Directs the Secretary of Health and Human Services to establish a National Nurse Corps Scholarship program to provide scholarships to individuals seeking nursing education in exchange for service from such individuals in critical nursing shortage areas or facilities upon completion of such education. Sets forth eligibility, application, payment, and reporting requirements. Authorizes appropriations for FY 2003 through 2007.
Requires the Secretary to award grants to schools of nursing and/or health care facilities to develop and support: (1) educational outreach programs to encourage entry into the profession, targeting primary, secondary, and other schools, the disadvantaged, underrepresented minorities, and underserved rural and urban communities; (2) career ladder programs; (3) gerontology curriculum and competencies and efforts to encourage long-term care nursing services for the elderly as a career choice; (4) nurse internship and residency programs; and (5) demonstrations of models and best practices in nursing care, including retention strategies. Authorizes appropriations for FY 2003 through 2007.
Requires the Secretary to develop and administer a comprehensive national multi-media public education campaign to encourage pursuit of the nursing profession. Includes grants for similar State campaigns. Authorizes appropriations for FY 2003 through 2007.
Requires the Secretary to award grants to area health education centers to develop models of excellence for nurses or expand existing school mentoring programs to include one for nurses. Authorizes appropriations for FY 2003 through 2007.
Establishes for advanced degree nursing students: (1) a fast-track nursing faculty loan program, providing loan forgiveness in exchange for teaching services; and (2) a scholarship and stipend program. Authorizes appropriations for FY 2003 through 2007.
Establishes a National Commission on the Recruitment and Retention of Nurses to make innovative and creative recommendations concerning recruitment, retention, and advancement. Authorizes appropriations for FY 2003 through 2007.
[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1864 Considered and Passed Senate (CPS)]
107th CONGRESS
1st Session
S. 1864
To amend the Public Health Service Act to establish a Nurse Corps and
recruitment and retention strategies to address the nursing shortage,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 20 (legislative day, December 18), 2001
Ms. Mikulski (for herself, Mr. Hutchinson, Mr. Kerry, Mr. Jeffords, Mr.
Gregg, Mr. Daschle, Mr. Frist, Mr. Kennedy, Ms. Collins, Mr. Lieberman,
Mr. Enzi, Mrs. Clinton, Mr. Warner, Mr. Johnson, Mr. Roberts, Mrs.
Lincoln, Mrs. Hutchison, Mrs. Murray, Mr. Smith of Oregon, Mr.
Sarbanes, Mr. Hagel, Mr. Torricelli, Mr. Cochran, Mr. Dayton, Mr.
Chafee, Mr. Graham, Mr. Lugar, Ms. Cantwell, Mr. Hatch, Mr. Leahy, Mrs.
Carnahan, Mr. Rockefeller, Ms. Stabenow, Mr. Corzine, Mr. Schumer, Mr.
Inouye, Mr. Miller, Mr. Wellstone, Mr. Harkin, Mr. Santorum, Mr. Reed,
and Mr. Bond) introduced the following bill; which was read twice,
considered, read the third time, and passed
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to establish a Nurse Corps and
recruitment and retention strategies to address the nursing shortage,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Nurse Reinvestment Act''.
SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
Title VIII of the Public Health Service Act (42 U.S.C. 296 et seq.)
is amended--
(1) in section 846(a)(3), by inserting ``in a nursing home,
in a hospice, in a home health agency, in a nurse-managed
health center, in a public health department,'' after ``in a
public hospital,'';
(2) in section 801, by adding at the end the following:
``(9) Health care facility.--The term `health care
facility' means an Indian Health service health center, a
Native Hawaiian health center, a hospital, a migrant health
center, a community health center, a Federally qualified health
center, a nurse-managed health center, a rural health clinic, a
nursing home, a home health care agency, a hospice, a public
health clinic, a long-term care facility, a skilled nursing
facility, or any other public, nonprofit, or private facility
designated by the Secretary.''; and
(3) by adding at the end the following:
``PART H--NATIONAL NURSE SERVICE CORPS SCHOLARSHIP PROGRAM
``SEC. 851. NATIONAL NURSE SERVICE CORPS SCHOLARSHIP PROGRAM.
``(a) Program Authorized.--The Secretary shall establish a National
Nurse Service Corps Scholarship program (referred to in this section as
the `program') that provides scholarships to individuals seeking
nursing education in exchange for service by such individuals in
critical nursing shortage areas or facilities.
