42 U.S.C. § 294a — Area health education centers

(a) Establishment of awards: The Secretary makes two kinds of awards. (1) Infrastructure development award: This helps an eligible entity start a health care workforce education program, or keep running one already operating, by planning, developing, operating, and evaluating an "area health education center program" (called the "Program" in this section). (2) Point of service maintenance and enhancement award: This helps an eligible entity maintain and improve an existing Program's effectiveness, and make changes as demographics, population needs, or other conditions change. (b) Eligible entities; application: (1) Eligible entities: (A) For an infrastructure development award, an eligible entity is a school of medicine or osteopathic medicine, an incorporated consortium of such schools, or their parent institution. In a state with no Program in operation, the Secretary may instead award to a school of nursing. (B) For a point of service award, an eligible entity is one that already received funds under this section, is operating a Program, and has a center or centers no longer eligible for financial assistance under the infrastructure award. (2) Application: An eligible entity applies to the Secretary in the form, manner, and timeframe the Secretary requires. (c) Use of funds: (1) Required activities: A grantee must use its funds to: (A) develop and carry out strategies, coordinated with the local one-stop job delivery system, to recruit underrepresented minority, disadvantaged, or rural-background individuals into health professions, and support them in reaching those careers; (B) develop and carry out strategies for community-based training and education for people seeking health careers in underserved areas, to build and keep a diverse workforce that delivers high-quality, primary-care-focused care, working with other federal and state workforce programs, the state workforce agency, local workforce boards, and health care safety-net sites; (C) prepare individuals to serve underserved areas and health disparity populations through field placements or preceptorships with community-based organizations, accredited primary care residency programs, federally qualified health centers, rural health clinics, public health departments, or similar facilities; (D) run interdisciplinary training involving physicians, physician assistants, nurse practitioners, nurse midwives, dentists, psychologists, pharmacists, optometrists, community health workers, and other health professionals, as practicable; (E) deliver or arrange continuing education and information for health professionals, emphasizing those serving underserved areas and health disparity populations; (F) propose and carry out effective ways to measure and evaluate the program's outcomes; and (G) establish a youth public health program to introduce and recruit high school students into health careers, focused on public health careers. (2) Innovative opportunities: A grantee may also: (A) develop innovative curricula with community-based partners to increase the supply of primary care providers for underserved areas and health disparity populations; (B) coordinate community-based research with academic health centers and speed the sharing of research results and best practices; and (C) develop other strategies to address identified workforce needs in the area the Program serves. (d) Requirements: (1) Area health education center program: (A) A grantee operating a medical or osteopathic school program must conduct at least 10 percent of required clinical education for medical students in community settings removed from its primary teaching facility. If the grantee is instead a nursing school or its parent institution, the Secretary must ensure (i) the nursing school does the same 10 percent rule for nursing students, and (ii) the grantee keeps a written agreement with a medical or osteopathic school to place that school's students at its training sites. (B) A grantee receiving point of service funds cannot pass that funding to a center still eligible for an infrastructure award. (2) Area health education center: Each Program must include at least one area health education center, and each center must: (A) be a public or private organization independent, in structure, governance, and operation, from the grantee and its parent institution; (B) not itself be a medical or osteopathic school, its parent institution, a branch or subunit of one, or a consortium of such entities; (C) serve an underserved area or population that is located away from the main teaching facilities and does not overlap the area or population served by any other center; (D) foster networking and collaboration between communities and academic and community-based health centers; (E) serve communities with a demonstrated need for health professionals, in partnership with academic medical centers; (F) address local health care workforce needs, coordinated with the public workforce investment system; and (G) have a community-based governing or advisory board that reflects the diversity of the communities involved. (e) Matching funds: To be eligible for assistance, a grantee must contribute, directly or through state, county, city, or private sector funds, recurring non-federal cash or in-kind contributions equal to at least 50 percent of the program's operating costs. At least 25 percent of the required non-federal contribution must be cash. A grantee may ask the Secretary to waive up to 75 percent of the required match for each of its first 3 funded years under an infrastructure award. (f) Limitation: At least 75 percent of the total amount given to a Program must go to the area health education centers participating in it. The Secretary may waive this requirement for a newly funded Program's first 2 years, to give it flexibility. (g) Award: Each award must be at least $250,000 a year per area health education center in the Program. If Congress hasn't appropriated enough to meet that minimum, the Secretary may lower the per-center amount, as long as the funding split required by subsection (j)(2) is kept. (h) Project terms: (1) Except as provided in paragraph (2), payments under an infrastructure development award may last no more than (A) 12 years for a whole Program, or (B) 6 years for a single center within a Program. (2) These time limits do not apply to point of service maintenance and enhancement awards, which keep funding existing centers and activities. (i) Inapplicability of provision: Despite any other provision of this subchapter, section 295j(a) of this title does not apply to an area health education center funded under this section. (j) Authorization of appropriations: (1) Congress authorized $41,250,000 a year for 2021 through 2025. (2) Of the amount appropriated each year: (A) no more than 35 percent may fund infrastructure development awards; (B) at least 60 percent must fund point of service maintenance and enhancement awards; (C) no more than 1 percent may fund grants and contracts to evaluate outcomes; and (D) no more than 4 percent may fund grants and contracts providing technical assistance to grantees. (3) A grantee may carry over funds from one fiscal year to another without the Secretary's approval, but never for more than 3 years. (k) Sense of Congress: Congress states that it is its sense that every state should have an area health education center program in effect under this section.