[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 4029 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 4029

To increase the number of well-educated nurses, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 29, 2006

 Mrs. Clinton introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To increase the number of well-educated nurses, 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 ``Nursing Education and Quality of 
Health Care Act of 2006''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The current nursing workforce is the largest group of 
        healthcare providers in the United States.
            (2) There will be a need for 1,200,000 new and replacement 
        nurses by 2014.
            (3) Over 37,000 qualified applicants were turned away from 
        entry-level nursing programs leading to a baccalaureate degree 
        in 2005. This number increases to 147,000 when all schools of 
        nursing are taken into account.
            (4) Insufficient numbers of faculty is the primary reason 
        given by schools of nursing for not accepting qualified 
        applicants.
            (5) The average age of doctorally-prepared nurse faculty is 
        almost 56 years old.
            (6) Nurses are the healthcare providers most likely to 
        intercept medication errors before the errors reach patients 
        and result in adverse events.
            (7) Employing a greater proportion of more highly educated 
        nurses may reduce the rates of patient mortality.

SEC. 3. RURAL NURSES TRAINING GRANT PROGRAM.

    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. RURAL NURSES TRAINING GRANT PROGRAM.

    ``(a) In General.--The Secretary shall award grants to, or enter 
into contracts with, eligible entities for the purpose of educating 
nurses to serve in rural areas.
    ``(b) Use of Funds.--An eligible entity that receives a grant under 
this section shall use grant funds to develop distance learning 
education by--
            ``(1) providing technology infrastructure to enhance or 
        increase--
                    ``(A) broadband connectivity; and
                    ``(B) education rooms wired for the Internet;
            ``(2) providing technology infrastructure for a video 
        conferencing network;
            ``(3) recruiting, training, and supporting community-based 
        faculty for classroom and clinical training; or
            ``(4) recruiting and supporting community-based sites for 
        clinical training.
    ``(c) Analyses.--Not later than 1 year after the Secretary awards 
grants under subsection (a), and annually thereafter, the Secretary, 
working with the Administrator of the Health Resources and Services 
Administration and appropriate nursing agencies, shall collect and 
perform analyses on the number of nurses in the United States to track 
rural nursing trends.
    ``(d) Report.--Not later than 2 years after the date of enactment 
of this Act, the Secretary shall generate an annual report about the 
status of the nursing workforce in the United States and shall 
disseminate the report as the Secretary determines appropriate.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of the fiscal years 2007 through 2011.''.

SEC. 4. NURSE FACULTY DEVELOPMENT.

    (a) Nurse Faculty Development Program.--Part D of title VIII of the 
Public Health Service Act (42 U.S.C. 296p et seq.) is amended by 
inserting after section 832 (as added by section 3) the following:

``SEC. 833. NURSE FACULTY DEVELOPMENT PROGRAM.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall award grants 
to eligible entities for the establishment and operation of 
demonstration projects that will expand the numbers of nurse faculty 
within schools of nursing, including--
            ``(1) developing recruitment programs for nurses with 
        academic credentials for faculty status who are not teaching at 
        the time;
            ``(2) offering scholarships that facilitate the return of 
        registered nurses to a school of nursing on a part-time basis 
        for graduate education that leads to a career in nursing 
        education;
            ``(3) providing additional education to enable nurses with 
        graduate degrees to serve as faculty by obtaining teaching 
        certificates;
            ``(4) developing accelerated doctoral programs that will 
        facilitate entry in a nursing faculty position;
            ``(5) developing online continuing education courses and 
        practice teaching opportunities for nurse faculty; and
            ``(6) developing research internships and fellowships for 
        nursing students at academic medical centers to foster interest 
        in academic research.
    ``(b) Report.--Not later than 2 years after the date of enactment 
of the Nursing Education and Quality of Health Care Act of 2006, the 
Comptroller General of the United States shall prepare and submit a 
report to Congress that--
            ``(1) addresses the causes of the nurse faculty shortage; 
        and
            ``(2) makes recommendations to increase the numbers and the 
        retention of nurse faculty members.
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of the fiscal years 2007 through 2011.''.
    (b) Doctoral Programs.--Section 811(f)(2) of the Public Health 
Service Act (42 U.S.C. 296j(f)(2)) is amended by striking the period at 
the end and inserting ``, except that in the case of a nurse faculty 
shortage, the Secretary may, in the Secretary's discretion, obligate 
more than 10 percent of such traineeships for individuals in doctoral 
degree programs.''.

SEC. 5. DEVELOPING THE RURAL NURSING WORKFORCE.

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

``SEC. 822. DEVELOPING THE RURAL NURSING WORKFORCE.

