I 

111TH CONGRESS 

1ST SESSION H. R. 2536 

To provide relief for the shortage of nurses in the United States, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 20, 2009 

Mr. WEXLER (for himself, Mr. SENSENBRENNER, Mrs. LOWEY, Mr. BILBRAY, 

and Mr. COHEN) introduced the following bill; which was referred to the 

Committee on the Judiciary, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To provide relief for the shortage of nurses in the United 

States, 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 ‘‘Emergency Nursing 

5 Supply Relief Act’’. 

6 SEC. 2. NURSING SHORTAGE RELIEF. 

7 (a) INCREASING VISA NUMBERS.—Section 106 of the 

8 American Competitiveness in the Twenty-first Century 


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1 Act of 2000 (Public Law 106–313; 8 U.S.C. 1153 note) 

2 is amended by adding at the end the following: 

3 ‘‘(e) VISA SHORTAGE RELIEF FOR NURSES AND

4 PHYSICAL THERAPISTS.— 

5 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

6 for petitions filed any time prior to September 30, 

7 2012, for employment-based immigrants (and their 

8 family members accompanying or following to join 

9 under section 203(d) of the Immigration and Na10 tionality Act (8 U.S.C. 1153(d))), which are or have 

11 been approved based on Schedule A, Group I as de12 fined in section 656.5 of title 20, Code of Federal 

13 Regulations, as promulgated by the Secretary of 

14 Labor, the numerical limitations set forth in sections 

15 201(d) and 202(a) of such Act (8 U.S.C. 1151(d) 

16 and 1152(a)) shall not apply. 

17 ‘‘(2) LIMITATION ON NUMBER OF VISAS.—The 

18 Secretary of State may not issue more than 20,000 

19 immigrant visa numbers in any one fiscal year (plus 

20 any available visa numbers under this paragraph not 

21 used during the preceding fiscal year) to principal 

22 beneficiaries of petitions pursuant to paragraph (1). 

23 ‘‘(3) EXPEDITED REVIEW.—The Secretary of 

24 Homeland Security shall provide a process for re25 viewing and acting upon petitions with respect to 


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1 immigrants described in paragraph (1) not later 

2 than 30 days after the date on which a completed 

3 petition has been filed. 

4 ‘‘(f) FEE FOR USE OF VISAS UNDER SUBSECTION

5 (a).— 

6 ‘‘(1) IN GENERAL.—The Secretary of Homeland 

7 Security shall impose a fee upon each petitioning 

8 employer who uses a visa provided under subsection 

9 (e) to provide employment for an alien as a profes10 sional nurse, except that— 

11 ‘‘(A) such fee shall be in the amount of 

12 $1,500 for each such alien nurse (but not for 

13 dependents accompanying or following to join 

14 who are not professional nurses); and 

15 ‘‘(B) no fee shall be imposed for the use of 

16 such visas if the employer demonstrates to the 

17 Secretary that— 

18 ‘‘(i) the employer is a health care fa19 cility that is located in a county or parish 

20 that received individual and public assist21 ance pursuant to Major Disaster Declara22 tion number 1603 or 1607; or 

23 ‘‘(ii) the employer is a health care fa24 cility that has been designated as a Health 

25 Professional Shortage Area facility by the 


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1 Secretary of Health and Human Services 

2 as defined in section 332 of the Public 

3 Health Service Act (42 U.S.C. 254e). 

4 ‘‘(2) FEE COLLECTION.—A fee imposed by the 

5 Secretary of Homeland Security pursuant to para6 graph (1) shall be collected by the Secretary as a 

7 condition of approval of an application for adjust8 ment of status by the beneficiary of a petition or by 

9 the Secretary of State as a condition of issuance of 

10 a visa to such beneficiary.’’. 

11 (b) CAPITATION GRANTS TO INCREASE THE NUM12 BER OF NURSING FACULTY AND STUDENTS; DOMESTIC

13 NURSING ENHANCEMENT ACCOUNT.—Part D of title VIII 

14 of the Public Health Service Act (42 U.S.C. 296p et seq.) 

15 is amended by adding at the end the following: 

16 ‘‘SEC. 832. CAPITATION GRANTS. 

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

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

19 Resources and Services Administration, shall award a 

20 grant each fiscal year in an amount determined in accord21 ance with subsection (c) to each eligible school of nursing 

22 that submits an application in accordance with this sec23 tion. 

