[Congressional Record Volume 153, Number 163 (Thursday, October 25, 2007)]
[Senate]
[Pages S13440-S13443]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN:
  S. 2230. A bill to amend title VIII of the Public Health Service Act 
to expand the nurse student loan program, to establish grant programs 
to address the nursing shortage, to amend title VII of the Higher 
Education Act of 1965 to provide for a nurse faculty pilot project, and 
for other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. BIDEN. Mr. President, today I am honored to introduce the Nursing 
Education Opportunities Act. This bill seeks to help alleviate both the 
nursing shortage faced in hospitals and clinics throughout the country, 
as well as the faculty shortage in nursing schools that constrains the 
number of new nurses who can be trained to fill the vacancies in our 
health facilities.
  As most people who have heard me talk about health care know, nurses 
have a soft spot in my heart. In 1987, I was stricken with a brain 
aneurysm and spent months recovering at Walter Reed Hospital. The 
surgeons who operated on me were spectacular and I can never thank them 
enough. But the nurses who took care of me during my stay at Walter 
Reed were the embodiment of absolute comfort and unquestioning 
kindness. Along with the top notch medical care they provided me, the 
nurses at Walter Reed literally breathed life back into my lungs, 
washed me, brushed my teeth and went on search missions for the most 
comfortable pillows available. As I often say, if there are any angels 
in heaven, they must be nurses.
  Unfortunately, right now our country is facing a nursing shortage. 
The American Hospital Association reported in July 2007 that United 
States hospitals had an estimated 116,000 registered nurse vacancies as 
of December 2006. Despite the nurse shortage and efforts to increase 
the pool of qualified nurses, schools of nursing struggle to increase 
student capacity. According to the American Association of Colleges of 
Nursing, AACN, the U.S. nursing schools turned away nearly 43,000 
qualified applicants in 2006 primarily due to an insufficient number of 
faculty.
  AACN reported in July 2006, a total of 637 faculty vacancies at 329 
nursing schools with baccalaureate or graduate programs, or both, 
across the Nation. Besides the vacancies, schools cited the need to 
create an additional 55 faculty positions to accommodate student 
demand. Most of the vacancies, approximately 53.7 percent, were faculty 
positions requiring a doctoral degree.
  The average ages of doctorally prepared nurse faculty holding the 
ranks of professor, associate professor and assistant professor are 
58.6, 55.8, and 51.6 years, respectively. Considering the average age 
of nurse faculty at retirement is 62.5 years, a wave of nurse faculty 
retirements is expected in the next decade. In fact, in 2007 the 
Association of Academic Health Centers surveyed chief executive 
officers from academic health centers regarding faculty shortages 
across various health professions. The CEOs rated the nursing faculty 
shortage as the most severe of all health professions with 81 percent 
noting the nursing faculty shortage as a problem.
  To address this nurse faculty shortage and to get more nurses 
trained, this bill provides three mechanisms to increase the number of 
and access to nurse faculty.
  First, the bill establishes a grant program to help schools establish 
doctoral nursing programs. Right now, there are 8 States, including my 
home State of Delaware, which do not have a doctoral nursing program in 
their State. This bill allows eligible schools to receive a grant up to 
$2,000,000 to be used to establish a doctoral degree program. The funds 
can be used to hire administrators, faculty and staff; retain current 
faculty; develop doctoral curriculum; repair and expand 
infrastructures; purchase additional equipment; develop and enhance 
clinical laboratories; recruit students; establish technology 
infrastructures; and other investments deemed necessary.
  Second, this bill establishes a doctoral nursing consortia pilot 
project to provide grants to partnerships of schools to allow them to 
share doctoral faculty and programmatic resources. This would allow 
schools with a shortage of faculty at the doctoral level to partner 
with other schools to provide proper education for their students. 
These grants can be awarded up to $500,000 and can be used to establish 
technology infrastructures; develop shared doctoral curriculum; hire 
faculty and staff; retain current faculty; provide travel stipends for 
nursing faculty who agree to teach nursing courses at consortium 
schools; provide scholarships for post-doctoral fellows who agree to 
teach a nursing course within the nursing doctoral curriculum; provide 
collaborative networks for nursing research; and other investments 
determined necessary.
  Third, I am pleased to include a nurse faculty pilot project that was 
part of the Nurse Faculty Higher Education Act introduced in the House 
of Representatives by Representative Carolyn McCarthy. This pilot 
project would provide grants to partnerships between accredited schools 
of nursing and hospitals or health facilities to fund release time for 
qualified nurse employees so they can earn a salary while obtaining an 
advanced degree in nursing with the goal of becoming nurse faculty. In 
short, this will make it easier for nurses to pursue an advanced degree 
by allowing them to work part time and retain some of their salary. 
Many nurses currently cannot afford to leave their jobs to go back to 
school because they would lose their salaries.
  In addition to these three provisions, the bill also amends the 
Public Health Service Act to provide that, in the case of a nurse 
faculty shortage, the Secretary of Health and Human Services

