Nurse Education Reauthorization Act of 1988

(House agreed to Senate amendments with amendments)

Nursing Shortage Reduction and Education Extension Act of 1988 - Title I: Special Projects - Replaces provisions of title VIII (Nursing Education) of the Public Health Service Act relating to nursing education opportunities for individuals from disadvantaged backgrounds with a new subpart on the same topic. Authorizes the Secretary of Health and Human Services to make grants and enter into contracts for special projects to increase nursing education opportunities for individuals from disadvantaged backgrounds. Prohibits the Secretary from approving or disapproving an application for a grant or contract until after consultation with the National Advisory Council on Nurse Education. Authorizes appropriations for FY 1989 through 1991.

Removes provisions authorizing the Secretary to make grants and enter into contracts for special projects to: (1) provide retraining for nurses after periods of professional inactivity; (2) demonstrate clinical nurse education programs which combine educational curricula and clinical practice; and (3) demonstrate methods to encourage nursing graduates to practice in health manpower shortage areas.

Replaces provisions authorizing grants and contracts for continuing education for nurses with provisions authorizing the Secretary to make grants and enter into contracts for special projects to demonstrate improved geriatric nursing training.

Replaces provisions authorizing grants and contracts to increase the supply or improve the distribution of nurses with provisions authorizing the Secretary to make grants and enter into contracts for special projects to: (1) increase the supply of nurses, including bilingual nurses, to meet the needs of rural areas; and (2) provide nursing education via satellite.

Revises the description of nursing education special projects eligible for certain grants and contracts with regard to: (1) priorities in training and education to upgrade the skills of paraprofessional nursing personnel; (2) development of curricula for certain nursing baccalaureate degree situations.

Authorizes the Secretary to make grants and enter into contracts for special projects to collect the names and addresses of health facilities and nursing students and nurses willing to enter into agreements under which the facilities would repay the educational loans of the individual.

Authorizes the Secretary to make grants and enter into contracts for geriatric nursing training. Requires applications for grants and contracts to be subject to peer review. Prohibits the Secretary from approving or disapproving an application unless the Secretary has received recommendations from the peer review group and has consulted with the Advisory Council on Nurses Education.

Authorizes the Secretary to make grants for demonstrating innovative hospital nursing practice models which include restructuring the role of the nurse, testing innovative wage structures, and evaluating the effectiveness of various benefits.

Authorizes the Secretary to make grants to nurse training entities: (1) to demonstrate innovative nursing practice models for services in the home and to demonstrate innovative nursing practice models for services in the home and long-term care facilities designed to increase recruitment and retention of nurses and improve nursing care; and (2) to develop projects to increase the exposure of nursing students to clinical practice in nursing home, home health, and gerontologic settings.

Authorizes appropriations for grants and contracts for special projects in nurse education and for advanced nurse education for FY 1989 through 1991.

Revises the guidelines for programs for the education of nurse practitioners and nurse midwives to require that they have not less than six full-time equivalent students. (Current law requires that they have eight students.)

Allows service commitments by nurse practitioner or nurse midwife traineeship recipients to include services in an Indian Health Service health center, a Native Hawaiian health center, a migrant health center, a rural health clinic, or a community health center in addition to the currently allowed service in a health manpower shortage area or a public health care facility.

Authorizes appropriations for certain nurse practitioner and nurse midwife programs for FY 1989 through 1991.

Directs the Secretary to make available, from the amounts appropriated for FY 1989 through 1991 to carry out titles VII (Health Research and Teaching Facilities and Training of Professional Health Personnel) and VIII (Nurse Education) of the Public Health Service Act, specified amounts each fiscal year to: (1) enhance the ability of a hospital meeting stated criteria to provide high quality inpatient services; and (2) improve the health care services furnished by a hospital meeting stated criteria.

Mandates that commissioned nurse officers in the Regular and Reserve Corps of the Public Health Service, while on active duty, be paid the same incentive special pay as commissioned nurse officers of the armed forces under specified Federal law.

Provides that, with respect to the Federal program of insured loans to graduate students in health professions schools, if in any fiscal year no ceiling has been established for the amount of new loans made and installments paid, any difference between the loans made and installments paid and the ceiling in a previous fiscal year which is carried over into the current fiscal year shall constitute the ceiling. Extends from September 30, 1991, to September 30, 1994, the termination date for the granting of insurance or the paying of installments.

Title II: Assistance to Nursing Students - Authorizes the Secretary to make grants for traineeships for students enrolled at least half-time in nursing masters degree programs who agree to complete the degree requirements by the end of the academic year in which the student is to receive the traineeships.

