[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4425 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 4425
To amend the Public Health Service Act to increase the number of
permanent faculty in palliative care at accredited allopathic and
osteopathic medical schools, nursing schools and other programs,
including social work, physician assistant, and chaplaincy education
programs, to promote education and research in palliative care and
hospice, and to support the development of faculty careers in academic
palliative and hospice care.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 16, 2025
Mr. Carter of Georgia (for himself and Mr. Bera) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to increase the number of
permanent faculty in palliative care at accredited allopathic and
osteopathic medical schools, nursing schools and other programs,
including social work, physician assistant, and chaplaincy education
programs, to promote education and research in palliative care and
hospice, and to support the development of faculty careers in academic
palliative and hospice care.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Palliative Care and Hospice
Education and Training Act''.
SEC. 2. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.
(a) In General.--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:
``SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.
``(a) Palliative Care and Hospice Education Programs.--
``(1) In general.--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).
``(2) Requirements.--
``(A) In general.--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.
``(B) Activities.--Activities conducted by a
program under this section may include the following:
``(i) Clinical training on providing
integrated palliative and hospice care
services.
``(ii) Interprofessional training to
practitioners from multiple disciplines and
specialties, including training on the
provision of care to individuals with serious
or life-threatening illnesses.
``(iii) 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.
``(C) Nonduplication.--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.
``(3) Priorities in making awards.--In awarding grants and
contracts under paragraph (1), the Secretary--
``(A) shall give priority to programs that
demonstrate coordination with another Federal or State
program, or another public or private entity;
``(B) shall give priority to applicants with
programs or activities that are expected to
substantially benefit--
``(i) individuals in rural or medically
underserved areas, frontier health professional
shortage areas (as defined in section 799B), or
Indian Tribes or Tribal organizations;
``(ii) pediatric populations; or
``(iii) racial and ethnic minority
populations; and
``(C) may give priority to any program that--
``(i) integrates palliative and hospice
care into primary care practice;
``(ii) 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;
``(iii) 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;
``(iv) 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;
``(v) 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
``(vi) proposes to conduct outreach to
communities that have a shortage of palliative
and hospice workforce professionals.
``(4) Expansion of existing programs.--Nothing in this
section shall be construed to--
``(A) 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
``(B) limit the number of education programs that
may be funded in a community.
``(b) Palliative Medicine Physician Training.--
``(1) In general.--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.
``(2) Requirements.--Each project for which a grant or
contract is made under this subsection shall--
``(A) be staffed by full-time teaching physicians
who have experience or training in interprofessional
team-based palliative medicine;
``(B) be based in a hospice and palliative medicine
fellowship program accredited by the Accreditation
Council for Graduate Medical Education;
``(C) 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;
``(D) develop specific performance-based measures
to evaluate the competency of trainees; and
``(E) provide training in interprofessional team-
based palliative medicine through one or both of the
training options described in paragraph (3).
``(3) Training options.--The training options referred to
in subparagraph (E) of paragraph (2) are as follows:
``(A) 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.
``(B) 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.
``(4) Definitions.--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--
``(A) offers postgraduate medical training in the
specialties and subspecialties of medicine; and
``(B) has been accredited by the Accreditation
Council for Graduate Medical Education or the American
Osteopathic Association through its Committee on
Postdoctoral Training.
``(c) Palliative Care and Hospice Academic Career Awards.--
``(1) Establishment of program.--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.
``(2) Eligible individuals.--For purposes of this
subsection, the term `eligible individual' means an individual
who--
``(A) 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
``(B) 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.
``(3) Limitations.--No award under paragraph (1) may be
made to an eligible individual unless the entity on behalf of
the eligible individual--
``(A) 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;
``(B) 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
``(C) 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.
``(4) Maintenance of effort.--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.
``(5) Amount and term.--
``(A) Amount.--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.
``(B) Term.--The term of an award made under this
subsection shall not exceed 5 years.
``(C) Payment to institution.--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.
``(6) Service requirement.--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.
``(d) Palliative Care Workforce Development.--
``(1) In general.--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).
``(2) Application.--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.
``(3) Use of funds.--Amounts awarded under a grant or
contract under paragraph (1) shall be used to carry out the
fellowship program described in paragraph (4).
``(4) Fellowship program.--
``(A) In general.--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.
``(B) Location.--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.
``(5) Targets.--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.
``(6) Amount of award.--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.
``(7) Maintenance of effort.--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.
``(e) Palliative Care and Hospice Career Incentive Awards.--
``(1) In general.--The Secretary sha