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S. 648 (rs) To establish legal standards and procedures for product liability litigation, and for other purposes. ...
108th CONGRESS 1st Session S. 648 To amend the Public Health Service Act with respect to health professions programs regarding the practice of pharmacy. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES March 18, 2003 Mr. Reed (for himself, Mr. Enzi, Mr. Johnson, Mr. Warner, Ms. Landrieu, Ms. Collins, Mr. Inouye, and Mr. Roberts) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions _______________________________________________________________________ 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 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. (7) The demand for pharmacists will increase as prescription drug use continues to grow. SEC. 3. HEALTH PROFESSIONS PROGRAM 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. ``(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; and ``(2) who obtained an educational loan for pharmacy education costs; 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 health care facility with a critical shortage of pharmacists, 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)(3) 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, 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 enrollees, loan repayments, and recipients; ``(B) the number of graduates; ``(C) the amount of loan repayments made; ``(D) which educational institution the recipients attended; ``(E) the number and placement location of the loan repayment recipients at health care facilities with a critical shortage of pharmacists; ``(F) the default rate and actions required; ``(G) the amount of outstanding default funds of the loan repayment program; ``(H) to the extent that it can be determined, the reason for the default; ``(I) the demographics of the individuals participating in the loan repayment program; and ``(J) 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, 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 areas with a critical shortage of pharmacists. ``(e) Breach of Agreement.-- ``(1) In general.--In the case of any program under this section under which an individual makes an agreement to provide health services for a period of time in accordance with such program in consideration of receiving an award of Federal funds regarding education as a pharmacist (including an award for the repayment of loans), the following applies if the agreement provides that this subsection is applicable: ``(A) In the case of a program under this section that makes an award of Federal funds for attending an accredited program of pharmacy (in this section referred to as a `pharmacy program'), the individual is liable to the Federal Government for the amount of such award (including amounts provided for expenses related to such attendance), and for interest on such amount at the maximum legal prevailing rate, if the individual-- ``(i) fails to maintain an acceptable level of academic standing in the pharmacy program (as indicated by the program in accordance with requirements established by the Secretary); ``(ii) is dismissed from the pharmacy program for disciplinary reasons; or ``(iii) voluntarily terminates the pharmacy program. ``(B) The individual is liable to the Federal Government for the amount of such award (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. ``(2) Waiver or suspension of liability.--In the case of an individual or health facility making an agreement for purposes of paragraph (1), the Secretary shall provide for the waiver or suspension of liability under such subsection if compliance by the individual or the health facility, as the case may be, with the agreements 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. ``(3) Date certain for recovery.--Subject to paragraph (2), any amount that the Federal Government is entitled to recover under paragraph (1) 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. ``(4) Availability.--Amounts recovered under paragraph (1) 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 an Indian Health Service health center, a Native Hawaiian health center, a hospital, a pharmacy, a Federal qualified health center, a rural health clinic, a nursing home, a home health agency, a hospice program, a public health clinic, a State or local department of public health, a skilled nursing facility, an ambulatory surgical center, or any other facility determined appropriate 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. PHARMACIST FACULTY LOAN PROGRAM. ``(a) Establishment.--The Secretary, acting through the Administrator of the Health Resources and Services Administration, may enter into an agreement with any school of pharmacy for the establishment and operation of a student loan fund in accordance with this section, to increase the number of qualified pharmacy faculty. ``(b) Agreements.--Each agreement entered into under subsection (a) shall-- ``(1) provide for the establishment of a student loan fund by the school involved; ``(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 school; ``(C) collections of principal and interest on loans made from the fund; and ``(D) any other earnings of the fund; ``(3) provide that the fund will be used only for loans to students of the school in accordance with subsection (c) and for costs of collection of such loans and interest thereon; ``(4) provide that loans may be made from such fund only to students pursuing a full-time course of study or, at the discretion of the Secretary, a part-time course of study; and ``(5) contain such other provisions as are necessary to protect the financial interests of the United States. ``(c) Loan Provisions.--Loans from any student loan fund established by a school pursuant to an agreement under subsection (a) shall be made to an individual on such terms and conditions as the school may determine, except that-- ``(1) such terms and conditions are subject to any conditions, limitations, and requirements prescribed by the Secretary; ``(2) in the case of any individual, the total of the loans for any academic year made by schools of pharmacy from loan funds established pursuant to agreements under subsection (a) may not exceed $35,000, plus any amount determined by the Secretary on an annual basis to reflect inflation; ``(3) an amount up to 85 percent of any such loan (plus interest thereon) shall be canceled by the school as follows:
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