---
kind: "section"
citation: "42 U.S.C. § 293k"
title: "42"
title_heading: "The Public Health and Welfare"
number: "293k"
heading: "Primary care training and enhancement"
release: "119-102"
url: "https://uscodex.org/usc/42/293k"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter V — Health Professions Education"
  - "Part C — Training in Family Medicine, General Internal Medicine, General Pediatrics, Physician Assistants, General Dentistry, and Pediatric Dentistry"
  - "Subpart 1 — medical training generally"
---

# §293k. Primary care training and enhancement

- (a) **Support and development of primary care training programs—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) may make grants to, or enter into contracts with, an [accredited](/usc/42/295p.md?p=1-E) public or [nonprofit](/usc/42/295p.md?p=8) private [hospital](/usc/42/1395dd.md?p=e-5), [school of medicine](/usc/42/295p.md?p=1-A) or osteopathic medicine, academically affiliated [physician](/usc/42/1320a–7h.md?p=e-11) assistant [training](/usc/42/285e–2.md?p=b-2) [program](/usc/42/274l–1.md?p=4), or a public or private [nonprofit](/usc/42/295p.md?p=8) entity which the [Secretary](/usc/42/201.md?p=c) has determined is capable of carrying out such grant or contract—
    - (A) to plan, develop, operate, or participate in an [accredited](/usc/42/295p.md?p=1-E) professional [training](/usc/42/285e–2.md?p=b-2) [program](/usc/42/274l–1.md?p=4), including an [accredited](/usc/42/295p.md?p=1-E) residency or internship [program](/usc/42/274l–1.md?p=4) in the field of [family](/usc/42/290ff–4.md?p=d-2) medicine, general internal medicine, or general pediatrics for medical students, interns, residents, or practicing [physicians](/usc/42/1395cc–4.md?p=a-2-E) as defined by the [Secretary](/usc/42/201.md?p=c);
    - (B) to provide need-based financial assistance in the form of traineeships and [fellowships](/usc/42/1862n–1.md?p=i-3) to medical students, interns, residents, practicing [physicians](/usc/42/1395cc–4.md?p=a-2-E), or other medical personnel, who are [participants](/usc/42/300gg–91.md?p=d-11) in any such [program](/usc/42/274l–1.md?p=4), and who plan to specialize or work in the practice of the fields defined in [subparagraph (A)](#a-1-A);
    - (C) to plan, develop, and operate a [program](/usc/42/274l–1.md?p=4) for the [training](/usc/42/285e–2.md?p=b-2) of [physicians](/usc/42/1395cc–4.md?p=a-2-E) who plan to teach in [family](/usc/42/290ff–4.md?p=d-2) medicine, general internal medicine, or general pediatrics [training](/usc/42/285e–2.md?p=b-2) [programs](/usc/42/274l–1.md?p=4);
    - (D) to plan, develop, and operate a [program](/usc/42/274l–1.md?p=4) for the [training](/usc/42/285e–2.md?p=b-2) of [physicians](/usc/42/1395cc–4.md?p=a-2-E) teaching in community-based settings;
    - (E) to provide financial assistance in the form of traineeships and [fellowships](/usc/42/1862n–1.md?p=i-3) to [physicians](/usc/42/1395cc–4.md?p=a-2-E) who are [participants](/usc/42/300gg–91.md?p=d-11) in any such [programs](/usc/42/274l–1.md?p=4) and who plan to teach or conduct research in a [family](/usc/42/290ff–4.md?p=d-2) medicine, general internal medicine, or general pediatrics [training](/usc/42/285e–2.md?p=b-2) [program](/usc/42/274l–1.md?p=4);
    - (F) to plan, develop, and operate a [physician assistant education program](/usc/42/295p.md?p=3), and for the [training](/usc/42/285e–2.md?p=b-2) of individuals who will teach in [programs](/usc/42/274l–1.md?p=4) to provide such [training](/usc/42/285e–2.md?p=b-2);
    - (G) to plan, develop, and operate a [program](/usc/42/274l–1.md?p=4) that identifies or develops innovative models of providing care, and trains primary care [physicians](/usc/42/1395cc–4.md?p=a-2-E) on such models and in new competencies, as recommended by the [Advisory Committee](/usc/42/7703.md?p=9) on [Training](/usc/42/285e–2.md?p=b-2) in Primary Care Medicine and Dentistry and the National Health Care Workforce [Commission](/usc/42/2000ff.md?p=1) established in [section 294q of this title](/usc/42/294q.md), which may include—
      - (i) providing [training](/usc/42/285e–2.md?p=b-2) to primary care [physicians](/usc/42/1395cc–4.md?p=a-2-E) relevant to providing care through patient-centered medical homes (as defined by the [Secretary](/usc/42/201.md?p=c) for purposes of this section);
      - (ii) developing tools and curricula relevant to patient-centered medical homes; and
      - (iii) providing continuing education to primary care [physicians](/usc/42/1395cc–4.md?p=a-2-E) relevant to patient-centered medical homes; and
    - (H) to plan, develop, and operate joint degree [programs](/usc/42/274l–1.md?p=4) to provide interdisciplinary and interprofessional graduate [training](/usc/42/285e–2.md?p=b-2) in public health and other health professions to provide [training](/usc/42/285e–2.md?p=b-2) in environmental health, infectious disease control, disease prevention and health promotion, epidemiological studies and injury control.
  - (2) **Duration of awards—** The period during which payments are made to an entity from an award of a grant or contract under this subsection shall be 5 years.
