Health Equity and Accountability Act of 2026

Title XXXIV of the Public Health Service Act, as added by section 2004, is amended by adding at the end the following:

“(a) In general.— The Secretary, acting through the Bureau of Health Workforce of the Health Resources and Services Administration, shall award a grant to an entity determined appropriate by the Secretary for the establishment of a national working group on workforce diversity.

(b) Representation.— In establishing the national working group under subsection (a):

(1) The grantee shall ensure that the group has representatives of each of the following:

(A) The Health Resources and Services Administration.

(B) The Department of Health and Human Services Data Council.

(C) The Office of Minority Health of the Department of Health and Human Services.

(D) The Substance Abuse and Mental Health Services Administration.

(E) The Bureau of Labor Statistics of the Department of Labor.

(F) The National Institute on Minority Health and Health Disparities.

(G) The Agency for Healthcare Research and Quality.

(H) The National Academy of Medicine.

(I) The Indian Health Service.

(J) The Centers for Medicare & Medicaid Services.

(K) The Department of Education.

(L) Institutions described in section 371(a) of the Higher Education Act of 1965.

(M) Consumer organizations.

(N) Health professional associations, including those that represent underrepresented minority populations.

(O) Researchers in the area of health workforce.

(P) Health workforce accreditation entities.

(Q) Private (including nonprofit) foundations that have sponsored workforce diversity initiatives.

(R) Local and State health departments.

(S) Representatives of community members to be included on admissions committees for health profession schools pursuant to subsection (c)(9).

(T) National community-based organizations that serve as a national intermediary to their rural or urban affiliate members and have demonstrated capacity to train health care professionals.

(U) The Veterans Health Administration.

(V) Other entities determined appropriate by the Secretary.

(2) The grantee shall ensure that, in addition to the representatives under paragraph (1), the working group has not less than 5 health professions students representing various health profession fields and levels of training.

(c) Activities.— The working group established under subsection (a) shall convene at least twice each year to complete the following activities:

(1) Review public and private health workforce diversity initiatives.

(2) Identify successful health workforce diversity programs and practices.

(3) Examine challenges relating to the development and implementation of health workforce diversity initiatives.

(4) Draft a national strategic work plan for health workforce diversity, including recommendations for public and private sector initiatives.

(5) Develop a framework and methods for the evaluation of current and future health workforce diversity initiatives.

(6) Develop recommended standards for workforce diversity that could be applicable to all health professions programs and programs funded under this Act.

(7) Develop guidelines to train health professionals to care for a diverse population.

(8) Develop a workforce data collection or tracking system to identify where health professionals of racial and ethnic minority groups practice.

(9) Develop a strategy for the inclusion of community members on admissions committees for health profession schools.

(10) Help with monitoring of standards for diversity, equity, and inclusion.

(11) Other activities determined appropriate by the Secretary.

(d) Annual report.— Not later than 1 year after the establishment of the working group under subsection (a), and annually thereafter, the working group shall prepare and make available to the general public for comment, an annual report on the activities of the working group. Such report shall include the recommendations of the working group for improving health workforce diversity.

(e) Coordination with other efforts.— In providing for the establishment of the working group under subsection (a), the Secretary shall take such steps as may be necessary to ensure that the work of the working group does not overlap with, or otherwise duplicate, other Federal Government efforts with respect to ensuring health equity in data collection in public health emergencies.

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) In general.— The Secretary, acting through the Deputy Assistant Secretary for Minority Health, and in collaboration with the Bureau of Health Workforce within the Health Resources and Services Administration and the National Institute on Minority Health and Health Disparities, shall establish a technical clearinghouse on health workforce diversity within the Office of Minority Health and coordinate current and future clearinghouses related to health workforce diversity.

(b) Information and services.— The clearinghouse established under subsection (a) shall offer the following information and services:

(1) Information on the importance of health workforce diversity.

(2) Statistical information relating to representation of underrepresented minority populations in health and allied health professions and occupations.

(3) Model health workforce diversity practices and programs, including integrated models of care.

(4) Admissions policies that promote health workforce diversity and are in compliance with Federal and State laws.

(5) Retainment policies that promote completion of health profession degrees for underserved populations.

(6) Lists of scholarship, loan repayment, and loan cancellation grants as well as fellowship information for underserved populations for health professions schools.

(7) Foundation and other large organizational initiatives relating to health workforce diversity.

(c) Consultation.— In carrying out this section, the Secretary shall consult with non-Federal entities which may include health professional associations representing minority populations and sections of major health professional associations representing minority populations to ensure the adequacy and accuracy of information.

(d) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration and the Director of the Centers for Disease Control and Prevention, shall award grants to eligible entities that demonstrate a commitment to health workforce diversity.

(b) Eligibility.— To be eligible to receive a grant under subsection (a), an entity shall—

(1) be an educational institution or entity that historically produces or trains meaningful numbers of underrepresented health professionals of minority populations, including—

(A) part B institutions, as defined in section 322 of the Higher Education Act of 1965;

(B) historically Black professional or graduate institutions eligible for grants under section 326 of such Act;

(C) Hispanic-serving health professions schools;

(D) Hispanic-serving institutions, as defined in section 502 of such Act;

(E) Tribal Colleges or Universities, as defined in section 316 of such Act;

(F) Asian American and Native American Pacific Islander-serving institutions, as defined in section 371(c) of such Act;

(G) institutions that have programs to recruit and retain underrepresented health professionals of minority populations, in which a significant number of the enrolled participants are from minority populations;

(H) health professional associations, which may include health professional associations representing underrepresented minority populations; and

(I) institutions, including national and regional community-based organizations with demonstrated commitment to a diversified workforce—

(i) located in communities with predominantly underrepresented minority populations;

(ii) with whom partnerships have been formed for the purpose of increasing workforce diversity; and

(iii) in which at least 20 percent of the enrolled participants are from underrepresented minority populations; 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.— Amounts received under a grant under subsection (a) shall be used to expand existing workforce diversity programs, implement new workforce diversity programs, or evaluate existing or new workforce diversity programs, including with respect to mental health care professions. Such programs shall enhance diversity by considering status as a member of a minority population as part of an individualized consideration of qualifications. Possible activities may include—

(1) educational outreach programs relating to opportunities in the health professions;

(2) scholarship, fellowship, grant, loan repayment, and loan cancellation programs;

(3) postbaccalaureate programs;

(4) academic enrichment programs, particularly targeting those who would not be competitive for health professions schools;

(5) supporting workforce diversity in kindergarten through 12th grade and other health pipeline programs;

(6) mentoring programs;

(7) internship or rotation programs involving hospitals, health systems, health plans, and other health entities;

(8) community partnership development for purposes relating to workforce diversity; or

(9) leadership training.

(d) Reports.— Not later than 1 year after receiving a grant under this section, and annually for the term of the grant, a grantee shall submit to the Secretary a report that summarizes and evaluates all activities conducted under the grant.

(e) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) In general.— The Secretary, acting through the Director of the National Institutes of Health, the Director of the Centers for Disease Control and Prevention, the Commissioner of Food and Drugs, the Director of the Agency for Healthcare Research and Quality, and the Administrator of the Health Resources and Services Administration, shall award grants that expand existing opportunities for scientists and researchers and promote the inclusion of underrepresented minority populations in the health professions.

(b) Research funding.— The head of each agency listed in subsection (a) shall establish or expand existing programs to provide research funding to scientists and researchers in training. Under such programs, the head of each such entity shall give priority in allocating research funding to support health research in traditionally underserved communities, including underrepresented minority populations, and research classified as community or participatory.

(c) Data collection.— The head of each agency listed in subsection (a) shall collect data on the number (expressed as an absolute number and a percentage) of underrepresented applicants from minority populations, and applicants from populations that are not minority populations, who receive and are denied agency funding at every stage of review. Such data shall be reported annually to the Secretary and the appropriate committees of Congress.

(d) Student loan reimbursement.— The Secretary shall establish a student loan reimbursement program to provide student loan reimbursement assistance to researchers who focus on racial and ethnic disparities in health. The Secretary shall promulgate regulations to define the scope and procedures for the program under this subsection.

(e) Student loan cancellation.— The Secretary shall establish a student loan cancellation program to provide student loan cancellation assistance to researchers who focus on racial and ethnic disparities in health. Students participating in the program shall make a minimum 5-year commitment to work at an accredited health professions school. The Secretary shall promulgate additional regulations to define the scope and procedures for the program under this subsection.

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, the Assistant Secretary for Mental Health and Substance Use, the Administrator of the Health Resources and Services Administration, and the Administrator of the Centers for Medicare & Medicaid Services, shall establish a program to award grants to universities and other institutions to enter into agreements with eligible individuals under which—

(1) the university or institution supports the eligible individual’s career in a nonresearch-related health and wellness profession; and

(2) the eligible individual commits to performing a period of obligated service in such a career to serve, or to work on health issues affecting, underserved communities, such as communities of racial and ethnic minority groups.

(b) Eligible individuals.— To be an eligible individual for purposes of subsection (a), an individual shall be a student in a health professions school, a graduate of such a school who is working in a health profession, an individual working in a health or wellness profession (including mental and behavioral health), or a faculty member of such a school.

(c) Application.— To seek a grant under this section, a university or other institution 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.— A university or other institution receiving a grant under this section shall use the grant for agreements described in subsection (a). Such agreements may—

(1) support an eligible individual’s health activities or projects that involve underserved communities, including communities of racial and ethnic minority groups;

(2) support an eligible individual’s health-related career advancement activities;

(3) pay, or reimburse for payment of, student loans or training or credentialing costs for eligible individuals who are health professionals and are focused on health issues affecting underserved communities, including communities of racial and ethnic minority groups; and

(4) establish and promote leadership training programs for eligible individuals to decrease health disparities and to increase cultural competence with the goal of increasing diversity in leadership positions.

(e) Definition.— In this section, the term career in a nonresearch-related health and wellness profession means employment or intended employment in the field of public health, health policy, health management, health administration, medicine, nursing, pharmacy, psychology, social work, psychiatry, other mental and behavioral health, allied health, community health, social work, or other fields determined appropriate by the Secretary, other than in a position that involves research.

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) In general.— The Director of the Agency for Healthcare Research and Quality (in this section referred to as the “Director”), in collaboration with the Deputy Assistant Secretary for Minority Health and the Director of the National Institute on Minority Health and Health Disparities, shall award grants to eligible entities to expand research on the link between health workforce diversity and quality health care.

