42 U.S.C. § 293 — Centers of excellence

Page 1012 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 293 school of medicine or osteopathic medicine in- volved meets the conditions described in sub- paragraph (A) of section 292s(b)(2) of this title or the conditions described in subparagraph (C) of such section. (B) For purposes of subparagraph (A), the conditions referred to in such subparagraph shall be applied with respect to graduates of the school involved whose date of graduation occurred approximately 3 years before June 30 of the fiscal year preceding the fiscal year for which the Federal capital contribution in- volved is made. (July 1, 1944, ch. 373, title VII, § 735, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2021; amended Pub. L. 102–531, title III, § 313(a)(1), Oct. 27, 1992, 106 Stat. 3507; Pub. L. 103–43, title XX, § 2014(d), June 10, 1993, 107 Stat. 217; Pub. L. 105–392, title I, § 134(c), Nov. 13, 1998, 112 Stat. 3578.) Editorial Notes PRIOR PROVISIONS A prior section 735 of act July 1, 1944, was classified to section 294h of this title prior to the general revision of this subchapter by Pub. L. 102–408. AMENDMENTS 1998—Subsec. (e)(2). Pub. L. 105–392 reenacted heading without change and amended text of par. (2) generally. Prior to amendment, text read as follows: ‘‘Amounts described in paragraph (1) that are returned to the Sec- retary before the fourth quarter of a fiscal year shall be obligated before the end of such fiscal year, and may not be obligated before the fourth quarter. For pur- poses of the preceding sentence, amounts returned to the Secretary during the last quarter of a fiscal year are deemed to have been returned during the first three quarters of the succeeding fiscal year.’’ 1993—Subsec. (f). Pub. L. 103–43 added subsec. (f). 1992—Subsec. (b). Pub. L. 102–531 inserted designa- tions for cls. (A) and (B) in first sentence. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1992 AMENDMENT Pub. L. 102–531, title III, § 313(c), Oct. 27, 1992, 106 Stat. 3507, provided that: ‘‘The amendments described in this section [amending this section and sections 293j, 293l, 294n, 295j, 295l, 295n, 295o, 296k, and 298b–7 of this title, repealing section 297j of this title, redesignating sub- part IV of part B of subchapter VI of this chapter as subpart III, and amending provisions set out as a note under section 295k of this title] are made, and take ef- fect, immediately after the enactment of the bill, H.R. 3508, of the One Hundred Second Congress [Pub. L. 102–408, approved Oct. 13, 1992].’’ PART B—HEALTH PROFESSIONS TRAINING FOR DIVERSITY § 293. Centers of excellence (a) In general The Secretary shall make grants to, and enter into contracts with, designated health profes- sions schools described in subsection (c), and other public and nonprofit health or educational entities, for the purpose of assisting the schools in supporting programs of excellence in health professions education for under-represented mi- nority individuals. (b) Required use of funds The Secretary may not make a grant under subsection (a) unless the designated health pro- fessions school involved agrees, subject to sub- section (c)(1)(C), to expend the grant— (1) to develop a large competitive applicant pool through linkages with institutions of higher education, local school districts, and other community-based entities and establish an education pipeline for health professions careers; (2) to establish, strengthen, or expand pro- grams to enhance the academic performance of under-represented minority students at- tending the school; (3) to improve the capacity of such school to train, recruit, and retain under-represented minority faculty including the payment of such stipends and fellowships as the Secretary may determine appropriate; (4) to carry out activities to improve the in- formation resources, clinical education, cur- ricula and cultural competence of the grad- uates of the school, as it relates to minority health issues; (5) to facilitate faculty and student research on health issues particularly affecting under- represented minority groups, including re- search on issues relating to the delivery of health care; (6) to carry out a program to train students of the school in providing health services to a significant number of under-represented mi- nority individuals through training provided to such students at community-based health facilities that— (A) provide such health services; and (B) are located at a site remote from the main site of the teaching facilities of the school; and (7) to provide