assurances that, for the first school year beginning after June 30, 1972 and for each school year thereafter, the number of students enrolled in such school as class of first-year students will not be less than a number equal to the sum of—

(i) the minimum enrollment of first-year students required under subparagraph (A); and

(ii) 10 per centum of the number of first-year students enrolled for the first school year beginning after June 30, 1970, if such number was not more than 100 or, if such number was more than 100, 5 per centum of such number of ten students, whichever is greater.

(2) School years after school year 1971-1972.

If the school year for which a class enrolled as a class of first-year students in a school was any school year beginning after June 30, 1972

(A) the number of students who enrolled in such class for such school year

(i) if such school has not previously received a grant for bonus enrollment students, must be not less than the sum of (I) the minimum number of first-year students which such school is required pursuant to subsection (f) of this section (or would be required pursuant to subsection (f) of this section except for paragraph (2) thereof) to enroll for such school year, and (II) 5 per centum of that number or 5 students, whichever is greater; or

(ii) if such school has previously qualified for a bonus enrollment grant under this section, must be not less than the sum of (I) the minimum number of students which such school was required, pursuant to paragraph (1)(B) or (2) (B) (as the case may be), to assure the Secretary would be enrolled for such school year, and (II) 5 per centum of that number or 5 students, whichever is greater; or

(B) the application of such school for a grant under this section for the fiscal year in which such school year begins contains or is supported by reasonable assurances that, for the first school year beginning after the close of such fiscal year and for each fiscal year thereafter, the number of students enrolled in such school as a class of firstyear students will not be less than the minimum number of students such school was required under subparagraph (A) to enroll as first-year students.

(f) Maintenance of effort and enrollment increase requirements.

(1) The Secretary shall not make a grant under this section to any school in a fiscal year beginning after June 30, 1971, unless the application for such grant contains or is supported by reasonable assurances satisfactory to the Secretary

(A) that for the first school year beginning after the close of the fiscal year in which such grant is first made and for each school year thereafter during which such a grant is made the first-year enrollment of full-time students in such school will exceed the number of such students enrolled in the school year beginning during the fiscal year ending June 30, 1971

(i) by 10 per centum of such number if such number was not more than 100, or

(ii) by 5 per centum of such number, or 10 students, whichever is greater, if such number was more than 100; and

(B) that the applicant will expend in carrying out its function as a school of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, or podiatry, as the case may be, during the fiscal year for which such grant is sought, an amount of funds (other than funds for construction as determined by the Secretary) from nonFederal sources which is at least as great as the average amount of funds expended by such applicant for such purpose (excluding expenditures of a nonrecurring nature) in the 3 fiscal years immediately preceding the fiscal year for which such grant is sought.

The requirements of subparagraph (A) shall be in addition to the requirements of section 293a (c) (2) of this title, where applicable.

(2) The Secretary is authorized to waive (in whole or in part) the provisions of paragraph (1)(A) if he determines, after consultation with the National Advisory Council on Health Professions Education, that the required increase in first-year enrollment of fulltime students in a school cannot, because of limitations of physical facilities available to the school for training or because of other relevant factors, be accomplished without lowering the quality of training provided therein.

(3) In those instances where enrollment increases proposed exceed the requirements of paragraph (1) (A), the Secretary shall satisfy himself, after consultation with the appropriate accreditation body or bodies (as defined in section 293a(b)(1) of this title), that there is reasonable assurance that such expanded program will meet the accreditation standards of such body or bodies.

(g) Plan requirement; on-site inspections; reports to congressional committees.

(1) In the case of a school which has not received a grant under subsection (a) of this section in a fiscal year beginning after June 30, 1971, an application by such school for a grant for a fiscal year beginning after that date shall contain or be accompanied by a plan to carry out or establish and carry out, during the two-school-year period commencing not later than the first day of the fiscal year next following the fiscal year in which the grant is made, specific projects in at least three of the following categories of projects or if the application is for a school of pharmacy, specific projects in the category described in clause (G) and specific projects in at least two other categories):

(A) Projects to effect significant improvements in the curriculum of such school (including projects for shortening of the length of time required to complete training programs provided by such school).

(B) Projects to establish cooperative interdisciplinary training among schools of medicine, dentistry, osteopathy, optometry, podiatry, pharmacy, veterinary medicine, nursing, public health, and allied health, including projects for training for the use of the team approach to the provision of health services.

(C) Projects to train for new roles, types, or levels of health personnel, including programs for the training of physicians' assistants, dental therapists, and other health professions' assistants, and nurse practitioners, in cooperation with appropriate academic institutions and hospitals.

