# H.R. 3200/Division C/Title V/Subtitle D
## SUBTITLE D — Grants for Comprehensive Programs to Provide Education to Nurses and Create a Pipeline to Nursing
### SEC. 2531. ESTABLISHMENT OF GRANT PROGRAM.

    (a) Purposes.—
       It is the purpose of this section to authorize grants to—
          (1) address the projected shortage of nurses by funding comprehensive programs to create a career ladder to nursing (including Certified Nurse Assistants, Licensed Practical Nurses, Licensed Vocational Nurses, and Registered Nurses) for incumbent ancillary health care workers;
          (2) increase the capacity for educating nurses by increasing both nurse faculty and clinical opportunities through collaborative programs between staff nurse organizations, health care providers, and accredited schools of nursing; and
          (3) provide training programs through education and training organizations jointly administered by health care providers and health care labor organizations or other organizations representing staff nurses and frontline health care workers, working in collaboration with accredited schools of nursing and academic institutions.
    (b) Grants.—
       Not later than 6 months after the date of the enactment of this Act, the Secretary of Labor (referred to in this section as the “Secretary”) shall establish a partnership grant program to award grants to eligible entities to carry out comprehensive programs to provide education to nurses and create a pipeline to nursing for incumbent ancillary health care workers who wish to advance their careers, and to otherwise carry out the purposes of this section.
    (c) Eligibility.—
       To be eligible for a grant under this section, an entity shall be—
          (1) a health care entity that is jointly administered by a health care employer and a labor union representing the health care employees of the employer and that carries out activities using labor management training funds as provided for under section 302(c)(6) of the Labor Management Relations Act, 1947 (29 U.S.C. 186(c)(6));
          (2) an entity that operates a training program that is jointly administered by—
                (A) one or more health care providers or facilities, or a trade association of health care providers; and
                (B) one or more organizations which represent the interests of direct care health care workers or staff nurses and in which the direct care health care workers or staff nurses have direct input as to the leadership of the organization;
          (3) a State training partnership program that consists of nonprofit organizations that include equal participation from industry, including public or private employers, and labor organizations including joint labor-management training programs, and which may include representatives from local governments, worker investment agency one-stop career centers, community-based organizations, community colleges, and accredited schools of nursing; or
          (4) a school of nursing (as defined in section 801 of the Public Health Service Act (42 U.S.C. 296)).
    (d) Additional Requirements for Health Care Employer Described in Subsection (c).—
       To be eligible for a grant under this section, a health care employer described in subsection (c) shall demonstrate that it—
          (1) has an established program within their facility to encourage the retention of existing nurses;
          (2) provides wages and benefits to its nurses that are competitive for its market or that have been collectively bargained with a labor organization; and
          (3) supports programs funded under this section through 1 or more of the following:
                (A) The provision of paid leave time and continued health coverage to incumbent health care workers to allow their participation in nursing career ladder programs, including certified nurse assistants, licensed practical nurses, licensed vocational nurses, and registered nurses.
                (B) Contributions to a joint labor-management training fund which administers the program involved.
                (C) The provision of paid release time, incentive compensation, or continued health coverage to staff nurses who desire to work full- or part-time in a faculty position.
                (D) The provision of paid release time for staff nurses to enable them to obtain a bachelor of science in nursing degree, other advanced nursing degrees, specialty training, or certification program.
                (E) The payment of tuition assistance which is managed by a joint labor-management training fund or other jointly administered program.
    (e) Other Requirements.—
          (1) Matching Requirement.—
                (A) In General.—
                   The Secretary may not make a grant under this section unless the applicant involved agrees, with respect to the costs to be incurred by the applicant in carrying out the program under the grant, to make available non-Federal contributions (in cash or in kind under subparagraph (B)) toward such costs in an amount equal to not less than $1 for each $1 of Federal funds provided in the grant. Such contributions may be made directly or through donations from public or private entities, or may be provided through the cash equivalent of paid release time provided to incumbent worker students.