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

25 under this section is that the eligible school of nursing 


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1 involved will expend the grant to increase the number of 

2 nursing faculty and students at the school, including by 

3 hiring new faculty, retaining current faculty, purchasing 

4 educational equipment and audiovisual laboratories, en5 hancing clinical laboratories, repairing and expanding in6 frastructure, or recruiting students. 

7 ‘‘(c) GRANT COMPUTATION.— 

8 ‘‘(1) AMOUNT PER STUDENT.—Subject to para9 graph (2), the amount of a grant to an eligible 

10 school of nursing under this section for a fiscal year 

11 shall be the total of the following: 

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

13 student who is enrolled at the school in a grad14 uate program in nursing that— 

15 ‘‘(i) leads to a master’s degree, a doc16 toral degree, or an equivalent degree; and 

17 ‘‘(ii) prepares individuals to serve as 

18 faculty through additional course work in 

19 education and ensuring competency in an 

20 advanced practice area. 

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

22 student who— 

23 ‘‘(i) is enrolled at the school in a pro24 gram in nursing leading to a bachelor of 

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1 gree, a graduate degree in nursing if such 

2 program does not meet the requirements of 

3 subparagraph (A), or an equivalent degree; 

4 and 

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

6 academic credits remaining in the pro7 gram. 

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

9 student who is enrolled at the school in a pro10 gram in nursing leading to an associate degree 

11 in nursing or an equivalent degree. 

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

13 of a grant to a school under paragraph (1), the Sec14 retary may not make a payment with respect to a 

15 particular student— 

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

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

18 who is enrolled in a graduate program in nurs19 ing leading to a master’s degree or an equiva20 lent degree; 

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

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

23 who is enrolled in a graduate program in nurs24 ing leading to a doctoral degree or an equiva25 lent degree; 


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

2 case of a student described in paragraph 

3 (1)(B); or 

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

5 case of a student described in paragraph 

6 (1)(C). 

7 ‘‘(d) ELIGIBILITY.—In this section, the term ‘eligible 

8 school of nursing’ means a school of nursing that— 

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

10 agency recognized by the Secretary of Education; 

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

12 Licensure Examination for Registered Nurses of not 

13 less than 80 percent for each of the 3 academic 

14 years preceding submission of the grant application; 

15 and 

16 ‘‘(3) has a graduation rate (based on the num17 ber of students in a class who graduate relative to, 

18 for a baccalaureate program, the number of students 

19 who were enrolled in the class at the beginning of 

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

21 number of students who were enrolled in the class 

22 at the end of the first year) of not less than 80 per23 cent for each of the 3 academic years preceding sub24 mission of the grant application. 


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

2 grant under this section to an eligible school of nursing 

3 only if the school gives assurances satisfactory to the Sec4 retary that, for each academic year for which the grant 

5 is awarded, the school will comply with the following: 

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

7 the National Council Licensure Examination for 

8 Registered Nurses of not less than 80 percent. 

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

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

11 80 percent. 

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

13 the first-year enrollment of full-time nursing stu14 dents in the school will exceed such enrollment for 

15 the preceding academic year by 5 percent or 5 stu16 dents, whichever is greater. 

17 ‘‘(B) Subparagraph (A) shall not apply to the 

18 first academic year for which a school receives a 

19 grant under this section. 

20 ‘‘(C) With respect to any academic year, the 

21 Secretary may waive application of subparagraph 

22 (A) if— 

23 ‘‘(i) the physical facilities at the school in24 volved limit the school from enrolling additional 

25 students; or 


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

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

3 for each of the 2 preceding academic years. 

4 ‘‘(4) Not later than 1 year after receiving a 

5 grant under this section, the school will formulate 

6 and implement a plan to accomplish at least 2 of the 

7 following: 

8 ‘‘(A) Establishing or significantly expand9 ing an accelerated baccalaureate degree nursing 

10 program designed to graduate new nurses in 12 

11 to 18 months. 

12 ‘‘(B) Establishing cooperative 

13 intradisciplinary education among schools of 

14 nursing with a view toward shared use of tech15 nological resources, including information tech16 nology. 

17 ‘‘(C) Establishing cooperative interdiscipli18 nary training between schools of nursing and 

19 schools of allied health, medicine, dentistry, os20 teopathy, optometry, podiatry, pharmacy, public 

21 health, or veterinary medicine, including train22 ing for the use of the interdisciplinary team ap23 proach to the delivery of health services. 


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1 ‘‘(D) Integrating core competencies on evi2 dence-based practice, quality improvements, and 

3 patient-centered care. 

4 ‘‘(E) Increasing admissions, enrollment, 

5 and retention of qualified individuals who are 

6 financially disadvantaged. 