``(b) Preference.--In awarding scholarships under this section, the
Secretary shall give preference to applicants with the greatest
financial need, applicants who agree to serve in health care facilities
experiencing nursing shortages in medically underserved areas,
applicants currently working in a health care facility who agree to
serve the period of obligated service at such facility, minority nurse
applicants, and applicants with an interest in a practice area of
nursing that has unmet needs.
``(c) Requirements.--To be eligible to participate in the program,
an individual must--
``(1) be accepted for enrollment, or be enrolled, in an
accredited school of nursing, on a full- or part-time basis, to
take courses leading to a collegiate or associate degree in
nursing, or a diploma in nursing;
``(2) submit an application to participate in the program;
and
``(3) enter into an agreement with the Secretary, at the
time of submittal of such application, to--
``(A) accept the conditions of the scholarship and
remain enrolled in a school of nursing;
``(B) maintain an acceptable level of academic
standing;
``(C) maintain enrollment in a course of study
until the individual completes the course of study; and
``(D) serve as a nurse for a period of not less
than 2 years in a critical nursing shortage area or
facility, or the individual may complete such required
period of service on a part-time basis subject to--
``(i) an agreement entered into by the
facility and the individual which is approved
by the Secretary; and
``(ii) the individual agrees in writing
that the period of obligated service will be
extended so that the aggregate amount of less
than full-time service performed will equal the
amount of service that would be performed
through full-time service.
``(d) Rule of Construction.--In selecting individuals to
participate in the program, the Secretary shall give preference to
individuals serving at public or nonprofit private facilities, unless
only a private facility is present in the geographic area that the
Secretary determines is experiencing a nursing shortage. While giving
priority to individuals who propose to provide service in public or
nonprofit private facilities, the Secretary must not disregard the
needs of areas that individuals seek to provide services in which no
public or nonprofit private facility is operating, including rural
areas.
``(e) Applications.--
``(1) In general.--The application forms for the programs
shall include--
``(A) a fair summary of the rights and liabilities
of an individual whose application is approved by the
Secretary; and
``(B) information respecting meeting a service
obligation and such other information as may be
necessary for the individual to understand the program.
``(2) Accessibility.--The application form and all other
information furnished by the Secretary shall be written so that
it may be understood by the average individual applying to participate
in the program. The Secretary shall make such application forms, and
other information available to individuals desiring to participate in
the program, on a date sufficiently early to ensure that such
individuals have adequate time to carefully review and evaluate such
forms and information.
``(3) Distribution.--The Secretary shall distribute to
junior and senior high schools, community colleges,
universities, and schools of nursing materials providing
information on the program and shall encourage the schools to
disseminate the materials to students of the schools.
``(f) Scholarship.--
``(1) In general.--A scholarship provided to a student for
a school year under a written contract under the program shall
consist of--
``(A) payment to, or (in accordance with paragraph
(2)) on behalf of the student of--
``(i) the tuition of the student in such
school year; and
``(ii) all other reasonable educational
expenses and support services, including fees,
books, and laboratory expenses incurred by the
student in such school year; and
``(B) payment to the student of a stipend of $400
per month (adjusted in accordance with paragraph (3))
for each month that the student is enrolled.
``(2) Contracts.--
``(A) With a school of nursing.--The Secretary may
contract with a school of nursing, in which a
participant in the program is enrolled, for the payment
to the school of nursing of the amounts of tuition and
other reasonable educational expenses described in
paragraph (1)(A).
``(B) With an individual.--The Secretary shall
prepare a written contract for the program that shall
be provided to any individual who is enrolled or
accepted for enrollment at a school of nursing and who
desires to participate in the program at the time that
an application is provided to such individual. The
contract described in this paragraph shall contain a
provision that any financial obligation of the United
States arising out of a contract entered into under
this section and any obligation of the individual which
is conditioned thereon, is contingent upon funds being
appropriated for scholarships under this section.
``(3) Monthly stipend.--The amount of the monthly stipend
for each month that a student is enrolled, specified in
paragraph (1)(B) and as previously adjusted (if at all) in
accordance with this paragraph, shall be increased by the
Secretary as the Secretary determines to be reasonable.
