scholarships and public health traineeships

scholarships and public health traineeships Sec. 408. (a) Effective October 1, 1977, part. C of title VII is amended by adding at the end thereof the following new subpart: “Subpart III— Traineeships for Students in Schools of Public Health and Other Graduate Programs “traineeships for students in schools of public health “Sec. 748. (a) The Secretary may make grants to accredited schools of public health for traineeships to train students enrolled in such schools. 90 STAT. 2280 “(b) (1) No grunt for traineeships may be made under subsection (a) unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, be submitted in such manner, and contain such information, as the Secretary by regulation may prescribe. Traineeships under such a grant shall he awarded in accordance with such regulations as the Secretary shall prescribe. The amount of any such grant shall be determined by the Secretary. “(2) Traineeships awarded under grants made under subsection (a) shall provide for such stipends and allowances (including travel and subsistence expenses and dependency allowances) for the trainees as the Secretary may deem necessary. “(3) In awarding traineeships under this section, each applicant shall assure to the satisfaction of the Secretary that at least the percent specified in paragraph (4) of the funds received under this section shall go to individuals who— “(A) (i) have previously received a post baccalaureate degree, or “(ii) have three years of work experience in health services; and “(B) are pursuing a course of study in— “(i) biostatistics or epidemiology, “(ii) health administration, health planning, or health policy analysis and planning, “(iii) environmental or occupational health, or “(iv) dietetics or nutrition. “(4) The percent referred to in paragraph (3) is— “(A) 45 percent for grants made for the fiscal year ending September 30, 1978, “(B) 55 percent for grants made for the fiscal year ending September 30, 1979, and “(C) 65 percent for grants made for the fiscal year ending September 30, 1980, and in succeeding fiscal years. “(c) For payments under grants under subsection (a), there are authorized to be appropriated $7,500,000 for the fiscal year ending September 30, 1978: $8,000,000 for the fiscal year ending September 30, 1979; and $9,000,000 for the fiscal year ending September 30, 1980. “traineeships for students in other graduate programs “Sec. 749. (a) The Secretary may make grants to public or nonprofit private educational entities, including graduate schools of social work but excluding accredited schools of public health, which offer a program in health administration, hospital administration, or health policy analysis and planning, which program is accredited by a body or bodies approved for such purpose by the Commissioner of Education and which meets such other quality standards as the Secretary by regulation may prescribe, for traineeships to train students enrolled in such a program. “(b) (1) No grant for traineeships may be made under subsection (a) unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, be submitted in such manner, and contain such information, as the Secretary by regulation may prescribe. Traineeships under such a grant shall fie awarded in accordance with such regulations as the Secretary shall prescribe. The amount of any such grant shall be determined by the Secretary. 90 STAT. 2281 “(2) Traineeships awarded under grants made under subsection (a) shall provide for such stipends and allowances (including travel and subsistence expenses and dependency allowances) for the trainees as the Secretary may deem necessary. “(3) In awarding traineeships under this section, each applicant shall assure to the satisfaction of the Secretary that at least 80 percent of the funds received under this section shall go to individuals who (A) have previously received a postbaccalaureate degree, or (B) have three years of work experience in health services. “(c) For payments under grants under subsection (a), there are authorized to be appropriated $2,500,000 for the fiscal year ending September 30, 1978; $2,500,000 for the fiscal year ending September 30, 1979; and $2,500,000 for the fiscal year ending September 30, 1980.”. (b) (1) Effective October 1, 1977, section 225 is repealed and part C of title VII (as amended by subsection (a)) is amended by adding after subpart III the following new subpart: “Subpart IV— National Health Service Corps Scholarships “national health service corps scholarship program “Sec. 751. (a) The Secretary shall establish the National Health Service Corps Scholarship Program (hereinafter in this subpart referred to as the ‘Scholarship Program’) to assure an adequate supply of trained physicians, dentists, and nurses for the National Health Service Corps (hereinafter in this subpart referred to as the ‘Corps’) and, if needed by the Corps, podiatrists, optometrists, pharmacists, graduates of schools of veterinary medicine, graduates of schools of public health, graduates of programs in health administration, graduates of programs for the training of physician assistants, expanded function dental auxiliaries, and nurse practitioners (as defined in section 822), and other health professionals. “(b) To be eligible to participate in the Scholarship Program, an individual must— “(1) be accepted for enrollment, or be enrolled, as a full-time student (A) in an accredited (as determined by the Secretary) educational institution in a State and (B) in a course of study or program, offered by such institution and approved by the Secretary, leading to a degree in medicine, osteopathy, dentistry, or other health profession; “(2) be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps of the Service or be eligible for selection for civilian service in the Corps; “(3) submit an application to participate in the Scholarship Program; and “(4) sign and submit to the Secretary, at the time of submittal of such application, a written contract (described in subsection (f)) to accept payment of a scholarship and to serve (in accordance with this subpart) for the applicable period of obligated service in a health manpower shortage area. “(c) In disseminating application forms and contract forms to individuals desiring to participate in the Scholarship Program, the Secretary shall include with such forms— “(1) a fair summary of the rights and liabilities of an individual whose application is approved (and whose contract is accepted) by the Secretary, including in the summary a clear explanation of the damages to which the United States is entitled90 STAT. 2282 under section 754 in the case of the individual’s breach of the contract; and “(2) such other information as may he necessary for the individual to understand the individual’s prospective participation in the Scholarship Program and service in the Corps. The application form, contract form, and all other information furnished by the Secretary under this subpart shall be written in a manner calculated to be understood by the average individual applying to participate in the Scholarship Program. The Secretary shall make such application forms, contract forms, and other information available to individuals desiring to participate in the Scholarship Program on a date sufficiently early to insure that such individuals have adequate time to carefully review and evaluate such forms and information. “(d) In determining which applications under the Scholarship Program to approve (and which contracts to accept), the Secretary shall give priority— “(1) first, to applications made (and contracts submitted) by individuals who have previously received scholarships under the Scholarship Program or under section 758; and “(2) second, to applications made (and contracts submitted)— “(A) in the school year ending in the fiscal year beginning October 1, 1977, by individuals who are entering their first or second year of study in a course of study or program described in subsection (b)(1)(B) in such school year; and “(B) in each school year thereafter, by individuals who are entering their first year of study in a course of study or program described in subsection (b)(1)(B) in such school year. “(e) (1) An individual becomes a participant in the Scholarship Program only upon the Secretary’s approval of the individual’s application submitted under subsection (b)(3) and the Secretary’s acceptance of the contract submitted by the individual under subsection (b)(4). “(2) The Secretary shall provide written notice to an individual promptly upon the Secretary’s approving, under paragraph (1), of the individual’s participation in the Scholarship Program. “(f) The written contract (referred to in this subpart) between the Secretary and an individual shall contain— “(1) an agreement that— “(A) subject to paragraph (2), the Secretary agrees (i) to provide the individual with a scholarship (described in subsection (g)) in each such school year or years for a period of years (not to exceed four school years) determined by the individual, during which period the individual is pursuing a course of study described in subsection (b)(1)(B), and (li) to accept (subject to the availability of appropriated funds for carrying out subpart II of part C of title III) the individual into the Corps (or for equivalent service as otherwise provided in this subpart); and “(B) subject to paragraph (2), the individual agrees— “(i) to accept provision of such a scholarship to the individual; “(ii) to maintain enrollment in a course of study described in subsection (b)(1)(B) until the individual completes the course of study; “(iii) while enrolled in such course of study, to maintain an acceptable level of academic standing (as deter-90 STAT. 2283mined under regulations of the Secretary by the educational institution offering such course of study); and “(iv) to serve for a time period (hereinafter in the subpart referred to as the ‘period of obligated service’) equal to— “(I) one year for each school year for which the individual was provided a scholarship under the Scholarship Program, or “(II) two years, whichever is greater, in a health manpower shortage area (designated under section 332) to which he is assigned by the Secretary as a member of the Corps, or as otherwise provided in this subpart; “(2) a provision that any financial obligation of the United States arising out of a contract entered into under this subpart and any obligation of the individual which is conditioned thereon, is contingent upon funds being appropriated for scholarships under this subpart and to carry out the purposes of subpart II of part C of title III; “(3) a statement of the damages to which the United States is entitled, under section 754, for the individual’s breach of the contract; and “(4) such other statements