Pharmacy Education Aid Act of 2003 - Amends the Public Health Service Act to permit payments of up to $35,000 on behalf of a qualifying individual with a pharmacy degree for the repayment of pharmacy education loans for each year (two-year minimum) that such person serves in a health care facility with a critical shortage of pharmacists. Provides for: (1) additional tax liability payments; (2) financial need preference; and (3) Federal repayment for recipient breach of agreement unless otherwise waived.
Directs the Secretary to make payments of up to $35,000 on behalf of a qualifying individual with a pharmacy degree or in the final year of such study for the repayment of pharmacy educational loans for each year (two-year minimum) that such person serves as a faculty member at a school of pharmacy which provides assistance to: (1) medically underserved areas; (2) prisons; (3) veterans or the armed forces; (4) the Indian Health Service; or (5) a disproportionate share hospital under the Social Security Act .
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3591 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 3591
To amend the Public Health Service Act with respect to health
professions programs regarding the practice of pharmacy.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 21, 2003
Mrs. Cubin (for herself, Mr. John, Mr. Pickering, Mr. Simpson, Mr.
Rogers of Michigan, and Mr. McGovern) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to health
professions programs regarding the practice of pharmacy.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Pharmacy Education Aid Act of
2003''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Pharmacists are an important link in our Nation's
health care system. A critical shortage of pharmacists is
threatening the ability of pharmacies to continue to provide
important prescription related services.
(2) In the landmark report entitled ``To Err is Human:
Building a Safer Health System'', the Institute of Medicine
reported that medication errors can be partially attributed to
factors that are indicative of a shortage of pharmacists (such
as too many customers, numerous distractions, and staff
shortages).
(3) Congress acknowledged in the Healthcare Research and
Quality Act of 1999 (Public Law 106-129) a growing demand for
pharmacists by requiring the Secretary of Health and Human
Services to conduct a study to determine whether there is a
shortage of pharmacists in the United States and, if so, to
what extent.
(4) As a result of Congress' concern about how a shortage
of pharmacists would impact the public health, the Secretary of
Health and Human Services published a report entitled ``The
Pharmacist Workforce: A Study in Supply and Demand for
Pharmacists'' in December of 2000.
(5) ``The Pharmacist Workforce: A Study in Supply and
Demand for Pharmacists'' found that ``While the overall supply
of pharmacists has increased in the past decade, there has been
an unprecedented demand for pharmacists and for pharmaceutical
care services, which has not been met by the currently
available supply'' and that the ``evidence clearly indicates
the emergence of a shortage of pharmacists over the past two
years''.
(6) The same study also found that ``The most striking
evidence of a pharmacist shortage stems from demonstrably
increased vacancy rates, difficulties in hiring, and
unprecedented increases in the volume and range of activities
demanded of today's pharmacist.''
(7) The study found that ``The factors causing the current
shortage are of a nature not likely to abate in the near future
without fundamental changes in pharmacy practice and
education.'' The study projects that the number of
prescriptions filled by community pharmacists will increase by
20 percent by 2004. In contrast, the number of community
pharmacists is expected to increase by only 6 percent by 2005.
(8) Regarding access to pharmacy services in rural areas,
the study found that ``Remoteness, isolation from other
professionals, lower economic returns, reduced opportunities
for advancement, and other rural practice characteristics
remain obstacles'' to attracting pharmacists.
(9) In June 2002, the American Hospital Association's
Commission on Workforce for Hospitals and Health Systems
released a report entitled ``In Our Hands: How Hospital Leaders
Can Build A Thriving Workforce''. The report included a finding
that 46 percent of our Nation's hospitals are experiencing a
shortage of pharmacists, with hospitals averaging a vacancy
rate for pharmacists of 12.7 percent.
(10) The demand for pharmacists will increase as
prescription drug use continues to grow.
SEC. 3. HEALTH PROFESSIONS PROGRAMS RELATED TO THE PRACTICE OF
PHARMACY.
Part E of title VII of the Public Health Service Act (42 U.S.C.
294n et seq.) is amended by adding at the end the following:
``Subpart 3--Pharmacy Workforce Development
``SEC. 781. LOAN REPAYMENT PROGRAM FOR PHARMACISTS SERVING IN CRITICAL
SHORTAGE FACILITIES.