``(g) Breach of Agreement.--In the case of an individual who enters
into an agreement under this section to provide service as a nurse in
consideration for receiving a scholarship, such individual is liable to
the Federal Government in accordance with sections 338E and 338F as
amended in the future. If the individual begins providing less than
full-time service but fails to begin or complete the period of
obligated service, the methods stated in section 338E(c) for
determining the damages for breach of the individual's written contract
will be used after converting periods of obligated service or of
service performed into their full-time equivalence.
``(h) Fund Regarding Use of Amounts Recovered for Contract
Breach.--There is established in the Treasury of the United States a
fund to be known as the National Nurse Service Corps Replacement Fund.
Such fund shall be governed under section 338F.
``(i) Service Information.--The Secretary shall provide to an
individual who has participated in the program and is nearing the
conclusion of his or her service obligation, information regarding
other opportunities for nursing in critical nursing shortage areas or
facilities.
``(j) Report.--Not later than 18 months after the first loan cycle,
and annually thereafter, the Secretary shall prepare and submit to
Congress a report describing the program, including statements
regarding--
``(1) the number of enrollees, scholarships, and grant
recipients by year of study;
``(2) the number of graduates;
``(3) the amount of scholarship payments made for each of
tuition, stipends, and other expenses;
``(4) which educational institution the scholar attended;
``(5) the number and placement location of the scholars;
``(6) the default rate and actions required;
``(7) the amount of outstanding default funds;
``(8) to the extent that it can be determined, the reason
for the default;
``(9) the demographics of the individuals participating in
the scholarship program; and
``(10) recommendations for future modifications of the
scholarship program.
``(k) Definitions.--In this section:
``(1) Community health center.--The term `community health
center' has the meaning given such term in section 330(a).
``(2) Critical nursing shortage area or facility.--
``(A) In general.--The term `critical nursing
shortage area or facility' means--
``(i) an urban or rural area that the
Secretary determines is experiencing a nursing
shortage;
``(ii) a population that the Secretary
determines has such a shortage; or
``(iii) a health care facility or other
public, nonprofit, or private facility that the
Secretary determines has a shortage.
``(B) Factors to consider.--In making a
determination regarding a critical nursing shortage
area or facility, the Secretary shall use the criteria
in section 846 for not more than 12 months, and after
such period--
``(i) the ratio of available nurses to the
number of individuals in the area or population
group;
``(ii) the demonstrated need of a health
care facility or other public, nonprofit, or
private facility in the area; or
``(iii) the presence of innovative
retention strategies utilized by eligible
facilities.
``(3) Rural health clinic.--The term `rural health clinic'
has the meaning given such term in section 1861(aa)(2) of the
Social Security Act.
``(l) Authorization of Appropriations.--For the purpose of payments
under agreements entered into under subsection (a), there are
authorized to be appropriated $40,000,000 for fiscal year 2003 and such
sums as may be necessary for fiscal years 2004 through 2007.
``PART I--INITIATIVES TO RECRUIT NURSES AND COMBAT THE NURSING SHORTAGE
``SEC. 855. NURSE RECRUITMENT GRANT PROGRAM.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to increase nursing education opportunities.
``(b) Eligible Entity.--In this section, the term `eligible entity'
means a school of nursing, or a health care facility, or a partnership
of such school and facility.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds received from such grant to--
``(1) support outreach programs at primary, junior, and
secondary schools that inform guidance counselors and students
of education opportunities regarding nursing;
``(2) carry out special projects to increase nursing
education opportunities for individuals who are from
disadvantaged backgrounds (including economically disadvantaged
backgrounds and racial and ethnic minorities underrepresented
among registered nurses) by providing student scholarships or
stipends, pre-entry preparation, or retention activities;
``(3) support education programs for nursing students who
require assistance with math, science, English, and medical
terminology;
``(4) meet the costs of dependent care and transportation
for individuals who are taking part in a nursing education
program at any level; or
``(5) support community-based partnerships seeking to
recruit nurses in rural communities and medically underserved
urban communities, and other communities experiencing a nursing
shortage.
``(d) Application.--An eligible entity desiring a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may reasonably require.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``SEC. 856. PUBLIC AWARENESS AND EDUCATION CAMPAIGN.
``(a) National Campaign.--
``(1) In general.--The Secretary shall develop and
administer a comprehensive national multi-media public
education campaign to enhance the image of the nursing
profession, promote diversity in the workforce, encourage
individuals to enter the nursing profession, and encourage
career development for individuals in the nursing profession.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection $4,000,000 for
fiscal year 2003 and such sums as may be necessary for fiscal
years 2004 through 2007.