stipends as the Secretary de- termines appropriate, in amounts as the Sec- retary determines appropriate. (c) Centers of excellence (1) Designated schools (A) In general The designated health professions schools referred to in subsection (a) are such schools that meet each of the conditions specified in subparagraphs (B) and (C), and that— (i) meet each of the conditions specified in paragraph (2)(A); (ii) meet each of the conditions specified in paragraph (3); (iii) meet each of the conditions speci- fied in paragraph (4); or (iv) meet each of the conditions specified in paragraph (5). (B) General conditions The conditions specified in this subpara- graph are that a designated health profes- sions school— (i) has a significant number of under-rep- resented minority individuals enrolled in the school, including individuals accepted for enrollment in the school; (ii) has been effective in assisting under- represented minority students of the school to complete the program of edu- cation and receive the degree involved; (iii) has been effective in recruiting under-represented minority individuals to Page 1013 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 293 1 So in original. Probably should be ‘‘paragraph’’. enroll in and graduate from the school, in- cluding providing scholarships and other financial assistance to such individuals and encouraging under-represented minor- ity students from all levels of the edu- cational pipeline to pursue health profes- sions careers; and (iv) has made significant recruitment ef- forts to increase the number of under-rep- resented minority individuals serving in faculty or administrative positions at the school. (C) Consortium The condition specified in this subpara- graph is that, in accordance with subsection (e)(1), the designated health profession school involved has with other health profes- sion schools (designated or otherwise) formed a consortium to carry out the pur- poses described in subsection (b) at the schools of the consortium. (D) Application of criteria to other programs In the case of any criteria established by the Secretary for purposes of determining whether schools meet the conditions de- scribed in subparagraph (B), this section may not, with respect to racial and ethnic minorities, be construed to authorize, re- quire, or prohibit the use of such criteria in any program other than the program estab- lished in this section. (2) Centers of excellence at certain historically black colleges and universities (A) Conditions The conditions specified in this subpara- graph are that a designated health profes- sions school— (i) is a school described in section 295p(1) of this title; and (ii) received a contract under section 295g–8b of this title for fiscal year 1987, as such section was in effect for such fiscal year. (B) Use of grant In addition to the purposes described in subsection (b), a grant under subsection (a) to a designated health professions school meeting the conditions described in subpara- graph (A) may be expended— (i) to develop a plan to achieve institu- tional improvements, including financial independence, to enable the school to sup- port programs of excellence in health pro- fessions education for under-represented minority individuals; and (ii) to provide improved access to the li- brary and informational resources of the school. (C) Exception The requirements of paragraph (1)(C) shall not apply to a historically black college or university that receives funding under para- graphs 1 (2) or (5). (3) Hispanic centers of excellence The conditions specified in this paragraph are that— (A) with respect to Hispanic individuals, each of clauses (i) through (iv) of paragraph (1)(B) applies to the designated health pro- fessions school involved; (B) the school agrees, as a condition of re- ceiving a grant under subsection (a), that the school will, in carrying out the duties described in subsection (b), give priority to carrying out the duties with respect to His- panic individuals; and (C) the school agrees, as a condition of re- ceiving a grant under subsection (a), that— (i) the school will establish an arrange- ment with 1 or more public or nonprofit community based Hispanic serving organi- zations, or public or nonprofit private in- stitutions of higher education, including schools of nursing, whose enrollment of students has traditionally included a sig- nificant number of Hispanic individuals, the purposes of which will be to carry out a program— (I) to identify Hispanic students who are interested in a career in the health profession