[Congressional Record Volume 155, Number 1 (Tuesday, January 6, 2009)]
[Senate]
[Page S59]
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.
  Mr. INOUYE. Mr. President, today I am, again, introducing the Nursing 
School Clinics Act. 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 
of nonprofit 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.
  The bill reinforces the principle of combining health care delivery 
in underserved areas with the 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 
financial incentives for clinic operators 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 a wide range 
of 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 
recognizes the central role nurses can perform as care givers to the 
medically underserved.
  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. 53

       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 School Clinics Act 
     of 2009''.

     SEC. 2. 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 (27), by striking ``and'' at the end;
       (2) by redesignating paragraph (28) as paragraph (29); and
       (3) by inserting after paragraph (27), the following new 
     paragraph:
       ``(28) nursing school clinic services (as defined in 
     subsection (y)) 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:
       ``(y) 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 (42 U.S.C. 1396a(a)(10)(C)(iv)) is 
     amended by inserting ``and (28)'' 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.
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