I 

111TH CONGRESS 

1ST SESSION H. R. 2043 

To amend the Public Health Service Act to authorize capitation grants to 

increase the number of nursing faculty and students, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 22, 2009 

Mrs. LOWEY introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty 

and students, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Nurse Education, Ex5 pansion, and Development Act of 2009’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) While the Nurse Reinvestment Act (Public 

9 Law 107–205) helped to increase applications to 

10 schools of nursing by 125 percent, schools of nursing 


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1 have been unable to accommodate the influx of in2 terested students because they have an insufficient 

3 number of nurse educators. The American Associa4 tion of Colleges of Nursing estimates that— 

5 (A) in the 2008–2009 school year— 

6 (i) 62.8 percent of schools of nursing 

7 had from 1 to 16 vacant faculty positions; 

8 and 

9 (ii) an additional 17.8 percent of 

10 schools of nursing needed additional fac11 ulty, but lacked the resources needed to 

12 add more positions; and 

13 (B) 49,948 eligible candidates were denied 

14 admission to schools of nursing in 2008, pri15 marily due to an insufficient number of faculty 

16 members. 

17 (2) A growing number of nurses with doctoral 

18 degrees are choosing careers outside of education. 

19 Over the last few years, 20.7 percent of doctoral 

20 nursing graduates reported seeking employment out21 side the education profession. 

22 (3) The average age of nurse faculty at retire23 ment is 62.5 years. With the average age of 

24 doctorally prepared nurse faculty at 55.6 years in 


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1 2007, a wave of retirements is expected within the 

2 next 10 years. 

3 (4) Master’s and doctoral programs in nursing 

4 are not producing a large enough pool of potential 

5 nurse educators to meet the projected demand for 

6 nurses over the next 10 years. While graduations 

7 from master’s and doctoral programs in nursing rose 

8 by 12.8 percent (or 1,918 graduates) and 4.5 per9 cent (or 24 graduates), respectively, in the 2008– 

10 2009 school year, projections still demonstrate a 

11 shortage of nurse faculty. Given current trends, 

12 there will be at least 2,616 unfilled faculty positions 

13 in 2012. 

14 (5) According to the November 2007 Monthly 

15 Labor Review of the Bureau of Labor Statistics, 

16 more than 1,000,000 new and replacement nurses 

17 will be needed by 2016. 

18 SEC. 3. CAPITATION GRANTS TO INCREASE THE NUMBER 

19 OF NURSING FACULTY AND STUDENTS. 

20 (a) GRANTS.—Part D of title VIII of the Public 

21 Health Service Act (42 U.S.C. 296p) is amended by add22 ing at the end the following: 

23 ‘‘SEC. 832. CAPITATION GRANTS. 

24 ‘‘(a) IN GENERAL.—For the purpose described in 

25 subsection (b), the Secretary, acting through the Health 


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1 Resources and Services Administration, shall award a 

2 grant each fiscal year in an amount determined in accord3 ance with subsection (c) to each eligible school of nursing 

4 that submits an application in accordance with this sec5 tion. 

6 ‘‘(b) PURPOSE.—A funding agreement for a grant 

7 under this section is that the eligible school of nursing 

8 involved will expend the grant to increase the number of 

9 nursing faculty and students at the school, including by 

10 hiring new faculty, retaining current faculty, purchasing 

11 educational equipment and audiovisual laboratories, en12 hancing clinical laboratories, repairing and expanding in13 frastructure, or recruiting students. 

14 ‘‘(c) GRANT COMPUTATION.— 

15 ‘‘(1) AMOUNT PER STUDENT.—Subject to para16 graph (2), the amount of a grant to an eligible 

17 school of nursing under this section for a fiscal year 

18 shall be the total of the following: 

19 ‘‘(A) $1,800 for each full-time or part-time 

20 student who is enrolled at the school in a grad21 uate program in nursing that— 

22 ‘‘(i) leads to a master’s degree, a doc23 toral degree, or an equivalent degree; and 

24 ‘‘(ii) prepares individuals to serve as 

25 faculty through additional course work in 


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1 education and ensuring competency in an 

2 advanced practice area. 

