42 U.S.C. § 294k — Training demonstration program

Page 1044 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294k entity or consortium agrees to make available non-Federal contributions toward the costs of the program to be funded under the grant in an amount that is not less than $1 for each $5 of Federal funds provided under the grant. (2) Determination of amount contributed Non-Federal contributions under paragraph (1) may be in cash or in-kind, fairly evaluated, including equipment or services. Amounts pro- vided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be in- cluded in determining the amount of such con- tributions. (d) Evaluation The Secretary shall take such action as may be necessary to evaluate the projects funded under this section and publish, make publicly available, and disseminate the results of such evaluations on as wide a basis as is practicable. (e) Reports Not later than 2 years after March 23, 2010, and annually thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives a report that— (1) describes the specific projects supported under this section; and (2) contains recommendations for Congress based on the evaluation conducted under sub- section (d). (Pub. L. 111–148, title III, § 3508, Mar. 23, 2010, 124 Stat. 530.) Editorial Notes CODIFICATION Section was enacted as part of the Patient Protection and Affordable Care Act, and not as part of the Public Health Service Act which comprises this chapter. PRIOR PROVISIONS A prior section 294j, act July 1, 1944, ch. 373, title VII, § 737, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2265; amended Aug. 1, 1977, Pub. L. 95–83, title III, § 307(c)(6), 91 Stat. 390; Dec. 19, 1977, Pub. L. 95–215, § 4(f), 91 Stat. 1506; Aug. 13, 1981, Pub. L. 97–35, title XXVII, § 2731, 95 Stat. 919; Jan. 4, 1983, Pub. L. 97–414, § 8(i), 96 Stat. 2061; Oct. 22, 1985, Pub. L. 99–129, title II, §§ 201(c), 204(c), 208(g)(2), 99 Stat. 525, 527, 531; Nov. 4, 1988, Pub. L. 100–607, title VI, §§ 602(l), 628(6), 629(b)(2), 102 Stat. 3124, 3145, 3146, defined ‘‘eligible in- stitution’’, ‘‘eligible lender’’, ‘‘line of credit’’, and ‘‘school of allied health’’, prior to the general amend- ment of this subchapter by Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 1994. See section 292o of this title. Section 294j–1, act July 1, 1944, ch. 373, title VII, § 737A, as added Aug. 13, 1981, Pub. L. 97–35, title XXVII, § 2732, 95 Stat. 919, which related to determination of el- igible students, was omitted in the general amendment of this subchapter by Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 1994. § 294k. Training demonstration program (a) In general The Secretary shall establish a training dem- onstration program to award grants to eligible entities to support— (1) training for medical residents and fellows to practice psychiatry and addiction medicine in underserved, community-based settings that integrate primary care with mental health and substance use disorder prevention and treatment services; (2) training (including for individuals com- pleting clinical training requirements for li- censure) for nurse practitioners, physician as- sistants, health service psychologists, coun- selors, nurses, and social workers to provide mental health and substance use disorder serv- ices in underserved community-based settings that integrate primary care and mental health and substance use disorder services, including such settings that serve pediatric populations; and (3) establishing, maintaining, or improving academic units or programs that— (A) provide training for students or fac- ulty, including through clinical experiences and research, to improve the ability to be able to recognize, diagnose, and treat mental health and substance use disorders, with a special focus on addiction or pediatric popu- lations; or (B) develop evidence-based practices or recommendations for the design of the units or programs described in subparagraph (A), including curriculum content standards. (b) Activities (1) Training for residents and fellows A recipient of a grant under subsection (a)(1)— (A) shall use the grant funds— (i)(I) to plan, develop, and operate a training program for medical psychiatry residents and fellows in addiction medicine practicing in eligible entities described in subsection (c)(1); or (II) to train new psychiatric residents and fellows in addiction medicine to pro- vide and expand access to integrated men- tal health and substance use disorder serv- ices; and (ii) to provide at least 1 training track that is— (I) a virtual training track that in- cludes an in-person rotation at a teach- ing health center or in a community- based setting, followed