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 Programs that meet the requirements of paragraph (2). A Palliative Care and Hospice Education Program receiving an award under this section shall support the training of health professionals in palliative and hospice care, including traineeships or fellowships. Such programs shall emphasize, as appropriate, patient and family engagement, integration of palliative and hospice care with primary and specialty care, and collaboration with community partners to address gaps in health care for individuals with serious or life-threatening illnesses. Activities conducted by a program under this section may include the following: Clinical training on providing integrated palliative and hospice care services. Interprofessional training to practitioners from multiple disciplines and specialties, including training on the provision of care to individuals with serious or life-threatening illnesses. Establishing or maintaining training-related community-based programs for individuals with serious or life-threatening illnesses and caregivers to improve quality of life, and where appropriate, health outcomes for individuals who have serious or life-threatening illnesses. A Palliative Care and Hospice Education Program under this section shall not duplicate the activities of existing education centers funded under this section or under section 753 or 865. In awarding grants and contracts under paragraph (1), the Secretary— shall give priority to programs that demonstrate coordination with another Federal or State program, or another public or private entity; shall give priority to applicants with programs or activities that are expected to substantially benefit— individuals in rural or medically underserved areas, frontier health professional shortage areas (as defined in section 799B), or Indian Tribes or Tribal organizations; pediatric populations; or racial and ethnic minority populations; and may give priority to any program that— integrates palliative and hospice care into primary care practice; provides training to integrate palliative and hospice care into other specialties across care settings, including practicing clinical specialists, health care administrators, faculty without backgrounds in palliative or hospice care, and students from all health professions; emphasizes integration of palliative and hospice care into existing service delivery locations and care across settings, including primary care clinics, medical homes, Federally qualified health centers, ambulatory care clinics, hospitals, including critical access hospitals, emergency care settings, assisted living and nursing facilities, and home- and community-based settings; supports the training and retraining of faculty, primary and specialty care providers, other direct care providers, and other appropriate professionals on palliative or hospice care; emphasizes education and engagement of family or caregivers on palliative and hospice care management within the context of chronic disease management and strategies to meet the needs of such family or caregivers; or proposes to conduct outreach to communities that have a shortage of palliative and hospice workforce professionals. Nothing in this section shall be construed to— prevent the Secretary from providing grants or contracts to expand existing education programs, including geriatric education programs 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 programs 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 who plan to teach or practice 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 Care and Hospice Academic Career Awards , to allopathic and osteopathic medical schools, nursing schools, and other programs, including social work, physician assistant, and chaplaincy education programs, or other schools or programs identified by the Secretary applying on behalf of eligible individuals to promote the career development of such individuals as academic hospice and palliative care specialists. For purposes of this subsection, the term eligible individual means an individual who— is board certified or board eligible in hospice and palliative medicine or has completed required specialty training in palliative and hospice care in the disciplines of nursing, social work, physician assistant, chaplaincy, or other discipline identified by the Secretary; and has a junior (nontenured) faculty appointment at an accredited (as determined by the Secretary) allopathic or osteopathic medical school, nursing school, or other programs, including social work, physician assistant, chaplaincy, or other education programs identified by the Secretary. No award under paragraph
(1)may be made to an eligible individual unless the entity on behalf of the eligible 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 entity which 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(b)(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 allopathic and osteopathic medical schools, nursing schools, and other programs, including social work, physician assistant, or chaplaincy education programs. 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 Program 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 Program 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 allopathic and osteopathic medical schools, nursing schools, and other programs, including psychology, pharmacy, social work, physician assistant, and chaplaincy education programs, 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 Program that is sponsoring the course, in collaboration with other Palliative Care and Hospice Education Programs, or at allopathic and osteopathic medical schools, nursing schools, or other programs, including pharmacy, social work, physician assistant, chaplaincy, and psychology education programs, or other health professions schools and programs approved by the Secretary. A Palliative Care and Hospice Education Program 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 not more than $150,000. Not more than 24 Palliative Care and Hospice Education Programs may receive an award under such paragraph. A Palliative Care and Hospice Education Program that receives an award under paragraph
(1)shall provide assurances to the Secretary that funds provided to the Program under the award will be used only to supplement, not to supplant, the amount of Federal, State, and local funds otherwise expended by such Program. The Secretary shall award grants or contracts under this subsection to institutions, including allopathic and osteopathic medical schools, nursing schools, and other programs, including social work, physician assistant, psychology, chaplaincy, and pharmacy education programs, or other programs approved by the Secretary, applying on behalf of 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, psychologist, or other health care professional pursuing a doctorate, masters, or other advanced degree with a focus in interprofessional team-based palliative care or related fields in an accredited school or education program; 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 allopathic and osteopathic medical schools, nursing schools, and other programs, including social work, physician assistant, psychology, chaplaincy, and pharmacy education programs or other programs approved by the Secretary. There are authorized to be appropriated to carry out this section, $15,000,000 for each of the fiscal years 2024 through 2028. . 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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