[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2731 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2731

 To fund comprehensive programs to ensure an adequate supply of nurses.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 4, 2009

  Mrs. McCarthy of New York introduced the following bill; which was 
 referred to the Committee on Energy and Commerce, and in addition to 
 the Committee on Education and Labor, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To fund comprehensive programs to ensure an adequate supply of nurses.

    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 Training and Retention Act of 
2009''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) America's healthcare system depends on an adequate 
        supply of trained nurses to deliver quality patient care.
            (2) Over the next 15 years, this shortage is expected to 
        grow significantly. The Health Resources and Services 
        Administration has projected that by 2020, there will be a 
        shortage of nurses in every State and that overall only 64 
        percent of the demand for nurses will be satisfied, with a 
        shortage of 1,016,900 nurses nationally.
            (3) To avert such a shortage, today's network of healthcare 
        workers should have access to education and support from their 
        employers to participate in educational and training 
        opportunities.
            (4) With the appropriate education and support, incumbent 
        healthcare workers and incumbent bedside nurses are untapped 
        sources which can meet these needs and address the nursing 
        shortage and provide quality care as the American population 
        ages.

SEC. 3. ESTABLISHMENT OF GRANT PROGRAM.

    (a) Purposes.--It is the purpose of this section to authorize 
grants to--
            (1) address the projected shortage of nurses by funding 
        comprehensive programs to create a career ladder to nursing 
        (including Certified Nurse Assistants, Licensed Practical 
        Nurses, Licensed Vocational Nurses, and Registered Nurses) for 
        incumbent ancillary healthcare workers;
            (2) increase the capacity for educating nurses by 
        increasing both nurse faculty and clinical opportunities 
        through collaborative programs between staff nurse 
        organizations, healthcare providers, and accredited schools of 
        nursing; and
            (3) provide training programs through education and 
        training organizations jointly administered by healthcare 
        providers and healthcare labor organizations or other 
        organizations representing staff nurses and frontline 
        healthcare workers, working in collaboration with accredited 
        schools of nursing and academic institutions.
    (b) Grants.--Not later than 6 months after the date of enactment of 
this Act, the Secretary of Labor (referred to in this section as the 
``Secretary'') shall establish a partnership grant program to award 
grants to eligible entities to carry out comprehensive programs to 
provide education to nurses and create a pipeline to nursing for 
incumbent ancillary healthcare workers who wish to advance their 
careers, and to otherwise carry out the purposes of this section.
    (c) Eligible Entities.--To be eligible to receive a grant under 
this section an entity shall--
            (1) be--
                    (A) a healthcare entity that is jointly 
                administered by a healthcare employer and a labor union 
                representing the healthcare employees of the employer 
                and that carries out activities using labor management 
                training funds as provided for under section 302 of the 
                Labor-Management Relations Act, 1947 (18 U.S.C. 
                186(c)(6));
                    (B) an entity that operates a training program that 
                is jointly administered by--
                            (i) one or more healthcare providers or 
                        facilities, or a trade association of 
                        healthcare providers; and
                            (ii) one or more organizations which 
                        represent the interests of direct care 
                        healthcare workers or staff nurses and in which 
                        the direct care healthcare workers or staff 
                        nurses have direct input as to the leadership 
                        of the organization; or
                    (C) a State training partnership program that 
                consists of non-profit organizations that include equal 
                participation from industry, including public or 
                private employers, and labor organizations including 
                joint labor-management training programs, and which may 
                include representatives from local governments, worker 
                investment agency one-stop career centers, community 
                based organizations, community colleges, and accredited 
                schools of nursing; and
            (2) submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require.
    (d) Additional Requirements for Healthcare Employer Described in 
Subsection (c).--To be eligible for a grant under this section, a 
healthcare employer described in subsection (c) shall demonstrate--
            (1) an established program within their facility to 
        encourage the retention of existing nurses;
            (2) it provides wages and benefits to its nurses that are 
        competitive for its market or that have been collectively 
        bargained with a labor organization; and
            (3) support for programs funded under this section through 
        1 or more of the following:
                    (A) The provision of paid leave time and continued 
                health coverage to incumbent healthcare workers to 
                allow their participation in nursing career ladder 
                programs, including Certified Nurse Assistants, 
                Licensed Practical Nurses, Licensed Vocational Nurses, 
                and Registered Nurses.
                    (B) Contributions to a joint labor-management 
                training fund which administers the program involved.
                    (C) The provision of paid release time, incentive 
                compensation, or continued health coverage to staff 
                nurses who desire to work full- or part-time in a 
                faculty position.
                    (D) The provision of paid release time for staff 
                nurses to enable them to obtain a Bachelor of Science 
                in Nursing degree, other advanced nursing degrees, 
                specialty training, or certification program.
                    (E) The payment of tuition assistance which is 
                managed by a joint labor-management training fund or 
                other jointly administered program.
    (e) Other Requirements.--
            (1) Matching requirement.--
                    (A) In general.--The Secretary may not make a grant 
                under this section unless the applicant involved 
                agrees, with respect to the costs to be incurred by the 
                applicant in carrying out the program under the grant, 