by a virtual rota- tion in which the resident or fellow con- tinues to support the care of patients at the teaching health center or in the community-based setting through the use of health information technology and, as appropriate, telehealth services; (II) an in-person training track that in- cludes a rotation, during which the resi- dent or fellow practices at a teaching health center or in a community-based setting; or (III) an in-person training track that includes a rotation during which the resident practices in a community-based setting that specializes in the treatment of infants, children, adolescents, or preg- nant or postpartum women; and (B) may use the grant funds to provide ad- ditional support for the administration of Page 1045 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294k 1 So in original. the program or to meet the costs of projects to establish, maintain, or improve faculty development, or departments, divisions, or other units necessary to implement such training. (2) Training for other providers A recipient of a grant under subsection (a)(2)— (A) shall use the grant funds to plan, de- velop, or operate a training program to pro- vide mental health and substance use dis- order services in underserved, community- based settings (including such settings that serve pediatric populations), as appropriate, that integrate primary care and mental health and substance use disorder prevention and treatment services; and (B) may use the grant funds to provide ad- ditional support for the administration of the program or to meet the costs of projects to establish, maintain, or improve faculty development, or departments, divisions, or other units necessary to implement such program. (3) Academic units or programs A recipient of a grant under subsection (a)(3) shall enter into a partnership with organiza- tions such as an education accrediting organi- zation (such as the Liaison Committee on Medical Education, the Accreditation Council for Graduate Medical Education, the Commis- sion on Osteopathic College Accreditation, the Accreditation Commission for Education in Nursing, the Commission on Collegiate Nurs- ing Education, the Accreditation Council for Pharmacy Education, the Council on Social Work Education, American Psychological As- sociation Commission on Accreditation, or the Accreditation Review Commission on Edu- cation for the Physician Assistant) to carry out activities under subsection (a)(3). (c) Eligible entities (1) Training for residents and fellows To be eligible to receive a grant under sub- section (a)(1), an entity shall— (A) be a consortium consisting of— (i) at least one teaching health center; and (ii) the sponsoring institution (or parent institution of the sponsoring institution) of— (I) a psychiatry residency program that is accredited by the Accreditation Council of Graduate Medical Education (or the parent institution of such a pro- gram); or (II) a fellowship in addiction medicine, as determined appropriate by the Sec- retary; or (B) be an entity described in subparagraph (A)(ii) that provides opportunities for resi- dents or fellows to train in community- based settings that integrate primary care with mental health and substance use dis- order prevention and treatment services. (2) Training for other providers To be eligible to receive a grant under sub- section (a)(2), an entity shall be— (A) a teaching health center (as defined in section 293l–1(f) of this title); (B) a Federally qualified health center (as defined in section 1396d(l)(2)(B) of this title); (C) a community mental health center (as defined in section 1395x(ff)(3)(B) of this title); (D) a rural health clinic (as defined in sec- tion 1395x(aa) of this title); (E) a health center operated by the Indian Health Service, an Indian tribe, a tribal or- ganization, or an urban Indian organization (as defined in section 1603 of title 25); or (F) an entity with a demonstrated record of success in providing training for nurse practitioners, physician assistants, health service psychologists counselors, nurses,,1 and social workers, including such entities that serve pediatric populations. (3) Academic units or programs To be eligible to receive a grant under sub- section (a)(3), an entity shall be a school of medicine or osteopathic medicine, a nursing school, a physician assistant training pro- gram, a school of pharmacy, a school of social work, an accredited public or nonprofit pri- vate hospital, an accredited medical residency program, or a public or private nonprofit enti- ty which the Secretary has determined is ca- pable of carrying out such grant. (d) Priority (1) In general In awarding