.
(b) Capacity building in primary care
(1) In general
The Secretary may make grants to or enter into contracts with accredited schools of medicine or osteopathic medicine to establish, maintain, or improve—
(A) academic units or programs that improve clinical teaching and research in fields defined in subsection (a)(1)(A); or
(B) programs that integrate academic administrative units in fields defined in subsection (a)(1)(A) to enhance interdisciplinary recruitment, training, and faculty development.
(2) Preference in making awards under this subsection
In making awards of grants and contracts under paragraph (1), the Secretary shall give preference to any qualified applicant for such an award that agrees to expend the award for the purpose of—
(A) establishing academic units or programs in fields defined in subsection (a)(1)(A); or
(B) substantially expanding such units or programs.
(3) Priorities in making awards
In awarding grants or contracts under paragraph (1), the Secretary shall give priority to qualified applicants that—
(A) proposes 1 a collaborative project between academic administrative units of primary care;
(B) proposes 1 innovative approaches to clinical teaching using models of primary care, such as the patient centered medical home, team management of chronic disease, and interprofessional integrated models of health care that incorporate transitions in health care settings and integration physical and mental health provision;
(C) have a record of training the greatest percentage of providers, or that have demonstrated significant improvements in the percentage of providers trained, who enter and remain in primary care practice;
(D) have a record of training individuals who are from underrepresented minority groups or from a rural or disadvantaged background;
(E) provide training in the care of vulnerable populations such as children, older adults, homeless individuals, victims of abuse or trauma, individuals with mental health or substance use disorders, individuals with HIV/AIDS, and individuals with disabilities;
(F) establish formal relationships and submit joint applications with federally qualified health centers, rural health clinics, area health education centers, or clinics located in underserved areas or that serve underserved populations;
(G) teach trainees the skills to provide interprofessional, integrated care through collaboration among health professionals;
(H) provide training in enhanced communication with patients, evidence-based practice, chronic disease management, preventive care, health information technology, or other competencies as recommended by the Advisory Committee on Training in Primary Care Medicine and Dentistry and the National Health Care Workforce Commission established in
(I) provide training in cultural competency and health literacy.
(4) Duration of awards
The period during which payments are made to an entity from an award of a grant or contract under this subsection shall be 5 years.
(c) Authorization of appropriations
(1) In general
For purposes of carrying out this section (other than subsection (b)(1)(B)), there are authorized to be appropriated $48,924,000 for each of fiscal years 2021 through 2025.
(2) Training programs
Fifteen percent of the amount appropriated pursuant to paragraph (1) in each such fiscal year shall be allocated to the physician assistant training programs described in subsection (a)(1)(F), which prepare students for practice in primary care.
(3) Integrating academic administrative units
For purposes of carrying out subsection (b)(1)(B), there are authorized to be appropriated $750,000 for each of fiscal years 2010 through 2014.
(July 1, 1944, ch. 373, title VII, §747, as added
Codification
Prior Provisions
A prior section 293k, act July 1, 1944, ch. 373, title VII, §747, as added
A prior section 747 of act July 1, 1944, was classified to
Another prior section 747 of act July 1, 1944, was classified to
Amendments
2020—Subsec. (a)(1)(G).
Subsec. (a)(3).
Subsec. (b)(3)(E).
Subsec. (c)(1).
1 So in original. Probably should be "propose".
§293k–1. Training opportunities for direct care workers
(a) In general
The Secretary shall award grants to eligible entities to enable such entities to provide new training opportunities for direct care workers who are employed in long-term care settings such as nursing homes (as defined in
(b) Eligibility
To be eligible to receive a grant under this section, an entity shall—
(1) be an institution of higher education (as defined in
(A) is accredited by a nationally recognized accrediting agency or association listed under
(B) has established a public-private educational partnership with a nursing home or skilled nursing facility, agency or entity providing home and community based services to individuals with disabilities, or other long-term care provider; and
(2) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(c) Use of funds
An eligible entity shall use amounts awarded under a grant under this section to provide assistance to eligible individuals to offset the cost of tuition and required fees for enrollment in academic programs provided by such entity.
(d) Eligible individual
(1) Eligibility
To be eligible for assistance under this section, an individual shall be enrolled in courses provided by a grantee under this subsection and maintain satisfactory academic progress in such courses.
