42 U.S.C. § 293k

Primary care training and enhancement

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(a) Support and development of primary care training programs(1) In generalThe Secretary may make grants to, or enter into contracts with, an accredited public or nonprofit private hospital, school of medicine or osteopathic medicine, academically affiliated physician assistant training program, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract—(A) to plan, develop, operate, or participate in an accredited professional training program, including an accredited residency or internship program in the field of family medicine, general internal medicine, or general pediatrics for medical students, interns, residents, or practicing physicians as defined by the Secretary;(B) to provide need-based financial assistance in the form of traineeships and fellowships to medical students, interns, residents, practicing physicians, or other medical personnel, who are participants in any such program, and who plan to specialize or work in the practice of the fields defined in subparagraph (A);(C) to plan, develop, and operate a program for the training of physicians who plan to teach in family medicine, general internal medicine, or general pediatrics training programs;(D) to plan, develop, and operate a program for the training of physicians teaching in community-based settings;(E) to provide financial assistance in the form of traineeships and fellowships to physicians who are participants in any such programs and who plan to teach or conduct research in a family medicine, general internal medicine, or general pediatrics training program;(F) to plan, develop, and operate a physician assistant education program, and for the training of individuals who will teach in programs to provide such training;(G) to plan, develop, and operate a program that identifies or develops innovative models of providing care, and trains primary care physicians on such models and in new competencies, as recommended by the Advisory Committee on Training in Primary Care Medicine and Dentistry and the National Health Care Workforce Commission established in section 294q of this title, which may include—(i) providing training to primary care physicians relevant to providing care through patient-centered medical homes (as defined by the Secretary for purposes of this section);(ii) developing tools and curricula relevant to patient-centered medical homes; and(iii) providing continuing education to primary care physicians relevant to patient-centered medical homes; and(H) to plan, develop, and operate joint degree programs to provide interdisciplinary and interprofessional graduate training in public health and other health professions to provide training in environmental health, infectious disease control, disease prevention and health promotion, epidemiological studies and injury control.(2) Duration of awards

The period during which payments are made to an entity from an award of a grant or contract under this subsection shall be 5 years.

(3) Priorities in making awards

In awarding grants or contracts under paragraph (1), the Secretary may give priority to qualified applicants that train residents in rural areas, including for Tribes or Tribal Organizations in such areas.

(b) Capacity building in primary care(1) In generalThe Secretary may make grants to or enter into contracts with accredited schools of medicine or osteopathic medicine to establish, maintain, or improve—(A) academic units or programs that improve clinical teaching and research in fields defined in subsection (a)(1)(A); or(B) programs that integrate academic administrative units in fields defined in subsection (a)(1)(A) to enhance interdisciplinary recruitment, training, and faculty development.(2) Preference in making awards under this subsectionIn making awards of grants and contracts under paragraph (1), the Secretary shall give preference to any qualified applicant for such an award that agrees to expend the award for the purpose of—(A) establishing academic units or programs in fields defined in subsection (a)(1)(A); or(B) substantially expanding such units or programs.(3) Priorities in making awardsIn awarding grants or contracts under paragraph (1), the Secretary shall give priority to qualified applicants that—(A) proposes 11 So in original. Probably should be “propose”. a collaborative project between academic administrative units of primary care;(B) proposes ¹ innovative approaches to clinical teaching using models of primary care, such as the patient centered medical home, team management of chronic disease, and interprofessional integrated models of health care that incorporate transitions in health care settings and integration physical and mental health provision;(C) have a record of training the greatest percentage of providers, or that have demonstrated significant improvements in the percentage of providers trained, who enter and remain in primary care practice;(D) have a record of training individuals who are from underrepresented minority groups or from a rural or disadvantaged background;(E) provide training in the care of vulnerable populations such as children, older adults, homeless individuals, victims of abuse or trauma, individuals with mental health or substance use disorders, individuals with HIV/AIDS, and individuals with disabilities;(F) establish formal relationships and submit joint applications with federally qualified health centers, rural health clinics, area health education centers, or clinics located in underserved areas or that serve underserved populations;(G) teach trainees the skills to provide interprofessional, integrated care through collaboration among health professionals;(H) provide training in enhanced communication with patients, evidence-based practice, chronic disease management, preventive care, health information technology, or other competencies as recommended by the Advisory Committee on Training in Primary Care Medicine and Dentistry and the National Health Care Workforce Commission established in section 294q of this title; or(I) provide training in cultural competency and health literacy.(4) Duration of awards

The period during which payments are made to an entity from an award of a grant or contract under this subsection shall be 5 years.

For purposes of carrying out this section (other than subsection (b)(1)(B)), there are authorized to be appropriated $48,924,000 for each of fiscal years 2021 through 2025.

(2) Training programs

Fifteen percent of the amount appropriated pursuant to paragraph (1) in each such fiscal year shall be allocated to the physician assistant training programs described in subsection (a)(1)(F), which prepare students for practice in primary care.

(3) Integrating academic administrative units

For purposes of carrying out subsection (b)(1)(B), there are authorized to be appropriated $750,000 for each of fiscal years 2010 through 2014.

(July 1, 1944, ch. 373, title VII, § 747, as added Pub. L. 111–148, title V, § 5301, Mar. 23, 2010, 124 Stat. 615; amended Pub. L. 116–136, div. A, title III, § 3401(3), Mar. 27, 2020, 134 Stat. 386.)Editorial NotesCodification

Pub. L. 111–148, title V, § 5301, Mar. 23, 2010, 124 Stat. 615, which directed the amendment of part C of title VII by striking out section 747 and inserting a new section 747, without specifying the act to be amended, was executed as an amendment to part C of title VII of act July 1, 1944, by adding this section and repealing former section 293k of this title, to reflect the probable intent of Congress.

Prior Provisions

A prior section 293k, act July 1, 1944, ch. 373, title VII, § 747, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2042; amended Pub. L. 105–392, title I, § 102(3), Nov. 13, 1998, 112 Stat. 3537, related to grants and contracts for training in family medicine, general internal medicine, general pediatrics, general dentistry, and pediatric dentistry, and training for physician assistants, prior to repeal by Pub. L. 111–148, title V, § 5301, Mar. 23, 2010, 124 Stat. 615. See Codification note above.

A prior section 747 of act July 1, 1944, was classified to section 294q–3 of this title prior to the general revision of this subchapter by Pub. L. 102–408.

Another prior section 747 of act July 1, 1944, was classified to section 294g of this title prior to repeal by Pub. L. 94–484.

Amendments

2020—Subsec. (a)(1)(G). Pub. L. 116–136, § 3401(3)(A)(i), substituted “to plan, develop, and operate a program that identifies or develops innovative models of providing care, and trains primary care physicians on such models and” for “to plan, develop, and operate a demonstration program that provides training” in introductory provisions.

Subsec. (a)(3). Pub. L. 116–136, § 3401(3)(A)(ii), added par. (3).

Subsec. (b)(3)(E). Pub. L. 116–136, § 3401(3)(B), substituted “substance use disorders” for “substance-related disorders”.

Subsec. (c)(1). Pub. L. 116–136, § 3401(3)(C), substituted “$48,924,000 for each of fiscal years 2021 through 2025” for “$125,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014”.