[[Page S13441]]

may obligate more than 10 percent of traineeships through the Advanced 
Education Nursing Grants for individuals in doctoral degree nursing 
programs. This is important to help advance nursing education and allow 
greater funding opportunities for doctoral students.
  But while this bill focuses heavily on increasing the number of nurse 
faculty to allow nursing schools to train more nurses, it also seeks to 
help nursing students as well.
  First, the bill explicitly includes accelerated degree nursing 
students as eligible for financial assistance through nursing programs 
in the Public Health Service Act, including the Nursing Student Loan 
Program. To address the shortage of qualified nurses, schools of 
nursing have developed accelerated, second-baccalaureate degree 
programs in nursing. Students in accelerated degree programs are those 
with a baccalaureate degree in another field who have decided to return 
to school to get a degree in nursing. The students in these programs 
have difficulty securing federal funding as this program category is 
not easily defined. Accelerated nursing degree programs are not typical 
4-year baccalaureate degree programs, as they take between 1 and 2 
years to complete. However, they are becoming increasingly popular. In 
2005, these programs graduated 3,769 students. In 2006 they graduated 
5,236--an additional 1,467 nursing graduates in a single year. 
Hospitals and other health facilities like hiring graduates from 
accelerated nursing degree programs because they often have 
demonstrated a record of success and work-ethic that facilitates a more 
rapid and smooth transition in to the highly complex health care 
environment. Accelerated nursing degree students are a critical element 
to meeting this country's nursing needs.
  Additionally, it is time to raise the yearly loan amounts available 
to all nursing students through the Nursing Student Loan Program. This 
important program, which provides long-term, low interest-rate loans to 
full-time and half-time financially needy students pursuing a course of 
study leading to a diploma, associate, baccalaureate or graduate degree 
in nursing, has not adjusted the maximum yearly loan amounts available 
for over a decade. Currently, a student can receive a maximum yearly 
loan of $2,500 for their first 2 years in a nursing school and $4,000 
per year during their second 2 years. This bill would adjust these 
totals to $4,400 in the first 2 years and $7,000 in the second 2 years, 
respectively. It is time to raise the yearly loan amounts, as the cost 
of tuition at nursing schools has increased substantially over the past 
decade.
  It is imperative that we in Congress act to help alleviate the 
nursing shortage and the nurse faculty shortage in this country. Nurses 
comprise the largest segment of health care providers in this country 
and they are crucial in ensuring the quality of care that Americans 
receive. I believe the initiatives contained in the Nursing Education 
Opportunities Act can help reduce these shortages. The American Academy 
of Nursing, American Association of Colleges of Nursing, American 
Nephrology Nurses' Association, American Nurses Association, American 
Organization of Nurse Executives, Association of Women's Health, 
Obstetric and Neonatal Nurses and the National League for Nursing all 
support this legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2230

       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 
     Opportunities Act''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) The American Hospital Association reported in July 2007 
     that United States hospitals need approximately 116,000 
     registered nurses to fill vacant positions nationwide.
       (2) To address the shortage of qualified nurses, schools of 
     nursing have developed accelerated, second-baccalaureate 
     degree programs in nursing. In 2005, these programs graduated 
     3,769 students. The number of accelerated degree graduates in 
     2006 was 5,236. This is an additional 1,467 nursing graduates 
     in 1 year.
       (3) Despite the nurse shortage and efforts to increase the 
     pool of qualified nurses, schools of nursing struggle to 
     increase student capacity. According to the American 
     Association of Colleges of Nursing (referred to in this Act 
     as the ``AACN''), United States nursing schools turned away 
     nearly 43,000 qualified applicants in 2006 primarily due to 
     an insufficient number of faculty.
       (4) The AACN reported in July 2006, a total of 637 faculty 
     vacancies at 329 nursing schools with baccalaureate or 
     graduate programs, or both, across the Nation. Besides the 
     vacancies, schools cited the need to create an additional 55 
     faculty positions to accommodate student demand. Most of the 
     vacancies (53.7 percent) were faculty positions requiring a 
     doctoral degree.
       (5) In 2007, the Association of Academic Health Centers 
     surveyed chief executive officers (CEOs) from academic health 
     centers regarding faculty shortages across various health 
     professions. The CEOs rated the nursing faculty shortage as 
     the most severe of all health professions with 81 percent 
     noting the nursing faculty shortage as a problem.
       (6) The average ages of doctorally-prepared nurse faculty 
     holding the ranks of professor, associate professor, and 
     assistant professor are 58.6, 55.8, and 51.6 years, 
     respectively. Considering the average age of nurse faculty at 
     retirement is 62.5 years, a wave of nurse faculty retirements 
     is expected in the next decade.
       (7) Master's and doctoral programs in nursing are not 
     producing a large enough pool of potential nurse educators to 
     meet the demand. In 2006, the AACN found that graduations 
     from doctoral nursing programs were up by only 1.4 percent 
     from the previous academic year.
       (8) Nurses are vital to the Nation's health care delivery 
     system. Due to the nurse shortage, patient safety and quality 
     of care are at risk. Given the findings described in 
     paragraphs (1) through (7), measures must be taken to address 
     the nurse shortage and nursing faculty shortage.

