[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1399 Reported in Senate (RS)]
<DOC>
Calendar No. 285
116th CONGRESS
1st Session
S. 1399
To amend title VIII of the Public Health Services Act to revise and
extend nursing workforce development programs.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 9, 2019
Mr. Merkley (for himself, Mr. Burr, Ms. Baldwin, Mrs. Blackburn, Mr.
Jones, and Ms. Collins) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
November 5, 2019
Reported by Mr. Alexander, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To amend title VIII of the Public Health Services Act to revise and
extend nursing workforce development programs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Title VIII Nursing
Workforce Reauthorization Act of 2019''.</DELETED>
<DELETED>SEC. 2. NURSING WORKFORCE DEVELOPMENT.</DELETED>
<DELETED> (a) In General.--Title VIII of the Public Health Service
Act (42 U.S.C. 296 et seq.) is amended--</DELETED>
<DELETED> (1) in section 801 (42 U.S.C. 296), by adding at
the end the following:</DELETED>
<DELETED> ``(18) 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 and that is associated with a school, college,
university or department of nursing, federally qualified health
center, or independent nonprofit health or social services
agency.'';</DELETED>
<DELETED> (2) in section 802(c) (42 U.S.C. 296a(c)), by
inserting ``, and how such project aligns with the goals in
section 806(a)'' before the period in the second
sentence;</DELETED>
<DELETED> (3) in section 803(b) (42 U.S.C. 296b(b)), by
adding at the end the following: ``Such Federal funds are
intended to supplement, not supplant, existing non-Federal
expenditures for such activities.'';</DELETED>
<DELETED> (4) in section 806 (42 U.S.C. 296e)--</DELETED>
<DELETED> (A) in subsection (a), by striking ``as
needed to'' and all that follows and inserting the
following: ``as needed to address national nursing
needs, including--</DELETED>
<DELETED> ``(1) addressing challenges, including through
supporting training and education of nursing students, related
to the distribution of the nursing workforce and existing or
projected nursing workforce shortages in geographic areas that
have been identified as having, or that are projected to have,
a nursing shortage;</DELETED>
<DELETED> ``(2) increasing access to and the quality of
health care services, including by supporting the training of
professional registered nurses, advanced practice registered
nurses, and advanced education nurses within community based
settings and in a variety of health delivery system settings;
or</DELETED>
<DELETED> ``(3) addressing the strategic goals and
priorities identified by the Secretary and that are in
accordance with this title.</DELETED>
<DELETED>Contracts may be entered into under this title with public or
private entities as determined necessary by the Secretary.'';</DELETED>
<DELETED> (B) in subsection (b)(2), by striking ``a
demonstration'' and all that follows and inserting the
following: ``the reporting of data and information
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.'';</DELETED>
<DELETED> (C) in subsection (e)(2), by inserting ``,
and have relevant expertise and experience'' before the
period at the end of the first sentence; and</DELETED>
<DELETED> (D) by adding at the end the
following:</DELETED>
<DELETED> ``(i) Biennial Report on Nursing Workforce Program
Improvements.--Not later than September 30, 2020, and biennially
thereafter, 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 that
contains 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 the identified goals and performance measures developed
for the respective programs and activities, and the extent to which the
Department coordinates with other Federal departments with programs
designed to improve the nursing workforce.'';</DELETED>
<DELETED> (5) in section 811 (42 U.S.C. 296j)--</DELETED>
<DELETED> (A) in subsection (b)--</DELETED>
<DELETED> (i) by striking ``Master's'' and
inserting ``graduate''; and</DELETED>
<DELETED> (ii) by inserting ``clinical nurse
leaders,'' after ``nurse
administrators,'';</DELETED>
<DELETED> (B) by redesignating subsections (f) and
(g) as subsections (g) and (h), respectively;
and</DELETED>
