S. 1874 (Reported-in-Senate)

To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, 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 “Title VIII Nursing Workforce Reauthorization Act of 2026”.

SEC. 2. Advanced nursing education grants.

Section 811 of the Public Health Service Act (42 U.S.C. 296j) is amended—

(1) in subsection (a)(2), by striking “programs.” and inserting the following: “programs, including individuals enrolled in—

“(A) authorized nurse practitioner programs described in subsection (c);

“(B) authorized nurse-midwifery programs described in subsection (d);

“(C) authorized nurse anesthesia programs described in subsection (e); and

“(D) authorized clinical nurse specialist programs described in subsection (f).”;

(2) in subsection (d)—

(A) in paragraph (1), by striking “midwives” and inserting “nurse-midwives”; and

(B) in paragraph (2), by striking “American College of Nurse-Midwives”; and

(3) in subsection (h)(1)(A), by striking “fees” and inserting “fees, including costs for clinical education and preceptors,”.

SEC. 3. Strengthening capacity for nurse education and practice.

(a) In general.—Part D of title VIII of the Public Health Service Act (42 U.S.C. 296p et seq.) is amended—

(1) in the part heading, by striking “basic”; and

(2) in section 831 (42 U.S.C. 296p)—

(A) in subsection (a)—

(i) in paragraph (1), by striking “or” after the semicolon;

(ii) in paragraph (2), by striking “methodologies.” and inserting “methodologies, audiovisual or other equipment, simulation and augmented reality resources, telehealth technologies, and virtual and physical laboratories; or”; and

(iii) by adding at the end the following:

“(3) increasing the number of faculty and students at schools of nursing in order to address nursing workforce shortages.”; and

(B) in subsection (b)—

(i) in paragraph (2), by striking “and survivors of domestic violence” and inserting “survivors of domestic violence, and survivors of sexual assault”;

(ii) in paragraph (3), by striking “or” after the semicolon;

(iii) in paragraph (4), by striking the period and inserting “; or”; and

(iv) by adding at the end the following:

“(5) partnering with a health care facility, nurse-managed health clinic, community health center, or other facility that provides health care in order to provide education opportunities for the purpose of establishing or expanding clinical education.”.

(b) Conforming amendment.—Section 806(f)(2)(C) of the Public Health Service Act (42 U.S.C. 296e(f)(2)(C)) is amended by striking “basic”.

SEC. 4. Nurse faculty demonstration program.

Section 846A of the Public Health Service Act (42 U.S.C. 297n–1) is amended—

(1) by amending subsection (a) to read as follows:

“(a) In general.—To increase the number of qualified nursing faculty, the Secretary may—

“(1) enter into an agreement with any accredited school of nursing for the establishment and operation of a student loan fund in accordance with subsection (b); and

“(2) award nurse faculty grants in accordance with subsection (c).”;

(2) in subsection (b)—

(A) by redesignating subparagraphs (A) through (D) of paragraph (2) as clauses (i) through (iv), respectively, and adjusting the margins accordingly;

(B) by redesignating paragraphs (1) through (5) as subparagraphs (A) through (E), respectively, and adjusting the margins accordingly;

(C) in subparagraph (C), as so redesignated, by striking “subsection (c)” and inserting “paragraph (2)”; and

(D) by striking “(b) Agreements—Each agreement entered into under subsection (a) shall—” and inserting the following:

“(b) School of nursing student loan fund.—

“(1) IN GENERAL.—Each agreement entered into under subsection (a)(1) shall—”;

(3) in subsection (c)—

(A) by striking “subsection (a)” each place it appears and inserting “subsection (a)(1)”;

(B) in paragraph (3), by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and adjusting the margins accordingly;

(C) in paragraph (6), by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and adjusting the margins accordingly;

(D) by redesignating paragraphs (1) through (6) as subparagraphs (A) through (F), respectively, and adjusting the margins accordingly; and

(E) in subparagraph (F)(ii), as so redesignated, by striking “subsection (e)” and inserting “paragraph (4)”;

(4) in subsection (e), by striking “subsection (c)(6)(B)” and inserting “paragraph (2)(F)(ii)”;

(5) by redesignating subsections (c) through (e) as paragraphs (2) through (4), respectively, and adjusting the margins accordingly; and

(6) by adding at the end the following:

“(c) Nurse faculty demonstration program.—

“(1) IN GENERAL.—The Secretary shall establish and carry out a demonstration program described in subsection (a)(2) under which eligible schools of nursing receive a grant for purposes of supplementing the salaries of eligible nursing faculty members to enhance recruitment and retention of nursing faculty members.