(2) Condition of assistance
As a condition of receiving assistance under this section, an individual shall agree that, following completion of the assistance period, the individual will work in the field of geriatrics, disability services, long term services and supports, or chronic care management for a minimum of 2 years under guidelines set by the Secretary.
(e) Authorization of appropriations
There is authorized to be appropriated to carry out this section, $10,000,000 for the period of fiscal years 2011 through 2013.
(July 1, 1944, ch. 373, title VII, §747A, as added
§293k–2. Training in general, pediatric, and public health dentistry
(a) Support and development of dental training programs
(1) In general
The Secretary may make grants to, or enter into contracts with, a school of dentistry, public or nonprofit private hospital, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract—
(A) to plan, develop, and operate, or participate in, an approved professional training program in the field of general dentistry, pediatric dentistry, or public health dentistry for dental students, residents, practicing dentists, dental hygienists, or other approved primary care dental trainees, that emphasizes training for general, pediatric, or public health dentistry;
(B) to provide financial assistance to dental students, residents, practicing dentists, and dental hygiene students who are in need thereof, who are participants in any such program, and who plan to work in the practice of general, pediatric, public heath dentistry, or dental hygiene;
(C) to plan, develop, and operate a program for the training of oral health care providers who plan to teach in general, pediatric, public health dentistry, or dental hygiene;
(D) to provide financial assistance in the form of traineeships and fellowships to dentists who plan to teach or are teaching in general, pediatric, or public health dentistry;
(E) to meet the costs of projects to establish, maintain, or improve dental faculty development programs in primary care (which may be departments, divisions or other units);
(F) to meet the costs of projects to establish, maintain, or improve predoctoral and postdoctoral training in primary care programs;
(G) to create a loan repayment program for faculty in dental programs; and
(H) to provide technical assistance to pediatric training programs in developing and implementing instruction regarding the oral health status, dental care needs, and risk-based clinical disease management of all pediatric populations with an emphasis on underserved children.
(2) Faculty loan repayment
(A) In general
A grant or contract under subsection (a)(1)(G) may be awarded to a program of general, pediatric, or public health dentistry described in such subsection to plan, develop, and operate a loan repayment program under which—
(i) individuals agree to serve full-time as faculty members; and
(ii) the program of general, pediatric or public health dentistry agrees to pay the principal and interest on the outstanding student loans of the individuals.
(B) Manner of payments
With respect to the payments described in subparagraph (A)(ii), upon completion by an individual of each of the first, second, third, fourth, and fifth years of service, the program shall pay an amount equal to 10, 15, 20, 25, and 30 percent, respectively, of the individual's student loan balance as calculated based on principal and interest owed at the initiation of the agreement.
(b) Eligible entity
For purposes of this subsection, entities eligible for such grants or contracts in general, pediatric, or public health dentistry shall include entities that have programs in dental or dental hygiene schools, or approved residency or advanced education programs in the practice of general, pediatric, or public health dentistry. Eligible entities may partner with schools of public health to permit the education of dental students, residents, and dental hygiene students for a master's year in public health at a school of public health.
(c) Priorities in making awards
With respect to training provided for under this section, the Secretary shall give priority in awarding grants or contracts to the following:
(1) Qualified applicants that propose collaborative projects between departments of primary care medicine and departments of general, pediatric, or public health dentistry.
(2) Qualified applicants that have a record of training the greatest percentage of providers, or that have demonstrated significant improvements in the percentage of providers, who enter and remain in general, pediatric, or public health dentistry.
(3) Qualified applicants that have a record of training individuals who are from a rural or disadvantaged background, or from underrepresented minorities.
(4) Qualified applicants that establish formal relationships with Federally qualified health centers, rural health centers, or accredited teaching facilities and that conduct training of students, residents, fellows, or faculty at the center or facility.
(5) Qualified applicants that conduct teaching programs targeting vulnerable populations such as older adults, homeless individuals, victims of abuse or trauma, individuals with mental health or substance use disorders, individuals with disabilities, and individuals with HIV/AIDS, and in the risk-based clinical disease management of all populations.
(6) Qualified applicants that include educational activities in cultural competency and health literacy.
