42 U.S.C. § 295f–1 — Public Health Workforce Loan Repayment Program

(a) Establishment The Secretary must set up the Public Health Workforce Loan Repayment Program, called "the Program," to make sure there are enough public health professionals, and to help recruit and keep them, in state, local, and tribal public health agencies facing critical shortages. (b) Eligibility To join, a person must meet one of two paths. Path one: (A)(i) be accepted for, or already enrolled in, the last semester of a program leading to a public-health-related certificate or degree — including fields like epidemiology, laboratory science, data systems, data science, informatics, or statistics — and (ii) already be employed by, or have accepted a job or related fellowship with, a state, local, or tribal public health agency the Secretary recognizes, starting after graduation. Path two: (B)(i) have graduated, within the past 10 years, with such a degree or certificate, and (ii) already be employed by, or have accepted a job or fellowship with, such an agency. Beyond either path, the person must also (2) be a United States citizen; (3)(A) apply to the Secretary to join the Program, and (B) sign the written contract described in subsection (c); and (4) not already be receiving loan relief for the same service under certain other federal loan-forgiveness provisions. (c) Contract The written contract between the Secretary and the participant must include: (1) the Secretary's promise to repay the participant's loans from their public health degree or certificate, under the contract's terms; (2) the participant's promise to work full-time for a state, local, or tribal public health agency, or a related fellowship, in a job related to their degree, for at least 3 straight years — the "period of obligated service"; (3) if applicable, the participant's promise to move to a priority service area chosen by the Secretary, in exchange for extra loan repayment; (4) a statement that the government's payment obligations, and the participant's matching obligations, depend on Congress actually appropriating the money; (5) a statement of the damages owed to the government if the participant breaks the contract; and (6) any other fair statement of each side's rights and duties. (d) Payments (1) In general: Loan repayment under the contract pays down the outstanding principal and interest on the education loans the participant took out for their public health degree or certificate. (2) Payments for years served: (A) For each year of service, the Secretary may pay up to $50,000 toward those loans. But if a participant's total eligible loans are under $150,000, the Secretary must instead pay no more than one-third of the loan balance for each year served. (B) In choosing who gets contracts, the Secretary may take steps to ensure that (i) a fair share go to people who qualify through the "already graduated" path, and (ii) contracts are spread fairly across the country's regions, across local, state, and tribal health departments, and across rural and urban areas. (3) Tax liability: Because loan repayments count as taxable income, the Secretary must also pay the participant up to an extra 39 percent of that year's loan repayment amount, to help cover the tax bill. (e) Postponing obligated service The Secretary may approve postponing when a participant's required service period begins. (f) Breach of contract A participant who breaks the contract faces the same financial penalties as under a related loan repayment law, section 254o, for breaking a contract under section 254l–1. If a participant never starts, or does not finish, their required service, the Secretary may waive or reduce the unfinished service or the damages owed, following the same rules as section 254o(d). (g) Eligible loans Loans that can be repaid under this program include: (1) any loan for education or training that led to a job with a health department; (2) nursing student loans under Part E of subchapter VI; (3) Federal Direct Stafford, PLUS, Unsubsidized Stafford, or Consolidation Loans under the Higher Education Act; (4) Federal Perkins Loans under the Higher Education Act; and (5) any other federal loan the Secretary decides fits. (h) Pilot program (1) In general: The Secretary must, as appropriate, create the Bio-Preparedness Workforce Pilot Program, to repay loans for health professionals skilled in infectious diseases and emergency preparedness and response, to keep enough of them available. It follows the same rules as the main Program, except eligibility requires the person to (A)(i) be enrolled in the final semester of an accredited program for a relevant health professions degree or certificate, or (ii) have graduated with one within the past 10 years; and (B) already be employed by, or have accepted a job with, (i) a federal health care facility; (ii) a nonprofit health facility in a health professional shortage area, a frontier health professional shortage area, or a medically underserved community; (iii) an entity getting funding under subchapter XXIV for clinical services; (iv) a health program or facility run by an Indian tribe, tribal organization, or urban Indian organization; or (v) another entity the Secretary decides fits, working as a specialist in infectious diseases or emergency preparedness and response. (2) Non-duplication of effort: The Secretary must make sure this pilot does not unnecessarily overlap with the National Health Service Corps Loan Repayment Program or any other Department of Health and Human Services loan repayment program. (3) Evaluation and report to Congress: (A) The Secretary must evaluate the pilot after its first group of recipients finishes. (B)(i) The Secretary must then report to the Senate Health, Education, Labor, and Pensions Committee and the House Energy and Commerce Committee, including outcomes such as the pilot's effect on recruiting and keeping infectious disease and emergency response professionals. (ii) That report must include a recommendation on whether to extend the pilot. (i) Authorization of appropriations Congress may spend $100,000,000 each year from 2023 through 2025 to carry out this section.