Health Professions Training and Nurse Education Improvement and Reauthorization Act of 1991

Summary

Health Professions Training and Nurse Education Improvement and Reauthorization Act of 1991 - Title I: Provisions Relating to Title VII - Health Professions Training Improvement and Reauthorization Act of 1991 - Subtitle A: General Provisions - Amends title VII (Health Research and Teaching Facilities and Training of Professional Health Personnel) of the Public Health Service Act to change the composition of the National Advisory Council on Health Professions Education and establish the Subcommittee on Allied Health. Prohibits making a grant, loan guarantee, or interest subsidy payment to specified types of educational institutions and programs which discriminate on the basis of race, color, religion, gender, national origin, age, disability, marital status, or educational affiliation (currently, on the basis of sex). Adds graduate programs in clinical social work to the list of institutions and programs covered. Modifies requirements and authorizations concerning the collection and reporting of certain data about specified types of health professionals. Requires all grant or contract applicants under title VII to instruct all trainees regarding precautions to prevent transmission of bloodborne diseases. Sets forth priorities in the awarding of competitive grants under titles VII or title VIII (Nurse Education) of the Act. Subtitle B: Student Assistance - Sets forth limits on the total principal amount of new loans made and installments paid for specified fiscal years under the Federal program of insured loans to health professions graduate students. Extends the date after which insurance may not be granted for loans or installments. Sets forth additional circumstances under which principal repayment may be deferred. Modifies loan consolidation requirements, including removing provisions prohibiting, in certain circumstances, the inclusion of such an insured loan in a consolidated loan under the authority of the Student Loan Marketing Association. Prohibits interest on such loans from being compounded more frequently than annually (currently, semiannually). Sets a maximum rate of interest. Provides for a quarterly special allowance to eligible loan holders based on a percentage of the unpaid principal of all eligible loans held by that holder. Requires an increase in the allowance if not promptly paid. Allows the educational institution or program attended by the borrower to assist in the collection of a delinquent loan by providing information on the borrower to lenders and holders. Mandates performance standards and fees to be paid by lenders and holders for the servicing of loans and for the processing of loan default claims. Requires (currently, allows) reduction in Federal payments to borrowers who are practicing their professions and have defaulted on their loans. Modifies the circumstances under which a lender or holder is not required to prosecute an action for default. Requires assessment of a risk-based premium on an eligible borrower and, if required, an eligible institution that is based on the default rate of the eligible institution involved. Allows an institution to pay off the outstanding principal and interest owed by defaulters to reduce the risk category of the institution. Removes provisions regulating premiums for insurance on the loans. Bars Federal or State time limits on enforcement of repayment of the loans. Allows the student loan insurance fund to be used for making payments in connection with the administration as well as for the collection or default of insured loans. Authorizes the use of a specified amount for the Office for Health Education Assistance Loans. Requires that borrowers under the loan insurance program who enter and remain in specified primary care fields receive preference for participation in the National Health Service Corps Loan Repayment Program. Increases the maximum amount which may be repaid per year in return for the borrower serving in a health professional shortage area. Cancels the borrower's repayment obligation on death or total permanent disability (currently, on death). Limits discharge through bankruptcy. Mandates a report to specified congressional committees regarding the default rates for each institution, lender, and loan holder. Modifies the authority of the Secretary of Health and Human Services to issue regulations regarding specified aspects of the loan insurance program. Requires each participating institution to have an annual workshop on the requirements of the program and require all student borrowers to attend. Establishes, in the Bureau of Health Professions, the Office for Health Education Assistance Loans to achieve a reduction in the number and amounts of defaults on loans made or guaranteed under specified provisions. Authorizes appropriations for Federal capital contributions to student loan funds under specified provisions. Subtitle C: Direct Student Loan Health Demonstration Program - Establishes a direct student loan health demonstration program to make assistance available to certain institutions for those institutions to use to make direct loans to health professions students. Directs the Secretary to borrow up to a specified amount from the Secretary of the Treasury each year to provide the assistance to the institutions. Authorizes selection of up to 20 eligible institutions for the program. Sets forth institutional eligibility and other requirements. Makes student borrowers under this program ineligible for loans under other specified provisions. Requires certain collection efforts. Terminates the authority to make loans under these provisions five years after enactment. Modifies the loan repayment program for allied health personnel to allow repayment in exchange for service in a medically underserved or rural community that can demonstrate a shortage of allied health professionals in a recognized discipline. (Current law allows repayment in exchange for service in one of a list of types of facilities and agencies.) Authorizes appropriations for scholarships for students in specified health fields schools who are of exceptional financial need. Repeals provisions mandating grants for medical school scholarships for individuals agreeing to enter family practice (known as Lister Hill scholars). Authorizes appropriations for scholarships for individuals from disadvantaged backgrounds. Modifies eligibility requirements for individuals to participate in a loan repayment program regarding service on the faculties of certain health professions schools. Limits payments to 20 percent of the principal and interest due on a loan (currently, 50 percent) of the principal and interest due on a loan for a given repayment year). Authorizes appropriations. Subtitle D: Grants and Contracts for Programs and Projects - Modifies application requirements and priorities regarding grants to establish, maintain, or improve departments of family medicine. Authorizes appropriations. Requires that agreements for developing and operating area health education center programs remain in effect for six years. Sets forth priorities. Mandates contracts to health education and training centers to improve services along the U.S.