<DELETED> (C) by inserting after subsection (e), the
following:</DELETED>
<DELETED> ``(f) Authorized Clinical Nurse Specialist Programs.--
Clinical nurse specialist programs eligible for support under this
section are education programs that--</DELETED>
<DELETED> ``(1) provide registered nurses with full-time
clinical nurse specialist education; and</DELETED>
<DELETED> ``(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.'';</DELETED>
<DELETED> (6) in section 831 (42 U.S.C. 296p)--</DELETED>
<DELETED> (A) in the section heading, by striking
``and quality grants'' and inserting ``quality, and
retention grants'';</DELETED>
<DELETED> (B) in subsection (b)(2), by striking
``other high-risk groups such as the elderly,
individuals with HIV/AIDS, substance abusers, the
homeless, and victims'' and inserting ``high risk
groups, such as the elderly, individuals with HIV/AIDS,
individuals with mental health or substance use
disorders, individuals who are homeless, and
survivors'';</DELETED>
<DELETED> (C) in subsection (c)(1)--</DELETED>
<DELETED> (i) in subparagraph (A)--
</DELETED>
<DELETED> (I) by striking
``advancement for nursing personnel''
and inserting the following:
``advancement for--</DELETED>
<DELETED> ``(i) nursing'';</DELETED>
<DELETED> (II) by striking
``professional nurses, advanced
education nurses, licensed practical
nurses, certified nurse assistants, and
home health aides'' and inserting
``professional registered nurses,
advanced practice registered nurses,
and nurses with graduate nursing
education''; and</DELETED>
<DELETED> (III) by adding at the end
the following:</DELETED>
<DELETED> ``(ii) individuals including
licensed practical nurses, licensed vocational
nurses, certified nurse assistants, home health
aides, diploma degree or associate degree
nurses, to become registered nurses with
baccalaureate degrees or nurses with graduate
nursing education;'';</DELETED>
<DELETED> (ii) in subparagraph (B), by
striking the period and inserting ``; and'';
and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(C) developing and implementing
internships, accredited fellowships, and accredited
residency programs in collaboration with one or more
accredited schools of nursing, to encourage the
mentoring and development of specialties.'';</DELETED>
<DELETED> (D) by striking subsection (e);</DELETED>
<DELETED> (E) by redesignating subsection (f)
through (h), as subsections (e) through (g),
respectively;</DELETED>
<DELETED> (F) in subsection (e) (as so
redesignated), by striking ``The Secretary shall submit
to the Congress before the end of each fiscal year''
and inserting ``As part of the report on nursing
workforce programs described in section 806(i), the
Secretary shall include'';</DELETED>
<DELETED> (G) in subsection (f) (as so
redesignated), by striking ``a school of nursing, as
defined in section 801(2),,'' and inserting ``an
accredited school of nursing, as defined in section
801(2), a health care facility, including federally
qualified health centers or nurse-managed health
clinics, or a partnership of such a school and
facility''; and</DELETED>
<DELETED> (H) in subsection (g) (as so
redesignated), by striking ``2010 through 2014'' and
inserting ``2020 through 2024'';</DELETED>
<DELETED> (7) by striking section 831A (42 U.S.C. 296p-
1);</DELETED>
<DELETED> (8) in section 846 (42 U.S.C. 297n)--</DELETED>
<DELETED> (A) by striking the last sentence of
subsection (a);</DELETED>
<DELETED> (B) in subsection (b)(1), by striking ``he
began such practice'' and inserting ``the individual
began such practice''; and</DELETED>
<DELETED> (C) in subsection (i)(I), by striking
``2003 through 2007'' and inserting ``2020 through
2024'';</DELETED>
<DELETED> (9) in section 846A(f) (42 U.S.C. 247n-1(f)), by
striking ``2010 through 2014'' and inserting ``2020 through
2024'';</DELETED>
<DELETED> (10) in section 847(g) (42 U.S.C. 297o(g)), by
striking ``such sums as may be necessary for each of fiscal
years 2010 through 2014'' and inserting ``$115,635,000 for each
of fiscal years 2020 through 2024'';</DELETED>
<DELETED> (11) in section 851 (42 U.S.C. 297t)--</DELETED>
<DELETED> (A) in subsection (b)(1)(A)(iv), by
striking ``and nurse anesthetists'' and inserting
``nurse anesthetists, and clinical nurse
specialists'';</DELETED>