of the rights and liabilities of the Secretary and of the individual, not inconsistent with the provisions of this subpart. “(g) (1) A scholarship provided to a student for a school year under a written contract under the Scholarship Program or under section 758 (relating to scholarships for first-year students of exceptional financial need), shall consist of— “(A) payment to, or (in accordance with paragraph (2)) on behalf of the student of the amount (except as provided in section 711) of— “(i) the tuition of the student in such school year; and “(ii) all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the student in such school year; and “(B) payment to the student of a stipend of $400 per month (adjusted in accordance with paragraph (3)) for each of the 12 consecutive months beginning with the first month of such school year. “(2) The Secretary may contract with an educational institution, in which a participant in the Scholarship Program is enrolled, for the payment to the educational institution of the amounts of tuition and other reasonable educational expenses described in paragraph (1)(A). Payment to such an educational institution may be made without regard to section 3648 of the Revised Statutes (31 U.S.C. 529). “(3) The amount of the monthly stipend, specified in paragraph (1)(B) and as previously adjusted (if at all) in accordance with this paragraph, shall be increased by the Secretary for each school year ending in a fiscal year beginning after September 30, 1978, by an amount (rounded to the next highest multiple of $1) equal to the amount of such stipend multiplied by the overall percentage (as set forth in the report transmitted to the Congress under section 5303 of title 5, United States Code) of the adjustment (if such adjustment is an increase) in the rates of pay under the General Schedule made effective in the fiscal year in which such school year ends. 90 STAT. 2284 “(h) Notwithstanding any other provision of law, individuals who have entered into written contracts with the Secretary under this section, while undergoing academic training, shall not be counted against any employment ceiling affecting the Department. “(i) The Secretary shall report to Congress on December 1 of each year— “(1) the number, and type of health profession training, of students receiving scholarships under the Scholarship Program; “(2) the educational institutions at which such students are receiving their training; “(3) the number of applications filed under this section in the school year beginning in such year and in prior school years; and “(4) the amount of tuition paid in the aggregate and at each educational institution for the school year beginning in such year and for prior school years. “(j) The administrative unit which administers section 770 shall— “(1) participate in the development of regulations, funding priorities, and application forms, and “(2) be consulted by, and may make recommendations to, the Secretary in the review of applications for scholarships and grants, with respect to the Scholarship Program. “obligated service “Sec. 752. (a) Except as provided in section 753, each individual who has entered into a written contract with the Secretary under section 751 shall provide service in the full-time clinical practice of such individuals profession as a member of the Corps for the period of obligated service provided in such contract. “(b) (1) The Secretary shall notify each individual required to provide service under the Scholarship Program, not later than 60 days before the date described in paragraph (5), of the opportunity of such individual to serve in the full-time clinical practice of his profession either as a commissioned officer in the Regular or Reserve Corps of the Service or as a civilian member of the Corps. The Secretary shall include in such notice sufficient information regarding the advantages and disadvantages to each alternative to enable an individual to make a decision on an informed basis. “(2) To be eligible to provide obligated service as a commissioned officer in the Service, an individual shall notify the. Secretary, not later than 30 days before the date described in paragraph (5), of the individual’s desire to provide such service as such an officer. “(3) If an individual who has notified the Secretary under paragraph (2) qualifies for an appointment as such an officer, the Secretary shall, as soon as possible after the date described in paragraph (5), appoint the individual as a commissioned officer of the Regular or Reserve Corps and of the Service and shall designate the individual as a member of the Corps. If an individual who has notified the Secretary under paragraph (2) does not so qualify, the Secretary shall, as soon as possible after the date described in paragraph (5), appoint such individual in accordance with paragraph (4). “(4) Except as provided in paragraph (3) and in section 753, the Secretary shall appoint each individual, as soon as possible after the date described in paragraph (5), to serve in the full-time clinical practice of his profession as a civilian member of the Corps. 