42 U.S.C. § 294q — National Health Care Workforce Commission

(a) Purpose This subsection explains why the Commission exists. It will: (1) act as a resource for Congress, the President, states, and local governments; (2) communicate and coordinate with the Departments of Health and Human Services, Labor, Veterans Affairs, Homeland Security, and Education; (3) study and evaluate whether education and training activities are meeting the demand for health care workers; (4) find barriers to better coordination among federal, state, and local levels and recommend ways to fix them; and (5) encourage new ideas to address population needs, changing technology, and other outside factors. (b) Establishment This subsection creates the National Health Care Workforce Commission, called the "Commission." (c) Membership (1) Number and appointment: The Comptroller General appoints 15 members, without following the usual rule in section 1004 of title 5. (2) Qualifications: Members must be nationally recognized experts in fields like health care labor market analysis, workforce analysis, health finance and economics, facility management, health plans and delivery systems, workforce education and training, philanthropy, or providing health care services. Together, members must bring a mix of professional views and broad geography — urban, suburban, rural, and frontier areas. The group must include at least one person representing each of: the health workforce and health professionals; employers, including small business and self-employed people; third-party payers; people skilled in health services and economics research; consumers; labor unions; state or local workforce investment boards; and educational institutions, from elementary schools through colleges and apprenticeship programs. Beyond that required minimum, the Comptroller General may add more people from those same categories or others. People directly involved in providing or teaching health care cannot make up a majority of the Commission's members. The Comptroller General must set up a system for members to publicly disclose financial and other conflicts of interest. Members count as congressional employees for certain federal-benefit rules, but not as "special government employees" under title 18. (3) Terms: Members normally serve 3-year terms, though the Comptroller General staggers the terms of the first group of members. Someone appointed to fill an unfinished term only serves the rest of that term. A member may keep serving past the end of their term until a successor takes office. Vacancies are filled the same way the original appointment was made. The first members had to be appointed by September 30, 2010. (4) Compensation: While working on Commission business, including travel time, a member is paid at the daily rate for Executive Schedule Level IV. While away from home on Commission business, a member may get travel expenses approved by the Chairman. Commission physicians may get a special pay allowance the same way government physicians do, under rules borrowed from the Tennessee Valley Authority's practice. For pay and benefits, Commission staff (other than the members) are treated like Senate employees, not like Government Accountability Office employees. (5) Chairman, Vice Chairman: The Comptroller General names one member as Chairman and one as Vice Chairman when appointing them for that term. If either job becomes vacant, the Comptroller General may name a replacement for the rest of that term. (6) Meetings: The Commission meets whenever the Chairman calls a meeting, but no less often than once every three months. (d) Duties (1) Recognition, dissemination, and communication: The Commission must recognize good partnership efforts between federal, state, and local governments on health career pathways; share information on practices that help keep health workers in their jobs; and share information on policies that affect recruiting, training, and retaining the health workforce. (2) Review of health care workforce and annual reports: Working with relevant agencies, the Commission must review current and future workforce supply and demand (using the topics in paragraph (3)); recommend national workforce priorities, goals, and policies to Congress and the Administration; submit a report on those reviews and recommendations by October 1 each year starting in 2011; and submit a second report reviewing at least one high-priority area (from paragraph (4)) by April 1 each year starting in 2011. (3) Specific topics to be reviewed: The Commission must look at: (A) current workforce supply, distribution, and demographics, with 10- and 25-year projections; (B) training capacity — how many students finish training, how many qualified teachers exist, the training infrastructure, and future training needs; (C) the education loan and grant programs in titles VII and VIII of the Public Health Service Act, including whether they should move under the Higher Education Act of 1965; (D) how federal policies, including Medicare and Medicaid graduate medical education rules and other workforce programs, affect the workforce; (E) the needs of special populations such as minorities, rural residents, medically underserved people, and people with disabilities, with policy recommendations to meet those needs; and (F) recommendations for loan repayment and scholarship programs that ask low-income, minority medical students to work in their home communities, if those communities are designated medically underserved. (4) High priority areas: (A) The starting