[Congressional Record Volume 164, Number 123 (Monday, July 23, 2018)]
[House]
[Pages H6605-H6608]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1515
TITLE VIII NURSING WORKFORCE REAUTHORIZATION ACT OF 2018
Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 959) to amend title VIII of the Public Health Service Act to
extend advanced education nursing grants to support clinical nurse
specialist programs, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 959
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
[[Page H6606]]
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Title VIII
Nursing Workforce Reauthorization Act of 2018''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. General provisions.
Sec. 3. Nurse practitioners, nurse midwives, nurse anesthetists, and
other advanced education nurses.
Sec. 4. Increasing nursing workforce diversity.
Sec. 5. Strengthening capacity for basic nurse education and practice.
Sec. 6. Student loans.
Sec. 7. National Advisory Council on Nurse Education and Practice.
Sec. 8. Other provisions.
SEC. 2. GENERAL PROVISIONS.
(a) Application.--Section 802(c) of the Public Health
Service Act (42 U.S.C. 296a(c)) is amended by striking
``shall address relevant national nursing needs that the
project will meet'' and inserting ``shall address relevant
national nursing needs that the project will address and how
the project aligns with the national nursing service goals
referred to in section 806(a)''.
(b) Use of Funds.--Section 803 of the Public Health Service
Act (42 U.S.C. 296b) is amended by adding at the end the
following:
``(c) Supplement Not Supplant.--Funds awarded as a grant
under this title for a project or activity shall be used to
supplement, not supplant, the non-Federal funds that would
otherwise be made available for such project or activity.''.
(c) Generally Applicable Provisions.--Section 806 of the
Public Health Service Act (42 U.S.C. 296e) is amended--
(1) in subsection (b), by amending paragraph (2) to read as
follows:
``(2) Evaluations.--The Secretary shall establish
procedures to ensure the annual evaluation of programs and
projects operated by recipients of grants under this title.
Such procedures shall ensure that continued funding for such
programs and projects will be conditioned upon the submission
of--
``(A) data demonstrating that satisfactory progress has
been made by the program or project in meeting the
performance outcome standards (as described in section 802)
of such program or project; and
``(B) a detailed description of activities conducted by
such program or project to meet such performance outcome
standards.'';
(2) in subsection (e)(2), by inserting ``, and have
relevant expertise and experience'' after ``who are not
officers or employees of the Federal Government''; and
(3) by adding at the end the following:
``(i) Annual Report on Nursing Workforce Programs.--
Annually, the Secretary shall submit to the Committee on
Health, Education, Labor, and Pensions of the Senate, and the
Committee on Energy and Commerce of the House of
Representatives, a report containing an assessment of the
programs and activities of the Department of Health and Human
Services related to enhancing the nursing workforce,
including the extent to which programs and activities under
this title meet identified goals and performance measures
developed for the respective programs and activities.''.
SEC. 3. NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE
ANESTHETISTS, AND OTHER ADVANCED EDUCATION
NURSES.
Section 811 of the Public Health Service Act (42 U.S.C.
296j) is amended--
(1) in subsection (b)--
(A) by striking ``R.N./Master's'' and inserting ``R.N./
graduate''; and
(B) by inserting ``clinical nurse leaders,'' before ``or
public health nurses'';
(2) by redesignating subsections (f) and (g) as subsections
(g) and (h), respectively;
(3) by inserting after subsection (e) the following new
subsection:
``(f) Authorized Clinical Nurse Specialist Programs.--
Clinical nurse specialist programs eligible for support under
this section are education programs that--
``(1) provide registered nurses with full-time clinical
nurse specialist education; and
``(2) have as their objective the education of clinical
nurse specialists who will upon completion of such a program
be qualified to effectively provide care through the wellness
and illness continuum to inpatients and outpatients
experiencing acute and chronic illness.''; and
(4) by adding at the end the following:
``(i) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$74,581,000 for each of fiscal years 2019 through 2023.''.