(D) Projects to make innovative modifications of existing programs of education in the health professions, including projects for the teaching of the organization, provision, financing, or evaluation, of health care.

(E) Projects to assist in significantly increasing the supply of adequately trained personnel in the health professions needed to meet the health needs of the Nation.

(F) Projects to establish, at schools of medicine, osteopathy, or dentistry, increased emphasis on, and training in, the science of clinical pharmacology; diagnosis, treatment, and prevention of drug and alcohol use and abuse; the assessment of the efficacy of various therapeutic regimens, and; in the case of schools of medicine and osteopathy, the science of nutrition.

(G) Projects to provide, at schools of pharmacy, for increased emphasis on, and training in, clinical pharmacy, drug use and abuse, and where appropriate clinical pharmacology.

(H) Projects to increase admissions to, and enrollment and retention in, such schools of qualified individuals who, due to socioeconomic factors, are financially or educationally disadvantaged.

(I) Projects to train and educate primary care health professionals with particular emphasis (in the case of schools of medicine, osteopathy, and dentistry) upon the establishment of new, or expansion of existing, programs for training in family medicine.

(2) The Secretary may make on-site inspections of any school, or require the supplying of information or data from any school, receiving a grant under subsection (a) of this section to determine the extent to which such school is carrying out the specific projects required to be included in the plan submitted by such school (pursuant to paragraph (1)) in connection with its application for such grant.

(3) The Secretary shall submit to the Committee on Labor and Public Welfare of the Senate and the Committee on Interstate and Foreign Commerce of the House of Representatives two reports containing full and complete information as to the extent to which schools receiving grants under subsection (a) of this section are carrying out the specific projects included in plans submitted by them pursuant to paragraph (1). The first such report shall be submitted not later than January 1, 1973, and the second such report shall be submitted not later than September 1, 1974.

(h) Enrollment and graduation determinations; "fulltime students".

(1) For purposes of this part and part F of this subchapter, regulations of the Secretary shall include provisions relating to determination of the number of students enrolled in a school, or in a particular year-class in a school, or the number of graduates, as the case may be, on the basis of estimates or on the basis of the number of students who

were enrolled in a school, or in a particular year-class in a school, or were graduates, in an earlier year, as the case may be, or on such basis as he deems appropriate for making such determination, and shall include methods of making such determination when a year-class was not in existence in an earlier year at a school.

(2) For purposes of this part and part F of this subchapter, the term "full-time students" (whether such term is used by itself or in connection with a particular year-class) means students pursuing a full-time course of study leading to a degree of doctor of medicine, doctor of dentistry, or an equivalent degree, doctor of osteopathy, bachelor of science in pharmacy or an equivalent degree, doctor of optometry or an equivalent degree, doctor of veterinary medicine or an equivalent degree, or doctor of podiatry or an equivalent degree.

(i) Applications for new schools.

In the case of a new school of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, or podiatry, which applies for a grant under this section in the fiscal year preceding the fiscal year in which it will admit its first class, the enrollment for purposes of subsections (a) and (b) of this section shall be the number of full-time students which the Secretary determines, on the basis of assurances provided by the school, will be enrolled in the school, in the fiscal year after the fiscal year in which the grant is made.

(j) Authorization of appropriations.

(1) There are authorized to be appropriated $200,000,000 for the fiscal year ending June 30, 1972, $213,000,000 for the fiscal year ending June 30, 1973, and $238,000,000 for the fiscal year ending June 30, 1974, for grants under this section to schools of medicine, osteopathy, and dentistry.

(2) There are authorized to be appropriated $34,000,000 for the fiscal year ending June 30, 1972, $37,000,000 for the fiscal year ending June 30, 1973, and $41,000,000 for the fiscal year ending June 30, 1974, for grants under this section to schools of veterinary medicine, optometry, pharmacy, and podiatry.

(3) No funds appropriated under any provision of this chapter (other than this subsection) may be used to make grants under this section. (As amended Nov. 18, 1971, Pub. L. 92-157, title I, § 104, 85 Stat. 437.)

AMENDMENTS

1971-Pub. L. 92-157, in revising the text, substituted provisions incorporated in subsecs. (a)-(1) respecting capitation grants for provisions respecting authorization of appropriations of $117,000,000 and $168,000,000 for fiscal years ending June 30, 1970, and 1971, respectively, for institutional grants and special project grants under former provisions of sections 295f-1 and 295f-2 of this title. SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 293a, 295f-5 of this title.

§ 295f-1. Start-up assistance.

(a) New schools eligible; conditions; amount of grant; new school status; payments: advances or reimbursement, intervals, conditions; authorization of appropriations.