(b) Eligibility.— To be eligible to receive a grant under subsection (a), an entity shall—

(1) be a clinical, public health, or health services research entity or other entity determined appropriate by the Director; 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.— Amounts received under a grant awarded under subsection (a) shall be used to support research that investigates the effect of health workforce diversity on—

(1) language access;

(2) cultural competence;

(3) patient satisfaction;

(4) timeliness of care;

(5) safety of care;

(6) effectiveness of care;

(7) efficiency of care;

(8) patient outcomes;

(9) community engagement;

(10) resource allocation;

(11) organizational structure;

(12) compliance of care; or

(13) other topics determined appropriate by the Director.

(d) Priority.— In awarding grants under subsection (a), the Director shall give individualized consideration to all relevant aspects of the applicant’s background. Consideration of prior research experience involving the health of underserved communities shall be such a relevant aspect.

(e) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) Establishment.— The Secretary, acting through the Office of Minority Health, in collaboration with the National Institute on Minority Health and Health Disparities, the Office for Civil Rights, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, and other appropriate public and private entities, shall establish and coordinate a health and health care disparities education program to support, develop, and implement educational initiatives and outreach strategies that inform health care professionals and the public about the existence of and methods to reduce racial and ethnic disparities in health and health care.

(b) Activities.— The Secretary, through the education program established under subsection (a), shall, through the use of public awareness and outreach campaigns targeting the general public and the medical community at large—

(1) disseminate scientific evidence for the existence and extent of racial and ethnic disparities in health care, including disparities that are not otherwise attributable to known factors such as access to care, patient preferences, or appropriateness of intervention, as described in the 2002 report of the National Academy of Medicine (formerly the “Institute of Medicine”) entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, as well as the impact of disparities related to age, disability status, socioeconomic status, sex, gender identity, and sexual orientation on racial and ethnic minority groups;

(2) disseminate new research findings to health care providers and patients to assist them in understanding, reducing, and eliminating health and health care disparities;

(3) disseminate information about the impact of linguistic and cultural barriers on health care quality and the obligation of health providers who receive Federal financial assistance to ensure that individuals with limited English proficiency have access to language access services;

(4) disseminate information about the importance and legality of racial, ethnic, disability status, socioeconomic status, sex, gender identity, and sexual orientation, and primary language data collection, analysis, and reporting;

(5) design and implement specific educational initiatives to health care providers relating to health and health care disparities;

(6) assess the impact of the programs established under this section in raising awareness of health and health care disparities and providing information on available resources; and

(7) design and implement specific educational initiatives to educate the health care workforce relating to unconscious bias.

(c) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.”.

Part B of title VII of the Public Health Service Act (42 U.S.C. 293 et seq.) is amended by adding at the end the following:

“742. Hispanic-serving institutions, historically Black colleges and universities, historically Black professional or graduate institutions, Asian American and Native American Pacific Islander-serving institutions, and Tribal Colleges.—

(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with the Secretary of Education, shall award grants to Hispanic-serving institutions, historically Black colleges and universities, historically Black professional or graduate institutions eligible for grants under section 326 of the Higher Education Act of 1965, Asian American and Native American Pacific Islander-serving institutions, Tribal Colleges or Universities, regional community-based organizations, and national minority medical associations, for counseling, mentoring, and providing information on financial assistance to prepare underrepresented minority individuals to enroll in and graduate from health professional schools and to increase services for underrepresented minority students including—

(1) mentoring with underrepresented health professionals;

(2) providing financial assistance information for continued education and applications to health professional schools; and

(3) retaining existing enrolled underrepresented minority students in a health professions school.

(b) Definitions.— In this section:

(1) Asian American and Native American Pacific Islander-serving institution.— The term Asian American and Native American Pacific Islander-serving institution has the meaning given such term in section 320(b) of the Higher Education Act of 1965.

(2) Hispanic-serving institution.— The term Hispanic-serving institution means an entity that—

(A) is a school or program for which there is a definition under section 799B;

(B) has an enrollment of full-time equivalent students that is made up of at least 9 percent Hispanic students;

(C) has been effective in carrying out programs to recruit Hispanic individuals to enroll in and graduate from the school;

(D) has been effective in recruiting and retaining Hispanic faculty members;

(E) has a significant number of graduates who are providing health services to medically underserved populations or to individuals in health professional shortage areas; and

(F) is a Hispanic Center of Excellence in Health Professions Education designated under section 736(d)(2).

(3) Historically Black college and university.— The term historically Black college and university has the meaning given the term part B institution as defined in section 322 of the Higher Education Act of 1965.

(4) Tribal college or university.— The term Tribal College or University has the meaning given such term in section 316(b) of the Higher Education Act of 1965.

(c) Certain loan repayment programs.— In carrying out the National Health Service Corps Loan Repayment Program established under subpart III of part D of title III and the loan repayment program under section 317F, the Secretary shall ensure, notwithstanding such subpart or section, that loan repayments of not less than $50,000 per year per person are awarded for repayment of loans incurred for enrollment or participation of underrepresented minority individuals in health professional schools and other health programs described in this section.

(d) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.”.

Section 317F(c)(1) of the Public Health Service Act (42 U.S.C. 247b–7(c)(1)) is amended by striking “$500,000 for fiscal year 1994, and such sums as may be necessary for each of the fiscal years 1995 through 2002” and inserting “such sums as may be necessary for each of fiscal years 2027 through 2031”.

Part D of title VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is amended by inserting after section 755 of such Act (42 U.S.C. 294e) the following:

“755A. Cooperative agreements for online degree programs.—

(a) Cooperative agreements.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, in consultation with the Director of the Centers for Disease Control and Prevention, the Director of the Agency for Healthcare Research and Quality, and the Deputy Assistant Secretary for Minority Health, shall enter into cooperative agreements with schools of public health and schools of allied health to design and implement online degree programs.

(b) Priority.— In entering into cooperative agreements under this section, the Secretary shall give priority to any school of public health or school of allied health that has an established track record of serving medically underserved communities.

(c) Requirements.— As a condition of entering into a cooperative agreement with the Secretary under this section, a school of public health or school of allied health shall agree to design and implement an online degree program that meets the following restrictions:

(1) Enrollment of individuals who have obtained a secondary school diploma or its recognized equivalent.

(2) Maintaining a significant enrollment of underrepresented minority or disadvantaged students.

(3) Achieving a high completion rate of enrolled underrepresented minority or disadvantaged students.

(d) Period of cooperative agreements.— The period during which payments are made through a cooperative agreement entered into under this section may not exceed 3 years.

(e) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.”.

(a) Sense of Congress.— It is the sense of Congress that the National Health Care Workforce Commission established by section 5101 of the Patient Protection and Affordable Care Act (42 U.S.C. 294q) should, in carrying out its assigned duties under that section, give attention to the needs of racial and ethnic minority groups, individuals with lower socioeconomic status, individuals with mental, developmental, and physical disabilities, lesbian, gay, bisexual, transgender, queer, and questioning populations, and individuals who are members of multiple minority or special population groups.

(b) Reauthorization.— Section 5101(h)(2) of the Patient Protection and Affordable Care Act (42 U.S.C. 294q(h)(2)) is amended by striking “such sums as may be necessary” and inserting “$3,000,000 for each of fiscal years 2027 through 2029”.

Subtitle B of title XXXIV of the Public Health Service Act, as added by section 3001, is further amended by inserting after section 3417 the following:

“3418. David Satcher Public Health and Health Services Corps.—

(a) In general.— The Director of the Centers for Disease Control and Prevention, in collaboration with the Administrator of the Health Resources and Services Administration and the Deputy Assistant Secretary for Minority Health, shall award grants to eligible entities to increase awareness among secondary and postsecondary students of career opportunities in the health professions.

(b) Eligibility.— To be eligible to receive a grant under subsection (a), an entity shall—

(1) be a clinical, public health, or health services organization, community-based or nonprofit entity, or other entity determined appropriate by the Director of the Centers for Disease Control and Prevention;

(2) serve a health professional shortage area, as determined by the Secretary;

(3) work with students, including those from racial and ethnic minority groups, that have expressed an interest in the health professions; and

(4) 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.— Grant awards under subsection (a) shall be used to support internships that will increase awareness among students of non-research-based, career opportunities in the following health professions:

(1) Medicine.

(2) Nursing.

(3) Public health.

(4) Pharmacy.

(5) Health administration and management.

(6) Health policy.

(7) Psychology.

(8) Dentistry.

(9) International health.

(10) Social work.

(11) Allied health.

(12) Psychiatry.

(13) Hospice care.

(14) Community health, patient navigation, and peer support.

(15) Other professions determined appropriate by the Director of the Centers for Disease Control and Prevention.

(d) Priority.— In awarding grants under subsection (a), the Director of the Centers for Disease Control and Prevention shall give priority to those entities that—

(1) serve a high proportion of individuals from disadvantaged backgrounds;

(2) have experience in health disparity elimination programs;

(3) facilitate the entry of disadvantaged individuals into institutions of higher education; and

(4) provide counseling or other services designed to assist disadvantaged individuals in successfully completing their education at the postsecondary level.

(e) Stipends.—

(1) In general.— Subject to paragraph (2), an entity receiving a grant under this section may use the funds made available through such grant to award stipends for educational and living expenses to students participating in the internship supported by the grant.

(2) Limitations.— A stipend awarded under paragraph (1) to an individual—

(A) may not be provided for a period that exceeds 6 months; and

(B) may not exceed $50 per day for an individual (notwithstanding any other provision of law regarding the amount of a stipend).

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

3419. Louis Stokes Public Health Scholars Program.—

(a) In general.— The Director of the Centers for Disease Control and Prevention, in collaboration with the Deputy Assistant Secretary for Minority Health, shall award scholarships to eligible individuals under subsection (b) who seek a career in public health.

(b) Eligibility.— To be eligible to receive a scholarship under subsection (a), an individual shall—

(1) have interest, knowledge, or skill in public health research or public health practice, or other health professions as determined appropriate by the Director of the Centers for Disease Control and Prevention;

(2) reside in a health professional shortage area as determined by the Secretary;

(3) demonstrate promise for becoming a leader in public health;

(4) secure admission to a 4-year institution of higher education; and

(5) 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.— Amounts received under an award under subsection (a) shall be used to support opportunities for students to become public health professionals.

(d) Priority.— In awarding grants under subsection (a), the Director shall give priority to those students that—

(1) are from disadvantaged backgrounds;

(2) have secured admissions to an institution described in section 371(a) of the Higher Education Act of 1965; and

(3) have identified a health professional as a mentor at their institution described in subsection (b)(4) and an academic advisor to assist in the completion of their baccalaureate degree.

(e) Scholarships.— The Secretary may approve payment of scholarships under this section for such individuals for any period of education in student undergraduate tenure, except that such a scholarship may not be provided to an individual for more than 4 years, and such a scholarship may not exceed $20,000 per academic year for an individual (notwithstanding any other provision of law regarding the amount of a scholarship).