grants under subsection (a)(1) or (a)(2), the Secretary shall give priority to eli- gible entities that— (A) demonstrate sufficient size, scope, and capacity to undertake the requisite training of an appropriate number of psychiatric resi- dents, fellows, health service psychologists, nurses nurse 1 practitioners, physician as- sistants counselors,,1 or social workers in addiction medicine per year to meet the needs of the area served; (B) demonstrate experience in training providers to practice team-based care that integrates mental health and substance use disorder prevention and treatment services with primary care in community-based set- tings, which may include such settings that serve pediatric populations; (C) demonstrate experience in using health information technology and, as appropriate, telehealth to support— (i) the delivery of mental health and sub- stance use disorder services at the eligible entities described in subsections (c)(1) and (c)(2); and (ii) community health centers in inte- grating primary care and mental health and substance use disorder treatment; or (D) have the capacity to expand access to mental health and substance use disorder services in areas with demonstrated need, as determined by the Secretary, such as tribal, rural, or other underserved communities. Page 1046 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294k (2) Academic units or programs In awarding grants under subsection (a)(3), the Secretary shall give priority to eligible en- tities that— (A) have a record of training the greatest percentage of mental health and substance use disorder providers who enter and remain in these fields or who enter and remain in settings with integrated primary care and mental and substance use disorder preven- tion and treatment services; (B) have a record of training individuals who are from underrepresented minority groups, including native populations, or from a rural or disadvantaged background; (C) provide training in the care (which may include trauma-informed care, as ap- propriate) of vulnerable populations such as infants, children, adolescents, pregnant and postpartum women, older adults, homeless individuals, victims of abuse or trauma, in- dividuals with disabilities, and other groups as defined by the Secretary; (D) teach trainees the skills to provide interprofessional, integrated care through collaboration among health professionals; or (E) provide training in cultural com- petency and health literacy. (e) Duration Grants awarded under this section shall be for a minimum of 5 years. (f) Study and report (1) Study (A) In general The Secretary, acting through the Admin- istrator of the Health Resources and Serv- ices Administration, shall conduct a study on the results of the demonstration program under this section. (B) Data submission Not later than 90 days after the comple- tion of the first year of the training program and each subsequent year that the program is in effect, each recipient of a grant under subsection (a) shall submit to the Secretary such data as the Secretary may require for analysis for the report described in para- graph (2). (2) Report to Congress Not later than 1 year after receipt of the data described in paragraph (1)(B), the Sec- retary shall submit to Congress a report that includes— (A) an analysis of the effect of the dem- onstration program under this section on the quality, quantity, and distribution of mental health and substance use disorder services; (B) an analysis of the effect of the dem- onstration program on the prevalence of un- treated mental health and substance use dis- orders in the surrounding communities of health centers participating in the dem- onstration; and (C) recommendations on whether the dem- onstration program should be expanded. (g) Authorization of appropriations There are authorized to be appropriated to carry out this section, and 1 $31,700,000 for each of fiscal years 2023 through 2027. (July 1, 1944, ch. 373, title VII, § 760, as added Pub. L. 114–255, div. B, title IX, § 9022, Dec. 13, 2016, 130 Stat. 1250; amended Pub. L. 117–328, div. FF, title I, § 1311(b), Dec. 29, 2022, 136 Stat. 5696.) Editorial Notes PRIOR PROVISIONS A prior section 294k, act July 1, 1944, ch. 373, title VII, § 738, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2265; amended Dec. 19, 1977, Pub. L. 95–215, § 4(e)(12), 91 Stat. 1506, related to repayment of loans of deceased or disabled borrowers from student loan insurance fund, prior to the general amendment of this subchapter by Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 1994. See section 292m of this title. Sections 294l to 294m were omitted in the general amendment