[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3487 Enrolled Bill (ENR)]

        H.R.3487

                      One Hundred Seventh Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

         Begun and held at the City of Washington on Wednesday,
          the twenty-third day of January, two thousand and two


                                 An Act


 
     To amend the Public Health Service Act with respect to health 
          professions programs regarding the field of nursing.

    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. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.

                       TITLE I--NURSE RECRUITMENT

Sec. 101. Definitions.
Sec. 102. Public service announcements regarding the nursing profession.
Sec. 103. National Nurse Service Corps.

                        TITLE II--NURSE RETENTION

Sec. 201. Building career ladders and retaining quality nurses.
Sec. 202. Comprehensive geriatric education.
Sec. 203. Nurse faculty loan program.
Sec. 204. Reports by General Accounting Office.

                       TITLE I--NURSE RECRUITMENT

SEC. 101. DEFINITIONS.

    Section 801 of the Public Health Service Act (42 U.S.C. 296) is 
amended by adding at the end the following:
        ``(9) Ambulatory surgical center.--The term `ambulatory 
    surgical center' has the meaning applicable to such term under 
    title XVIII of the Social Security Act.
        ``(10) Federally qualified health center.--The term `Federally 
    qualified health center' has the meaning given such term under 
    section 1861(aa)(4) of the Social Security Act.
        ``(11) Health care facility.--The term `health care facility' 
    means an Indian Health Service health center, a Native Hawaiian 
    health center, a hospital, a Federally qualified health center, a 
    rural health clinic, a nursing home, a home health agency, a 
    hospice program, a public health clinic, a State or local 
    department of public health, a skilled nursing facility, an 
    ambulatory surgical center, or any other facility designated by the 
    Secretary.
        ``(12) Home health agency.--The term `home health agency' has 
    the meaning given such term in section 1861(o) of the Social 
    Security Act.
        ``(13) Hospice program.--The term `hospice program' has the 
    meaning given such term in section 1861(dd)(2) of the Social 
    Security Act.
        ``(14) Rural health clinic.--The term `rural health clinic' has 
    the meaning given such term in section 1861(aa)(2) of the Social 
    Security Act.
        ``(15) Skilled nursing facility.--The term `skilled nursing 
    facility' has the meaning given such term in section 1819(a) of the 
    Social Security Act.''.

SEC. 102. PUBLIC SERVICE ANNOUNCEMENTS REGARDING THE NURSING 
              PROFESSION.

    Title VIII of the Public Health Service Act (42 U.S.C. 296 et seq.) 
is amended by adding at the end the following:

                 ``PART H--PUBLIC SERVICE ANNOUNCEMENTS

``SEC. 851. PUBLIC SERVICE ANNOUNCEMENTS.

    ``(a) In General.--The Secretary shall develop and issue public 
service announcements that advertise and promote the nursing 
profession, highlight the advantages and rewards of nursing, and 
encourage individuals to enter the nursing profession.
    ``(b) Method.--The public service announcements described in 
subsection (a) shall be broadcast through appropriate media outlets, 
including television or radio, in a manner intended to reach as wide 
and diverse an audience as possible.
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2003 through 2007.

``SEC. 852. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS.

    ``(a) In General.--The Secretary may award grants to eligible 
entities to support State and local advertising campaigns through 
appropriate media outlets to promote the nursing profession, highlight 
the advantages and rewards of nursing, and encourage individuals from 
disadvantaged backgrounds to enter the nursing profession.
    ``(b) Use of Funds.--An eligible entity that receives a grant under 
subsection (a) shall use funds received through such grant to acquire 
local television and radio time, place advertisements in local 
newspapers, or post information on billboards or on the Internet in a 
manner intended to reach as wide and diverse an audience as possible, 
in order to--
        ``(1) advertise and promote the nursing profession;
        ``(2) promote nursing education programs;
        ``(3) inform the public of financial assistance regarding such 
    education programs;
        ``(4) highlight individuals in the community who are practicing 
    nursing in order to recruit new nurses; or
        ``(5) provide any other information to recruit individuals for 
    the nursing profession.
    ``(c) Limitation.--An eligible entity that receives a grant under 
subsection (a) shall not use funds received through such grant to 
advertise particular employment opportunities.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2003 through 2007.''.