``(a) In General.--In the case of any individual--
``(1) who has received a baccalaureate degree in pharmacy
or a Doctor of Pharmacy degree from an accredited program;
``(2) who obtained an educational loan for pharmacy
education costs; and
``(3) who is licensed without restrictions in the State in
which the designated health care facility is located;
the Secretary may enter into an agreement with such individual who
agrees to serve as a full-time pharmacist for a period of not less than
2 years at a designated health care facility, to make payments in
accordance with subsection (b), for and on behalf of that individual,
on the principal of and interest on any loan of that individual
described in paragraph (2) which is outstanding on the date the
individual begins such service.
``(b) Manner of Payments.--
``(1) In general.--The payments described in subsection (a)
may consist of payment, in accordance with paragraph (2), on
behalf of the individual of the principal, interest, and
related expenses on government and commercial loans received by
the individual regarding the undergraduate or graduate education of the
individual (or both), which loans were made for--
``(A) tuition expenses;
``(B) all other reasonable educational expenses,
including fees, books, and laboratory expenses,
incurred by the individual; or
``(C) reasonable living expenses as determined by
the Secretary.
``(2) Payments for years served.--
``(A) In general.--For each year of obligated
service that an individual contracts to serve under
subsection (a) the Secretary may pay up to $35,000 on
behalf of the individual for loans described in
paragraph (1). In making a determination of the amount
to pay for a year of such service by an individual, the
Secretary shall consider the extent to which each such
determination--
``(i) affects the ability of the Secretary
to maximize the number of agreements that may
be provided under this section from the amounts
appropriated for such agreements;
``(ii) provides an incentive to serve in
areas with the greatest shortages of
pharmacists; and
``(iii) provides an incentive with respect
to the pharmacist involved remaining in the
area and continuing to provide pharmacy
services after the completion of the period of
obligated service under agreement.
``(B) Repayment schedule.--Any arrangement made by
the Secretary for the making of loan repayments in
accordance with this subsection shall provide that any
repayments for a year of obligated service shall be
made not later than the end of the fiscal year in which
the individual completes such year of service.
``(3) Tax liability.--For the purpose of providing
reimbursements for tax liability resulting from payments under
paragraph (2) on behalf of an individual--
``(A) the Secretary shall, in addition to such
payments, make payments to the individual in an amount
equal to 39 percent of the total amount of loan
repayments made for the taxable year involved; and
``(B) may make such additional payments as the
Secretary determines to be appropriate with respect to
such purpose.
``(4) Payment schedule.--The Secretary may enter into an
agreement with the holder of any loan for which payments are
made under this section to establish a schedule for the making
of such payments.
``(c) Preferences.--In entering into agreements under subsection
(a), the Secretary shall give preference to qualified applicants with
the greatest financial need.
``(d) Reports.--
``(1) Annual report.--Not later than 18 months after the
date of enactment of the Pharmacy Education Aid Act of 2003,
and annually thereafter, the Secretary shall prepare and submit
to Congress a report describing the program carried out under
this section, including statements regarding--
``(A) the number of applicants and contract
recipients;
``(B) the amount of loan repayments made;
``(C) which educational institution the recipients
attended;
``(D) the number and practice locations of the loan
repayment recipients at health care facilities with a
critical shortage of pharmacists;
``(E) the default rate and actions required;
``(F) the amount of outstanding default funds of
the loan repayment program;
``(G) to the extent that it can be determined, the
reason for the default;
``(H) the demographics of the individuals
participating in the loan repayment program; and
``(I) an evaluation of the overall costs and
benefits of the program.
``(2) 5-year report.--Not later than 5 years after the date
of enactment of the Pharmacy Education Aid Act of 2003, the
Secretary shall prepare and submit to Congress a report on how
the program carried out under this section interacts with other
Federal loan repayment programs for pharmacists and determining
the relative effectiveness of such programs in increasing
pharmacists practicing in underserved areas.
``(e) Application of Certain Provisions.--
``(1) In general.--The provisions of section 338C, 338G,
and 338I shall apply to the program established under this
section in the same manner and to the same extent as such
provisions apply to the National Health Service Corps Loan
Repayment Program under subpart III of part D of title III,
including the applicability of provisions regarding
reimbursements for increased tax liability and bankruptcy.
``(2) Breach of agreement.--An individual who enters into
an agreement under subsection (a) shall be liable to the
Federal Government for the amount of the award under such
agreement (including amounts provided for expenses related to
such attendance), and for interest on such amount at the
maximum legal prevailing rate, if the individual fails to
provide health services in accordance with the program under
this section for the period of time applicable under the
program.