(7) Qualified applicants that have a high rate for placing graduates in practice settings that serve underserved areas or health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
(8) Qualified applicants that intend to establish a special populations oral health care education center or training program for the didactic and clinical education of dentists, dental health professionals, and dental hygienists who plan to teach oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
(d) Application
An eligible entity desiring a grant under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(e) Duration of award
The period during which payments are made to an entity from an award of a grant or contract under subsection (a) shall be 5 years. The provision of such payments shall be subject to annual approval by the Secretary and subject to the availability of appropriations for the fiscal year involved to make the payments.
(f) Authorizations of appropriations
For the purpose of carrying out subsections (a) and (b), there is authorized to be appropriated $28,531,000 for each of fiscal years 2021 through 2025.
(g) Carryover funds
An entity that receives an award under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case may any funds be carried over pursuant to the preceding sentence for more than 3 years.
(July 1, 1944, ch. 373, title VII, §748, as added
Prior Provisions
A prior section 748 of act July 1, 1944, was renumbered section 749 and is classified to
Another prior section 748 of act July 1, 1944, was classified to
Another prior section 748 of act July 1, 1944, was classified to
Amendments
2020—Subsec. (c)(5).
Subsec. (f).
§293l. Advisory Committee on Training in Primary Care Medicine and Dentistry
(a) Establishment
The Secretary shall establish an advisory committee to be known as the Advisory Committee on Training in Primary Care Medicine and Dentistry (in this section referred to as the "Advisory Committee").
(b) Composition
(1) In general
The Secretary shall determine the appropriate number of individuals to serve on the Advisory Committee. Such individuals shall not be officers or employees of the Federal Government.
(2) Appointment
Not later than 90 days after November 13, 1998, the Secretary shall appoint the members of the Advisory Committee from among individuals who are health professionals. In making such appointments, the Secretary shall ensure a fair balance between the health professions, that at least 75 percent of the members of the Advisory Committee are health professionals, a broad geographic representation of members and a balance between urban and rural members. Members shall be appointed based on their competence, interest, and knowledge of the mission of the profession involved.
(3) Minority representation
In appointing the members of the Advisory Committee under paragraph (2), the Secretary shall ensure the adequate representation of women and minorities.
(c) Terms
(1) In general
A member of the Advisory Committee shall be appointed for a term of 3 years, except that of the members first appointed—
(A) 1/3 of such members shall serve for a term of 1 year;
(B) 1/3 of such members shall serve for a term of 2 years; and
(C) 1/3 of such members shall serve for a term of 3 years.
(2) Vacancies
(A) In general
A vacancy on the Advisory Committee shall be filled in the manner in which the original appointment was made and shall be subject to any conditions which applied with respect to the original appointment.
(B) Filling unexpired term
An individual chosen to fill a vacancy shall be appointed for the unexpired term of the member replaced.
(d) Duties
The Advisory Committee shall—
(1) provide advice and recommendations to the Secretary concerning policy and program development and other matters of significance concerning the activities under
(2) not later than 3 years after November 13, 1998, and annually thereafter, prepare and submit to the Secretary, and the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report describing the activities of the Committee, including findings and recommendations made by the Committee concerning the activities under
(3) develop, publish, and implement performance measures for programs under this part;
(4) develop and publish guidelines for longitudinal evaluations (as described in
(5) recommend appropriation levels for programs under this part.
(e) Meetings and documents
(1) Meetings
The Advisory Committee shall meet not less than 2 times each year. Such meetings shall be held jointly with other related entities established under this subchapter where appropriate.
(2) Documents
Not later than 14 days prior to the convening of a meeting under paragraph (1), the Advisory Committee shall prepare and make available an agenda of the matters to be considered by the Advisory Committee at such meeting. At any such meeting, the Advisory Council 1 shall distribute materials with respect to the issues to be addressed at the meeting. Not later than 30 days after the adjourning of such a meeting, the Advisory Committee shall prepare and make available a summary of the meeting and any actions taken by the Committee based upon the meeting.
(f) Compensation and expenses
(1) Compensation
Each member of the Advisory Committee shall be compensated at a rate equal to the daily equivalent of the annual rate of basic pay prescribed for level IV of the Executive Schedule under
(2) Expenses
The members of the Advisory Committee shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of
(g) FACA
The Federal Advisory Committee Act shall apply to the Advisory Committee under this section only to the extent that the provisions of such Act do not conflict with the requirements of this section.