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

3420. Patsy Mink Health and Gender Research Fellowship Program.—

(a) In general.— The Director of the Centers for Disease Control and Prevention, in collaboration with the Deputy Assistant Secretary for Minority Health, the Assistant Secretary for Mental Health and Substance Use, and the Director of the Indian Health Service, shall award research fellowships to eligible individuals under subsection (b) to conduct research that will examine gender and health disparities and to pursue a career in the health professions.

(b) Eligibility.— To be eligible to receive a fellowship under subsection (a), an individual shall—

(1) have experience in health research or public health practice;

(2) reside in a health professional shortage area designated by the Secretary under section 332;

(3) have expressed an interest in the health professions;

(4) demonstrate promise for becoming a leader in the field of women’s sexual and reproductive health, including family planning;

(5) secure admission to a health professions school or graduate program with an emphasis in gender studies; and

(6) 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.— A fellowship awarded under subsection (a) to an eligible individual under subsection (b) shall be used to support an opportunity for the individual to become a researcher and advance the research base on the intersection between gender and health.

(d) Priority.— In awarding fellowships under subsection (a), the Director of the Centers for Disease Control and Prevention shall give priority to those applicants that—

(1) are from disadvantaged backgrounds; and

(2) have identified a mentor and academic advisor who will assist in the completion of their graduate or professional degree and have secured a research assistant position with a researcher working in the area of gender and health.

(e) Fellowships.— The Director of the Centers for Disease Control and Prevention may approve fellowships for individuals under this section for any period of education in the student’s graduate or health profession tenure, except that such a fellowship may not be provided to an individual for more than 3 years, and such a fellowship may not exceed $25,000 per academic year for an individual (notwithstanding any other provision of law regarding the amount of a fellowship).

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

3421. Paul David Wellstone International Health Fellowship Program.—

(a) In general.— The Director of the Agency for Healthcare Research and Quality, in collaboration with the Deputy Assistant Secretary for Minority Health, shall award research fellowships to eligible individuals under subsection (b) to advance their understanding of international health.

(b) Eligibility.— To be eligible to receive a fellowship under subsection (a), an individual shall—

(1) have educational experience in the field of international health;

(2) reside in a health professional shortage area as determined by the Secretary;

(3) demonstrate promise for becoming a leader in the field of international health;

(4) be in the fourth year of a 4-year institution of higher education or a recent graduate of a 4-year institution of higher education; and

(5) 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.— A fellowship awarded under subsection (a) to an eligible individual under subsection (b) shall be used to support an opportunity for the individual to become a health professional and to advance the knowledge of the individual about international issues relating to health care access and quality.

(d) Priority.— In awarding fellowships under subsection (a), the Director of the Agency for Healthcare Research and Quality shall give priority to eligible individuals under subsection (b) that—

(1) are from a disadvantaged background; and

(2) have identified a mentor at a health professions school or institution, an academic advisor to assist in the completion of their graduate or professional degree, and an advisor from an international health non-governmental organization, private volunteer organization, or other international institution or program that focuses on increasing health care access and quality for residents in developing countries.

(e) Fellowships.— A fellowship awarded under this section may not—

(1) be provided to an eligible individual for more than a period of 6 months;

(2) be awarded to a graduate of a 4-year institution of higher education that has not been enrolled in such institution for more than 1 year; or

(3) exceed $8,000 per academic year (notwithstanding any other provision of law regarding the amount of a fellowship).

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

3422. Edward R. Roybal Health Scholar Program.—

(a) In general.— The Director of the Agency for Healthcare Research and Quality, the Administrator of the Centers for Medicare & Medicaid Services, and the Administrator of the Health Resources and Services Administration, in collaboration with the Deputy Assistant Secretary for Minority Health, shall award grants to eligible entities under subsection (b) to expose entering graduate students to the health professions.

(b) Eligibility.— To be eligible to receive a grant under subsection (a), an entity shall—

(1) be a clinical, public health, or health services organization, community-based, academic, or nonprofit entity, or other entity determined appropriate by the Director of the Agency for Healthcare Research and Quality;

(2) serve in a health professional shortage area designated by the Secretary under section 332;

(3) work with students obtaining a degree in the health professions; and

(4) 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.— Amounts received under a grant awarded under subsection (a) shall be used to support opportunities that expose students to non-research-based health professions, including—

(1) public health policy;

(2) health care and pharmaceutical policy;

(3) health care administration and management;

(4) health economics; and

(5) other professions determined appropriate by the Director of the Agency for Healthcare Research and Quality, the Administrator of the Centers for Medicare & Medicaid Services, or the Administrator of the Health Resources and Services Administration.

(d) Priority.— In awarding grants under subsection (a), the Director of the Agency for Healthcare Research and Quality, the Administrator of the Centers for Medicare & Medicaid Services, and the Administrator of the Health Resources and Services Administration, in collaboration with the Deputy Assistant Secretary for Minority Health, shall give priority to entities that—

(1) have experience with health disparity elimination programs;

(2) facilitate training in the fields described in subsection (c); and

(3) provide counseling or other services designed to assist students in successfully completing their education at the postsecondary level.

(e) Stipends.—

(1) In general.— Subject to paragraph (2), an entity receiving a grant under this section may use the funds made available through such grant to award stipends for educational and living expenses to students participating in the opportunities supported by the grant.

(2) Limitations.— A stipend awarded under paragraph (1) to an individual—

(A) may not be provided for a period that exceeds 2 months; and

(B) may not exceed $100 per day (notwithstanding any other provision of law regarding the amount of a stipend).

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

3423. Leadership fellowship programs.—

(a) In general.— The Secretary shall award grants to national minority medical or health professional associations to develop leadership fellowship programs for underrepresented health professionals in order to—

(1) assist such professionals in becoming future leaders in public health and health care delivery institutions; and

(2) increase diversity in decision-making positions that can improve the health of underserved communities.

(b) Use of funds.— A leadership fellowship program supported under this section shall—

(1) focus on training mid-career physicians and health care executives who have documented leadership experience and a commitment to public health services in underserved communities; and

(2) support Federal public health policy and budget programs, and priorities that impact health equity, through activities such as didactic lectures and leader site visits.

(c) Period of grants.— The period during which payments are made under a grant awarded under subsection (a) may not exceed 3 years.

(d) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.”.

Section 402E of the Higher Education Act of 1965 (20 U.S.C. 1070a–15) is amended by striking subsection (g) and inserting the following:

“(g) Collaboration in health profession diversity training programs.— The Secretary shall coordinate with the Secretary of Health and Human Services to ensure that there is collaboration between the goals of the program under this section and programs of the Health Resources and Services Administration that promote health workforce diversity. The Secretary of Education shall take such measures as may be necessary to encourage students participating in projects assisted under this section to consider health profession careers.

(h) Funding.— From amounts appropriated pursuant to the authority of section 402A(g), the Secretary shall, to the extent practicable, allocate funds for projects authorized by this section in an amount that is not less than $31,000,000 for each of the fiscal years 2027 through 2031.”.

(a) DGME determinations.— Section 1886(h)(4) of the Social Security Act (42 U.S.C. 1395ww(h)(4)), as amended by section 2006(a), is amended—

(1) in subparagraph (E), by striking “Subject to subparagraphs (J) and (K), such rules” and inserting “Subject to subparagraphs (J), (K), and (M), such rules”;

(2) in subparagraph (J), by striking “Such rules” and inserting “Subject to subparagraph (M), such rules”;

(3) in subparagraph (K), by striking “In determining” and inserting “Subject to subparagraph (M), in determining”; and

(4) by adding at the end the following new subparagraph:

“(M) Treatment of certain residents and interns.— For purposes of cost-reporting periods beginning on or after October 1, 2027, in determining the hospital’s number of full-time equivalent residents for purposes of this paragraph, all time spent by an intern or resident in an approved medical residency training program shall be counted toward the determination of full-time equivalency if the hospital—

(i) is recognized as a subsection (d) hospital;

(ii) is recognized as a subsection (d) Puerto Rico hospital;

(iii) is reimbursed under a reimbursement system authorized under section 1814(b)(3); or

(iv) is a provider-based hospital outpatient department.”.

(b) IME determinations.— Section 1886(d)(5)(B)(xi) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(xi)) is amended—

(1) in subclause (II), by striking “In determining” and inserting “Subject to subclause (IV), in determining”;

(2) in subclause (III), by striking “In determining” and inserting “Subject to subclause (IV), in determining”; and

(3) by inserting after subclause (III) the following new subclause:

“(IV) For purposes of cost-reporting periods beginning on or after October 1, 2027, the provisions of subparagraph (M) of subsection (h)(4) shall apply under this subparagraph in the same manner as they apply under such subsection.”.

(a) Grants.— The Secretary of Health and Human Services, acting jointly with the Secretary of Education and the Secretary of Labor, shall make grants to eligible institutions of higher educations for the purposes of—

(1) in accordance with subsection (b), developing capacity—

(A) to build an evidence base for successful strategies for increasing local health equity; and

(B) to serve as national models of driving local health equity; and

(2) in accordance with subsection (c), developing a strategic partnership with the community in which the institution is located.

(b) Developing capacity for increasing local health equity.— As a condition of receipt of a grant under subsection (a), an institution of higher education shall agree to use such grant to build an evidence base for successful strategies for increasing local health equity, and to serve as a national model of driving local health equity, by supporting—

(1) resources to strengthen institutional metrics and capacity to execute institution-wide health workforce goals that can serve as models for increasing health equity in communities across the United States;

(2) collaborations among a cohort of institutions in implementing systemic change, partnership development, and programmatic efforts supportive of health equity goals across disciplines and populations; and

(3) enhanced or newly developed data systems and research infrastructure capable of informing current and future workforce efforts and building a foundation for a broader research agenda targeting urban health disparities.

(c) Strategic partnerships.— As a condition of receipt of a grant under subsection (a), an institution of higher education shall agree to use the grant to develop a strategic partnership with the community in which such institution is located for the purposes of—

(1) strengthening connections between such institution and the community—

(A) to improve evaluation of, and address, the health and health workforce needs of such community; and

(B) to engage such community in health workforce development;

(2) developing, enhancing, or accelerating innovative undergraduate and graduate programs in the biomedical sciences and health professions; and

(3) strengthening pipeline programs in the biomedical sciences and health professions, including by developing partnerships between institutions of higher education and elementary schools and secondary schools to recruit the next generation of health professionals earlier in the pipeline to a health care career.

(d) Definition of eligible institution of higher education.— For purposes of this section, the term eligible institution of higher education includes—

(1) a program authorized under section 317(a) of the Higher Education Act of 1965 (20 U.S.C. 1059d(a)); and

(2) a professional or graduate institution described in section 326 of such Act (20 U.S.C. 1063b).