<DELETED> (B) in subsection (d)(3)--</DELETED>
<DELETED> (i) by striking ``3 years after
the date of enactment of this section'' and
inserting ``2 years after the date of enactment
of the Title VIII Nursing Workforce
Reauthorization Act'';</DELETED>
<DELETED> (ii) by striking ``Labor and Human
Resources'' and inserting ``Health, Education,
Labor, and Pensions''; and</DELETED>
<DELETED> (iii) by inserting ``Energy and''
before ``Commerce''; and</DELETED>
<DELETED> (C) in subsection (g), by striking ``under
this title'' and inserting ``for carrying out parts B,
C, and D'';</DELETED>
<DELETED> (12) in section 865(e) (42 U.S.C. 298(e)), by
striking ``2014'' and inserting ``2024''; and</DELETED>
<DELETED> (13) in section 871 (42 U.S.C. 298d), by striking
``$338,000,000 for fiscal year 2010, and such sums as may be
necessary for each of the fiscal years 2011 through 2016'' and
inserting ``$133,837,000 for each of fiscal years 2020 through
2024''.</DELETED>
<DELETED> (b) Evaluation and Report on Nurse Loan Repayment
Programs.--</DELETED>
<DELETED> (1) Evaluation.--The Comptroller General shall
conduct an evaluation of the nurse loan repayment programs
administered by the Health Resources and Services
Administration. Such evaluation shall include--</DELETED>
<DELETED> (A) the manner in which payments are made
under such programs;</DELETED>
<DELETED> (B) the existing oversight functions
necessary to ensure the proper use of such programs,
including payments made as part of such
programs;</DELETED>
<DELETED> (C) the identification of gaps, if any, in
oversight functions; and</DELETED>
<DELETED> (D) information on the number of nurses
assigned to facilities pursuant to such programs,
including the type of facility to which nurses are
assigned and the impact of modifying the eligibility
requirements for programs under section 846 of the
Public Health Service Act (42 U.S.C. 297n), such as the
impact on entities to which nurses had previously been
assigned prior to fiscal year 2019 (such as federally
qualified health centers and facilities affiliated with
the Indian Health Service).</DELETED>
<DELETED> (2) Report.--Not later than 18 months after the
enactment of this Act, the Comptroller General 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 on the evaluation under paragraph (1),
which may include recommendations to improve relevant nursing
workforce loan repayment programs.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Title VIII Nursing Workforce
Reauthorization Act of 2019''.
SEC. 2. NURSING WORKFORCE DEVELOPMENT.
(a) In General.--Title VIII of the Public Health Service Act (42
U.S.C. 296 et seq.) is amended--
(1) in section 801 (42 U.S.C. 296), by adding at the end
the following:
``(18) 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
and that is associated with a school, college, university or
department of nursing, federally qualified health center, or
independent nonprofit health or social services agency.'';
(2) in section 802(c) (42 U.S.C. 296a(c)), by inserting ``,
and how such project aligns with the goals in section 806(a)''
before the period in the second sentence;
(3) in section 803(b) (42 U.S.C. 296b(b)), by adding at the
end the following: ``Such Federal funds are intended to
supplement, not supplant, existing non-Federal expenditures for
such activities.'';
(4) in section 806 (42 U.S.C. 296e)--
(A) in subsection (a), by striking ``as needed to''
and all that follows and inserting the following: ``as
needed to address national nursing needs, including--
``(1) addressing challenges, including through supporting
training and education of nursing students, related to the
distribution of the nursing workforce and existing or projected
nursing workforce shortages in geographic areas that have been
identified as having, or that are projected to have, a nursing
shortage;
``(2) increasing access to and the quality of health care
services, including by supporting the training of professional
registered nurses, advanced practice registered nurses, and
advanced education nurses within community based settings and
in a variety of health delivery system settings; or
``(3) addressing the strategic goals and priorities
identified by the Secretary and that are in accordance with
this title.
