[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 706 Introduced in Senate (IS)]
107th CONGRESS
1st Session
S. 706
To amend the Social Security Act to establish programs to alleviate the
nursing profession shortage, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 5, 2001
Mr. Kerry (for himself, Mr. Jeffords, Mr. Daschle, Mrs. Hutchinson, Mr.
Leahy, Mr. Reid, Mr. Hollings, Mr. Johnson, Mr. Schumer, Ms. Mikulski,
Mrs. Murray, Mr. Torricelli, Mr. Inouye, Mr. Reed, Mrs. Clinton, Mr.
Bingaman, Mr. Harkin, Mr. Sarbanes, Mr. Lieberman, Mr. Rockefeller, Mr.
Kennedy, Mrs. Lincoln, and Ms. Snowe) introduced the following bill;
which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend the Social Security Act to establish programs to alleviate the
nursing profession 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. EXPANSION OF NURSING TRAINING EDUCATION PAYMENTS TO QUALIFIED
NONHOSPITAL PROVIDERS.
Section 1861(v)(1) of the Social Security Act (42 U.S.C.
1395x(v)(1)) is amended by adding at the end the following new
subparagraph:
``(V)(i) For portions of cost reporting periods beginning on or
after October 1, 2001, the Secretary shall establish rules for making
payments to qualified nonhospital providers for the reasonable costs of
providing nursing training if such costs are incurred in the operation
of a training program that is operated by a hospital.
``(ii) The rules established under clause (i) shall--
``(I) be similar to rules for payments to hospitals under
this subsection for such reasonable costs; and
``(II) specify the form and manner in which such payments
will be made and the portion of such payments that will be made
from each of the trust funds under this title.
``(iii) No payment shall be made to a qualified nonhospital
provider under this subparagraph for such reasonable costs to the
extent that such reasonable costs are otherwise reimbursed under this
title or under any other Federal program.
``(iv) For purposes of this subparagraph, the term `qualified
nonhospital providers' means--
``(I) a Federally qualified health center (as defined in
section 1861(aa)(4));
``(II) a rural health clinic (as defined in section
1861(aa)(2));
``(III) a Medicare+Choice organization under part C; and
``(IV) any other provider (other than a hospital) that the
Secretary determines to be appropriate.''.
SEC. 3. REIMBURSEMENT OF THE COSTS OF PROVIDING NURSING TRAINING
EDUCATION BY HOSPICE AND HOME HEALTH PROVIDERS.
Title XVIII (42 U.S.C. 1395 et seq.) is amended by adding at the
end the following new section:
``reimbursement of the costs of providing nursing training education by
hospice and home health providers
``Sec. 1897. (a) Payments.--
``(1) In general.--The Secretary shall establish rules for
making payments to qualified entities for the reasonable costs
of providing nursing training during fiscal years 2002 through
2006. Subject to subsection (c), such payments shall be in
addition to payments otherwise made to such entities under this
title.
``(2) Rules.--The rules established under paragraph (1)
shall ensure that reimbursement is made for the costs of
training nurses to furnish items and services which are
specific to the qualified entity.
``(3) Qualified entity defined.--For purposes of this
section, the term `qualified entity' means--
``(I) a hospice program providing hospice care; and
``(II) a home health agency (as defined in section
1861(o)).
``(b) Maintenance of Effort.--The Secretary shall ensure that a
qualified entity does not use amounts received under this section to
reduce or eliminate staffing problems that the entity may have.
``(c) Prohibition on Double Payments.--No payment shall be made to
a qualified entity under this section for the reasonable costs of
providing nursing training to the extent that such costs are otherwise
reimbursed under this title or under any other Federal program.
``(d) Funding.--For purposes of making payments under this section,
there are appropriated, out of any money in the Treasury not otherwise
appropriated, such sums as may be necessary for each of fiscal years
2002 through 2006.''.
SEC. 4. TEMPORARY INCREASE IN FEDERAL MATCHING RATE FOR MEDICAID NURSE
AIDE TRAINING AND COMPETENCY EVALUATION PROGRAMS.
Section 1903(a)(2)(B) of the Social Security Act (42 U.S.C.