of this subchapter by Pub. L. 102–408. Section 294l, act July 1, 1944, ch. 373, title VII, § 739, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2266; amended Dec. 19, 1977, Pub. L. 95–215, § 4(e)(13), 91 Stat. 1506; Aug. 13, 1981, Pub. L. 97–35, title XXVII, § 2733, 95 Stat. 920, related to eligibility of insti- tutions and recordation and availability of informa- tion. See section 292n of this title. Section 294l–1, act July 1, 1944, ch. 373, title VII, § 739A, as added Nov. 4, 1988, Pub. L. 100–607, title VI, § 602(m), 102 Stat. 3124, related to reissuance and refi- nancing of certain loans. Section 294m, act July 1, 1944, ch. 373, title VII, § 740, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 170; amended Oct. 13, 1964, Pub. L. 88–654, § 1(a), (b), 78 Stat. 1086; Oct. 22, 1965, Pub. L. 89–290, §§ 2(b), 4 (a), (f)(1), (2), 79 Stat. 1056–1058; Nov. 2, 1966, Pub. L. 89–709, § 3(a), (b), 80 Stat. 1103; Nov. 3, 1966, Pub. L. 89–751, § 5(c)(1), 80 Stat. 1232; Aug. 16, 1968, Pub. L. 90–490, title I, § 121(a)(1), (2), (5)(B), 82 Stat. 777, 778; Nov. 18, 1971, Pub. L. 92–157, title I, § 105(e)(1), (4), (f)(2), 85 Stat. 451; Aug. 23, 1974, Pub. L. 93–385, § 2(b), 88 Stat. 741; Apr. 22, 1976, Pub. L. 94–278, title XI, § 1105(b), 90 Stat. 416; Oct. 12, 1976, Pub. L. 94–484, title IV, § 402, 90 Stat. 2266; Oct. 22, 1985, Pub. L. 99–129, title II, § 209(a)(1), (j)(1), 99 Stat. 532, 536; Nov. 4, 1988, Pub. L. 100–607, title VI, §§ 603(a), 628(7), 629(b)(2), 102 Stat. 3125, 3145, 3146; Nov. 6, 1990, Pub. L. 101–527, § 5(a), (b), 104 Stat. 2322, 2323, related to loan agree- ments for establishment of student loan funds. See sec- tion 292q of this title. AMENDMENTS 2022—Pub. L. 117–328, § 1311(b)(1), substituted ‘‘mental health and substance use disorder’’ for ‘‘mental and substance use disorders’’ wherever appearing. Subsec. (a)(2). Pub. L. 117–328, § 1311(b)(2), inserted ‘‘(including for individuals completing clinical training requirements for licensure)’’ after ‘‘training’’ and ‘‘counselors, nurses,’’ after ‘‘psychologists,’’ and sub- stituted ‘‘services, including such settings that serve pediatric populations;’’ for ‘‘services;’’. Subsec. (a)(3)(A). Pub. L. 117–328, § 1311(b)(3), sub- stituted ‘‘disorders’’ for ‘‘disorder’’ and inserted ‘‘or pe- diatric populations’’ after ‘‘addiction’’. Subsec. (b)(2)(A). Pub. L. 117–328, § 1311(b)(4), inserted ‘‘(including such settings that serve pediatric popu- lations)’’ after ‘‘settings’’. Subsec. (c)(2)(F). Pub. L. 117–328, § 1311(b)(5), inserted ‘‘counselors, nurses,’’ after ‘‘psychologists’’ and sub- stituted ‘‘workers, including such entities that serve pediatric populations.’’ for ‘‘workers.’’ Subsec. (d)(1)(A). Pub. L. 117–328, § 1311(b)(6), inserted ‘‘health service psychologists, nurses’’ after ‘‘fellows,’’ and ‘‘counselors,’’ after ‘‘physician assistants’’. Subsec. (d)(1)(B). Pub. L. 117–328, § 1311(b)(7), inserted ‘‘health’’ after ‘‘mental’’ and ‘‘, which may include Page 1047 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294n such settings that serve pediatric populations’’ after ‘‘settings’’. Subsec. (d)(2)(C). Pub. L. 117–328, § 1311(b)(8), inserted ‘‘(which may include trauma-informed care, as appro- priate)’’ after ‘‘care’’. Subsec. (f)(2)(B). Pub. L. 117–328, § 1311(b)(10), sub- stituted ‘‘disorders’’ for ‘‘disorder’’. Subsec. (g). Pub. L. 117–328, § 1311(b)(9), substituted ‘‘, and $31,700,000 for each of fiscal years 2023 through 2027’’ for ‘‘$10,000,000 for each of fiscal years 2018 through 2022’’. PART E—HEALTH PROFESSIONS AND PUBLIC HEALTH WORKFORCE SUBPART 1—HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS Statutory Notes and Related Subsidiaries FUNDING FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER TRAINING FOR HEALTH CARE PROFES- SIONALS, PARAPROFESSIONALS, AND PUBLIC SAFETY OFFICERS Pub. L. 117–2, title II, § 2703, Mar. 11, 2021, 135 Stat. 46, provided that: ‘‘(a) IN GENERAL.—In addition to amounts otherwise available, there is appropriated to the Secretary [of Health and Human Services] for fiscal year 2021, out of any money in the Treasury not otherwise appropriated, $80,000,000, to remain available until expended, for the purpose described in subsection (b). ‘‘(b) USE OF FUNDING.