[Congressional Record (Bound Edition), Volume 148 (2002), Part 10]
[House]
[Pages 13808-13814]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         NURSE REINVESTMENT ACT

  Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and concur in 
the Senate amendment to the bill (H.R. 3487) to amend the Public 
Service Act with respect to health professions programs regarding the 
field of nursing.
  The Clerk read as follows:

       Senate amendment:
       Strike out all after the enacting clause and insert:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Nurse Reinvestment Act''.

     SEC. 2. TABLE OF CONTENTS.

       The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.

                       TITLE I--NURSE RECRUITMENT

Sec. 101. Definitions.
Sec. 102. Public service announcements regarding the nursing 
              profession.
Sec. 103. National Nurse Service Corps.

                       TITLE II--NURSE RETENTION

Sec. 201. Building career ladders and retaining quality nurses.
Sec. 202. Comprehensive geriatric education.
Sec. 203. Nurse faculty loan program.
Sec. 204. Reports by General Accounting Office.

                       TITLE I--NURSE RECRUITMENT

     SEC. 101. DEFINITIONS.

       Section 801 of the Public Health Service Act (42 U.S.C. 
     296) is amended by adding at the end the following:
       ``(9) Ambulatory surgical center.--The term `ambulatory 
     surgical center' has the meaning applicable to such term 
     under title XVIII of the Social Security Act.
       ``(10) Federally qualified health center.--The term 
     `Federally qualified health center' has the meaning given 
     such term under section 1861(aa)(4) of the Social Security 
     Act.
       ``(11) Health care facility.--The term `health care 
     facility' means an Indian Health Service health 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, an ambulatory surgical center, or 
     any other facility designated by the Secretary.
       ``(12) Home health agency.--The term `home health agency' 
     has the meaning given such term in section 1861(o) of the 
     Social Security Act.
       ``(13) Hospice program.--The term `hospice program' has the 
     meaning given such term in section 1861(dd)(2) of the Social 
     Security Act.
       ``(14) Rural health clinic.--The term `rural health clinic' 
     has the meaning given such term in section 1861(aa)(2) of the 
     Social Security Act.
       ``(15) Skilled nursing facility.--The term `skilled nursing 
     facility' has the meaning given such term in section 1819(a) 
     of the Social Security Act.''.

     SEC. 102. PUBLIC SERVICE ANNOUNCEMENTS REGARDING THE NURSING 
                   PROFESSION.

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

                 ``PART H--PUBLIC SERVICE ANNOUNCEMENTS

     ``SEC. 851. PUBLIC SERVICE ANNOUNCEMENTS.

       ``(a) In General.--The Secretary shall develop and issue 
     public service announcements that advertise and promote the 
     nursing profession, highlight the advantages and rewards of 
     nursing, and encourage individuals to enter the nursing 
     profession.
       ``(b) Method.--The public service announcements described 
     in subsection (a) shall be broadcast through appropriate 
     media outlets, including television or radio, in a manner 
     intended to reach as wide and diverse an audience as 
     possible.
       ``(c) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2003 
     through 2007.

     ``SEC. 852. STATE AND LOCAL PUBLIC SERVICE ANNOUNCEMENTS.

       ``(a) In General.--The Secretary may award grants to 
     eligible entities to support State and local advertising 
     campaigns through appropriate media outlets to promote the 
     nursing profession, highlight the advantages and rewards of 
     nursing, and encourage individuals from disadvantaged 
     backgrounds to enter the nursing profession.
       ``(b) Use of Funds.--An eligible entity that receives a 
     grant under subsection (a) shall use funds received through 
     such grant to acquire local television and radio time, place 
     advertisements in local newspapers, or post information on 
     billboards or on the Internet in a manner intended to reach 
     as wide and diverse an audience as possible, in order to--
       ``(1) advertise and promote the nursing profession;
       ``(2) promote nursing education programs;
       ``(3) inform the public of financial assistance regarding 
     such education programs;
       ``(4) highlight individuals in the community who are 
     practicing nursing in order to recruit new nurses; or
       ``(5) provide any other information to recruit individuals 
     for the nursing profession.
       ``(c) Limitation.--An eligible entity that receives a grant 
     under subsection (a) shall not use funds received through 
     such grant to advertise particular employment opportunities.
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2003 
     through 2007.''.

     SEC. 103. NATIONAL NURSE SERVICE CORPS.

       (a) Loan Repayment Program.--Section 846(a) of the Public 
     Health Service Act (42 U.S.C. 297n(a)) is amended--
       (1) in paragraph (3), by striking ``in an Indian Health 
     Service health center'' and all that follows to the semicolon 
     and inserting ``at a health care facility with a critical 
     shortage of nurses''; and
       (2) by adding at the end the following: ``After fiscal year 
     2007, the Secretary may not, pursuant to any agreement 
     entered into under this subsection, assign a nurse to any 
     private entity unless that entity is nonprofit.''.
       (b) Establishment of Scholarship Program.--Section 846 of 
     the Public Health Service Act (42 U.S.C. 297n) is amended--
       (1) in the heading for the section, by striking ``loan 
     repayment program'' and inserting ``loan repayment and 
     scholarship programs'';
       (2) by redesignating subsections (d), (f), (g), and (h) as 
     subsections (f), (h), (i), and (g), respectively;
       (3) by transferring subsections (f) and (g) (as so 
     redesignated) from their current placements, by inserting 
     subsection (f) after subsection (e), and by inserting 
     subsection (g) after subsection (f) (as so inserted); and
       (4) by inserting after subsection (c) the following 
     subsection:
       ``(d) Scholarship Program.--
       ``(1) In general.--The Secretary shall (for fiscal years 
     2003 and 2004) and may (for fiscal years thereafter) carry 
     out a program of entering into contracts with eligible 
     individuals under which such individuals agree to serve as 
     nurses for a period of not less than 2 years at a health care 
     facility with a critical shortage of nurses, in consideration 
     of the Federal Government agreeing to provide to the 
     individuals scholarships for attendance at schools of 
     nursing.
       ``(2) Eligible individuals.--In this subsection, the term 
     `eligible individual' means an

