April 30, 2026
Mr. Ruiz (for himself and Mr. Bilirakis) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To strengthen recruitment, training, and retention of the health center workforce to improve access to care and health outcomes in rural and underserved communities, and for other purposes.
Section 1. Short title
This Act may be cited as the Developing the Community Health Workforce Act of 2026
.
Sec. 2. Improving recruitment and retention of Federal qualified health center staff
(a) Priority to FQHCs and rural health clinics
Section 333(a) of the Public Health Service Act (42 U.S.C. 254f(a)) is amended by adding at the end the following:
(4)
In approving applications for assignment of members of the Corps, the Secretary shall, notwithstanding paragraph (3), give priority to applications with respect to health professional shortage areas that are Federally qualified health centers and rural health clinics, as defined in section 1861(aa) of the Social Security Act.
(b) Loan repayment program
(1) In general
The Secretary of Health and Human Services shall award grants to Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))) for the purpose of addressing health professional workforce shortages by making loan repayments on behalf of health care professionals serving at such centers.
(2) Applications
To seek a grant under paragraph (1), a Federally qualified health center shall submit an application to the Secretary of Health and Human Services at such time, in such manner, and containing such information as the Secretary may require. At a minimum, such an application shall include—
(A)
a description of the center’s capacity to address specific regional workforce shortages, supported by data;
(B)
a plan for making loan repayments as described in paragraph (1); and
(C)
a description of the center’s use of an interdisciplinary approach to care (such as through the use of teams to provide care that include physicians, nurses, social workers, community health workers, pharmacists, and other health care professionals).
Sec. 3. Community Health Center Workforce Pipeline Program
(a) Grants To recruit, train, and retain a community-Based health center workforce
(1) In general
Section 330 of the Public Health Service Act (42 U.S.C. 254b) is amended—
(A)
by redesignating subsection (r) as subsection (u); and
(B)
by inserting after subsection (q) the following new subsection:
(r) Recruiting, training, and retaining a community-Based workforce
The Secretary may award grants to health centers for the purpose of assisting such centers in—
(1)
recruiting and hiring staff with the skills and experience necessary to effectively serve health center patient populations in rural and underserved areas; and
(2)
supporting career advancement and workforce development opportunities for such staff.
(b) FQHCs deemed eligible To register as apprenticeship program
Not later than 180 days after the date of the enactment of this Act, the Secretary of Labor shall revise the regulations under part 29 of title 29, Code of Federal Regulations, as in effect on the date of the enactment of this Act, so that Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))) are eligible to register as apprenticeship programs under such part.
(c) Health centers career opportunities
Section 330 of the Public Health Service Act (42 U.S.C. 254b) is further amended by inserting after subsection (r), as inserted by subsection (a) of this section, the following:
(s) Health centers career opportunities
(1) In general
The Secretary may award grants to institutions of higher education, including community colleges and minority-serving institutions, to establish partnerships with one or more health centers funded under this section for training students in health professions.
(2) Use of funds
(A) Costs
An institution of higher education receiving a grant under this subsection may use the grant to pay the costs of training, including the salary of the clinicians or other educators who provide the training.
(B) Training supported
The training supported pursuant to a grant under this subsection may include formal training and mentorships.
(C) Types of training
The types of training supported pursuant to a grant under this subsection may include clinical, information technology, operations, finance, or other training for students of health professions, as determined by the institution of higher education receiving the grant in partnership with the health center involved.
(3) Definitions
In this subsection:
(A)
The term institution of higher education means an institution of higher education described in subsection (a) or (b) of section 101 of the Higher Education Act of 1965.
(B)
The term minority-serving institution means an institution of higher education described in section 371(a) of the Higher Education Act of 1965.
(d) Behavioral health specialists
Section 330 of the Public Health Service Act (42 U.S.C. 254b) is further amended by inserting after subsection (s), as inserted by subsection (c) of this section, the following:
(t) Behavioral health specialists
(1) In general
The Secretary may award grants to health centers to establish, operate, or expand training programs for behavioral health specialists.
(2) Use of funds
The training programs for behavioral health specialists supported pursuant to a grant under this subsection may include—
(A)
stipends for personnel to operate the training programs;
(B)
apprenticeship programs; and
(C)
other recruitment and retention activities for behavioral health specialists.
Sec. 4. Expanding hospital and FQHC partnerships for graduate medical education
(a) Payments to teaching health centers
(1) In general
Section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended—
(A)
in subsection (a)(1), by inserting , or that have in effect a covered agreement with a sponsoring institution so listed,
after relevant accrediting body
; and
(B)
in subsection (j), by adding at the end the following new paragraph:
(5) Covered agreement
The term covered agreement means a written contract, memorandum of understanding, or other written agreement entered into for not less than 2 years for the purpose of conducting an approved graduate medical residency training program.
(2) Effective date
The amendment made by paragraph (1) shall apply with respect to expenses incurred on or after October 1, 2025.
(b) Medicare GME cap
Section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) is amended—
(1)
in subsection (4)(F), by striking and (10)
and inserting (10), and (11)
; and
(2)
by adding at the end the following new paragraph:
(11) Training programs at Federally qualified health centers
(A) In general
For cost reporting periods beginning on or after October 1, 2025, in the case of a hospital that has an approved medical residency training program where a significant portion of such program occurs at a Federally qualified health center (as determined by the Secretary), the Secretary shall increase the otherwise applicable resident limit for such hospital by 3 full-time equivalent residency positions.
(B) Definitions
In this paragraph:
(i) Otherwise applicable resident limit
The term
otherwise applicable resident limitmeans, with respect to a hospital, the limit otherwise applicable under subparagraphs (F)(i) and (H) of paragraph (4) on the resident level for the hospital determined without regard to this paragraph but taking into account paragraphs (7)(A), (7)(B), (8)(A), (8)(B), (9)(A), and (10)(A).(ii) Resident level
The term
resident levelhas the meaning given such term in paragraph (7)(C)(i).
Sec. 5. Expanding FQHC services
(a) Behavioral health professional and case manager services
(1) Medicare
Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)) is amended—
(A)
in paragraph (1)—
(i)
in subparagraph (B), by inserting such services furnished on or after October 1, 2025, by a behavioral health consultant, peer support specialist, or other behavioral health professional (as such terms are defined by the Secretary),
before and such services
;
(ii)
in subparagraph (C), by striking and
at the end;
(iii)
in subparagraph (D), by striking the comma at the end and inserting , and
; and
(iv)
by inserting after subparagraph (D) the following new subparagraph:
(E)
case management services furnished on or after October 1, 2025, by a case manager (as defined by the Secretary),; and
(B)
in paragraph (3)(A), by striking (D)
and inserting (E)
.
(2) Medicaid
Section 1905(l)(2)(A) of the Social Security Act (42 U.S.C. 1396d(l)(2)(A)) is amended by inserting and (E)
before of section
.
(b) Guidance on State Medicaid payments to FQHCs
Section 1902(bb) of the Social Security Act (42 U.S.C. 1396a(bb)) is amended by adding at the end the following new paragraph:
(7) Study and guidance on payment adjustments
Not later than October 1, 2025, and not less frequently than annually thereafter, the Secretary shall—
(A)
conduct a study on any differences in the methods by which State plans adjust the payment amount under paragraph (3) for services furnished during a fiscal year; and
(B)
based on the results of the study conducted under subparagraph (A), issue guidance to State plans on best practices for adjusting the payment amount under paragraph (3) for services furnished during a fiscal year.