    ``(a) In General.--The Secretary shall award grants to, and enter 
into contracts with, eligible entities to increase the nursing 
opportunities for individuals who reside in rural communities. The 
activities funded under this section shall include--
            ``(1) increasing and expanding pipeline programs, 
        including--
                    ``(A) mathematics and science programs;
                    ``(B) Nurse Medical Academy of Science and Health 
                (MASH) Camp and other health career pipeline programs 
                for middle school and secondary school students tied to 
                higher education curricula;
                    ``(C) nurse mentor programs that provide experience 
                for secondary school students in clinical settings to 
                learn about the nursing profession;
                    ``(D) training for middle school and secondary 
                school guidance counselors; and
                    ``(E) programs that attract nontraditional nursing 
                students, including minorities and men;
            ``(2) supporting a web-based healthcare workforce 
        development system that will be a database-driven website to 
        connect employers, educators, rural communities, and students 
        with the nursing pipeline and recruitment programs described in 
        this section; and
            ``(3) increasing the program capacity of accelerated 
        registered nurse programs that recruit individuals with 
        baccalaureate degrees in other fields into baccalaureate or 
        graduate degree nursing programs that serve rural communities, 
        by--
                    ``(A) increasing the number of faculty;
                    ``(B) increasing clinical training sites; and
                    ``(C) providing financial incentives, including 
                loan forgiveness and tuition assistance for nurses who 
                practice in rural areas.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of the fiscal years 2007 through 2011.''.

SEC. 6. NURSING AND THE QUALITY OF HEALTHCARE.

    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 J--NURSING AND IMPROVING HEALTHCARE

``SEC. 861. LINKING NURSING EDUCATION AND QUALITY OUTCOMES PROGRAM.

    ``(a) In General.--The Secretary, in collaboration with the 
Administrator of the Health Resources and Services Administration and 
the Director of the Agency for Healthcare Research and Quality, shall 
award grants to entities that meet the requirements of subsection (b) 
to enable the entities to carry out demonstration projects that advance 
the education, delivery, or measurement of quality and patient safety 
in nursing practice.
    ``(b) Eligibility.--To be eligible to receive a demonstration 
project grant under this section, an entity shall--
            ``(1) be a school of nursing, a nursing center, an academic 
        health center, a State or local government, or any other public 
        or private nonprofit entity determined appropriate by the 
        Secretary;
            ``(2) submit to the Secretary an application in accordance 
        with section 802;
            ``(3) form a partnership with 1 or more eligible entities; 
        and
            ``(4) submit a plan to the Secretary that assures grant 
        funds received under this section will be used to support the 
        implementation and evaluation of healthcare quality improvement 
        activities that include--
                    ``(A) with respect to healthcare systems, 
                activities relating to improving patient safety, 
                timeliness of care, effectiveness of care, equity and 
                efficiency of care, and patient-centeredness; or
                    ``(B) with respect to patients, activities, 
                including activities relating to staying healthy, 
                getting well, living with illness or disability, and 
                coping with end of life issues.
    ``(c) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to entities that will carry out 1 or more 
of the following:
            ``(1) Implementation.--Implementing initiatives in 
        professional nursing education to enhance patient safety 
        efforts through evidence-based practice and quality improvement 
        strategies by--
                    ``(A) developing partnerships between accredited 
                schools of nursing and health care facilities, as 
                defined in section 801, to educate registered nurses in 
                clinical leadership, interdisciplinary team management, 
                systems administration, outcomes and risk management, 
                and education, for implementation in multiple 
                healthcare settings; and
                    ``(B) providing scholarships for registered 
                professional nurses to pursue advanced nursing 
                education in accordance with subsection (a).
            ``(2) Education.--Integrating quality and safety 
        competencies into nursing education programs by--
                    ``(A) disseminating patient safety education 
                content to a nurse faculty administrator to integrate 
                quality competencies into each school of nursing that 
                are consistent with technical standards that are 
                developed or adopted by voluntary consensus standards 
                bodies under section 12(d) of the National Technology 
                Transfer and Advancement Act of 1995 (15 U.S.C. 272 
                note); and
                    ``(B) developing ongoing web-based modules for 
                continued nurse faculty education to bring research 
                evidence into practice not later than 2 years after 
                receiving a grant under this section; and
            ``(3) provide continuing education for practicing nurses, 
        including--
                    ``(A) developing web-based modules related to 
                patient safety, including topics of evidenced-based 
                practice, professional communication, patient or 
                family-centered care, systems thinking, informatics, 
                collaborative practice, medication, and practice error; 
                and
                    ``(B) developing systems for the dissemination of 
                continuing education through facility-based staff 
                development and orientation.
    ``(d) Evaluation.--The Secretary shall award grants to entities 
described in subsection (b) to collect data and study the potential 
benefits of basic and advanced nursing education levels or 
certification status in the efforts to promote quality improvement 
strategies and enhance patient outcomes and cost saving measures, by--
            ``(1) compiling and analyzing quality indicator data from 
        existing databases and other sources to evaluate relationships 
        between basic and advanced nursing education levels or 
        certification status on nursing sensitive indicators and 
        quality outcomes;
            ``(2) working in consultation with State departments of 
        health or other nonprofit patient safety organizations; or
            ``(3) demonstrating the cost savings and sustainability of 
        the demonstration projects.
    ``(e) Report.--Not later than 2 years after the date of enactment 
of the Nursing Education and Quality of Health Care Act of 2006, the 
Secretary shall submit a report to Congress on the results of the 
program under this section.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of the fiscal years 2007 through 2011.''.
                                 <all>