``(3) Waiver or suspension of liability.--In the case of an
individual or health facility making an agreement for purposes
of subsection (a), the Secretary shall provide for the waiver
or suspension of liability under paragraph (2) if compliance by
the individual or the health facility, as the case may be, with
the agreement involved is impossible, or would involve extreme
hardship to the individual or facility, and if enforcement of
the agreements with respect to the individual or facility would be
unconscionable.
``(4) Date certain for recovery.--Subject to paragraph (3),
any amount that the Federal Government is entitled to recover
under paragraph (2) shall be paid to the United States not
later than the expiration of the 3-year period beginning on the
date the United States becomes so entitled.
``(5) Availability.--Amounts recovered under paragraph (2)
with respect to a program under this section shall be available
for the purposes of such program, and shall remain available
for such purposes until expended.
``(f) Definition.--In this section, the term `health care facility'
means a facility with a critical shortage of pharmacists as determined
by the Secretary.
``(g) Authorization of Appropriations.--For the purpose of payments
under agreements entered into under subsection (a), there are
authorized to be appropriated such sums as may be necessary for each of
fiscal years 2004 through 2008.
``SEC. 782. PHARMACY FACULTY LOAN REPAYMENT PROGRAM.
``(a) Establishment of Program.--The Secretary shall establish a
program under which the Secretary will enter into contracts with
individuals described in subsection (b) and such individuals will agree
to serve as faculty members of schools of pharmacy in consideration of
the Federal Government agreeing to pay, for each year of such service,
not more than $35,000 of the principal and interest of the educational
loans of such individuals.
``(b) Eligible Individuals.--An individual is described in this
subsection if such individual--
``(1) has a baccalaureate degree in pharmacy or a Doctor of
Pharmacy degree from an accredited program; or
``(2) is enrolled as a full-time student--
``(A) in an accredited pharmacy program; and
``(B) in the final year of a course of a study or
program, offered by such institution and approved by
the Secretary, leading to a baccalaureate degree in
pharmacy or a Doctor of Pharmacy degree from such a
school.
``(c) Requirements Regarding Faculty Positions.--The Secretary may
not enter into a contract under subsection (a) unless--
``(1) the individual involved has entered into a contract
with a school of pharmacy to serve as a member of the faculty
of the school for not less than 2 years; and
``(2) the contract referred to in paragraph (1) provides
that--
``(A) the school will, for each year for which the
individual will serve as a member of the faculty under
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;
``(B) the payments made by the school pursuant to
subparagraph (A) on behalf of the individual will be in
addition to the compensation that the individual would
otherwise receive for serving as a member of such
faculty; and
``(C) 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 subsection
(a).
``(d) Applicability of Certain Provisions.--The provisions of
sections 338C, 338G, and 338I shall apply to the program established in
subsection (a) to the same extent and in the same manner as such
provisions apply to the National Health Service Corps Loan Repayment
Program established in subpart III of part D of title III, including
the applicability of provisions regarding reimbursements for increased
tax liability and regarding bankruptcy.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of fiscal years 2004 through 2008.
``SEC. 783. DEFINITIONS.
``In this subpart:
``(1) School of pharmacy.--The term `school of pharmacy'
means a college or school of pharmacy (as defined in section
799B) that, in providing clinical experience for students,
requires that the students serve in a clinical rotation in
which pharmacist services are provided at or for--
``(A) a medical facility that serves a substantial
number of individuals who reside in or are members of a
medically underserved community (as so defined);
``(B) an entity described in any of subparagraphs
(A) through (L) of section 340B(a)(4) (relating to the
definition of covered entity);
``(C) a health care facility of the Department of
Veterans Affairs or of any of the Armed Forces of the
United States;
``(D) a health care facility of the Bureau of
Prisons;
``(E) a health care facility operated by, or with
funds received from, the Indian Health Service; or
``(F) a disproportionate share hospital under
section 1923 of the Social Security Act.
``(2) Pharmacist services.--The term `pharmacist services'
includes drug therapy management services furnished by a
pharmacist, individually or on behalf of a pharmacy provider,
and such services and supplies furnished incident to the
pharmacist's drug therapy management services, that the
pharmacist is legally authorized to perform (in the State in
which the individual performs such services) in accordance with
State law (or the State regulatory mechanism provided for by
State law).''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Sponsor introductory remarks on measure. (CR E2418-2419)
Referred to the Subcommittee on Health.
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