     SEC. 3. NURSING STUDENT LOAN PROGRAM.

       Title VIII of the Public Health Service Act (42 U.S.C. 296 
     et seq.) is amended--
       (1) in section 835(b)(4), by inserting ``(including a 
     student in an accelerated nursing degree program who is 
     pursuing a second baccalaureate degree or a master's degree 
     as an entry level nursing degree)'' after ``graduate degree 
     in nursing''; and
       (2) in section 836--
       (A) in subsection (a)--
       (i) by striking ``$2,500'' and inserting ``$4,400'';
       (ii) by striking ``$4,000'' and inserting ``$7,000''; and
       (iii) by striking ``$13,000'' and inserting ``$22,900''; 
     and
       (B) in subsection (b)--
       (i) in paragraph (1), by inserting ``(including a student 
     in an accelerated nursing degree program who is pursuing a 
     second baccalaureate degree or a master's degree as an entry 
     level nursing degree)'' after ``graduate degree in nursing''; 
     and
       (ii) in paragraph (2), by inserting ``(including a student 
     in an accelerated nursing degree program who is pursuing a 
     second baccalaureate degree)'' after ``equivalent degree''.

     SEC. 4. ACCELERATED NURSING DEGREE PROGRAMS.

       Section 801(3) of the Public Health Service Act (42 U.S.C. 
     296(3)) is amended by inserting ``(including an accelerated 
     nursing degree program)'' before ``and including''.

     SEC. 5. ADVANCED EDUCATION NURSING GRANTS.

       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 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. 6. GRANT PROGRAM FOR DOCTORAL NURSING PROGRAMS.

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

     ``SEC. 832. GRANT PROGRAM FOR DOCTORAL NURSING PROGRAMS.

       ``(a) In General.--The Secretary shall award grants to 
     eligible entities to enable the eligible entities to 
     establish doctoral nursing degree programs.
       ``(b) Eligible Entity.--In this section, the term `eligible 
     entity' means an entity that is 1 of the `eligible entities' 
     as such term is defined in section 801.
       ``(c) Application.--An eligible entity that desires a grant 
     under this section shall submit an application to the 
     Secretary at such time, in such manner, and accompanied by 
     such information as the Secretary may require.
       ``(d) Selection of Grant Recipients.--Not later than 6 
     months after the date of enactment of the Nursing Education 
     Opportunities Act, the Secretary shall establish requirements 
     and procedures for the administration of grants under this 
     section and procedures for selecting grant recipients. In 
     awarding grants under this section, the Secretary shall 
     consider the following:
       ``(1) Doctoral nursing program distribution.--Providing 
     priority to eligible entities located in States in which 
     there are no doctoral nursing degree programs.
       ``(2) Geographic distribution.--Providing an equitable 
     geographic distribution of such grants.

[[Page S13442]]

       ``(3) Rural and urban areas.--Distributing such grants to 
     rural and urban areas.
       ``(4) Prior experience or exceptional programs.--Whether 
     the eligible entity has demonstrated--
       ``(A) prior experience in, or exceptional programs for, the 
     preparation of baccalaureate prepared nurses or master's 
     prepared nurses; and
       ``(B) an interest in establishing a doctoral nursing degree 
     program.
       ``(e) Grant Amount.--Each grant awarded under this section 
     shall be equal to not more than $2,000,000.
       ``(f) Grant Duration.--A grant awarded under this section 
     shall be for a period of not more than 5 years.
       ``(g) Use of Funds.--An eligible entity that receives a 
     grant under this section shall use the grant funds to 
     establish a doctoral nursing degree program, including--
       ``(1) hiring administrators, faculty, and staff;
       ``(2) retaining current faculty;
       ``(3) developing doctoral curriculum;
       ``(4) repairing and expanding infrastructures;
       ``(5) purchasing educational equipment;
       ``(6) developing and enhancing clinical laboratories;
       ``(7) recruiting students;
       ``(8) establishing technology infrastructures; and
       ``(9) other investments determined necessary by the 
     eligible entity for the development of a doctoral nursing 
     degree program.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section not 
     more than $40,000,000 for fiscal year 2008 and such sums as 
     may be necessary for each of the 4 succeeding fiscal 
     years.''.