“(2) ELIGIBLE ENTITIES.—To be eligible to receive a grant under this subsection, an entity shall—

“(A) be an accredited school of nursing; and

“(B) submit an application to the Secretary, at such time, in such manner, and containing such information as the Secretary may require, including—

“(i) (I) to the extent such information is available to the school of nursing, the salary history of nursing faculty at such school who previously were nurses in clinical practice, for the most recent 3-year period ending on the date of application, adjusted for inflation as appropriate and broken down by credentials, experience, and levels of education of such nurses; or

“(II) if the information described in subclause (I) is not available, information on the average local salary of nurses in clinical practice, adjusted for inflation as appropriate and broken down by credentials, experience, and levels of education of the individual nurses, in accordance with such requirements as the Secretary may specify;

“(ii) an attestation of the average nursing faculty salary at the school of nursing during the most recent 3-year period prior to the date of application, adjusted for inflation, as appropriate, broken down by credentials, experience, and levels of education of such faculty members;

“(iii) the number of nursing faculty member vacancies at the entity at the time of application, and the entity’s projection of such vacancies over the ensuing 5-year period; and

“(iv) a description of the entity's plans to identify funding sources to sustainably continue, after the 3-year grant period, the salary available to the eligible nursing faculty member pursuant to the program under this subsection during such grant program and to retain eligible nursing faculty members after the end of the grant period.

“(3) AWARDS.—A grant awarded under this subsection, with respect to supporting eligible nursing faculty members, shall—

“(A) be awarded to the school of nursing to supplement the salaries of eligible faculty members at the school of nursing, annually, for up to a 3-year period, in an amount equal to, for each eligible nursing faculty member at the eligible entity during the grant period, the difference between—

“(i) the average salary of nurses in clinical practice, as submitted under subclause (I) or (II) of paragraph (2)(B)(i); and

“(ii) the greater of—

“(I) the salary for the eligible nursing faculty member at the school of nursing; or

“(II) the average nursing faculty salary, as submitted under paragraph (2)(B)(ii) for faculty members with the same or similar credentials and level of education;

“(B) notwithstanding section 803(a), be used in its entirety to supplement the eligible faculty member's salary; and

“(C) be conditioned upon the school of nursing maintaining, for each year in which the award is made as described in subparagraph (A), a salary for such faculty member at a level that is not less than the greater of the amount under subclause (I) or (II) of subparagraph (A)(ii).

“(4) PRIORITY.—In awarding grants under this subsection, the Secretary shall—

“(A) ensure the equitable geographic distribution of awards;

“(B) give priority to applications from schools of nursing that demonstrate—

“(i) the greatest need for such grant, which may be based upon the financial circumstances of the school of nursing, the number of eligible nurse faculty members, the planned number of students to be trained or admitted off a wait list; or

“(ii) training or partnerships to serve vulnerable patient populations, such as through the location or activity of a school in a health professional shortage area (as defined in section 332); and

“(C) ensure that not less than 20 percent of the total amount awarded is awarded to eligible entities located in States with populations under 1,500,000.

“(5) RULE OF CONSTRUCTION.—Nothing in this subsection precludes a school of nursing or an eligible nursing faculty member receiving an award under this section from obtaining or receiving any other form of Federal support or funding.

“(6) REPORT.—Not later than 3 years after the date of enactment of this subsection, the Secretary shall submit to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives, a report that evaluates the program established under this subsection, including—

“(A) the impact of such program on recruitment and retention rates of nursing faculty, as available, and specifically for each faculty member participating in the program; and

“(B) recommendations and considerations for Congress on continuing the program under this subsection.

“(7) DEFINITIONS.—In this subsection:

“(A) ELIGIBLE NURSING FACULTY MEMBER.—The term ‘eligible nursing faculty member’ means a nursing faculty member who—

“(i) was hired by a school of nursing within the 2-year period preceding the submission of an application under paragraph (2), or a prospective nursing faculty member;

“(ii) is currently employed at the school of nursing and who demonstrates the need for such support;

“(iii) previously worked as a nurse in clinical practice or as a nurse faculty member at another school of nursing; or

“(iv) may work on a part-time basis as a nursing faculty member, for whom such award amounts described in paragraph (3) shall be prorated relative to the amount of time participating in part-time teaching.

“(B) INFLATION.—The term ‘inflation’ means the Consumer Price Index for all urban consumers (all items; U.S. city average).

“(8) AUTHORIZATION OF APPROPRIATIONS.—To carry out this subsection, there is authorized to be appropriated $15,000,000 for the period of fiscal years 2027 through 2031.

“(9) SUNSET.—The authority of the Secretary to award grants under this section shall terminate on September 30, 2031. Any grant awarded before such date shall continue in accordance with the terms of the grant, but no grant may be awarded under this subsection after such date.”.

SEC. 5. State and regional nursing workforce center data collection pilot program.

