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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1928 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 1928

To increase home healthcare services, particularly for underserved and 
at-risk populations, by assisting visiting nurse associations and other 
   non-profit home health agencies to improve training and workforce 
  development for home healthcare nurses, promoting and facilitating 
    academic-practice collaborations, and enhancing recruitment and 
                  retention of home healthcare nurses.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             April 2, 2009

  Mr. Kagen (for himself, Mr. Terry, Mr. Boswell, Mrs. Bono Mack, Ms. 
  Bordallo, and Mr. Yarmuth) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
To increase home healthcare services, particularly for underserved and 
at-risk populations, by assisting visiting nurse associations and other 
   non-profit home health agencies to improve training and workforce 
  development for home healthcare nurses, promoting and facilitating 
    academic-practice collaborations, and enhancing recruitment and 
                  retention of home healthcare nurses.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Home Healthcare Nurse Promotion Act 
of 2009''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) There is a significant shortage of home healthcare 
        nurses, which is harming individuals' access to cost-effective 
        home healthcare, particularly among underserved and high-risk 
        populations. A recent survey found that 59 percent of visiting 
        nurse associations indicated they must decline patient 
        referrals on a weekly basis.
            (2) The increasing aging population, prevalence of chronic 
        disease, and strong preference by individuals to live 
        independently at home as long as possible will create an 
        unprecedented demand for home-based care during the next 
        several decades. By 2020, home health utilization is projected 
        to increase by 36 percent.
            (3) The demand for home healthcare nurses is projected to 
        increase by 109 percent by 2020, compared to 37 percent for 
        hospital nurses.
            (4) An estimated 1,000,000 new registered nurses will be 
        needed by 2016 to fill new demand for nurses and replace 
        retirees.
            (5) Visiting nurse associations have been shown to lower 
        costs for high-cost patient populations. Yet because they 
        provide a substantial amount of uncompensated care, they are 
        increasingly unable to compete for nurses in a national nursing 
        shortage environment.
            (6) A recent survey by the Visiting Nurses Association of 
        America found that--
                    (A) staff nursing rate shortages average around 10 
                percent;
                    (B) 81 percent of visiting nurse associations 
                indicate that salary limitations are the number one 
                barrier to recruitment; and
                    (C) 22 percent of visiting nurse associations 
                indicate that their local hospital offers salaries 
                $10,000 greater than they are able to offer.
    (b) Purpose.--The purpose of this Act is to increase home health 
care services, particularly for underserved and at-risk populations, 
by--
            (1) assisting visiting nurse associations and other non-
        profit home health agencies to improve training and workforce 
        development for home healthcare nurses;
            (2) promoting and facilitating academic-practice 
        collaborations; and
            (3) improving recruitment and retention of home healthcare 
        nurses.

SEC. 3. DEFINING VISITING NURSE ASSOCIATION.

    Section 801 of the Public Health Service Act (42 U.S.C. 296) is 
amended by adding at the end the following new paragraph:
            ``(16) Visiting nurse association.--The term `visiting 
        nurse association' means a home health agency that--
                    ``(A) has a participation agreement in effect under 
                section 1866 of the Social Security Act;
                    ``(B) is a nonprofit entity exempt from taxation 
                under section 501(c)(3) of the Internal Revenue Code of 
                1986;
                    ``(C) is organized and participating under title 
                XVIII of the Social Security Act as a provider of 
                services separately from any other provider of services 
                under such title; and
                    ``(D) is governed by a board of directors and all 
                members of the board (excluding the head of the agency 
                in any case in which the head of the agency is a board 
                member) serve on such board on an exclusively volunteer 
                basis.''.

SEC. 4. HOME HEALTH TRAINING AND LOAN FORGIVENESS PROGRAMS.

    (a) Home Health Nurse Training Programs.--Part D of title VIII of 
the Public Health Service Act (42 U.S.C. 296p) is amended by adding at 
the end the following new sections:

``SEC. 832. HOME HEALTH NURSE TRAINING PROGRAM GRANTS.

    ``(a) In General.--The Secretary may make grants under this section 
to visiting nurse associations for the purpose of providing training in 
home health care to nurses who--
            ``(1) are hired by a visiting nurse association to provide 
        home health care; and
            ``(2) have no recent nursing work experience in home health 
        care.
    ``(b) Priority for Grants.--When awarding grants under subsection 
(a), the Secretary shall give priority to visiting nurse associations 
that provide medically-necessary home health care to individuals who 
request home health services (as defined in section 1861(m) of the 
Social Security Act) from such associations, regardless of ability to 
pay.

``SEC. 833. PILOT PROGRAM FOR HOME HEALTH TRAINING AT SCHOOLS OF 
              NURSING.

    ``(a) In General.--Not later than the last day of the 90-day period 
beginning on the date of enactment of this section, the Secretary shall 
establish a pilot program to make grants to a number (to be determined 
by the Secretary, but to be not less than five and not more than 10) of 
accredited schools of nursing that have entered into partnerships with 
visiting nurse associations for the purpose of developing and 
implementing a curriculum on home health care at such schools.
    ``(b) Application.--In order to qualify for a grant under 
subsection (a), a school of nursing must submit an application to the 
Secretary--
            ``(1) demonstrating that the school has established a 
        partnership with a visiting nurse association as required in 
        subsection (a); and
            ``(2) containing--
                    ``(A) a description of how the school and the 
                association will work collaboratively to develop and 
                implement a curriculum on home health care for the 
                students at the school;
                    ``(B) a description of how academic-practice 
                collaboration will occur, such as--
                            ``(i) utilizing visiting nurse faculty from 
                        the visiting nurse association; and
                            ``(ii) promoting student nurse internships, 
                        mentoring opportunities, or other collaborative 
                        activities to aid in the education and 
                        practical home healthcare experience of nursing 
                        students; and
                    ``(C) any other information required by the 
                Secretary.
    ``(c) Termination Date.--The pilot program under subsection (a) 
shall terminate at the end of the 5-year period beginning on the date 
of enactment of this section.
    ``(d) Report.--Not later than the last day of the first calendar 
year following the date of enactment of this section and the end of 
each succeeding calendar year, the Secretary shall submit to Congress a 
report on the pilot program under subsection (a).

``SEC. 834. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated to carry out this part 
(other than section 831) such sums as may be necessary in each fiscal 
year.''.
    (b) Loan Forgiveness for Certain Nurses.--
            (1) Amendments regarding service for visiting nurse 
        associations.--Section 846 of such Act (42 U.S.C. 297n) is 
        amended--
                    (A) in subsection (a)(3), by inserting ``or for a 
                visiting nurse association'' after ``critical shortage 
                of nurses'';
                    (B) in subsection (g)(2)--
                            (i) by striking ``or health facility'' and 
                        inserting ``, health facility, or visiting 
                        nurse association'';
                            (ii) by striking ``or the health facility'' 
                        and inserting ``, the health facility, or the 
                        visiting nurse association''; and
                            (iii) by striking ``or facility'' each 
                        place it appears and inserting ``, facility, or 
                        association''; and
                    (C) in subsection (h)(5) by inserting ``and 
                visiting nurse associations'' before the semicolon at 
                the end.
            (2) Technical amendments.--Section 846 of such Act (42 
        U.S.C. 297n) is further amended--
                    (A) by striking subsection (f); and
                    (B) by redesignating subsections (g) through (i) as 
                subsections (f) through (h), respectively.
                                 <all>
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