[[Page 13809]]

     individual who is enrolled or accepted for enrollment as a 
     full-time or part-time student in a school of nursing.
       ``(3) Service requirement.--
       ``(A) In general.--The Secretary may not enter into a 
     contract with an eligible individual under this subsection 
     unless the individual agrees to serve as a nurse at a health 
     care facility with a critical shortage of nurses for a period 
     of full-time service of not less than 2 years, or for a 
     period of part-time service in accordance with subparagraph 
     (B).
       ``(B) Part-time service.--An individual may complete the 
     period of service described in subparagraph (A) on a part-
     time basis if the individual has a written agreement that--
       ``(i) is entered into by the facility and the individual 
     and is approved by the Secretary; and
       ``(ii) provides that the period of obligated service will 
     be extended so that the aggregate amount of service performed 
     will equal the amount of service that would be performed 
     through a period of full-time service of not less than 2 
     years.
       ``(4) Applicability of certain provisions.--The provisions 
     of subpart III of part D of title III shall, except as 
     inconsistent with this section, apply to the program 
     established in paragraph (1) in the same manner and to the 
     same extent as such provisions apply to the National Health 
     Service Corps Scholarship Program established in such 
     subpart.''.
       (c) Preference.--Section 846(e) of the Public Health 
     Service Act (42 U.S.C. 297n(e)) is amended by striking 
     ``under subsection (a)'' and all that follows through the 
     period and inserting ``under subsection (a) or (d), the 
     Secretary shall give preference to qualified applicants with 
     the greatest financial need.''.
       (d) Reports.--Subsection (h) of section 846 of the Public 
     Health Service Act (42 U.S.C. 297n) (as redesignated by 
     subsection (b)(2)) is amended to read as follows:
       ``(h) Reports.--Not later than 18 months after the date of 
     enactment of the Nurse Reinvestment Act, and annually 
     thereafter, the Secretary shall prepare and submit to the 
     Congress a report describing the programs carried out under 
     this section, including statements regarding--
       ``(1) the number of enrollees, scholarships, loan 
     repayments, and grant recipients;
       ``(2) the number of graduates;
       ``(3) the amount of scholarship payments and loan 
     repayments made;
       ``(4) which educational institution the recipients 
     attended;
       ``(5) the number and placement location of the scholarship 
     and loan repayment recipients at health care facilities with 
     a critical shortage of nurses;
       ``(6) the default rate and actions required;
       ``(7) the amount of outstanding default funds of both the 
     scholarship and loan repayment programs;
       ``(8) to the extent that it can be determined, the reason 
     for the default;
       ``(9) the demographics of the individuals participating in 
     the scholarship and loan repayment programs;
       ``(10) justification for the allocation of funds between 
     the scholarship and loan repayment programs; and
       ``(11) an evaluation of the overall costs and benefits of 
     the programs.''.
       (e) Funding.--Subsection (i) of section 846 of the Public 
     Health Service Act (42 U.S.C. 297n) (as redesignated by 
     subsection (b)(2)) is amended to read as follows:
       ``(i) Funding.--
       ``(1) Authorization of appropriations.--For the purpose of 
     payments under agreements entered into under subsection (a) 
     or (d), there are authorized to be appropriated such sums as 
     may be necessary for each of fiscal years 2003 through 2007.
       ``(2) Allocations.--Of the amounts appropriated under 
     paragraph (1), the Secretary may, as determined appropriate 
     by the Secretary, allocate amounts between the program under 
     subsection (a) and the program under subsection (d).''.

                       TITLE II--NURSE RETENTION

     SEC. 201. BUILDING CAREER LADDERS AND RETAINING QUALITY 
                   NURSES.

       Section 831 of the Public Health Service Act (42 U.S.C. 
     296p) is amended to read as follows:

     ``SEC. 831. NURSE EDUCATION, PRACTICE, AND RETENTION GRANTS.

       ``(a) Education Priority Areas.--The Secretary may award 
     grants to or enter into contracts with eligible entities 
     for--
       ``(1) expanding the enrollment in baccalaureate nursing 
     programs;
       ``(2) developing and implementing internship and residency 
     programs to encourage mentoring and the development of 
     specialties; or
       ``(3) providing education in new technologies, including 
     distance learning methodologies.
       ``(b) Practice Priority Areas.--The Secretary may award 
     grants to or enter into contracts with eligible entities 
     for--
       ``(1) establishing or expanding nursing practice 
     arrangements in noninstitutional settings to demonstrate 
     methods to improve access to primary health care in medically 
     underserved communities;
       ``(2) providing care for underserved populations and other 
     high-risk groups such as the elderly, individuals with HIV-
     AIDS, substance abusers, the homeless, and victims of 
     domestic violence;
       ``(3) providing managed care, quality improvement, and 
     other skills needed to practice in existing and emerging 
     organized health care systems; or
       ``(4) developing cultural competencies among nurses.
       ``(c) Retention Priority Areas.--The Secretary may award 
     grants to and enter into contracts with eligible entities to 
     enhance the nursing workforce by initiating and maintaining 
     nurse retention programs pursuant to paragraph (1) or (2).
       ``(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 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 
     nurses, advanced education nurses, licensed practical nurses, 
     certified nurse assistants, and home health aides; and
       ``(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.
       ``(2) Enhancing patient care delivery systems.--
       ``(A) Grants.--The Secretary may award grants to eligible 
     entities to improve the retention of nurses and enhance 
     patient care that is directly related to nursing activities 
     by enhancing collaboration and communication among nurses and 
     other health care professionals, and by promoting nurse 
     involvement in the organizational and clinical decisionmaking 
     processes of a health care facility.
       ``(B) Preference.--In making awards of grants under this 
     paragraph, the Secretary shall give a preference to 
     applicants that have not previously received an award under 
     this paragraph.
       ``(C) Continuation of an award.--The Secretary shall make 
     continuation of any award under this paragraph beyond the 
     second year of such award contingent on the recipient of such 
     award having demonstrated to the Secretary measurable and 
     substantive improvement in nurse retention or patient care.
       ``(d) Other Priority Areas.--The Secretary may award grants 
     to or enter into contracts with eligible entities to address 
     other areas that are of high priority to nurse education, 
     practice, and retention, as determined by the Secretary.
       ``(e) Preference.--For purposes of any amount of funds 
     appropriated to carry out this section for fiscal year 2003, 
     2004, or 2005 that is in excess of the amount of funds 
     appropriated to carry out this section for fiscal year 2002, 
     the Secretary shall give preference to awarding grants or 
     entering into contracts under subsections (a)(2) and (c).
       ``(f) Report.--The Secretary shall submit to the Congress 
     before the end of each fiscal year a report on the grants 
     awarded and the contracts entered into under this section. 
     Each such report shall identify the overall number of such 
     grants and contracts and provide an explanation of why each 
     such grant or contract will meet the priority need of the 
     nursing workforce.
       ``(g) Eligible Entity.--For purposes of this section, the 
     term `eligible entity' includes a school of nursing, a health 
     care facility, or a partnership of such a school and 
     facility.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2003 
     through 2007.''.

