Title 42 — The Public Health and WelfareRelease 119-73not60
§294a Area Health Education Centers
Title 42 › Chapter 6A— PUBLIC HEALTH SERVICE › Subchapter V— HEALTH PROFESSIONS EDUCATION › Part D— Interdisciplinary, Community-Based Linkages › § 294a
Summary
The Secretary must make two kinds of awards. One type helps eligible schools start or run area health education center programs. The other type helps eligible programs keep improving existing centers when community needs change. Eligible groups for start-up awards are schools of medicine or osteopathic medicine, or their parent institutions or consortia. If a State has no such medical program, a school of nursing may get a start-up award. Eligible groups for maintenance awards are programs that already got money under this rule and run centers that can no longer get start-up funds. Applicants must apply when and how the Secretary requires. Grant money must be used to recruit people from underrepresented, disadvantaged, or rural backgrounds into health careers; provide community-based training focused on primary care in underserved areas; place students in field sites and preceptorships; run interdisciplinary training and continuing education; measure and evaluate program results; and run a youth public health program. Grantees may also create new curricula, do community research, and use other strategies to build the local workforce. Each program must include at least one center that is independent from the awardee and not a medical school or its branch. Centers must serve an underserved area or population that does not duplicate another center, work with academic centers and local workforce systems, and have a community board that reflects local diversity. Grantees that are medical schools must put at least 10 percent of required medical student clinical education in community sites away from the main teaching hospital. If a nursing school gets a start-up award, it must put at least 10 percent of required nursing student clinical education in remote community sites and have a written agreement with a medical school to place medical students in those sites. Recipients must provide non-Federal matching support equal to at least 50 percent of program costs, with at least 25 percent of the match in cash. A waiver up to 75 percent of the match can be requested for each of the first 3 years of a start-up award. At least 75 percent of funds must go to the centers (the Secretary may waive that for the first 2 years of new programs). Awards must be at least $250,000 per center each year, unless appropriations are too small. Start-up awards may fund a program for up to 12 years and an individual center for up to 6 years; maintenance awards are not limited by those periods. Congress authorized $41,250,000 for each of fiscal years 2021 through 2025. Of yearly funds, no more than 35 percent may support start-up awards, at least 60 percent must support maintenance awards, no more than 1 percent may pay for outcomes evaluation, and no more than 4 percent may pay for technical assistance. Funds may be carried forward between fiscal years for up to 3 years. Congress hopes every State will have a program.
Full Legal Text
Title 42, §294a
The Public Health and Welfare — Source: USLM XML via OLRC
(a)The Secretary shall make the following 2 types of awards in accordance with this section:
(1)The Secretary shall make awards to eligible entities to enable such entities to initiate health care workforce educational programs or to continue to carry out comparable programs that are operating at the time the award is made by planning, developing, operating, and evaluating an area health education center program.
(2)The Secretary shall make awards to eligible entities to maintain and improve the effectiveness and capabilities of an existing area health education center program, and make other modifications to the program that are appropriate due to changes in demographics, needs of the populations served, or other similar issues affecting the area health education center program. For the purposes of this section, the term “Program” refers to the area health education center program.
(b)(1)(A)For purposes of subsection (a)(1), the term “eligible entity” means a school of medicine or osteopathic medicine, an incorporated consortium of such schools, or the parent institutions of such a school. With respect to a State in which no area health education center program is in operation, the Secretary may award a grant or contract under subsection (a)(1) to a school of nursing.
(B)For purposes of subsection (a)(2), the term “eligible entity” means an entity that has received funds under this section, is operating an area health education center program, including an area health education center or centers, and has a center or centers that are no longer eligible to receive financial assistance under subsection (a)(1).
(2)An eligible entity desiring to receive an award under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(c)(1)An eligible entity shall use amounts awarded under a grant under subsection (a)(1) or (a)(2) to carry out the following activities:
(A)Develop and implement strategies, in coordination with the applicable one-stop delivery system under section 3151(e) of title 29, to recruit individuals from underrepresented minority populations or from disadvantaged or rural backgrounds into health professions, and support such individuals in attaining such careers.