7 ‘‘(F) Increasing enrollment of minority and 

8 diverse student populations. 

9 ‘‘(G) Increasing enrollment of new grad10 uate baccalaureate nursing students in graduate 

11 programs that educate nurse faculty members. 

12 ‘‘(H) Developing post-baccalaureate resi13 dency programs to prepare nurses for practice 

14 in specialty areas where nursing shortages are 

15 most severe. 

16 ‘‘(I) Increasing integration of geriatric con17 tent into the core curriculum. 

18 ‘‘(J) Partnering with economically dis19 advantaged communities to provide nursing 

20 education. 

21 ‘‘(K) Expanding the ability of nurse man22 aged health centers to provide clinical education 

23 training sites to nursing students. 

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

25 the Secretary that includes updated information on 


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1 the school with respect to student enrollment, stu2 dent retention, graduation rates, passage rates on 

3 the National Council Licensure Examination for 

4 Registered Nurses, the number of graduates em5 ployed as nursing faculty or nursing care providers 

6 within 12 months of graduation, and the number of 

7 students who are accepted into graduate programs 

8 for further nursing education. 

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

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

11 Secretary’s requests for information, to determine 

12 the extent to which the school is complying with the 

13 requirements of this section. 

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

15 evaluate the results of grants under this section and sub16 mit to Congress— 

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

18 the enactment of this section, an interim report on 

19 such results; and 

20 ‘‘(2) not later than September 30, 2010, a final 

21 report on such results. 

22 ‘‘(g) APPLICATION.—An eligible school of nursing 

23 seeking a grant under this section shall submit an applica24 tion to the Secretary at such time, in such manner, and 


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1 containing such information and assurances as the Sec2 retary may require. 

3 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—In ad4 dition to the amounts in the Domestic Nursing Enhance5 ment Account, established under section 833, there are 

6 authorized to be appropriated such sums as may be nec7 essary to carry out this section. 

8 ‘‘SEC. 833. DOMESTIC NURSING ENHANCEMENT ACCOUNT. 

9 ‘‘(a) ESTABLISHMENT.—There is established in the 

10 general fund of the Treasury a separate account which 

11 shall be known as the ‘Domestic Nursing Enhancement 

12 Account’. Notwithstanding any other provision of law, 

13 there shall be deposited as offsetting receipts into the ac14 count all fees collected under section 106(f) of the Amer15 ican Competitiveness in the Twenty-first Century Act of 

16 2000 (Public Law 106–313; 8 U.S.C. 1153 note). Nothing 

17 in this subsection shall prohibit the depositing of other 

18 moneys into the account established under this section. 

19 ‘‘(b) USE OF FUNDS.—Amounts collected under sec20 tion 106(f) of the American Competitiveness in the Twen21 ty-first Century Act of 2000, and deposited into the ac22 count established under subsection (a) shall be used by 

23 the Secretary of Health and Human Services to carry out 

24 section 832. Such amounts shall be available for obligation 

25 only to the extent, and in the amount, provided in advance 


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1 in appropriations Acts. Such amounts are authorized to 

2 remain available until expended.’’. 

3 (c) GLOBAL HEALTH CARE COOPERATION.— 

4 (1) IN GENERAL.—Title III of the Immigration 

5 and Nationality Act (8 U.S.C. 1401 et seq.) is 

6 amended by inserting after section 317 the fol7 lowing: 

8 ‘‘SEC. 317A. TEMPORARY ABSENCE OF ALIENS PROVIDING 

9 HEALTH CARE IN DEVELOPING COUNTRIES. 

10 ‘‘(a) IN GENERAL.—Notwithstanding any other pro11 vision of this Act, the Secretary of Homeland Security 

12 shall allow an eligible alien and the spouse or child of such 

13 alien to reside in a candidate country during the period 

14 that the eligible alien is working as a physician or other 

15 health care worker in a candidate country. During such 

16 period the eligible alien and such spouse or child shall be 

17 considered— 

18 ‘‘(1) to be physically present and residing in the 

19 United States for purposes of naturalization under 

20 section 316(a); and 

21 ‘‘(2) to meet the continuous residency require22 ments under section 316(b). 

