I 111th CONGRESS 1st Session H. R. 1928 IN THE HOUSE OF REPRESENTATIVES April 2, 2009 Mr. Kagen (for himself, Mr. Terry, Mr. Boswell, Mrs. Bono Mack, Ms. Bordallo, and Mr. Yarmuth) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To increase home healthcare services, particularly for underserved and at-risk populations, by assisting visiting nurse associations and other non-profit home health agencies to improve training and workforce development for home healthcare nurses, promoting and facilitating academic-practice collaborations, and enhancing recruitment and retention of home healthcare nurses.

1.

Short title

This Act may be cited as the Home Healthcare Nurse Promotion Act of 2009.

2.

Findings and purpose

(a)

Findings

Congress makes the following findings: (1)There is a significant shortage of home healthcare nurses, which is harming individuals’ access to cost-effective home healthcare, particularly among underserved and high-risk populations. A recent survey found that 59 percent of visiting nurse associations indicated they must decline patient referrals on a weekly basis. (2)The increasing aging population, prevalence of chronic disease, and strong preference by individuals to live independently at home as long as possible will create an unprecedented demand for home-based care during the next several decades. By 2020, home health utilization is projected to increase by 36 percent. (3)The demand for home healthcare nurses is projected to increase by 109 percent by 2020, compared to 37 percent for hospital nurses. (4)An estimated 1,000,000 new registered nurses will be needed by 2016 to fill new demand for nurses and replace retirees. (5)Visiting nurse associations have been shown to lower costs for high-cost patient populations. Yet because they provide a substantial amount of uncompensated care, they are increasingly unable to compete for nurses in a national nursing shortage environment. (6)A recent survey by the Visiting Nurses Association of America found that— (A)staff nursing rate shortages average around 10 percent; (B)81 percent of visiting nurse associations indicate that salary limitations are the number one barrier to recruitment; and (C)22 percent of visiting nurse associations indicate that their local hospital offers salaries $10,000 greater than they are able to offer. (b)

Purpose

The purpose of this Act is to increase home health care services, particularly for underserved and at-risk populations, by— (1)assisting visiting nurse associations and other non-profit home health agencies to improve training and workforce development for home healthcare nurses; (2)promoting and facilitating academic-practice collaborations; and (3)improving recruitment and retention of home healthcare nurses.

3.

Defining visiting nurse association

Section 801 of the Public Health Service Act (42 U.S.C. 296) is amended by adding at the end the following new paragraph: (16)

Visiting nurse association

The term visiting nurse association means a home health agency that— (A)has a participation agreement in effect under section 1866 of the Social Security Act; (B)is a nonprofit entity exempt from taxation under section 501(c)(3) of the Internal Revenue Code of 1986; (C)is organized and participating under title XVIII of the Social Security Act as a provider of services separately from any other provider of services under such title; and (D)is governed by a board of directors and all members of the board (excluding the head of the agency in any case in which the head of the agency is a board member) serve on such board on an exclusively volunteer basis. .

4.

Home health training and loan forgiveness programs

(a)

Home health nurse training programs

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 new sections:

832.

Home health nurse training program grants

(a)

In general

The Secretary may make grants under this section to visiting nurse associations for the purpose of providing training in home health care to nurses who— (1)are hired by a visiting nurse association to provide home health care; and (2)have no recent nursing work experience in home health care. (b)

Priority for grants

When awarding grants under subsection (a), the Secretary shall give priority to visiting nurse associations that provide medically-necessary home health care to individuals who request home health services (as defined in section 1861(m) of the Social Security Act) from such associations, regardless of ability to pay.

833.

Pilot program for home health training at schools of nursing

(a)

In general

Not later than the last day of the 90-day period beginning on the date of enactment of this section, the Secretary shall establish a pilot program to make grants to a number (to be determined by the Secretary, but to be not less than five and not more than 10) of accredited schools of nursing that have entered into partnerships with visiting nurse associations for the purpose of developing and implementing a curriculum on home health care at such schools. (b)

Application

In order to qualify for a grant under subsection (a), a school of nursing must submit an application to the Secretary— (1)demonstrating that the school has established a partnership with a visiting nurse association as required in subsection (a); and (2)containing— (A)a description of how the school and the association will work collaboratively to develop and implement a curriculum on home health care for the students at the school; (B)a description of how academic-practice collaboration will occur, such as— (i)utilizing visiting nurse faculty from the visiting nurse association; and (ii)promoting student nurse internships, mentoring opportunities, or other collaborative activities to aid in the education and practical home healthcare experience of nursing students; and (C)any other information required by the Secretary. (c)

Termination date

The pilot program under subsection (a) shall terminate at the end of the 5-year period beginning on the date of enactment of this section. (d)

Report

Not later than the last day of the first calendar year following the date of enactment of this section and the end of each succeeding calendar year, the Secretary shall submit to Congress a report on the pilot program under subsection (a).

834.

Authorization of appropriations

There is authorized to be appropriated to carry out this part (other than section 831) such sums as may be necessary in each fiscal year.

. (b)

Loan forgiveness for certain nurses

(1)

Amendments regarding service for visiting nurse associations

Section 846 of such Act (42 U.S.C. 297n) is amended— (A)in subsection (a)(3), by inserting or for a visiting nurse association after critical shortage of nurses; (B)in subsection (g)(2)— (i)by striking or health facility and inserting , health facility, or visiting nurse association; (ii)by striking or the health facility and inserting , the health facility, or the visiting nurse association; and (iii)by striking or facility each place it appears and inserting , facility, or association; and (C)in subsection (h)(5) by inserting and visiting nurse associations before the semicolon at the end. (2)

Technical amendments

Section 846 of such Act (42 U.S.C. 297n) is further amended— (A)by striking subsection (f); and (B)by redesignating subsections (g) through (i) as subsections (f) through (h), respectively.