involved; and (II) to facilitate the educational prepa- ration of such students to enter the health professions school; and (ii) the school will make efforts to re- cruit Hispanic students, including students who have participated in the under- graduate or other matriculation program carried out under arrangements estab- lished by the school pursuant to clause (i)(II) and will assist Hispanic students re- garding the completion of the educational requirements for a degree from the school. (4) Native American centers of excellence Subject to subsection (e), the conditions specified in this paragraph are that— (A) with respect to Native Americans, each of clauses (i) through (iv) of paragraph (1)(B) applies to the designated health professions school involved; (B) the school agrees, as a condition of re- ceiving a grant under subsection (a), that the school will, in carrying out the duties described in subsection (b), give priority to carrying out the duties with respect to Na- tive Americans; and (C) the school agrees, as a condition of re- ceiving a grant under subsection (a), that— (i) the school will establish an arrange- ment with 1 or more public or nonprofit private institutions of higher education, including schools of nursing, whose enroll- ment of students has traditionally in- cluded a significant number of Native Americans, the purpose of which arrange- ment will be to carry out a program— (I) to identify Native American stu- dents, from the institutions of higher education referred to in clause (i), who are interested in health professions ca- reers; and (II) to facilitate the educational prepa- ration of such students to enter the des- ignated health professions school; and (ii) the designated health professions school will make efforts to recruit Native Page 1014 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 293 2 So in original. The word ‘‘and’’ probably should not appear. American students, including students who have participated in the under- graduate program carried out under ar- rangements established by the school pur- suant to clause (i) and will assist Native American students regarding the comple- tion of the educational requirements for a degree from the designated health profes- sions school. (5) Other centers of excellence The conditions specified in this paragraph are— (A) with respect to other centers of excel- lence, the conditions described in clauses (i) through (iv) of paragraph (1)(B); and (B) that the health professions school in- volved has an enrollment of under-rep- resented minorities above the national aver- age for such enrollments of health profes- sions schools. (d) Designation as center of excellence (1) In general Any designated health professions school re- ceiving a grant under subsection (a) and meet- ing the conditions described in paragraph (2) or (5) of subsection (c) shall, for purposes of this section, be designated by the Secretary as a Center of Excellence in Under-Represented Minority Health Professions Education. (2) Hispanic centers of excellence Any designated health professions school re- ceiving a grant under subsection (a) and meet- ing the conditions described in subsection (c)(3) shall, for purposes of this section, be des- ignated by the Secretary as a Hispanic Center of Excellence in Health Professions Education. (3) Native American centers of excellence Any designated health professions school re- ceiving a grant under subsection (a) and meet- ing the conditions described in subsection (c)(4) shall, for purposes of this section, be des- ignated by the Secretary as a Native Amer- ican Center of Excellence in Health Profes- sions Education. Any consortium receiving such a grant pursuant to subsection (e) shall, for purposes of this section, be so designated. (e) Authority regarding Native American centers of excellence With respect to meeting the conditions speci- fied in subsection (c)(4), the Secretary may make a grant under subsection (a) to a des- ignated health professions school that does not meet such conditions if— (1) the school has formed a consortium in ac- cordance with subsection (d)(1); and (2) the schools of the consortium collectively meet such conditions, without regard to whether the schools individually meet such conditions. (f) Duration of grant The period during which payments are made under a grant under subsection (a) may not ex- ceed 5 years. Such payments shall be subject to annual approval by the Secretary and to the availability of appropriations for the fiscal year involved to make the payments. (g) Definitions