SEC. 4. INCREASING NURSING WORKFORCE DIVERSITY.
Section 821 of the Public Health Service Act (42 U.S.C.
296m) is amended by adding at the end the following:
``(d) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$17,343,000 for each of fiscal years 2019 through 2023.''.
SEC. 5. STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND
PRACTICE.
(a) Nurse Education, Practice, Quality, and Retention
Grants.--Section 831 of the Public Health Service Act (42
U.S.C. 296p) is amended--
(1) in the section heading, by striking ``and quality'' and
inserting ``quality, and retention'';
(2) in subsection (b), by amending paragraph (2) to read as
follows:
``(2) providing care for underserved populations and high-
risk groups, which may include the elderly, individuals with
HIV/AIDS, individuals with mental health or substance use
disorders, individuals who are homeless, and victims and
survivors of domestic violence;'';
(3) in subsection (c), by amending paragraph (1) to read as
follows:
``(1) Grants for career ladder programs.--The Secretary may
award grants to and enter into contracts with eligible
entities for programs--
``(A) to promote career advancement for--
``(i) nursing personnel in a variety of training settings,
cross training or specialty training among diverse population
groups, and the advancement of individuals, including to
become professional registered nurses, advanced practice
registered nurses, and nurses with graduate nursing
education; and
``(ii) individuals, including licensed practical nurses,
licensed vocational nurses, certified nurse assistants, and
diploma degree or associate degree nurses, to become
baccalaureate-prepared registered nurses or nurses with
graduate nursing education;
``(B) to assist individuals in obtaining education and
training required to enter the nursing profession and advance
within such profession, such as by providing career
counseling and mentoring; and
``(C) to develop and implement internships, accredited
fellowships, and accredited residency programs in
collaboration with one or more accredited schools of nursing
to encourage mentoring and development of specialties.'';
(4) by striking subsection (e) (relating to preference);
(5) by redesignating subsections (f) through (h) as
subsections (e) and (g), respectively;
(6) in subsection (e), as so redesignated, by striking
``The Secretary shall submit to the Congress before the end
of each fiscal year a'' and inserting ``As part of the report
on nursing workforce programs described in section 806(i),
the Secretary shall'';
(7) by amending subsection (f), as redesignated by
paragraph (5), to read as follows:
``(f) Definitions.--For purposes of this section:
``(1) Eligible entity.--The term `eligible entity' includes
an accredited school of nursing, a health care facility, a
partnership of such a school and facility, a federally
qualified health center, or a nurse-managed health clinic.
``(2) Nurse-managed health clinic.--The term `nurse-managed
health clinic' means a nurse-practice arrangement, managed by
advanced practice nurses, that provides primary care or
wellness services to underserved or vulnerable populations
that is associated with a school, college, university or
department of nursing, federally qualified health center, or
independent nonprofit health or social services agency.'';
and
(8) in subsection (g), as redesignated by paragraph (5), by
striking ``such sums as may be necessary for each of fiscal
years 2010 through 2014'' and inserting ``$41,913,000 for
each of fiscal years 2019 through 2023''.
(b) Nurse Retention Grants.--Section 831A of the Public
Health Service Act (42 U.S.C. 296p-1) is repealed.
SEC. 6. STUDENT LOANS.
(a) Loan Repayment and Scholarship Programs.--Section 846
of the Public Health Service Act (42 U.S.C. 297n) is
amended--
(1) in subsection (b)(1), by striking ``he began such
practice'' and inserting ``the individual began such
practice'';
(2) in subsection (d)(1), by striking ``(for fiscal years
2003 and 2004) and may (for fiscal years thereafter)'';
(3) in subsection (h), in the matter preceding paragraph
(1), by striking ``Not later than'' through ``regarding'' and
inserting ``The annual report on nursing workforce programs,
as required by section 806(i), shall include information
regarding the programs carried out under this section,
including''; and
(4) in subsection (i)(1), by striking ``such sums as may be
necessary for each of fiscal years 2003 through 2007'' and
inserting ``$87,135,000 for each of fiscal years 2019 through
2023''.