3 ‘‘(B) $1,405 for each full-time or part-time 

4 student who— 

5 ‘‘(i) is enrolled at the school in a pro6 gram in nursing leading to a bachelor of 

7 science degree, a bachelor of nursing de8 gree, a graduate degree in nursing if such 

9 program does not meet the requirements of 

10 subparagraph (A), or an equivalent degree; 

11 and 

12 ‘‘(ii) has not more than 3 years of 

13 academic credits remaining in the pro14 gram. 

15 ‘‘(C) $966 for each full-time or part-time 

16 student who is enrolled at the school in a pro17 gram in nursing leading to an associate degree 

18 in nursing or an equivalent degree. 

19 ‘‘(2) LIMITATION.—In calculating the amount 

20 of a grant to a school under paragraph (1), the Sec21 retary may not make a payment with respect to a 

22 particular student— 

23 ‘‘(A) for more than 2 fiscal years in the 

24 case of a student described in paragraph (1)(A) 

25 who is enrolled in a graduate program in nursVerDate Nov 24 2008 21:52 Apr 23, 2009 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2043.IH H2043

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1 ing leading to a master’s degree or an equiva2 lent degree; 

3 ‘‘(B) for more than 4 fiscal years in the 

4 case of a student described in paragraph (1)(A) 

5 who is enrolled in a graduate program in nurs6 ing leading to a doctoral degree or an equiva7 lent degree; 

8 ‘‘(C) for more than 3 fiscal years in the 

9 case of a student described in paragraph 

10 (1)(B); or 

11 ‘‘(D) for more than 2 fiscal years in the 

12 case of a student described in paragraph 

13 (1)(C). 

14 ‘‘(d) ELIGIBILITY.—For purposes of this section, the 

15 term ‘eligible school of nursing’ means a school of nursing 

16 that— 

17 ‘‘(1) is accredited by a nursing accrediting 

18 agency recognized by the Secretary of Education; 

19 ‘‘(2) has a passage rate on the National Council 

20 Licensure Examination for Registered Nurses of not 

21 less than 80 percent for each of the 3 school years 

22 preceding submission of the grant application; and 

23 ‘‘(3) has a graduation rate (based on the num24 ber of students in a class who graduate relative to, 

25 for a baccalaureate program, the number of students 


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1 who were enrolled in the class at the beginning of 

2 junior year or, for an associate degree program, the 

3 number of students who were enrolled in the class 

4 at the end of the first year) of not less than 80 per5 cent for each of the 3 school years preceding submis6 sion of the grant application. 

7 ‘‘(e) REQUIREMENTS.—The Secretary may award a 

8 grant under this section to an eligible school of nursing 

9 only if the school gives assurances satisfactory to the Sec10 retary that, for each school year for which the grant is 

11 awarded, the school will comply with the following: 

12 ‘‘(1) The school will maintain a passage rate on 

13 the National Council Licensure Examination for 

14 Registered Nurses of not less than 80 percent. 

15 ‘‘(2) The school will maintain a graduation rate 

16 (as described in subsection (d)(3)) of not less than 

17 80 percent. 

18 ‘‘(3)(A) Subject to subparagraphs (B) and (C), 

19 the first-year enrollment of full-time nursing stu20 dents in the school will exceed such enrollment for 

21 the preceding school year by 5 percent or 5 students, 

22 whichever is greater. 

23 ‘‘(B) Subparagraph (A) does not apply to the 

24 first school year for which a school receives a grant 

25 under this section. 


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1 ‘‘(C) With respect to any school year, the Sec2 retary may waive application of subparagraph (A) 

3 if— 

4 ‘‘(i) the physical facilities at the school in5 volved limit the school from enrolling additional 

6 students; or 

7 ‘‘(ii) the school has increased enrollment in 

8 the school (as described in subparagraph (A)) 

9 for each of the 2 preceding school years. 

10 ‘‘(4) Not later than 1 year after receipt of the 

11 grant, the school will formulate and implement a 

12 plan to accomplish at least 2 of the following: 

13 ‘‘(A) Establishing or significantly expand14 ing an accelerated baccalaureate degree nursing 

15 program designed to graduate new nurses in 12 

16 to 18 months. 