     SEC. 202. COMPREHENSIVE GERIATRIC EDUCATION.

       (a) Comprehensive Geriatric Education.--Title VIII of the 
     Public Health Service Act (42 U.S.C. 296 et seq.) (as amended 
     by section 102) is amended by adding at the end the 
     following:

              ``PART I--COMPREHENSIVE GERIATRIC EDUCATION

     ``SEC. 855. COMPREHENSIVE GERIATRIC EDUCATION.

       ``(a) Program Authorized.--The Secretary shall award grants 
     to eligible entities to develop and implement, in 
     coordination with programs under section 753, programs and 
     initiatives to train and educate individuals in providing 
     geriatric care for the elderly.
       ``(b) Use of Funds.--An eligible entity that receives a 
     grant under subsection (a) shall use funds under such grant 
     to--
       ``(1) provide training to individuals who will provide 
     geriatric care for the elderly;
       ``(2) develop and disseminate curricula relating to the 
     treatment of the health problems of elderly individuals;
       ``(3) train faculty members in geriatrics; or
       ``(4) provide continuing education to individuals who 
     provide geriatric care.
       ``(c) Application.--An eligible entity desiring a grant 
     under subsection (a) shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may reasonably require.
       ``(d) Eligible Entity.--For purposes of this section, the 
     term `eligible entity' includes a school of nursing, a health 
     care facility, a program leading to certification as a 
     certified nurse assistant, a partnership of such a school and 
     facility, or a partnership of such a program and facility.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2003 
     through 2007.''.
       (b) Technical Amendment.--Section 753(a)(1) of the Public 
     Health Service Act (42 U.S.C. 294c) is amended by striking 
     ``, and section 853(2),'' and inserting ``, and section 
     801(2),''.

     SEC. 203. NURSE FACULTY LOAN PROGRAM.

       Part E of title VIII of the Public Health Service Act (42 
     U.S.C. 297a et seq.) is amended by inserting after section 
     846 the following:

[[Page 13810]]



                      ``nurse faculty loan program

       ``Sec. 846A. (a) Establishment.--The Secretary, acting 
     through the Administrator of the Health Resources and 
     Services Administration, may enter into an agreement with any 
     school of nursing for the establishment and operation of a 
     student loan fund in accordance with this section, to 
     increase the number of qualified nursing faculty.
       ``(b) Agreements.--Each agreement entered into under 
     subsection (a) shall--
       ``(1) provide for the establishment of a student loan fund 
     by the school involved;
       ``(2) provide for deposit in the fund of--
       ``(A) the Federal capital contributions to the fund;
       ``(B) an amount equal to not less than one-ninth of such 
     Federal capital contributions, contributed by such school;
       ``(C) collections of principal and interest on loans made 
     from the fund; and
       ``(D) any other earnings of the fund;
       ``(3) provide that the fund will be used only for loans to 
     students of the school in accordance with subsection (c) and 
     for costs of collection of such loans and interest thereon;
       ``(4) provide that loans may be made from such fund only to 
     students pursuing a full-time course of study or, at the 
     discretion of the Secretary, a part-time course of study in 
     an advanced degree program described in section 811(b); and
       ``(5) contain such other provisions as are necessary to 
     protect the financial interests of the United States.
       ``(c) Loan Provisions.--Loans from any student loan fund 
     established by a school pursuant to an agreement under 
     subsection (a) shall be made to an individual on such terms 
     and conditions as the school may determine, except that--
       ``(1) such terms and conditions are subject to any 
     conditions, limitations, and requirements prescribed by the 
     Secretary;
       ``(2) in the case of any individual, the total of the loans 
     for any academic year made by schools of nursing from loan 
     funds established pursuant to agreements under subsection (a) 
     may not exceed $30,000, plus any amount determined by the 
     Secretary on an annual basis to reflect inflation;
       ``(3) an amount up to 85 percent of any such loan (plus 
     interest thereon) shall be canceled by the school as follows:
       ``(A) upon completion by the individual of each of the 
     first, second, and third year of full-time employment, 
     required by the loan agreement entered into under this 
     subsection, as a faculty member in a school of nursing, the 
     school shall cancel 20 percent of the principle of, and the 
     interest on, the amount of such loan unpaid on the first day 
     of such employment; and
       ``(B) upon completion by the individual of the fourth year 
     of full-time employment, required by the loan agreement 
     entered into under this subsection, as a faculty member in a 
     school of nursing, the school shall cancel 25 percent of the 
     principle of, and the interest on, the amount of such loan 
     unpaid on the first day of such employment;
       ``(4) such a loan may be used to pay the cost of tuition, 
     fees, books, laboratory expenses, and other reasonable 
     education expenses;
       ``(5) such a loan shall be repayable in equal or graduated 
     periodic installments (with the right of the borrower to 
     accelerate repayment) over the 10-year period that begins 9 
     months after the individual ceases to pursue a course of 
     study at a school of nursing; and
       ``(6) such a loan shall--
       ``(A) beginning on the date that is 3 months after the 
     individual ceases to pursue a course of study at a school of 
     nursing, bear interest on the unpaid balance of the loan at 
     the rate of 3 percent per annum; or
       ``(B) subject to subsection (e), if the school of nursing 
     determines that the individual will not complete such course 
     of study or serve as a faculty member as required under the 
     loan agreement under this subsection, bear interest on the 
     unpaid balance of the loan at the prevailing market rate.
       ``(d) Payment of Proportionate Share.--Where all or any 
     part of a loan, or interest, is canceled under this section, 
     the Secretary shall pay to the school an amount equal to the 
     school's proportionate share of the canceled portion, as 
     determined by the Secretary.
       ``(e) Review by Secretary.--At the request of the 
     individual involved, the Secretary may review any 
     determination by a school of nursing under subsection 
     (c)(6)(B).
       ``(f) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2003 
     through 2007.''.