23 ‘‘(b) DEFINITIONS.—In this section: 


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1 ‘‘(1) CANDIDATE COUNTRY.—The term ‘can2 didate country’ means a country that the Secretary 

3 of State determines to be— 

4 ‘‘(A) eligible for assistance from the Inter5 national Development Association, in which the 

6 per capita income of the country is equal to or 

7 less than the historical ceiling of the Inter8 national Development Association for the appli9 cable fiscal year, as defined by the International 

10 Bank for Reconstruction and Development; 

11 ‘‘(B) classified as a lower middle income 

12 country in the then most recent edition of the 

13 World Development Report for Reconstruction 

14 and Development published by the International 

15 Bank for Reconstruction and Development and 

16 having an income greater than the historical 

17 ceiling for International Development Associa18 tion eligibility for the applicable fiscal year; or 

19 ‘‘(C) qualified to be a candidate country 

20 due to special circumstances, including natural 

21 disasters or public health emergencies. 

22 ‘‘(2) ELIGIBLE ALIEN.—The term ‘eligible 

23 alien’ means an alien who— 

24 ‘‘(A) has been lawfully admitted to the 

25 United States for permanent residence; and 


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1 ‘‘(B) is a physician or other healthcare 

2 worker. 

3 ‘‘(c) CONSULTATION.—The Secretary of Homeland 

4 Security shall consult with the Secretary of State in car5 rying out this section. 

6 ‘‘(d) PUBLICATION.—The Secretary of State shall 

7 publish— 

8 ‘‘(1) not later than 180 days after the date of 

9 the enactment of this section, a list of candidate 

10 countries; 

11 ‘‘(2) an updated version of the list required by 

12 paragraph (1) not less often than once each year; 

13 and 

14 ‘‘(3) an amendment to the list required by 

15 paragraph (1) at the time any country qualifies as 

16 a candidate country due to special circumstances 

17 under subsection (b)(1)(C).’’. 

18 (2) RULEMAKING.— 

19 (A) REQUIREMENT.—Not later than 180 

20 days after the date of the enactment of this 

21 Act, the Secretary of Homeland Security shall 

22 promulgate regulations to carry out the amend23 ments made by this subsection. 

24 (B) CONTENT.—The regulations promul25 gated pursuant to paragraph (1) shall— 


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1 (i) permit an eligible alien (as defined 

2 in section 317A of the Immigration and 

3 Nationality Act, as added by paragraph 

4 (1)) and the spouse or child of the eligible 

5 alien to reside in a foreign country to work 

6 as a physician or other healthcare worker 

7 as described in subsection (a) of such sec8 tion 317A for not less than a 12-month pe9 riod and not more than a 24-month period, 

10 and shall permit the Secretary to extend 

11 such period for an additional period not to 

12 exceed 12 months, if the Secretary deter13 mines that such country has a continuing 

14 need for such a physician or other 

15 healthcare worker; 

16 (ii) provide for the issuance of docu17 ments by the Secretary to such eligible 

18 alien, and such spouse or child, if appro19 priate, to demonstrate that such eligible 

20 alien, and such spouse or child, if appro21 priate, is authorized to reside in such 

22 country under such section 317A; and 

23 (iii) provide for an expedited process 

24 through which the Secretary shall review 

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1 side in a foreign country pursuant to sub2 section (a) of such section 317A if the Sec3 retary of State determines a country is a 

4 candidate country pursuant to subsection 

5 (b)(1)(C) of such section 317A. 

6 (3) TECHNICAL AND CONFORMING AMEND7 MENTS.— 

8 (A) DEFINITION.—Section 

9 101(a)(13)(C)(ii) of the Immigration and Na10 tionality Act (8 U.S.C. 1101(a)(13)(C)(ii)) is 

11 amended by adding at the end the following: 

12 ‘‘except in the case of an eligible alien, or the 

13 spouse or child of such alien, who is authorized 

14 to be absent from the United States under sec15 tion 317A,’’. 

16 (B) DOCUMENTARY REQUIREMENTS.—Sec17 tion 211(b) of such Act (8 U.S.C. 1181(b)) is 

18 amended by inserting ‘‘, including an eligible 

19 alien authorized to reside in a foreign country 

20 under section 317A and the spouse or child of 

21 such eligible alien, if appropriate,’’ after 

22 ‘‘101(a)(27)(A),’’. 

23 (C) INELIGIBLE ALIENS.—Section 

24 212(a)(7)(A)(i)(I) of such Act (8 U.S.C. 

25 1182(a)(7)(A)(i)(I)) is amended by inserting 


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1 ‘‘other than an eligible alien authorized to re2 side in a foreign country under section 317A 

3 and the spouse or child of such eligible alien, if 

4 appropriate,’’ after ‘‘Act,’’. 