(July 1, 1944, ch. 373, title VII, §749, formerly §748, as added
References in Text
The Federal Advisory Committee Act, referred to in subsec. (g), is
Codification
November 13, 1998, referred to in subsec. (b)(2), was in the original "the date of enactment of this Act", which was translated as meaning the date of enactment of
Prior Provisions
A prior section 293l, act July 1, 1944, ch. 373, title VII, §748, as added
A prior section 749 of act July 1, 1944, was classified to
Another prior section 749 of act July 1, 1944, was classified to
Amendments
2020—Subsec. (d)(2).
2010—Subsec. (d)(3) to (5).
Termination of Advisory Committees
1 So in original. Probably should be "Committee".
§293l–1. Teaching health centers development grants
(a) Program authorized
The Secretary may award grants under this section to teaching health centers for the purpose of establishing new accredited or expanded primary care residency programs.
(b) Amount and duration
Grants awarded under this section shall be for a term of not more than 3 years and the maximum award may not be more than $500,000.
(c) Use of funds
Amounts provided under a grant under this section shall be used to cover the costs of—
(1) establishing or expanding a primary care residency training program described in subsection (a), including costs associated with—
(A) curriculum development;
(B) recruitment, training and retention of residents and faculty: 1
(C) accreditation by the Accreditation Council for Graduate Medical Education (ACGME), the American Dental Association (ADA), or the American Osteopathic Association (AOA); and
(D) faculty salaries during the development phase; and
(2) technical assistance provided by an eligible entity.
(d) Application
A teaching health center seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.
(e) Preference for certain applications
In selecting recipients for grants under this section, the Secretary shall give preference to any such application that documents an existing affiliation agreement with an area health education center program as defined in
(f) Definitions
In this section:
(1) Eligible entity
The term "eligible entity" means an organization capable of providing technical assistance including an area health education center program as defined in
(2) Primary care residency program
The term "primary care residency program" means an approved graduate medical residency training program (as defined in
(3) Teaching health center
(A) In general
The term "teaching health center" means an entity that—
(i) is a community based, ambulatory patient care center; and
(ii) operates a primary care residency program.
(B) Inclusion of certain entities
Such term includes the following:
(i) A Federally qualified health center (as defined in
(ii) A community mental health center (as defined in
(iii) A rural health clinic, as defined in
(iv) A health center operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization (as defined in
(v) An entity receiving funds under subchapter VIII.
(g) Authorization of appropriations
There is authorized to be appropriated, $25,000,000 for fiscal year 2010, $50,000,000 for fiscal year 2011, $50,000,000 for fiscal year 2012, and such sums as may be necessary for each fiscal year thereafter to carry out this section. Not to exceed $5,000,000 annually may be used for technical assistance program grants.
(July 1, 1944, ch. 373, title VII, §749A, as added
1 So in original. The colon probably should be a semicolon.
subpart 2—training in underserved communities
§293m. Rural physician training grants
(a) In general
The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a grant program for the purposes of assisting eligible entities in recruiting students most likely to practice medicine in underserved rural communities, providing rural-focused training and experience, and increasing the number of recent allopathic and osteopathic medical school graduates who practice in underserved rural communities.
(b) Eligible entities
In order to be eligible to receive a grant under this section, an entity shall—
(1) be a school of allopathic or osteopathic medicine accredited by a nationally recognized accrediting agency or association approved by the Secretary for this purpose, or any combination or consortium of such schools; and
(2) submit an application to the Secretary that includes a certification that such entity will use amounts provided to the institution as described in subsection (d)(1).
(c) Priority
In awarding grant funds under this section, the Secretary shall give priority to eligible entities that—
(1) demonstrate a record of successfully training students, as determined by the Secretary, who practice medicine in underserved rural communities;
(2) demonstrate that an existing academic program of the eligible entity produces a high percentage, as determined by the Secretary, of graduates from such program who practice medicine in underserved rural communities;
(3) demonstrate rural community institutional partnerships, through such mechanisms as matching or contributory funding, documented in-kind services for implementation, or existence of training partners with interprofessional expertise in community health center training locations or other similar facilities; or
(4) submit, as part of the application of the entity under subsection (b), a plan for the long-term tracking of where the graduates of such entity practice medicine.
(d) Use of funds
(1) Establishment
An eligible entity receiving a grant under this section shall use the funds made available under such grant to establish, improve, or expand a rural-focused training program (referred to in this section as the "Program") meeting the requirements described in this subsection and to carry out such program.