SEC. 103. NATIONAL NURSE SERVICE CORPS.

    (a) Loan Repayment Program.--Section 846(a) of the Public Health 
Service Act (42 U.S.C. 297n(a)) is amended--
        (1) in paragraph (3), by striking ``in an Indian Health Service 
    health center'' and all that follows to the semicolon and inserting 
    ``at a health care facility with a critical shortage of nurses''; 
    and
        (2) by adding at the end the following: ``After fiscal year 
    2007, the Secretary may not, pursuant to any agreement entered into 
    under this subsection, assign a nurse to any private entity unless 
    that entity is nonprofit.''.
    (b) Establishment of Scholarship Program.--Section 846 of the 
Public Health Service Act (42 U.S.C. 297n) is amended--
        (1) in the heading for the section, by striking ``loan 
    repayment program'' and inserting ``loan repayment and scholarship 
    programs'';
        (2) by redesignating subsections (d), (f), (g), and (h) as 
    subsections (f), (h), (i), and (g), respectively;
        (3) by transferring subsections (f) and (g) (as so 
    redesignated) from their current placements, by inserting 
    subsection (f) after subsection (e), and by inserting subsection 
    (g) after subsection (f) (as so inserted); and
        (4) by inserting after subsection (c) the following subsection:
    ``(d) Scholarship Program.--
        ``(1) In general.--The Secretary shall (for fiscal years 2003 
    and 2004) and may (for fiscal years thereafter) carry out a program 
    of entering into contracts with eligible individuals under which 
    such individuals agree to serve as nurses for a period of not less 
    than 2 years at a health care facility with a critical shortage of 
    nurses, in consideration of the Federal Government agreeing to 
    provide to the individuals scholarships for attendance at schools 
    of nursing.
        ``(2) Eligible individuals.--In this subsection, the term 
    `eligible individual' means an individual who is enrolled or 
    accepted for enrollment as a full-time or part-time student in a 
    school of nursing.
        ``(3) Service requirement.--
            ``(A) In general.--The Secretary may not enter into a 
        contract with an eligible individual under this subsection 
        unless the individual agrees to serve as a nurse at a health 
        care facility with a critical shortage of nurses for a period 
        of full-time service of not less than 2 years, or for a period 
        of part-time service in accordance with subparagraph (B).
            ``(B) Part-time service.--An individual may complete the 
        period of service described in subparagraph (A) on a part-time 
        basis if the individual has a written agreement that--
                ``(i) is entered into by the facility and the 
            individual and is approved by the Secretary; and
                ``(ii) provides that the period of obligated service 
            will be extended so that the aggregate amount of service 
            performed will equal the amount of service that would be 
            performed through a period of full-time service of not less 
            than 2 years.
        ``(4) Applicability of certain provisions.--The provisions of 
    subpart III of part D of title III shall, except as inconsistent 
    with this section, apply to the program established in paragraph 
    (1) in the same manner and to the same extent as such provisions 
    apply to the National Health Service Corps Scholarship Program 
    established in such subpart.''.
    (c) Preference.--Section 846(e) of the Public Health Service Act 
(42 U.S.C. 297n(e)) is amended by striking ``under subsection (a)'' and 
all that follows through the period and inserting ``under subsection 
(a) or (d), the Secretary shall give preference to qualified applicants 
with the greatest financial need.''.
    (d) Reports.--Subsection (h) of section 846 of the Public Health 
Service Act (42 U.S.C. 297n) (as redesignated by subsection (b)(2)) is 
amended to read as follows:
    ``(h) Reports.--Not later than 18 months after the date of 
enactment of the Nurse Reinvestment Act, and annually thereafter, the 
Secretary shall prepare and submit to the Congress a report describing 
the programs carried out under this section, including statements 
regarding--
        ``(1) the number of enrollees, scholarships, loan repayments, 
    and grant recipients;
        ``(2) the number of graduates;
        ``(3) the amount of scholarship payments and loan repayments 
    made;
        ``(4) which educational institution the recipients attended;
        ``(5) the number and placement location of the scholarship and 
    loan repayment recipients at health care facilities with a critical 
    shortage of nurses;
        ``(6) the default rate and actions required;
        ``(7) the amount of outstanding default funds of both the 
    scholarship and loan repayment programs;
        ``(8) to the extent that it can be determined, the reason for 
    the default;
        ``(9) the demographics of the individuals participating in the 
    scholarship and loan repayment programs;
        ``(10) justification for the allocation of funds between the 
    scholarship and loan repayment programs; and
        ``(11) an evaluation of the overall costs and benefits of the 
    programs.''.
    (e) Funding.--Subsection (i) of section 846 of the Public Health 
Service Act (42 U.S.C. 297n) (as redesignated by subsection (b)(2)) is 
amended to read as follows:
    ``(i) Funding.--
        ``(1) Authorization of appropriations.--For the purpose of 
    payments under agreements entered into under subsection (a) or (d), 
    there are authorized to be appropriated such sums as may be 
    necessary for each of fiscal years 2003 through 2007.
        ``(2) Allocations.--Of the amounts appropriated under paragraph 
    (1), the Secretary may, as determined appropriate by the Secretary, 
    allocate amounts between the program under subsection (a) and the 
    program under subsection (d).''.

