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42 U.S.C. § 295h — Loan repayment program for substance use disorder treatment workforce

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 295h — Loan repayment program for substance use disorder treatment workforce

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Source location: Title 42, Chapter 6A, § 295h; chapter-6a-public-health-service.md

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**(a) In general** The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall carry out a program under which— (1) the Secretary enters into agreements with individuals to make payments in accordance with subsection (b) on the principal of and interest on any eligible loan; and (2) the individuals each agree to the requirements of service in substance use disorder treatment employment, as described in subsection (d). **(b) Payments** For each year of obligated service by an individual pursuant to an agreement under subsection (a), the Secretary shall make a payment to such individual as follows: (1) **Service in a shortage area** — The Secretary shall pay— (A) for each year of obligated service by an individual pursuant to an agreement under subsection (a), ⅙ of the principal of and interest on each eligible loan of the individual which is outstanding on the date the individual began service pursuant to the agreement; and (B) for completion of the sixth and final year of such service, the remainder of such principal and interest. (2) **Maximum amount** — The total amount of payments under this section to any individual shall not exceed $250,000. **(c) Eligible loans** The loans eligible for repayment under this section are each of the following: (1) Any loan for education or training for a substance use disorder treatment employment. (2) Any loan under part E of subchapter VI (relating to nursing student loans). (3) Any Federal Direct Stafford Loan, Federal Direct PLUS Loan, Federal Direct Unsubsidized Stafford Loan, or Federal Direct Consolidation Loan (as such terms are used in section 455 of the Higher Education Act of 1965 [[20 U.S.C. 1087e](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1087e&num=0&edition=prelim)]). (4) Any Federal Perkins Loan under part E of title I 11 So in original. Probably should be “part E of title IV of the Higher Education Act of 1965”. of the Higher Education Act of 1965. (5) Any other Federal loan as determined appropriate by the Secretary. **(d) Requirements of service** Any individual receiving payments under this program as required by an agreement under subsection (a) shall agree to an annual commitment to full-time employment, with no more than 1 year passing between any 2 years of covered employment, in substance use disorder treatment employment in the United States in— (1) a Mental Health Professional Shortage Area, as designated under [section 254e of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254e&num=0&edition=prelim); or (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. **(e) Ineligibility for double benefits** No borrower may, for the same service, receive a reduction of loan obligations or a loan repayment under both— (1) this section; and (2) any Federally supported loan forgiveness program, including under section 254l–1, 254q–1, or 297n of this title, or section 428J, 428L, 455(m), or 460 of the Higher Education Act of 1965 [[20 U.S.C. 1078–10](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1078–10&num=0&edition=prelim), 1078–12, 1087e(m), 1087j]. **(f) 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 subsection (a). (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. **(g) Additional criteria** The Secretary— (1) may establish such criteria and rules to carry out this section as the Secretary determines are needed and in addition to the criteria and rules specified in this section; and (2) shall give notice to the committees specified in subsection (h) of any criteria and rules so established. **(h) Report to Congress** Not later than 5 years after October 24, 2018, and every other year thereafter, the Secretary shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on— (1) the number and location of borrowers who have qualified for loan repayments under this section; and (2) the impact of this section on the availability of substance use disorder treatment employees nationally and in shortage areas and counties described in subsection (d). **(i) Definition** In this section: (1) The terms “Indian tribe” and “tribal organization” have the meanings given those terms in [section 5304 of title 25](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section5304&num=0&edition=prelim). (2) The term “municipality” means a city, town, or other public body created by or pursuant to State law, or an Indian tribe. (3) The term “substance use disorder treatment employment” means full-time employment (including a fellowship)— (A) 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 disorder, including master’s level social workers, psychologists, counselors, marriage and family therapists, psychiatric mental health practitioners, occupational therapists, psychology doctoral interns, and behavioral health paraprofessionals and physicians, physician assistants, and nurses, who are licensed or certified in accordance with applicable State and Federal laws; and (B) which is located at a substance use disorder treatment program, private physician practice, hospital or health system-affiliated inpatient treatment center or outpatient clinic (including an academic medical center-affiliated treatment program), correctional facility or program, youth detention center or program, inpatient psychiatric facility, crisis stabilization unit, community health center, community mental health or other specialty community behavioral health center, recovery center, school, community-based organization, telehealth platform, migrant health center, health program or facility operated by an Indian tribe or tribal organization, Federal medical facility, or any other facility as determined appropriate for purposes of this section by the Secretary. **(j) Authorization of appropriations** There are authorized to be appropriated to carry out this section $40,000,000 for each of fiscal years 2026 through 2030.