(e) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

(a) Establishment.— There is established in the Health Resources and Services Administration of the Department of Health and Human Services a Health Professions Workforce Fund to provide for expanded and sustained national investment in the health professions and nursing workforce development programs under titles VII and title VIII of the Public Health Service Act (42 U.S.C. 292 et seq.; 42 U.S.C. 296 et seq.).

(b) Funding.—

(1) In general.— There is authorized to be appropriated, and there is appropriated, out of any monies in the Treasury not otherwise appropriated, to the Health Professions Workforce Fund—

(A) $392,000,000 for fiscal year 2027;

(B) $412,000,000 for fiscal year 2028;

(C) $432,000,000 for fiscal year 2029;

(D) $454,000,000 for fiscal year 2030;

(E) $476,000,000 for fiscal year 2031;

(F) $500,000,000 for fiscal year 2032;

(G) $525,000,000 for fiscal year 2033; and

(H) $552,000,000 for fiscal year 2034.

(2) Health professions education programs.— For the purpose of carrying out health professions education programs authorized under title VII of the Public Health Service Act (42 U.S.C. 292 et seq.), in addition to any other amounts authorized to be appropriated for such purpose, there is authorized to be appropriated out of any monies in the Health Professions Workforce Fund, the following:

(A) $265,000,000 for fiscal year 2027.

(B) $278,000,000 for fiscal year 2028.

(C) $292,000,000 for fiscal year 2029.

(D) $307,000,000 for fiscal year 2030.

(E) $322,000,000 for fiscal year 2031.

(F) $338,000,000 for fiscal year 2032.

(G) $355,000,000 for fiscal year 2033.

(H) $373,000,000 for fiscal year 2034.

(3) Nursing workforce development programs.— For the purpose of carrying out nursing workforce development programs authorized under title VIII of the Public Health Service Act (42 U.S.C. 296 et seq.), in addition to any other amounts authorized to be appropriated for such purpose, there is authorized to be appropriated out of any monies in the Health Professions Workforce Fund, the following:

(A) $127,000,000 for fiscal year 2027.

(B) $134,000,000 for fiscal year 2028.

(C) $140,000,000 for fiscal year 2029.

(D) $147,000,000 for fiscal year 2030.

(E) $154,000,000 for fiscal year 2031.

(F) $162,000,000 for fiscal year 2032.

(G) $170,000,000 for fiscal year 2033.

(H) $179,000,000 for fiscal year 2034.

(a) Support for nursing education and the future nursing workforce.— Part D of title VIII of the Public Health Service Act (42 U.S.C. 296p et seq.) is amended by adding at the end the following:

“832. Nursing education enhancement and modernization grants in underserved areas.—

(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, may award grants to schools of nursing for—

(1) increasing the number of faculty and students at such schools in order to enhance the preparedness of the United States for, and the ability of the United States to address and quickly respond to, public health emergencies declared under section 319 and pandemics; or

(2) the enhancement and modernization of nursing education programs.

(b) Priority.— In selecting grant recipients under this section, the Secretary shall give priority to schools of nursing that—

(1) are located in a medically underserved community;

(2) are located in a health professional shortage area as defined under section 332(a); or

(3) are institutions of higher education listed under section 371(a) of the Higher Education Act of 1965.

(c) Consideration.— In awarding grants under this section, the Secretary, to the extent practicable, may ensure equitable distribution of awards among the geographic regions of the United States.

(d) Use of funds.— A school of nursing that receives a grant under this section may use the funds awarded through such grant for activities that include—

(1) enhancing enrollment and retention of students at such school, with a priority for students from disadvantaged backgrounds (including racial or ethnic groups underrepresented in the nursing workforce), individuals from rural and underserved areas, low-income individuals, and first generation college students (as defined in section 402A(h)(3) of the Higher Education Act of 1965);

(2) creating, supporting, or modernizing educational programs and curriculum at such school;

(3) retaining current faculty, and hiring new faculty, with an emphasis on faculty from racial or ethnic groups who are underrepresented in the nursing workforce;

(4) modernizing infrastructure at such school, including audiovisual or other equipment, personal protective equipment, simulation and augmented reality resources, telehealth technologies, and virtual and physical laboratories;

(5) partnering with a health care facility, nurse-managed health clinic, community health center, or other facility that provides health care in order to provide educational opportunities for the purpose of establishing or expanding clinical education;

(6) enhancing and expanding nursing programs that prepare nurse researchers and scientists;

(7) establishing nurse-led intradisciplinary and interprofessional educational partnerships; and

(8) other activities that the Secretary determines further the development, improvement, and expansion of schools of nursing.

(e) Reports from entities.— Each school of nursing awarded a grant under this section shall submit an annual report to the Secretary on the activities conducted under such grant.

(f) Report to Congress.— Not later than 5 years after the date of the enactment of this section, the Secretary shall 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 that provides a summary of the activities and outcomes associated with grants made under this section. Such report shall include—

(1) a list of schools of nursing receiving grants under this section, including the primary geographic location of any school of nursing that was improved or expanded through such a grant;

(2) the total number of students who are enrolled at or who have graduated from any school of nursing that was improved or expanded through a grant under this section;

(3) to the extent such information is available, the effects of the grants awarded under this section on retaining and hiring of faculty, including any increase in diverse faculty, the number of clinical education partnerships, the modernization of nursing education infrastructure, and other ways this section helps address and quickly respond to public health emergencies and pandemics;

(4) recommendations for improving the grants awarded under this section; and

(5) any other considerations as the Secretary determines appropriate.

(g) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $1,000,000,000, to remain available until expended.”.

(b) Strengthening nurse education.— The heading of part D of title VIII of the Public Health Service Act (42 U.S.C. 296p et seq.) is amended by striking “Basic”.

It is the sense of Congress that eliminating the limit of the number of residency positions that receive some level of Medicare support under section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)), also referred to as the Medical graduate medical education cap, is critical to—

(1) ensuring an appropriate supply of physicians to meet the health care needs in the United States;

(2) facilitating equitable access for all who seek health care;

(3) increasing the racial and ethnic diversity of physicians in the United States; and

(4) mitigating disparities in health and health care.

(a) Grants to eligible entities.—

(1) Authority to provide grants.— The Secretary of Health and Human Services (in this section referred to as the “Secretary”), acting through the Bureau of Health Workforce within the Health Resources and Services Administration, the National Institute on Minority Health and Health Disparities, or the Office of Minority Health, may award grants to eligible entities under paragraph (2) to carry out activities described in subsection (b).

(2) Eligibility.— To be eligible to receive a grant under this section, an entity shall—

(A) be a clinical, public health, or health services organization, a community-based or nonprofit entity, an academic institution, a faith-based organization, a State, county, or local government, an area health education center, or another entity determined appropriate by the Secretary; and

(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

(b) Authorized activities.— A grant awarded under this section shall be used—

(1) to provide services to assist unemployed and underemployed skilled immigrants, residing in the United States, who have legal, permanent work authorization and who are internationally educated health professionals, enter into the health workforce of the United States with employment matching their health professional skills and education, and advance in employment to positions that better match their health professional education and expertise;

(2) to provide training opportunities to reduce barriers to entry and advancement in the health workforce for skilled, internationally educated immigrants;

(3) to educate employers regarding the abilities and capacities of internationally educated health professionals;

(4) to assist in the evaluation of foreign credentials;

(5) to support preceptorships for international medical graduates in primary care training; and

(6) to facilitate access to contextualized and accelerated courses on English as a second language.

(a) Study.— The Comptroller General of the United States shall conduct a study on strategies for increasing the diversity of the health professional workforce. Such study shall include an analysis of strategies for increasing the number of health professionals from rural, lower income, and underrepresented minority communities, including which strategies are most effective for achieving such goal.

(b) Report.— Not later than 2 years after the date of enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under subsection (a), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.

(a) Conrad State 30 program extension.—

(1) In general.— Section 220(c) of the Immigration and Nationality Technical Corrections Act of 1994 (Public Law 103–416; 8 U.S.C. 1182 note) is amended by striking “September 30, 2015” and inserting “the date that is 3 years after the date of the enactment of the Health Equity and Accountability Act of 2026”.

(2) Effective date.— The amendment made by paragraph (1) shall take effect as if enacted on September 30, 2018.

(b) Retaining physicians who have practiced in medically underserved communities.— Section 201(b)(1) of the Immigration and Nationality Act (8 U.S.C. 1151(b)(1)) is amended by adding at the end the following:

“(F)

(i) Alien physicians who have completed service requirements of a waiver requested under section 203(b)(2)(B)(ii), including—

(I) alien physicians who completed such service before the date of the enactment of the Health Equity and Accountability Act of 2026; and

(II) the spouse or children of an alien physician described in subclause (I).

(ii) Nothing in this subparagraph may be construed—

(I) to prevent the filing of a petition with the Secretary of Homeland Security for classification under section 204(a) or the filing of an application for adjustment of status under section 245 by an alien physician described in clause (i)(I) before the date on which such alien physician completed the service described in section 214(l) or worked full-time as a physician for an aggregate of 5 years at the location identified in the section 214(l) waiver or in an area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals; or

(II) to permit the Secretary of Homeland Security to grant a petition or application described in subclause (I) until the alien has satisfied all of the requirements of the waiver received under section 214(l).”.

(c) Employment protections for physicians.—

(1) Exceptions to 2-year foreign residency requirement.— Section 214(l)(1) of the Immigration and Nationality Act (8 U.S.C. 1184(l)(1)) is amended—

(A) in the matter preceding subparagraph (A), by striking “Attorney General” and inserting “Secretary of Homeland Security”;

(B) in subparagraph (A), by striking “Director of the United States Information Agency” and inserting “Secretary of State”;

(C) in subparagraph (B), by inserting “, except as provided in paragraphs (7) and (8)” before the semicolon at the end;

(D) in subparagraph (C), by amending clauses (i) and (ii) to read as follows:

“(i) the alien demonstrates a bona fide offer of full-time employment at a health facility or health care organization, which employment has been determined by the Secretary of Homeland Security to be in the public interest; and

(ii) the alien—

(I) has accepted employment with the health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals;

(II) begins employment by the later of the date that is—

(aa) 120 days after receiving such waiver;

(bb) 120 days after completing graduate medical education or training under a program approved pursuant to section 212(j)(1); or

(cc) 120 days after receiving nonimmigrant status or employment authorization, if the alien or the alien’s employer petitions for such nonimmigrant status or employment authorization not later than 120 days after the date on which the alien completes his or her graduate medical education or training under a program approved pursuant to section 212(j)(1); and

(III) agrees to continue to work for a total of not less than 3 years in the status authorized for such employment under this subsection, except as provided in paragraph (8); and”; and

(E) in subparagraph (D), in the matter preceding clause (i), by inserting “except as provided in paragraph (8),” before “in the case”.