5 (D) CLERICAL AMENDMENT.—The table of 

6 contents of such Act is amended by inserting 

7 after the item relating to section 317 the fol8 lowing: 

‘‘Sec. 317A. Temporary absence of aliens providing health care in developing 

countries.’’. 

9 (4) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated to U.S. 

11 Citizenship and Immigration Services such sums as 

12 may be necessary to carry out this subsection and 

13 the amendments made by this subsection. 

14 (d) ATTESTATION BY HEALTH CARE WORKERS.— 

15 (1) ATTESTATION REQUIREMENT.—Section 

16 212(a)(5) of the Immigration and Nationality Act (8 

17 U.S.C. 1182(a)(5)) is amended by adding at the end 

18 the following: 

19 ‘‘(E) HEALTH CARE WORKERS WITH

20 OTHER OBLIGATIONS.— 

21 ‘‘(i) IN GENERAL.—An alien who 

22 seeks to enter the United States for the 

23 purpose of performing labor as a physician 

24 or other health care worker is inadmissible 


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1 unless the alien submits to the Secretary of 

2 Homeland Security or the Secretary of 

3 State, as appropriate, an attestation that 

4 the alien is not seeking to enter the United 

5 States for such purpose during any period 

6 in which the alien has an outstanding obli7 gation to the government of the alien’s 

8 country of origin or the alien’s country of 

9 residence. 

10 ‘‘(ii) OBLIGATION DEFINED.—In this 

11 subparagraph, the term ‘obligation’ means 

12 an obligation incurred as part of a valid, 

13 voluntary individual agreement in which 

14 the alien received financial assistance to 

15 defray the costs of education or training to 

16 qualify as a physician or other health care 

17 worker in consideration for a commitment 

18 to work as a physician or other health care 

19 worker in the alien’s country of origin or 

20 the alien’s country of residence. 

21 ‘‘(iii) WAIVER.—The Secretary of 

22 Homeland Security may waive a finding of 

23 inadmissibility under clause (i) if the Sec24 retary determines that— 


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1 ‘‘(I) the obligation was incurred 

2 by coercion or other improper means; 

3 ‘‘(II) the alien and the govern4 ment of the country to which the alien 

5 has an outstanding obligation have 

6 reached a valid, voluntary agreement, 

7 pursuant to which the alien’s obliga8 tion has been deemed satisfied, or the 

9 alien has shown to the satisfaction of 

10 the Secretary that the alien has been 

11 unable to reach such an agreement 

12 because of coercion or other improper 

13 means; or 

14 ‘‘(III) the obligation should not 

15 be enforced due to other extraordinary 

16 circumstances, including undue hard17 ship that would be suffered by the 

18 alien in the absence of a waiver.’’. 

19 (2) EFFECTIVE DATE; APPLICATION.— 

20 (A) EFFECTIVE DATE.—The amendment 

21 made by paragraph (1) shall take effect on the 

22 date that is 180 days after the date of the en23 actment of this Act. 

24 (B) APPLICATION BY THE SECRETARY.— 

25 Not later than the effective date described in 


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1 subparagraph (A), the Secretary of Homeland 

2 Security shall begin to carry out subparagraph 

3 (E) of section 212(a)(5) of the Immigration 

4 and Nationality Act, as added by paragraph 

5 (1), including the requirement for the attesta6 tion and the granting of a waiver described in 

7 clause (iii) of such subparagraph (E), regard8 less of whether regulations to implement such 

9 subparagraph have been promulgated. 

10 SEC. 3. NURSE TRAINING AND RETENTION DEMONSTRA11 TION GRANT ACT OF 2008. 

12 (a) FINDINGS.—Congress makes the following find13 ings: 

14 (1) America’s healthcare system depends on an 

15 adequate supply of trained nurses to deliver quality 

16 patient care. 

17 (2) Over the next 15 years, this shortage is ex18 pected to grow significantly. The Health Resources 

19 and Services Administration has projected that by 

20 2020, there will be a shortage of nurses in every 

21 State and that overall only 64 percent of the de22 mand for nurses will be satisfied, with a shortage of 

23 1,016,900 nurses nationally. 

24 (3) To avert such a shortage, today’s network 

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1 cation and support from their employers to partici2 pate in educational and training opportunities. 

3 (4) With the appropriate education and sup4 port, incumbent healthcare workers and incumbent 

5 bedside nurses are untapped sources which can meet 

6 these needs and address the nursing shortage and 

7 provide quality care as the American population 

8 ages. 

