I 

116TH CONGRESS 

1ST SESSION H. R. 728 

To amend title VIII of the Public Health Service Act to extend advanced 

education nursing grants to support clinical nurse specialist programs, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 23, 2019 

Mr. JOYCE of Ohio (for himself, Ms. GABBARD, Mr. RODNEY DAVIS of Illinois, 

Ms. BONAMICI, Ms. MATSUI, Ms. CASTOR of Florida, Mr. MCKINLEY, 

and Ms. UNDERWOOD) introduced the following bill; which was referred 

to the Committee on Energy and Commerce 

A BILL 

To amend title VIII of the Public Health Service Act to 

extend advanced education nursing grants to support 

clinical nurse specialist programs, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Title VIII Nursing Workforce Reauthorization Act of 

6 2019’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents of 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. General provisions. 

Sec. 3. Nurse practitioners, nurse midwives, nurse anesthetists, and other advanced education nurses. 

Sec. 4. Increasing nursing workforce diversity. 

Sec. 5. Strengthening capacity for basic nurse education and practice. 

Sec. 6. Student loans. 

Sec. 7. National Advisory Council on Nurse Education and Practice. 

Sec. 8. Other provisions. 

3 SEC. 2. GENERAL PROVISIONS. 

4 (a) APPLICATION.—Section 802(c) of the Public 

5 Health Service Act (42 U.S.C. 296a(c)) is amended by 

6 striking ‘‘shall address relevant national nursing needs 

7 that the project will meet’’ and inserting ‘‘shall address 

8 relevant national nursing needs that the project will ad9 dress and how the project aligns with the national nursing 

10 service goals referred to in section 806(a)’’. 

11 (b) USE OF FUNDS.—Section 803 of the Public 

12 Health Service Act (42 U.S.C. 296b) is amended by add13 ing at the end the following: 

14 ‘‘(c) SUPPLEMENT NOT SUPPLANT.—Funds awarded 

15 as a grant under this title for a project or activity shall 

16 be used to supplement, not supplant, the non-Federal 

17 funds that would otherwise be made available for such 

18 project or activity.’’. 

19 (c) GENERALLY APPLICABLE PROVISIONS.—Section 

20 806 of the Public Health Service Act (42 U.S.C. 296e) 

21 is amended— 


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1 (1) in subsection (b), by amending paragraph 

2 (2) to read as follows: 

3 ‘‘(2) EVALUATIONS.—The Secretary shall es4 tablish procedures to ensure the annual evaluation of 

5 programs and projects operated by recipients of 

6 grants under this title. Such procedures shall ensure 

7 that continued funding for such programs and 

8 projects will be conditioned upon the submission 

9 of— 

10 ‘‘(A) data demonstrating that satisfactory 

11 progress has been made by the program or 

12 project in meeting the performance outcome 

13 standards (as described in section 802) of such 

14 program or project; and 

15 ‘‘(B) a detailed description of activities 

16 conducted by such program or project to meet 

17 such performance outcome standards.’’; 

18 (2) in subsection (e)(2), by inserting ‘‘, and 

19 have relevant expertise and experience’’ after ‘‘who 

20 are not officers or employees of the Federal Govern21 ment’’; and 

22 (3) by adding at the end the following: 

23 ‘‘(i) ANNUAL REPORT ON NURSING WORKFORCE

24 PROGRAMS.—Annually, the Secretary shall submit to the 

25 Committee on Health, Education, Labor, and Pensions of 


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1 the Senate, and the Committee on Energy and Commerce 

2 of the House of Representatives, a report containing an 

3 assessment of the programs and activities of the Depart4 ment of Health and Human Services related to enhancing 

5 the nursing workforce, including the extent to which pro6 grams and activities under this title meet identified goals 

7 and performance measures developed for the respective 

8 programs and activities.’’. 