     SEC. 204. REPORTS BY GENERAL ACCOUNTING OFFICE.

       (a) National Variations.--Not later than 4 years after the 
     date of the enactment of this Act, the Comptroller General of 
     the United States shall conduct a survey to determine 
     national variations in the nursing shortage at hospitals, 
     nursing homes, and other health care providers, and submit a 
     report, including recommendations, to the Congress on Federal 
     remedies to ease nursing shortages. The Comptroller General 
     shall submit to the Congress this report describing the 
     findings relating to ownership status and associated 
     remedies.
       (b) Hiring Differences Among Certain Private Entities.--The 
     Comptroller General of the United States shall conduct a 
     study to determine differences in the hiring of nurses by 
     nonprofit private entities as compared to the hiring of 
     nurses by private entities that are not nonprofit. In 
     carrying out the study, the Comptroller General shall 
     determine the effect of the inclusion of private entities 
     that are not nonprofit in the program under section 846 of 
     the Public Health Service Act. Not later than 4 years after 
     the date of the enactment of this Act, the Comptroller 
     General shall submit to the Congress a report describing the 
     findings of the study.
       (c) Nursing Scholarships.--The Comptroller General of the 
     United States shall conduct an evaluation of whether the 
     program carried out under section 846(d) of the Public Health 
     Service Act has demonstrably increased the number of 
     applicants to schools of nursing and, not later than 4 years 
     after the date of the enactment of this Act, submit a report 
     to the Congress on the results of such evaluation.
  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Bilirakis) and the gentleman from Ohio (Mr. Brown) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida (Mr. Bilirakis).


                             General Leave

  Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks on this legislation, and to insert extraneous material on the 
bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise today in support of H.R. 3487, the Nurse 
Reinvestment Act.
  Over the past several weeks, both the Senate and the House have 
worked to reach agreement on legislation that will help alleviate the 
national nursing shortage. We have all heard about issues with 
recruitment and retention of nursing staff across the nursing 
continuum. Our health and long-term care systems rely heavily on the 
services of these dedicated health care professionals. Nurses provide 
critical medical services necessary to ensure quality health care. Our 
legislation provides new authority to the Secretary of Health and Human 
Services to ensure that we will have an adequate supply of qualified 
nurses in our health care system.

                              {time}  2000

  To address the nursing shortage, this legislation focuses on two key 
areas. The first one pertains to the recruitment of new nurses, which 
means we must encourage more young people to choose this challenging 
and fulfilling career. This legislation directs the Secretary of Health 
and Human Services to create public service announcements designed to 
promote nursing and nursing education programs. Secondly, this 
legislation focuses on the training of those in the profession by 
building on the recruitment theme.
  The compromise bill we are considering today expands title 8 of the 
Public Health Service Act to include scholarships for students entering 
the nursing profession. In exchange, students must enter a commitment 
to serve in a health facility determined to have a critical shortage of 
nurses.
  Third, H.R. 3487 focuses on the retention of the talented workforce 
that is in the system today. To aid in the retention of qualified 
nurses, the legislation provides the HHS Secretary with authority to 
expand on career ladder programs that promote career advancement of 
nurses within the profession. The bill also allows grants to enhance 
the nursing workforce by initiating and retaining nurse retention 
programs. Moreover, this legislation authorizes grants for programs 
that will train and educate individuals in providing care for elderly, 
which may be critical with our aging baby boom population.
  Our efforts to recruit and retain qualified nursing professionals 
will be in vain if we do not also address our system for educating 
nurses. If we are successful in recruiting nurses to the profession, we 
will need to build up our Nation's capacity to educate nurses. To this 
end, the bill establishes a faculty loan cancellation program to 
encourage people to complete advanced education and treat future 
nurses. Under this program, Ph.D. and master's nursing students will be 
eligible to receive loans if they agree to teach in a nursing schooling 
upon completion of their degree. For every year up to 4 years

[[Page 13811]]