-Mexico border and in other high-impact urban or rural areas (currently, along the U.S.-Mexico border). Sets forth priorities. Authorizes agreements with eligible schools of medicine and osteopathic medicine for the planning, development, and operation of State supported area health education center programs meeting specified requirements. Authorizes appropriations. Requires matching non-Federal contributions. Adds a school of osteopathic medicine, a school of public health, and a graduate program in clinical psychology to the definition of "health professions school" for provisions mandating grants or contracts (currently, mandating grants) for programs of excellence in health professions education for minority individuals. Authorizes appropriations for such grants. Allows grants and contracts under existing provisions to be used to: (1) plan, develop, and operate, or participate in (currently, to plan, develop, and operate) a professional training program, including a residency or internship program (currently a residency program) in internal medicine or pediatrics for allopathic and osteopathic students, interns, residents, or practicing physicians (currently, for residents); and (2) provide financial assistance to allopathic and osteopathic students, interns, residents, practicing physicians, or other medical personnel (currently, to residents) who plan to work in general internal medicine and general pediatrics. Authorizes appropriations. Modifies eligibility requirements. Allows grants and contracts for educational assistance to individuals from disadvantaged backgrounds to be used for graduate programs in clinical social work. Modifies preferences (currently, priorities) in making the grants and contracts. Authorizes appropriations. Removes provisions setting aside certain funds for specified purposes. Authorizes limited payment of stipends. Authorizes appropriations for grants for retention programs for health professions schools with individuals with disadvantaged backgrounds. Authorizes grants and contracts to increase the number of underrepresented minority faculty at certain types of health professions schools. Authorizes appropriations. Replaces provisions authorizing grants for two-year schools of medicine or osteopathy with provisions authorizing grants and contracts for studies and demonstration projects regarding health professions education, licensing, credentialing, continuing competency, and discipline. Replaces provisions authorizing grants and contracts for model projects on faculty and curriculum development and development of new clinical training sites with provisions authorizing grants and contracts regarding chiropractic health care. Repeals provisions authorizing grants and contracts for training in preventive medicine. Transfers and authorizes appropriations for remaining similar provisions. Authorizes appropriations for grants and contracts for training physician assistants. Authorizes appropriations for grants and contracts for: (1) studies and demonstration projects regarding health professions education, licensing, credentialing, continuing competency, and discipline; (2) chiropractic health care; and (3) certain projects with respect to hospitals and schools of podiatric medicine. Amends provisions relating to training with respect to acquired immune deficiency syndrome (AIDS) to modify eligibility for grants and contracts and allow such awards to be used with regard to: (1) faculty, students, and health professions practitioners (currently, faculty and students); (2) individuals infected with the human immunodeficiency virus (HIV) and individuals at high risk for such infection (currently, individuals with AIDS); and (3) developing curricula for care, treatment, and prevention (currently, care and treatment). Modifies preferences in making grants. Authorizes appropriations for: (1) the grants; and (2) grants to assist dental schools and certain programs with respect to oral health care to patients with AIDS. Modifies eligibility requirements regarding grants and contracts relating to geriatric education. Allows certain grants and contracts to be used to train physicians and dentists to teach geriatric medicine, geriatric psychiatry, or geriatric dentistry (currently, to teach geriatric medicine or geriatric dentistry). Modifies the associated training options. Authorizes appropriations. Subtitle E: Personnel in Public Health, Health Administration and Allied Health - Adds references to Healthy People 2000: National Health Promotion and Disease Prevention Objectives to provisions authorizing grants and contracts for certain special projects involving schools of public health. Sets forth purposes of such projects. Authorizes appropriations. Authorizes appropriations for grants for: (1) graduate programs in health administration; and (2) traineeships for students in other graduate programs. Requires that public health traineeships under existing provisions be used to increase the number of graduate students preparing to serve the Healthy People 2000 objectives. Sets forth priorities and preferences and modifies program requirements. Authorizes appropriations. Replaces provisions authorizing grants and contracts relating to the training of allied health professionals with provisions authorizing grants and contracts for: (1) increasing program enrollments or establishing programs to increase the number of individuals in allied health professions with demonstrated personnel shortages to provide individuals to serve in medically underserved or rural communities; (2) planning, developing, establishing, and operating certain allied health training programs; and (3) training centers for allied health professions for student traineeships. Authorizes appropriations. Allows grants and contracts for training of allied health professions to be used with regard to postbaccalaureate (currently, doctoral or postdoctoral) training. Sets forth preferences. Authorizes appropriations. Replaces provisions authorizing grants and contracts for educational assistance to disadvantaged individuals in allied health training with provisions establishing the Division of Allied Health in the Bureau of Health Professions. Subtitle F: Miscellaneous Programs - Modifies the