[Congressional Record Volume 155, Number 112 (Thursday, July 23, 2009)]
[Senate]
[Pages S8042-S8044]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 1512. A bill to fund comprehensive programs to ensure an adequate 
supply of nurses; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. DURBIN. This is a critical time in America. For the first time in 
many decades, we have a real opportunity to reform our healthcare 
system and improve how care is delivered in our country and the ability 
for Americans to access such quality care.
  The delivery of quality care in our country is as great as it is 
because of the more than 2.9 million nurses in our country. Americans 
depend on nurses to deliver quality patient care, yet our nation faces 
a critical shortage of nurses. The U.S. Bureau of Labor Statistics 
projects that more than 1.2 million new and replacement nurses will be 
needed by 2014 to keep up with the aging Baby Boomer population and the 
increased demand for health care.
  As we work toward reform of health insurance, we need to prioritize 
increasing the number of nurses entering the workforce. We can do that 
by building on the current healthcare workforce. That allows us to work 
with people who are familiar with the work environment in the health 
field, require less time in orientation than new workers, and represent 
a diverse population more representative of the patients being served.
  Today, I am pleased to introduce the Nurse Training and Retention Act 
to assist states and localities in creating career ladders for current 
healthcare workers who are ready to upgrade their skills. Many people 
in the healthcare workforce are in entry level jobs that don't always 
offer opportunities for advancement. For much of this population, 
advanced education is unaffordable and unattainable. The legislation I 
am proposing offers incumbent healthcare workers realistic options to 
enhance their skills, advance their careers, and meet the growing 
demand for nurses.
  The legislation authorizes the Department of Labor to award grants to 
support training programs for healthcare workers. Health aides can use 
these programs to earn a certificate or degree in nursing. Nurses can 
upgrade their skills and qualifications so that they can serve as nurse 
faculty, which would help relieve the backlog of qualified applicants 
who aren't in nursing school because of the lack of faculty.
  Programs administered by joint labor/management training partnerships 
have made great progress educating and retaining nurses. The proposed 
grant program builds on the good work these partnerships have done and 
encourages further collaboration with colleges and universities. The 
combination of support in the workplace and collaboration with nursing 
schools to meet the needs of the non-traditional student means these 
students are performing very well in nursing school. These new nurses 
have higher retention rates than other, more traditional students who 
do not have work experience in the field. Another benefit of the career 
ladder is that these collaborations are building a more diverse nursing 
workforce.
  Another important player in this process is the employer. That's why 
my bill asks employers of incumbent healthcare workers to invest in the 
training programs. This completes the partnership, so that labor, 
employer, and the participating school are all working together to 
retain and grow the healthcare workforce we have today.
  Nurses play an invaluable role in patient care in this country. By 
supporting our current healthcare workforce and offering these 
individuals a chance to move up in the field, the Nurse Training and 
Retention Act can help us tap an overlooked resource. I urge my 
colleagues to join me in supporting this legislation.

[[Page S8043]]

  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. 1512

       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

[[Page S8044]]

     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.

                          ____________________