[Congressional Record Volume 147, Number 7 (Monday, January 22, 2001)]
[Senate]
[Pages S321-S322]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. INOUYE:
  S. 53. A bill to amend title XIX of the Social Security Act to 
provide for coverage of services provided by nursing school clinics 
under State Medicaid programs; to the Committee on Finance.


                   Nursing School Clinics Act of 2001

  Mr. INOUYE. Mr. President, I rise today to introduce the Nursing 
School Clinics Act of 2001. This measure builds on our concerted 
efforts to provide access to quality health care for all Americans by 
offering grants and incentives for nursing schools to establish primary 
care clinics in underserved areas where additional medical services are 
most needed. In addition, this measure provides the opportunity for 
nursing schools to enhance the scope of student training and education 
by providing firsthand clinical experience in primary care facilities.
  Primary care clinics administered by nursing schools are university 
or nonprofit entity primary care centers developed mainly in 
collaboration with university schools of nursing and the communities 
they serve. These centers are staffed by faculty and staff who are 
nurse practitioners and public health nurses. Students supplement 
patient care while receiving preceptorships provided by college of 
nursing faculty and primary care physicians, often associated with 
academic institutions, who serve as collaborators with nurse 
practitioners. To date, the comprehensive models of care provided by 
nursing clinics have yielded excellent results, including significantly 
fewer emergency room visits, fewer hospital inpatient days, and less 
use of specialists, as compared to conventional primary health care.
  This bill reinforces the principle of combining health care delivery 
in underserved areas with education of advanced practice nurses. To 
accomplish these objectives, Title XIX of the Social Security Act would 
be amended to designate that the services provided in these nursing 
school clinics are reimbursable under Medicaid. The combination of 
grants and the provision of Medicaid reimbursement furnishes the 
incentives and operational resources to establish the clinics.
  In order to meet the increasing challenges of bringing cost-effective 
and quality health care to all Americans, we must consider and debate 
various proposals, both large and small. Most importantly, we must 
approach the issue of health care with creativity and determination, 
ensuring that all reasonable avenues are pursued. Nurses have always 
been an integral part of health care delivery. The Nursing School 
Clinics Act of 2001 recognizes the central role they can perform as 
care givers to the medically underserved.
  Mr. President, I ask unanimous consent that the text of this bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record as follows:

                                 S. 53

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. MEDICAID COVERAGE OF SERVICES PROVIDED BY NURSING 
                   SCHOOL CLINICS.

       (a) In General.--Section 1905(a) of the Social Security Act 
     (42 U.S.C. 1396d(a)) is amended--
       (1) in paragraph (26), by striking ``and'' at the end;
       (2) by redesignating paragraph (27) as paragraph (28); and
       (3) by inserting after paragraph (26), the following new 
     paragraph:
       ``(27) nursing school clinic services (as defined in 
     subsection (x)) furnished by or under the supervision of a 
     nurse practitioner or a clinical nurse specialist (as defined 
     in section 1861(aa)(5)), whether or not the nurse 
     practitioner or clinical nurse specialist is under the 
     supervision of, or associated with, a physician or other 
     health care provider; and''.
       (b) Nursing School Clinic Services Defined.--Section 1905 
     of the Social Security Act (42 U.S.C. 1396d) is amended by 
     adding at the end the following new subsection:
       ``(x) The term `nursing school clinic services' means 
     services provided by a health care facility operated by an 
     accredited school of nursing which provides primary care, 
     long-term care, mental health counseling, home health 
     counseling, home health care, or other health care services 
     which are within the scope of practice of a registered 
     nurse.''.
       (c) Conforming Amendment.--Section 1902(a)(10)(C)(iv) of 
     the Social Security Act

[[Page S322]]

     (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by inserting ``and 
     (27)'' after ``(24)''.
       (d) Effective Date.--The amendments made by this section 
     shall be effective with respect to payments made under a 
     State plan under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) for calendar quarters commencing with 
     the first calendar quarter beginning after the date of 
     enactment of this Act.
                                 ______