high-priority topics include: integrated workforce planning that maximizes skills across disciplines; analyzing the demand for workers given growing health information technology; aligning Medicare and Medicaid graduate medical education with workforce goals; removing barriers to entering and staying in primary care, including provider pay; and the training capacity, projected demand, and health-system integration of the nursing, oral health, mental and behavioral health, allied and public health, and emergency medical service workforces, plus how providers are distributed geographically compared to need. (B) The Commission may add more topics on its own, and Congress may recommend more as well. (5) Grant program: The Commission must review and report to Congress on the State Health Care Workforce Development Grant program under section 294r; recommend grant recipients to that program's administrative agent, working with the Department of Labor and the Department of Education; assess how the grants are being carried out; and collect and share performance data and best practices from the grants with Congress, federal agencies, and the public. (6) Study: The Commission must study effective ways to pay for health care career education and training, including public health and allied health. (7) Recommendations: The Commission must recommend to Congress, the Department of Labor, and the Department of Health and Human Services how to improve safety, health, and worker protections for the health care workforce. (8) Assessment: The Commission must assess, and receive reports from, the National Center for Health Care Workforce Analysis created under section 294n(b). (e) Consultation with Federal, State, and local agencies, Congress, and other organizations (1) In general: The Commission must consult with several federal agencies, Congress, the Medicare Payment Advisory Commission, the Medicaid and CHIP Payment and Access Commission, and — where practical — state and local agencies, Indian tribes, voluntary health organizations, professional societies, and other health care partnerships. (2) Obtaining official data: Following established privacy rules, the Commission may get information directly from any executive branch agency that it needs to do its work. (3) Detail of Federal Government employees: A federal employee may be temporarily assigned to the Commission without extra pay, and this does not interrupt or reduce their civil service status. (f) Director and staff; experts and consultants Subject to review by the Comptroller General to keep the Commission running efficiently, the Commission may: hire and pay an executive director, capped at Executive Schedule Level V pay, and other staff needed for its work, without following normal competitive-service hiring rules; ask federal agencies for help; make contracts or other arrangements for its work, without following the usual rule in section 6101 of title 41; make advance, progress, and other payments related to its work; cover transportation and living costs for people who serve without pay; and make its own internal rules and regulations. (g) Powers (1) Data collection: The Commission must use existing published and unpublished information where possible, including by coordinating with the Bureau of Labor Statistics; carry out or fund new research when existing information isn't enough; and let interested parties submit information for the Commission's reports and recommendations. (2) Access of the Government Accountability Office to information: The Comptroller General may see all of the Commission's deliberations, records, and data immediately, on request. (3) Periodic audit: An independent public accountant under contract with the Commission must audit it periodically. (h) Authorization of appropriations (1) Request for appropriations: The Commission requests its own funding the same way the Comptroller General does, and that money is kept separate from the Comptroller General's own funding. (2) Authorization: Congress may spend whatever amount is necessary to carry out this section. (3) Gifts and services: The Commission cannot accept gifts, bequests, or donated property, but may accept and use donated services. (i) Definitions (1) "Health care workforce" means everyone who provides direct patient care or support for it — a long list that includes physicians, nurses, nurse practitioners, primary care providers, physician assistants, pharmacists, dentists and dental hygienists, allied health professionals, chiropractors, community health workers, direct care workers, psychologists and other behavioral and mental health professionals (including substance abuse workers), social workers, physical and occupational therapists, certified nurse midwives, podiatrists, the EMS workforce (including volunteer ambulance staff and firefighters who perform EMS work), licensed complementary and alternative medicine providers, integrative health practitioners, public health professionals, and any other health professional the Comptroller General decides fits. (2) "Health professionals" includes: (A) a similar long list of direct-care roles — dentists, nurses, physician assistants, pharmacists, and the others named above; (B) national groups representing health professionals; (C) representatives of medical, nursing, dental, pharmacy, and other health training schools and programs; (D) representatives of public and private teaching hospitals and outpatient facilities, including federal ones; and (E) any other health professional the Comptroller General decides fits.