  - (3) **Priorities in making awards—** In awarding grants or contracts under [paragraph (1)](#a-1), the [Secretary](/usc/42/201.md?p=c) may give priority to qualified applicants that train residents in rural areas, including for Tribes or [Tribal Organizations](/usc/42/629a.md?p=a-6) in such areas.
- (b) **Capacity building in primary care—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) may make grants to or enter into contracts with [accredited](/usc/42/295p.md?p=1-E) [schools](/usc/42/6372.md?p=1) of medicine or osteopathic medicine to establish, maintain, or improve—
    - (A) academic [units](/usc/42/1395w–114b.md?p=g-2) or [programs](/usc/42/274l–1.md?p=4) that improve clinical teaching and research in fields defined in [subsection (a)(1)(A)](#a-1-A); or
    - (B) [programs](/usc/42/274l–1.md?p=4) that integrate academic administrative [units](/usc/42/1395w–114b.md?p=g-2) in fields defined in [subsection (a)(1)(A)](#a-1-A) to enhance interdisciplinary recruitment, [training](/usc/42/285e–2.md?p=b-2), and faculty development.
  - (2) **Preference in making awards under this subsection—** In making awards of grants and contracts under [paragraph (1)](#b-1), the [Secretary](/usc/42/201.md?p=c) shall give preference to any qualified applicant for such an award that agrees to expend the award for the purpose of—
    - (A) establishing academic [units](/usc/42/1395w–114b.md?p=g-2) or [programs](/usc/42/274l–1.md?p=4) in fields defined in [subsection (a)(1)(A)](#a-1-A); or
    - (B) substantially expanding such [units](/usc/42/1395w–114b.md?p=g-2) or [programs](/usc/42/274l–1.md?p=4).
  - (3) **Priorities in making awards—** In awarding grants or contracts under [paragraph (1)](#b-1), the [Secretary](/usc/42/201.md?p=c) shall give priority to qualified applicants that—
    - (A) proposes[^1] a collaborative [project](/usc/42/11360.md?p=20) between academic administrative [units](/usc/42/1395w–114b.md?p=g-2) of primary care;
    - (B) proposes[^1] innovative approaches to clinical teaching using models of primary care, such as the patient centered medical home, team management of chronic disease, and interprofessional integrated models of health care that incorporate transitions in health care settings and integration physical and mental health provision;
    - (C) have a record of [training](/usc/42/285e–2.md?p=b-2) the greatest percentage of providers, or that have demonstrated significant improvements in the percentage of providers trained, who enter and remain in primary care practice;
    - (D) have a record of [training](/usc/42/285e–2.md?p=b-2) individuals who are from underrepresented [minority groups](/usc/42/285t.md?p=c-3) or from a rural or disadvantaged background;
    - (E) provide [training](/usc/42/285e–2.md?p=b-2) in the care of vulnerable populations such as [children](/usc/42/256e.md?p=g-2), older adults, [homeless individuals](/usc/42/290cc–34.md?p=2), victims of abuse or trauma, individuals with mental health or substance use disorders, individuals with HIV/AIDS, and individuals with disabilities;
    - (F) establish formal relationships and submit joint applications with [federally qualified health centers](/usc/42/254c.md?p=b-2), [rural health clinics](/usc/42/254c.md?p=b-2), [area health education centers](/usc/42/295p.md?p=12), or clinics located in underserved areas or that serve underserved populations;
    - (G) teach trainees the skills to provide interprofessional, integrated care through collaboration among health professionals;
    - (H) provide [training](/usc/42/285e–2.md?p=b-2) in enhanced communication with patients, evidence-based practice, chronic disease management, preventive care, [health information](/usc/42/300jj.md?p=4) technology, or other competencies as recommended by the [Advisory Committee](/usc/42/7703.md?p=9) on [Training](/usc/42/285e–2.md?p=b-2) in Primary Care Medicine and Dentistry and the National Health Care Workforce [Commission](/usc/42/2000ff.md?p=1) established in [section 294q of this title](/usc/42/294q.md); or
    - (I) provide [training](/usc/42/285e–2.md?p=b-2) in [cultural competency](/usc/42/295p.md?p=15) and [health literacy](/usc/42/295p.md?p=21).
  - (4) **Duration of awards—** The period during which payments are made to an entity from an award of a grant or contract under this subsection shall be 5 years.
- (c) **Authorization of appropriations—**
  - (1) **In general—** For purposes of carrying out this section (other than [subsection (b)(1)(B)](#b-1-B)), there are authorized to be appropriated $48,924,000 for each of fiscal years 2021 through 2025.
  - (2) **Training programs—** Fifteen percent of the amount appropriated pursuant to [paragraph (1)](#c-1) in each such fiscal year shall be allocated to the [physician](/usc/42/1320a–7h.md?p=e-11) assistant [training](/usc/42/285e–2.md?p=b-2) [programs](/usc/42/274l–1.md?p=4) described in [subsection (a)(1)(F)](#a-1-F), which prepare students for practice in primary care.
  - (3) **Integrating academic administrative units—** For purposes of carrying out [subsection (b)(1)(B)](#b-1-B), there are authorized to be appropriated $750,000 for each of fiscal years 2010 through 2014.