9 (b) PURPOSES OF GRANT PROGRAM.—It is the pur10 pose of this section to authorize grants to— 

11 (1) address the projected shortage of nurses by 

12 funding comprehensive programs to create a career 

13 ladder to nursing (including Certified Nurse Assist14 ants, Licensed Practical Nurses, Licensed Vocational 

15 Nurses, and Registered Nurses) for incumbent ancil16 lary healthcare workers; 

17 (2) increase the capacity for educating nurses 

18 by increasing both nurse faculty and clinical oppor19 tunities through collaborative programs between 

20 staff nurse organizations, healthcare providers, and 

21 accredited schools of nursing; and 

22 (3) provide training programs through edu23 cation and training organizations jointly adminis24 tered by healthcare providers and healthcare labor 

25 organizations or other organizations representing 


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1 staff nurses and frontline healthcare workers, work2 ing in collaboration with accredited schools of nurs3 ing and academic institutions. 

4 (c) GRANTS.—Not later than 6 months after the date 

5 of enactment of this Act, the Secretary of Labor (referred 

6 to in this section as the ‘‘Secretary’’) shall establish a 

7 partnership grant program to award grants to eligible en8 tities to carry out comprehensive programs to provide edu9 cation to nurses and create a pipeline to nursing for in10 cumbent ancillary healthcare workers who wish to advance 

11 their careers, and to otherwise carry out the purposes of 

12 this section. 

13 (d) ELIGIBLE ENTITIES.—To be eligible to receive a 

14 grant under this section an entity shall— 

15 (1) be— 

16 (A) a healthcare entity that is jointly ad17 ministered by a healthcare employer and a labor 

18 union representing the healthcare employees of 

19 the employer and that carries out activities 

20 using labor management training funds as pro21 vided for under section 302 of the Labor-Man22 agement Relations Act, 1947 (18 U.S.C. 

23 186(c)(6)); 

24 (B) an entity that operates a training pro25 gram that is jointly administered by— 


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1 (i) one or more healthcare providers 

2 or facilities, or a trade association of 

3 healthcare providers; and 

4 (ii) one or more organizations which 

5 represent the interests of direct care 

6 healthcare workers or staff nurses and in 

7 which the direct care healthcare workers or 

8 staff nurses have direct input as to the 

9 leadership of the organization; or 

10 (C) a State training partnership program 

11 that consists of non-profit organizations that 

12 include equal participation from industry, in13 cluding public or private employers, and labor 

14 organizations including joint labor-management 

15 training programs, and which may include rep16 resentatives from local governments, worker in17 vestment agency one-stop career centers, com18 munity based organizations, community col19 leges, and accredited schools of nursing; and 

20 (2) submit to the Secretary an application at 

21 such time, in such manner, and containing such in22 formation as the Secretary may require. 

23 (e) ADDITIONAL REQUIREMENTS FOR HEALTHCARE

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1 ble for a grant under this section, a healthcare employer 

2 described in subsection (d) shall demonstrate— 

3 (1) an established program within their facility 

4 to encourage the retention of existing nurses; 

5 (2) it provides wages and benefits to its nurses 

6 that are competitive for its market or that have been 

7 collectively bargained with a labor organization; and 

8 (3) support for programs funded under this sec9 tion through 1 or more of the following: 

10 (A) The provision of paid leave time and 

11 continued health coverage to incumbent 

12 healthcare workers to allow their participation 

13 in nursing career ladder programs, including 

14 Certified Nurse Assistants, Licensed Practical 

15 Nurses, Licensed Vocational Nurses, and Reg16 istered Nurses. 

17 (B) Contributions to a joint labor-manage18 ment or other jointly administered training 

19 fund which administers the program involved. 

20 (C) The provision of paid release time, in21 centive compensation, or continued health cov22 erage to staff nurses who desire to work full- or 

23 part-time in a faculty position. 

24 (D) The provision of paid release time for 

25 staff nurses to enable them to obtain a bachelor 


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1 of science in nursing degree, other advanced 

2 nursing degrees, specialty training, or certifi3 cation program. 

4 (E) The payment of tuition assistance to 

5 incumbent healthcare workers. 

6 (f) OTHER REQUIREMENTS.— 

7 (1) MATCHING REQUIREMENT.— 

8 (A) IN GENERAL.—The Secretary may not 

9 make a grant under this section unless the ap10 plicant involved agrees, with respect to the costs 

11 to be incurred by the applicant in carrying out 

12 the program under the grant, to make available 

13 non-Federal contributions (in cash or in kind 

14 under subparagraph (B)) toward such costs in 

15 an amount equal to not less than $1 for each 

16 $1 of Federal funds provided in the grant. Such 

17 contributions may be made directly or through 

18 donations from public or private entities, or 

19 may be provided through the cash equivalent of 

20 paid release time provided to incumbent worker 

21 students. 