(2) Structure of Program
An eligible entity shall—
(A) enroll no fewer than 10 students per class year into the Program; and
(B) develop criteria for admission to the Program that gives priority to students—
(i) who have originated from or lived for a period of 2 or more years in an underserved rural community; and
(ii) who express a commitment to practice medicine in an underserved rural community.
(3) Curricula
The Program shall require students to enroll in didactic coursework and clinical experience particularly applicable to medical practice in underserved rural communities, including—
(A) clinical rotations in underserved rural communities, and in applicable specialties, or other coursework or clinical experience deemed appropriate by the Secretary; and
(B) in addition to core school curricula, additional coursework or training experiences focused on medical issues prevalent in underserved rural communities.
(4) Residency placement assistance
Where available, the Program shall assist all students of the Program in obtaining clinical training experiences in locations with postgraduate programs offering residency training opportunities in underserved rural communities, or in local residency training programs that support and train physicians to practice in underserved rural communities.
(5) Program student cohort support
The Program shall provide and require all students of the Program to participate in group activities designed to further develop, maintain, and reinforce the original commitment of such students to practice in an underserved rural community.
(e) Annual reporting
An eligible entity receiving a grant under this section shall submit an annual report to the Secretary on the success of the Program, based on criteria the Secretary determines appropriate, including the residency program selection of graduating students who participated in the Program.
(f) Regulations
Not later than 60 days after March 23, 2010, the Secretary shall by regulation define "underserved rural community" for purposes of this section.
(g) Supplement not supplant
Any eligible entity receiving funds under this section shall use such funds to supplement, not supplant, any other Federal, State, and local funds that would otherwise be expended by such entity to carry out the activities described in this section.
(h) Maintenance of effort
With respect to activities for which funds awarded under this section are to be expended, the entity shall agree to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives a grant under this section.
(i) Authorization of appropriations
There are authorized to be appropriated $4,000,000 for each of the fiscal years 2010 through 2013.
(July 1, 1944, ch. 373, title VII, §749B, as added
Prior Provisions
A prior section 293m, act July 1, 1944, ch. 373, title VII, §749, as added
§§293n to 293p. Repealed. Pub. L. 105–392, title I, §102(4), Nov. 13, 1998, 112 Stat. 3539
Section 293n, act July 1, 1944, ch. 373, title VII, §750, as added
Section 293o, act July 1, 1944, ch. 373, title VII, §751, as added
Section 293p, act July 1, 1944, ch. 373, title VII, §752, as added
Part D—Interdisciplinary, Community-Based Linkages
§294. General provisions
(a) Collaboration
To be eligible to receive assistance under this part, an academic institution shall use such assistance in collaboration with 2 or more disciplines.
(b) Activities
An entity shall use assistance under this part to carry out innovative demonstration projects for strategic workforce supplementation activities as needed to meet national goals for interdisciplinary, community-based linkages. Such assistance may be used consistent with this part—
(1) to develop and support training programs;
(2) for faculty development;
(3) for model demonstration programs;
(4) for the provision of stipends for fellowship trainees;
(5) to provide technical assistance; and
(6) for other activities that will produce outcomes consistent with the purposes of this part.
(July 1, 1944, ch. 373, title VII, §750, as added
Prior Provisions
A prior section 294, act July 1, 1944, ch. 373, title VII, §761, as added
Another prior section 294, act July 1, 1944, ch. 373, title VII, §727, as added Oct. 12, 1976,
Another prior section 294, act July 1, 1944, ch. 373, title VII, §740, as added Sept. 24, 1963,
A prior section 750 of act July 1, 1944, was classified to
§294a. Area health education centers
(a) Establishment of awards
The Secretary shall make the following 2 types of awards in accordance with this section:
(1) Infrastructure development award
The Secretary shall make awards to eligible entities to enable such entities to initiate health care workforce educational programs or to continue to carry out comparable programs that are operating at the time the award is made by planning, developing, operating, and evaluating an area health education center program.
(2) Point of service maintenance and enhancement award
The Secretary shall make awards to eligible entities to maintain and improve the effectiveness and capabilities of an existing area health education center program, and make other modifications to the program that are appropriate due to changes in demographics, needs of the populations served, or other similar issues affecting the area health education center program. For the purposes of this section, the term "Program" refers to the area health education center program.