9 SEC. 3. NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE 

10 ANESTHETISTS, AND OTHER ADVANCED EDU11 CATION NURSES. 

12 Section 811 of the Public Health Service Act (42 

13 U.S.C. 296j) is amended— 

14 (1) in subsection (b)— 

15 (A) by striking ‘‘R.N./Master’s’’ and in16 serting ‘‘R.N./graduate’’; and 

17 (B) by inserting ‘‘clinical nurse leaders,’’ 

18 before ‘‘or public health nurses’’; 

19 (2) by redesignating subsections (f) and (g) as 

20 subsections (g) and (h), respectively; 

21 (3) by inserting after subsection (e) the fol22 lowing new subsection: 

23 ‘‘(f) AUTHORIZED CLINICAL NURSE SPECIALIST

24 PROGRAMS.—Clinical nurse specialist programs eligible 


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1 for support under this section are education programs 

2 that— 

3 ‘‘(1) provide registered nurses with full-time 

4 clinical nurse specialist education; and 

5 ‘‘(2) have as their objective the education of 

6 clinical nurse specialists who will upon completion of 

7 such a program be qualified to effectively provide 

8 care through the wellness and illness continuum to 

9 inpatients and outpatients experiencing acute and 

10 chronic illness.’’; and 

11 (4) by adding at the end the following: 

12 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to carry out this section 

14 $74,581,000 for each of fiscal years 2020 through 2024.’’. 

15 SEC. 4. INCREASING NURSING WORKFORCE DIVERSITY. 

16 Section 821 of the Public Health Service Act (42 

17 U.S.C. 296m) is amended by adding at the end the fol18 lowing: 

19 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

20 are authorized to be appropriated to carry out this section 

21 $17,343,000 for each of fiscal years 2020 through 2024.’’. 


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1 SEC. 5. STRENGTHENING CAPACITY FOR BASIC NURSE 

2 EDUCATION AND PRACTICE. 

3 (a) NURSE EDUCATION, PRACTICE, QUALITY, AND

4 RETENTION GRANTS.—Section 831 of the Public Health 

5 Service Act (42 U.S.C. 296p) is amended— 

6 (1) in the section heading, by striking ‘‘AND

7 QUALITY’’ and inserting ‘‘QUALITY, AND RETEN8 TION’’; 

9 (2) in subsection (b), by amending paragraph 

10 (2) to read as follows: 

11 ‘‘(2) providing care for underserved populations 

12 and high-risk groups, which may include the elderly, 

13 individuals with HIV/AIDS, individuals with mental 

14 health or substance use disorders, individuals who 

15 are homeless, and victims and survivors of domestic 

16 violence;’’; 

17 (3) in subsection (c), by amending paragraph 

18 (1) to read as follows: 

19 ‘‘(1) GRANTS FOR CAREER LADDER PRO20 GRAMS.—The Secretary may award grants to and 

21 enter into contracts with eligible entities for pro22 grams— 

23 ‘‘(A) to promote career advancement for— 

24 ‘‘(i) nursing personnel in a variety of 

25 training settings, cross training or spe26 cialty training among diverse population 


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1 groups, and the advancement of individ2 uals, including to become professional reg3 istered nurses, advanced practice reg4 istered nurses, and nurses with graduate 

5 nursing education; and 

6 ‘‘(ii) individuals, including licensed 

7 practical nurses, licensed vocational nurses, 

8 certified nurse assistants, and diploma de9 gree or associate degree nurses, to become 

10 baccalaureate-prepared registered nurses 

11 or nurses with graduate nursing education; 

12 ‘‘(B) to assist individuals in obtaining edu13 cation and training required to enter the nurs14 ing profession and advance within such profes15 sion, such as by providing career counseling and 

16 mentoring; and 

17 ‘‘(C) to develop and implement internships, 

18 accredited fellowships, and accredited residency 

19 programs in collaboration with one or more ac20 credited schools of nursing to encourage men21 toring and development of specialties.’’; 

22 (4) by striking subsection (e) (relating to pref23 erence); 

24 (5) by redesignating subsections (f) through (h) 

25 as subsections (e) and (g), respectively; 


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1 (6) in subsection (e), as so redesignated, by 

2 striking ‘‘The Secretary shall submit to the Congress 

3 before the end of each fiscal year a’’ and inserting 

4 ‘‘As part of the report on nursing workforce pro5 grams described in section 806(i), the Secretary 

6 shall’’; 

7 (7) by amending subsection (f), as redesignated 

8 by paragraph (5), to read as follows: 

9 ‘‘(f) DEFINITIONS.—For purposes of this section: 

10 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en11 tity’ includes an accredited school of nursing, a 

12 health care facility, a partnership of such a school 

13 and facility, a federally qualified health center, or a 

14 nurse-managed health clinic. 