Contracts may be entered into under this title with public or private
entities as determined necessary by the Secretary.'';
(B) in subsection (b)(2), by striking ``a
demonstration'' and all that follows and inserting the
following: ``the reporting of data and information
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.'';
(C) in subsection (e)(2), by inserting ``, and have
relevant expertise and experience'' before the period
at the end of the first sentence; and
(D) by adding at the end the following:
``(i) Biennial Report on Nursing Workforce Program Improvements.--
Not later than September 30, 2020, and biennially thereafter, 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 that contains 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 the
identified goals and performance measures developed for the respective
programs and activities, and the extent to which the Department
coordinates with other Federal departments regarding programs designed
to improve the nursing workforce.'';
(5) in section 811 (42 U.S.C. 296j)--
(A) in subsection (b)--
(i) by striking ``Master's'' and inserting
``graduate''; and
(ii) by inserting ``clinical nurse
leaders,'' after ``nurse administrators,'';
(B) by redesignating subsections (f) and (g) as
subsections (g) and (h), respectively; and
(C) by inserting after subsection (e), the
following:
``(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
(6) in section 831 (42 U.S.C. 296p)--
(A) in the section heading, by striking ``and
quality grants'' and inserting ``quality, and retention
grants'';
(B) in subsection (b)(2), by striking ``other high-
risk groups such as the elderly, individuals with HIV/
AIDS, substance abusers, the homeless, and victims''
and inserting ``high risk groups, such as the elderly,
individuals with HIV/AIDS, individuals with mental
health or substance use disorders, individuals who are
homeless, and survivors'';
(C) in subsection (c)(1)--
(i) in subparagraph (A)--
(I) by striking ``advancement for
nursing personnel'' and inserting the
following: ``advancement for--
``(i) nursing'';
(II) by striking ``professional
nurses, advanced education nurses,
licensed practical nurses, certified
nurse assistants, and home health
aides'' and inserting ``professional
registered nurses, advanced practice
registered nurses, and nurses with
graduate nursing education''; and
(III) by adding at the end the
following:
``(ii) individuals including licensed
practical nurses, licensed vocational nurses,
certified nurse assistants, home health aides,
diploma degree or associate degree nurses, and
other health professionals, such as health
aides or community health practitioners
certified under the Community Health Aide
Program of the Indian Health Service, to become
registered nurses with baccalaureate degrees or
nurses with graduate nursing education;'';
(ii) in subparagraph (B), by striking the
period and inserting ``; and''; and
(iii) by adding at the end the following:
``(C) developing and implementing internships,
accredited fellowships, and accredited residency
programs in collaboration with one or more accredited
schools of nursing, to encourage the mentoring and
development of specialties.'';
(D) by striking subsection (e);
(E) by redesignating subsection (f) through (h), as
subsections (e) through (g), respectively;
(F) in subsection (e) (as so redesignated), by
striking ``The Secretary shall submit to the Congress
before the end of each fiscal year'' and inserting ``As
part of the report on nursing workforce programs
described in section 806(i), the Secretary shall
include'';
(G) in subsection (f) (as so redesignated), by
striking ``a school of nursing, as defined in section
801(2),,'' and inserting ``an accredited school of
nursing, as defined in section 801(2), a health care
facility, including federally qualified health centers
or nurse-managed health clinics, or a partnership of
such a school and facility''; and
(H) in subsection (g) (as so redesignated), by
striking ``2010 through 2014'' and inserting ``2020