``(b) State Campaigns.--
``(1) In general.--The Secretary shall award grants to
eligible entities to establish the multi-media campaigns
described in subsection (a) at a State level.
``(2) Definitions.--
``(A) Eligible entity.--The term `eligible entity'
means a professional State nursing association, State
health care provider association, school of nursing,
and any other entity that provides similar services or
serves a like function.
``(B) State health care provider association.--The
term `State health care provider association' means a
professional association of hospitals, nursing homes,
home health care agencies, hospices, consortia of said
associations, or other such entities deemed eligible by
the Secretary.
``(3) Limitation.--An eligible entity that receives a grant
under this subsection shall not use funds received through such
grant to advertise particular employment opportunities or
recruit members or affiliates of such entity.
``(4) Application.--Each eligible entity that desires a
grant under this subsection shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may reasonably require.
``(5) Equitable broadcasting.--The campaigns described in
paragraph (1) shall be broadcast in such a manner as to inform
diverse populations throughout the State of nursing
opportunities, including rural populations.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $4,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``PART J--INITIATIVES TO STRENGTHEN THE NURSE WORKFORCE
``SEC. 857. GRANTS FOR CAREER LADDER PROGRAMS.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to assist individuals and develop programs to assist
individuals in obtaining education and training required to enter the
nursing profession and advance within such profession.
``(b) Definition.--The term `eligible entity' means a school of
nursing or a health care facility, or a partnership of such school and
facility.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use such funds received through such grant to--
``(1) establish student scholarships or stipends for nurse
professionals, licensed practical nurses, certified nurse
assistants, and home health aides who enroll in entry level
nursing programs, advanced practice nursing degree programs,
RN/Master nursing degree programs, doctoral nursing programs,
nurse administrator programs, and training programs focused on
specific technology use or disease management;
``(2) provide career counseling to individuals seeking to
advance within the nursing profession;
``(3) provide employees of the facility advanced training
and education at the school of nursing or health care facility;
``(4) establish or expand nursing practice arrangements in
noninstitutional settings to demonstrate methods to improve
access to primary health care in medically underserved
communities; and
``(5) develop programs, including distance learning
programs in coordination with the Office for the Advancement of
Telehealth, to facilitate educational advancement for
individuals with existing degrees or health care training.
``(d) Application.--An eligible entity seeking a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such a manner, and containing such information as the
Secretary may reasonably require.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $20,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``SEC. 858. AREA HEALTH EDUCATION CENTERS PROGRAM.
``(a) Program Authorized.--The Secretary shall award grants to area
health education centers to contract with schools of nursing to expand
the operation of area health education centers under section 751 to
work in communities to develop models of excellence for school nurses,
public health nurses, perinatal outreach nurses, and other community-
based nurses, or to expand any junior and senior high school mentoring
programs to include a nurse mentoring program.
``(b) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``SEC. 859. GRANTS FOR NURSE TRAINING IN LONG-TERM CARE FOR THE
ELDERLY.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to develop and incorporate gerontology curriculum and
competencies and to encourage individuals to enter the nursing
profession with a focus on providing long-term care for the elderly.
``(b) Eligible Entity.--The term `eligible entity' means a--
``(1) school of nursing;
``(2) health care facility; or
``(3) partnership of paragraphs (1) and (2).
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds under such grant to--
``(1) provide training to individuals who will provide
long-term care for the elderly;
``(2) develop stand alone courses in gerontological nursing
to support concentrations, minors, and majors in the
discipline;
``(3) train faculty members in gerontological nursing; or
``(4) provide continuing education in gerontological
nursing.
``(d) Application.--An eligible entity desiring a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may reasonably require.
``(e) Definitions.--For the purposes of this section, the term
`health care facility' means a hospital, nursing home, home health care
agency, hospice, skilled nursing facility, long-term care facility, or
any other facility designated by the Secretary.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $12,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``SEC. 860. GRANTS FOR INTERNSHIP AND RESIDENCY PROGRAMS.
``(a) Program Authorized.--The Secretary shall award grants to an
eligible entity to develop internship and residency programs that
encourage mentoring and the development of specialties.