that a loan recipient teaches, he or she will have an increasing 
portion of their loan canceled.
  Nurses are invaluable, Mr. Speaker, to the success and quality of our 
health care system. The legislation helps ensure that our Nation will 
have a well-trained supply of nurses on which to rely. Again, this 
legislation, and I am very proud to say this, was put together with a 
bipartisan effort of the House and the Senate. And I would certainly be 
remiss if I did not mention the gentlewoman from California (Mrs. 
Capps), who is a nurse herself who has lived these particular problems 
and she has been a pusher, I guess is the best way I can put it, on 
this; and we are very, very grateful to her for this and to her staff.
  I would like to thank my colleagues for their hard work and 
dedication to this issue, and I would also add thanks to the gentleman 
from Maryland (Mr. Ehrlich), the gentleman from Kentucky (Mr. 
Whitfield), the gentleman from Tennessee (Mr. Bryant), and the 
gentlewoman from New York (Mrs. Kelly). There are so many from the 
other side of the aisle and our side who have been so helpful because 
of the great interest in trying to solve this particular problem.
  I would like to take a moment to thank some of the staff who worked 
on this bill. Please forgive me if I miss anyone in this process. I 
would like to recognize a few people. First, Anne Esposito, who 
recently left my staff, was instrumental in obtaining House passage of 
the bill. John Ford, Jeremy Sharp, and Katie Porter on the minority 
were also most helpful, as were Steve Tilton, Erin Ockunzzi, Cheryl 
Jaeger, and Pat Morrisey from my staff. I thank each of them for their 
hard work on this legislation. I know that we all should feel awfully 
proud and awfully good about having passed this or at least brought it 
to this particular point.
  I urge my colleagues to join me in support of H.R. 3487, the Nurse 
Reinvestment Act.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, there are three nurses in the House of Representatives, 
the gentlewoman from New York (Mrs. McCarthy), the gentlewoman from 
Texas (Ms. Eddie Bernice Johnson), and the gentlewoman from California 
(Mrs. Capps).
  Mr. Speaker, I yield 5 minutes to the gentlewoman from California 
(Mrs. Capps), who, as a registered nurse and a member of the 
Subcommittee on Health of the Committee on Energy and Commerce, has 
been the driving force and turned this dream into a reality and, as the 
gentleman from Florida (Mr. Bilirakis) has said, has simply not let up 
on this issue.
  Mrs. CAPPS. Mr. Speaker, I thank my colleague for yielding me time.
  Mr. Speaker, I rise in strong support of the Nurse Reinvestment Act, 
and I urge my colleagues to vote for this important legislation.
  Mr. Speaker, I want to thank the gentleman from Florida (Mr. 
Bilirakis) for putting up with me, the gentleman from Louisiana (Mr. 
Tauzin), and especially ranking members, the gentleman from Michigan 
(Mr. Dingell) and the gentleman from Ohio (Mr. Brown), and all of the 
staff for the hard work put into this bill. I will mention by name as 
well: Katie Porter, John Ford, Steve Tilton, Cheryl Yaeger, and from my 
office, Jeremy Sharp.
  Together we have crafted good legislation that will help us deal with 
the nursing shortage.
  This bill marks a major commitment by the Congress to end the 
shortage of nurses. The bill is based on legislation that I introduced 
in April of last year, H.R. 1436, and represents a major step forward 
in nursing education. I am grateful for the support of 238 co-sponsors 
of that bill and the nursing and public health groups that helped us 
move it forward.
  The Nurse Reinvestment Act will authorize new scholarships for 
prospective nurses to complete their education more quickly and join 
the workforce. These scholarships will enable a broader range of people 
to find their way into a very rewarding career, one that will always be 
in demand, no matter the strength or weakness of the economy.
  The bill also authorizes grants to train all levels of the nursing 
workforce in geriatric care. This will better prepare our nurses to 
deal with the coming retirement of the baby boom generation. And the 
bill addresses the shortages of nursing faculty by providing loan 
assistance to nurses who want to teach.
  It also expands current nursing programs to include career ladder 
grant programs and nursing retention programs. These new programs will 
help make the nursing profession more attractive to potential nurses 
and to provide for more upward mobility.
  And, finally, the legislation will authorize public service 
announcements to educate the public about the need for more nurses, the 
opportunities available for educational assistance, and the rewards of 
this kind of care-giving career. One of the major problems nursing 
faces is the perception that it is an unappealing career and women's 
work. These PSA's will help us counter that impression and explain the 
value and the benefits of a career in nursing.
  Mr. Speaker, I am, as my colleague mentioned, one of three nurses 
currently serving in Congress. Before I was elected to the House of 
Representatives, I served the people of Santa Barbara County as a 
public health nurse for 20 years. I do know first hand the challenges 
facing our hospitals and health care providers and the consequences if 
we fail to meet them. Nurses are the backbone of our public health 
system. As we struggle to prepare our Nation for everyday public health 
emergencies, and extraordinary events like bio-terrorism, we certainly 
cannot afford to be without enough nurses. September 11 and the anthrax 
letters remind us that our safety and well-being depends in part on the 
ability of our hospitals to care for us and our loved ones. Having 
enough nurses is a critical component of that care. Nurses are the 
first line of defense in all these scenarios. They will be the ones 
treating the victims of biological and conventional terror attacks, and 
right now we do not have enough of them.
  Data on the nursing workforce shows that staffing shortages are 
increasing and recruiting new registered nurses is becoming 
progressively more difficult. We already today need 125,000 RN's to 
fill existing vacancies according to the American Hospitals 
Association; and by 2010, 40 percent of the RN workforce will be over 
50 years old. In contrast, the number of RN's under 35 has fallen to 
just a little over 18 percent. Simply put, there are not enough new 
nurses joining the workforce to replace those expected to retire in the 
next 10 years, and this problem will be compounded by the 78 million 
baby boomers retiring and needing more health care.
  Congress needs to act on this problem quickly. We need to pass the 
Nurse Reinvestment Act, and then we need to appropriate sufficient 
funds to the program it creates. This bill represent several good steps 
toward a comprehensive solution toward the nursing shortage; but if we 
do not fund it, it will be of little help.
  Funding for nursing education programs right now is around $100 
million. We certainly have to increase our commitment to nursing. To be 
sure, there is much more that we will need to do. But this is an 
excellent start, and I am pleased that we have finally come to this 
point. So I urge all of my colleagues to support nurses and vote for 
the Nurse Reinvestment Act.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I must say that last evening, late last night about 
11:15, 11:30, my favorite uncle, my wife's and mine, passed away with 
leukemia. And during these last few weeks when he was in the hospital 
in Tarpon Springs, Florida, my hometown; and afterwards with the 
hospice people at his home for 3 or 4 days, well, the dedication of 
nurses was just there and I do not think I told any of them; but I 
wanted to tell them about this piece of legislation, but they were 
awfully busy.