through 2024'';
(7) by striking section 831A (42 U.S.C. 296p-1);
(8) in section 846 (42 U.S.C. 297n)--
(A) by striking the last sentence of subsection
(a);
(B) in subsection (b)(1), by striking ``he began
such practice'' and inserting ``the individual began
such practice''; and
(C) in subsection (i)(I), by striking ``2003
through 2007'' and inserting ``2020 through 2024'';
(9) in section 846A(f) (42 U.S.C. 247n-1(f)), by striking
``2010 through 2014'' and inserting ``2020 through 2024'';
(10) in section 847(g) (42 U.S.C. 297o(g)), by striking
``such sums as may be necessary for each of fiscal years 2010
through 2014'' and inserting ``$115,635,000 for each of fiscal
years 2020 through 2024'';
(11) in section 851 (42 U.S.C. 297t)--
(A) in subsection (b)(1)(A)(iv), by striking ``and
nurse anesthetists'' and inserting ``nurse
anesthetists, and clinical nurse specialists'';
(B) in subsection (d)(3)--
(i) by striking ``3 years after the date of
enactment of this section'' and inserting ``2
years after the date of enactment of the Title
VIII Nursing Reauthorization Act'';
(ii) by striking ``Labor and Human
Resources'' and inserting ``Health, Education,
Labor, and Pensions''; and
(iii) by inserting ``Energy and'' before
``Commerce''; and
(C) in subsection (g), by striking ``under this
title'' and inserting ``for carrying out parts B, C,
and D'';
(12) by striking sections 861 and 862 (42 U.S.C. 297w and
297x);
(13) in section 865(e) (42 U.S.C. 298(e)), by striking
``2014'' and inserting ``2024''; and
(14) in section 871 (42 U.S.C. 298d), by striking
``$338,000,000 for fiscal year 2010, and such sums as may be
necessary for each of the fiscal years 2011 through 2016'' and
inserting ``$133,837,000 for each of fiscal years 2020 through
2024''.
(b) Evaluation and Report on Nurse Loan Repayment Programs.--
(1) Evaluation.--The Comptroller General shall conduct an
evaluation of the nurse loan repayment programs administered by
the Health Resources and Services Administration. Such
evaluation shall include--
(A) the manner in which payments are made under
such programs;
(B) the existing oversight functions necessary to
ensure the proper use of such programs, including
payments made as part of such programs;
(C) the identification of gaps, if any, in
oversight functions; and
(D) information on the number of nurses assigned to
facilities pursuant to such programs, including the
type of facility to which nurses are assigned and the
impact of modifying the eligibility requirements for
programs under section 846 of the Public Health Service
Act (42 U.S.C. 297n), such as the impact on entities to
which nurses had previously been assigned prior to
fiscal year 2019 (such as federally qualified health
centers and facilities affiliated with the Indian
Health Service).
(2) Report.--Not later than 18 months after the enactment
of this Act, the Comptroller General 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 on the evaluation under paragraph
(1), which may include recommendations to improve relevant
nursing workforce loan repayment programs.
Calendar No. 285
116th CONGRESS
1st Session
S. 1399
_______________________________________________________________________
A BILL
To amend title VIII of the Public Health Services Act to revise and
extend nursing workforce development programs.
_______________________________________________________________________
November 5, 2019
Reported with an amendment
Title VIII Nursing Workforce Reauthorization Act of 2019
#1399 | S Congress #116
Policy Area: Health
Subjects: Congressional oversightEducation programs fundingGovernment studies and investigationsHealth care coverage and accessHealth care qualityHealth facilities and institutionsHealth personnelHealth programs administration and fundingMedical educationMental healthNursingStudent aid and college costs
Last Action: Placed on Senate Legislative Calendar under General Orders. Calendar No. 285. (11/5/2019)
Bill Text Source: Congress.gov
Summary and Impacts
Original Text