(2) Allowable visa status for physicians fulfilling waiver requirements in medically underserved areas.— Section 214(l)(2)(A) of such Act (8 U.S.C. 1184(l)(2)(A)) is amended to read as follows:

“(A) Upon the request of an interested Federal agency or an interested State agency for recommendation of a waiver under this section by a physician who is maintaining valid nonimmigrant status under section 101(a)(15)(J) and received a favorable recommendation by the Secretary of State, the Secretary of Homeland Security may adjust the status of such physician to any status authorized for employment under this Act. The numerical limitations set forth in subsection (g)(1)(A) shall not apply to any alien whose status is adjusted pursuant to this subparagraph.”.

(3) Violation of agreements.— Section 214(l)(3)(A) of such Act (8 U.S.C. 1184(l)(3)(A)) is amended by inserting “substantial requirement of an” before “agreement entered into”.

(4) Physician employment in underserved areas.— Section 214(l) of such Act, as amended by this subsection, is further amended by adding at the end the following:

“(4)

(A) If an interested State agency denies an application for a waiver under paragraph (1)(B) from a physician pursuing graduate medical education or training pursuant to section 101(a)(15)(J) because the State has requested the maximum number of waivers permitted for that fiscal year, the physician’s nonimmigrant status shall be extended for up to 6 months if the physician agrees to seek a waiver under this subsection (except for paragraph (1)(D)(ii)) to work for an employer described in paragraph (1)(C) in a State that has not yet requested the maximum number of waivers.

(B) Such physician shall be authorized to work only for the employer referred to in subparagraph (A) during the period beginning on the date on which a new waiver application is filed with such State and ending on the earlier of—

(i) the date on which the Secretary of Homeland Security denies such waiver; or

(ii) the date on which the Secretary approves an application for adjustment of status under paragraph (2)(A) pursuant to the approval of such waiver.”.

(5) Contract requirements.— Section 214(l) of such Act, as amended by this subsection, is further amended by adding at the end the following:

“(5) An alien granted a waiver under paragraph (1)(C) shall enter into an employment agreement with the contracting health facility or health care organization that—

(A) specifies—

(i) the maximum number of on-call hours per week (which may be a monthly average) that the alien will be expected to be available; and

(ii) the compensation the alien will receive for on-call time;

(B) specifies—

(i) whether the contracting facility or organization—

(I) has secured medical malpractice liability protection for the alien under section 224(g) of the Public Health Service Act (42 U.S.C. 233(g)); or

(II) will pay the alien's malpractice insurance premiums; and

(ii) the amount of such liability protection that will be provided;

(C) describes all of the work locations that the alien will work and includes a statement that the contracting facility or organization will not add additional work locations without the approval of the Federal agency or State agency that requested the waiver; and

(D) does not include a non-compete provision.

(6) An alien granted a waiver under this subsection whose employment relationship with a health facility or health care organization terminates under paragraph (1)(C)(ii) during the 3-year service period required under paragraph (1) shall be considered to be maintaining lawful status in an authorized period of stay during the 120-day period referred to in items (aa) and (bb) of subclause (III) of paragraph (1)(C)(ii) or the 45-day period referred to in subclause (III)(cc) of such paragraph.”.

(6) Recapturing waiver slots lost to other States.— Section 214(l) of such Act, as amended by this subsection, is further amended by adding at the end the following:

“(7) If a recipient of a waiver under this subsection terminates the recipient’s employment with a health facility or health care organization pursuant to paragraph (1)(C)(ii), including termination of employment because of circumstances described in paragraph (1)(C)(ii)(III), and accepts new employment with such a facility or organization in a different State, the State from which the alien is departing may be granted an additional waiver by the Secretary of State for use in the fiscal year in which the alien’s employment was terminated.”.

(7) Exception To 3-year work requirement.— Section 214(l) of such Act, as amended by this subsection, is further amended by adding at the end the following:

“(8) The 3-year work requirement set forth in subparagraphs (C) and (D) of paragraph (1) shall not apply if—

(A)

(i) the Secretary of Homeland Security determines the existence of extenuating circumstances, including violations by the employer of the employment agreement with the alien or of labor and employment laws, which justify a lesser period of employment at such facility or organization; and

(ii) the alien demonstrates, not later than 120 days after the employment termination date (unless the Secretary determines that extenuating circumstances would justify an extension), another bona fide offer of employment at a health facility or health care organization in a geographic area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals, for the remainder of such 3-year period;

(B)

(i) the interested State agency that requested the waiver attests to the existence of extenuating circumstances, including violations by the employer of the employment agreement with the alien or of labor and employment laws, which justify a lesser period of employment at such facility or organization; and

(ii) the alien demonstrates, not later than 120 days after the employment termination date (unless the Secretary determines that extenuating circumstances would justify an extension), another bona fide offer of employment at a health facility or health care organization in a geographic area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals, for the remainder of such 3-year period; or

(C) the alien—

(i) elects not to pursue a determination of extenuating circumstances pursuant to subparagraph (A) or (B);

(ii) terminates the alien’s employment relationship with the health facility or health care organization at which the alien was employed;

(iii) demonstrates, not later than 45 days after the employment termination date, another bona fide offer of employment at a health facility or health care organization in a geographic area or areas, in the State that requested the alien’s waiver, which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals; and

(iv) agrees to be employed for the remainder of such 3-year period, and 1 additional year for each termination under clause (ii).”.

(d) Allotment of Conrad State 30 waivers.—

(1) In general.— Section 214(l) of the Immigration and Nationality Act (8 U.S.C. 1184(l)), as amended by subsection (c), is further amended by adding at the end the following:

“(9)

(A)

(i) All States shall be allotted a total of 35 waivers under paragraph (1)(B) for a fiscal year if 90 percent of the waivers available to the States receiving at least 5 waivers were used in the previous fiscal year.

(ii) When an allotment occurs under clause (i), all States shall be allotted an additional 5 waivers under paragraph (1)(B) for each subsequent fiscal year if 90 percent of the waivers available to the States receiving at least 5 waivers were used in the previous fiscal year. If the States are allotted 45 or more waivers for a fiscal year, the States will only receive an additional increase of 5 waivers the following fiscal year if 95 percent of the waivers available to the States receiving at least 1 waiver were used in the previous fiscal year.

(B) Any increase in allotments under subparagraph (A) shall be maintained indefinitely, unless in a fiscal year the total number of such waivers granted is 5 percent lower than in the last year in which there was an increase in the number of waivers allotted pursuant to this paragraph, in which case—

(i) the number of waivers allotted shall be decreased by 5 for all States beginning in the next fiscal year; and

(ii) each additional 5 percent decrease in such waivers granted from the last year in which there was an increase in the allotment, shall result in an additional decrease of 5 waivers allotted for all States, provided that the number of waivers allotted for all States shall not drop below 30.”.

(2) Academic medical centers.— Section 214(l)(1)(D) of such Act, as amended by subsection (c)(1)(E), is further amended—

(A) in clause (ii), by striking “and” at the end;

(B) in clause (iii), by striking the period at the end and inserting “; and”; and

(C) by adding at the end the following:

“(iv) in the case of a request by an interested State agency—

(I) the head of such agency determines that the alien is to practice medicine in, or be on the faculty of a residency program at, an academic medical center (as defined in section 411.355(e)(2) of title 42, Code of Federal Regulations, or a similar successor regulation), without regard to whether such facility is located within an area designated by the Secretary of Health and Human Services as having a shortage of health care professionals; and

(II) the head of such agency determines that—

(aa) the alien physician’s work is in the public interest; and

(bb) the grant of such waiver would not cause the number of the waivers granted on behalf of aliens for such State for a fiscal year to exceed 3 (within the limitation in subparagraph (B) and subject to paragraph (6)), in accordance with the conditions of this clause.”.

(e) Amendments to the procedures, definitions, and other provisions related to physician immigration.—

(1) Dual intent for physicians seeking graduate medical training.— Section 214(b) of the Immigration and Nationality Act (8 U.S.C. 1184(b)) is amended by striking “and other than a nonimmigrant described in any provision of section 101(a)(15)(H)(i) except subclause (b1) of such section)” and inserting “a nonimmigrant described in any provision of section 101(a)(15)(H)(i) (except subclause (b1) of such section), and an alien coming to the United States to receive graduate medical education or training as described in section 212(j) or to take examinations required to receive graduate medical education or training as described in section 212(j))”.

(2) Physician national interest waiver clarifications.—

(A) Practice and geographic area.— Section 203(b)(2)(B)(ii)(I) of the Immigration and Nationality Act (8 U.S.C. 1153(b)(2)(B)(ii)(I)) is amended by striking items (aa) and (bb) and inserting the following:

“(aa) the alien physician agrees to work on a full-time basis practicing primary care, specialty medicine, or a combination thereof, in an area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals, or at a health care facility under the jurisdiction of the Secretary of Veterans Affairs; or

(bb) the alien physician is pursuing such waiver based upon service at a facility or facilities that serve patients who reside in a geographic area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals (without regard to whether such facility or facilities are located within such an area) and a Federal agency, or a local, county, regional, or State department of public health determines the alien physician’s work was or will be in the public interest.”.

(B) Five-year service requirement.— Section 203(b)(2)(B)(ii) of such Act, as amended by subparagraph (A), is further amended—

(i) by moving subclauses (II), (III), and (IV) 4 ems to the left; and

(ii) in subclause (II)—

(I) by inserting “(aa)” after “(II)”; and

(II) by adding at the end the following:

“(bb) The 5-year service requirement described in item (aa) shall begin on the date on which the alien physician begins work in the shortage area in any legal status and not on the date on which an immigrant visa petition is filed or approved. Such service shall be aggregated without regard to when such service began and without regard to whether such service began during or in conjunction with a course of graduate medical education.

(cc) An alien physician shall not be required to submit an employment contract with a term exceeding the balance of the 5-year commitment yet to be served or an employment contract dated within a minimum time period before filing a visa petition under this subsection.

(dd) An alien physician shall not be required to file additional immigrant visa petitions upon a change of work location from the location approved in the original national interest immigrant petition.”.

(3) Technical clarification regarding advanced degree for physicians.— Section 203(b)(2)(A) of such Act is amended by adding at the end the following: “An alien physician holding a foreign medical degree that has been deemed sufficient for acceptance by an accredited United States medical residency or fellowship program is a member of the professions holding an advanced degree or its equivalent.”.

