42 U.S.C. § 294c — Education and training relating to geri-

Page 1033 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294c Pub. L. 100–607, title VI, §§ 628(5), 629(b)(2), 102 Stat. 3145, 3146, related to limitations on individually insured loans and loan insurance, prior to the general revision of this subchapter by Pub. L. 102–408. See section 292b of this title. Another prior section 294b, act July 1, 1944, ch. 373, title VII, § 742, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 172; amended Oct. 22, 1965, Pub. L. 89–290, § 4(c), 79 Stat. 1057; Nov. 2, 1966, Pub. L. 89–709, § 3(e), 80 Stat. 1103; Nov. 3, 1966, Pub. L. 89–751, § 5(b), 80 Stat. 1232; Aug. 16, 1968, Pub. L. 90–490, title I, § 121(b), 82 Stat. 778; July 9, 1971, Pub. L. 92–52, § 1(a), 85 Stat. 144; Nov. 18, 1971, Pub. L. 92–157, title I, § 105(a), (f)(2), 85 Stat. 449, 451; Aug. 23, 1974, Pub. L. 93–385, § 2(a), 88 Stat. 741; Apr. 22, 1976, Pub. L. 94–278, title XI, § 1105(a), 90 Stat. 416; Oct. 12, 1976, Pub. L. 94–484, title I, § 101(e), title IV, §§ 404, 406(d), 90 Stat. 2244, 2267, 2268, which related to authorization of appropriations, was transferred to sec- tion 294o of this title. A prior section 752 of act July 1, 1944, was classified to section 293p of this title prior to repeal by Pub. L. 105–392. Another prior section 752 of act July 1, 1944, was clas- sified to section 294u of this title prior to renumbering by Pub. L. 97–35. AMENDMENTS 2022—Pub. L. 117–328, § 2227(1), inserted ‘‘rural and’’ after ‘‘serving in’’ in section catchline. Subsec. (a). Pub. L. 117–328, § 2227(2), substituted ‘‘, as appropriate, shall make grants to, and enter into con- tracts with, eligible entities to support access to ac- credited continuing medical education for primary care physicians and health care providers at community health centers or rural health clinics to improve and increase access to care for patients in rural and medi- cally underserved areas. Such grants or contracts may be used’’ for ‘‘shall make grants to, and enter into con- tracts with, eligible entities’’ and ‘‘health care pro- viders’’ for ‘‘faculty members’’ and inserted ‘‘increase primary care physician and health care provider knowl- edge,’’ after ‘‘practice environment,’’. Subsec. (b). Pub. L. 117–328, § 2227(3), inserted ‘‘, such as a community health center or rural health clinic’’ before period at end. Subsec. (c). Pub. L. 117–328, § 2227(4), which directed substitution of ‘‘may require, including—’’ and pars. (1) and (2) for ‘‘by require.’’, was executed by making the substitution for ‘‘may require.’’, to reflect the probable intent of Congress. Subsec. (d). Pub. L. 117–328, § 2227(5), amended subsec. (d) generally. Prior to amendment, text read as follows: ‘‘An eligible entity shall use amounts awarded under a grant or contract under this section to provide innova- tive supportive activities to enhance education through distance learning, continuing educational activities, collaborative conferences, and electronic and tele- learning activities, with priority for primary care.’’ Subsecs. (e), (f). Pub. L. 117–328, § 2227(7), added sub- secs. (e) and (f). Former subsec. (e) redesignated (g). Subsec. (g). Pub. L. 117–328, § 2227(6), (8), redesignated subsec. (e) as (g) and substituted ‘‘fiscal years 2023 through 2025’’ for ‘‘the fiscal years 2010 through 2014, and such sums as may be necessary for each subsequent fiscal year’’. § 294c. Education and training relating to geri- atrics (a) Geriatrics Workforce Enhancement Program (1) In general The Secretary shall award grants, contracts, or cooperative agreements under this sub- section to entities described in paragraph (1), (3), or (4) of section 295p of this title, section 296(2) of this title, or section 298(d) of this title, or other health professions schools or programs approved by the Secretary, for the establishment or operation of Geriatrics Workforce Enhancement Programs that meet the requirements of paragraph (2). (2) Requirements (A) In general A Geriatrics Workforce Enhancement Pro- gram receiving an award under this section shall support the training of health profes- sionals in geriatrics, including traineeships or fellowships. Such programs shall empha- size, as appropriate, patient and family en- gagement, integration of geriatrics with pri- mary care and other appropriate specialties, and collaboration with community partners to address gaps in health care for older adults. (B) Activities Activities conducted by a program under this section may include the following: (i) Clinical training on providing inte- grated geriatrics and primary care deliv- ery services. (ii) Interprofessional training to practi- tioners