     SEC. 7. DOCTORAL NURSING CONSORTIA PILOT PROJECT.

       Part D of title VIII of the Public Health Service Act (42 
     U.S.C. 296p et seq.), as amended by section 6, is further 
     amended by adding at the end the following:

     ``SEC. 833. DOCTORAL NURSING CONSORTIA PILOT PROJECT.

       ``(a) Purpose.--The purpose of the pilot project under this 
     section is to provide grants to partnerships of eligible 
     entities to establish consortia to enhance and expand the 
     availability of doctoral nurse faculty and education by 
     enabling the partners involved to share doctoral faculty and 
     programmatic resources so that the nursing faculty shortage 
     does not further inhibit the preparation of future nurses or 
     nurse faculty.
       ``(b) In General.--The Secretary shall award grants to 
     partnerships of eligible entities to enable the partnerships 
     to establish doctoral nursing consortia.
       ``(c) Definitions.--In this section:
       ``(1) Doctoral nursing consortium.--The term `doctoral 
     nursing consortium' means a partnership that includes 2 or 
     more of--
       ``(A) eligible entities within the same State;
       ``(B) eligible entities within different States; or
       ``(C) eligible entities establishing a doctoral nursing 
     program.
       ``(2) Eligible entity.--The term `eligible entity' has the 
     meaning given the term in section 832(b).
       ``(d) Application.--A partnership of eligible entities that 
     desires a grant under this section shall submit an 
     application to the Secretary at such time, in such manner, 
     and accompanied by such information as the Secretary may 
     require. Such partnership may apply for a grant under this 
     section each year of the pilot project.
       ``(e) Selection.--Not later than 6 months after the date of 
     enactment of the Nursing Education Opportunities Act, the 
     Secretary shall establish requirements and procedures for the 
     administration of grants under this section and procedures 
     for selecting grant recipients.
       ``(f) Consideration in Making Awards.--In awarding grants 
     under this section, the Secretary shall consider the 
     following:
       ``(1) Prior experience or exceptional programs.--Eligible 
     entities that have demonstrated prior experience in, or 
     exceptional programs for, the preparation of--
       ``(A) doctorally prepared nursing faculty and nursing 
     researchers; and
       ``(B) baccalaureate prepared nurses or master's prepared 
     nurses.
       ``(2) Geographic distribution.--Providing an equitable 
     geographic distribution of such grants.
       ``(3) Rural and urban areas.--Distributing such grants to 
     rural and urban areas.
       ``(4) New grantees.--Awarding grants to eligible entities 
     that have not previously received a grant under this section.
       ``(g) Grant Amount.--The Secretary shall determine the 
     amount of each grant awarded under this section based on the 
     purpose of this section, which amount shall not be more than 
     $500,000.
       ``(h) Use of Funds.--A partnership of eligible entities 
     that receives a grant under this section shall use the grant 
     funds to establish a doctoral nursing consortium that shall 
     share doctoral faculty and programmatic resources, such as--
       ``(1) establishing technology infrastructures;
       ``(2) developing shared doctoral curriculum;
       ``(3) hiring faculty and staff;
       ``(4) retaining current faculty;
       ``(5) providing travel stipends for nursing faculty who 
     agree to teach nursing courses at another eligible entity 
     within the doctoral nursing consortium;
       ``(6) providing scholarships for post-doctoral fellows who 
     agree to teach a nursing course within the nursing doctoral 
     consortium;
       ``(7) providing collaborative networks for nursing 
     research; and
       ``(8) other investments determined necessary by the 
     eligible entities for use within the doctoral nursing 
     consortium.
       ``(i) Grant Duration.--The pilot project under this section 
     shall be for a period of not more than 5 years.
       ``(j) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section not 
     more than $10,000,000 for fiscal year 2008 and such sums as 
     may be necessary for each of the 4 succeeding fiscal 
     years.''.

     SEC. 8. NURSE FACULTY PILOT PROJECT.