(4) Short-Term work authorization for physicians completing their residencies.—

(A) In general.— A physician completing graduate medical education or training described in section 212(j) of the Immigration and Nationality Act (8 U.S.C. 1182(j)) as a nonimmigrant described in section 101(a)(15)(H)(i) of such Act (8 U.S.C. 1101(a)(15)(H)(i))—

(i) shall have such nonimmigrant status automatically extended until October 1 of the fiscal year for which a petition for a continuation of such nonimmigrant status has been submitted in a timely manner and the employment start date for the beneficiary of such petition is October 1 of that fiscal year; and

(ii) shall be authorized to be employed incident to status during the period between the filing of such petition and October 1 of such fiscal year.

(B) Termination.— The physician's status and employment authorization shall terminate on the date that is 30 days after the date on which a petition described in clause (i)(I) is rejected, denied, or revoked.

(C) Automatic extension.— A physician's status and employment authorization will automatically extend to October 1 of the next fiscal year if all of the visas described in section 101(a)(15)(H)(i) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(H)(i)) that were authorized to be issued for the fiscal year have been issued.

(5) Applicability of section 212(e) to spouses and children of J–1 exchange visitors.— A spouse or child of an exchange visitor described in section 101(a)(15)(J) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(J)) shall not be subject to the requirements under section 212(e) of such Act (8 U.S.C. 1182(e)).

(f) Annual Conrad State 30 J–1 Visa Waiver Program statistical report.— The Director of U.S. Citizenship and Immigration Service shall submit an annual report to Congress and to the Secretary of Health and Human Services that identifies the number of aliens admitted during the most recently concluded fiscal year as a result of the Conrad State 30 J–1 Visa Waiver Program established under sections 212(e) and 214(l) of the Immigration and Nationality Act (8 U.S.C. 1182(e) and 1184(l)), broken down by State.

Subpart II of part C of title VII of the Public Health Service Act (42 U.S.C. 293m et seq.) is amended by adding at the end the following:

“749C. Grants for schools of medicine and schools of osteopathic medicine in underserved areas.—

(a) In general.— The Secretary may award grants to institutions of higher education (including consortiums of such institutions) for the establishment, improvement, or expansion of a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine.

(b) Priority.— In selecting grant recipients under this section, the Secretary shall give priority to any institution of higher education (or consortium of such institutions) that—

(1) proposes to use the grant for the establishment of a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine, in an area—

(A) in which—

(i) no other such school is based; or

(ii) in the case in which the school of medicine or osteopathic medicine proposed to be established would be a minority-serving institution, no other minority-serving institution that includes a school of medicine or osteopathic medicine is based; and

(B) that is a medically underserved community or a health professional shortage area; or

(2) is a minority-serving institution described in section 371(a) of the Higher Education Act of 1965 or an institution or program described in section 326(e) of such Act.

(c) Considerations.— In awarding grants under this section, the Secretary, to the extent practicable, may ensure equitable distribution of awards among the geographical regions of the United States.

(d) Use of funds.— An institution of higher education (or a consortium of such institutions)—

(1) shall use grant amounts received under this section to—

(A) recruit, enroll, and retain medical students who are pursuing a degree of doctor of medicine or doctor of osteopathy, including individuals who are from disadvantaged backgrounds (including racial and ethnic groups underrepresented among medical students and health professions), individuals from rural and underserved areas, low-income individuals, and first generation college students, at a school of medicine or osteopathic medicine or a branch campus of a school of medicine or osteopathic medicine; and

(B) develop, implement, and expand curriculum that emphasizes care for rural and underserved populations, including accessible and culturally and linguistically appropriate care and services, at such school or branch campus; and

(2) may use grant amounts received under this section to—

(A) plan and construct—

(i) a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine, in an area in which no other such school is based; or

(ii) a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine, that will be a minority-serving institution, in an area in which no other such school that is a minority-serving institution is based;

(B) plan, develop, and meet criteria for accreditation for a school of medicine or osteopathic medicine or a branch campus of a school of medicine or osteopathic medicine;

(C) hire faculty, including faculty from racial and ethnic groups who are underrepresented among the medical and other health professions, and other staff to serve at such a school or branch campus;

(D) support educational programs at such a school or branch campus;

(E) modernize and expand infrastructure at such a school or branch campus; and

(F) support other activities that the Secretary determines further the establishment, improvement, or expansion of a school of medicine or osteopathic medicine or a branch campus of a school of medicine or osteopathic medicine.

(e) Application.— To be eligible to receive a grant under subsection (a), an institution of higher education (or a consortium of such institutions), shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a description of the institution’s or consortium's planned activities described in subsection (d).

(f) Reporting.—

(1) Reports from entities.— Each institution of higher education, or consortium of such institutions, awarded a grant under this section shall submit an annual report to the Secretary on the activities conducted under such grant.

(2) Report to Congress.— Not later than 5 years after the date of enactment of this section and every 5 years thereafter, the Secretary shall 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 that provides a summary of the activities and outcomes associated with grants made under this section. Such reports shall include a list of awardees, including their primary geographic location, and location of any school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine that was established, improved, or expanded under this program.

(g) Definitions.— In this section:

(1) Branch campus.—

(A) In general.— The term branch campus, with respect to a school of medicine or osteopathic medicine, means an additional location of such school that is geographically apart and independent of the main campus, at which the school offers at least 50 percent of the program leading to a degree of doctor of medicine or doctor of osteopathy that is offered at the main campus.

(B) Independence from main campus.— For purposes of subparagraph (A), the location of a school described in such subparagraph shall be considered to be independent of the main campus described in such subparagraph if the location—

(i) is permanent in nature;

(ii) offers courses in educational programs leading to a degree, certificate, or other recognized educational credential;

(iii) has its own faculty and administrative or supervisory organization; and

(iv) has its own budgetary and hiring authority.

(2) First generation college student.— The term first generation college student has the meaning given such term in section 402A(h)(3) of the Higher Education Act of 1965.

(3) Health professional shortage area.— The term health professional shortage area has the meaning given such term in section 332(a).

(4) Institution of higher education.— The term institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965.

(5) Medically underserved community.— The term medically underserved community has the meaning given such term in section 799B(6).

(h) Authorization of appropriations.— There is authorized to be appropriated such sums as may be necessary to carry out this section.”.

This subtitle may be cited as the “STAR Plus Scholarship Act”.

(a) In general.— Part F of title VII of the Public Health Service Act (42 U.S.C. 295h) is amended by adding at the end the following:

“782. Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program.—

(a) Establishment.— The Secretary, acting through the Administrator of the Health Resources and Services Administration (in this section referred to as the “Secretary”) shall establish the Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program (in this section referred to as the “Scholarship Program”) to award scholarships to assure an adequate supply of individuals in covered employment.

(b) Eligibility; application; written contract.— 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 covered employment;

(2) submit an application to participate in the Scholarship Program; and

(3) 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 section) for the applicable period of obligated service in a mental health professional shortage area.

(c) Review and evaluation of information and forms by prospective applicant.—

(1) Contents of application and contract forms.— In disseminating application forms and contract forms to individuals desiring to participate in the Scholarship Program, the Secretary shall include with such forms—

(A) 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 entitled under subsection (j) in the case of the individual’s breach of the contract; and

(B) such other information as may be necessary for the individual to understand the individual’s prospective participation in the Scholarship Program, including a statement of all factors considered in approving applications for participation in the Scholarship Program and in approving specific positions and employers that are eligible for the Scholarship Program.

(2) Clarity; availability.— The application form, contract form, and all other information furnished by the Secretary under this section 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 ensure that such individuals have adequate time to carefully review and evaluate such forms and information.

(3) Education and assistance.—

(A) Distribution of informational materials.— The Secretary shall distribute to health professions schools materials providing information on the Scholarship Program and shall encourage the schools to disseminate the materials to the students of the schools.

(B) End of obligated service.—

(i) Encouragement to continue service.— In the case of any health professional whose period of obligated service under the Scholarship Program is nearing completion, the Secretary shall encourage the individual to remain in a mental health professional shortage area and to continue in covered employment.

(ii) Assistance in transition.— During the period in which a health professional is planning and making the transition from obligated service under the Scholarship Program, the Secretary may provide assistance to the professional regarding such transition if the professional is remaining in a mental health professional shortage area and is continuing in covered employment.

(d) Factors considered in providing contracts; priorities.—

(1) Factors considered in providing contracts.— In providing contracts under the Scholarship Program—

(A) the Secretary shall consider the extent of the demonstrated interest of the applicants for the contracts in providing substance use disorder treatment and behavioral and mental health services; and

(B) may consider such other factors regarding the applicants as the Secretary determines to be relevant to selecting qualified individuals to participate in such Program.

(2) Priorities.— In providing contracts under the Scholarship Program, the Secretary shall give priority—

(A) to any application for such a contract submitted by an individual who has characteristics that increase the probability that the individual will continue to serve in a mental health professional shortage area after the period of obligated service pursuant to subsection (f) is completed; and

(B) to any application for such a contract submitted by an individual who is from a group or population that is underrepresented in the substance use disorder treatment and behavioral and mental health workforce.

(e) Commencement of participation in Scholarship Program; notice.—

(1) Commencement of participation.— An individual becomes a participant in the Scholarship Program only upon the Secretary’s approval of the individual’s application submitted under subsection (b)(2) and the Secretary’s acceptance of the contract submitted by the individual under subsection (b)(3).

(2) Notice.— 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) Written contract; contents.— The written contract (referred to in this section) between the Secretary and an individual shall contain—

(1) an agreement that—

(A) subject to paragraph (2), the Secretary agrees to provide the individual with a scholarship (described in subsection (g)) for a period of one or more school years during which the individual is pursuing a course of study described in subsection (b)(1)(B); 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 determined under regulations of the Secretary by the educational institution offering such course of study); and

(iv) to serve for a time period (in this section referred to as the “period of obligated service”) equal to one year for each school year for which the individual was provided a scholarship under the Scholarship Program, in covered employment in a mental health professional shortage area (designated under section 332);

(2) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual which is conditioned thereon, is contingent upon funds being appropriated for scholarships under this section;

(3) a statement of the damages to which the United States is entitled, under subsection (j), 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 section.

(g) Scholarship provisions; contract with educational institution; increase in monthly stipend.—

(1) Scholarship provisions.— A scholarship provided to a student for a school year under a written contract under the Scholarship Program shall consist of payment to, or (in accordance with paragraph (2)) on behalf of, the student of the amount (except as provided in section 711) of—

(A) the tuition of the student in such school year; and

(B) all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the student in such school year.

(2) Contract with educational institution.— 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). Payment to such an educational institution may be made without regard to section 3324 of title 31, United States Code.