15 ‘‘(2) NURSE-MANAGED HEALTH CLINIC.—The 

16 term ‘nurse-managed health clinic’ means a nurse17 practice arrangement, managed by advanced practice 

18 nurses, that provides primary care or wellness serv19 ices to underserved or vulnerable populations that is 

20 associated with a school, college, university or de21 partment of nursing, federally qualified health cen22 ter, or independent nonprofit health or social serv23 ices agency.’’; and 

24 (8) in subsection (g), as redesignated by para25 graph (5), by striking ‘‘such sums as may be necVerDate Sep 11 2014 02:06 Feb 01, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H728.IH H728

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1 essary for each of fiscal years 2010 through 2014’’ 

2 and inserting ‘‘$41,913,000 for each of fiscal years 

3 2020 through 2024’’. 

4 (b) NURSE RETENTION GRANTS.—Section 831A of 

5 the Public Health Service Act (42 U.S.C. 296p–1) is re6 pealed. 

7 SEC. 6. STUDENT LOANS. 

8 (a) LOAN REPAYMENT AND SCHOLARSHIP PRO9 GRAMS.—Section 846 of the Public Health Service Act (42 

10 U.S.C. 297n) is amended— 

11 (1) in subsection (b)(1), by striking ‘‘he began 

12 such practice’’ and inserting ‘‘the individual began 

13 such practice’’; 

14 (2) in subsection (d)(1), by striking ‘‘(for fiscal 

15 years 2003 and 2004) and may (for fiscal years 

16 thereafter)’’; 

17 (3) in subsection (h), in the matter preceding 

18 paragraph (1), by striking ‘‘Not later than’’ through 

19 ‘‘regarding’’ and inserting ‘‘The annual report on 

20 nursing workforce programs, as required by section 

21 806(i), shall include information regarding the pro22 grams carried out under this section, including’’; 

23 and 

24 (4) in subsection (i)(1), by striking ‘‘such sums 

25 as may be necessary for each of fiscal years 2003 


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1 through 2007’’ and inserting ‘‘$87,135,000 for each 

2 of fiscal years 2020 through 2024’’. 

3 (b) NURSE FACULTY LOAN PROGRAM.—Section 

4 846A of the Public Health Service Act (42 U.S.C. 297n– 

5 1) is amended by striking ‘‘such sums as may be necessary 

6 for each of fiscal years 2010 through 2014’’ and inserting 

7 ‘‘$28,500,000 for each of fiscal years 2020 through 

8 2024’’. 

9 SEC. 7. NATIONAL ADVISORY COUNCIL ON NURSE EDU10 CATION AND PRACTICE. 

11 Section 851 of the Public Health Service Act (42 

12 U.S.C. 297t) is amended— 

13 (1) in subsection (b)(1)(A)(iv), by striking ‘‘and 

14 nurse anesthetists’’ and inserting ‘‘nurse anes15 thetists, and clinical nurse specialists’’; 

16 (2) in subsection (d), by amending paragraph 

17 (3) to read as follows: 

18 ‘‘(3) not later than 2 years after the date of en19 actment of the Title VIII Nursing Workforce Reau20 thorization Act of 2019, and every 2 years there21 after, prepare and submit to the Secretary, the Com22 mittee on Health, Education, Labor, and Pensions 

23 of the Senate, and the Committee on Energy and 

24 Commerce of the House of Representatives, a report 

25 describing the activities of the Council, including 


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1 findings and recommendations made by the Council 

2 concerning the activities under this title.’’; and 

3 (3) in subsection (g), by striking ‘‘under this 

4 title’’ and inserting ‘‘for carrying out parts B, C, 

5 and D of this title’’. 

6 SEC. 8. OTHER PROVISIONS. 

7 (a) PUBLIC SERVICE ANNOUNCEMENTS.—Part G of 

8 title VIII of the Public Health Service Act (42 U.S.C. 

9 297w et seq.) is repealed. 

10 (b) FUNDING.—Part I of title VIII of the Public 

11 Health Service Act (42 U.S.C. 298d) is repealed. 

Æ 


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