(b) Eligible entities; application
(1) Eligible entities
(A) Infrastructure development
For purposes of subsection (a)(1), the term "eligible entity" means a school of medicine or osteopathic medicine, an incorporated consortium of such schools, or the parent institutions of such a school. With respect to a State in which no area health education center program is in operation, the Secretary may award a grant or contract under subsection (a)(1) to a school of nursing.
(B) Point of service maintenance and enhancement
For purposes of subsection (a)(2), the term "eligible entity" means an entity that has received funds under this section, is operating an area health education center program, including an area health education center or centers, and has a center or centers that are no longer eligible to receive financial assistance under subsection (a)(1).
(2) Application
An eligible entity desiring to receive an award under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(c) Use of funds
(1) Required activities
An eligible entity shall use amounts awarded under a grant under subsection (a)(1) or (a)(2) to carry out the following activities:
(A) Develop and implement strategies, in coordination with the applicable one-stop delivery system under
(B) Develop and implement strategies to foster and provide community-based training and education to individuals seeking careers in health professions within underserved areas for the purpose of developing and maintaining a diverse health care workforce that is prepared to deliver high-quality care, with an emphasis on primary care, in underserved areas or for health disparity populations, in collaboration with other Federal and State health care workforce development programs, the State workforce agency, and local workforce investment boards, and in health care safety net sites.
(C) Prepare individuals to more effectively provide health services to underserved areas and health disparity populations through field placements or preceptorships in conjunction with community-based organizations, accredited primary care residency training programs, Federally qualified health centers, rural health clinics, public health departments, or other appropriate facilities.
(D) Conduct and participate in interdisciplinary training that involves physicians, physician assistants, nurse practitioners, nurse midwives, dentists, psychologists, pharmacists, optometrists, community health workers, public and allied health professionals, or other health professionals, as practicable.
(E) Deliver or facilitate continuing education and information dissemination programs for health care professionals, with an emphasis on individuals providing care in underserved areas and for health disparity populations.
(F) Propose and implement effective program and outcomes measurement and evaluation strategies.
(G) Establish a youth public health program to expose and recruit high school students into health careers, with a focus on careers in public health.
(2) Innovative opportunities
An eligible entity may use amounts awarded under a grant under subsection (a)(1) or subsection (a)(2) to carry out any of the following activities:
(A) Develop and implement innovative curricula in collaboration with community-based accredited primary care residency training programs, Federally qualified health centers, rural health clinics, behavioral and mental health facilities, public health departments, or other appropriate facilities, with the goal of increasing the number of primary care physicians and other primary care providers prepared to serve in underserved areas and health disparity populations.
(B) Coordinate community-based participatory research with academic health centers, and facilitate rapid flow and dissemination of evidence-based health care information, research results, and best practices to improve quality, efficiency, and effectiveness of health care and health care systems within community settings.
(C) Develop and implement other strategies to address identified workforce needs and increase and enhance the health care workforce in the area served by the area health education center program.
(d) Requirements
(1) Area health education center program
In carrying out this section, the Secretary shall ensure the following:
(A) An entity that receives an award under this section shall conduct at least 10 percent of clinical education required for medical students in community settings that are removed from the primary teaching facility of the contracting institution for grantees that operate a school of medicine or osteopathic medicine. In States in which an entity that receives an award under this section is a nursing school or its parent institution, the Secretary shall alternatively ensure that—
(i) the nursing school conducts at least 10 percent of clinical education required for nursing students in community settings that are remote from the primary teaching facility of the school; and
(ii) the entity receiving the award maintains a written agreement with a school of medicine or osteopathic medicine to place students from that school in training sites in the area health education center program area.
(B) An entity receiving funds under subsection (a)(2) does not distribute such funding to a center that is eligible to receive funding under subsection (a)(1).