                       TITLE II--NURSE RETENTION

SEC. 201. BUILDING CAREER LADDERS AND RETAINING QUALITY NURSES.

    Section 831 of the Public Health Service Act (42 U.S.C. 296p) is 
amended to read as follows:

``SEC. 831. NURSE EDUCATION, PRACTICE, AND RETENTION GRANTS.

    ``(a) Education Priority Areas.--The Secretary may award grants to 
or enter into contracts with eligible entities for--
        ``(1) expanding the enrollment in baccalaureate nursing 
    programs;
        ``(2) developing and implementing internship and residency 
    programs to encourage mentoring and the development of specialties; 
    or
        ``(3) providing education in new technologies, including 
    distance learning methodologies.
    ``(b) Practice Priority Areas.--The Secretary may award grants to 
or enter into contracts with eligible entities for--
        ``(1) establishing or expanding nursing practice arrangements 
    in noninstitutional settings to demonstrate methods to improve 
    access to primary health care in medically underserved communities;
        ``(2) providing care for underserved populations and other 
    high-risk groups such as the elderly, individuals with HIV/AIDS, 
    substance abusers, the homeless, and victims of domestic violence;
        ``(3) providing managed care, quality improvement, and other 
    skills needed to practice in existing and emerging organized health 
    care systems; or
        ``(4) developing cultural competencies among nurses.
    ``(c) Retention Priority Areas.--The Secretary may award grants to 
and enter into contracts with eligible entities to enhance the nursing 
workforce by initiating and maintaining nurse retention programs 
pursuant to paragraph (1) or (2).
        ``(1) Grants for career ladder programs.--The Secretary may 
    award grants to and enter into contracts with eligible entities for 
    programs--
            ``(A) to promote career advancement for nursing personnel 
        in a variety of training settings, cross training or specialty 
        training among diverse population groups, and the advancement 
        of individuals including to become professional nurses, 
        advanced education nurses, licensed practical nurses, certified 
        nurse assistants, and home health aides; and
            ``(B) to assist individuals in obtaining education and 
        training required to enter the nursing profession and advance 
        within such profession, such as by providing career counseling 
        and mentoring.
        ``(2) Enhancing patient care delivery systems.--
            ``(A) Grants.--The Secretary may award grants to eligible 
        entities to improve the retention of nurses and enhance patient 
        care that is directly related to nursing activities by 
        enhancing collaboration and communication among nurses and 
        other health care professionals, and by promoting nurse 
        involvement in the organizational and clinical decisionmaking 
        processes of a health care facility.
            ``(B) Preference.--In making awards of grants under this 
        paragraph, the Secretary shall give a preference to applicants 
        that have not previously received an award under this 
        paragraph.
            ``(C) Continuation of an award.--The Secretary shall make 
        continuation of any award under this paragraph beyond the 
        second year of such award contingent on the recipient of such 
        award having demonstrated to the Secretary measurable and 
        substantive improvement in nurse retention or patient care.
    ``(d) Other Priority Areas.--The Secretary may award grants to or 
enter into contracts with eligible entities to address other areas that 
are of high priority to nurse education, practice, and retention, as 
determined by the Secretary.
    ``(e) Preference.--For purposes of any amount of funds appropriated 
to carry out this section for fiscal year 2003, 2004, or 2005 that is 
in excess of the amount of funds appropriated to carry out this section 
for fiscal year 2002, the Secretary shall give preference to awarding 
grants or entering into contracts under subsections (a)(2) and (c).
    ``(f) Report.--The Secretary shall submit to the Congress before 
the end of each fiscal year a report on the grants awarded and the 
contracts entered into under this section. Each such report shall 
identify the overall number of such grants and contracts and provide an 
explanation of why each such grant or contract will meet the priority 
need of the nursing workforce.
    ``(g) Eligible Entity.--For purposes of this section, the term 
`eligible entity' includes a school of nursing, a health care facility, 
or a partnership of such a school and facility.
    ``(h) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2003 through 2007.''.