[[Page 13812]]

  Mr. Speaker, I yield such time as he may consume to the gentleman 
from Maryland (Mr. Ehrlich), who is a member of the committee.
  Mr. EHRLICH. Mr. Speaker, I rise in support of H.R. 3487, as amended. 
We have already heard this bill is absolutely critical. In Maryland, 
our health care facilities are now reporting a shortage of 2,000 nurses 
statewide. This shortage directly affects the quality of care 
Marylanders receive in hospitals, in community health centers, in 
doctors' offices, and even their homes. This act spurs both nurse 
recruitment to attract more young people into the profession, as well 
as nurse retention to hold on to experienced nurses.
  As we have heard, this legislation contains provisions for public 
service announcements to advertise and promote the nursing profession, 
highlight the advantages and rewards of nursing, and encourage 
individuals to enter this critical profession. It also establishes a 
scholarship program for students who want to become nurses but may not 
be able to afford nursing school.
  The act creates a scholarship program to help individuals who agree 
to serve at least 2 years at a health care facility in a nurse shortage 
area. To improve retention, the bill gives the Secretary of Health and 
Human Services the authority to provide grants for nurse education 
practices and retention grants. These grants may go to programs to help 
train nurses in specialty areas, serve underserved populations such as 
the elderly and substance abusers, and work for a higher nursing 
degree, among other nurse-retention programs.
  Mr. Speaker, this act gives the Health Resources and Services 
Administration the authority to offer loan repayment opportunities for 
nurses to gain advance degrees in order to become nursing faculty. 
Faculty who serve 4 years in nurse-shortage areas will have 85 percent 
of their school loans repaid for them.
  I would like to thank the chairman. We could not do this without the 
gentleman from Florida (Mr. Bilirakis). His leadership has been 
terrific, and he has been as dogged as the gentlewoman from California 
(Mrs. Capps). I also want to thank the gentlewoman from New York (Mrs. 
Kelly), my colleague and friend, for her hard work on this; the 
gentleman from Ohio (Mr. Brown); and, of course, the man who makes it 
all possible, the chairman of the committee, the gentleman from 
Louisiana (Mr. Tauzin). But without the gentleman from Florida (Mr. 
Bilirakis), we would not be standing here today. I know the gentlewoman 
from California (Mrs. Capps) agrees with that thought.
  Mr. Speaker, this investment in the nursing workforce improves our 
Nation's health delivery system, and it is crucial to the health and 
public safety of all Americans. I congratulate everybody associated 
with the bill. It will be signed by the President. It is good policy. 
It is a bipartisan bill. I look forward to its enactment into law.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentlewoman 
from New York (Mrs. McCarthy), who also is a registered nurse.
  Mrs. McCARTHY of New York. Mr. Speaker, I was a nurse for over 30 
years before I came to Congress and the gentlewoman from California 
(Mrs. Capps) and I talk about it. We are still nurses. We just happen 
to have a side job as being a Congressperson. That is the way we look 
at it here. That is why I take the nursing shortage very personally; 
and also why, last December when we passed a version of the Nurse 
Reinvestment Act, I was happy that we started looking at the issue 
because it is an important issue to all of us. But we still need to do 
more for our nurses. That is why I and the gentlewoman from California 
(Mrs. Bono) introduced H.R. 4654, the Nurse Retention and Quality of 
Care Act. This is a bill that provides $20 million in grant monies to 
hospitals to help them become magnet hospitals.
  On Long Island where I live, we have an RN vacancy rate of 8 percent 
and an 16 percent LPN vacancy rate. In addition, 126,000 nurses are 
needed nationwide.
  One solution to keep and retain nurses immediately would be to help 
hospitals obtain magnet hospital status. Magnet hospitals are hospitals 
that have reorganized care to be more hands-on, team-oriented, patient-
centered, and as a result are attracting more nurses.
  I and the gentlewoman from California (Mrs. Bono) wanted to give 
hospitals a chance to become better workplaces for health care 
professionals. Even in times of nursing shortages, magnet hospitals 
enjoy low turn-over and job satisfaction. The average length of 
employment for registered nurses in magnet hospitals is 8 years, twice 
the length of employment in nonmagnet hospitals. Magnet hospitals give 
our nurses the ability to make their own schedules, which, by the way, 
is one of the biggest contentions with nurses in hospitals today. In 
addition, nurses are on all administration boards and continued 
education for all levels of nursing are provided.
  As a result, magnet hospitals report lower mortality rates, higher 
patient satisfaction and greater cost efficiency.

                              {time}  2015

  The patients experience shorter stays in hospital and intensive care 
units. Best of all, nurses are enjoying their jobs again.
  The nurses I spoke to at my Long Island magnet hospitals say that 
their quality of life has dramatically improved due to the changes 
made, and I think this is something that we are starting to really 
address now. With this particular bill, we are looking at all of the 
aspects of what our nurses are facing on a daily basis. We have sicker 
patients in the hospitals today. The job has gotten harder and harder. 
Higher tech has come in, but yet there is one thing all nurses have in 
common, and this is the compassion to take care of the people. That is 
why we went into nursing in the first place.
  Mr. Speaker, I rise today thrilled that the Nurse Reinvestment Act 
now includes our magnet hospital language, and it has truly become a 
bill that will help all nurses, but this is a win-win situation. Not 
only is it good for our nurses and our hospitals, but it really is good 
for our patients, and again, that comes back down to those that need us 
the most, especially when they are sick.
  I commend my colleagues in both Houses for their diligent work 
negotiating for a better bill and urge all Members to support this 
important piece of legislation.
  Mr. BILIRAKIS. Mr. Speaker, I yield such time as she may consume to 
the gentlewoman from New York (Mrs. Kelly).
  Mrs. KELLY. Mr. Speaker, I rise in strong support of the Nurse 
Reinvestment Act. This is a substantial step in addressing the growing 
shortage of nurses currently being experienced by health care 
facilities nationwide. I thank the gentleman from Florida (Mr. 
Bilirakis), the Subcommittee on Health chairman, and the gentlewoman 
from California (Mrs. Capps), for their hard work in bringing this 
legislation to the floor.
  As a professional patient advocate, I hope that this measure will 
increase the number of health professionals available to care for the 
growing number of patients we have, the growing number, as well as 
being more ill when they are in the hospital.
  The bill contains practical and creative solutions to eliminating the 
nursing shortage. It focuses on recruitment, retention, career 
enhancement and faculty development. The Nurse Reinvestment Act will 
provide a framework for increasing awareness about opportunities in the 
nursing profession, growing enrollment in nursing schools, and 
providing staff coverage for areas experiencing acute shortages.
  Funding for outreach and public awareness campaigns will help us tap 
into new communities, seeking those people who may not traditionally 
have considered health care as a career. The National Nurse Service 
Corps expanded loan repayment assistance and a scholarship program 
contained in this bill will further entice prospective students to 
serve in areas where the need is the greatest.
  We hope that nurses currently practicing will find this legislation 
provides funding for the development of