functions and composition of and authorizes appropriations for the Council on Graduate Medical Education. Modifies the uses of grants and contracts under provisions relating to rural health training (currently, to health care for rural areas). Changes eligibility requirements. Removes provisions mandating a study of manpower training needs in rural areas. Authorizes appropriations. Establishes the Council on Medical Licensure to take specified actions, including giving advice regarding the establishment and operation of a system of verifying and maintaining information on the qualifications of individuals to practice medicine. Directs the Secretary of Health and Human Services to determine whether the system is operating efficiently and without discrimination on the basis of race, color, religion, gender, national origin, age, disability, marital status, or educational affiliation and, if the system fails either test, to make recommendations regarding establishment of an alternative system. Mandates an annual study of at least ten States regarding licensure of domestic and foreign medical graduates. Subtitle G: Repealers and Technical and Conforming Amendments - Repeals provisions relating to grants and loan guarantees and interest subsidies for construction of teaching facilities for medical, dental, and other health personnel. Modifies testing requirements for admission to the United States of aliens who are graduates of unaccredited medical schools. Title II: Provisions Relating to Title VIII - Nurse Education Improvement and Reauthorization Act of 1991 - Amends title VIII (Nurse Education) of the Public Health Service Act to authorize grants and contracts for special projects to: (1) provide education for nurses serving in medically underserved or rural communities (currently, provide continuing education for nurses); and (2) provide nursing education courses to rural areas (currently, to rural areas through telecommunications via satellite). Removes provisions authorizing grants and contracts for: (1) facilitating agreements between health facilities and nursing students regarding repayment of educational loans by the facilities in return for service by the students in the facilities; and (2) geriatrics health education centers. Allows grants for innovative hospital nursing practice models to also be used for models in primary care and long-term care settings. Authorizes appropriations. Authorizes appropriations for grants and contracts relating to advanced nurse education. Removes provisions requiring certain special considerations in making grants and contracts for the education of nurse practitioners and nurse midwives. Authorizes appropriations. Authorizes grants and contracts for support, including traineeships and fellowships, to develop resources or strengthen programs or faculty to address the National Health Objectives for the Year 2000. Authorizes appropriations. Authorizes appropriations for grants and contracts to increase nursing education opportunities for individuals from disadvantaged backgrounds. Makes non-nurses as well as nurses eligible for traineeships for masters and doctoral degree nursing programs, requiring non-nurses to first complete basic nursing preparation. Removes provisions authorizing grants for postbaccalaureate fellowships for faculty for certain studies. Authorizes appropriations for grants and contracts for advanced nurse education. Authorizes appropriations for grants for: (1) traineeships for licensed registered nurses to become nurse anesthetists and for developing and operating programs for the education of nurse anesthetists; and (2) improvement of existing programs for the education of nurse anesthetists. Authorizes appropriations for loan repayments, under existing provisions, in exchange for service in certain health facilities. Repeals provisions authorizing appropriations for allotments to schools of nursing for Federal capital contributions to their student loan funds. Amends remaining provisions relating to Federal capital contributions to allow allotted funds which have been returned to the Secretary of Health and Human Services to be available until expended (currently, to be available in the fiscal year of return and the subsequent fiscal year). Modifies requirements regarding the capital distribution of the balance of the loan fund. Requires certain scholarship recipients to serve as a nurse for a period equal to the number of years of the scholarship (currently, for a period of not less than two years). Authorizes appropriations. Repeals provisions authorizing loans to nursing students who enter into agreements with health facilities to engage in employment as nurses during a period of time not more than the period during which the students receive loan assistance. Prohibits making grants, loan guarantees, or interest subsidy payments under title VIII (Nurse Education) of the Public Health Service Act to any school of nursing which discriminates on the basis of race, color, religion, gender, national origin, age, disability, marital status, or educational affiliation (currently, on the basis of sex). Requires a report to specified congressional committees to be submitted every two years (currently, biannually). Authorizes grants for fellowships to licensed vocational or practical nurses, nursing assistants, and other paraprofessional nursing personnel to assist in obtaining professional nursing education to attain the level of registered nurse. Requires a fellowship recipient to contract with a long-term care facility certified under titles XVIII (Medicare) or XIX (Medicaid) of the Social Security Act to engage in full-time employment at the registered nurse level for a period not less than the period of assistance to the fellowship recipient. Authorizes appropriations. Authorizes grants to nursing schools for the establishment or expansion of clinical training sites or training affiliations to provide training and experience in primary care. Authorizes appropriations. Title III: Miscellaneous Provisions - Provides for the continuation of any grant or contract in effect on enactment of this Act for that grant or contract's full duration, notwithstanding termination by any provision of this Act.

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4 official files

• Reported to Senate (text)

  Reported to Senate · EN

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• Introduced in Senate (text)

  Introduced in Senate · EN

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• Reported to Senate with amendment(s)

  summary · EN · 21 November 1991

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• Introduced in Senate

  summary · EN · 7 November 1991

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