(b) Nurse Faculty Loan Program.--Section 846A of the Public
Health Service Act (42 U.S.C. 297n-1) is amended by striking
``such sums as may be necessary for each of fiscal years 2010
through 2014'' and inserting ``$28,500,000 for each of fiscal
years 2019 through 2023''.
SEC. 7. NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND
PRACTICE.
Section 851 of the Public Health Service Act (42 U.S.C.
297t) is amended--
(1) in subsection (b)(1)(A)(iv), by striking ``and nurse
anesthetists'' and inserting ``nurse anesthetists, and
clinical nurse specialists'';
(2) in subsection (d), by amending paragraph (3) to read as
follows:
``(3) not later than 2 years after the date of enactment of
the Title VIII Nursing Workforce Reauthorization Act of 2018,
and every 2 years thereafter, prepare and submit to the
Secretary, the Committee on Health, Education, Labor, and
Pensions of the Senate, and the Committee on Energy and
Commerce of the House of Representatives, a report describing
the activities of the Council, including findings and
recommendations made by the Council concerning the activities
under this title.''; and
(3) in subsection (g), by striking ``under this title'' and
inserting ``for carrying out parts B, C, and D of this
title''.
[[Page H6607]]
SEC. 8. OTHER PROVISIONS.
(a) Public Service Announcements.--Part G of title VIII of
the Public Health Service Act (42 U.S.C. 297w et seq.) is
repealed.
(b) Funding.--Part I of title VIII of the Public Health
Service Act (42 U.S.C. 298d) is repealed.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Burgess) and the gentleman from Texas (Mr. Gene Green) each
will control 20 minutes.
The Chair recognizes the gentleman from Texas (Mr. Burgess).
general leave
Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days to revise and extend their remarks and insert
extraneous material in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 959, the Title VIII Nursing
Workforce Reauthorization Act of 2018, which was introduced by the
gentleman from Ohio (Mr. Joyce).
The bill reauthorizes the title VIII Nursing Workforce Development
Programs for fiscal years 2019 through 2023. Title VIII programs, in
addition to the title VII physician workforce programs, expired several
years ago, but have continued to receive appropriations. This bill
reauthorizes title VIII programs at the fiscal year 2018 level.
While our appropriations process has continued to fund these programs
without a reauthorization, there remains uncertainty regarding how much
money the programs will receive each year.
These programs range from providing our advanced practice nurses with
additional educational opportunities to increasing the nursing
workforce diversity.
The bill includes grants for nurses at different levels of education
to obtain further education so that they can advance within the nursing
profession. Additionally, this legislation reauthorizes loan repayment
scholarships and grants for education, practice, quality, and
retention. These provisions are essential in educating and retaining a
qualified nurse workforce.
Mr. Speaker, I urge Members to support H.R. 959, and I reserve the
balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, I rise in support of H.R. 959, the Title VIII Nursing
Workforce Reauthorization Act.
I thank the main sponsor of the legislation, Representative David
Joyce, and original cosponsors including: Representative Doris Matsui,
Representative Kathy Castor, and Representative Tulsi Gabbard for their
hard work on this important legislation.
An estimated 10,000 people are turning 65 years old in America every
day. That trend will continue through the end of the decade. In
addition to an aging population, the United States faces rising
healthcare costs, prevalent chronic diseases, and the rise in substance
abuse disorders. In order to meet this increased need for care, we need
to grow the largest group of healthcare providers in our Nation:
nurses.
The title VIII programs bolster nursing education at all levels, from
entry-level preparation through graduate study, and provides support
for institutions that educate nurses for practice in rural and
medically underserved communities. This program is designed to address
specific needs within the nursing workforce and America's patient
population.