from multiple disciplines and spe- cialties, including training on the provi- sion of care to older adults. (iii) Establishing or maintaining train- ing-related community-based programs for older adults and caregivers to improve health outcomes for older adults. (iv) Providing education on Alzheimer’s disease and related dementias to families and caregivers of older adults, direct care workers, and health professions students, faculty, and providers. (3) Duration Each grant, contract, or cooperative agree- ment or contract awarded under paragraph (1) shall be for a period not to exceed 5 years. (4) Applications To be eligible to receive a grant, contract, or cooperative agreement under paragraph (1), an entity described in such paragraph shall sub- mit to the Secretary an application at such time, in such manner, and containing such in- formation as the Secretary may require. (5) Program requirements (A) In general In awarding grants, contracts, and cooper- ative agreements under paragraph (1), the Secretary— (i) shall give priority to programs that demonstrate coordination with another Federal or State program or another pub- lic or private entity; (ii) shall give priority to applicants with programs or activities that are expected to substantially benefit rural or medically underserved populations of older adults, or serve older adults in Indian Tribes or Trib- al organizations; and (iii) may give priority to any program that— (I) integrates geriatrics into primary care practice; (II) provides training to integrate geri- atric care into other specialties across Page 1034 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294c care settings, including practicing clin- ical specialists, health care administra- tors, faculty without backgrounds in geriatrics, and students from all health professions; (III) emphasizes integration of geri- atric care into existing service delivery locations and care across settings, in- cluding primary care clinics, medical homes, Federally qualified health cen- ters, ambulatory care clinics, critical ac- cess hospitals, emergency care, assisted living and nursing facilities, and home- and community-based services, which may include adult daycare; (IV) supports the training and retrain- ing of faculty, primary care providers, other direct care providers, and other ap- propriate professionals on geriatrics; (V) emphasizes education and engage- ment of family caregivers on disease management and strategies to meet the needs of caregivers of older adults; or (VI) proposes to conduct outreach to communities that have a shortage of geriatric workforce professionals. (B) Special consideration In awarding grants, contracts, and cooper- ative agreements under this section, the Secretary shall give special consideration to entities that provide services in areas with a shortage of geriatric workforce profes- sionals. (6) Priority The Secretary may provide awardees with additional support for activities in areas of demonstrated need, which may include edu- cation and training for home health workers, family caregivers, and direct care workers on care for older adults. (7) Reporting (A) Reports from entities Each entity awarded a grant, contract, or cooperative agreement under this section shall submit an annual report to the Sec- retary on the activities conducted under such grant, contract, or cooperative agree- ment, which may include information on the number of trainees, the number of profes- sions and disciplines, the number of partner- ships with health care delivery sites, the number of faculty and practicing profes- sionals who participated in such programs, and other information, as the Secretary may require. (B) Report to Congress Not later than 4 years after March 27, 2020, and every 5 years thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Sen- ate and the Committee on Energy and Com- merce of the House of Representatives a re- port that provides a summary of the activi- ties and outcomes associated with grants, contracts, and cooperative agreements made under this section. Such reports shall in- clude— (i) information on the number of train- ees, faculty, and professionals who partici- pated in programs under this section; (ii) information on the impact of the pro- gram conducted under this section on the health status of older adults, including in areas with a shortage of health profes- sionals; and (iii) information on outreach and edu- cation provided under this section to fami- lies and caregivers of older adults. (C) Public availability The Secretary shall make reports sub- mitted under paragraph (B) publically avail- able on the internet website of the Depart- ment of Health