Authorizes appropriations for traineeships for advanced education of professional nurses for FY 1989 through 1991.

Authorizes the Secretary to make grants for traineeships for licensed registered nurses to become nurse anesthetists and for projects to develop and operate programs for the education of nurse anestetists. Limits traineeship payments to amounts necessary for tuition and fees and a stipend and allowances, including travel and subsistence expenses, for trainees.

Authorizes appropriations for traineeships for nurse anesthetists for FY 1989 through 1991.

Prohibits provisions relating to collection, by schools of nursing, of student loan funds from being construed to require such schools to reimburse the student loan program for loans that became uncollectable prior to 1983.

Lowers the cap on the amount of loans to any student made by nursing schools in the first two academic years, but raises the cap on the aggregate of the loans for all years. Requires the schools to give preference in making the loans to persons with exceptional financial need as well as to those given priority under current law. Requires that all loan recipients be in financial need. (Current law requires all loan recipients to be in exceptional financial need.) Allows a loan repayment deferral for up to ten years (currently, five years) of loan repayment for borrowers pursuing certain nursing studies half-time (currently, full-time). Lowers the interest rate from six to five percent on such student loans. Removes provisions allowing the Secretary to repay loans for certain persons from a low-income or disadvantaged family.

Requires that certain unexpended nursing student loan funds be available to carry out provisions of this Act relating to nursing scholarships. Applies such requirement retroactively to September 30, 1988, subject to exception.

Delays until the last calendar quarter of 1994 the period during which there must be a capital distribution of the balance of the nursing school student loan fund established under specified provisions.

Includes, as qualifying for loan repayment under specified provisions, nursing service in an Indian Health Service health center, a Native Hawaiian health center, a public hospital, a migrant health center, a community health center, nursing facility, a rural health clinic, or a health facility determined by the Secretary to have a critical shortage of nurses. Sets forth financial need and geographic priorities in entering into loan repayment agreements. Authorizes appropriations for FY 1989 through 1991.

Authorizes the Secretary to make grants for scholarships for nursing students in financial need. Requires applicant schools to agree to: (1) give priority in providing scholarships to individuals from disadvantaged backgrounds; and (2) require student recipients of the scholarships to agree to serve as a nurse at least two years in specified types of facilities. Authorizes appropriations for FY 1989 through 1991.

Authorizes the Secretary to make loans to individuals to assist the individuals in attending schools of nursing if the individuals enter into contracts with health facilities to engage in full-time employment as nurses for a period of time not more than the period during which they receive loan assistance. Directs the Secretary to give preference to disadvantaged and minority individuals underrepresented in the nursing profession.

Sets forth requirements for students and health care facilities. Directs the Secretary to designate underserved geographic areas. Limits loans to 100 percent of the costs of tuition, reasonable living expenses, books, fees, and transportation. Limits interest to five percent.

Directs the Secretary to make available at least 35 percent of amounts appropriated for a fiscal year for loans to individuals who will serve as nurses in rural areas designated as underserved geographic areas.

Authorizes appropriations for FY 1989 through 1991.

Terminates the authority to make loans on September 30, 1991.

Title III: General Provisions of Title VIII - Renames the National Advisory Council on Nurse Training as the Advisory Council on Nurses Education. Changes its composition to increase the number of members and require representation by practicing professional nurses and from associate degree schools of nursing.

Directs the Secretary of Health and Human Services to provide, directly or through contract, for evaluations of projects carried out under this title and for dissemination of information developed as a result of the projects. Sets forth reporting requirements.

Title IV: Waiver of Liability for Certain Sale of Facility Under Program of Construction and Modernization of Medical Facilities - Declares that, if the Secretary of Health and Human Services certifies compliance with conditions of this title, provisions of the Public Health Service Act imposing liability in the nature of recovery by the Government of funds provided for the construction or modernization of medical facilities shall not apply to the sale of a specified facility in San Juan County, Utah, on November 26, 1986.

Sets forth the conditions which must be met, including that: (1) the transferor county, a political subdivision of the State of Utah, establish and administer an irrevocable trust to satisfy, with respect to such facility, its obligation under Federal laws and regulations to provide for adequate facilities to furnish needed services for persons unable to pay; and (2) the transferee corporation agree to satisfy the obligation of the county to provide such services for persons unable to pay.

Directs the Secretary to make such determination within 12 months after enactment of this Act and to certify the determination to the Congress.

Directs the Secretary to monitor compliance and, if conditions are not met or either party fails to carry out its duties, to ensure that proceedings are commenced to recover the amounts as provided by current law.

Title V: Effective Date - Sets forth the effective dates of this Act.