This legislation will reauthorize title VIII of the Public Health
Service Act that provides Federal resources toward nursing workforce
development programs, including the recruitment, retention, and
advanced education of skilled nursing professionals.
This bill extends advanced education nursing grants to support
clinical nurse specialists, clinical nurse leaders, defines nurse-
managed health clinics, adds clinical nurse specialists to the National
Advisory Council on Nurse Education and Practice, and reauthorizes loan
repayments, scholarships, and grants for education, practice, quality,
and retention.
This bipartisan legislation passed the Energy and Commerce Committee
on voice vote earlier this month. I ask my colleagues to join me in
supporting this important legislation to expand and strengthen our
American nursing workforce, and I reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, I yield such time as he may consume to the
gentleman from Ohio (Mr. Joyce), the author of the bill.
Mr. JOYCE of Ohio. Mr. Speaker, I rise today in support of my
legislation, H.R. 959, the Title VIII Nursing Workforce Reauthorization
Act of 2018.
First, I want to thank Chairman Walden and Ranking Member Pallone for
moving this legislation through the Energy and Commerce Committee. It
is easy to see why nursing consistently ranks as the most trusted
profession in America. As the husband of a nurse, and co-chair of the
Congressional Nursing Caucus, I know the amount of dedication and
support nurses put into their daily task of caring for every patient.
An estimated 10,000 baby boomers are turning 65 years old every day.
In order to meet this increased demand for care, we need to grow the
largest group of healthcare providers: nurses.
Despite the importance of nurses to the wellbeing of patients, we
face a projected nursing shortage that will leave too many patients
without the care that they need. The shortage will affect the entire
healthcare system, so we need to do all we can to make sure that those
individuals are interested in this valued career path and have access
to high-quality education opportunities.
My bill authorizes funds for loan payback programs and grants for
advanced education, workforce diversity, and nursing recruitment
programs. This bill will expand our Nation's trained nursing workforce
so they can provide the highest quality care American patients need.
Mr. Speaker, I am thankful for the incredible bipartisan support this
bill has received on behalf of the Nation's nurses, and I urge my
colleagues to support this important legislation.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 2 minutes to the
gentlewoman from Hawaii (Ms. Gabbard), who is a cosponsor of this bill.
Ms. GABBARD. Mr. Speaker, I would like to thank my colleague,
Congressman Joyce, who has been a great leader on these issues relating
to our nursing workforce. I appreciate working with him as co-chair of
the House Congressional Nursing Caucus, where we are able to bring a
lot of these issues and challenges to life.
We all know that nurses and caregivers are the heartbeat of our
healthcare providers. Day in and day out, they provide lifesaving care
with empathy, compassion, and care in the most trying and stressful
situations. But across the country, we continue to see nursing
workforce shortages, especially in our rural and underserved
communities, like many in my home State of Hawaii where people on
different islands are literally separated by a body of water sometimes
from getting access to the care that they need.
In the next 2 years alone, the United States is on track to face a
shortage of nearly 200,000 nursing professionals. These shortages not
only drive up the cost of healthcare for those most in need, but they
actually endanger the wellbeing and care of our patients.
As our healthcare system faces heightened and complex challenges,
like an aging population, increase in chronic diseases, an ever-
worsening opioid epidemic, and so much more, our healthcare workers
must have the training they need to address the needs of our
communities.
Reauthorizing Federal funding for vital programs that provide nurses
with training, education, and support, will help grow our nursing
workforce, both in my home State of Hawaii and across the country, and
expand access to the quality care for our children, our veterans, our
seniors, and all of our communities.
Mr. Speaker, I urge my colleagues to support this bipartisan
legislation, and empower our nurses and healthcare professionals to
continue serving and caring for the people in our communities.
Mr. GENE GREEN of Texas. Mr. Speaker, we have no further speakers,
and I yield back the balance of my time.