``(b) Definition.--The term `eligible entity' means a partnership
of a school of nursing and health care facility.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use such funds received through such grant to--
``(1) develop internship and residency programs and
curriculum and training programs for graduates of a nursing
program;
``(2) provide support for faculty and mentors; and
``(3) provide support for nurses participating in
internship and residency programs on both a full-time and part-
time basis.
``(d) Application.--An eligible entity seeking a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such a manner, and containing such information as the
Secretary may reasonably require.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``SEC. 861. DEVELOPING RETENTION STRATEGIES AND BEST PRACTICES IN
NURSING STAFF MANAGEMENT.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to carry out and evaluate demonstrations of models
and best practices in nursing care and develop innovative strategies or
approaches for retention of professional nurses.
``(b) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means--
``(A) a partnership or coalition containing a
health care facility and a school of nursing;
``(B) a partnership or coalition containing a
health care facility and another organization with
expertise in outcome and cost-effectiveness
measurement; or
``(C) containing a health care facility
demonstrating proficiency in outcomes and cost-
effectiveness measurement, and receipt of accreditation
by an accepted organization shall constitute evidence
of such proficiency.
``(2) Nurse leadership.--The term `nurse leadership'
includes nurse executives, nurse administrators, and nurse
managers.
``(3) Professional nurse.--The term `professional nurse'
means a registered nurse who holds a valid and unrestricted
license to practice nursing in a State.
``(c) Distribution of Grants.--Grants awarded under this section
shall be distributed among a variety of geographic regions and among a
range of different types and sizes of health care facilities.
``(d) Duration of Grants.--Grants awarded under this section shall
be awarded for a period not greater than 2 years (and may be renewable
only once).
``(e) Allocation.--The Secretary shall determine the amount of a
grant awarded under this section to the nursing services of the health
care facility based on the number of staffed beds as follows, and if
the Secretary deems appropriate these amounts may be adjusted:
``(1) A maximum of $200,000 for a facility with less than
100 staffed beds.
``(2) A maximum of $400,000 for a facility with less than
400 staffed beds.
``(3) A maximum of $600,000 for a facility with 400 or more
staffed beds.
``(f) Priority Criteria.--The Secretary shall give priority in
awarding grants under this section to health care facilities that have
not previously received a grant under this section, and in the case of
a grant renewal, the Secretary shall give priority to grant recipients
who have demonstrated outcome improvements or have been designated as a
magnet hospital by the American Nurses Credentialing Center.
``(g) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use such grant funds to do one or more of the
following:
``(1) Improve the quality of the health care facility work
environment, including improving communication and
collaboration among health care professionals.
``(2) Initiate or maintain aggressive nurse retention
programs, including other initiatives as deemed appropriate by
the nurse retention committee at the health care facility.
``(3) Reduce workplace injuries.
``(4) Reduce rates of nursing sensitive patient outcomes.
``(5) Provide high quality evaluations of the cost-
effectiveness and patient-outcomes of best practices, to assist
health care facility decision-makers in determining appropriate
nurse retention strategies.
``(6) Promote continuing nursing education and career
development.
``(h) Application.--
``(1) In general.--An eligible entity desiring a grant
under subsection (a) shall submit an application to the
Secretary at such time, and in such manner, and containing such
information as the Secretary may reasonably require.
``(2) Contents.--The application submitted under paragraph
(1) shall include a description of--
``(A) the project or projects proposed to be
carried out with grant funds;
``(B) the means by which to evaluate the project
with respect to its cost-effectiveness and outcomes as
they relate to staff turnover, workplace injuries, and
patient care outcomes that are sensitive to nursing
care; and
``(C) the system of patient outcomes measurement,
which shall be described by the nurse leadership and
professional nurses of the health care facility and
shall be sensitive to nursing care and shall evaluate
the specific needs of the patients served by the health
care facility and the educational needs of the nursing
staff at such facility to meet the needs of the
patients, and the health care facility must allocate
sufficient funds to carry out the system;
``(D) the health care facility's organizational and
clinical decision-making processes that incorporate the
input of the nursing staff, including the development
of a nurse retention committee, the inclusion of nurse
executive participation in senior level management of
the health care facility, and a nurse residency
training program for new graduate nurses entering the
workforce on a full-time basis, or nurses returning to
work at a health care facility on a full-time basis
after an absence of not less than 3 years without
working in the nursing field.
``(i) Authorization of Appropriations.--There is to be authorized
to be appropriated to carry out this section $10,000,000 for fiscal
year 2003 and such sums as may be necessary for fiscal years 2004
through 2007.