In this section: (1) Designated health professions school (A) In general The term ‘‘health professions school’’ means, except as provided in subparagraph (B), a school of medicine, a school of osteo- pathic medicine, a school of dentistry, a school of pharmacy, or a graduate program in behavioral or mental health. (B) Exception The definition established in subparagraph (A) shall not apply to the use of the term ‘‘designated health professions school’’ for purposes of subsection (c)(2). (2) Program of excellence The term ‘‘program of excellence’’ means any program carried out by a designated health professions school with a grant made under subsection (a), if the program is for pur- poses for which the school involved is author- ized in subsection (b) or (c) to expend the grant. (3) Native Americans The term ‘‘Native Americans’’ means Amer- ican Indians, Alaskan Natives, Aleuts, and Na- tive Hawaiians. (h) Formula for allocations (1) Allocations Based on the amount appropriated under subsection (i) for a fiscal year, the following subparagraphs shall apply as appropriate: (A) In general If the amounts appropriated under sub- section (i) for a fiscal year are $24,000,000 or less— (i) the Secretary shall make available $12,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(2)(A); and (ii) and 2 available after grants are made with funds under clause (i), the Secretary shall make available— (I) 60 percent of such amount for grants under subsection (a) to health professions schools that meet the condi- tions described in paragraph (3) or (4) of subsection (c) (including meeting the conditions under subsection (e)); and (II) 40 percent of such amount for grants under subsection (a) to health professions schools that meet the condi- tions described in subsection (c)(5). (B) Funding in excess of $24,000,000 If amounts appropriated under subsection (i) for a fiscal year exceed $24,000,000 but are less than $30,000,000— (i) 80 percent of such excess amounts shall be made available for grants under subsection (a) to health professions schools that meet the requirements de- scribed in paragraph (3) or (4) of subsection (c) (including meeting conditions pursuant to subsection (e)); and (ii) 20 percent of such excess amount shall be made available for grants under Page 1015 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 293 subsection (a) to health professions schools that meet the conditions described in subsection (c)(5). (C) Funding in excess of $30,000,000 If amounts appropriated under subsection (i) for a fiscal year exceed $30,000,000 but are less than $40,000,000, the Secretary shall make available— (i) not less than $12,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(2)(A); (ii) not less than $12,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (3) or (4) of subsection (c) (in- cluding meeting conditions pursuant to subsection (e)); (iii) not less than $6,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(5); and (iv) after grants are made with funds under clauses (i) through (iii), any remain- ing excess amount for grants under sub- section (a) to health professions schools that meet the conditions described in paragraph (2)(A), (3), (4), or (5) of sub- section (c). (D) Funding in excess of $40,000,000 If amounts appropriated under subsection (i) for a fiscal year are $40,000,000 or more, the Secretary shall make available— (i) not less than $16,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(2)(A); (ii) not less than $16,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (3) or (4) of subsection (c) (in- cluding meeting conditions pursuant to subsection (e)); (iii) not less than $8,000,000 for grants under subsection (a) to health professions schools that meet the conditions described in subsection (c)(5); and (iv) after grants are made with funds under clauses (i) through (iii), any remain- ing funds for grants under subsection (a) to health professions schools that meet the conditions described in paragraph (2)(A), (3), (4), or (5) of subsection (c). (2) No limitation Nothing in this subsection shall be con- strued as limiting the centers of excellence re- ferred to in this section to the designated amount, or to preclude such entities from competing for grants under this section. (3) Maintenance of effort (A) In general With respect to activities for which a grant made under this part are authorized to be expended, the Secretary may not make such a grant to a center of excellence for any fiscal year unless the center agrees to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the