SEC. 202. COMPREHENSIVE GERIATRIC EDUCATION.

    (a) Comprehensive Geriatric Education.--Title VIII of the Public 
Health Service Act (42 U.S.C. 296 et seq.) (as amended by section 102) 
is amended by adding at the end the following:

              ``PART I--COMPREHENSIVE GERIATRIC EDUCATION

``SEC. 855. COMPREHENSIVE GERIATRIC EDUCATION.

    ``(a) Program Authorized.--The Secretary shall award grants to 
eligible entities to develop and implement, in coordination with 
programs under section 753, programs and initiatives to train and 
educate individuals in providing geriatric care for the elderly.
    ``(b) 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 
    geriatric care for the elderly;
        ``(2) develop and disseminate curricula relating to the 
    treatment of the health problems of elderly individuals;
        ``(3) train faculty members in geriatrics; or
        ``(4) provide continuing education to individuals who provide 
    geriatric care.
    ``(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.
    ``(d) Eligible Entity.--For purposes of this section, the term 
`eligible entity' includes a school of nursing, a health care facility, 
a program leading to certification as a certified nurse assistant, a 
partnership of such a school and facility, or a partnership of such a 
program and facility.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2003 through 2007.''.
    (b) Technical Amendment.--Section 753(a)(1) of the Public Health 
Service Act (42 U.S.C. 294c) is amended by striking ``, and section 
853(2),'' and inserting ``, and section 801(2),''.

SEC. 203. NURSE FACULTY LOAN PROGRAM.

    Part E of title VIII of the Public Health Service Act (42 U.S.C. 
297a et seq.) is amended by inserting after section 846 the following:

                      ``nurse faculty loan program

    ``Sec. 846A. (a) Establishment.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, may 
enter into an agreement with any school of nursing for the 
establishment and operation of a student loan fund in accordance with 
this section, to increase the number of qualified nursing faculty.
    ``(b) Agreements.--Each agreement entered into under subsection (a) 
shall--
        ``(1) provide for the establishment of a student loan fund by 
    the school involved;
        ``(2) provide for deposit in the fund of--
            ``(A) the Federal capital contributions to the fund;
            ``(B) an amount equal to not less than one-ninth of such 
        Federal capital contributions, contributed by such school;
            ``(C) collections of principal and interest on loans made 
        from the fund; and
            ``(D) any other earnings of the fund;
        ``(3) provide that the fund will be used only for loans to 
    students of the school in accordance with subsection (c) and for 
    costs of collection of such loans and interest thereon;
        ``(4) provide that loans may be made from such fund only to 
    students pursuing a full-time course of study or, at the discretion 
    of the Secretary, a part-time course of study in an advanced degree 
    program described in section 811(b); and
        ``(5) contain such other provisions as are necessary to protect 
    the financial interests of the United States.
    ``(c) Loan Provisions.--Loans from any student loan fund 
established by a school pursuant to an agreement under subsection (a) 
shall be made to an individual on such terms and conditions as the 
school may determine, except that--
        ``(1) such terms and conditions are subject to any conditions, 
    limitations, and requirements prescribed by the Secretary;
        ``(2) in the case of any individual, the total of the loans for 
    any academic year made by schools of nursing from loan funds 
    established pursuant to agreements under subsection (a) may not 
    exceed $30,000, plus any amount determined by the Secretary on an 
    annual basis to reflect inflation;
        ``(3) an amount up to 85 percent of any such loan (plus 
    interest thereon) shall be canceled by the school as follows:
            ``(A) upon completion by the individual of each of the 
        first, second, and third year of full-time employment, required 
        by the loan agreement entered into under this subsection, as a 
        faculty member in a school of nursing, the school shall cancel 
        20 percent of the principle of, and the interest on, the amount 
        of such loan unpaid on the first day of such employment; and
            ``(B) upon completion by the individual of the fourth year 
        of full-time employment, required by the loan agreement entered 
        into under this subsection, as a faculty member in a school of 
        nursing, the school shall cancel 25 percent of the principle 
        of, and the interest on, the amount of such loan unpaid on the 
        first day of such employment;
        ``(4) such a loan may be used to pay the cost of tuition, fees, 
    books, laboratory expenses, and other reasonable education 
    expenses;
        ``(5) such a loan shall be repayable in equal or graduated 
    periodic installments (with the right of the borrower to accelerate 
    repayment) over the 10-year period that begins 9 months after the 
    individual ceases to pursue a course of study at a school of 
    nursing; and
        ``(6) such a loan shall--
            ``(A) beginning on the date that is 3 months after the 
        individual ceases to pursue a course of study at a school of 
        nursing, bear interest on the unpaid balance of the loan at the 
        rate of 3 percent per annum; or
            ``(B) subject to subsection (e), if the school of nursing 
        determines that the individual will not complete such course of 
        study or serve as a faculty member as required under the loan 
        agreement under this subsection, bear interest on the unpaid 
        balance of the loan at the prevailing market rate.
    ``(d) Payment of Proportionate Share.--Where all or any part of a 
loan, or interest, is canceled under this section, the Secretary shall 
pay to the school an amount equal to the school's proportionate share 
of the canceled portion, as determined by the Secretary.
    ``(e) Review by Secretary.--At the request of the individual 
involved, the Secretary may review any determination by a school of 
nursing under subsection (c)(6)(B).
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2003 through 2007.''.

SEC. 204. REPORTS BY GENERAL ACCOUNTING OFFICE.

    (a) National Variations.--Not later than 4 years after the date of 
the enactment of this Act, the Comptroller General of the United States 
shall conduct a survey to determine national variations in the nursing 
shortage at hospitals, nursing homes, and other health care providers, 
and submit a report, including recommendations, to the Congress on 
Federal remedies to ease nursing shortages. The Comptroller General 
shall submit to the Congress this report describing the findings 
relating to ownership status and associated remedies.
    (b) Hiring Differences Among Certain Private Entities.--The 
Comptroller General of the United States shall conduct a study to 
determine differences in the hiring of nurses by nonprofit private 
entities as compared to the hiring of nurses by private entities that 
are not nonprofit. In carrying out the study, the Comptroller General 
shall determine the effect of the inclusion of private entities that 
are not nonprofit in the program under section 846 of the Public Health 
Service Act. Not later than 4 years after the date of the enactment of 
this Act, the Comptroller General shall submit to the Congress a report 
describing the findings of the study.
    (c) Nursing Scholarships.--The Comptroller General of the United 
States shall conduct an evaluation of whether the program carried out 
under section 846(d) of the Public Health Service Act has demonstrably 
increased the number of applicants to schools of nursing and, not later 
than 4 years after the date of the enactment of this Act, submit a 
report to the Congress on the results of such evaluation.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.