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Federal law — U.S. Code and appendices · legal_authorities

20 U.S.C. § 1087e — Terms and conditions of loans

**(a) In general** (1) **Parallel terms, conditions, benefits, and amounts** — Unless otherwise specified in this part, loans made to borrowers under this part shall have the same terms, conditions, and benefits, and be available in the same amounts, as loans made to borrowers, and first disbursed on June 30, 2010, under sections 1078, 1078–2, 1078–3, and 1078–8 of this title. (2) **Designation of loans** — Loans made to borrowers under this part that, except as otherwise specified in this part, have the same terms, conditions, and benefits as loans made to borrowers under— (A) [section 1078 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1078&num=0&edition=prelim) shall be known as “Federal Direct Stafford Loans”; (B) [section 1078–2 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1078-2&num=0&edition=prelim) shall be known as “Federal Direct PLUS Loans”; (C) [section 1078–3 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1078-3&num=0&edition=prelim) shall be known as “Federal Direct Consolidation Loans”; and (D) [section 1078–8 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1078-8&num=0&edition=prelim) shall be known as “Federal Direct Unsubsidized Stafford Loans”. (3) **Termination of authority to make interest subsidized loans and Federal Direct PLUS loans to graduate and professional students** (A) *Termination of authority to make interest subsidized loans to graduate and professional students* — Subject to subparagraph (B), and notwithstanding any provision of this part or part B— (i) for any period of instruction beginning on or after July 1, 2012, a graduate or profess

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42 U.S.C. § 254e — Health professional shortage areas

**(a) Designation by Secretary; removal from areas designated; “medical facility” defined** (1) For purposes of this subpart the term “health professional shortage area” means (A) an area in an urban or rural area (which need not conform to the geographic boundaries of a political subdivision and which is a rational area for the delivery of health services) which the Secretary determines has a health manpower shortage and which is not reasonably accessible to an adequately served area, (B) a population group which the Secretary determines has such a shortage, or (C) a public or nonprofit private medical facility or other public facility which the Secretary determines has such a shortage. All Federally qualified health centers and rural health clinics, as defined in section 1861(aa) of the Social Security Act ([42 U.S.C. 1395x(aa)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa&num=0&edition=prelim)), that meet the requirements of [section 254g of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254g&num=0&edition=prelim) shall be automatically designated as having such a shortage. The Secretary shall not remove an area from the areas determined to be health professional shortage areas under subparagraph (A) of the preceding sentence until the Secretary has afforded interested persons and groups in such area an opportunity to provide data and information in support of the designation as a health professional shortage area or a population group described in subparagraph (B) of such sentence or a facility described in subparagraph (C) of such sentence, and has made a determination on the basis of the data and information submitted by such persons and groups and other data and information availabl

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25 U.S.C. § 5304 — Authorization of appropriations

**(a) In general** There are authorized to be appropriated such sums as may be necessary to carry out this subchapter. **(b) Availability of appropriations** Notwithstanding any other provision of this chapter, the provision of funds under this chapter shall be subject to the availability of appropriations and the Secretary is not required to reduce funding for programs, projects, or activities serving a tribe in order to make funds available to another tribe or tribal organization under this chapter.