``SEC. 862. FAST-TRACK FACULTY LOAN PROGRAM.
``(a) In General.--In the case of any individual--
``(1) who has received a collegiate or associate degree in
nursing (or an equivalent degree), a diploma in nursing, or a
graduate degree in nursing;
``(2) who obtained 1 or more loans related to nursing
training costs for a masters or a doctoral degree;
``(3) who is capable, in the opinion of the public or
nonprofit private school of nursing in which the student is
accepted for enrollment or enrolled, of maintaining good
standing in such course of study; and
``(4) who enters into a written agreement with the
Secretary to teach at an accredited school of nursing for each
year of assistance after the masters or doctoral degree has
been obtained or two years (whichever is greater), or may
complete such required period of service on a part-time basis subject
to--
``(A) an agreement entered into by the accredited
school of nursing and individual which is approved by
the Secretary; and
``(B) the individual agrees in writing that the
required period of service will be extended so that the
aggregate amount of less than full-time service
performed will equal the amount of service that would
be performed through full-time service,
the Secretary shall make payments in accordance with subsection (c) of
this section, for and on behalf of that individual, on the principal of
and interest on any loan of that individual provided under this section
which is outstanding on the date the individual begins the service
specified in the agreement described in paragraph (4) of this
subsection. Assistance provided under this section for a part-time
masters degree program shall be provided for not more than 6 years and
for a part-time doctoral degree program for not more than 7 years.
``(b) Terms of Agreement.--The agreement described in paragraph (4)
of subsection (a) shall also provide that the total of the loans for
any academic year made pursuant to an agreement under subsection (a)
may not exceed $35,000 (indexed for inflation) in the case of any
student.
``(c) Manner of Payments.--For each year of service, the Secretary
shall in equal installments pay 85 percent of the principal of, and
interest on the loans for an individual pursuant to an agreement under
subsection (a)(4).
``(d) Payment by Due Date.-- Notwithstanding the requirement of
completion of service specified in subsection (c) of this section, the
Secretary shall, on or before the due date thereof, pay any loan or
loan installment which may fall due within the period of service for
which the borrower may receive payments under this subsection, upon the
declaration of such borrower, at such times and in such manner as the
Secretary may prescribe (and supported by such other evidence as the
Secretary may reasonably require), that the borrower is then serving as
described by subsection (a)(4) of this section, and that the borrower
will continue to so serve for the period required (in the absence of
this subsection) to entitle the borrower to have made the payments
provided by this subsection for such period, except that not more than
85 percent of the principal of any such loan shall be paid pursuant to
this subsection.
``(e) Breach of Agreement.--The Secretary may make payments under
subsection (a) of this section on behalf of an individual only if the
agreement under such subsection provides that section 860(c) of this
title is applicable to the individual. The Secretary may declare an
individual in breach of the agreement if an individual fails to
complete the year of service for which the payment was made.
``(f) Preferences Regarding Participants.--In entering into
agreements under subsection (a) of this section, the Secretary shall
give preference to qualified applicants with the greatest financial
need.
``(g) Breach of Agreement.--
``(1) In general.--In the case of any program under this
section under which an individual makes an agreement to teach
at an accredited school of nursing for a period of time in
accordance with such program in consideration of receiving an
award of Federal funds regarding education as a nurse
(including an award for the repayment of loans), the following
applies if the agreement provides that this subsection is
applicable: the individual is liable to the Federal Government
for the amount of such award (including amounts provided for
expenses related to such attendance), and for interest on such
amount at the maximum legal prevailing rate, if the individual
fails to teach at an accredited school of nursing in accordance
with the program under this section for the period of time
applicable under the program.
``(2) Waiver or suspension of liability.--In the case of an
individual making an agreement for purposes of paragraph (1),
the Secretary shall provide for the waiver or suspension of
liability under such subsection if compliance by the individual
with the agreements involved is impossible, or would involve
extreme hardship to the individual and if enforcement of the
agreements with respect to the individual would be
unconscionable.
``(3) Date certain for recovery.--Subject to paragraph (2),
any amount that the Federal Government is entitled to recover
under paragraph (1) shall be paid to the United States not
later than the expiration of the 3-year period beginning on the
date the United States becomes so entitled.