17 ‘‘(B) Establishing cooperative intradisci18 plinary education among schools of nursing 

19 with a view toward shared use of technological 

20 resources, including information technology. 

21 ‘‘(C) Establishing cooperative interdisci22 plinary training between schools of nursing and 

23 schools of allied health, medicine, dentistry, os24 teopathy, optometry, podiatry, pharmacy, public 

25 health, or veterinary medicine, including trainVerDate Nov 24 2008 21:52 Apr 23, 2009 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2043.IH H2043

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1 ing for the use of the interdisciplinary team ap2 proach to the delivery of health services. 

3 ‘‘(D) Integrating core competencies on evi4 dence-based practice, quality improvements, and 

5 patient-centered care. 

6 ‘‘(E) Increasing admissions, enrollment, 

7 and retention of qualified individuals who are 

8 financially disadvantaged. 

9 ‘‘(F) Increasing enrollment of minority and 

10 diverse student populations. 

11 ‘‘(G) Increasing enrollment of new grad12 uate baccalaureate nursing students in graduate 

13 programs that educate nurse faculty members. 

14 ‘‘(H) Developing post-baccalaureate resi15 dency programs to prepare nurses for practice 

16 in specialty areas where nursing shortages are 

17 most severe. 

18 ‘‘(I) Increasing integration of geriatric con19 tent into the core curriculum. 

20 ‘‘(J) Partnering with economically dis21 advantaged communities to provide nursing 

22 education. 

23 ‘‘(K) Expanding the ability of nurse man24 aged health centers to provide clinical education 

25 training sites to nursing students. 


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1 ‘‘(5) The school will submit an annual report to 

2 the Secretary that includes updated information on 

3 the school with respect to student enrollment, stu4 dent retention, graduation rates, passage rates on 

5 the National Council Licensure Examination for 

6 Registered Nurses, the number of graduates em7 ployed as nursing faculty or nursing care providers 

8 within 12 months of graduation, and the number of 

9 students who are accepted into graduate programs 

10 for further nursing education. 

11 ‘‘(6) The school will allow the Secretary to 

12 make on-site inspections, and will comply with the 

13 Secretary’s requests for information, to determine 

14 the extent to which the school is complying with the 

15 requirements of this section. 

16 ‘‘(f) REPORTS TO CONGRESS.—The Secretary shall 

17 evaluate the results of grants under this section and sub18 mit to the Congress— 

19 ‘‘(1) not later than 18 months after the date of 

20 the enactment of this section, an interim report on 

21 such results; and 

22 ‘‘(2) not later than the end of fiscal year 2010, 

23 a final report on such results. 

24 ‘‘(g) APPLICATION.—To seek a grant under this sec25 tion, a school nursing shall submit an application to the 


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1 Secretary at such time, in such manner, and containing 

2 such information and assurances as the Secretary may re3 quire. 

4 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

5 ‘‘(1) IN GENERAL.—For the costs of carrying 

6 out this section (except the costs described in para7 graph (2)), there are authorized to be appropriated 

8 $75,000,000 for fiscal year 2010, $85,000,000 for 

9 fiscal year 2011, and $95,000,000 for fiscal year 

10 2012. 

11 ‘‘(2) ADMINISTRATIVE COSTS.—For the costs of 

12 administering this section, including the costs of 

13 evaluating the results of grants and submitting re14 ports to the Congress, there are authorized to be ap15 propriated such sums as may be necessary for each 

16 of fiscal years 2010, 2011, and 2012.’’. 

17 (b) GAO STUDY.— 

18 (1) IN GENERAL.—Not later than 1 year after 

19 the date of the enactment of this Act, the Comp20 troller General of the United States shall conduct a 

21 study and submit a report to the Congress on ways 

22 to increase participation in the nurse faculty profes23 sion. 

24 (2) CONTENTS OF REPORT.—The report re25 quired by paragraph (1) shall include the following: 


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1 (A) A discussion of the master’s degree 

2 and doctoral degree programs that are success3 ful in placing graduates as faculty in schools of 

4 nursing. 

5 (B) An examination of compensation dis6 parities throughout the nursing profession and 

7 compensation disparities between higher edu8 cation instructional faculty generally and higher 

9 education instructional nursing faculty. 

Æ 


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