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20 U.S.C. § 1001 — General definition of institution of higher education

**(a) Institution of higher education** For purposes of this chapter, other than subchapter IV, the term “institution of higher education” means an educational institution in any State that— (1) admits as regular students only persons having a certificate of graduation from a school providing secondary education, or the recognized equivalent of such a certificate, or persons who meet the requirements of [section 1091(d) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1091/d&num=0&edition=prelim); (2) is legally authorized within such State to provide a program of education beyond secondary education; (3) provides an educational program for which the institution awards a bachelor’s degree or provides not less than a 2-year program that is acceptable for full credit toward such a degree, or awards a degree that is acceptable for admission to a graduate or professional degree program, subject to review and approval by the Secretary; (4) is a public or other nonprofit institution; and (5) is accredited by a nationally recognized accrediting agency or association, or if not so accredited, is an institution that has been granted preaccreditation status by such an agency or association that has been recognized by the Secretary for the granting of preaccreditation status, and the Secretary has determined that there is satisfactory assurance that the institution will meet the accreditation standards of such an agency or association within a reasonable time. **(b) Additional institutions included** For purposes of this chapter, other than subchapter IV, the term “institution of higher education” also includes— (1) any school that provides not less than a 1-year program of training to prepare students for gainful employment in a re

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Federal law — U.S. Code and appendices · legal_authorities

20 U.S.C. § 1078–10 — Loan forgiveness for teachers

**(a) Statement of purpose** It is the purpose of this section to encourage individuals to enter and continue in the teaching profession. **(b) Program authorized** The Secretary shall carry out a program, through the holder of the loan, of assuming the obligation to repay a qualified loan amount for a loan made under section 1078 or 1078–8 of this title, in accordance with subsection (c), for any new borrower on or after October 1, 1998, who— (1) has been employed as a full-time teacher for 5 consecutive complete school years— (A) in a school or location that qualifies under [section 1087ee(a)(2)(A) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section1087ee/a/2/A&num=0&edition=prelim) for loan cancellation for Perkins loan recipients who teach in such schools or locations; and (B) if employed as an elementary school or secondary school teacher, is highly qualified as defined in section 9101 11 See References in Text note below. of the Elementary Secondary 22 So in original. Probably should be preceded by “and”. Education Act of 1965 [[20 U.S.C. 7801](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title20-section7801&num=0&edition=prelim)], or meets the requirements of subsection (g)(3); and (2) is not in default on a loan for which the borrower seeks forgiveness. **(c) Qualified loans amount** (1) **In general** — The Secretary shall repay not more than $5,000 in the aggregate of the loan obligation on a loan made under section 1078 or 1078–8 of this title that is outstanding after the completion of the fifth complete school year of teaching described in subsection (b)(1). No borrower may receive a reduction of loan obligations under both this section and [section 1087j of this title](https://uscode.house.

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42 U.S.C. § 294e — Allied health and other disciplines

**(a) In general** The Secretary may make grants or contracts under this section to help entities fund activities of the type described in subsection (b). **(b) Activities** Activities of the type described in this subsection include the following: (1) Assisting entities in meeting the costs associated with expanding or establishing programs that will increase the number of individuals trained in allied health professions. Programs and activities funded under this paragraph may include— (A) those that expand enrollments in allied health professions with the greatest shortages or whose services are most needed by geriatric populations or for maternal and child health; (B) those that provide rapid transition training programs in allied health fields to individuals who have baccalaureate degrees in health-related sciences; (C) those that establish community-based allied health training programs that link academic centers to rural clinical settings; (D) those that provide career advancement training for practicing allied health professionals; (E) those that expand or establish clinical training sites for allied health professionals in medically underserved or rural communities in order to increase the number of individuals trained; (F) those that develop curriculum that will emphasize knowledge and practice in the areas of prevention and health promotion, geriatrics, long-term care, home health and hospice care, and ethics; (G) those that expand or establish interdisciplinary training programs that promote the effectiveness of allied health practitioners in geriatric assessment and the rehabilitation of the elderly; (H) those that expand or establish demonstration centers to emphasize innovative models to link allied health clinical practice, educa

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42 U.S.C. § 295p — Definitions