center for the fiscal year preceding the fiscal year for which the school receives such a grant. (B) Use of Federal funds With respect to any Federal amounts re- ceived by a center of excellence and avail- able for carrying out activities for which a grant under this part is authorized to be ex- pended, the center shall, before expending the grant, expend the Federal amounts ob- tained from sources other than the grant, unless given prior approval from the Sec- retary. (i) Authorization of appropriations To carry out this section, there is authorized to be appropriated $23,711,000 for each of fiscal years 2021 through 2025. (July 1, 1944, ch. 373, title VII, § 736, as added Pub. L. 105–392, title I, § 101(a), Nov. 13, 1998, 112 Stat. 3525; amended Pub. L. 111–148, title V, § 5401, Mar. 23, 2010, 124 Stat. 642; Pub. L. 116–136, div. A, title III, § 3401(1), Mar. 27, 2020, 134 Stat. 385.) Editorial Notes REFERENCES IN TEXT Section 295g–8b of this title, referred to in subsec. (c)(2)(A)(ii), was omitted in the general amendment of this subchapter by Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 1994. PRIOR PROVISIONS A prior section 293, act July 1, 1944, ch. 373, title VII, § 736, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2022, authorized grants to schools of medicine, osteopathic medicine, and dentistry for need-based scholarships, prior to the general amendment of this part by Pub. L. 105–392. Another prior section 293, act July 1, 1944, ch. 373, title VII, § 720, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 164; amended Sept. 4, 1964, Pub. L. 88–581, § 3(a), 78 Stat. 919; Oct. 22, 1965, Pub. L. 89–290, § 3(a), 79 Stat. 1056; Nov. 2, 1966, Pub. L. 89–709, § 2(a), 80 Stat. 1103; Aug. 16, 1968, Pub. L. 90–490, title I, § 101(a), (b)(1), 82 Stat. 773; Nov. 18, 1971, Pub. L. 92–157, title I, § 102(a), 85 Stat. 431; Oct. 12, 1976, Pub. L. 94–484, title I, § 101(c), title III, § 302, 90 Stat. 2244, 2253; Aug. 13, 1981, Pub. L. 97–35, title XXVII, § 2723(a), (b), 95 Stat. 915, authorized grants for construction of teaching facilities for med- ical, dental, and other health personnel, prior to the general revision of this subchapter by Pub. L. 102–408. A prior section 736 of act July 1, 1944, was classified to section 294i of this title prior to the general revision of this subchapter by Pub. L. 102–408. AMENDMENTS 2020—Subsec. (i). Pub. L. 116–136 added subsec. (i) and struck out former subsec. (i). Text read as follows: ‘‘There are authorized to be appropriated to carry out this section— ‘‘(1) $50,000,000 for each of the fiscal years 2010 through 2015; and ‘‘(2) and such sums as are necessary for each subse- quent fiscal year.’’ 2010—Subsecs. (h), (i). Pub. L. 111–148 added subsecs. (h) and (i) and struck out former subsec. (h) which re- lated to authorization of appropriations for fiscal years 1998 through 2002 and allocations of amounts. Statutory Notes and Related Subsidiaries SAVINGS PROVISION Pub. L. 105–392, title I, § 110, Nov. 13, 1998, 112 Stat. 3562, provided that: ‘‘In the case of any authority for Page 1016 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 293a making awards of grants or contracts that is termi- nated by the amendments made by this subtitle [sub- title A (§§ 101–110) of title I of Pub. L. 105–392, see Tables for classification], the Secretary of Health and Human Services may, notwithstanding the termination of the authority, continue in effect any grant or contract made under the authority that is in effect on the day before the date of the enactment of this Act [Nov. 13, 1998], subject to the duration of any such grant or con- tract not exceeding the period determined by the Sec- retary in first approving such financial assistance, or in approving the most recent request made (before the date of such enactment) for continuation of such assist- ance, as the case may be.’’ § 293a. Scholarships for disadvantaged students (a) In general The Secretary may make a grant to an eligi- ble entity (as defined in subsection (d)(1)) under this section for the awarding of scholarships by schools to any full-time student who is an eligi- ble individual as defined in subsection (d). Such scholarships may be expended only for tuition expenses, other reasonable educational expenses, and reasonable living expenses incurred in the attendance of such school. (b) Preference in providing scholarships The Secretary may not make a grant to an en- tity under subsection (a) unless the health pro- fessions and nursing schools involved agree that, in providing scholarships pursuant to the