and Human Services. (b) Geriatric academic career awards (1) Establishment of program The Secretary shall, as appropriate, estab- lish or maintain a program to provide geri- atric academic career awards to eligible enti- ties applying on behalf of eligible individuals to promote the career development of such in- dividuals as academic geriatricians or other academic geriatrics health professionals. (2) Eligibility (A) Eligible entity For purposes of this subsection, the term ‘‘eligible entity’’ means— (i) an entity described in paragraph (1), (3), or (4) of section 295p of this title or sec- tion 296(2) of this title; or (ii) another accredited health professions school or graduate program approved by the Secretary. (B) Eligible individual For purposes of this subsection, the term ‘‘eligible individual’’ means an individual who— (i)(I) is board certified or board eligible in internal medicine, family practice, psy- chiatry, or licensed dentistry, or has com- pleted required training in a discipline and is employed in an accredited health profes- sions school or graduate program that is approved by the Secretary; or (II) has completed an approved fellow- ship program in geriatrics, or has com- pleted specialty training in geriatrics as required by the discipline and any addi- tional geriatrics training as required by the Secretary; and (ii) has a junior, nontenured, faculty ap- pointment at an accredited health profes- sions school or graduate program in geri- atrics or a geriatrics health profession. (C) Clarification If an eligible individual is promoted during the period of an award under this subsection and thereby no longer meets the criteria of subparagraph (B)(ii), the individual shall continue to be treated as an eligible indi- vidual through the term of the award. (3) Application requirements In order to receive an award under para- graph (1), an eligible entity, on behalf of an el- igible individual, shall— (A) submit to the Secretary an applica- tion, at such time, in such manner, and con- Page 1035 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294c taining such information as the Secretary may require; (B) provide, in such form and manner as the Secretary may require, assurances that the eligible individual will meet the service requirement described in paragraph (6); and (C) provide, in such form and manner as the Secretary may require, assurances that the individual has a full-time faculty ap- pointment in a health professions institu- tion and documented commitment from such eligible entity that the individual will spend 75 percent of the individual’s time that is supported by the award on teaching and de- veloping skills in interdisciplinary edu- cation in geriatrics. (4) Equitable distribution In making awards under this subsection, the Secretary shall seek to ensure geographical distribution among award recipients, includ- ing among rural or medically underserved areas of the United States. (5) Amount and duration (A) Amount The amount of an award under this sub- section shall be at least $75,000 for fiscal year 2021, adjusted for subsequent years in accordance with the consumer price index. The Secretary shall determine the amount of an award under this subsection for indi- viduals who are not physicians. (B) Duration The Secretary shall make awards under paragraph (1) for a period not to exceed 5 years. (6) Service requirement An individual who receives an award under this subsection shall provide training in clin- ical geriatrics, including the training of inter- professional teams of health care profes- sionals. The provision of such training shall constitute at least 75 percent of the obliga- tions of such individual under the award. (c) Nonapplicability of provision Notwithstanding any other provision of this subchapter, section 295j(a) of this title shall not apply to awards made under this section. (d) Authorization of appropriations There is authorized to be appropriated $40,737,000 for each of fiscal years 2021 through 2025 for purposes of carrying out this section. (July 1, 1944, ch. 373, title VII, § 753, as added Pub. L. 105–392, title I, § 103, Nov. 13, 1998, 112 Stat. 3544; amended Pub. L. 107–205, title II, § 202(b), Aug. 1, 2002, 116 Stat. 817; Pub. L. 111–148, title V, § 5305(a), (b), Mar. 23, 2010, 124 Stat. 622, 624; Pub. L. 111–256, § 2(f)(5), Oct. 5, 2010, 124 Stat. 2644; Pub. L. 116–136, div. A, title III, § 3403, Mar. 27, 2020, 134 Stat. 388; Pub. L. 116–260, div. BB, title III, § 331(a), Dec. 27, 2020, 134 Stat. 2938.) Editorial Notes PRIOR PROVISIONS A prior section 294c, act July 1, 1944, ch. 373, title VII, § 765, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2047, authorized