## Footnotes

[^1]: So in original. Probably should be “propose”.

## Source credit

(July 1, 1944, ch. 373, title VII, § 747, as added Pub. L. 111–148, title V, § 5301, Mar. 23, 2010, 124 Stat. 615; amended Pub. L. 116–136, div. A, title III, § 3401(3), Mar. 27, 2020, 134 Stat. 386.)

## Notes

### Editorial Notes

### Codification

Pub. L. 111–148, title V, § 5301, Mar. 23, 2010, 124 Stat. 615, which directed the amendment of part C of title VII by striking out section 747 and inserting a new section 747, without specifying the act to be amended, was executed as an amendment to part C of title VII of act July 1, 1944, by adding this section and repealing former section 293k of this title, to reflect the probable intent of Congress.

### Prior Provisions

A prior section 293k, act July 1, 1944, ch. 373, title VII, § 747, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2042; amended Pub. L. 105–392, title I, § 102(3), Nov. 13, 1998, 112 Stat. 3537, related to grants and contracts for training in family medicine, general internal medicine, general pediatrics, general dentistry, and pediatric dentistry, and training for physician assistants, prior to repeal by Pub. L. 111–148, title V, § 5301, Mar. 23, 2010, 124 Stat. 615. See Codification note above.

A prior section 747 of act July 1, 1944, was classified to section 294q–3 of this title prior to the general revision of this subchapter by Pub. L. 102–408.

Another prior section 747 of act July 1, 1944, was classified to section 294g of this title prior to repeal by Pub. L. 94–484.

### Amendments

2020—Subsec. (a)(1)(G). Pub. L. 116–136, § 3401(3)(A)(i), substituted “to plan, develop, and operate a program that identifies or develops innovative models of providing care, and trains primary care physicians on such models and” for “to plan, develop, and operate a demonstration program that provides training” in introductory provisions.

Subsec. (a)(3). Pub. L. 116–136, § 3401(3)(A)(ii), added par. (3).

Subsec. (b)(3)(E). Pub. L. 116–136, § 3401(3)(B), substituted “substance use disorders” for “substance-related disorders”.

Subsec. (c)(1). Pub. L. 116–136, § 3401(3)(C), substituted “$48,924,000 for each of fiscal years 2021 through 2025” for “$125,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014”.