(h) Employment ceiling of Department unaffected.— 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) Obligated service.— Any individual receiving payments under the Scholarship Program as required by an agreement under this section shall agree to an annual commitment to work full-time in covered employment, with no more than 1 year passing between any 2 years of covered employment, in the United States in—

(1) a mental health professional shortage area, as designated under section 332;

(2) a county (or a municipality, if not contained within any county) where the mean drug overdose death rate per 100,000 people over the past 3 years for which official data is available from the State, is higher than the most recent available national average overdose death rate per 100,000 people, as reported by the Centers for Disease Control and Prevention; or

(3) any facility, program, center, or clinic as determined appropriate by the Secretary for purposes of this section because of a shortage of mental health professionals, including private practices and other medical facilities designated under section 332(a) as having such a shortage.

(j) Breach.—

(1) Liquidated damages formula.— The Secretary may establish a liquidated damages formula to be used in the event of a breach of an agreement entered into under this section.

(2) Limitation.— The failure by an individual to complete the full period of service obligated pursuant to such an agreement, taken alone, shall not constitute a breach of the agreement, so long as the individual completed in good faith the years of service for which payments were made to the individual under this section.

(k) Fund regarding use of amounts recovered for contract breach To replace services lost as result of breach.—

(1) Establishment of Fund.— There is established in the Treasury of the United States a fund to be known as the Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program Replacement Fund (in this subsection referred to as the “Fund”). The Fund shall consist of such amounts as may be appropriated under paragraph (2) to the Fund. Amounts appropriated for the Fund shall remain available until expended.

(2) Authorization of Appropriations to Fund.— For each fiscal year, there is authorized to be appropriated to the Fund an amount equal to the sum of—

(A) the amount collected during the preceding fiscal year by the Federal Government pursuant to the liability of individuals under subsection (j) for the breach of contracts entered into under this section; and

(B) the aggregate of the amount of interest accruing during the preceding fiscal year on obligations held in the Fund pursuant to paragraph (4) and the amount of proceeds from the sale or redemption of such obligations during such fiscal year.

(3) Use of Fund.—

(A) Payments to certain health facilities.— Amounts in the Fund and available pursuant to appropriations Acts may, subject to subparagraph (B), be expended by the Secretary to make payments to any entity that has a need for a health professional to provide substance use disorder treatment and behavioral and mental health services as a result of the breach by an individual of a contract entered into under this section.

(B) Purpose of payments.— An entity receiving payments pursuant to subparagraph (A) may expend the payments to recruit and employ a health professional to provide substance use disorder treatment and behavioral and mental health services to patients of the entity, or to enter into a contract with such a professional to provide the services to the patients.

(4) Investment.—

(A) In general.— The Secretary of the Treasury shall invest such amounts of the Fund as such Secretary determines are not required to meet current withdrawals from the Fund. Such investments may be made only in interest-bearing obligations of the United States. For such purpose, such obligations may be acquired on original issue at the issue price, or by purchase of outstanding obligations at the market price.

(B) Sale of obligations.— Any obligation acquired by the Fund may be sold by the Secretary of the Treasury at the market price.

(l) Covered employment defined.— In this section, the term covered employment means—

(1) full-time employment (including a fellowship) where the primary intent and function of the position is the direct treatment or recovery support of patients with or in recovery from a substance use, behavioral health, or mental health disorder; and

(2) may include employment as a physician (with a degree of doctor of medicine or doctor of osteopathy), a psychiatric nurse, a social worker, a marriage and family therapist, a mental health counselor, an addiction counselor, an occupational therapist, a psychologist, a psychiatrist, a child and adolescent psychiatrist, or a neurologist.

(m) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $75,000,000 for each of fiscal years 2027 through 2031.”.

(b) Exclusion of scholarship from gross income of the recipient.—

(1) In general.— Section 117(c)(2) of the Internal Revenue Code of 1986 is amended—

(A) by striking “or” at the end of subparagraph (B);

(B) by striking the period at the end of subparagraph (C) and inserting “, or”; and

(C) by adding at the end the following new subparagraph:

“(D) section 782 of the Public Health Service Act.”.

(2) Effective date.— The amendments made by this section shall apply to taxable years ending after the date of the enactment of this Act.

This subtitle may be cited as the “Advancing Culturally Competent and Equitable Supportive Services in Mental Health Act” or the “ACCESS in Mental Health Act”.

The purpose of this subtitle is to increase the number, size, and quality of accredited graduate training programs for mental and behavioral health professions at minority-serving institutions to address shortages in the mental and behavioral health professional workforce and diversify such workforce.

Part A of title VII of the Higher Education Act of 1965 (20 U.S.C. 1070) is amended—

(1) by redesignating subpart 5 as subpart 6;

(2) in section 731—

(A) in the section heading, by striking “subparts 1 through 4” and inserting “subparts 1 through 5”;

(B) in subsection (a), by striking “subparts 1 through 4” and inserting “subparts 1 through 5”;

(C) in subsection (b), by striking “subparts 1 through 4” and inserting “subparts 1 through 5”; and

(D) in subsection (d), by striking “subpart 1, 2, 3, or 4” and inserting “subpart 1, 2, 3, 4, or 5”; and

(3) by inserting after subpart 4 the following:

In this subpart:

“(1) Cost of attendance.— The term cost of attendance has the meaning given that term in section 472.

(2) Culturally responsive care.— The term culturally responsive care means care that is conducted or provided in a manner that is responsive to the beliefs, backgrounds, customs, interpersonal styles, lived experiences, language, and behaviors of individuals who are receiving the care, and in a manner that has the greatest likelihood of ensuring maximum benefit and participation in the treatment provided.

(3) Eligible institution.— The term eligible institution means—

(A) an institution of higher education that is—

(i) a part B institution (as defined in section 322);

(ii) a Hispanic-serving institution (as defined in section 502);

(iii) a Tribal College or University (as defined in section 316);

(iv) an Alaska Native-serving institution (as defined in section 317(b));

(v) a Native Hawaiian-serving institution (as defined in section 317(b));

(vi) a Predominantly Black Institution (as defined in section 318);

(vii) an Asian American and Native American Pacific Islander-serving institution (as defined in section 320(b)); or

(viii) a Native American-serving, nontribal institution (as defined in section 319);

(B) a consortium of institutions described in subparagraph (A); or

(C) an institution described in subparagraph (A), or a consortium described in subparagraph (B), in partnership with any other institution of higher education, but only if the program supported with a grant under this subpart is carried out at an institution described in subparagraph (A).

(4) Health professional shortage area.— The term health professional shortage area means an area designated as a health professional shortage area by the Administrator of the Health Resources and Services Administration of the Department of Health and Human Services.

(5) Mental or behavioral health professional.— The term mental or behavioral health professional means an individual with a graduate degree from an institution of higher education with an accredited program that prepares students for State licensing or certification in fields such as psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance use disorder prevention and treatment, marriage and family counseling, school counseling, professional counseling, child and adolescent psychiatry, or any other provider that is a State licensed or certified mental health professional qualified under State law to provide mental health services.

(6) School-based mental health services provider.— The term school-based mental health services provider has the meaning given the term in section 4102 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7112).

(7) Trauma-informed care.— The term trauma-informed care means care received by individuals who have experienced or witnessed trauma that is healing-centered and culturally responsive in accordance with professional standards of practice and accounting for patients’ experiences and that recognizes the emotional, behavioral, and developmental challenges that can accompany trauma exposure in order to eliminate or mitigate triggers that may cause re-traumatization of the patient.

(a) Program authorized.— From amounts made available to carry out this section for each fiscal year and not reserved under subsection (b), the Secretary is authorized to award grants, on a competitive basis, to eligible institutions—

(1) to establish, expand, or improve graduate programs in mental and behavioral health professions, including programs that train school-based mental services providers; or

(2) to engage in planning activities necessary for the establishment of new graduate programs in mental and behavioral health professions, including programs that train school-based mental health services providers.

(b) Reservation.— The Secretary may reserve not more than 2 percent of the funds made available to carry out this section for a fiscal year to provide technical assistance to eligible institutions on matters relating to the grant program under this section and the implementation of programs supported by such grants.

(c) Use of funds.—

(1) Required use of funds.— An eligible institution that receives a grant under subsection (a)(1) shall use not less than 5 percent of grant funds to award scholarships or stipends, based on financial need, to cover all or part of a student’s cost of attendance for the mental or behavioral health graduate program. Scholarships and stipends awarded under this subsection shall prioritize students who are from health professional shortage areas.

(2) Allowable use of funds.— After fulfilling the requirement in paragraph (1), an eligible institution that receives a grant under subsection (a)(1) shall use any remaining grant funds to carry out one or more of the following activities:

(A) Establish new accredited graduate programs that prepare students for State licensing and certification to serve as mental or behavioral health professionals or school-based mental health services providers, including through hiring and compensating faculty, purchasing or developing culturally responsive course materials, or other activities necessary to establish such programs.

(B) Ensure that graduate programs in mental or behavioral health professions offered by the institution are preparing professionals who are highly qualified, are able to provide culturally responsive care and trauma-informed care, and are equipped to serve in health professional shortage areas or other high-need areas or schools, which may include—

(i) recruiting, training, retraining, or retaining faculty for such programs;

(ii) designing or redesigning such programs—

(I) to prepare mental or behavioral health professionals to serve in health professional shortage areas or other high-need areas or schools, provide culturally responsive care and trauma-informed care to diverse patients, and meet the needs of the whole child or person;

(II) to incorporate rigorous academic content and scientifically valid research; and

(III) to adequately prepare students to meet State licensure and certification standards; and

(iii) developing or implementing high quality course materials, which may include purchasing necessary educational materials or other academic resources, to support the design or redesign of the program as described in clause (ii).

(C) Provide students with sustained and high-quality preservice and clinical experience that is aligned with graduate education standards for their respective fields, which may include—

(i) arranging for exemplary mental or behavioral health professionals in relevant fields or work settings to mentor students who are prospective mental or behavioral health professionals; or

(ii) substantially increasing the level of interaction between faculty at institutions of higher education and new and experienced mental or behavioral health professionals, and providing support, including preparation time, for such interactions.

(D) Establish partnerships with other institutions of higher education with accredited programs that prepare students for State licensing or certification in mental or behavioral health fields to allow cross registration or other forms of program collaboration determined eligible by the Secretary for the purposes of expanding access to classes, certificate programs, or degree programs in mental or behavioral health fields for students from racial or ethnic minority communities.

(E) Develop and implement supportive services for former students of the institution who work as mental or behavioral health professionals or partnerships with school districts, State or local agencies, or other places of employment for former students to promote retention in those professions, including services such as—

(i) mental or behavioral health professional mentoring from exemplary mental or behavioral health professionals in relevant fields or work settings, including those working in schools or home-based care settings;

(ii) materials, resources, and support for mental or behavioral health professionals during their first 3 years of employment in such profession; or

(iii) services to prevent or mitigate secondary trauma or burnout associated with working in mental health professional shortage areas or other high-need areas or schools.