appropriations for purpose of carrying out subpart I of this part, prior to the general amendment of this part by Pub. L. 105–392. Another prior section 294c, act July 1, 1944, ch. 373, title VII, § 730, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2258, related to sources of funds for eligible student loans, prior to the general amendment of this subchapter by Pub. L. 102–408. See section 292c of this title. Another prior section 294c, act July 1, 1944, ch. 373, title VII, § 743, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 172; amended Oct. 22, 1965, Pub. L. 89–290, § 4(d), 79 Stat. 1057; Nov. 3, 1966, Pub. L. 89–751, § 5(c)(2), (3), 80 Stat. 1233; Aug. 16, 1968, Pub. L. 90–490, title I, § 121(c), 82 Stat. 778; July 9, 1971, Pub. L. 92–52, § 1(b), 85 Stat. 144; Nov. 18, 1971, Pub. L. 92–157, title I, § 105(e)(2), (f)(2), 85 Stat. 451; Oct. 12, 1976, Pub. L. 94–484, title IV, §§ 405, 406(e), 90 Stat. 2267, 2268, which related to the dis- tribution of assets from loan funds, was transferred to section 294p of this title. AMENDMENTS 2020—Pub. L. 116–136 amended section generally. Prior to amendment, section consisted of subsecs. (a) to (e) which related to geriatric education centers, geriatric training regarding physicians and dentists, geriatric faculty fellowships, geriatric workforce development, and geriatric career incentive awards, respectively. Subsec. (a)(7)(B). Pub. L. 116–260, in introductory pro- visions, substituted ‘‘Coronavirus Aid, Relief, and Eco- nomic Security Act’’ for ‘‘Title VII Health Care Work- force Reauthorization Act of 2019’’ in the original, and accordingly, ‘‘the date of enactment of the Coronavirus Aid, Relief, and Economic Security Act’’ was trans- lated to ‘‘March 27, 2020’’. The Coronavirus Aid, Relief, and Economic Security Act, Pub. L. 116–136, was ap- proved Mar. 27, 2020. 2010—Subsec. (b)(2)(E). Pub. L. 111–256 substituted ‘‘elderly individuals with intellectual disabilities’’ for ‘‘elderly mentally retarded individuals’’. Subsec. (c)(2) to (4). Pub. L. 111–148, § 5305(b)(2), added pars. (2) to (4) and struck out former pars. (2) and (3) which described eligible individuals and limitations for Geriatric Academic Career Awards. Former par. (4) re- designated (5). Subsec. (c)(5). Pub. L. 111–148, § 5305(b)(1), redesig- nated par. (4) as (5). Former par. (5) redesignated (6). Subsec. (c)(5)(A). Pub. L. 111–148, § 5305(b)(3)(A), in- serted ‘‘for individuals who are physicians’’ before ‘‘shall equal’’ and inserted at end ‘‘The Secretary shall determine the amount of an Award under this section for individuals who are not physicians.’’ Subsec. (c)(5)(C). Pub. L. 111–148, § 5305(b)(3)(B), added subpar. (C). Subsec. (c)(6). Pub. L. 111–148, § 5305(b)(1), redesig- nated par. (5) as (6). Subsecs. (d), (e). Pub. L. 111–148, § 5305(a), added sub- secs. (d) and (e). 2002—Subsec. (a)(1). Pub. L. 107–205 substituted ‘‘, and section 296(2) of this title,’’ for ‘‘, and section 298b(2) of this title,’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2020 AMENDMENT Pub. L. 116–260, div. BB, title III, § 331(d), Dec. 27, 2020, 134 Stat. 2938, provided that: ‘‘The amendments made by subsections (a), (b), and (c) [amending this section and sections 297n–1 and 297t of this title] shall take ef- fect as if included in the enactment of the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116–136).’’ DEFINITIONS For meaning of references to an intellectual dis- ability and to individuals with intellectual disabilities in provisions amended by section 2 of Pub. L. 111–256, see section 2(k) of Pub. L. 111–256, set out as a note under section 1400 of Title 20, Education. Page 1036 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 294d § 294d. Quentin N. Burdick program for rural interdisciplinary training (a) Grants The Secretary may make grants or contracts under this section to help entities fund author- ized activities under an application approved under subsection (c). (b) Use of amounts (1) In general Amounts provided under subsection (a) shall be used by the recipients to fund interdiscipli- nary training projects designed to— (A) use innovative or evidence-based meth- ods to train health care practitioners to pro- vide services in rural areas; (B) demonstrate and evaluate innovative interdisciplinary methods and models de- signed to provide access to cost-effective comprehensive health care; (C) deliver health care services to individ- uals residing in rural areas; (D) enhance the amount of relevant re- search conducted concerning health care issues in rural areas; and (E) increase the recruitment and retention of health care practitioners from rural areas and make rural