       Title VII of the Higher Education Act of 1965 (20 U.S.C. 
     1133 et seq.) is amended by adding at the end the following:

                 ``PART F--NURSE FACULTY PILOT PROJECT

     ``SEC. 781. PURPOSES.

       ``The purposes of this part are to create a pilot program--
       ``(1) to provide scholarships to qualified nurses in 
     pursuit of an advanced degree with the goal of becoming 
     faculty members in an accredited nursing program; and
       ``(2) to provide grants to partnerships between accredited 
     schools of nursing and hospitals or health facilities to fund 
     release time for qualified nurse employees, so that those 
     employees can earn a salary while obtaining an advanced 
     degree in nursing with the goal of becoming nurse faculty.

     ``SEC. 782. ASSISTANCE AUTHORIZED.

       ``(a) Competitive Grants Authorized.--The Secretary may, on 
     a competitive basis, award grants to, and enter into 
     contracts and cooperative agreements with, partnerships 
     composed of an accredited school of nursing at an institution 
     of higher education and a hospital or health facility to 
     establish not more than 5 pilot projects to enable such 
     hospital or health facility to retain its staff of 
     experienced nurses while providing a mechanism to have these 
     individuals become, through an accelerated nursing education 
     program, faculty members of an accredited school of nursing.
       ``(b) Duration; Evaluation and Dissemination.--
       ``(1) Duration.--Grants under this part shall be awarded 
     for a period of 3 to 5 years.
       ``(2) Mandatory evaluation and dissemination.--Grants under 
     this part shall be primarily used for evaluation, and 
     dissemination to other institutions of higher education, of 
     the information obtained through the activities described in 
     section 781(2).
       ``(c) Considerations in Making Awards.--In awarding grants 
     and entering into contracts and cooperative agreements under 
     this section, the Secretary shall consider the following:
       ``(1) Geographic distribution.--Providing an equitable 
     geographic distribution of such grants.
       ``(2) Rural and urban areas.--Distributing such grants to 
     urban and rural areas.
       ``(3) Range and type of institution.--Ensuring that the 
     activities to be assisted are developed for a range of types 
     and sizes of institutions of higher education.
       ``(4) Prior experience or exceptional programs.--
     Institutions of higher education with demonstrated prior 
     experience in providing advanced nursing education programs 
     to prepare nurses interested in pursuing a faculty role.
       ``(d) Uses of Funds.--Funds made available by grant, 
     contract, or cooperative agreement under this part may be 
     used--
       ``(1) to develop a new national demonstration initiative to 
     align nursing education with the emerging challenges of 
     healthcare delivery; and
       ``(2) for any 1 or more of the following innovations in 
     educational programs:
       ``(A) To develop a clinical simulation laboratory in a 
     hospital, health facility, or accredited school of nursing.
       ``(B) To purchase distance learning technologies.
       ``(C) To fund release time for qualified nurses enrolled in 
     the graduate nursing program.
       ``(D) To provide for faculty salaries.
       ``(E) To collect and analyze data on educational outcomes.

     ``SEC. 783. APPLICATIONS.

       ``Each partnership desiring to receive a grant, contract, 
     or cooperative agreement under this part shall submit an 
     application to the Secretary at such time, in such manner, 
     and accompanied by such information as the Secretary may 
     require. Each application shall include assurances that--
       ``(1) the individuals enrolled in the program will be 
     qualified nurses in pursuit of a master's or doctoral degree 
     in nursing and have a contractual obligation with the 
     hospital or health facility that is in partnership with the 
     institution of higher education;
       ``(2) the hospital or health facility of employment would 
     be the clinical site for the accredited school of nursing 
     program;
       ``(3) individuals will also maintain their employment on a 
     part time basis to the hospital or health facility that 
     allowed them to participate in the program, and will receive 
     an income from the hospital or health facility, as a part 
     time employee, and release times or flexible schedules to 
     accommodate the individuals' class schedules; and
       ``(4) upon completion of the program, an individual agrees 
     to teach for 2 years in an

[[Page S13443]]

     accredited school of nursing for each year of support the 
     individual received under this program.

     ``SEC. 784. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated for this part not 
     more than $10,000,000 for fiscal year 2008 and such sums as 
     may be necessary for each of the 4 succeeding fiscal years.

     ``SEC. 785. DEFINITION.

       ``For purposes of this part, the term `health facility' 
     means an Indian Health Service health service center, a 
     Native Hawaiian health center, a hospital, a Federally 
     qualified health center, a rural health clinic, a nursing 
     home, a home health agency, a hospice program, a public 
     health clinic, a State or local department of public health, 
     a skilled nursing facility, or ambulatory surgical center.''.
                                 ______