90 STAT. 2285 “(5) (A) With respect to an individual receiving a degree from a school of medicine, osteopathy, or dentistry, the date referred to in paragraphs (1) through (4) shall be the date upon which the individual completes the training required for such degree, except that the Secretary shall, at the request of such individual, defer such date until the end of the period of time (not to exceed three years) required for the individual to complete an internship, residency, or other advanced clinical training. No such period of internship, residency, or other advanced clinical training shall be counted toward satisfying a period of obligated service under this subpart. “(B) With respect to an individual receiving a degree from an institution other than a school of medicine, osteopathy, or dentistry, the date referred to in paragraphs (1) through (4) shall be the date upon which the individual completes his academic, training leading to such degree. “(c) An individual shall be considered to have begun serving a period of obligated service— “(1) on the date such individual is appointed as an officer in a Regular or Reserve Corps of the Service or as a member of the Corps, or “(2) in the case of an individual who has entered into an agreement with the Secretary under section 753, on the date specified in such agreement, whichever is earlier. “(d) The Secretary shall assign individuals performing obligated service in accordance with a written contract under the Scholarship Program to health manpower shortage areas in accordance with subpart II of part C of title II. If the Secretary determines that there is no need in a health manpower shortage area (designated under section 332) for a member of the profession in which an individual is obligated to provide service under a written contract, the Secretary may detail such individual to serve his period of obligated service as a full-time member of such profession in such unit of the Department as the Secretary may determine. “(e) Notwithstanding any other provision of this title, if the Secretary determines that an individual who is or has been a participant in the Scholarship Program demonstrates exceptional promise for medical research, the Secretary may permit such individual to perform his service obligation under the National Research Service Award program established under section 472. “private practice “Sec. 753. (a) The Secretary shall release an individual from all or part of his service obligation under section 752 (a) if the individual applies for such a release under this section and enters into a written agreement with the Secretary under which the individual agrees to engage for a period equal to the remaining period of Ms service obligation in the full-time private clinical practice (including service as a salaried employee in an entity directly providing health services) of his health profession— “(1) in the case of an individual who is performing obligated service as a member of the Corps in a health manpower shortage area on the date of his application for such a release, in the health manpower shortage area in which such individual is serving on such date; or 90 STAT. 2286 “(2) in the case of any other individual, in a health manpower shortage area (designated under section 332) which (A) has a priority for the assignment of Corps members under section 333(c), and (B) has a sufficient financial base to sustain such private practice and to provide the individual with income of not less than the income of members of the Corps. In the case of an individual described in paragraph (1), the Secretary shall release the individual from his service obligation under this subsection only if the Secretary determines that the area in which the individual is serving meets the requirement of clause (B) of paragraph (2). “(b) The written agreement described in subsection (a) shall— “(1) provide that during the period of private practice by an individual pursuant to the agreement— “(A) any person who receives health services provided by the individual in connection with such practice will be charged for such services at the usual and customary rate prevailing in the area in which such services are provided, except that if such person is unable to pay such charge, such person shall be charged at a reduced rate or not charged any fee; and “(B) the individual in providing health services in connection with such practice shall not discriminate against, any person on the basis of such person’s ability to pay for such services or because payment for the health services provided to such person will be made under the insurance program established under part A or B of title XVIII of the Social Security Act or under a State plan for medical assistance approved under title XIX of such Act; and “(2) contain such additional provisions as the Secretary may require to carry out the purposes of this section. For purposes of paragraph (1)(A), the Secretary shall by regulation prescribe the method for determining a person’s ability to pay a charge for health services and the method of determining the amount (if any) to be charged such person based on such ability. “breach of scholarship contract “Sec. 754. (a) An individual (other than an individual described in subsection (b)) who has entered into a written contract with the Secretary under section 751 and who fails to accept payment, or instructs the educational institution in which he is enrolled not to accept payment, in whole or in part, of a scholarship under such contract, shall, in addition to any service or other obligation or liability under the contract, be liable to the United States for the amount of $1,500 as liquidated