``(4) Availability.--Amounts recovered under paragraph (1)
with respect to a program under this section shall be available
for the purposes of such program, and shall remain available
for such purposes until expended.
``(h) Authorization of Appropriations.--For the purpose of payments
under agreements entered into under subsection (a) of this section,
there are authorized to be appropriated $10,000,000 for fiscal year
2003, and such sums as may be necessary for fiscal years 2004 through
2007.
``SEC. 863. STIPEND AND SCHOLARSHIP PROGRAM.
``(a) Program Authorized.--
``(1) In general.--The Secretary shall establish a
scholarship and stipend program to encourage individuals to
seek a masters degree or a doctoral degree at a school of
nursing.
``(2) Limitation.--Assistance provided under paragraph (1)
for a part-time masters degree program shall be provided for
not more than 6 years and for a part-time doctoral degree
program not more than 7 years.
``(b) Eligibility.--To be eligible to receive a scholarship or
stipend under this section, an individual shall--
``(1) submit an application to the Secretary at such time,
in such manner, and containing such information as the
Secretary may reasonably require;
``(2) be accepted for enrollment, or be enrolled, in an
accredited school of nursing, on a full- or part-time basis to
take courses leading to a masters degree or doctoral degree;
``(3) enter into an agreement with the Secretary, at the
time of submittal of such application, to--
``(A) accept the conditions of the scholarship and
remain enrolled in a school of nursing;
``(B) maintain an acceptable level of academic
standing; and
``(C) maintain enrollment in a course of study
until the individual completes the course of study; and
``(4) teach at an accredited school of nursing for 1 year
for each year of assistance with a course load determined by
the school of nursing where the teaching will take place, and
the individual may complete such required period of service on
a part-time basis subject to--
``(A) an agreement entered into by the facility and
the individual which is approved by the Secretary; and
``(B) the individual agrees in writing that the
period of obligated service will be extended so that
the aggregate amount of less than full-time service
will equal the amount of service that would be
performed through full-time service.
``(c) Application.--The Secretary shall disseminate application
forms to individuals and in such forms, include--
``(1) a summary of the rights and liabilities of an
individual whose application is approved by the Secretary; and
``(2) information respecting meeting the service obligation
described in subsection (b)(4).
``(d) Scholarship.--
``(1) In general.--A scholarship provided to a student for
a school year under a written contract under the program shall
consist of--
``(A) payment to, or (in accordance with paragraph
(2)) on behalf of the student of--
``(i) the tuition of the student in such
school year; and
``(ii) all other reasonable educational
expenses and support services, including fees,
books, and laboratory expenses incurred by the
student in such school year; and
``(B) payment to the student of a stipend of $400
per month (adjusted in accordance with paragraph (3))
for each month that the student is enrolled.
``(2) Contracts.--
``(A) With a school of nursing.--The Secretary may
contract with a school of nursing, in which a
participant in the program is enrolled, for the payment
to the school of nursing of the amounts of tuition and
other reasonable educational expenses described in
paragraph (1)(A).
``(B) With an individual.--The Secretary shall
prepare a written contract for the program that shall
be provided to any individual who is enrolled or
accepted for enrollment at a school of nursing and who
desires to participate in the program at the time that
an application is provided to such individual. The
contract described in this paragraph shall contain a
provision that any financial obligation of the United
States arising out of a contract entered into under
this section and any obligation of the individual which
is conditioned thereon, is contingent upon funds being
appropriated for scholarships under this section.
``(3) Monthly stipend.--The amount of the monthly stipend
for each month that a student is enrolled, specified in
paragraph (1)(B) and as previously adjusted (if at all) in
accordance with this paragraph, shall be increased by the
Secretary as the Secretary determines to be reasonable.
``(e) Breach of Agreement.--In the case of an individual who enters
into an agreement under this section to provide service as a nurse in
consideration for receiving a scholarship, such individual is liable to
the Federal Government in accordance with sections 338E and 338F as
amended in the future. If the individual begins providing less than
full-time service but fails to begin or complete the period of
obligated service, the methods stated in section 338E(c) for
determining the damages for breech of the individual's written contract
will be used after converting periods of obligated service or of
service performed into their full-time equivalence.
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for fiscal year 2003
and such sums as may be necessary for fiscal years 2004 through 2007.
``PART K--NATIONAL COMMISSION
``SEC. 865. NATIONAL COMMISSION.