22 (B) DETERMINATION OF AMOUNT OF NON23 FEDERAL CONTRIBUTION.—Non-Federal con24 tributions required in subparagraph (A) may be 

25 in cash or in kind (including paid release time), 


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1 fairly evaluated, including equipment or services 

2 (and excluding indirect or overhead costs). 

3 (C) SUPPLEMENT, NOT SUPPLANT.— 

4 Funds made available under this section shall 

5 supplement, and not supplant, resources dedi6 cated by an entity, or other Federal, State, or 

7 localfunds available to carry out activities de8 scribed in this section. 

9 (2) REQUIRED COLLABORATION.—Entities car10 rying out or overseeing programs carried out with 

11 assistance provided under this section shall dem12 onstrate collaboration with accredited schools of 

13 nursing which may include community colleges and 

14 other academic institutions providing associate, 

15 bachelor’s, or advanced nursing degree programs or 

16 specialty training or certification programs. 

17 (g) ACTIVITES.—Amounts awarded to an entity 

18 under a grant under this section shall be used for the fol19 lowing: 

20 (1) To carry out programs that provide edu21 cation and training to establish nursing career lad22 ders to educate incumbent healthcare workers to be23 come nurses (including Certified Nurse Assistants, 

24 Licensed Practical Nurses, Licensed Vocational 


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1 Nurses, and Registered Nurses). Such programs 

2 shall include one or more of the following: 

3 (A) Preparing incumbent workers to return 

4 to the classroom through English as a second 

5 language education, GED education, precollege 

6 counseling, college preparation classes, and sup7 port with entry level college classes that are a 

8 prerequisite to nursing. 

9 (B) Providing tuition assistance with pref10 erence for dedicated cohort classes in commu11 nity colleges, universities, accredited schools of 

12 nursing with supportive services including tu13 toring and counseling. 

14 (C) Providing assistance in preparing for 

15 and meeting all nursing licensure tests and re16 quirements. 

17 (D) Carrying out orientation and 

18 mentorship programs that assist newly grad19 uated nurses in adjusting to working at the 

20 bedside to ensure their retention post gradua21 tion, and ongoing programs to support nurse 

22 retention. 

23 (E) Providing stipends for release time and 

24 continued healthcare coverage to enable incumVerDate Nov 24 2008 01:22 May 23, 2009 Jkt 079200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\H2536.IH H2536

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1 bent healthcare workers to participate in these 

2 programs. 

3 (2) To carry out programs that assist nurses in 

4 obtaining advanced degrees and completing specialty 

5 training or certification programs and to establish 

6 incentives for nurses to assume nurse faculty posi7 tions on a part-time or full-time basis. Such pro8 grams shall include one or more of the following: 

9 (A) Increasing the pool of nurses with ad10 vanced degrees who are interested in teaching 

11 by funding programs that enable incumbent 

12 nurses to return to school. 

13 (B) Establishing incentives for advanced 

14 degree bedside nurses who wish to teach in 

15 nursing programs so they can obtain a leave 

16 from their bedside position to assume a full- or 

17 part-time position as adjunct or full time fac18 ulty without the loss of salary or benefits. 

19 (C) Collaboration with accredited schools 

20 of nursing which may include community col21 leges and other academic institutions providing 

22 associate, bachelor’s, or advanced nursing de23 gree programs, or specialty training or certifi24 cation programs, for nurses to carry out innovaVerDate Nov 24 2008 01:22 May 23, 2009 Jkt 079200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\H2536.IH H2536

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1 tive nursing programs which meet the needs of 

2 bedside nursing and healthcare providers. 

3 (h) PREFERENCE.—In awarding grants under this 

4 section the Secretary shall give preference to programs 

5 that— 

6 (1) provide for improving nurse retention; 

7 (2) provide for improving the diversity of the 

8 new nurse graduates to reflect changes in the demo9 graphics of the patient population; 

10 (3) provide for improving the quality of nursing 

11 education to improve patient care and safety; 

12 (4) have demonstrated success in upgrading in13 cumbent healthcare workers to become nurses or 

14 which have established effective programs or pilots 

15 to increase nurse faculty; or 

16 (5) are modeled after or affiliated with such 

17 programs described in paragraph (4). 