For purposes of this subchapter: (1) (A) The terms “school of medicine”, “school of dentistry”, “school of osteopathic medicine”, “school of pharmacy”, “school of optometry”, “school of podiatric medicine”, “school of veterinary medicine”, “school of public health”, and “school of chiropractic” mean an accredited public or nonprofit private school in a State that provides training leading, respectively, to a degree of doctor of medicine, a degree of doctor of dentistry or an equivalent degree, a degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree or a degree of doctor of pharmacy or an equivalent degree, a degree of doctor of optometry or an equivalent degree, a degree of doctor of podiatric medicine or an equivalent degree, a degree of doctor of veterinary medicine or an equivalent degree, a graduate degree in public health or an equivalent degree, and a degree of doctor of chiropractic or an equivalent degree, and including advanced training related to such training provided by any such school. (B) The terms “graduate program in health administration” and “graduate program in clinical psychology” mean an accredited graduate program in a public or nonprofit private institution in a State that provides training leading, respectively, to a graduate degree in health administration or an equivalent degree and a doctoral degree in clinical psychology or an equivalent degree. (C) The terms “graduate program in clinical social work” and “graduate program in marriage and family therapy” and “graduate program in professional counseling” mean an accredited graduate program in a public or nonprofit private institution in a State that provides training, respectively, in a concentration in health or mental health care leadin

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42 U.S.C. § 292d — Eligibility of borrowers and terms of insured loans

**(a) In general** A loan by an eligible lender shall be insurable by the Secretary under the provisions of this subpart only if— (1) made to— (A) a student who— (i) (I) has been accepted for enrollment at an eligible institution, or (II) in the case of a student attending an eligible institution, is in good standing at that institution, as determined by the institution; (ii) is or will be a full-time student at the eligible institution; (iii) has agreed that all funds received under such loan shall be used solely for tuition, other reasonable educational expenses, including fees, books, and laboratory expenses, and reasonable living expenses, incurred by such students; and (iv) in the case of a pharmacy student, has satisfactorily completed three years of training; or (B) an individual who— (i) has previously had a loan insured under this subpart when the individual was a full-time student at an eligible institution; (ii) is in a period during which, pursuant to paragraph (2), the principal amount of such previous loan need not be paid; and (iii) has agreed that all funds received under the proposed loan shall be used solely for repayment of interest due on previous loans made under this subpart; (2) evidenced by a note or other written agreement which— (A) is made without security and without endorsement, except that if the borrower is a minor and such note or other written agreement executed by him would not, under the applicable law, create a binding obligation, an endorsement may be required; (B) provides for repayment of the principal amount of the loan in installments over a period of not less than 10 years (unless sooner repaid) nor more than 25 years beginning not earlier than 9 months nor later than 12 mo

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42 U.S.C. § 292c — Sources of funds

Loans made by eligible lenders in accordance with this subpart shall be insurable by the Secretary whether made from funds fully owned by the lender or from funds held by the lender in a trust or similar capacity and available for such loans.

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42 U.S.C. § 295j — Preferences and required information in certain programs

**(a) Preferences in making awards** (1) **In general** — Subject to paragraph (2), in making awards of grants or contracts under any of sections 293k and 294 of this title, the Secretary shall give preference to any qualified applicant that— (A) has a high rate for placing graduates in practice settings having the principal focus of serving residents of medically underserved communities; (B) during the 2-year period preceding the fiscal year for which such an award is sought, has achieved a significant increase in the rate of placing graduates in such settings; or (C) utilizes a longitudinal evaluation (as described in [section 294n(d)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section294n/d/2&num=0&edition=prelim)) and reports data from such system to the national workforce database (as established under [section 294n(b)(2)(E) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section294n/b/2/E&num=0&edition=prelim)). (2) **Limitation regarding peer review** — For purposes of paragraph (1), the Secretary may not give an applicant preference if the proposal of the applicant is ranked at or below the 20th percentile of proposals that have been recommended for approval by peer review groups. **(b) “Graduate” defined** For purposes of this section, the term “graduate” means, unless otherwise specified, an individual who has successfully completed all training and residency requirements necessary for full certification in the health profession selected by the individual. **(c) Exceptions for new programs** (1) **In general** — To permit new programs to compete equitably for funding under this section, those new programs that meet at least 4 of the criteria described in paragraph (3)

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