1396b(a)(2)(B)) is amended by striking ``(or, for calendar quarters
beginning on or after July 1, 1988, and before October 1, 1990, the
lesser of 90 percent or the Federal medical assistance percentage plus
25 percentage points)'' and inserting ``(or, for calendar quarters
beginning on or after October 1, 2001, and before October 1, 2006, 90
percent)''.
SEC. 5. EXCLUSION OF CERTAIN AMOUNTS RECEIVED UNDER THE NATIONAL
NURSING SERVICE CORPS SCHOLARSHIP PROGRAM.
(a) In General.--Section 117(c) (relating to the exclusion from
gross income amounts received as a qualified scholarship) is amended--
(1) by striking ``Subsections (a)'' and inserting the
following:
``(1) In general.--Except as provided in paragraph (2),
subsections (a)'', and
(2) by adding at the end the following new paragraph:
``(2) Exceptions.--Paragraph (1) shall not apply to any
amount received by an individual under the National Nursing
Service Corps Scholarship program under part J of title VIII of
the Public Health Service Act.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to amounts received in taxable years beginning after December 31,
2001.
SEC. 6. 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,'' after ``in a public
hospital,''; and
(2) by adding at the end the following:
``PART H--INITIATIVES TO COMBAT NURSING SHORTAGES
``SEC. 851. PUBLIC SERVICE ANNOUNCEMENTS.
``(a) In General.--The Secretary shall develop and issue public
service announcements that shall advertise and promote the nursing
profession, highlight the advantages and rewards of nursing, and
encourage individuals from diverse communities and backgrounds to enter
the nursing profession.
``(b) Method.--The public service announcements described in
subsection (a) shall be broadcast in appropriate languages via
appropriate media outlets, including on television or radio, in a
manner intended to reach as wide and diverse an audience as possible.
``SEC. 852. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS.
``(a) In General.--The Secretary shall award grants to eligible
entities to support State and local advertising campaigns via
appropriate media outlets to promote the nursing profession, highlight
the advantages and rewards of nursing, and encourage individuals from
disadvantaged communities and backgrounds to enter the nursing
profession.
``(b) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means a
professional State nursing association, State health care
provider association, accredited school of nursing, and any
other entity that provides similar services or serves a like
function.
``(2) 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.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds received through such grant to buy local
television and radio time, place advertisements in local newspapers,
post information on billboards or on the Internet, or utilize other
appropriate media outlets in order to--
``(1) advertise and promote the nursing profession;
``(2) promote nursing education programs;
``(3) inform the public of public assistance regarding such
education programs;
``(4) highlight individuals in the community that are
presently practicing nursing in order to recruit new nurses; or
``(5) provide any other information to recruit individuals
to enroll in nursing programs.
``(d) Method.--The campaigns described in subsection (a) shall be
broadcast in appropriate languages on television or radio, or placed in
newspapers as advertisements, posted on billboards or the Internet, or
publicized via other appropriate media outlets in a manner intended to
reach as wide and diverse an audience as possible.
``(e) 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.
``SEC. 853. NURSE RECRUITMENT GRANT PROGRAM.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to increase nursing education opportunities.
``(b) 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) provide assistance to diploma, associate degree, and
collegiate schools of nursing to support remedial education
programs for nursing students who require assistance with math,
science, English, and medical terminology; or
``(4) meet the costs of child care and transportation for
individuals who are taking part in a nursing education program
at any level.
``(c) 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.
``SEC. 854. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated to carry out this part,
$20,000,000 for each of the fiscal years 2002 through 2004.
``PART I--INITIATIVES TO STRENGTHEN THE NURSING WORKFORCE
``SEC. 861. CAREER LADDER GRANT PROGRAM.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to assist individuals in obtaining education required
to enter the nursing profession and advance within such profession.
``(b) Eligible Entity.--The term `eligible entity' means a diploma,
associate degree, or collegiate school of nursing.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds under such grant to 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's nursing degree programs, doctoral nursing
programs, public health nursing programs, nurse educator programs,
nurse administrator programs, and training programs focused on specific
technology use or disease management.
``(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.
