[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5324 Introduced in House (IH)]






108th CONGRESS
  2d Session
                                H. R. 5324

 To amend the Public Health Service Act to authorize capitation grants 
 to increase the number of nursing faculty and students, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 8, 2004

Mrs. Lowey (for herself and Mrs. Capps) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to authorize capitation grants 
 to increase the number of nursing faculty and students, 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 Education, Expansion, and 
Development Act of 2004''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) While the Nurse Reinvestment Act (Public Law 107-205) 
        helped to increase applications to schools of nursing by 60 
        percent, schools of nursing have been unable to accommodate the 
        influx of interested students because they have an insufficient 
        number of nurse educators. It is estimated that--
                    (A) in the 2003-2004 school year--
                            (i) 61.5 percent of schools of nursing had 
                        from 1 to 15 vacant faculty positions; and
                            (ii) an additional 30.9 percent of schools 
                        of nursing needed additional faculty, but 
                        lacked the resources needed to add more 
                        positions; and
                    (B) 18,105 eligible candidates were denied 
                admission to schools of nursing in 2003, primarily due 
                to an insufficient number of faculty members.
            (2) A growing number of nurses with doctoral degrees are 
        choosing careers outside of education. Over the last few years, 
        there has been a 12 percent increase in doctoral nursing 
        graduates seeking employment outside the education profession.
            (3) The average age of nurse faculty at retirement is 62.5 
        years. With the average age of doctorally-prepared faculty 
        currently 53.5 years, a wave of retirements is expected within 
        the next 10 years.
            (4) Master's and doctoral programs in nursing are not 
        producing a large enough pool of potential nurse educators to 
        meet the projected demand for nurses over the next 10 years. In 
        the 2003-2004 school year, graduations from master's programs 
        in nursing were down 2.5 percent or 251 graduates, and 
        graduations from doctoral programs decreased by 9.9 percent or 
        44 graduates.
            (5) According to the February 2004 Monthly Labor Review of 
        the Bureau of Labor Statistics, more than 1,000,000 new and 
        replacement nurses will be needed by 2012.

SEC. 3. CAPITATION GRANTS TO INCREASE THE NUMBER OF NURSING FACULTY AND 
              STUDENTS.

    (a) Grants.--Part D of title VIII of the Public Health Service Act 
(42 U.S.C. 296p) is amended by adding at the end the following:

``SEC. 832. CAPITATION GRANTS.