                (B) Determination of Amount of non-Federal Contribution.—
                   Non-Federal contributions required in subparagraph (A) may be in cash or in kind (including paid release time), fairly evaluated, including equipment or services (and excluding indirect or overhead costs). Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.
          (2) Required Collaboration.—
             Entities carrying out or overseeing programs carried out with assistance provided under this section shall demonstrate collaboration with accredited schools of nursing which may include community colleges and other academic institutions providing associate, bachelor's, or advanced nursing degree programs or specialty training or certification programs.
    (f) Use of Funds.—
       Amounts awarded to an entity under a grant under this section shall be used for the following:
          (1) To carry out programs that provide education and training to establish nursing career ladders to educate incumbent health care workers to become nurses (including certified nurse assistants, licensed practical nurses, licensed vocational nurses, and registered nurses). Such programs shall include one or more of the following:
                (A) Preparing incumbent workers to return to the classroom through English -as-a-second language education, GED education, pre-college counseling, college preparation classes, and support with entry level college classes that are a prerequisite to nursing.
                (B) Providing tuition assistance with preference for dedicated cohort classes in community colleges, universities, accredited schools of nursing with supportive services including tutoring and counseling.
                (C) Providing assistance in preparing for and meeting all nursing licensure tests and requirements.
                (D) Carrying out orientation and mentorship programs that assist newly graduated nurses in adjusting to working at the bedside to ensure their retention postgraduation, and ongoing programs to support nurse retention.
                (E) Providing stipends for release time and continued health care coverage to enable incumbent health care workers to participate in these programs.
          (2) To carry out programs that assist nurses in obtaining advanced degrees and completing specialty training or certification programs and to establish incentives for nurses to assume nurse faculty positions on a part-time or full-time basis. Such programs shall include one or more of the following:
                (A) Increasing the pool of nurses with advanced degrees who are interested in teaching by funding programs that enable incumbent nurses to return to school.
                (B) Establishing incentives for advanced degree bedside nurses who wish to teach in nursing programs so they can obtain a leave from their bedside position to assume a full- or part-time position as adjunct or full-time faculty without the loss of salary or benefits.
                (C) Collaboration with accredited schools of nursing which may include community colleges and other academic institutions providing associate, bachelor's, or advanced nursing degree programs, or specialty training or certification programs, for nurses to carry out innovative nursing programs which meet the needs of bedside nursing and health care providers.
    (g) Preference.—
       In awarding grants under this section the Secretary shall give preference to programs that—
          (1) provide for improving nurse retention;
          (2) provide for improving the diversity of the new nurse graduates to reflect changes in the demographics of the patient population;
          (3) provide for improving the quality of nursing education to improve patient care and safety;
          (4) have demonstrated success in upgrading incumbent health care workers to become nurses or which have established effective programs or pilots to increase nurse faculty; or
          (5) are modeled after or affiliated with such programs described in paragraph (4).
    (h) Evaluation.—
          (1) Program Evaluations.—
             An entity that receives a grant under this section shall annually evaluate, and submit to the Secretary a report on, the activities carried out under the grant and the outcomes of such activities. Such outcomes may include—
                (A) an increased number of incumbent workers entering an accredited school of nursing and in the pipeline for nursing programs;
                (B) an increasing number of graduating nurses and improved nurse graduation and licensure rates;
                (C) improved nurse retention;
                (D) an increase in the number of staff nurses at the health care facility involved;
                (E) an increase in the number of nurses with advanced degrees in nursing;
                (F) an increase in the number of nurse faculty;
                (G) improved measures of patient quality (which may include staffing ratios of nurses, patient satisfaction rates, patient safety measures); and
                (H) an increase in the diversity of new nurse graduates relative to the patient population.
          (2) General Report.—
             Not later than 2 years after the date of the enactment of this Act, and annually thereafter, the Secretary of Labor shall, using data and information from the reports received under paragraph (1), submit to the Congress a report concerning the overall effectiveness of the grant program carried out under this section.
    (i) Authorization of Appropriations.—
       There are authorized to be appropriated to carry out this section such sums as may be necessary.