(2) Area health education center
The Secretary shall ensure that each area health education center program includes at least 1 area health education center, and that each such center—
(A) is a public or private organization whose structure, governance, and operation is independent from the awardee and the parent institution of the awardee;
(B) is not a school of medicine or osteopathic medicine, the parent institution of such a school, or a branch campus or other subunit of a school of medicine or osteopathic medicine or its parent institution, or a consortium of such entities;
(C) designates an underserved area or population to be served by the center which is in a location removed from the main location of the teaching facilities of the schools participating in the program with such center and does not duplicate, in whole or in part, the geographic area or population served by any other center;
(D) fosters networking and collaboration among communities and between academic health centers and community-based centers;
(E) serves communities with a demonstrated need of health professionals in partnership with academic medical centers;
(F) addresses the health care workforce needs of the communities served in coordination with the public workforce investment system; and
(G) has a community-based governing or advisory board that reflects the diversity of the communities involved.
(e) Matching funds
With respect to the costs of operating a program through a grant under this section, to be eligible for financial assistance under this section, an entity shall make available (directly or through contributions from State, county or municipal governments, or the private sector) recurring non-Federal contributions in cash or in kind, toward such costs in an amount that is equal to not less than 50 percent of such costs. At least 25 percent of the total required non-Federal contributions shall be in cash. An entity may apply to the Secretary for a waiver of not more than 75 percent of the matching fund amount required by the entity for each of the first 3 years the entity is funded through a grant under subsection (a)(1).
(f) Limitation
Not less than 75 percent of the total amount provided to an area health education center program under subsection (a)(1) or (a)(2) shall be allocated to the area health education centers participating in the program under this section. To provide needed flexibility to newly funded area health education center programs, the Secretary may waive the requirement in the sentence for the first 2 years of a new area health education center program funded under subsection (a)(1).
(g) Award
An award to an entity under this section shall be not less than $250,000 annually per area health education center included in the program involved. If amounts appropriated to carry out this section are not sufficient to comply with the preceding sentence, the Secretary may reduce the per center amount provided for in such sentence as necessary, provided the distribution established in subsection (j)(2) is maintained.
(h) Project terms
(1) In general
Except as provided in paragraph (2), the period during which payments may be made under an award under subsection (a)(1) may not exceed—
(A) in the case of a program, 12 years; or
(B) in the case of a center within a program, 6 years.
(2) Exception
The periods described in paragraph (1) shall not apply to programs receiving point of service maintenance and enhancement awards under subsection (a)(2) to maintain existing centers and activities.
(i) Inapplicability of provision
Notwithstanding any other provision of this subchapter,
(j) Authorization of appropriations
(1) In general
There is authorized to be appropriated to carry out this section $41,250,000 for each of fiscal years 2021 through 2025.
(2) Requirements
Of the amounts appropriated for a fiscal year under paragraph (1)—
(A) not more than 35 percent shall be used for awards under subsection (a)(1);
(B) not less than 60 percent shall be used for awards under subsection (a)(2);
(C) not more than 1 percent shall be used for grants and contracts to implement outcomes evaluation for the area health education centers; and
(D) not more than 4 percent shall be used for grants and contracts to provide technical assistance to entities receiving awards under this section.
(3) Carryover funds
An entity that receives an award under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case may any funds be carried over pursuant to the preceding sentence for more than 3 years.
(k) Sense of Congress
It is the sense of the Congress that every State have an area health education center program in effect under this section.
(July 1, 1944, ch. 373, title VII, §751, as added
Prior Provisions
A prior section 294a, act July 1, 1944, ch. 373, title VII, §762, as added
Another prior section 294a, act July 1, 1944, ch. 373, title VII, §728, as added Oct. 12, 1976,
Another prior section 294a, act July 1, 1944, ch. 373, title VII, §741, as added Sept. 24, 1963,
A prior section 751 of act July 1, 1944, was classified to
Another prior section 751 of act July 1, 1944, was classified to
Another prior section 751 of act July 1, 1944, was classified to
Amendments
2020—Subsec. (j)(1).
2014—Subsec. (c)(1)(A).
2010—
Effective Date of 2014 Amendment
Amendment by
Waiver of Requirements
Similar provisions were contained in the following prior appropriation acts:
§294b. Continuing educational support for health professionals serving in underserved communities
(a) In general
The Secretary shall make grants to, and enter into contracts with, eligible entities to improve health care, increase retention, increase representation of minority faculty members, enhance the practice environment, and provide information dissemination and educational support to reduce professional isolation through the timely dissemination of research findings using relevant resources.