(B)Develop and implement strategies to foster and provide community-based training and education to individuals seeking careers in health professions within underserved areas for the purpose of developing and maintaining a diverse health care workforce that is prepared to deliver high-quality care, with an emphasis on primary care, in underserved areas or for health disparity populations, in collaboration with other Federal and State health care workforce development programs, the State workforce agency, and local workforce investment boards, and in health care safety net sites.
(C)Prepare individuals to more effectively provide health services to underserved areas and health disparity populations through field placements or preceptorships in conjunction with community-based organizations, accredited primary care residency training programs, Federally qualified health centers, rural health clinics, public health departments, or other appropriate facilities.
(D)Conduct and participate in interdisciplinary training that involves physicians, physician assistants, nurse practitioners, nurse midwives, dentists, psychologists, pharmacists, optometrists, community health workers, public and allied health professionals, or other health professionals, as practicable.
(E)Deliver or facilitate continuing education and information dissemination programs for health care professionals, with an emphasis on individuals providing care in underserved areas and for health disparity populations.
(F)Propose and implement effective program and outcomes measurement and evaluation strategies.
(G)Establish a youth public health program to expose and recruit high school students into health careers, with a focus on careers in public health.
(2)An eligible entity may use amounts awarded under a grant under subsection (a)(1) or subsection (a)(2) to carry out any of the following activities:
(A)Develop and implement innovative curricula in collaboration with community-based accredited primary care residency training programs, Federally qualified health centers, rural health clinics, behavioral and mental health facilities, public health departments, or other appropriate facilities, with the goal of increasing the number of primary care physicians and other primary care providers prepared to serve in underserved areas and health disparity populations.
(B)Coordinate community-based participatory research with academic health centers, and facilitate rapid flow and dissemination of evidence-based health care information, research results, and best practices to improve quality, efficiency, and effectiveness of health care and health care systems within community settings.
(C)Develop and implement other strategies to address identified workforce needs and increase and enhance the health care workforce in the area served by the area health education center program.
(d)(1)In carrying out this section, the Secretary shall ensure the following:
(A)An entity that receives an award under this section shall conduct at least 10 percent of clinical education required for medical students in community settings that are removed from the primary teaching facility of the contracting institution for grantees that operate a school of medicine or osteopathic medicine. In States in which an entity that receives an award under this section is a nursing school or its parent institution, the Secretary shall alternatively ensure that—
(i)the nursing school conducts at least 10 percent of clinical education required for nursing students in community settings that are remote from the primary teaching facility of the school; and
(ii)the entity receiving the award maintains a written agreement with a school of medicine or osteopathic medicine to place students from that school in training sites in the area health education center program area.
(B)An entity receiving funds under subsection (a)(2) does not distribute such funding to a center that is eligible to receive funding under subsection (a)(1).
(2)The Secretary shall ensure that each area health education center program includes at least 1 area health education center, and that each such center—
(A)is a public or private organization whose structure, governance, and operation is independent from the awardee and the parent institution of the awardee;
(B)is not a school of medicine or osteopathic medicine, the parent institution of such a school, or a branch campus or other subunit of a school of medicine or osteopathic medicine or its parent institution, or a consortium of such entities;
(C)designates an underserved area or population to be served by the center which is in a location removed from the main location of the teaching facilities of the schools participating in the program with such center and does not duplicate, in whole or in part, the geographic area or population served by any other center;
(D)fosters networking and collaboration among communities and between academic health centers and community-based centers;
(E)serves communities with a demonstrated need of health professionals in partnership with academic medical centers;
(F)addresses the health care workforce needs of the communities served in coordination with the public workforce investment system; and
(G)has a community-based governing or advisory board that reflects the diversity of the communities involved.
