
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC254q-1]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
                       Part D--Primary Health Care
 
       subpart iii--scholarship program and loan repayment program
 
Sec. 254q-1. Grants to States for loan repayment programs


(a) In general

                      (1) Authority for grants

        The Secretary, acting through the Administrator of the Health 
    Resources and Services Administration, may make grants to States for 
    the purpose of assisting the States in operating programs described 
    in paragraph (2) in order to provide for the increased availability 
    of primary health services in health professional shortage areas.

                     (2) Loan repayment programs

        The programs referred to in paragraph (1) are, subject to 
    subsection (c) of this section, programs of entering into contracts 
    under which the State involved agrees to pay all or part of the 
    principal, interest, and related expenses of the educational loans 
    of health professionals in consideration of the professionals 
    agreeing to provide primary health services in health professional 
    shortage areas.

              (3) Direct administration by State agency

        The Secretary may not make a grant under paragraph (1) unless 
    the State involved agrees that the program operated with the grant 
    will be administered directly by a State agency.

(b) Requirement of matching funds

                           (1) In general

        The Secretary may not make a grant under subsection (a) of this 
    section unless the State agrees that, with respect to the costs of 
    making payments on behalf of individuals under contracts made 
    pursuant to paragraph (2) of such subsection, the State will make 
    available (directly or through donations from public or private 
    entities) non-Federal contributions in cash toward such costs in an 
    amount equal to not less than $1 for each $1 of Federal funds 
    provided in the grant.

       (2) Determination of amount of non-Federal contribution

        In determining the amount of non-Federal contributions in cash 
    that a State has provided pursuant to paragraph (1), the Secretary 
    may not include any amounts provided to the State by the Federal 
    Government.

(c) Coordination with Federal program

    (1) Assignments for health professional shortage areas under 
                               Federal program

        The Secretary may not make a grant under subsection (a) of this 
    section unless the State involved agrees that, in carrying out the 
    program operated with the grant, the State will assign health 
    professionals participating in the program only to public and 
    nonprofit private entities located in and providing health services 
    in health professional shortage areas.

                (2) Remedies for breach of contracts

        The Secretary may not make a grant under subsection (a) of this 
    section unless the State involved agrees that the contracts provided 
    by the State pursuant to paragraph (2) of such subsection will 
    provide remedies for any breach of the contracts by the health 
    professionals involved.

            (3) Limitation regarding contract inducements

        (A) Except as provided in subparagraph (B), the Secretary may 
    not make a grant under subsection (a) of this section unless the 
    State involved agrees that the contracts provided by the State 
    pursuant to paragraph (2) of such subsection will not be provided on 
    terms that are more favorable to health professionals than the most 
    favorable terms that the Secretary is authorized to provide for 
    contracts under the Loan Repayment Program under section 254l-1 of 
    this title, including terms regarding--
            (i) the annual amount of payments provided on behalf of the 
        professionals regarding educational loans; and
            (ii) the availability of remedies for any breach of the 
        contracts by the health professionals involved.

        (B) With respect to the limitation established in subparagraph 
    (A) regarding the annual amount of payments that may be provided to 
    a health professional under a contract provided by a State pursuant 
    to subsection (a)(2) of this section, such limitation shall not 
    apply with respect to a contract if--
            (i) the excess of such annual payments above the maximum 
        amount authorized in section 254l-1(g)(2)(A) of this title for 
        annual payments regarding contracts is paid solely from non-
        Federal contributions under subsection (b) of this section; and
            (ii) the contract provides that the health professional 
        involved will satisfy the requirement of obligated service under 
        the contract solely through the provision of primary health 
        services in a health professional shortage area that is 
        receiving priority for purposes of section 254f-1(a)(1) of this 
        title and that is authorized to receive assignments under 
        section 254f of this title of individuals who are participating 
        in the Scholarship Program under section 254l of this title.

(d) Restrictions on use of funds

    The Secretary may not make a grant under subsection (a) of this 
section unless the State involved agrees that the grant will not be 
expended--
        (1) to conduct activities for which Federal funds are expended--
            (A) within the State to provide technical or other 
        nonfinancial assistance under subsection (f) of section 254c of 
        this title;
            (B) under a memorandum of agreement entered into with the 
        State under subsection (h) of such section; or
            (C) under a grant under section 254r of this title; or

        (2) for any purpose other than making payments on behalf of 
    health professionals under contracts entered into pursuant to 
    subsection (a)(2) of this section.