—The Secretary, acting through the Administrator of the Health Resources and Serv- ices Administration, shall, taking into consideration the needs of rural and medically underserved commu- nities, use amounts appropriated by subsection (a) to award grants or contracts to health professions schools, academic health centers, State or local gov- ernments, Indian Tribes and Tribal organizations, or other appropriate public or private nonprofit entities (or consortia of entities, including entities promoting multidisciplinary approaches), to plan, develop, oper- ate, or participate in health professions and nursing training activities for health care students, residents, professionals, paraprofessionals, trainees, and public safety officers, and employers of such individuals, in evidence-informed strategies for reducing and address- ing suicide, burnout, mental health conditions, and substance use disorders among health care profes- sionals.’’ FUNDING FOR EDUCATION AND AWARENESS CAMPAIGN ENCOURAGING HEALTHY WORK CONDITIONS AND USE OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES BY HEALTH CARE PROFESSIONALS Pub. L. 117–2, title II, § 2704, Mar. 11, 2021, 135 Stat. 46, provided that: ‘‘(a) IN GENERAL.—In addition to amounts otherwise available, there is appropriated to the Secretary [of Health and Human Services] for fiscal year 2021, out of any money in the Treasury not otherwise appropriated, $20,000,000, to remain available until expended, for the purpose described in subsection (b). ‘‘(b) Use of Funds.—The Secretary, acting through the Director of the Centers for Disease Control and Pre- vention and in consultation with the medical profes- sional community, shall use amounts appropriated by subsection (a) to carry out a national evidence-based education and awareness campaign directed at health care professionals and first responders (such as emer- gency medical service providers), and employers of such professionals and first responders. Such awareness campaign shall— ‘‘(1) encourage primary prevention of mental health conditions and substance use disorders and secondary and tertiary prevention by encouraging health care professionals to seek support and treatment for their own mental health and substance use concerns; and ‘‘(2) help such professionals to identify risk factors in themselves and others and respond to such risks.’’ FUNDING FOR GRANTS FOR HEALTH CARE PROVIDERS TO PROMOTE MENTAL HEALTH AMONG THEIR HEALTH PROFESSIONAL WORKFORCE Pub. L. 117–2, title II, § 2705, Mar. 11, 2021, 135 Stat. 46, provided that: ‘‘(a) IN GENERAL.—In addition to amounts otherwise available, there is appropriated to the Secretary [of Health and Human Services] for fiscal year 2021, out of any money in the Treasury not otherwise appropriated, $40,000,000, to remain available until expended, for the purpose described in subsection (b). ‘‘(b) USE OF FUNDS.—The Secretary, acting through the Administrator of the Health Resources and Serv- ices Administration, shall, taking into consideration the needs of rural and medically underserved commu- nities, use amounts appropriated by subsection (a) to award grants or contracts to entities providing health care, including health care providers associations and Federally qualified health centers, to establish, en- hance, or expand evidence-informed programs or proto- cols to promote mental health among their providers, other personnel, and members.’’ § 294n. Health professions workforce information and analysis (a) Purpose It is the purpose of this section to— (1) provide for the development of informa- tion describing the health professions work- force and the analysis of workforce related issues; and (2) provide necessary information for deci- sion-making regarding future directions in health professions and nursing programs in re- sponse to societal and professional needs. (b) National Center for Health Care Workforce Analysis (1) Establishment The Secretary shall establish the National Center for Health Workforce Analysis (re- ferred to in this section as the ‘‘National Cen- ter’’). (2) Purposes The National Center, in coordination to the extent practicable with the National Health Care Workforce Commission (established in section 294q of this title), and relevant re- gional and State centers and agencies, shall— (A) provide for the development of infor- mation describing and analyzing the health care workforce and workforce related issues; (B) carry out the activities under section 295k(a) of this title; (C) annually evaluate programs under this subchapter; (D) develop and publish performance meas- ures and benchmarks for programs under this subchapter; and (E) establish, maintain, and publicize a na- tional Internet registry of each grant award- ed under this subchapter and a database to collect data from longitudinal evaluations (as described in subsection (d)(2)) on per- formance measures (as developed under sec- tions 293l(d)(3), 294f(d)(3), and 294o(a)(3) of this title). (3) Collaboration and data sharing (A) In general The National Center shall collaborate with Federal agencies and relevant professional