(F) Disseminate information on effective practices for the preparation of mental or behavioral health professionals, including practices for obtaining any certifications or licenses needed to practice as a mental or behavioral health professional or a school-based mental health services provider in a State.

(G) Develop strategies to increase awareness, interest, and experiential learning opportunities in mental and behavioral health careers, especially among racial and ethnic minority communities, including through partnerships with State educational agencies, local educational agencies, or other institutions of higher education to increase awareness of and interest in such careers among elementary school students, secondary school students, or undergraduate students.

(3) Planning grants.— An eligible institution that receives a grant under subsection (a)(2) shall use the grant to engage in planning activities necessary for the establishment of at least 1 new graduate program in mental or behavioral health professions.

(d) Application.— To be eligible to receive a grant under this section, an eligible institution shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. An eligible institution applying for a grant under subsection (a)(2) shall include in the institution’s application for such grant information demonstrating evidence of—

(1) an institutional commitment to opening and sustaining a graduate program that prepares students to work as a mental or behavioral health professional; and

(2) a relationship with the relevant professional organization, accreditation agency or association, or regulatory body to ensure that planning aligns with professional standards and State credentialing requirements.

(e) Grant amount.—

(1) In general.— The minimum amount of each grant under subsection (a)(1) shall be $500,000.

(2) Planning grants.— The amount of each grant under subsection (a)(2) shall be an amount determined by the Secretary.

(f) Limitation on administrative expenses.— An eligible institution that receives a grant under this section may use not more than 3 percent of funds provided to administer the grant, not including salary and benefits for faculty and staff.

(g) Regulations.— The Secretary shall prescribe such regulations as may be necessary to carry out this section.

(h) Report.— Not later than 2 years after the date of enactment of this section, and not less frequently than once every 2 years thereafter, the Secretary shall submit to the authorizing committees a report on the grant program under this section. Each report shall include—

(1) descriptions of the programs supported with grants under this section;

(2) demographic information about the students served by such programs; and

(3) such other information as the Secretary determines appropriate.

(i) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each fiscal year.

(a) In general.— The Secretary is authorized to carry out a program under which the Secretary shall pay to an eligible institution such sums as may be necessary to enable the institution to provide each eligible student with a grant in the amount of $10,000 for each year during which the student attends an eligible graduate program at the institution.

(b) Application.— To be eligible to receive a grant under this section, a student shall submit to the institution an application at such time, in such manner, and containing such information as the Secretary, in consultation with the institution, may require.

(c) Distribution to students.— Subject to subsection (d), grants to students under this section shall be made in accordance with a process determined by the Secretary for such purpose, in such manner as will best accomplish the purpose of this section.

(d) Limitation on secretarial and institutional authority.— In carrying out the grant program under this section, the Secretary and any institution participating in the program may not—

(1) convert a grant into a loan or otherwise require a student to repay any portion of the grant amount; or

(2) require a student to complete a service obligation as a condition of receiving such a grant.

(e) Report.— Not later than 2 years after the date of enactment of this section, and not less frequently than once every 2 years thereafter, the Secretary shall submit to the authorizing committees a report on the grant program under this section. Each report shall include information on the following:

(1) The number and demographic information of students who received grants under this section.

(2) The degrees obtained by such recipients.

(3) Such other information as the Secretary determines appropriate.

(f) Definitions.— In this section:

(1) Eligible graduate program.— The term eligible graduate program means a graduate degree program in a mental or behavioral health profession, including school-based mental health services, offered by an eligible institution.

(2) Eligible student.— The term eligible student means a student who—

(A) is enrolled in an eligible graduate program at a eligible institution participating in the program under this section;

(B) is in good academic standing, as determined by the institution; and

(C) has submitted an application to the institution in accordance with subsection (b).

(g) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each fiscal year.”.

(a) Priority to FQHCs and rural health clinics.— Section 333(a) of the Public Health Service Act (42 U.S.C. 254f(a)) is amended by adding at the end the following:

“(4) In approving applications for assignment of members of the Corps, the Secretary shall, notwithstanding paragraph (3), give priority to applications with respect to health professional shortage areas that are Federally qualified health centers and rural health clinics, as defined in section 1861(aa) of the Social Security Act.”.

(b) Loan repayment program.—

(1) In general.— The Secretary of Health and Human Services shall award grants to Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))) for the purpose of addressing health professional workforce shortages by making loan repayments on behalf of health care professionals serving at such centers.

(2) Applications.— To seek a grant under paragraph (1), a Federally qualified health center shall submit an application to the Secretary of Health and Human Services at such time, in such manner, and containing such information as the Secretary may require. At a minimum, such an application shall include—

(A) a description of the center’s capacity to address specific regional workforce shortages, supported by data;

(B) a plan for making loan repayments as described in paragraph (1); and

(C) a description of the center’s use of an interdisciplinary approach to care (such as through the use of teams to provide care that include physicians, nurses, social workers, community health workers, pharmacists, and other health care professionals).

(a) Grants To recruit, train, and retain a community-Based health center workforce.—

(1) In general.— Section 330 of the Public Health Service Act (42 U.S.C. 254b) is amended—

(A) by redesignating subsection (r) as subsection (u); and

(B) by inserting after subsection (q) the following new subsection:

“(r) Recruiting, training, and retaining a community-Based workforce.— The Secretary may award grants to health centers for the purpose of assisting such centers in—

(1) recruiting and hiring staff with the skills and experience necessary to effectively serve health center patient populations in rural and underserved areas; and

(2) supporting career advancement and workforce development opportunities for such staff.”.

(b) FQHCs deemed eligible To register as apprenticeship program.— Not later than 180 days after the date of the enactment of this Act, the Secretary of Labor shall revise the regulations under part 29 of title 29, Code of Federal Regulations, as in effect on the date of the enactment of this Act, so that Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))) are eligible to register as apprenticeship programs under such part.

(c) Health centers career opportunities.— Section 330 of the Public Health Service Act (42 U.S.C. 254b), as amended by subsection (a), is further amended by inserting after subsection (r) the following:

“(s) Health centers career opportunities.—

(1) In general.— The Secretary may award grants to institutions of higher education, including community colleges and minority-serving institutions, to establish partnerships with one or more health centers funded under this section for training students in health professions.

(2) Use of funds.—

(A) Costs.— An institution of higher education receiving a grant under this subsection may use the grant to pay the costs of training, including the salary of the clinicians or other educators who provide the training.

(B) Training supported.— The training supported pursuant to a grant under this subsection may include formal training and mentorships.

(C) Types of training.— The types of training supported pursuant to a grant under this subsection may include clinical, information technology, operations, finance, or other training for students of health professions, as determined by the institution of higher education receiving the grant in partnership with the health center involved.

(3) Definitions.— In this subsection:

(A) The term institution of higher education means an institution of higher education described in subsection (a) or (b) of section 101 of the Higher Education Act of 1965.

(B) The term minority-serving institution means an institution of higher education described in section 371(a) of the Higher Education Act of 1965.”.

(d) Behavioral health specialists.— Section 330 of the Public Health Service Act (42 U.S.C. 254b), as amended by subsection (c), is further amended by inserting after subsection (s) the following:

“(t) Behavioral health specialists.—

(1) In general.— The Secretary may award grants to health centers to establish, operate, or expand training programs for behavioral health specialists.

(2) Use of funds.— The training programs for behavioral health specialists supported pursuant to a grant under this subsection may include—

(A) stipends for personnel to operate the training programs;

(B) apprenticeship programs; and

(C) other recruitment and retention activities for behavioral health specialists.”.

(a) Payments to teaching health centers.—

(1) In general.— Section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended—

(A) in subsection (a)(1), in the matter preceding subparagraph (A), by inserting “, or that have in effect a covered agreement with a sponsoring institution so listed,” after “relevant accrediting body”; and

(B) in subsection (j), by adding at the end the following new paragraph:

“(5) Covered agreement.— The term covered agreement means a written contract, memorandum of understanding, or other written agreement entered into for a period of not less than 2 years for the purpose of conducting an approved graduate medical residency training program.”.

(2) Effective date.— The amendments made by paragraph (1) shall apply with respect to expenses incurred on or after October 1, 2027.

(b) Medicare GME cap.— Section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) is amended—

(1) in paragraph (4)(F)(i), by striking “and (10)” and inserting “(10), and (11)”; and

(2) by adding at the end the following new paragraph:

“(11) Training programs at Federally qualified health centers.—

(A) In general.— For cost reporting periods beginning on or after October 1, 2027, in the case of a hospital that has an approved medical residency training program where a significant portion of such program occurs at a Federally qualified health center (as determined by the Secretary), the Secretary shall increase the otherwise applicable resident limit for such hospital by 3 full-time equivalent residency positions.

(B) Definitions.— In this paragraph:

(i) Otherwise applicable resident limit.— The term “otherwise applicable resident limit” means, with respect to a hospital, the limit otherwise applicable under subparagraphs (F)(i) and (H) of paragraph (4) on the resident level for the hospital determined without regard to this paragraph but taking into account subparagraphs (A) and (B) of paragraph (7), subparagraphs (A) and (B) of paragraph (8), and paragraphs (9)(A) and (10)(A).

(ii) Resident level.— The term “resident level” has the meaning given such term in paragraph (7)(C)(i).”.

(a) Behavioral health professional and case manager services.—

(1) Medicare.— Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)) is amended—

(A) in paragraph (1)—

(i) in subparagraph (B), by inserting “such services furnished on or after October 1, 2026, by a behavioral health consultant, peer support specialist, or other behavioral health professional (as such terms are defined by the Secretary),” before “and such services”;

(ii) in subparagraph (C), by striking “and” at the end;

(iii) in subparagraph (D), by striking the comma at the end and inserting “, and”; and

(iv) by inserting after subparagraph (D) the following new subparagraph:

“(E) case management services furnished on or after October 1, 2026, by a case manager (as defined by the Secretary),”; and

(B) in paragraph (3)(A), by striking “(D)” and inserting “(E)”.

(2) Medicaid.— Section 1905(l)(2)(A) of the Social Security Act (42 U.S.C. 1396d(l)(2)(A)) is amended by inserting “and (E)” before “of section”.

(b) Guidance on State Medicaid payments to FQHCs.— Section 1902(bb) of the Social Security Act (42 U.S.C. 1396a(bb)) is amended by adding at the end the following new paragraph:

“(7) Study and guidance on payment adjustments.— Not later than October 1, 2027, and not less frequently than annually thereafter, the Secretary shall—

(A) conduct a study on any differences in the methods by which State plans adjust the payment amount under paragraph (3) for services furnished during a fiscal year; and

(B) based on the results of the study conducted under subparagraph (A), issue guidance to State plans on best practices for adjusting the payment amount under paragraph (3) for services furnished during a fiscal year.”.