grant, the schools will give preference to students for whom the costs of attending the schools would constitute a severe financial hardship and, not- withstanding other provisions of this section, to former recipients of scholarships under sections 293 and 293d(d)(2)(B) of this title (as such sec- tions existed on the day before November 13, 1998). (c) Amount of award In awarding grants to eligible entities that are health professions and nursing schools, the Sec- retary shall give priority to eligible entities based on the proportion of graduating students going into primary care, the proportion of underrepresented minority students, and the proportion of graduates working in medically underserved communities. (d) Definitions In this section: (1) Eligible entities The term ‘‘eligible entities’’ means an entity that— (A) is a school of medicine, osteopathic medicine, dentistry, nursing (as defined in section 296 of this title), pharmacy, podiatric medicine, optometry, veterinary medicine, public health, chiropractic, or allied health, a school offering a graduate program in be- havioral and mental health practice, or an entity providing programs for the training of physician assistants; and (B) is carrying out a program for recruit- ing and retaining students from disadvan- taged backgrounds, including students who are members of racial and ethnic minority groups. (2) Eligible individual The term ‘‘eligible individual’’ means an in- dividual who— (A) is from a disadvantaged background; (B) has a financial need for a scholarship; and (C) is enrolled (or accepted for enrollment) at an eligible health professions or nursing school as a full-time student in a program leading to a degree in a health profession or nursing. (July 1, 1944, ch. 373, title VII, § 737, as added Pub. L. 105–392, title I, § 101(a), Nov. 13, 1998, 112 Stat. 3531.) Editorial Notes PRIOR PROVISIONS A prior section 293a, act July 1, 1944, ch. 373, title VII, § 737, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2023, authorized grants to health professions schools for provision of scholarships and undergraduate assistance, prior to the general amendment of this part by Pub. L. 105–392. Another prior section 293a, act July 1, 1944, ch. 373, title VII, § 721, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 165; amended Sept. 4, 1964, Pub. L. 88–581, § 3(b), 78 Stat. 919; Oct. 22, 1965, Pub. L. 89–290, §§ 3(b), (c), 5(a), 79 Stat. 1056–1058; Nov. 2, 1966, Pub. L. 89–709, § 2(b), 80 Stat. 1103; Aug. 16, 1968, Pub. L. 90–490, title I, §§ 103(a)(3), 105(a), (b), 82 Stat. 774; Nov. 18, 1971, Pub. L. 92–157, title I, §§ 102(e), (f)(1), (2)(A), (g), (h), (j)(2), (3), (7)(A), 108(b)(1), 85 Stat. 434–437, 461; Oct. 12, 1976, Pub. L. 94–484, title III, §§ 301, 303, 308(a), 90 Stat. 2253, 2254, 2256; Aug. 1, 1977, Pub. L. 95–83, title III, § 307(b), 91 Stat. 389; Oct. 17, 1979, Pub. L. 96–88, title III, § 301(a)(1), title V, § 507, 93 Stat. 677, 692; Aug. 13, 1981, Pub. L. 97–35, title XXVII, §§ 2723(c), (d), 2724(a), 95 Stat. 916; Nov. 4, 1988, Pub. L. 100–607, title VI, §§ 628(4), 629(b)(2), 102 Stat. 3145, 3146; Aug. 16, 1989, Pub. L. 101–93, § 5(o)(1), 103 Stat. 614, related to applications and eligibility for grants for construction of teaching facilities for medical, dental, and other health personnel, prior to the general revi- sion of this subchapter by Pub. L. 102–408. A prior section 737 of act July 1, 1944, was classified to section 294j of this title prior to the general revision of this subchapter by Pub. L. 102–408. § 293b. Loan repayments and fellowships regard- ing faculty positions (a) Loan repayments (1) Establishment of program The Secretary shall establish a program of entering into contracts with individuals de- scribed in paragraph (2) under which the indi- viduals agree to serve as members of the fac- ulties of schools described in paragraph (3) in consideration of the Federal Government agreeing to pay, for each year of such service, not more than $30,000 of the principal and in- terest of the educational loans of such individ- uals. (2) Eligible individuals The individuals referred to in paragraph (1) are individuals from disadvantaged back- grounds who— (A) have a degree in medicine, osteopathic medicine, dentistry, nursing, or another health profession; (B) are enrolled in an approved graduate training program in medicine, osteopathic medicine, dentistry, nursing, or other health profession; or (C) are enrolled as full-time students— (i) in an accredited (as determined by the Secretary) school described in paragraph (3); and