                to make available non-Federal contributions (in cash or 
                in kind under subparagraph (B)) toward such costs in an 
                amount equal to not less than $1 for each $1 of Federal 
                funds provided in the grant. Such contributions may be 
                made directly or through donations from public or 
                private entities, or may be provided through the cash 
                equivalent of paid release time provided to incumbent 
                worker students.
                    (B) Determination of amount of non-federal 
                contribution.--Non-Federal contributions required in 
                subparagraph (A) may be in cash or in kind (including 
                paid release time), fairly evaluated, including 
                equipment or services (and excluding indirect or 
                overhead costs). Amounts provided by the Federal 
                Government, or services assisted or subsidized to any 
                significant extent by the Federal Government, may not 
                be included in determining the amount of such non-
                Federal contributions.
            (2) Required collaboration.--Entities carrying out or 
        overseeing programs carried out with assistance provided under 
        this section shall demonstrate collaboration with accredited 
        schools of nursing which may include community colleges and 
        other academic institutions providing Associate, Bachelor's, or 
        advanced nursing degree programs or specialty training or 
        certification programs.
    (f) Activities.--Amounts awarded to an entity under a grant under 
this section shall be used for the following:
            (1) To carry out programs that provide education and 
        training to establish nursing career ladders to educate 
        incumbent healthcare workers to become nurses (including 
        Certified Nurse Assistants, Licensed Practical Nurses, Licensed 
        Vocational Nurses, and Registered Nurses). Such programs shall 
        include one or more of the following:
                    (A) Preparing incumbent workers to return to the 
                classroom through English as a second language 
                education, GED education, pre-college counseling, 
                college preparation classes, and support with entry 
                level college classes that are a prerequisite to 
                nursing.
                    (B) Providing tuition assistance with preference 
                for dedicated cohort classes in community colleges, 
                universities, accredited schools of nursing with 
                supportive services including tutoring and counseling.
                    (C) Providing assistance in preparing for and 
                meeting all nursing licensure tests and requirements.
                    (D) Carrying out orientation and mentorship 
                programs that assist newly graduated nurses in 
                adjusting to working at the bedside to ensure their 
                retention post graduation, and ongoing programs to 
                support nurse retention.
                    (E) Providing stipends for release time and 
                continued healthcare coverage to enable incumbent 
                healthcare workers to participate in these programs.
            (2) To carry out programs that assist nurses in obtaining 
        advanced degrees and completing specialty training or 
        certification programs and to establish incentives for nurses 
        to assume nurse faculty positions on a part-time or full-time 
        basis. Such programs shall include one or more of the 
        following:
                    (A) Increasing the pool of nurses with advanced 
                degrees who are interested in teaching by funding 
                programs that enable incumbent nurses to return to 
                school.
                    (B) Establishing incentives for advanced degree 
                bedside nurses who wish to teach in nursing programs so 
                they can obtain a leave from their bedside position to 
                assume a full- or part-time position as adjunct or 
                full-time faculty without the loss of salary or 
                benefits.
                    (C) Collaboration with accredited schools of 
                nursing which may include community colleges and other 
                academic institutions providing Associate, Bachelor's, 
                or advanced nursing degree programs, or specialty 
                training or certification programs, for nurses to carry 
                out innovative nursing programs which meet the needs of 
                bedside nursing and healthcare providers.
    (g) Preference.--In awarding grants under this section the 
Secretary shall give preference to programs that--
            (1) provide for improving nurse retention;
            (2) provide for improving the diversity of the new nurse 
        graduates to reflect changes in the demographics of the patient 
        population;
            (3) provide for improving the quality of nursing education 
        to improve patient care and safety;
            (4) have demonstrated success in upgrading incumbent 
        healthcare workers to become nurses or which have established 
        effective programs or pilots to increase nurse faculty; or
            (5) are modeled after or affiliated with such programs 
        described in paragraph (4).
    (h) Evaluation.--
            (1) Program evaluations.--An entity that receives a grant 
        under this section shall annually evaluate, and submit to the 
        Secretary a report on, the activities carried out under the 
        grant and the outcomes of such activities. Such outcomes may 
        include--
                    (A) an increased number of incumbent workers 
                entering an accredited school of nursing and in the 
                pipeline for nursing programs;
                    (B) an increasing number of graduating nurses and 
                improved nurse graduation and licensure rates;
                    (C) improved nurse retention;
                    (D) an increase in the number of staff nurses at 
                the healthcare facility involved;
                    (E) an increase in the number of nurses with 
                advanced degrees in nursing;
                    (F) an increase in the number of nurse faculty;
                    (G) improved measures of patient quality (which may 
                include staffing ratios of nurses, patient satisfaction 
                rates, patient safety measures); and
                    (H) an increase in the diversity of new nurse 
                graduates relative to the patient population.
            (2) General report.--Not later than 2 years after the date 
        of enactment of this Act, and annually thereafter, the 
        Secretary of Labor shall, using data and information from the 
        reports received under paragraph (1), submit to Congress a 
        report concerning the overall effectiveness of the grant 
        program carried out under this section.
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, such sums as may be necessary.
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