(1) In the case of any new school of medicine, osteopathy or dentistry which begins instruction

(A) the ability of such school to use a grant under this section to (i) accelerate the date it will begin instruction, or (ii) increase the number of students in its entering class, and

(B) the other resources available to such school, make a grant to such school for each year such school is a new school (as determined under paragraph (4)). No school may receive a grant under this subsection unless the Secretary estimates that the number of full-time students enrolled in its first academic year of operation will exceed twenty-three.

(2) The Secretary shall determine the amount of any grant under this subsection; but no such grant to any school may exceed

(A) in the case of the year preceding the first year in which such school has students enrolled, an amount equal to the product of $10,000 and the number of full-time students which the Secretary estimates will enroll in such school in such first year;

(B) in the case of the first year in which such school has students enrolled, an amount equal to the product of $7,500 and the number of full-time students enrolled in such school in such year;

(C) in the case of the second year in which such school has students enrolled, an amount equal to the product of $5,000 and the number of full-time students enrolled in such school in such year;

(D) in the case of the third year in which such school has students enrolled, an amount equal to the product of $2,500 and the number of full-time students enrolled in such school in such year. Estimates by the Secretary under this subsection of the number of full-time students enrolled in a school may be made on the basis of assurances provided by the school.

(3) The Secretary shall give special consideration to each application of a school for grant assistance under this subsection which contains or is reasonably supported by assurances, that, because of the use that the school will make of existing facilities (including Federal medical or dental facilities), it will be able to accelerate the date on which it will begin its teaching program.

(4) For purposes of this subsection, any school of medicine, osteopathy, or dentistry shall be considered a new school for any year if such year is the year preceding the first year in which such school has students enrolled, such first year, and the next two years.

(5) Payments under grants under this subsection may be made in advance or by way of reimbursement, and at such intervals and on such conditions, as the Secretary finds necessary.

(6) There is authorized to be appropriated to make grants under this subsection not to exceed $10,000,000 for the fiscal year ending June 30, 1972, and a like amount for each of the next two fiscal years. Sums appropriated under this paragraph shall remain available until expended.

credited status; amount of grant; year of expenditure; limitation of funds; applications: filing date, approval by Secretary; enrollment date for third-year students; payments: advances or reimbursement; intervals, conditions.

(1) The Secretary shall make a grant to any public or nonprofit private two-year school of medicine (or any school accredited as such a two-year school) which intends to become a school accredited to grant the degree of doctor of medicine. The amount of the grant to a school under this subsection shall be equal to the product of $50,000 and the number of thirdyear students which the Secretary determines will be initially enrolled in such school. Upon application by the school, the Secretary shall (if the school so requests) make a grant to such school for expenditure in the year preceding the initial enrollment of third-year students in such school, or thereafter. No school may receive more than one grant under this subsection.

(2) No grant may be made under this subsection unless an application therefor has been submitted before July 1, 1974, and the school enrolls third-year students not later than the school year beginning in the fiscal year ending June 30, 1975. The Secretary may not approve an application for a grant under this subsection unless he determines it contains or is supported by reasonable assurances that the school for which the application is made will be affiliated with an accredited hospital in the fiscal year for which such grant is made. Payments under grants under this subsection may be made in advance or by way of reimbursement, and at such intervals and on such conditions, as the Secretary finds necessary. (As amended Nov. 18, 1971, Pub. L. 92-157, title I, § 104, 85 Stat. 443.)

AMENDMENTS

1971-Pub. L. 92–157, in revising the text, substituted provisions incorporated in subsecs. (a) and (b) respecting start-up assistance to new schools and two-year schools of medicine with prospective accredited status for former provisions respecting institutional grants, providing in subsec. (a) for distribution, computations, increases, and adjustments; subsec. (b) for enrollment increase requirement, waiver thereof, limitation, and exceptions; subsec. (c) for determination of number of students enrolled and definition of "full-time students"; and subsec. (d) for full time students in new schools.

SECTION REFERRED TO IN OTHER SECTIONS This section is referred to in sections 295f, 295f-5 of this title.

§ 295f-2. Special project grants and contracts. (a) Description of programs.