    ``(a) In General.--For the purpose described in subsection (b), the 
Secretary, acting through the Health Resources and Services 
Administration, shall award a grant each fiscal year in an amount 
determined in accordance with subsection (c) to each eligible school of 
nursing that submits an application in accordance with this section.
    ``(b) Purpose.--A funding agreement for a grant under this section 
is that the eligible school of nursing involved will expend the grant 
to increase the number of nursing faculty and students at the school, 
including by hiring new faculty, retaining current faculty, purchasing 
educational equipment and audiovisual laboratories, enhancing clinical 
laboratories, repairing and expanding infrastructure, or recruiting 
students.
    ``(c) Grant Computation.--
            ``(1) Amount per student.--Subject to paragraph (2), the 
        amount of a grant to an eligible school of nursing under this 
        section for a fiscal year shall be the total of the following:
                    ``(A) $1,800 for each full-time or part-time 
                student who is enrolled at the school in a graduate 
                program of education in nursing that--
                            ``(i) leads to a master's degree, a 
                        doctoral degree, or an equivalent degree; and
                            ``(ii) prepares individuals to serve as 
                        faculty through additional course work in 
                        education and ensuring competency in an 
                        advanced practice area.
                    ``(B) $1,405 for each full-time or part-time 
                student who--
                            ``(i) is enrolled at the school in a 
                        program of education in nursing leading to the 
                        degree of bachelor of science, bachelor of 
                        nursing, or an equivalent degree; and
                            ``(ii) has not more than 3 years of 
                        academic credits remaining in the program.
                    ``(C) $966 for each full-time or part-time student 
                who is enrolled at the school in a program of education 
                in nursing leading to an associate degree in nursing or 
                an equivalent degree.
            ``(2) Limitation.--In calculating the amount of a grant to 
        a school under paragraph (1), the Secretary may not make a 
        payment with respect to a particular student--
                    ``(A) for more than 2 fiscal years in the case of a 
                student described in paragraph (1)(A) who is enrolled 
                in a graduate program of education in nursing leading 
                to a master's degree or an equivalent degree;
                    ``(B) for more than 4 fiscal years in the case of a 
                student described in paragraph (1)(A) who is enrolled 
                in a graduate program of education in nursing leading 
                to a doctoral degree or an equivalent degree;
                    ``(C) for more than 3 fiscal years in the case of a 
                student described in paragraph (1)(B); or
                    ``(D) for more than 2 fiscal years in the case of a 
                student described in paragraph (1)(C).
    ``(d) Eligibility.--For purposes of this section, the term 
`eligible school of nursing' means a school of nursing that--
            ``(1) is accredited by a nursing accrediting agency 
        recognized by the Secretary of Education;
            ``(2) has a passage rate on the National Council Licensure 
        Examination for Registered Nurses of not less than 80 percent 
        for each of the 3 school years preceding submission of the 
        grant application; and
            ``(3) has a graduation rate (based on the number of 
        students in a class who graduate relative to, for a 
        baccalaureate program, the number of students who were enrolled 
        in the class at the beginning of junior year or, for an 
        associate degree program, the number of students who were 
        enrolled in the class at the end of the first year) of not less 
        than 80 percent for each of the 3 school years preceding 
        submission of the grant application.
    ``(e) Requirements.--The Secretary may award a grant under this 
section to an eligible school of nursing only if the school gives 
assurances satisfactory to the Secretary that, for each school year for 
which the grant is awarded, the school will comply with the following:
            ``(1) The school will maintain a passage rate on the 
        National Council Licensure Examination for Registered Nurses of 
        not less than 80 percent.
            ``(2) The school will maintain a graduation rate (as 
        described in subsection (d)(3)) of not less than 80 percent.
            ``(3)(A) Subject to subparagraphs (B) and (C), the first-
        year enrollment of full-time nursing students in the school 
        will exceed such enrollment for the preceding school year by 5 
        percent or 5 students, whichever is greater.
            ``(B) Subparagraph (A) does not apply to the first school 
        year for which a school receives a grant under this section.
            ``(C) With respect to any school year, the Secretary may 
        waive application of subparagraph (A) if--
                    ``(i) the physical facilities at the school 
                involved limit the school from enrolling additional 
                students; or
                    ``(ii) the school has increased enrollment in the 
                school (as described in subparagraph (A)) for each of 
                the 2 preceding school years.
            ``(4) Not later than 1 year after receipt of the grant, the 
        school will formulate and implement a plan to accomplish at 
        least 2 of the following:
                    ``(A) Establishing or significantly expanding an 
                accelerated baccalaureate degree nursing program 
                designed to graduate new nurses in 12 to 18 months.
                    ``(B) Establishing cooperative intradisciplinary 
                education among schools of nursing with a view toward 
                shared use of technological resources, including 
                information technology.
                    ``(C) Establishing cooperative interdisciplinary 
                training between schools of nursing and schools of 
                allied health, medicine, dentistry, osteopathy, 
                optometry, podiatry, pharmacy, public health, or 
                veterinary medicine, including training for the use of 
                the interdisciplinary team approach to the delivery of 
                health services.
                    ``(D) Integrating core competencies on evidence-
                based practice, quality improvements, and patient-
                centered care.
                    ``(E) Increasing admissions, enrollment, and 
                retention of qualified individuals who are financially 
                disadvantaged.
                    ``(F) Increasing enrollment of minority and diverse 
                student populations.
                    ``(G) Increasing enrollment of new graduate 
                baccalaureate nursing students in graduate programs 
                that educate nurse faculty members.
                    ``(H) Developing post-baccalaureate residency 
                programs to prepare nurses for practice in specialty 
                areas where nursing shortages are most severe.
                    ``(I) Increasing integration of geriatric content 
                into the core curriculum.
                    ``(J) Partnering with economically disadvantaged 
                communities to provide nursing education.
                    ``(K) Expanding the ability of nurse managed health 
                centers to provide clinical education training sites to 
                nursing students.
            ``(5) The school will submit an annual report to the 
        Secretary that includes updated information on the school with 
        respect to student enrollment, student retention, graduation 
        rates, passage rates on the National Council Licensure 
        Examination for Registered Nurses, the number of graduates 
        employed as nursing faculty or nursing care providers within 12 
        months of graduation, and the number of students who are 
        accepted into graduate programs for further nursing education.
            ``(6) The school will allow the Secretary to make on-site 
        inspections, and will comply with the Secretary's requests for 
        information, to determine the extent to which the school is 
        complying with the requirements of this section.
    ``(g) Reports to Congress.--The Secretary shall evaluate the 
results of grants under this section and submit to the Congress--
            ``(1) not later than 18 months after the date of the 
        enactment of this section, an interim report on such results; 
        and
            ``(2) not later than the end of fiscal year 2007, a final 
        report on such results.
    ``(h) Application.--To seek a grant under this section, a school 
nursing shall submit an application to the Secretary at such time, in 
such manner, and containing such information and assurances as the 
Secretary may require.
    ``(i) Authorization of Appropriations.--
            ``(1) In general.--For the costs of carrying out this 
        section (except the costs described in paragraph (2)), there 
        are authorized to be appropriated $75,000,000 for fiscal year 
        2005, $85,000,000 for fiscal year 2006, and $95,000,000 for 
        fiscal year 2007.
            ``(2) Administrative costs.--For the costs of administering 
        this section, including the costs of evaluating the results of 
        grants and submitting reports to the Congress, there are 
        authorized to be appropriated such sums as may be necessary for 
        each of fiscal years 2005, 2006, and 2007.''.
    (b) GAO Study.--
            (1) In general.--Not later than 1 year after the date of 
        the enactment of this Act, the Comptroller General of the 
        United States shall conduct a study and submit a report to the 
        Congress on ways to increase participation in the nurse faculty 
        profession.
            (2) Contents of report.--The report required by paragraph 
        (1) shall include the following:
                    (A) A discussion of the master's degree and 
                doctoral degree programs that are successful in placing 
                graduates as faculty in schools of nursing.
                    (B) An examination of compensation disparities 
                throughout the nursing profession and compensation 
                disparities between higher education instructional 
                faculty generally and higher education instructional 
                nursing faculty.
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