``(a) In General.--There is established a commission known as the
National Commission on the Recruitment and Retention of Nurses
(referred to in this section as the `Commission').
``(b) Duties.--The Commission shall meet at least 4 times and study
and make innovative and creative recommendations in the following
areas, and shall widely disseminate its findings, including to the
appropriate committees of Congress regarding--
``(1) strategies necessary to address the nursing shortage
in the long term;
``(2) best practices in the recruitment and retention of
nurses and the impact on patients and staff of employing
participatory, collaborative, and patient-centered models of
nursing care, which shall include the examination of--
``(A) reasons behind low nurse vacancy rates and
turnover in the workplace;
``(B) practices that are not effective in
recruiting and retaining nurses and why;
``(C) how successful recruitment and retention
practices work, why they are successful and how health
care facilities with lower than average retention rates
can improve their working conditions to improve their
retention rates, including an examination of hospitals
and other health care facilities with higher than
average retention rates, and the role of different
stakeholders in the workplace, such as nurses, doctors,
other health professionals and employees, and
management at all levels;
``(D) factors that influence career satisfaction
for nurses;
``(E) to what extent successful recruitment and
retention practices are unique to a particular
situation or applicable across the field; and
``(F) the effectiveness of best practices for
recruitment and retention for different populations of
nurses, such as nurses who choose nursing as a second
career, nurses from various racial and ethnic groups,
male and female nurses, and nurses with varying ages
and experience levels;
``(3) the facilitation of career advancement within the
nursing profession;
``(4) attracting middle and high school students into
nursing careers; and
``(5) attracting individuals who may pursue nursing careers
after they have pursued other careers.
``(c) Consultation.--In carrying out the duties described in
subsection (b), the Commission shall consult with the Health Resources
and Services Administration's Bureau of Health Professions, the
American Nurses Credentialing Center's Magnet Nursing Services
Recognition Program, the National Advisory Council on Nurse Education
and Practice, the National Institute of Nursing Research, and other
appropriate resources that may provide information or other assistance.
``(d) Membership.--Not later than 12 months after the date of
enactment of this section, the Comptroller General shall appoint 21
members of the Commission (taking into account rural and urban areas,
geographic diversity, racial and ethnic diversity, and relevant
experience) of whom--
``(1) 8 shall be nurses with different levels of education,
and a significant portion of whom shall be currently practicing
nurses;
``(2) 6 shall be representatives (with various management
experiences) of employers such as hospitals, long term care
facilities, and home health agencies;
``(3) 1 shall be a representative of schools of nursing;
``(4) 1 shall be a representative of primary and secondary
schools;
``(5) 1 shall be a representative from the Departments of
Health and Human Services, Education, Labor, and Veterans
Affairs; and
``(6) 1 shall be a physician.
``(e) Chairs.--The Secretary of the Department of Health and Human
Services and the Secretary of Labor shall jointly chair the Commission.
``(f) Subcommittees.--The Chairs shall have the authority to create
subcommittees as they determine is necessary.
``(g) Staff.--The Chairs shall provide any staff that the
Commission shall require.
``(h) Quorum.--Eleven members of the Commission shall constitute a
quorum.
``(i) Vacancies.--Any vacancy in the Commission shall not affect
the powers of the Commission, but shall be filled in the same manner as
the original appointment and shall be made not later than 30 days after
the date on which the Commission is given notice of such vacancy.
``(j) Compensation.--Members of the Commission shall receive no
additional compensation by reason of their service to the Commission.
Each member shall be allowed travel expenses, including per diem in
lieu of subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States Code, while
away from their homes or regular places of business in the performance
of services for the Commission.
``(k) Report.--Not later than 24 months after the date of enactment
of this section, the Commission shall prepare and submit to Congress
and widely disseminate in the health care field, a report that makes
the recommendations described in subsection (b).
``(l) Sunset.--This section shall be effective for 24 months from
the date of enactment of this section.
``(m) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $750,000 for fiscal year 2002
for use in fiscal years 2002 and 2003.''.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S13946-13947)
Passed/agreed to in Senate: Introduced in the Senate, read twice, considered, read the third time, and passed without amendment by Unanimous Consent.(consideration: CR S14065)
Introduced in the Senate, read twice, considered, read the third time, and passed without amendment by Unanimous Consent. (consideration: CR S14065)
Message on Senate action sent to the House.
Received in the House.
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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