practice a more attractive career choice for health care practitioners. (2) Methods A recipient of funds under subsection (a) may use various methods in carrying out the projects described in paragraph (1), including— (A) the distribution of stipends to students of eligible applicants; (B) the establishment of a post-doctoral fellowship program; (C) the training of faculty in the economic and logistical problems confronting rural health care delivery systems; or (D) the purchase or rental of transpor- tation and telecommunication equipment where the need for such equipment due to unique characteristics of the rural area is demonstrated by the recipient. (3) Administration (A) In general An applicant shall not use more than 10 percent of the funds made available to such applicant under subsection (a) for adminis- trative expenses. (B) Training Not more than 10 percent of the individ- uals receiving training with funds made available to an applicant under subsection (a) shall be trained as doctors of medicine or doctors of osteopathy. (C) Limitation An institution that receives a grant under this section shall use amounts received under such grant to supplement, not sup- plant, amounts made available by such insti- tution for activities of the type described in subsection (b)(1) in the fiscal year preceding the year for which the grant is received. (c) Applications Applications submitted for assistance under this section shall— (1) be jointly submitted by at least two eligi- ble applicants with the express purpose of as- sisting individuals in academic institutions in establishing long-term collaborative relation- ships with health care providers in rural areas; and (2) designate a rural health care agency or agencies for clinical treatment or training, in- cluding hospitals, community health centers, migrant health centers, rural health clinics, community behavioral and mental health cen- ters, long-term care facilities, Native Hawai- ian health centers, or facilities operated by the Indian Health Service or an Indian tribe or tribal organization or Indian organization under a contract with the Indian Health Serv- ice under the Indian Self-Determination Act [25 U.S.C. 5321 et seq.]. (d) Definitions For the purposes of this section, the term ‘‘rural’’ means geographic areas that are located outside of standard metropolitan statistical areas. (July 1, 1944, ch. 373, title VII, § 754, as added Pub. L. 105–392, title I, § 103, Nov. 13, 1998, 112 Stat. 3547; amended Pub. L. 116–136, div. A, title III, § 3401(7), Mar. 27, 2020, 134 Stat. 386.) Editorial Notes REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (c)(2), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which is classified principally to subchapter I (§ 5321 et seq.) of chapter 46 of Title 25, Indians. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of Title 25 and Tables. PRIOR PROVISIONS A prior section 294d, act July 1, 1944, ch. 373, title VII, § 766, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2047, authorized grants and contracts for de- velopment of advanced training of allied health profes- sionals, prior to the general amendment of this part by Pub. L. 105–392. Another prior section 294d, act July 1, 1944, ch. 373, title VII, § 731, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2258; amended Aug. 1, 1977, Pub. L. 95–83, title III, § 307(c)(1), (2), 91 Stat. 389, 390; Dec. 19, 1977, Pub. L. 95–215, § 4(a)–(d), (e)(6), 91 Stat. 1505, 1506; Dec. 17, 1980, Pub. L. 96–538, title IV, § 402, 94 Stat. 3192; Aug. 13, 1981, Pub. L. 97–35, title XXVII, § 2728, 95 Stat. 918; Oct. 22, 1985, Pub. L. 99–129, title II, §§ 208(a), (b)(1), (2), (c)(1), (d), (i), 211(a)(2), 99 Stat. 529–532, 539; Nov. 4, 1988, Pub. L. 100–607, title VI, § 602(e), (f), 102 Stat. 3123; Apr. 6, 1991, Pub. L. 102–25, title III, § 374, 105 Stat. 95; July 23, 1992, Pub. L. 102–325, title IV, § 427(b)(2), 106 Stat. 549, related to eligibility of borrowers and terms of insurance, prior to the general amendment of this subchapter by Pub. L. 102–408. See section 292d of this title. Another prior section 294d, act July 1, 1944, ch. 373, title VII, § 744, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 173; amended Oct. 22, 1965, Pub. L. 89–290, § 4(e), 79 Stat. 1057; Nov. 3, 1966, Pub. L. 89–751, § 5(a), 80 Stat. 1230; Aug. 16, 1968, Pub. L. 90–490, title I, § 121(d), 82 Stat. 778; July 9, 1971, Pub. L. 92–52, § 1(c), 85 Stat. 144; Nov. 18, 1971, Pub. L. 92–157, title I, § 105(e)(3), (f)(2), 85 Stat. 451, provided for loans to schools to capitalize health professions student loan funds, prior to repeal by Pub. L. 94–484, title IV, § 406(a)(1), Oct. 12, 1976, 90 Stat. 2268.