[[Page H6608]]
Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time, and
only to point out that this bill did pass in the previous Congress, in
the 114th Congress, both in subcommittee and full committee, but was
never enacted into law.
The author of that bill in the last Congress was our colleague, Lois
Capps, on the Energy and Commerce Committee, and I know she will be
grateful to see that her work has finally cleared the floor of the
House and on to the Senate, and we will be successful.
Mr. Speaker, I yield back the balance of my time, and I urge an
``aye'' vote.
Mr. WALDEN. Mr. Speaker, I rise in support of H.R. 959, the Title
VIII Nursing Workforce Reauthorization Act of 2018. I'd like to thank
Representative David Joyce for his work on this important bill. It is
one of four bipartisan public health bills the House will vote on
today, each of which passed through the Energy and Commerce Committee
unanimously at both the Health Subcommittee and our full committee.
H.R. 959 would reauthorize nursing workforce development programs,
which support the recruitment, retention, and advanced education of
skilled nursing professionals. The bill extends advanced education
nursing grants to support clinical nurse specialists and clinical nurse
leaders, defines nurse-managed health clinics, adds clinical nurse
specialists to the National Advisory Council on Nurse Education, and
reauthorizes loan repayments, scholarships, and grants for education,
practice, quality, and retention.
In rural areas of the country, like my district in Oregon, nurses
play an especially critical role in our health care delivery system,
and they've told me about the importance of this legislation. That's
why it's critical we reauthorize these programs.
Mr. Speaker, I urge my colleagues to support this bill
Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 959,
the Nursing Workforce Reauthorization Act of 2018.
It is undeniable that nurses play a critical role in our society's
function, as they are trusted healthcare professionals who are the
heart and soul of the healthcare system.
H.R. 959 amends the Public Health Service Act by extending support
for nursing workforce programs and grants through the fiscal year 2022.
This bill will reauthorize the Title VIII nursing workforce
development programs.
Further, eligibility for advanced nursing education grants will be
expanded to include education programs for clinical nurse leaders and
all combined registered nurse and graduate degree programs.
The Nursing Workforce Reauthorization Act bolsters nursing education
at all levels, strengthens nursing education and funds institutions
educating nurses to practice in rural and medically underserved
communities.
For nearly six decades, the nursing workforce development programs
have helped fortify the workforce by increasing the number of students,
faculty, and practicing nurses.
Unfortunately, health inequities, inflated costs, and poor health
care outcomes are intensifying because of today's shortfall of
appropriately prepared licensed vocational/practical nurses (LVNs/
LPNs), registered nurses (RNs), advanced practice registered nurses
(APRNs), and nurse faculty.
This trend must be ameliorated, as the importance of nurses cannot be
understated.
Nurses are extremely vital components to quality healthcare and
patient education.
Nurses are the primary professionals delivering quality health care
in the nation, as there are over 4.2 million Registered Nurses in
practice today.
Moreover, the nurse workforce is expected to continue to grow, due to
the current technological advancements for treatments, preventive care
needs, and the rising demand from new health reform enrollments.
It is imperative that the nursing shortage in society be eliminated,
as the need for qualified, experienced nurses is rising and will
continue to do so.
Insufficient federal investments in nursing education, training, and
the overall workforce will only be a detriment to our nation's quality
of healthcare.
H.R. 959 ensures that nursing workforce development programs will
continue to address the specific needs of the nursing and nurse faculty
workforce as well as patients in our communities.
By modernizing the current nursing workforce development programs,
through technical training and further financial funding, nurses will
be able to fulfill the needs of their patients at the highest level.
Further funding and training for nurses at all levels ensures that
all types and levels of nurses have concrete training and are able to
deliver high quality healthcare.
I urge my colleagues to join me in supporting H.R. 959, which will
strengthen the future of nursing and the health of the nation.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Texas (Mr. Burgess) that the House suspend the rules and
pass the bill, H.R. 959, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________