(b) Eligible entities
For purposes of this section, the term "eligible entity" means an entity described in
(c) Application
An eligible entity desiring to receive an award under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(d) Use of funds
An eligible entity shall use amounts awarded under a grant or contract under this section to provide innovative supportive activities to enhance education through distance learning, continuing educational activities, collaborative conferences, and electronic and telelearning activities, with priority for primary care.
(e) Authorization
There is authorized to be appropriated to carry out this section $5,000,000 for each of the fiscal years 2010 through 2014, and such sums as may be necessary for each subsequent fiscal year.
(July 1, 1944, ch. 373, title VII, §752, as added
Prior Provisions
A prior section 294b, act July 1, 1944, ch. 373, title VII, §752, as added
Another prior section 294b, act July 1, 1944, ch. 373, title VII, §763, as added
Another prior section 294b, act July 1, 1944, ch. 373, title VII, §729, as added Oct. 12, 1976,
Another prior section 294b, act July 1, 1944, ch. 373, title VII, §742, as added Sept. 24, 1963,
A prior section 752 of act July 1, 1944, was classified to
Another prior section 752 of act July 1, 1944, was classified to
§294c. Education and training relating to geriatrics
(a) Geriatrics Workforce Enhancement Program
(1) In general
The Secretary shall award grants, contracts, or cooperative agreements under this subsection to entities described in paragraph (1), (3), or (4) of
(2) Requirements
(A) In general
A Geriatrics Workforce Enhancement Program receiving an award under this section shall support the training of health professionals in geriatrics, including traineeships or fellowships. Such programs shall emphasize, as appropriate, patient and family engagement, integration of geriatrics with primary care and other appropriate specialties, and collaboration with community partners to address gaps in health care for older adults.
(B) Activities
Activities conducted by a program under this section may include the following:
(i) Clinical training on providing integrated geriatrics and primary care delivery services.
(ii) Interprofessional training to practitioners from multiple disciplines and specialties, including training on the provision of care to older adults.
(iii) Establishing or maintaining training-related community-based programs for older adults and caregivers to improve health outcomes for older adults.
(iv) Providing education on Alzheimer's disease and related dementias to families and caregivers of older adults, direct care workers, and health professions students, faculty, and providers.
(3) Duration
Each grant, contract, or cooperative agreement or contract awarded under paragraph (1) shall be for a period not to exceed 5 years.
(4) Applications
To be eligible to receive a grant, contract, or cooperative agreement under paragraph (1), an entity described in such paragraph shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(5) Program requirements
(A) In general
In awarding grants, contracts, and cooperative agreements under paragraph (1), the Secretary—
(i) shall give priority to programs that demonstrate coordination with another Federal or State program or another public or private entity;
(ii) shall give priority to applicants with programs or activities that are expected to substantially benefit rural or medically underserved populations of older adults, or serve older adults in Indian Tribes or Tribal organizations; and
(iii) may give priority to any program that—
(I) integrates geriatrics into primary care practice;
(II) provides training to integrate geriatric care into other specialties across care settings, including practicing clinical specialists, health care administrators, faculty without backgrounds in geriatrics, and students from all health professions;
(III) emphasizes integration of geriatric care into existing service delivery locations and care across settings, including primary care clinics, medical homes, Federally qualified health centers, ambulatory care clinics, critical access hospitals, emergency care, assisted living and nursing facilities, and home- and community-based services, which may include adult daycare;
(IV) supports the training and retraining of faculty, primary care providers, other direct care providers, and other appropriate professionals on geriatrics;
(V) emphasizes education and engagement of family caregivers on disease management and strategies to meet the needs of caregivers of older adults; or
(VI) proposes to conduct outreach to communities that have a shortage of geriatric workforce professionals.
(B) Special consideration
In awarding grants, contracts, and cooperative agreements under this section, the Secretary shall give special consideration to entities that provide services in areas with a shortage of geriatric workforce professionals.
(6) Priority
The Secretary may provide awardees with additional support for activities in areas of demonstrated need, which may include education and training for home health workers, family caregivers, and direct care workers on care for older adults.
(7) Reporting
(A) Reports from entities
Each entity awarded a grant, contract, or cooperative agreement under this section shall submit an annual report to the Secretary on the activities conducted under such grant, contract, or cooperative agreement, which may include information on the number of trainees, the number of professions and disciplines, the number of partnerships with health care delivery sites, the number of faculty and practicing professionals who participated in such programs, and other information, as the Secretary may require.