Sec. 2. Palliative care and hospice education and training
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Part D of title VII of the Public Health Service Act ( 42 U.S.C. 294 et seq.) is amended by inserting after section 759 the following: The Secretary shall award grants or contracts under this section to entities described in paragraph (1), (3), or
(4)of section 799B, and section 801(2), for the establishment or operation of Palliative Care and Hospice Education Centers that meet the requirements of paragraph (2). A Palliative Care and Hospice Education Center meets the requirements of this paragraph if such Center— improves the interprofessional team-based training of health professionals in palliative care, including residencies, traineeships, or fellowships; develops and disseminates interprofessional team-based curricula relating to the palliative treatment of the complex health problems of individuals with serious or life-threatening illnesses; supports the training and retraining of faculty to provide instruction in interprofessional team-based palliative care; supports interprofessional team-based continuing education of health professionals who provide palliative care to patients with serious or life-threatening illness; provides students (including residents, trainees, and fellows) with clinical training in interprofessional team-based palliative care in appropriate health settings, including hospitals, hospices, home care, long-term care facilities, and ambulatory care centers; establishes traineeships for individuals who are preparing for advanced education nursing degrees, social work degrees, or advanced degrees in physician assistant studies, with a focus in interprofessional team-based palliative care in appropriate health settings, including hospitals, hospices, home care, long-term care facilities, and ambulatory care centers; supports collaboration between multiple specialty training programs (such as medicine, nursing, social work, physician assistant, chaplaincy, and pharmacy) and clinical training sites to provide training in interprofessional team-based palliative care; and does not duplicate the activities of existing education centers funded under this section or under section 753 or 865. Nothing in this section shall be construed to— prevent the Secretary from providing grants to expand existing education centers, including geriatric education centers established under section 753 or 865, to provide for education and training focused specifically on palliative care, including for non-geriatric populations; or limit the number of education centers that may be funded in a community. The Secretary may make grants to, and enter into contracts with, schools of medicine, schools of osteopathic medicine, teaching hospitals, and graduate medical education programs for the purpose of providing support for projects that fund the training of physicians (including residents, trainees, and fellows) who plan to teach palliative medicine. Each project for which a grant or contract is made under this subsection shall— be staffed by full-time teaching physicians who have experience or training in interprofessional team-based palliative medicine; be based in a hospice and palliative medicine fellowship program accredited by the Accreditation Council for Graduate Medical Education; provide training in interprofessional team-based palliative medicine through a variety of service rotations, such as consultation services, acute care services, extended care facilities, ambulatory care and comprehensive evaluation units, hospices, home care, and community care programs; develop specific performance-based measures to evaluate the competency of trainees; and provide training in interprofessional team-based palliative medicine through one or both of the training options described in paragraph (3). The training options referred to in subparagraph
(E)of paragraph
(2)are as follows: 1-year retraining programs in hospice and palliative medicine for physicians who are faculty at schools of medicine and osteopathic medicine, or others determined appropriate by the Secretary. 1- or 2-year training programs that are designed to provide training in interprofessional team-based hospice and palliative medicine for physicians who have completed graduate medical education programs in any medical specialty leading to board eligibility in hospice and palliative medicine pursuant to the American Board of Medical Specialties. For purposes of this subsection, the term graduate medical education means a program sponsored by a school of medicine, a school of osteopathic medicine, a hospital, or a public or private institution that— offers postgraduate medical training in the specialties and subspecialties of medicine; and has been accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association through its Committee on Postdoctoral Training. The Secretary shall establish a program to provide awards, to be known as the Palliative Medicine and Hospice Academic Career Awards , to eligible individuals to promote the career development of such individuals as academic hospice and palliative care physicians. To be eligible to receive an award under paragraph (1), an individual shall— be board certified or board eligible in hospice and palliative medicine; and have a junior (non-tenured) faculty appointment at an accredited (as determined by the Secretary) school of medicine or osteopathic medicine. No award under paragraph
(1)may be made to an eligible individual unless the individual— has submitted to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require, and the Secretary has approved such application; provides, in such form and manner as the Secretary may require, assurances that the individual will meet the service requirement described in paragraph (6); and provides, in such form and manner as the Secretary may require, assurances that the individual has a full-time faculty appointment in a health professions institution and documented commitment from such institution to spend a majority of the total funded time of such individual on teaching and developing skills in education in interprofessional team-based palliative care. An eligible individual who receives an award under paragraph