The Secretary may make grants to assist schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, and podiatry in meeting the costs of special projects to

(1) effect significant improvements in the curriculums of any such schools (including projects to shorten the length of time required for training in such schools), with particular emphasis, in the case of schools of medicine or osteopathy, upon the establishment of new, or expansion of existing, programs for training in family medicine;

(2) develop programs for cooperative interdisciplinary training among schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, podiatry, nursing, public health,

and allied health, including projects for training in the use of the team approach to the delivery of health services;

(3) develop and operate training programs, and train, for new roles, types, or levels of health personnel, including programs for the training of physicians' assistants and other health professions' assistants;

(4) plan, develop, or establish new programs, or innovative modifications of existing programs, of education in such health professions, including the teaching of the organization, delivery, financing, or evaluation of health care;

(5) research, development, or demonstrate advances in the various fields related to education in such health professions;

(6) assist in increasing the supply, or improving the distribution, by geographic area or specialty group, of adequately trained personnel in such health professions needed to meet the health needs of the Nation;

(7) establish and operate programs at schools of medicine or osteopathy (and where applicable at other health professions schools) (A) providing increased emphasis on, and training in, the science of clinical pharmacology, the prevention, diagnosis, treatment, and rehabilitation of alcoholism and drug dependence, and the assessment of the efficacy of various therapeutic regimens, or (B) providing increased emphasis on, and training and research in, the science of human nutrition and the application of such science to health;

(8) establish and operate projects designed to identify, and increase admissions to and enrollment in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, and podiatry of, individuals whose background and interests make it reasonable to assume that they will engage in the practice of their health profession in rural or other areas having a severe shortage of personnel in such health profession;

(9) establish and operate projects designed to increase admissions to and enrollment in such schools of qualified individuals from minority or low-income groups;

(10) plan experimental teaching programs or facilities;

(11) provide traineeships (including costs of training and fees, stipends, and allowances for the students (including travel and subsistence expenses and dependency allowances)) for full-time students to secure part of their education under a preceptor in family practice, pediatrics, internal medicine, or other health fields designated by the Secretary, or in rural or other areas having a severe shortage of physicians;

(12) utilize health personnel more efficiently, through the use of computer technology and otherwise;

(13) encourage new or more effective approaches to the organization and delivery of health services through the use of the team approach to delivery of health services and the utilization of computer technology to process biomedical information in the provision of health services; or

(14) establish and operate programs in the interdisciplinary training of health personnel for

the provision of emergency medical services, with particular emphasis on the establishment and operation of training programs affording clinical experience in emergency medical services systems receiving assistance under subchapter X of this chapter.

The Secretary may also enter into contracts with public or private health or educational entities to carry out any project described in this subsection. (b) Additional related uses.

Grants and contracts may also be made by the Secretary under this section for

(1) the discovery, collection, development, or confirmation of information for,

(2) the planning, development, demonstration, establishment, or maintenance of,

(3) the alteration or renovation of existing facilities for, any project described in subsection (a) of this section.

(c) Contract authority.

Contracts under this section may be entered into without regard to section 529 of Title 31 and section 5 of Title 41.

(d) Authorization of appropriations.

There are authorized to be appropriated $118,000,000 for the fiscal year ending June 30, 1972, $138,000,000 for the fiscal year ending June 30, 1973, and $156,000,000 for the fiscal year ending June 30, 1974, for the purpose of making payments pursuant to grants and contracts under this section. Funds appropriated under this subsection for the fiscal year ending June 30, 1972, shall remain available for obligation through September 30, 1972. (As amended Nov. 18, 1971, Pub. L. 92-157, title I, § 104, 85 Stat. 444; Nov. 16, 1973, Pub. L. 93-154, § 3(b), 87 Stat. 604.)

AMENDMENTS

1973-Subsec. (a) (14). Pub. L. 93–154 added par. (14). 1971-Pub. L. 92–157, in revising the text, substituted special project grants and contracts provisions respecting (a) description of programs, (b) additional related uses, (c) contract authority, and (d) authorization of appropriations for former provisions respecting special project grants, determination of need for emergency financial assistance, and report to Congress by June 30, 1971, former subsec. (a) providing for special projects to plan, develop, or establish new programs or modifications of existing programs of education in health professions or to effect significant improvements in curriculums or for research in various fields related to education in health professions, or to develop training for new levels or types of health professions personnel, or to assist schools in serious financial straits to meet costs of operation or have special need for financial assistance to meet accreditation requirements, or to assist the schools to meet costs of planning experimental teaching facilities or experimental design thereof, or otherwise strengthen, improve, or expand personnel training programs, or help increase supply of trained personnel to meet health needs of the Nation.

SECTION REFERRED TO IN OTHER SECTIONS This section is referred to in section 295f-5 of this title. § 295f-3. Grants to assist health professions schools which are in financial distress.

(a) Authorization of appropriations.

There are authorized to be appropriated $20,000,000 for the fiscal year ending June 30, 1972, $15,000,000 for the fiscal year ending June 30, 1972, and