damages. “(b) An individual who has entered into a written contract with the Secretary under section 751 and who— “(1) fails to maintain an acceptable level of academic standing in the educational institution in which he is enrolled (such level determined by the educational institution under regulations of the Secretary), “(2) is dismissed from such educational institution for disciplinary reasons, or “(3) voluntarily terminates the training in such an educational institution for which he is provided a scholarship under such contract, before the completion of such training, in lieu of any service obligation arising under such contract, shall be90 STAT. 2287 liable to the United States for the amount which has been paid to him, or on Ids behalf, under the contract. “(c) If an individual breaches his written contract by failing (for any reason) either to begin such individual’s service obligation in accordance with section 752 or 753 or to complete such service obligation, the United States shall be entitled to recover from the individual an amount determined in accordance with the formula A=3ϕ ( t—s t ) in which ‘A’ is the amount the United States is entitled to recover. ‘ϕ’ is the sum of the amount paid under this subpart to or on behalf of the individual and the interest on such amount which would be payable if at the time it was paid it was a loan bearing interest at the maximum legal prevailing rate, as determined by the Treasurer of the United States; ‘t’ is the total number of months in the individual’s period of obligated service; and ‘s’ is the number of months of such period served by him in accordance with section 752 or a written agreement under section 753. Any amount of damages which the United States is entitled to recover under this subsection shall, within the one year period beginning on the date of the breach of the written contract, be paid to the United States. “(d) (1) Any obligation of an individual under the Scholarship Program (or a contract thereunder) for service or payment of damages shall be canceled upon the death of the individual. “(2) The Secretary shall by regulation provide for the waiver or suspension of any obligation of service or payment by an individual under the Scholarship Program (or a contract thereunder) whenever compliance by the individual is impossible or would involve extreme hardship to the individual and it enforcement of such obligation with respect to any individual would be unconscionable. “(3) Any obligation of an individual under the Scholarship Program (or a contract thereunder) for payment of damages may he released by a discharge in bankruptcy under title 11 of the United States Code only if such discharge is granted after the expiration of the five-year period beginning on the first date that payment of such damages is required. “special chants for former corps members to enter private practice “Sec. 755. (a) The Secretary may make one grant to an individual (other than an individual who has entered into an agreement under section 753)— “(1) who has completed his period of obligated service in the Corps, and “(2) who has agreed in writing— “(A) to engage in the private full-time clinical practice of his profession in a health manpower shortage area (designated under section 332 and described in paragraphs (1) and (2) of section 753(a)) for a period (beginning not later than one year after the date he completed his period of obligated service in the Corps) of not less than one year; “(B) to conduct such practice in accordance with the provisions of section 753(b)(1); and “(C) to such additional conditions as the Secretary may require to carry out the purposes of this section;90 STAT. 2288 to assist such individual in meeting the costs of beginning the practice of such individual’s profession in accordance with such agreement, including the costs of acquiring equipment and renovating facilities for use in providing health services, and of hiring nurses and other personnel to assist in providing health services. Such grant may not be used for the purchase or construction of any building. “(b) The amount of the grant under subsection (a) to an individual shall be— “(1) $12,500, if the individual agrees to practice his profession in accordance with the agreement for a period of at least one year, but less than two years; or “(2) $25,000 if the individual agrees to practice his profession in accordance with the agreement for a period of at least two years. “(c) The Secretary may not make a grant under this section unless an application therefor hag been submitted to, and approved by, the Secretary. “(d) If the Secretary determines that an individual hag breached a written agreement entered into under subsection (a), he shall, as soon as practicable after making such determination, notify the individual of such determination. If within 120 days after the date of giving such notice, such individual is not practicing his profession in accordance with the agreement under such subsection and has not provided assurances satisfactory to the Secretary that he will not knowingly violate such agreement again, the United States shall be entitled to recover from such individual an amount determined under section 754(c), except that in applying the formula contained in such section, ‘ϕ’ shall be the sum of the amount of the grant made under subsection (a) to such individual and the interest on such amount