[[Page 13813]]

internships, residency and mentoring programs, and education and new 
emerging technologies. Nurses also should be encouraged to seek 
specialty training and other opportunities to enhance their skills as a 
result of this bill.
  An especially important component of the bill is a provision to 
ensure that nursing schools have adequate faculty. A loan forgiveness 
program will be available for nurses pursuing advanced education who 
will teach in nursing schools.
  In short, the bill will help make sure that the classroom seats in 
our Nation's nursing schools are filled and that practicing nurses 
remain in the field and pursue higher skill levels. This will help 
relieve the nursing shortage that we are experiencing. Nurses are 
stretched too thin, and we need to get more nurses on the hospital 
floors to provide much-needed care for patients.
  It is a good step. It is a first step in helping America continue to 
have caring and outstanding medical nursing care. I urge all of my 
colleagues to support this measure and help strengthen our Nation's 
health care workforce.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman 
from Illinois (Mr. Davis).
  Mr. DAVIS of Illinois. Mr. Speaker, I want to first of all commend 
and congratulate the gentleman from Florida (Mr. Bilirakis) and the 
gentleman from Ohio (Mr. Brown) for their outstanding leadership on 
health issues, and I also want to commend the gentleman from Louisiana 
(Mr. Tauzin) and the gentleman from Michigan (Mr. Dingell) for the 
leadership that they provide. I could not let this opportunity go by 
without coming over to congratulate and commend the gentlewoman from 
California (Mrs. Capps) for the outstanding leadership she has provided 
on this issue as well as so many others.
  I was listening to the debate and was thinking of Loyola University, 
Rush-Presbyterian St. Luke's, University of Illinois, Cook County 
Hospital, Mount Sinai Hospital, Westside Veterans Administration, 
Heinz, Northwestern, Mercy Hospital, Malcolm X College, the Chicago 
Rehabilitation Institute, all of which have nursing schools and nursing 
programs in my congressional district, all who lament the fact that we 
do not have enough nurses, in many instances, to fill some of the 
classes.
  This deal will create an opportunity for many institutions not to 
find it necessary to import nurses. There is a wealth of talent, 
individuals around who with a little nudging and a little help will 
choose nursing as a career. This is an opportunity. It is a great one.
  Again, I commend the gentlewoman from California (Mrs. Capps) and all 
of those who have made it happen.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself 4 minutes.
  I want to thank the gentleman from Louisiana (Mr. Tauzin) and the 
gentleman from Florida (Mr. Bilirakis) for their fine work and for 
working with the gentleman from Michigan (Mr. Dingell), the gentlewoman 
from California (Mrs. Capps) and with me on the issue of the nurse 
shortage and their commitment to send a bill to the President's desk.
  Special thanks to staff members Steve Tilton and Cheryl Jaeger, and 
Katie Porter in my office and John Ford, and Jeremy Sharp for the work 
they did on this legislation.
  Nurses are the heart of our health care system. They have the most 
contact with patients. With the threat and reality of bioterrorism, 
they are on the front lines treating exposure to biological and 
chemical agents as well as a surge of ``worried well'' patients. They 
make a functioning health care system an effective health care system, 
and to be sure, they do not receive nearly enough gratitude.
  There is not a Member in this House or Senate who does not recognize 
the severity of the nursing shortage. While the facts to substantiate 
the shortage are glaring, the solutions are far less clear. The House 
and Senate each passed legislation that reflected their sincere and 
strong commitment to tackling the problem. Both bodies put in a 
tremendous amount of work to reach a compromise between the two bills, 
and I am pleased in joining with my colleagues with the end result.
  This bill is not intended to provide all the answers. Its modest but 
critical purpose is to alleviate the nursing shortage by jump-starting 
recruitment and fostering retention.
  Under recruitment, our bill will establish public service 
announcements and expands the current loan repayment programs to 
include scholarships.
  Under retention, our bill will help schools of nursing to train 
nurses in geriatric care. It also establishes a career ladder grant 
program and a faculty loan cancellation program. It provides resources 
to health care facilities to improve their staff management.
  While this bill will not cure the shortage, it is also much more than 
a bandaid. The bill will provide substantial authority and ultimately 
resources to interest men and women in becoming nurses and furthering 
their careers in nursing and improving the quality of their work 
environment. It sends a strong message to nurses that we value their 
hard work, we recognize their inherent value in the delivery of quality 
health care in this country, and we are committed to helping them in 
their efforts to help others.
  Mr. Speaker, I ask the House to support this legislation.
  Mr. BENTSEN. Mr. Speaker, I rise today in strong support of the 
conference report for H.R. 3487, the Nurse Reinvestment Act. As the 
representative for Texas Medical Center, the home of four nursing 
schools, I strongly believe that we need to provide sufficient federal 
funding for nursing education and retention programs. In a time when 
many of our nation's hospitals are facing nursing shortages, this 
legislation is an important first step in our effort to recruit and 
train more nurses to meet patient needs.
  This bill will expand a nurse loan repayment program to include 
scholarship for needy students. In exchange for this scholarship 
assistance, nurses will be required to serve for a period of time in 
health care facilities that face a critical shortage of nurses. The 
requirement to serve will vary according to the amount of assistance 
each nursing student receives.
  This legislation will also provide resources to nursing schools to 
train nurses of all levels to care for an aging population. As a larger 
portion of our population reaches retirement age, there will be an 
increased need for skilled nurses. Nursing schools will be allowed to 
develop new curricula, faculty development, and offer continuing 
education classes.
  Another important provision included in this bill will provide grants 
to nursing schools for Faculty Loan Programs. Nursing schools will 
offer loans to advanced degree students with the expectation that these 
advanced trained nurses will join the faculty to teach new nurses. In 
our local area, there is shortage of both trained nurses and trained 
faculty members. I believe we need both more nursing teachers and 
students in order to increase the supply of nurses.
  This measure would also expand current basic nursing training 
programs to provide grants to establish career ladder programs. With 
these programs, health care facilities would be able to offer new 
opportunities for nurses to increase their responsibilities and career 
opportunities. If nurses believe that they can achieve advancement in 
their careers, they will be more likely to be attracted to this 
profession.
  Finally, this bill provides for public service announcements to 
promote the nursing professions. With more information, it is hoped 
that more people will enter the nursing field when they realize that it 
is a vital part of our health care profession. With nurses, our health 
care facilities can provide quality care to patients. All of these 
programs are necessary to ensure that tomorrow's nurses will be trained 
to care for all Americans.
  Mr. Speaker, I urge my colleagues to support this effort to increase 
nursing education and recruitment programs.
  Ms. DeLAURO. Mr. Speaker, I rise in strong support of the bipartisan 
Nurse Reinvestment Act, and I thank the gentlewoman from California for 
her commitment to addressing our Nation's nursing shortage. She has 
worked so hard to ensure this body could take the first steps in 
addressing the concerns of nurses and the issues which have plagued the 
nursing profession.
  In my home state of Connecticut, more than 3,200 nurses have left the 
State or given up their licenses since 1996. Nurse vacancy rates are up 
50 percent since that time, and the number of newly licensed nurses is 
down 25 percent from 4 years ago.