(e)With respect to the costs of operating a program through a grant under this section, to be eligible for financial assistance under this section, an entity shall make available (directly or through contributions from State, county or municipal governments, or the private sector) recurring non-Federal contributions in cash or in kind, toward such costs in an amount that is equal to not less than 50 percent of such costs. At least 25 percent of the total required non-Federal contributions shall be in cash. An entity may apply to the Secretary for a waiver of not more than 75 percent of the matching fund amount required by the entity for each of the first 3 years the entity is funded through a grant under subsection (a)(1).
(f)Not less than 75 percent of the total amount provided to an area health education center program under subsection (a)(1) or (a)(2) shall be allocated to the area health education centers participating in the program under this section. To provide needed flexibility to newly funded area health education center programs, the Secretary may waive the requirement in the sentence for the first 2 years of a new area health education center program funded under subsection (a)(1).
(g)An award to an entity under this section shall be not less than $250,000 annually per area health education center included in the program involved. If amounts appropriated to carry out this section are not sufficient to comply with the preceding sentence, the Secretary may reduce the per center amount provided for in such sentence as necessary, provided the distribution established in subsection (j)(2) is maintained.
(h)(1)Except as provided in paragraph (2), the period during which payments may be made under an award under subsection (a)(1) may not exceed—
(A)in the case of a program, 12 years; or
(B)in the case of a center within a program, 6 years.
(2)The periods described in paragraph (1) shall not apply to programs receiving point of service maintenance and enhancement awards under subsection (a)(2) to maintain existing centers and activities.
(i)Notwithstanding any other provision of this subchapter, section 295j(a) of this title shall not apply to an area health education center funded under this section.
(j)(1)There is authorized to be appropriated to carry out this section $41,250,000 for each of fiscal years 2021 through 2025.
(2)Of the amounts appropriated for a fiscal year under paragraph (1)—
(A)not more than 35 percent shall be used for awards under subsection (a)(1);
(B)not less than 60 percent shall be used for awards under subsection (a)(2);
(C)not more than 1 percent shall be used for grants and contracts to implement outcomes evaluation for the area health education centers; and
(D)not more than 4 percent shall be used for grants and contracts to provide technical assistance to entities receiving awards under this section.
(3)An entity that receives an award under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case may any funds be carried over pursuant to the preceding sentence for more than 3 years.
(k)It is the sense of the Congress that every State have an area health education center program in effect under this section.
Legislative History
Notes & Related Subsidiaries
Editorial Notes
Prior Provisions
A prior section 294a, act
July 1, 1944, ch. 373, title VII, § 762, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2046, authorized grants and contracts for public health special projects, prior to the general amendment of this part by Pub. L. 105–392. Another prior section 294a, act