18 (i) EVALUATION.— 

19 (1) PROGRAM EVALUATIONS.—An entity that 

20 receives a grant under this section shall annually 

21 evaluate, and submit to the Secretary a report on, 

22 the activities carried out under the grant and the 

23 outcomes of such activities. Such outcomes may in24 clude— 


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1 (A) an increased number of incumbent 

2 workers entering an accredited school of nurs3 ing and in the pipeline for nursing programs; 

4 (B) an increasing number of graduating 

5 nurses and improved nurse graduation and li6 censure rates; 

7 (C) improved nurse retention; 

8 (D) an increase in the number of staff 

9 nurses at the healthcare facility involved; 

10 (E) an increase in the number of nurses 

11 with advanced degrees in nursing; 

12 (F) an increase in the number of nurse 

13 faculty; 

14 (G) improved measures of patient quality 

15 as determined by the Secretary; and 

16 (H) an increase in the diversity of new 

17 nurse graduates relative to the patient popu18 lation. 

19 (2) GENERAL REPORT.—Not later than Sep20 tember 30, 2011, the Secretary of Labor shall, using 

21 data and information from the reports received 

22 under paragraph (1), submit to Congress a report 

23 concerning the overall effectiveness of the grant pro24 gram carried out under this section. 


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1 (j) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 for fiscal years 2010, 2011, and 2012, such sums as may 

4 be necessary. Funds appropriated under this subsection 

5 shall remain available until expended without fiscal year 

6 limitation. 

7 SEC. 4. COLLECTION OF DATA AND REPORTS TO CONGRESS 

8 ON FOREIGN-TRAINED NURSES AND PHYS9 ICAL THERAPISTS NEWLY ADMITTED TO THE 

10 UNITED STATES EACH FISCAL YEAR. 

11 (a) REQUIREMENT TO COLLECT DATA.—With re12 spect to each fiscal year, beginning with fiscal year 2009, 

13 the Secretary of Homeland Security shall collect the fol14 lowing data for each alien that acquires the status of a 

15 lawful permanent resident or a temporary alien worker 

16 (including as a temporary professional worker under the 

17 North American Free Trade Agreement) during that fiscal 

18 year for employment as a professional nurse or physical 

19 therapist: 

20 (1) The country of residence and country of na21 tionality of the alien at the time such status is ac22 quired. 

23 (2) The country or countries in which the alien 

24 received the professional education and training to 

25 be licensed as a nurse or a physical therapist. 


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1 (3) The name and address of the petitioning 

2 employer. 

3 (4) The name and and address of any recruit4 ing agency used by the petitioning employer with re5 spect to the recruitment, processing or preparation 

6 of the alien for the employment involved. 

7 (5) The processing time for review and action 

8 on the petition with respect to each such aliens. 

9 (b) RESEARCH OF DATA FROM PRIOR FISCAL

10 YEARS.— 

11 (1) With respect to the fiscal years 2004 

12 through 2008, the Secretary shall determine which 

13 of the data required to be collected pursuant to sub14 section (a) are available for retrieval in electronic 

15 databases maintained by the Secretary. 

16 (2) In preparing the report for fiscal year 2009 

17 mandated by this section, the Secretary shall include 

18 a summary of all such available data for fiscal years 

19 2004 through 2008. 

20 (c) REPORTS.—The Secretary shall submit annual re21 ports aggregating the data collected under subsection (a), 

22 and, with respect to the report for fiscal year 2009, such 

23 additional data identified pursuant to subsection (b), 

24 along with such related information as the Secretary de25 termines to be appropriate, to the Committees on the JuVerDate Nov 24 2008 01:22 May 23, 2009 Jkt 079200 PO 00000 Frm 00033 Fmt 6652 Sfmt 6201 E:\BILLS\H2536.IH H2536

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1 diciary of the House of Representatives and the Senate 

2 not later than 90 days after the end of each fiscal year. 

3 Such reports shall include— 

4 (1) the aggregate number of aliens who ac5 quired a status described in subsection (a) during 

6 such fiscal year and subtotals of the status cat7 egories acquired; 

8 (2) subtotals within each status category for the 

9 data element collected pursuant to subsection (a); 

10 and 

11 (3) the average processing times for each dif12 ferent type of petition or application involved in the 

13 acquisition of status. 

14 (d) PUBLICATION IN THE FEDERAL REGISTER.—The 

15 Secretary shall cause to have published in the Federal 

16 Register notice of the submittal to the Committees on the 

17 Judiciary of the House of Representatives and the Senate 

18 of each report required under subsection (c) and of the 

19 availability to the public of each such report. 

Æ 


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