which would be payable if at the time it was paid it was a loan bearing interest at the maximum legal prevailing rate, ‘s’ shall be the number of months that such individual agreed to practice his profession under such agreement, and ‘s’ shall be the number of months that such individual practices his profession in accordance with such agreement. “authorization of appropriations “Sec. 756. (a) There are authorized to be appropriated for scholarships under this subpart $75,000,000 for the fiscal year ending September 30, 1978, $140,000,000 for the fiscal year ending September 30, 1979, and $200,000,000 for the fiscal year ending September 30, 1980. For the fiscal year ending September 30, 1981, and for each of the two succeeding fiscal years, there are authorized to be appropriated such sums as may be necessary to continue to make scholarship awards to students who have entered into written contracts under the Scholarship Program before October 1, 1980. “(b) Of the sums appropriated under this section (1) 90 percent shall be obligated for scholarships for medical, osteopathic, and dental students, and (2) 10 percent of such 90 percent shall be obligated for scholarships for dental students.”. (2) (A) Except as provided in subparagraph (B), the amendment made by paragraph (1) of this subsection shall apply with respect to scholarships awarded under the National Health Service Corps Scholarship Program from appropriations for such Program for fiscal years beginning after September 30, 1977. (B) The provisions of section 225(f)(1) of the Public, Health Service Act (as in effect on September 30, 1977) prescribing the90 STAT. 2289 financial obligation of a participant in the Public Health and National Health Service Corps Scholarship Program who fails to complete an active duty service obligation incurred under that Program shall apply to any individual who received a scholarship under such Program for any school year ending before September 30, 1977, irrespective of whether such individual received such a scholarship after that date. (C) Periods of internship or residency served before September 30, 1976, in a facility of the National Health Service Corps or other facility of the Public Health Service in accordance with an agreement entered into under section 225(b) of the Public Health Service Act (as in effect before that date) shall be creditable in satisfying a service obligation incurred under the Public Health and National Health Service Corps Scholarship Program as revised by this subsection. (c) Effective October 1, 1977, part C of title VII (as amended by subsections (a) and (b)) is amended by adding after subpart IV the following new subpart: “Subpart V— Other Scholarships “scholarships for first-year students of exceptional financial need “Sec. 758. (a) The Secretary shall make grants to a public or nonprofit school of medicine, osteopathy, dentistry, optometry, pharmacy, podiatry, or veterinary medicine which is accredited as provided in section 721(b)(1)(B), for scholarships to be awarded by the school to full-time students thereof who are of exceptional financial need and who are in their first year of study at such school in the school year ending in the fiscal year in which such grant is made. “(b) (1) Scholarships may be awarded by a school from a grant under subsection (a) only to individuals who have been accepted by it for enrollment as full-time students in their first year of study at such school. “(2) A scholarship awarded to a student for a school year under a grant made under subsection (a) shall be the scholarship described in section 751(g). “(3) For purposes of this section, the term ‘first year of study’ means, with respect to a student of a school other than a school of pharmacy, the student’s first year of postbaccalaureate study at such school. “(c) The Secretary shall distribute grants under this section among all schools of the health professions, but shall give priority in distributing such grants to schools of medicine, osteopathy, and dentistry. “(d) For the purpose of making grants under this section, there is authorized to be appropriated $16,000,000 for the fiscal year ending September 30, 1978, $17,000,000 for the fiscal year ending September 30, 1979, and $18,000,000 for the fiscal year ending September 30, 1980. “lister hill scholarship program “Sec. 759. (a) The Secretary annually shall make grants to at least 10 individuals (to be known as Lister Hill scholars) for scholarships of up to $8,000 per year for up to four years of medical school if such individuals agree to enter into the family practice of medicine in a health manpower shortage area in accordance with this section. Grants made under this section shall be made only from funds appropriated under subsection (b). 90 STAT. 2290 “(b) There are authorized to be appropriated to carry out the purposes of this section $80,000 for the fiscal year ending September 30, 1977, $160,000 for the fiscal year ending September 30, 1978, $240,000 for the fiscal year ending September 30, 1979, and $320,000 for the fiscal year ending September 30, 1980. For the fiscal year ending September 30, 1981 end for each succeeding fiscal year, there are authorized to be appropriated such sums as may be necessary to continue to make such grants to students who (prior to October 1, 1980) have received such a grant under this section during such succeeding fiscal year.”.