(e) Reports

    The Secretary may not make a grant under subsection (a) of this 
section unless the State involved agrees--
        (1) to submit to the Secretary reports providing the same types 
    of information regarding the program operated pursuant to such 
    subsection as reports submitted pursuant to subsection (i) of 
    section 254l-1 of this title provide regarding the Loan Repayment 
    Program under such section; and
        (2) to submit such a report not later than January 10 of each 
    fiscal year immediately following any fiscal year for which the 
    State has received such a grant.

(f) Requirement of application

    The Secretary may not make a grant under subsection (a) of this 
section unless an application for the grant is submitted to the 
Secretary and the application is in such form, is made in such manner, 
and contains such agreements, assurances, and information as the 
Secretary determines to be necessary to carry out such subsection.

(g) Noncompliance

                           (1) In general

        The Secretary may not make payments under subsection (a) of this 
    section to a State for any fiscal year subsequent to the first 
    fiscal year of such payments unless the Secretary determines that, 
    for the immediately preceding fiscal year, the State has complied 
    with each of the agreements made by the State under this section.

       (2) Reduction in grant relative to number of breached 
                                  contracts

        (A) Before making a grant under subsection (a) of this section 
    to a State for a fiscal year, the Secretary shall determine the 
    number of contracts provided by the State under paragraph (2) of 
    such subsection with respect to which there has been an initial 
    breach by the health professionals involved during the fiscal year 
    preceding the fiscal year for which the State is applying to receive 
    the grant.
        (B) Subject to paragraph (3), in the case of a State with 1 or 
    more initial breaches for purposes of subparagraph (A), the 
    Secretary shall reduce the amount of a grant under subsection (a) of 
    this section to the State for the fiscal year involved by an amount 
    equal to the sum of the expenditures of Federal funds made regarding 
    the contracts involved and an amount representing interest on the 
    amount of such expenditures, determined with respect to each 
    contract on the basis of the maximum legal rate prevailing for loans 
    made during the time amounts were paid under the contract, as 
    determined by the Treasurer of the United States.

               (3) Waiver regarding reduction in grant

        The Secretary may waive the requirement established in paragraph 
    (2)(B) with respect to the initial breach of a contract if the 
    Secretary determines that such breach by the health professional 
    involved was attributable solely to the professional having a 
    serious illness.

(h) ``State'' defined

    For purposes of this section, the term ``State'' means each of the 
several States.

(i) Authorization of appropriations

                           (1) In general

        For the purpose of making grants under subsection (a) of this 
    section, there is authorized to be appropriated $10,000,000 for each 
    of the fiscal years 1991 through 1995, and such sums as may be 
    necessary for each of the fiscal years 1998 through 2002.

                          (2) Availability

        Amounts appropriated under paragraph (1) shall remain available 
    until expended.

(July 1, 1944, ch. 373, title III, Sec. 338I, formerly Sec. 338H, as 
added Pub. L. 100-177, title II, Sec. 203, Dec. 1, 1987, 101 Stat. 999; 
renumbered Sec. 338I and amended Pub. L. 101-597, title II, Sec. 204, 
title III, Sec. 301, title IV, Sec. 401(b)[(a)], Nov. 16, 1990, 104 
Stat. 3027, 3029, 3035; Pub. L. 105-392, title IV, Sec. 408, Nov. 13, 
1998, 112 Stat. 3589.)


                            Prior Provisions

    A prior section 338I of act July 1, 1944, was classified to section 
254r of this title prior to repeal by Pub. L. 100-713, title I, 
Sec. 104(b)(1), Nov. 23, 1988, 102 Stat. 4787.


                               Amendments

    1998--Subsec. (i)(1). Pub. L. 105-392 inserted ``, and such sums as 
may be necessary for each of the fiscal years 1998 through 2002'' before 
period at end.
    1990--Pub. L. 101-597, Sec. 401(b)[(a)], substituted reference to 
health professional shortage area for reference to health manpower 
shortage area wherever appearing in subsecs. (a)(1), (2) and (c)(1), 
(3)(B)(ii).
    Pub. L. 101-597, Sec. 301, amended section generally, substituting 
present provisions for provisions which related to: in subsec. (a), 
grants; in subsec. (b), applications; in subsec. (c), Federal share; and 
in subsec. (d), authorization of appropriations.

                  Section Referred to in Other Sections

    This section is referred to in sections 254o-1, 254r, 293b of this 
title.