(1)shall provide assurances to the Secretary that funds provided to the eligible individual under this subsection will be used only to supplement, not to supplant, the amount of Federal, State, and local funds otherwise expended by the eligible individual. The amount of an award under this subsection shall be equal to the award amount provided for under section 753(c)(5)(A) for the fiscal year involved. The term of an award made under this subsection shall not exceed 5 years. The Secretary shall make payments for awards under this subsection to institutions, including schools of medicine and osteopathic medicine. An individual who receives an award under this subsection shall provide training in palliative care and hospice, including the training of interprofessional teams of health care professionals. The provision of such training shall constitute a majority of the total funded obligations of such individual under the award. The Secretary shall award grants or contracts under this subsection to entities that operate a Palliative Care and Hospice Education Center pursuant to subsection (a)(1). To be eligible for an award under paragraph (1), an entity described in such paragraph shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. Amounts awarded under a grant or contract under paragraph
(1)shall be used to carry out the fellowship program described in paragraph (4). Pursuant to paragraph (3), a Palliative Care and Hospice Education Center that receives an award under this subsection shall use such funds to offer short-term intensive courses (referred to in this subsection as a fellowship ) that focus on interprofessional team-based palliative care that provide supplemental training for faculty members in medical schools and other health professions schools with programs in psychology, pharmacy, nursing, social work, physician assistant education, chaplaincy, or other health disciplines, as approved by the Secretary. Such a fellowship shall be open to current faculty, and appropriately credentialed volunteer faculty and practitioners, who do not have formal training in palliative care, to upgrade their knowledge and clinical skills for the care of individuals with serious or life-threatening illness and to enhance their interdisciplinary and interprofessional teaching skills. A fellowship under this paragraph shall be offered either at the Palliative Care and Hospice Education Center that is sponsoring the course, in collaboration with other Palliative Care and Hospice Education Centers, or at medical schools, schools of nursing, schools of pharmacy, schools of social work, schools of chaplaincy or pastoral care education, graduate programs in psychology, physician assistant education programs, or other health professions schools approved by the Secretary with which the Centers are affiliated. Participation in a fellowship under this paragraph shall be accepted with respect to complying with continuing health profession education requirements. As a condition of such acceptance, the recipient shall subsequently provide a minimum of 18 hours of voluntary instruction in palliative care content (that has been approved by a palliative care and hospice education center) to students or trainees in health-related educational, home, hospice, or long-term care settings. A Palliative Care and Hospice Education Center that receives an award under paragraph
(1)shall meet targets approved by the Secretary for providing training in interprofessional team-based palliative care to a certain number of faculty or practitioners during the term of the award, as well as other parameters established by the Secretary. Each award under paragraph
(1)shall be in the amount of $150,000. Not more than 24 Palliative Care and Hospice Education Centers may receive an award under such paragraph. A Palliative Care and Hospice Education Center that receives an award under paragraph
(1)shall provide assurances to the Secretary that funds provided to the Center under the award will be used only to supplement, not to supplant, the amount of Federal, State, and local funds otherwise expended by such Center. The Secretary shall award grants or contracts under this subsection to individuals described in paragraph
(2)to foster greater interest among a variety of health professionals in entering the field of palliative care. To be eligible to receive an award under paragraph (1), an individual shall— be an advanced practice nurse, a social worker, physician assistant, pharmacist, chaplain, or student of psychology who is pursuing a doctorate, masters, or other advanced degree with a focus in interprofessional team-based palliative care or related fields in an accredited health professions school; and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. As a condition of receiving an award under paragraph (1), an individual shall agree that, following completion of the award period, the individual will teach or practice palliative care in health-related educational, home, hospice, or long-term care settings for a minimum of 5 years under guidelines established by the Secretary. The Secretary shall make payments for awards under paragraph
(1)to institutions that include schools of medicine, osteopathic medicine, nursing, social work, psychology, chaplaincy or pastoral care education, dentistry, and pharmacy, or other allied health discipline in an accredited health professions school or program (such as a physician assistant education program) that is approved by the Secretary. There are authorized to be appropriated to carry out this section, $15,000,000 for each of the fiscal years 2019 through 2023. . The amendment made by this section shall be effective beginning on the date that is 90 days after the date of enactment of this Act.
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Sec. 2
Palliative care and hospice education and training
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