(a) In general.—Title VIII of the Public Health Service Act (42 U.S.C. 296 et seq.) is amended by striking “Part G—Public Service Announcements” and inserting the following:

“PART G—Nursing workforce centers

“SEC. 861. State and regional nursing workforce center data collection pilot program.

“(a) In general.—The Secretary may carry out a 3-year pilot program under which the Secretary awards grants, or enters into contracts with, eligible entities to establish new or enhance existing State- and regional based nursing workforce centers, evaluate the impact of State-and regional based nursing workforce centers on outcomes, and assess the feasibility of nursing workforce public-private partnerships. The Secretary shall begin implementation of such pilot program not later than 1 year after the date of enactment of the Title VIII Nursing Workforce Reauthorization Act of 2026.

“(b) Award terms.—

“(1) TERM.—The term of a grant or contract awarded under the pilot program under subsection (a) shall be 3 years.

“(2) MATCHING REQUIREMENT.—As a condition on receipt of a grant or contract under the pilot program under subsection (a), the Secretary shall require the applicant to agree, with respect to costs to be incurred by the applicant in carrying out the activities funded through the grant or contract, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is equal to not less than $1 for each $4 of Federal funds provided through the grant or contract. Such contributions may be made directly or through donations from public or private entities.

“(c) Eligibility.—To be eligible to receive a grant or contract under this section, an entity shall be—

“(1) a State agency;

“(2) a State board of nursing;

“(3) a nonprofit; or

“(4) a school of nursing.

“(d) Equitable distribution.—In awarding grants or contracts under this section, the Secretary shall ensure, to the greatest extent possible, that such grants and contracts are equitably distributed among the geographical regions of the United States.

“(e) Priority.—In selecting the eligible entity to be awarded a grant or contract under this section for a nursing workforce center in a particular State, the Secretary shall give priority to eligible entities that—

“(1) propose to provide statewide services;

“(2) have expertise in the State’s nursing workforce issues;

“(3) have a history of convening entities to address nursing workforce issues; and

“(4) have partnerships with entities that traditionally educate or employ the State’s nurses.

“(f) Use of funds.—A recipient of a grant or contract under this section may use such award for purposes of—

“(1) collecting, analyzing, and reporting data regarding nursing workforce training programs under this Act to the National Center for Health Workforce Analysis and to the public; and

“(2) providing technical assistance to local and regional entities on the collection, analysis, and reporting of data and making recommendations to improve nursing workforce capacity.

“(g) Reports.—Not later than 2 years after the date on which the first grant or contract is awarded under the pilot program under subsection (a), and annually thereafter, the Secretary shall submit to Congress a report on the grants and contracts awarded under such pilot program during the year covered by the report. Each such report shall include—

“(1) a description of initiatives to study the unique characteristics of State nursing workforces, and efforts to increase the number of new nurses, recruit nurses to the nursing profession, and retain nurses in the workplace;

“(2) impact data on nurses served by nursing workforce centers, including demographic information of the individuals served, the number of such individuals, and the types of services provided;

“(3) the effectiveness of establishing formal public-private relationships for purposes of understanding the national nursing workforce through improved data collection and standardization;

“(4) data on continuous evaluation and quality improvement, and other relevant data as determined by the Secretary; and

“(5) the Secretary’s recommendations and best practices for—

“(A) reducing shortages among different nursing specialties;

“(B) reducing shortages in rural and underserved areas;

“(C) improving geographical distribution of the nursing workforce; and

“(D) reducing shortages among different types of nursing employers.

“(h) Data collection.—The recipient of a grant or contract under this section shall provide the Secretary with such information (including data and assurances), at such time, and in such manner as the Secretary may require in order to prepare the report under subsection (g).

“(i) Funding.—

“(1) IN GENERAL.—From the amounts appropriated to carry out this title, the Secretary may use up to $1,500,000 for each of fiscal years 2027 through 2029 for purposes of carrying out this section.

“(2) LIMITATION.—Paragraph (1) shall not apply for a fiscal year unless the amount made available to carry out parts B, C, and D for such fiscal year exceeds the amount appropriated to carry out such parts for fiscal year 2026.”.

(b) Authorization of appropriations.—Section 871(a) of the Public Health Service Act (42 U.S.C. 298d(a)) is amended by striking “and D” and inserting “D, and G”.

SEC. 6. Authorization of appropriations.

Section 871 of the Public Health Service Act (42 U.S.C. 298d), as amended by section 5(b), is further amended—

(1) in subsection (a), by striking “$137,837,000 for each of fiscal years 2021 through 2025” and inserting “$184,337,000 for each of fiscal years 2027 through 2031”; and

(2) in subsection (b), by striking “$117,135,000 for each of the fiscal years 2021 through 2025” and inserting “$121,135,000 for each of fiscal years 2027 through 2031”.