[[Page 13814]]

  Further, the average age of licensed nurses in my state is 45, 
compared to the national average of 42. There is a widening gap between 
the increasing need for nursing care and the number of women and men 
who will be there to provide the care that their patients need. These 
statistics only begin to indicate the severity of our nursing shortage, 
one that mirrors what is happening nationally.
  Nurses play a critical role and are often underappreciated in our 
health care system. Anyone who has spent time in any hospital knows how 
hard nurses work and the high quality of care that they provide. 
Congress needs to support nurses, just as they support our loved ones 
and us when we need it the most. The Nurse Reinvestment Act is that 
first step to achieve these goals.
  This bill would establish nurse scholarships in exchange for 
requiring those nurses to serve facilities with critical shortages. It 
would provide resources to schools of nursing to train nurses of all 
levels to care for an older population. The Nursing Reinvestment Act 
would also provide incentives and grant programs to ensure that nurses 
stay in the profession and have opportunities to move up the career 
ladder. It establishes public service announcements to change age-old 
stereotypes about the nursing profession and improve recruiting.
  I am proud that nurses have been the driving force behind this bill. 
Together, they played a large role in developing the legislation and 
fighting for its passage. They were out on the front lines. They know 
better than anyone the challenges that nurses face day in and day out, 
and their experience and ideas informed this bipartisan effort and 
built a strong piece of legislation.
  Again, I would like to thank my colleague, Mrs. Capps, for all of her 
hard work on this bill, and I urge my colleagues to support this bill 
so that we may meet this urgent need as soon as possible.
  Mr. DINGELL. Mr. Speaker, I rise in support of the Nurse Reinvestment 
Act. This bill is a solid down payment in our effort to address severe 
shortages in the nursing profession. This is not the first nursing 
shortage we have seen, but I am dedicated to finding a real solution so 
that it may be our last. Nurses are the unsung heroes in health care, 
and today they need our help.
  As is the case with any bill of importance, much of the credit goes 
to our colleagues who are willing to do the hard work. None has worked 
harder on behalf of the nursing professions than my friend and 
colleague, Representative Capps. She has been tireless and today her 
efforts pay off. I congratulate her on a job well done. Of course, we 
would not be here without bipartisan support and cooperation. I thank 
the Chairman of the Health Subcommittee, Representative Bilirakis, 
Subcommittee Ranking Member Brown, and Chairman Tauzin.
  The national nursing shortage reached crisis level in 1999 and 
experts are predicting that by 2008, the nation will be short 450,000 
nurses. This shortage of nurses has dramatic detrimental repercussions 
for American citizens. When there are too few nurses at bedsides, 
patients are significantly more likely to suffer serious complications, 
according to one study published recently in the New England Journal of 
Medicine.
  So far, my home state of Michigan has fared better than many other 
states against the national nursing shortage because so many Canadian 
nurses have crossed the Ambassador Bridge and Detroit-Windsor Tunnel 
for U.S. nursing jobs. Metro Detroit hospitals import 15 to 20 percent 
of their nursing staff from Canada. A study by the University of 
Detroit-Mercy, however, reports that by 2008, Michigan will need 1.4 
million registered nurses, but only 656,000 will be available.
  The bill before us today seeks to rectify these problems and reverse 
their implications. The Nurse Reinvestment Act establishes nurse 
scholarships to provide educational scholarships in exchange for 
commitment to serve in a public or private non-profit health facility 
determined to have a critical shortage of nurses. H.R. 3487 further 
establishes nurse retention and patient safety enhancement grants to 
assist health care facilities to retain nurses and improve patient care 
delivery through more collaboration between nurses and other health 
care professionals.
  H.R. 3487 establishes comprehensive geriatric training grants for 
nurses, it establishes faculty loan cancellation programs to allow 
nurses full-time study and rapid completion of advanced degree studies, 
and it establishes a career ladder grant program to assist individuals 
in the nursing workforce to obtain more education. Finally, the Nurse 
Reinvestment Act will help us recruit more nurses through public 
service announcements and other educational programs. These will inform 
the public about nursing as a profession and career and will tell 
potential nurses about the resources available to them if they choose 
to enter this wonderful profession.
  I salute the efforts of Representative Capps and my other colleagues 
that have brought us this far and I urge my colleagues to join me in 
support of this bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield back the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I, too, have no further requests for 
time, and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Grucci). The question is on the motion 
offered by the gentleman from Florida (Mr. Bilirakis) that the House 
suspend the rules and concur in the Senate amendment to the bill, H.R. 
3487.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the Senate amendment was 
concurred in.
  A motion to reconsider was laid on the table.

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