``SEC. 862. GRANTS FOR CURRICULUM DEVELOPMENT.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to develop and incorporate gerontology curriculum and
competencies.
``(b) Eligible Entity.--The term `eligible entity' means a diploma,
associate degree, or collegiate school of nursing.
``(c) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds under such grant to develop stand alone
courses in geriatric nursing to support concentrations, minors, and
majors in the discipline, to hire faculty who are certified in
geriatric nursing, to train nursing faculty members in gerontology, to
provide continuing education in gerontology for practicing nurses at
diploma, associate degree, and baccalaureate schools of 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.
``SEC. 863. GRANTS FOR PARTNERSHIPS.
``(a) In General.--The Secretary shall award grants to eligible
entities to enable such entities to form partnerships to carry out the
activities described in subsection (d).
``(b) Eligible Entity.--The term `eligible entity' means an
accredited school of nursing and a health care facility that forms a
partnership to provide the services described in this section.
``(c) Health Care Facility.--The term `health care facility' means
a hospital, nursing home, home health care agency, hospice, federally
qualified health center, rural health clinic, or public health clinic.
``(d) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds received through such grant to--
``(1) provide employees of the facility advanced training
and education at the school or facility;
``(2) establish or expand nursing practice arrangements in
noninstitutional settings to demonstrate methods to improve
access to primary health care in medically underserved
communities; and
``(3) purchase distance learning technology to extend
general education and training programs to rural areas, and to
extend specialty education and training programs to all areas.
``(e) 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.
``SEC. 864. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated to carry out this part,
$20,000,000 for each of the fiscal years 2002 through 2004.
``PART J--NATIONAL NURSING SERVICE CORPS SCHOLARSHIP PROGRAM
``SEC. 871. NATIONAL NURSING 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 areas
with nursing shortages.
``(b) Preference.--In awarding scholarships under this section, the
Secretary shall give preference to applicants with the greatest
financial need, and applicants who agree to serve in health facilities
experiencing nursing shortages in medically underserved areas.
``(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, to take courses leading to a
baccalaureate 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 payment of a scholarship and remain
enrolled in a nursing school;
``(B) maintain an acceptable level of academic
standing; and
``(C) serve as a nurse for a period of not less
than 2 years in an Indian Health Service health center,
a Native Hawaiian health center, a public hospital, a
migrant health center, a community health center, a
rural health clinic, a nursing home, a home health
agency, hospice, or a public or nonprofit private
health facility determined by the Secretary to have a
critical shortage of nurses.
``(d) 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
nursing schools materials providing information on the program
and shall encourage the schools to disseminate the materials to
students of the schools.
``(e) 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 12 consecutive months beginning with the first
month of the school year.
``(2) Contract.--The Secretary may contract with a nursing
school, in which a participant in the program is enrolled, for
the payment to the nursing school of the amounts of tuition and
other reasonable educational expenses described in paragraph
(1)(A).
``(3) Monthly stipend.--The amount of the monthly stipend,
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.
``(f) Breach of Agreement.--
``(1) In general.--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 for the amount
of such scholarship, and for interest on such scholarship at
the maximum legal prevailing rate, if the individual--
``(A) fails to maintain an acceptable level of
academic standing in the nursing program;
``(B) is dismissed from the nursing program for
disciplinary reasons;
``(C) voluntarily terminates the nursing program;
or
``(D) fails to provide services in accordance with
the program under this section for the period of time
applicable under the program.
``(2) Waiver or suspension of liability.--The Secretary
shall provide for the waiver or suspension of liability under
this section if compliance by the individual with the agreement
is impossible, or would involve extreme hardship to the
individual, or if enforcement of the agreement 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.
``(g) Definitions.--In this section:
``(1) Community health center.--The term ``community health
center'' has the meaning given such term in section 330(a).
``(2) Rural health clinic.--The term ``rural health
clinic'' has the meaning given such term in section 1861(aa)(2)
of the Social Security Act.
``(h) Authorization of Appropriations.--For the purpose of payments
under agreements entered into under subsection (a), there are
authorized to be appropriated $65,000,000 for each of the fiscal years
2002 through 2004.''.
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