July 1, 1944, ch. 373, title VII, § 728, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2257; amended Dec. 19, 1977, Pub. L. 95–215, § 4(e)(2)–(4), 91 Stat. 1506; Dec. 17, 1980, Pub. L. 96–538, title IV, § 401, 94 Stat. 3192; Aug. 13, 1981, Pub. L. 97–35, title XXVII, § 2726, 95 Stat. 916; Oct. 22, 1985, Pub. L. 99–129, title I, § 101, title II, § 208(h), 99 Stat. 523, 532; Nov. 4, 1988, Pub. L. 100–607, title VI, §§ 602(a)–(d), 636, title VII, § 707, 102 Stat. 3122, 3149, 3159; Nov. 18, 1988, Pub. L. 100–690, title II, § 2615(b), 102 Stat. 4239; Aug. 16, 1989, Pub. L. 101–93, § 5(g)(1), 103 Stat. 612, related to Federal student loan insurance program, prior to the general amendment of this subchapter by Pub. L. 102–408. See section 292a of this title. Another prior section 294a, act
July 1, 1944, ch. 373, title VII, § 741, as added Sept. 24, 1963, Pub. L. 88–129, § 2(b), 77 Stat. 171; amended Oct. 13, 1964, Pub. L. 88–654, § 1(c), (d), 78 Stat. 1086; Oct. 22, 1965, Pub. L. 89–290, § 4(b), (f)(3), (4), (g)(1), 79 Stat. 1057, 1058; Nov. 2, 1966, Pub. L. 89–709, § 3(c), (d), 80 Stat. 1103; Nov. 3, 1966, Pub. L. 89–751, § 4, 80 Stat. 1230; Aug. 16, 1968, Pub. L. 90–490, title I, § 121(a)(3), (4), (5)(A), 82 Stat. 777; Nov. 18, 1971, Pub. L. 92–157, title I, § 105(b)–(d), (e)(4), (f)(2), 85 Stat. 449–451; Oct. 27, 1972, Pub. L. 92–585, § 4, 86 Stat. 1293; Oct. 12, 1976, Pub. L. 94–484, title IV, §§ 403(a), (b), (d), 407(d)(1), 90 Stat. 2266, 2279, which related to loan provisions, was transferred to section 294n of this title. A prior section 751 of act
July 1, 1944, was classified to section 293o of this title prior to repeal by Pub. L. 105–392. Another prior section 751 of act
July 1, 1944, was classified to section 294r of this title prior to the general amendment of this subchapter by Pub. L. 102–408. Another prior section 751 of act
July 1, 1944, was classified to section 294t of this title prior to renumbering by Pub. L. 97–35.
Amendments
2020—Subsec. (j)(1). Pub. L. 116–136 substituted “$41,250,000 for each of fiscal years 2021 through 2025” for “$125,000,000 for each of the fiscal years 2010 through 2014”. 2014—Subsec. (c)(1)(A). Pub. L. 113–128 substituted “the applicable one-stop delivery system under section 3151(e) of title 29,” for “the applicable one-stop delivery system under section 2864(c) of title 29,”. 2010—Pub. L. 111–148 amended section generally. Prior to amendment, section consisted of subsecs. (a) to (c) which related to authority for provision of financial assistance, requirements for centers, and allocations and costs.
Statutory Notes and Related Subsidiaries
Effective Date
of 2014 AmendmentAmendment by Pub. L. 113–128 effective on the first day of the first full program year after
July 22, 2014 (
July 1, 2015), see section 506 of Pub. L. 113–128, set out as an
Effective Date
note under section 3101 of Title 29, Labor. Waiver of Requirements Pub. L. 118–47, div. D, title II, Mar. 23, 2024, 138 Stat. 649, provided in part: “That for any program operating under section 751 of the PHS [Public Health Service] Act [42 U.S.C. 294a] on or before
January 1, 2009, the Secretary of Health and Human Services (referred to in this title as the ‘Secretary’) may hereafter waive any of the requirements contained in section 751(d)(2)(A) and 751(d)(2)(B) of such Act for the full project period of a grant under such section”. Similar provisions were contained in the following prior appropriation acts: Pub. L. 117–328, div. H, title II, Dec. 29, 2022, 136 Stat. 4854. Pub. L. 117–103, div. H, title II, Mar. 15, 2022, 136 Stat. 442. Pub. L. 116–260, div. H, title II, Dec. 27, 2020, 134 Stat. 1567. Pub. L. 116–94, div. A, title II, Dec. 20, 2019, 133 Stat. 2556. Pub. L. 115–245, div. B, title II, Sept. 28, 2018, 132 Stat. 3068. Pub. L. 115–141, div. H, title II, Mar. 23, 2018, 132 Stat. 715. Pub. L. 115–31, div. H, title II,
May 5, 2017, 131 Stat. 519. Pub. L. 114–113, div. H, title II, Dec. 18, 2015, 129 Stat. 2600. Pub. L. 113–235, div. G, title II, Dec. 16, 2014, 128 Stat. 2467. Pub. L. 113–76, div. H, title II, Jan. 17, 2014, 128 Stat. 363.
Reference
Citations & Metadata
Citation
42 U.S.C. § 294a
Title 42 — The Public Health and Welfare
Last Updated
Apr 5, 2026
Release point: 119-73not60