; (4) a summary of any clinical practice changes or notable improvements in patient care; (5) patient referrals from health centers that participate in the program to outside specialist care, and any patient care provided at the health center that, prior to the program, would have been referred to outside specialists; (6) retention rates of physicians at participating health centers; and (7) satisfaction rates of physicians with the education program at participating health centers. (e) Authorization of appropriations To carry out this section, there are authorized to be appropriated $20,000,000 for each of fiscal years 2020 through 2024. .